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Sample records for controlled trial pluto

  1. PLUTO trial protocol: percutaneous shunting for lower urinary tract obstruction randomised controlled trial.

    Science.gov (United States)

    Kilby, Mark; Khan, Khalid; Morris, Katie; Daniels, Jane; Gray, Richard; Magill, Laura; Martin, Bill; Thompson, Peter; Alfirevic, Zarko; Kenny, Simon; Bower, Sarah; Sturgiss, Stephen; Anumba, Dilly; Mason, Gerald; Tydeman, Graham; Soothill, Peter; Brackley, Karen; Loughna, Pamela; Cameron, Alan; Kumar, Sailesh; Bullen, Phil

    2007-07-01

    The primary objective is to determine whether intrauterine vesicoamniotic shunting for fetal bladder outflow obstruction, compared with conservative, noninterventional care, improves prenatal and perinatal mortality and renal function. The secondary objectives are to determine if shunting for fetal bladder outflow obstruction improves perinatal morbidity, to determine if improvement in outcomes is related to prognostic assessment at diagnosis and, if possible, derive a prognostic risk index and to determine the safety and long-term efficacy of shunting. A multicentre randomised controlled trial (RCT). Fetal medicine units. Pregnant women with singleton, male fetus with isolated lower urinary tract obstruction (LUTO). Following ultrasound diagnosis of LUTO in a male fetus and exclusion of other structural and chromosomal anomalies, participation in the trial will be discussed with the mother and written information given. Consent for participation in the trial will be taken and the mother randomised via the internet to either insertion of a vesicoamniotic shunt or expectant management. During pregnancy, both groups will be followed with regular ultrasound scans looking at viability, renal measurements and amniotic fluid volume. Following delivery, babies will be followed up by paediatric nephrologists/urologists at 4-6 weeks, 12 months and 3 and 5 years to assess renal function via serum creatinine, renal ultrasound and need for dialysis/transplant. The main outcome measures will be perinatal mortality rates and renal function at 4-6 weeks and 12 months measured via serum creatinine, renal ultrasound and need for dialysis/transplant. Wellbeing of Women. ESTIMATED COMPLETION DATE: September 2010. TRIAL ALGORITHM: [flowchart: see text].

  2. Cost effectiveness of home ultraviolet B phototherapy for psoriasis: economic evaluation of a randomised controlled trial (PLUTO study).

    Science.gov (United States)

    Koek, Mayke B G; Sigurdsson, Vigfús; van Weelden, Huib; Steegmans, Paul H A; Bruijnzeel-Koomen, Carla A F M; Buskens, Erik

    2010-04-20

    To assess the costs and cost effectiveness of phototherapy with ultraviolet B light provided at home compared with outpatient ultraviolet B phototherapy for psoriasis. Cost utility, cost effectiveness, and cost minimisation analyses performed alongside a pragmatic randomised clinical trial (the PLUTO study) at the end of phototherapy (mean 17.6 weeks) and at one year after the end of phototherapy (mean 68.4 weeks). Secondary care, provided by a dermatologist in the Netherlands. 196 adults with psoriasis who were clinically eligible for narrowband (TL-01) ultraviolet B phototherapy were recruited from the dermatology departments of 14 hospitals and were followed until the end of phototherapy. From the end of phototherapy onwards, follow-up was continued for an unselected, consecutive group of 105 patients for one year after end of phototherapy. Ultraviolet B phototherapy provided at home (intervention) and conventional outpatient ultraviolet B phototherapy (control) in a setting reflecting routine practice in the Netherlands. Both treatments used narrowband ultraviolet B lamps (TL-01). Total costs to society, quality adjusted life years (QALYs) as calculated using utilities measured by the EQ-5D questionnaire, and the number of days with a relevant treatment effect (>/=50% improvement of the baseline self administered psoriasis area and severity index (SAPASI)). Home phototherapy is at least as effective and safe as outpatient phototherapy, therefore allowing cost minimisation analyses (simply comparing costs). The average total costs by the end of phototherapy were euro800 for home treatment and euro752 for outpatient treatment, showing an incremental cost per patient of euro48 (95% CI euro-77 to euro174). The average total costs by one year after the end of phototherapy were euro1272 and euro1148 respectively (difference euro124, 95% CI euro-155 to euro403). Cost utility analyses revealed that patients experienced equal health benefits-that is, a gain of 0

  3. Pluto.

    Science.gov (United States)

    Binzel, Richard P.

    1990-01-01

    Discussed are details of what is known about the composition, physical characteristics, and formation of the planet Pluto and its satellite, Charon. Alignments of these bodies and details of their rotations and revolutions are described. (CW)

  4. Pluto

    Energy Technology Data Exchange (ETDEWEB)

    Binzel, R.P. (Massachusetts Institute of Technology, Cambridge (USA))

    1990-06-01

    A new picture of Pluto has begun to emerge during the past decade. Dedicated observational efforts using a variety of modern instruments, aided by some fortuitous celestial alignments, have produced a number of surprises. Pluto has a satellite, Charon, so large that the two objects can virtually be considered a double planet. The planet has bright polar caps and a darker, mottled equatorial region. A layer of methane ice covers most of its surface. Pluto even possesses a thin atmosphere; when the planet is farthest from the sun, all or part of the atmosphere may freeze and fall to the surface as snow. Charon's surface, which appears to be quite different from Pluto's, may be a great expanse of water ice. Pluto's size and density are much like those of Triton, the large satellite of Neptune that was recently visited by the Voyager 2 probe. These and other similarities suggest that both bodies may be leftover planetesimals, relics from the early days of the solar system that managed not to be swept up by the giant outer planets. In this scenario, Triton was captured by Neptune, whereas Pluto was able to survive as a bona fide planet in an independent orbit about the sun.

  5. Home versus outpatient ultraviolet B phototherapy for mild to severe psoriasis: pragmatic multicentre randomised controlled non-inferiority trial (PLUTO study).

    Science.gov (United States)

    Koek, Mayke B G; Buskens, Erik; van Weelden, Huib; Steegmans, Paul H A; Bruijnzeel-Koomen, Carla A F M; Sigurdsson, Vigfús

    2009-05-07

    To determine whether ultraviolet B phototherapy at home is equally safe and equally effective as ultraviolet B phototherapy in an outpatient setting for patients with psoriasis. Pragmatic multicentre single blind randomised clinical trial (PLUTO study). Dermatology departments of 14 hospitals in the Netherlands. 196 patients with psoriasis who were clinically eligible for narrowband (TL-01) ultraviolet B phototherapy. The first 105 consecutive patients were also followed for one year after therapy. Ultraviolet B phototherapy at home using a TL-01 home phototherapy unit compared with standard narrowband ultraviolet B phototherapy in an outpatient setting. Both therapies were done in a setting reflecting routine daily practice in the Netherlands. The main outcome measure was effectiveness as measured by the proportion of patients with a 50% or more reduction of the baseline psoriasis area and severity index (PASI) or self administered psoriasis area and severity index (SAPASI), called the PASI 50 and SAPASI 50 (relevant treatment effect). Another outcome of effectiveness was the percentage reduction in median scores on the PASI as well as SAPASI. Also the proportions of patients reaching the PASI 75 and SAPASI 75 (successful treatment effect), and the PASI 90 and SAPASI 90 (almost complete clearance) were calculated. Other secondary outcomes were quality of life (SF-36, psoriasis disability index), burden of treatment (questionnaire), patients' preferences and satisfaction (questionnaire), and dosimetry and short term side effects (diary). 82% of the patients treated at home compared with 79% of the patients treated in an outpatient setting reached the SAPASI 50 (difference 2.8%, 95% confidence interval -8.6% to 14.2%), and 70% compared with 73% reached the PASI 50 (-2.3%, -15.7% to 11.1%). For patients treated at home the median SAPASI score decreased 82% (from 6.7 to 1.2) and the median PASI score decreased 74% (from 8.4 to 2.2), compared with 79% (from 7.0 to 1

  6. The Percutaneous shunting in Lower Urinary Tract Obstruction (PLUTO) study and randomised controlled trial: evaluation of the effectiveness, cost-effectiveness and acceptability of percutaneous vesicoamniotic shunting for lower urinary tract obstruction.

    Science.gov (United States)

    Morris, R K; Malin, G L; Quinlan-Jones, E; Middleton, L J; Diwakar, L; Hemming, K; Burke, D; Daniels, J; Denny, E; Barton, P; Roberts, T E; Khan, K S; Deeks, J J; Kilby, M D

    2013-12-01

    Congenital lower urinary tract obstruction (LUTO) is a disease associated with high perinatal mortality and childhood morbidity. Fetal vesicoamniotic shunting (VAS) bypasses the obstruction with the potential to improve outcome. To determine the effectiveness, cost-effectiveness and patient acceptability of VAS for fetal LUTO. A multicentre, randomised controlled trial incorporating a prospective registry, decision-analytic health economic model and preplanned Bayesian analysis using elicited opinions. Patient acceptability was evaluated by interview in a qualitative study. Fetal medicine departments in the UK, Ireland and the Netherlands. Pregnant women with a male singleton fetus with LUTO. In utero percutaneous VAS compared with conservative care. The primary outcome was survival to 28 days. Secondary outcome measures were survival and renal function at 1 year of age, cost of care and cost per additional life-year and per disability-free survival at the end of 1 year. The trial stopped early with 31 women randomised because of difficulties in recruitment. Of those randomised to VAS and conservative management, 3/16 (19%) and 2/15 (13%), respectively, did not receive their allocated intervention. Based on intention-to-treat analysis, survival at 28 days was higher if allocated VAS (50%) than conservative management (27%) [relative risk (RR) 1.88, 95% confidence interval (CI) 0.71 to 4.96, p = 0.27]. At 12 months survival was 44% in the VAS arm and 20% in the conservative arm (RR 2.19, 95% CI 0.69 to 6.94, p = 0.25). Neither difference was statistically significant. Of survivors at 1 year, two in the VAS arm had no evidence of renal impairment and four in the VAS arm and two in the conservative arm required medical management. One baby in the conservative arm had end-stage renal failure at 1 year. VAS was more expensive because of additional surgery and intensive care. VAS cost £15,500 per survivor at 1 year and £43,900 per disability-free year. Elicited

  7. UVB phototherapy in an outpatient setting or at home: a pragmatic randomised single-blind trial designed to settle the discussion. The PLUTO study

    Directory of Open Access Journals (Sweden)

    van Weelden Huib

    2006-08-01

    Full Text Available Abstract Background Home ultraviolet B (UVB treatment is a much-debated treatment, especially with regard to effectiveness, safety and side effects. However, it is increasingly being prescribed, especially in the Netherlands. Despite ongoing discussions, no randomised research has been performed, and only two studies actually compare two groups of patients. Thus, firm evidence to support or discourage the use of home UVB phototherapy has not yet been obtained. This is the goal of the present study, the PLUTO study (Dutch acronym for "national trial on home UVB phototherapy for psoriasis". Methods We designed a pragmatic randomised single-blind multi-centre trial. This trial is designed to evaluate the impact of home UVB treatment versus UVB phototherapy in a hospital outpatient clinic as to effectiveness, quality of life and cost-effectiveness. In total 196 patients with psoriasis who were clinically eligible for UVB phototherapy were included. Normally 85% of the patients treated with UVB show a relevant clinical response. With a power of 80% and a 0.05 significance level it will be possible to detect a reduction in effectiveness of 15%. Effectiveness will be determined by calculating differences in the Psoriasis Area and Severity Index (PASI and the Self Administered PASI (SAPASI scores. Quality of life is measured using several validated generic questionnaires and a disease-specific questionnaire. Other outcome measures include costs, side effects, dosimetry, concomitant use of medication and patient satisfaction. Patients are followed throughout the therapy and for 12 months thereafter. The study is no longer recruiting patients, and is expected to report in 2006. Discussion In the field of home UVB phototherapy this trial is the first randomised parallel group study. As such, this trial addresses the weaknesses encountered in previous studies. The pragmatic design ensures that the results can be well generalised to the target population

  8. Evaluation of the cost effectiveness of vesico-amniotic shunting in the management of congenital lower urinary tract obstruction (based on data from the PLUTO Trial).

    Science.gov (United States)

    Diwakar, Lavanya; Morris, Rachel K; Barton, Pelham; Middleton, Lee J; Kilby, Mark D; Roberts, Tracy E

    2013-01-01

    To determine the cost-effectiveness of in-utero percutaneous Vesico Amniotic Shunt (VAS) in the management of fetal lower urinary tract obstruction (LUTO). Model based economic analysis using data from the randomised controlled arm of the PLUTO (percutaneous vesico-amniotic shunting for lower urinary tract obstruction) trial. Fetal medicine departments in United Kingdom, Ireland and Netherlands. Pregnant women with a male, singleton fetus with LUTO. Costs and outcomes were prospectively collected in the trial; three separate base case analyses were performed using the intention to treat (ITT), per protocol and uniform prior methods. Deterministic and probabilistic sensitivity analyses were performed to explore data uncertainty. Survival at 28 days, 1 year and disease free survival at 1 year. VAS was more expensive but appeared to result in higher rates of survival compared with conservative management in patients with LUTO. Using ITT analysis the incremental cost effectiveness ratios based on outcomes of survival at 28 days, 1 year, or 1 morbidity-free year on the VAS arm were £ 15,506, £ 15,545, and £ 43,932, respectively. VAS is a more expensive option compared to the conservative approach in the management of individuals with LUTO. Data from the RCT suggest that VAS improves neonatal survival but does not result in significant improvements in morbidity. Our analysis concludes that VAS is not likely to be cost effective in the management of these patients given the NICE (National Institute of Health and Clinical Excellence) cost threshold of £ 20,000 per QALY.

  9. Evaluation of the cost effectiveness of vesico-amniotic shunting in the management of congenital lower urinary tract obstruction (based on data from the PLUTO Trial.

    Directory of Open Access Journals (Sweden)

    Lavanya Diwakar

    Full Text Available OBJECTIVE: To determine the cost-effectiveness of in-utero percutaneous Vesico Amniotic Shunt (VAS in the management of fetal lower urinary tract obstruction (LUTO. DESIGN: Model based economic analysis using data from the randomised controlled arm of the PLUTO (percutaneous vesico-amniotic shunting for lower urinary tract obstruction trial. SETTING: Fetal medicine departments in United Kingdom, Ireland and Netherlands. POPULATION OR SAMPLE: Pregnant women with a male, singleton fetus with LUTO. METHODS: Costs and outcomes were prospectively collected in the trial; three separate base case analyses were performed using the intention to treat (ITT, per protocol and uniform prior methods. Deterministic and probabilistic sensitivity analyses were performed to explore data uncertainty. MAIN OUTCOME MEASURES: Survival at 28 days, 1 year and disease free survival at 1 year. RESULTS: VAS was more expensive but appeared to result in higher rates of survival compared with conservative management in patients with LUTO. Using ITT analysis the incremental cost effectiveness ratios based on outcomes of survival at 28 days, 1 year, or 1 morbidity-free year on the VAS arm were £ 15,506, £ 15,545, and £ 43,932, respectively. CONCLUSIONS: VAS is a more expensive option compared to the conservative approach in the management of individuals with LUTO. Data from the RCT suggest that VAS improves neonatal survival but does not result in significant improvements in morbidity. Our analysis concludes that VAS is not likely to be cost effective in the management of these patients given the NICE (National Institute of Health and Clinical Excellence cost threshold of £ 20,000 per QALY.

  10. Percutaneous vesicoamniotic shunting versus conservative management for fetal lower urinary tract obstruction (PLUTO): a randomised trial.

    Science.gov (United States)

    Morris, Rachel K; Malin, Gemma L; Quinlan-Jones, Elisabeth; Middleton, Lee J; Hemming, Karla; Burke, Danielle; Daniels, Jane P; Khan, Khalid S; Deeks, Jon; Kilby, Mark D

    2013-11-02

    Fetal lower urinary tract obstruction (LUTO) is associated with high perinatal and long-term childhood mortality and morbidity. We aimed to assess the effectiveness of vesicoamniotic shunting for treatment of LUTO. In a randomised trial in the UK, Ireland, and the Netherlands, women whose pregnancies with a male fetus were complicated by isolated LUTO were randomly assigned by a central telephone and web-based randomisation service to receive either the intervention (placement of vesicoamniotic shunt) or conservative management. Allocation could not be masked from clinicians or participants because of the invasive nature of the intervention. Diagnosis was by prenatal ultrasound. The primary outcome was survival of the baby to 28 days postnatally. All primary analyses were done on an intention-to-treat basis, but these results were compared with those of an as-treated analysis to investigate the effect of a fairly large proportion of crossovers. We used Bayesian methods to estimate the posterior probability distribution of the effectiveness of vesicoamniotic shunting at 28 days. The study is registered with the ISRCTN Register, number ISRCTN53328556. 31 women with singleton pregnancies complicated by LUTO were included in the trial and main analysis, with 16 allocated to the vesicoamniotic shunt group and 15 to the conservative management group. The study closed early because of poor recruitment. There were 12 livebirths in each group. In the vesicoamniotic shunt group one intrauterine death occurred and three pregnancies were terminated. In the conservative management group one intrauterine death occurred and two pregnancies were terminated. Of the 16 pregnancies randomly assigned to vesicoamniotic shunting, eight neonates survived to 28 days, compared with four from the 15 pregnancies assigned to conservative management (intention-to-treat relative risk [RR] 1·88, 95% CI 0·71-4·96; p=0·27). Analysis based on treatment received showed a larger effect (3·20, 1

  11. An overview of the literature on congenital lower urinary tract obstruction and introduction to the PLUTO trial: percutaneous shunting in lower urinary tract obstruction.

    Science.gov (United States)

    Morris, R Katie; Kilby, Mark D

    2009-02-01

    Congenital lower urinary tract obstruction (LUTO) comprises a heterogeneous group of pathologies causing obstruction to the urethra, the most common being posterior urethral valves. Such pathology is often associated with high perinatal mortality and varying degrees of perinatal and infant morbidity. A high proportion of LUTO may be visualised during routine second trimester (and first trimester) ultrasound giving rise to the possibility of determining individual fetal prognosis and treatments such as vesico-amniotic shunting, with a view to altering pathogenesis. The aims of the percutaneous shunting in low urinary tract obstruction (PLUTO) trial are to determine the effectiveness of these treatments and accuracy of the investigations with the primary outcome measures being perinatal mortality and postnatal renal function.

  12. Clues From Pluto's Ions

    Science.gov (United States)

    Kohler, Susanna

    2016-05-01

    Nearly a year ago, in July 2015, the New Horizons spacecraft passed by the Pluto system. The wealth of data amassed from that flyby is still being analyzed including data from the Solar Wind Around Pluto (SWAP) instrument. Recent examination of this data has revealedinteresting new information about Plutos atmosphere and how the solar wind interacts with it.A Heavy Ion TailThe solar wind is a constant stream of charged particles released by the Sun at speeds of around 400 km/s (thats 1 million mph!). This wind travels out to the far reaches of the solar system, interacting with the bodies it encounters along the way.By modeling the SWAP detections, the authors determine the directions of the IMF that could produce the heavy ions detected. Red pixels represent IMF directions permitted. No possible IMF could reproduce the detections if the ions are nitrogen (bottom panels), and only retrograde IMF directions can produce the detections if the ions are methane. [Adapted from Zirnstein et al. 2016]New Horizons data has revealed that Plutos atmosphere leaks neutral nitrogen, methane, and carbon monoxide molecules that sometimes escape its weak gravitational pull. These molecules become ionized and are subsequently picked up by the passing solar wind, forming a tail of heavy ions behind Pluto. The details of the geometry and composition of this tail, however, had not yet been determined.Escaping MethaneIn a recent study led by Eric Zirnstein (Southwest Research Institute), the latest analysis of data from the SWAP instrument on board New Horizons is reported. The team used SWAPs ion detections from just after New Horizons closest approach to Pluto to better understand how the heavy ions around Pluto behave, and how the solar wind interacts with Plutos atmosphere.In the process of analyzing the SWAP data, Zirnstein and collaborators first establish what the majority of the heavy ions picked up by the solar wind are. Models of the SWAP detections indicate they are unlikely

  13. Effects of clopidogrel and aspirin in combination versus aspirin alone on platelet activation and major receptor expression in diabetic patients: the PLavix Use for Treatment Of Diabetes (PLUTO-Diabetes) trial.

    Science.gov (United States)

    Serebruany, Victor L; Malinin, Alex I; Pokov, Alex; Barsness, Gregory; Hanley, Dan F

    2008-01-01

    Clopidogrel is widely used in diabetic patients after vascular events; however, the ability of this thienopyridine to yield additional antiplatelet protection on top of aspirin has never been explored in a controlled study with comprehensive assessment of platelet activity. The objective of this study was to compare the antiplatelet profiles of clopidogrel + aspirin in combination (C + ASA) versus aspirin alone (ASA) in patients with type 2 diabetes mellitus. Seventy patients with documented diabetes already treated with antecedent aspirin were randomly assigned to receive C + ASA or ASA in the PLUTO-Diabetes trial. Platelet studies included adenosine diphosphate-, collagen-, and arachidonic acid-induced aggregometry; PFA-100 (Dade-Behring, Miami, FL) and Ultegra (Accumetrics, San Diego, CA) analyzers; and expression of 6 major receptors by flow cytometry at baseline and at day 30 after randomization. There were no differences in the baseline clinical and platelet characteristics between the C + ASA and ASA groups, or subsequent significant changes in platelet biomarkers in the ASA group, except for diminished collagen-induced aggregation (P = .02). In contrast, when compared with the ASA group, therapy with C + ASA resulted in significant inhibition of platelet activity assessed by adenosine diphosphate aggregation (P = .0001); closure time prolongation (P = .0003) and reduction of platelet activation units with Ultegra (P = .0001); and expression of platelet/endothelial cell adhesion molecule 1 (P = .002), glycoprotein IIb/IIIa antigen (P = .0002), and activity (P = .0001). Treatment with C + ASA for 1 month provides significantly greater inhibition of platelet activity than ASA alone in diabetic patients in this small randomized trial. However, despite dual antiplatelet regimen, diabetic patients exhibit high residual activity of some platelet biomarkers, including unaffected protease-activated receptor 1 receptor expression.

  14. Dynamics of Pluto and Charon

    Energy Technology Data Exchange (ETDEWEB)

    Dobrovolskis, A.R. (NASA Ames Research Center, IA (USA))

    1989-11-01

    The dynamics of the Pluto-Charon system are reviewed from a historical perspective. Although Pluto's orbit crosses Neptune's, an intricate system of nested resonances keeps these planets apart. Pluto's orbit is apparently chaotic as well. Pluto always keeps the same face turned toward Charon, and vice versa. Tides also damp Charon's orbital eccentricity and inclination. Precession of Pluto's orbital plane causes Pluto's obliquity to vary periodically from formally prograde to retrograde. Pluto is probably an original member of the Solar system, but not an escape satellite of Neptune. The Voyager II encounter with Neptune, the final Pluto-Charon mutual events, and the next generation of telescopes are bound to reveal some surprises.

  15. Pluto: The Farthest Planet (Usually).

    Science.gov (United States)

    Universe in the Classroom, 1988

    1988-01-01

    Provides background information about the planet Pluto. Includes the history of Pluto and discusses some of the common misconceptions about the planets. Addresses some of the recent discoveries about Pluto and contains a resource list of books, articles, and a videotape. (TW)

  16. The Pluto event generator

    Energy Technology Data Exchange (ETDEWEB)

    Froehlich, Ingo [Institut fuer Kernphysik, 60438 Frankfurt am Main (Germany); Holzmann, Romain [Gesellschaft fuer Schwerionenphysik, 64291 Darmstadt (Germany)

    2008-07-01

    Pluto is a Monte-Carlo event generator designed for hadronic interactions from close-to-threshold to intermediate energies, as well as for studies of heavy ion reactions. The package is entirely based on Root, without the need of additional packages, and uses the embedded C++ interpreter of root to control the event production. The package includes realistic models of resonance production by using mass-dependent Breit-Wigner sampling. The calculation of partial and total widths for resonances is taken into account. Particular attention is paid to the electromagnetic decays, motivated by the physics program of HADES. For elementary reactions, angular distributions (e.g. for the primary meson emission) can be attached by the user in a very simple way as well as multi-particle correlations. Hand-made models (which may change all decay parameters) can be included by the user without recompilation using the CINT interpreter. This contribution gives an overview of the technical implementation of the framework and presents examples of the included physics.

  17. Pluto followed its heart: reorientation and faulting of Pluto due to volatile loading in Sputnik Planum

    Science.gov (United States)

    Tuttle Keane, James; Matsuyama, Isamu; Kamata, Shunichi; Steckloff, Jordan

    2016-10-01

    The New Horizons flyby of Pluto revealed the dwarf planet to be a strikingly diverse, geologically active world. Perhaps the most intriguing feature on the New Horizons encounter hemisphere is Sputnik Planum—a 1000 km diameter, probable impact basin, filled with several kilometers of actively convecting volatile ices (N2, CH4, CO). One salient characteristic of Sputnik Planum is its curious alignment with the Pluto-Charon tidal axis. The alignment of large geologic features with principal axis of inertia (such as the tidal axis) is the hallmark of global reorientation, i.e. true polar wander. Here we show that the present location of Sputnik Planum is a natural consequence of loading of 1-2 km of volatile ices within the Sputnik Planum basin. Larger volatile ice thicknesses (like those inferred from studies of ice convection within Sputnik Planum) betray an underlying negative gravity anomaly associated with the basin. As Pluto reoriented in response to the loading of volatile ices within Sputnik Planum, stresses accumulated within the lithosphere (as each geographic location experiences a change in tidal/rotational potential). These reorientation stresses, coupled with loading stresses, and stresses from the freezing of a subsurface ocean resulted in the fracturing of Pluto's lithosphere in a characteristic, global pattern of extensional faults. Our predicted pattern of extensional faults due to this reorientation closely replicates the observed distribution of faults on Pluto (more so than global expansion, orbit migration, de-spinning, or loading alone). Sputnik Planum likely formed ~60° northwest of its present location, and was loaded with volatile ices over millions of years due to seasonal volatile transport cycles. This result places Pluto in a truly unique category of planetary bodies where volatiles are not only controlling surface geology and atmospheric processes, but they are also directly controlling the orientation of the entire dwarf planet

  18. Barchan dunes on Pluto?

    Science.gov (United States)

    Parteli, Eric J. R.; Pöschel, Thorsten

    2017-06-01

    We show that the orientation and morphology of bedforms occurring on top of Pluto's smooth ice coats are consistent with an aeolian origin under conditions of unidirectional flow. From scaling relations for dune size as a function of attributes of atmosphere and sediments, we find that the average diameter of the granular particles constituting such bedforms — assuming an aeolian origin — lies within the range 600 μm< d < 750 μm. Our findings show that, owing to the effect of hysteresis in the minimal threshold wind velocity for saltation, dune migration on Pluto can occur under wind speeds that are common to Earth and Mars.

  19. Nonisothermal Pluto atmosphere models

    Energy Technology Data Exchange (ETDEWEB)

    Hubbard, W.B.; Yelle, R.V.; Lunine, J.I. (Arizona Univ., Tucson (USA))

    1990-03-01

    The present thermal profile calculation for a Pluto atmosphere model characterized by a high number fraction of CH4 molecules encompasses atmospheric heating by solar UV flux absorption and conductive transport cooling to the surface of Pluto. The stellar occultation curve predicted for an atmosphere of several-microbar surface pressures (which entail the existence of a substantial temperature gradient close to the surface) agrees with observations and implies that the normal and tangential optical depth of the atmosphere is almost negligible. The minimum period for atmospheric methane depletion is calculated to be 30 years. 29 refs.

  20. The Pluto++ Event Generator

    CERN Document Server

    Fröhlich, I; Galatyuk, T; Hejny, V; Holzmann, R; Kagarlis, M; Kühn, W; Messchendorp, J G; Metag, V; Pleier, M -A; Przygoda, W; Ramstein, B; Ritman, J; Salabura, P; Stroth, J; Sudol, M

    2007-01-01

    Pluto is a Monte-Carlo event generator designed for hadronic interactions from Pion production threshold to intermediate energies of a few GeV per nucleon, as well as for studies of heavy ion reactions. This report gives an overview of the design of the package, the included models and the user interface.

  1. Pluto or Bust!

    Science.gov (United States)

    Fisher, Diane

    2005-01-01

    This article begins with a discussion of the development of the solar system. It also focuses on the fact that in January 2006, NASA plans to launch the New Horizons spacecraft to Pluto-Charon and on to one or more of the icy Kuiper Belt Objects. Sections of the article include: (1) Investigating the Aftermath; (2) Designing a Mission to…

  2. World beyond Pluto

    CERN Document Server

    Marlowe, Stephen

    2014-01-01

    What happens when a hardened criminal on the run for his life gets mixed up with an all-girl symphony traveling between lesser-populated planets in a futile attempt to bring culture to their rowdy inhabitants? Well, to put it mildly, hijinks ensue. Read Stephen Marlowe's thoroughly entertaining World Beyond Pluto to find out the rest.

  3. Quick Trip to Pluto

    Institute of Scientific and Technical Information of China (English)

    刘新

    1994-01-01

    At a current distance of 4. 5 billion kilometers from the sun, Pluto isthe only planet in our solar system not yet visited by a spacecraft. Mostmission plans call for a long and expensive journey to the faraway planet.But a recent proposal by scientists at the Jet Propulsion Laboratory (JPL)

  4. Destination pluto: New horizons performance during the approach phase

    Science.gov (United States)

    Flanigan, Sarah H.; Rogers, Gabe D.; Guo, Yanping; Kirk, Madeline N.; Weaver, Harold A.; Owen, William M.; Jackman, Coralie D.; Bauman, Jeremy; Pelletier, Frederic; Nelson, Derek; Stanbridge, Dale; Dumont, Phillip J.; Williams, Bobby; Stern, S. Alan; Olkin, Cathy B.; Young, Leslie A.; Ennico, Kimberly

    2016-11-01

    The New Horizons spacecraft began its journey to the Pluto-Charon system on January 19, 2006 on-board an Atlas V rocket from Cape Canaveral, Florida. As the first mission in NASA's New Frontiers program, the objective of the New Horizons mission is to perform the first exploration of ice dwarfs in the Kuiper Belt, extending knowledge of the solar system to include the icy "third zone" for the first time. Arriving at the correct time and correct position relative to Pluto on July 14, 2015 depended on the successful execution of a carefully choreographed sequence of events. The Core command sequence, which was developed and optimized over multiple years and included the highest-priority science observations during the closest approach period, was contingent on precise navigation to the Pluto-Charon system and nominal performance of the guidance and control (G&C) subsystem. The flyby and gravity assist of Jupiter on February 28, 2007 was critical in placing New Horizons on the path to Pluto. Once past Jupiter, trajectory correction maneuvers (TCMs) became the sole source of trajectory control since the spacecraft did not encounter any other planetary bodies along its flight path prior to Pluto. During the Pluto approach phase, which formally began on January 15, 2015, optical navigation images were captured primarily with the Long Range Reconnaissance Imager to refine spacecraft and Pluto-Charon system trajectory knowledge, which in turn was used to design TCMs. Orbit determination solutions were also used to update the spacecraft's on-board trajectory knowledge throughout the approach phase. Nominal performance of the G&C subsystem, accurate TCM designs, and high-quality orbit determination solutions resulted in final Pluto-relative B-plane arrival conditions that facilitated a successful first reconnaissance of the Pluto-Charon system.

  5. Tectonic Activity on Pluto After the Charon-Forming Impact

    CERN Document Server

    Barr, Amy C

    2014-01-01

    The Pluto-Charon system, likely formed from an impact, has reached the endpoint of its tidal evolution. During its evolution into the dual-synchronous state, the equilibrium tidal figures of Pluto and Charon would have also evolved as angular momentum was transferred from Pluto's spin to Charon's orbit. The rate of tidal evolution is controlled by Pluto's interior physical and thermal state. We examine three interior models for Pluto: an undifferentiated rock/ice mixture, differentiated with ice above rock, and differentiated with an ocean. For the undifferentiated case without an ocean, the Pluto-Charon binary does not evolve to its current state unless its internal temperature $T_i>200$ K, which would likely lead to strong tidal heating, melting, and differentiation. Without an ocean, Pluto's interior temperature must be higher than 240 K for Charon to evolve on a time scale less than the age of the solar system. Further tidal heating would likely create an ocean. If New Horizons finds evidence of ancient t...

  6. Birth Control in Clinical Trials

    Science.gov (United States)

    Stewart, J.; Beyer, B. K.; Chadwick, K.; De Schaepdrijver, L.; Desai, M.; Enright, B.; Foster, W.; Hui, J. Y.; Moffat, G. J.; Tornesi, B.; Van Malderen, K.; Wiesner, L.; Chen, C. L.

    2015-01-01

    The Health and Environmental Sciences Institute (HESI) Developmental and Reproductive Toxicology Technical Committee sponsored a pharmaceutical industry survey on current industry practices for contraception use during clinical trials. The objectives of the survey were to improve our understanding of the current industry practices for contraception requirements in clinical trials, the governance processes set up to promote consistency and/or compliance with contraception requirements, and the effectiveness of current contraception practices in preventing pregnancies during clinical trials. Opportunities for improvements in current practices were also considered. The survey results from 12 pharmaceutical companies identified significant variability among companies with regard to contraception practices and governance during clinical trials. This variability was due primarily to differences in definitions, areas of scientific uncertainty or misunderstanding, and differences in company approaches to enrollment in clinical trials. The survey also revealed that few companies collected data in a manner that would allow a retrospective understanding of the reasons for failure of birth control during clinical trials. In this article, suggestions are made for topics where regulatory guidance or scientific publications could facilitate best practice. These include provisions for a pragmatic definition of women of childbearing potential, guidance on how animal data can influence the requirements for male and female birth control, evidence-based guidance on birth control and pregnancy testing regimes suitable for low- and high-risk situations, plus practical methods to ascertain the risk of drug-drug interactions with hormonal contraceptives. PMID:27042398

  7. Condensation of Pluto's Minor Atmospheric Constituents

    Science.gov (United States)

    Barth, Erika L.

    2017-04-01

    The New Horizons missions has brought us many new insights into conditions in Pluto's atmosphere. Trace species such as C2H6, C2H2, C2H4 and HCN have been confirmed. Given the entry and exit temperature profiles measured by the spacecraft as well as the abundances of these species, each (along with CH4) will be highly supersaturated near Pluto's surface. A Pluto version of CARMA (Community Aerosol and Radiation Model for Atmospheres) has been constructed to model the ices formed when these species condense onto haze particles present in the atmosphere. All of the above listed species will nucleate onto the haze particles for the entry temperature profile, whereas only C2H6, C2H2, and HCN nucleate using the higher surface temperature exit profile. HCN ices form at the highest altitudes 15 km above the surface. C2H6 and C2H2 ices form at similar altitudes, 8-10 km at the entry site and below 5 km at the exit site. CH4 and C2H4 ices only form near the surface at the entry site. The cold temperatures near Pluto's surface play an important role in the efficiency of the nucleation and subsequent condensation processes, controlling the number and size of the ice particles.

  8. Haze in Pluto's atmosphere

    Science.gov (United States)

    Cheng, A. F.; Summers, M. E.; Gladstone, G. R.; Strobel, D. F.; Young, L. A.; Lavvas, P.; Kammer, J. A.; Lisse, C. M.; Parker, A. H.; Young, E. F.; Stern, S. A.; Weaver, H. A.; Olkin, C. B.; Ennico, K.

    2017-07-01

    Haze in Pluto's atmosphere was detected in images by both the Long Range Reconnaissance Imager (LORRI) and the Multispectral Visible Imaging Camera (MVIC) on New Horizons. LORRI observed haze up to altitudes of at least 200 km above Pluto's surface at solar phase angles from ∼20° to ∼169°. The haze is structured with about ∼20 layers, and the extinction due to haze is greater in the northern hemisphere than at equatorial or southern latitudes. However, more haze layers are discerned at equatorial latitudes. A search for temporal variations found no evidence for motions of haze layers (temporal changes in layer altitudes) on time scales of 2 to 5 hours, but did find evidence of changes in haze scale height above 100 km altitude. An ultraviolet extinction attributable to the atmospheric haze was also detected by the ALICE ultraviolet spectrograph on New Horizons. The haze particles are strongly forward-scattering in the visible, and a microphysical model of haze is presented which reproduces the visible phase function just above the surface with 0.5 μm spherical particles, but also invokes fractal aggregate particles to fit the visible phase function at 45 km altitude and account for UV extinction. A model of haze layer generation by orographic excitation of gravity waves is presented. This model accounts for the observed layer thickness and distribution with altitude. Haze particles settle out of the atmosphere and onto Pluto's surface, at a rate sufficient to alter surface optical properties on seasonal time scales. Pluto's regional scale albedo contrasts may be preserved in the face of the haze deposition by atmospheric collapse.

  9. The Solar Wind Around Pluto (SWAP) Instrument Aboard New Horizons

    CERN Document Server

    McComas, D; Bagenal, F; Casey, P; Delamere, P; Demkee, D; Dunn, G; Elliott, H; Hanley, J; Johnson, K; Langle, J; Miller, G; Pope, S; Reno, M; Rodríguez, B; Schwadron, N; Valek, P; Weidner, S

    2007-01-01

    The Solar Wind Around Pluto (SWAP) instrument on New Horizons will measure the interaction between the solar wind and ions created by atmospheric loss from Pluto. These measurements provide a characterization of the total loss rate and allow us to examine the complex plasma interactions at Pluto for the first time. Constrained to fit within minimal resources, SWAP is optimized to make plasma-ion measurements at all rotation angles as the New Horizons spacecraft scans to image Pluto and Charon during the flyby. In order to meet these unique requirements, we combined a cylindrically symmetric retarding potential analyzer (RPA) with small deflectors, a top-hat analyzer, and a redundant/coincidence detection scheme. This configuration allows for highly sensitive measurements and a controllable energy passband at all scan angles of the spacecraft.

  10. The Chemistry of Pluto and its Satellites

    Science.gov (United States)

    Cruikshank, Dale P.

    2017-01-01

    Pluto's bulk composition and the composition of the surface layers hold clues to the origin and evolution of a number of other Solar System bodies of comparable size in the region beyond Neptune. The July 14, 2015 flyby of the Pluto system with the New Horizons spacecraft afforded the opportunity to corroborate and greatly improve discoveries about the planet and its satellites derived Earth-based studies. It also revealed extraordinary details of the surface and atmosphere of Pluto, as well as the geology and composition of Charon and two smaller satellites. With a mean density of 1.86 g/sq cm, the bulk composition of Pluto is about two-thirds anhydrous solar composition rocky material and one-third volatiles (primarily H2O in liquid and solid states) by mass, the surface is a veneer of ices dominated by N2, with smaller amounts of CH4 and CO, as well as limited exposures of H2O ice (considered to be "bedrock"). N2, CH4, and CO occur as solid solutions at temperature-dependent mutual concentrations, each component being soluble in the others. Frozen C2H6 as a minor component has also been identified. Sublimation and recondensation of N2, CH4, and CO over seasonal (248 y) and Milankovich-type megaseasons (approx. 3 My) result in the redistribution of these ices over time and with latitude control. Solid N2 is found in glaciers originating in higher elevations and flowing at the present time into a basin structure larger than the State of Texas, forming a convecting lens of N2 that overturns on a timescale of order 10 My. The varied colors of Pluto's landscape arise from the energetic processing of the surface ices in processes that break the simple molecules and reassemble complex organic structures consisting of groups of aromatic rings connected by aliphatic chains. When synthesized in the laboratory by UV or electron irradiation of a Pluto mix of ice, this material, called tholin, has colors closely similar to Pluto. The Pluto ice tholin analog contains

  11. Geological mapping of Sputnik Planitia on Pluto

    Science.gov (United States)

    White, Oliver L.; Moore, Jeffrey M.; McKinnon, William B.; Spencer, John R.; Howard, Alan D.; Schenk, Paul M.; Beyer, Ross A.; Nimmo, Francis; Singer, Kelsi N.; Umurhan, Orkan M.; Stern, S. Alan; Ennico, Kimberly; Olkin, Cathy B.; Weaver, Harold A.; Young, Leslie A.; Cheng, Andrew F.; Bertrand, Tanguy; Binzel, Richard P.; Earle, Alissa M.; Grundy, Will M.; Lauer, Tod R.; Protopapa, Silvia; Robbins, Stuart J.; Schmitt, Bernard

    2017-05-01

    The geology and stratigraphy of the feature on Pluto informally named Sputnik Planitia is documented through geologic mapping at 1:2,000,000 scale. All units that have been mapped are presently being affected to some degree by the action of flowing N2 ice. The N2 ice plains of Sputnik Planitia display no impact craters, and are undergoing constant resurfacing via convection, glacial flow and sublimation. Condensation of atmospheric N2 onto the surface to form a bright mantle has occurred across broad swathes of Sputnik Planitia, and appears to be partly controlled by Pluto's obliquity cycles. The action of N2 ice has been instrumental in affecting uplands terrain surrounding Sputnik Planitia, and has played a key role in the disruption of Sputnik Planitia's western margin to form chains of blocky mountain ranges, as well in the extensive erosion by glacial flow of the uplands to the east of Sputnik Planitia.

  12. PLUTO first report.

    Science.gov (United States)

    Otte, Jean-Bernard; Meyers, Rebecka

    2010-11-01

    The PLUTO is a registry developed by an international collaboration of the Liver Tumors Strategy Group (SIOPEL) of the SIOP. Although the number of patients collected in PLUTO to date is too small to add any analytic power to the existing literature, this new registry has great promise. It has been created to clarify issues regarding the role of liver transplantation in the treatment of children with unresectable liver tumors. By reviewing the results to date, we hope we can motivate more centers to participate, enroll patients, complete data entry, and boost the potential impact of the collaborative effort. To achieve this goal, a large number of patients are needed, which requires an intensified international collaboration. Pediatric oncologists, pediatric surgical oncologists, and pediatric liver transplant surgeons are all encouraged to participate and contribute. This is a preliminary glimpse of what we hope to be a series of interim reports over the next decade from the steering committee to help guide therapy in this very challenging group of children. © 2010 John Wiley & Sons A/S.

  13. Pluto is the new Mars!

    Science.gov (United States)

    Moore, Jeffrey M.; Mckinnon, William B.; Spencer, John R.; Howard, Alan D.; Grundy, William M.; Stern, S. Alan; Weaver, Harold A.; Young, Leslie A.; Ennico, Kimberly; Olkin, Cathy

    2016-01-01

    Data from NASA's New Horizons encounter with Pluto in July 2015 revealed an astoundingly complex world. The surface seen on the encounter hemisphere ranged in age from ancient to recent. A vast craterless plain of slowly convecting solid nitrogen resides in a deep primordial impact basin, reminiscent of young enigmatic deposits in Mars' Hellas basin. Like Mars, regions of Pluto are dominated by valleys, though the Pluto valleys are thought to be carved by nitrogen glaciers. Pluto has fretted terrain and halo craters. Pluto is cut by tectonics of several different ages. Like Mars, vast tracts on Pluto are mantled by dust and volatiles. Just as on Mars, Pluto has landscapes that systematically vary with latitude due to past and present seasonal (and mega-seasonal) effects on two major volatiles. On Mars, those volatiles are H2O and CO2; on Pluto they are CH4 and N2. Like Mars, some landscapes on Pluto defy easy explanation. In the Plutonian arctic there is a region of large (approx. 40 km across) deep (approx. 3-4 km) pits that probably could not be formed by sublimation, or any other single process, alone. Equally bizarre is the Bladed terrain, which is composed of fields of often roughly aligned blade-like ridges covering the flanks and crests of broad regional swells. Topping the unexpected are two large mounds approximately150 km across, approx. 5-6 km high, with great central depressions at their summits. The central depressions are almost as deep as the mounds are tall. These mounds have many of the characteristics of volcanic mountains seen on Mars and elsewhere in the inner solar system. Hypotheses for the formation of these Plutonian mounds so far all have challenges, principally revolving around the need for H2O ice to support their relief and the difficulty imagining mechanisms that would mobilize H2O. From the perspective of one year after the encounter, our appreciation of the extent of Pluto's diversity and complexity is quite reminiscent of the

  14. Origin of Triton and Pluto

    Energy Technology Data Exchange (ETDEWEB)

    McKinnon, W.B. (Washington Univ., St. Louis, MO (USA). Nuclear Medicine Div.)

    1984-09-27

    A simple hypothesis on the origin of Triton and Pluto is that Triton and Pluto are independent representatives of large outer Solar System planetesimals. Triton is simply captured, with potentially spectacular consequences that include runaway melting of interior ices and release to the surface of clathrated CH/sub 4/, CO and N/sub 2/. Condensed remnants of this proto-atmosphere could account for features in Triton's unique spectrum.

  15. Diameters of Triton and Pluto

    Energy Technology Data Exchange (ETDEWEB)

    Morrison, D.; Cruikshank, D.P. (Hawaii Univ., Honolulu (USA). Inst. for Astronomy); Brown, R.H. (Hawaii Univ., Honolulu (USA). Dept. of Physics and Astronomy; Hawaii Univ., Honolulu (USA). Hawaii Inst. of Geophysics)

    1982-12-02

    Upper limits are reported to the thermal IR emission from Triton, the major satellite of Neptune, and Pluto, the outermost planet, that permit significant upper limits to be set on their diameters and also demonstrate that both are high albedo objects. These results exclude the possibility that Triton is the largest planetary satellite and are consistent with the small size of Pluto deduced from other data.

  16. PFERD Mission: Pluto Flyby Exploration/Research Design

    Science.gov (United States)

    Lemke, Gary; Zayed, Husni; Herring, Jason; Fuehne, Doug; Sutton, Kevin; Sharkey, Mike

    1990-01-01

    The Pluto Flyby Exploration/Research Design (PFERD) mission will consist of a flyby spacecraft to Pluto and its satellite, Charon. The mission lifetime is expected to be 18 years. The Titan 4 with a Centaur upper stage will be utilized to launch the craft into the transfer orbit. The proposal was divided into six main subsystems: (1) scientific instrumentation; (2) command, communications, and control: (3) altitude and articulation control; (4) power and propulsion; (5) structures and thermal control; and (6) mission management and costing. Tradeoff studies were performed to optimize all factors of design, including survivability, performance, cost, and weight. Problems encountered in the design are also presented.

  17. Barchan dunes on Pluto?

    Directory of Open Access Journals (Sweden)

    Parteli Eric J. R.

    2017-01-01

    Full Text Available We show that the orientation and morphology of bedforms occurring on top of Pluto’s smooth ice coats are consistent with an aeolian origin under conditions of unidirectional flow. From scaling relations for dune size as a function of attributes of atmosphere and sediments, we find that the average diameter of the granular particles constituting such bedforms — assuming an aeolian origin — lies within the range 600 μm< d < 750 μm. Our findings show that, owing to the effect of hysteresis in the minimal threshold wind velocity for saltation, dune migration on Pluto can occur under wind speeds that are common to Earth and Mars.

  18. Supported employment: randomised controlled trial*

    Science.gov (United States)

    Howard, Louise M.; Heslin, Margaret; Leese, Morven; McCrone, Paul; Rice, Christopher; Jarrett, Manuela; Spokes, Terry; Huxley, Peter; Thornicroft, Graham

    2010-01-01

    Background There is evidence from North American trials that supported employment using the individual placement and support (IPS) model is effective in helping individuals with severe mental illness gain competitive employment. There have been few trials in other parts of the world. Aims To investigate the effectiveness and cost-effectiveness of IPS in the UK. Method Individuals with severe mental illness in South London were randomised to IPS or local traditional vocational services (treatment as usual) (ISRCTN96677673). Results Two hundred and nineteen participants were randomised, and 90% assessed 1 year later. There were no significant differences between the treatment as usual and intervention groups in obtaining competitive employment (13% in the intervention group and 7% in controls; risk ratio 1.35, 95% CI 0.95–1.93, P = 0.15), nor in secondary outcomes. Conclusions There was no evidence that IPS was of significant benefit in achieving competitive employment for individuals in South London at 1-year follow-up, which may reflect suboptimal implementation. Implementation of IPS can be challenging in the UK context where IPS is not structurally integrated with mental health services, and economic disincentives may lead to lower levels of motivation in individuals with severe mental illness and psychiatric professionals. PMID:20435968

  19. Reorientation and faulting of Pluto due to volatile loading within Sputnik Planitia.

    Science.gov (United States)

    Keane, James T; Matsuyama, Isamu; Kamata, Shunichi; Steckloff, Jordan K

    2016-12-01

    Pluto is an astoundingly diverse, geologically dynamic world. The dominant feature is Sputnik Planitia-a tear-drop-shaped topographic depression approximately 1,000 kilometres in diameter possibly representing an ancient impact basin. The interior of Sputnik Planitia is characterized by a smooth, craterless plain three to four kilometres beneath the surrounding rugged uplands, and represents the surface of a massive unit of actively convecting volatile ices (N2, CH4 and CO) several kilometres thick. This large feature is very near the Pluto-Charon tidal axis. Here we report that the location of Sputnik Planitia is the natural consequence of the sequestration of volatile ices within the basin and the resulting reorientation (true polar wander) of Pluto. Loading of volatile ices within a basin the size of Sputnik Planitia can substantially alter Pluto's inertia tensor, resulting in a reorientation of the dwarf planet of around 60 degrees with respect to the rotational and tidal axes. The combination of this reorientation, loading and global expansion due to the freezing of a possible subsurface ocean generates stresses within the planet's lithosphere, resulting in a global network of extensional faults that closely replicate the observed fault networks on Pluto. Sputnik Planitia probably formed northwest of its present location, and was loaded with volatiles over million-year timescales as a result of volatile transport cycles on Pluto. Pluto's past, present and future orientation is controlled by feedbacks between volatile sublimation and condensation, changing insolation conditions and Pluto's interior structure.

  20. Pluto and other dwarf planets

    CERN Document Server

    Saxena, Shalini

    2017-01-01

    The reclassification of Pluto in 2006 not only decreased the number of planets in our solar system by one but also introduced the new category of dwarf planet. Readers will come to understand what separates a dwarf planet from a planet-or for that matter from any of the other bodies found within the solar system. They'll learn about Pluto itself, as well as its fellow dwarf planets, Ceres, Makemake, Haumea, and Eris. Full of recent information, this title is sure to inspire an interest in space science among young readers.

  1. Geology and Composition of Pluto and Charon from New Horizons

    Science.gov (United States)

    Spencer, John R.; Stern, S. Alan; Moore, Jeffrey M.; Grundy, W. M.; McKinnon, William B.; Cruikshank, Dale P.; Weaver, Harold A.; Olkin, Catherine B.; Young, Leslie; Ennico, Kimberly; New Horizons Geology/Geophysics and Composition Theme Teams

    2016-10-01

    Data gathered by New Horizons during its July 2015 flyby has revolutionized our understanding of the geology and surface composition of Pluto and Charon. While much of Pluto's ice shell is ancient and rigid, as evinced by locally high crater densities and deep graben, much of the surface has been reworked, up to the present day, by a bewildering variety of geological processes. These include deposition and erosion of kilometers of mantle material, sublimation, apparent cryovolcanism, chaotic breakup of the crust to form rugged mountains, erosion and creation of channel networks by probable glacial action, and active glaciation. Pluto's anti-Charon hemisphere is dominated by 1000 km wide field of actively convecting nitrogen and other ices, informally called Sputnik Planum, occupying a large depression of probable impact origin. Color and composition is very varied, and is dominated by dark red tholins and N2, CH4, and CO ices, with H2O ice bedrock also exposed in many places. Apart from Sputnik Planum, color and composition is strongly correlated with latitude, showing the importance of insolation in controlling ice distribution. Charon shows pervasive extensional tectonism and locally extensive cryovolcanic resurfacing, both dating from early in solar system history. Its color and surface composition, dominated by H2O ice plus NH3 hydrate, is remarkably uniform apart from a thin deposit of dark red material near the north pole which may be due to cold-trapping and radiolysis of hydrocarbons escaping from Pluto. Neither Pluto nor Charon is likely to have experienced tidal heating during the period when observable landforms were created. Charon's surface shows resurfacing comparable in extent and age to many Saturnian and Uranian satellites such as Dione or Ariel, suggesting that observed activity on these satellites may not necessarily be tidally-driven. Pluto demonstrates that resurfacing on small volatile-rich icy bodies can be powered for at least 4.5 Ga by

  2. Methods & Strategies: Poor, Poor Pluto

    Science.gov (United States)

    Graham, Lori; West, Courtney; Jones, Lindsay

    2013-01-01

    Just as students never stop learning, neither do librarians and teachers. Learning is a process that is facilitated by interest and applicability. Therefore, it is imperative to develop instructional activities that students deem important and relevant. "Why is Pluto no longer a planet?" is a question whose answer many people, young and…

  3. New Horizons Mission to Pluto

    Science.gov (United States)

    Delgado, Luis G.

    2011-01-01

    This slide presentation reviews the trajectory that will take the New Horizons Mission to Pluto. Included are photographs of the spacecraft, the launch vehicle, the assembled vehicle as it is being moved to the launch pad and the launch. Also shown are diagrams of the assembled parts with identifying part names.

  4. Planetary science: Pluto's telltale heart

    Science.gov (United States)

    Barr, Amy C.

    2016-12-01

    Studies of a large frost-filled basin on Pluto show that this feature altered the dwarf planet's spin axis, driving tectonic activity on its surface, and hint at the presence of a subsurface ocean. See Letters p.86, p.90, p.94 & p.97

  5. Longitudinal and temporal variability of Pluto

    Science.gov (United States)

    Protopapa, S.; Boehnhardt, H.; Barrera, L.; Grundy, W. M.; Cruikshank, D. P.; Sunshine, J. M.; Feaga, L. M.; A'Hearn, M. F.

    2011-10-01

    In particular, we present low dispersion L band spectroscopy together with high dispersion spectroscopy in H and K bands of Pluto acquired with the NACO instrument at the ESO VLT on 27 June 2008. The nature and properties of the compounds present on the surface of Pluto are investigated by applying a Hapke radiative transfer model to the measured spectra. The 2008 observations are compared with 2005 measurements obtained with the same instrument and spectroscopic mode, covering similar sub-earth longitudes. A systematic study of Pluto's surface composition is presented in order to characterize the spatial and temporal distribution of Pluto's surface ices. The spectra of Pluto obtained at different sub-earth longitudes do not show any significant difference in the wavelength range between 2.9 and 3.7μm. No changes in the ratio between pure and diluted methane ice are observed from 2005 to 2008, indicating that Pluto's resurfacing process has slowed down or stopped.

  6. Escape and Stand of the Pluto Atmosphere

    Institute of Scientific and Technical Information of China (English)

    GAO Chong-Yi

    2002-01-01

    Molar mass μmin of the lightest gas, which will exist "forever" in the atmosphere at the planet surface,can be evaluated by Jeans rule. The μmin of Pluto is 17.3 g@ mol-1. It is evident that both N2 and CO can be major atmospheric composition at the Pluto surface, and will exist "forever". CH4 can only be escaping slowly from Pluto atmosphere, and still holds quite a proportion in current Pluto atmosphere. However, it will not escape from Titan (or Jupiter, Saturn) atmosphere largely, and will exist "forever". Given the quantitylevelof partial pressure of CH4 in Pluto and Titan (or Jupiter, Saturn) original atmosphere is the same, it will be clear that the current partial pressure of CH4 in Pluto surface atmosphere is 10-3 Pa.

  7. The puzzling detection of x-rays from Pluto by Chandra

    Science.gov (United States)

    Lisse, C. M.; McNutt, R. L.; Wolk, S. J.; Bagenal, F.; Stern, S. A.; Gladstone, G. R.; Cravens, T. E.; Hill, M. E.; Kollmann, P.; Weaver, H. A.; Strobel, D. F.; Elliott, H. A.; McComas, D. J.; Binzel, R. P.; Snios, B. T.; Bhardwaj, A.; Chutjian, A.; Young, L. A.; Olkin, C. B.; Ennico, K. A.

    2017-05-01

    Using Chandra ACIS-S, we have obtained low-resolution imaging X-ray spectrophotometry of the Pluto system in support of the New Horizons flyby on 14 July 2015. Observations were obtained in a trial ;seed; campaign conducted in one visit on 24 Feb 2014, and a follow-up campaign conducted soon after the New Horizons flyby that consisted of 3 visits spanning 26 Jul to 03 Aug 2015. In a total of 174 ksec of on-target time, in the 0.31 to 0.60 keV passband, we measured 8 total photons in a co-moving 11 × 11 pixel2 box (the 90% flux aperture determined by observations of fixed background sources in the field) measuring ∼121,000 × 121,000 km2 (or ∼100 × 100 RPluto) at Pluto. No photons were detected from 0.60 to 1.0 keV in this box during the same exposures. Allowing for background, we find a net signal of 6.8 counts and a statistical noise level of 1.2 counts, for a detection of Pluto in this passband at > 99.95% confidence. The Pluto photons do not have the spectral shape of the background, are coincident with a 90% flux aperture co-moving with Pluto, and are not confused with any background source, so we consider them as sourced from the Pluto system. The mean 0.31 - 0.60 keV X-ray power from Pluto is 200 +200/-100 MW, in the middle range of X-ray power levels seen for other known Solar System emission sources: auroral precipitation, solar X-ray scattering, and charge exchange (CXE) between solar wind (SW) ions and atmospheric neutrals. We eliminate auroral effects as a source, as Pluto has no known magnetic field and the New Horizons Alice UV spectrometer detected no airglow from Pluto during the flyby. Nano-scale atmospheric haze particles could lead to enhanced resonant scattering of solar X-rays from Pluto, but the energy signature of the detected photons does not match the solar spectrum and estimates of Pluto's scattered X-ray emission are 2 to 3 orders of magnitude below the 3.9 ± 0.7 × 10-5cps found in our observations. Charge-exchange-driven emission

  8. Pluto: Planet or "Dwarf Planet"?

    Science.gov (United States)

    Voelzke, M. R.; de Araújo, M. S. T.

    2010-09-01

    In August 2006 during the XXVI General Assembly of the International Astronomical Union (IAU), taken place in Prague, Czech Republic, new parameters to define a planet were established. According to this new definition Pluto will be no more the ninth planet of the Solar System but it will be changed to be a "dwarf planet". This reclassification of Pluto by the academic community clearly illustrates how dynamic science is and how knowledge of different areas can be changed and evolves through the time, allowing to perceive Science as a human construction in a constant transformation, subject to political, social and historical contexts. These epistemological characteristics of Science and, in this case, of Astronomy, constitute important elements to be discussed in the lessons, so that this work contributes to enable Science and Physics teachers who perform a basic education to be always up to date on this important astronomical fact and, thereby, carry useful information to their teaching.

  9. Crater Morphologies on Pluto and Charon: Anticipating New Horizons

    Science.gov (United States)

    Schenk, P.; Bray, V. J.; McKinnon, W. B.; White, O. L.; Moore, J. M.

    2014-12-01

    Impact craters are among the few geologic features we have some confidence will be present in the Pluto/Charon system. Crater morphologies are important as tracers of thermal history (through the mechanism of viscous relaxation), and can be used to probe through icy crusts (in terms of excavating deeper layers as on Ganymede or penetrating through floating ice shells as on Europa). New Horizons will have the opportunity to examine crater morphologies on Pluto to resolutions Charon to ~250 meters over significant areas. Stereo-derived topography maps are anticipated over 20-35% of each body. The first task will be to place the observed craters (assuming they are not deeply eroded) into Solar System context. Crater morphology on icy satellites is controlled primarily by surface gravity. Charon has similar surface gravity to the icy Saturnian satellites and we expect craters on Charon to resemble those seen by Cassini, where the dominant landform will be prominent central peaks. Pluto surface gravity is midway between Ganymede and Rhea. Triton, with similar surface gravity and internal composition to Pluto, is of no help due to the paucity of resolved craters there. This opens the possibility of observing landforms seen on Ganymede, such as central dome craters, palimpsests and perhaps even a multiring basin or two, albeit at larger diameters than we would see on Ganymede. Several issues complicate our rosy picture. A key unresolved concern is that impact velocities in the Pluto system are only a few km/s, in the low end of the hypervelocity range. Numerical models imply possible differences during excavation, producing deeper simple craters than on the icy satellites. Impacts occurring at velocities well below the mean (topographic data sets is unclear. Any viscous relaxation (driven by internal or modest tidal heating) or mass wasting erosion (by volatile redistribution) will also work to reduce crater depths on Pluto in different ways, but cratering onto the likely

  10. a randomized controlled clinical trial

    OpenAIRE

    2013-01-01

    In this study we aimed to evaluate the effectiveness of Iyengar yoga in chronic neck pain by means of a randomized clinical trial. 77 with chronic neck pain who scored > 40 mm on a 100-mm visual analog scale (VAS) were randomized to a nine week Iyengar yoga program with weekly 90-minute classes or to a self-care/exercise program. The primary outcome measure was change of mean pain at rest (VAS) from baseline to week ten. Secondary outcomes included pain at motion, functional disabilit...

  11. Pluto-charon mutual events

    Energy Technology Data Exchange (ETDEWEB)

    Binzel, R.P. (Massachusetts Institute of Technology, Cambridge (USA))

    1989-11-01

    Since 1985, planetary astronomers have been working to take advantage of a once-per-century apparent alignment between Pluto and its satellite, Charon, which has allowed mutual occultation and transit events to be observed. There events, which will cease in 1990, have permitted the first precise determinations of their individual radii, densities, and surface compositions. In addition, information on their surface albedo distributions can be obtained.

  12. Operational trials of single- and multi-element CR-39 dosemeters for the DIDO and PLUTO reactors at the Harwell Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Gallacher, G.G.; Perks, C.A. (AEA Environment and Energy, Harwell (United Kingdom))

    1993-04-01

    Single- and multi-element CR-39 dosemeters, developed at the Harwell Laboratory, and a commercially available multi-element CR-39 dosemeter (obtained from Track Analysis Systems Ltd), were evaluated for their potential as neutron dosemeters for personnel working at Harwell Laboratory's research reactors. Owing to the angular dependence of the CR-39 (processed using electrochemical etching), the single-element dosemeter was found to be impractical. Consequently, a multi-element dosemeter was developed, which consisted of a cube of side 36 mm with CR-39 elements (also processed using electrochemical etching) attached to each of the sides. Although this dosemeter was technically suitable for this type of dosimetry, it was considered to be unacceptably bulky in personnel trials. The commercially available CR-39 dosemeter tested was much smaller (the CR-39 was only chemically etched) and this was considered to be acceptable as a personnel dosemeter. In addition, trials with personnel working at active handling glove boxes indicated that single-element dosemeters might be adequate, but further work would be needed to verify this. (author).

  13. New Horizons Sees Pluto (Animation) Note: There is debate within the science community as to whether

    Science.gov (United States)

    2007-01-01

    The Long Range Reconnaissance Imager (LORRI) on New Horizons acquired images of the Pluto field three days apart in late September 2006, in order to see Pluto's motion against a dense background of stars. LORRI took three frames at 1-second exposures on both Sept. 21 and Sept. 24. Because it moved along its predicted path, Pluto was detected in all six images. These images are displayed using false-color to represent different intensities: the lowest intensity level is black, different shades of red mark intermediate intensities, and the highest intensity is white. The images appear pixilated because they were obtained in a mode that compensates for the drift in spacecraft pointing over long exposure times. LORRI also made these observations before operators uploaded new flight-control software in October; the upgraded software package includes an optical navigation capability that will make LORRI approximately three times more sensitive still than for these Pluto observations.

  14. Razors versus clippers. A randomised controlled trial.

    Science.gov (United States)

    Taylor, Tracy; Tanner, Judith

    2005-12-01

    The purpose of this randomised controlled trial was to determine if patients showed a preference for preoperative hair removal with razors or clippers and to identify if one method was associated with more trauma or postoperative infections. The trial took place in a day surgery unit with patients who were having a range of surgical procedures including hernias and varicose veins. This study was sponsored by an award from the NATN/3M Clinical Fellowship.

  15. Control groups in recent septic shock trials

    DEFF Research Database (Denmark)

    Pettilä, Ville; Hjortrup, Peter Buhl; Jakob, Stephan M

    2016-01-01

    , and mortality outcomes, and calculated a data completeness score to provide an overall view of quality of reporting. RESULTS: A total of 24 RCTs were included (mean n = 287 patients and 71 % of eligible patients were randomized). Of the 24 studies, 14 (58 %) presented baseline data on vasopressors and 58......PURPOSE: The interpretation of septic shock trial data is profoundly affected by patients, control intervention, co-interventions and selected outcome measures. We evaluated the reporting of control groups in recent septic shock trials. METHODS: We searched for original articles presenting...... randomized clinical trials (RCTs) in adult septic shock patients from 2006 to 2016. We included RCTs focusing on septic shock patients with at least two parallel groups and at least 50 patients in the control group. We selected and evaluated data items regarding patients, control group characteristics...

  16. Placebo-Controlled Trials, Ethics of

    NARCIS (Netherlands)

    van der Graaf, R; Rid, Annette

    2015-01-01

    There are often good scientific and ethical reasons for using placebo controls in clinical trials. At the same time placebo use is controversial, especially when an established effective treatment is being withheld from the control group. This article gives an overview of the key ethical positions

  17. Placebo-Controlled Trials, Ethics of

    NARCIS (Netherlands)

    van der Graaf, R; Rid, Annette

    2015-01-01

    There are often good scientific and ethical reasons for using placebo controls in clinical trials. At the same time placebo use is controversial, especially when an established effective treatment is being withheld from the control group. This article gives an overview of the key ethical positions i

  18. Hybrid Simulations of Pluto's Plasma Interaction

    Science.gov (United States)

    Feyerabend, M.; Simon, S.; Motschmann, U.; Liuzzo, L.

    2016-12-01

    We study the interaction between Pluto and the solar wind at the time of the New Horizons (NH) flyby by applying a hybrid (kinetic ions, fluid electrons) simulation model. The use of a hybrid model is necessary since the gyroradii of the involved ion species are more than an order of magnitude larger than the obstacle to the solar wind and thus, Pluto's interaction region displays considerable asymmetries. We investigate the three-dimensional structure and extension of the various plasma signatures seen along the NH trajectory. Especially, we will constrain possible asymmetries in the shape of Pluto's bow shock, plasma tail and Plutopause (i.e., the boundary between the solar wind and the population of plutogenic ions) which may arise from the large ion gyroradii. Starting from the upstream solar wind parameters measured by NH, we investigate the dependency of these plasma signatures on the density of Pluto's ionosphere and on the solar wind ram pressure. We also include Pluto's largest moon Charon into the simulation model and study the simultaneous interaction between both bodies and the solar wind. Data from NH suggest that Charon mainly acts as a plasma absorber without an appreciable atmosphere. For various relative positions of Pluto and Charon, we investigate the deformation of Charon's wake when exposed to the inhomogeneous plasma flow in the Pluto interaction region, as well as a possible feedback of Charon on the structure of Pluto's induced magnetosphere.

  19. Pluto's atmosphere near perihelion

    Energy Technology Data Exchange (ETDEWEB)

    Trafton, L.M. (Univ. of Texas, Austin (USA))

    1989-11-01

    A recent stellar occultation has confirmed predictions that Pluto has an atmosphere which is sufficiently thick to uniformly envelope the planet and to extend far above the surface. Pluto's atmosphere consists of methane and perhaps other volatile gases at temperatures below their freezing points; it should regulate the surface temperature of its volatile ices to a globally uniform value. As Pluto approaches and passes through perihelion, a seasonal maximum in the atmospheric bulk and a corresponding minimum in the exposed volatile ice abundance is expected to occur. The lag in maximum atmospheric bulk relative to perihelion will be diagnostic of the surface thermal properties. An estimate of Pluto's atmospheric bulk may result if a global darkening (resulting from the disappearance of the seasonally deposited frosts) occurs before the time of maximum atmospheric bulk. The ice deposited shortly after perihelion may be diagnostic of the composition of Pluto's volatile reservoir.

  20. Pluto Express power system architecture

    Energy Technology Data Exchange (ETDEWEB)

    Carr, G.A. [California Inst. of Tech., Pasadena, CA (United States). Jet Propulsion Lab.

    1996-12-31

    The Pluto Express power system must answer the challenge of the next generation spacecraft by reducing its power, mass and volume envelopes. Technology developed by the New Millennium Program will enable the power system to meet the stringent requirements for the Pluto Express mission without exceeding the spacecraft mass and volume budgets. Traditionally, there has been an increasing trend of the percentage of mass of the power system electronics with respect to the total spacecraft mass. With all of the previous technology focus on high density digital packaging, the power system electronics have not been keeping pace forcing the spacecraft to absorb a relative increase in the power system mass. The increasing trend can be reversed by using mixed signal ASICs and high density multi-chip-module (MCM) packaging techniques validated by the New Millennium Program. As the size of the spacecraft shrinks, the power system electronics must become tightly integrated with the spacecraft loads. The power system architecture needs the flexibility to accommodate the specific load requirements without sacrificing the capability for growth or reduction as the spacecraft requirements change throughout the development. Modularity is a key requirement that will reduce the overall power system cost. Although the focus has been on shrinking the power system volume and mass, the efficiency and functionality cannot be ignored. Increased efficiency and functionality will only enhance the power systems capability to reduce spacecraft power requirements. The combination of the New Millennium packaging technologies with the Pluto Express power system architecture will produce a product with the capability to meet a wide range of mission profiles while reducing system development costs.

  1. Randomized controlled trials - a matter of design.

    Science.gov (United States)

    Spieth, Peter Markus; Kubasch, Anne Sophie; Penzlin, Ana Isabel; Illigens, Ben Min-Woo; Barlinn, Kristian; Siepmann, Timo

    2016-01-01

    Randomized controlled trials (RCTs) are the hallmark of evidence-based medicine and form the basis for translating research data into clinical practice. This review summarizes commonly applied designs and quality indicators of RCTs to provide guidance in interpreting and critically evaluating clinical research data. It further reflects on the principle of equipoise and its practical applicability to clinical science with an emphasis on critical care and neurological research. We performed a review of educational material, review articles, methodological studies, and published clinical trials using the databases MEDLINE, PubMed, and ClinicalTrials.gov. The most relevant recommendations regarding design, conduction, and reporting of RCTs may include the following: 1) clinically relevant end points should be defined a priori, and an unbiased analysis and report of the study results should be warranted, 2) both significant and nonsignificant results should be objectively reported and published, 3) structured study design and performance as indicated in the Consolidated Standards of Reporting Trials statement should be employed as well as registration in a public trial database, 4) potential conflicts of interest and funding sources should be disclaimed in study report or publication, and 5) in the comparison of experimental treatment with standard care, preplanned interim analyses during an ongoing RCT can aid in maintaining clinical equipoise by assessing benefit, harm, or futility, thus allowing decision on continuation or termination of the trial.

  2. Pluto's atmosphere

    Energy Technology Data Exchange (ETDEWEB)

    Elliot, J.L.; Dunham, E.W.; Bosh, A.S.; Slivan, S.M.; Young, L.A.

    1989-01-01

    Airborne CCD photometer observations of Pluto's June 9, 1988 stellar occultation have yielded an occultation lightcurve, probing two regions on the sunrise limb 2000 km apart, which reveals an upper atmosphere overlying an extinction layer with an abrupt upper boundary. The extinction layer may surround the entire planet. Attention is given to a model atmosphere whose occultation lightcurve closely duplicates observations; fits of the model to the immersion and emersion lightcurves exhibit no significant derived atmosphere-structure differences. Assuming a pure methane atmosphere, surface pressures of the order of 3 microbars are consistent with the occultation data. 43 references.

  3. Pluto and Charon - the dance goes on

    Energy Technology Data Exchange (ETDEWEB)

    Beatty, J.K.

    1987-09-01

    Various methods for estimating the diameters of Pluto and Charon are discussed. The application of speckle interferometry, the timing of occultations, and the monitoring of Charon and Pluto rotations to calculate the diameter of the planet and its satellite are described. Walker (1980) estimated Charon's diameter as greater than 1200 km using the occultated star method; the speckle interferometry estimates of Baier and Weigelt (1983) are between 2710-3460 km for Pluto and between 1050-1520 km for Charon; and using the mutual events method Dunbar and Tedesco (1986) estimated the diameter of Pluto as 2300 + or - 100 km and of Charon as 1500 + or - 100 km. The use of IRAS data combined with visual brightness to estimate planet and satellite diameters is examined; Tedesco et al. (1987) estimated Pluto's diameter as 2200 + or - 150 km and Charon's as 1300 + or - 150 km, and Aumann and Walker (1987) obtained estimates of 2360 km for Pluto and 1534 km for Charon. The compositions of Pluto's and Charon's atmospheres are analyzed.

  4. Pluto-Charon solar wind interaction dynamics

    Science.gov (United States)

    Hale, J. P. M.; Paty, C. S.

    2017-05-01

    This work studies Charon's effects on the Pluto-solar wind interaction using a multifluid MHD model which simulates the interactions of Pluto and Charon with the solar wind as well as with each other. Specifically, it investigates the ionospheric dynamics of a two body system in which either one or both bodies possess an ionosphere. Configurations in which Charon is directly upstream and directly downstream of Pluto are considered. Depending on ionospheric and solar wind conditions, Charon could periodically pass into the solar wind flow upstream of Pluto. The results of this study demonstrate that in these circumstances Charon modifies the upstream flow, both in the case in which Charon possesses an ionosphere, and in the case in which Charon is without an ionosphere. This modification amounts to a change in the gross structure of the interaction region when Charon possesses an ionosphere but is more localized when Charon lacks an ionosphere. Furthermore, evidence is shown that supports Charon acting to partially shield Pluto from the solar wind when it is upstream of Pluto, resulting in a decrease in ionospheric loss by Pluto.

  5. The Hawthorne Effect: a randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    van Haselen Robbert

    2007-07-01

    Full Text Available Abstract Background The 'Hawthorne Effect' may be an important factor affecting the generalisability of clinical research to routine practice, but has been little studied. Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge, no attempt has been made to quantify them. Our aim was to compare minimal follow-up to intensive follow-up in participants in a placebo controlled trial of Ginkgo biloba for treating mild-moderate dementia. Methods Participants in a dementia trial were randomised to intensive follow-up (with comprehensive assessment visits at baseline and two, four and six months post randomisation or minimal follow-up (with an abbreviated assessment at baseline and a full assessment at six months. Our primary outcomes were cognitive functioning (ADAS-Cog and participant and carer-rated quality of life (QOL-AD. Results We recruited 176 participants, mainly through general practices. The main analysis was based on Intention to treat (ITT, with available data. In the ANCOVA model with baseline score as a co-variate, follow-up group had a significant effect on outcome at six months on the ADAS-Cog score (n = 140; mean difference = -2.018; 95%CI -3.914, -0.121; p = 0.037 favouring the intensive follow-up group, and on participant-rated quality of life score (n = 142; mean difference = -1.382; 95%CI -2.642, -0.122; p = 0.032 favouring minimal follow-up group. There was no significant difference on carer quality of life. Conclusion We found that more intensive follow-up of individuals in a placebo-controlled clinical trial of Ginkgo biloba for treating mild-moderate dementia resulted in a better outcome than minimal follow-up, as measured by their cognitive functioning. Trial registration Current controlled trials: ISRCTN45577048

  6. Dust ablation in Pluto's atmosphere

    Science.gov (United States)

    Horanyi, Mihaly; Poppe, Andrew; Sternovsky, Zoltan

    2016-04-01

    Based on measurements by dust detectors onboard the Pioneer 10/11 and New Horizons spacecraft the total production rate of dust particles born in the Edgeworth Kuiper Belt (EKB) has been be estimated to be on the order of 5 ṡ 103 kg/s in the approximate size range of 1 - 10 μm. Dust particles are produced by collisions between EKB objects and their bombardment by both interplanetary and interstellar dust particles. Dust particles of EKB origin, in general, migrate towards the Sun due to Poynting-Robertson drag but their distributions are further sculpted by mean-motion resonances as they first approach the orbit of Neptune and later the other planets, as well as mutual collisions. Subsequently, Jupiter will eject the vast majority of them before they reach the inner solar system. The expected mass influx into Pluto atmosphere is on the order of 200 kg/day, and the arrival speed of the incoming particles is on the order of 3 - 4 km/s. We have followed the ablation history as function of speed and size of dust particles in Pluto's atmosphere, and found that volatile rich particles can fully sublimate due to drag heating and deposit their mass in narrow layers. This deposition might promote the formation of the haze layers observed by the New Horizons spacecraft. This talk will explore the constraints on the composition of the dust particles by comparing the altitude of the deposition layers to the observed haze layers.

  7. Where is the Geophysical Evidence for the Giant Impact Origin of the Pluto System?

    Science.gov (United States)

    McKinnon, W. B.; Singer, K. N.; Nimmo, F.; Spencer, J. R.; Young, L. A.; Weaver, H. A., Jr.; Stern, S. A.

    2016-12-01

    Prior to the New Horizons flyby of the Pluto system, it was anticipated that both Pluto and Charon might show geological or geophysical evidence of the giant impact thought responsible for the formation of Charon and the smaller satellites. Although dynamical and compositional evidence still supports the giant impact model (McKinnon et al., submitted to Icarus), the question remains as to whether the geology of Pluto or Charon records evidence of this cataclysm. The collision speed and energy were most likely not large enough to melt all the ices in the precursor bodies, so surviving geological evidence is not out of the question. Specifically, Pluto post-impact should have been rapidly rotating (with a period as short as 5-6 hr) and highly distorted; Charon under most circumstances would have rapidly despun but have been a highly distorted triaxial body. The tidal evolution end state for both is close to spherical, but fossil figures were anticipated, which in addition to providing direct evidence for post-impact tidal evolution, would provide important clues to thermal and structural evolution. For Pluto, McKinnon and Singer (DPS 2014, abs. 419.07) predicted a flattening >1% (radii differences >10 km) for a strengthless icy lithosphere and an unrelaxed rock core. For a fully relaxed core, they predicted a >2-3 km fossil bulge supported by icy lithospheric strength (corresponding to a minimum past lithosphere thickness of 50 km). New Horizons image analyses have limited any oblateness for Pluto to 0.6% (Nimmo et al., Icarus, in press), which corresponds to <7 km flattening. So Pluto may yet possess a geophysically meaningful oblateness, only one not yet directly detectable (moreover, in order to be consistent with the observations, Pluto's rock core either completed its formation post-spindown, or was too weak to support much non-hydrostatic topography). Such an equator-to-pole surface elevation difference, even a subtle one, could express itself through control

  8. The Moons of Uranus, Neptune and Pluto.

    Science.gov (United States)

    Brown, Robert Hamilton; Cruikshank, Dale P.

    1985-01-01

    In preparation for the Voyager flybys in 1989, the pace of ground-based investigations of the moons of Uranus, Neptune, and Pluto has quickened considerably. Information derived from these investigations is presented. (JN)

  9. Surface compositions across Pluto and Charon.

    Science.gov (United States)

    Grundy, W M; Binzel, R P; Buratti, B J; Cook, J C; Cruikshank, D P; Dalle Ore, C M; Earle, A M; Ennico, K; Howett, C J A; Lunsford, A W; Olkin, C B; Parker, A H; Philippe, S; Protopapa, S; Quirico, E; Reuter, D C; Schmitt, B; Singer, K N; Verbiscer, A J; Beyer, R A; Buie, M W; Cheng, A F; Jennings, D E; Linscott, I R; Parker, J Wm; Schenk, P M; Spencer, J R; Stansberry, J A; Stern, S A; Throop, H B; Tsang, C C C; Weaver, H A; Weigle, G E; Young, L A

    2016-03-18

    The New Horizons spacecraft mapped colors and infrared spectra across the encounter hemispheres of Pluto and Charon. The volatile methane, carbon monoxide, and nitrogen ices that dominate Pluto's surface have complicated spatial distributions resulting from sublimation, condensation, and glacial flow acting over seasonal and geological time scales. Pluto's water ice "bedrock" was also mapped, with isolated outcrops occurring in a variety of settings. Pluto's surface exhibits complex regional color diversity associated with its distinct provinces. Charon's color pattern is simpler, dominated by neutral low latitudes and a reddish northern polar region. Charon's near-infrared spectra reveal highly localized areas with strong ammonia absorption tied to small craters with relatively fresh-appearing impact ejecta. Copyright © 2016, American Association for the Advancement of Science.

  10. Surface Compositions Across Pluto and Charon

    CERN Document Server

    Grundy, W M; Buratti, B J; Cook, J C; Cruikshank, D P; Ore, C M Dalle; Earle, A M; Ennico, K; Howett, C J A; Lunsford, A W; Olkin, C B; Parker, A H; Philippe, S; Protopapa, S; Quirico, E; Reuter, D C; Schmitt, B; Singer, K N; Verbiscer, A J; Beyer, R A; Buie, M W; Cheng, A F; Jennings, D E; Linscott, I R; Parker, J Wm; Schenk, P M; Spencer, J R; Stansberry, J A; Stern, S A; Throop, H B; Tsang, C C C; Weaver, H A; Weigle, G E; Young, L A

    2016-01-01

    The New Horizons spacecraft mapped colors and infrared spectra across the encounter hemispheres of Pluto and Charon. The volatile ices CH$_4$, CO, and N$_2$, that dominate Pluto's surface, have complicated spatial distributions resulting from sublimation, condensation, and glacial flow acting over seasonal and geological timescales. Pluto's H$_2$O ice "bedrock" is also mapped, with isolated outcrops occurring in a variety of settings. Pluto's surface exhibits complex regional color diversity associated with its distinct provinces. Charon's color pattern is simpler, dominated by neutral low latitudes and a reddish northern polar region. Charon near infrared spectra reveal highly localized areas with strong NH$_3$ absorption tied to small craters with relatively fresh-appearing impact ejecta.

  11. Geochemistry of Soils from the PLUTO Database

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Geochemical data for soils collected in the United States and analyzed by the USGS. The data were originally entered into the in-house PLUTO database. This is a...

  12. Clobazam: uncontrolled and standard controlled clinical trials.

    Science.gov (United States)

    Ban, T A; Amin, M M

    1979-01-01

    1 In an uncontrolled clinical trial, carried out in 11 psychiatric patients with the clinical diagnoses of anxiety neurosis and depressive neurosis, clobazam, a new benzodiazepine preparation, in the dosage range 10-60 mg daily produced statistically significant improvement in the total and both factor scores of the Hamilton Anxiety Scale (HAM-A). The lowest mean total HAM-A scores occurred with a mean clobazam dosage of 48 mg daily. 2 Results of the uncontrolled clinical trial were further substantiated in a standard-controlled clinical study in which no statistically significant difference between the therapeutic effectiveness of clobazam and diazepam could be revealed. The lowest mean total HAM-A scores occurred with a mean clobazam dosage of 49 mg daily. There was a lower incidence of adverse effects reported in patients receiving clobazam than in those taking the control drug (diazepam).

  13. Discovering Pluto's atmosphere

    Energy Technology Data Exchange (ETDEWEB)

    Beatty, J.K.; Killian, A.

    1988-12-01

    Observations of the occultation of an obscure 12th-magnitude star in eastern Virgo by Pluto on June 9, 1988 are discussed. The occultation was observed by astronomers aboard NASA's Kuiper Airborne Observatory flying over the Pacific. The prediction of the occultation and the results of the observations are examined. The study demonstrated that Pluto has a thin atmosphere and that its diameter is about two-thirds that of the moon.

  14. Discovery of two new satellites of Pluto.

    Science.gov (United States)

    Weaver, H A; Stern, S A; Mutchler, M J; Steffl, A J; Buie, M W; Merline, W J; Spencer, J R; Young, E F; Young, L A

    2006-02-23

    Pluto's first known satellite, Charon, was discovered in 1978. It has a diameter (approximately 1,200 km) about half that of Pluto, which makes it larger, relative to its primary, than any other moon in the Solar System. Previous searches for other satellites around Pluto have been unsuccessful, but they were not sensitive to objects less, similar150 km in diameter and there are no fundamental reasons why Pluto should not have more satellites. Here we report the discovery of two additional moons around Pluto, provisionally designated S/2005 P 1 (hereafter P1) and S/2005 P 2 (hereafter P2), which makes Pluto the first Kuiper belt object known to have multiple satellites. These new satellites are much smaller than Charon, with estimates of P1's diameter ranging from 60 km to 165 km, depending on the surface reflectivity; P2 is about 20 per cent smaller than P1. Although definitive orbits cannot be derived, both new satellites appear to be moving in circular orbits in the same orbital plane as Charon, with orbital periods of approximately 38 days (P1) and approximately 25 days (P2).

  15. The subsurface of Pluto from submillimetre observations

    Science.gov (United States)

    Greaves, J. S.; Whitelaw, A. C. M.; Bendo, G. J.

    2015-04-01

    Surface areas on Pluto change in brightness and colour, at optical to infrared wavelengths, over time-scales as short as years. The subsurface contains a reservoir of frozen volatiles, but little is known about it because Pluto is out of reach for cm-radar. Here we present a 0.85 mm wavelength light curve of the Pluto system, from archival data taken in 1997 August with the SCUBA (Submillimetre Common-User Bolometer Array) camera on the James Clerk Maxwell Telescope (JCMT). This wavelength probes for the first time to just below the skin depth of thermal changes over Pluto's day. The light curve differs significantly from counterparts in the mid- to far-infrared, in a longitude range that is optically dark on Pluto's surface. An estimate from Herschel of the 0.5 mm flux in 2012 is comparable to the mean 0.45 mm flux from SCUBA in 1997, suggesting that layers centimetres below the surface have not undergone any gross temperature change. The longitudes that are relatively submillimetre-faint could have a different emissivity, perhaps with a subsurface layer richer in nitrogen or methane ices than at the surface. The Radio Science Experiment (REX) instrument on New Horizons may be able to constrain physical properties deeper down, as it looks back on Pluto's nightside after the 2015 July flyby.

  16. Results from PLUTO at PETRA

    CERN Document Server

    Blobel, Volker

    1979-01-01

    Results obtained at the e/sup +/e/sup -/ storage ring PETRA by the PLUTO collaboration at c.m. energies of 13, 17 and 27.4 GeV are presented. New limits on QED cut-off parameters are determined from Bhabha scattering; at 27.4 GeV the limits are Lambda /sub +/>38 GeV and Lambda /sub -/>60 GeV. The measured values of the total hadronic cross section, and the study of the jet character of the hadronic events are well consistent with the expected production of b mesons (with q/sub b/=1/3), but do not require additional new quarks with charge 2/3. Hadronic events from two-photon exchange processes are observed with comparable rates as events from one-photon exchange. First results on the hadronic cross section in gamma gamma collisions are given. (8 refs).

  17. Randomised controlled trials: important but overrated?

    LENUS (Irish Health Repository)

    Boylan, J F

    2012-02-01

    Practising physicians individualise treatments, hoping to achieve optimal outcomes by tackling relevant patient variables. The randomised controlled trial (RCT) is universally accepted as the best means of comparison. Yet doctors sometimes wonder if particular patients might benefit more from treatments that fared worse in the RCT comparisons. Such clinicians may even feel ostracised by their peers for stepping outside treatments based on RCTs and guidelines. Are RCTs the only acceptable evaluations of how patient care can be assessed and delivered? In this controversy we explore the interpretation of RCT data for practising clinicians facing individualised patient choices. First, critical care anaesthetists John Boylan and Brian Kavanagh emphasise the dangers of bias and show how Bayesian approaches utilise prior probabilities to improve posterior (combined) probability estimates. Secondly, Jane Armitage, of the Clinical Trial Service Unit in Oxford, argues why RCTs remain essential and explores how the quality of randomisation can be improved through systematic reviews and by avoiding selective reporting.

  18. Geology Before Pluto: Pre-Encounter Considerations

    Science.gov (United States)

    Moore, Jeffrey M.

    2014-01-01

    Pluto, its large satellite Charon, and its four known satellites represent the first trans-Neptunian Kuiper Belt objects populating the outer-most solar system beyond the gas giant planets to be studied in detail from a spacecraft (New Horizons). A complete picture of the solar nebula, and solar system formation cannot be confidently formulated until representatives of this group of bodies at the edge of solar space have been examined. The Pluto system is composed of unique lunar- and intermediate-sized objects that can tell us much about how objects with volatile icy compositions evolve. Modeling of the interior suggests that geologic activity may have been to some degree, and observations of frost on the surface could imply the need for a geologic reservoir for the replenishment of these phases. However, the putative indicators of Pluto's geologic history are inconclusive and unspecific. Detailed examination of Pluto's geologic record is the only plausible means of bridging the gap between theory and observations. In this talk I will examine the potential importance of these tentative indications of geologic activity and how specific spacecraft observations have been designed and used to constrain the Pluto system's geologic history. The cameras of New Horizons will provide robust data sets that should be immanently amenable to geological analysis of the Pluto System's landscapes. In this talk, we begin with a brief discussion of the planned observations by New Horizons' cameras that will bear most directly on geological interpretability. Then I will broadly review major geological processes that could potentially operate of the surfaces of Pluto and its moons. I will first survey exogenic processes (i.e., those for which energy for surface modification is supplied externally to the planetary surface): impact cratering, sedimentary processes (including volatile migration) and the work of wind. I will conclude with an assessment of prospects for endogenic activity

  19. Detection of CO and HCN in Pluto's atmosphere with ALMA

    Science.gov (United States)

    Lellouch, E.; Gurwell, M.; Butler, B.; Fouchet, T.; Lavvas, P.; Strobel, D. F.; Sicardy, B.; Moullet, A.; Moreno, R.; Bockelée-Morvan, D.; Biver, N.; Young, L.; Lis, D.; Stansberry, J.; Stern, A.; Weaver, H.; Young, E.; Zhu, X.; Boissier, J.

    2017-04-01

    stratopause temperature. The HCN column is (1.6 ± 0.4)× 1014 cm-2 , suggesting a surface-referred vertically-integrated net production rate of ∼2 × 107 cm-2 s-1. Although HCN rotational line cooling affects Pluto's atmosphere heat budget, the amounts determined in this study are insufficient to explain the well-marked mesosphere and upper atmosphere's ∼70 K temperature, which if controlled by HCN cooling would require HCN mole fractions of (3-7) ×10-4 over 400-800 km. We finally report an upper limit on the HC3N column density (<2 × 1013 cm-2) and on the HC15N / HC14N ratio (<1/125).

  20. Formation and evolution of Pluto's small satellites

    CERN Document Server

    Walsh, Kevin J

    2015-01-01

    Pluto's system of 5 known satellites are in a puzzling orbital configuration. Each of the four small satellites are on low-eccentricity and low-inclination orbits situated near a mean motion resonance with the largest satellite Charon. The Pluto-Charon binary likely formed as a result of a giant impact and so the simplest explanation for the small satellites is that they accreted from debris of that collision. The Pluto-Charon binary has evolved outward since its formation due to tidal forces, which drove them into their current doubly synchronous state. Meanwhile, leftover debris from the formation of Charon was not initially distant enough from Pluto-Charon to explain the orbits of the current small satellites. The outstanding problems of the system are the movement of debris outward and the small satellites location near mean motion resonances with Charon. This work explores the dynamical behavior of collisionally interacting debris orbiting the Pluto-Charon system. While this work specifically tests initi...

  1. Diagnostic randomized controlled trials: the final frontier.

    Science.gov (United States)

    Rodger, Marc; Ramsay, Tim; Fergusson, Dean

    2012-08-16

    Clinicians, patients, governments, third-party payers, and the public take for granted that diagnostic tests are accurate, safe and effective. However, we may be seriously misled if we are relying on robust study design to ensure accurate, safe, and effective diagnostic tests. Properly conducted, randomized controlled trials are the gold standard for assessing the effectiveness and safety of interventions, yet are rarely conducted in the assessment of diagnostic tests. Instead, diagnostic cohort studies are commonly performed to assess the characteristics of a diagnostic test including sensitivity and specificity. While diagnostic cohort studies can inform us about the relative accuracy of an experimental diagnostic intervention compared to a reference standard, they do not inform us about whether the differences in accuracy are clinically important, or the degree of clinical importance (in other words, the impact on patient outcomes). In this commentary we provide the advantages of the diagnostic randomized controlled trial and suggest a greater awareness and uptake in their conduct. Doing so will better ensure that patients are offered diagnostic procedures that will make a clinical difference.

  2. Recent randomized controlled trials in otolaryngology.

    Science.gov (United States)

    Banglawala, Sarfaraz M; Lawrence, Lauren A; Franko-Tobin, Emily; Soler, Zachary M; Schlosser, Rodney J; Ioannidis, John

    2015-03-01

    To assess recent trends in the prevalence and quality of reporting of randomized controlled trials (RCTs) in 4 otolaryngology journals. Methodology and reporting analysis. Randomized controlled trials in 4 otolaryngology journals. All RCTs published from 2011 to 2013 in 4 major otolaryngology journals were examined for characteristics of study design, quality of design and reporting, and funding. Of 5279 articles published in 4 leading otolaryngology journals from 2011 to 2013, 189 (3.3%) were RCTs. The majority of RCTs were clinical studies (86%), with the largest proportion consisting of sinonasal topics (31%). Most interventions were medical (46%), followed by surgical (38%) and mixed (16%). In terms of quality, randomization method was reported in 54% of RCTs, blinding in 33%, and adverse events in 65%. Intention-to-treat analysis was used in 32%; P values were reported in 87% and confidence intervals in 10%. Research funding was most often absent or not reported (55%), followed by not-for-profit (25%). Based on review of 4 otolaryngology journals, RCTs are still a small proportion of all published studies in the field of otolaryngology. There seem to be trends toward improvement in quality of design and reporting of RCTs, although many quality features remain suboptimal. Practitioners both designing and interpreting RCTs should critically evaluate RCTs for quality. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  3. Is Pluto a planet? Student powered video rap ';battle' over tiny Pluto's embattled planetary standing

    Science.gov (United States)

    Beisser, K.; Cruikshank, D. P.; McFadden, T.

    2013-12-01

    Is Pluto a planet? Some creative low income Bay-area middle-schoolers put a musical spin on this hot science debate with a video rap ';battle' over tiny Pluto's embattled planetary standing. The students' timing was perfect, with NASA's New Horizons mission set to conduct the first reconnaissance of Pluto and its moons in July 2015. Pluto - the last of the nine original planets to be explored by spacecraft - has been the subject of scientific study and speculation since Clyde Tombaugh discovered it in 1930, orbiting the Sun far beyond Neptune. Produced by the students and a very creative educator, the video features students 'battling' back and forth over the idea of Pluto being a planet. The group collaborated with actual space scientists to gather information and shot their video before a 'green screen' that was eventually filled with animations and visuals supplied by the New Horizons mission team. The video debuted at the Pluto Science Conference in Maryland in July 2013 - to a rousing response from researchers in attendance. The video marks a nontraditional approach to the ongoing 'great planet debate' while educating viewers on a recently discovered region of the solar system. By the 1990s, researchers had learned that Pluto possessed multiple exotic ices on its surface, a complex atmosphere and seasonal cycles, and a large moon (Charon) that likely resulted from a giant impact on Pluto itself. It also became clear that Pluto was no misfit among the planets - as had long been thought - but the largest and brightest body in a newly discovered 'third zone' of our planetary system called the Kuiper Belt. More recent observations have revealed that Pluto has a rich system of satellites - five known moons - and a surface that changes over time. Scientists even speculate that Pluto may possess an internal ocean. For these and other reasons, the 2003 Planetary Decadal Survey ranked a Pluto/Kuiper Belt mission as the highest priority mission for NASA's newly created

  4. New Horizons: Gas and Plasma in the Pluto System

    Science.gov (United States)

    Young, Leslie; Gladstone, Randy; Summers, Michael; Bagenal, Fran; Stern, S. Alan; Weaver, Harold A.; Olkin, Catherine B.; Ennico, Kimberly; Moore, Jeffrey M.; Grundy, William M.; New Horizons Atmospheres Science Theme Team, New Horizons Particles and Plasma Science Theme Team

    2016-10-01

    NASA's New Horizons mission gave us information about gas and plasma in the Pluto system from Pluto's surface up to a distance of ~200,000 km beyond Pluto. This review will give an overview of our current theories and observations of the near-surface atmospheric structure; the properties, production and settling of Pluto's ubiquitous haze; the minor atmospheric species and atmospheric chemistry; the energetics and high-altitude thermal structure; the escape rate and the pickup of methane ions; the effect of methane impacting Charon; and Pluto's heavy-ion tail. Details are given in other presentations at this conference.This work was supported by NASA's New Horizons project.

  5. Resolved CCD Photometry of Pluto and Charon

    Energy Technology Data Exchange (ETDEWEB)

    Jones, J.H.; Waddell, P.; Christian, C.A.

    1988-04-01

    Highly resolved CCD images of Pluto and Charon near maximum separation are measured with point spread function fitting techniques to determine independent magnitudes and an accurate separation for Pluto and Charon. A measured separation of 0.923 + or - 0.005 arcsec at a position angle of 173.3 + or - 0.3 deg on June 18, 1987 UT produced a value of 19558.0 + or - 153.0 km for the radius of Charon's orbit. An apparent B magnitude of 14.877 + or - 0.009 and (B-I) color of 1.770 + or - 0.015 are determined for Pluto, while Charon is fainter with B = 18.826 + or - 0.011 and slightly bluer with (B-I) = 1.632 + or - 0.018. 18 references.

  6. TPCI: The PLUTO-CLOUDY Interface

    CERN Document Server

    Salz, M; Mignone, A; Schneider, P C; Czesla, S; Schmitt, J H M M

    2015-01-01

    We present an interface between the (magneto-) hydrodynamics code PLUTO and the plasma simulation and spectral synthesis code CLOUDY. By combining these codes, we constructed a new photoionization hydrodynamics solver: The PLUTO-CLOUDY Interface (TPCI), which is well suited to simulate photoevaporative flows under strong irradiation. The code includes the electromagnetic spectrum from X-rays to the radio range and solves the photoionization and chemical network of the 30 lightest elements. TPCI follows an iterative numerical scheme: First, the equilibrium state of the medium is solved for a given radiation field by CLOUDY, resulting in a net radiative heating or cooling. In the second step, the latter influences the (magneto-) hydrodynamic evolution calculated by PLUTO. Here, we validated the one-dimensional version of the code on the basis of four test problems: Photoevaporation of a cool hydrogen cloud, cooling of coronal plasma, formation of a Stroemgren sphere, and the evaporating atmosphere of a hot Jupi...

  7. Craters of the Pluto-Charon system

    Science.gov (United States)

    Robbins, Stuart J.; Singer, Kelsi N.; Bray, Veronica J.; Schenk, Paul; Lauer, Tod R.; Weaver, Harold A.; Runyon, Kirby; McKinnon, William B.; Beyer, Ross A.; Porter, Simon; White, Oliver L.; Hofgartner, Jason D.; Zangari, Amanda M.; Moore, Jeffrey M.; Young, Leslie A.; Spencer, John R.; Binzel, Richard P.; Buie, Marc W.; Buratti, Bonnie J.; Cheng, Andrew F.; Grundy, William M.; Linscott, Ivan R.; Reitsema, Harold J.; Reuter, Dennis C.; Showalter, Mark R.; Tyler, G. Len; Olkin, Catherine B.; Ennico, Kimberly S.; Stern, S. Alan; New Horizons Lorri, Mvic Instrument Teams

    2017-05-01

    NASA's New Horizons flyby mission of the Pluto-Charon binary system and its four moons provided humanity with its first spacecraft-based look at a large Kuiper Belt Object beyond Triton. Excluding this system, multiple Kuiper Belt Objects (KBOs) have been observed for only 20 years from Earth, and the KBO size distribution is unconstrained except among the largest objects. Because small KBOs will remain beyond the capabilities of ground-based observatories for the foreseeable future, one of the best ways to constrain the small KBO population is to examine the craters they have made on the Pluto-Charon system. The first step to understanding the crater population is to map it. In this work, we describe the steps undertaken to produce a robust crater database of impact features on Pluto, Charon, and their two largest moons, Nix and Hydra. These include an examination of different types of images and image processing, and we present an analysis of variability among the crater mapping team, where crater diameters were found to average ± 10% uncertainty across all sizes measured (∼0.5-300 km). We also present a few basic analyses of the crater databases, finding that Pluto's craters' differential size-frequency distribution across the encounter hemisphere has a power-law slope of approximately -3.1 ± 0.1 over diameters D ≈ 15-200 km, and Charon's has a slope of -3.0 ± 0.2 over diameters D ≈ 10-120 km; it is significantly shallower on both bodies at smaller diameters. We also better quantify evidence of resurfacing evidenced by Pluto's craters in contrast with Charon's. With this work, we are also releasing our database of potential and probable impact craters: 5287 on Pluto, 2287 on Charon, 35 on Nix, and 6 on Hydra.

  8. Craters of the Pluto-Charon System

    Science.gov (United States)

    Robbins, Stuart J.; Singer, Kelsi N.; Bray, Veronica J.; Schenk, Paul; Lauer, Todd R.; Weaver, Harold A.; Runyon, Kirby; Mckinnon, William B.; Beyer, Ross A.; Porter, Simon; hide

    2016-01-01

    NASA's New Horizons flyby mission of the Pluto-Charon binary system and its four moons provided humanity with its first spacecraft-based look at a large Kuiper Belt Object beyond Triton. Excluding this system, multiple Kuiper Belt Objects (KBOs) have been observed for only 20 years from Earth, and the KBO size distribution is unconstrained except among the largest objects. Because small KBOs will remain beyond the capabilities of ground-based observatories for the foreseeable future, one of the best ways to constrain the small KBO population is to examine the craters they have made on the Pluto-Charon system. The first step to understanding the crater population is to map it. In this work, we describe the steps undertaken to produce a robust crater database of impact features on Pluto, Charon, and their two largest moons, Nix and Hydra. These include an examination of different types of images and image processing, and we present an analysis of variability among the crater mapping team, where crater diameters were found to average +/-10% uncertainty across all sizes measured (approx.0.5-300 km). We also present a few basic analyses of the crater databases, finding that Pluto's craters' differential size-frequency distribution across the encounter hemisphere has a power-law slope of approximately -3.1 +/- 0.1 over diameters D approx. = 15-200 km, and Charon's has a slope of -3.0 +/- 0.2 over diameters D approx. = 10-120 km; it is significantly shallower on both bodies at smaller diameters. We also better quantify evidence of resurfacing evidenced by Pluto's craters in contrast with Charon's. With this work, we are also releasing our database of potential and probable impact craters: 5287 on Pluto, 2287 on Charon, 35 on Nix, and 6 on Hydra.

  9. Beyond the New Horizon: The Future of Pluto

    CERN Document Server

    Lund, Michael B

    2015-01-01

    Since its discovery in 1930, Pluto's mass has been a value that has repeatedly been calculated. Additionally, the search for Planet X prior to Pluto's discovery results in mass calculations that date back several decades earlier. Over its observed history, the mass of Pluto has consistently decreased. We reassess earlier predictions of Pluto's fate, and rule out the hypothesis that Pluto's mass has been constant over the last century. We are able to fit linear and quadratic equations to Pluto's mass as a function of both time and distance. The observations that will be made by New Horizons will help to determine if we can expect Pluto to continue to shrink until it has negative mass, or if it will begin to increase in mass again.

  10. Increasing recruitment to randomised trials: a review of randomised controlled trials

    Directory of Open Access Journals (Sweden)

    Torgerson David J

    2006-07-01

    Full Text Available Abstract Background Poor recruitment to randomised controlled trials (RCTs is a widespread and important problem. With poor recruitment being such an important issue with respect to the conduct of randomised trials, a systematic review of controlled trials on recruitment methods was undertaken in order to identify strategies that are effective. Methods We searched the register of trials in Cochrane library from 1996 to end of 2004. We also searched Web of Science for 2004. Additional trials were identified from personal knowledge. Included studies had to use random allocation and participants had to be allocated to different methods of recruitment to a 'real' randomised trial. Trials that randomised participants to 'mock' trials and trials of recruitment to non-randomised studies (e.g., case control studies were excluded. Information on the study design, intervention and control, and number of patients recruited was extracted by the 2 authors. Results We identified 14 papers describing 20 different interventions. Effective interventions included: telephone reminders; questionnaire inclusion; monetary incentives; using an 'open' rather than placebo design; and making trial materials culturally sensitive. Conclusion Few trials have been undertaken to test interventions to improve trial recruitment. There is an urgent need for more RCTs of recruitment strategies.

  11. Randomized controlled trials of COX-2 inhibitors

    DEFF Research Database (Denmark)

    Stefansdottir, Gudrun; De Bruin, Marie L; Knol, Mirjam J

    2011-01-01

    BACKGROUND: Naproxen, ibuprofen and diclofenac are frequently used as comparators in randomized controlled trials (RCTs) on the safety and efficacy of cyclooxygenase (COX)-2 inhibitors. Different comparator doses may influence the results of RCTs. It has been hypothesized that RCTs of COX-2...... 1995 and 2009 in which celecoxib or rofecoxib were compared with naproxen, ibuprofen or diclofenac. All articles labelled as RCTs mentioning rofecoxib or celecoxib and one or more of the comparator drugs in the title and/or abstract were included. We extracted information on doses of both non...... dose trends in the case of rofecoxib. CONCLUSIONS: Although the dose trends over time differed for RCTs comparing rofecoxib and celecoxib with diclofenac, ibuprofen or naproxen, the results of our study do not support the hypothesis that dose trends influenced the decision to continue marketing...

  12. Enhancing adoptive parenting: a randomized controlled trial.

    Science.gov (United States)

    Rushton, Alan; Monck, Elizabeth; Leese, Morven; McCrone, Paul; Sharac, Jessica

    2010-10-01

    The aim was to conduct a pragmatic randomized controlled trial (RCT) to evaluate two parenting programmes designed for adopters of children late placed from care. Adoptive parents, with children between 3 and 8 years who were screened to have serious behavioural problems early in the placement, participated in home-based, manualized, parenting programmes delivered by trained and supervised family social workers. The adopters who agreed to join the study were randomly allocated to one of two parenting interventions or to a "services as usual" group. Baseline, immediate post-intervention and six-month follow-ups were assessed using questionnaires and adopter interviews. No cases were lost to follow-up at any point and satisfaction was high with both parenting interventions. At the six-month follow-up, a significant difference (p parenting" in favour of the intervention group (Effect Size d = 0.7). Negative parenting approaches were reduced in the intervention group. However, no significant differences in child problems were found between the intervention groups and control group, adjusting for baseline scores. Costs analysis showed that a relatively modest investment in post-adoption support would be well spent in improving adopters' satisfaction with parenting in the intervention group compared to the routine service group.

  13. Landslides on Charon and not on Pluto

    Science.gov (United States)

    Beyer, Ross A.; Singer, Kelsi N.; Nimmo, Francis; Moore, Jeffrey M.; McKinnon, William B.; Schenk, Paul M.; Spencer, John R.; Weaver, Harold A.; Olkin, Catherine B.; Young, Leslie; Ennico, Kimberly; Stern, S. Alan; New Horizons Science Team

    2016-10-01

    Landslide features are observed on Charon but not on Pluto. This observation is another that reinforces the different strength regime of surface materials on the two bodies. Pluto's surface, although underlain by strong water ice, is primarily mantled with a variety of geologically weak ice species. Observations of these features indicate that they flow and move, but do so in a manner similar to glacial flow, and the strength and steepening required to precipitate a landslide simply isn't present in these materials under the pressure and temperature conditions on Pluto's surface. There are certainly areas of local mass-wasting, but no substantial landslide deposits. There are some locations on Pluto, notably along the fossae walls, and perhaps on the steeper montes surfaces that could have fostered landslides, but no landslide deposits have been observed nor are there obvious landslide alcoves that would have sourced them. The resolution of observations along the fossae may prevent identification there, and the toes of the steeper montes are embayed by geologically recent plains material which could be overlaying any landslide deposits.Charon, however, has a water-ice surface which exhibits many strength-dominated geologic features, and also exhibits landslide deposits. There are not many of these features and they are confined to the informally named Serenity Chasma, which has relatively steep, tall slopes, perfect for landslide initiation. We will discuss the physical characteristics of these landslide deposits and their context amongst other landslide features in the solar system.

  14. Climate zones on Pluto and Charon

    Science.gov (United States)

    Binzel, Richard P.; Earle, Alissa M.; Buie, Marc W.; Young, Leslie A.; Stern, S. Alan; Olkin, Cathy B.; Ennico, Kimberly; Moore, Jeffrey M.; Grundy, Will; Weaver, Harold A.; Lisse, Carey M.; Lauer, Tod R.

    2017-05-01

    We give an explanatory description of the unusual ;climate zones; on Pluto that arise from its high obliquity (mean 115°) and high amplitude (±12°) of obliquity oscillation over a 2.8 million year period. The zones we describe have astronomically defined boundaries and do not incorporate atmospheric circulation. For such a high mean obliquity, the lines of tropics (greatest latitudes where the Sun can be overhead) cycle closer to each pole than does each arctic circle, which in turn cycle nearly to the equator. As a consequence in an astronomical context, Pluto is more predominantly ;tropical; than ;arctic.; Up to 97% of Pluto's surface area can experience overhead Sun when the obliquity cycle is at its minimum of 103°. At this same obliquity phase (most recently occurring 0.8 Myr ago), 78% of Pluto's surface experienced prolonged intervals without sunlight or ;arctic winter; (and corresponding ;arctic summer;). The intersection of these climate zones implies that a very broad range of Pluto's latitudes (spanning 13-77° in each hemisphere; 75% of the total surface area) are both tropical and arctic. While some possible correlations to these climate zones are suggested by comparison with published maps of Pluto and Charon yielded by the New Horizons mission, in this work we present a non-physical descriptive analysis only. For example, the planet-wide dark equatorial band presented by Stern et al. (2015; Science, 350, 292-299) corresponds to Pluto's permanent ;diurnal zone.; In this zone spanning latitudes within ±13° of the equator, day-night cycles occur each Pluto rotation (6.4 days) such that neither ;arctic winter; nor ;arctic summer; has been experienced in this zone for at least 20 million years. The stability of this and other climate zones may extend over several Gyr. Temperature modeling shows that the continuity of diurnal cycles in this region may be the key factor enabling a long-term stability for the high albedo contrast between Tombaugh Regio

  15. Exploring potential Pluto-generated neutral tori

    Science.gov (United States)

    Smith, Howard T.; Hill, Matthew; KollMann, Peter; McHutt, Ralph

    2015-11-01

    The NASA New Horizons mission to Pluto is providing unprecedented insight into this mysterious outer solar system body. Escaping molecular nitrogen is of particular interest and possibly analogous to similar features observed at moons of Saturn and Jupiter. Such escaping N2 has the potential of creating molecular nitrogen and N (as a result of molecular dissociation) tori or partial toroidal extended particle distributions. The presence of these features would present the first confirmation of an extended toroidal neutral feature on a planetary scale in our solar system. While escape velocities are anticipated to be lower than those at Enceladus, Io or even Europa, particle lifetimes are much longer in Pluto’s orbit because as a result of much weaker solar interaction processes along Pluto’s orbit (on the order of tens of years). Thus, with a ~248 year orbit, Pluto may in fact be generating an extended toroidal feature along it orbit.For this work, we modify and apply our 3-D Monte Carlo neutral torus model (previously used at Saturn, Jupiter and Mercury) to study/analyze the theoretical possibility and scope of potential Pluto-generated neutral tori. Our model injects weighted particles and tracks their trajectories under the influence of all gravitational fields with interactions with other particles, solar photons and Pluto collisions. We present anticipated N2 and N tori based on current estimates of source characterization and environmental conditions. We also present an analysis of sensitivity to assumed initial conditions. Such results can provide insight into the Pluto system as well as valuable interpretation of New Horizon’s observational data.

  16. A Randomized, Controlled Clinical Trial Comparing Efficacy, Safety ...

    African Journals Online (AJOL)

    A Randomized, Controlled Clinical Trial Comparing Efficacy, Safety and Cost Effectiveness of ... Log in or Register to get access to full text downloads. ... Pharmacological control of pain is the mainstay of management of osteoarthritis.

  17. [Placebo control and clinical trial of Chinese medicine].

    Science.gov (United States)

    Wu, Jing

    2010-10-01

    World Health Organization aims to develop safe, effective and practical traditional medicine. Traditional Chinese medicine (TCM) and other complementary and alternative medicine are being recognized in the whole world nowadays. However, the definite effect of Chinese medicine is still in need of scientific research proof. Placebo control is of equal importance to active control and blank control in clinical trial of TCM. This article briefly reviewed the importance of placebo control and commented on its present situation in clinical trial of TCM. This article also brought up the preliminary proposals of placebo application in TCM clinical trial. We should emphasize scientific placebo preparation and good design of placebo-controlled trial, which are directed by International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use. A good clinical trial project will avoid unnecessary wastes and provide safe and effective treatment for people.

  18. Past epochs of significantly higher pressure atmospheres on Pluto

    Science.gov (United States)

    Stern, S. A.; Binzel, R. P.; Earle, A. M.; Singer, K. N.; Young, L. A.; Weaver, H. A.; Olkin, C. B.; Ennico, K.; Moore, J. M.; McKinnon, W. B.; Spencer, J. R.; New Horizons Geology; Geophysics; Atmospheres Teams

    2017-05-01

    Pluto is known to have undergone thousands of cycles of obliquity change and polar precession. These variations have a large and corresponding impact on the total average solar insolation reaching various places on Pluto's surface as a function of time. Such changes could produce dramatic increases in surface pressure and may explain certain features observed by New Horizons on Pluto's surface, including some that indicate the possibility of surface paleo-liquids. This paper is the first to discuss multiple lines of geomorphological evidence consistent with higher pressure epochs in Pluto's geologic past, and it also the first to provide a mechanism for potentially producing the requisite high pressure conditions needed for an environment that could support liquids on Pluto. The presence of such liquids and such conditions, if borne out by future work, would fundamentally affect our view of Pluto's past climate, volatile transport, and geological evolution. This paper motivates future, more detailed climate modeling and geologic interpretation efforts in this area.

  19. Pragmatic design in randomized controlled trials.

    Science.gov (United States)

    Purgato, M; Barbui, C; Stroup, S; Adams, C

    2015-01-01

    At more than 10 years after the paper by Hotopf and colleagues regarding pragmatic trials in psychiatry, the field has evolved and is evolving further. There have been many developments in our understanding of what pragmatism really means, and excellent examples of truly pragmatic trials in psychiatry are currently available. Funders have helped encourage more emphasis on the need for such studies, but 'local' and trans-national regulations could help more. Consumers of the evidence should have a greater voice in generating the research agenda and, as this happens, the questions generated are more likely to be answered by a pragmatic approach to trials.

  20. Pluto - comments on crustal composition, evidence for global differentiation

    Energy Technology Data Exchange (ETDEWEB)

    Stern, S.A. (Colorado Univ., Boulder (USA))

    1989-09-01

    Evidence is presented in support of the hypothesis that the crust of Pluto consists of nearly pure volatiles and that Pluto has differentiated. The evidence includes the rapid atmospheric escape rate and the presence of methane frost on Pluto. Consideration is given to the implications of the hypothesis, including atmospheric and surface composition, topography, and the implications for Charon and other bodies. The possibility of conducting observations to test the theory is discussed. 33 refs.

  1. Tholins as Coloring Agents on Pluto

    Science.gov (United States)

    Cruikshank, D. P.; Materese, C. K.; Imanaka, H.; Dalle Ore, C.; Sandford, S. A.; Nuevo, M.

    2015-12-01

    The shape of the reflectance spectrum of Pluto recorded with telescopes, 0.3-1.0 μm, shows the planet's yellow-red color (1). Additionally, multi-filter images of Pluto with the MVIC camera on the New Horizons spacecraft report concentrations of the coloring agent(s) in some regions of the surface, and apparent near absence in other regions. Tholins are refractory organic solids of complex structure and high molecular weight, with a wide range of color ranging from yellow and orange to dark red, and through tan to black. They are readily synthesized in the laboratory by energetic processing of mixtures of the ices (N2, CH4, CO) known on Pluto's surface (2), or the same molecules in the gas phase (3). Energy in the form of UV light, electrons, protons, or coronal discharge are all effective to one degree or another in producing various types of tholins; details of the composition and yield vary with experimental conditions. Chemical analysis of ice tholins shows carboxylic acids, urea, and HCN and other nitriles. Aromatic/olefinic, amide, and other functional groups are identified in XANES analysis (4). The ice tholins produce by e- irradiation have a higher concentration of N than UV ice tholins, with N/C ~0.9 (versus ~0.5 for UV tholins) and O/C~0.2. EUV photolysis of Pluto atmosphere analog yields pale yellow solids relatively transparent in the visual, and with aliphatic CH bonds prominent in IR spectra. This material may be responsible for Pluto's hazes (5). Various tholins are the principal coloring agents on Pluto's surface, probably Charon's colored region, and on numerous other outer Solar System bodies (6). Refs: 1. Cruikshank, D. P. et al. 2014 DPS abstract #419.04; 2. Cruikshank et al. 2015 Icarus 246, 82; 3. Krasnopolsky & Cruikshank 1999 JGR 104 E9, 21,979; 4. Materese, C. K. et al. 2014 Ap.J. 788:111, June 20; 5. Imanaka, H. et al. 2014 DPS abstract #419.10; 6. Cruikshank, D. P. et al. 2005 Adv. Space Res. 36, 178.

  2. Spectroscopy of Pluto's Small Satellites

    Science.gov (United States)

    Cook, Jason C.; Cruikshank, Dale P.; Dalle Ore, Cristina M.; Ennico, Kimberly; Grundy, William M.; Olkin, Catherine B.; Philippe, Sylvain; Protopapa, Silvia; Schmitt, Bernard; Stern, S. Alan; Weaver, Harold A.; Young, Leslie; New Horizons Surface Composition Theme Team

    2016-10-01

    On July 14, 2015, New Horizons made its closest approach to the Pluto system. Among its many tasks were spectroscopic observations of Nix, Hydra and Kerberos using LEISA (Linear Etalon Imaging Spectral Array), the near infrared imaging spectrograph, and component of the Ralph instrument (Reuter, D.C., Stern, S.A., Scherrer, J., et al. 2008, Space Sci. Rev. 140, 129). Shapes and composition inferred from images were discussed in Weaver et al. (2016, Science, 351). Styx was not observed with LEISA because it was too distant and faint.Observations of Nix were made at 60,000 and 162,000 km from New Horizons. At best, Nix filled ˜130 LEISA pixels. At the continuum level, the disk integrated spectrum has an I/F˜0.4 and a blue slope. Evident in the spectrum are deep bands at 1.5, 1.65 and 2.0 μm, indicating crystalline H2O-ice. At band minimum, the I/F˜0.1 and 0.05 for the 1.5 and 2.0 μm bands, respectively. These nearly saturated bands suggest that H2O-ice is either large grained or very pure. We also see an absorption band at 2.21 μm that well matches NH3-hydrate.Observations of Hydra were made at 240,000 and 370,000 km from New Horizons. Hydra was barely resolved and covered ˜3-5 LEISA pixels. Hydra's spectrum has a continuum I/F˜0.35, a blue slope weaker than Nix's, crystalline H2O-ice and the 1.5 and 2.0 μm bands have minimum I/F˜0.12 and 0.07, respectively. Since the bands on Hydra are slightly weaker, the H2O-ice grains are either smaller or contaminated by a greater fraction of dark material. Hydra's spectrum also shows the NH3-hydrate absorption at 2.21 μm, but like the H2O-ice bands, it too appears weaker on Hydra than Nix.Finally, New Horizons made a LEISA observation of Kerberos at 394,000 km distance. At a scale of 24 km/pix, Kerberos fills ˜40% of a LEISA pixel. The signal-to-noise of the data is low. Nonetheless, we attempt to extract the spectrum.At DPS, we will present spectra of all three objects, examine the disk resolved spectra of Nix

  3. Challenges of randomized controlled trial design in plastic surgery.

    Science.gov (United States)

    Hassanein, Aladdin H; Herrera, Fernando A; Hassanein, Omar

    2011-01-01

    Randomized controlled trials are the gold standard of evidence-based medicine. In the field of plastic surgery, designing these studies is much more challenging than in pharmaceutical medicine. Randomized trials in plastic surgery encompass several road blocks including problems shared with other surgical trials: equipoise, high cost, placebo issues and learning curves following the establishment of a novel approach. In addition, plastic surgery has more subjective outcomes, thus making study design even more difficult in assessing the end result.

  4. Design of the Pluto Event Generator

    CERN Document Server

    Fröhlich, I; Holzmann, R; Markert, J; Ramstein, B; Salabura, P; Stroth, J

    2009-01-01

    We present the design of the simulation package Pluto, aimed at the study of hadronic interactions at SIS and FAIR energies. Its main mission is to offer a modular framework with an object-oriented structure, thereby making additions such as new particles, decays of resonances, new models up to modules for entire changes easily applicable. Overall consistency is ensured by a plugin- and distribution manager. Particular features are the support of a modular structure for physics process descriptions, and the possibility to access the particle stream for on-line modifications. Additional configuration and self-made classes can be attached by the user without re-compiling the package, which makes Pluto extremely configurable.

  5. Design of the pluto event generator

    Energy Technology Data Exchange (ETDEWEB)

    Froehlich, I; Galatyuk, T; Markert, J; Stroth, J [Institut fuer Kernphysik, Goethe-Universitaet, 60438 Frankfurt (Germany); Holzmann, R; Salabura, P [GSI Helmholtzzentrum fuer Schwerionenforschung GmbH, 64291 Darmstadt (Germany); Ramstein, B, E-mail: Froehlich@physik.uni-frankfurt.d [Institut de Physique Nucleaire d' Orsay, CNRS/IN2P3, 91406 Orsay Cedex (France)

    2010-04-01

    We present the design of the simulation package Pluto, aimed at the study of hadronic interactions at SIS and FAIR energies. Its main mission is to offer a modular framework with an object-oriented structure, thereby making additions such as new particles, decays of resonances, new models up to modules for entire changes easily applicable. Overall consistency is ensured by a plugin- and distribution manager. Particular features are the support of a modular structure for physics process descriptions, and the possibility to access the particle stream for on-line modifications. Additional configuration and self-made classes can be attached by the user without re-compiling the package, which makes Pluto extremely configurable.

  6. Impact and cratering rates onto Pluto

    Science.gov (United States)

    Greenstreet, Sarah; Gladman, Brett; McKinnon, William B.

    2015-09-01

    The New Horizons spacecraft fly-through of the Pluto system in July 2015 will provide humanity's first data for the crater populations on Pluto and its binary companion, Charon. In principle, these surfaces could be dated in an absolute sense, using the observed surface crater density (# craters/km2 larger than some threshold crater diameter D). Success, however, requires an understanding of both the cratering physics and absolute impactor flux. The Canada-France Ecliptic Plane Survey (CFEPS) L7 synthetic model of classical and resonant Kuiper belt populations (Petit, J.M. et al. [2011]. Astron. J. 142, 131-155; Gladman, B. et al. [2012]. Astron. J. 144, 23-47) and the scattering object model of Kaib et al. (Kaib, N., Roškar, R., Quinn, T. [2011]. Icarus 215, 491-507) calibrated by Shankman et al. (Shankman, C. et al. [2013]. Astrophys. J. 764, L2-L5) provide such impact fluxes and thus current primary cratering rates for each dynamical sub-population. We find that four sub-populations (the q 100km) connects to smaller projectiles, we compute cratering rates using five model impactor size distributions: a single power-law, a power-law with a knee, a power-law with a divot, as well as the "wavy" size distributions described in Minton et al. (Minton, D.A. et al. [2012]. Asteroids Comets Meteors Conf. 1667, 6348) and Schlichting et al. (Schlichting, H.E., Fuentes, C.I., Trilling, D.E. [2013]. Astron. J. 146, 36-42). We find that there is only a small chance that Pluto has been hit in the past 4 Gyr by even one impactor with a diameter larger than the known break in the projectile size distribution (d ≈ 100km) which would create a basin on Pluto (D ⩾ 400km in diameter). We show that due to present uncertainties in the impactor size distribution between d = 1- 100km , computing absolute ages for the surface of Pluto is entirely dependent on the extrapolation to small sizes and thus fraught with uncertainty. We show, however, what the ages would be for several cases

  7. Surface Compositions Across Pluto and Charon

    Science.gov (United States)

    Grundy, W. M.; Binzel, R. P.; Buratti, B. J.; Cook, J. C.; Cruikshank, D. P.; Dalle Ore, C. M.; Earle, A. M.; Ennico, K.; Howett, C. J. A.; Lunsford, A. W.; hide

    2016-01-01

    The Kuiper Belt hosts a swarm of distant, icy objects ranging in size from small, primordial planetesimals to much larger, highly evolved objects, representing a whole new class of previously unexplored cryogenic worlds. Pluto, the largest among them, along with its system of five satellites, has been revealed by NASAs New Horizons spacecraft flight through the system in July 2015, nearly a decade after its launch.

  8. New Horizons Pluto Flyby Guest Operations

    Science.gov (United States)

    Simon, M.; Turney, D.; Fisher, S.; Carr, S. S.

    2015-12-01

    On July 14, 2015, after 9.5 years of cruise, NASA's New Horizons spacecraft flew past the Pluto system to gather first images humankind had ever seen on Pluto and its five moons. While much has been discovered about the Pluto system since New Horizons launch in 2006, the system has never been imaged at high resolution and anticipation of the "First Light" of the Pluto system had been anticipated by planetary enthusiasts for decades. The Johns Hopkins Applied Physics Laboratory (APL), which built and operates New Horizons, was the focal point for gathering three distinct groups: science and engineering team members; media and public affairs representatives; and invited public, including VIP's. Guest operations activities were focused on providing information primarily to the invited public and VIP's. High level objectives for the Guest Operations team was set to entertain and inform the general public, offer media reaction shots, and to deconflict activities for the guests from media activities wherever possible. Over 2000 people arrived at APL in the days surrounding closest approach for guest, science or media operations tracks. Reaction and coverage of the Guest Operations events was universally positive and global in impact: iconic pictures of the auditorium waving flags during the moment of closest approach were published in media outlets on every continent. Media relations activities ensured coverage in all key media publications targeted for release, such as the New York Times, Science, Le Monde, and Nature. Social and traditional media coverage of the events spanned the globe. Guest operations activities are designed to ensure that a guest has a memorable experience and leaves with a lifelong memory of the mission and their partnership in the activity. Results, lessons learned, and other data from the New Horizons guest operations activity will be presented and analyzed.

  9. Analysis of scientific truth status in controlled rehabilitation trials.

    Science.gov (United States)

    Kerry, Roger; Madouasse, Aurélien; Arthur, Antony; Mumford, Stephen D

    2013-08-01

    Systematic reviews, meta-analyses and clinical guidelines (reviews) are intended to inform clinical practice, and in this sense can be thought of as scientific truthmakers. High-quality controlled trials should align to this truth, and method quality markers should predict truth status. We sought to determine in what way controlled trial quality relates to scientific truth, and to determine predictive utility of trial quality and bibliographic markers. A sample of reviews in rehabilitation medicine was examined. Two scientific truth dimensions were established based on review outcomes. Quality and bibliographic markers were extracted from associated trials for use in a regression analysis of their predictive utility for trial truth status. Probability analysis was undertaken to examine judgments of future trial truth status. Of the 93 trials included in contemporaneous reviews, overall, n = 45 (48%) were true. Randomization was found more in true trials than false trials in one truth dimension (P = 0.03). Intention-to-treat analysis was close to significant in one truth dimension (P = 0.058), being more commonly used in false trials. There were no other significant differences in quality or bibliographic variables between true and false trials. Regression analysis revealed no significant predictors of trial truth status. Probability analysis reported that the reasonable chance of future trials being true was between 2 and 5%, based on a uniform prior. The findings are at odds with what is considered gold-standard research methods, but in line with previous reports. Further work should focus on scientific dynamics within healthcare research and evidence-based practice constructs. © 2012 John Wiley & Sons Ltd.

  10. Reorientation and faulting of Pluto due to volatile loading within Sputnik Planitia

    Science.gov (United States)

    Keane, James T.; Matsuyama, Isamu; Kamata, Shunichi; Steckloff, Jordan K.

    2016-12-01

    Pluto is an astoundingly diverse, geologically dynamic world. The dominant feature is Sputnik Planitia—a tear-drop-shaped topographic depression approximately 1,000 kilometres in diameter possibly representing an ancient impact basin. The interior of Sputnik Planitia is characterized by a smooth, craterless plain three to four kilometres beneath the surrounding rugged uplands, and represents the surface of a massive unit of actively convecting volatile ices (N2, CH4 and CO) several kilometres thick. This large feature is very near the Pluto-Charon tidal axis. Here we report that the location of Sputnik Planitia is the natural consequence of the sequestration of volatile ices within the basin and the resulting reorientation (true polar wander) of Pluto. Loading of volatile ices within a basin the size of Sputnik Planitia can substantially alter Pluto’s inertia tensor, resulting in a reorientation of the dwarf planet of around 60 degrees with respect to the rotational and tidal axes. The combination of this reorientation, loading and global expansion due to the freezing of a possible subsurface ocean generates stresses within the planet’s lithosphere, resulting in a global network of extensional faults that closely replicate the observed fault networks on Pluto. Sputnik Planitia probably formed northwest of its present location, and was loaded with volatiles over million-year timescales as a result of volatile transport cycles on Pluto. Pluto’s past, present and future orientation is controlled by feedbacks between volatile sublimation and condensation, changing insolation conditions and Pluto’s interior structure.

  11. Pluto's Light Curve in 1933-1934

    CERN Document Server

    Schaefer, Bradley E; Smith, Luke Timothy

    2008-01-01

    We are reporting on a new accurate photographic light curve of Pluto for 1933-1934 when the heliocentric distance was 40 AU. We used 43 B-band and V-band images of Pluto on 32 plates taken on 15 nights from 19 March 1933 to 10 March 1934. Most of these plates were taken with the Mount Wilson 60" and 100" telescopes, but 7 of the plates (now at the Harvard College Observatory) were taken with the 12" and 16" Metcalf doublets at Oak Ridge. The plates were measured with an iris diaphragm photometer, which has an average one-sigma photometric error on these plates of 0.08 mag as measured by the repeatability of constant comparison stars. The modern B and V magnitudes for the comparison stars were measured with the Lowell Observatory Hall 1.1-m telescope. The magnitudes in the plate's photographic system were converted to the Johnson B- and V-system after correction with color terms, even though they are small in size. We find that the average B-band mean opposition magnitude of Pluto in 1933-1934 was 15.73 +- 0.0...

  12. Clinical Research Methodology 3: Randomized Controlled Trials.

    Science.gov (United States)

    Sessler, Daniel I; Imrey, Peter B

    2015-10-01

    Randomized assignment of treatment excludes reverse causation and selection bias and, in sufficiently large studies, effectively prevents confounding. Well-implemented blinding prevents measurement bias. Studies that include these protections are called randomized, blinded clinical trials and, when conducted with sufficient numbers of patients, provide the most valid results. Although conceptually straightforward, design of clinical trials requires thoughtful trade-offs among competing approaches-all of which influence the number of patients required, enrollment time, internal and external validity, ability to evaluate interactions among treatments, and cost.

  13. Design and Validity of Randomized Controlled Dental Restorative Trials

    Directory of Open Access Journals (Sweden)

    Gerd Göstemeyer

    2016-05-01

    Full Text Available Background: The evidence stemming from trials on restorative materials is shaped not only by trial findings, but also trial design and validity. We aimed to evaluate both aspects in randomized controlled dental restorative trials published from 2005–2015. Methods: Using systematic review methodology, we retrieved trials comparing restorative or adhesive dental materials. Two authors independently assessed design, risk of bias, registration status, and findings of trials. Descriptive and regression analyses were performed. Results: 114 studies on 15,321 restorations placed mainly in permanent teeth of 5232 patients were included. Per trial, the median number of patients was 37 (25th/75th percentiles: 30/51. Follow-up was 24 (20/48 months. Seventeen percent of trials reported on sample size calculations, 2% had been registered. Most trials (90% used US Public Health Service (USPHS criteria, and had a high risk of bias. More recent trials were more likely to have been registered, to have reported on sample size calculations, to be of low risk of bias, and to use other than USPHS-criteria. Twenty-three percent of trials yielded significant differences between groups. The likelihood of such differences was significantly increased in older studies, studies with potential reporting bias, published in journals with high impact factor (>2, longer follow-up periods, and not using USPHS-criteria. Conclusions: The majority of dental restorative trials published from 2005–2015 had limited validity. Risk of bias decreased in more recent trials. Future trials should aim for high validity, be registered, and use defined and appropriate sample sizes, follow-up periods, and outcome measures.

  14. Subgroup analyses in randomised controlled trials: cohort study on trial protocols and journal publications.

    Science.gov (United States)

    Kasenda, Benjamin; Schandelmaier, Stefan; Sun, Xin; von Elm, Erik; You, John; Blümle, Anette; Tomonaga, Yuki; Saccilotto, Ramon; Amstutz, Alain; Bengough, Theresa; Meerpohl, Joerg J; Stegert, Mihaela; Olu, Kelechi K; Tikkinen, Kari A O; Neumann, Ignacio; Carrasco-Labra, Alonso; Faulhaber, Markus; Mulla, Sohail M; Mertz, Dominik; Akl, Elie A; Bassler, Dirk; Busse, Jason W; Ferreira-González, Ignacio; Lamontagne, Francois; Nordmann, Alain; Gloy, Viktoria; Raatz, Heike; Moja, Lorenzo; Rosenthal, Rachel; Ebrahim, Shanil; Vandvik, Per O; Johnston, Bradley C; Walter, Martin A; Burnand, Bernard; Schwenkglenks, Matthias; Hemkens, Lars G; Bucher, Heiner C; Guyatt, Gordon H; Briel, Matthias

    2014-07-16

    To investigate the planning of subgroup analyses in protocols of randomised controlled trials and the agreement with corresponding full journal publications. Cohort of protocols of randomised controlled trial and subsequent full journal publications. Six research ethics committees in Switzerland, Germany, and Canada. 894 protocols of randomised controlled trial involving patients approved by participating research ethics committees between 2000 and 2003 and 515 subsequent full journal publications. Of 894 protocols of randomised controlled trials, 252 (28.2%) included one or more planned subgroup analyses. Of those, 17 (6.7%) provided a clear hypothesis for at least one subgroup analysis, 10 (4.0%) anticipated the direction of a subgroup effect, and 87 (34.5%) planned a statistical test for interaction. Industry sponsored trials more often planned subgroup analyses compared with investigator sponsored trials (195/551 (35.4%) v 57/343 (16.6%), P<0.001). Of 515 identified journal publications, 246 (47.8%) reported at least one subgroup analysis. In 81 (32.9%) of the 246 publications reporting subgroup analyses, authors stated that subgroup analyses were prespecified, but this was not supported by 28 (34.6%) corresponding protocols. In 86 publications, authors claimed a subgroup effect, but only 36 (41.9%) corresponding protocols reported a planned subgroup analysis. Subgroup analyses are insufficiently described in the protocols of randomised controlled trials submitted to research ethics committees, and investigators rarely specify the anticipated direction of subgroup effects. More than one third of statements in publications of randomised controlled trials about subgroup prespecification had no documentation in the corresponding protocols. Definitive judgments regarding credibility of claimed subgroup effects are not possible without access to protocols and analysis plans of randomised controlled trials. © The DISCO study group 2014.

  15. The New Horizons Mission to Pluto and Flyby of Jupiter

    Science.gov (United States)

    Stern, Alan; Weaver, Hal; Young, Leslie; Bagenal, Fran; Binzel, Richard; Buratti, Bonnie; Cheng, andy; Cruikshank, Dale; Gladstone, Randy; Grundy, Will; Hinson, David; Horanyi, Mihaly; Jennings, Don; Linscott, Ivan; McComas, Dave; McKinnon, William; McNutt, Ralph; Moore, Jeffrey; Murchie, Scott; Olkin, Cathy; Porco, Carolyn; Reitsema, Harold; Reuter, Dennis; Slater, Dave; Spencer, John

    2008-01-01

    New Horizons (NH) is NASA's mission to provide the first in situ reconnaissance of Pluto and its moons Charon, Nix, and Hydra. The NH spacecraft will reach Pluto in July 2015 and will then, if approved for an extended mission phase, continue on to a flyby encounter with one or more Kuiper belt objects (KBOs). NH was launched on 19 January 2006 and received a gravity assist during a flyby encounter with Jupiter (with closest approach at -32 RJ on 28 February 2007) that reduced its flight time to Pluto by 3 years. During the Jupiter flyby, NH collected a trove of multi-wavelength imaging and fields-and-particles measurements. Among the many science results at Jupiter were a detection of planet-wide mesoscale waves, eruptions of atmospheric ammonia clouds, unprecedented views of Io's volcanic plumes and Jupiter's tenuous ring system, a first close-up of the Little Red Spot (LRS), first sightings of polar lightning, and a trip down the tail of the magnetosphere. In 2015, NH will conduct a seven-month investigation of the Pluto system culminating in a closest approach some 12,500 km from Pluto's surface. Planning is presently underway for the Pluto encounter with special emphasis on longidentified science goals of studying the terrain, geology, and composition of the surfaces of Pluto and Charon, examining the composition and structure of Pluto's atmosphere, searching for an atmosphere on Charon, and characterizing Pluto's ionosphere and solar wind interaction. Detailed inspections will also be performed of the newly discovered satellites Nix and Hydra. Additionally, NH will characterize energetic particles in Pluto's environment, refine the bulk properties of Pluto and Charon, and search for additional satellites and rings.

  16. Pluto confidential an insider account of the ongoing battles over the status of Pluto

    CERN Document Server

    Maran, Stephen P

    2009-01-01

    When the International Astronomical Union (IAU) adopted a new definition of a ""planet"" in August 2006, Pluto became a dwarf planet, drawing a divisive line in science and public opinions. The controversy of whether Pluto is a planet continues years later, and passion about the decision remains, pitting scientist against scientist and invoking sentiments and nostalgia from the rest of the world.With the IAU definition, the future of space objects is forever changed. Learn how this resolution came to be and what it means for astronomy, who implemented it and who is against it, and

  17. Spectrophotometry of Pluto-Charon mutual events - Individual spectra of Pluto and Charon

    Science.gov (United States)

    Sawyer, S. R.; Barker, E. S.; Cochran, A. L.; Cochran, W. D.

    1987-01-01

    Time-resolved spectra of the March 3 and April 4, 1987 mutual events of Pluto and Charon, obtained with spectral coverage from 5500 to 10,000 A with 25-A spectral resolution, are discussed. Charon has a featureless reflectance spectrum, with no evidence of methane absorption. Charon's reflectance appears neutral in color and corresponds to a geometric albedo of about 0.37 at 6000 A. The Pluto reflectance spectrum displays methane absorption bands at 7300, 7900, 8400, 8600, and 8900 A and is red in color, with a geometric albedo of about 0.56 at 6000 A.

  18. Effect of diclofenac suppository on pain control during flexible cystoscopy-A randomized controlled trial

    National Research Council Canada - National Science Library

    Nadeem, Mehwash; Ather, M Hammad

    2016-01-01

    TRIAL DESIGN: To compare the difference in pain score during flexible cystoscopy between patients undergoing the procedure with plain lubricating gel only and plain gel with diclofenac suppository in a randomized control trial. METHODS...

  19. Sexual assault resistance education for university women: study protocol for a randomized controlled trial (SARE trial)

    National Research Council Canada - National Science Library

    Senn, Charlene Y; Eliasziw, Misha; Barata, Paula C; Thurston, Wilfreda E; Newby-Clark, Ian R; Radtke, H Lorraine; Hobden, Karen L

    2013-01-01

    .... The aim of this randomized controlled trial is to determine whether a novel, small-group sexual assault resistance education program can reduce the incidence of sexual assault among university...

  20. Hallucination focused integrative treatment : A randomized controlled trial

    NARCIS (Netherlands)

    Jenner, JA; Nienhuis, FJ; Wiersma, D; van de Willige, G

    2004-01-01

    Improvements in psychopathology, subjective burden, and coping with voices after hallucination focused integrative treatment (HIT) were studied in chronic schizophrenic patients with persistent (> 10 years), drug-refractory auditory hallucinations. In a randomized controlled trial, routine care was

  1. The ethics of placebo-controlled trials: methodological justifications.

    Science.gov (United States)

    Millum, Joseph; Grady, Christine

    2013-11-01

    The use of placebo controls in clinical trials remains controversial. Ethical analysis and international ethical guidance permit the use of placebo controls in randomized trials when scientifically indicated in four cases: (1) when there is no proven effective treatment for the condition under study; (2) when withholding treatment poses negligible risks to participants; (3) when there are compelling methodological reasons for using placebo, and withholding treatment does not pose a risk of serious harm to participants; and, more controversially, (4) when there are compelling methodological reasons for using placebo, and the research is intended to develop interventions that can be implemented in the population from which trial participants are drawn, and the trial does not require participants to forgo treatment they would otherwise receive. The concept of methodological reasons is essential to assessing the ethics of placebo controls in these controversial last two cases. This article sets out key considerations relevant to considering whether methodological reasons for a placebo control are compelling.

  2. Qigong and Fibromyalgia: Randomized Controlled Trials and Beyond

    OpenAIRE

    Jana Sawynok; Mary Lynch

    2014-01-01

    Introduction. Qigong is currently considered as meditative movement, mindful exercise, or complementary exercise and is being explored for relief of symptoms in fibromyalgia. Aim. This narrative review summarizes randomized controlled trials, as well as additional studies, of qigong published to the end of 2013 and discusses relevant methodological issues. Results. Controlled trials indicate regular qigong practice (daily, 6–8 weeks) produces improvements in core domains for fibromyalgia (pai...

  3. Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial

    DEFF Research Database (Denmark)

    Kreiner, Frederik; Galbo, Henrik

    2010-01-01

    To elucidate in polymyalgia rheumatica (PMR) the role of tumor necrosis factor (TNF) α and the therapeutic potential of blockade with soluble TNF-α receptor, we carried out the first randomized controlled trial with etanercept in PMR.......To elucidate in polymyalgia rheumatica (PMR) the role of tumor necrosis factor (TNF) α and the therapeutic potential of blockade with soluble TNF-α receptor, we carried out the first randomized controlled trial with etanercept in PMR....

  4. Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial

    DEFF Research Database (Denmark)

    Kreiner, Frederik; Galbo, Henrik

    2010-01-01

    To elucidate in polymyalgia rheumatica (PMR) the role of tumor necrosis factor (TNF) a and the therapeutic potential of blockade with soluble TNF-a receptor, we carried out the first randomized controlled trial with etanercept in PMR.......To elucidate in polymyalgia rheumatica (PMR) the role of tumor necrosis factor (TNF) a and the therapeutic potential of blockade with soluble TNF-a receptor, we carried out the first randomized controlled trial with etanercept in PMR....

  5. New Horizons: Anticipated Scientific Investigations at the Pluto System

    CERN Document Server

    Young, Leslie A; Weaver, Harold A; Bagenal, Fran; Binzel, Richard P; Buratti, Bonnie; Cheng, Andrew F; Cruikshank, Dale; Gladstone, G Randall; Grundy, William M; Hinson, David P; Horanyi, Mihaly; Jennings, Donald E; Linscott, Ivan R; McComas, David J; McKinnon, William B; McNutt, Ralph; Moore, Jeffery M; Murchie, Scott; Porco, Carolyn C; Reitsema, Harold; Reuter, Dennis C; Spencer, John R; Slater, David C; Strobel, Darrell; Summers, Michael E; Tyler, G Leonard

    2007-01-01

    The New Horizons spacecraft will achieve a wide range of measurement objectives at the Pluto system, including color and panchromatic maps, 1.25-2.50 micron spectral images for studying surface compositions, and measurements of Pluto's atmosphere (temperatures, composition, hazes, and the escape rate). Additional measurement objectives include topography, surface temperatures, and the solar wind interaction. The fulfillment of these measurement objectives will broaden our understanding of the Pluto system, such as the origin of the Pluto system, the processes operating on the surface, the volatile transport cycle, and the energetics and chemistry of the atmosphere. The mission, payload, and strawman observing sequences have been designed to acheive the NASA-specified measurement objectives and maximize the science return. The planned observations at the Pluto system will extend our knowledge of other objects formed by giant impact (such as the Earth-moon), other objects formed in the outer solar system (such ...

  6. New Horizons at Pluto: Asking the right questions

    Science.gov (United States)

    Young, Leslie; Stern, S. Alan; Olkin, Catherine B.; Spencer, John R.; Cheng, Andrew F.; Weaver, Harold A.; Ennico, Kimberly; Moore, Jeffrey M.; Grundy, William M.; Bagenal, Fran; Gladstone, Randy; Lunine, Jonathan I.; New Horizons Science Team

    2016-10-01

    In the 1980's and 1990's, breakthroughs about Pluto and the outer solar system laid the groundwork for the Outer Planets Science Working Group (1992), the Pluto Kuiper Express mission Science Definition Team (1996), and the Announcement of Opportunity for the Pluto Kuiper-Belt mission in 2001. These included specific science goals that molded the mission design, instrument selection, and observing sequence. These goals held up amazingly well over the decades. This historical review of New Horizons will explain how ground-based and theoretical work prepared us for a successful investigation of Pluto, and speculate on some of the new questions raised by the New Horizons flyby of the Pluto system.This work was supported by NASA's New Horizons project.

  7. The interiors of Pluto and Charon: Structure, composition, and implications

    Energy Technology Data Exchange (ETDEWEB)

    Simonelli, D.P. (NASA Ames Research Center, IA (USA) Cornell Univ., Ithaca, NY (USA)); Reynolds, R.T. (NASA Ames Research Center, IA (USA))

    1989-11-01

    The authors review recent models of the internal structure of Pluto and Charon made possible by analysis of the Pluto/Charon mutual events. At a mean density of just over 2 g cm{sup {minus}3} and a predicted rock mass fraction of roughly 0.7, the Pluto/Charon system is significantly rockier than the icy satellites of the giant planets, a contrast which may reflect its formation in a CO-rich outer solar nebula rather than a circumplanetary nebula. Pluto and Charon may in fact be so rocky that they lost volatiles early in their history (possibly during a Charon-forming impact event), although this is still an open issue. Finally, they review the outlook for future study of the Pluto and Charon interiors.

  8. Methane on Triton and Pluto - New CCD spectra

    Science.gov (United States)

    Apt, J.; Carleton, N. P.; Mackay, C. D.

    1983-01-01

    Spectra of Triton and of Pluto from 4553-9558 A at 25 A resolution are presented. Both spectra show the methane absorption near 8900 A; its equivalent width was 16 times greater on Pluto than on Triton at the time of the observations. This is the first published observation of the 8900 A feature in Triton's spectrum. The previously reported 27 m-amagat abundance of the Pluto atmosphere ignored contributions due to methane ice and should therefore be regarded as an upper limit. The observations of the Pluto spectrum discussed here show sharp structure in the 8900 and 8600 A bands; the case for an atmosphere on Pluto may turn on whether new laboratory measurements show that such structure is present in methane ice.

  9. Impact of industry collaboration on randomised controlled trials in oncology.

    Science.gov (United States)

    Linker, Anne; Yang, Annie; Roper, Nitin; Whitaker, Evans; Korenstein, Deborah

    2017-02-01

    Industry funders can simply provide money or collaborate in trial design, analysis or reporting of clinical trials. Our aim was to assess the impact of industry collaboration on trial methodology and results of randomised controlled trials (RCT). We searched PubMed for oncology RCTs published May 2013 to December 2015 in peer-reviewed journals with impact factor > 5 requiring reporting of funder role. Two authors extracted methodologic (primary end-point; blinding of the patient, clinician and outcomes assessor; and analysis) and outcome data. We used descriptive statistics and two-sided Fisher exact tests to compare characteristics of trials with collaboration, with industry funding only, and without industry funding. We included 224 trials. Compared to those without industry funding, trials with collaboration used more placebo control (RR 3·59, 95% CI [1·88-6·83], p industry collaboration were more likely to use some high-quality methods than those without industry funding, with similar rates of positive results. Our findings suggest that collaboration is not associated with trial outcomes and that mandatory disclosure of funder roles may mitigate bias. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Pluto in Hi-Def Note: There is debate within the science community as to whether Pluto should be

    Science.gov (United States)

    2008-01-01

    This image demonstrates the first detection of Pluto using the high-resolution mode on the New Horizons Long-Range Reconnaissance Imager (LORRI). The mode provides a clear separation between Pluto and numerous nearby background stars. When the image was taken on October 6, 2007, Pluto was located in the constellation Serpens, in a region of the sky dense with background stars. Typically, LORRI's exposure time in hi-res mode is limited to approximately 0.1 seconds, but by using a special pointing mode that allowed an increase in the exposure time to 0.967 seconds, scientists were able to spot Pluto, which is approximately 15,000 times fainter than human eyes can detect. New Horizons was still too far from Pluto (3.6 billion kilometers, or 2.2 billion miles) for LORRI to resolve any details on Pluto's surface that won't happen until summer 2014, approximately one year before closest approach. For now the entire Pluto system remains a bright dot to the spacecraft's telescopic camera, though LORRI is expected to start resolving Charon from Pluto seeing them as separate objects in summer 2010.

  11. "Pluto Has Been a Planet My Whole Life!" Emotions, Attitudes, and Conceptual Change in Elementary Students' Learning about Pluto's Reclassification

    Science.gov (United States)

    Broughton, Suzanne H.; Sinatra, Gale M.; Nussbaum, E. Michael

    2013-01-01

    Learning about certain scientific topics has potential to spark strong emotions among students. We investigated whether emotions predicted students' attitudes after engaging in independent rereading and/or rereading plus discussion about Pluto's reclassification. Fifth and sixth grade students read a refutation text on Pluto's reclassification.…

  12. Pluto in Hi-Def Note: There is debate within the science community as to whether Pluto should be

    Science.gov (United States)

    2008-01-01

    This image demonstrates the first detection of Pluto using the high-resolution mode on the New Horizons Long-Range Reconnaissance Imager (LORRI). The mode provides a clear separation between Pluto and numerous nearby background stars. When the image was taken on October 6, 2007, Pluto was located in the constellation Serpens, in a region of the sky dense with background stars. Typically, LORRI's exposure time in hi-res mode is limited to approximately 0.1 seconds, but by using a special pointing mode that allowed an increase in the exposure time to 0.967 seconds, scientists were able to spot Pluto, which is approximately 15,000 times fainter than human eyes can detect. New Horizons was still too far from Pluto (3.6 billion kilometers, or 2.2 billion miles) for LORRI to resolve any details on Pluto's surface that won't happen until summer 2014, approximately one year before closest approach. For now the entire Pluto system remains a bright dot to the spacecraft's telescopic camera, though LORRI is expected to start resolving Charon from Pluto seeing them as separate objects in summer 2010.

  13. From Density Contrast to Compositional Difference on Pluto and Charon

    Science.gov (United States)

    Bierson, C. J.; Nimmo, F.; McKinnon, W. B.

    2016-12-01

    Leading up to the New Horizons encounter, modeling work suggested that if Pluto and Charon formed in a giant impact Charon would be more ice rich than Pluto [1,2]. Conversely, if Pluto and Charon both formed in-situ they should have the same bulk composition. New Horizons has confirmed that Pluto and Charon have distinct bulk densities, 1854 ± 11 kg m-3 and 1701 ± 33 kg m-3 respectively [3]. The question is whether this density contrast necessarily implies a compositional difference. We investigate if differences in the porous structure of Pluto and Charon could explain this observed density contrast. We couple a thermal model [4] with a model of viscous pore closure [5]. We include both the temperature dependence and the effect of porosity on thermal conductivity of the ice mantle. Due to the both lower gravity and lower heat flux, Charon can maintain a thicker porous layer over the age of the solar system. This effect however, only produces a bulk density contrast between Pluto and Charon of 60 kg m-3 , compared with the observed density contrast of 153±44 kg m-3. Other factors such as a modern ocean on Pluto, larger compression in Pluto's interior, and chemical water-rock interactions are also considered. None of these processes, even when combined, can explain the observed density contrast. From this we conclude that Pluto and Charon must be compositionally distinct. We will discuss the implications this compositional difference has for the formation and evolution of the Pluto-Charon system. References: [1] Canup, Science (2005). [2] Canup, The Astronomical Journal (2010). [3] Nimmo et al. arXiv preprint (2016). [4] Robuchon and Nimmo. Icarus (2011) [5] Besserer et al. JGR: Planets (2013)

  14. The Wind, Temperature, and Surface Pressure on Pluto from a Pluto General Circulation Model

    Science.gov (United States)

    Zalucha, A. M.; Gulbis, A.

    2011-12-01

    A variety of methods have been used to derive Pluto's atmospheric temperature, composition, and surface pressure from spectra and stellar occultation data, while wind is less easily determined. Gravity wave dissipation has been investigated [1] in the 18 March 2007 stellar occultation dataset [2], demonstrating that wind is occurring in the form of perturbations about a mean. Rossby waves have also been proposed [2] as an explanation to the 2007 dataset; however the method was used incorrectly. General circulation models (GCMs) are a ubiquitous tool in the field of planetary atmospheres to solve for the global state of the atmosphere in a physically consistent manner, but only recently have they began to be developed for Pluto. We use a Pluto version of the Massachusetts Institute of Technology (MIT) GCM to solve for the first time for wind, temperature, and surface pressure globally in Pluto's atmosphere. The Pluto version of the MIT GCM (PGCM) uses the MIT GCM dynamical core [3] with a radiative-conductive model [4]. It includes vertical thermal conduction and non-local thermodynamic equilibrium heating and cooling by methane at 3.3 um and 7.6 um, respectively. We perform a parameter sweep with methane volume mixing ratios of 0.2, 0.6, and 1% and initial global mean surface pressures of 6-26 ubar. We ran the model from rest starting in the model year 1973. We compared the PGCM results with occultation data from the years 1988, 2002, 2006, and 2007. Model light curves were calculated from the PGCM temperature output (averaged at 90 day intervals) at the corresponding date and Pluto latitudes of each occultation. The match between data and PGCM is better than between data and the radiative-conductive equilibrium solution (i.e. no wind), but the PGCM light curves contain wave-like features while the data do not. We do not believe that this feature represents an atmospheric wave; rather, it is numerical noise known to occur in 2D GCMs. The PGCM-predicted zonal

  15. Control groups in recent septic shock trials: a systematic review.

    Science.gov (United States)

    Pettilä, Ville; Hjortrup, Peter Buhl; Jakob, Stephan M; Wilkman, Erika; Perner, Anders; Takala, Jukka

    2016-12-01

    The interpretation of septic shock trial data is profoundly affected by patients, control intervention, co-interventions and selected outcome measures. We evaluated the reporting of control groups in recent septic shock trials. We searched for original articles presenting randomized clinical trials (RCTs) in adult septic shock patients from 2006 to 2016. We included RCTs focusing on septic shock patients with at least two parallel groups and at least 50 patients in the control group. We selected and evaluated data items regarding patients, control group characteristics, and mortality outcomes, and calculated a data completeness score to provide an overall view of quality of reporting. A total of 24 RCTs were included (mean n = 287 patients and 71 % of eligible patients were randomized). Of the 24 studies, 14 (58 %) presented baseline data on vasopressors and 58 % the proportion of patients with elevated lactate values. Five studies (21 %) provided data to estimate the proportion of septic shock patients fulfilling the Sepsis-3 definition. The mean data completeness score was 19 out of 36 (range 8-32). Of 18 predefined control group characteristics, a mean of 8 (range 2-17) were reported. Only 2 (8 %) trials provided adequate data to confirm that their control group treatment represented usual care. Recent trials in septic shock provide inadequate data on the control group treatment and hemodynamic values. We propose a standardized trial dataset to be created and validated, comprising characteristics of patient population, interventions administered, hemodynamic values achieved, surrogate organ dysfunction, and mortality outcomes, to allow better analysis and interpretation of future trial results.

  16. The Home-Based Older People's Exercise (HOPE) trial: study protocol for a randomised controlled trial

    OpenAIRE

    Forster Anne; Young John; Barber Sally; Clegg Andrew; Iliffe Steve

    2011-01-01

    Abstract Background Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility. Methods/Design The Home-Based Older People's Exercise (HOPE) trial is a two arm, assessor blind pilot randomised controlled trial (RCT) to a...

  17. Radiation hydrodynamics integrated in the PLUTO code

    Science.gov (United States)

    Kolb, Stefan M.; Stute, Matthias; Kley, Wilhelm; Mignone, Andrea

    2013-11-01

    Aims: The transport of energy through radiation is very important in many astrophysical phenomena. In dynamical problems the time-dependent equations of radiation hydrodynamics have to be solved. We present a newly developed radiation-hydrodynamics module specifically designed for the versatile magnetohydrodynamic (MHD) code PLUTO. Methods: The solver is based on the flux-limited diffusion approximation in the two-temperature approach. All equations are solved in the co-moving frame in the frequency-independent (gray) approximation. The hydrodynamics is solved by the different Godunov schemes implemented in PLUTO, and for the radiation transport we use a fully implicit scheme. The resulting system of linear equations is solved either using the successive over-relaxation (SOR) method (for testing purposes) or using matrix solvers that are available in the PETSc library. We state in detail the methodology and describe several test cases to verify the correctness of our implementation. The solver works in standard coordinate systems, such as Cartesian, cylindrical, and spherical, and also for non-equidistant grids. Results: We present a new radiation-hydrodynamics solver coupled to the MHD-code PLUTO that is a modern, versatile, and efficient new module for treating complex radiation hydrodynamical problems in astrophysics. As test cases, either purely radiative situations, or full radiation-hydrodynamical setups (including radiative shocks and convection in accretion disks) were successfully studied. The new module scales very well on parallel computers using MPI. For problems in star or planet formation, we added the possibility of irradiation by a central source.

  18. Safety of placebo controls in pediatric hypertension trials.

    Science.gov (United States)

    Smith, P Brian; Li, Jennifer S; Murphy, M Dianne; Califf, Robert M; Benjamin, Daniel K

    2008-04-01

    Many clinical trials, including those in pediatric populations, use a placebo arm for medical conditions for which there are readily available therapeutic interventions. Several short-term efficacy trials of antihypertensive medications performed in response to Food and Drug Administration-issued written requests have used a placebo arm; whether the use of a placebo arm is safe in children with hypertension is unknown. We sought to define the rates of adverse events in 10 short-term antihypertensive trials to determine whether these trials resulted in increased risk to pediatric patients receiving placebo. We combined patient-level data from 10 antihypertensive efficacy trials performed in pediatric patients that were submitted to the Food and Drug Administration from 1998 to 2005. We determined the number and type of all of the adverse events reported during the placebo-controlled portion of the clinical trials and compared these numbers between the patients who received placebo and those who received active drug. Among the 1707 children in the 10 studies, we observed no differences in the rates of adverse events reported between the patients who received placebo and those who received active drug. Only 5 patients suffered a serious adverse event during the trials; none were thought by the investigators to be related to study drug, and only 1 occurred in a patient receiving placebo. Short-term exposure to placebo in pediatric trials of antihypertensive medications appears to be safe.

  19. Drug interactions in controlled clinical trials.

    Science.gov (United States)

    Gershon, S

    1982-12-01

    As much information as possible should be obtained in clinical trials to assess possible interactions between test drugs and concomitant medications prescribed for other medical indications. Side effect profiles were compared in patients taking buspirone, mean = 20 mg/day; diazepam, 20 mg/day; clorazepate, 23 mg/day; and placebo, with or without concomitant medications. Approximately 1,000 anxious patients were included in the analysis; 700 received buspirone. The use of a variety of common medications did not affect the side effect profile in the buspirone, clorazepate, and placebo groups, but did increase the incidence of side effects in the diazepam group. The increased incidence of sedation noted with diazepam and clorazepate, however, was not due to concomitant medication.

  20. Neutronics and thermal hydraulics feedback models of the Harwell materials testing reactors DIDO and PLUTO: I Neutronics analysis

    Energy Technology Data Exchange (ETDEWEB)

    Javadi, M.

    1986-10-01

    Neutronics modelling of the Harwell MTRs DIDO and PLUTO has been achieved in the WIMS-E framework using (r,z) and (x,y) two dimensional diffusion theory. The modelling takes into account fuel burnup and the presence of the coarse control arms and experimental rigs. The modelling is validated by comparisons with measurements of thermal and fast flux distributions.

  1. Veterinary clinical research database for homeopathy: placebo-controlled trials.

    Science.gov (United States)

    Clausen, J; Albrecht, H; Mathie, R T

    2013-04-01

    Veterinary homeopathy has led a somewhat shadowy existence since its first introduction. Only in the last three decades has the number of clinical trials increased considerably. This literature is generally not well perceived, which may be partly a consequence of the diffuse and somewhat inaccessible nature of some of the relevant research publications. The Veterinary Clinical Research Database for Homeopathy (VetCR) was launched in 2006 to provide information on existing clinical research in veterinary homeopathy and to facilitate the preparation of systematic reviews. The aim of the present report is to provide an overview of this first database on clinical research in veterinary homeopathy, with a special focus on its content of placebo controlled clinical trials and summarising what is known about placebo effects in animals. In April 2012, the VetCR database contained 302 data records. Among these, 203 controlled trials were identified: 146 randomised and 57 non-randomised. In 97 of those 203 trials, the homeopathic medical intervention was compared to placebo. A program of formal systematic reviews of peer-reviewed randomised controlled trials in veterinary homeopathy is now underway; detailed findings from the program's data extraction and appraisal approach, including the assessment of trial quality (risk of bias), will be reported in due course. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Inadequate description of educational interventions in ongoing randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Pino Cécile

    2012-05-01

    Full Text Available Abstract Background The registration of clinical trials has been promoted to prevent publication bias and increase research transparency. Despite general agreement about the minimum amount of information needed for trial registration, we lack clear guidance on descriptions of non-pharmacologic interventions in trial registries. We aimed to evaluate the quality of registry descriptions of non-pharmacologic interventions assessed in ongoing randomized controlled trials (RCTs of patient education. Methods On 6 May 2009, we searched for all ongoing RCTs registered in the 10 trial registries accessible through the World Health Organization International Clinical Trials Registry Platform. We included trials evaluating an educational intervention (that is, designed to teach or train patients about their own health and dedicated to participants, their family members or home caregivers. We used a standardized data extraction form to collect data related to the description of the experimental intervention, the centers, and the caregivers. Results We selected 268 of 642 potentially eligible studies and appraised a random sample of 150 records. All selected trials were registered in 4 registers, mainly ClinicalTrials.gov (61%. The median [interquartile range] target sample size was 205 [100 to 400] patients. The comparator was mainly usual care (47% or active treatment (47%. A minority of records (17%, 95% CI 11 to 23% reported an overall adequate description of the intervention (that is, description that reported the content, mode of delivery, number, frequency, duration of sessions and overall duration of the intervention. Further, for most reports (59%, important information about the content of the intervention was missing. The description of the mode of delivery of the intervention was reported for 52% of studies, the number of sessions for 74%, the frequency of sessions for 58%, the duration of each session for 45% and the overall duration for 63

  3. Pluto and Charon: Surface Colors and Compositions - A Hypothesis

    Science.gov (United States)

    Cruikshank, D. P.

    2016-01-01

    The surface of Pluto displays an array of colors ranging from yellow to red to brown, while the surface of Charon is largely gray with a north polar zone of red color similar to regions on Pluto. Pluto's surface shows layers of intensely colored material in tilted and transported blocks, and fractured geo-graphical units. This arrangement suggests episodes of formation or deposition of that material interspersed with episodes of emplacement of ices having little or no color. The ices identified on the surfaces of these two bodies (N2, CH4, CO, C2H6, H2O on Pluto, and H2O and NH3 on Charon) are colorless, as are nearly all ices in a powdery state. The colors on Pluto probably arise from the in situ formation of a macro-molecular carbonaceous material generated by energetic processing of the ices on the surface. Laboratory experiments producing refractory tholins particularly relevant to Pluto explored the chemistry of both UV and low-energy electron bombardment of a mix of Pluto ices (N2:CH4:CO = 100:1:1). We can term this Pluto ice tholin PIT. Water ice in the crystalline state characterizes Charon's surface, and while most of Charon's surface is neutral in color, with geometric albedo approximately 0.38, the polar zone and a light cover of fainter but similar reddish color over some surface regions suggest a common origin with the colored material on Pluto. NH3 or NH3 x nH2O was identified from disk-integrated Earth-based spectra, and a few concentrated NH3 exposures have been found in the New Horizons spectral images.

  4. Constraints on Pluto's Hazes from 2-Color Occultation Lightcurves

    Science.gov (United States)

    Hartig, Kara; Barry, T.; Carriazo, C. Y.; Cole, A.; Gault, D.; Giles, B.; Giles, D.; Hill, K. M.; Howell, R. R.; Hudson, G.; Loader, B.; Mackie, J. A.; Olkin, C. B.; Rannou, P.; Regester, J.; Resnick, A.; Rodgers, T.; Sicardy, B.; Skrutskie, M. F.; Verbiscer, A. J.; Wasserman, L. H.; Watson, C. R.; Young, E. F.; Young, L. A.; Buie, M. W.; Nelson, M.

    2015-11-01

    The controversial question of aerosols in Pluto's atmosphere first arose in 1988, when features in a Pluto occultation lightcurve were alternately attributed to haze opacity (Elliot et al. 1989) or a thermal inversion (Eshleman 1989). A stellar occultation by Pluto in 2002 was observed from several telescopes on Mauna Kea in wavelengths ranging from R- to K-bands (Elliot et al. 2003). This event provided compelling evidence for haze on Pluto, since the mid-event baseline levels were systematically higher at longer wavelengths (as expected if there were an opacity source that scattered more effectively at shorter wavelengths). However, subsequent occultations in 2007 and 2011 showed no significant differences between visible and IR lightcurves (Young et al. 2011).The question of haze on Pluto was definitively answered by direct imaging of forward-scattering aerosols by the New Horizons spacecraft on 14-JUL-2015. We report on results of a bright stellar occultation which we observed on 29-JUN-2015 in B- and H-bands from both grazing and central sites. As in 2007 and 2011, we see no evidence for wavelength-dependent extinction. We will present an analysis of haze parameters (particle sizes, number density profiles, and fractal aggregations), constraining models of haze distribution to those consistent with and to those ruled out by the occultation lightcurves and the New Horizons imaging.References:Elliot, J.L., et al., "Pluto's Atmosphere." Icarus 77, 148-170 (1989)Eshleman, V.R., "Pluto's Atmosphere: Models based on refraction, inversion, and vapor pressure equilibrium." Icarus 80 439-443 (1989)Elliot, J.L., et al., "The recent expansion of Pluto's atmosphere." Nature 424 165-168 (2003)Young, E.F., et al., "Search for Pluto's aerosols: simultaneous IR and visible stellar occultation observations." EPSC-DPS Joint Meeting 2011, held 2-7 October 2011 in Nantes, France (2011)

  5. Hemispherical Pluto and Charon Color Composition From New Horizons

    Science.gov (United States)

    Ennico, K.; Parker, A.; Howett, C. A. J.; Olkin, C. B.; Spencer, J. R.; Grundy, W. M.; Reuter, D. E.; Cruikshank, D. P.; Binzel, R. P.; Buie, M. W.; hide

    2016-01-01

    New Horizons flew by Pluto and its moons on July 14, 2015 [1]. In the days prior to the closest approach (C/A), panchromatic and color observations of Pluto and Charon were made covering a fully complete range of longitudes. Although only a fraction of this "late-approach" data series has been transmitted to the ground, the results indicate Pluto's latitudinal coloring trends seen on the encounter hemisphere continues on the far side. Charon's red pole is visible from a multitude of longitudes and its colors are uniform with longitude at lower latitudes.

  6. Features of surface topography and the geological activity of Pluto

    Science.gov (United States)

    Vidmachenko, A. P.

    2016-05-01

    According to the data "New Horizons" of the spacecraft, researchers were able to specify the diameter of Pluto-2374 km. Its surface temperature in the equatorial region varies from 33 to 55 K over the planet's orbital period around the Sun in ~248 years. Presumably the surface of Pluto has a rocky base covered with a mantle of water ice, of frozen methane, nitrogen, ammonia and CO. Due to the large eccentricity of the orbit of Pluto, as it approaches the Sun, the ice melts, and the atmosphere is formed mainly of nitrogen and methane; while removing of the planet from the Sun - the atmosphere freezes out again.

  7. Results from PIXON-Processed HRC Images of Pluto

    Science.gov (United States)

    Young, E. F.; Buie, M. W.; Young, L. A.

    2005-08-01

    We examine the 384 dithered images of Pluto and Charon taken with the Hubble Space Telescope's High Resolution Camera (HRC) under program GO-9391. We have deconvolved the individual images with synthetic point spread functions (PSF) generated with TinyTim v6.3 using PIXON processing (Puetter and Yahil 1999). We reconstruct a surface albedo map of Pluto using a backprojection algorithm. At present, this algorithm does not include Hapke phase function or backscattering parameters. We compare this albedo map to earlier maps based on HST and mutual event observations (e.g., Stern et al. 1997, Young et al. 2001), looking for changes in albedo distribution and B-V color distribution. Pluto's volatile surface ices are closely tied to its atmospheric column abundance, which has doubled in the interval between 1989 and 2002 (Sicardy et al. 2003, Elliot et al. 2003). A slight rise (1.5 K) in the temperature of nitrogen ice would support the thicker atmosphere. We examine the albedo distribution in the context of Pluto's changing atmosphere. Finally, a side effect of the PIXON processing is that we are better able to search for additional satellites in the Pluto-Charon system. We find no satellites within a 12 arcsec radius of Pluto brighter than a 5-sigma upper limit of B=25.9. In between Pluto and Charon this upper limit is degraded to B=22.8 within one Rp of Pluto's surface, improving to B=25.1 at 10 Rp (Charon's semimajor axis). This research was supported by a grant from NASA's Planetary Astronomy Program (NAG5-12516) and STScI grant GO-9391. Elliot, J.L., and 28 co-authors (2003), ``The recent expansion of Pluto's atmosphere," Nature 424, 165-168. R. C. Puetter and A. Yahil (1999), ``The Pixon Method of Image Reconstruction" in Astronomical Data Analysis Software and Systems VIII, D. M. Mehringer, R. L. Plante & D. A. Roberts, eds., ASP Conference Series, 172, pp. 307-316. Sicardy, B. and 40 co-authors (2003), ``Large changes in Pluto's atmosphere as revealed by recent

  8. Processes Modifying Cratered Terrains on Pluto

    Science.gov (United States)

    Moore, J. M.

    2015-01-01

    The July encounter with Pluto by the New Horizons spacecraft permitted imaging of its cratered terrains with scales as high as approximately 100 m/pixel, and in stereo. In the initial download of images, acquired at 2.2 km/pixel, widely distributed impact craters up to 260 km diameter are seen in the near-encounter hemisphere. Many of the craters appear to be significantly degraded or infilled. Some craters appear partially destroyed, perhaps by erosion such as associated with the retreat of scarps. Bright ice-rich deposits highlight some crater rims and/or floors. While the cratered terrains identified in the initial downloaded images are generally seen on high-to-intermediate albedo surfaces, the dark equatorial terrain informally known as Cthulhu Regio is also densely cratered. We will explore the range of possible processes that might have operated (or still be operating) to modify the landscape from that of an ancient pristinely cratered state to the present terrains revealed in New Horizons images. The sequence, intensity, and type of processes that have modified ancient landscapes are, among other things, the record of climate and volatile evolution throughout much of the Pluto's existence. The deciphering of this record will be discussed. This work was supported by NASA's New Horizons project.

  9. Geology of Pluto and Charon Overview

    Science.gov (United States)

    Moore, Jeffrey Morgan

    2015-01-01

    Pluto's surface was found to be remarkably diverse in terms of its range of landforms, terrain ages, and inferred geological processes. There is a latitudinal zonation of albedo. The conspicuous bright albedo heart-shaped feature informally named Tombaugh Regio is comprised of several terrain types. Most striking is Texas-sized Sputnik Planum, which is apparently level, has no observable craters, and is divided by polygons and ovoids bounded by shallow troughs. Small smooth hills are seen in some of the polygon-bounding troughs. These hills could either be extruded or exposed by erosion. Sputnik Planum polygon/ovoid formation hypotheses range from convection to contraction, but convection is currently favored. There is evidence of flow of plains material around obstacles. Mountains, especially those seen south of Sputnik Planum, exhibit too much relief to be made of CH4, CO, or N2, and thus are probably composed of H2O-ice basement material. The north contact of Sputnik Planum abuts a scarp, above which is heavily modified cratered terrain. Pluto's large moon Charon is generally heavily to moderately cratered. There is a mysterious structure in the arctic. Charon's surface is crossed by an extensive system of rift faults and graben. Some regions are smoother and less cratered, reminiscent of lunar maria. On such a plain are large isolated block mountains surrounded by moats. At this conference we will present highlights of the latest observations and analysis. This work was supported by NASA's New Horizons project

  10. Drug versus placebo randomized controlled trials in neonates: A review of ClinicalTrials.gov registry.

    Science.gov (United States)

    Desselas, Emilie; Pansieri, Claudia; Leroux, Stephanie; Bonati, Maurizio; Jacqz-Aigrain, Evelyne

    2017-01-01

    Despite specific initiatives and identified needs, most neonatal drugs are still used off-label, with variable dosage administrations and schedules. In high risk preterm and term neonates, drug evaluation is challenging and randomized controlled trials (RCT) are difficult to conduct and even more is the use of a placebo, required in the absence of a reference validated drug to be used as comparator. We analyzed the complete ClinicalTrials.gov registry 1) to describe neonatal RCT involving a placebo, 2) to report on the medical context and ethical aspects of placebo use. Placebo versus drug RCT (n = 146), either prevention trials (n = 57, 39%) or therapeutic interventions (n = 89, 61%), represent more than a third of neonatal trials registered in the National Institute of Health clinical trial database (USA) since 1999. They mainly concerned preterm infants, evaluating complications of prematurity. Most trials were conducted in the USA, were single centered, and funded by non-profit organizations. For the three top drug trials evaluating steroids (n = 13, 9.6%), erythropoietin (EPO, n = 10, 6.8%) and nitric oxide (NO, n = 9, 6.2%), the objectives of the trial and follow-up were analyzed in more details. Although a matter of debate, the use of placebo should be promoted in neonates to evaluate a potential new treatment, in the absence of reference drug. Analysis of the trials evaluating steroids showed that long-term follow-up of exposed patients, although required by international guidelines, is frequently missing and should be planned to collect additional information and optimize drug evaluation in these high-risk patients.

  11. Drug versus placebo randomized controlled trials in neonates: A review of ClinicalTrials.gov registry

    Science.gov (United States)

    Desselas, Emilie; Pansieri, Claudia; Leroux, Stephanie; Bonati, Maurizio; Jacqz-Aigrain, Evelyne

    2017-01-01

    Background Despite specific initiatives and identified needs, most neonatal drugs are still used off-label, with variable dosage administrations and schedules. In high risk preterm and term neonates, drug evaluation is challenging and randomized controlled trials (RCT) are difficult to conduct and even more is the use of a placebo, required in the absence of a reference validated drug to be used as comparator. Methods We analyzed the complete ClinicalTrials.gov registry 1) to describe neonatal RCT involving a placebo, 2) to report on the medical context and ethical aspects of placebo use. Results Placebo versus drug RCT (n = 146), either prevention trials (n = 57, 39%) or therapeutic interventions (n = 89, 61%), represent more than a third of neonatal trials registered in the National Institute of Health clinical trial database (USA) since 1999. They mainly concerned preterm infants, evaluating complications of prematurity. Most trials were conducted in the USA, were single centered, and funded by non-profit organizations. For the three top drug trials evaluating steroids (n = 13, 9.6%), erythropoietin (EPO, n = 10, 6.8%) and nitric oxide (NO, n = 9, 6.2%), the objectives of the trial and follow-up were analyzed in more details. Conclusion Although a matter of debate, the use of placebo should be promoted in neonates to evaluate a potential new treatment, in the absence of reference drug. Analysis of the trials evaluating steroids showed that long-term follow-up of exposed patients, although required by international guidelines, is frequently missing and should be planned to collect additional information and optimize drug evaluation in these high-risk patients. PMID:28192509

  12. Choosing a control intervention for a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Djulbegovic Benjamin

    2003-04-01

    Full Text Available Abstract Background Randomised controlled clinical trials are performed to resolve uncertainty concerning comparator interventions. Appropriate acknowledgment of uncertainty enables the concurrent achievement of two goals : the acquisition of valuable scientific knowledge and an optimum treatment choice for the patient-participant. The ethical recruitment of patients requires the presence of clinical equipoise. This involves the appropriate choice of a control intervention, particularly when unapproved drugs or innovative interventions are being evaluated. Discussion We argue that the choice of a control intervention should be supported by a systematic review of the relevant literature and, where necessary, solicitation of the informed beliefs of clinical experts through formal surveys and publication of the proposed trial's protocol. Summary When clinical equipoise is present, physicians may confidently propose trial enrollment to their eligible patients as an act of therapeutic beneficence.

  13. Chemotherapeutic trial to control enterobiasis in schoolchildren.

    Science.gov (United States)

    Yang, Y S; Kim, S W; Jung, S H; Huh, S; Lee, J H

    1997-12-01

    To assess several chemotherapeutic schemes for control of enterobiasis, 738 children in five primary schools in Chunchon, Korea, were studied from May 1994 to June 1995. They were divided into 6 groups by the schemes: treatment of once or twice a year; treatment of positive cases or of whole class students; treatment with or without family members. The overall egg positive rate before intervention was 17.5% out of 789 children. Treating all individuals in a class together with family members of positive cases brought better control efficacy than other schemes (p = 0.000). However, when egg positive rate is less than 30%, treating only egg positive cases also can reduce egg positive rate. The confounding factors for the enterobiasis control in primary schoolchildren were new-comer to a class and familial infection.

  14. Steroids In caRdiac Surgery (SIRS) trial: acute kidney injury substudy protocol of an international randomised controlled trial

    National Research Council Canada - National Science Library

    Garg, Amit X; Vincent, Jessica; Cuerden, Meaghan; Parikh, Chirag; Devereaux, P J; Teoh, Kevin; Yusuf, Salim; Hildebrand, Ainslie; Lamy, Andre; Zuo, Yunxia; Sessler, Daniel I; Shah, Pallav; Abbasi, Seyed Hesameddin; Quantz, Mackenzie; Yared, Jean-Pierre; Noiseux, Nicolas; Tagarakis, Georgios; Rochon, Antoine; Pogue, Janice; Walsh, Michael; Chan, Matthew T V; Lamontagne, Francois; Salehiomran, Abbas; Whitlock, Richard

    2014-01-01

    Steroids In caRdiac Surgery trial (SIRS) is a large international randomised controlled trial of methylprednisolone or placebo in patients undergoing cardiac surgery with the use of a cardiopulmonary bypass pump...

  15. Controlled trials in children: quantity, methodological quality and descriptive characteristics of pediatric controlled trials published 1948-2006.

    Directory of Open Access Journals (Sweden)

    Denise Thomson

    Full Text Available BACKGROUND: The objective of this study was to describe randomized controlled trials (RCTs and controlled clinical trials (CCTs in child health published between 1948 and 2006, in terms of quantity, methodological quality, and publication and trial characteristics. We used the Trials Register of the Cochrane Child Health Field for overall trends and a sample from this to explore trial characteristics in more detail. METHODOLOGY/PRINCIPAL FINDINGS: We extracted descriptive data on a random sample of 578 trials. Ninety-six percent of the trials were published in English; the percentage of child-only trials was 90.5%. The most frequent diagnostic categories were infectious diseases (13.2%, behavioural and psychiatric disorders (11.6%, neonatal critical care (11.4%, respiratory disorders (8.9%, non-critical neonatology (7.9%, and anaesthesia (6.5%. There were significantly fewer child-only studies (i.e., more mixed child and adult studies over time (P = 0.0460. The proportion of RCTs to CCTs increased significantly over time (P<0.0001, as did the proportion of multicentre trials (P = 0.002. Significant increases over time were found in methodological quality (Jadad score (P<0.0001, the proportion of double-blind studies (P<0.0001, and studies with adequate allocation concealment (P<0.0001. Additionally, we found an improvement in reporting over time: adequate description of withdrawals and losses to follow-up (P<0.0001, sample size calculations (P<0.0001, and intention-to-treat analysis (P<0.0001. However, many trials still do not describe their level of blinding, and allocation concealment was inadequately reported in the majority of studies across the entire time period. The proportion of studies with industry funding decreased slightly over time (P = 0.003, and these studies were more likely to report positive conclusions (P = 0.028. CONCLUSIONS/SIGNIFICANCE: The quantity and quality of pediatric controlled trials has increased over time; however

  16. Weed Control Trials in Cottonwood Plantations

    Science.gov (United States)

    R. M. Krinard

    1964-01-01

    Weed control in the first year is essential for establishing a cottonwood plantation, for the young trees can neither survive nor grow well if they must compete with other plants. Once the light and moisture conditions are established in its favor, cottonwood becomes the fastest growing tree in the South.

  17. Prevention of abdominal wound infection (PROUD trial, DRKS00000390: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Heger Ulrike

    2011-11-01

    Full Text Available Abstract Background Wound infection affects a considerable portion of patients after abdominal operations, increasing health care costs and postoperative morbidity and affecting quality of life. Antibacterial coating has been suggested as an effective measure to decrease postoperative wound infections after laparotomies. The INLINE metaanalysis has recently shown the superiority of a slowly absorbable continuous suture for abdominal closure; with PDS plus® such a suture has now been made available with triclosan antibacterial coating. Methods/Design The PROUD trial is designed as a randomised, controlled, observer, surgeon and patient blinded multicenter superiority trial with two parallel groups and a primary endpoint of wound infection during 30 days after surgery. The intervention group will receive triclosan coated polydioxanone sutures, whereas the control group will receive the standard polydioxanone sutures; abdominal closure will otherwise be standardized in both groups. Statistical analysis is based on intention-to-treat population via binary logistic regression analysis, the total sample size of n = 750 is sufficient to ensure alpha = 5% and power = 80%, an interim analysis will be carried out after data of 375 patients are available. Discussion The PROUD trial will yield robust data to determine the effectiveness of antibacterial coating in one of the standard sutures for abdominal closure and potentially lead to amendment of current guidelines. The exploration of clinically objective parameters as well as quality of life holds immediate relevance for clinical management and the pragmatic trial design ensures high external validity. Trial Registration The trial protocol has been registered with the German Clinical Trials Register (DRKS00000390.

  18. Acupuncture for Posttraumatic Stress Disorder: A Systematic Review of Randomized Controlled Trials and Prospective Clinical Trials

    Directory of Open Access Journals (Sweden)

    Young-Dae Kim

    2013-01-01

    Full Text Available To evaluate the current evidence for effectiveness of acupuncture for posttraumatic stress disorder (PTSD in the form of a systematic review, a systematic literature search was conducted in 23 electronic databases. Grey literature was also searched. The key search terms were “acupuncture” and “PTSD.” No language restrictions were imposed. We included all randomized or prospective clinical trials that evaluated acupuncture and its variants against a waitlist, sham acupuncture, conventional therapy control for PTSD, or without control. Four randomized controlled trials (RCTs and 2 uncontrolled clinical trials (UCTs out of 136 articles in total were systematically reviewed. One high-quality RCT reported that acupuncture was superior to waitlist control and therapeutic effects of acupuncture and cognitive-behavioral therapy (CBT were similar based on the effect sizes. One RCT showed no statistical difference between acupuncture and selective serotonin reuptake inhibitors (SSRIs. One RCT reported a favorable effect of acupoint stimulation plus CBT against CBT alone. A meta-analysis of acupuncture plus moxibustion versus SSRI favored acupuncture plus moxibustion in three outcomes. This systematic review and meta-analysis suggest that the evidence of effectiveness of acupuncture for PTSD is encouraging but not cogent. Further qualified trials are needed to confirm whether acupuncture is effective for PTSD.

  19. Acupuncture for posttraumatic stress disorder: a systematic review of randomized controlled trials and prospective clinical trials.

    Science.gov (United States)

    Kim, Young-Dae; Heo, In; Shin, Byung-Cheul; Crawford, Cindy; Kang, Hyung-Won; Lim, Jung-Hwa

    2013-01-01

    To evaluate the current evidence for effectiveness of acupuncture for posttraumatic stress disorder (PTSD) in the form of a systematic review, a systematic literature search was conducted in 23 electronic databases. Grey literature was also searched. The key search terms were "acupuncture" and "PTSD." No language restrictions were imposed. We included all randomized or prospective clinical trials that evaluated acupuncture and its variants against a waitlist, sham acupuncture, conventional therapy control for PTSD, or without control. Four randomized controlled trials (RCTs) and 2 uncontrolled clinical trials (UCTs) out of 136 articles in total were systematically reviewed. One high-quality RCT reported that acupuncture was superior to waitlist control and therapeutic effects of acupuncture and cognitive-behavioral therapy (CBT) were similar based on the effect sizes. One RCT showed no statistical difference between acupuncture and selective serotonin reuptake inhibitors (SSRIs). One RCT reported a favorable effect of acupoint stimulation plus CBT against CBT alone. A meta-analysis of acupuncture plus moxibustion versus SSRI favored acupuncture plus moxibustion in three outcomes. This systematic review and meta-analysis suggest that the evidence of effectiveness of acupuncture for PTSD is encouraging but not cogent. Further qualified trials are needed to confirm whether acupuncture is effective for PTSD.

  20. Surgical trials in oncology. the importance of quality control in the TME trial.

    Science.gov (United States)

    Klein Kranenbarg, E; van de Velde, C J H

    2002-05-01

    Results from randomised trials provide the best scientific evidence of efficacy or inefficacy of the therapy. The evaluation of surgical procedures involves problems in addition to those associated with medical experimentation. Surgery, unlike a pill, is not a standardised, reproducible entity, but a unique product whose details are defined by, for example, the skill of the surgeon. Quality assurance is important for treatment and also for data handling. The different treatments (surgery, pathology, radiotherapy, etc.) should be familiar to all participating physicians prior to the start of the trial. Instructions can be given by means of a well-written protocol, videotapes, workshops and instructors at the dissection table. The data collection and data check should be done by data managers and co-ordinators for the separate disciplines. Errors and missing data should be completed and feedback to the physician is essential. Close contact between an active co-ordinating data centre, including co-ordinators for the separate disciplines, and all participating physicians is essential to conduct a quality controlled multicentre, multidisciplinary trial. Continuous enthusiasm can be maintained by the organisation of regular workshops, distribution of newsletters and trial up-dates at scientific meetings. The efforts from all of the involved co-ordinators, data managers, instructors and physicians have resulted in a very successful trial with rapid accrual, good quality treatments and procedures, good quality data, and a high participation rate among hospitals and patients. Quality control is expensive and labour-intensive, but it is worthwhile.

  1. Pluto behaving badly: false beliefs and their consequences.

    Science.gov (United States)

    Berkowitz, Shari R; Laney, Cara; Morris, Erin K; Garry, Maryanne; Loftus, Elizabeth F

    2008-01-01

    We exposed college students to suggestive materials in order to lead them to believe that, as children, they had a negative experience at Disneyland involving the Pluto character. A sizable minority of subjects developed a false belief or memory that Pluto had uncomfortably licked their ear. Suggestions about a positive experience with Pluto led to even greater acceptance of a lovable ear-licking episode. False beliefs and memories had repercussions; those seduced by the bad suggestions were not willing to pay as much for a Pluto souvenir. These findings are among the first to demonstrate that false beliefs can have repercussions for people, meaning that they can influence their later thoughts, beliefs, and behaviors.

  2. Pluto Moons exhibit Orbital Angular Momentum Quantization per Mass

    Directory of Open Access Journals (Sweden)

    Potter F.

    2012-10-01

    Full Text Available The Pluto satellite system of the planet plus five moons is shown to obey the quan- tum celestial mechanics (QCM angular momentum per mass quantization condition predicted for any gravitationally bound system.

  3. The atmosphere of Pluto as observed by New Horizons.

    Science.gov (United States)

    Gladstone, G Randall; Stern, S Alan; Ennico, Kimberly; Olkin, Catherine B; Weaver, Harold A; Young, Leslie A; Summers, Michael E; Strobel, Darrell F; Hinson, David P; Kammer, Joshua A; Parker, Alex H; Steffl, Andrew J; Linscott, Ivan R; Parker, Joel Wm; Cheng, Andrew F; Slater, David C; Versteeg, Maarten H; Greathouse, Thomas K; Retherford, Kurt D; Throop, Henry; Cunningham, Nathaniel J; Woods, William W; Singer, Kelsi N; Tsang, Constantine C C; Schindhelm, Eric; Lisse, Carey M; Wong, Michael L; Yung, Yuk L; Zhu, Xun; Curdt, Werner; Lavvas, Panayotis; Young, Eliot F; Tyler, G Leonard

    2016-03-18

    Observations made during the New Horizons flyby provide a detailed snapshot of the current state of Pluto's atmosphere. Whereas the lower atmosphere (at altitudes of less than 200 kilometers) is consistent with ground-based stellar occultations, the upper atmosphere is much colder and more compact than indicated by pre-encounter models. Molecular nitrogen (N2) dominates the atmosphere (at altitudes of less than 1800 kilometers or so), whereas methane (CH4), acetylene (C2H2), ethylene (C2H4), and ethane (C2H6) are abundant minor species and likely feed the production of an extensive haze that encompasses Pluto. The cold upper atmosphere shuts off the anticipated enhanced-Jeans, hydrodynamic-like escape of Pluto's atmosphere to space. It is unclear whether the current state of Pluto's atmosphere is representative of its average state--over seasonal or geologic time scales. Copyright © 2016, American Association for the Advancement of Science.

  4. The Atmosphere of Pluto as Observed by New Horizons

    CERN Document Server

    Gladstone, G Randall; Ennico, Kimberly; Olkin, Catherine B; Weaver, Harold A; Young, Leslie A; Summers, Michael E; Strobel, Darrell F; Hinson, David P; Kammer, Joshua A; Parker, Alex H; Steffl, Andrew J; Linscott, Ivan R; Parker, Joel Wm; Cheng, Andrew F; Slater, David C; Versteeg, Maarten H; Greathouse, Thomas K; Retherford, Kurt D; Throop, Henry; Cunningham, Nathaniel J; Woods, William W; Singer, Kelsi N; Tsang, Constantine C C; Schindhelm, Eric; Lisse, Carey M; Wong, Michael L; Yung, Yuk L; Zhu, Xun; Curdt, Werner; Lavvas, Panayotis; Young, Eliot F; Tyler, G Leonard

    2016-01-01

    Observations made during the New Horizons flyby provide a detailed snapshot of the current state of Pluto's atmosphere. While the lower atmosphere (at altitudes <200 km) is consistent with ground-based stellar occultations, the upper atmosphere is much colder and more compact than indicated by pre-encounter models. Molecular nitrogen (N$_2$) dominates the atmosphere (at altitudes <1800 km or so), while methane (CH$_4$), acetylene (C$_2$H$_2$), ethylene (C$_2$H$_4$), and ethane (C$_2$H$_6$) are abundant minor species, and likely feed the production of an extensive haze which encompasses Pluto. The cold upper atmosphere shuts off the anticipated enhanced-Jeans, hydrodynamic-like escape of Pluto's atmosphere to space. It is unclear whether the current state of Pluto's atmosphere is representative of its average state--over seasonal or geologic time scales.

  5. Randomized controlled trials – a matter of design

    Science.gov (United States)

    Spieth, Peter Markus; Kubasch, Anne Sophie; Penzlin, Ana Isabel; Illigens, Ben Min-Woo; Barlinn, Kristian; Siepmann, Timo

    2016-01-01

    Randomized controlled trials (RCTs) are the hallmark of evidence-based medicine and form the basis for translating research data into clinical practice. This review summarizes commonly applied designs and quality indicators of RCTs to provide guidance in interpreting and critically evaluating clinical research data. It further reflects on the principle of equipoise and its practical applicability to clinical science with an emphasis on critical care and neurological research. We performed a review of educational material, review articles, methodological studies, and published clinical trials using the databases MEDLINE, PubMed, and ClinicalTrials.gov. The most relevant recommendations regarding design, conduction, and reporting of RCTs may include the following: 1) clinically relevant end points should be defined a priori, and an unbiased analysis and report of the study results should be warranted, 2) both significant and nonsignificant results should be objectively reported and published, 3) structured study design and performance as indicated in the Consolidated Standards of Reporting Trials statement should be employed as well as registration in a public trial database, 4) potential conflicts of interest and funding sources should be disclaimed in study report or publication, and 5) in the comparison of experimental treatment with standard care, preplanned interim analyses during an ongoing RCT can aid in maintaining clinical equipoise by assessing benefit, harm, or futility, thus allowing decision on continuation or termination of the trial. PMID:27354804

  6. The Exploration of the Pluto System by New Horizons

    Science.gov (United States)

    Weaver, Harold; Stern, S. Alan

    2016-07-01

    The New Horizons (NH) mission was selected by NASA in November 2001 to conduct the first in situ reconnaissance of Pluto and the Kuiper belt. The NH spacecraft was launched on 2006 January 19, received a gravity assist from Jupiter during closest approach on 2007 February 28, and flew 12,500 km above Pluto's surface on 2015 July 14. NH carried a sophisticated suite of seven scientific instruments, altogether weighing less than 30 kg and drawing less than 30 W of power, that includes panchromatic and color imagers, ultraviolet and infrared spectral imagers, a radio science package, plasma and charged particle sensors, and a dust counting experiment. The NH flyby of the Pluto system executed flawlessly, providing unprecedented detail on the Pluto-Charon binary and Pluto's four small moons (Styx, Nix, Kerberos, and Hydra, in order of their orbital distance from Pluto). Pluto's surface displays diverse landforms, terrain ages, albedos, colors, and composition gradients. Evidence is found for a water-ice crust, geologically young surface units, surface ice convection, wind streaks, volatile transport, and glacial flow. NH discovered trace hydrocarbons in Pluto's atmosphere, multiple global haze layers, and a surface pressure near 10 microbars. Pluto's diverse surface geology and long term activity raise fundamental questions about how small planets remain active many billions of years (Gyr) after formation. Charon displays tectonics, evidence for a heterogeneous crustal composition, and a puzzling giant hood of dark material covering its North Pole. Crater density statistics for Charon's surface give a crater retention age of 4-4.5 Ga, indicating that Charon's geological evolution largely ceased early in its history. Nix and Hydra have high albedos suggestive of H2O-ice covered surfaces. Crater densities on Nix and Hydra indicate surface ages > 4 Ga. All the small satellites have highly elongated shapes and are rotating much faster then synchronous with their orbital

  7. The floating ices on the surface of Pluto

    Science.gov (United States)

    Vidmachenko, A. P.

    2016-05-01

    The average temperature of of Pluto surface is about 40 K. Because of the substantial eccentricity of the orbit of Pluto when approaching the Sun - the ice melts on its surface, and this leads to the formation of an atmosphere consisting mainly of nitrogen and methane sublimated. Water ice is not only deep, but there is also on the surface of the planet, forming a mountain range up to 3-4 km altitude, and small unique icebergs.

  8. Separate spectra of Pluto and its satellite Charon

    Energy Technology Data Exchange (ETDEWEB)

    Fink, U.; Disanti, M.A.

    1988-01-01

    The March 3, 1987 occultation of Charon by Pluto was observed spectroscopically from 5400 to 10,200 A at a resolution of 12 A. The midpoint of the event occurred at 11:06 UT; the depth of the event at 6800 A was 0.162 mag. The spectrum of Charon is completely featureless and almost perfectly flat; the red slope and the CH4 absorption features can be attributed solely to Pluto. 17 references.

  9. Optical Navigation Preparations for New Horizons Pluto Flyby

    Science.gov (United States)

    Owen, William M., Jr.; Dumont, Philip J.; Jackman, Coralie D.

    2012-01-01

    The New Horizons spacecraft will encounter Pluto and its satellites in July 2015. As was the case for the Voyager encounters with Jupiter, Saturn, Uranus and Neptune, mission success will depend heavily on accurate spacecraft navigation, and accurate navigation will be impossible without the use of pictures of the Pluto system taken by the onboard cameras. We describe the preparations made by the New Horizons optical navigators: picture planning, image processing algorithms, software development and testing, and results from in-flight imaging.

  10. Kepler K2 Precision Lightcurve Observations of Pluto: Preliminary Results

    Science.gov (United States)

    Lisse, Casey M.; Benecchi, Susan D.; Binzel, Richard; Schwamb, Megan Elizabeth; New Horizons Science Team

    2016-10-01

    Pluto is a key object in the third zone of our Solar System and provides important insight into formation and collisional processes that were at work in the early solar system. In July 2015 the New Horizons spacecraft successfully obtained high resolution fly-by clear filter imaging observations of the Pluto system. We report on our continued monitoring of the Pluto system from October-December 2015 using the Kepler spacecraft's imaging photometer during Campaign 7 of the K2 extended mission (Howell et al. 2014). We obtained an unprecedented 83-day nearly continuous lightcurve with measurements every 30 minutes using Kepler's long cadence sampling. The result was 3,980 discrete, unresolved measurements of the combined Pluto system. The 3-month baseline allowed us to sample rotational variations and solar phase angles ranging from 1.1°-1.7° during the period of observation. This dataset is a key baseline for advancing the study of Pluto's actively evolving surface-atmosphere interaction as revealed by the surface geomorphology discovered by New Horizons. Our challenge is to gain an understanding of the ways in which Pluto's surface can be evolving as it recedes from the Sun, and of the influence of Pluto and Charon on each other. In this paper, we present our preliminary results from our K2 dataset. We describe the challenges in reducing the K2 lightcurve data for a target moving across the K2 FOV, and our progress in understanding the lightcurve's variability, which in our current reduction is due to a combination of systematics in the K2 dataset and inherent characteristics of the Pluto system's rotation and changing orbital geometry wrt the Sun and the Earth.This work was supported by NASA's K2 and New Horizons missions.

  11. Directional sensitivity of "first trial" reactions in human balance control.

    NARCIS (Netherlands)

    Oude Nijhuis, L.B.; Allum, J.H.J.; Borm, G.F.; Honegger, F.; Overeem, S.; Bloem, B.R.

    2009-01-01

    Support-surface movements are commonly used to examine balance control. Subjects typically receive a series of identical or randomly interspersed multidirectional balance perturbations and the atypical "first trial reaction" (evoked by the first perturbation) is often excluded from further analysis.

  12. Franklin, Lavoisier, and Mesmer: origin of the controlled clinical trial.

    Science.gov (United States)

    Herr, Harry W

    2005-01-01

    In 1784, a Royal Commission headed by Benjamin Franklin and Antoine Lavoisier designed a series of ingenious experiments to debunk France's greatest medical rogue, Anton Mesmer, and his bizarre healing of illnesses based on his bogus theory of animal magnetism. Using intentional subject ignorance and sham interventions to investigate mesmerism, Franklin's commission provided a model for the controlled clinical trial.

  13. A controlled trial of ambroxol in chronic bronchitis.

    Science.gov (United States)

    Guyatt, G H; Townsend, M; Kazim, F; Newhouse, M T

    1987-10-01

    Ambroxol is a mucolytic agent which is widely used in chronic bronchitis in Europe. We conducted a double-blind randomized controlled trial of ambroxol vs matched placebo in 90 patients with chronic bronchitis and difficulty clearing secretions. It was concluded that there was no advantage to taking ambroxol.

  14. Yoga in schizophrenia : a systematic review of randomised controlled trials

    NARCIS (Netherlands)

    Vancampfort, D.; Vansteelandt, K.; Scheewe, T.; Probst, M.; Knapen, J.; De Herdt, A.; De Hert, M.

    2012-01-01

    Vancampfort D, Vansteelandt K, Scheewe T, Probst M, Knapen J, De Herdt A, De Hert M. Yoga in schizophrenia: a systematic review of randomised controlled trials. Objective: The objective of this systematic review was to assess the effectiveness of yoga as a complementary treatment on general psychopa

  15. Amalgam and ART restorations in children: a controlled clinical trial

    NARCIS (Netherlands)

    Amorim, R.G. de; Leal, S.C.; Mulder, J.; Creugers, N.H.J.; Frencken, J.E.F.M.

    2014-01-01

    OBJECTIVES: The aims of this study were to compare 2-year cumulative survival rates of amalgam and atraumatic restorative treatment (ART) restorations in primary molars and to investigate the determinants of the survival rate of restorations. MATERIALS AND METHODS: A controlled clinical trial using

  16. Yoga in schizophrenia : a systematic review of randomised controlled trials

    NARCIS (Netherlands)

    Vancampfort, D.; Vansteelandt, K.; Scheewe, T.; Probst, M.; Knapen, J.; De Herdt, A.; De Hert, M.

    2012-01-01

    Vancampfort D, Vansteelandt K, Scheewe T, Probst M, Knapen J, De Herdt A, De Hert M. Yoga in schizophrenia: a systematic review of randomised controlled trials. Objective: The objective of this systematic review was to assess the effectiveness of yoga as a complementary treatment on general psychopa

  17. Using Randomized Controlled Trials to Evaluate Interventions for Releasing Prisoners

    Science.gov (United States)

    Pettus-Davis, Carrie; Howard, Matthew Owen; Dunnigan, Allison; Scheyett, Anna M.; Roberts-Lewis, Amelia

    2016-01-01

    Randomized controlled trials (RCTs) are rarely used to evaluate social and behavioral interventions designed for releasing prisoners. Objective: We use a pilot RCT of a social support intervention (Support Matters) as a case example to discuss obstacles and strategies for conducting RCT intervention evaluations that span prison and community…

  18. The effect of orthodontic referral guidelines: A randomised controlled trial

    OpenAIRE

    Conboy, Frances; O'Brien, K.

    2000-01-01

    Objective To develop and evaluate the effectiveness of referral guidelines for the referral of orthodontic patients to consultant and specialist practijioner orthodontists. Design Single centre randomised controlled trial with random allocation of referral guidelines for orthodontic treatment to general dental practitioners. Setting Hospital orthodontic departments and specialist orthodontic practices in Manchester and Stockport. Subjects General dental practitioners and the patients they ref...

  19. Asthma Self-Management Model: Randomized Controlled Trial

    Science.gov (United States)

    Olivera, Carolina M. X.; Vianna, Elcio Oliveira; Bonizio, Roni C.; de Menezes, Marcelo B.; Ferraz, Erica; Cetlin, Andrea A.; Valdevite, Laura M.; Almeida, Gustavo A.; Araujo, Ana S.; Simoneti, Christian S.; de Freitas, Amanda; Lizzi, Elisangela A.; Borges, Marcos C.; de Freitas, Osvaldo

    2016-01-01

    Information for patients provided by the pharmacist is reflected in adhesion to treatment, clinical results and patient quality of life. The objective of this study was to assess an asthma self-management model for rational medicine use. This was a randomized controlled trial with 60 asthmatic patients assigned to attend five modules presented by…

  20. Chemical Control of Pennesetum Purpureum Laboratory Trials

    Directory of Open Access Journals (Sweden)

    B.N Tripathi

    1977-10-01

    Full Text Available Dichloral urea, diethyl chloracetamide, nitrourea, chloralhydrate, sodium trichloroacetate, sodium borate, ammonium thiocynate, sodium arsenite, arsenic oxide-sulphuric acid mixture, sodium chlorate, maleic hydrazide and the salts containing inorganic ions Cu/sup 2+/, Co/sup 2+/, MoO/sub 4//sup 2-/ and Zn/sup 2+/ were tested in experimental plots for their phytotoxic activity on a hybrid variety of Pennesetum purpureum. Sodium borate (2500 Kg/hectare, Sodium arsenite (250 Kg/hectare and sodium chlorate (1000 Kg/hectare through soil and ammonium thiocyanate (100 Kg/hectare through direct spray function as growth retardants. Arsenic oxide-sulphuric acid (100 : 300 Kg/hectare spray kills the existing leaves. Sodium chlorate (250 Kg/hectare spray exerts phytocidal action on young plants (3 weeks. Maleic hydrazide (50 Kg/hectare exerts permanent growth suppressant action on older plants (height >=1 m and kills the existing leaves of younger plants (height=<0.5 m. Copper sulphate (100 Kg/hectare induces partial drying of existing leaves and cobalt sulphate in the same dose induces yellowing of leaves extending the period of growth beyond the season of maximum growth of the control. Ammonium molybdate and Zinc acetate in the same dose do not exert any perceptible effect.

  1. The Atmosphere of Pluto as Observed by New Horizons

    Science.gov (United States)

    Gladstone, Randy

    2016-07-01

    A major goal of the New Horizons (NH) mission was to explore and characterize the structure and composition of Pluto's atmosphere. Several instruments onboard NH contributed to these goals, primarily: 1) the REX instrument, through uplink X-band radio occultations, 2) the Alice instrument, through extreme- and far-ultraviolet solar occultations, and 3) the LORRI panchromatic and MVIC color imagers, through high-resolution imaging. The associated datasets were obtained near closest approach of NH to Pluto at 11:48 UT on 14 July 2015. Pressure and temperature profiles of the lower atmosphere are derived from the REX radio occultation data, the composition and structure of the extended atmosphere are derived from the Alice solar occultation data, and the distribution and properties of Pluto's hazes are derived from the LORRI and MVIC imaging data. The observations made during the NH flyby provide a detailed snapshot of the current state of Pluto's atmosphere. While the lower atmosphere (at altitudes less than 200 km) is largely consistent with ground-based stellar occultations, the upper atmosphere is much colder and more compact than indicated by pre-encounter models. Molecular nitrogen dominates the atmosphere (at altitudes less than 1800 km or so), while methane, acetylene, ethylene, and ethane are important minor species, and likely help produce the haze which surrounds Pluto. The cold upper atmosphere considerably reduces the magnitude of the hydrodynamic escape of Pluto's atmosphere to space. In this talk an overview of the atmosphere science results will be presented.

  2. Global distribution of Pluto's atmosphere

    Energy Technology Data Exchange (ETDEWEB)

    Trafton, L.; Stern, S.A.

    1983-04-15

    Pluto's volatile atmosphere currently extends essentially uniformly around the globe and has nearly uniform thickness, discounting topographic elevation differences and tidal effects. Although in equilibrium with the surface ice, the atmosphere does not noticeably freeze out on the night side, during eclipses of the Sun by Charon, or at the poles during Pluto's present season near perihelion. The bulk thermal tide is negligible. The rotational and tidal deformations of the atmosphere affect the atmospheric thickness of 0.6--2% for a pure CH/sub 4/ atmosphere, depending on the unknown mass of Charon, and up to 15% for an atmosphere with high mean molecular weight. An important consequence of the global uniformity of Pluto's atmosphere and the observed CH/sub 4/ column abundance of 27 +- 7 m--Am is that Pluto's surface is close to 58 K over the entire globe. This compares with the value approx.43 K expected on the basis of insolation and blackbody radiation. We suggest that the explanation for Pluto's elevated surface temperature is the low thermal emissivity of solid CH/sub 4/, expected on the basis of the absence of a rotational spectrum in the gas. Solid CH/sub 4/, which covers an appreciable portion of Pluto's surface, can absorb sunlight in the visible and near-infrared bands but lacks opacity at thermal wavelengths to radiate the absorbed energy efficiently.

  3. Placebo-controlled trials and the Declaration of Helsinki.

    Science.gov (United States)

    Lewis, John A; Jonsson, Bertil; Kreutz, Gottfried; Sampaio, Cristina; van Zwieten-Boot, Barbara

    2002-04-13

    A revised version of the Declaration of Helsinki, issued in October, 2000, remains a vital expression of medical ethics, and deserves unanimous support. A strict interpretation of the declaration seems to rule out clinical trials that use a placebo control group whenever licensed therapeutic methods already exist, preferring active controls. Although the efficacy of some new medicines can be satisfactorily established without the use of a placebo, for others the judicious use of placebo remains essential to establish their effectiveness.

  4. Ear Acupuncture for Acute Sore Throat: A Randomized Controlled Trial

    Science.gov (United States)

    2014-09-26

    SEP 2014 2. REPORT TYPE Final 3. DATES COVERED 4. TITLE AND SUBTITLE Ear acupuncture for acute sore throat. A randomized controlled trial...Auncular Acupuncture is a low risk option for acute pain control •Battlefield acupuncture (BFA) IS a specific auncular acupuncture technique •BFA IS...Strengths: Prospect1ve RCT •Weaknesses Small sample stze. no sham acupuncture performed, patients not blinded to treatment •Th1s study represents an

  5. Calculating sample size in trials using historical controls.

    Science.gov (United States)

    Zhang, Song; Cao, Jing; Ahn, Chul

    2010-08-01

    Makuch and Simon [Sample size considerations for non-randomised comparative studies. J Chronic Dis 1980; 33: 175-81.] developed a sample size formula for historical control trials. When assessing power, they assumed the true control treatment effect to be equal to the observed effect from the historical control group. Many researchers have pointed out that the Makuch-Simon approach does not preserve the nominal power and type I error when considering the uncertainty in the true historical control treatment effect. To develop a sample size formula that properly accounts for the underlying randomness in the observations from the historical control group. We reveal the extremely skewed nature in the distributions of power and type I error, obtained over all the random realizations of the historical control data. The skewness motivates us to derive a sample size formula that controls the percentiles, instead of the means, of the power and type I error. A closed-form sample size formula is developed to control arbitrary percentiles of power and type I error for historical control trials. A simulation study further demonstrates that this approach preserves the operational characteristics in a more realistic scenario where the population variances are unknown and replaced by sample variances. The closed-form sample size formula is derived for continuous outcomes. The formula is more complicated for binary or survival time outcomes. We have derived a closed-form sample size formula that controls the percentiles instead of means of power and type I error in historical control trials, which have extremely skewed distributions over all the possible realizations of historical control data.

  6. Fusion-Enabled Pluto Orbiter and Lander

    Science.gov (United States)

    Thomas, Stephanie

    2017-01-01

    The Pluto orbiter mission proposed here is credible and exciting. The benefits to this and all outer-planet and interstellar-probe missions are difficult to overstate. The enabling technology, Direct Fusion Drive, is a unique fusion engine concept based on the Princeton Field-Reversed Configuration (PFRC) fusion reactor under development at the Princeton Plasma Physics Laboratory. The truly game-changing levels of thrust and power in a modestly sized package could integrate with our current launch infrastructure while radically expanding the science capability of these missions. During this Phase I effort, we made great strides in modeling the engine efficiency, thrust, and specific impulse and analyzing feasible trajectories. Based on 2D fluid modeling of the fusion reactors outer stratum, its scrape-off-layer (SOL), we estimate achieving 2.5 to 5 N of thrust for each megawatt of fusion power, reaching a specific impulse, Isp, of about 10,000 s. Supporting this model are particle-in-cell calculations of energy transfer from the fusion products to the SOL electrons. Subsequently, this energy is transferred to the ions as they expand through the magnetic nozzle and beyond. Our point solution for the Pluto mission now delivers 1000 kg of payload to Pluto orbit in 3.75 years using 7.5 N constant thrust. This could potentially be achieved with a single 1 MW engine. The departure spiral from Earth orbit and insertion spiral to Pluto orbit require only a small portion of the total delta-V. Departing from low Earth orbit reduces mission cost while increasing available mission mass. The payload includes a lander, which utilizes a standard green propellant engine for the landing sequence. The lander has about 4 square meters of solar panels mounted on a gimbal that allows it to track the orbiter, which beams 30 to 50 kW of power using a 1080 nm laser. Optical communication provides dramatically high data rates back to Earth. Our mass modeling investigations revealed that if

  7. The Difficult Birth of NASA's Pluto Mission

    Science.gov (United States)

    Neufeld, Michael J.

    2016-10-01

    The complex and contested origins of the New Horizons mission to Pluto, launched by NASA in 2006, provides a window on how space science policy has been formulated in the United States before and after the turn of the twenty-first century, and how the shifting network of institutions that support and shape space science have changed since 1989. Those decades that have so far been little studied except by policy scholars seeking lessons from the NASA Administrator Daniel Goldin's attempt to force a small-spacecraft technological revolution on space science in the 1990s. The New Horizons case study reveals a shift in the balance of power around 2000 among the important players in the field, increasing the influence of non-NASA actors—notably Congress, science groups and planetary-exploration lobbies. In addition, the origins of New Horizons reveals how contingent the emergence of a particular space science mission can be.

  8. RANDOMIZED CONTROLLED CLINICAL TRIALS IN ORTHOPEDICS: DIFFICULTIES AND LIMITATIONS

    Science.gov (United States)

    Malavolta, Eduardo Angeli; Demange, Marco Kawamura; Gobbi, Riccardo Gomes; Imamura, Marta; Fregni, Felipe

    2015-01-01

    Randomized controlled clinical trials (RCTs) are considered to be the gold standard for evidence-based medicine nowadays, and are important for directing medical practice through consistent scientific observations. Steps such as patient selection, randomization and blinding are fundamental for conducting a RCT, but some additional difficulties are presented in trials that involve surgical procedures, as is common in orthopedics. The aim of this article was to highlight and discuss some difficulties and possible limitations on RCTs within the field of surgery. PMID:27027037

  9. Simulating a Thin Accretion Disk Using PLUTO

    Science.gov (United States)

    Phillipson, Rebecca; Vogeley, Michael S.; Boyd, Patricia T.

    2017-08-01

    Accreting black hole systems such as X-ray binaries and active galactic nuclei exhibit variability in their luminosity on many timescales ranging from milliseconds to tens of days, and even hundreds of days. The mechanism(s) driving this variability and the relationship between short- and long-term variability is poorly understood. Current studies on accretion disks seek to determine how the changes in black hole mass, the rate at which mass accretes onto the central black hole, and the external environment affect the variability on scales ranging from stellar-mass black holes to supermassive black holes. Traditionally, the fluid mechanics equations governing accretion disks have been simplified by considering only the kinematics of the disk, and perhaps magnetic fields, in order for their phenomenological behavior to be predicted analytically. We seek to employ numerical techniques to study accretion disks including more complicated physics traditionally ignored in order to more accurately understand their behavior over time. We present a proof-of-concept three dimensional, global simulation using the astrophysical hydrodynamic code PLUTO of a simplified thin disk model about a central black hole which will serve as the basis for development of more complicated models including external effects such as radiation and magnetic fields. We also develop a tool to generate a synthetic light curve that displays the variability in luminosity of the simulation over time. The preliminary simulation and accompanying synthetic light curve demonstrate that PLUTO is a reliable code to perform sophisticated simulations of accretion disk systems which can then be compared to observational results.

  10. Map of the Pluto System - Children's Edition

    Science.gov (United States)

    Hargitai, H. I.

    2016-12-01

    Cartography is a powerful tool in the scientific visualization and communication of spatial data. Cartographic visualization for children requires special methods. Although almost all known solid surface bodies in the Solar System have been mapped in detail during the last more than 5 decades, books and publications that target children, tweens and teens never include any of the cartographic results of these missions. We have developed a series of large size planetary maps with the collaboration of planetary scientists, cartographers and graphic artists. The maps are based on photomosaics and DTMs that were redrawn as artwork. This process necessarily involved generalization, interpretation and transformation into the visual language that can be understood by children. In the first project we selected six planetary bodies (Venus, the Moon, Mars, Io, Europa and Titan) and invited six illustrators of childrens'books. Although the overall structure of the maps look similar, the visual approach was significantly different. An important addition was that the maps contained a narrative: different characters - astronauts or "alien-like lifeforms" - interacted with the surface. The map contents were translated into 11 languages and published online at https://childrensmaps.wordpress.com.We report here on the new map of the series. Following the New Horizons' Pluto flyby we have started working on a map that, unlike the others, depicts a planetary system, not only one body. Since only one hemisphere was imaged in high resolution, this map is showing the encounter hemispheres of Pluto and Charon. Projected high resolution image mosaics with informal nomenclature were provided by the New Horizons Team. The graphic artist is Adrienn Gyöngyösi. Our future plan is to produce a book format Children's Atlas of Solar System bodies that makes planetary cartographic and astrogeologic results more accessible for children, and the next generation of planetary scientists among them.

  11. The Sexunzipped trial: optimizing the design of online randomized controlled trials.

    Science.gov (United States)

    Bailey, Julia V; Pavlou, Menelaos; Copas, Andrew; McCarthy, Ona; Carswell, Ken; Rait, Greta; Hart, Graham; Nazareth, Irwin; Free, Caroline; French, Rebecca; Murray, Elizabeth

    2013-12-11

    Sexual health problems such as unwanted pregnancy and sexually transmitted infection are important public health concerns and there is huge potential for health promotion using digital interventions. Evaluations of digital interventions are increasingly conducted online. Trial administration and data collection online offers many advantages, but concerns remain over fraudulent registration to obtain compensation, the quality of self-reported data, and high attrition. This study addresses the feasibility of several dimensions of online trial design-recruitment, online consent, participant identity verification, randomization and concealment of allocation, online data collection, data quality, and retention at 3-month follow-up. Young people aged 16 to 20 years and resident in the United Kingdom were recruited to the "Sexunzipped" online trial between November 2010 and March 2011 (n=2036). Participants filled in baseline demographic and sexual health questionnaires online and were randomized to the Sexunzipped interactive intervention website or to an information-only control website. Participants were also randomly allocated to a postal request (or no request) for a urine sample for genital chlamydia testing and receipt of a lower (£10/US$16) or higher (£20/US$32) value shopping voucher compensation for 3-month outcome data. The majority of the 2006 valid participants (90.98%, 1825/2006) were aged between 18 and 20 years at enrolment, from all four countries in the United Kingdom. Most were white (89.98%, 1805/2006), most were in school or training (77.48%, 1545/1994), and 62.81% (1260/2006) of the sample were female. In total, 3.88% (79/2036) of registrations appeared to be invalid and another 4.00% (81/2006) of participants gave inconsistent responses within the questionnaire. The higher value compensation (£20/US$32) increased response rates by 6-10%, boosting retention at 3 months to 77.2% (166/215) for submission of online self-reported sexual health

  12. Trial-to-trial adaptation in control of arm reaching and standing posture.

    Science.gov (United States)

    Pienciak-Siewert, Alison; Horan, Dylan P; Ahmed, Alaa A

    2016-12-01

    Classical theories of motor learning hypothesize that adaptation is driven by sensorimotor error; this is supported by studies of arm and eye movements that have shown that trial-to-trial adaptation increases with error. Studies of postural control have shown that anticipatory postural adjustments increase with the magnitude of a perturbation. However, differences in adaptation have been observed between the two modalities, possibly due to either the inherent instability or sensory uncertainty in standing posture. Therefore, we hypothesized that trial-to-trial adaptation in posture should be driven by error, similar to what is observed in arm reaching, but the nature of the relationship between error and adaptation may differ. Here we investigated trial-to-trial adaptation of arm reaching and postural control concurrently; subjects made reaching movements in a novel dynamic environment of varying strengths, while standing and holding the handle of a force-generating robotic arm. We found that error and adaptation increased with perturbation strength in both arm and posture. Furthermore, in both modalities, adaptation showed a significant correlation with error magnitude. Our results indicate that adaptation scales proportionally with error in the arm and near proportionally in posture. In posture only, adaptation was not sensitive to small error sizes, which were similar in size to errors experienced in unperturbed baseline movements due to inherent variability. This finding may be explained as an effect of uncertainty about the source of small errors. Our findings suggest that in rehabilitation, postural error size should be considered relative to the magnitude of inherent movement variability.

  13. Qigong and Fibromyalgia: Randomized Controlled Trials and Beyond

    Directory of Open Access Journals (Sweden)

    Jana Sawynok

    2014-01-01

    Full Text Available Introduction. Qigong is currently considered as meditative movement, mindful exercise, or complementary exercise and is being explored for relief of symptoms in fibromyalgia. Aim. This narrative review summarizes randomized controlled trials, as well as additional studies, of qigong published to the end of 2013 and discusses relevant methodological issues. Results. Controlled trials indicate regular qigong practice (daily, 6–8 weeks produces improvements in core domains for fibromyalgia (pain, sleep, impact, and physical and mental function that are maintained at 4–6 months compared to wait-list subjects or baselines. Comparisons with active controls show little difference, but compared to baseline there are significant and comparable effects in both groups. Open-label studies provide information that supports benefit but remain exploratory. An extension trial and case studies involving extended practice (daily, 6–12 months indicate marked benefits but are limited by the number of participants. Benefit appears to be related to amount of practice. Conclusions. There is considerable potential for qigong to be a useful complementary practice for the management of fibromyalgia. However, there are unique methodological challenges, and exploration of its clinical potential will need to focus on pragmatic issues and consider a spectrum of trial designs. Mechanistic considerations need to consider both system-wide and more specific effects.

  14. Randomized Controlled Trials of Add-On Antidepressants in Schizophrenia.

    Science.gov (United States)

    Terevnikov, Viacheslav; Joffe, Grigori; Stenberg, Jan-Henry

    2015-05-19

    Despite adequate treatment with antipsychotics, a substantial number of patients with schizophrenia demonstrate only suboptimal clinical outcome. To overcome this challenge, various psychopharmacological combination strategies have been used, including antidepressants added to antipsychotics. To analyze the efficacy of add-on antidepressants for the treatment of negative, positive, cognitive, depressive, and antipsychotic-induced extrapyramidal symptoms in schizophrenia, published randomized controlled trials assessing the efficacy of adjunctive antidepressants in schizophrenia were reviewed using the following parameters: baseline clinical characteristics and number of patients, their on-going antipsychotic treatment, dosage of the add-on antidepressants, duration of the trial, efficacy measures, and outcomes. There were 36 randomized controlled trials reported in 41 journal publications (n=1582). The antidepressants used were the selective serotonin reuptake inhibitors, duloxetine, imipramine, mianserin, mirtazapine, nefazodone, reboxetin, trazodone, and bupropion. Mirtazapine and mianserin showed somewhat consistent efficacy for negative symptoms and both seemed to enhance neurocognition. Trazodone and nefazodone appeared to improve the antipsychotics-induced extrapyramidal symptoms. Imipramine and duloxetine tended to improve depressive symptoms. No clear evidence supporting selective serotonin reuptake inhibitors' efficacy on any clinical domain of schizophrenia was found. Add-on antidepressants did not worsen psychosis. Despite a substantial number of randomized controlled trials, the overall efficacy of add-on antidepressants in schizophrenia remains uncertain mainly due to methodological issues. Some differences in efficacy on several schizophrenia domains seem, however, to exist and to vary by the antidepressant subgroups--plausibly due to differences in the mechanisms of action. Antidepressants may not worsen the course of psychosis. Better designed

  15. Impact of Length or Relevance of Questionnaires on Attrition in Online Trials: Randomized Controlled Trial

    Science.gov (United States)

    Kalaitzaki, Eleftheria; White, Ian R; Khadjesari, Zarnie; Murray, Elizabeth; Linke, Stuart; Thompson, Simon G; Godfrey, Christine; Wallace, Paul

    2011-01-01

    Background There has been limited study of factors influencing response rates and attrition in online research. Online experiments were nested within the pilot (study 1, n = 3780) and main trial (study 2, n = 2667) phases of an evaluation of a Web-based intervention for hazardous drinkers: the Down Your Drink randomized controlled trial (DYD-RCT). Objectives The objective was to determine whether differences in the length and relevance of questionnaires can impact upon loss to follow-up in online trials. Methods A randomized controlled trial design was used. All participants who consented to enter DYD-RCT and completed the primary outcome questionnaires were randomized to complete one of four secondary outcome questionnaires at baseline and at follow-up. These questionnaires varied in length (additional 23 or 34 versus 10 items) and relevance (alcohol problems versus mental health). The outcome measure was the proportion of participants who completed follow-up at each of two follow-up intervals: study 1 after 1 and 3 months and study 2 after 3 and 12 months. Results At all four follow-up intervals there were no significant effects of additional questionnaire length on follow-up. Randomization to the less relevant questionnaire resulted in significantly lower rates of follow-up in two of the four assessments made (absolute difference of 4%, 95% confidence interval [CI] 0%-8%, in both study 1 after 1 month and in study 2 after 12 months). A post hoc pooled analysis across all four follow-up intervals found this effect of marginal statistical significance (unadjusted difference, 3%, range 1%-5%, P = .01; difference adjusted for prespecified covariates, 3%, range 0%-5%, P = .05). Conclusions Apparently minor differences in study design decisions may have a measurable impact on attrition in trials. Further investigation is warranted of the impact of the relevance of outcome measures on follow-up rates and, more broadly, of the consequences of what we ask participants to

  16. The Cessation in Pregnancy Incentives Trial (CPIT: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Tappin David M

    2012-07-01

    Full Text Available Abstract Background Seventy percent of women in Scotland have at least one baby, making pregnancy an opportunity to help most young women quit smoking before their own health is irreparably compromised. By quitting during pregnancy their infants will be protected from miscarriage and still birth as well as low birth weight, asthma, attention deficit disorder and adult cardiovascular disease. In the UK, the NICE guidelines: ‘How to stop smoking in pregnancy and following childbirth’ (June 2010 highlighted that little evidence exists in the literature to confirm the efficacy of financial incentives to help pregnant smokers to quit. Its first research recommendation was to determine: Within a UK context, are incentives an acceptable, effective and cost-effective way to help pregnant women who smoke to quit? Design and methods This study is a phase II exploratory individually randomized controlled trial comparing standard care for pregnant smokers with standard care plus the additional offer of financial voucher incentives to engage with specialist cessation services and/or to quit smoking during pregnancy. Participants (n = 600 will be pregnant smokers identified at maternity booking who, when contacted by specialist cessation services, agree to having their details passed to the NHS Smokefree Pregnancy Study Helpline to discuss the trial. The NHS Smokefree Pregnancy Study Helpline will be responsible for telephone consent and follow-up in late pregnancy. The primary outcome will be self reported smoking in late pregnancy verified by cotinine measurement. An economic evaluation will refine cost data collection and assess potential cost-effectiveness while qualitative research interviews with clients and health professionals will assess the level of acceptance of this form of incentive payment. The research questions are: What is the likely therapeutic efficacy? Are incentives potentially cost-effective? Is individual randomization an

  17. Clinical trials of antihypertensives: Nature of control and design

    Directory of Open Access Journals (Sweden)

    Bhaswat S Chakraborty

    2011-01-01

    Full Text Available This paper reviews the critical issues in the control and design of antihypertension (anti-HT clinical trials. The international guidelines and current clinical and biostatistical practices were reviewed for relevant clinical, design, end-point assessments and regulatory issues. The results are grouped mainly into ethical, protocol and assessment issues. Ethical issues arise as placebo-controlled trials (PCTs for HT-lowering agents in patients with moderate to severe HT are undertaken. Patients with organ damage due to HT should not be included in long-term PCT. Active-control trials, however, are suitable for all randomized subsets of patients, including men and women, and different ethnic and age groups. Severity subgroups must be studied separately with consideration to specific study design. Mortality and morbidity outcome studies are not required in anti-HT trials except when significant mortality and cardiovascular morbidity are suspected. Generally, changes in both systolic and diastolic blood pressures (BP at the end of the dosing interval from the baseline are compared between the active and the control arms as the primary endpoint of anti-HT effect. Onset of the anti-HT effect can be studied as the secondary endpoint. For maintenance of efficacy, long-term studies of ≥6 months need to be undertaken. Error-free measurement of BP is a serious issue as spontaneous changes in BP are large and active drug effect on diastolic BP is often small. Placebo-controlled short-term studies (of ~12 weeks for dose-response and titration are very useful. Safety studies must be very vigilant on hypotension, orthostatic hypotension and effects on heart. In dose-response studies, at least three doses in addition to placebo should be used to well characterize the benefits and side-effects.

  18. UK Dermatology Clinical Trials Network’s STOP GAP trial (a multicentre trial of prednisolone versus ciclosporin for pyoderma gangrenosum: protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Craig Fiona F

    2012-04-01

    Full Text Available Abstract Background Pyoderma gangrenosum (PG is a rare inflammatory skin disorder characterised by painful and rapidly progressing skin ulceration. PG can be extremely difficult to treat and patients often require systemic immunosuppression. Recurrent lesions of PG are common, but the relative rarity of this condition means that there is a lack of published evidence regarding its treatment. A systematic review published in 2005 found no randomised controlled trials (RCTs relating to the treatment of PG. Since this time, one small RCT has been published comparing infliximab to placebo, but none of the commonly used systemic treatments for PG have been formally assessed. The UK Dermatology Clinical Trials Network’s STOP GAP Trial has been designed to address this lack of trial evidence. Methods The objective is to assess whether oral ciclosporin is more effective than oral prednisolone for the treatment of PG. The trial design is a two-arm, observer-blind, parallel-group, randomised controlled trial comparing ciclosporin (4 mg/kg/day to prednisolone (0.75 mg/kg/day. A total of 140 participants are to be recruited over a period of 4 years, from up to 50 hospitals in the UK and Eire. Primary outcome of velocity of healing at 6 weeks is assessed blinded to treatment allocation (using digital images of the ulcers. Secondary outcomes include: (i time to healing; (ii global assessment of improvement; (iii PG inflammation assessment scale score; (iv self-reported pain; (v health-related quality of life; (vi time to recurrence; (vii treatment failures; (viii adverse reactions to study medications; and (ix cost effectiveness/utility. Patients with a clinical diagnosis of PG (excluding granulomatous PG; measurable ulceration (that is, not pustular PG; and patients aged over 18 years old who are able to give informed consent are included in the trial. Randomisation is by computer generated code using permuted blocks of randomly varying size

  19. Mass-radius relationships and constraints on the composition of Pluto. II

    Science.gov (United States)

    Lupo, M. J.; Lewis, J. S.

    1980-01-01

    A model of Pluto's interior is presented based on new estimates of its mass within the range of possible masses. The model is consistent with the most recent observations by Arnold et al., and calls for a silicate-poor, H2O ice-rock bulk composition of Pluto. The results of the Charon-Pluto eclipses will lead to a more conclusive constraint to Pluto's bulk composition.

  20. Observational Constraints on a Pluto Torus of Circumsolar Neutral Gas

    Science.gov (United States)

    Hill, M. E.; Kollmann, P.; McNutt, R. L., Jr.; Smith, H. T.; Bagenal, F.; Brown, L. E.; Elliott, H. A.; Haggerty, D. K.; Horanyi, M.; Krimigis, S. M.; Kusterer, M. B.; Lisse, C. M.; McComas, D. J.; Piquette, M. R.; Sidrow, E. J.; Strobel, D. F.; Szalay, J.; Vandegriff, J. D.; Zirnstein, E.; Ennico Smith, K.; Olkin, C.; Weaver, H. A., Jr.; Young, L. A.; Stern, S. A.

    2015-12-01

    We present the concept of a neutral gas torus surrounding the Sun, aligned with Pluto's orbit, and place observational constraints based primarily on comparison of New Horizons (NH) measurements with a 3-D Monte Carlo model adapted from analogous satellite tori surrounding Saturn and Jupiter. Such a torus, or perhaps partial torus, should result from neutral N2 escaping from Pluto's exosphere. Unlike other more massive planets closer to the Sun, neutrals escape Pluto readily owing, e.g., to the high thermal speed relative to the escape velocity. Importantly, escaped neutrals have a long lifetime due to the great distance from the Sun, ~100 years for photoionization of N2 and ~180 years for photoionization of N, which results from disassociated N2. Despite the lengthy 248-year orbit, these long e-folding lifetimes may allow an enhanced neutral population to form an extended gas cloud that modifies the N2 spatial profile near Pluto. These neutrals are not directly observable by NH but once ionized N2+ or N+ are picked up by the solar wind, reaching ~50 keV, making these pickup ions (PUIs) detectable by NH's Pluto Energetic Particle Spectrometer Science Investigation (PEPSSI) instrument. PEPSSI observations analyzed to date may constrain the N2 density; the remaining ~95% of the encounter data, scheduled for downlink in August along with similarly anticipated data from the Solar Wind Around Pluto (SWAP) experiment, should help determine the Pluto outgassing rates. Measurements from SWAP include the solar wind speed, a quantity that greatly enhances PUI studies by enabling us to directly account for the PUI distribution's sensitive dependence on plasma speed. Note that anomalous cosmic ray Si observed at Voyager is overabundant by a factor of ~3000 relative to interstellar composition. This might be related to "outer source" PUIs, but the fact that N2 and Si are indistinguishable in many instruments could mean that N2 is actually driving this apparent Si discrepancy.

  1. Haze in Pluto's Atmosphere: Implications for Processes and Evolution

    Science.gov (United States)

    Cheng, A. F.; Summers, M. E.; Gladstone, R.; Strobel, D. F.; Young, L. A.; Lavvas, P.; Kammer, J.; Lisse, C. M.; Parker, A. H.; Young, E. F.; Stern, A.; Weaver, H. A., Jr.; Olkin, C.; Ennico Smith, K.

    2016-12-01

    Haze in Pluto's atmosphere was detected by New Horizons imaging to altitudes above 200 km at solar phase angles from 20° to 169°, and it was detected by the UV solar occultation up to 300 km altitude. The haze is strongly forward scattering in the visible, and a microphysical model of haze reproduces the visible phase function just above the surface with 0.5 µm spherical particles, but also invokes fractal aggregate particles to fit the visible phase function at 45 km altitude and to account for UV extinction. The visible phase function at the bottom of the atmosphere has a back scatter lobe which is absent from the phase function measured 45 km above the surface, making the latter phase function similar to that for haze in Titan's upper atmosphere. Pluto's haze may form by similar processes to those responsible for the detached haze layer in the upper atmosphere of Titan. It is suggested that haze particles form fractal aggregates which grow larger and more spherical as they settle downwards through the bottom 15 km of the atmosphere. Haze particles settle onto Pluto's surface, at a rate sufficient to alter surface optical properties on seasonal (hundred-year) time scales. However, if this picture applies to Pluto's atmosphere throughout the Pluto year, then haze particles would rapidly accumulate to an optically thick surface layer within thousands of years. These particles would not be processed into tholins except by cosmic rays, and the striking albedo contrasts on Pluto, with very bright and dark regions, would be difficult to understand. Pluto's regional scale albedo contrasts may be preserved by atmospheric collapse.

  2. A pragmatic multi-centred randomised controlled trial of yoga for chronic low back pain: Trial protocol

    OpenAIRE

    Cox, Helen; Tilbrook, Helen; Aplin, John; Chuang, Ling-Hsiang; Hewitt, Catherine; Jayakody, Shalmini; Semlyen, Anna; Soares, Marta O; Torgerson, David; Trewhela, Alison; Watt, Ian; Worthy, Gill

    2010-01-01

    A systematic review revealed three small randomised controlled trials of yoga for low back pain, all of which showed effects on back pain that favoured the yoga group. To build on these studies a larger trial, with longer term follow-up, and a number of different yoga teachers delivering the intervention is required. This study protocol describes the details of a randomised controlled trial (RCT) to determine the effectiveness and cost-effectiveness of Yoga for chronic Low Back Pain, which is...

  3. Is sham laser a valid control for acupuncture trials?

    Science.gov (United States)

    Irnich, Dominik; Salih, Norbert; Offenbächer, Martin; Fleckenstein, Johannes

    2011-01-01

    Methodological problems of acupuncture trials focus on adequate placebo controls. In this trial we evaluated the use of sham laser acupuncture as a control procedure. Thirty-four healthy volunteers received verum laser (invisible infrared laser emission and red light, 45 s and 1 J per point) and sham laser (red light) treatment at three acupuncture points (LI4, LU7 and LR3) in a randomized, double-blinded, cross-over design. The main outcome measure was the ratio of correct to incorrect ratings of treatment immediately after each session. The secondary outcome measure was the occurrence of deqi-like sensations at the acupuncture points and their intensity on a 10-fold visual analog scale (VAS; 10 being the strongest sensible sensation). We pooled the results of three former trials to evaluate the credibility of sham laser acupuncture when compared to needle acupuncture. Fifteen out of 34 (44%) healthy volunteers (age: 28 ± 10.7 years) identified the used laser device after the first session and 14 (41%) after the second session. Hence, both treatments were undistinguishable (P = .26). Deqi-like sensations occurred in 46% of active laser (2.34 VAS) and in 49.0% of sham laser beams (2.49 VAS). The credibility of sham laser was not different from needle acupuncture. Sham laser acupuncture can serve as a valid placebo control in laser acupuncture studies. Due to similar credibility and the lack of sensory input on the peripheral nervous system, sham laser acupuncture can also serve as a sham control for acupuncture trials, in order to evaluate needling effects per se.

  4. Is Sham Laser a Valid Control for Acupuncture Trials?

    Directory of Open Access Journals (Sweden)

    Dominik Irnich

    2011-01-01

    Full Text Available Methodological problems of acupuncture trials focus on adequate placebo controls. In this trial we evaluated the use of sham laser acupuncture as a control procedure. Thirty-four healthy volunteers received verum laser (invisible infrared laser emission and red light, 45 s and 1 J per point and sham laser (red light treatment at three acupuncture points (LI4, LU7 and LR3 in a randomized, double-blinded, cross-over design. The main outcome measure was the ratio of correct to incorrect ratings of treatment immediately after each session. The secondary outcome measure was the occurrence of deqi-like sensations at the acupuncture points and their intensity on a 10-fold visual analog scale (VAS; 10 being the strongest sensible sensation. We pooled the results of three former trials to evaluate the credibility of sham laser acupuncture when compared to needle acupuncture. Fifteen out of 34 (44% healthy volunteers (age: 28 ± 10.7 years identified the used laser device after the first session and 14 (41% after the second session. Hence, both treatments were undistinguishable (P = .26. Deqi-like sensations occurred in 46% of active laser (2.34 VAS and in 49.0% of sham laser beams (2.49 VAS. The credibility of sham laser was not different from needle acupuncture. Sham laser acupuncture can serve as a valid placebo control in laser acupuncture studies. Due to similar credibility and the lack of sensory input on the peripheral nervous system, sham laser acupuncture can also serve as a sham control for acupuncture trials, in order to evaluate needling effects per se.

  5. Probiotics in the prevention of eczema: a randomised controlled trial

    OpenAIRE

    Allen, Stephen J; Jordan, Sue; Storey, Melanie; Catherine A Thornton; Gravenor, Michael B.; Garaiova, Iveta; Plummer, Susan F; Wang, Duolao; Morgan, Gareth

    2014-01-01

    Objective To evaluate a multistrain, high-dose probiotic in the prevention of eczema. Design A randomised, double-blind, placebo-controlled, parallel group trial. Settings Antenatal clinics, research clinic, children at home. Patients Pregnant women and their infants. Interventions Women from 36 weeks gestation and their infants to age 6 months received daily either the probiotic (Lactobacillus salivarius CUL61, Lactobacillus paracasei CUL08, Bifidobacterium animalis subspecies lactis CUL34 a...

  6. Outcomes in registered, ongoing randomized controlled trials of patient education.

    Directory of Open Access Journals (Sweden)

    Cécile Pino

    Full Text Available BACKGROUND: With the increasing prevalence of chronic noncommunicable diseases, patient education is becoming important to strengthen disease prevention and control. We aimed to systematically determine the extent to which registered, ongoing randomized controlled trials (RCTs evaluated an educational intervention focus on patient-important outcomes (i.e., outcomes measuring patient health status and quality of life. METHODS: On May 6, 2009, we searched for all ongoing RCTs registered in the World Health Organization International Clinical Trials Registry platform. We used a standardized data extraction form to collect data and determined whether the outcomes assessed were 1 patient-important outcomes such as clinical events, functional status, pain, or quality of life or 2 surrogate outcomes, such as biological outcome, treatment adherence, or patient knowledge. PRINCIPAL FINDINGS: We selected 268 of the 642 potentially eligible studies and assessed a random sample of 150. Patient-important outcomes represented 54% (178 of 333 of all primary outcomes and 46% (286 of 623 of all secondary outcomes. Overall, 69% of trials (104 of 150 used at least one patient-important outcome as a primary outcome and 66% (99 of 150 as a secondary outcome. Finally, for 31% of trials (46 of 150, primary outcomes were only surrogate outcomes. The results varied by medical area. In neuropsychiatric disorders, patient important outcomes represented 84% (51 of 61 of primary outcomes, as compared with 54% (32 of 59 in malignant neoplasm and 18% (4 of 22 in diabetes mellitus trials. In addition, only 35% assessed the long-term impact of interventions (i.e., >6 months. CONCLUSIONS: There is a need to improve the relevance of outcomes and to assess the long term impact of educational interventions in RCTs.

  7. Genetic susceptibility testing and readiness to control weight: Results from a randomized controlled trial

    NARCIS (Netherlands)

    Meisel, S.F.; Beeken, R.J.; Jaarsveld, C.H.M. van; Wardle, J.

    2015-01-01

    OBJECTIVE: To test the hypothesis that adding obesity gene feedback (FTO) to simple weight control advice at a life stage with raised risk of weight gain (university) increases readiness to control weight. METHODS: Individually randomized controlled trial comparing the effect of: (i) simple weight c

  8. Should desperate volunteers be included in randomised controlled trials?

    Science.gov (United States)

    Allmark, P; Mason, S

    2006-09-01

    Randomised controlled trials (RCTs) sometimes recruit participants who are desperate to receive the experimental treatment. This paper defends the practice against three arguments that suggest it is unethical first, desperate volunteers are not in equipoise. Second clinicians, entering patients onto trials are disavowing their therapeutic obligation to deliver the best treatment; they are following trial protocols rather than delivering individualised care. Research is not treatment; its ethical justification is different. Consent is crucial. Third, desperate volunteers do not give proper consent: effectively, they are coerced. This paper responds by advocating a notion of equipoise based on expert knowledge and widely shared values. Where such collective, expert equipoise exists there is a prima facie case for an RCT. Next the paper argues that trial entry does not involve clinicians disavowing their therapeutic obligation; individualised care based on insufficient evidence is not in patients best interest. Finally, it argues that where equipoise exists it is acceptable to limit access to experimental agents; desperate volunteers are not coerced because their desperation does not translate into a right to receive what they desire.

  9. The rapid formation of Sputnik Planitia early in Pluto's history

    Science.gov (United States)

    Hamilton, Douglas P.; Stern, S. A.; Moore, J. M.; Young, L. A.; Binzel, R. P.; Buie, M. W.; Buratti, B. J.; Cheng, A. F.; Ennico, K.; Grundy, W. M.; Linscott, I. R.; McKinnon, W. B.; Olkin, C. B.; Reitsema, H. J.; Reuter, D. C.; Schenk, P.; Showalter, M. R.; Spencer, J. R.; Tyler, G. L.; Weaver, H. A.

    2016-12-01

    Pluto's Sputnik Planitia is a bright, roughly circular feature that resembles a polar ice cap. It is approximately 1,000 kilometres across and is centred on a latitude of 25 degrees north and a longitude of 175 degrees, almost directly opposite the side of Pluto that always faces Charon as a result of tidal locking. One explanation for its location includes the formation of a basin in a giant impact, with subsequent upwelling of a dense interior ocean. Once the basin was established, ice would naturally have accumulated there. Then, provided that the basin was a positive gravity anomaly (with or without the ocean), true polar wander could have moved the feature towards the Pluto-Charon tidal axis, on the far side of Pluto from Charon. Here we report modelling that shows that ice quickly accumulates on Pluto near latitudes of 30 degrees north and south, even in the absence of a basin, because, averaged over its orbital period, those are Pluto's coldest regions. Within a million years of Charon's formation, ice deposits on Pluto concentrate into a single cap centred near a latitude of 30 degrees, owing to the runaway albedo effect. This accumulation of ice causes a positive gravity signature that locks, as Pluto's rotation slows, to a longitude directly opposite Charon. Once locked, Charon raises a permanent tidal bulge on Pluto, which greatly enhances the gravity signature of the ice cap. Meanwhile, the weight of the ice in Sputnik Planitia causes the crust under it to slump, creating its own basin (as has happened on Earth in Greenland). Even if the feature is now a modest negative gravity anomaly, it remains locked in place because of the permanent tidal bulge raised by Charon. Any movement of the feature away from 30 degrees latitude is countered by the preferential recondensation of ices near the coldest extremities of the cap. Therefore, our modelling suggests that Sputnik Planitia formed shortly after Charon did and has been stable, albeit gradually losing

  10. The rapid formation of Sputnik Planitia early in Pluto's history.

    Science.gov (United States)

    Hamilton, Douglas P; Stern, S A; Moore, J M; Young, L A

    2016-11-30

    Pluto's Sputnik Planitia is a bright, roughly circular feature that resembles a polar ice cap. It is approximately 1,000 kilometres across and is centred on a latitude of 25 degrees north and a longitude of 175 degrees, almost directly opposite the side of Pluto that always faces Charon as a result of tidal locking. One explanation for its location includes the formation of a basin in a giant impact, with subsequent upwelling of a dense interior ocean. Once the basin was established, ice would naturally have accumulated there. Then, provided that the basin was a positive gravity anomaly (with or without the ocean), true polar wander could have moved the feature towards the Pluto-Charon tidal axis, on the far side of Pluto from Charon. Here we report modelling that shows that ice quickly accumulates on Pluto near latitudes of 30 degrees north and south, even in the absence of a basin, because, averaged over its orbital period, those are Pluto's coldest regions. Within a million years of Charon's formation, ice deposits on Pluto concentrate into a single cap centred near a latitude of 30 degrees, owing to the runaway albedo effect. This accumulation of ice causes a positive gravity signature that locks, as Pluto's rotation slows, to a longitude directly opposite Charon. Once locked, Charon raises a permanent tidal bulge on Pluto, which greatly enhances the gravity signature of the ice cap. Meanwhile, the weight of the ice in Sputnik Planitia causes the crust under it to slump, creating its own basin (as has happened on Earth in Greenland). Even if the feature is now a modest negative gravity anomaly, it remains locked in place because of the permanent tidal bulge raised by Charon. Any movement of the feature away from 30 degrees latitude is countered by the preferential recondensation of ices near the coldest extremities of the cap. Therefore, our modelling suggests that Sputnik Planitia formed shortly after Charon did and has been stable, albeit gradually losing

  11. Electrocardiogram ST Analysis During Labor : A Systematic Review and Meta-analysis of Randomized Controlled Trials

    NARCIS (Netherlands)

    Saccone, Gabriele; Schuit, Ewoud; Amer-Wåhlin, Isis; Xodo, Serena; Berghella, Vincenzo

    2016-01-01

    OBJECTIVE: To compare the effectiveness of cardiotocography plus ST analysis with cardiotocography alone during labor. DATA SOURCES: Randomized controlled trials were identified by searching electronic databases. METHODS OF STUDY SELECTION: We included all randomized controlled trials comparing intr

  12. Electrocardiogram ST Analysis During Labor : A Systematic Review and Meta-analysis of Randomized Controlled Trials

    NARCIS (Netherlands)

    Saccone, Gabriele; Schuit, Ewoud; Amer-Wåhlin, Isis; Xodo, Serena; Berghella, Vincenzo

    OBJECTIVE: To compare the effectiveness of cardiotocography plus ST analysis with cardiotocography alone during labor. DATA SOURCES: Randomized controlled trials were identified by searching electronic databases. METHODS OF STUDY SELECTION: We included all randomized controlled trials comparing

  13. The Asthma Control Questionnaire as a clinical trial endpoint

    DEFF Research Database (Denmark)

    Barnes, P J; Casale, T B; Dahl, Ronald;

    2014-01-01

    The goal of asthma treatment is to control the disease according to guidelines issued by bodies such as the Global Initiative for Asthma. Effective control is dependent upon evaluation of symptoms, initiation of appropriate treatment and minimization of the progressive adverse effects...... of the disease and its therapies. Although individual outcome measures have been shown to correlate with asthma control, composite endpoints are preferred to enable more accurate and robust monitoring of the health of the individual patient. A number of validated instruments are utilized to capture...... these component endpoints; however, there is no consensus on the optimal instrument for use in clinical trials. The Asthma Control Questionnaire (ACQ) has been shown to be a valid, reliable instrument that allows accurate and reproducible assessment of asthma control that compares favourably with other commonly...

  14. The Home-Based Older People's Exercise (HOPE trial: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Forster Anne

    2011-06-01

    Full Text Available Abstract Background Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility. Methods/Design The Home-Based Older People's Exercise (HOPE trial is a two arm, assessor blind pilot randomised controlled trial (RCT to assess the effectiveness of a 12 week exercise intervention (the HOPE programme designed to improve the mobility and functional abilities of frail older people living at home, compared with usual care. The primary outcome is the timed-up-and-go test (TUGT, measured at baseline and 14 weeks post-randomisation. Secondary outcomes include the Barthel Index of activities of daily living (ADL, EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D quality of life measure and the geriatric depression scale (GDS, measured at baseline and 14 weeks post-randomisation. We will record baseline frailty using the Edmonton Frail Scale (EFS, record falls and document muscle/joint pain. We will test the feasibility of collection of data to identify therapy resources required for delivery of the intervention. Discussion The HOPE trial will explore and evaluate a home-based exercise intervention for frail older people. Although previous RCTs have used operationalised, non-validated methods of measuring frailty, the HOPE trial is, to our knowledge, the first RCT of an exercise intervention for frail older people that includes a validated method of frailty assessment at baseline. Trial registration ISRCTN: ISRCTN57066881

  15. On the Provenance of Pluto's Nitrogen (N2)

    CERN Document Server

    Singer, Kelsi N

    2015-01-01

    N2 is abundant in Pluto's atmosphere and on its surface, but the supply is depleted by prodigious atmospheric escape. We demonstrate that cometary impacts could not have delivered enough N2 mass to resupply Pluto's atmospheric escape over time; thus Pluto's N2 is likely endogenous, and therefore was either acquired early in its history or created by chemistry inside/on Pluto. We find that cratering could excavate a considerable amount of N2 to resupply the atmosphere against escape if the near-surface N2 reservoir is deep. However, we find that this process likely falls short of that necessary to resupply the atmosphere against escape by at least an order of magnitude. We conclude that either the escape of N2 from Pluto's atmosphere was on average much lower than the predictions for the current epoch, or that internal activity could be necessary to bring N2 to the surface and resupply escape losses. Observations made by the New Horizons spacecraft in mid-2015 will yield further constraints on the provenance a...

  16. Heterogeneous and Evolving Distributions of Pluto's Volatile Surface Ices

    Science.gov (United States)

    Grundy, William M.; Olkin, C. B.; Young, L. A.; Buie, M. W.; Young, E. F.

    2013-10-01

    We report observations of Pluto's 0.8 to 2.4 µm reflectance spectrum with IRTF/SpeX on 70 nights over the 13 years from 2001 to 2013. The spectra show numerous vibrational absorption features of simple molecules CH4, CO, and N2 condensed as ices on Pluto's surface. These absorptions are modulated by the planet's 6.39 day rotation period, enabling us to constrain the longitudinal distributions of the three ices. Absorptions of CO and N2 are concentrated on Pluto's anti-Charon hemisphere, unlike absorptions of less volatile CH4 ice that are offset by roughly 90° from the longitude of maximum CO and N2 absorption. In addition to the diurnal/longitudinal variations, the spectra show longer term trends. On decadal timescales, Pluto's stronger CH4 absorption bands have deepened, while the amplitude of their diurnal variation has diminished, consistent with additional CH4 absorption by high northern latitude regions rotating into view as the sub-Earth latitude moves north (as defined by the system's angular momentum vector). Unlike the CH4 absorptions, Pluto's CO and N2 absorptions are declining over time, suggesting more equatorial or southerly distributions of those species. The authors gratefully thank the staff of IRTF for their tremendous assistance over the dozen+ years of this project. The work was funded in part by NSF grants AST-0407214 and AST-0085614 and NASA grants NAG5-4210 and NAG5-12516.

  17. On the Origin of Pluto's Small Satellites by Resonant Transport

    CERN Document Server

    Cheng, W H; Lee, Man Hoi

    2014-01-01

    The orbits of Pluto's four small satellites (Styx, Nix, Kerberos, and Hydra) are nearly circular and coplanar with the orbit of the large satellite Charon, with orbital periods nearly in the ratios 3:1, 4:1, 5:1, and 6:1 with Charon's orbital period. These properties suggest that the small satellites were created during the same impact event that placed Charon in orbit and had been pushed to their current positions by being locked in mean-motion resonances with Charon as Charon's orbit was expanded by tidal interactions with Pluto. Using the Pluto-Charon tidal evolution models developed by Cheng et al. (2014), we show that stable capture and transport of a test particle in multiple resonances at the same mean-motion commensurability is possible at the 5:1, 6:1, and 7:1 commensurabilities, if Pluto's zonal harmonic $J_{2P} = 0$. However, the test particle has significant orbital eccentricity at the end of the tidal evolution of Pluto-Charon in almost all cases, and there are no stable captures and transports a...

  18. IRAS observations of the Pluto-Charon system

    Energy Technology Data Exchange (ETDEWEB)

    Aumann, H.H.; Walker, R.G.

    1987-10-01

    High-signal-to-noise-ratio observations of the Pluto-Charon system at 25, 60, and 100 microns using IRAS are combined with visual-magnitude and mutual-eclipse constraints to evaluate thermal models of Pluto and Charon. These models are consistent with eclipse observation by Dunbar and Tedesco (1986) but not with Reinsch and Pakull (1987). The most likely model for Charon is the standard asteroid model, typical for the icy Galilean and Saturnian satellites. Charon models with a significant atmosphere can be ruled out. Based on currently available radius and albedo constraints, no significant numerical distinction is possible between Pluto models ranging from isothermal spheres with surface emissivity between 0.4 and 0.9. Concerns regarding the viability of an emissivity as low as 0.4 favor the higher-emissivity models. The globally uniform surface temperature of Pluto may thus at present be as low as 45 K, with a methane column abundance of 6.7 cm atm. The most likely models are centered on radii of 1180 and 747 km and albedos of 0.47 and 0.26 for Pluto and Charon, respectively. 21 references.

  19. Challenges in randomized controlled trials and emerging multiple sclerosis therapeutics.

    Science.gov (United States)

    Huang, DeRen

    2015-12-01

    The remarkable global development of disease-modifying therapies (DMTs) specific for multiple sclerosis (MS) has significantly reduced the frequency of relapse, slowed the progression of disability, and improved the quality of life in patients with MS. With increasing numbers of approved DMTs, neurologists in North America and Europe are able to present multiple treatment options to their patients to achieve a better therapeutic outcome, and in many cases, no evidence of disease activity. MS patients have improved accessibility to various DMTs at no or minimal out-of-pocket cost. The ethical guidelines defined by the Edinburgh revision of the Declaration of Helsinki strongly discourage the use of placebo control groups in modern MS clinical trials. The use of an active comparator control group increases the number of participants in each group that is essential to achieve statistical significance, thus further increasing the difficulty of completing randomized controlled trials (RCTs) for the development of new MS therapies. There is evidence of a high prevalence of MS and a large number of patients in Asia. The belief of the existence of Asian types of MS that are distinct from Western types, and regulatory policies are among the reasons why DMTs are limited in most Asian countries. Lack of access to approved DMTs provides a good opportunity for clinical trials that are designed for the development of new MS therapies. Recently, data from RCTs have demonstrated excellent recruitment of participants and the completion of multi-nation and single-nation MS trials within this region. Recent studies using the McDonald MS diagnostic criteria carefully excluded patients with neuromyelitis optica (NMO) and NMO spectrum disorder, and demonstrated that patients with MS in Asia have clinical characteristics and treatment responses similar to those in Western countries.

  20. Controlled human malaria infection trials: How tandems of trust and control construct scientific knowledge.

    Science.gov (United States)

    Bijker, Else M; Sauerwein, Robert W; Bijker, Wiebe E

    2016-02-01

    Controlled human malaria infections are clinical trials in which healthy volunteers are deliberately infected with malaria under controlled conditions. Controlled human malaria infections are complex clinical trials: many different groups and institutions are involved, and several complex technologies are required to function together. This functioning together of technologies, people, and institutions is under special pressure because of potential risks to the volunteers. In this article, the authors use controlled human malaria infections as a strategic research site to study the use of control, the role of trust, and the interactions between trust and control in the construction of scientific knowledge. The authors argue that tandems of trust and control play a central role in the successful execution of clinical trials and the construction of scientific knowledge. More specifically, two aspects of tandems of trust and control will be highlighted: tandems are sites where trust and control coproduce each other, and tandems link the personal, the technical, and the institutional domains. Understanding tandems of trust and control results in setting some agendas for both clinical trial research and science and technology studies.

  1. Difficulties in recruitment for a randomized controlled trial involving hysterosalpingography

    Directory of Open Access Journals (Sweden)

    Helmerhorst Frans M

    2006-06-01

    Full Text Available Abstract Background The usefulness of hysterosalpingography (HSG as routine investigation in the fertility work-up prior to laparoscopy and dye had been assessed in a randomized controlled trial. Recruiting subjects to the study was more difficult than anticipated. The objective of this study was to explore possible reasons for non-participation in the trial. Methods All newly referred subfertile women admitted to the Reproductive Medicine Clinic of Leiden University Medical Centre between 1 April 1997 and 31 December 1999, were eligible for the study. The reasons for non-participation were evaluated by scrutinizing the medical records. Results Out of 759 women, a total of 127 (17% agreed to participate in the trial. The most important reason for non-participation was because of exclusion criteria (73%. Other reasons were inattentive clinicians (3% and patient-associated reasons (24%. Patient refusal and indecisiveness to enroll in the study were the most common patient-associated reasons. The most frequently stated reason for trial refusal was reluctance to undergo laparoscopy and dye mainly due to issues related to anesthesia and scheduling of procedure. Conclusion Almost three-quarters of recruitment difficulties in this study were due to unavoidable reasons. To overcome the remaining avoidable reasons for non-participation, attention should be paid to appropriate instruction of the study protocol to the participating doctors and to provide adequate information, in layman's terms, to the patients. Reminding patients by notes or telephone calls for attending the clinic are helpful. It may be contingent upon tracing the reasons of clinicians and patients for non-participation to improve enrollment during a trial.

  2. Sample size in orthodontic randomized controlled trials: are numbers justified?

    Science.gov (United States)

    Koletsi, Despina; Pandis, Nikolaos; Fleming, Padhraig S

    2014-02-01

    Sample size calculations are advocated by the Consolidated Standards of Reporting Trials (CONSORT) group to justify sample sizes in randomized controlled trials (RCTs). This study aimed to analyse the reporting of sample size calculations in trials published as RCTs in orthodontic speciality journals. The performance of sample size calculations was assessed and calculations verified where possible. Related aspects, including number of authors; parallel, split-mouth, or other design; single- or multi-centre study; region of publication; type of data analysis (intention-to-treat or per-protocol basis); and number of participants recruited and lost to follow-up, were considered. Of 139 RCTs identified, complete sample size calculations were reported in 41 studies (29.5 per cent). Parallel designs were typically adopted (n = 113; 81 per cent), with 80 per cent (n = 111) involving two arms and 16 per cent having three arms. Data analysis was conducted on an intention-to-treat (ITT) basis in a small minority of studies (n = 18; 13 per cent). According to the calculations presented, overall, a median of 46 participants were required to demonstrate sufficient power to highlight meaningful differences (typically at a power of 80 per cent). The median number of participants recruited was 60, with a median of 4 participants being lost to follow-up. Our finding indicates good agreement between projected numbers required and those verified (median discrepancy: 5.3 per cent), although only a minority of trials (29.5 per cent) could be examined. Although sample size calculations are often reported in trials published as RCTs in orthodontic speciality journals, presentation is suboptimal and in need of significant improvement.

  3. Randomized, placebo-controlled trials of dichlorphenamide in periodic paralysis.

    Science.gov (United States)

    Sansone, Valeria A; Burge, James; McDermott, Michael P; Smith, Patty C; Herr, Barbara; Tawil, Rabi; Pandya, Shree; Kissel, John; Ciafaloni, Emma; Shieh, Perry; Ralph, Jeffrey W; Amato, Antony; Cannon, Steve C; Trivedi, Jaya; Barohn, Richard; Crum, Brian; Mitsumoto, Hiroshi; Pestronk, Alan; Meola, Giovanni; Conwit, Robin; Hanna, Michael G; Griggs, Robert C

    2016-04-12

    To determine the short-term and long-term effects of dichlorphenamide (DCP) on attack frequency and quality of life in hyperkalemic (HYP) and hypokalemic (HOP) periodic paralysis. Two multicenter randomized, double-blind, placebo-controlled trials lasted 9 weeks (Class I evidence), followed by a 1-year extension phase in which all participants received DCP. Forty-four HOP and 21 HYP participants participated. The primary outcome variable was the average number of attacks per week over the final 8 weeks of the double-blind phase. The median attack rate was lower in HOP participants on DCP than in participants on placebo (0.3 vs 2.4, p = 0.02). The 9-week mean change in the Physical Component Summary score of the Short Form-36 was also better in HOP participants receiving DCP (treatment effect = 7.29 points, 95% confidence interval 2.26 to 12.32, p = 0.006). The median attack rate was also lower in HYP participants on DCP (0.9 vs 4.8) than in participants on placebo, but the difference in median attack rate was not significant (p = 0.10). There were no significant effects of DCP on muscle strength or muscle mass in either trial. The most common adverse events in both trials were paresthesia (47% DCP vs 14% placebo, both trials combined) and confusion (19% DCP vs 7% placebo, both trials combined). DCP is effective in reducing the attack frequency, is safe, and improves quality of life in HOP periodic paralysis. These studies provide Class I evidence that DCP significantly reduces attack frequency in HOP but lacked the precision to support either efficacy or lack of efficacy of DCP in HYP. © 2016 American Academy of Neurology.

  4. Randomized, placebo-controlled trials of dichlorphenamide in periodic paralysis

    Science.gov (United States)

    Burge, James; McDermott, Michael P.; Smith, Patty C.; Herr, Barbara; Tawil, Rabi; Pandya, Shree; Kissel, John; Ciafaloni, Emma; Shieh, Perry; Ralph, Jeffrey W.; Amato, Antony; Cannon, Steve C.; Trivedi, Jaya; Barohn, Richard; Crum, Brian; Mitsumoto, Hiroshi; Pestronk, Alan; Meola, Giovanni; Conwit, Robin; Hanna, Michael G.; Griggs, Robert C.

    2016-01-01

    Objective: To determine the short-term and long-term effects of dichlorphenamide (DCP) on attack frequency and quality of life in hyperkalemic (HYP) and hypokalemic (HOP) periodic paralysis. Methods: Two multicenter randomized, double-blind, placebo-controlled trials lasted 9 weeks (Class I evidence), followed by a 1-year extension phase in which all participants received DCP. Forty-four HOP and 21 HYP participants participated. The primary outcome variable was the average number of attacks per week over the final 8 weeks of the double-blind phase. Results: The median attack rate was lower in HOP participants on DCP than in participants on placebo (0.3 vs 2.4, p = 0.02). The 9-week mean change in the Physical Component Summary score of the Short Form–36 was also better in HOP participants receiving DCP (treatment effect = 7.29 points, 95% confidence interval 2.26 to 12.32, p = 0.006). The median attack rate was also lower in HYP participants on DCP (0.9 vs 4.8) than in participants on placebo, but the difference in median attack rate was not significant (p = 0.10). There were no significant effects of DCP on muscle strength or muscle mass in either trial. The most common adverse events in both trials were paresthesia (47% DCP vs 14% placebo, both trials combined) and confusion (19% DCP vs 7% placebo, both trials combined). Conclusions: DCP is effective in reducing the attack frequency, is safe, and improves quality of life in HOP periodic paralysis. Classification of evidence: These studies provide Class I evidence that DCP significantly reduces attack frequency in HOP but lacked the precision to support either efficacy or lack of efficacy of DCP in HYP. PMID:26865514

  5. Directional sensitivity of "first trial" reactions in human balance control.

    Science.gov (United States)

    Oude Nijhuis, Lars B; Allum, John H J; Borm, George F; Honegger, Flurin; Overeem, Sebastiaan; Bloem, Bastiaan R

    2009-06-01

    Support-surface movements are commonly used to examine balance control. Subjects typically receive a series of identical or randomly interspersed multidirectional balance perturbations and the atypical "first trial reaction" (evoked by the first perturbation) is often excluded from further analysis. However, this procedure may obscure vital information about neurophysiological mechanisms associated with the first perturbation and, by analogy, fully unexpected falls. We studied first trial reactions, aiming to clarify their directional impact on postural control and to characterize the underlying neurophysiological substrate. We instructed 36 subjects to maintain balance following support-surface rotations in six different directions. Perturbations in each direction were delivered in blocks, consisting of 10 serial stimuli. Full body kinematics, surface reactive forces, and electromyographic (EMG) responses were recorded. Regardless of direction, for the very first rotation, displacement of the center of mass was 15% larger compared with the ensuing nine identical rotations (P postural instability, mainly due to increased response amplitudes. Although rapid habituation occurs following presentation of identical stimuli, subjects immediately become unstable again when the perturbation direction suddenly changes. Excessive responses due to a failure to combine proprioceptive and vestibular cues effectively may explain this instability seen with first trials, particularly when falling backward.

  6. A randomised controlled trial of complete denture impression materials.

    Science.gov (United States)

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

    2014-08-01

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

  7. Review of Randomized Controlled Trials of Massage in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Anna-Kaisa Niemi

    2017-04-01

    Full Text Available Preterm birth affects about 10% of infants born in the United States. Massage therapy is being used in some neonatal intensive care units for its potential beneficial effects on preterm infants. This article reviews published randomized controlled trials on the effects of massage in preterm infants. Most studies evaluating the effect of massage in weight gain in premature infants suggest a positive effect on weight gain. Increase in vagal tone has been reported in infants who receive massage and has been suggested as a possible mechanism for improved weight gain. More studies are needed on the underlying mechanisms of the effects of massage therapy on weight gain in preterm infants. While some trials suggest improvements in developmental scores, decreased stress behavior, positive effects on immune system, improved pain tolerance and earlier discharge from the hospital, the number of such studies is small and further evidence is needed. Further studies, including randomized controlled trials, are needed on the effects of massage in preterm infants.

  8. Financial incentives for smoking cessation in pregnancy: randomised controlled trial.

    Science.gov (United States)

    Tappin, David; Bauld, Linda; Purves, David; Boyd, Kathleen; Sinclair, Lesley; MacAskill, Susan; McKell, Jennifer; Friel, Brenda; McConnachie, Alex; de Caestecker, Linda; Tannahill, Carol; Radley, Andrew; Coleman, Tim

    2015-01-27

    To assess the efficacy of a financial incentive added to routine specialist pregnancy stop smoking services versus routine care to help pregnant smokers quit. Phase II therapeutic exploratory single centre, individually randomised controlled parallel group superiority trial. One large health board area with a materially deprived, inner city population in the west of Scotland, United Kingdom. 612 self reported pregnant smokers in NHS Greater Glasgow and Clyde who were English speaking, at least 16 years of age, less than 24 weeks pregnant, and had an exhaled carbon monoxide breath test result of 7 ppm or more. 306 women were randomised to incentives and 306 to control. The control group received routine care, which was the offer of a face to face appointment to discuss smoking and cessation and, for those who attended and set a quit date, the offer of free nicotine replacement therapy for 10 weeks provided by pharmacy services, and four, weekly support phone calls. The intervention group received routine care plus the offer of up to £400 of shopping vouchers: £50 for attending a face to face appointment and setting a quit date; then another £50 if at four weeks' post-quit date exhaled carbon monoxide confirmed quitting; a further £100 was provided for continued validated abstinence of exhaled carbon monoxide after 12 weeks; a final £200 voucher was provided for validated abstinence of exhaled carbon monoxide at 34-38 weeks' gestation. The primary outcome was cotinine verified cessation at 34-38 weeks' gestation through saliva (incentives were documented. Significantly more smokers in the incentives group than control group stopped smoking: 69 (22.5%) versus 26 (8.6%). The relative risk of not smoking at the end of pregnancy was 2.63 (95% confidence interval 1.73 to 4.01) Pincentives need to be offered to achieve one extra quitter in late pregnancy) was 7.2 (95% confidence interval 5.1 to 12.2). The mean birth weight was 3140 g (SD 600 g) in the incentives group

  9. Randomized controlled trials – a matter of design

    Directory of Open Access Journals (Sweden)

    Spieth PM

    2016-06-01

    Full Text Available Peter Markus Spieth,1,2 Anne Sophie Kubasch,3 Ana Isabel Penzlin,4 Ben Min-Woo Illigens,2,5 Kristian Barlinn,6 Timo Siepmann2,6,7 1Department of Anesthesiology and Critical Care Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, 2Center for Clinical Research and Management Education, Division of Health Care Sciences, Dresden International University, 3Pediatric Rheumatology and Immunology, Children’s Hospital, University Hospital Carl Gustav Carus, Technische Universität Dresden, 4Institute of Clinical Pharmacology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony, Germany; 5Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 6Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Saxony, Germany; 7Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, Oxfordshire, UK Abstract: Randomized controlled trials (RCTs are the hallmark of evidence-based medicine and form the basis for translating research data into clinical practice. This review summarizes commonly applied designs and quality indicators of RCTs to provide guidance in interpreting and critically evaluating clinical research data. It further reflects on the principle of equipoise and its practical applicability to clinical science with an emphasis on critical care and neurological research. We performed a review of educational material, review articles, methodological studies, and published clinical trials using the databases MEDLINE, PubMed, and ClinicalTrials.gov. The most relevant recommendations regarding design, conduction, and reporting of RCTs may include the following: 1 clinically relevant end points should be defined a priori, and an unbiased analysis and report of the study results should be warranted, 2 both significant and nonsignificant results should be objectively

  10. The Declaration of Helsinki and clinical trials: a focus on placebo-controlled trials in schizophrenia.

    Science.gov (United States)

    Carpenter, William T; Appelbaum, Paul S; Levine, Robert J

    2003-02-01

    The authors' goal was to consider ethical approaches to placebo-controlled clinical trials in the light of the evolving Declaration of Helsinki, with special attention to applications to research on schizophrenia. They review the Helsinki position on placebos, including the 2002 Clarification, exploring the potential negative effects of banning placebos in studies involving conditions for which at least partially effective treatments exist. The Clarification is examined as an approach to this issue that, in contrast to earlier formulations, better acknowledges the complexity of clinical research and the need for protocol-specific determinations. Placebo controls in schizophrenia studies are used to illustrate issues relevant to all clinical research on therapeutic interventions. The Helsinki Clarification provides a basis for operationalizing criteria for review of placebo use in clinical trials. Six criteria are proposed for judging the ethical acceptability of placebo controls, including the likelihood that the intervention being tested will have clinically significant advantages over existing treatments, the presence of compelling reasons for placebo use, subject selection that minimizes the possibility of serious adverse consequences, and a risk-versus-benefit analysis that favors the advantages from placebo use over the risks to subjects. The Helsinki Clarification constitutes an important advance in international approaches to placebo use, requiring protocol-by-protocol judgments on complex issues of clinical research ethics. When operationalized, it provides review boards with a useful methodology for reaching determinations on the appropriateness of placebo controls in particular studies.

  11. Observations of Pluto-Charon mutual events

    Energy Technology Data Exchange (ETDEWEB)

    Blanco, C.; Di Martino, M.; Ferreri, W. (Catania Universita (Italy); Osservatorio Astronomico, Turin (Italy))

    1989-07-01

    As part of the planned 'Pluto-Charon Mutual Eclipse Season Campaign', one mutual event was observed at the ESO Observatory on July 10, 1986 and seven mutual events were observed at the Serra La Nave stellar station of Catania Astrophysical Observatory from April 29 to July 21, 1987. At ESO the measurements were performed at the 61-cm Bochum telescope equipped with a photon-counting system and U, B, V, filters; at Serra La Nave the Cassegrain focus of the 91-cm reflector was equipped with a photon-counting system and B and V filters. The observed light losses and contact times do not show relevant systematic deviations from the predicted ones. An examination of the behavior of the B and V light curves gives slight indications of a different slope of the B and V light loss of the same event for a superior or an inferior event, and shows that the superior events are shallower at wavelengths longer than B. 6 refs.

  12. High Resolution HST Images of Pluto and Charon

    Science.gov (United States)

    1994-05-01

    At the Edge of the Solar System Click here to jump to photo. The remote planet Pluto and its moon Charon orbit the Sun at a mean distance of almost 6,000 million kilometres, or nearly fourty times farther out than the Earth. During a recent investigation by an international group of astronomers [1], the best picture ever of Pluto and Charon [2] was secured with the European Space Agency's Faint Object Camera at the Hubble Space Telescope (HST). It shows the two objects as individual disks, and it is likely that further image enhancement will allow us to see surface features on Pluto. A Very Special Pair of Celestial Objects Almost all the known facts about these two bodies show that they are quite unusual: Pluto's orbit around the Sun is much more elongated and more inclined to the main plane of the Solar System than that of any other major planet; Charon's orbit around Pluto is nearly perpendicular to this plane; their mutual distance is amazingly small when compared to their size; Charon is half the size of Pluto and the ratio of their masses is much closer to unity than is the case for all other planets and their moons. Moreover, both are small and solid bodies, in contrast to the other, large and gaseous planets in the outer Solar System. We do not know why this is so. But there is another important aspect which makes Pluto and Charon even more interesting: at this very large distance from the Sun, any evolutionary changes happen very slowly. It is therefore likely that Pluto and Charon hold important clues to the conditions that prevailed in the early Solar System and thus to the origin and the evolution of the Solar System as a whole. Long and Difficult Analysis Ahead The present image shows that the overall quality of the new data obtained with the ESA Faint Object Camera on the refurbished Hubble Space Telescope is extremely good. However, such an image represents only the first step of a subsequent, detailed analysis with the ultimate goal of determining

  13. Haze in Pluto's atmosphere: Results from SOFIA and ground-based observations of the 2015 June 29 Pluto occultation

    Science.gov (United States)

    Bosh, A. S.; Person, M. J.; Zuluaga, C. A.; Sickafoose, A. A.; Levine, S. E.; Pasachoff, J. M.; Babcock, B. A.; Dunham, E. W.; McLean, I.; Wolf, J.; Abe, F.; Becklin, E.; Bida, T. A.; Bright, L. P.; Brothers, T.; Christie, G.; Collins, P. L.; Durst, R. F.; Gilmore, A. C.; Hamilton, R.; Harris, H. C.; Johnson, C.; Kilmartin, P. M.; Kosiarek, M. R.; Leppik, K.; Logsdon, S. E.; Lucas, R.; Mathers, S.; Morley, C. J. K.; Nelson, P.; Ngan, H.; Pfüller, E.; Natusch, T.; Röser, H.-P.; Sallum, S.; Savage, M.; Seeger, C. H.; Siu, H.; Stockdale, C.; Suzuki, D.; Thanathibodee, T.; Tilleman, T.; Tristram, P. J.; Van Cleve, J.; Varughese, C.; Weisenbach, L. W.; Widen, E.; Wiedemann, M.

    2015-11-01

    We observed the 29 June 2015 occultation by Pluto from SOFIA and several ground-based sites in New Zealand. Pre-event astrometry (described in Zuluaga et al., this conference) allowed us to navigate SOFIA into Pluto's central flash (Person et al., this conference). Fortuitously, the central flash also fell over the Mt. John University Observatory (Pasachoff et al., this conference). We combine all of our airborne and ground-based data to produce a geometric solution for the occultation and to investigate the state of Pluto's atmosphere just two weeks before the New Horizons spacecraft's close encounter with Pluto. We find that the atmosphere parameters at half-light are unchanged from our observations in 2011 (Person et al. 2013) and 2013 (Bosh et al. 2015). By combining our light-curve inversion with recent radius measurements from New Horizons, we find strong evidence for an extended haze layer in Pluto's atmosphere. See also Sickafoose et al. (this conference) for an evaluation of the particle sizes and properties.SOFIA is jointly operated by the Universities Space Research Association, Inc. (USRA), under NASA contract NAS2-97001, and the Deutsches SOFIA Institut (DSI) under DLR contract 50 OK 0901 to the University of Stuttgart. Support for this work was provided by NASA SSO grants NNX15AJ82G (Lowell Observatory), NNX10AB27G (MIT), and NNX12AJ29G (Williams College), and by the National Research Foundation of South Africa.

  14. A randomized controlled trial to promote volunteering in older adults.

    Science.gov (United States)

    Warner, Lisa M; Wolff, Julia K; Ziegelmann, Jochen P; Wurm, Susanne

    2014-12-01

    Volunteering is presumed to confer health benefits, but interventions to encourage older adults to volunteer are sparse. Therefore, a randomized controlled trial with 280 community-dwelling older German adults was conducted to test the effects of a theory-based social-cognitive intervention against a passive waiting-list control group and an active control intervention designed to motivate physical activity. Self-reports of weekly volunteering minutes were assessed at baseline (5 weeks before the intervention) as well as 2 and 6 weeks after the intervention. Participants in the treatment group increased their weekly volunteering minutes to a greater extent than participants in the control groups 6 weeks after the intervention. We conclude that a single, face-to-face group session can increase volunteering among older community-dwelling adults. However, the effects need some time to unfold because changes in volunteering were not apparent 2 weeks after the intervention.

  15. Pushing back the frontier - A mission to the Pluto-Charon system

    Energy Technology Data Exchange (ETDEWEB)

    Farquhar, R.; Stern, S.A. (NASA, Washington, DC (USA) Colorado Univ., Boulder (USA))

    1990-08-01

    A flyby mission to Pluto is proposed. The size, orbit, atmosphere, and surface of Pluto, and the Pluto-Charon system are described. The benefits of a planetary flyby compared to ground observations are discussed in terms of imaging capabilities. Planned payloads include a plasma science package, a UV spectrometer, and a thermal mapper. The advantages of a dual launch to Mars and the need for a Jupiter-Pluto transfer are considered. A diagram of a spacecraft for a flyby study of Pluto is provided.

  16. Radonexposure with the treatment of rheumatic diseases - randomized controlled trials

    Energy Technology Data Exchange (ETDEWEB)

    Falkenbach, A. [Krankenanstalt Gasteiner Heilstollen, Bad Gastein-Boeckstein (Austria)]|[Forschungsinstitut Gastein, Bad Gastein (Austria); Kovac, J.; Brandmaier, P. [Krankenanstalt Gasteiner Heilstollen, Bad Gastein-Boeckstein (Austria); Soto, J. [Dept. of Medical Physics, Univ. of Cantabria (Spain)

    2001-07-01

    The objective was to investigate whether there is evidence for the effectiveness of radon therapy in the treatment of rheumatic diseases. Method: Medline and MedKur databases were searched for randomised controlled clinical trials. Radon therapy centres and experts in the field were contacted, proceedings were hand-searched and bibliographies were checked for references of potential impact. Four clinical trials evaluating the effect of radon in patients suffering from rheumatic diseases with no or only a small number of drop-outs met the inclusion criteria. In patients with degenerative disease of the spine and large joints, two trials [1,2] reported less pain on pressure of painful paraspinal muscle points after a series of radon baths at a concentration of 0.8 kBq/L and 3 kBq/L, respectively. The alleviation of pain was most pronounced in the weeks following the treatment period. [3]. At six months follow-up serial immersion in combined radon and CO{sub 2} baths reduced pain and functional restrictions in patients with rheumatoid arthritis (n=60) more effectively than bathing in CO{sub 2} only. [4] In 130 patients with ankylosing spondylitis a complex rehabilitation program at a health resort (group 1 and 2) showed greater and longer-lasting differences to a control group staying at home (group 3), if speleotherapeutic radon exposure (group 1) was added (as compared to an added sauna treatment, group 2). Conclusion: The four trials meeting the inclusion criteria showed beneficial effects of radon therapy compared to interventions without radon exposure. Up to nine months after the treatment period significantly better results were observed, if radon therapy is added. (orig.)

  17. A Randomised Controlled Trial of complete denture impression materials

    Science.gov (United States)

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

    2014-01-01

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

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

  18. On the origin of the Pluto-Charon binary

    Energy Technology Data Exchange (ETDEWEB)

    Mckinnon, W.B. (Washington Univ., Saint Louis, MO (USA))

    1989-09-01

    The normalized angular momentum density of Pluto-Charon (0.45) exceeds the critical value of 0.39 above which no stably rotating single object exists, suggesting a collisional origin for this binary. The effects of viscosity on Pluto's rotational stability and on the density of Charon are considered. Both a more or less dense Charon would be consistent with a collisional origin if one (the least massive) or both protoobjects were differentiated. It is noted that the angular momentum of the system requires the protoobjects to be comparably (if not equally) sized if off-center impact velocities vary between escape (about 1.3 km/s) and somewhat greater values (about 2.5 km/s) appropriate to Pluto's eccentric and inclined solar orbit. 30 refs.

  19. The Small Satellites of Pluto as Observed by New Horizons

    CERN Document Server

    Weaver, H A; Buratti, B J; Grundy, W M; Lauer, T R; Olkin, C B; Parker, A H; Porter, S B; Showalter, M R; Spencer, J R; Stern, S A; Verbiscer, A J; McKinnon, W B; Moore, J M; Robbins, S J; Schenk, P; Singer, K N; Barnouin, O S; Cheng, A F; Ernst, C M; Lisse, C M; Jennings, D E; Lunsford, A W; Reuter, D C; Hamilton, D P; Kaufmann, D E; Ennico, K; Young, L A; Beyer, R A; Binzel, R P; Bray, V J; Chaikin, A L; Cook, J C; Cruikshank, D P; Ore, C M Dalle; Earle, A M; Gladstone, G R; Howett, C J A; Linscott, I R; Nimmo, F; Parker, J Wm; Philippe, S; Protopapa, S; Reitsema, H J; Schmitt, B; Stryk, T; Summers, M E; Tsang, C C C; Throop, H H B; White, O L; Zangari, A M

    2016-01-01

    The New Horizons mission has provided resolved measurements of Pluto's moons Styx, Nix, Kerberos, and Hydra. All four are small, with equivalent spherical diameters of $\\approx$40 km for Nix and Hydra and ~10 km for Styx and Kerberos. They are also highly elongated, with maximum to minimum axis ratios of $\\approx$2. All four moons have high albedos ( $\\approx$50-90 %) suggestive of a water-ice surface composition. Crater densities on Nix and Hydra imply surface ages $\\gtrsim$ 4 Ga. The small moons rotate much faster than synchronous, with rotational poles clustered nearly orthogonal to the common pole directions of Pluto and Charon. These results reinforce the hypothesis that the small moons formed in the aftermath of a collision that produced the Pluto-Charon binary.

  20. Sham Acupressure Controls Used in Randomized Controlled Trials: A Systematic Review and Critique

    OpenAIRE

    Jing-Yu Tan; Suen, Lorna K P; Tao Wang; Alexander Molassiotis

    2015-01-01

    Objectives To explore the commonly utilized sham acupressure procedures in existing acupressure trials, and to assess whether different types of sham interventions yield different therapeutic outcomes, and, as far as possible, to identify directions for the future development of an adequate sham acupressure method. Methods Randomized controlled trials comparing true acupressure with sham interventions were included. Thirteen electronic databases were adopted to locate relevant studies from in...

  1. Individual nutrition therapy and exercise regime: A controlled trial of injured, vulnerable elderly (INTERACTIVE trial

    Directory of Open Access Journals (Sweden)

    Whitehead Craig

    2008-02-01

    Full Text Available Abstract Background Proximal femoral fractures are amongst the most devastating consequences of osteoporosis and injurious accidental falls with 25–35% of patients dying in the first year post-fracture. Effective rehabilitation strategies are evolving however, despite established associations between nutrition, mobility, strength and strength-related functional outcomes; there has been only one small study with older adults immediately following fragility fracture where a combination of both exercise and nutrition have been provided. The aim of the INTERACTIVE trial is to establish whether a six month, individualised exercise and nutrition program commencing within fourteen days of surgery for proximal femur fracture, results in clinically and statistically significant improvements in physical function, body composition and quality of life at an acceptable level of cost and resource use and without increasing the burden of caregivers. Methods and Design This randomised controlled trial will be performed across two sites, a 500 bed acute hospital in Adelaide, South Australia and a 250 bed acute hospital in Sydney, New South Wales. Four hundred and sixty community-dwelling older adults aged > 70 will be recruited after suffering a proximal femoral fracture and followed into the community over a 12-month period. Participants allocated to the intervention group will receive a six month individualised care plan combining resistance training and nutrition therapy commencing within 14 days post-surgery. Outcomes will be assessed by an individual masked to treatment allocation at six and 12 months. To determine differences between the groups at the primary end-point (six months, ANCOVA or logistic regression will be used with models adjusted according to potential confounders. Discussion The INTERACTIVE trial is among the first to combine nutrition and exercise therapy as an early intervention to address the serious consequence of rapid deconditioning

  2. An investigation of Haze Heating and Cooling in Pluto's Atmosphere

    Science.gov (United States)

    Zhang, X.; Strobel, D. F.; Imanaka, H.

    2016-12-01

    During the Pluto flyby, an ultraviolet imaging spectrometer ALICE onboard New Horizon spacecraft revealed an unexpected cold atmosphere on Pluto (Gladstone et al., 2016, Science, 351.6279). The missing cooling agent is still a mystery. The required abundance of hydrogen cyanide (HCN) to explain the thermal profile are not consistent with the recent ALMA observations (Lellouch et al. 2016, Arxiv:1606.03293v1). Here we investigate another possible candidate: haze particles. Haze particles are likely formed via hydrocarbon and nitrile chemistry in Pluto's atmosphere. Numerous global haze layers have been discovered in the New Horizons images (Gladstone et al. 2016, Science, 351.6279). Based on the LOng Range Reconnaissance Imager (LORRI) observations, Gladstone et al. (2016) gave the line-of-sight optical depth of the haze particles of 0.16 at wavelength of 0.6 microns for 0.2 micron particles with scale height of 50 km. The FUV solar occultation by ALICE reveals that the line-of-sight haze opacity reaches unity at 75 km above surface (Gao et al. 2016, submitted; Young et al. 2016, in prep). Pluto's hazes might radiatively heat and cool the atmosphere and alter the temperature profile, as previously suggested on Jupiter's middle atmosphere (Zhang et al. 2015, Nature Communications, 6, doi: 10.1038/ncomms10231). Based on the vertical profile of haze opacity derived from ALICE observations (Gao et al. 2016, submitted; Young et al. 2016, in prep), we calculate the UV and visible heating and infrared cooling rates on Pluto. We tested different refractive indices of haze particles based on Titan- and Saturn-like hazes and a recent laboratory study in Pluto-like environment (Imanaka et al. 2015, AAS/DPS Meeting). We found that the haze heating and cooling effects could be potentially large compared with the heating from methane and cooling from CO, HCN and C2 hydrocarbons. Possible non-thermodynamic equilibrium between gas and particles is also discussed.

  3. Pluto's plasma wake oriented away from the ecliptic plane

    Science.gov (United States)

    Pérez-de-Tejada, H.; Durand-Manterola, H.; Reyes-Ruiz, M.; Lundin, R.

    2015-01-01

    Conditions similar to those observed in the solar wind interaction with Venus and Mars where there is a planetary atmosphere in the absence of a global intrinsic magnetic field may also be applicable to Pluto. With up to 24 μbars inferred for the Pluto atmosphere it is possible that the feeble solar photon radiation flux that reaches by its orbit, equivalent to ∼10-3 that at Earth, is sufficient to produce an ionization component that can be eroded by the solar wind. In view of the reduced solar wind density (∼10-3 with respect to that at 1 AU) that should be available by Pluto its total kinetic energy will be significantly smaller than that at Earth. However, the parameter values that are implied for the interaction process between the solar wind and the local upper ionosphere are sufficient to produce a plasma wake that should extend downstream from Pluto. In view of its low gravity force the plasma wake should have a wider cross-section than that in the Venus and Mars plasma environment. Since Pluto rotates with the axis tilted ∼30° away from the ecliptic plane the plasma wake will be influenced by a Magnus force that has a large component is the north-south solar polar direction. That force will be responsible for propelling the plasma wake with a component that can be directed away from that plane. It is estimated that transport of solar wind momentum to the upper Pluto's ionosphere implies rotation periods smaller than that of the solid body, and thus large values of the Magnus force that can increase the orientation of the plasma wake away from the ecliptic plane.

  4. Did the Kozai Resonance Help Form Pluto's Small Moons?

    Science.gov (United States)

    Cuk, Matija; (Luke) Dones, Henry C.; Nesvorny, David; Walsh, Kevin J.

    2016-05-01

    The origin of the small moons of Pluto is currently poorly understood. They most likely originated from debris ejected from Pluto and Charon during their formation in the giant impact. However, the moons' large separation from Pluto and massive past tidal evolution of Charon make it very hard to emplace collisional fragments on circular orbits in the 40-60 Pluto radii zone where the four small moons are found. Here we propose that the Pluto system has a parallel in the triple Trans-Neptunian Object (TNO) 1999 TC36. Both systems have large obliquities, and have additional components outside the inner binary that probably formed in a giant impact and has likely gone through a rapid tidal evolution immediately following formation. Our hypothesis is that loosely bound ejecta from giant impacts can experience strong perturbations from the Sun (the ``Kozai resonance") as long as major axes of their elongated orbits are perpendicular to the binary's heliocentric orbit. This process could decouple the debris from the inner boundary long enough for the inner binary to evolve tidally and prevent further Kozai oscillations through its quadrupole moment. If the debris is dominated by one large fragment, a triple can form (as in the case of 1999 TC36), while a large population of fragments would experience collisions and make a disk surrounding the inner binary (as in the case of Pluto). At the meeting we will present numerical simulations of this process using numerical integrator COMPLEX which includes both tides and solar perturbations, and can integrate dynamics of satellites on crossing orbits.

  5. Long-term surface temperature modeling of Pluto

    Science.gov (United States)

    Earle, Alissa M.; Binzel, Richard P.; Young, Leslie A.; Stern, S. A.; Ennico, K.; Grundy, W.; Olkin, C. B.; Weaver, H. A.

    2017-05-01

    NASA's New Horizons' reconnaissance of the Pluto system has revealed at high resolution the striking albedo contrasts from polar to equatorial latitudes on Pluto, as well as the sharpness of boundaries for longitudinal variations. These contrasts suggest that Pluto must undergo dynamic evolution that drives the redistribution of volatiles. Using the New Horizons results as a template, we explore the surface temperature variations driven seasonally on Pluto considering multiple timescales. These timescales include the current orbit (248 years) as well as the timescales for obliquity precession (peak-to-peak amplitude of 23° over 3 million years) and regression of the orbital longitude of perihelion (3.7 million years). These orbital variations create epochs of ;Extreme Seasons; where one pole receives a short, relatively warm summer and long winter, while the other receives a much longer, but less intense summer and short winter. We use thermal modeling to build upon the long-term insolation history model described by Earle and Binzel (2015) and investigate how these seasons couple with Pluto's albedo contrasts to create temperature effects. From this study we find that a bright region at the equator, once established, can become a site for net deposition. We see the region informally known as Sputnik Planitia as an example of this, and find it will be able to perpetuate itself as an ;always available; cold trap, thus having the potential to survive on million year or substantially longer timescales. Meanwhile darker, low-albedo, regions near the equator will remain relative warm and generally not attract volatile deposition. We argue that the equatorial region is a ;preservation zone; for whatever albedo is seeded there. This offers insight as to why the equatorial band of Pluto displays the planet's greatest albedo contrasts.

  6. Pluto's Haze from 2002 - 2015: Correlation with the Solar Cycle

    Science.gov (United States)

    Young, Eliot; Klein, Viliam; Hartig, Kara; Resnick, Aaron; Mackie, Jason; Carriazo, Carolina; Watson, Charles; Skrutskie, Michael; Verbiscer, Anne; Nelson, Matthew; Howell, Robert; Wasserman, Lawrence; Hudson, Gordon; Gault, David; Barry, Tony; Sicardy, Bruno; Cole, Andrew; Giles, Barry; Hill, Kym

    2017-04-01

    Occultations by Pluto were observed 2002, 2007, 2011 and 2015, with each event observed simultaneously in two or more wavelengths. Separate wavelengths allow us to discriminate between haze opacity and refractive effects due to an atmosphere's thermal profile - these two effects are notoriously hard to separate if only single-wavelength lightcurves are available. Of those four occultations, the amount of haze in Pluto's atmosphere was highest in 2002 (Elliot et al. 2003 report an optical depth of 0.11 at 0.73 µm in the zenith direction), but undetectable in the 2007 and 2011 events (we find optical depth upper limits of 0.012 and 0.010 at 0.6 µm). Cheng et al. (2016) report a zenith optical depth of 0.018 at 0.6 µm from the haze profiles seen in New Horizons images. These four data points are correlated with the solar cycle. The 2002 haze detection occurred just after the peak of solar cycle 23, the 2007 and 2011 non-detections occurred during the solar minimum between peaks 23 and 24, and the New Horizons flyby took place just after the peak of solar cycle 24. This suggests that haze production on Pluto (a) is driven by solar UV photons or charged particles, (b) that sources and sinks on Pluto have timescales shorter than a few Earth years, and (c) the haze precursors on Pluto are not produced by Lyman-alpha radiation, because Lyman-alpha output only decreased by about one third in between the cycle 23 and 24 peaks, much less than the observed change in Pluto's haze abundances. References: Elliot, J.L. et al. (2003) Nature, Volume 424, Issue 6945, pp. 165-168.

  7. What influences recruitment to randomised controlled trials? A review of trials funded by two UK funding agencies

    Directory of Open Access Journals (Sweden)

    Francis David

    2006-04-01

    Full Text Available Abstract Background A commonly reported problem with the conduct of multicentre randomised controlled trials (RCTs is that recruitment is often slower or more difficult than expected, with many trials failing to reach their planned sample size within the timescale and funding originally envisaged. The aim of this study was to explore factors that may have been associated with good and poor recruitment in a cohort of multicentre trials funded by two public bodies: the UK Medical Research Council (MRC and the Health Technology Assessment (HTA Programme. Methods The cohort of trials was identified from the administrative databases held by the two funding bodies. 114 trials that recruited participants between 1994 and 2002 met the inclusion criteria. The full scientific applications and subsequent trial reports submitted by the trial teams to the funders provided the principal data sources. Associations between trial characteristics and recruitment success were tested using the Chi-squared test, or Fisher's exact test where appropriate. Results Less than a third (31% of the trials achieved their original recruitment target and half (53% were awarded an extension. The proportion achieving targets did not appear to improve over time. The overall start to recruitment was delayed in 47 (41% trials and early recruitment problems were identified in 77 (63% trials. The inter-relationship between trial features and recruitment success was complex. A variety of strategies were employed to try to increase recruitment, but their success could not be assessed. Conclusion Recruitment problems are complex and challenging. Many of the trials in the cohort experienced recruitment difficulties. Trials often required extended recruitment periods (sometimes supported by additional funds. While this is of continuing concern, success in addressing the trial question may be more important than recruitment alone.

  8. Exercise and manual physiotherapy arthritis research trial (EMPART): a multicentre randomised controlled trial.

    LENUS (Irish Health Repository)

    French, Helen P

    2009-01-01

    Osteoarthritis (OA) of the hip is a major cause of functional disability and reduced quality of life. Management options aim to reduce pain and improve or maintain physical functioning. Current evidence indicates that therapeutic exercise has a beneficial but short-term effect on pain and disability, with poor long-term benefit. The optimal content, duration and type of exercise are yet to be ascertained. There has been little scientific investigation into the effectiveness of manual therapy in hip OA. Only one randomized controlled trial (RCT) found greater improvements in patient-perceived improvement and physical function with manual therapy, compared to exercise therapy.

  9. Surgical trial in traumatic intracerebral hemorrhage (STITCH(Trauma: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Gregson Barbara A

    2012-10-01

    Full Text Available Abstract Background Intracranial hemorrhage occurs in over 60% of severe head injuries in one of three types: extradural (EDH; subdural (SDH; and intraparenchymal (TICH. Prompt surgical removal of significant SDH and EDH is established and widely accepted. However, TICH is more common and is found in more than 40% of severe head injuries. It is associated with a worse outcome but the role for surgical removal remains undefined. Surgical practice in the treatment of TICHs differs widely around the world. The aim of early surgery in TICH removal is to prevent secondary brain injury. There have been trials of surgery for spontaneous ICH (including the STICH II trial, but none so far of surgery for TICH. Methods/Design The UK National Institutes of Health Research has funded STITCH(Trauma to determine whether a policy of early surgery in patients with TICH improves outcome compared to a policy of initial conservative treatment. It will include a health economics component and carry out a subgroup analysis of patients undergoing invasive monitoring. This is an international multicenter pragmatic randomized controlled trial. Patients are eligible if: they are within 48 h of injury; they have evidence of TICH on CT scan with a confluent volume of attenuation significantly raised above that of the background white and grey matter that has a total volume >10 mL; and their treating neurosurgeon is in equipoise. Patients will be ineligible if they have: a significant surface hematoma (EDH or SDH requiring surgery; a hemorrhage/contusion located in the cerebellum; three or more separate hematomas fulfilling inclusion criteria; or severe pre-existing physical or mental disability or severe co-morbidity which would lead to poor outcome even if the patient made a full recovery from the head injury. Patients will be randomized via an independent service. Patients randomized to surgery receive surgery within 12 h. Both groups will be monitored according to

  10. Alzheimer’s disease multiple intervention trial (ADMIT: study protocol for a randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Callahan Christopher M

    2012-06-01

    Full Text Available Abstract Background Given the current lack of disease-modifying therapies, it is important to explore new models of longitudinal care for older adults with dementia that focus on improving quality of life and delaying functional decline. In a previous clinical trial, we demonstrated that collaborative care for Alzheimer’s disease reduces patients’ neuropsychiatric symptoms as well as caregiver stress. However, these improvements in quality of life were not associated with delays in subjects’ functional decline. Trial design Parallel randomized controlled clinical trial with 1:1 allocation. Participants A total of 180 community-dwelling patients aged ≥45 years who are diagnosed with possible or probable Alzheimer’s disease; subjects must also have a caregiver willing to participate in the study and be willing to accept home visits. Subjects and their caregivers are enrolled from the primary care and geriatric medicine practices of an urban public health system serving Indianapolis, Indiana, USA. Interventions All patients receive best practices primary care including collaborative care by a dementia care manager over two years; this best practices primary care program represents the local adaptation and implementation of our prior collaborative care intervention in the urban public health system. Intervention patients also receive in-home occupational therapy delivered in twenty-four sessions over two years in addition to best practices primary care. The focus of the occupational therapy intervention is delaying functional decline and helping both subjects and caregivers adapt to functional impairments. The in-home sessions are tailored to the specific needs and goals of each patient-caregiver dyad; these needs are expected to change over the course of the study. Objective To determine whether best practices primary care plus home-based occupational therapy delays functional decline among patients with Alzheimer’s disease compared

  11. Mass-radius relationships and constraints on the composition of Pluto

    Science.gov (United States)

    Lupo, M. J.; Lewis, J. S.

    1980-01-01

    With the new upper limit of Pluto's mass, an upper limit for Pluto's density of 1.74 g/cu cm has been found. Assuming Pluto to be 100% methane, available methane density data can be used to set a lower limit of 0.53 g/cu cm on Pluto's density, thus placing an absolute upper limit of 1909 km on the radius and a lower limit of 0.32 on the albedo. The results of 280 computer models covering a wide range of composition ratios of rock, water ice, and methane ice are reported. Limits are placed on Pluto's silicate content, and a simple spacecraft method for determining Pluto's water content from its density and moment of inertia is given. The low thermal conductivity and strength of solid methane suggest rapid solid-state convection in Pluto's methane layer.

  12. Uranus, Neptune, Pluto, and the outer solar system

    CERN Document Server

    Elkins-Tanton, Linda T

    2010-01-01

    Unlike all the planets closer to the Sun, known since antiquity, the farthest reaches are the discoveries of the modern world. Uranus was discovered in 1781, Neptune in 1846, Pluto in 1930, the Kuiper belt group of objects in 1992, and though the Oort cloud has been theorized since 1950, its first member was found in 2004. The discovery of the outer planets made such an impression on the minds of mankind that they were immortalized in the names of the newly discovered elements: uranium, neptunium, and plutonium, an astonishingly deadly constituent of atomic bombs. Uranus, Neptune, Pluto, and t

  13. Basic Design of a LWR Fuel Compatibility Test Facility (PLUTO)

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Chang Hwan; Chun, Se Young; Kim, Bok Deuk; Park, Jong Kuk; Chun, Tae Hyun; Kim, Hyoung Kyu; Oh, Dong Seok

    2009-04-15

    KAERI is performing a project for developing a compatibility test facility and the relevant technology for an LWR fuel assembly. It includes the compatibility test and the long term wear test for dual fuel assemblies, and the pressure drop test, uplift force test, flow-induced vibration test, damping test, and the debris filtering capability test for a single fuel assembly. This compatibility test facility of the fuel assemblies is named PLUTO from Performance Test Facility for Fuel Assembly Hydraulics and Vibrations. The PLUTO will be basically constructed for a PWR fuel assembly, and it will be considered to test for the fuel assemblies of other reactors.

  14. Effect of Playful Balancing Training - A Pilot Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop; Jessen, Jari Due

    2013-01-01

    We used the modular playware in the form of modular interactive tiles for playful training of community-dwelling elderly with balancing problem. During short-term play on the modular interactive tiles, the elderly were playing physical, interactive games that were challenging their dynamic balance......, agility, endurance, and sensor-motoric reaction. A population of 12 elderly (average age: 79) with balancing problems (DGI average score: 18.7) was randomly assigned to control group or tiles training group, and tested before and after intervention. The tiles training group had statistical significant...... increase in balancing performance (DGI score: 21.3) after short-term playful training with the modular interactive tiles, whereas the control group remained with a score indicating balancing problems and risk of falling (DGI score: 16.6). The small pilot randomized controlled trial suggests...

  15. ORCHIDS: an Observational Randomized Controlled Trial on Childhood Differential Susceptibility

    Directory of Open Access Journals (Sweden)

    Chhangur Rabia R

    2012-10-01

    Full Text Available Abstract Background A central tenet in developmental psychopathology is that childhood rearing experiences have a major impact on children’s development. Recently, candidate genes have been identified that may cause children to be differentially susceptible to these experiences (i.e., susceptibility genes. However, our understanding of the differential impact of parenting is limited at best. Specifically, more experimental research is needed. The ORCHIDS study will investigate gene-(gene-environment interactions to obtain more insight into a moderating effects of polymorphisms on the link between parenting and child behavior, and b behavioral mechanisms that underlie these gene-(gene-environment interactions in an experimental design. Methods/Design The ORCHIDS study is a randomized controlled trial, in which the environment will be manipulated with an intervention (i.e., Incredible Years parent training. In a screening, families with children aged 4–8 who show mild to (subclinical behavior problems will be targeted through community records via two Dutch regional healthcare organizations. Assessments in both the intervention and control condition will be conducted at baseline (i.e., pretest, after 6 months (i.e., posttest, and after 10 months (i.e., follow-up. Discussion This study protocol describes the design of a randomized controlled trial that investigates gene-(gene-environment interactions in the development of child behavior. Two hypotheses will be tested. First, we expect that children in the intervention condition who carry one or more susceptibility genes will show significantly lower levels of problem behavior and higher levels of prosocial behavior after their parent(s received the Incredible Years training, compared to children without these genes, or children in the control group. Second, we expect that children carrying one or more susceptibility genes will show a heightened sensitivity to changes in parenting behaviors, and

  16. Partner randomized controlled trial: study protocol and coaching intervention

    Directory of Open Access Journals (Sweden)

    Garbutt Jane M

    2012-04-01

    Full Text Available Abstract Background Many children with asthma live with frequent symptoms and activity limitations, and visits for urgent care are common. Many pediatricians do not regularly meet with families to monitor asthma control, identify concerns or problems with management, or provide self-management education. Effective interventions to improve asthma care such as small group training and care redesign have been difficult to disseminate into office practice. Methods and design This paper describes the protocol for a randomized controlled trial (RCT to evaluate a 12-month telephone-coaching program designed to support primary care management of children with persistent asthma and subsequently to improve asthma control and disease-related quality of life and reduce urgent care events for asthma care. Randomization occurred at the practice level with eligible families within a practice having access to the coaching program or to usual care. The coaching intervention was based on the transtheoretical model of behavior change. Targeted behaviors included 1 effective use of controller medications, 2 effective use of rescue medications and 3 monitoring to ensure optimal control. Trained lay coaches provided parents with education and support for asthma care, tailoring the information provided and frequency of contact to the parent's readiness to change their child's day-to-day asthma management. Coaching calls varied in frequency from weekly to monthly. For each participating family, follow-up measurements were obtained at 12- and 24-months after enrollment in the study during a telephone interview. The primary outcomes were the mean change in 1 the child's asthma control score, 2 the parent's quality of life score, and 3 the number of urgent care events assessed at 12 and 24 months. Secondary outcomes reflected adherence to guideline recommendations by the primary care pediatricians and included the proportion of children prescribed controller medications

  17. Randomized control trial of computer-based rehabilitation of spatial neglect syndrome: the RESPONSE trial protocol.

    Science.gov (United States)

    Vleet, Thomas Van; DeGutis, Joseph; Dabit, Sawsan; Chiu, Christopher

    2014-02-07

    Spatial neglect is a frequent and debilitating consequence of acquired brain injury and currently has no widely accepted standard of care. While previous interventions for spatial neglect have targeted patients' overt spatial deficits (e.g., reduced contralesional visual scanning), far fewer have directly targeted patients' non-spatial deficits (e.g., sustained attention deficits). Considering that non-spatial deficits have shown to be highly predictive of long-term disability, we developed a novel computer based training program that targets both sustained (tonic) and moment-to-moment (phasic) aspects of non-spatial attention (Tonic and Phasic Alertness Training, TAPAT). Preliminary studies demonstrate that TAPAT is safe and effective in improving both spatial and non-spatial attention deficits in the post-acute recovery phase in neglect patients. The purpose of the current trial (referred to as the REmediation of SPatial Neglect or RESPONSE trial) is to compare TAPAT to an active control training condition, include a larger sample of patients, and assess both cognitive and functional outcomes. We will employ a multi-site, longitudinal, blinded randomized controlled trial (RCT) design with a target sample of 114 patients with spatial neglect. Patients will either perform, at their home, the experimental TAPAT training program or an active control computer games condition for thirty minutes/day, five days a week, over three months. Patients will be assessed on a battery of cognitive and functional outcomes on three occasions: a) immediately before training, b) within forty-eight hours post completion of total training, and c) after a three-month no-contact period post completion of total training, to assess the longevity of potential training effects. The strengths of this protocol are that it tests an innovative, in-home administered treatment that targets a fundamental deficit in neglect, employs highly sensitive computer-based assessments of cognition as well as

  18. Laparoscopic versus open gastrectomy for gastric cancer, a multicenter prospectively randomized controlled trial (LOGICA-trial).

    Science.gov (United States)

    Haverkamp, Leonie; Brenkman, Hylke J F; Seesing, Maarten F J; Gisbertz, Suzanne S; van Berge Henegouwen, Mark I; Luyer, Misha D P; Nieuwenhuijzen, Grard A P; Wijnhoven, Bas P L; van Lanschot, Jan J B; de Steur, Wobbe O; Hartgrink, Henk H; Stoot, Jan H M B; Hulsewé, Karel W E; Spillenaar Bilgen, Ernst J; Rütter, Jeroen E; Kouwenhoven, Ewout A; van Det, Marc J; van der Peet, Donald L; Daams, Freek; Draaisma, Werner A; Broeders, Ivo A M J; van Stel, Henk F; Lacle, Miangela M; Ruurda, Jelle P; van Hillegersberg, Richard

    2015-07-29

    For gastric cancer patients, surgical resection with en-bloc lymphadenectomy is the cornerstone of curative treatment. Open gastrectomy has long been the preferred surgical approach worldwide. However, this procedure is associated with considerable morbidity. Several meta-analyses have shown an advantage in short-term outcomes of laparoscopic gastrectomy compared to open procedures, with similar oncologic outcomes. However, it remains unclear whether the results of these Asian studies can be extrapolated to the Western population. In this trial from the Netherlands, patients with resectable gastric cancer will be randomized to laparoscopic or open gastrectomy. The study is a non-blinded, multicenter, prospectively randomized controlled superiority trial. Patients (≥18 years) with histologically proven, surgically resectable (cT1-4a, N0-3b, M0) gastric adenocarcinoma and European Clinical Oncology Group performance status 0, 1 or 2 are eligible to participate in the study after obtaining informed consent. Patients (n = 210) will be included in one of the ten participating Dutch centers and are randomized to either laparoscopic or open gastrectomy. The primary outcome is postoperative hospital stay (days). Secondary outcome parameters include postoperative morbidity and mortality, oncologic outcomes, readmissions, quality of life and cost-effectiveness. In this randomized controlled trial laparoscopic and open gastrectomy are compared in patients with resectable gastric cancer. It is expected that laparoscopic gastrectomy will result in a faster recovery of the patient and a shorter hospital stay. Secondly, it is expected that laparoscopic gastrectomy will be associated with a lower postoperative morbidity, less readmissions, higher cost-effectiveness, better postoperative quality of life, but with similar mortality and oncologic outcomes, compared to open gastrectomy. The study started on 1 December 2014. Inclusion and follow-up will take 3 and 5

  19. Treatment success in pragmatic randomised controlled trials: a review of trials funded by the UK Health Technology Assessment programme

    Directory of Open Access Journals (Sweden)

    Raftery James

    2011-05-01

    Full Text Available Abstract Background Previous research reviewed treatment success and whether the collective uncertainty principle is met in RCTs in the US National Cancer Institute portfolio. This paper classifies clinical trials funded by the UK HTA programme by results using the method applied to the US Cancer Institute trials, and compares the two portfolios. Methods Data on all completed randomised controlled trials funded by the HTA programme 1993-2008 were extracted. Each trial's primary results was classified into six categories; 1 statistically significant in favour of the new treatment, 2 statistically significant in favour of the control treatment 3 true negative, 4 truly inconclusive, 5 inconclusive in favour of new treatment or 6 inconclusive in favour of control treatment. Trials were classified by comparing the 95% confidence interval for the difference in primary outcome to the difference specified in the sample size calculation. The results were compared with Djulbegovic's analysis of NCI trials. Results Data from 51 superiority trials were included, involving over 48,000 participants and a range of diseases and interventions. 85 primary comparisons were available because some trials had more than two randomised arms or had several primary outcomes. The new treatment had superior results (whether significant or not in 61% of the comparisons (52/85 95% CI 49.9% to 71.6%. The results were conclusive in 46% of the comparisons (19% statistically significant in favour of the new treatment, 5% statistically significant in favour of the control and 22% true negative. The results were classified as truly inconclusive (i.e. failed to answer the question asked for 24% of comparisons (20/85. HTA trials included fewer truly inconclusive and statistically significant results and more results rated as true negative than NCI trials. Conclusions The pattern of results in HTA trials is similar to that of the National Cancer Institute portfolio. Differences that

  20. A Randomized Controlled Trial of Caries Prevention in Dental Practice.

    Science.gov (United States)

    Tickle, M; O'Neill, C; Donaldson, M; Birch, S; Noble, S; Killough, S; Murphy, L; Greer, M; Brodison, J; Verghis, R; Worthington, H V

    2017-07-01

    We conducted a parallel group randomized controlled trial of children initially aged 2 to 3 y who were caries free, to prevent the children becoming caries active over the subsequent 36 mo. The setting was 22 dental practices in Northern Ireland, and children were randomly assigned by a clinical trials unit (CTU) (using computer-generated random numbers, with allocation concealed from the dental practice until each child was recruited) to the intervention (22,600-ppm fluoride varnish, toothbrush, 50-mL tube of 1,450 ppm fluoride toothpaste, and standardized, evidence-based prevention advice) or advice-only control at 6-monthly intervals. The primary outcome measure was conversion from caries-free to caries-active states. Secondary outcome measures were number of decayed, missing, or filled teeth (dmfs) in caries-active children, number of episodes of pain, and number of extracted teeth. Adverse reactions were recorded. Calibrated external examiners, blinded to the child's study group, assessed the status of the children at baseline and after 3 y. In total, 1,248 children (624 randomized to each group) were recruited, and 1,096 (549 intervention, 547 control) were included in the final analyses. Eighty-seven percent of intervention and 86% of control children attended every 6-mo visit ( P = 0.77). A total of 187 (34%) in the intervention group converted to caries active compared to 213 (39%) in the control group (odds ratio, 0.81; 95% confidence interval, 0.64-1.04; P = 0.11). Mean dmfs of those with caries in the intervention group was 7.2 compared to 9.6 in the control group ( P = 0.007). There was no significant difference in the number of episodes of pain between groups ( P = 0.81) or in the number of teeth extracted in caries-active children ( P = 0.95). Ten children in the intervention group had adverse reactions of a minor nature. This well-conducted trial failed to demonstrate that the intervention kept children caries free, but there was evidence that once

  1. RTGs Options for Pluto Fast Flyby Mission

    Energy Technology Data Exchange (ETDEWEB)

    Schock, Alfred

    1993-10-01

    A small spacecraft design for the Pluto Fast Flyby (PFF) Mission is under study by the Jet Propulsion Laboratory (JPL) for the National Aeronautics and Space Administration (NASA), for a possible launch as early as 1998. JPL's 1992 baseline design calls for a power source able to furnish an energy output of 3963 kWh and a power output of 69 watts(e) at the end of the 9.2-year mission. Satisfying those demands is made difficult because NASA management has set a goal of reducing the spacecraft mass from a baseline value of 166 kg to ~110 kg, which implies a mass goal of less than 10 kg for the power source. To support the ongoing NASA/JPL studies, the Department of Energy's Office of Special Applications (DOE/OSA) commissioned Fairchild Space to prepare and analyze conceptual designs of radioisotope power systems for the PFF mission. Thus far, a total of eight options employing essentially the same radioisotope heat source modules were designed and subjected to thermal, electrical, structural, and mass analyses by Fairchild. Five of these - employing thermoelectric converters - are described in the present paper, and three - employing free-piston Stirling converters - are described in the companion paper presented next. The system masses of the thermoelectric options ranged from 19.3 kg to 10.2 kg. In general, the options requiring least development are the heaviest, and the lighter options require more development with greater programmatic risk. There are four duplicate copies

  2. Aerobic exercise for Alzheimer's disease: A randomized controlled pilot trial

    Science.gov (United States)

    Van Sciver, Angela; Mahnken, Jonathan D.; Honea, Robyn A.; Brooks, William M.; Billinger, Sandra A.; Swerdlow, Russell H.; Burns, Jeffrey M.

    2017-01-01

    Background There is increasing interest in the role of physical exercise as a therapeutic strategy for individuals with Alzheimer’s disease (AD). We assessed the effect of 26 weeks (6 months) of a supervised aerobic exercise program on memory, executive function, functional ability and depression in early AD. Methods and findings This study was a 26-week randomized controlled trial comparing the effects of 150 minutes per week of aerobic exercise vs. non-aerobic stretching and toning control intervention in individuals with early AD. A total of 76 well-characterized older adults with probable AD (mean age 72.9 [7.7]) were enrolled and 68 participants completed the study. Exercise was conducted with supervision and monitoring by trained exercise specialists. Neuropsychological tests and surveys were conducted at baseline,13, and 26 weeks to assess memory and executive function composite scores, functional ability (Disability Assessment for Dementia), and depressive symptoms (Cornell Scale for Depression in Dementia). Cardiorespiratory fitness testing and brain MRI was performed at baseline and 26 weeks. Aerobic exercise was associated with a modest gain in functional ability (Disability Assessment for Dementia) compared to individuals in the ST group (X2 = 8.2, p = 0.02). There was no clear effect of intervention on other primary outcome measures of Memory, Executive Function, or depressive symptoms. However, secondary analyses revealed that change in cardiorespiratory fitness was positively correlated with change in memory performance and bilateral hippocampal volume. Conclusions Aerobic exercise in early AD is associated with benefits in functional ability. Exercise-related gains in cardiorespiratory fitness were associated with improved memory performance and reduced hippocampal atrophy, suggesting cardiorespiratory fitness gains may be important in driving brain benefits. Trial registration ClinicalTrials.gov NCT01128361 PMID:28187125

  3. Statistical issues in randomised controlled trials: a narrative synthesis

    Directory of Open Access Journals (Sweden)

    Bolaji Emmanuel Egbewale

    2015-05-01

    Full Text Available Randomised controlled trials (RCT s are gold standard in the evaluation of treatment efficacy in medical investigations, only if well designed and implemented. Till date, distorted views and misapplications of statistical procedures involved in RCTs are still in practice. Hence, clarification of concepts and acceptable practices related to certain statistical issues involved in the design, conduct and reporting of randomised controlled trials is needed. This narrative synthesis aimed at providing succinct but clear information on the concepts and practices of selected statistical issues in RCT s to inform correct applications. The use of tests of significance is no longer acceptable as means to compare baseline similarity between treatment groups and in determining which covariate(s should be included in the model for adjustment. Distribution of baseline attributes simply presented in tabular form is however, rather preferred. Regarding covariate selection, such approach that makes use of information on the degree of correlation between the covariate(s and the outcome variable is more in tandem with statistical principle(s than that based on tests of significance. Stratification and minimisation are not alternatives to covariate adjusted analysis; in fact they establish the need for one. Intention-to-treat is the preferred approach for the evaluation of primary outcome measures and researchers have responsibility to report whether or not the procedure was followed. A major use of results from subgroup analysis is to generate hypothesis for future clinical trials. Since RCT s are gold standard in the comparison of medical interventions, researchers cannot afford the practices of distorted allocation or statistical procedures in this all important experimental design method.

  4. Statistical issues in randomised controlled trials: a narrative synthesis

    Institute of Scientific and Technical Information of China (English)

    Bolaji; Emmanuel; Egbewale

    2015-01-01

    Randomised controlled trials(RCTs) are gold standard in the evaluation of treatment efficacy in medical investigations, only if well designed and implemented. Till date, distorted views and misapplications of statistical procedures involved in RCTs are still in practice. Hence, clarification of concepts and acceptable practices related to certain statistical issues involved in the design, conduct and reporting of randomised controlled trials is needed. This narrative synthesis aimed at providing succinct but clear information on the concepts and practices of selected statistical issues in RCTs to inform correct applications. The use of tests of significance is no longer acceptable as means to compare baseline similarity between treatment groups and in determining which covariate(s) should be included in the model for adjustment. Distribution of baseline attributes simply presented in tabular form is however, rather preferred. Regarding covariate selection, such approach that makes use of information on the degree of correlation between the covariate(s) and the outcome variable is more in tandem with statistical principle(s) than that based on tests of significance. Stratification and minimisation are not alternatives to covariate adjusted analysis; in fact they establish the need for one. Intention-totreat is the preferred approach for the evaluation of primary outcome measures and researchers have responsibility to report whether or not the procedure was followed. A major use of results from subgroup analysis is to generate hypothesis for future clinical trials. Since RCTs are gold standard in the comparison of medical interventions, researchers cannot afford the practices of distorted allocation or statistical procedures in this all important experimental design method.

  5. Cardiopulmonary resuscitation support application on a smartphone - randomized controlled trial.

    Science.gov (United States)

    Sakai, Tomohiko; Kitamura, Tetsuhisa; Nishiyama, Chika; Murakami, Yukiko; Ando, Masahiko; Kawamura, Takashi; Tasaki, Osamu; Kuwagata, Yasuyuki; Shimazu, Takeshi; Iwami, Taku

    2015-01-01

    This simulation trial aimed to compare the quality of cardiopulmonary resuscitation (CPR) with and without the newly-developed CPR support application on smartphones. In this trial, participants were randomly assigned to either the CPR support application group or the control group, stratified by sex and previous CPR training. Participants' CPR skills were evaluated by a 2-min case-based scenario test using the Leardal Resusci Anne PC Skill reporting Manikin System(®). The outcome measures were the proportion of chest compressions performed in each group and the number of total chest compressions and appropriate chest compressions performed during the 2-min test period. A total of 84 participants were enrolled and completed the protocol. All participants in the CPR support application group performed chest compressions, compared with only 31 (75.6%) in the control group (Psmartphones contributed to increasing the implementation rate and the number of total chest compressions performed and may assist in improving the survival rate for out-of-hospital cardiac arrests (UMIN000004740).

  6. Further development of the 'Pluto'-burner; Weiterentwicklung des Pluto-Brenners (Simulationsunterstuetzung)

    Energy Technology Data Exchange (ETDEWEB)

    Baykal, S.; Gass, J.

    2004-07-01

    This well-illustrated final report for the Swiss Federal Office of Energy (SFOE) made by the Laboratory for Thermodynamics at the Federal Institute of Technology in Zurich presents the measurements made and the results obtained from tests made on the 'Pluto' burner. This burner is a low-power oil-evaporation burner with a power of 5 - 15 kW with a high potential for use as an atomizer burner in well-insulated single-family homes. The report presents a multitude of results in graphical form. The simulations carried out at the laboratory investigated the use of the burner in a condensing heating unit with top-to-bottom airflow and provided the basis for optimisation of the burner's performance and manufacturing costs.

  7. Sleep disorders in patients with depression or schizophrenia: A randomized controlled trial using acupuncture treatment

    NARCIS (Netherlands)

    Bosch, M.P.C.; Noort, M.W.M.L. van den; Staudte, H.; Lim, S.; Yeo, S.; Coenen, A.M.L.; Luijtelaar, E.L.J.M. van

    2016-01-01

    Introduction: The purpose of this preliminary clinical trial was to investigate whether acupuncture has a positive influence on sleep and symptomatology in patients with schizophrenia or depression. Methods: A randomized controlled trial was used. One hundred participants were recruited: 40

  8. Cognitive Stimulation in Patients with Dementia: Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Daniela Mapelli

    2013-08-01

    Full Text Available Background/Aims: This study explores the effective outcomes of a structured cognitive stimulation treatment to improve cognition and behavioral symptoms in people with dementia (PWDs, using a randomized controlled clinical trial. Methods: Thirty PWDs were divided into three groups: experimental (treated with cognitive stimulation, placebo (treated with occupational therapy, and control (continuing with the usual activities of the nursing home. Assessment, at baseline and after a period of 8 weeks, was performed using the Clinical Dementia Rating Scale, activities of daily living, Mini-Mental State Examination, Esame Neuropsicologico Breve 2, Geriatric Depression Scale and Behavioral Pathology in Alzheimer's Disease Scale. Results: Only the experimental group improved its performance in cognitive tests (p Conclusions: The results suggest that a cognitive stimulation treatment for PWDs would improve not only their cognition, but also behavioral symptoms.

  9. A control clinicial trial of a new anxiolytic 'clobazam'.

    Science.gov (United States)

    Singh, G; Kumar, V; Kapur, R

    1984-04-01

    Clobazam as a twice-a-day dosage (10 mg-20 mg) regimen and Diazepam in a thrice-a-day schedule (5 mg-5 mg-5 mg) were both effective in controlling moderate to severe anxiety neurosis. 83 patients were studied in a controlled, randomised, double-blind trial. Patients received active drug for the first six weeks and placebo for the next two weeks. Weekly evaluation was performed clinically for anxiolytic effect as well as effect on motor coordination studied on the Pursuit Rotor. Clobazam did not significantly differ from Diazepam in the dosage schedules studied. At the end of the two-week placebo treatment period, patients on Clobazam showed more improvement. Motor coordination was not impaired in both treatment groups. Clobazam treated patients had better motor performance at the end of the 14-day post-treatment placebo period. Side effects were reported with equal frequency in both the populations.

  10. Transparency of Outcome Reporting and Trial Registration of Randomized Controlled Trials Published in the Journal of Consulting and Clinical Psychology.

    Directory of Open Access Journals (Sweden)

    Marleine Azar

    Full Text Available Confidence that randomized controlled trial (RCT results accurately reflect intervention effectiveness depends on proper trial conduct and the accuracy and completeness of published trial reports. The Journal of Consulting and Clinical Psychology (JCCP is the primary trials journal amongst American Psychological Association (APA journals. The objectives of this study were to review RCTs recently published in JCCP to evaluate (1 adequacy of primary outcome analysis definitions; (2 registration status; and, (3 among registered trials, adequacy of outcome registrations. Additionally, we compared results from JCCP to findings from a recent study of top psychosomatic and behavioral medicine journals.Eligible RCTs were published in JCCP in 2013-2014. For each RCT, two investigators independently extracted data on (1 adequacy of outcome analysis definitions in the published report, (2 whether the RCT was registered prior to enrolling patients, and (3 adequacy of outcome registration.Of 70 RCTs reviewed, 12 (17.1% adequately defined primary or secondary outcome analyses, whereas 58 (82.3% had multiple primary outcome analyses without statistical adjustment or undefined outcome analyses. There were 39 (55.7% registered trials. Only two trials registered prior to patient enrollment with a single primary outcome variable and time point of assessment. However, in one of the two trials, registered and published outcomes were discrepant. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to psychosomatic and behavioral medicine journals, the proportion of published trials with adequate outcome analysis declarations was significantly lower in JCCP (17.1% versus 32.9%; p = 0.029. The proportion of registered trials in JCCP (55.7% was comparable to behavioral medicine journals (52.6%; p = 0.709.The quality of published outcome analysis definitions and trial registrations in JCCP is

  11. Transparency of Outcome Reporting and Trial Registration of Randomized Controlled Trials Published in the Journal of Consulting and Clinical Psychology.

    Science.gov (United States)

    Azar, Marleine; Riehm, Kira E; McKay, Dean; Thombs, Brett D

    2015-01-01

    Confidence that randomized controlled trial (RCT) results accurately reflect intervention effectiveness depends on proper trial conduct and the accuracy and completeness of published trial reports. The Journal of Consulting and Clinical Psychology (JCCP) is the primary trials journal amongst American Psychological Association (APA) journals. The objectives of this study were to review RCTs recently published in JCCP to evaluate (1) adequacy of primary outcome analysis definitions; (2) registration status; and, (3) among registered trials, adequacy of outcome registrations. Additionally, we compared results from JCCP to findings from a recent study of top psychosomatic and behavioral medicine journals. Eligible RCTs were published in JCCP in 2013-2014. For each RCT, two investigators independently extracted data on (1) adequacy of outcome analysis definitions in the published report, (2) whether the RCT was registered prior to enrolling patients, and (3) adequacy of outcome registration. Of 70 RCTs reviewed, 12 (17.1%) adequately defined primary or secondary outcome analyses, whereas 58 (82.3%) had multiple primary outcome analyses without statistical adjustment or undefined outcome analyses. There were 39 (55.7%) registered trials. Only two trials registered prior to patient enrollment with a single primary outcome variable and time point of assessment. However, in one of the two trials, registered and published outcomes were discrepant. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to psychosomatic and behavioral medicine journals, the proportion of published trials with adequate outcome analysis declarations was significantly lower in JCCP (17.1% versus 32.9%; p = 0.029). The proportion of registered trials in JCCP (55.7%) was comparable to behavioral medicine journals (52.6%; p = 0.709). The quality of published outcome analysis definitions and trial registrations in JCCP is

  12. Randomized Controlled Trial of Primary Care Pediatric Parenting Programs

    Science.gov (United States)

    Mendelsohn, Alan L.; Dreyer, Benard P.; Brockmeyer, Carolyn A.; Berkule-Silberman, Samantha B.; Huberman, Harris S.; Tomopoulos, Suzy

    2011-01-01

    Objectives To determine whether pediatric primary care–based programs to enhance parenting and early child development reduce media exposure and whether enhanced parenting mediates the effects. Design Randomized controlled trial. Setting Urban public hospital pediatric primary care clinic. Participants A total of 410 mother-newborn dyads enrolled after childbirth. Interventions Patients were randomly assigned to 1 of 2 interventions, the Video Interaction Project (VIP) and Building Blocks (BB) interventions, or to a control group. The VIP intervention comprised 1-on-1 sessions with a child development specialist who facilitated interactions in play and shared reading through review of videotapes made of the parent and child on primary care visit days; learning materials and parenting pamphlets were also provided. The BB intervention mailed parenting materials, including age-specific newsletters suggesting activities to facilitate interactions, learning materials, and parent-completed developmental questionnaires (Ages and Stages questionnaires). Outcome Measures Electronic media exposure in the home using a 24-hour recall diary. Results The mean (SD) exposure at 6 months was 146.5 (125.0) min/d. Exposure to VIP was associated with reduced total duration of media exposure compared with the BB and control groups (mean [SD] min/d for VIP, 131.6 [118.7]; BB, 151.2 [116.7]; control, 155.4 [138.7]; P=.009). Enhanced parent-child interactions were found to partially mediate relations between VIP and media exposure for families with a ninth grade or higher literacy level (Sobel statistic=2.49; P=.01). Conclusion Pediatric primary care may represent an important venue for addressing the public health problem of media exposure in young children at a population level. Trial Registration clinicaltrials.gov Identifier: NCT00212576 PMID:21199979

  13. Pressure ulcers: effectiveness of risk-assessment tools. A randomised controlled trial (the ULCER trial).

    Science.gov (United States)

    Webster, Joan; Coleman, Kerrie; Mudge, Alison; Marquart, Louise; Gardner, Glenn; Stankiewicz, Monica; Kirby, Julie; Vellacott, Catherine; Horton-Breshears, Margaret; McClymont, Alice

    2011-04-01

    To evaluate the effectiveness of two pressure-ulcer screening tools against clinical judgement in preventing pressure ulcers. A single blind randomised controlled trial. A large metropolitan tertiary hospital. 1231 patients admitted to internal medicine or oncology wards. Patients were excluded if their hospital stay was expected to be 2 days or less. Participants allocated to either a Waterlow (n=410) or Ramstadius (n=411) screening tool group or to a clinical judgement group (n=410) where no formal risk screening instrument was used. Incidence of hospital acquired pressure ulcers ascertained by regular direct observation. Use of any devices for the prevention of pressure ulcers, documentation of a pressure plan and any dietetic or specialist skin integrity review were recorded. On admission, 71 (5.8%) patients had an existing pressure ulcer. The incidence of hospital-acquired pressure ulcers was similar between groups (clinical judgement 28/410 (6.8%); Waterlow 31/411 (7.5%); Ramstadius 22/410 (5.4%), p=0.44). Significant associations with pressure injury in regression modelling included requiring a dietetic referral, being admitted from a location other than home and age over 65 years. The authors found no evidence to show that two common pressure-ulcer risk-assessment tools are superior to clinical judgement to prevent pressure injury. Resources associated with use of these tools might be better spent on careful daily skin inspection and improving management targetted at specific risks. The trial was registered with the Australian and New Zealand Clinicat Trials Registry (ACTRN 12608000541303).

  14. Internal structure of Pluto and Charon with an iron core

    CERN Document Server

    Aitta, A

    2015-01-01

    Pluto has been observed by the New Horizons space probe to have some relatively fresh ice on the old ices covering most of the surface. Pluto was thought to consist of only a rocky core below the ice. Here I show that Pluto can have an iron core, as can also its companion Charon, which has recently been modelled to have one. The presence of an iron core means the giant impact origin calculations should be redone to include iron and thus higher temperatures. An iron core leads to the possibility of a different geology. An originally molten core becomes solid later, with contraction and a release of latent heat. The space vacated allows the upper rock layers to flow downwards at some locations at the surface of the core, and some of the ice above the rock to descend, filling the spaces left by the rock motion downwards. These phenomena can lead to the forces recently deforming the icy surface of Pluto, and in a lesser way, of Charon.

  15. Topographic Mapping of Pluto and Charon Using New Horizons Data

    Science.gov (United States)

    Schenk, P. M.; Beyer, R. A.; Moore, J. M.; Spencer, J. R.; McKinnon, W. B.; Howard, A. D.; White, O. M.; Umurhan, O. M.; Singer, K.; Stern, S. A.; Weaver, H. A.; Young, L. A.; Ennico Smith, K.; Olkin, C.; Horizons Geology, New; Geophysics Imaging Team

    2016-06-01

    New Horizons 2015 flyby of the Pluto system has resulted in high-resolution topographic maps of Pluto and Charon, the most distant objects so mapped. DEM's over ~30% of each object were produced at 100-300 m vertical and 300-800 m spatial resolutions, in hemispheric maps and high-resolution linear mosaics. Both objects reveal more relief than was observed at Triton. The dominant 800-km wide informally named Sputnik Planum bright ice deposit on Pluto lies in a broad depression 3 km deep, flanked by dispersed mountains 3-5 km high. Impact craters reveal a wide variety of preservation states from pristine to eroded, and long fractures are several km deep with throw of 0-2 km. Topography of this magnitude suggests the icy shell of Pluto is relatively cold and rigid. Charon has global relief of at least 10 km, including ridges of 2-3 km and troughs of 3-5 km of relief. Impact craters are up to 6 km deep. Vulcan Planum consists of rolling plains and forms a topographic moat along its edge, suggesting viscous flow.

  16. Upper limits of possible photochemical hazes on Pluto

    Energy Technology Data Exchange (ETDEWEB)

    Stansberry, J.A.; Lunine, J.I.; Tomasko, M.G. (Univ. of Arizona, Tucson (USA))

    1989-11-01

    Elliot et al. (1989) invoked a haze layer near the surface of Pluto to explain certain features of a stellar occultation by that planet in June, 1988. The primary requirements for this haze layer were that it achieve unity tangential optical depth at a radius of 1174 km and be essentially transparent above 1189 km. The authors explore here the possibility that aerosols generated through methane photolysis could be responsible for such a haze layer. A comprehensive model of aerosol production, particle growth, sedimentation and condensation is applied to the atmosphere of Pluto using pressures, temperatures and composition derived from the stellar occultation and other data. They test two atmosphere models proposed in the literature, one from Elliot et al. (1989), and one from Hubbard et al. (1989), as well as a range of optical properties for the particles. In order to produce a haze with unity tangential optical depth at 1174 km, they had to use an aerosol mass production rate equal to twice the total methane dissociation rate due to solar UV expected for Pluto and assume that the particles produced were 10 times more absorbing than those in other hazes in the outer solar system. The possibility of condensation in the atmosphere was considered but did not result in distinctly different haze optical depths. If a photochemical haze on Pluto was responsible for the occultation lightcurve measured by Elliot et al., operation of a photochemical system different from those on Titan, Uranus or Neptune is indicated.

  17. The photochemistry of Pluto's atmosphere as illuminated by New Horizons

    Science.gov (United States)

    Wong, Michael L.; Fan, Siteng; Gao, Peter; Liang, Mao-Chang; Shia, Run-Lie; Yung, Yuk; Kammer, Joshua A.; Summers, Michael; Gladstone, Randy; Young, Leslie; New Horizons Science Team

    2016-10-01

    New Horizons has granted us an unprecedented glimpse at the structure and composition of Pluto's atmosphere, which is comprised mostly of N2 with trace amounts of CH4, CO, and the photochemical products thereof. Through photochemistry, higher-order hydrocarbons are generated, coagulating into tholins and resulting in global haze layers. The photochemical processes on Pluto are analogous to those occurring in Titan's atmosphere, which have been constrained by comparison to Cassini measurements. The New Horizons dataset offers us a second glimpse at a natural hydrocarbon factory, which will teach us how these processes operate at lower pressures and temperatures. Here we present a state-of-the-art photochemical model for Pluto's atmosphere to explain the abundance profiles of CH4, C2H2, C2H4, and C2H6, the total column density of HCN, and to predict the abundance profiles of oxygen-bearing species. The CH4 profile can be best matched by taking a constant-with-altitude Kzz of 1 × 103 cm2 s–1 and a fixed CH4 surface mixing ratio of 4 × 10–3. Condensation is key to fitting the C2 hydrocarbon profiles. We find that C2H4 must have a much lower saturation vapor pressure than predicted by extrapolations of laboratory measurements to Pluto temperatures. We also find best-fit values for the sticking coefficients of C2H2, C2H4, C2H6, and HCN.

  18. Detection of CO and HCN in Pluto's atmosphere with ALMA

    CERN Document Server

    Lellouch, E; Butler, B; Fouchet, T; Lavvas, P; Strobel, D F; Sicardy, B; Moullet, A; Moreno, R; Bockelée-Morvan, D; Biver, N; Young, L; Lis, D; Stansberry, J; Stern, A; Weaver, H; Young, E; Zhu, X; Boissier, J

    2016-01-01

    Observations of the Pluto-Charon system, acquired with the ALMA interferometer on June 12-13, 2015, have yielded a detection of the CO(3-2) and HCN(4-3) rotational transitions from Pluto, providing a strong confirmation of the presence of CO, and the first observation of HCN, in Pluto's atmosphere. The CO and HCN lines probe Pluto's atmosphere up to ~450 km and ~900 km altitude, respectively. The CO detection yields (i) a much improved determination of the CO mole fraction, as 515+/-40 ppm for a 12 ubar surface pressure (ii) clear evidence for a well-marked temperature decrease (i.e., mesosphere) above the 30-50 km stratopause and a best-determined temperature of 70+/-2 K at 300 km, in agreement with recent inferences from New Horizons / Alice solar occultation data. The HCN line shape implies a high abundance of this species in the upper atmosphere, with a mole fraction >1.5x10-5 above 450 km and a value of 4x10-5 near 800 km. The large HCN abundance and the cold upper atmosphere imply supersaturation of HCN...

  19. Stargazing from New Horizons: Ultraviolet Stellar Occultations by Pluto's Atmosphere

    Science.gov (United States)

    Kammer, Joshua A.; Stern, S. Alan; Weaver, Harold A.; Young, Leslie; Ennico, Kimberly; Olkin, Catherine B.; Gladstone, Randy; Summers, Michael; Steffl, Andrew; Greathouse, Thomas K.; Versteeg, Maarten; Retherford, Kurt D.; Parker, Joel Wm.; Schindhelm, Eric; Strobel, Darrell F.; New Horizons ATM Theme Team, New Horizons Science Team

    2016-10-01

    Not long after the New Horizons encounter with Pluto last July, the Alice ultraviolet imaging spectrograph observed signatures of UV absorption by Pluto's atmosphere during two distinct occultation events. During these events, UV bright stars (the Sun, as well as two B-type stars) passed behind Pluto as seen by the spacecraft, and the attenuated starlight revealed the clear presence of nitrogen, methane, and several other hydrocarbons. Their mixing ratios vary with altitude, including localized peaks in the density of minor hydrocarbons such as C2H2 and C2H4. At about 300 km above Pluto's surface, these particular species are found to have mixing ratios relative to CH4 of approximately 10% and 1%, respectively. While this overall composition was expected pre-New Horizons, the vertical profiles of these species were surprising. In this presentation I will discuss the analysis of these occultations, including several profiles of key atmospheric species, and how they might play a role in explaining the presence of high-altitude haze on this cold, small, distant planet.

  20. Methane and Nitrogen Abundances On Pluto and Eris

    CERN Document Server

    Tegler, S C; Grundy, W M; Romanishin, W; Abernathy, M R; Bovyn, M J; Burt, J A; Evans, D E; Maleszewski, C K; Thompson, Z; Vilas, F

    2010-01-01

    We present spectra of Eris from the MMT 6.5 meter telescope and Red Channel Spectrograph (5700-9800 angstroms; 5 angstroms per pix) on Mt. Hopkins, AZ, and of Pluto from the Steward Observatory 2.3 meter telescope and Boller and Chivens spectrograph (7100-9400 angstroms; 2 angstroms per pix) on Kitt Peak, AZ. In addition, we present laboratory transmission spectra of methane-nitrogen and methane-argon ice mixtures. By anchoring our analysis in methane and nitrogen solubilities in one another as expressed in the phase diagram of Prokhvatilov and Yantsevich (1983), and comparing methane bands in our Eris and Pluto spectra and methane bands in our laboratory spectra of methane and nitrogen ice mixtures, we find Eris' bulk methane and nitrogen abundances are about 10% and about 90%, and Pluto's bulk methane and nitrogen abundances are about 3% and about 97%. Such abundances for Pluto are consistent with values reported in the literature. It appears that the bulk volatile composition of Eris is similar to the bulk...

  1. Guidelines for controlled trials of prophylactic treatment of chronic migraine in adults

    DEFF Research Database (Denmark)

    Silberstein, S.; Tfelt-Hansen, P.; Dodick, D.W.

    2008-01-01

    In 1991 the Clinical Trials Subcommittee of the International Headache Society (IHS) developed and published its first edition of the Guidelines on controlled trials of drugs in episodic migraine because only quality trials can form the basis for international collaboration on drug therapy...... to assist in the design of well-controlled clinical trials of chronic migraine in adults, and do not apply to studies in children or adolescents Udgivelsesdato: 2008/5...

  2. Testing the activitystat hypothesis: a randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Gomersall Sjaan

    2012-10-01

    Full Text Available Abstract Background The activitystat hypothesis proposes that when physical activity or energy expenditure is increased or decreased in one domain, there will be a compensatory change in another domain to maintain an overall, stable level of physical activity or energy expenditure. To date, there has been no experimental study primarily designed to test the activitystat hypothesis in adults. The aim of this trial is to determine the effect of two different imposed exercise loads on total daily energy expenditure and physical activity levels. Methods This study will be a randomised, multi-arm, parallel controlled trial. Insufficiently active adults (as determined by the Active Australia survey aged 18–60 years old will be recruited for this study (n=146. Participants must also satisfy the Sports Medicine Australia Pre-Exercise Screening System and must weigh less than 150 kg. Participants will be randomly assigned to one of three groups using a computer-generated allocation sequence. Participants in the Moderate exercise group will receive an additional 150 minutes of moderate to vigorous physical activity per week for six weeks, and those in the Extensive exercise group will receive an additional 300 minutes of moderate to vigorous physical activity per week for six weeks. Exercise targets will be accumulated through both group and individual exercise sessions monitored by heart rate telemetry. Control participants will not be given any instructions regarding lifestyle. The primary outcome measures are activity energy expenditure (doubly labeled water and physical activity (accelerometry. Secondary measures will include resting metabolic rate via indirect calorimetry, use of time, maximal oxygen consumption and several anthropometric and physiological measures. Outcome measures will be conducted at baseline (zero weeks, mid- and end-intervention (three and six weeks with three (12 weeks and six month (24 week follow-up. All assessors will be

  3. Spectroscopy of Pluto, 380-930 Nm at Six Longitudes

    Science.gov (United States)

    Cruikshank, D. P.; Pinilla-Alonso, N.; Lorenzi, V.; Grundy, William; Licandro, J.; Binzel, R. P.

    2014-01-01

    We have obtained spectra of the Pluto-Charon pair (unresolved) in the wavelength range 380-930 nm with resolution approx..450 at six roughly equally spaced longitudes. The data were taken in May and June, 2014, with the 4.2-m Isaac Newton Telescope at Roque de Los Muchachos Observatory in the Canary Islands, using the ACAM (auxiliary-port camera) in spectrometer mode, and using two solar analog stars. The new spectra clearly show absorption bands of solid CH4 at 620, 728, and 850-910 nm, which were known from earlier work. The 620-nm CH4 band is intrinsically very weak, and its appearance indicates a long optical path-length through the ice. This is especially true if it arises from CH4 dissolved in N2 ice. Earlier work (Owen et al. Science 261, 745, 1993) on the near-infrared spectrum of Pluto (1-2.5 microns) has shown that the CH4 bands are shifted to shorter wavelengths because the CH4 occurs as a solute in beta-phase crystalline N2. The optical path-length through the N2 crystals must be on the order of several cm to produce the N2 band observed at 2.15 microns. The new spectra exhibit a pronounced red slope across the entire wavelength range; the slope is variable with longitude, and differs in a small but significant way from that measured at comparable longitudes by Grundy & Fink (Icarus 124, 329, 1996) in their 15-year study of Pluto's spectrum (500-1000 nm). The new spectra will provide an independent means for calibrating the color filter bands on the Multispectral Visible Imaging Camera (MVIC) (Reuter et al. Space Sci. Rev. 140, 129, 2008) on the New Horizons spacecraft, which will encounter the Pluto-Charon system in mid-2015. They will also form the basis of modeling the spectrum of Pluto at different longitudes to help establish the nature of the non-ice component(s) of Pluto's surface. It is presumed that the non-ice component is the source of the yellow-red coloration of Pluto, which is known to be variable across the surface.

  4. Dilatation or no dilatation of the cervix during cesarean section (Dondi Trial): a randomized controlled trial.

    Science.gov (United States)

    Kirscht, Jade; Weiss, Christel; Nickol, Jana; Berlit, Sebastian; Tuschy, Benjamin; Hoch, Benjamin; Trebin, Amelie-Verena; Große-Steffen, Thomas; Sütterlin, Marc; Kehl, Sven

    2017-01-01

    To assess the effects of mechanical dilatation of the cervix during cesarean section on postoperative morbidity. A total of 447 women with elective cesarean section were included in the Dondi trial (Dilatation or no dilatation of the cervix during cesarean section). The primary outcome measure of this randomized controlled trial was postpartum hemorrhage (PPH) within 6 weeks. Infectious morbidity (puerperal fever, endometritis, wound infection, and urinary tract infection), blood loss (need for blood transfusion or change in hemoglobin levels), and operating time were also evaluated. The rate of PPH within 6 weeks was not different between the two groups [dilatation group: 5 (2.4 %), no dilatation group: 3 (1.2 %), p = 0.479]. Infectious morbidity, blood loss, and operating time were not diverse as well. The only significant difference between the two groups was the rate of retained products of conception with fewer cases after cervical dilatation (0 versus 6.2 %, p cesarean section compared with no dilatation of the cervix did not influence the risk of postpartum hemorrhage. However, there were fewer cases with retained products of conception after dilatation.

  5. Likely country of origin in publications on randomised controlled trials and controlled clinical trials during the last 60 years

    DEFF Research Database (Denmark)

    Gluud, Christian; Nikolova, Dimitrinka

    2007-01-01

    The number of publications on clinical trials is unknown as well as the countries publishing most trial reports. To try to examine these questions we performed an ecological study.......The number of publications on clinical trials is unknown as well as the countries publishing most trial reports. To try to examine these questions we performed an ecological study....

  6. Amantadine for dyskinesias in Parkinson's disease: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Hideyuki Sawada

    Full Text Available BACKGROUND: Dyskinesias are some of the major motor complications that impair quality of life for patients with Parkinson's disease. The purpose of the present study was to investigate the efficacy of amantadine in Parkinson's disease patients suffering from dyskinesias. METHODS: In this multi-center, double-blind, randomized, placebo-controlled, cross-over trial, 36 patients with Parkinson's disease and dyskinesias were randomized, and 62 interventions, which included amantadine (300 mg/day or placebo treatment for 27 days, were analyzed. At 15 days after washout, the treatments were crossed over. The primary outcome measure was the changes in the Rush Dyskinesia Rating Scale (RDRS during each treatment period. The secondary outcome measures were changes in the Unified Parkinson's Disease Rating Scale part IVa (UPDRS-IVa, dyskinesias, part IVb (motor fluctuations, and part III (motor function. RESULTS: RDRS improved in 64% and 16% of patients treated with amantadine or placebo, respectively, with significant differences between treatments. The adjusted odds-ratio for improvement by amantadine was 6.7 (95% confidence interval, 1.4 to 31.5. UPDRS-IVa was improved to a significantly greater degree in amantadine-treated patients [mean (SD of 1.83 (1.56] compared with placebo-treated patients [0.03 (1.51]. However, there were no significant effects on UPDRS-IVb or III scores. CONCLUSIONS: Results from the present study demonstrated that amantadine exhibited efficacious effects against dyskinesias in 60-70% of patients. TRIAL REGISTRATION: UMIN Clinical Trial Registry UMIN000000780.

  7. Acupuncture for dry eye: a randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Kim Ae-Ran

    2009-12-01

    Full Text Available Abstract Background Dry eye is usually managed by conventional medical interventions such as artificial tears, anti-inflammatory drugs and surgical treatment. However, since dry eye is one of the most frequent ophthalmologic disorders, safer and more effective methods for its treatment are necessary, especially for vulnerable patients. Acupuncture has been widely used to treat patients with dry eye. Our aim is to evaluate the effectiveness and safety of acupuncture for this condition. Methods/Design A randomised, patient-assessor blinded, sham (non-acupuncture point, shallow acupuncture controlled study was established. Participants allocated to verum acupuncture and sham acupuncture groups will be treated three times weekly for three weeks for a total of nine sessions per participant. Seventeen points (GV23; bilateral BL2, GB4, TE23, Ex1 (Taiyang, ST1 and GB20; and left SP3, LU9, LU10 and HT8 for men, right for women have been selected for the verum acupuncture; for the sham acupuncture, points have been selected that do not coincide with a classical acupuncture point and that are located close to the verum points, except in the case of the rim of the eye. Ocular surface disease index, tear film breakup time, the Schirmer I test, medication quantification scale and general assessment of improvement will be used as outcome variables for evaluating the effectiveness of acupuncture. Safety will also be assessed at every visit. Primary and secondary outcomes will be assessed four weeks after screening. All statistical analyses will be performed using analysis of covariance. Discussion The results of this trial will be used as a basis for clarifying the efficacy of acupuncture for dry eye. Trial registration ClinicalTrials.gov NCT00969280.

  8. Mixing Methods in Randomized Controlled Trials (RCTs): Validation, Contextualization, Triangulation, and Control

    Science.gov (United States)

    Spillane, James P.; Pareja, Amber Stitziel; Dorner, Lisa; Barnes, Carol; May, Henry; Huff, Jason; Camburn, Eric

    2010-01-01

    In this paper we described how we mixed research approaches in a Randomized Control Trial (RCT) of a school principal professional development program. Using examples from our study we illustrate how combining qualitative and quantitative data can address some key challenges from validating instruments and measures of mediator variables to…

  9. Mixing Methods in Randomized Controlled Trials (RCTs): Validation, Contextualization, Triangulation, and Control

    Science.gov (United States)

    Spillane, James P.; Pareja, Amber Stitziel; Dorner, Lisa; Barnes, Carol; May, Henry; Huff, Jason; Camburn, Eric

    2010-01-01

    In this paper we described how we mixed research approaches in a Randomized Control Trial (RCT) of a school principal professional development program. Using examples from our study we illustrate how combining qualitative and quantitative data can address some key challenges from validating instruments and measures of mediator variables to…

  10. What device should be used for telementoring? Randomized controlled trial.

    Science.gov (United States)

    Budrionis, Andrius; Hartvigsen, Gunnar; Lindsetmo, Rolv-Ole; Bellika, Johan Gustav

    2015-09-01

    The paper analyzes behavioral patterns of mentors while using different mentoring devices to demonstrate the feasibility of multi-platform mentoring. The fundamental differences of devices supporting telementoring create threats for the perception and interpretation of the transmitted video, highlighting the necessity of exploring hardware usability aspects in a safety critical surgical mentoring scenario. Three types of devices, based on the screen size, formed the arms for the randomized controlled trial. Streaming video recordings of a laparoscopic procedure to the mentors imitated the mentoring scenario. User preferences and response times were recorded while participating in a session performed on all devices. Median response to a mentoring request times were similar for mobile platforms; expected durations were considerably longer for stationary computer. Ability to perceive and identify anatomical structures was insignificantly lower on small sized devices. Stationary and tablet platforms were nearly equally preferred by the most of participants as default telementoring hardware. As a side effect, incompatibility of daily duties of the surgeons in the hospital and telementoring responsibilities while implementing systems locally was identified. Scaling up the use of the service in combination with the organizational changes of clinical staff looks like a promising solution. The trial demonstrated the feasibility of using all three types of devices for the purpose of mentoring, allowing users to choose the preferred platform. The paper provided initial results on the quality assurance of telementoring systems imposed by the regulatory documents. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Exercise Training and Weight Gain in Obese Pregnant Women: A Randomized Controlled Trial (ETIP Trial.

    Directory of Open Access Journals (Sweden)

    Kirsti Krohn Garnæs

    2016-07-01

    .04. Systolic blood pressure was significantly lower in the exercise group (mean 120.4 mm Hg compared to the control group (mean 128.1 mm Hg, with a mean difference of -7.73 mm Hg (95% CI -13.23, -2.22; p = 0.006. No significant between-group differences were seen in diastolic blood pressure, blood measurements, skinfold thickness, or body composition in late pregnancy. In per protocol analyses, late pregnancy systolic blood pressure was 115.7 (95% CI 110.0, 121.5 mm Hg in the exercise group (significant between-group difference, p = 0.001, and diastolic blood pressure was 75.1 (95% CI 71.6, 78.7 mm Hg (significant between-group difference, p = 0.02. We had planned to recruit 150 women into the trial; hence, under-recruitment represents a major limitation of our results. Another limitation to our study was the low adherence to the exercise program, with only 50% of the women included in the intention-to-treat analysis adhering as described in the study protocol.In this trial we did not observe a reduction in GWG among overweight/obese women who received a supervised exercise training program during their pregnancy. The incidence of GDM in late pregnancy seemed to be lower in the women randomized to exercise training than in the women receiving standard maternity care only. Systolic blood pressure in late pregnancy was also apparently lower in the exercise group than in the control group. These results indicate that supervised exercise training might be beneficial as a part of standard pregnancy care for overweight/obese women.ClinicalTrials.gov NCT01243554.

  12. Stress debriefing after childbirth: a randomised controlled trial.

    Science.gov (United States)

    Priest, Susan R; Henderson, Jenni; Evans, Sharon F; Hagan, Ronald

    2003-06-02

    To test whether critical incident stress debriefing after childbirth reduces the incidence of postnatal psychological disorders. Randomised single-blind controlled trial stratified for parity and delivery mode. Two large maternity hospitals in Perth. 1745 women who delivered healthy term infants between April 1996 and December 1997 (875 allocated to intervention and 870 to control group). An individual, standardised debriefing session based on the principles of critical incident stress debriefing carried out within 72 hours of delivery. Diagnosis of stress disorders or depression in the 12 months postpartum, using structured psychological interview and criteria of the Diagnostic and statistical manual of mental disorders, 4th edition. Follow-up information was available for 1730 women (99.1%), 482 of whom underwent psychological interview. There were no significant differences between control and intervention groups in scores on Impact of Events or Edinburgh Postnatal Depression Scales at 2, 6 or 12 months postpartum, or in proportions of women who met diagnostic criteria for a stress disorder (intervention, 0.6% v control, 0.8%; P = 0.58) or major or minor depression (intervention, 17.8% v control, 18.2%; relative risk [95% CI], 0.99 [0.87-1.11]) during the postpartum year. Nor were there differences in median time to onset of depression (intervention, 6 [interquartile range, 4-9] weeks v control, 4 [3-8] weeks; P = 0.84), or duration of depression (intervention, 24 [12-46] weeks v control, 22 [10-52] weeks; P = 0.98). There is a high prevalence of depression in women during the first year after childbirth. A session of midwife-led, critical incident stress debriefing was not effective in preventing postnatal psychological disorders, but had no adverse effects.

  13. Geomorphological Mapping of Sputnik Planum on Pluto

    Science.gov (United States)

    White, Oliver; Moore, Jeffrey M.; Stern, S. Alan; Weaver, Harold A.; Olkin, Catherine B.; Ennico, Kimberly; Young, Leslie; Cheng, Andrew F.; New Horizons Geology, Geophysics and Imaging Theme Team, New Horizons Composition Theme Team

    2016-10-01

    The New Horizons flyby of Pluto in July 2015 provided extensive high-resolution coverage of its encounter hemisphere. The most prominent surface feature in this hemisphere is the high albedo region informally named Tombaugh Regio, the western portion of which is represented by the expansive nitrogen ice plains informally named Sputnik Planum. A large fraction of Sputnik Planum displays a distinct cellular pattern, with individual cells typically displaying ovoid planforms and shallow pitting on a scale of a few hundred meters. Troughs with medial ridges define the boundaries between cells. Prior studies have argued that this pattern is indicative of solid-state convection occurring within the nitrogen ice. The southern non-cellular plains are either featureless or display dense fields of often elongate and aligned pits typically reaching a few km across, which are interpreted to have formed via sublimation.The mapping that will be presented at DPS focuses on identifying the different plains units that compose Sputnik Planum and defining the boundaries between them, which aids in assessing their time sequencing and correlation to one another. The cellular plains are divided into bright and dark units; the nature of the contact between the two indicates that ice of the bright plains, interpreted to have been recently emplaced via glacial flow from the highlands to the east of Sputnik Planum, is overlying ice of the dark plains, interpreted to be an older ice mass with a higher abundance of entrained dark material. Reconciling the seemingly contradictory models of a layered and also convecting Sputnik Planum requires consideration of the timescale of lateral flow of the bright plains ice relative to the timescale of convective overturn. The non-cellular plains are universally bright and display evidence for southwards flow of the ice, based on the orientations of elongate sublimation pits as well as the presence of 'extinct cells' that appear to have migrated away

  14. Exercise and manual physiotherapy arthritis research trial (EMPART: a multicentre randomised controlled trial

    Directory of Open Access Journals (Sweden)

    O'Connell Paul

    2009-01-01

    Full Text Available Abstract Background Osteoarthritis (OA of the hip is a major cause of functional disability and reduced quality of life. Management options aim to reduce pain and improve or maintain physical functioning. Current evidence indicates that therapeutic exercise has a beneficial but short-term effect on pain and disability, with poor long-term benefit. The optimal content, duration and type of exercise are yet to be ascertained. There has been little scientific investigation into the effectiveness of manual therapy in hip OA. Only one randomized controlled trial (RCT found greater improvements in patient-perceived improvement and physical function with manual therapy, compared to exercise therapy. Methods and design An assessor-blind multicentre RCT will be undertaken to compare the effect of a combination of manual therapy and exercise therapy, exercise therapy only, and a waiting-list control on physical function in hip OA. One hundred and fifty people with a diagnosis of hip OA will be recruited and randomly allocated to one of 3 groups: exercise therapy, exercise therapy with manual therapy and a waiting-list control. Subjects in the intervention groups will attend physiotherapy for 6–8 sessions over 8 weeks. Those in the control group will remain on the waiting list until after this time and will then be re-randomised to one of the two intervention groups. Outcome measures will include physical function (WOMAC, pain severity (numerical rating scale, patient perceived change (7-point Likert scale, quality of life (SF-36, mood (hospital anxiety and depression scale, patient satisfaction, physical activity (IPAQ and physical measures of range of motion, 50-foot walk and repeated sit-to stand tests. Discussion This RCT will compare the effectiveness of the addition of manual therapy to exercise therapy to exercise therapy only and a waiting-list control in hip OA. A high quality methodology will be used in keeping with CONSORT guidelines. The

  15. INvestigational Vertebroplasty Efficacy and Safety Trial (INVEST: a randomized controlled trial of percutaneous vertebroplasty

    Directory of Open Access Journals (Sweden)

    Stout Lydia

    2007-12-01

    -primary outcomes are the modified Roland score and pain numerical rating scale at 1 month. Discussion Although extensively utilized throughout North America for palliation of pain, vertebroplasty still has not undergone rigorous study. The study outlined above represents the first randomized, controlled study that can account for a placebo effect in the setting of vertebroplasty. Trial Registration Current Controlled Trials ISRCTN81871888

  16. Clinical review: Strict or loose glycemic control in critically ill patients - implementing best available evidence from randomized controlled trials

    NARCIS (Netherlands)

    Schultz, M.J.; Harmsen, R.E.; Spronk, P.E.

    2010-01-01

    Glycemic control aiming at normoglycemia, frequently referred to as 'strict glycemic control' (SGC), decreased mortality and morbidity of adult critically ill patients in two randomized controlled trials (RCTs). Five successive RCTs, however, failed to show benefit of SGC with one trial even reporti

  17. Effects of the Finnish Alzheimer disease exercise trial (FINALEX): a randomized controlled trial.

    Science.gov (United States)

    Pitkälä, Kaisu H; Pöysti, Minna M; Laakkonen, Marja-Liisa; Tilvis, Reijo S; Savikko, Niina; Kautiainen, Hannu; Strandberg, Timo E

    2013-05-27

    Few rigorous clinical trials have investigated the effectiveness of exercise on the physical functioning of patients with Alzheimer disease (AD). To investigate the effects of intense and long-term exercise on the physical functioning and mobility of home-dwelling patients with AD and to explore its effects on the use and costs of health and social services. A randomized controlled trial. A total of 210 home-dwelling patients with AD living with their spousal caregiver. The 3 trial arms included (1) group-based exercise (GE; 4-hour sessions with approximately 1-hour training) and (2) tailored home-based exercise (HE; 1-hour training), both twice a week for 1 year, and (3) a control group (CG) receiving the usual community care. The Functional Independence Measure (FIM), the Short Physical Performance Battery, and information on the use and costs of social and health care services. All groups deteriorated in functioning during the year after randomization, but deterioration was significantly faster in the CG than in the HE or GE group at 6 (P = .003) and 12 (P = .015) months. The FIM changes at 12 months were -7.1 (95% CI, -3.7 to -10.5), -10.3 (95% CI, -6.7 to -13.9), and -14.4 (95% CI, -10.9 to -18.0) in the HE group, GE group, and CG, respectively. The HE and GE groups had significantly fewer falls than the CG during the follow-up year. The total costs of health and social services for the HE patient-caregiver dyads (in US dollars per dyad per year) were $25,112 (95% CI, $17,642 to $32,581) (P = .13 for comparison with the CG), $22,066 in the GE group ($15,931 to $28,199; P = .03 vs CG), and $34,121 ($24,559 to $43,681) in the CG. An intensive and long-term exercise program had beneficial effects on the physical functioning of patients with AD without increasing the total costs of health and social services or causing any significant adverse effects. anzctr.org.au Identifier: ACTRN12608000037303.

  18. Reporting of consistency of blood pressure control in randomized controlled trials of antihypertensive drugs: a systematic review of 1372 trial reports.

    Science.gov (United States)

    Fischer, Urs; Webb, Alastair J S; Howard, Sally C; Rothwell, Peter M

    2012-07-01

    Hypertension is a powerful treatable risk factor for stroke. Reports of randomized controlled trials (RCTs) of antihypertensive drugs rightly concentrate on clinical outcomes, but control of blood pressure (BP) during follow-up is also important, particularly given that inconsistent control is associated with a high risk of stroke and that antihypertensive drug classes differ in this regard. We performed a systematic review of reporting of BP control in RCTs of antihypertensive drugs. We searched bibliographic databases (1950-2009) for systematic reviews of RCTs of BP-lowering and identified the main report of all trials. We identified 94 larger trials (>100 participants/arm, >1-year follow-up) and 1278 smaller/shorter trials. Ninety-one (96.8%) larger trials reported some data on mean BP during follow-up, but none reported effects on the consistency of control of BP over time. Although 81 (86.2%) larger trials reported group distribution of BP at baseline (usually SD), only 22 (23.4%) reported such data at any follow-up visit. Eleven (11.7%) larger trials reported group distribution of the change in BP from baseline to follow-up, but 61 (64.9%) reported no data at all on group distribution of BP at follow-up. Thirty-nine (41.5%) trials reported the proportion of patients reaching some BP target during follow-up, but no trial reported data on the consistency of control to target within individuals over time. Similar proportions were observed in the 1278 smaller/short trials. Reporting of BP control is limited in RCTs of BP-lowering drugs. We suggest reporting guidelines.

  19. ROLE OF CELECOXIB IN BENIGN BREAST DISEASE: RANDOMISED CONTROL TRIAL

    Directory of Open Access Journals (Sweden)

    Soumen Das

    2012-06-01

    Full Text Available Benign Breast Disease (BBD, commonest cause of morbidity in females due to breast diseases, still offers therapeutic challenge. Several drug therapies (with Evening Primrose Oil, Danazol etc have been tried, but none made gold standard. Reports on effect of Cox-2 inhibitors are scarce. This randomized control trial aims at determination of effect of Cox- inhibitors (Celecoxib in BBD in comparison to Evening Primrose Oil (EPO . Celecoxib showed better reduction in lump size (in 80% than EPO group (in 50%. Pain reduction was excellent in COX -2 groups as compared to EPO group. Recurrence rate was also lower in Celecoxib group at 10 weeks. Side effects were almost nil in both the groups. Celecoxib is better than EPO in the management of BBD. Short course therapy with COX-2 inhibitors gives good pain relief, greater reduction in lump size, low recurrence with minimum side effects.

  20. Acupressure therapy for morning sickness. A controlled clinical trial.

    Science.gov (United States)

    Hyde, E

    1989-01-01

    A prospective, controlled clinical trial examined the efficacy of acupressure therapy for morning sickness, using a two group, random assignment, crossover design. Subjects in Group 1 (N = 8) used acupressure wristbands for five days, followed by five days without therapy. Subjects in Group 2 (N = 8) had no therapy for five days, followed by five days use of wristbands. The Multiple Affect Adjective Checklist and Sickness Impact Profile were used, and extent of nausea was assessed at baseline, day five, and day ten. Use of acupressure wristbands relieved morning sickness for 12 of 16 subjects (chi 2 = 5.31 with Yates' correction factor, df = 1, p less than .025). Acupressure therapy resulted in statistically significant (p less than .05) reductions in anxiety, depression, behavioral dysfunction, and nausea. Limitations of the study and suggestions for future research are presented.

  1. Acupucture as pain relief during delivery - a randomized controlled trial

    DEFF Research Database (Denmark)

    Borup, Lissa; Wurlitzer, Winnie; Hedegaard, Morten

    2009-01-01

    Background: Many women need some kind of analgesic treatment to relieve pain during childbirth. The objective of our study was to compare the effect of acupuncture with transcutaneous electric nerve stimulation (TENS) and traditional analgesics for pain relief and relaxation during delivery...... with respect to pain intensity, birth experience, and obstetric outcome. Methods: A randomized controlled trial was conducted with 607 healthy women in labor at term who received acupuncture, TENS, or traditional analgesics. Primary outcomes were the need for pharmacological and invasive methods, level of pain...... with the intention-to-treat principle. Results: Use of pharmacological and invasive methods was significantly lower in the acupuncture group (acupuncture vs traditional, p acupuncture vs TENS, p = 0.031). Pain scores were comparable. Acupuncture did not influence the duration of labor or the use of oxytocin...

  2. Acupuncture as pain relief during delivery: a randomized controlled trial

    DEFF Research Database (Denmark)

    Borup, Lissa; Wurlitzer, Winnie; Hedegaard, Morten

    2009-01-01

    BACKGROUND: Many women need some kind of analgesic treatment to relieve pain during childbirth. The objective of our study was to compare the effect of acupuncture with transcutaneous electric nerve stimulation (TENS) and traditional analgesics for pain relief and relaxation during delivery...... with respect to pain intensity, birth experience, and obstetric outcome. METHODS: A randomized controlled trial was conducted with 607 healthy women in labor at term who received acupuncture, TENS, or traditional analgesics. Primary outcomes were the need for pharmacological and invasive methods, level of pain...... with the intention-to-treat principle. RESULTS: Use of pharmacological and invasive methods was significantly lower in the acupuncture group (acupuncture vs traditional, p acupuncture vs TENS, p = 0.031). Pain scores were comparable. Acupuncture did not influence the duration of labor or the use of oxytocin...

  3. Reported challenges in nurse-led randomised controlled trials

    DEFF Research Database (Denmark)

    Wang Vedelø, Tina; Lomborg, Kirsten

    2011-01-01

    , nursing research, nursing, research, challenges, barriers, nurse's role, nurse attitude, attitude of health personnel. Findings: The literature on reported challenges and barriers between 1999 and 2009 showed that the most often experienced problems were (i) sufficient patient recruitment, (ii......Aims: The purpose of this integrative literature review was to explore and discuss the methodological challenges nurse researchers report after conducting nurse-led randomised controlled trials in clinical hospital settings. Our research questions were (i) what are the most commonly experienced...... and the clinical nursing staff. Two lessons learned from this integrative review can be highlighted. First, we recommend researchers openly to share their experiences of barriers and challenges. They should describe factors that may have inhibited the desired outcome. Second, efforts to improve the collaboration...

  4. [Critical of the additive model of the randomized controlled trial].

    Science.gov (United States)

    Boussageon, Rémy; Gueyffier, François; Bejan-Angoulvant, Theodora; Felden-Dominiak, Géraldine

    2008-01-01

    Randomized, double-blind, placebo-controlled clinical trials are currently the best way to demonstrate the clinical effectiveness of drugs. Its methodology relies on the method of difference (John Stuart Mill), through which the observed difference between two groups (drug vs placebo) can be attributed to the pharmacological effect of the drug being tested. However, this additive model can be questioned in the event of statistical interactions between the pharmacological and the placebo effects. Evidence in different domains has shown that the placebo effect can influence the effect of the active principle. This article evaluates the methodological, clinical and epistemological consequences of this phenomenon. Topics treated include extrapolating results, accounting for heterogeneous results, demonstrating the existence of several factors in the placebo effect, the necessity to take these factors into account for given symptoms or pathologies, as well as the problem of the "specific" effect.

  5. Controlled trial of plasma exchange in treatment of Raynaud's syndrome.

    Science.gov (United States)

    O'Reilly, M J; Talpos, G; Roberts, V C; White, J M; Cotton, L T

    1979-01-01

    Twenty-seven patients with Raynaud's syndrome had their digital vessel patency assessed by Doppler ultrasound after different thermal stresses. Digital vessel patency rates differed significantly after stresses at 15 degrees C and 45 degrees C. In a randomised controlled trial placebo and heparin had no effect either on patients' symptoms or on the patency of their digital vessels. Plasma exchange improved both symptoms and vessel patency rates at 15 degrees C and 21 degrees C. Improvement in seven out of eight of these patients has been maintained for six months. Assessing digital vessel patency by Doppler techniques allow continuous, atraumatic, and safe evaluation of the effects of different methods of treatment on the patency of the digital vessels and has helped to indicate that plasma exchange is a useful adjunct in the management of patients with severe Raynaud's syndrome. PMID:376042

  6. Guidelines for controlled trials of drugs in tension-type headache: second edition.

    Science.gov (United States)

    Bendtsen, L; Bigal, M E; Cerbo, R; Diener, H C; Holroyd, K; Lampl, C; Mitsikostas, D D; Steiner, T J; Tfelt-Hansen, P

    2010-01-01

    The Clinical Trials Subcommittee of the International Headache Society published its first edition of the guidelines on controlled trials of drugs in tension-type headache in 1995. These aimed 'to improve the quality of controlled clinical trials in tension-type headache', because 'good quality controlled trials are the only way to convincingly demonstrate the efficacy of a drug, and form the basis for international agreement on drug therapy'. The Committee published similar guidelines for clinical trials in migraine and cluster headache. Since 1995 several studies on the treatment of episodic and chronic tension-type headache have been published, providing new information on trial methodology for this disorder. Furthermore, the classification of the headaches, including tension-type headache, has been revised. These developments support the need for also revising the guidelines for drug treatments in tension-type headache. These Guidelines are intended to assist in the design of well-controlled clinical trials in tension-type headache.

  7. The Pluto Energetic Particle Spectrometer Science Investigation (PEPSSI) on the New Horizons Mission

    CERN Document Server

    McNutt, Ralph L; Gurnee, Reid S; Hill, Matthew E; Cooper, Kim A; Andrews, G Bruce; Keath, Edwin P; Krimigis, Stamatios M; Mitchell, Donald G; Tossman, Barry; Bagenal, Fran; Boldt, John D; Bradley, Walter; Devereux, William S; Ho, George C; Jaskulek, Stephen E; LeFevere, Thomas W; Malcom, Horace; Marcus, Geoffrey A; Hayes, John R; Moore, G Ty; Williams, Bruce D; Wilson, Paul; Brown, L E; Kusterer, M; Vandegriff, J

    2007-01-01

    The Pluto Energetic Particle Spectrometer Science Investigation (PEPSSI) comprises the hardware and accompanying science investigation on the New Horizons spacecraft to measure pick-up ions from Pluto's outgassing atmosphere. To the extent that Pluto retains its characteristics similar to those of a "heavy comet" as detected in stellar occultations since the early 1980s, these measurements will characterize the neutral atmosphere of Pluto while providing a consistency check on the atmospheric escape rate at the encounter epoch with that deduced from the atmospheric structure at lower altitudes by the ALICE, REX, and SWAP experiments on New Horizons. In addition, PEPSSI will characterize any extended ionosphere and solar wind interaction while also characterizing the energetic particle environment of Pluto, Charon, and their associated system. First proposed for development for the Pluto Express mission in September 1993, what became the PEPSSI instrument went through a number of development stages to meet the...

  8. HST- STIS Observations of Pluto and Charon Contemporaneous with the New Horizons Encounter

    Science.gov (United States)

    Cunningham, Nathaniel J.; Schindhelm, Eric R.; Cook, Jason C.; Kammer, Joshua; Stern, S. Alan; Trafton, Laurence M.

    2016-10-01

    We present mid-ultraviolet (MUV) observations of Pluto and Charon taken with the Space Telescope Imaging Spectrograph (STIS) onboard the Hubble Space Telescope. These spectra were taken in June 2015, one month prior to the close encounter of the New Horizons spacecraft with the Pluto system. Based on New Horizons' characterization of Pluto's atmosphere, we expect significant but spectrally flat attenuation by haze at MUV wavelengths, and insufficient absorption by atmospheric hydrocarbons to produce measurable spectral features. We use the new STIS spectra to characterize the surfaces of Pluto and Charon by fitting Hapke models to the measured MUV geometric albedos of Pluto and Charon. We find that fitting Pluto's measured albedo slope requires inclusion of water ice and tholins in the model, consistent with New Horizons results; modeling of Charon's flat albedo slope does not yield significant constraints on surface composition.

  9. The far ultraviolet spectrum of Pluto and the discovery of its ionosphere

    Science.gov (United States)

    Steffl, A.; Stern, A.; Gladstone, R.; Parker, J. W.; Greathouse, T. K.; Retherford, K. D.; Young, L. A.; Schindhelm, E.; Kammer, J.; Strobel, D. F.; Summers, M. E.; Versteeg, M.; Olkin, C.; Weaver, H. A., Jr.; Hinson, D. P.; Linscott, I.

    2016-12-01

    During the New Horizons spacecraft's encounter with Pluto in July 2015, the Alice far ultraviolet spectrograph made numerous observations of Pluto and its atmosphere. We present here the far ultraviolet spectrum of Pluto. We observe faint emission ( 34.7 eV; wavelength < 36nm). Notably absent from Pluto's spectrum are emission lines from argon at 104.8 and 106.7 nm. We place upper limits on the amount of argon in Pluto's atmosphere above the tau=1 level (observed to be at 750km tangent altitude) that are significantly lower than previous models. We also identify and derive column densities for various hydrocarbon species such as C2H4 through their absorption of sunlight reflected from Pluto's surface.

  10. Pluto and Charon Seen with the New Horizons Spacecraft

    Science.gov (United States)

    Cruikshank, D. P.; Stern, S. A.; Weaver, H. A.; Young, L. A.; Ennico, K.; Olkin, C. B.

    2016-01-01

    After nearly a decade en route, New Horizons flew through the Pluto system in July 2015. The encounter hemisphere of Pluto shows ongoing surface geological activity centered on a vast basin (Sputnik Planum [SP]*) containing a thick layer of volatile ices with a crater retention age no greater than approximately 10 Ma. Surrounding terrains show active glacial flow, apparent transport and rotation of large buoyant water-ice crustal blocks, and pitting, likely by sublimation erosion and/or collapse. Also seen are constructional mounds with central depressions, and ridges with complex bladed textures. Pluto has ancient cratered terrains up to approximately 4 Ga old that are fractured and mantled, and perhaps eroded by glacial processes. Charon does not appear to be currently active, but experienced major tectonism and resurfacing nearly 4 Ga ago. Imaging spectrometer observations of Pluto reveal the encounter hemisphere to be dominated by volatile ices of N2, CO, and CH4, along with non-volatile components that include H2O and tholins. The most volatile of Pluto's ices (N2 and CO) are especially prevalent in the western half of Tombaugh Regio (TR), and the strikingly flat Sputnik Planum basin, which lies a few km below surrounding elevations. The high mobility of N2 and CO ices enables SP's surface to refresh itself sufficiently rapidly that no impact craters are seen there. This likely occurs through a combination of solid state convective overturning and sublimation/ condensation that produces regular patterns of pits and ridges on scales of 102 to 103 m. In many areas, CH4 appears to favor topographically high regions. Its propensity to condense on ridges could play a role in forming the bladed terrain seen in Tartarus Dorsa. H2O can be discerned across much of Cthulhu Regio, and also in a few isolated spots. In many regions, H2O ice is associated with reddish tholin coloration. Pluto's atmosphere was probed with the radio science experiment (REX) and the Alice UV

  11. A controlled trial of the father's role in breastfeeding promotion.

    Science.gov (United States)

    Pisacane, Alfredo; Continisio, Grazia Isabella; Aldinucci, Maria; D'Amora, Stefania; Continisio, Paola

    2005-10-01

    To investigate whether supporting fathers to recognize the relevance of their role in the success of breastfeeding and teaching them how to prevent and to manage the most common lactation problems would result in more women breastfeeding. A controlled trial, in which the participating fathers were allocated in 2-month blocks to a child care training session, was conducted of 280 mothers considering breastfeeding and their 280 partners at a university obstetric department in Naples, Italy. Support and advice about breastfeeding was provided to all of the mothers. Among the fathers of the intervention group, the training session included the management of breastfeeding; among those of the control group, it did not. Primary outcome was the prevalence of full breastfeeding at 6 months. Secondary outcomes were the proportion of women who perceived their milk to be insufficient, who stopped breastfeeding because of problems, and who reported to have received help in breastfeeding management by their partners. The prevalence of full breastfeeding at 6 months was 25% (35 of 140) in the intervention group and 15% (21 of 140) in the control group and that of any breastfeeding at 12 months was 19% (27) and 11% (16), respectively. Perceived milk insufficiency was significantly more frequent among the mothers of the control group (38 [27%] of 140 vs 12 [8.6%] of 140), as well as breastfeeding interruption because of problems with lactation (25 [18%] of 140 vs 6 [4%] of 140). Moreover, significantly more women in the intervention group reported receiving support and relevant help with infant feeding management from their partners (128 [91%] of 140 vs 48 [34%] of 140). Among the women who had reported difficulties with lactation in the intervention and control groups (96 [69%] and 89 [64%], respectively), the prevalence of full breastfeeding at 6 months was 24% and 4.5%, respectively. Teaching fathers how to prevent and to manage the most common lactation difficulties is

  12. Placement Of Cardiac PacemaKEr Trial (POCKET – rationale and design: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Peter Magnusson

    2017-04-01

    Full Text Available Background: A pacemaker system consists of one or two leads connected to a device that is implanted into a pocket formed just below the collarbone. This pocket is typically subcutaneous, that is, located just above the pectoral fascia. Even though the size of pacemakers has decreased markedly, complications due to superficial implants do occur. An alternative technique would be intramuscular placement of the pacemaker device, but there are no randomized controlled trials (RCTs to support this approach, which is the rationale for the Placement Of Cardiac PacemaKEr Trial (POCKET. The aim is to study if intramuscular is superior to subcutaneous placement of a pacemaker pocket. Methods: In October 2016, we started to enroll 200 consecutive patients with an indication for bradycardia pacemaker implantation. Patients are randomized to random block sizes, stratified by age group (cut-off: 65 years and sex, and then randomized to either subcutaneous or intramuscular implant. A concealed allocation procedure is employed, using sequentially numbered, sealed envelopes. Pocket site is blinded to the patient and in all subsequent care. The primary endpoint is patient overall satisfaction with the pocket location at 24 months as measured using a visual analog scale (VAS 0-10. Secondary endpoints are: complications, patient-reported satisfaction at 1, 12, and 24 months (overall satisfaction, pain, discomfort, degree of unsightly appearance, movement problems, and sleep problems due to device. Conclusions: POCKET is a prospective interventional RCT designed to evaluate if intramuscular is superior to subcutaneous placement of a bradycardia pacemaker during a two-year follow-up.

  13. The chronic kidney disease Water Intake Trial (WIT): results from the pilot randomised controlled trial

    Science.gov (United States)

    Clark, William F; Sontrop, Jessica M; Huang, Shih-Han; Gallo, Kerri; Moist, Louise; House, Andrew A; Weir, Matthew A; Garg, Amit X

    2013-01-01

    Background and objectives Increased water intake may benefit kidney function. Prior to initiating a larger randomised controlled trial (RCT), we examined the safety and feasibility of asking adults with chronic kidney disease (CKD) to increase their water intake. Design, setting, participants and measurements Beginning in October 2012, we randomly assigned 29 adults with stage 3 CKD (estimated glomerular filtration rate (eGFR) 30–60 mL/min/1.73 m2 and albuminuria) to one of the two groups of water intake: hydration (n=18) or standard (n=11). We asked the hydration group to increase their water intake by 1.0–1.5 L/day (in addition to usual intake, depending on sex and weight) for 6 weeks, while the control group carried on with their usual intake. Participants collected a 24 h urine sample at baseline and at 2 and 6 weeks after randomisation. Our primary outcome was the between-group difference in change in 24 h urine volume from baseline to 6 weeks. Results (63%)of participants were men, 81% were Caucasians and the average age was 61 years (SD 14 years). The average baseline eGFR was 40 mL/min/1.73 m2 (SD 11 mL/min/1.73 m2); the median albumin to creatinine ratio was 19 mg/mmol (IQR 6–74 mg/mmol). Between baseline and 6-week follow-up, the hydration group's average 24 h urine volume increased by 0.7 L/day (from 2.3 to 3.0 L/day) and the control group's 24 h urine decreased by 0.3 L/day (from 2.0 to 1.7 L/day; between-group difference in change: 0.9 L/day (95% CI 0.4 to 1.5; p=0.002)). We found no significant changes in urine, serum osmolality or electrolyte concentrations, or eGFR. No serious adverse events or changes in quality of life were reported. Conclusions A pilot RCT indicates adults with stage 3 CKD can successfully and safely increase water intake by up to 0.7 L/day in addition to usual fluid intake. Trial registration Registered with Clinical Trials—government identifier NCT01753466. PMID:24362012

  14. Visual and infrared studies of asteroids and the Pluto-Charon system

    Science.gov (United States)

    Tedesco, Edward F.

    1991-01-01

    The strategy of the project was to: (1) analyze light curves of Pluto-Charon mutual eclipse event light curves to derive models of the Pluto-Charon system; (2) use these results in planning and reducing HST observations tentatively scheduled to be obtained in Aug. 1991 to determine Pluto-Charon mass ratio; and (3) obtain visual and IR photometry of selected asteroids to help determine their albedos, sizes, shapes, pole orientations, taxonomic classes, and phase functions.

  15. Optimal Macronutrient Content of the Diet for Adolescents With Prediabetes; RESIST a Randomised Control Trial

    National Research Council Canada - National Science Library

    Garnett, Sarah P; Gow, Megan; Ho, Mandy; Baur, Louise A; Noakes, Manny; Woodhead, Helen J; Broderick, Carolyn R; Burrell, Susie; Chisholm, Kerryn; Halim, Jocelyn; De, Sukanya; Steinbeck, Katherine; Srinivasan, Shubha; Ambler, Geoffrey R; Kohn, Michael R; Cowell, Chris T

    2013-01-01

    ...: This study was a randomized controlled trial, known as Researching Effective Strategies to Improve Insulin Sensitivity in Children and Teenagers, in 2 hospitals in Sydney, Australia. Participants...

  16. Handsearching the EMHJ for reports of randomized controlled trials by U.K. Cochrane Centre (Bahrain).

    Science.gov (United States)

    Al Hajeri, A; Al Sayyad, J; Eisinga, A

    2006-01-01

    This study used handsearching to find reports of randomized controlled trials in the Eastern Mediterranean Health Journal (EMHJ). EMBASE and MEDLINE were also searched electronically to identify if the reports found by the handsearch were already included in either of these databases. Nine reports were identified: 7 randomized controlled trials and 2 controlled clinical trials. The added value of the handsearch over EMBASE was 6 additional reports and over MEDLINE was 4. Reports identified were sent to the UK Cochrane Centre for verification and publication in The Cochrane Central Register of Controlled Trials (CENTRAL).

  17. What can qualitative research do for randomised controlled trials? A systematic mapping review

    Science.gov (United States)

    O'Cathain, A; Thomas, K J; Drabble, S J; Rudolph, A; Hewison, J

    2013-01-01

    Objective To develop an empirically based framework of the aspects of randomised controlled trials addressed by qualitative research. Design Systematic mapping review of qualitative research undertaken with randomised controlled trials and published in peer-reviewed journals. Data sources MEDLINE, PreMEDLINE, EMBASE, the Cochrane Library, Health Technology Assessment, PsycINFO, CINAHL, British Nursing Index, Social Sciences Citation Index and ASSIA. Eligibility criteria Articles reporting qualitative research undertaken with trials published between 2008 and September 2010; health research, reported in English. Results 296 articles met the inclusion criteria. Articles focused on 22 aspects of the trial within five broad categories. Some articles focused on more than one aspect of the trial, totalling 356 examples. The qualitative research focused on the intervention being trialled (71%, 254/356); the design, process and conduct of the trial (15%, 54/356); the outcomes of the trial (1%, 5/356); the measures used in the trial (3%, 10/356); and the target condition for the trial (9%, 33/356). A minority of the qualitative research was undertaken at the pretrial stage (28%, 82/296). The value of the qualitative research to the trial itself was not always made explicit within the articles. The potential value included optimising the intervention and trial conduct, facilitating interpretation of the trial findings, helping trialists to be sensitive to the human beings involved in trials, and saving money by steering researchers towards interventions more likely to be effective in future trials. Conclusions A large amount of qualitative research undertaken with specific trials has been published, addressing a wide range of aspects of trials, with the potential to improve the endeavour of generating evidence of effectiveness of health interventions. Researchers can increase the impact of this work on trials by undertaking more of it at the pretrial stage and being explicit

  18. The Norwegian tenecteplase stroke trial (NOR-TEST): Randomised controlled trial of tenecteplase vs. alteplase in acute ischaemic stroke

    OpenAIRE

    2014-01-01

    Background: Alteplase is the only approved thrombolytic agent for acute ischaemic stroke. The overall benefit from alteplase is substantial, but some evidence indicates that alteplase also has negative effects on the ischaemic brain. Tenecteplase may be more effective and less harmfull than alteplase, but large randomised controlled phase 3 trials are lacking. The Norwegian Tenecteplase Stroke Trial (NOR-TEST) aims to compare efficacy and safety of tenecteplase vs. alteplase. Methods/Desig...

  19. 3D modeling of organic haze in Pluto's atmosphere

    Science.gov (United States)

    Bertrand, Tanguy; Forget, François

    2017-05-01

    The New Horizons spacecraft, which flew by Pluto on July 14, 2015, revealed the presence of haze in Pluto's atmosphere that were formed by CH4/N2 photochemistry at high altitudes in Pluto's atmosphere, as on Titan and Triton. In order to help the analysis of the observations and further investigate the formation of organic haze and its evolution at global scales, we have implemented a simple parameterization of the formation of organic haze in our Pluto General Circulation Model. The production of haze in our model is based on the different steps of aerosol formation as understood on Titan and Triton: photolysis of CH4 in the upper atmosphere by Lyman-α UV radiation, production of various gaseous species, and conversion into solid particles through accumulation and aggregation processes. The simulations use properties of aerosols similar to those observed in the detached haze layer on Titan. We compared two reference simulations ran with a particle radius of 50 nm: with, and without South Pole N2 condensation. We discuss the impact of the particle radius and the lifetime of the precursors on the haze distribution. We simulate CH4 photolysis and the haze formation up to 600 km above the surface. Results show that CH4 photolysis in Pluto's atmosphere in 2015 occurred mostly in the sunlit summer hemisphere with a peak at an altitude of 250 km, though the interplanetary source of Lyman-α flux can induce some photolysis even in the Winter hemisphere. We obtained an extensive haze up to altitudes comparable with the observations, and with non-negligible densities up to 500 km altitude. In both reference simulations, the haze density is not strongly impacted by the meridional circulation. With No South Pole N2 condensation, the maximum nadir opacity and haze extent is obtained at the North Pole. With South Pole N2 condensation, the descending parcel of air above the South Pole leads to a latitudinally more homogeneous haze density with a slight density peak at the South

  20. Probing Pluto's Atmosphere Using Ground-Based Stellar Occultations

    Science.gov (United States)

    Sicardy, Bruno; Rio de Janeiro Occultation Team, Granada Team, International Occultation and Timing Association, Royal Astronomical Society New Zealand Occultation Section, Lucky Star associated Teams

    2016-10-01

    Over the last three decades, some twenty stellar occultations by Pluto have been monitored from Earth. They occur when the dwarf planet blocks the light from a star for a few minutes as it moves on the sky. Such events led to the hint of a Pluto's atmosphere in 1985, that was fully confirmed during another occultation in 1988, but it was only in 2002 that a new occultation could be recorded. From then on, the dwarf planet started to move in front of the galactic center, which amplified by a large factor the number of events observable per year.Pluto occultations are essentially refractive events during which the stellar rays are bent by the tenuous atmosphere, causing a gradual dimming of the star. This provides the density, pressure and temperature profiles of the atmosphere from a few kilometers above the surface up to about 250 km altitude, corresponding respectively to pressure levels of about 10 and 0.1 μbar. Moreover, the extremely fine spatial resolution (a few km) obtained through this technique allows the detection of atmospheric gravity waves, and permits in principle the detection of hazes, if present.Several aspects make Pluto stellar occultations quite special: first, they are the only way to probe Pluto's atmosphere in detail, as the dwarf planet is far too small on the sky and the atmosphere is far too tenuous to be directly imaged from Earth. Second, they are an excellent example of participative science, as many amateurs have been able to record those events worldwide with valuable scientific returns, in collaboration with professional astronomers. Third, they reveal Pluto's climatic changes on decade-scales and constrain the various seasonal models currently explored.Finally, those observations are fully complementary to space exploration, in particular with the New Horizons (NH) mission. I will show how ground-based occultations helped to better calibrate some NH profiles, and conversely, how NH results provide some key boundary conditions

  1. New Horizons: Bridge to the Beginning - to Pluto and Beyond

    Science.gov (United States)

    Weir, H. M.; Hallau, K. G.; Seaton, P.; Beisser, K.; New Horizons Education; Public Outreach Team

    2010-12-01

    Launched on Jan. 19, 2006, NASA’s New Horizons mission to Pluto and the Kuiper Belt will help us understand worlds at the edge of our solar system by making the first reconnaissance of Pluto and Charon - a "double planet" and the last planet in our solar system to be visited by spacecraft. However, New Horizons’ closest approach to Pluto will not occur until July 14, 2015, and the majority of the craft's time over the next 5 years will be spent in "hibernation." The Education and Public Outreach (EPO) team, however, will not be hibernating as we wait for New Horizons to reach its destination. With three distinct tools-- Educator Fellows, online learning modules and a planetarium program--the team seeks to excite and engage teachers, students and the public with information about the journey to Pluto and beyond. In the past year, the specially selected educators who participate as New Horizons Educator Fellows have trained more than 1,000 teachers across the U.S. on the New Horizons mission and the science behind it. Thousands more students, parents, educators, and citizens have learned about New Horizons from the mission's scientists, engineers and outreach professionals. New Horizons Fellows also distribute another EPO tool: online learning modules. These classroom-ready learning modules consist of educator guides, student handouts, detailed activities, and potential adaptations for students with special needs or disabilities. Some also offer online interactives to convey complex and dynamic concepts. The modules are web-accessible for both students and teachers, and are aligned with relevant national standards. The third tool is a highly visual way to engage the general public and supplement educational programs: a planetarium program that highlights the New Horizons mission from launch to destination Pluto. This program focuses on the engineering design of the spacecraft, with a focus on the concept of the electromagnetic spectrum. In the unique environment

  2. Radio Occultation Measurements of Pluto's Atmosphere with New Horizons

    Science.gov (United States)

    Hinson, David P.; Linscott, Ivan; Young, Leslie; Stern, S. Alan; Bird, Mike; Ennico, Kimberly; Gladstone, Randy; Olkin, Catherine B.; Pätzold, Martin; Strobel, Darrell F.; Summers, Michael; Tyler, G. Leonard; Weaver, Harold A.; Woods, Will; New Horizons Science Team

    2016-10-01

    The reconnaissance of the Pluto System by New Horizons in July 2015 included a radio occultation at Pluto. The observation was performed with signals transmitted simultaneously by four antennas of the NASA Deep Space Network, two at the Goldstone complex in California and two at the Canberra complex in Australia. Each antenna radiated 20 kW without modulation at a wavelength of 4.17 cm. New Horizons received the four signals with its 2.1-m high-gain antenna, where the signals were split into pairs and processed independently by two identical REX radio science instruments. Each REX relied on a different ultra-stable oscillator as its frequency reference. The signals were digitized and filtered, and the data samples were stored on the spacecraft for later transmission to Earth. Six months elapsed before all data had arrived on the ground, and the results reported here are the first to utilize the complete set of observations. Pluto's tenuous atmosphere is a significant challenge for radio occultation sounding, which led us to develop a specialized method of analysis. We began by calibrating each signal to remove effects not associated with Pluto's atmosphere, including the diffraction pattern from Pluto's surface. We reduced the noise and increased our sensitivity to the atmosphere by averaging the results from the four signals, while using other combinations of the signals to characterize the noise. We then retrieved profiles of number density, pressure, and temperature from the averaged phase profiles at both occultation entry and exit. Finally, we used a combination of analytical methods and Monte Carlo simulations to determine the accuracy of the measurements. The REX profiles provide the first direct measure of the surface pressure and temperature structure in Pluto's lower atmosphere. There are significant differences between the structure at entry (193.5°E, 17.0°S, sunset) and exit (15.7°E, 15.1°N, sunrise), which arise from spatial variations in surface

  3. The reporting quality of randomized controlled trials in orthodontics.

    Science.gov (United States)

    Lempesi, Evangelia; Koletsi, Despina; Fleming, Padhraig S; Pandis, Nikolaos

    2014-06-01

    Accurate trial reporting facilitates evaluation and better use of study results. The objective of this article is to investigate the quality of reporting of randomized controlled trials (RCTs) in leading orthodontic journals, and to explore potential predictors of improved reporting. The 50 most recent issues of 4 leading orthodontic journals until November 2013 were electronically searched. Reporting quality assessment was conducted using the modified CONSORT statement checklist. The relationship between potential predictors and the modified CONSORT score was assessed using linear regression modeling. 128 RCTs were identified with a mean modified CONSORT score of 68.97% (SD = 11.09). The Journal of Orthodontics (JO) ranked first in terms of completeness of reporting (modified CONSORT score 76.21%, SD = 10.1), followed by American Journal of Orthodontics and Dentofacial Orthopedics (AJODO) (73.05%, SD = 10.1). Journal of publication (AJODO: β = 10.08, 95% CI: 5.78, 14.38; JO: β = 16.82, 95% CI: 11.70, 21.94; EJO: β = 7.21, 95% CI: 2.69, 11.72 compared to Angle), year of publication (β = 0.98, 95% CI: 0.28, 1.67 for each additional year), region of authorship (Europe: β = 5.19, 95% CI: 1.30, 9.09 compared to Asia/other), statistical significance (significant: β = 3.10, 95% CI: 0.11, 6.10 compared to non-significant) and methodologist involvement (involvement: β = 5.60, 95% CI: 1.66, 9.54 compared to non-involvement) were all significant predictors of improved modified CONSORT scores in the multivariable model. Additionally, median overall Jadad score was 2 (IQR = 2) across journals, with JO (median = 3, IQR = 1) and AJODO (median = 3, IQR = 2) presenting the highest score values. The reporting quality of RCTs published in leading orthodontic journals is considered suboptimal in various CONSORT areas. This may have a bearing in trial result interpretation and use in clinical decision making and evidence- based orthodontic treatment interventions. Copyright

  4. Accrual and drop out in a primary prevention randomised controlled trial: qualitative study

    Directory of Open Access Journals (Sweden)

    Price Jackie F

    2011-01-01

    Full Text Available Abstract Background Recruitment and retention of participants are critical to the success of a randomised controlled trial. Gaining the views of potential trial participants who decline to enter a trial and of trial participants who stop the trial treatment is important and can help to improve study processes. Limited research on these issues has been conducted on healthy individuals recruited for prevention trials in the community. Methods Semi-structured interviews with people who were eligible but had declined to participate in the Aspirin for Asymptomatic Atherosclerosis (AAA trial (N = 11, and AAA trial participants who had stopped taking the trial medication (N = 11. A focus group with further participants who had stopped taking the trial medication (N = 6. (Total participants N = 28. Results Explanations for declining to participate could be divided into two groups: the first group were characterised by a lack of necessity to participate and a tendency to prioritise other largely mundane problems. The second group's concern was with a high level of perceived risk from participating. Explanations for stopping trial medication fell into four categories: side effects attributed to the trial medication; starting on aspirin or medication contraindicating to aspirin; experiencing an outcome event, and changing one's mind. Conclusions These results indicate that when planning trials (especially in preventive medicine particular attention should be given to designing appropriate recruitment materials and processes that fully inform potential recruits of the risks and benefits of participation. Trial registration ISRCTN66587262

  5. Biofeedback treatment for Tourette syndrome: a preliminary randomized controlled trial.

    Science.gov (United States)

    Nagai, Yoko; Cavanna, Andrea E; Critchley, Hugo D; Stern, Jeremy J; Robertson, Mary M; Joyce, Eileen M

    2014-03-01

    To study the clinical effectiveness of biofeedback treatment in reducing tics in patients with Tourette syndrome. Despite advances in the pharmacologic treatment of patients with Tourette syndrome, many remain troubled by their tics, which may be resistant to multiple medications at tolerable doses. Electrodermal biofeedback is a noninvasive biobehavioral intervention that can be useful in managing neuropsychiatric and neurologic conditions. We conducted a randomized controlled trial of electrodermal biofeedback training in 21 patients with Tourette syndrome. After training the patients for 3 sessions a week over 4 weeks, we observed a significant reduction in tic frequency and improved indices of subjective well-being in both the active-biofeedback and sham-feedback (control) groups, but there was no difference between the groups in these measurements. Furthermore, the active-treatment group did not demonstrably learn to reduce their sympathetic electrodermal tone using biofeedback. Our findings indicate that this form of biofeedback training was unable to produce a clinical effect greater than placebo. The main confounding factor appeared to be the 30-minute duration of the training sessions, which made it difficult for patients to sustain a reduction in sympathetic tone when their tics themselves were generating competing phasic electrodermal arousal responses. Despite a negative finding in this study, electrodermal biofeedback training may have a role in managing tics if optimal training schedules can be identified.

  6. PLUTO code for computational Astrophysics: News and Developments

    Science.gov (United States)

    Tzeferacos, P.; Mignone, A.

    2012-01-01

    We present an overview on recent developments and functionalities available with the PLUTO code for astrophysical fluid dynamics. The recent extension of the code to a conservative finite difference formulation and high order spatial discretization of the compressible equations of magneto-hydrodynamics (MHD), complementary to its finite volume approach, allows for a highly accurate treatment of smooth flows, while avoiding loss of accuracy near smooth extrema and providing sharp non-oscillatory transitions at discontinuities. Among the novel features, we present alternative, fully explicit treatments to include non-ideal dissipative processes (namely viscosity, resistivity and anisotropic thermal conduction), that do not suffer from the usual timestep limitation of explicit time stepping. These methods, offsprings of the multistep Runge-Kutta family that use a Chebyshev polynomial recursion, are competitive substitutes of computationally expensive implicit schemes that involve sparse matrix inversion. Several multi-dimensional benchmarks and appli-cations assess the potential of PLUTO to efficiently handle many astrophysical problems.

  7. Sublimation as a Landform-Shaping Process on Pluto

    Science.gov (United States)

    Moore, J. M.; Howard, A. D.; White, O. L.; Umurhan, O. M.; Schenk, P. M.; Beyer, R. A.; McKinnon, W. B.; Singer, K. N.; Spencer, J. R.; Stern, S. A.; hide

    2016-01-01

    Several icy-world surfaces in the solar system exhibit sublimation-driven landform modification erosion, condensation, and mass wasting [1]. In addition to the obvious role of gravity, mass wasting can work in conjunction with internal disaggregation of a landform's relief-supporting material through the loss (or deteriorating alteration) of its cohesive matrix. To give a conspicuous example, Callisto's landscape exhibits widespread erosion from sublimation erosion of slopes, which results in smooth, undulating, low albedo plains composed of lag deposits, with isolated high albedo pinnacles perched on remnants of crater rims due to the re-precipitation of ice on local cold traps [2, 3, 4]. Sublimation-driven mass wasting was anticipated on Pluto prior to the encounter (see refs in [5]). Here we report on several landscapes on Pluto we interpret to be formed, or at least heavily modified, by sublimation erosion.

  8. AMTEC radioisotope power system for the Pluto Express mission

    Energy Technology Data Exchange (ETDEWEB)

    Ivanenok, J.F. III; Sievers, R.K. [Advanced Modular Power Systems, Inc., Ann Arbor, MI (United States)

    1995-12-31

    The Alkali Metal Thermal to Electric Converter (AMTEC) technology has made substantial advances in the last 3 years through design improvements and technical innovations. In 1993 programs began to produce an AMTEC cell specifically for the NASA Pluto Express Mission. A set of efficiency goals was established for this series of cells to be developed. According to this plan, cell {number_sign}8 would be 17% efficient but was actually 18% efficient. Achieving this goal, as well as design advances that allow the cell to be compact, has resulted in pushing the cell from an unexciting 2 W/kg and 2% efficiency to very attractive 40 W/kg and 18% measured efficiency. This paper will describe the design and predict the performance of a radioisotope powered AMTEC system for the Pluto Express mission.

  9. Pluto's interaction with the solar wind

    Energy Technology Data Exchange (ETDEWEB)

    Bagenal, F. (Univ. of Colorado, Boulder (USA)); McNutt, R.L. Jr. (Massachusetts Institute of Technology, Cambridge (USA))

    1989-11-01

    If Pluto's atmospheric escape rate is significantly greater than 1.5 x 10{sup 27} molecules s{sup {minus}1} then the interaction with the tenuous solar wind at 30 A.U. will be like that of a comet: there will be extensive ion pick-up upstream and the size of the interaction region will vary directly with variations in the solar wind flux. If the escape flux is much less, then one expects that the solar wind will be deflected around Pluto's ionosphere in a Venus-like interaction. In either case, the weak interplanetary magnetic field at 30 A.U. results in very large gyroradii for the picked up ions and a thick bow shock, necessitating a kinetic treatment of the interaction. Strong variations in the size of the interaction region are expected on time scales of days due to changes in the solar wind.

  10. Power system comparison for the Pluto Express mission

    Energy Technology Data Exchange (ETDEWEB)

    Harty, R.B. [Rockwell Aerospace, Canoga Park, CA (United States). Rocketdyne Div.

    1995-12-31

    This paper presents a comparison of three advanced radioisotope power systems, along with a down sized RTG for the Pluto Express mission. These three advanced radioisotope power systems were the Radioisotope Alkali Metal Thermal--to-Electric Converter (RAMTEC), Radioisotope Stirling, and Radioisotope Thermophotovoltaic (RTPV). For the Pluto Express mission, the power requirement at the end of the 10-y mission is 74 We. It was found that all three advanced power systems could meet the required end of mission power with two General Purpose Heat Source (GPHS) modules. The RTG required six modules to meet the power requirement. Only the RAMTEC and RTPV met the mass goal of 9.5 kg. The AMTEC has a radiator area more than a factor of 10 lower than the Stirling and RTPV power systems, which simplifies spacecraft integration.

  11. Resonant interactions and chaotic rotation of Pluto's small moons.

    Science.gov (United States)

    Showalter, M R; Hamilton, D P

    2015-06-04

    Four small moons--Styx, Nix, Kerberos and Hydra--follow near-circular, near-equatorial orbits around the central 'binary planet' comprising Pluto and its large moon, Charon. New observational details of the system have emerged following the discoveries of Kerberos and Styx. Here we report that Styx, Nix and Hydra are tied together by a three-body resonance, which is reminiscent of the Laplace resonance linking Jupiter's moons Io, Europa and Ganymede. Perturbations by the other bodies, however, inject chaos into this otherwise stable configuration. Nix and Hydra have bright surfaces similar to that of Charon. Kerberos may be much darker, raising questions about how a heterogeneous satellite system might have formed. Nix and Hydra rotate chaotically, driven by the large torques of the Pluto-Charon binary.

  12. Myopia Control with Bifocal Contact Lenses: A Randomized Clinical Trial.

    Science.gov (United States)

    Aller, Thomas A; Liu, Maria; Wildsoet, Christine F

    2016-04-01

    Most studies have reported only minimal reductions in myopia progression with bifocal or progressive multifocal spectacles, although somewhat larger, although mostly still clinically insignificant, effects have been reported in children with nearpoint esophoria and/or accommodative dysfunctions. The CONTROL study was a 1-year, prospective, randomized, clinical trial of bifocal contact lenses for control of myopia in children with eso fixation disparities at near. Eighty-six myopic subjects, aged 8 to 18 years, were enrolled in the study after passing the screening examination. Of these, 79 completed lens assignment and 78 completed the study. The mean refractive error of these 79 subjects was -2.69 ± 1.40D (SD), and all had progressed by -0.50D or more since their last examination. All subjects also had eso fixation disparity at near. Subjects were randomly assigned to wear either Vistakon Acuvue 2 (single-vision soft contact lenses [SVSCLs]) or Vistakon Acuvue Bifocal (bifocal soft contact lenses [BFSCLs]). Bifocal adds were selected to neutralize the associated phoria. Treatment outcomes included cycloplegic autorefraction and axial length, assessed in terms of changes after 6 and 12 months of treatment from pretreatment baseline values. The BFSCLs significantly slowed myopia progression, with statistically significant differences between the treatment groups after 6 months. After 12 months of treatment, the SVSCL group had progressed by -0.79 ± 0.43D compared with -0.22 ± 0.34D for the BFSCL group (cycloplegic objective spherical equivalent, average of two eyes). Corresponding axial length changes were 0.24 ± 0.17 mm and 0.05 ± 0.14 mm, respectively. All of these differences were found to be statistically significant (unpaired t-tests, p 70%) compared with most published results with multifocal spectacles. Further studies are warranted to identify the critical factors and mechanisms underlying this myopia control effect.

  13. Effect of irradiation on the surface of Pluto

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, R.E. (Univ. of Virginia, Charlottesville (USA))

    1989-11-01

    The surface of Pluto is exposed to cosmic ray particles which slowly alter the reflectance of the condensed methane and the UV absorbed in the atmosphere may produce precipitates. Depending on the rates of the competing regolith processes and the rate of replenishment of the methane the surface can appear bright, red, or dark. Here the relevant laboratory data show that, in the absence of any local particle precipitation, the amount of darkening occurring in one orbit is small.

  14. Pluto's Atmosphere from the July 2010 Stellar Occultation

    Science.gov (United States)

    Person, Michael J.; Elliot, J. L.; Bosh, A. S.; Gulbis, A. A. S.; Jensen-Clem, R.; Lockhart, M. F.; Zangari, A. M.; Zuluaga, C. A.; Levine, S. E.; Pasachoff, J. M.; Souza, S. P.; Lu, M.; Malamut, C.; Rojo, P.; Bailyn, C. D.; MacDonald, R. K. D.; Ivarsen, K. M.; Reichart, D. E.; LaCluyze, A. P.; Nysewander, M. C.; Haislip, J. B.

    2010-10-01

    We have observed the 4 July 2010 stellar occultation by Pluto as part of our program of monitoring Pluto's atmospheric changes over the last decade. Successful observations were obtained from three sites: Cerro Calan and Cerro Tololo, Chile, as well as the HESS-project site (High Energy Stereoscopic System) in southwestern Namibia. Successful telescope apertures ranged from 0.45 m to 1.0 m and resulted in seven occultation light curves for the event from among the three sites. Simultaneous analysis of the seven light curves indicates that Pluto's atmosphere continues to be stable, as the calculated atmospheric radii are consistent with those detected in 2006 (Elliot et al., AJ 134, 1, 2007) and 2007 (Person et al., AJ 136, 1510, 2008), continuing the stability that followed the large pressure increase detected between 1988 (Millis et al., Icarus 105, 282, 1993) and 2002 (Elliot et al., Nature 424, 165, 2003). We will present the overall astrometric solution as well as current profiles for Pluto's upper atmospheric temperature and pressure obtained from inversion of the light curves (Elliot, Person, and Qu, AJ 126, 1041, 2003). This work was supported, in part, by grants NNX10AB27G to MIT, NNX08AO50G to Williams College, and NNH08AI17I to the USNO from NASA's Planetary Astronomy Division. The 0.75-m ATOM (Automatic Telescope for Optical Monitoring) light curve was obtained with the generous assistance of the HESS-project staff, arranged by Stefan Wagner and Marcus Hauser of the University of Heidelberg. The 0.45-m Goto telescope at Cerro Calán National Astronomical Observatory, Universidad de Chile, was donated by the Government of Japan. PROMPT (Panchromatic Robotic Optical Monitoring and Polarimetry Telescopes) observations at Cerro Tololo were made possible by the Robert Martin Ayers Science Fund. Student participation was supported in part by NSF's REU program and NASA's Massachusetts Space Grant.

  15. The chronic care for wet age related macular degeneration (CHARMED) study: a randomized controlled trial

    OpenAIRE

    Markun, Stefan; Dishy, Avraham; Neuner-Jehle, Stefan; Rosemann, Thomas; Frei, Anja

    2015-01-01

    BACKGROUND: In real life, outcomes in wet age related macular degeneration (W-AMD) continue to fall behind the results from randomized controlled trials. The aim of this trial was to assess if outcomes can be improved by an intervention in healthcare organization following recommendations of the Chronic Care Model (CCM). METHODS: Multi-centered randomized controlled clinical trial. The multifaceted intervention consisted in reorganization of care (delivery by trained chronic care coaches, ...

  16. The Chronic Care for Wet Age Related Macular Degeneration (CHARMED) Study: A Randomized Controlled Trial

    OpenAIRE

    Stefan Markun; Avraham Dishy; Stefan Neuner-Jehle; Thomas Rosemann; Anja Frei

    2015-01-01

    Background In real life, outcomes in wet age related macular degeneration (W-AMD) continue to fall behind the results from randomized controlled trials. The aim of this trial was to assess if outcomes can be improved by an intervention in healthcare organization following recommendations of the Chronic Care Model (CCM). Methods Multi-centered randomized controlled clinical trial. The multifaceted intervention consisted in reorganization of care (delivery by trained chronic care coaches, using...

  17. The Effect of Surface Ice and Topography on the Atmospheric Circulation and Distribution of Nitrogen Ice on Pluto.

    Science.gov (United States)

    Rafkin, Scot; Soto, Alejandro; Michaels, Timothy

    2016-04-01

    A newly developed general circulation model (GCM) for Pluto is used to investigate the unexpected and highly heterogeneous distribution of nitrogen surface ice imaged by the New Horizons spacecraft on the surface of Pluto. The GCM is based on the GFDL Flexible Modeling System (FMS) dynamical core, solved on a discretized latitude/longitude horizontal grid and a pressure-based hybrid vertical coordinate. Model physics include a 3-band radiative scheme, molecular thermal conduction within the atmosphere, subsurface thermal conduction, and a nitrogen volatile cycle. The radiative-conductive model takes into account the 2.3, 3.3 and 7.8 μm bands of CH4, including non-local thermodynamic equilibrium effects. The subsurface conduction model assumes a water ice regolith. In the case of nitrogen surface ice deposition, additional super-surface layers are added above the water ice regolith to properly account for conductive energy flow through the nitrogen ice. The nitrogen volatile cycle is based on a vapor pressure equilibrium assumption between the atmosphere and surface. Prior to the arrival of the New Horizons spacecraft, the expectation was that the volatile surface ice distribution on the surface of Pluto would be strongly controlled by the latitudinal temperature gradient resulting primarily from the slow seasonal variations of radiative-conductive equilibrium. If this were the case, then Pluto would have broad latitudinal bands of both ice covered surface and ice free surface, as dictated by the season. Furthermore, the circulation, and thus the transport of volatiles, was thought to be driven almost exclusively by sublimation and deposition flows (so-called "condensation flows") associated with the volatile cycle. In contrast to expectations, images from New Horizon showed an extremely complex, heterogeneous distribution of surface ices draped over topography of substantial geologic diversity. To maintain such an ice distribution, the atmospheric circulation and

  18. The Effect of Surface Ice and Topography on the Atmospheric Circulation and Distribution of Nitrogen Ice on Pluto

    Science.gov (United States)

    Rafkin, Scot C. R.; Soto, Alejandro; Michaels, Timothy I.

    2016-10-01

    A newly developed general circulation model (GCM) for Pluto is used to investigate the impact of a heterogeneous distribution of nitrogen surface ice and large scale topography on Pluto's atmospheric circulation. The GCM is based on the GFDL Flexible Modeling System (FSM). Physics include a gray model radiative-conductive scheme, subsurface conduction, and a nitrogen volatile cycle. The radiative-conductive model takes into account the 2.3, 3.3 and 7.8 μm bands of CH4 and CO, including non-local thermodynamic equilibrium effects. including non-local thermodynamic equilibrium effects. The nitrogen volatile cycle is based on a vapor pressure equilibrium assumption between the atmosphere and surface. Prior to the arrival of the New Horizons spacecraft, the expectation was that the volatile ice distribution on the surface of Pluto would be strongly controlled by the latitudinal temperature gradient. If this were the case, then Pluto would have broad latitudinal bands of both ice covered surface and ice free surface, as dictated by the season. Further, the circulation, and the thus the transport of volatiles, was thought to be driven almost exclusively by sublimation and deposition flows associated with the volatile cycle. In contrast to expectations, images from New Horizon showed an extremely complex, heterogeneous distribution of surface ices draped over substantial and variable topography. To produce such an ice distribution, the atmospheric circulation and volatile transport must be more complex than previously envisioned. Simulations where topography, surface ice distributions, and volatile cycle physics are added individually and in various combinations are used to individually quantify the importance of the general circulation, topography, surface ice distributions, and condensation flows. It is shown that even regional patches of ice or large craters can have global impacts on the atmospheric circulation, the volatile cycle, and hence, the distribution of

  19. Reorientation of Sputnik Planitia implies a subsurface ocean on Pluto.

    Science.gov (United States)

    Nimmo, F; Hamilton, D P; McKinnon, W B; Schenk, P M; Binzel, R P; Bierson, C J; Beyer, R A; Moore, J M; Stern, S A; Weaver, H A; Olkin, C B; Young, L A; Smith, K E

    2016-12-01

    The deep nitrogen-covered basin on Pluto, informally named Sputnik Planitia, is located very close to the longitude of Pluto's tidal axis and may be an impact feature, by analogy with other large basins in the Solar System. Reorientation of Sputnik Planitia arising from tidal and rotational torques can explain the basin's present-day location, but requires the feature to be a positive gravity anomaly, despite its negative topography. Here we argue that if Sputnik Planitia did indeed form as a result of an impact and if Pluto possesses a subsurface ocean, the required positive gravity anomaly would naturally result because of shell thinning and ocean uplift, followed by later modest nitrogen deposition. Without a subsurface ocean, a positive gravity anomaly requires an implausibly thick nitrogen layer (exceeding 40 kilometres). To prolong the lifetime of such a subsurface ocean to the present day and to maintain ocean uplift, a rigid, conductive water-ice shell is required. Because nitrogen deposition is latitude-dependent, nitrogen loading and reorientation may have exhibited complex feedbacks.

  20. PLUTO'S SEASONS: NEW PREDICTIONS FOR NEW HORIZONS

    Energy Technology Data Exchange (ETDEWEB)

    Young, L. A. [Southwest Research Institute, Boulder, CO 80302 (United States)

    2013-04-01

    Since the last Pluto volatile transport models were published in 1996, we have (1) new stellar occultation data from 2002 and 2006-2012 that show roughly twice the pressure as the first definitive occultation from 1988, (2) new information about the surface properties of Pluto, (3) a spacecraft due to arrive at Pluto in 2015, and (4) a new volatile transport model that is rapid enough to allow a large parameter-space search. Such a parameter-space search coarsely constrained by occultation results reveals three broad solutions: a high-thermal inertia, large volatile inventory solution with permanent northern volatiles (PNVs; using the rotational north pole convention); a lower thermal-inertia, smaller volatile inventory solution with exchanges of volatiles between hemispheres and a pressure plateau beyond 2015 (exchange with pressure plateau, EPP); and solutions with still smaller volatile inventories, with exchanges of volatiles between hemispheres and an early collapse of the atmosphere prior to 2015 (exchange with early collapse, EEC). PNV and EPP are favored by stellar occultation data, but EEC cannot yet be definitively ruled out without more atmospheric modeling or additional occultation observations and analysis.

  1. The Pluto system after the New Horizons flyby

    Science.gov (United States)

    Olkin, Catherine B.; Ennico, Kimberly; Spencer, John

    2017-09-01

    In July 2015, NASA's New Horizons mission performed a flyby of Pluto, revealing details about the geology, surface composition and atmospheres of this world and its moons that are unobtainable from Earth. With a resolution as small as 80 metres per pixel, New Horizons' images identified a large number of surface features, including a large basin filled with glacial ices that appear to be undergoing convection. Maps of surface composition show latitudinal banding, with non-volatile material dominating the equatorial region and volatile ices at mid- and polar latitudes. This pattern is driven by the seasonal cycle of solar insolation. New Horizons' atmospheric investigation found the temperature of Pluto's upper atmosphere to be much cooler than previously modelled. Images of forward-scattered sunlight revealed numerous haze layers extending up to 200 km from the surface. These discoveries have transformed our understanding of icy worlds in the outer Solar System, demonstrating that even at great distances from the Sun, worlds can have active geologic processes. This Review addresses our current understanding of the Pluto system and places it in context with previous investigations.

  2. New Horizons Educator Fellowship Program: Taking You to Pluto

    Science.gov (United States)

    Weir, H. M.; Beisser, K.; Hallau, K. G.

    2011-12-01

    The New Horizons Educator Fellowship Program (NHEFP), originally based on the MESSENGER Fellows Program, is a public outreach initiative for motivated volunteers across the nation. These volunteers are master teachers who communicate the excitement of NASA's New Horizons mission to Pluto and information about recent discoveries to teachers, students, and people in their local communities. Many of the Fellows utilize their experiences and knowledge as members of other programs such as MESSENGER Fellows, Heliophysics Educator Ambassadors, Solar System Educators and Ambassadors to promote the mission thorough professional development workshops incorporating themes, activities, and recent discoveries with other NASA programs to present a well-rounded view of our Solar System. Unlike teacher-volunteer programs tied to missions that take place closer to Earth, the time between New Horizons' launch and its closest approach to Pluto is 9.5 years, with the spacecraft in hibernation for most of its voyager. NHEFP has maintained a core group of Fellows who, through periodic face-to-face or remote training, have taken advantage of opportunities for networking, sharing of ideas in best practices, activities, and presenting and keeping audiences interested in the mission during its long journey to Pluto. This involvement has been key to the program's success.

  3. The photochemistry of Pluto's atmosphere as illuminated by New Horizons

    Science.gov (United States)

    Wong, Michael L.; Fan, Siteng; Gao, Peter; Liang, Mao-Chang; Shia, Run-Lie; Yung, Yuk L.; Kammer, Joshua A.; Summers, Michael E.; Gladstone, G. Randall; Young, Leslie A.; Olkin, Catherine B.; Ennico, Kimberly; Weaver, Harold A.; Stern, S. Alan

    2017-05-01

    New Horizons has granted us an unprecedented glimpse at the structure and composition of Pluto's atmosphere, which is comprised mostly of N2 with trace amounts of CH4, CO, and the photochemical products thereof. Through photochemistry, higher-order hydrocarbons are generated, coagulating into aerosols and resulting in global haze layers. Here we present a state-of-the-art photochemical model for Pluto's atmosphere to explain the abundance profiles of CH4, C2H2, C2H4, and C2H6, the total column density of HCN, and to predict the abundance profiles of oxygen-bearing species. The CH4 profile can be best matched by taking a constant-with-altitude eddy diffusion coefficient Kzz profile of 1 × 103 cm2 s-1 and a fixed CH4 surface mixing ratio of 4 × 10-3. Condensation is key to fitting the C2 hydrocarbon profiles. We find that C2H4 must have a much lower saturation vapor pressure than predicted by extrapolations of laboratory measurements to Pluto temperatures. We also find best-fit values for the sticking coefficients of C2H2, C2H4, C2H6, and HCN. The top three precipitating species are C2H2, C2H4, and C2H6, with precipitation rates of 179, 95, and 62 g cm-2 s-1, respectively.

  4. Obliquity evolution of the minor satellites of Pluto and Charon

    Science.gov (United States)

    Quillen, Alice C.; Nichols-Fleming, Fiona; Chen, Yuan-Yuan; Noyelles, Benoît

    2017-09-01

    New Horizons mission observations show that the small satellites Styx, Nix, Kerberos and Hydra, of the Pluto-Charon system, have not tidally spun-down to near synchronous spin states and have high obliquities with respect to their orbit about the Pluto-Charon binary (Weaver, 2016). We use a damped mass-spring model within an N-body simulation to study spin and obliquity evolution for single spinning non-round bodies in circumbinary orbit. Simulations with tidal dissipation alone do not show strong obliquity variations from tidally induced spin-orbit resonance crossing and this we attribute to the high satellite spin rates and low orbital eccentricities. However, a tidally evolving Styx exhibits intermittent obliquity variations and episodes of tumbling. During a previous epoch where Charon migrated away from Pluto, the minor satellites could have been trapped in orbital mean motion inclination resonances. An outward migrating Charon induces large variations in Nix and Styx's obliquities. The cause is a commensurability between the mean motion resonance frequency and the spin precession rate of the spinning body. As the minor satellites are near mean motion resonances, this mechanism could have lifted the obliquities of all four minor satellites. The high obliquities need not be primordial if the minor satellites were at one time captured into mean motion resonances.

  5. Sublimation as a landform-shaping process on Pluto

    Science.gov (United States)

    Moore, Jeffrey M.; Howard, Alan D.; Umurhan, Orkan M.; White, Oliver L.; Schenk, Paul M.; Beyer, Ross A.; McKinnon, William B.; Spencer, John R.; Grundy, Will M.; Lauer, Tod R.; Nimmo, Francis; Young, Leslie A.; Stern, S. Alan; Weaver, Harold A.; Olkin, Cathy B.; Ennico, Kimberly

    2017-05-01

    Fields of pits, both large and small, in Tombaugh Regio (Sputnik Planitia, and the Pitted Uplands to the east), and along the scarp of Piri Rupes, are examples of landscapes on Pluto where we conclude that sublimation drives their formation and evolution. Our heuristic modeling closely mimics the form, spacing, and arrangement of a variety of Tombaugh Regio's pits. Pluto's sublimation modified landforms appear to require a significant role for (diffusive) mass wasting as suggested by our modeling. In our models, the temporal evolution of pitted surfaces is such that initially lots of time passes with little happening, then eventually, very rapid development of relief and rapid sublimation. Small pits on Sputnik Planitia are consistent with their formation in N2-dominated materials. As N2-ice readily flows, some other ``stiffer'' volatile ice may play a role in supporting the relief of sublimation degraded landforms that exhibit several hundred meters of relief. A strong candidate is CH4, which is spectroscopically observed to be associated with these features, but the current state of rheological knowledge for CH4 ice at Pluto conditions is insufficient for a firm assessment.

  6. Global albedos of Pluto and Charon from LORRI New Horizons observations

    Science.gov (United States)

    Buratti, B. J.; Hofgartner, J. D.; Hicks, M. D.; Weaver, H. A.; Stern, S. A.; Momary, T.; Mosher, J. A.; Beyer, R. A.; Verbiscer, A. J.; Zangari, A. M.; Young, L. A.; Lisse, C. M.; Singer, K.; Cheng, A.; Grundy, W.; Ennico, K.; Olkin, C. B.

    2017-05-01

    The exploration of the Pluto-Charon system by the New Horizons spacecraft represents the first opportunity to understand the distribution of albedo and other photometric properties of the surfaces of objects in the Solar System's ;Third Zone; of distant ice-rich bodies. Images of the entire illuminated surface of Pluto and Charon obtained by the Long Range Reconnaissance Imager (LORRI) camera provide a global map of Pluto that reveals surface albedo variegations larger than any other Solar System world except for Saturn's moon Iapetus. Normal reflectances on Pluto range from 0.08-1.0, and the low-albedo areas of Pluto are darker than any region of Charon. Charon exhibits a much blander surface with normal reflectances ranging from 0.20-0.73. Pluto's albedo features are well-correlated with geologic features, although some exogenous low-albedo dust may be responsible for features seen to the west of the area informally named Tombaugh Regio. The albedo patterns of both Pluto and Charon are latitudinally organized, with the exception of Tombaugh Regio, with darker regions concentrated at the Pluto's equator and Charon's northern pole. The phase curve of Pluto is similar to that of Triton, the large moon of Neptune believed to be a captured Kuiper Belt Object (KBO), while Charon's is similar to that of the Moon. Preliminary Bond albedos are 0.25 ± 0.03 for Charon and 0.72 ± 0.07 for Pluto. Maps of an approximation to the Bond albedo for both Pluto and Charon are presented for the first time. Our work shows a connection between very high albedo (near unity) and planetary activity, a result that suggests the KBO Eris may be currently active.

  7. Evaluating cognitive effort in a randomized controlled trial.

    Science.gov (United States)

    Turner, Travis H; Renfroe, Jenna B; Morella, Kristen; Marriott, Bernadette P

    2016-09-01

    Many randomized controlled trials (RCTs) of neuropsychiatric conditions involve cognitive outcome measures; however, validity of cognitive data relies on adequate effort during testing, and such screening is seldom performed. Given well-established rates of 10 to 30% poor effort in clinical settings, this is not a trivial concern. This preliminary study evaluated effort during cognitive testing in an RCT of omega-3 supplementation to reduce suicidality in a high-risk psychiatric population. An interim analysis of sustained attentions measures from the Connors Performance Test (CPT-2) at baseline for the first 60 participants was conducted. Previously validated cut points to detect insufficient effort on the CPT-2 were applied. At baseline, 12% (7) were identified as giving poor effort. Follow-up analyses indicated less psychiatric distress and suicidality among those who gave poor effort. Results suggest comparable likelihood of a poor effort on cognitive testing in clinical and RCT participation. Reduced psychiatric distress in the poor effort group raises concern regarding interpretation of other measures. The importance of screening cognitive data for effort in RCTs is highlighted. Future studies will examine effort at follow-up visits, and explore relationships to attrition, adherence, and response to treatment. Copyright © 2016 John Wiley & Sons, Ltd.

  8. Clinical randomized controlled trial of chemomechanical caries removal (Carisolv).

    Science.gov (United States)

    Lozano-Chourio, M A; Zambrano, O; González, H; Quero, M

    2006-05-01

    The purpose of this study was to compare the chemomechanical caries-removal system (Carisolv) with high-speed excavation in cavitated occlusal caries of primary molars. Design and setting. The study was a randomized controlled, clinical trial in which the two techniques were compared in each subject. Participants were chosen from public schools, in Maracaibo County, Zulia State, Venezuela. The sample consisted of 80 primary molars selected from 40 children (mean age 7.7+/-0.7 years). Each patient had at least two contralateral primary molars with cavitated occlusal caries and approximately equal-size access to lesions. The outcome variables were: clinically complete caries removal, size of the opening of the cavity, volume of carious tissue removed, pain during caries removal, anaesthesia requested by the patient, caries-removal time, and behaviour and preference of patients. All treated molars were clinically caries free whichever caries-removal procedure was used. When Carisolv' was used the final cavity entrance sizes were smaller (Premoved was less (Premoval was three times longer (7.51+/-1.83 min, Premoval of occlusal dentinal caries in cavitated primary molars; it is more conservative of dental tissue and appeared to be more comfortable for most patients, although the clinical time spent is longer than when using high-speed excavation.

  9. Pneumatic retinopexy versus scleral buckling: a randomised controlled trial.

    Science.gov (United States)

    Mulvihill, A; Fulcher, T; Datta, V; Acheson, R

    1996-01-01

    Pneumatic retinopexy (PR) is a technique for repairing certain retinal detachments which is easier to perform than conventional sceral buckling (SB) surgery but has comparable results. We performed a prospective, randomised, controlled trial to determine for ourselves whether PR is a safe and acceptable procedure. Twenty patients presenting consecutively with retinal detachments which fulfilled the selection criteria were randomised to have their detachments repaired by either PR or SB, ten patients in each group. The suitable patients had a single retinal break or small group of breaks of not greater than one clock hour in size, situated within the superior eight clock hours of retina. Patients with significant proliferative vitreoretinopathy or other fundus disorders were excluded. All patients in the PR group had local anaesthesia while all those in the SB group had general anaesthesia. Successful reattachment of the retina was achieved with one or more procedures in 90 percent of the PR group and in 100 percent of the SB group. We feel that narrowing the selection criteria for PR may further improve the success rate.

  10. Improving pediatric prevention via the internet: a randomized, controlled trial.

    Science.gov (United States)

    Christakis, Dimitri A; Zimmerman, Frederick J; Rivara, Frederick P; Ebel, Beth

    2006-09-01

    Innovations to improve the delivery of pediatric preventive care are needed. We enrolled children, 0 to 11 years of age, into a factorial, randomized, controlled trial of a tailored, evidence-based, Web site (MyHealthyChild) that provided information on prevention topics before a scheduled well-child visit. There were 2 components of the intervention, namely, parental Web content and provider notification. Parental Web content provided information to parents about prevention topics; provider notification communicated to physicians topics that were of interest to parents. We assigned 887 children randomly to 4 groups (usual care, content only, content and notification, or notification only). Outcomes were determined with telephone follow-up surveys conducted 2 to 4 weeks after the visit. Poisson regression analysis was used to determine the independent effects of each intervention on the number of topics discussed and the number of preventive practices implemented. Parents in the notification/content group and in the notification-only group reported discussing more MyHealthyChild topics with their provider. Parents in the notification/content group and in the content-only group reported implementing more MyHealthyChild topic suggestions (such as use of a safety device). A Web-based intervention can activate parents to discuss prevention topics with their child's provider. Delivery of tailored content can promote preventive practices.

  11. [Review of controled clinical trials of behavioral treatment for obesity].

    Science.gov (United States)

    Márquez-Ibáñez, B; Armendáriz-Anguiano, A L; Bacardí-Gascón, M; Jiménez-Cruz, A

    2008-01-01

    The increased prevalence of obesity has been associated to an increment in chronic-degenerative diseases. The behavioral conduct therapies (BCT) have been used to help subjects develop a series of skills to reach a healthy weight. We conducted a review of the literature of BCT from controlled clinical trials registered at PubMed from January 2000 to november 2006. We found five long-term (> or = 12 months) studies and analyzed each study. The percent of weight loss at the end of follow up ranged from 3% to 9% of the initial weight; the percent of retention fluctuated from 92% at three months to 55% at 24 months. There were no similar reported studies conducted in Latino or Hispanic population. These results suggest that the change in loss of weight with BCT are modest at the end of the follow up period and that most of the studies report low adherence to treatment. It is recommended that public and private funds are needed to implement effective and safe multicentric long term randomized studies on different cultural populations, including most Latin-American countries.

  12. Validating Obstetric Emergency Checklists using Simulation: A Randomized Controlled Trial.

    Science.gov (United States)

    Bajaj, Komal; Rivera-Chiauzzi, Enid Y; Lee, Colleen; Shepard, Cynthia; Bernstein, Peter S; Moore-Murray, Tanya; Smith, Heather; Nathan, Lisa; Walker, Katie; Chazotte, Cynthia; Goffman, Dena

    2016-10-01

    Background The World Health Organization's Surgical Safety Checklist has demonstrated significant reduction in surgical morbidity. The American Congress of Obstetricians and Gynecologists District II Safe Motherhood Initiative (SMI) safety bundles include eclampsia and postpartum hemorrhage (PPH) checklists. Objective To determine whether use of the SMI checklists during simulated obstetric emergencies improved completion of critical actions and to elicit feedback to facilitate checklist revision. Study Design During this randomized controlled trial, teams were assigned to use a checklist during one of two emergencies: eclampsia and PPH. Raters scored teams on critical step completion. Feedback was elicited through structured debriefing. Results In total, 30 teams completed 60 scenarios. For eclampsia, trends toward higher completion were noted for blood pressure and airway management. For PPH, trends toward higher completion rates were noted for PPH stage assessment and fundal massage. Feedback resulted in substantial checklist revision. Participants were enthusiastic about using checklists in a clinical emergency. Conclusion Despite trends toward higher rates of completion of critical tasks, teams using checklists did not approach 100% task completion. Teams were interested in the application of checklists and provided feedback necessary to substantially revise the checklists. Intensive implementation planning and training in use of the revised checklists will result in improved patient outcomes.

  13. Sexual Absorption of Vaginal Progesterone: A Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Kathryn S. Merriam

    2015-01-01

    Full Text Available Objective. To determine if sexual intercourse reduces absorption of vaginal progesterone gel in women and to determine if progesterone is absorbed by the male during intercourse. Study Design. Prospective, randomized, cross over, controlled study of 20 reproductive-aged women and their male sexual partners randomized to receive vaginal progesterone gel (Crinone 8% gel, Actavis Inc., USA or placebo cream. Serum progesterone for both male and female partners were measured 10 hours after intercourse. One week later, subjects were crossed over to receive the opposite formulation. In the third week, women used progesterone gel at night and abstained from intercourse. Results. Serum progesterone was significantly reduced with vaginal progesterone gel + intercourse compared with vaginal progesterone gel + abstinence (P=0.0075. Men absorbed significant progesterone during intercourse with a female partner using vaginal progesterone gel compared to placebo (P=0.0008. Conclusion(s. Vaginal progesterone gel is reduced in women after intercourse which may decrease drug efficacy during luteal phase support. Because men absorb low levels of progesterone during intercourse, exposure could cause adverse effects such as decreased libido. This study is registered under Clinical Trial number NCT01959464.

  14. Is the randomized controlled drug trial in Europe lagging behind the USA?

    NARCIS (Netherlands)

    Lambers Heerspink, Hiddo J.; Knol, Mirjam J.; Tijssen, Robert J. W.; van Leeuwen, Thed N.; Grobbee, Diederick E.; de Zeeuw, Dick

    2008-01-01

    WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT? center dot The USA, UK and Germany have a strong position in performance of drug and nondrug randomized controlled trials. center dot Europe's position in the quantitative and qualitative performance in drug randomized controlled trials in particular, and fa

  15. Acceptance and commitment therapy for fibromyalgia: a randomized controlled trial.

    Science.gov (United States)

    Wicksell, R K; Kemani, M; Jensen, K; Kosek, E; Kadetoff, D; Sorjonen, K; Ingvar, M; Olsson, G L

    2013-04-01

    Fibromyalgia (FM) is characterized by widespread pain and co-morbid symptoms such as fatigue and depression. For FM, medical treatments alone appear insufficient. Recent meta-analyses point to the utility of cognitive behaviour therapy (CBT), but effects are moderate. Within the continuous development of CBT, the empirical support for acceptance and commitment therapy (ACT) has increased rapidly. ACT focuses on improving functioning by increasing the patient's ability to act in accordance with personal values also in the presence of pain and distress (i.e., psychological flexibility). However, no study has yet explored the utility of ACT in FM. To evaluate the efficacy of ACT for FM and the role of psychological inflexibility as a mediator of improvement. In this randomized controlled trial, ACT was evaluated in comparison to a waiting list control condition. Forty women diagnosed with FM participated in the study. Assessments were made pre- and post-treatment and at 3 months of follow-up. The ACT intervention consisted of 12 weekly group sessions. Significant differences in favour of ACT were seen in pain-related functioning, FM impact, mental health-related quality of life, self-efficacy, depression, anxiety and psychological inflexibility. Changes in psychological inflexibility during the course of treatment were found to mediate pre- to follow-up improvements in outcome variables. The results correspond with previous studies on ACT for chronic pain and suggest the utility of ACT for FM as well as the role of psychological inflexibility as a mediator of improvement. © 2012 European Federation of International Association for the Study of Pain Chapters.

  16. Phytothermotherapy in osteoarthritis: a randomized controlled clinical trial.

    Science.gov (United States)

    Fioravanti, Antonella; Bellisai, Barbara; Iacoponi, Francesca; Manica, Patrizia; Galeazzi, Mauro

    2011-05-01

    The aim of this study was to assess the efficacy of adding a cycle of phytothermotherapy (a traditional treatment with fermenting grass used in Trentino-Alto Adige, Italy) to the usual drug treatment, in patients with primary symptomatic osteoarthritis (OA) of the knee, hip, or lumbar spine. In this randomized, single-blind, controlled trial, 218 outpatients were enrolled; 109 patients were treated with a cycle of phytothermotherapy at the thermal resort of Garniga Terme (Trento, Italy) for 10 days; the other 109 patients continued regular outpatient care. Patients were assessed at baseline, after 2 weeks, and after 3 months from the beginning of the study and were evaluated using a visual analogue scale (VAS) for spontaneous pain, a Health Assessment Questionnaire, the Lequesne index for hip and knee osteoarthritis, and the Rolland Morris Questionnaire for lumbar spine OA and symptomatic drug consumption. In patients treated with phytothermotherapy, a significant improvement of VAS and a reduction of nonsteroidal anti-inflammatory drug consumption at the end of treatment and 3 months later were observed. In the control group, no significant differences were noted. The analyses performed separately for each subgroup for OA localization showed that the best results were evident in lumbar spine OA. Concerning tolerability, in the group treated with phytothermotherapy 10% of patients presented side-effects due to treatment, but these were of low intensity and did not interrupt the therapy. In conclusion, the results show beneficial effects of a cycle of phytothermotherapy in patients with OA of the hip, knee, or lumbar spine. Phytothermotherapy may therefore be a useful aid alongside the usual pharmacologic and physiokinesic therapies, or may be used as a valid alternative for patients who do not tolerate pharmacologic treatments.

  17. Guidelines for controlled trials of drugs in tension-type headache: second edition

    DEFF Research Database (Denmark)

    Bendtsen, L; Bigal, M E; Cerbo, R

    2010-01-01

    controlled trials are the only way to convincingly demonstrate the efficacy of a drug, and form the basis for international agreement on drug therapy'. The Committee published similar guidelines for clinical trials in migraine and cluster headache. Since 1995 several studies on the treatment of episodic......The Clinical Trials Subcommittee of the International Headache Society published its first edition of the guidelines on controlled trials of drugs in tension-type headache in 1995. These aimed 'to improve the quality of controlled clinical trials in tension-type headache', because 'good quality...... and chronic tension-type headache have been published, providing new information on trial methodology for this disorder. Furthermore, the classification of the headaches, including tension-type headache, has been revised. These developments support the need for also revising the guidelines for drug treatments...

  18. Echinacea for treating the common cold: A randomized controlled trial

    Science.gov (United States)

    Barrett, Bruce; Brown, Roger; Rakel, Dave; Mundt, Marlon; Bone, Kerry; Barlow, Shari; Ewers, Tola

    2011-01-01

    Background Echinacea is widely used to treat common cold. Objective To assess potential benefits of echinacea as common cold treatment. Design Randomized controlled trial with four parallel groups: 1) no pills, 2) placebo pills (blinded), 3) echinacea pills (blinded), or 4) echinacea pills (open-label). (NCT00065715) Setting Community-based trial. Participants People aged 12 to 80 years with new onset common cold. Interventions Extracts of Echinacea purpurea and E. angustifolia root were used to make tablets standardized to alkamide content. Indistinguishable placebo tablets contained only inert ingredients. Measurements The primary outcome was area-under-the-curve global severity, with severity assessed twice daily by self report on the Wisconsin Upper Respiratory Symptom Survey (WURSS-21). Secondary outcomes included interleukin-8 and neutrophil count from nasal wash assessed at intake and two days later. Results Of 719 enrolled, 713 completed the protocol. Participants were 64% female and 88% white, with mean age 33.7 years. Mean global severity was 236 and 258 for blinded and unblinded echinacea, 264 for blinded placebo, and 286 for those without pills. Contrasting the two blinded groups yields a 28 point (95% CI = −69 to 13) trend toward benefit for echinacea (p=0.089). Mean illness duration for the blinded and unblinded echinacea groups was 6.34 and 6.76 days, respectively, compared to 6.87 days for blinded placebo and 7.03 for no pills. Contrasting blinded groups yields a 0.53 day (95% CI = −1.25 to 0.19) trend toward benefit (p = 0.075). Median change interleukin-8 (pg/mL) and neutrophil cell count were: no pills (30, 1), blinded placebo (39, 1), blinded echinacea (58, 2), and open-label echinacea (70, 1), also not statistically significant. Limitations Higher-than-expected variability limited power to detect small-but-potentially-important benefits. Conclusions The observed shorter illness duration and lower severity seen in the echinacea groups were

  19. Probiotics in the prevention of eczema: a randomised controlled trial

    Science.gov (United States)

    Allen, Stephen J; Jordan, Sue; Storey, Melanie; Thornton, Catherine A; Gravenor, Michael B; Garaiova, Iveta; Plummer, Susan F; Wang, Duolao; Morgan, Gareth

    2014-01-01

    Objective To evaluate a multistrain, high-dose probiotic in the prevention of eczema. Design A randomised, double-blind, placebo-controlled, parallel group trial. Settings Antenatal clinics, research clinic, children at home. Patients Pregnant women and their infants. Interventions Women from 36 weeks gestation and their infants to age 6 months received daily either the probiotic (Lactobacillus salivarius CUL61, Lactobacillus paracasei CUL08, Bifidobacterium animalis subspecies lactis CUL34 and Bifidobacterium bifidum CUL20; total of 1010 organisms/day) or matching placebo. Main outcome measure Diagnosed eczema at age 2 years. Infants were followed up by questionnaire. Clinical examination and skin prick tests to common allergens were done at 6 months and 2 years. Results The cumulative frequency of diagnosed eczema at 2 years was similar in the probiotic (73/214, 34.1%) and placebo arms (72/222, 32.4%; OR 1.07, 95% CI 0.72 to 1.6). Among the secondary outcomes, the cumulative frequency of skin prick sensitivity at 2 years was reduced in the probiotic (18/171; 10.5%) compared with the placebo arm (32/173; 18.5%; OR 0.52, 95% CI 0.28 to 0.98). The statistically significant differences between the arms were mainly in sensitisation to cow's milk and hen's egg proteins at 6 months. Atopic eczema occurred in 9/171 (5.3%) children in the probiotic arm and 21/173 (12.1%) in the placebo arm (OR 0.40, 95% CI 0.18 to 0.91). Conclusions The study did not provide evidence that the probiotic either prevented eczema during the study or reduced its severity. However, the probiotic seemed to prevent atopic sensitisation to common food allergens and so reduce the incidence of atopic eczema in early childhood. Trial registration Number ISRCTN26287422. PMID:24947281

  20. Patient controlled analgesia with remifentanil versus epidural analgesia in labour : randomised multicentre equivalence trial

    NARCIS (Netherlands)

    Freeman, Liv M; Bloemenkamp, Kitty W; Franssen, Maureen T; Papatsonis, Dimitri N; Hajenius, Petra J; Hollmann, Markus W; Woiski, Mallory D; Porath, Martina; van den Berg, Hans J; van Beek, Erik; Borchert, Odette W H M; Schuitemaker, Nico; Sikkema, J Marko; Kuipers, A H M; Logtenberg, Sabine L M; van der Salm, Paulien C M; Oude Rengerink, Katrien; Lopriore, Enrico; van den Akker-van Marle, M Elske; le Cessie, Saskia; van Lith, Jan M; Struys, Michel M; Mol, Ben Willem J; Dahan, Albert; Middeldorp, Johanna M; Oude Rengerink, K

    2015-01-01

    OBJECTIVE: To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared with epidural analgesia during labour. DESIGN: Multicentre randomised controlled equivalence trial. SETTING: 15 hospitals in the Netherlands. PARTICIPANTS: Women with an interm

  1. Systemic corticosteroid monotherapy for clinically diagnosed acute rhinosinusitis: a randomized controlled trial

    NARCIS (Netherlands)

    Venekamp, R.P.; Bonten, M.J.; Rovers, M.M.; Verheij, T.J.; Sachs, A.P.

    2012-01-01

    BACKGROUND: Patients with acute rhinosinusitis are frequently encountered in primary care. Although corticosteroids are being increasingly used for symptom control, evidence supporting their use is inconclusive. We conducted a randomized controlled trial to examine the effectiveness of systemic cort

  2. Influence of reported study design characteristics on intervention effect estimates from randomised controlled trials

    DEFF Research Database (Denmark)

    Savović, J; Jones, He; Altman, Dg

    2012-01-01

    The design of randomised controlled trials (RCTs) should incorporate characteristics (such as concealment of randomised allocation and blinding of participants and personnel) that avoid biases resulting from lack of comparability of the intervention and control groups. Empirical evidence suggests...

  3. Predictors of Missed Research Appointments in a Randomized Placebo-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Stéphanie J.E. Becker

    2014-09-01

     Younger patients with no college education, who believe their health can be controlled, are more likely to miss a research appointment when enrolled in a randomized placebo injection-controlled trial

  4. Control Group Design, Contamination and Drop-Out in Exercise Oncology Trials : A Systematic Review

    NARCIS (Netherlands)

    Bisschop, Charlotte N. Steins; Courneya, Kerry S.; Velthuis, Miranda J.; Monninkhof, Evelyn M.; Jones, Lee W.; Friedenreich, Christine; van der Wall, Elsken; Peeters, Petra H. M.; May, Anne M.

    2015-01-01

    Purpose Important considerations for exercise trials in cancer patients are contamination and differential drop-out among the control group members that might jeopardize the internal validity. This systematic review provides an overview of different control groups design characteristics of

  5. Labour pain with remifentanil patient-controlled analgesia versus epidural analgesia : a randomised equivalence trial

    NARCIS (Netherlands)

    Logtenberg, Slm; Oude Rengerink, K; Verhoeven, C J; Freeman, L M; van den Akker, Esa; Godfried, M B; van Beek, E; Borchert, Owhm; Schuitemaker, N; van Woerkens, Ecsm; Hostijn, I; Middeldorp, J M; van der Post, J A; Mol, B W

    OBJECTIVE: To distinguish satisfaction with pain relief using remifentanil patient-controlled analgesia (RPCA) compared with epidural analgesia (EA) in low-risk labouring women. DESIGN: Randomised controlled equivalence trial. SETTING: Eighteen midwifery practices and six hospitals in the

  6. A descriptive analysis of a representative sample of pediatric randomized controlled trials published in 2007

    Directory of Open Access Journals (Sweden)

    Thomson Denise

    2010-12-01

    Full Text Available Abstract Background Randomized controlled trials (RCTs are the gold standard for trials assessing the effects of therapeutic interventions; therefore it is important to understand how they are conducted. Our objectives were to provide an overview of a representative sample of pediatric RCTs published in 2007 and assess the validity of their results. Methods We searched Cochrane Central Register of Controlled Trials using a pediatric filter and randomly selected 300 RCTs published in 2007. We extracted data on trial characteristics; outcomes; methodological quality; reporting; and registration and protocol characteristics. Trial registration and protocol availability were determined for each study based on the publication, an Internet search and an author survey. Results Most studies (83% were efficacy trials, 40% evaluated drugs, and 30% were placebo-controlled. Primary outcomes were specified in 41%; 43% reported on adverse events. At least one statistically significant outcome was reported in 77% of trials; 63% favored the treatment group. Trial registration was declared in 12% of publications and 23% were found through an Internet search. Risk of bias (ROB was high in 59% of trials, unclear in 33%, and low in 8%. Registered trials were more likely to have low ROB than non-registered trials (16% vs. 5%; p = 0.008. Effect sizes tended to be larger for trials at high vs. low ROB (0.28, 95% CI 0.21,0.35 vs. 0.16, 95% CI 0.07,0.25. Among survey respondents (50% response rate, the most common reason for trial registration was a publication requirement and for non-registration, a lack of familiarity with the process. Conclusions More than half of this random sample of pediatric RCTs published in 2007 was at high ROB and three quarters of trials were not registered. There is an urgent need to improve the design, conduct, and reporting of child health research.

  7. Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study.

    Science.gov (United States)

    Lewin, Simon; Glenton, Claire; Oxman, Andrew D

    2009-09-10

    To examine the use of qualitative approaches alongside randomised trials of complex healthcare interventions. Review of randomised controlled trials of interventions to change professional practice or the organisation of care. Systematic sample of 100 trials published in English from the register of the Cochrane Effective Practice and Organisation of Care Review Group. Published and unpublished qualitative studies linked to the randomised controlled trials were identified through database searches and contact with authors. Data were extracted from each study by two reviewers using a standard form. We extracted data describing the randomised controlled trials and qualitative studies, the quality of these studies, and how, if at all, the qualitative and quantitative findings were combined. A narrative synthesis of the findings was done. 30 of the 100 trials had associated qualitative work and 19 of these were published studies. 14 qualitative studies were done before the trial, nine during the trial, and four after the trial. 13 studies reported an explicit theoretical basis and 11 specified their methodological approach. Approaches to sampling and data analysis were poorly described. For most cases (n=20) we found no indication of integration of qualitative and quantitative findings at the level of either analysis or interpretation. The quality of the qualitative studies was highly variable. Qualitative studies alongside randomised controlled trials remain uncommon, even where relatively complex interventions are being evaluated. Most of the qualitative studies were carried out before or during the trials with few studies used to explain trial results. The findings of the qualitative studies seemed to be poorly integrated with those of the trials and often had major methodological shortcomings.

  8. Photometric study of Pluto near perihelion. Pt. 2. Refined rotation period. Color indices

    Energy Technology Data Exchange (ETDEWEB)

    Lyutyj, V.M.; Tarashchuk, V.P. (Moskovskij Gosudarstvennyj Univ. (USSR). Gosudarstvennyj Astronomicheskij Inst. ' ' GAISh' ' ; Kievskij Gosudarstvennyj Univ. (Ukrainian SSR))

    1984-07-01

    Results of UBV photometry of Pluto during 1982-1983 are reported. Using all photoelectric observations of 1953-1983 a more accurate period is calculated. The significant reddening at maximum light (phases 0.6-0.7) is revealed. The secular variations of the mean brightness of Pluto does not contradict a 124-year periodicity.

  9. Trials

    Directory of Open Access Journals (Sweden)

    Michele Fornaro

    2010-01-01

    Full Text Available Mental Retardation (MR is a developmental disability characterized by impairments in adaptive daily life skills and difficulties in social and interpersonal functioning. Since multiple causes may contribute to MR, associated clinical pictures may vary accordingly. Nevertheless, when psychiatric disorders as Treatment Resistant Depression (TRD and/or alcohol abuse co-exist, their proper detection and management is often troublesome, essentially due to a limited vocabulary MR people could use to describe their symptoms, feelings and concerns, and the lack of reliable screening tools. Furthermore, MR people are among the most medicated subjects, with (over prescription of antidepressants and/or typical antipsychotics being the rule rather than exception. Thus, treatment resistance or even worsening of depression, constitute frequent occurrences. This report describes the case of a person with MR who failed to respond to repetitive trials of antidepressant monotherapies, finally recovering using aripiprazole to fluvoxamine augmentation upon consideration of a putative bipolar diathesis for “agitated” TRD. Although further controlled investigations are needed to assess a putative bipolar diathesis in some cases of MR associated to TRD, prudence is advised in the long-term prescription of antidepressant monotherapies in such conditions.

  10. Evaluating traditional Chinese medicine using modern clinical trial design and statistical methodology: application to a randomized controlled acupuncture trial.

    Science.gov (United States)

    Lao, Lixing; Huang, Yi; Feng, Chiguang; Berman, Brian M; Tan, Ming T

    2012-03-30

    Traditional Chinese medicine (TCM), used in China and other Asian counties for thousands of years, is increasingly utilized in Western countries. However, due to inherent differences in how Western medicine and this ancient modality are practiced, employing the so-called Western medicine-based gold standard research methods to evaluate TCM is challenging. This paper is a discussion of the obstacles inherent in the design and statistical analysis of clinical trials of TCM. It is based on our experience in designing and conducting a randomized controlled clinical trial of acupuncture for post-operative dental pain control in which acupuncture was shown to be statistically and significantly better than placebo in lengthening the median survival time to rescue drug. We demonstrate here that PH assumptions in the common Cox model did not hold in that trial and that TCM trials warrant more thoughtful modeling and more sophisticated models of statistical analysis. TCM study design entails all the challenges encountered in trials of drugs, devices, and surgical procedures in the Western medicine. We present possible solutions to some but leave many issues unresolved.

  11. Metabolic deterioration of the sedentary control group in clinical trials

    National Research Council Canada - National Science Library

    Mahesh J. Patel; Cris A. Slentz; William E. Kraus

    2011-01-01

    Randomized clinical trials of exercise training regimens in sedentary individuals have provided a mechanistic understanding of the long-term health benefits and consequences of physical activity and inactivity...

  12. Attitudes toward Placebo-Controlled Clinical Trials of Patients with Schizophrenia in Japan.

    Directory of Open Access Journals (Sweden)

    Norio Sugawara

    Full Text Available Although the use of placebo in clinical trials of schizophrenia patients is controversial because of medical and ethical concerns, placebo-controlled clinical trials are commonly used in the licensing of new drugs.The objective of this study was to assess the attitudes toward placebo-controlled clinical trials among patients with schizophrenia in Japan.Using a cross-sectional design, we recruited patients (n = 251 aged 47.7±13.2 (mean±SD with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who were admitted to six psychiatric hospitals from December 2013 to March 2014. We employed a 14-item questionnaire specifically developed to survey patients' attitudes toward placebo-controlled clinical trials.The results indicated that 33% of the patients would be willing to participate in a placebo-controlled clinical trial. Expectations for improvement of disease, a guarantee of hospital treatment continuation, and encouragement by family or friends were associated with the willingness to participate in such trials, whereas a belief of additional time required for medical examinations was associated with non-participation.Fewer than half of the respondents stated that they would be willing to participate in placebo-controlled clinical trials. Therefore, interpreting the results from placebo-controlled clinical trials could be negatively affected by selection bias.

  13. Experiences of a long-term randomized controlled prevention trial in a maiden environment: Estonian Postmenopausal Hormone Therapy trial

    Directory of Open Access Journals (Sweden)

    Rahu Mati

    2008-08-01

    Full Text Available Abstract Background Preventive drugs require long-term trials to show their effectiveness or harms and often a lot of changes occur during post-marketing studies. The purpose of this article is to describe the research process in a long-term randomized controlled trial and discuss the impact and consequences of changes in the research environment. Methods The Estonian Postmenopausal Hormone Therapy trial (EPHT, originally planned to continue for five years, was planned in co-operation with the Women's International Study of Long-Duration Oestrogen after Menopause (WISDOM in the UK. In addition to health outcomes, EPHT was specifically designed to study the impact of postmenopausal hormone therapy (HT on health services utilization. Results After EPHT recruited in 1999–2001 the Women's Health Initiative (WHI in the USA decided to stop the estrogen-progestin trial after a mean of 5.2 years in July 2002 because of increased risk of breast cancer and later in 2004 the estrogen-only trial because HT increased the risk of stroke, decreased the risk of hip fracture, and did not affect coronary heart disease incidence. WISDOM was halted in autumn 2002. These decisions had a major influence on EPHT. Conclusion Changes in Estonian society challenged EPHT to find a balance between the needs of achieving responses to the trial aims with a limited budget and simultaneously maintaining the safety of trial participants. Flexibility was the main key for success. Rapid changes are not limited only to transiting societies but are true also in developed countries and the risk must be included in planning all long-term trials. The role of ethical and data monitoring committees in situations with emerging new data from other studies needs specification. Longer funding for preventive trials and more flexibility in budgeting are mandatory. Who should prove the effectiveness of an (old drug for a new preventive indication? In preventive drug trials companies may

  14. Comparison communities in a cluster randomised trial innovate in response to 'being controlled'.

    Science.gov (United States)

    Hawe, Penelope; Riley, Therese; Gartrell, Alexandra; Turner, Karen; Canales, Claudia; Omstead, Darlene

    2015-05-01

    We conducted qualitative interviews among primary health care teams and community agencies in eight communities in Victoria, Australia which had (1) agreed to be part of a universal primary care and community development intervention to reduce post natal depression and promote maternal health; and (2) were randomised to the comparison arm. The purpose was to document their experience with and interpretation of the trial. Although 'control' in a controlled trial refers to the control of confounding of the trial result by factors other than allocation to the intervention, participants interpreted 'control' to mean restrictions on what they were allowed to do during the trial period. They had agreed not to use the Edinburgh Post Natal Depression Scale or the SF 36 in clinical practice and not to implement any of the elements of the intervention. We found that no elements of the intervention were implemented. However, the extension of the trial from three to five years made the trial agreement a strain. The imposition of trial conditions also encouraged a degree of lateral thinking and innovation in service delivery (quality improvement). This may have potentially contributed to the null trial results. The observations invite interrogation of intervention theory and consequent rethinking of the way contamination in a cluster trial is defined.

  15. Randomized Controlled Trials of Pediatric Massage: A Review

    Directory of Open Access Journals (Sweden)

    Shay Beider

    2007-01-01

    Full Text Available The existing reviews of massage therapy (MT research are either limited to infants, adults, or were conducted prior to the publication of the most recent studies using pediatric samples. Randomized controlled trials (RCTs of pediatric MT are reviewed. A literature search yielded 24 RCTs of pediatric MT, defined as the manual manipulation of soft tissue intended to promote health and well-being in recipients between 2 and 19 years of age. Because RCTs of pediatric MT varied considerably in the amount and types of data reported, quantitative and narrative review methods were both used. Single-dose and multiple-dose effects were examined separately. Among single-dose effects, significant reductions of state anxiety were observed at the first session (g = 0.59, P < 0.05 and the last session (g = 1.10, P < 0.01 of a course of treatment. Effects for salivary cortisol (g = 0.28, negative mood (g = 0.52 and behavior (g = 0.37 were non-significant. Three of eleven multiple-dose effects were statistically significant. These were trait anxiety (g = 0.94, P < 0.05, muscle tone (g = 0.90, P < 0.01 and arthritis pain (g = 1.33, P < 0.01. Results of studies not permitting effect size calculation were judged to be generally consistent with quantitative results. MT benefits pediatric recipients, though not as universally as sometimes reported. Numerous weaknesses endemic to MT research (e.g. low statistical power, frequent failure to report basic descriptive statistics are identified, and recommendations for future pediatric MT research are discussed.

  16. Exercise training and habitual physical activity: a randomized controlled trial.

    Science.gov (United States)

    Swift, Damon L; Johannsen, Neil M; Tudor-Locke, Catrine; Earnest, Conrad P; Johnson, William D; Blair, Steven N; Sénéchal, Martin; Church, Timothy S

    2012-12-01

    Exercise training reduces adiposity and risk of cardiovascular disease. However, the combined effects of habitual free-living physical activity and aerobic training on waist circumference, weight, fitness, and blood pressure in postmenopausal women are unknown. To evaluate the effects of habitual physical activity levels during aerobic training on weight, waist circumference, fitness, and blood pressure. Secondary analysis of an RCT. Original data collected April 2001 to June 2005 and analyzed in 2012. Postmenopausal women in a supervised exercise trial. Women (n=325) were randomized to 4, 8, or 12 kcal/kg per week of aerobic training or a control group for 6 months. All outcome measures were collected at baseline and follow-up. Changes in dependent variables within each training group were evaluated across tertiles of pedometer-determined habitual physical activity outside exercise training sessions. Changes in waist circumference and weight. Reductions in waist circumference were significantly greater with higher steps/day accumulated outside exercise training compared to lower levels in the 4 (high: -4.8 cm vs low: -1.4 cm, p=0.03); 8 (high: -4.2 cm vs low: -0.4 cm, p=0.03), and 12 kcal/kg per week groups (high: -4.1 cm vs low: -0.7 cm, p=0.05). For all groups, p-trend≤0.03. A trend was observed for greater weight reduction with higher steps/day in the 4 kcal/kg per week group (p-trend=0.04) but not for the other exercise doses. No effects were observed for blood pressure or fitness measures (all p>0.05). In postmenopausal women, higher habitual physical activity while participating in aerobic training was associated with greater reductions in central adiposity, and was supportive of weight loss compared to lower levels. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. ASSESSMENT OF AMLODIPINE ANTIHYPERTENSIVE EFFECT HOMOGENEITY IN CONTROLLED TRIAL

    Directory of Open Access Journals (Sweden)

    V. M. Gorbunov

    2016-01-01

    Full Text Available Aim. To compare influence of amlodipine and spirapril on ambulatory blood pressure profile, including antihypertensive effect smoothness in patients with arterial hypertension (HT.Methods. 39 patients (aged 53,7±10,0 y.o. with HT were included in the open, randomized, cross-over study, 30 patients completed study. The duration of every therapies was 4 weeks, initial control period and wash-out period between therapies lasted 1 week. The initial daily dose of amlodipine was 5 mg, standard dose of spirapril (6 mg/daily was not changed during the trial. After 1-2 weeks of treatment amlodipine dose was increased up to 10 mg/daily as well as dihydrochlorothiazide was added, if necessary. Ambulatory blood pressure monitoring (ABPM was performed initially and at the end of both therapies.Results. Both drugs demonstrated good antihypertensive effect according to ABPM data. Decrease of systolic/diastolic blood pressure was 11,2±1,8/7,6±1,2 mm Hg in amlodipine therapy and 10,0±1,8/7,1±1,2 in spirapril therapy (p<0,0001. The smoothness indexes (SI were 0,65/0,45 and 0,55/0,45, respectively, differences between two therapies were not significant. However the individual analysis of the SI distribution (with SI=0,5 as a satisfactory criterion, showed that antihypertensive effect smoothness is better in amlodipine therapy than this in spirapril one.Conclusion. Amlodipine has prominent as well as smooth antihypertensive effect, that gives it advantages in the long-term antihypertensive therapy.

  18. Preventing deformational plagiocephaly through parent guidance: a randomized, controlled trial.

    Science.gov (United States)

    Aarnivala, Henri; Vuollo, Ville; Harila, Virpi; Heikkinen, Tuomo; Pirttiniemi, Pertti; Valkama, A Marita

    2015-09-01

    Deformational plagiocephaly (DP) occurs frequently in otherwise healthy infants. Many infants with DP undergo physiotherapy or helmet therapy, and ample treatment-related research is available. However, the possibility of preventing DP has been left with little attention. We sought to evaluate the effectiveness of intervention in the newborn's environment, positioning, and handling on the prevalence of DP at 3 months and to investigate the causal relationship between DP and cervical imbalance. We carried out a randomized controlled trial, with healthy newborns randomized into two groups at birth. All families received standard positioning instructions to prevent SIDS. Additionally, the intervention group received detailed instructions regarding the infant's environment, positioning, and handling, with the goal of creating a nonrestrictive environment that promotes spontaneous physical movement and symmetrical motor development. Two- and three-dimensional photogrammetry served to assess cranial shape and goniometry to measure cervical motion. At 3 months, the prevalence of DP was lower in the intervention group in both 2D (11 vs 31 %) and 3D analyses (15 vs 33 %), and the asymmetry was milder in the intervention group. Infants with DP at follow-up had also developed more torticollis. An early educational intervention reduces the prevalence and severity of DP at 3 months. •Deformational plagiocephaly, often with associated torticollis, is common in healthy infants. •Parental education is frequently recommended for preventing deformational plagiocephaly, although information regarding the effectiveness of preventive strategies is scarce. •Early parent guidance effectively reduces the prevalence and severity of DP and improves the cervical range of motion at three months. •Educating both parents and professionals about proper infant positioning on a national scale could help minimize public healthcare costs.

  19. Extended treatment for cigarette smoking cessation: a randomized control trial.

    Science.gov (United States)

    Laude, Jennifer R; Bailey, Steffani R; Crew, Erin; Varady, Ann; Lembke, Anna; McFall, Danielle; Jeon, Anna; Killen, Diana; Killen, Joel D; David, Sean P

    2017-08-01

    To test the potential benefit of extending cognitive-behavioral therapy (CBT) relative to not extending CBT on long-term abstinence from smoking. Two-group parallel randomized controlled trial. Patients were randomized to receive non-extended CBT (n = 111) or extended CBT (n = 112) following a 26-week open-label treatment. Community clinic in the United States. A total of 219 smokers (mean age: 43 years; mean cigarettes/day: 18). All participants received 10 weeks of combined CBT + bupropion sustained release (bupropion SR) + nicotine patch and were continued on CBT and either no medications if abstinent, continued bupropion + nicotine replacement therapy (NRT) if increased craving or depression scores, or varenicline if still smoking at 10 weeks. Half the participants were randomized at 26 weeks to extended CBT (E-CBT) to week 48 and half to non-extended CBT (no additional CBT sessions). The primary outcome was expired CO-confirmed, 7-day point-prevalence (PP) at 52- and 104-week follow-up. Analyses were based on intention-to-treat. PP abstinence rates at the 52-week follow-up were comparable across non-extended CBT (40%) and E-CBT (39%) groups [odds ratio (OR) = 0.99; 95% confidence interval (CI) = 0.55, 1.78]. A similar pattern was observed across non-extended CBT (39%) and E-CBT (33%) groups at the 104-week follow-up (OR = 0.79; 95% CI= 0.44, 1.40). Prolonging cognitive-behavioral therapy from 26 to 48 weeks does not appear to improve long-term abstinence from smoking. © 2017 Society for the Study of Addiction.

  20. The Pluto system: Initial results from its exploration by New Horizons

    CERN Document Server

    Stern, S A; Ennico, K; Gladstone, G R; Grundy, W M; McKinnon, W B; Moore, J M; Olkin, C B; Spencer, J R; Weaver, H A; Young, L A; Andert, T; Andrews, J; Banks, M; Bauer, B; Bauman, J; Barnouin, O S; Bedini, P; Beisser, K; Beyer, R A; Bhaskaran, S; Binzel, R P; Birath, E; Bird, M; Bogan, D J; Bowman, A; Bray, V J; Brozovic, M; Bryan, C; Buckley, M R; Buie, M W; Buratti, B J; Bushman, S S; Calloway, A; Carcich, B; Cheng, A F; Conard, S; Conrad, C A; Cook, J C; Cruikshank, D P; Custodio, O S; Ore, C M Dalle; Deboy, C; Dischner, Z J B; Dumont, P; Earle, A M; Elliott, H A; Ercol, J; Ernst, C M; Finley, T; Flanigan, S H; Fountain, G; Freeze, M J; Greathouse, T; Green, J L; Guo, Y; Hahn, M; Hamilton, D P; Hamilton, S A; Hanley, J; Harch, A; Hart, H M; Hersman, C B; Hill, A; Hill, M E; Hinson, D P; Holdridge, M E; Horanyi, M; Howard, A D; Howett, C J A; Jackman, C; Jacobson, R A; Jennings, D E; Kammer, J A; Kang, H K; Kaufmann, D E; Kollmann, P; Krimigis, S M; Kusnierkiewicz, D; Lauer, T R; Lee, J E; Lindstrom, K L; Linscott, I R; Lisse, C M; Lunsford, A W; Mallder, V A; Martin, N; McComas, D J; McNutt, R L; Mehoke, D; Mehoke, T; Melin, E D; Mutchler, M; Nelson, D; Nimmo, F; Nunez, J I; Ocampo, A; Owen, W M; Paetzold, M; Page, B; Parker, A H; Parker, J W; Pelletier, F; Peterson, J; Pinkine, N; Piquette, M; Porter, S B; Protopapa, S; Redfern, J; Reitsema, H J; Reuter, D C; Roberts, J H; Robbins, S J; Rogers, G; Rose, D; Runyon, K; Retherford, K D; Ryschkewitsch, M G; Schenk, P; Schindhelm, E; Sepan, B; Showalter, M R; Singer, K N; Soluri, M; Stanbridge, D; Steffl, A J; Strobel, D F; Stryk, T; Summers, M E; Szalay, J R; Tapley, M; Taylor, A; Taylor, H; Throop, H B; Tsang, C C C; Tyler, G L; Umurhan, O M; Verbiscer, A J; Versteeg, M H; Vincent, M; Webbert, R; Weidner, S; Weigle, G E; White, O L; Whittenburg, K; Williams, B G; Williams, K; Williams, S; Woods, W W; Zangari, A M; Zirnstein, E

    2015-01-01

    The Pluto system was recently explored by NASA's New Horizons spacecraft, making closest approach on 14 July 2015. Pluto's surface displays diverse landforms, terrain ages, albedos, colors, and composition gradients. Evidence is found for a water-ice crust, geologically young surface units, surface ice convection, wind streaks, volatile transport, and glacial flow. Pluto's atmosphere is highly extended, with trace hydrocarbons, a global haze layer, and a surface pressure near 10 microbars. Pluto's diverse surface geology and long-term activity raise fundamental questions about how small planets remain active many billions of years after formation. Pluto's large moon Charon displays tectonics and evidence for a heterogeneous crustal composition, its north pole displays puzzling dark terrain. Small satellites Hydra and Nix have higher albedos than expected.

  1. The Pluto system: Initial results from its exploration by New Horizons.

    Science.gov (United States)

    Stern, S A; Bagenal, F; Ennico, K; Gladstone, G R; Grundy, W M; McKinnon, W B; Moore, J M; Olkin, C B; Spencer, J R; Weaver, H A; Young, L A; Andert, T; Andrews, J; Banks, M; Bauer, B; Bauman, J; Barnouin, O S; Bedini, P; Beisser, K; Beyer, R A; Bhaskaran, S; Binzel, R P; Birath, E; Bird, M; Bogan, D J; Bowman, A; Bray, V J; Brozovic, M; Bryan, C; Buckley, M R; Buie, M W; Buratti, B J; Bushman, S S; Calloway, A; Carcich, B; Cheng, A F; Conard, S; Conrad, C A; Cook, J C; Cruikshank, D P; Custodio, O S; Dalle Ore, C M; Deboy, C; Dischner, Z J B; Dumont, P; Earle, A M; Elliott, H A; Ercol, J; Ernst, C M; Finley, T; Flanigan, S H; Fountain, G; Freeze, M J; Greathouse, T; Green, J L; Guo, Y; Hahn, M; Hamilton, D P; Hamilton, S A; Hanley, J; Harch, A; Hart, H M; Hersman, C B; Hill, A; Hill, M E; Hinson, D P; Holdridge, M E; Horanyi, M; Howard, A D; Howett, C J A; Jackman, C; Jacobson, R A; Jennings, D E; Kammer, J A; Kang, H K; Kaufmann, D E; Kollmann, P; Krimigis, S M; Kusnierkiewicz, D; Lauer, T R; Lee, J E; Lindstrom, K L; Linscott, I R; Lisse, C M; Lunsford, A W; Mallder, V A; Martin, N; McComas, D J; McNutt, R L; Mehoke, D; Mehoke, T; Melin, E D; Mutchler, M; Nelson, D; Nimmo, F; Nunez, J I; Ocampo, A; Owen, W M; Paetzold, M; Page, B; Parker, A H; Parker, J W; Pelletier, F; Peterson, J; Pinkine, N; Piquette, M; Porter, S B; Protopapa, S; Redfern, J; Reitsema, H J; Reuter, D C; Roberts, J H; Robbins, S J; Rogers, G; Rose, D; Runyon, K; Retherford, K D; Ryschkewitsch, M G; Schenk, P; Schindhelm, E; Sepan, B; Showalter, M R; Singer, K N; Soluri, M; Stanbridge, D; Steffl, A J; Strobel, D F; Stryk, T; Summers, M E; Szalay, J R; Tapley, M; Taylor, A; Taylor, H; Throop, H B; Tsang, C C C; Tyler, G L; Umurhan, O M; Verbiscer, A J; Versteeg, M H; Vincent, M; Webbert, R; Weidner, S; Weigle, G E; White, O L; Whittenburg, K; Williams, B G; Williams, K; Williams, S; Woods, W W; Zangari, A M; Zirnstein, E

    2015-10-16

    The Pluto system was recently explored by NASA's New Horizons spacecraft, making closest approach on 14 July 2015. Pluto's surface displays diverse landforms, terrain ages, albedos, colors, and composition gradients. Evidence is found for a water-ice crust, geologically young surface units, surface ice convection, wind streaks, volatile transport, and glacial flow. Pluto's atmosphere is highly extended, with trace hydrocarbons, a global haze layer, and a surface pressure near 10 microbars. Pluto's diverse surface geology and long-term activity raise fundamental questions about how small planets remain active many billions of years after formation. Pluto's large moon Charon displays tectonics and evidence for a heterogeneous crustal composition; its north pole displays puzzling dark terrain. Small satellites Hydra and Nix have higher albedos than expected. Copyright © 2015, American Association for the Advancement of Science.

  2. A randomised controlled trial of Silirum vaccine for control of paratuberculosis in farmed red deer.

    Science.gov (United States)

    Stringer, L A; Wilson, P R; Heuer, C; Mackintosh, C G

    2013-12-07

    A randomised controlled trial to assess the efficacy of Silirum vaccine in control of paratuberculosis in young farmed deer was carried out in 2008-2009 in six New Zealand herds with a history of clinical disease. Vaccination with Silirum was carried out in four-month-old deer, and vaccinates (n=1671) and controls (n=1664) were weighed at vaccination and at 8 and 12 months old, when faecal samples were collected from 125 vaccinates and 123 controls on five farms. Deer were slaughtered between 11 and 20 months of age, and the incidence of gross visceral lymph node (VLN) pathology typical of paratuberculosis in deer, that is, enlarged and/or granulomatous VLN, was recorded. Clinical disease was confirmed in 18 controls and seven vaccinates, representing a vaccine efficacy estimate of 60 per cent (95% CI 3 per cent to 83 per cent, P=0.04). Forty-seven percent (95% CI 38 per cent to 56 per cent) of faecal samples from vaccinates and 55 per cent (95% CI 46 per cent to 64 per cent) from controls were Mycobacterium avium subspecies paratuberculosis positive (P=0.5). Average daily liveweight gain did not differ between the cohorts. At slaughter, 1.4 per cent of vaccinates and 4.5 per cent of controls had VLN pathology, RR=0.32 (95% CI 0.19 to 0.54, Pvaccination with Silirum may be useful as an aid to control losses associated with clinical paratuberculosis in young deer.

  3. Massage Therapy and Labor Outcomes: a Randomized Controlled Trial

    Science.gov (United States)

    Janssen, Patricia; Shroff, Farah; Jaspar, Paula

    2012-01-01

    Introduction Massage is a time-honored method by which women have received comfort throughout the millennia, yet it has not been rigorously evaluated in the modern day delivery suite. No study to date that we are aware of has evaluated the effect of massage therapy by a regulated massage therapist on labor pain. The purpose of this study was to evaluate the effectiveness of massage therapy provided by registered massage therapists in managing pain among women in active labor. Methods BC Women’s Hospital, Vancouver, BC. Research Design: a randomized controlled trial. Participants: 77 healthy nulliparous women presenting in spontaneous labor. Intervention: Swedish massage administered for up to five hours by a registered massage therapist during labor vs. standard care. Main outcome measures include: cervical dilation at the time of administration of epidural, compared using estimated marginal means in an analysis of covariance. We also compared perception of pain at three time periods during labor according to cervical dilation at 3–4 cm, 5–7 cm, and 8–10 cm using the McGill Present Pain Intensity Scale. Results The mean cervical dilation at the time of epidural insertion after adjustment for station of the presenting part, cervical dilation, and status of membranes on admission to hospital was 5.9 cm (95% CI 5.2–6.7) compared to 4.9 in the control group (95% CI 4.2–5.8). Scores on the McGill Pain Scale were consistently lower in the massage therapy group (13.3 vs. 16.9 at 3–4 cm, 13.3 vs. 15.8 at 5–6 cm, and 19.4 vs. 28.3 at 7–8 cm), although these differences were not statistically significant. Conclusions Our findings from this pilot study suggest that massage therapy by a registered massage therapist has the potential to be an effective means of pain management that may be associated with delayed use of epidural analgesia. It may therefore have the potential to reduce exposure to epidural analgesia during labor and decrease rates of associated

  4. Secnidazole Treatment of Bacterial Vaginosis: A Randomized Controlled Trial.

    Science.gov (United States)

    Hillier, Sharon L; Nyirjesy, Paul; Waldbaum, Arthur S; Schwebke, Jane R; Morgan, Franklin G; Adetoro, Nikki A; Braun, Carol J

    2017-08-01

    To evaluate secnidazole as a single oral dose treatment for bacterial vaginosis in a phase 2 randomized, double-blind, placebo-controlled study. In a phase 2, randomized, double-blind, dose-ranging, placebo-controlled study, women with bacterial vaginosis who met all Amsel criteria (discharge; pH 4.7 or greater; 20% or greater clue cells; positive whiff test) were randomized one to one to one at 24 U.S. centers to 1 or 2 g secnidazole compared with placebo. The primary endpoint was clinical cure (normalization of discharge, amine odor, and clue cells) 21-30 days after treatment. Secondary endpoints included microbiologic cure, defined as a Nugent score of 0-3, and therapeutic cure, defined as meeting criteria for both clinical and microbiologic cure. The modified intent to treat was used for efficacy analyses and included all randomized patients who met the enrollment criteria. Assuming a clinical cure rate of 40% in the active groups and 15% in the placebo group, a sample size of 52 patients per group provided approximately 80% power to detect a significant difference between groups (.05 level [two-sided]) using a Cochran-Mantel-Haenszel test. Between May and September 2014, 215 patients were enrolled. In the intent-to-treat population, the clinical cure rate was 65.3% for the 2-g group, 49.3% for the 1-g group, and 19.4% for the placebo group. The modified intent-to-treat population included 188 women (median age 33 years; 32% with four or more bacterial vaginosis episodes in the previous year; 54% black) with baseline Nugent scores 4 or greater. Clinical, microbiologic, and therapeutic cure rates were 67.7%, 40.3%, and 40.3% for 2 g secnidazole and 51.6%, 23.4%, and 21.9% for 1 g secnidazole compared with 17.7%, 6.5%, and 6.5% for placebo, respectively (Pbacterial vaginosis treatment (Pbacterial vaginosis treatment. ClinicalTrials.gov, NCT02147899.

  5. Getting added value from using qualitative research with randomized controlled trials: a qualitative interview study

    OpenAIRE

    2014-01-01

    Background Qualitative research is undertaken with randomized controlled trials of health interventions. Our aim was to explore the perceptions of researchers with experience of this endeavour to understand the added value of qualitative research to the trial in practice. Methods A telephone semi-structured interview study with 18 researchers with experience of undertaking the trial and/or the qualitative research. Results Interviewees described the added value of qualitative research for the...

  6. Sham Acupressure Controls Used in Randomized Controlled Trials: A Systematic Review and Critique.

    Directory of Open Access Journals (Sweden)

    Jing-Yu Tan

    Full Text Available To explore the commonly utilized sham acupressure procedures in existing acupressure trials, and to assess whether different types of sham interventions yield different therapeutic outcomes, and, as far as possible, to identify directions for the future development of an adequate sham acupressure method.Randomized controlled trials comparing true acupressure with sham interventions were included. Thirteen electronic databases were adopted to locate relevant studies from inception to July 3, 2014. Meanwhile, eight Chinese journals on complementary and alternative medicine were manually searched to locate eligible articles. In addition, eligible studies listed in the reference lists of the included papers and other related systematic reviews on acupressure were also screened to further search any potentially eligible trials. Methodological quality of the included studies was evaluated using the risk of bias assessment tool developed by the Cochrane Back Review Group. Descriptive analysis was adopted to summarize the therapeutic outcomes.Sixty-six studies with 7265 participants were included. Methodological quality of the included trials was generally satisfactory. Six types of sham acupressure approaches were identified and "non-acupoint" stimulation was the most frequently utilized sham point while an acupressure device was the most commonly used approach for administering sham treatments. Acupressure therapy was a beneficial approach in managing a variety of health problems and the therapeutic effect was found to be more effective in the true acupressure groups than that in the sham comparative groups. No clear association could be identified between different sham acupressure modalities and the reported treatment outcomes.A great diversity of sham acupressure controls have been used in clinical practice and research. A solid conclusion whether different sham alternatives are related to different treatment outcomes cannot be derived because of

  7. Complementary feeding: a Global Network cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Pasha Omrana

    2011-01-01

    Full Text Available Abstract Background Inadequate and inappropriate complementary feeding are major factors contributing to excess morbidity and mortality in young children in low resource settings. Animal source foods in particular are cited as essential to achieve micronutrient requirements. The efficacy of the recommendation for regular meat consumption, however, has not been systematically evaluated. Methods/Design A cluster randomized efficacy trial was designed to test the hypothesis that 12 months of daily intake of beef added as a complementary food would result in greater linear growth velocity than a micronutrient fortified equi-caloric rice-soy cereal supplement. The study is being conducted in 4 sites of the Global Network for Women's and Children's Health Research located in Guatemala, Pakistan, Democratic Republic of the Congo (DRC and Zambia in communities with toddler stunting rates of at least 20%. Five clusters per country were randomized to each of the food arms, with 30 infants in each cluster. The daily meat or cereal supplement was delivered to the home by community coordinators, starting when the infants were 6 months of age and continuing through 18 months. All participating mothers received nutrition education messages to enhance complementary feeding practices delivered by study coordinators and through posters at the local health center. Outcome measures, obtained at 6, 9, 12, and 18 months by a separate assessment team, included anthropometry; dietary variety and diversity scores; biomarkers of iron, zinc and Vitamin B12 status (18 months; neurocognitive development (12 and 18 months; and incidence of infectious morbidity throughout the trial. The trial was supervised by a trial steering committee, and an independent data monitoring committee provided oversight for the safety and conduct of the trial. Discussion Findings from this trial will test the efficacy of daily intake of meat commencing at age 6 months and, if beneficial, will

  8. Maximising the value of combining qualitative research and randomised controlled trials in health research: the QUAlitative Research in Trials (QUART) study--a mixed methods study.

    Science.gov (United States)

    O'Cathain, Alicia; Thomas, Kate J; Drabble, Sarah J; Rudolph, Anne; Goode, Jackie; Hewison, Jenny

    2014-06-01

    Researchers sometimes undertake qualitative research with randomised controlled trials (RCTs) of health interventions. To systematically explore how qualitative research is being used with trials and identify ways of maximising its value to the trial aim of providing evidence of effectiveness of health interventions. A sequential mixed methods study with four components. (1) Database search of peer-reviewed journals between January 2008 and September 2010 for articles reporting the qualitative research undertaken with specific trials, (2) systematic search of database of registered trials to identify studies combining qualitative research and trials, (3) survey of 200 lead investigators of trials with no apparent qualitative research and (4) semistructured telephone interviews with 18 researchers purposively sampled from the first three methods. Qualitative research was undertaken with at least 12% of trials. A large number of articles reporting qualitative research undertaken with trials (n=296) were published between 2008 and 2010. A total of 28% (82/296) of articles reported qualitative research undertaken at the pre-trial stage and around one-quarter concerned drugs or devices. The articles focused on 22 aspects of the trial within five broad categories. Some focused on more than one aspect of the trial, totalling 356 examples. The qualitative research focused on the intervention being trialled (71%, 254/356), the design and conduct of the trial (15%, 54/356), the outcomes of the trial (1%, 5/356), the measures used in the trial (3%, 10/356), and the health condition in the trial (9%, 33/356). The potential value of the qualitative research to the trial endeavour included improving the external validity of trials and facilitating interpretation of trial findings. This value could be maximised by using qualitative research more at the pre-trial stage and reporting findings with explicit attention to the implications for the trial endeavour. During interviews

  9. Blinding in randomized control trials: the enigma unraveled.

    Directory of Open Access Journals (Sweden)

    Vartika Saxena

    2016-03-01

    Full Text Available The search for new treatments and testing of new ideas begins in the laboratory and then established in clinical research settings. Studies addressing the same therapeutic problem may produce conflicting results hence Randomised Clinical Trial is regarded as the most valid method for assessing the benefits and harms of healthcare interventions. The next challenge face by the medical community is the validity of such trials as theses tend to deviate from the truth because of various biases. For the avoidance of the same it has been suggested that the validity or quality of primary trials should be assessed under blind conditions. Thus blinding, is a crucial method for reducing bias in randomized clinical trials. Blinding can be defined as withholding information about the assigned interventions from people involved in the trial who may potentially be prejudiced by this knowledge. In this article we make an effort to define blinding, explain its chronology, hierarchy and discuss methods of blinding, its assessment, its possibility, un-blinding and finally the latest guidelines.

  10. DeLLITE Depression in late life: an intervention trial of exercise. Design and recruitment of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Keeling Sally

    2008-05-01

    Full Text Available Abstract Background Physical activity shows potential in combating the poor outcomes associated with depression in older people. Meta-analyses show gaps in the research with poor trial design compromising certainty in conclusions and few programmes showing sustained effects. Methods/design The Depression in Late Life: an Intervention Trial of Exercise (DeLLITE is a 12 month randomised controlled trial of a physical activity intervention to increase functional status in people aged 75 years and older with depressive symptoms. The intervention involves an individualised activity programme based on goal setting and progression of difficulty of activities delivered by a trained nurse during 8 home visits over 6 months. The control group received time matched home visits to discuss social contacts and networks. Baseline, 6 and 12 months measures were assessed in face to face visits with the primary outcome being functional status (SPPB, NEADL. Secondary outcomes include depressive symptoms (Geriatric Depression Scale, quality of life (SF-36, physical activity (AHS Physical Activity Questionnaire and falls (self report. Discussion Due to report in 2008 the DeLLITE study has recruited 70% of those eligible and tests the efficacy of a home based, goal setting physical activity programme in improving function, mood and quality of life in older people with depressive symptomatology. If successful in improving function and mood this trial could prove for the first time that there are long term health benefit of physical activity, independent of social activity, in this high risk group who consume excess health related costs. Trial registration Australian and New Zealand Clinical Trials Register ACTRN12605000475640

  11. Reporting of positive results in randomized controlled trials of mindfulness-based mental health interventions

    NARCIS (Netherlands)

    Coronado-Montoya, S.; Levis, A.W.; Kwakkenbos, C.M.C.; Steele, R.J.; Turner, E.H.; Thombs, B.D.

    2016-01-01

    Background A large proportion of mindfulness-based therapy trials report statistically significant results, even in the context of very low statistical power. The objective of the present study was to characterize the reporting of "positive" results in randomized controlled trials of mindfulness-bas

  12. Maximising the impact of qualitative research in feasibility studies for randomised controlled trials: guidance for researchers

    NARCIS (Netherlands)

    O’Cathain, A.; Hoddinott, P.; Lewin, S.; Thomas, K.J.; Young, B.; Adamson, J.; Jansen, J.F.M.; Mills, N.; Moore, G.; Donovan, J.L.

    2015-01-01

    Feasibility studies are increasingly undertaken in preparation for randomised controlled trials in order to explore uncertainties and enable trialists to optimise the intervention or the conduct of the trial. Qualitative research can be used to examine and address key uncertainties prior to a full t

  13. Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial.

    LENUS (Irish Health Repository)

    Carney, John

    2010-10-01

    The transversus abdominis plane (TAP) block provides effective postoperative analgesia in adults undergoing major abdominal surgery. Its efficacy in children remains unclear, with no randomized clinical trials in this population. In this study, we evaluated its analgesic efficacy over the first 48 postoperative hours after appendectomy performed through an open abdominal incision, in a randomized, controlled, double-blind clinical trial.

  14. Effects of Pre-Trial Response Requirements on Self-Control Choices by Rats and Pigeons

    Science.gov (United States)

    Mazur, James E.

    2012-01-01

    Parallel experiments with rats and pigeons examined whether the size of a pre-trial ratio requirement would affect choices in a self-control situation. In different conditions, either 1 response or 40 responses were required before each trial. In the first half of each experiment, an adjusting-ratio schedule was used, in which subjects could…

  15. Survey and Practice of Reporting Quality of Randomized Controlled Clinical Trials on Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    LI Ting-qian; MAO Bing; WANG Gang; CHANG Jing; WANG Lei

    2008-01-01

    @@ Evidence obtained from randomized controlled trials (RCTs) has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully understand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner.

  16. Trial History Effects in Stroop Task Performance Are Independent of Top-Down Control

    NARCIS (Netherlands)

    Lorist, Monicque M.; Jolij, Jacob

    2012-01-01

    In this study we sought to elucidate what mechanisms underlie the effects of trial history on information processing. We explicitly focused on the contribution of conflict control and S-R binding to sequential trial effects. Performance and brain activity were measured during two hours of continuous

  17. Covariate Adjustment Strategy Increases Power in the Randomized Controlled Trial With Discrete-Time Survival Endpoints

    Science.gov (United States)

    Safarkhani, Maryam; Moerbeek, Mirjam

    2013-01-01

    In a randomized controlled trial, a decision needs to be made about the total number of subjects for adequate statistical power. One way to increase the power of a trial is by including a predictive covariate in the model. In this article, the effects of various covariate adjustment strategies on increasing the power is studied for discrete-time…

  18. The Paracetamol (Acetaminophen) In Stroke (PAIS) trial : a multicentre, randomised, placebo-controlled, phase III trial

    NARCIS (Netherlands)

    den Hertog, Heleen M.; van der Worp, H. Bart; van Gemert, H. Maarten A.; Algra, Ate; Kappelle, L. Jaap; Van Gijn, Jan; Koudstaal, Peter J.; Dippel, Diederik W. J.

    2009-01-01

    Background High body temperature in the first 12-24 h after stroke onset is associated with poor functional outcome. The Paracetamol (Acetaminophen) In Stroke (PAIS) trial aimed to assess whether early treatment with paracetamol improves functional outcome in patients with acute stroke by reducing b

  19. The talking card: Randomized controlled trial of a novel audio-recording tool for asthma control.

    Science.gov (United States)

    Cowden, John D; Wilkerson-Amendell, Sharon; Weathers, Laura; Gonzalez, Emma D; Dinakar, Chitra; Westbrook, David H; Williams, Arthur R

    2015-01-01

    Asthma care plans typically include complicated written instructions. Customized, audio-recorded instructions may bridge health literacy gaps and improve treatment plan understanding. To measure the effects of a recordable greeting card-style tool (Talking Card) on asthma control and parental care of children with asthma. Multisite randomized trial in two primary care clinics, including children 4-11 years old with uncontrolled asthma and their parents. Parent-child dyads were randomized to usual care of asthma or usual care plus the Talking Card. Dyads completed three asthma-focused visits over 3 months. At the visit, card recipients received customized instructions recorded by the pediatrician onto an audio chip in the card. Asthma control was measured by using the Childhood Asthma Control Test. Card use and parental satisfaction were measured by parental survey (card arm only). Outcomes were analyzed by using generalized estimating equations and frequency distributions. Sixty-four dyads participated and attended 166 clinic visits. Card use was associated with a 1.6-point increase in Childhood Asthma Control Test score (p = 0.02) and a clinic visit regardless of card use with a three-point increase (p asthma. The Talking Card, a novel audio communication tool, was associated with improved asthma control and deemed highly desirable by parents and children struggling to control asthma. This inexpensive portable tool may be useful in other chronic disorders and in locales with low literacy and poor access to digital technology.

  20. Spectroscopic constraints on Pluto's coupled surface and atmosphere: context for the New Horizons encounter

    Science.gov (United States)

    Young, Eliot F.

    2017-01-01

    Pluto's bright surface is a direct result of the transport of volatiles on seasonal timescales. Over the course of a Pluto year (248 years), nitrogen, CO and methane frosts migrate over different parts of Pluto's surface. Pluto's atmosphere is predominantly N2 gas, supported by the vapor pressure of nitrogen frost -- the most volatile of Pluto's surface constituents. New Horizons obtained spectral image cubes of Pluto's surface in the 2 - 2.5 µm range, where N2, CO, CH4 and other frosts have diagnostic features. Some of the surprising results from New Horizons were the inhomogeneity of N2 frost distribution (why is there "Tombaugh Regio," a concentration of bright N2 frost?) and CH4 frost features on certain topographic locations. Given that the vapor pressure of N2 frost is about five orders of magnitude higher than that of CH4 at a given temperature, one might expect Pluto's seasonal warming and cooling cycles to act as a massive distillery and separate N2 and CH4 frosts. Ground-based spectroscopy from Keck using NIRSPEC extends our spectroscopy of Pluto to the 2.8 - 3.5 µm range, beyond New Horizon's limit. We see that the 3.3 µm band of methane frost is nearly zero, ruling out any N2 frost on Pluto that does not have CH4 frost mixed in. Furthermore, the edge of the 3.3 µm feature is diagnostic of pure CH4 ice vs. CH4 that is mixed in an N2 matrix. The mixed state of N2 and CH4 ices, a surprise given their drastically different vapor pressures, has changed the paradigm of how Pluto's surface frosts and atmosphere are coupled. In particular, Keck spectra help us extend the snapshot of the New Horizons flyby to models of volatile transport that span an entire Pluto orbit. Certain scenarios are prohibited, such as the case where Pluto's atmosphere freezes out during aphelion. Some of the lessons learned for Pluto's seasonal atmospheric behavior can be applied to other frost-covered TNOs in highly eccentric orbits, like Eris or Makemake.

  1. The Fate of Debris in the Pluto-Charon System

    Science.gov (United States)

    Smullen, Rachel A.; Kratter, Kaitlin M.

    2017-01-01

    The Pluto-Charon system has come into sharper focus following the fly by of New Horizons. We use N-body simulations to probe the unique dynamical history of this binary dwarf planet system. We follow the evolution of the debris disc that might have formed during the Charon-forming giant impact. First, we note that in-situ formation of the four circumbinary moons is extremely difficult if Charon undergoes eccentric tidal evolution. We track collisions of disc debris with Charon, estimating that hundreds to hundreds of thousands of visible craters might arise from 0.3-5 km radius bodies. New Horizons data suggesting a dearth of these small craters may place constraints on the disc properties. While tidal heating will erase some of the cratering history, both tidal and radiogenic heating may also make it possible to differentiate disc debris craters from Kuiper belt object craters. We also track the debris ejected from the Pluto-Charon system into the Solar System; while most of this debris is ultimately lost from the Solar System, a few tens of 10-30 km radius bodies could survive as a Pluto-Charon collisional family. Most are plutinos in the 3:2 resonance with Neptune, while a small number populate nearby resonances. We show that migration of the giant planets early in the Solar System's history would not destroy this collisional family. Finally, we suggest that identification of such a family would likely need to be based on composition as they show minimal clustering in relevant orbital parameters.

  2. The fate of debris in the Pluto-Charon system

    Science.gov (United States)

    Smullen, Rachel A.; Kratter, Kaitlin M.

    2017-04-01

    The Pluto-Charon system has come into sharper focus following the flyby of New Horizons. We use N-body simulations to probe the unique dynamical history of this binary dwarf planet system. We follow the evolution of the debris disc that might have formed during the Charon-forming giant impact. First, we note that in situ formation of the four circumbinary moons is extremely difficult if Charon undergoes eccentric tidal evolution. We track collisions of disc debris with Charon, estimating that hundreds to hundreds of thousands of visible craters might arise from 0.3-5 km radius bodies. New Horizons data suggesting a dearth of these small craters may place constraints on the disc properties. While tidal heating will erase some of the cratering history, both tidal and radiogenic heating may also make it possible to differentiate disc debris craters from Kuiper belt object craters. We also track the debris ejected from the Pluto-Charon system into the Solar system; while most of this debris is ultimately lost from the Solar system, a few tens of 10-30 km radius bodies could survive as a Pluto-Charon collisional family. Most are plutinos in the 3:2 resonance with Neptune, while a small number populate nearby resonances. We show that migration of the giant planets early in the Solar system's history would not destroy this collisional family. Finally, we suggest that identification of such a family would likely need to be based on composition as they show minimal clustering in relevant orbital parameters.

  3. Beyond Randomized Controlled Trials in Attempted Suicide Research

    Science.gov (United States)

    Hatcher, Simon; Sharon, Cynthia; Coggan, Carol

    2009-01-01

    There is a lack of evidence about what is the best treatment for people who present to hospital after self harm. Most treatment trials have been small and involved unrepresentative groups of patients which result in inconclusive findings. Here we note some of the characteristics of attempted suicide which make it a difficult subject to study. We…

  4. Beyond Randomized Controlled Trials in Attempted Suicide Research

    Science.gov (United States)

    Hatcher, Simon; Sharon, Cynthia; Coggan, Carol

    2009-01-01

    There is a lack of evidence about what is the best treatment for people who present to hospital after self harm. Most treatment trials have been small and involved unrepresentative groups of patients which result in inconclusive findings. Here we note some of the characteristics of attempted suicide which make it a difficult subject to study. We…

  5. Randomized controlled trials in frontotemporal dementia: cognitive and behavioral outcomes

    OpenAIRE

    Justin B. Miller; Banks, Sarah J.; Léger, Gabriel C; Cummings, Jeffrey L.

    2014-01-01

    Progress has been made in understanding the genetics and molecular biology of frontotemporal dementia (FTD). Targets for intervention have been identified, therapies are being developed, and clinical trials are advancing. A major challenge for FTD research is that multiple underlying pathologies can be associated with heterogeneous phenotypes. The neuropsychological profiles associated with FTD spectrum disorders often include executive dysfunction, language impairments and behavioral disturb...

  6. Can user testing of a clinical trial patient information sheet make it fit-for-purpose? - a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Silcock Jonathan

    2011-07-01

    Full Text Available Abstract Background The participant information sheet (PIS provided to potential trial participants is a critical part of the process of valid consent. However, there is long-standing concern that these lengthy and complex documents are not fit-for-purpose. This has been supported recently through the application of a performance-based approach to testing and improving readability called user testing. This method is now widely used to improve patient medicine leaflets - determining whether people can find and understand key facts. This study applied for the first time a controlled design to determine whether a PIS developed through user testing had improved readability over the original, using a sheet from a UK trial in acute myeloid leukemia (AML16. Methods In the first phase the performance of the original PIS was tested on people in the target group for the trial. There were three rounds of testing including 50 people in total - with the information revised according to its performance after each of the first 2 rounds. In the second phase, the revised PIS was compared with the original in a parallel groups randomised controlled trial (RCT A total of 123 participants were recruited and randomly allocated to read one version of the PIS to find and show understanding of 21 key facts. Results The first, developmental phase produced a revised PIS significantly altered in its wording and layout. In the second, trial phase 66% of participants who read the revised PIS were able to show understanding of all aspects of the trial, compared with 15% of those reading the original version (Odds Ratio 11.2; Chi-square = 31.5 p p Conclusions The original PIS for the AML16 trial may not have enabled valid consent. Combining performance-based user testing with expertise in writing for patients and information design led to a significantly improved and preferred information sheet. User testing is an efficient method for indicating strengths and weaknesses in

  7. Numerical simulations of thin accretion discs with PLUTO

    CERN Document Server

    Parthasarathy, Varadarajan

    2014-01-01

    Our goal is to perform global simulations of thin accretion discs around compact bodies like neutron stars with dipolar magnetic profile and black holes by exploiting the facilities provided by state-of-the-art grid-based, high resolution shock capturing (HRSC) and finite volume codes. We have used the Godunov-type code PLUTO to simulate a thin disc around a compact object prescribed with a pseudo-Newtonian potential in a purely hydrodynamical (HD) regime, with numerical viscosity as a first step towards achieving our goal as mentioned above.

  8. Earth, Meet Pluto: The New Horizons Education and Communications Partnership

    Science.gov (United States)

    Buckley, M.

    2015-12-01

    The unique partnership between the NASA New Horizons education/communications and public affairs programs tapped into the excitement of visiting an unexplored planet in a new region of the solar system - resulting in unprecedented public participation in and coverage of a planetary mission. With a range of hands-on learning experiences, Web materials and online , the program provided opportunities for students, educators, museums, science centers, the media, Web surfers and other members of the public to ride along on the first mission to Pluto and the Kuiper Belt. The programs leveraged resources, materials and expertise to address a wide range of traditional and nontraditional audiences while providing consistent messages and information on this historic NASA endeavor. The E/C program included a variety of formal lesson plans and learning materials — based on New Horizons science and engineering goals, and aligned with National Research Council's National Science Education Standards — that continue to help students in grades K-12 learn more about science, technology, engineering and mathematics. College students designed and built an actual flight instrument on New Horizons and held internships with the spacecraft integration and test team. New Horizons E/C programs went well beyond the classroom, from a chance for people to send their names to Pluto on board the New Horizons spacecraft before launch, to opportunities for the public to access milestone events and the first-ever close-up views of Pluto in places such as museums, science centers and libraries, TV and the Web — as well as thousands who attended interactive "Plutopalooza" road shows across the country. Teamed with E/C was the public affairs strategy to communicate New Horizons news and messages to media, mission stakeholders, the scientific community and the public. These messages include various aspects of New Horizons, including the progress of the mission and key milestones and achievements

  9. Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial.

    Science.gov (United States)

    Oakeshott, Pippa; Kerry, Sally; Aghaizu, Adamma; Atherton, Helen; Hay, Sima; Taylor-Robinson, David; Simms, Ian; Hay, Phillip

    2010-04-08

    To determine whether screening and treating women for chlamydial infection reduces the incidence of pelvic inflammatory disease over the subsequent 12 months. Randomised controlled trial. Common rooms, lecture theatres, and student bars at universities and further education colleges in London. 2529 sexually active female students, mean age 21 years (range 16-27). Participants completed a questionnaire and provided self taken vaginal swabs, with follow-up after one year. Samples were randomly allocated to immediate testing and treatment for chlamydial infection, or storage and analysis after a year (deferred screening controls). Incidence of clinical pelvic inflammatory disease over 12 months. Baseline prevalence of chlamydia was 5.4% (68/1254) in screened women and 5.9% (75/1265) in controls. 94% (2377/2529) of women were followed up after 12 months. The incidence of pelvic inflammatory disease was 1.3% (15/1191) in screened women compared with 1.9% (23/1186) in controls (relative risk 0.65, 95% confidence interval 0.34 to 1.22). Seven of 74 control women (9.5%, 95% confidence interval 4.7% to 18.3%) who tested positive for chlamydial infection at baseline developed pelvic inflammatory disease over 12 months compared with one of 63 (1.6%) screened women (relative risk 0.17, 0.03 to 1.01). However, most episodes of pelvic inflammatory disease occurred in women who tested negative for chlamydia at baseline (79%, 30/38). 22% (527/2377) of women reported being tested independently for chlamydia during the trial. Although some evidence suggests that screening for chlamydia reduces rates of pelvic inflammatory disease, especially in women with chlamydial infection at baseline, the effectiveness of a single chlamydia test in preventing pelvic inflammatory disease over 12 months may have been overestimated. Trial registration ClinicalTrials.gov NCT00115388.

  10. Randomized controlled trials in relapsed/refractory follicular lymphoma: a systematic review and meta-analysis.

    Science.gov (United States)

    Police, Rachel L; Trask, Peter C; Wang, Jianmin; Olivares, Robert; Khan, Shahnaz; Abbe, Adeline; Colosia, Ann; Njue, Annete; Sherril, Beth; Ruiz-Soto, Rodrigo; Kaye, James A; Hamadani, Mehdi

    2016-10-01

    This systematic literature review evaluated the clinical efficacy and safety of interventions used in relapsed/refractory follicular lymphoma. Primary efficacy outcomes were objective response rate, progression-free survival and overall survival. Safety endpoints were grade 3/4 toxicities, serious adverse events and withdrawals or deaths due to toxicity. Studies were selected if they were randomized controlled trials reporting on the efficacy or safety of treatments for relapsed or refractory follicular lymphoma, and if outcomes were reported separately from trials that included other lymphoid neoplasms. We used the Bucher method for conducting adjusted indirect comparisons within a meta-analysis. We identified 10 randomized controlled trials of treatments for relapsed/refractory follicular lymphoma. The most prominent drug investigated (alone or in combination) was rituximab. Most trials did not report median overall survival. Two trials reported median event-free survival (range, 1.2-23.2 months). Six of ten trials reported objective response rate (range, 9-93%). Meta-analysis showed only one statistically significant result: rituximab + bortezomib yielded a significantly higher objective response rate than rituximab monotherapy (relative risk, 1.28; 95% confidence interval, 1.11-1.47). Otherwise, there were no discernable differences in overall survival or progression-free survival, partly due to insufficient reporting of results in the clinical trials. The relatively small number of randomized controlled trials, few overlapping treatment arms, and variability in the randomized controlled trial features and in the endpoints studied complicate the formal comparison of therapies for relapsed/refractory follicular lymphoma. Additional well-designed randomized controlled trials are needed to fully understand the relative outcomes of older and more recently developed therapies.

  11. Active Video Game Exercise Training Improves the Clinical Control of Asthma in Children: Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Evelim L F D Gomes

    Full Text Available The aim of the present study was to determine whether aerobic exercise involving an active video game system improved asthma control, airway inflammation and exercise capacity in children with moderate to severe asthma.A randomized, controlled, single-blinded clinical trial was carried out. Thirty-six children with moderate to severe asthma were randomly allocated to either a video game group (VGG; N = 20 or a treadmill group (TG; n = 16. Both groups completed an eight-week supervised program with two weekly 40-minute sessions. Pre-training and post-training evaluations involved the Asthma Control Questionnaire, exhaled nitric oxide levels (FeNO, maximum exercise testing (Bruce protocol and lung function.No differences between the VGG and TG were found at the baseline. Improvements occurred in both groups with regard to asthma control and exercise capacity. Moreover, a significant reduction in FeNO was found in the VGG (p < 0.05. Although the mean energy expenditure at rest and during exercise training was similar for both groups, the maximum energy expenditure was higher in the VGG.The present findings strongly suggest that aerobic training promoted by an active video game had a positive impact on children with asthma in terms of clinical control, improvement in their exercise capacity and a reduction in pulmonary inflammation.Clinicaltrials.gov NCT01438294.

  12. International collaborative trials, placebo controls and The Declaration of Helsinki: need for clarification in paragraph 32.

    Science.gov (United States)

    Malik, A Y; Ghafoor, F

    2012-01-01

    Inequities in socio-economic and healthcare systems between developed and developing countries have been thrown into sharp relief by globalisation. At the same time, pharmaceutical companies have started conducting clinical trials in developing countries in order to reduce their costs substantially. Together, these two developments create ethical challenges for sponsors and researchers of these trials. One such challenge is that of placebo-controlled trials (PCTs). In this paper we analyse Paragraph 32 of the Declaration of Helsinki referring to PCTs, identifying ambiguities in the wording, and then examine three arguments presented by sponsors of PCTs in developing countries, in defence of such trials. These arguments are: (i) a placebo control provides a definitive answer, and is therefore methodologically superior; (ii) placebo-controlled trials are ethical because they serve the principle of utility, and (iii) interpreting the "best current proven intervention" as the local standard of care allows PCTs to be conducted, if the local standard of care is "no treatment". We argue that PCTs are not methodologically superior; nor are they ethically defensible. Other trial designs conforming to the ethics of research are feasible; the reason for conducting PCTs is expediency. We further propose that, given the global applicability of the Declaration of Helsinki, it is imperative to remove the ambiguities in Paragraph 32. In the context of collaborative trials, when a treatment exists, conducting PCTs is ethically unacceptable, irrespective of the geographic location of the trial. Universal standards ought to be applied universally.

  13. Using Guasha to treat musculoskeletal pain: A systematic review of controlled clinical trials

    Directory of Open Access Journals (Sweden)

    Choi Sun-Mi

    2010-01-01

    Full Text Available Abstract Background Guasha is a therapeutic method for pain management using tools to scrape or rub the surface of the body to relieve blood stagnation. This study aims to systematically review the controlled clinical trials on the effectiveness of using Guasha to treat musculoskeletal pain. Methods We searched 11 databases (without language restrictions: MEDLINE, Allied and Complementary Medicine (AMED, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL, Korean Studies Information (KSI, DBPIA, Korea Institute of Science and Technology Information (KISTI, KoreaMed, Research Information Service System (RISS, China National Knowledge Infrastructure (CNKI and the Cochrane Library. The search strategy was Guasha (OR scraping AND pain. Risk of bias was assessed with the Cochrane criteria (i.e. sequence generation, blinding, incomplete outcome measures and allocation concealment. Results Five randomized controlled trials (RCTs and two controlled clinical trials (CCTs were included in the present study. Two RCTs compared Guasha with acupuncture in terms of effectiveness, while the other trials compared Guasha with no treatment (1 trial, acupuncture (4 trials, herbal injection (1 trial and massage or electric current therapy (1 trial. While two RCTs suggested favorable effects of Guasha on pain reduction and response rate, the quality of these RCTs was poor. One CCT reported beneficial effects of Guasha on musculoskeletal pain but had low methodological quality. Conclusion Current evidence is insufficient to show that Guasha is effective in pain management. Further RCTs are warranted and methodological quality should be improved.

  14. The Nordic Aortic Valve Intervention (NOTION trial comparing transcatheter versus surgical valve implantation: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Thyregod Hans Gustav

    2013-01-01

    Full Text Available Abstract Background Degenerative aortic valve (AV stenosis is the most prevalent heart valve disease in the western world. Surgical aortic valve replacement (SAVR has until recently been the standard of treatment for patients with severe AV stenosis. Whether transcatheter aortic valve implantation (TAVI can be offered with improved safety and similar effectiveness in a population including low-risk patients has yet to be examined in a randomised setting. Methods/Design This randomised clinical trial will evaluate the benefits and risks of TAVI using the transarterial CoreValve System (Medtronic Inc., Minneapolis, MN, USA (intervention group compared with SAVR (control group in patients with severe degenerative AV stenosis. Randomisation ratio is 1:1, enrolling a total of 280 patients aged 70 years or older without significant coronary artery disease and with a low, moderate, or high surgical risk profile. Trial outcomes include a primary composite outcome of myocardial infarction, stroke, or all-cause mortality within the first year after intervention (expected rates 5% for TAVI, 15% for SAVR. Exploratory safety outcomes include procedure complications, valve re-intervention, and cardiovascular death, as well as cardiac, cerebral, pulmonary, renal, and vascular complications. Exploratory efficacy outcomes include New York Heart Association functional status, quality of life, and valve prosthesis and cardiac performance. Enrolment began in December 2009, and 269 patients have been enrolled up to December 2012. Discussion The trial is designed to evaluate the performance of TAVI in comparison with SAVR. The trial results may influence the choice of treatment modality for patients with severe degenerative AV stenosis. Trial registration ClinicalTrials.gov: NCT01057173

  15. Physical activity as an aid to smoking cessation during pregnancy (LEAP trial: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ussher Michael

    2012-10-01

    Full Text Available Abstract Background Many women try to stop smoking in pregnancy but fail. One difficulty is that there is insufficient evidence that medications for smoking cessation are effective and safe in pregnancy and thus many women prefer to avoid these. Physical activity (PA interventions may assist cessation; however, trials examining these interventions have been too small to detect or exclude plausible beneficial effects. The London Exercise And Pregnant smokers (LEAP trial is investigating whether a PA intervention is effective and cost-effective when used for smoking cessation by pregnant women, and will be the largest study of its kind to date. Methods/design The LEAP study is a pragmatic, multi-center, two-arm, randomized, controlled trial that will target pregnant women who smoke at least one cigarette a day (and at least five cigarettes a day before pregnancy, and are between 10 and 24 weeks pregnant. Eligible patients are individually randomized to either usual care (that is, behavioral support for smoking cessation or usual care plus a intervention (entailing supervised exercise on a treadmill plus PA consultations. The primary outcome of the trial is self-reported and biochemically validated continuous abstinence from smoking between a specified quit date and the end of pregnancy. The secondary outcomes, measured at 1 and 4 weeks after the quit date, and at the end of pregnancy and 6 months after childbirth, are PA levels, depression, self-confidence, and cigarette withdrawal symptoms. Smoking status will also be self-reported at 6 months after childbirth. In addition, perinatal measures will be collected, including antenatal complications, duration of labor, mode of delivery, and birth and placental weight. Outcomes will be analyzed on an intention-to-treat basis, and logistic regression models used to compare treatment effects on the primary outcome. Discussion This trial will assess whether a PA intervention is effective when used for

  16. Systematic care for caregivers of patients with dementia: a multicenter, cluster-randomized, controlled trial

    NARCIS (Netherlands)

    Spijker, A.; Wollersheim, H.C.H.; Teerenstra, S.; Graff, M.J.L.; Adang, E.M.M.; Verhey, F.; Vernooij-Dassen, M.J.F.J.

    2011-01-01

    OBJECTIVE: To evaluate the effectiveness of the Systematic Care Program for Dementia (SCPD) on patient institutionalization and to determine the predictors of institutionalization. DESIGN: Single-blind, multicenter, cluster-randomized, controlled trial. SETTING: Six community mental health services

  17. Screening and brief intervention targeting risky drinkers in Danish general practice - a pragmatic controlled trial

    DEFF Research Database (Denmark)

    Beich, A.; Gannik, D.; Saelan, H.;

    2007-01-01

    AIMS: Recommendations for routine alcohol screening and brief counselling intervention in primary health care rest on results from intervention efficacy studies. By conducting a pragmatic controlled trial (PCT), we aimed at evaluating the effectiveness of the WHO recommendations for screening...

  18. Promotion of physical activity and fitness in sedentary patients with Parkinson's disease : randomised controlled trial

    NARCIS (Netherlands)

    van Nimwegen, Marlies; Speelman, Arlene D.; Overeem, Sebastiaan; van de Warrenburg, Bart P.; Smulders, Katrijn; Dontje, Manon L.; Borm, George F.; Backx, Frank J. G.; Bloem, Bastiaan R.; Munneke, Marten

    2013-01-01

    Objective To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson's disease. Design Multicentre randomised controlled trial. Setting 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). Parti

  19. Promotion of physical activity and fitness in sedentary patients with Parkinson's disease : randomised controlled trial

    NARCIS (Netherlands)

    van Nimwegen, Marlies; Speelman, Arlene D.; Overeem, Sebastiaan; van de Warrenburg, Bart P.; Smulders, Katrijn; Dontje, Manon L.; Borm, George F.; Backx, Frank J. G.; Bloem, Bastiaan R.; Munneke, Marten

    2013-01-01

    Objective To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson's disease. Design Multicentre randomised controlled trial. Setting 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). Parti

  20. Evaluation of occupational health interventions using a randomized controlled trial: challenges and alternative research designs

    NARCIS (Netherlands)

    Schelvis, R.M; Oude Hengel, K.M.; Burdorf, A.; Blatter, B.M.; Strijk, J.E.; Beek, A.J. van

    2015-01-01

    Occupational health researchers regularly conduct evaluative intervention research for which a randomized controlled trial (RCT) may not be the most appropriate design (eg, effects of policy measures, organizational interventions on work schedules). This article demonstrates the appropriateness of a

  1. [Effects of a stepwise approach to behavioural problems in dementia: a cluster randomised controlled trial

    NARCIS (Netherlands)

    Pieper, M.J.; Francke, A.L.; Steen, J.T. van der; Scherder, E.J.; Twisk, J.W.R.; Kovach, C.R.; Achterberg, W.P.

    2016-01-01

    OBJECTIVE: To investigate whether implementation of a stepwise multidisciplinary intervention ('STA OP!' ['STAND UP!']) is effective in reducing behavioural problems and depressive symptoms in nursing home residents with advanced dementia. DESIGN: Cluster randomised controlled trial. METHOD: We

  2. Representation of people with intellectual disabilities in randomised controlled trials on antipsychotic treatment for behavioural problems

    NARCIS (Netherlands)

    Scheifes, A.; Stolker, J.J.; Nijman, H.L.I.; Egberts, A.C.G.; Heerdink, E.R.

    2011-01-01

    Background Behavioural problems are common in people with intellectual disability (ID) and are often treated with antipsychotics. Aim To establish the frequency and characteristics of people with ID included in randomised controlled trials (RCTs) on antipsychotic treatment for behavioural problems

  3. Structured risk assessment and violence in acute psychiatric wards: randomised controlled trial

    National Research Council Canada - National Science Library

    Abderhalden, Christoph; Needham, Ian; Dassen, Theo; Halfens, Ruud; Haug, Hans-Joachim; Fischer, Joachim E

    2008-01-01

    .... To assess whether such risk assessments decrease the incidence of violence and coercion. A cluster randomised controlled trial was conducted with 14 acute psychiatric admission wards as the units of randomisation, including a preference arm...

  4. Cognitive behavioral therapy for insomnia in euthymic bipolar disorder: study protocol for a randomized controlled trial

    National Research Council Canada - National Science Library

    Steinan, Mette Kvisten; Krane-Gartiser, Karoline; Langsrud, Knut; Sand, Trond; Kallestad, Håvard; Morken, Gunnar

    2014-01-01

    .... In this randomized controlled trial, we wish to compare CBT-I and treatment as usual with treatment as usual alone to determine its effect in improving quality of sleep, stabilizing minor mood...

  5. Controlled clinical trial of selective decontamination for the treatment of severe acute pancreatitis

    NARCIS (Netherlands)

    E.J.T. Luiten (Ernest); W.C.J. Hop (Wim); J.F. Lange (Johan); H.A. Bruining (Hajo)

    1995-01-01

    textabstractOBJECTIVE: A randomized, controlled, multicenter trial was undertaken in 102 patients with objective evidence of severe acute pancreatitis to evaluate whether selective decontamination reduces mortality. SUMMARY BACKGROUND DATA: Secondary pancreatic infectio

  6. Augmented cognitive behavioral therapy for poststroke depressive symptoms: A randomized controlled trial

    NARCIS (Netherlands)

    Kootker, J.A.; Rasquin, S.M.C.; Lem, F.C.; Heugten, C.M. van; Fasotti, L.; Geurts, A.C.H.

    2017-01-01

    OBJECTIVE: To evaluate the effectiveness of individually tailored cognitive behavioral therapy (CBT) for reducing depressive symptoms with or without anxiety poststroke. DESIGN: Multicenter, assessor-blinded, randomized controlled trial. SETTING: Ambulatory rehabilitation setting. PARTICIPANTS:

  7. Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi

    National Research Council Canada - National Science Library

    Pitchford, Nicola J

    2015-01-01

    .... This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi...

  8. Whole Animal Experiments Should Be More Like Human Randomized Controlled Trials

    OpenAIRE

    2013-01-01

    The quality of reporting of animal studies lags behind that of human randomized controlled trials but a series of additions to the ARRIVE guidelines will help ensure that the standards are comparable.

  9. Rizatriptan vs. ibuprofen in migraine: a randomised placebo-controlled trial

    OpenAIRE

    Misra, Usha Kant; Kalita, Jayantee; Yadav, Rama Kant

    2007-01-01

    The objective of this study was to compare the efficacy of rizatriptan and ibuprofen in migraine. The study was a randomised placebo-controlled trial in a tertiary care teaching hospital. Migraine patients with

  10. Supervised exercise therapy versus usual care for patellofemoral pain syndrome : an open label randomised controlled trial

    NARCIS (Netherlands)

    van Linschoten, R.; van Middelkoop, M.; Berger, M. Y.; Heintjes, E. M.; Verhaar, J. A. N.; Willemsen, S. P.; Koes, B. W.; Bierma-Zeinstra, S. M.

    2009-01-01

    Objective To assess the effectiveness of supervised exercise therapy compared with usual care with respect to recovery, pain, and function in patients with patellofemoral pain syndrome. Design Open label randomised controlled trial. Setting General practice and sport physician practice. Participants

  11. Supervised exercise therapy versus usual care for patellofemoral pain syndrome : an open label randomised controlled trial

    NARCIS (Netherlands)

    van Linschoten, R.; van Middelkoop, M.; Berger, M. Y.; Heintjes, E. M.; Verhaar, J. A. N.; Willemsen, S. P.; Koes, B. W.; Bierma-Zeinstra, S. M.

    2009-01-01

    Objective To assess the effectiveness of supervised exercise therapy compared with usual care with respect to recovery, pain, and function in patients with patellofemoral pain syndrome. Design Open label randomised controlled trial. Setting General practice and sport physician practice. Participants

  12. Augmented cognitive behavioral therapy for post stroke depressive symptoms : a randomized controlled trial

    NARCIS (Netherlands)

    Kootker, Joyce A; Rasquin, Sascha Mc; Lem, Frederik C; van Heugten, Caroline M; Fasotti, Luciano; Geurts, Alexander C

    2016-01-01

    OBJECTIVE: To evaluate the effectiveness of individually tailored cognitive behavioral therapy (CBT) for reducing depressive symptoms with or without anxiety post stroke. DESIGN: Multi-center, assessor-blinded, randomized controlled trial. SETTING: Six ambulatory rehabilitation settings in The Nethe

  13. Yoga for persistent fatigue in breast cancer survivors: a randomized controlled trial

    National Research Council Canada - National Science Library

    Bower, Julienne E; Garet, Deborah; Sternlieb, Beth; Ganz, Patricia A; Irwin, Michael R; Olmstead, Richard; Greendale, Gail

    2012-01-01

    .... The authors conducted a 2-group randomized controlled trial to determine the feasibility and efficacy of an Iyengar yoga intervention for breast cancer survivors with persistent post-treatment fatigue...

  14. Arthrocentesis as initial treatment for temporomandibular joint arthropathy : A randomized controlled trial

    NARCIS (Netherlands)

    Vos, L. M.; Huddleston Slater, J. J. R.; Stegenga, B.

    2014-01-01

    Objective: To determine the effectiveness of arthrocentesis compared to conservative treatment as initial treatment with regard to temporomandibular joint pain and mandibular movement. Patients and methods: In this randomized controlled trial, 80 patients with arthralgia of the TMJ (classified accor

  15. Randomized controlled trial of the Pentax AWS, Glidescope, and Macintosh laryngoscopes in predicted difficult intubation.

    LENUS (Irish Health Repository)

    Malik, M A

    2009-11-01

    The purpose of this study was to determine the potential for the Pentax AWS and the Glidescope to reduce the difficulty of tracheal intubation in patients at increased risk for difficult tracheal intubation, in a randomized, controlled clinical trial.

  16. International Conference on Harmonisation; choice of control group and related issues in clinical trials; availability. Notice.

    Science.gov (United States)

    2001-05-14

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "E10 Choice of Control Group and Related Issues in Clinical Trials." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance sets forth general principles that are relevant to all controlled trials and are especially pertinent to the major clinical trials intended to demonstrate drug (including biological drug) efficacy. The guidance describes the principal types of control groups and discusses their appropriateness in particular situations. The guidance is intended to assist sponsors and investigators in the choice of control groups for clinical trials.

  17. Sodium Restriction in Patients With CKD : A Randomized Controlled Trial of Self-management Support

    NARCIS (Netherlands)

    Meuleman, Yvette; Hoekstra, Tiny; Dekker, Friedo W.; Navis, Gerjan; Vogt, Liffert; van der Boog, Paul J. M.; Bos, Willem Jan W.; van Montfrans, Gert A.; van Dijk, Sandra

    Background: To evaluate the effectiveness and sustainability of self-managed sodium restriction in patients with chronic kidney disease. Study Design: Open randomized controlled trial. Setting & Participants: Patients with moderately decreased kidney function from 4 hospitals in the Netherlands.

  18. Controlled clinical trial of selective decontamination for the treatment of severe acute pancreatitis

    NARCIS (Netherlands)

    E.J.T. Luiten (Ernest); W.C.J. Hop (Wim); J.F. Lange (Johan); H.A. Bruining (Hajo)

    1995-01-01

    textabstractOBJECTIVE: A randomized, controlled, multicenter trial was undertaken in 102 patients with objective evidence of severe acute pancreatitis to evaluate whether selective decontamination reduces mortality. SUMMARY BACKGROUND DATA: Secondary pancreatic

  19. The challenge of recruiting patients into a placebo-controlled surgical trial

    DEFF Research Database (Denmark)

    Hare, Kristoffer B; Lohmander, L Stefan; Roos, Ewa M.

    2014-01-01

    patient into the RCT, 11.9 individuals needed to be screened. A total of 69% of participating patients considered the oral information to be the most important and the most common reason for participating was the contribution to research (90%). CONCLUSIONS: Patients are willing to participate...... in an orthopedic placebo-controlled surgical trial. Oral information given by the surgeon to the patient and the contribution to research are important aspects to enhance patient recruitment. TRIAL REGISTRATION: ClinicalTrials.gov NCT01264991, registered 21 December 2010....... component only adds to this complexity. The purpose of this study was to report the challenges of recruiting patients into an orthopedic placebo-controlled surgical trial, to determine the number of patients needed to be screened and allocated in order to include one participant into the trial...

  20. Acupuncture for Posttraumatic Stress Disorder: A Systematic Review of Randomized Controlled Trials and Prospective Clinical Trials

    OpenAIRE

    Young-Dae Kim; In Heo; Byung-Cheul Shin; Cindy Crawford; Hyung-Won Kang; Jung-Hwa Lim

    2013-01-01

    To evaluate the current evidence for effectiveness of acupuncture for posttraumatic stress disorder (PTSD) in the form of a systematic review, a systematic literature search was conducted in 23 electronic databases. Grey literature was also searched. The key search terms were “acupuncture” and “PTSD.” No language restrictions were imposed. We included all randomized or prospective clinical trials that evaluated acupuncture and its variants against a waitlist, sham acupuncture, conventional th...

  1. The Charon-forming giant impact as a source of Pluto's dark equatorial regions

    Science.gov (United States)

    Sekine, Yasuhito; Genda, Hidenori; Kamata, Shunichi; Funatsu, Taro

    2017-01-01

    Pluto exhibits complex regional diversity in its surface materials 1,2 . One of the most striking features is the dark reddish material, possibly organic matter, along Pluto's equator coexisting with the H2O-rich crust 2 . Little is known, however, about the surface process responsible for the dark equatorial regions. Here, we propose that Pluto's dark regions were formed through reactions in elongated pools of liquid water near the equator, generated by the giant impact that formed Charon 3-5 . Our laboratory experiments show that dark reddish organic matter, comparable to Pluto's dark materials, is produced through polymerization of simple organic compounds 6,7 that would have been present in proto-Pluto (for example, formaldehyde) by prolonged heating at temperatures ≥50 °C. Through hydrodynamic impact simulations, we demonstrate that an impactor, one-third the mass of Pluto, colliding with proto-Pluto—with an interior potential temperature of 150-200 K—could have generated both a Charon-sized satellite and high-temperature regions around Pluto's equator. We also propose that high-velocity giant impacts result in global or hemispherical darkening and reddening, suggesting that the colour variety of large Kuiper belt objects 8-12 could have been caused by frequent, stochastic giant impacts in a massive outer protoplanetary disk in the early Solar System 13-16 .

  2. Multi-fluid MHD study of the solar wind interaction with Pluto

    Science.gov (United States)

    Dong, C.; Ma, Y.; McComas, D. J.; Bhattacharjee, A.; Zirnstein, E.; Toth, G.; Luhmann, J. G.; Wang, L.

    2016-12-01

    The study of the solar wind interaction with Pluto's upper atmosphere has triggered a great of interest in recent years. The Solar Wind Around Pluto (SWAP) instrument onboard New Horizon (NH) spacecraft has provided a wealth of detailed and quantitative information about Pluto and its interaction with the tenuous solar wind out at 33 AU. The SWAP data reveals Pluto's unique interaction with the solar wind as a hybrid of comet-like and the Venus/Mars-like interactions. While SWAP data has provided many of the key results, a lot of details are still missing merely based on NH flyby observations. In order to further investigate the solar wind-Pluto interaction from a global point of view, we develop a 3-D multi-fluid MHD (MF-MHD) model. The MF-MHD model solves separate continuity, momentum and energy equations for each ion species. We adopt the 1-D modeled neutral atmosphere, which is based on NH observations, as the MF-MHD input. Photoionization, charge exchange and electron impact ionization are all included in the MF-MHD model. We will study the ion escape rate, and Pluto's magnetosphere and heavy ion tail structure. We will also do some data-model comparisons. This work has the potential to improve our understanding of present day Pluto's unique solar wind interaction and thus enhance the science returned from the NH mission.

  3. On the Roles of Escape Erosion and the Relaxation of Craters on Pluto

    CERN Document Server

    Stern, S Alan; Zangari, Amanda

    2014-01-01

    Pluto and its satellites will be the most distant objects ever reconnoitered when NASA's New Horizons spacecraft conducts its intensive flyby of this system in 2015. The size-frequency distribution (SFD) of craters on the surfaces in the Pluto system have long been expected to provide a useful measure of the size distribution of Kuiper Belt Objects (KBOs) down to much smaller size scales than presently observed. However, currently predicted escape rates of Pluto's atmosphere suggest that of order one-half to several kilometers of nitrogen ice has been removed from Pluto's surface over geologic time. Because this range of depths is comparable to or greater than most expected crater depths on Pluto, one might expect that many craters on Pluto's surface may have been removed or degraded by this process, biasing the observed crater SFD relative to the production-function crater SFD. Further, if Pluto's surface volatile layer is comparable to or deeper than crater depths, and if the viscosity of this layer surface...

  4. Isotopic constraints on the source of Pluto's nitrogen and the history of atmospheric escape

    Science.gov (United States)

    Mandt, Kathleen E.; Mousis, Olivier; Luspay-Kuti, Adrienn

    2016-10-01

    The origin and evolution of nitrogen in solar system bodies is an important question for understanding processes that took place during the formation of the planets and solar system bodies. Pluto has an atmosphere that is 99% molecular nitrogen, but it is unclear if this nitrogen is primordial or derived from ammonia in the protosolar nebula. The nitrogen isotope ratio is an important tracer of the origin of nitrogen on solar system bodies, and can be used at Pluto to determine the origin of its nitrogen. After evaluating the potential impact of escape and photochemistry on Pluto's nitrogen isotope ratio (14N/15N), we find that if Pluto's nitrogen originated as N2 the current ratio in Pluto's atmosphere would be greater than 324 while it would be less than 157 if the source of Pluto's nitrogen were NH3. The New Horizons spacecraft successfully visited the Pluto system in July 2015 providing a potential opportunity to measure 14N/15N in N2.

  5. The Puzzling Detection of X-rays From Pluto by Chandra

    CERN Document Server

    Lisse, C M; Wolk, S J; Bagenal, F; Stern, S A; Gladstone, G R; Cravens, T E; Hill, M E; Kollmann, P; Weaver, H A; Strobel, D F; Elliott, H A; McComas, D J; Binzel, R P; Snios, B T; Bhardwaj, A; Chutjian, A; Young, L A; Olkin, C B; Ennico, K A

    2016-01-01

    Using Chandra ACIS-S, we have obtained imaging Xray spectrophotometry of the Pluto system in support of the New Horizons flyby on 14 July 2015. 174 ksec of observations were obtained on 4 visits in Feb 2014 to Aug 2015. We measured a net signal of 6.8 counts and a noise level of 1.2 counts in a comoving 11 x 11 pixel box (100 x 100 R_Pluto) in the 0.31 to 0.60 keV passband for a detection at > 99.95 C.L. The Pluto photons do not match the background spectrum, are coincident with a 90% flux aperture comoving with Pluto, and are not sky source confused. The mean 0.31 to 0.60 keV Xray power from Pluto is 200 MW, in the midrange of Xray power levels seen for known solar system emission sources: auroral precipitation, solar Xray scattering, and charge exchange (CXE) between solar wind (SW) ions & atmospheric neutrals. We eliminate auroral effects as a source, as Pluto has no known magnetic field & the New Horizons Alice UV spectrometer detected no airglow from Pluto during the flyby. Nano-scale atmospheric...

  6. Global Albedos of Pluto and Charon from LORRI New Horizons Observations

    CERN Document Server

    Buratti, B J; Hicks, M D; Weaver, H A; Stern, S A; Momary, T; Mosher, J A; Beyer, R A; Young, L A; Ennico, K; Olkin, C B

    2016-01-01

    The exploration of the Pluto-Charon system by the New Horizons spacecraft represent the first opportunity to understand the distribution of albedo and other photometric properties of the surfaces of objects in the Solar System's "Third Zone" within the context of a geologic world. Images of the entire illuminated surface of Pluto and Charon obtained by the Long Range Reconnaissance Imager (LORRI) camera provide a global map of Pluto that revealed surface albedo variegations larger than any other world except for Saturn's moon Iapetus. Normal reflectances on Pluto range from 0.08-1.0. Charon exhibits a much blander surface with normal reflectances ranging from 0.20-0.73. Pluto's albedo features are well-correlated with geologic features, although some exogenous low-albedo dust may be responsible for features seen to the west of the area informally named Tombaugh Regio. The albedo patterns of both Pluto and Charon are latitudinally organized, with the exception of Tombaugh Regio. The low-albedo areas of Pluto a...

  7. Pluto's interaction with its space environment: Solar wind, energetic particles, and dust.

    Science.gov (United States)

    Bagenal, F; Horányi, M; McComas, D J; McNutt, R L; Elliott, H A; Hill, M E; Brown, L E; Delamere, P A; Kollmann, P; Krimigis, S M; Kusterer, M; Lisse, C M; Mitchell, D G; Piquette, M; Poppe, A R; Strobel, D F; Szalay, J R; Valek, P; Vandegriff, J; Weidner, S; Zirnstein, E J; Stern, S A; Ennico, K; Olkin, C B; Weaver, H A; Young, L A

    2016-03-18

    The New Horizons spacecraft carried three instruments that measured the space environment near Pluto as it flew by on 14 July 2015. The Solar Wind Around Pluto (SWAP) instrument revealed an interaction region confined sunward of Pluto to within about 6 Pluto radii. The region's surprisingly small size is consistent with a reduced atmospheric escape rate, as well as a particularly high solar wind flux. Observations from the Pluto Energetic Particle Spectrometer Science Investigation (PEPSSI) instrument suggest that ions are accelerated and/or deflected around Pluto. In the wake of the interaction region, PEPSSI observed suprathermal particle fluxes equal to about 1/10 of the flux in the interplanetary medium and increasing with distance downstream. The Venetia Burney Student Dust Counter, which measures grains with radii larger than 1.4 micrometers, detected one candidate impact in ±5 days around New Horizons' closest approach, indicating an upper limit of <4.6 kilometers(-3) for the dust density in the Pluto system.

  8. Open versus laparoscopically-assisted oesophagectomy for cancer: a multicentre randomised controlled phase III trial - the MIRO trial

    Directory of Open Access Journals (Sweden)

    Msika Simon

    2011-07-01

    Full Text Available Abstract Background Open transthoracic oesophagectomy is the standard treatment for infracarinal resectable oesophageal carcinomas, although it is associated with high mortality and morbidity rates of 2 to 10% and 30 to 50%, respectively, for both the abdominal and thoracic approaches. The worldwide popularity of laparoscopic techniques is based on promising results, including lower postoperative morbidity rates, which are related to the reduced postoperative trauma. We hypothesise that the laparoscopic abdominal approach (laparoscopic gastric mobilisation in oesophageal cancer surgery will decrease the major postoperative complication rate due to the reduced surgical trauma. Methods/Design The MIRO trial is an open, controlled, prospective, randomised multicentre phase III trial. Patients in study arm A will receive laparoscopic-assisted oesophagectomy, i.e., a transthoracic oesophagectomy with two-field lymphadenectomy and laparoscopic gastric mobilisation. Patients in study arm B will receive the same procedure, but with the conventional open abdominal approach. The primary objective of the study is to evaluate the major postoperative 30-day morbidity. Secondary objectives are to assess the overall 30-day morbidity, 30-day mortality, 30-day pulmonary morbidity, disease-free survival, overall survival as well as quality of life and to perform medico-economic analysis. A total of 200 patients will be enrolled, and two safety analyses will be performed using 25 and 50 patients included in arm A. Discussion Postoperative morbidity remains high after oesophageal cancer surgery, especially due to major pulmonary complications, which are responsible for 50% of the postoperative deaths. This study represents the first randomised controlled phase III trial to evaluate the benefits of the minimally invasive approach with respect to the postoperative course and oncological outcomes in oesophageal cancer surgery. Trial Registration NCT00937456 (ClinicalTrials.gov

  9. Comparison of Topical Nifedipine With Oral Nifedipine for Treatment of Anal Fissure: A Randomized Controlled Trial

    OpenAIRE

    Golfam, Farzaneh; Golfam, Parisa; Golfam, Babak; Pahlevani, Puyan

    2014-01-01

    Background: Medical sphincterotomy has gained popularity as a treatment for anal fissure. Calcium channel blockers in topical forms could also be appropriate with low adverse effects. Objectives: This was a prospective randomized controlled trial to compare topical and oral nifedipine in the treatment of chronic anal fissure. Patients and Methods: A prospective randomized controlled trial was conducted at two centers of Shahed University. One hundred and thirty patients with chronic anal fiss...

  10. Effect of prenatal DHA supplementation on the infant epigenome: results from a randomized controlled trial

    OpenAIRE

    van Dijk, Susan J.; Zhou, Jing; Peters, Timothy J; Buckley, Michael; Sutcliffe, Brodie; Oytam, Yalchin; Robert A Gibson; McPhee, Andrew; Yelland, Lisa N; Makrides, Maria; Molloy, Peter L.; Beverly S Muhlhausler

    2016-01-01

    Background Evidence is accumulating that nutritional exposures in utero can influence health outcomes in later life. Animal studies and human epidemiological studies have implicated epigenetic modifications as playing a key role in this process, but there are limited data from large well-controlled human intervention trials. This study utilized a large double-blind randomized placebo-controlled trial to test whether a defined nutritional exposure in utero, in this case docosahexaenoic acid (D...

  11. Effect of diclofenac suppository on pain control during flexible cystoscopy-A randomized controlled trial

    Science.gov (United States)

    Nadeem, Mehwash; Ather, M Hammad

    2016-01-01

    TRIAL DESIGN: To compare the difference in pain score during flexible cystoscopy between patients undergoing the procedure with plain lubricating gel  only and plain gel with diclofenac suppository in a randomized control trial. METHODS:  A total of 60 male patients with an indication of flexible cystoscopy were enrolled in a prospective, randomized controlled study. Patients were randomized in two groups. In group “A”, patients received diclofenac suppository one hour prior to the procedure while group “B” did not receive diclofenac suppository. Both groups received 10 ml of intra-urethral  plain gel for lubrication during flexible cystoscopy. Pain score was recorded immediately after the procedure using the visual analogue scale (VAS). Pre- and post-procedure pulse rate and systolic blood pressure was also recorded. Statistical analyses were performed using chi-square test and student t-test. Regression analysis was performed to address the confounding variables. RESULTS: Both groups were comparable for variables including age, duration of procedure, level of operating surgeon and indication of procedure. Most common indication for flexible cystoscopy was removal of double J stent. There was a statistically significant difference in the mean pain score between two groups ( p = 0.012).  The difference in post-procedure mean pulse rate in the two groups was statistically significant ( p= 0.01) however there was no difference observed in mean post procedure systolic blood pressure. Regression analysis showed that none of the confounding variables were significantly affecting pain perception. CONCLUSIONS: Intra rectal diclofenac suppository is simple and effective pre-emptive analgesia. We recommend its routine use during flexible cystoscopy for better pain control. PMID:28299180

  12. Origin of the Pluto-Charon system: Constraints from the New Horizons flyby

    Science.gov (United States)

    McKinnon, William B.; Stern, S. A.; Weaver, H. A.; Nimmo, F.; Bierson, C. J.; Grundy, W. M.; Cook, J. C.; Cruikshank, D. P.; Parker, A. H.; Moore, J. M.; Spencer, J. R.; Young, L. A.; Olkin, C. B.; Ennico Smith, K.

    2017-05-01

    New Horizon's accurate determination of the sizes and densities of Pluto and Charon now permit precise internal models of both bodies to be constructed. Assuming differentiated rock-ice structures, we find that Pluto is close to 2/3 solar-composition anhydrous rock by mass and Charon 3/5 solar-composition anhydrous rock by mass. Pluto and Charon are closer to each other in density than to other large (≳1000-km diameter) Kuiper belt bodies. Despite this, we show that neither the possible presence of an ocean under Pluto's water ice shell (and no ocean within Charon), nor enhanced porosity at depth in Charon's icy crust compared with that of Pluto, are sufficient to make Pluto and Charon's rock mass fractions match. All four small satellites (Styx, Nix, Kerberos, Hydra) appear much icier in comparison with either Pluto or Charon. In terms of a giant impact origin, both these inferences are most consistent with the relatively slow collision of partly differentiated precursor bodies (Canup, Astrophys. J. 141, 35, 2011). This is in turn consistent with dynamical conditions in the ancestral Kuiper belt, but implies that the impact precursors themselves accreted relatively late and slowly (to limit 26Al and accretional heating). The iciness of the small satellites is not consistent with direct formation of the Pluto-Charon system from a streaming instability in the solar nebula followed by prompt collapse of gravitationally bound ;pebble piles,; a proposed formation mechanism for Kuiper belt binaries (Nesvorný et al., Astron. J. 140, 785-793, 2010). Growth of Pluto-scale bodies by accretion of pebbles in the ancestral Kuiper belt is not ruled out, however, and may be needed to prevent the precursor bodies from fully differentiating, due to buried accretional heat, prior to the Charon-forming impact.

  13. Randomized controlled trials for Alzheimer disease and Parkinson disease.

    Science.gov (United States)

    Lauretani, Fulvio; Ticinesi, Andrea; Meschi, Tiziana; Teresi, Giulio; Ceda, Gian Paolo; Maggio, Marcello

    2016-06-01

    The continuous increase in elderly and oldest-old population, and subsequent rise in prevalence of chronic neurological diseases like Alzheimer's disease (AD) and Parkinson's disease (PD), are a major challenge for healthcare systems. These two conditions are the most prevalent neurodegenerative diseases in older persons and physicians should engage treatment for these patients. In this field, Randomized Clinical Trials (RCTs) specifically focused on elderly populations are still lacking. The aim of this study was to identify RCTs conducted among AD and PD and to examine the difference between mean age of enrollment and incidence of these two neurodegenerative diseases. We found that the scenario is different between PD and AD. In particular, the enrollment for PD trials seems to include younger persons than AD, although the incidence of both diseases is similar and highest after 80 years old. The consequence of these results could influence conclusive guidelines of treatment in older parkinsonian patients.

  14. A controlled trial of amitriptyline and cianopramine in major depression.

    Science.gov (United States)

    Mellsop, G W; Burgess, C D; Vijayasenan, M E

    1985-01-01

    The therapeutic efficacy and adverse effects of amitriptyline and cianopramine were compared in a double-blind, randomized, flexible-dose trial in 40 patients with major depressive episodes. The two drugs were equally effective in reducing scores on the Hamilton Psychiatric Rating Scale for Depression and on a global scale. Both drugs were associated with significant adverse effects. Fewer adverse effects were associated with cianopramine, however, which lacks antimuscarinic activity.

  15. Statin tolerability: In defence of placebo-controlled trials

    OpenAIRE

    Tobert, Jonathan A; Newman, Connie B.

    2015-01-01

    Background Statin intolerance is a barrier to effective lipid-lowering treatment. A significant number of patients stop prescribed statins, or can take only a reduced dose, because of adverse events attributed to the statin, and are then considered statin-intolerant. Methods Examination of differences between statin and placebo in withdrawal rates due to adverse events – a good measure of tolerability – in statin cardiovascular outcome trials in patients with advanced disease and complex medi...

  16. Targeting intensive versus conventional glycaemic control for type 1 diabetes mellitus: a systematic review with meta-analyses and trial sequential analyses of randomised clinical trials

    OpenAIRE

    Kähler, Pernille; Grevstad, Berit; Almdal, Thomas; Gluud, Christian; Wetterslev, Jørn; Vaag, Allan; Hemmingsen, Bianca

    2014-01-01

    Objective To assess the benefits and harms of targeting intensive versus conventional glycaemic control in patients with type 1 diabetes mellitus. Design A systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. Data sources The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded and LILACS to January 2013. Study selection Randomised clinical trials that prespecified different targets of glycaemic control in participants at any age with...

  17. Mindfulness Meditation Training and Executive Control Network Resting State Functional Connectivity: A Randomized Controlled Trial.

    Science.gov (United States)

    Taren, Adrienne A; Gianaros, Peter J; Greco, Carol M; Lindsay, Emily K; Fairgrieve, April; Brown, Kirk Warren; Rosen, Rhonda K; Ferris, Jennifer L; Julson, Erica; Marsland, Anna L; Creswell, J David

    Mindfulness meditation training has been previously shown to enhance behavioral measures of executive control (e.g., attention, working memory, cognitive control), but the neural mechanisms underlying these improvements are largely unknown. Here, we test whether mindfulness training interventions foster executive control by strengthening functional connections between dorsolateral prefrontal cortex (dlPFC)-a hub of the executive control network-and frontoparietal regions that coordinate executive function. Thirty-five adults with elevated levels of psychological distress participated in a 3-day randomized controlled trial of intensive mindfulness meditation or relaxation training. Participants completed a resting state functional magnetic resonance imaging scan before and after the intervention. We tested whether mindfulness meditation training increased resting state functional connectivity (rsFC) between dlPFC and frontoparietal control network regions. Left dlPFC showed increased connectivity to the right inferior frontal gyrus (T = 3.74), right middle frontal gyrus (MFG) (T = 3.98), right supplementary eye field (T = 4.29), right parietal cortex (T = 4.44), and left middle temporal gyrus (T = 3.97, all p < .05) after mindfulness training relative to the relaxation control. Right dlPFC showed increased connectivity to right MFG (T = 4.97, p < .05). We report that mindfulness training increases rsFC between dlPFC and dorsal network (superior parietal lobule, supplementary eye field, MFG) and ventral network (right IFG, middle temporal/angular gyrus) regions. These findings extend previous work showing increased functional connectivity among brain regions associated with executive function during active meditation by identifying specific neural circuits in which rsFC is enhanced by a mindfulness intervention in individuals with high levels of psychological distress. Clinicaltrials.gov,NCT01628809.

  18. Canadian Optically-guided approach for Oral Lesions Surgical (COOLS trial: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Poh Catherine F

    2011-10-01

    Full Text Available Abstract Background Oral cancer is a major health problem worldwide. The 5-year survival rate ranges from 30-60%, and has remained unchanged in the past few decades. This is mainly due to late diagnosis and high recurrence of the disease. Of the patients who receive treatment, up to one third suffer from a recurrence or a second primary tumor. It is apparent that one major cause of disease recurrence is clinically unrecognized field changes which extend beyond the visible tumor boundary. We have previously developed an approach using fluorescence visualization (FV technology to improve the recognition of the field at risk surrounding a visible oral cancer that needs to be removed and preliminary results have shown a significant reduction in recurrence rates. Method/Design This paper describes the study design of a randomized, multi-centre, double blind, controlled surgical trial, the COOLS trial. Nine institutions across Canada will recruit a total of 400 patients with oral severe dysplasia or carcinoma in situ (N = 160 and invasive squamous cell carcinoma (N = 240. Patients will be stratified by participating institution and histology grade and randomized equally into FV-guided surgery (experimental arm or white light-guided surgery (control arm. The primary endpoint is a composite of recurrence at or 1 cm within the previous surgery site with 1 the same or higher grade histology compared to the initial diagnosis (i.e., the diagnosis used for randomization; or 2 further treatment due to the presence of severe dysplasia or higher degree of change at follow-up. This is the first randomized, multi-centre trial to validate the effectiveness of the FV-guided surgery. Discussion In this paper we described the strategies, novelty, and challenges of this unique trial involving a surgical approach guided by the FV technology. The success of the trial requires training, coordination, and quality assurance across multiple sites within Canada. The COOLS

  19. Remifentanil patient controlled analgesia versus epidural analgesia in labour. A multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Freeman Liv M

    2012-07-01

    Full Text Available Abstract Background Pain relief during labour is a topic of major interest in the Netherlands. Epidural analgesia is considered to be the most effective method of pain relief and recommended as first choice. However its uptake by pregnant women is limited compared to other western countries, partly as a result of non-availability due to logistic problems. Remifentanil, a synthetic opioid, is very suitable for patient controlled analgesia. Recent studies show that epidural analgesia is superior to remifentanil patient controlled analgesia in terms of pain intensity score; however there was no difference in satisfaction with pain relief between both treatments. Methods/design The proposed study is a multicentre randomized controlled study that assesses the cost-effectiveness of remifentanil patient controlled analgesia compared to epidural analgesia. We hypothesize that remifentanil patient controlled analgesia is as effective in improving pain appreciation scores as epidural analgesia, with lower costs and easier achievement of 24 hours availability of pain relief for women in labour and efficient pain relief for those with a contraindication for epidural analgesia. Eligible women will be informed about the study and randomized before active labour has started. Women will be randomly allocated to a strategy based on epidural analgesia or on remifentanil patient controlled analgesia when they request pain relief during labour. Primary outcome is the pain appreciation score, i.e. satisfaction with pain relief. Secondary outcome parameters are costs, patient satisfaction, pain scores (pain-intensity, mode of delivery and maternal and neonatal side effects. The economic analysis will be performed from a short-term healthcare perspective. For both strategies the cost of perinatal care for mother and child, starting at the onset of labour and ending ten days after delivery, will be registered and compared. Discussion This study, considering cost

  20. Is Pluto a planet? A historical journey through the solar system

    CERN Document Server

    Weintraub, David A

    2007-01-01

    A Note from the Author: On August 24, 2006, at the 26th General Assembly of the International Astronomical Union (IAU) in Prague, by a majority vote of only the 424 members present, the IAU (an organization of over 10,000 members) passed a resolution defining planet in such a way as to exclude Pluto and established a new class of objects in the solar system to be called ""dwarf planets,"" which was deliberately designed to include Pluto. With the discovery of Eris (2003 UB313)--an outer solar system object thought to be both slightly larger than Pluto and twice as far from the Sun--astrono

  1. Possible scenarios that the New Horizons spacecraft may find in its close encounter with Pluto

    CERN Document Server

    Durand-Manterola, Hector Javier

    2015-01-01

    Next year, 2015, the New Horizons spacecraft will have a close encounter with Pluto. In the present study we discuss some possibilities regarding what the spacecraft may encounter during its approach to Pluto. Among them we should include: the presence of geological activity due to heat generated by tides; the unlikely presence of an intrinsic magnetic field; the possibility of a plasmasphere and a plasmapause; the position of an ionopause; the existence of an ionospheric trans-terminator flow similar to that at Venus and Mars; and the presence of a Magnus force that produces a deflection of Pluto plasma wake. This deflection oscillates up and down in its orbit around the sun.

  2. CVF spectrophotometry of Pluto - Correlation of composition with albedo. [Circularly variable filter

    Energy Technology Data Exchange (ETDEWEB)

    Marcialis, R.L.; Lebofsky, L.A. (JPL, Pasadena, CA (USA) Arizona Univ., Tucson (USA))

    1991-02-01

    The present time-resolved, 0.96-2.65-micron spectrophotometry for the Pluto-Charon system indicates night-to-night variations in the depths of the methane absorptions such that the bands' equivalent width is near minimum light. The interpretation of these data in terms of a depletion of methane in dark regions of the planet, relative to bright ones, is consistent with the Buie and Fink (1987) observations. The near-IR spectrum of Pluto seems to be dominated by surface frost. It is suggested that the dark equatorial regions of Pluto are redder than those of moderate albedo. 28 refs.

  3. Escape of Pluto's Atmosphere: In Situ Measurements from New Horizons and Remote Observations from Chandra

    Science.gov (United States)

    McNutt, R. L., Jr.; Hill, M. E.; Kollmann, P.; Krimigis, S. M.; Brown, L. E.; Kusterer, M. B.; Lisse, C. M.; Mitchell, D. G.; Vandegriff, J. D.; McComas, D. J.; Bagenal, F.; Elliott, H. A.; Ennico Smith, K.; Horanyi, M.; Olkin, C.; Piquette, M. R.; Stern, A.; Strobel, D. F.; Szalay, J.; Valek, P. W.; Weaver, H. A., Jr.; Weidner, S.; Young, L. A.; Zirnstein, E.; Wolk, S. J.

    2015-12-01

    The escape rate of Pluto's atmosphere is of significant scientific interest. It is a Group 1 science goal of the New Horizons mission. In addition, a Group 3 science goal of the mission has been to characterize the energetic particle environment of the Pluto system. The Pluto Energetic Particle Spectrometer Science Investigation (PEPSSI) is a compact, energy by time-of-flight (TOF) instrument developed to address both of these science goals. Pluto is known to have an atmosphere, and current models postulate a majority N2 composition with free escape of up to ~1028 molecules/sec. This is very similar to the physical situation of a variety comets observed in the inner heliosphere. However, the gravitational field of Pluto exerts a significant effect on the escaping neutrals, unlike at a comet. The ionization of neutrals emitted from comets results in heavy ions, which are accelerated by the convective solar-wind electric field. The expected major ionization product near Pluto is singly ionized N2 molecules with pickup energies sufficient to be measured with PEPSSI. In the process of measuring the local energetic particle environment, such measurements will also provide constraints on the local density of Pluto's extended atmosphere, which, along with plasma measurements from the Solar Wind Around Pluto (SWAP) instrument also on New Horizons should allow the inference of the strengh and extent of mass-loading of the solar wind due to Pluto's atmosphere. Pluto's neutral atmosphere also provides a source population for charge exchange of highly ionized, minor ions in the solar wind, such as O, C, and N. This process allows these ions to capture one electron and be left in an excited state. That state, in turn decays with the emission of a low-energy (100 eV to 1 keV) X-ray, which can be detected at Earth. Such observations have been made of comets since the X-ray emission discovery in 1996 and used to infer cometary outgassing rates. Similar observatins have been made

  4. CVF spectrophotometry of Pluto - Correlation of composition with albedo. [circularly variable filter

    Science.gov (United States)

    Marcialis, Robert L.; Lebofsky, Larry A.

    1991-01-01

    The present time-resolved, 0.96-2.65-micron spectrophotometry for the Pluto-Charon system indicates night-to-night variations in the depths of the methane absorptions such that the bands' equivalent width is near minimum light. The interpretation of these data in terms of a depletion of methane in dark regions of the planet, relative to bright ones, is consistent with the Buie and Fink (1987) observations. The near-IR spectrum of Pluto seems to be dominated by surface frost. It is suggested that the dark equatorial regions of Pluto are redder than those of moderate albedo.

  5. The Fate of Debris in the Pluto-Charon System

    CERN Document Server

    Smullen, Rachel A

    2016-01-01

    The Pluto-Charon system has come into sharper focus following the fly by of New Horizons. We use N-body simulations to probe the unique dynamical history of this binary dwarf planet system. We follow the evolution of the debris disc that might have formed during the Charon-forming giant impact. First, we note that in-situ formation of the four circumbinary moons is extremely difficult if Charon undergoes eccentric tidal evolution. We track collisions of disc debris with Charon, estimating that hundreds to hundreds of thousands of visible craters might arise from 0.3-5 km radius bodies. New Horizons data suggesting a dearth of these small craters may place constraints on the disc properties. While tidal heating will erase some of the cratering history, both tidal and radiogenic heating may also make it possible to differentiate disc debris craters from Kuiper belt object craters. We also track the debris ejected from the Pluto-Charon system into the Solar System; while most of this debris is ultimately lost fr...

  6. Discovery of carbon monoxide in the upper atmosphere of Pluto

    CERN Document Server

    Greaves, J S; Friberg, P

    2011-01-01

    Pluto's icy surface has changed colour and its atmosphere has swelled since its last closest approach to the Sun in 1989. The thin atmosphere is produced by evaporating ices, and so can also change rapidly, and in particular carbon monoxide should be present as an active thermostat. Here we report the discovery of gaseous CO via the 1.3mm wavelength J=2-1 rotational transition, and find that the line-centre signal is more than twice as bright as a tentative result obtained by Bockelee-Morvan et al. in 2000. Greater surface-ice evaporation over the last decade could explain this, or increased pressure could have caused the atmosphere to expand. The gas must be cold, with a narrow line-width consistent with temperatures around 50 K, as predicted for the very high atmosphere, and the line brightness implies that CO molecules extend up to approximately 3 Pluto radii above the surface. The upper atmosphere must have changed markedly over only a decade since the prior search, and more alterations could occur by the...

  7. Advanced radioisotope power source options for Pluto Express

    Energy Technology Data Exchange (ETDEWEB)

    Underwood, M.L. [California Inst. of Technology, Pasadena, CA (United States). Jet Propulsion Lab.

    1995-12-31

    In the drive to reduce mass and cost, Pluto Express is investigating using an advanced power conversion technology in a small Radioisotope Power Source (RPS) to deliver the required mission power of 74 W(electric) at end of mission. Until this year the baseline power source under consideration has been a Radioisotope Thermoelectric Generator (RTG). This RTG would be a scaled down GPHS RTG with an inventory of 6 General Purpose Heat Sources (GPHS) and a mass of 17.8 kg. High efficiency, advanced technology conversion options are being examined to lower the power source mass and to reduce the amount of radioisotope needed. Three technologies are being considered as the advanced converter technology: the Alkali Metal Thermal-to-Electric Converter (AMTEC), Thermophotovoltaic (TPV) converters, and Stirling Engines. Conceptual designs for each of these options have been prepared. Each converter would require only 2 GPHSs to provide the mission power and would have a mass of 6.1, 7.2, and 12.4 kg for AMTEC, TPV, and Stirling Engines respectively. This paper reviews the status of each technology and the projected performance of an advanced RPS based on each technology. Based on the projected performance and spacecraft integration issues, Pluto Express would prefer to use the AMTEC based RPS. However, in addition to technical performance, selection of a power technology will be based on many other factors.

  8. Hydrocarbon and HCN Condensation in the Atmosphere of Pluto

    Science.gov (United States)

    Fan, S.; Gao, P.; Limpasuvan, D. L.; Willacy, K.; Yung, Y. L.

    2016-12-01

    Observations by the New Horizons spacecraft revealed the presence of haze in the Pluto atmosphere, which have been shown by microphysical models to be likely composed of fractal aggregates originating from CH4 photolysis and subsequent polymerization of higher hydrocarbons. However, temperatures in the Pluto atmosphere are such that higher hydrocarbons, such as C2H2, C2H4, C2H6, as we well as HCN, should condense, possibly onto the fractal aggregate haze particles. This process can change their shape, as well as their optical properties. We use a modified microphysical model to investigate the characteristics of haze particles as C2 hydrocarbons and HCN condense on them during their sedimentation through the atmosphere. The composition of the particles as a function of altitude can in turn inform the interpretation of New Horizons observations. In addition, we use the condensation rates from the microphysics model to augment the photochemical model that calculates the concentrations of C2 hydrocarbons and HCN to ensure self-consistency.

  9. Reorientation of Sputnik Planitia implies a subsurface ocean on Pluto

    Science.gov (United States)

    Nimmo, F.; Hamilton, D. P.; McKinnon, W. B.; Schenk, P. M.; Binzel, R. P.; Bierson, C. J.; Beyer, R. A.; Moore, J. M.; Stern, S. A.; Weaver, H. A.; Olkin, C. B.; Young, L. A.; Smith, K. E.; Moore, J. M.; McKinnon, W. B.; Spencer, J. R.; Beyer, R.; Binzel, R. P.; Buie, M.; Buratti, B.; Cheng, A.; Cruikshank, D.; Ore, C. Dalle; Earle, A.; Gladstone, R.; Grundy, W.; Howard, A. D.; Lauer, T.; Linscott, I.; Nimmo, F.; Parker, J.; Porter, S.; Reitsema, H.; Reuter, D.; Roberts, J. H.; Robbins, S.; Schenk, P. M.; Showalter, M.; Singer, K.; Strobel, D.; Summers, M.; Tyler, L.; White, O. L.; Umurhan, O. M.; Banks, M.; Barnouin, O.; Bray, V.; Carcich, B.; Chaikin, A.; Chavez, C.; Conrad, C.; Hamilton, D. P.; Howett, C.; Hofgartner, J.; Kammer, J.; Lisse, C.; Marcotte, A.; Parker, A.; Retherford, K.; Saina, M.; Runyon, K.; Schindhelm, E.; Stansberry, J.; Steffl, A.; Stryk, T.; Throop, H.; Tsang, C.; Verbiscer, A.; Winters, H.; Zangari, A.; Stern, S. A.; Weaver, H. A.; Olkin, C. B.; Young, L. A.; Smith, K. E.

    2016-12-01

    The deep nitrogen-covered basin on Pluto, informally named Sputnik Planitia, is located very close to the longitude of Pluto’s tidal axis and may be an impact feature, by analogy with other large basins in the Solar System. Reorientation of Sputnik Planitia arising from tidal and rotational torques can explain the basin’s present-day location, but requires the feature to be a positive gravity anomaly, despite its negative topography. Here we argue that if Sputnik Planitia did indeed form as a result of an impact and if Pluto possesses a subsurface ocean, the required positive gravity anomaly would naturally result because of shell thinning and ocean uplift, followed by later modest nitrogen deposition. Without a subsurface ocean, a positive gravity anomaly requires an implausibly thick nitrogen layer (exceeding 40 kilometres). To prolong the lifetime of such a subsurface ocean to the present day and to maintain ocean uplift, a rigid, conductive water-ice shell is required. Because nitrogen deposition is latitude-dependent, nitrogen loading and reorientation may have exhibited complex feedbacks.

  10. Pluto's atmosphere from stellar occultations in 2012 and 2013

    CERN Document Server

    Dias-Oliveira, A; Lellouch, E; Vieira-Martins, R; Assafin, M; Camargo, J I B; Braga-Ribas, F; Gomes-Júnior, A R; Benedetti-Rossi, G; Colas, F; Decock, A; Doressoundiram, A; Dumas, C; Emilio, M; Polleri, J Fabrega; Gil-Hutton, R; Gillon, M; Girard, J; Hau, G; Ivanov, V D; Jehin, E; Lecacheux, J; Leiva, R; Lopez-Sisterna, C; Mancini, L; Maury, A; Meza, E; Morales, N; Nagy, L; Opitom, C; Ortiz, J L; Pollock, J; Roques, F; Snodgrass, C; Soulier, J F; Thirouin, A; Vanzi, L; Widemann, T; Reichart, D E; LaCluyze, A P; Haislip, J B; Ivarsen, K M; Dominik, M; Jørgensen, U; Skottfelt, J

    2015-01-01

    We analyze two multi-chord stellar occultations by Pluto observed on July 18th, 2012 and May 4th, 2013, and monitored respectively from five and six sites. They provide a total of fifteen light-curves, twelve of them being used for a simultaneous fit that uses a unique temperature profile, assuming a clear (no-haze) and pure N_2 atmosphere, but allowing for a possible pressure variation between the two dates. We find a solution that fits satisfactorily (i.e. within the noise level) all the twelve light-curves, providing atmospheric constraints between ~1,190 km (pressure ~ 11 \\mubar) and ~ 1,450 km (pressure ~0.1 \\mubar) from Pluto's center. Our main results are: (1) the best-fitting temperature profile shows a stratosphere with strong positive gradient between 1,190 km (at 36 K, 11 \\mubar) and r = 1,215 km (6.0 \\mubar), where a temperature maximum of 110 K is reached; above it is a mesosphere with negative thermal gradient of -0.2 K/km up to ~ 1,390 km (0.25 \\mubar), where, the mesosphere connects itself to ...

  11. Periodontal treatment to improve glycaemic control in diabetic patients: study protocol of the randomized, controlled DIAPERIO trial

    Directory of Open Access Journals (Sweden)

    Bou Christophe

    2009-08-01

    Full Text Available Abstract Background Periodontitis is a common, chronic inflammatory disease caused by gram-negative bacteria leading to destruction of tissues supporting the teeth. Epidemiological studies have consistently shown increased frequency, extent and severity of periodontitis among diabetic adults. More recently, some controlled clinical trials have also suggested that periodontal treatment could improve glycaemic control in diabetic patients. However current evidence does not provide sufficient information on which to confidently base any clinical recommendations. The main objective of this clinical trial is to assess whether periodontal treatment could lead to a decrease in glycated haemoglobin levels in metabolically unbalanced diabetic patients suffering from chronic periodontitis. Methods The DIAPERIO trial is an open-label, 13-week follow-up, randomized, controlled trial. The total target sample size is planned at 150 participants, with a balanced (1:1 treatment allocation (immediate treatment vs delayed treatment. Periodontal treatment will include full mouth non-surgical scaling and root planing, systemic antibiotherapy, local antiseptics (chlorhexidine 0.12% and oral health instructions. The primary outcome will be the difference in change of HbA1c between the two groups after the 13-weeks' follow-up. Secondary outcomes will be the difference in change of fructosamine levels and quality of life between the two groups. Discussion The DIAPERIO trial will provide insight into the question of whether periodontal treatment could lead to an improvement in glycaemic control in metabolically unbalanced diabetic patients suffering from periodontitis. The results of this trial will help to provide evidence-based recommendations for clinicians and a draft framework for designing national health policies. Trial registration Current Controlled Trials ISRCTN15334496

  12. How do parents experience being asked to enter a child in a randomised controlled trial?

    Directory of Open Access Journals (Sweden)

    Young Bridget

    2009-02-01

    Full Text Available Abstract Background As the number of randomised controlled trials of medicines for children increases, it becomes progressively more important to understand the experiences of parents who are asked to enrol their child in a trial. This paper presents a narrative review of research evidence on parents' experiences of trial recruitment focussing on qualitative research, which allows them to articulate their views in their own words. Discussion Parents want to do their best for their children, and socially and legally their role is to care for and protect them yet the complexities of the medical and research context can challenge their fulfilment of this role. Parents are simultaneously responsible for their child and cherish this role yet they are dependent on others when their child becomes sick. They are keen to exercise responsibility for deciding to enter a child in a trial yet can be fearful of making the 'wrong' decision. They make judgements about the threat of the child's condition as well as the risks of the trial yet their interpretations often differ from those of medical and research experts. Individual pants will experience these and other complexities to a greater or lesser degree depending on their personal experiences and values, the medical situation of their child and the nature of the trial. Interactions at the time of trial recruitment offer scope for negotiating these complexities if practitioners have the flexibility to tailor discussions to the needs and situation of individual parents. In this way, parents may be helped to retain a sense that they have acted as good parents to their child whatever decision they make. Summary Discussing randomised controlled trials and gaining and providing informed consent is challenging. The unique position of parents in giving proxy consent for their child adds to this challenge. Recognition of the complexities parents face in making decisions about trials suggests lines for future

  13. Getting added value from using qualitative research with randomized controlled trials: a qualitative interview study.

    Science.gov (United States)

    O'Cathain, Alicia; Goode, Jackie; Drabble, Sarah J; Thomas, Kate J; Rudolph, Anne; Hewison, Jenny

    2014-06-09

    Qualitative research is undertaken with randomized controlled trials of health interventions. Our aim was to explore the perceptions of researchers with experience of this endeavour to understand the added value of qualitative research to the trial in practice. A telephone semi-structured interview study with 18 researchers with experience of undertaking the trial and/or the qualitative research. Interviewees described the added value of qualitative research for the trial, explaining how it solved problems at the pretrial stage, explained findings, and helped to increase the utility of the evidence generated by the trial. From the interviews, we identified three models of relationship of the qualitative research to the trial. In 'the peripheral' model, the trial was an opportunity to undertake qualitative research, with no intention that it would add value to the trial. In 'the add-on' model, the qualitative researcher understood the potential value of the qualitative research but it was viewed as a separate and complementary endeavour by the trial lead investigator and wider team. Interviewees described how this could limit the value of the qualitative research to the trial. Finally 'the integral' model played out in two ways. In 'integral-in-theory' studies, the lead investigator viewed the qualitative research as essential to the trial. However, in practice the qualitative research was under-resourced relative to the trial, potentially limiting its ability to add value to the trial. In 'integral-in-practice' studies, interviewees described how the qualitative research was planned from the beginning of the study, senior qualitative expertise was on the team from beginning to end, and staff and time were dedicated to the qualitative research. In these studies interviewees described the qualitative research adding value to the trial although this value was not necessarily visible beyond the original research team due to the challenges of publishing this research

  14. WORKBENCH FOR CONTROL SYSTEMS TRIALS BASED ON VIPA 300 CONTROLLER AND ADVANTECH INPUT/OUTPUT CARD

    Directory of Open Access Journals (Sweden)

    M. V. Levinskyi

    2015-01-01

    Full Text Available The topic is about workbench creation for control systems trials based on VIPA 300 industrial PLC and model of control object which is implemented in MatLab Simulink program on PC. Connection between controller and the PC is provided by the Advantech PCI-1711 input/output card of discrete and analog signals. Object identification,control system synthesis, creation of control device structure and its parametrical identification, as a rule, is done on a PC in a modelling environment, e.g. in MatLab. But often, using this PC modelling, the hardware and software features of algorithms which were obtained during system synthesis are not considered in a specific industrial PLC.It is considered a good idea to use a composite version where obtained algorithms are tested in a real industrial PLC and control object is substituted by a model which is working on a PC in real time scale. In this case software realization of algorithms in a specific PLC are fully taken into account and substitution of real control object by itsmodel considerably reduces the costs for carrying out experiments and allows to study the system behavior when control object parameters and modes of operation vary greatly. The creation of workbench stipulates several stages: configuration and programming of industrial PLC VIPA 313 SC, installation and configuration of Advantech PCI- 1711 input/output card, tuning of Simulink modelling environment for working in real time scale using Real-Time Windows Target Library, testing of workbench by using constant and harmonic signals of different frequencies. Work results of virtual stabilization system are compared with combined version. In virtual stabilization system PID governor and control object are implemented in Simulink. In combined version control object is still implemented in Simulink and PID governor - in VIPA 313 SC controller (using functional block FB58 from Step7 standard library.

  15. A randomized controlled trial of Human Papillomavirus (HPV testing for cervical cancer screening: trial design and preliminary results (HPV FOCAL Trial

    Directory of Open Access Journals (Sweden)

    Smith Laurie W

    2010-03-01

    Full Text Available Abstract Background In the HPV FOCAL trial, we will establish the efficacy of hr-HPV DNA testing as a stand-alone screening test followed by liquid based cytology (LBC triage of hr-HPV-positive women compared to LBC followed by hr-HPV triage with ≥ CIN3 as the outcome. Methods/Design HPV-FOCAL is a randomized, controlled, three-armed study over a four year period conducted in British Columbia. It will recruit 33,000 women aged 25-65 through the province's population based cervical cancer screening program. Control arm: LBC at entry and two years, and combined LBC and hr-HPV at four years among those with initial negative results and hr-HPV triage of ASCUS cases; Two Year Safety Check arm: hr-HPV at entry and LBC at two years in those with initial negative results with LBC triage of hr-HPV positives; Four Year Intervention Arm: hr-HPV at entry and combined hr-HPV and LBC at four years among those with initial negative results with LBC triage of hr-HPV positive cases Discussion To date, 6150 participants have a completed sample and epidemiologic questionnaire. Of the 2019 women enrolled in the control arm, 1908 (94.5% were cytology negative. Women aged 25-29 had the highest rates of HSIL (1.4%. In the safety arm 92.2% of women were hr-HPV negative, with the highest rate of hr-HPV positivity found in 25-29 year old women (23.5%. Similar results were obtained in the intervention arm HPV FOCAL is the first randomized trial in North America to examine hr-HPV testing as the primary screen for cervical cancer within a population-based cervical cancer screening program. Trial Registration International Standard Randomised Controlled Trial Number Register, ISRCTN79347302

  16. A MultiCenter Pilot Randomized Controlled Trial of Remote Ischemic Preconditioning in Major Vascular Surgery.

    Science.gov (United States)

    Healy, D A; Boyle, E; McCartan, D; Bourke, M; Medani, M; Ferguson, J; Yagoub, H; Bashar, K; O'Donnell, M; Newell, J; Canning, C; McMonagle, M; Dowdall, J; Cross, S; O'Daly, S; Manning, B; Fulton, G; Kavanagh, E G; Burke, P; Grace, P A; Moloney, M Clarke; Walsh, S R

    2015-11-01

    A pilot randomized controlled trial that evaluated the effect of remote ischemic preconditioning (RIPC) on clinical outcomes following major vascular surgery was performed. Eligible patients were those scheduled to undergo open abdominal aortic aneurysm repair, endovascular aortic aneurysm repair, carotid endarterectomy, and lower limb revascularization procedures. Patients were randomized to RIPC or to control groups. The primary outcome was a composite clinical end point comprising any of cardiovascular death, myocardial infarction, new-onset arrhythmia, cardiac arrest, congestive cardiac failure, cerebrovascular accident, renal failure requiring renal replacement therapy, mesenteric ischemia, and urgent cardiac revascularization. Secondary outcomes were components of the primary outcome and myocardial injury as assessed by serum troponin values. The primary outcome occurred in 19 (19.2%) of 99 controls and 14 (14.1%) of 99 RIPC group patients (P = .446). There were no significant differences in secondary outcomes. Our trial generated data that will guide future trials. Further trials are urgently needed. © The Author(s) 2015.

  17. Diarrhea and dengue control in rural primary schools in Colombia: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Overgaard Hans J

    2012-10-01

    Full Text Available Abstract Background Diarrheal diseases and dengue fever are major global health problems. Where provision of clean water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal illness, but stored water also provides breeding sites for dengue vector mosquitoes. Poor household water management and sanitation are therefore potential determinants of both diseases. Little is known of the role of stored water for the combined risk of diarrhea and dengue, yet a joint role would be important for developing integrated control and management efforts. Even less is known of the effect of integrating control of these diseases in school settings. The objective of this trial was to investigate whether interventions against diarrhea and dengue will significantly reduce diarrheal disease and dengue entomological risk factors in rural primary schools. Methods/design This is a 2×2 factorial cluster randomized controlled trial. Eligible schools were rural primary schools in La Mesa and Anapoima municipalities, Cundinamarca, Colombia. Eligible pupils were school children in grades 0 to 5. Schools were randomized to one of four study arms: diarrhea interventions (DIA; dengue interventions (DEN; combined diarrhea and dengue interventions (DIADEN; and control (C. Schools were allocated publicly in each municipality (strata at the start of the trial, obviating the need for allocation concealment. The primary outcome for diarrhea is incidence rate of diarrhea in school children and for dengue it is density of adult female Aedes aegypti per school. Approximately 800 pupils from 34 schools were enrolled in the trial with eight schools in the DIA arm, nine in the DEN, eight in the DIADEN, and nine in the control arms. The trial status as of June 2012 was: completed baseline data collections; enrollment, randomization, and allocation of schools. The trial was funded by the Research Council of Norway and the Lazos de

  18. Diarrhea and dengue control in rural primary schools in Colombia: study protocol for a randomized controlled trial

    Science.gov (United States)

    2012-01-01

    Background Diarrheal diseases and dengue fever are major global health problems. Where provision of clean water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal illness, but stored water also provides breeding sites for dengue vector mosquitoes. Poor household water management and sanitation are therefore potential determinants of both diseases. Little is known of the role of stored water for the combined risk of diarrhea and dengue, yet a joint role would be important for developing integrated control and management efforts. Even less is known of the effect of integrating control of these diseases in school settings. The objective of this trial was to investigate whether interventions against diarrhea and dengue will significantly reduce diarrheal disease and dengue entomological risk factors in rural primary schools. Methods/design This is a 2×2 factorial cluster randomized controlled trial. Eligible schools were rural primary schools in La Mesa and Anapoima municipalities, Cundinamarca, Colombia. Eligible pupils were school children in grades 0 to 5. Schools were randomized to one of four study arms: diarrhea interventions (DIA); dengue interventions (DEN); combined diarrhea and dengue interventions (DIADEN); and control (C). Schools were allocated publicly in each municipality (strata) at the start of the trial, obviating the need for allocation concealment. The primary outcome for diarrhea is incidence rate of diarrhea in school children and for dengue it is density of adult female Aedes aegypti per school. Approximately 800 pupils from 34 schools were enrolled in the trial with eight schools in the DIA arm, nine in the DEN, eight in the DIADEN, and nine in the control arms. The trial status as of June 2012 was: completed baseline data collections; enrollment, randomization, and allocation of schools. The trial was funded by the Research Council of Norway and the Lazos de Calandaima Foundation

  19. Maximising the impact of qualitative research in feasibility studies for randomised controlled trials: guidance for researchers.

    Science.gov (United States)

    O'Cathain, Alicia; Hoddinott, Pat; Lewin, Simon; Thomas, Kate J; Young, Bridget; Adamson, Joy; Jansen, Yvonne Jfm; Mills, Nicola; Moore, Graham; Donovan, Jenny L

    2015-01-01

    Feasibility studies are increasingly undertaken in preparation for randomised controlled trials in order to explore uncertainties and enable trialists to optimise the intervention or the conduct of the trial. Qualitative research can be used to examine and address key uncertainties prior to a full trial. We present guidance that researchers, research funders and reviewers may wish to consider when assessing or undertaking qualitative research within feasibility studies for randomised controlled trials. The guidance consists of 16 items within five domains: research questions, data collection, analysis, teamwork and reporting. Appropriate and well conducted qualitative research can make an important contribution to feasibility studies for randomised controlled trials. This guidance may help researchers to consider the full range of contributions that qualitative research can make in relation to their particular trial. The guidance may also help researchers and others to reflect on the utility of such qualitative research in practice, so that trial teams can decide when and how best to use these approaches in future studies.

  20. Headache : The placebo effects in the control groups in randomized clinical trials; An analysis of systematic reviews

    NARCIS (Netherlands)

    de Groot, Femke M.; Voogt-Bode, Annieke; Passchier, Jan; Berger, Marjolein Y.; Koes, Bart W.; Verhagen, Arianne P.

    Objective: The purpose of this study is to describe the effects in the placebo and "no treatment" arms in trials with headache patients. Method: This is a secondary analysis of randomized controlled trials from 8 systematic reviews and selected trials with a "no treatment" or placebo control group.

  1. Collaborative Depression Trial (CADET: multi-centre randomised controlled trial of collaborative care for depression - study protocol

    Directory of Open Access Journals (Sweden)

    Kessler David

    2009-10-01

    Full Text Available Abstract Background Comprising of both organisational and patient level components, collaborative care is a potentially powerful intervention for improving depression treatment in UK primary Care. However, as previous models have been developed and evaluated in the United States, it is necessary to establish the effect of collaborative care in the UK in order to determine whether this innovative treatment model can replicate benefits for patients outside the US. This Phase III trial was preceded by a Phase II patient level RCT, following the MRC Complex Intervention Framework. Methods/Design A multi-centre controlled trial with cluster-randomised allocation of GP practices. GP practices will be randomised to usual care control or to "collaborative care" - a combination of case manager coordinated support and brief psychological treatment, enhanced specialist and GP communication. The primary outcome will be symptoms of depression as assessed by the PHQ-9. Discussion If collaborative care is demonstrated to be effective we will have evidence to enable the NHS to substantially improve the organisation of depressed patients in primary care, and to assist primary care providers to deliver a model of enhanced depression care which is both effective and acceptable to patients. Trial Registration Number ISRCTN32829227

  2. Recommendations on multiple testing adjustment in multi-arm trials with a shared control group.

    Science.gov (United States)

    Howard, Dena R; Brown, Julia M; Todd, Susan; Gregory, Walter M

    2016-09-19

    Multi-arm clinical trials assessing multiple experimental treatments against a shared control group can offer efficiency advantages over independent trials through assessing an increased number of hypotheses. Published opinion is divided on the requirement for multiple testing adjustment to control the family-wise type-I error rate (FWER). The probability of a false positive error in multi-arm trials compared to equivalent independent trials is affected by the correlation between comparisons due to sharing control data. We demonstrate that this correlation in fact leads to a reduction in the FWER, therefore FWER adjustment is not recommended solely due to sharing control data. In contrast, the correlation increases the probability of multiple false positive outcomes across the hypotheses, although standard FWER adjustment methods do not control for this. A stringent critical value adjustment is proposed to maintain equivalent evidence of superiority in two correlated comparisons to that obtained within independent trials. FWER adjustment is only required if there is an increased chance of making a single claim of effectiveness by testing multiple hypotheses, not due to sharing control data. For competing experimental therapies, the correlation between comparisons can be advantageous as it eliminates bias due to the experimental therapies being compared to different control populations.

  3. Blinding Techniques in Randomized Controlled Trials of Laser Therapy: An Overview and Possible Solution

    Directory of Open Access Journals (Sweden)

    Ian Relf

    2008-01-01

    Full Text Available Low-level laser therapy has evidence accumulating about its effectiveness in a variety of medical conditions. We reviewed 51 double blind randomized controlled trials (RCTs of laser treatment. Analysis revealed 58% of trials showed benefit of laser over placebo. However, less than 5% of the trials had addressed beam disguise or allocation concealment in the laser machines used. Many of the trials used blinding methods that rely on staff cooperation and are therefore open to interference or bias. This indicates significant deficiencies in laser trial methodology. We report the development and preliminary testing of a novel laser machine that can blind both patient and operator to treatment allocation without staff participation. The new laser machine combines sealed preset and non-bypassable randomization codes, decoy lights and sound, and a conical perspex tip to overcome laser diode glow detection.

  4. The CHIPS Randomized Controlled Trial (Control of Hypertension in Pregnancy Study)

    Science.gov (United States)

    von Dadelszen, Peter; Singer, Joel; Lee, Terry; Rey, Evelyne; Ross, Susan; Asztalos, Elizabeth; Murphy, Kellie E.; Menzies, Jennifer; Sanchez, Johanna; Gafni, Amiram; Helewa, Michael; Hutton, Eileen; Koren, Gideon; Lee, Shoo K.; Logan, Alexander G.; Ganzevoort, Wessel; Welch, Ross; Thornton, Jim G.; Moutquin, Jean-Marie

    2016-01-01

    To determine whether clinical outcomes differed by occurrence of severe hypertension in the international CHIPS trial (Control of Hypertension in Pregnancy Study), adjusting for the interventions of “less tight” (target diastolic blood pressure [dBP] 100 mm Hg) versus “tight” control (target dBP 85 mm Hg). In this post-hoc analysis of CHIPS data from 987 women with nonsevere nonproteinuric preexisting or gestational hypertension, mixed effects logistic regression was used to compare the following outcomes according to occurrence of severe hypertension, adjusting for allocated group and the influence of baseline factors: CHIPS primary (perinatal loss or high-level neonatal care for >48 hours) and secondary outcomes (serious maternal complications), birth weight <10th percentile, preeclampsia, delivery at <34 or <37 weeks, platelets <100×109/L, elevated liver enzymes with symptoms, maternal length of stay ≥10 days, and maternal readmission before 6 weeks postpartum. Three hundred and thirty-four (34.1%) women in CHIPS developed severe hypertension that was associated with all outcomes examined except for maternal readmission (P=0.20): CHIPS primary outcome, birth weight <10th percentile, preeclampsia, preterm delivery, elevated liver enzymes (all P<0.001), platelets <100×109/L (P=0.006), and prolonged hospital stay (P=0.03). The association between severe hypertension and serious maternal complications was seen only in less tight control (P=0.02). Adjustment for preeclampsia (464, 47.3%) did not negate the relationship between severe hypertension and the CHIPS primary outcome (P<0.001), birth weight <10th percentile (P=0.005), delivery at <37 (P<0.001) or <34 weeks (P<0.001), or elevated liver enzymes with symptoms (P=0.02). Severe hypertension is a risk marker for adverse maternal and perinatal outcomes, independent of BP control or preeclampsia co-occurrence. Clinical Trial Registration— URL: http://pre-empt.cfri.ca/. Unique identifier: ISRCTN

  5. The RESPITE trial: remifentanil intravenously administered patient-controlled analgesia (PCA) versus pethidine intramuscular injection for pain relief in labour: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Wilson, Matthew; MacArthur, Christine; Gao Smith, Fang; Homer, Leanne; Handley, Kelly; Daniels, Jane

    2016-12-12

    The commonest opioid used for pain relief in labour is pethidine (meperidine); however, its effectiveness has long been challenged and the drug has known side effects including maternal sedation, nausea and potential transfer across the placenta to the foetus. Over a third of women receiving pethidine require an epidural due to inadequate pain relief. Epidural analgesia increases the risk of an instrumental vaginal delivery and its associated effects. Therefore, there is a clear need for a safe, effective, alternative analgesic to pethidine. Evidence suggests that remifentanil patient-controlled analgesia (PCA) reduces epidural conversion rates compared to pethidine; however, no trial has yet investigated this as a primary endpoint. We are, therefore, comparing pethidine intramuscular injection to remifentanil PCA in a randomised controlled trial. Women in established labour, requesting systemic opioid pain relief, will be randomised to either intravenously administered remifentanil PCA (interven