WorldWideScience

Sample records for conventional disease-modifying anti-rheumatic

  1. Distribution of Podoplanin in Synovial Tissues in Rheumatoid Arthritis Patients Using Biologic or Conventional Disease-Modifying Anti-Rheumatic Drugs.

    Science.gov (United States)

    Takakubo, Yuya; Oki, Hiroharu; Naganuma, Yasushi; Saski, Kan; Sasaki, Akiko; Tamaki, Yasunobu; Suran, Yang; Konta, Tsuneo; Takagi, Michiaki

    2017-01-01

    Podoplanin (PDPN) mediates tumor cell migration and invasion, which phenomena might also play a role in severe rheumatoid arthritis (RA). Therefore, the precise cellular distribution of PDPN and it's relationships with inflammation was studied in RA treated with biologic disease-modifying anti-rheumatic drugs (DMARD) or conventional DMARDs (cDMARD). PDPN+ cells were immunostained by NZ-1 mAb, and scored (3+; >50%/ area, 2+; 20%- 50%, 1+; 5%-20%, 0: <5%) in synovial tissues from RA treated with biologic DMARDs (BIO, n=20) or cDMARD (n=20) for comparison with osteoarthritis (OA, n=5), followed by cell grading of inflammation and cell-typing. Inflammatory synovitis score was 1.4 in both BIO and cDMARD, compared to only 0.2 in OA. PDPN+ cells were found in the lining layer (BIO 1.6, cDMARD 1.3, OA 0.2) and lymphoid aggregates (BIO 0.6, cDMRD 0.7, OA 0.2), and correlated with RA-inflammation in BIO- and cDMARD-groups in both area (r=0.7/0.9, r=0.6/0.7, respectively p<0.05). PDPN was expressed in CD68+ type A macrophage-like and 5B5+ type B fibroblast-like cells in the lining layer, and in IL- 17+ cells in lymphoid aggregates in RA. PDPN was markedly increased in the immunologically inflamed RA synovitis, which was surgically treated due to BIO- and cDMARD-resistant RA. PDPN may have potential of a new marker of residual arthritis in local joints for inflammation-associated severe RA. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  2. Radiographic outcome in Hispanic early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs

    International Nuclear Information System (INIS)

    Contreras-Yanez, Irazu; Rull-Gabayet, Marina; Vazquez-LaMadrid, Jorge; Pascual-Ramos, Virginia

    2011-01-01

    Objectives: To determine rates of incident erosive disease in early rheumatoid arthritis patients, to identify baseline predictors and to evaluate erosion's impact on patient-reported outcomes. Methods: 82 patients with ≤12 months of disease duration, ≥3 years of follow-up and conventional treatment were included. Consecutive evaluations assessed swollen and tender joint counts, treatment and comorbidity, acute reactant-phase determinations and patient-reported outcomes. Digitized radiographs of the hands and feet were obtained at baseline and yearly thereafter. RA was defined as erosive when at least one unequivocal cortical bone defect was detected. Descriptive statistics and Cox regression analysis were performed. Results: At baseline, 71 of the patients were Female Sign , population median (range) age was of 38.7 (16-78.2) years, 58 patients had antibodies and all the patients had active disease and substantial disability. Follow-up cohort was of 299.3 person-years. At last follow-up (49 ± 13.8 months), 28 patients developed erosions. Erosion's location was the feet, in 12 patients. Incident rates of erosive disease at one, two, three and four years were of 8.1, 12.8, 13.8 and 5.6 per 100 person-years, respectively. Higher C-reactive protein (HR: 1.20, 95%CI: 1.04-1.4, p = 0.01) and positive antibodies (HR: 5.09, 95%CI: 1.08-23.86, p = 0.04) were baseline predictors of incident erosive disease. Erosions had minor impact on patient-reported outcomes. Conclusion: Rheumatoid arthritis patients with antibodies and higher C reactive protein at baseline are at risk for incident erosions which appear most frequently at the feet. Up to 1/3 patients conventionally treated develop incident erosions, which minimally impact function.

  3. Radiographic outcome in Hispanic early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs

    Energy Technology Data Exchange (ETDEWEB)

    Contreras-Yanez, Irazu, E-mail: uzari02@hotmail.com.mx [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Rull-Gabayet, Marina, E-mail: rull.marina@gmail.com [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Vazquez-LaMadrid, Jorge, E-mail: docjvlradiologo@yahoo.com [Department of Radiology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Pascual-Ramos, Virginia, E-mail: virtichu@gmail.com.mx [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico)

    2011-08-15

    Objectives: To determine rates of incident erosive disease in early rheumatoid arthritis patients, to identify baseline predictors and to evaluate erosion's impact on patient-reported outcomes. Methods: 82 patients with {<=}12 months of disease duration, {>=}3 years of follow-up and conventional treatment were included. Consecutive evaluations assessed swollen and tender joint counts, treatment and comorbidity, acute reactant-phase determinations and patient-reported outcomes. Digitized radiographs of the hands and feet were obtained at baseline and yearly thereafter. RA was defined as erosive when at least one unequivocal cortical bone defect was detected. Descriptive statistics and Cox regression analysis were performed. Results: At baseline, 71 of the patients were Female Sign , population median (range) age was of 38.7 (16-78.2) years, 58 patients had antibodies and all the patients had active disease and substantial disability. Follow-up cohort was of 299.3 person-years. At last follow-up (49 {+-} 13.8 months), 28 patients developed erosions. Erosion's location was the feet, in 12 patients. Incident rates of erosive disease at one, two, three and four years were of 8.1, 12.8, 13.8 and 5.6 per 100 person-years, respectively. Higher C-reactive protein (HR: 1.20, 95%CI: 1.04-1.4, p = 0.01) and positive antibodies (HR: 5.09, 95%CI: 1.08-23.86, p = 0.04) were baseline predictors of incident erosive disease. Erosions had minor impact on patient-reported outcomes. Conclusion: Rheumatoid arthritis patients with antibodies and higher C reactive protein at baseline are at risk for incident erosions which appear most frequently at the feet. Up to 1/3 patients conventionally treated develop incident erosions, which minimally impact function.

  4. Tumour necrosis factor inhibitors versus combination intensive therapy with conventional disease modifying anti-rheumatic drugs in established rheumatoid arthritis: TACIT non-inferiority randomised controlled trial.

    Science.gov (United States)

    Scott, David L; Ibrahim, Fowzia; Farewell, Vern; O'Keeffe, Aidan G; Walker, David; Kelly, Clive; Birrell, Fraser; Chakravarty, Kuntal; Maddison, Peter; Heslin, Margaret; Patel, Anita; Kingsley, Gabrielle H

    2015-03-13

    To determine whether intensive combinations of synthetic disease modifying drugs can achieve similar clinical benefits at lower costs to high cost biologics such as tumour necrosis factor inhibitors in patients with active rheumatoid arthritis resistant to initial methotrexate and other synthetic disease modifying drugs. Open label pragmatic randomised multicentre two arm non-inferiority trial over 12 months. 24 rheumatology clinics in England. Patients with rheumatoid arthritis who were eligible for treatment with tumour necrosis factor inhibitors according to current English guidance were randomised to either the tumour necrosis factor inhibitor strategy or the combined disease modifying drug strategy. Biologic strategy: start tumour necrosis factor inhibitor; second biologic in six month for non-responders. Alternative strategy: start combination of disease modifying drugs; start tumour necrosis factor inhibitors after six months in non-responders. reduction in disability at 12 months measured with patient recorded heath assessment questionnaire (range 0.00-3.00) with a 0.22 non-inferiority margin for combination treatment versus the biologic strategy. quality of life, joint damage, disease activity, adverse events, and costs. Intention to treat analysis used multiple imputation methods for missing data. 432 patients were screened: 107 were randomised to tumour necrosis factor inhibitors and 101 started taking; 107 were randomised to the combined drug strategy and 104 started taking the drugs. Initial assessments were similar; 16 patients were lost to follow-up (seven with the tumour necrosis factor inhibitor strategy, nine with the combined drug strategy); 42 discontinued the intervention but were followed-up (19 and 23, respectively). The primary outcome showed mean falls in scores on the health assessment questionnaire of -0.30 with the tumour necrosis factor inhibitor strategy and -0.45 with the alternative combined drug strategy. The difference between

  5. Patients' considerations in the decision-making process of initiating disease-modifying anti-rheumatic drugs

    NARCIS (Netherlands)

    Nota, Ingrid; Drossaert, Constance H.C.; Taal, Erik; van de Laar, Mart A F J

    2015-01-01

    Objectives To explore what considerations patients have when deciding about disease-modifying anti-rheumatic drugs (DMARDs) and what information patients need to participate in the decision-making process. Methods In-depth face-to-face interviews were conducted with 32 inflammatory arthritis

  6. Real-life experience of using conventional disease-modifying anti-rheumatic drugs (DMARDs) in psoriatic arthritis (PsA). Retrospective analysis of the efficacy of methotrexate, sulfasalazine, and leflunomide in PsA in comparison to spondyloarthritides other than PsA and literature review of the use of conventional DMARDs in PsA

    Science.gov (United States)

    Roussou, Euthalia; Bouraoui, Aicha

    2017-01-01

    Objective With the aim of assessing the response to treatment with conventional disease-modifying anti-rheumatic drugs (DMARDs) used in patients with psoriatic arthritis (PsA), data on methotrexate, sulfasalazine (SSZ), and leflunomide were analyzed from baseline and subsequent follow-up (FU) questionnaires completed by patients with either PsA or other spondyloarthritides (SpAs). Material and Methods A single-center real-life retrospective analysis was performed by obtaining clinical data via questionnaires administered before and after treatment. The indices used were erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), wellbeing (WB), and treatment effect (TxE). The indices measured at baseline were compared with those measured on one occasion in a FU visit at least 1 year later. Results A total of 73 patients, 51 with PsA (mean age 49.8±12.8 years; male-to-female ratio [M:F]=18:33) and 22 with other SpAs (mean age 50.6±16 years; M:F=2:20), were studied. BASDAI, BASFI, and WB displayed consistent improvements during FU assessments in both PsA patients and controls in comparison to baseline values. SSZ exhibited better efficacy as confirmed by TxE in both PsA patients and controls. ESR and CRP displayed no differences in either the PsA or the SpA group between the cases before and after treatment. Conclusion Real-life retrospective analysis of three DMARDs used in PsA (and SpAs other than PsA) demonstrated that all three DMARDs that were used brought about improvements in BASDAI, BASFI, TxE, and WB. However, the greatest improvements at FU were seen with SSZ use in both PsA and control cohorts. PMID:28293446

  7. A comparison of discontinuation rates of tofacitinib and biologic disease-modifying anti-rheumatic drugs in rheumatoid arthritis: a systematic review and Bayesian network meta-analysis.

    Science.gov (United States)

    Park, Sun-Kyeong; Lee, Min-Young; Jang, Eun-Jin; Kim, Hye-Lin; Ha, Dong-Mun; Lee, Eui-Kyung

    2017-01-01

    The purpose of this study was to compare the discontinuation rates of tofacitinib and biologics (tumour necrosis factor inhibitors (TNFi), abatacept, rituximab, and tocilizumab) in rheumatoid arthritis (RA) patients considering inadequate responses (IRs) to previous treatment(s). Randomised controlled trials of tofacitinib and biologics - reporting at least one total discontinuation, discontinuation due to lack of efficacy (LOE), and discontinuation due to adverse events (AEs) - were identified through systematic review. The analyses were conducted for patients with IRs to conventional synthetic disease-modifying anti-rheumatic drugs (cDMARDs) and for patients with biologics-IR, separately. Bayesian network meta-analysis was used to estimate rate ratio (RR) of a biologic relative to tofacitinib with 95% credible interval (CrI), and probability of RR being tofacitinib and biologics in the cDMARDs-IR group. In the biologics-IR group, however, TNFi (RR 0.17, 95% CrI 0.01-3.61, P[RRtofacitinib did. Despite the difference, discontinuation cases owing to LOE and AEs revealed that tofacitinib was comparable to the biologics. The comparability of discontinuation rate between tofacitinib and biologics was different based on previous treatments and discontinuation reasons: LOE, AEs, and total (due to other reasons). Therefore, those factors need to be considered to decide the optimal treatment strategy.

  8. Biologics or tofacitinib for rheumatoid arthritis in incomplete responders to methotrexate or other traditional disease-modifying anti-rheumatic drugs

    DEFF Research Database (Denmark)

    Singh, Jasvinder A; Hossain, Alomgir; Tanjong Ghogomu, Elizabeth

    2016-01-01

    , tocilizumab) and small molecule tofacitinib, versus comparator (MTX, DMARD, placebo (PL), or a combination) in adults with rheumatoid arthritis who have failed to respond to methotrexate (MTX) or other disease-modifying anti-rheumatic drugs (DMARDs), i.e., MTX/DMARD incomplete responders (MTX.......78)) were similarly inconclusive and downgraded to low quality for both imprecision and indirectness.Main results text shows the results for tofacitinib and differences between medications. AUTHORS' CONCLUSIONS: Based primarily on RCTs of 6 months' to 12 months' duration, there is moderate quality evidence...

  9. Adverse drug reactions associated with the use of disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Machado-Alba

    2014-12-01

    Full Text Available This study describes the adverse drug reactions (ADRs and their incidence in patients with rheumatoid arthritis who were treated in the Colombian health system. A retrospective cohort study was conducted using information from all patients who were diagnosed with rheumatoid arthritis and attended specialized health care centers in the cities of Bogotá, Cali, Manizales, Medellin, and Pereira between 1 December 2009 and 30 August 2013. The ADRs were obtained from medical records and the pharmacovigilance system registry and sorted by frequency and affected tissue according to World Health Organization Adverse Reaction Terminology (WHO-ART. A total of 949 reports of ADRs were obtained from 419 patients (32.8 ADRs per 100 patient-years; these patients were from a cohort of 1 364 patients being treated for rheumatoid arthritis and followed up for an average of 23.8 months (± 12.9. The cohort was mostly female (366, 87.4% and had a mean age of 52.7 years (± 13.1. The highest numbers of ADRs were reported following the use of tocilizumab, rituximab, and infliximab (28.8, 23.1, and 13.3 reports per 100 patient-years respectively. The most frequently reported ADRs were elevated transaminase levels and dyspepsia. Overall, 87.7% of ADRs were classified as type A, 36.6% as mild, 40.7% as moderate, and 22.7% as severe. As a result, 73.2% of patients who experienced an ADR stopped taking their drugs. The occurrence of ADRs in patients treated for rheumatoid arthritis is common, especially in those associated with the use of biotechnologically produced anti-rheumatic drugs. This outcome should be studied in future research and monitoring is needed to reduce the risks in these patients.

  10. Clinical utility of therapeutic drug monitoring in biological disease modifying anti-rheumatic drug treatment of rheumatic disorders: a systematic narrative review.

    Science.gov (United States)

    Van Herwaarden, Noortje; Van Den Bemt, Bart J F; Wientjes, Maike H M; Kramers, Cornelis; Den Broeder, Alfons A

    2017-08-01

    Biological Disease Modifying Anti-Rheumatic Drugs (bDMARDs) have improved the treatment outcomes of inflammatory rheumatic diseases including Rheumatoid Arthritis and spondyloarthropathies. Inter-individual variation exists in (maintenance of) response to bDMARDs. Therapeutic Drug Monitoring (TDM) of bDMARDs could potentially help in optimizing treatment for the individual patient. Areas covered: Evidence of clinical utility of TDM in bDMARD treatment is reviewed. Different clinical scenarios will be discussed, including: prediction of response after start of treatment, prediction of response to a next bDMARD in case of treatment failure of the first, prediction of successful dose reduction or discontinuation in case of low disease activity, prediction of response to dose-escalation in case of active disease and prediction of response to bDMARD in case of flare in disease activity. Expert opinion: The limited available evidence does often not report important outcomes for diagnostic studies, such as sensitivity and specificity. In most clinical relevant scenarios, predictive value of serum (anti-) drug levels is absent, therefore the use of TDM of bDMARDs cannot be advocated. Well-designed prospective studies should be done to further investigate the promising scenarios to determine the place of TDM in clinical practice.

  11. Disease-modifying anti-rheumatic drug use in pregnant women with rheumatic diseases: a systematic review of the risk of congenital malformations.

    Science.gov (United States)

    Baldwin, Corisande; Avina-Zubieta, Antonio; Rai, Sharan K; Carruthers, Erin; De Vera, Mary A

    2016-01-01

    Despite the high incidence of rheumatic diseases during the reproductive years, little is known about the impact of disease-modifying anti-rheumatic drug (DMARD) use during pregnancy. Our objective was to systematically review and appraise evidence in women with rheumatic disease on the use of traditional and biologic DMARDs during pregnancy and the risk of congenital malformation outcomes. We conducted a systematic search of MEDLINE, EMBASE, and INTERNATIONAL PHARMACEUTICAL ABSTRACTS databases. Inclusion criteria were: 1) study sample including women with rheumatic disease; 2) use of traditional and/or biologic DMARDs during pregnancy; and 3) congenital malformation outcome(s) reported. We extracted information on study design, data source, number of exposed pregnancies, type of DMARD, number of live births, and number of congenital malformations. Altogether, we included 79 studies; the majority were based on designs that did not involve a comparison group, including 26 case reports, 17 case series, 20 cross-sectional studies, and 4 surveys. Studies that had a comparator group included 1 case control, 10 cohort studies, and 1 controlled trial. Hydroxychloroquine and azathioprine represent the most studied traditional DMARD exposures and, among biologics, most of the reports were on infliximab and etanercept. This is the first systematic review on the use of both traditional and biologic DMARDs during pregnancy among women with rheumatic diseases and congenital malformation outcomes, with a focus on study design and quality. Findings confirm the limited number of studies, as well as the need to improve study designs.

  12. Long-Term Outcomes in Puerto Ricans with Rheumatoid Arthritis (RA) Receiving Early Treatment with Disease-Modifying Anti-Rheumatic Drugs using the American College of Rheumatology Definition of Early RA.

    Science.gov (United States)

    Varela-Rosario, Noemí; Arroyo-Ávila, Mariangelí; Fred-Jiménez, Ruth M; Díaz-Correa, Leyda M; Pérez-Ríos, Naydi; Rodríguez, Noelia; Ríos, Grissel; Vilá, Luis M

    2017-01-01

    Early treatment of rheumatoid arthritis (RA) results in better long-term outcomes. However, the optimal therapeutic window has not been clearly established. To determine the clinical outcome of Puerto Ricans with RA receiving early treatment with conventional and/or biologic disease-modifying anti-rheumatic drugs (DMARDs) based on the American College of Rheumatology (ACR) definition of early RA. A cross-sectional study was performed in a cohort of Puerto Ricans with RA. Demographic features, clinical manifestations, disease activity, functional status, and pharmacotherapy were determined. Early treatment was defined as the initiation of DMARDs (conventional and/or biologic) in less than 6 months from the onset of symptoms attributable to RA. Patients who received early (disease duration was 14.9 years and 337 (87.0%) patients were women. One hundred and twenty one (31.3%) patients received early treatment. In the multivariate analysis adjusted for age and sex, early treatment was associated with better functional status, lower probability of joint deformities, intra-articular injections and joint replacement surgeries, and lower scores in the physician's assessments of global health, functional impairment and physical damage of patients. Using the ACR definition of early RA, this group of patients treated with DMARDs within 6 months of disease had better long-term outcomes with less physical damage and functional impairment.

  13. Quantity and economic value of unused oral anti-cancer and biological disease-modifying anti-rheumatic drugs among outpatient pharmacy patients who discontinue therapy.

    Science.gov (United States)

    Bekker, C L; Melis, E J; Egberts, A C G; Bouvy, M L; Gardarsdottir, H; van den Bemt, B J F

    2018-03-24

    Patients sometimes discontinue the use of expensive oral anti-cancer drug (OACD) or biological disease-modifying anti-rheumatic drug (bDMARD) therapies early, leading to medication waste if the patient has not used all dispensed medication. To determine the proportion of patients who have unused OACDs or bDMARDs after therapy discontinuation, and the quantity and economic value of these unused medications. Furthermore, patients' reasons for therapy discontinuation and their disposal method for unused medications were determined. In a retrospective follow-up study using a Dutch outpatient pharmacy database, patients (≥18 years) who did not refill an OACD or bDMARD prescription, dispensed between November 2015 and February 2016, within two weeks of the prescription end date were contacted by phone and asked about their unused medication and reasons thereof. The economic value was calculated using Dutch medication prices. Data were descriptively analyzed in STATA13. The database included 1173 patients, of whom 159 likely had discontinued therapy and were contacted. Of these, 88 patients were excluded (39 refilled, 47 missing, and 2 other). Of the 71 patients who had discontinued therapy, 39 (54.9%) had unused medications, comprising 22 OACD users (mean age 63.0 (SD ± 15.9) years, 50.0% female) and 17 bDMARD users (mean age 50.7 (SD ± 13.5) years, 47.1% female). A total of 59 packages were unused, with a total value of €60,341. Unused OACD packages and bDMARD packages had median values of €179 (IQR €24-2487) and €992 (IQR €681-1093), respectively. Patients primarily discontinued therapy due to adverse or insufficient effects. This study illustrates that more than half of patients discontinuing OACD or bDMARD therapies have unused medication. This emphasizes the need for waste-reducing interventions. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Biologic disease-modifying anti-rheumatic drugs and the risk of non-vertebral osteoporotic fractures in patients with rheumatoid arthritis aged 50 years and over.

    Science.gov (United States)

    Roussy, J-P; Bessette, L; Bernatsky, S; Rahme, E; Lachaine, J

    2013-09-01

    Prevention of bone mineral density loss in rheumatoid arthritis (RA) has been associated with use of biologic disease-modifying anti-rheumatic drugs (DMARDs). However, in this study, we could not demonstrate a reduction in the risk of non-vertebral fractures. Additional research is required to clarify the impact of biologic DMARDs on fracture risk in RA. Small studies have suggested biologic DMARDs preserve bone mineral density at 6-12 months. Our objective was to determine the association between biologic DMARD use and the risk of non-vertebral osteoporotic fractures in RA subjects aged ≥50 years. A nested case-control study was conducted using Quebec physician billing and hospital discharge data. RA subjects were identified from International Classification of Disease-9/10 codes in billing and hospitalisation data and followed from cohort entry until the earliest of non-vertebral osteoporotic fracture, death, or end of study period. Controls were matched to cases (4:1 ratio) on age, sex, and date of cohort entry. Biologic DMARD exposure was defined as being on treatment for ≥180 days pre-fracture (index). Conditional logistic regression was used, adjusting for indicators of RA severity, comorbidity, drugs influencing fracture risk, and measures of health care utilisation. Over the study period, 1,515 cases were identified (6,023 controls). The most frequent fracture site was hip/femur (42.3%). In total, 172 subjects (49 cases and 123 controls) were exposed to biologic DMARDs. The median duration of exposure was 735 (interquartile range (IQR), 564) and 645 (IQR, 903) days in cases and controls, respectively. We were unable to demonstrate an association between biologic DMARDs and fracture risk (odds ratio, 1.03; 95% confidence interval, 0.42-2.53). RA duration significantly increased the fracture risk. Despite the positive impact of biologic DMARDs on bone remodelling observed in small studies, we were unable to demonstrate a reduction in the risk of non

  15. Providing patients with information about disease-modifying anti-rheumatic drugs: Individually or in groups? A pilot randomized controlled trial comparing adherence and satisfaction.

    Science.gov (United States)

    Homer, Dawn; Nightingale, Peter; Jobanputra, Paresh

    2009-06-01

    Communicating information about disease-modifying anti-rheumatic drugs (DMARDs) before patients start treatment is a key role for some rheumatology clinical nurse specialists. This is done in our unit to promote understanding of the risks and benefits of drug therapy and encourage timely and reliable use of DMARDs. Information is routinely provided individually but this can lead to delays in starting treatment because of limited nursing resources. In this randomized trial we tested the feasibility of giving patients, who were about to start on a DMARD, information about the drug in groups and compared this with information given individually. Adults with a clinical diagnosis of rheumatoid arthritis or psoriatic arthritis who were referred to the nursing team for counselling about starting on methotrexate, sulfasalazine or leflunomide were included. Patients who had previously taken a DMARD were not excluded and those consenting were randomized to receive drug information individually or in groups (of three to six patients). We provided all patients with written materials about the relevant drug and discussed the risks and benefits of drug use verbally. Patients allocated to group counselling received this intervention in a teaching room, with a slide presentation. The primary outcome was adherence with medication use, ascertained by pill counts, self-report diaries and prescription dispensation. Secondary outcomes included satisfaction with information about medicines (SIMS) by questionnaire; time taken to provide information; adherence to scheduled hospital appointments and blood monitoring schedules; and DMARD continuation rates at four and twelve months. Of 127 eligible patients referred for counselling about DMARDs, 62 consented to take part: 32 were randomized to receive drug information individually and 30 to receiving it in groups. Patients allocated to the two different interventions were comparable for age and diagnoses at baseline but more patients

  16. Safety and effectiveness of tacrolimus add-on therapy for rheumatoid arthritis patients without an adequate response to biological disease-modifying anti-rheumatic drugs (DMARDs): Post-marketing surveillance in Japan.

    Science.gov (United States)

    Takeuchi, Tsutomu; Ishida, Kota; Shiraki, Katsuhisa; Yoshiyasu, Takashi

    2018-01-01

    Post-marketing surveillance (PMS) was conducted to assess the safety and effectiveness of tacrolimus (TAC) add-on therapy for patients with rheumatoid arthritis (RA) and an inadequate response to biological disease-modifying anti-rheumatic drugs (DMARDs). Patients with RA from 180 medical sites across Japan were registered centrally with an electronic investigation system. The observational period was 24 weeks from the first day of TAC administration concomitantly with biological DMARDs. Safety and effectiveness populations included 624 and 566 patients, respectively. Patients were predominantly female (81.1%), with a mean age of 61.9 years. Overall, 125 adverse drug reactions (ADRs) occurred in 94 patients (15.1%), and 15 serious ADRs occurred in 11 patients (1.8%). These incidences were lower compared with previously reported incidences after TAC treatment in PMS, and all of the observed ADRs were already known. A statistically significant improvement was observed in the primary effectiveness variable of Simplified Disease Activity Index after TAC treatment; 62.7% of patients achieved remission or low disease activity at week 24. TAC is well tolerated and effective when used as an add-on to biological DMARDs in Japanese patients with RA who do not achieve an adequate response to biological DMARDs in a real-world clinical setting.

  17. Long term effectiveness of RA-1, a standardized Ayurvedic medicine as a monotherapy and in combination with disease modifying anti-rheumatic drugs in the treatment of rheumatoid arthritis.

    Science.gov (United States)

    Chopra, Arvind; Saluja, Manjit; Kianifard, Toktam; Chitre, Deepa; Venugopalan, Anuradha

    2018-03-08

    Data on long term use of Ayurvedic drugs is sparse. They may prove useful if combined with modern medicine in certain clinical situations (integrative medicine). We present the results of a long term observational study of RA-1 (Ayurvedic drug) used in the treatment of rheumatoid arthritis (RA). On completion of a 16 week randomized controlled study, 165 consenting volunteer patients were enrolled into a three year open label phase (OLP) study. Patients were symptomatic with persistent active disease and naïve for disease modifying anti-rheumatic drugs (DMARD). 57 patients were on fixed low dose prednisone. Patients were examined every 10-14 weeks in a routine rheumatology practice using standard care norms. They continued RA-1 (Artrex ™, 2 tablets twice daily) throughout the study period and were generally advised to lead a healthy life style. Based on clinical judgment, rheumatologist added DMARD and/or steroids (modified if already in use) to patients with inadequate response; chloroquine and/or methotrexate commonly used. Treatment response was assessed using American College of Rheumatology (ACR) efficacy measures and ACR 20% improvement index standard update statistical software (SAS and SPSS) were used; significant at p Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

  18. Increased baseline RUNX2, caspase 3 and p21 gene expressions in the peripheral blood of disease-modifying anti-rheumatic drug-naïve rheumatoid arthritis patients are associated with improved clinical response to methotrexate therapy.

    Science.gov (United States)

    Tchetina, Elena V; Demidova, Natalia V; Markova, Galina A; Taskina, Elena A; Glukhova, Svetlana I; Karateev, Dmitry E

    2017-10-01

    To investigate the potential of the baseline gene expression in the whole blood of disease-modifying anti-rheumatic drug-naïve rheumatoid arthritis (RA) patients for predicting the response to methotrexate (MTX) treatment. Twenty-six control subjects and 40 RA patients were examined. Clinical, immunological and radiographic parameters were assessed before and after 24 months of follow-up. The gene expressions in the whole blood were measured using real-time reverse transcription polymerase chain reaction. The protein concentrations in peripheral blood mononuclear cells were quantified using enzyme-linked immunosorbent assay. Receiver operating characteristic curve analyses were used to suggest thresholds that were associated with the prediction of the response. Decreases in the disease activity at the end of the study were accompanied by significant increases in joint space narrowing score (JSN). Positive correlations between the expressions of the Unc-51-like kinase 1 (ULK1) and matrix metalloproteinase 9 (MMP-9) genes with the level of C-reactive protein and MMP-9 expression with Disease Activity Score of 28 joints (DAS28) and swollen joint count were noted at baseline. The baseline tumor necrosis factor (TNF)α gene expression was positively correlated with JSN at the end of the follow-up, whereas p21, caspase 3, and runt-related transcription factor (RUNX)2 were correlated with the ΔDAS28 values. Our results suggest that the expressions of MMP-9 and ULK1 might be associated with disease activity. Increased baseline gene expressions of RUNX2, p21 and caspase 3 in the peripheral blood might predict better responses to MTX therapy. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  19. Tofacitinib with conventional synthetic disease-modifying antirheumatic drugs in Chinese patients with rheumatoid arthritis: Patient-reported outcomes from a Phase 3 randomized controlled trial.

    Science.gov (United States)

    Li, Zhanguo; An, Yuan; Su, Houheng; Li, Xiangpei; Xu, Jianhua; Zheng, Yi; Li, Guiye; Kwok, Kenneth; Wang, Lisy; Wu, Qizhe

    2018-02-01

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We assess the effect of tofacitinib + conventional synthetic disease-modifying anti rheumatic drugs (csDMARDs) on patient-reported outcomes in Chinese patients with RA and inadequate response to DMARDs. This analysis of data from the Phase 3 study ORAL Sync included Chinese patients randomized 4 : 4 : 1 : 1 to receive tofacitinib 5 mg twice daily, tofacitinib 10 mg twice daily, placebo→tofacitinib 5 mg twice daily, or placebo→tofacitinib 10 mg twice daily, with csDMARDs. Placebo non-responders switched to tofacitinib at 3 months; the remaining placebo patients switched at 6 months. Least squares mean changes from baseline were reported for Health Assessment Questionnaire-Disability Index (HAQ-DI), patient assessment of arthritis pain (Pain), patient global assessment of disease activity (PtGA), physician global assessment of disease activity (PGA), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scores, Short Form 36 (SF-36), and Work Limitations Questionnaire (WLQ), using a mixed-effects model for repeated measures. Overall, 216 patients were included (tofacitinib 5 mg twice daily, n = 86; tofacitinib 10 mg twice daily, n = 86; placebo→tofacitinib 5 mg twice daily, n = 22; placebo→tofacitinib 10 mg twice daily, n = 22). At month 3, tofacitinib elicited significant improvements in HAQ-DI, Pain, PtGA, PGA and SF-36 Physical Component Summary scores. Improvements were generally maintained through 12 months. Tofacitinib 5 and 10 mg twice daily + csDMARDs resulted in improvements in health-related quality of life, physical function and Pain through 12 months in Chinese patients with RA. © 2018 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  20. Aggressive combination therapy with intra-articular glucocorticoid injections and conventional disease-modifying anti-rheumatic drugs in early rheumatoid arthritis: second-year clinical and radiographic results from the CIMESTRA study

    DEFF Research Database (Denmark)

    Hetland, M.L.; Stengaard-Pedersen, K.; Junker, P.

    2008-01-01

    -articular corticosteroid. This paper presents the results of the second year of the randomised, controlled double-blind CIMESTRA (Ciclosporine, Methotrexate, Steroid in RA) study. METHODS: 160 patients with early RA (duration

  1. A short history of anti-rheumatic therapy - VI. Rheumatoid arthritis drugs

    Directory of Open Access Journals (Sweden)

    G. Pasero

    2011-09-01

    Full Text Available The treatment of rheumatoid arthritis traditionally includes symptomatic drugs, showing a prompt action on pain and infl ammation, but without any infl uence on disease progression, and other drugs that could modify the disease course and occasionally induce clinical remission (DMARDs or disease modifying anti-rheumatic drugs. This review describes the historical steps that led to the use of the main DMARDs in rheumatoid arthritis, such as gold salts, sulphasalazine, chloroquine and hydroxychloroquine, D-penicillamine, and other immunoactive drugs, including methotrexate, azathioprine, cyclosporin and lefl unomide. The historical evolution of use of these drugs is then discussed, including the strategy of progressive (“therapeutic pyramid” or of more aggressive treatment, through the simultaneous use of two or more DMARDs (“combination therapy”.

  2. [Anti-rheumatic therapy in patients with rheumatoid arthritis undergoing hemodialysis].

    Science.gov (United States)

    Akiyama, Yuji

    2011-01-01

    Hemodialysis (HD) patients have been increasing recently. Some rheumatoid arthritis (RA) patients need hemodialysis (HD), though the proportion is not high. At present, such patients are almost treated with corticosteroids and/or nonsteroidal anti-inflammatory drugs alone, even if they have a high disease activity that would require disease-modifying anti-rheumatic drug (DMARD) therapy, partly because the safety of DMARDs in RA patients with end-stage renal disease has not been confirmed. Their joint destruction would be inevitable and lead to impaired activities of daily living. As there are no guidelines for the use of DMARDs in HD patients, here I reviewed the previous reports about the treatment of DMARDs including biologics for patients with RA undergoing HD.

  3. Anti-Rheumatic Potential of Pakistani Medicinal Plants: A Review

    International Nuclear Information System (INIS)

    Kamal, M.; Adnan, M.; Murad, W.; Tariq, A.; Bibi, H.; Rahman, H.; Shinwari, Z. K.

    2016-01-01

    Present review aimed to provide a comprehensive documentation of plants used as anti-rheumatic ethnomedicines in Pakistan and to suggest future recommendations. Data on anti-rheumatic plants was collected from published scientific papers, reports and thesis using online searching engines such as Google Scholar PubMed and Science Direct. Five distinct zones in the country were classified on the basis of geography, humidity and rainfall. We used Sorenson similarity index for plants and their parts used between different zones. A total of 137 anti-rheumatic plant species representing 55 families and 104 genera are used in Pakistan. Herbs (87 plants) were the primary source of anti-rheumatic medicinal plants, while leaves (22 % plant species) were the most frequently used part in the preparation of ethnomedicinal recipes. Highest number of 52 medicinal plant species were found in Zone A having high mountains and cold climate where the prevalence of rheumatism was more common. Solanum surattense was found with highest conservation concerns as it was using in 13 different areas against rheumatism. Results of Sorenson index revealed that there is a similarity of plants and its parts uses between different zones. In conclusions, geography and climate have an important role in causing rheumatic disease. Pakistan has a number of anti-rheumatic plants that are used by the local populations through their traditional knowledge. Moreover, inter zonal similarities among plants and its part uses indicate higher pharmacological potency of these medicinal plants. Further, the review will also provide an insight regarding the conservation status of reported plants. (author)

  4. Disease-modifying anti-rheumatic drugs til behandling af ankyloserende spondylitis

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek; Egsmose, Charlotte

    2009-01-01

    Ankylosing spondylitis (AS) is an inflammatory disorder affecting the axial skeleton, peripheral joints, entheses and extra-articular sites. Patients with early disease, a higher level of erythrocyte sedimentation rate and/or peripheral arthritis might benefit from sulfasalazine. Otherwise...

  5. The Impact of Conventional and Biological Disease Modifying Antirheumatic Drugs on Bone Biology. Rheumatoid Arthritis as a Case Study.

    Science.gov (United States)

    Barreira, Sofia Carvalho; Fonseca, João Eurico

    2016-08-01

    The bone and the immune system have a very tight interaction. Systemic immune-mediated inflammatory diseases, such as rheumatoid arthritis (RA), induce bone loss, leading to a twofold increase in osteoporosis and an increase of fragility fracture risk of 1.35-2.13 times. This review focuses on the effects of conventional and biological disease modifying antirheumatic drugs (DMARDs) on bone biology, in the context of systemic inflammation, with a focus on RA. Published evidence supports a decrease in osteoclastic activity induced by DMARDs, which leads to positive effects on bone mineral density (BMD). It is unknown if this effect could be translated into fracture risk reduction. The combination with antiosteoclastic drugs can have an additional benefit.

  6. short history of anti-rheumatic therapy. IV. Corticosteroids

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available In 1948 a corticosteroid compound was administered for the first time to a patient affected by rheumatoid arthritis by Philip Showalter Hench, a rheumatologist at the Mayo Clinic in Rochester, Minnesota (USA. He was investigating since 1929 the role of adrenal gland-derived substances in rheumatoid arthritis. For the discovery of cortisone and its applications in anti-rheumatic therapy, Hench, along with Edward Calvin Kendall and Tadeusz Reichstein, won the 1950 Nobel Prize for Medicine. In this review we summarize the main stages that led to the identification of the so-called compound E, which was used by Hench. We also consider the subsequent development of steroid therapy in rheumatic diseases, through the introduction of new molecules with less mineralocorticoid effects, such as prednisone, and more recently, deflazacort.

  7. Kynurenic acid content in anti-rheumatic herbs.

    Science.gov (United States)

    Zgrajka, Wojciech; Turska, Monika; Rajtar, Grażyna; Majdan, Maria; Parada-Turska, Jolanta

    2013-01-01

    The use of herbal medicines is common among people living in rural areas and increasingly popular in urbanized countries. Kynurenic acid (KYNA) is a metabolite of kynurenine possessing anti-inflammatory, anti-oxidative and pain reliving properties. Previous data indicated that the content of KYNA in the synovial fluid of patients with rheumatoid arthritis is lower than in patients with osteoarthritis. Rheumatoid arthritis is a chronic, systemic inflammatory disorder affecting about 1% of the world's population. The aim of the presented study was to investigate the content of KYNA in 11 herbal preparations used in rheumatic diseases. The following herbs were studied: bean pericarp, birch leaf, dandelion root, elder flower, horsetail herb, nettle leaf, peppermint leaf and willow bark. An anti-rheumatic mixture of the herbs Reumatefix and Reumaflos tea were also investigated. The herbs were prepared according to producers' directions. In addition, the herbal supplement Devil's Claw containing root of Harpagophytum was used. KYNA content was measured using the high-performance liquid chromatography method, and KYNA was detected fluorometrically. KYNA was found in all studied herbal preparations. The highest content of KYNA was found in peppermint, nettle, birch leaf and the horsetail herb. The lowest content of KYNA was found in willow bark, dandelion root and in the extract from the root of Harpagophytum. These findings indicate that the use of herbal preparations containing a high level of KYNA can be considered as a supplementary measure in rheumatoid arthritis therapy, as well as in rheumatic diseases prevention.

  8. A short history of anti-rheumatic therapy. II. Aspirin

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available The discovery of aspirin, an antipyretic, anti-inflammatory and analgesic drug, undoubtedly represents a milestone in the history of medical therapy. Since ancient times the derivatives of willow (Salix alba were used to treat a variety of fevers and pain syndromes, although the first report dates back to 1763 when the English Reverend Edward Stone described the effect of an extract of the bark willow in treating malaria. In the XIX century many apothecaries and chemists, including the Italian Raffaele Piria and Cesare Bertagnini, developed the biological processes of extraction and chemical synthesis of salicylates, and then analyzed their therapeutic properties and pharmacokinetic and pharmacodynamic characteristics. In 1899 the Bayer Company, where Felix Hoffmann, Heinrich Dreser and Arthur Eichengrün worked, recorded acetyl-salicylic acid under the name “Aspirin”. In the XX century, besides the definition of the correct applications of aspirin in the anti-rheumatic therapy being defined, Lawrence L. Crawen identified the property of this drug as an anti-platelet agent, thus opening the way for more widespread uses in cardiovascular diseases.

  9. Efficacy and safety of tofacitinib following inadequate response to conventional synthetic or biological disease-modifying antirheumatic drugs.

    Science.gov (United States)

    Charles-Schoeman, Christina; Burmester, Gerd; Nash, Peter; Zerbini, Cristiano A F; Soma, Koshika; Kwok, Kenneth; Hendrikx, Thijs; Bananis, Eustratios; Fleischmann, Roy

    2016-07-01

    Biological disease-modifying antirheumatic drugs (bDMARDs) have shown diminished clinical response following an inadequate response (IR) to ≥1 previous bDMARD. Here, tofacitinib was compared with placebo in patients with an IR to conventional synthetic DMARDs (csDMARDs; bDMARD-naive) and in patients with an IR to bDMARDs (bDMARD-IR). Data were taken from phase II and phase III studies of tofacitinib in patients with rheumatoid arthritis (RA). Patients received tofacitinib 5 or 10 mg twice daily, or placebo, as monotherapy or with background methotrexate or other csDMARDs. Efficacy endpoints and incidence rates of adverse events (AEs) of special interest were assessed. 2812 bDMARD-naive and 705 bDMARD-IR patients were analysed. Baseline demographics and disease characteristics were generally similar between treatment groups within subpopulations. Across subpopulations, improvements in efficacy parameters at month 3 were generally significantly greater for both tofacitinib doses versus placebo. Clinical response was numerically greater with bDMARD-naive versus bDMARD-IR patients (overlapping 95% CIs). Rates of safety events of special interest were generally similar between tofacitinib doses and subpopulations; however, patients receiving glucocorticoids had more serious AEs, discontinuations due to AEs, serious infection events and herpes zoster. Numerically greater clinical responses and incidence rates of AEs of special interest were generally reported for tofacitinib 10 mg twice daily versus tofacitinib 5 mg twice daily (overlapping 95% CIs). Tofacitinib demonstrated efficacy in both bDMARD-naive and bDMARD-IR patients with RA. Clinical response to tofacitinib was generally numerically greater in bDMARD-naive than bDMARD-IR patients. The safety profile appeared similar between subpopulations. (NCT00413660, NCT00550446, NCT00603512, NCT00687193, NCT00960440, NCT00847613, NCT00814307, NCT00856544, NCT00853385). Published by the BMJ Publishing Group Limited

  10. The effect of newer anti-rheumatic drugs on osteogenic cell proliferation: an in-vitro study

    Directory of Open Access Journals (Sweden)

    Laing Patrick

    2009-05-01

    Full Text Available Abstract Background Disease modifying anti-rheumatic drugs (DMARDs may interfere with bone healing. Previous studies give conflicting advice regarding discontinuation of these drugs in the peri-operative setting. No consensus exists in current practice especially with the newer DMARDs such as Leflunomide, Etanercept, and Infliximab. The aim of this study was to assess the in-vitro effect of these drugs alone and in relevant clinical combinations on Osteoblast activity. Methods Osteoblasts were cultured from femoral heads obtained from five young otherwise healthy patients undergoing total hip replacement. The cells were cultured using techniques that have been previously described. A full factorial design was used to set up the experiment on samples obtained from the five donors. Normal therapeutic concentrations of the various DMARDs were added alone and in combination to the media. The cell proliferation was estimated after two weeks using spectrophotometric technique using Roche Cell proliferation Kit. Multilevel regression analysis was used to estimate which drugs or combination of drugs significantly affected cell proliferation. Results Infliximab and Leflunomide had an overall significant inhibitory effect (p Conclusion Our study indicates that in-vitro osteoblast proliferation can be inhibited by the presence of certain DMARDs. Combinations of drugs had an influence and could negate the action of a drug on osteoblast proliferation. The response to drugs may be donor-dependent.

  11. Radiographic assessment of disease progression in rheumatoid arthritis patients undergoing early disease-modifying anti-rheumatic drug treatment

    International Nuclear Information System (INIS)

    Wick, M.C.

    2002-04-01

    Rheumatoid arthritis (RA) is a common systemic disease predominantly involving the joints. Since the pathogenesis, etiology and pathophysiological mechanisms of RA have only been partially elucidated, a definitive therapy has not been established. Precise diagnosis and follow-up therapy requires objective quantification, and radiological analyses are considered to be the most appropriate method. The aim of this study was to retrospectively determine the time-dependent progression of joint damage in patients with pharmacologically-treated RA, and to determine which therapeutic agents demonstrate the highest efficacy. Outpatient records, laboratory values, therapy schemes and radiographs from hands and feet of 150 RA patients were collected, analyzed and statistically evaluated. Radiographs were quantified using the Larsen score and supportively using the 'RheumaCoach-Rheumatology' computer software. Our observations reveal that radiologically-detectable damage is most pronounced during the first year of disease, while mitigated and generally progressing linearly thereafter. Overall Larsen scores linearly increased from year 0 to 10 (r=0.853), during which the mean Larsen score increased 7.93 ± 0.76 per year. During the first year, RA progression was similar regardless of the medication administered (gold-compounds, AU; chloroquine, CQ; methotrexate, MTX; sulfasalazine SSZ). While MTX and CQ treatment showed no difference when examined as mean 5-year increment of Larsen score, AU and SSZ showed up to 3 fold higher RA progression compared with MTX. The Larsen score in year 1 did not correlate with that of years 2 to 5. In contrast, Larsen scores in year 2 were linearly related to each of the subsequent 3 years. Despite similar ESR values in various medication groups, cumulative ESR correlated with RA progression, and its reduction with therapeutic efficacy. In conclusion, this study found that, (i) early DMARD-treated RA progressed more rapidly during the first than in subsequent years, and (ii) a linear increase during the first ten years after diagnosis upon retrospective assessment using the original Larsen score, (iii) therapy with methotrexate and chloroquine yielded equal results, and were superior to sulfasalazine or oral gold-compounds, and (iv) despite the effectiveness of cumulative ESR in evaluating RA progression, (v) radiographs of the hands and feet to predict RA were most useful when assessed using the original Larsen score at baseline, after one and two years. (author)

  12. Tofacitinib in Combination With Conventional Disease-Modifying Antirheumatic Drugs in Patients With Active Rheumatoid Arthritis: Patient-Reported Outcomes From a Phase III Randomized Controlled Trial.

    Science.gov (United States)

    Strand, Vibeke; Kremer, Joel M; Gruben, David; Krishnaswami, Sriram; Zwillich, Samuel H; Wallenstein, Gene V

    2017-04-01

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We compared patient-reported outcomes (PROs) in patients with RA treated with tofacitinib or placebo in combination with conventional disease-modifying antirheumatic drugs (DMARDs). In a 12-month, phase III randomized controlled trial (ORAL Sync), patients (n = 795) with active RA and previous inadequate response to therapy with ≥1 conventional or biologic DMARD were randomized 4:4:1:1 to tofacitinib 5 mg twice daily (BID), tofacitinib 10 mg BID, placebo advanced to 5 mg BID, or placebo to 10 mg BID, in combination with stable background DMARD therapy. PROs included patient global assessment of arthritis (PtGA), patient assessment of arthritis pain (Pain), physical function (Health Assessment Questionnaire disability index [HAQ DI]), health-related quality of life (Short Form 36 health survey [SF-36]), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue [FACIT-F]), and sleep (Medical Outcomes Study Sleep [MOS Sleep]). At month 3, statistically significant improvements from baseline versus placebo were reported in PtGA, Pain, HAQ DI, all 8 SF-36 domains, FACIT-F, and MOS Sleep with tofacitinib 10 mg BID, and in PtGA, Pain, HAQ DI, 7 SF-36 domains, FACIT-F, and MOS Sleep with tofacitinib 5 mg BID. Improvements were sustained to month 12. Significantly more tofacitinib-treated patients reported improvements of greater than or equal to the minimum clinically important differences at month 3 versus placebo in all PROs, except the SF-36 role-emotional domain (significant for tofacitinib 10 mg BID). Patients with active RA treated with tofacitinib combined with background conventional DMARD therapy reported sustained, significant, and clinically meaningful improvements in PROs versus placebo. © 2016, The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

  13. A comparative study of renal dysfunction in patients with inflammatory arthropathies: strong association with cardiovascular diseases and not with anti-rheumatic therapies, inflammatory markers or duration of arthritis.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2012-02-01

    AIMS: The aim of this study was to investigate the prevalence of chronic kidney disease (CKD) among comparable patients with rheumatoid arthritis (RA) and seronegative inflammatory arthritis, and to explore any predictive factors for renal impairment. METHODS: Consecutive patients with peripheral joint disease (oligo and polyarthritis) were recruited from our inflammatory arthritis clinics. We divided patients in two groups: RA group and seronegative inflammatory arthritis group. The cohort consisted of 183 patients (RA = 107, seronegative arthritis = 76 [psoriatic arthritis = 69, undifferentiated oligoarthritis = 7]). Estimated glomerular filtration rate (eGFR) was calculated using the established Modification of Diet in Renal Disease equation. Demographic details, disease-specific characteristics, anti-rheumatic drugs and the presence of cardiovascular diseases were recorded. RESULTS: In total, 17.48% (n = 32) of the cohort had CKD. There was no statistically significant variation between the two groups as regards baseline demographics, disease characteristics, use of anti-rheumatic drugs and the presence of individual cardiovascular diseases. We found that eGFR and the presence of CKD were similar among these groups. Among patients with CKD, 72% had undiagnosed CKD. No association of statistical significance was noted between CKD and the use of corticosteroids, disease-modifying antirheumatic drugs and anti-tumor necrosis factor agents. The association of cardiovascular diseases with CKD remained significant after adjusting for confounders (age, gender, duration of arthritis, high C-reactive protein, use of anti-rheumatic drugs). CONCLUSIONS: Patients with inflammatory arthritis are more prone to have CKD. This could have serious implications, as the majority of rheumatology patients use non-steroidal anti-inflammatory drugs and different immunosuppressives, such as methotrexate. No association of kidney dysfunction was noted with inflammatory disease

  14. Efficacy of conventional synthetic disease-modifying antirheumatic drugs, glucocorticoids and tofacitinib: a systematic literature review informing the 2013 update of the EULAR recommendations for management of rheumatoid arthritis

    NARCIS (Netherlands)

    Gaujoux-Viala, Cécile; Nam, Jackie; Ramiro, Sofia; Landewé, Robert; Buch, Maya H.; Smolen, Josef S.; Gossec, Laure

    2014-01-01

    To update a previous systematic review assessing the efficacy of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) in rheumatoid arthritis (RA). Two systematic reviews of the literature using PubMed, Embase and the Cochrane library were performed from 2009 until January 2013 to

  15. Efficacy of glucocorticoids, conventional and targeted synthetic disease-modifying antirheumatic drugs: a systematic literature review informing the 2016 update of the EULAR recommendations for the management of rheumatoid arthritis

    NARCIS (Netherlands)

    Chatzidionysiou, Katerina; Emamikia, Sharzad; Nam, Jackie; Ramiro, Sofia; Smolen, Josef; van der Heijde, Désirée; Dougados, Maxime; Bijlsma, Johannes; Burmester, Gerd; Scholte, Marieke; van Vollenhoven, Ronald; Landewé, Robert

    2017-01-01

    To perform a systematic literature review (SLR) informing the 2016 update of the recommendations for the management of rheumatoid arthritis (RA). An SLR for the period between 2013 and 2016 was undertaken to assess the efficacy of glucocorticoids (GCs), conventional synthetic disease-modifying

  16. Simultaneous Response in Several Domains in Patients with Psoriatic Disease Treated with Etanercept as Monotherapy or in Combination with Conventional Synthetic Disease-modifying Antirheumatic Drugs.

    Science.gov (United States)

    Behrens, Frank; Meier, Lothar; Prinz, Jörg C; Jobst, Jürgen; Lippe, Ralph; Löschmann, Peter-Andreas; Lorenz, Hanns-Martin

    2018-04-01

    To evaluate patients with psoriatic arthritis (PsA) receiving etanercept (ETN) monotherapy or ETN plus conventional synthetic disease-modifying antirheumatic drugs (csDMARD) to determine the proportion achieving a clinically meaningful response in arthritis, psoriasis, and quality of life simultaneously. A prospective, multicenter, 52-week observational study in patients with active PsA evaluated treatment with ETN in clinical practice (ClinicalTrials.gov: NCT00293722). This analysis assessed simultaneous achievement of 3 treatment targets: low disease activity (LDA) based on 28-joint count Disease Activity Score (DAS28); body surface area (BSA) involvement ≤ 3%; and a score > 45 on the Medical Outcomes Study Short Form-12 (SF-12) physical component summary. Of 579 patients, 380 received ETN monotherapy and 199 received combination ETN plus csDMARD. At 52 weeks, data for all 3 disease domains were available for 251 patients receiving monotherapy and 151 receiving combination therapy. In the monotherapy and combination therapy groups, 61 (24.3%) and 37 (24.5%) patients, respectively, achieved all 3 treatment targets simultaneously. A significantly greater proportion of patients receiving monotherapy versus combination therapy achieved SF-12 > 45 (43.0% vs 31.8%; p < 0.05) and DAS28 LDA (72.5% vs 62.3%; p < 0.05). Conversely, BSA ≤ 3% was reached by a significantly greater proportion receiving combination therapy (75.5% vs 56.6%; p < 0.001). However, baseline BSA involvement was higher for the monotherapy group. While nearly half the patients achieved arthritis and psoriasis treatment targets simultaneously and one-fourth reached all 3 treatment targets, combining ETN and csDMARD did not substantially improve clinical response compared with ETN monotherapy in this real-world PsA patient population.

  17. Baricitinib in Patients with Rheumatoid Arthritis and an Inadequate Response to Conventional Disease-Modifying Antirheumatic Drugs in United States and Rest of World: A Subset Analysis.

    Science.gov (United States)

    Wells, Alvin F; Greenwald, Maria; Bradley, John D; Alam, Jahangir; Arora, Vipin; Kartman, Cynthia E

    2018-06-01

    This article evaluates the efficacy and safety of baricitinib 4 mg versus placebo in United States including Puerto Rico (US) and rest of the world (ROW) subpopulations using data pooled from RA-BEAM and RA-BUILD, which enrolled patients with moderate-to-severe adult-onset rheumatoid arthritis (RA). In RA-BEAM, patients with an inadequate response (IR) to methotrexate, at least one X-ray erosion, and high sensitivity C-reactive protein (hsCRP) ≥ 6 mg/L were randomized to placebo or orally administered baricitinib 4 mg daily or subcutaneously administered adalimumab 40 mg every other week. In RA-BUILD, patients with an IR to at least one conventional synthetic disease-modifying antirheumatic drug (csDMARD) and with hsCRP ≥ 3.6 mg/L were randomized to placebo or baricitinib 2 or 4 mg daily. Patients in both trials were biologic naive. In this post hoc analysis, data from both studies were pooled (714 baricitinib 4 mg-treated, 716 placebo-treated patients). Overall, 188 US and 1242 ROW patients were included. Subgroups differed in baseline characteristics including race, weight, age, time since RA diagnosis, current corticosteroid use, and previous csDMARD use. At weeks 12 and 24, baricitinib-treated patients had larger responses compared to placebo-treated patients for multiple efficacy outcomes: American College of Rheumatology 20/50/70 response, low disease activity, remission, Disease Activity Score 28-C-reactive protein, and Health Assessment Questionnaire-Disability Index. Overall, similar efficacy was observed in US and ROW subgroups with no notable safety differences between subgroups at weeks 12 or 24. Baricitinib 4 mg was efficacious compared to placebo in US and ROW subpopulations. Safety was similar between subgroups. Eli Lilly & Company and Incyte Corporation. ClinicalTrials.gov identifiers, NCT01721057; NCT01710358.

  18. The Impact of Low-Dose Disease-modifying Anti-rheumatics Drugs (DMARDs) on Bone Mineral Density of Premenopausal Women in Early Rheumatoid Arthritis.

    Science.gov (United States)

    Rexhepi, Sylejman; Rexhepi, Mjellma; Sahatçiu-Meka, Vjollca; Mahmutaj, Vigan; Boshnjaku, Shkumbin

    2016-04-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by symmetrical polyarthritis and multisystemic involvement. The aim of this study was to assess the impact of low dose of methotrexate on bone mineral density (BMD) in patients with early rheumatoid arthritis (RA). This paper follows a retrospective study, which involves 60 female patients with early onset RA diagnosed according to the American Rheumatism Association Criteria (ACR/EULAR 2010). The patients were divided into two groups group I was composed of thirty patients treated with dose of 7.5 mg/weekly methotrexate (MTX), while group II included thirty patients treated with dose of 2 g/daily sulfasalazine (SSZ). The Disease Activity was measured by a combination of Erythrocyte Sedimentation Rate (ESR) and Disease Activity Score (DAS-28). Bone mineral density of the lumbar spine (L2-4), and femoral neck, was measured by dual energy X-ray absorptiometry (DEXA) (Stratos 800). Laboratory findings included: In this study, we found no negative effect on BMD in RA patients treated with low dose MTX in comparison to patients treated with SSZ. There was not observed significant difference in BMD of the lumbar spine, femur neck or trochanter, of MTX and SSZ patients in the pretreatment phase, nor after 12 months of treatment. No significant change in the biochemical parameters of the both groups. Based on the results of our study, low dose of methotrexate has no negative effect on BMD in premenopausal RA patients. We believe that these results might provide new insights and that further longitudinal studies with larger groups of premenopausal RA patients are required.

  19. Analysis of the data on pregnancy and lactation provided by patient information leaflets of anti-rheumatic drugs in Argentina.

    Science.gov (United States)

    Sabando, Miguel Ormaza; Saavedra, Maira Arias; Sequeira, Gabriel; Kerzberg, Eduardo

    2018-04-01

    To analyse the level of consistency and updating of the information on pregnancy and lactation provided by patient information leaflets (PILs) of the antirheumatic drugs approved in Argentina. Inconsistencies between the 2016 EULAR Task Force recommendations on the use of anti-rheumatic drugs during pregnancy and lactation and the information provided by PILs of the same drugs approved in Argentina were analysed along with inconsistencies within the PILs of different registered trademarks of these drugs. Eighty-eight PILs of 32 drugs were analysed. Out of the 88 PILs, 50% presented information inconsistencies as to pregnancy. Medications comprised in this group were: hydroxychloroquine, sulfasalazine, azathioprine, tacrolimus, cyclosporine, NSAIDs (during the first two trimesters), celecoxib, some glucocorticoids, colchicine, and some anti-TNF drugs (etanercept, adalimumab and infliximab) during part of the pregnancy. As for lactation, 56% had information inconsistencies. Medications encompassed in this group were: hydroxychloroquine, chloroquine, sulfasalazine, azathioprine, tacrolimus, cyclosporine, NSAIDs, celecoxib, meprednisone, prednisone, colchicine, and anti-TNF drugs. Out of 17 drugs that had more than one registered trademark, information inconsistencies on pregnancy were found in the PILs of sulfasalazine, diclofenac, ibuprofen and methylprednisolone. Concerning lactation, inconsistencies were present in the PILs of hydroxychloroquine, sulfasalazine, diclofenac, ibuprofen, meprednisone, and colchicine. At least half of the PILs of anti-rheumatic drugs analysed in this study had information inconsistencies on pregnancy and lactation. This is a serious state of affairs because the consensual decision-making process between patient and professional may be compromised, which, in turn, may give rise to medical-legal issues.

  20. MS Disease-Modifying Medications

    Science.gov (United States)

    ... disease-modifying therapies Approval: 2014 US; 2014 CAN Pregnancy Category C (see footnote, page 11) Rash, headache, fever, nasal congestion, nausea, urinary tract infection, fatigue, insomnia, upper respiratory tract infection, herpes viral ...

  1. Rapid screening of non-steroidal anti-inflammatory drugs illegally added in anti-rheumatic herbal supplements and herbal remedies by portable ion mobility spectrometry.

    Science.gov (United States)

    Li, Mengjiao; Ma, Haiyan; Gao, Jinglin; Zhang, Lina; Wang, Xinyu; Liu, Di; Bian, Jing; Jiang, Ye

    2017-10-25

    In this work, for the first time, a high-performance ion mobility spectrometry with electrospray ionization (ESI-HPIMS) method has been employed as a rapid screening tool for the detection of acetaminophen, ibuprofen, naproxen, diclofenac sodium and indomethacin illegally added in anti-rheumatic herbal supplements and herbal remedies. Samples were dissolved and filtered through a 0.45μm microporous membrane, then the filtrate was directly injected into the high-performance ion mobility spectrometry for analysis. Using this approach, the screening of illegal additions can be accomplished in as rapid as two to three minutes with no pretreatment required. The proposed method provided a LOD of 0.06-0.33μgmL -1 , as well as a good seperation of the five NSAIDs. The precision of the method was 0.1-0.4% (repeatability, n=6) and 0.9-3.3% (reproducibility, n=3). The proposed method appeared to be simple, rapid and highly specific, thus could be effective for the in-situ screening of NSAIDs in anti-rheumatic herbal supplements and herbal remedies. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. O uso de drogas anti-reumáticas na gravidez Use of anti-rheumatic drugs during pregnancy

    Directory of Open Access Journals (Sweden)

    Roger A. Levy

    2005-06-01

    sendo estudada na prevenção do bloqueio cardíaco total da síndrome do lúpus neonatal. O uso de prednisona e prednisolona é limitado a menor dose eficaz, não atinge a circulação fetal, mas pode induzir os efeitos colaterais maternos já conhecidos. Azatioprina e ciclosporina são utilizadas, quando indicadas formalmente, sem aparente risco fetal. Metotrexato e leflunomide devem ser evitados a qualquer custo e o tratamento interrompido três meses antes da tentativa de concepção. Todas as decisões terapêuticas em pacientes grávidas devem ser individualizadas e os riscos e benefícios considerados.The prescription of anti-rheumatic drugs in fertile patients should take into account the current knowledge about their effects on conception, pregnancy and lactation. Judicious advice and pregnancy planning is ideal when possible. With the incorporation of new substances and the constant appearance of recent data in the literature this subject has to be continuously updated. The FDA risk factor rating is sometimes contradictory to our practice, in part because results from animal studies may not be directly applicable to humans. Biologic response modifiers seem to be safely used during pregnancy, since they are large molecules that are not capable of crossing the placenta. Non-steroidal anti-inflammatory drugs including specific COX-2 inhibitors may impair implantation of the ovum but can be used once pregnancy is under way, they should be avoided after 32 weeks, when there is a relationship with fetal complications. COX-2 inhibitors must be avoided due to its risk of renal mal-formation. Low-dose aspirin can be used safely during pregnancy. Low molecular weight heparins are preferred, since the unfractionated heparins have an increased risk of inducing thrombocytopenia and bleeding. Hydroxychloroquine is used and in fact recommended in lupus pregnancy with patients' benefits and no fetal risk. Warfarin is teratogenic if given between the 6th and 9th gestational

  3. Randomised controlled trial of tumour necrosis factor inhibitors against combination intensive therapy with conventional disease-modifying antirheumatic drugs in established rheumatoid arthritis: the TACIT trial and associated systematic reviews.

    Science.gov (United States)

    Scott, David L; Ibrahim, Fowzia; Farewell, Vern; O'Keeffe, Aidan G; Ma, Margaret; Walker, David; Heslin, Margaret; Patel, Anita; Kingsley, Gabrielle

    2014-10-01

    Rheumatoid arthritis (RA) is initially treated with methotrexate and other disease-modifying antirheumatic drugs (DMARDs). Active RA patients who fail such treatments can receive tumour necrosis factor inhibitors (TNFis), which are effective but expensive. We assessed whether or not combination DMARDs (cDMARDs) give equivalent clinical benefits at lower costs in RA patients eligible for TNFis. An open-label, 12-month, pragmatic, randomised, multicentre, two-arm trial [Tumour necrosis factor inhibitors Against Combination Intensive Therapy (TACIT)] compared these treatment strategies. We then systematically reviewed all comparable published trials. The TACIT trial involved 24 English rheumatology clinics. Active RA patients eligible for TNFis. The TACIT trial compared cDMARDs with TNFis plus methotrexate or another DMARD; 6-month non-responders received (a) TNFis if in the cDMARD group; and (b) a second TNFi if in the TNFi group. The Heath Assessment Questionnaire (HAQ) was the primary outcome measure. The European Quality of Life-5 Dimensions (EQ-5D), joint damage, Disease Activity Score for 28 Joints (DAS28), withdrawals and adverse effects were secondary outcome measures. Economic evaluation linked costs, HAQ changes and quality-adjusted life-years (QALYs). In total, 432 patients were screened; 104 started on cDMARDs and 101 started on TNFis. The initial demographic and disease assessments were similar between the groups. In total, 16 patients were lost to follow-up (nine in the cDMARD group, seven in the TNFi group) and 42 discontinued their intervention but were followed up (23 in the cDMARD group and 19 in the TNFi group). Intention-to-treat analysis with multiple imputation methods used for missing data showed greater 12-month HAQ score reductions with initial cDMARDs than with initial TNFis [adjusted linear regression coefficient 0.15, 95% confidence interval (CI) -0.003 to 0.31; p = 0.046]. Increases in 12-month EQ-5D scores were greater with initial c

  4. Effect of sanhuangwuji powder, anti-rheumatic drugs, and ginger-partitioned acupoint stimulation on the treatment of rheumatoid arthritis with peptic ulcer: a randomized controlled study.

    Science.gov (United States)

    Liu, Defang; Guo, Mingyang; Hu, Yonghe; Liu, Taihua; Yan, Jiao; Luo, Yong; Yun, Mingdong; Yang, Min; Zhang, Jun; Guo, Linglin

    2015-06-01

    To observe the efficacy and safety of oral sanhuangwuji powder, anti-rheumatic drugs (ARDs), and ginger-partitioned acupoint stimulation at zusanli (ST 36) on the treatment of rheumatoid arthritis (RA) complicated by peptic ulcer. This prospective randomized controlled study included 180 eligible inpatients and outpatients randomly assigned to an ARD treatment (n.= 60), ginger-partitioned stimulation (n = 60), or combination treatment (n = 60). Patients assigned to the ARD group were given oral celecoxib, methotrexate, and esomeprazole. Patients assigned to the ginger-partitioned stimulation group were given ginger-partitioned acupoint stimulation at zusanli (ST 36) in addition to the ARDs. Patients in the combination treatment group were given oral sanhuangwuji powder, ginger-partitioned acupoint stimulation at susanli (ST 36), and ARDs. All patients were followed up for 2 months to evaluate clinical effects and safety. The study was registered in the World Health Organization database at the General Hospital of Chengdu Military Area Command Chinese People's Liberation Army (ChiCTR-TCC12002824). The combination treatment group had significantly greater improvements in RA symptoms, laboratory outcomes, and gastrointestinal symptom scores, compared with the other groups (P ginger-partitioned stimulation group (χ2= 6.171, P ginger-partitioned acupoint stimulation at zusanli (ST 36), oral sanhuangwuji powder, and ARDs had a better clinical effect for RA with complicated peptic ulcer, compared with ARD treatmentalone or in combination with ginger-partitioned acupoint stimulation.

  5. Disease-modifying drugs in Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Ghezzi L

    2013-12-01

    Full Text Available Laura Ghezzi, Elio Scarpini, Daniela Galimberti Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy Abstract: Alzheimer's disease (AD is an age-dependent neurodegenerative disorder and the most common cause of dementia. The early stages of AD are characterized by short-term memory loss. Once the disease progresses, patients experience difficulties in sense of direction, oral communication, calculation, ability to learn, and cognitive thinking. The median duration of the disease is 10 years. The pathology is characterized by deposition of amyloid beta peptide (so-called senile plaques and tau protein in the form of neurofibrillary tangles. Currently, two classes of drugs are licensed by the European Medicines Agency for the treatment of AD, ie, acetylcholinesterase inhibitors for mild to moderate AD, and memantine, an N-methyl-D-aspartate receptor antagonist, for moderate and severe AD. Treatment with acetylcholinesterase inhibitors or memantine aims at slowing progression and controlling symptoms, whereas drugs under development are intended to modify the pathologic steps leading to AD. Herein, we review the clinical features, pharmacologic properties, and cost-effectiveness of the available acetylcholinesterase inhibitors and memantine, and focus on disease-modifying drugs aiming to interfere with the amyloid beta peptide, including vaccination, passive immunization, and tau deposition. Keywords: Alzheimer's disease, acetylcholinesterase inhibitors, memantine, disease-modifying drugs, diagnosis, treatment

  6. Classifying PML risk with disease modifying therapies.

    Science.gov (United States)

    Berger, Joseph R

    2017-02-01

    To catalogue the risk of PML with the currently available disease modifying therapies (DMTs) for multiple sclerosis (MS). All DMTs perturb the immune system in some fashion. Natalizumab, a highly effective DMT, has been associated with a significant risk of PML. Fingolimod and dimethyl fumarate have also been unquestionably associated with a risk of PML in the MS population. Concerns about PML risk with other DMTs have arisen due to their mechanism of action and pharmacological parallel to other agents with known PML risk. A method of contextualizing PML risk for DMTs is warranted. Classification of PML risk was predicated on three criteria:: 1) whether the underlying condition being treated predisposes to PML in the absence of the drug; 2) the latency from initiation of the drug to the development of PML; and 3) the frequency with which PML is observed. Among the DMTs, natalizumab occupies a place of its own with respect to PML risk. Significantly lesser degrees of risk exist for fingolimod and dimethyl fumarate. Whether PML will be observed with other DMTs in use for MS, such as, rituximab, teriflunomide, and alemtuzumab, remains uncertain. A logical classification for stratifying DMT PML risk is important for both the physician and patient in contextualizing risk/benefit ratios. As additional experience accumulates regarding PML and the DMTs, this early effort will undoubtedly require revisiting. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Tofacitinib with conventional synthetic disease‐modifying antirheumatic drugs in Chinese patients with rheumatoid arthritis: Patient‐reported outcomes from a Phase 3 randomized controlled trial

    OpenAIRE

    Li, Zhanguo; An, Yuan; Su, Houheng; Li, Xiangpei; Xu, Jianhua; Zheng, Yi; Li, Guiye; Kwok, Kenneth; Wang, Lisy; Wu, Qizhe

    2018-01-01

    Abstract Aim Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We assess the effect of tofacitinib + conventional synthetic disease‐modifying anti rheumatic drugs (csDMARDs) on patient‐reported outcomes in Chinese patients with RA and inadequate response to DMARDs. Methods This analysis of data from the Phase 3 study ORAL Sync included Chinese patients randomized 4 : 4 : 1 : 1 to receive tofacitinib 5 mg twice daily, tofacitinib 10 mg twice daily, p...

  8. Barriers and facilitators to disease-modifying antirheumatic drug use in patients with inflammatory rheumatic diseases: a qualitative theory-based study.

    Science.gov (United States)

    Voshaar, Marieke; Vriezekolk, Johanna; van Dulmen, Sandra; van den Bemt, Bart; van de Laar, Mart

    2016-10-21

    Although disease-modifying anti-rheumatic drugs (DMARDs) are the cornerstone of treatment for inflammatory rheumatic diseases, medication adherence to DMARDs is often suboptimal. Effective interventions to improve adherence to DMARDs are lacking, and new targets are needed to improve adherence. The aim of the present study was to explore patients' barriers and facilitators of optimal DMARD use. These factors might be used as targets for adherence interventions. In a mixed method study design, patients (n = 120) with inflammatory arthritis (IA) completed a questionnaire based on an existing adapted Theoretical Domains Framework (TDF) to identify facilitators and barriers of DMARD use. A subgroup of these patients (n = 21) participated in focus groups to provide insights into their facilitators and barriers. The answers to the questionnaires and responses of the focus groups were thematically coded by three researchers independently and subsequently categorized. The barriers and facilitators that were reported by IA patients presented large inter-individual variations. The identified barriers and facilitators could be captured in the following domains based on an adapted TDF: (i) knowledge, (ii) emotions, (iii) attention, memory, and decision processes, (iv) social influences, (v) beliefs about capability, (vi) beliefs about consequences, (vii) motivation and goals, (viii) goal conflict, (ix) environmental context and resources, and (x) skills. Patients with IA have a variety of barriers and facilitators with regard to their DMARD use. All of these barriers and facilitators could be categorized into adapted domains of the TDF. Interventions that address individual facilitators and barriers, based on capability, opportunity, and motivation, are needed to develop strategies for medication adherence that are tailored to individual patient needs.

  9. Infections and treatment of patients with rheumatic diseases

    DEFF Research Database (Denmark)

    Atzeni, F; Bendtzen, K; Bobbio-Pallavicini, F

    2008-01-01

    , and for the shortest possible time should therefore greatly reduce the risk of infections. Infection is a major co-morbidity in rheumatoid arthritis (RA), and conventional disease-modifying anti-rheumatic drugs (DMARDs) can increase the risk of their occurrence, including tuberculosis. TNF-alpha plays a key role...

  10. 77 FR 59930 - Clinical Development Programs for Disease-Modifying Agents for Peripheral Neuropathy; Public...

    Science.gov (United States)

    2012-10-01

    ...] Clinical Development Programs for Disease-Modifying Agents for Peripheral Neuropathy; Public Workshop... to the clinical development of disease-modifying agents for the treatment of peripheral neuropathy... disease-modifying products for the management of peripheral neuropathy. Date and Time: The public workshop...

  11. Assessing the effectiveness of synthetic and biologic disease-modifying antirheumatic drugs in psoriatic arthritis – a systematic review

    Directory of Open Access Journals (Sweden)

    Kingsley GH

    2015-05-01

    positive benefit. For biologics, TNF inhibitors already licensed for use were effective and similar benefits were seen with newer agents including ustekinumab, secukinumab, brodalumab, and abatacept, although the latter did not impact on skin problems. Important limitations of the systematic review included, first, the fact that for many agents there were little data and, second, much of the recent data for newer biologics were only available in abstract form. Conclusion: Conventional disease-modifying agents, with the possible exception of leflunomide, do not show clear evidence of disease-modifying effects in psoriatic arthritis, though a newer synthetic disease-modifying agents, apremilast, appears more effective. Biologic agents appear more beneficial, although more evidence is required for newer agents. This review suggests that it may be necessary to review existing national and international management guidelines for psoriatic arthritis. Keywords: psoriatic arthritis, disease-modifying antirheumatic drugs, biologics

  12. Established and novel disease-modifying treatments in multiple sclerosis.

    Science.gov (United States)

    Cross, A H; Naismith, R T

    2014-04-01

    Multiple sclerosis (MS) is a presumed autoimmune disorder of the central nervous system, resulting in inflammatory demyelination and axonal and neuronal injury. New diagnostic criteria that incorporate magnetic resonance imaging have resulted in earlier and more accurate diagnosis of MS. Several immunomodulatory and immunosuppressive therapeutic agents are available for relapsing forms of MS, which allow individualized treatment based upon the benefits and risks. Disease-modifying therapies introduced in the 1990s, the beta-interferons and glatiramer acetate, have an established track record of efficacy and safety, although they require administration via injection. More recently, monoclonal antibodies have been engineered to act through specific mechanisms such as blocking alpha-4 integrin interactions (natalizumab) or lysing cells bearing specific markers, for example CD52 (alemtuzumab) or CD20 (ocrelizumab and ofatumumab). These agents can be highly efficacious, but sometimes have serious potential complications (natalizumab is associated with progressive multifocal leukoencephalopathy; alemtuzumab is associated with the development of new autoimmune disorders). Three new oral therapies (fingolimod, teriflunomide and dimethyl fumarate, approved for MS treatment from 2010 onwards) provide efficacy, tolerability and convenience; however, as yet, there are no long-term postmarketing efficacy and safety data in a general MS population. Because of this lack of long-term data, in some cases, therapy is currently initiated with the older, safer injectable medications, but patients are monitored closely with the plan to switch therapies if there is any indication of a suboptimal response or intolerance or lack of adherence to the initial therapy. For patients with MS who present with highly inflammatory and potentially aggressive disease, the benefit-to-risk ratio may support initiating therapy using a drug with greater potential efficacy despite greater risks (e

  13. Discontinuing disease-modifying therapy in progressive multiple sclerosis: can we stop what we have started?

    LENUS (Irish Health Repository)

    Lonergan, Roisin

    2012-02-01

    Disease-modifying therapy is ineffective in disabled patients (Expanded Disability Status Scale [EDSS] > 6.5) with secondary progressive multiple sclerosis (MS) without relapses, or in primary progressive MS. Many patients with secondary progressive MS who initially had relapsing MS continue to use disease-modifying therapies. The enormous associated costs are a burden to health services. Regular assessment is recommended to guide discontinuation of disease-modifying therapies when no longer beneficial, but this is unavailable to many patients, particularly in rural areas. The objectives of this study are as follows: 1. To observe use of disease-modifying therapies in patients with progressive multiple sclerosis and EDSS > 6.5. 2. To examine approaches used by a group of international MS experts to stopping-disease modifying therapies in patients with secondary progressive MS without relapses. During an epidemiological study in three regions of Ireland (southeast Dublin city, and Wexford and Donegal Counties), we recorded details of disease-modifying therapies in patients with progressive MS and EDSS > 6.5. An e-questionnaire was sent to 26 neurologists with expert knowledge of MS, asking them to share their approach to stopping disease-modifying therapies in patients with secondary progressive MS. Three hundred and thirty-six patients were studied: 88 from southeast Dublin, 99 from Wexford and 149 from Donegal. Forty-four had EDSS > 6.5: 12 were still using disease-modifying therapies. Of the surveyed neurologists, 15 made efforts to stop disease-modifying therapies in progressive multiple sclerosis, but most did not insist. A significant proportion (12 of 44 patients with progressive MS and EDSS > 6.5) was considered to be receiving therapy without benefit. Eleven of the 12 were from rural counties, reflecting poorer access to neurology services. The costs of disease-modifying therapies in this group (>170,000 euro yearly) could be re-directed towards development

  14. [Therapeutic Concepts for Treatment of Patients with Non-infectious Uveitis Biologic Disease Modifying Antirheumatic Drugs].

    Science.gov (United States)

    Walscheid, Karoline; Pleyer, Uwe; Heiligenhaus, Arnd

    2018-04-12

    Biologic disease modifying antirheumatic drugs (bDMARDs) can be highly efficient in the treatment of various non-infectious uveitis entities. Currently, the TNF-α-inhibitor Adalimumab is the only in-label therapeutic option, whereas, all other bDMARDs need to be given as an off-label therapy. bDMARDs are indicated in diseases refractory to conventional synthetic DMARD therapy and/or systemic steroids, or in patients in whom treatment with those is not possible due to side effects. Therapeutic mechanisms currently employed are cytokine-specific (interferons, inhibition of TNF-α or of interleukin [IL]-1-, IL-6- or IL-17-signalling), inhibit T cell costimulation (CTLA-4 fusion protein), or act via depletion of B cells (anti-CD20). All bDMARDs need to be administered parenterally, and therapy is initiated by the treating internal specialist only after interdisciplinary coordination of all treating subspecialties and after exclusion of contraindications. Regular clinical and laboratory monitoring is mandatory for all patients while under bDMARD therapy. Georg Thieme Verlag KG Stuttgart · New York.

  15. Biologics for rheumatoid arthritis: an overview of Cochrane reviews

    DEFF Research Database (Denmark)

    Singh, Jasvinder A; Christensen, Robin; Wells, George A

    2010-01-01

    the biologic disease-modifying anti-rheumatic drugs (DMARDs) are very effective in treating rheumatoid arthritis (RA), however there is a lack of head-to-head comparison studies.......the biologic disease-modifying anti-rheumatic drugs (DMARDs) are very effective in treating rheumatoid arthritis (RA), however there is a lack of head-to-head comparison studies....

  16. Proposal for a new nomenclature of disease-modifying antirheumatic drugs

    NARCIS (Netherlands)

    Smolen, Josef S.; van der Heijde, Desiree; Machold, Klaus P.; Aletaha, Daniel; Landewe, Robert

    2014-01-01

    In light of the recent emergence of new therapeutics for rheumatoid arthritis, such as kinase inhibitors and biosimilars, a new nomenclature for disease-modifying antirheumatic drugs (DMARDs), which are currently often classified as synthetic (or chemical) DMARDs (sDMARDS) and biological DMARDs

  17. Disease-modifying antirheumatic drugs in pregnancy - Current status and implications for the future

    NARCIS (Netherlands)

    Vroom, Fokaline; de Walle, Hermien E. K.; van de Laar, Mart A. J. F.; Brouwers, Jacobus R. B. J.; de Jong-van den Berg, Lolkje T. W.

    2006-01-01

    Drug use during pregnancy is sometimes unavoidable, especially in chronic inflammatory diseases such as rheumatoid arthritis (RA). The use of disease-modifying antirheumatic drugs (DMARDs) often starts in the early stage of RA; therefore, women of reproductive age are at risk for exposure to a DMARD

  18. Factors associated with influenza and pneumococcal vaccine uptake among rheumatoid arthritis patients in Denmark invited to participate in a pneumococcal vaccine trial (Immunovax_RA)

    DEFF Research Database (Denmark)

    Nguyen, MTT; Lindegaard, H.; Hendricks, O.

    2017-01-01

    the survey during scheduled follow-up visits. The questionnaire included questions concerning previous influenza and pneumococcal vaccine uptake, attitudes about vaccination, and socio-demographic factors. Factors associated with recalled vaccine uptake were assessed by multivariate logistic regression....... Results: A total of 192 RA patients completed the survey, 134 (70%) of whom were women and 90 (47%) were aged ≥ 65 years. Sixty-seven patients (35%) received conventional disease-modifying anti-rheumatic drugs (cDMARDs) and 125 (65%) combination therapy with biological disease-modifying anti...

  19. A short history of anti-rheumatic therapy - V. Analgesics

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available The pharmacological treatment of pain has very ancient origins, when plant-derived products were used, including mandrake extracts and opium, a dried latex obtained from Papaver somniferum. In the XVI and XVII centuries opium came into the preparation of two compounds widely used for pain relief: laudanum and Dover’s powder. The analgesic properties of extracts of willow bark were then recognized and later, in the second half of the XIX century, experimental studies on chemically synthesized analgesics were planned, thus promoting the marketing of some derivatives of para-amino-phenol and pyrazole, the predecessors of paracetamol and metamizol. In the XX century, nonsteroidal anti-inflammatory drugs were synthesized, such as phenylbutazone, which was initially considered primarily a pain medication. The introduction on the market of centrally acting analgesics, such as tramadol, sometimes used in the treatment of rheumatic pain. is quite recent.

  20. Critical appraisal of the guidelines for the management of ankylosing spondylitis: disease-modifying antirheumatic drugs.

    Science.gov (United States)

    Soriano, Enrique R; Clegg, Daniel O; Lisse, Jeffrey R

    2012-05-01

    Surprisingly, little data are available for the use of disease-modifying antirheumatic drugs in ankylosing spondylitis. Sulfasalazine has been the best studied. Efficacy data for individual agents (including pamidronate) and combinations of agents are detailed in this review. Intriguingly, these agents continue to be used with some frequency, even in the absence of efficacy data. To answer these questions, additional systematic studies of these agents in ankylosing spondylitis are needed and will likely need to be done by interested collaborative groups such as SPARTAN.

  1. New FDA-Approved Disease-Modifying Therapies for Multiple Sclerosis.

    Science.gov (United States)

    English, Clayton; Aloi, Joseph J

    2015-04-01

    Interferon injectables and glatiramer acetate have served as the primary disease-modifying treatments for multiple sclerosis (MS) since their introduction in the 1990s and are first-line treatments for relapsing-remitting forms of MS (RRMS). Many new drug therapies were launched since early 2010, expanding the drug treatment options considerably in a disease state that once had a limited treatment portfolio. The purpose of this review is to critically evaluate the safety profile and efficacy data of disease-modifying agents for MS approved by the US Food and Drug Administration (FDA) from 2010 to the present and provide cost and available pharmacoeconomic data about each new treatment. Peer-reviewed clinical trials, pharmacoeconomic studies, and relevant pharmacokinetic/pharmacologic studies were identified from MEDLINE (January 2000-December 2014) by using the search terms multiple sclerosis, fingolimod, teriflunomide, alemtuzumab, dimethyl fumarate, pegylated interferon, peginterferon beta-1a, glatiramer 3 times weekly, and pharmacoeconomics. Citations from available articles were also reviewed for additional references. The databases publically available at www.clinicaltrials.gov and www.fda.gov were searched for unpublished studies or studies currently in progress. A total of 5 new agents and 1 new dosage formulation were approved by the FDA for the treatment of RRMS since 2010. Peginterferon beta-1a and high-dose glatiramer acetate represent 2 new effective injectable options for MS that reduce burden of administration seen with traditional interferon and low-dose glatiramer acetate. Fingolimod, teriflunomide, and dimethyl fumarate represent new oral agents available for MS, and their efficacy in reducing annualized relapse rates is 48% to 55%, 22% to 36.3%, and 44% to 53%, respectively, compared with placebo. Alemtuzumab is a biologic given over a 2-year span that reduced annualized relapse rates by 55% in treatment-naive patients and by 49% in patients

  2. Infections in patients with multiple sclerosis: Implications for disease-modifying therapy.

    Science.gov (United States)

    Celius, E G

    2017-11-01

    Patients with multiple sclerosis have an increased risk of infections compared to the general population. The increased risk has been described for decades and is not alone attributed to the use of disease-modifying drugs, but secondary to the disability. The introduction of more potent immunomodulatory drugs may cause an additional challenge, and depending on the mechanism of action, a treatment-induced increased risk of bacterial, viral, fungal or parasitic infections is observed. The choice of treatment in the individual patient with infections and multiple sclerosis must be guided by the drugs' specific mechanism of action, the drug-specific risk of infection and comorbidities. Increased monitoring and follow-up through treatment registries is warranted to increase our understanding and thereby improve management. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. [The trend of developing new disease-modifying drugs in Alzheimer's disease].

    Science.gov (United States)

    Arai, Hiroyuki; Furukawa, Katsutoshi; Tomita, Naoki; Ishiki, Aiko; Okamura, Nobuyuki; Kudo, Yukitsuka

    2016-03-01

    Development of symptomatic treatment of Alzheimer s disease by cholinesterase inhibitors like donepezil was successful. However, it is a disappointment that development of disease-modifying drugs such as anti-amyloid drug based on amyloid-cascade theory has been interrupted or unsuccessful. Therefore, we have to be more cautious regarding inclusion criteria for clinical trials of new drugs. We agree that potentially curative drugs should be started before symptoms begin as a preemptive therapy or prevention trial. The concept of personalized medicine also is important when ApoE4-related amyloid reducing therapy is considered. Unfortunately, Japanese-ADNI has suffered a setback since 2014. However, Ministry of Health, Labour and Welfare gave a final remark that there was nothing wrong in the data managing process in the J-ADNI data center. We should pay more attention to worldwide challenges of speeding up new drug development.

  4. SQ grass sublingual allergy immunotherapy tablet for disease-modifying treatment of grass pollen allergic rhinoconjunctivitis

    DEFF Research Database (Denmark)

    Dahl, Ronald; Roberts, Graham; de Blic, Jacques

    2016-01-01

    BACKGROUND: Allergy immunotherapy is a treatment option for allergic rhinoconjunctivitis (ARC). It is unique compared with pharmacotherapy in that it modifies the immunologic pathways that elicit an allergic response. The SQ Timothy grass sublingual immunotherapy (SLIT) tablet is approved in North...... America and throughout Europe for the treatment of adults and children (≥5 years old) with grass pollen-induced ARC. OBJECTIVE: The clinical evidence for the use of SQ grass SLIT-tablet as a disease-modifying treatment for grass pollen ARC is discussed in this review. METHODS: The review included...... the suitability of SQ grass SLIT-tablet for patients with clinically relevant symptoms to multiple Pooideae grass species, single-season efficacy, safety, adherence, coseasonal initiation, and cost-effectiveness. The data from the long-term SQ grass SLIT-tablet clinical trial that evaluated a clinical effect 2...

  5. Patients’ satisfaction with and views about treatment with disease-modifying drugs in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Caroline Vieira Spessotto

    2016-08-01

    Full Text Available ABSTRACT Objective The treatment of multiple sclerosis (MS with disease-modifying-drugs (DMDs is evolving and new drugs are reaching the market. Efficacy and safety aspects of the drugs are crucial, but the patients’ satisfaction with the treatment must be taken into consideration. Methods Individual interview with patients with MS regarding their satisfaction and points of view on the treatment with DMDs. Results One hundred and twenty eight patients attending specialized MS Units in five different cities were interviewed. Over 80% of patients were very satisfied with the drugs in use regarding convenience and perceived benefits. The only aspect scoring lesser values was tolerability. Conclusion Parameters for improving treatment in MS must include efficacy, safety, and patient satisfaction with the given DMD.

  6. Developing Disease-Modifying Treatments in Alzheimer's Disease - A Perspective from Roche and Genentech.

    Science.gov (United States)

    Doody, R

    2017-01-01

    Alzheimer's disease (AD) is a chronic neurodegenerative disease for which no preventative or disease-modifying treatments currently exist. Pathological hallmarks include amyloid plaques and neurofibrillary tangles composed of hyper-phosphorylated tau protein. Evidence suggests that both pathologies are self-propagating once established. However, the lag time between neuropathological changes in the brain and the onset of even subtle clinical symptomatology means that patients are often diagnosed late when pathology, and neurodegeneration secondary to these changes, may have been established for several years. Complex pathological pathways associated with susceptibility to AD and changes that occur downstream of the neuropathologic process further contribute to the challenging endeavour of developing novel disease-modifying therapy. Recognising this complexity, effective management of AD must include reliable screening and early diagnosis in combination with effective therapeutic management of the pathological processes. Roche and Genentech are committed to addressing these unmet needs through developing a comprehensive portfolio of diagnostics and novel therapies. Beginning with the most scientifically supported targets, this approach includes two targeted amyloid-β monoclonal antibody therapies, crenezumab and gantenerumab, and an anti-tau monoclonal antibody, RO7105705, as well as a robust biomarker platform to aid in the early identification of people at risk or in the early stages of AD. Identification and implementation of diagnostic tools will support the enrolment of patients into clinical trials; furthermore, these tools should also support evaluation of the clinical efficacy and safety profile of the novel therapeutic agents tested in these trials. This review discusses the therapeutic agents currently under clinical development.

  7. Download this PDF file

    African Journals Online (AJOL)

    psoriatic arthritis (PsA), and inflammatory bowel disease (IBD), as ... The biologic disease-modifying anti-rheumatic drugs (DMARDs) are classified according to .... (an integrin receptor antagonist) may also be effective in Crohn's disease and ...

  8. Adherence to Disease Modifying Drugs among Patients with Multiple Sclerosis in Germany: A Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Kerstin Hansen

    Full Text Available Long-term therapies such as disease modifying therapy for Multiple Sclerosis (MS demand high levels of medication adherence in order to reach acceptable outcomes. The objective of this study was to describe adherence to four disease modifying drugs (DMDs among statutorily insured patients within two years following treatment initiation. These drugs were interferon beta-1a i.m. (Avonex, interferon beta-1a s.c. (Rebif, interferon beta-1b s.c. (Betaferon and glatiramer acetate s.c. (Copaxone.This retrospective cohort study used pharmacy claims data from the data warehouse of the German Institute for Drug Use Evaluation (DAPI from 2001 through 2009. New or renewed DMD prescriptions in the years 2002 to 2006 were identified and adherence was estimated during 730 days of follow-up by analyzing the medication possession ratio (MPR as proxy for compliance and persistence defined as number of days from initiation of DMD therapy until discontinuation or interruption.A total of 52,516 medication profiles or therapy cycles (11,891 Avonex, 14,060 Betaferon, 12,353 Copaxone and 14,212 Rebif from 50,057 patients were included into the analysis. Among the 4 cohorts, no clinically relevant differences were found in available covariates. The Medication Possession Ratio (MPR measured overall compliance, which was 39.9% with a threshold MPR≥0.8. There were small differences in the proportion of therapy cycles during which a patient was compliant for the following medications: Avonex (42.8%, Betaferon (40.6%, Rebif (39.2%, and Copaxone (37%. Overall persistence was 32.3% at the end of the 24 months observation period, i.e. during only one third of all included therapy cycles patients did not discontinue or interrupt DMD therapy. There were also small differences in the proportion of therapy cycles during which a patient was persistent as follows: Avonex (34.2%, Betaferon (33.4%, Rebif (31.7% and Copaxone (29.8%.Two years after initiating MS-modifying therapy, only

  9. A new proposal for randomized start design to investigate disease-modifying therapies for Alzheimer disease.

    Science.gov (United States)

    Zhang, Richard Y; Leon, Andrew C; Chuang-Stein, Christy; Romano, Steven J

    2011-02-01

    The increasing prevalence of Alzheimer disease (AD) and lack of effective agents to attenuate progression have accelerated research and development of disease modifying (DM) therapies. The traditional parallel group design and single time point analysis used in the support of past AD drug approvals address symptomatic benefit over relatively short treatment durations. More recent trials investigating disease modification are by necessity longer in duration and require larger sample sizes. Nevertheless, trial design and analysis remain mostly unchanged and may not be adequate to meet the objective of demonstrating disease modification. Randomized start design (RSD) has been proposed as an option to study DM effects, but its application in AD trials may have been hampered by certain methodological challenges. To address the methodological issues that have impeded more extensive use of RSD in AD trial and to encourage other researchers to develop novel design and analysis methodologies to better ascertain DM effects for the next generation of AD therapies, we propose a stepwise testing procedure to evaluate potential DM effects of novel AD therapies. Alzheimer Disease Assessment Scale-Cognitive Subscale (ADAS-cog) is used for illustration. We propose to test three hypotheses in a stepwise sequence. The three tests pertain to treatment difference at two separate time points and a difference in the rate of change. Estimation is facilitated by the Mixed-effects Model for Repeated Measures approach. The required sample size is estimated using Monte Carlo simulations and by modeling ADAS-cog data from prior longitudinal AD studies. The greatest advantage of the RSD proposed in this article is its ability to critically address the question on a DM effect. The AD trial using the new approach would be longer (12-month placebo period plus 12-month delay-start period; total 24-month duration) and require more subjects (about 1000 subjects per arm for the non-inferiority margin

  10. Baseline predictors of persistence to first disease-modifying treatment in multiple sclerosis.

    Science.gov (United States)

    Zettl, U K; Schreiber, H; Bauer-Steinhusen, U; Glaser, T; Hechenbichler, K; Hecker, M

    2017-08-01

    Patients with multiple sclerosis (MS) require lifelong therapy. However, success of disease-modifying therapies is dependent on patients' persistence and adherence to treatment schedules. In the setting of a large multicenter observational study, we aimed at assessing multiple parameters for their predictive power with respect to discontinuation of therapy. We analyzed 13 parameters to predict discontinuation of interferon beta-1b treatment during a 2-year follow-up period based on data from 395 patients with MS who were treatment-naïve at study onset. Besides clinical characteristics, patient-related psychosocial outcomes were assessed as well. Among patients without clinically relevant fatigue, males showed a higher persistence rate than females (80.3% vs 64.7%). Clinically relevant fatigue scores decreased the persistence rate in men and especially in women (71.4% and 51.2%). Besides gender and fatigue, univariable and multivariable analyses revealed further factors associated with interferon beta-1b therapy discontinuation, namely lower quality of life, depressiveness, and higher relapse rate before therapy initiation, while higher education, living without a partner, and higher age improved persistence. Patients with higher grades of fatigue and depressiveness are at higher risk to prematurely discontinue MS treatment; especially, women suffering from fatigue have an increased discontinuation rate. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Disease-modifying treatments for early and advanced multiple sclerosis: a new treatment paradigm.

    Science.gov (United States)

    Giovannoni, Gavin

    2018-06-01

    The treatment of multiple sclerosis is evolving rapidly with 11 classes of disease-modifying therapies (DMTs). This article provides an overview of a new classification system for DMTs and treatment paradigm for using these DMTs effectively and safely. A summary of research into the use of more active approaches to early and effective treatment of multiple sclerosis with defined treatment targets of no evident disease activity (NEDA). New insights are discussed that is allowing the field to begin to tackle more advanced multiple sclerosis, including people with multiple sclerosis using wheelchairs. However, the need to modify expectations of what can be achieved in more advanced multiple sclerosis are discussed; in particular, the focus on neuronal systems with reserve capacity, for example, upper limb, bulbar and visual function. The review describes a new more active way of managing multiple sclerosis and concludes with a call to action in solving the problem of slow adoption of innovations and the global problem of untreated, or undertreated, multiple sclerosis.

  12. Fertility, pregnancy and childbirth in patients with multiple sclerosis: impact of disease-modifying drugs.

    Science.gov (United States)

    Amato, Maria Pia; Portaccio, Emilio

    2015-03-01

    In recent decades, pregnancy-related issues in multiple sclerosis (MS) have received growing interest. MS is more frequent in women than in men and typically starts during child-bearing age. An increasing number of disease-modifying drugs (DMDs) for the treatment of MS are becoming available. Gathering information on their influences on pregnancy-related issues is of crucial importance for the counselling of MS patients. As for the immunomodulatory drugs (interferons and glatiramer acetate), accumulating evidence points to the relative safety of pregnancy exposure in terms of maternal and foetal outcomes. In case of higher clinical disease activity before pregnancy, these drugs could be continued until conception. As for the 'newer' drugs (fingolimod, natalizumab, teriflunomide, dimethyl fumarate and alemtuzumab), the information is more limited. Whereas fingolimod and teriflunomide are likely associated with an increased risk of foetal malformations, the effects of natalizumab, dimethyl fumarate and alemtuzumab still need to be ascertained. This article provides a review of the available information on the use of DMDs during pregnancy, with a specific focus on fertility, foetal development, delivery and breast-feeding.

  13. Biologic and oral disease-modifying antirheumatic drug monotherapy in rheumatoid arthritis

    Science.gov (United States)

    Emery, Paul; Sebba, Anthony; Huizinga, Tom W J

    2013-01-01

    Clinical evidence demonstrates coadministration of tumour necrosis factor inhibitor (TNFi) agents and methotrexate (MTX) is more efficacious than administration of TNFi agents alone in patients with rheumatoid arthritis, leading to the perception that coadministration of MTX with all biologic agents or oral disease-modifying antirheumatic drugs is necessary for maximum efficacy. Real-life registry data reveal approximately one-third of patients taking biologic agents use them as monotherapy. Additionally, an analysis of healthcare claims data showed that when MTX was prescribed in conjunction with a biologic agent, as many as 58% of patients did not collect the MTX prescription. Given this discrepancy between perception and real life, we conducted a review of the peer-reviewed literature and rheumatology medical congress abstracts to determine whether data support biologic monotherapy as a treatment option for patients with rheumatoid arthritis. Our analysis suggests only for tocilizumab is there evidence that the efficacy of biologic monotherapy is comparable with combination therapy with MTX. PMID:23918035

  14. Adherence to synthetic disease-modifying Antirheumatic Drugs in Rheumatoid Arthritis: Results of the OBSERVAR Study.

    Science.gov (United States)

    Juan Mas, Antonio; Castañeda, Santos; Cantero Santamaría, José I; Baquero, José L; Del Toro Santos, Francisco J

    2017-12-27

    Treatment compliance with disease-modifying antirheumatic drugs (DMARD) is essential to achieve the therapeutic goals in rheumatoid arthritis (RA). However, despite the need for good compliance, there is evidence that patients with RA frequently fail to use DMARD for the control of RA. Thus, the main objective of the OBSERVAR study is to evaluate the reasons for the lack of therapeutic adherence to synthetic DMARD in these patients. A Delphi process involving 18 randomly selected Spanish rheumatologists determined the level of agreement with 66 causes of noncompliance selected from the literature in relation to synthetic DMARD in RA. The reasons for noncompliance were consistent in 75.7%, although 3 reasons (4.5%) were highly consistent: 1) not knowing what to do in the case of an adverse event with DMARD; 2) not having undergone adherence screening by health personnel for early detection of "noncompliant patients"; and 3) not having undergone interventions or strategies that improve adherence. In order to improve adherence to RA treatment with synthetic DMARD, the patient should be adequately informed of each new treatment introduced, the patient's compliance profile should be incorporated into the clinical routine and the patient's motivation for therapeutic compliance be reinforced through the methods available to us. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  15. The Neuroprotective Disease-Modifying Potential of Psychotropics in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Edward C. Lauterbach

    2012-01-01

    Full Text Available Neuroprotective treatments in Parkinson's disease (PD have remained elusive. Psychotropics are commonly prescribed in PD without regard to their pathobiological effects. The authors investigated the effects of psychotropics on pathobiological proteins, proteasomal activity, mitochondrial functions, apoptosis, neuroinflammation, trophic factors, stem cells, and neurogenesis. Only findings replicated in at least 2 studies were considered for these actions. Additionally, PD-related gene transcription, animal model, and human neuroprotective clinical trial data were reviewed. Results indicate that, from a PD pathobiology perspective, the safest drugs (i.e., drugs least likely to promote cellular neurodegenerative mechanisms balanced against their likelihood of promoting neuroprotective mechanisms include pramipexole, valproate, lithium, desipramine, escitalopram, and dextromethorphan. Fluoxetine favorably affects transcription of multiple genes (e.g., MAPT, GBA, CCDC62, HIP1R, although it and desipramine reduced MPTP mouse survival. Haloperidol is best avoided. The most promising neuroprotective investigative priorities will involve disease-modifying trials of the safest agents alone or in combination to capture salutary effects on H3 histone deacetylase, gene transcription, glycogen synthase kinase-3, α-synuclein, reactive oxygen species (ROS, reactive nitrogen species (RNS, apoptosis, inflammation, and trophic factors including GDNF and BDNF.

  16. Huperzine A: Is it an Effective Disease-Modifying Drug for Alzheimer's Disease?

    Science.gov (United States)

    Qian, Zhong Ming; Ke, Ya

    2014-01-01

    Alzheimer's disease (AD) is a progressive neurodegenerative disorder for which there is no cure. Huperzine A (HupA) is a natural inhibitor of acetylcholinesterase (AChE) derived from the Chinese folk medicine Huperzia serrata (Qian Ceng Ta). It is a licensed anti-AD drug in China and is available as a nutraceutical in the US. A growing body of evidence has demonstrated that HupA has multifaceted pharmacological effects. In addition to the symptomatic, cognitive-enhancing effect via inhibition of AChE, a number of recent studies have reported that this drug has "non-cholinergic" effects on AD. Most important among these is the protective effect of HupA on neurons against amyloid beta-induced oxidative injury and mitochondrial dysfunction as well as via the up-regulation of nerve growth factor and antagonizing N-methyl-d-aspartate receptors. The most recent discovery that HupA may reduce brain iron accumulation lends further support to the argument that HupA could serve as a potential disease-modifying agent for AD and also other neurodegenerative disorders by significantly slowing down the course of neuronal death.

  17. Huperzine A: Is it an Effective Disease-Modifying Drug for Alzheimer’s Disease?

    Science.gov (United States)

    Qian, Zhong Ming; Ke, Ya

    2014-01-01

    Alzheimer’s disease (AD) is a progressive neurodegenerative disorder for which there is no cure. Huperzine A (HupA) is a natural inhibitor of acetylcholinesterase (AChE) derived from the Chinese folk medicine Huperzia serrata (Qian Ceng Ta). It is a licensed anti-AD drug in China and is available as a nutraceutical in the US. A growing body of evidence has demonstrated that HupA has multifaceted pharmacological effects. In addition to the symptomatic, cognitive-enhancing effect via inhibition of AChE, a number of recent studies have reported that this drug has “non-cholinergic” effects on AD. Most important among these is the protective effect of HupA on neurons against amyloid beta-induced oxidative injury and mitochondrial dysfunction as well as via the up-regulation of nerve growth factor and antagonizing N-methyl-d-aspartate receptors. The most recent discovery that HupA may reduce brain iron accumulation lends further support to the argument that HupA could serve as a potential disease-modifying agent for AD and also other neurodegenerative disorders by significantly slowing down the course of neuronal death. PMID:25191267

  18. Huperzine A: is it an effective disease-modifying drug for Alzheimer’s disease?

    Directory of Open Access Journals (Sweden)

    Zhong Ming eQian

    2014-08-01

    Full Text Available Alzheimer's disease (AD is a progressive neurodegenerative disorder for which there is no cure. Huperzine A (HupA is a natural inhibitor of acetylcholinesterase (AChE derived from the Chinese folk medicine Huperzia serrata (Qian Ceng Ta. It is a licensed anti-AD drug in China and is available as a nutraceutical in the US. A growing body of evidence has demonstrated that HupA has multifaceted pharmacological effects. In addition to the symptomatic, cognitive-enhancing effect via inhibition of AChE, a number of recent studies have reported that this drug has non-cholinergic effects on AD. Most important among these is the protective effect of HupA on neurons against amyloid beta-induced oxidative injury and mitochondrial dysfunction as well as via the up-regulation of nerve growth factor and antagonizing N-methyl-D-aspartate receptors. The most recent discovery that HupA may reduce brain iron accumulation lends further support to the argument that HupA could serve as a potential disease-modifying agent for AD and also other neurodegenerative disorders by significantly slowing down the course of neuronal death.

  19. Perspectives and experiences of Dutch multiple sclerosis patients and multiple sclerosis-specialized neurologists on injectable disease-modifying treatment

    NARCIS (Netherlands)

    Visser, Leo H.; Heerings, Marco A.; Jongen, Peter J.; van der Hiele, Karin

    2016-01-01

    Background: The adherence to treatment with injectable disease-modifying drugs (DMDs) in multiple sclerosis (MS) may benefit from adequate information provision and management of expectations. The communication between patients and physicians is very important in this respect. The current study

  20. Health-Related Quality of Life in Patients with Multiple Sclerosis : Impact of Disease-Modifying Drugs

    NARCIS (Netherlands)

    Jongen, Peter Joseph

    Multiple sclerosis (MS) has a profound impact on health-related quality of life (HRQoL), a comprehensive subjective measure of the patient's health status. Assessment of HRQoL informs on the potential advantages and disadvantages of disease-modifying drugs (DMDs) beyond their effects on

  1. Pamidronate infusion improved two cases of intractable seronegative rheumatoid arthritise

    Directory of Open Access Journals (Sweden)

    Mansour Salesi

    2011-01-01

    Full Text Available Pamidronate is a bisphosphonate derivative that can inhibit bone resorption by actions on osteoclasts and increase bone density in spite of treatment with steroids. This drug has the anti-inflammatory effect by increase apoptosis of monocytes. 5-10 percent of rheumatoid arthritis patients is seronegative and may be resistant to conventional disease modifying anti rheumatic drugs (DMARDs. Intravenous (IV pamidronate can be effective in disease control in seronegative rheumatoid arthritis. We report two cases of seronegative and drug resistant rheumatoid arthritis that favorably responds to pamidronate.

  2. Monitoring patients with rheumatoid arthritis in routine care

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Jensen, Dorte Vendelbo; Krogh, Niels Steen

    2014-01-01

    OBJECTIVES: Advances in aggressive use of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) as well as biological DMARDs (bDMARDs) have improved the treatment armamentarium for rheumatologists, and modern treatment principles include a treat-to-target (T2T) strategy. However......, little is known about the feasibility of a T2T strategy in patients with rheumatoid arthritis (RA) treated in routine care. The aim of the present study was to (i) present the annual number of patients included in DANBIO between 2006 and 2013 and their disease characteristics and (ii) estimate coverage...

  3. Infections and treatment of patients with rheumatic diseasesTumor necrosis factor-alpha binding capacity and anti-infliximab antibodies measured by fluid-phase radioimmunoassays as predictors of clinical efficacy of infliximab in Crohn's disease

    DEFF Research Database (Denmark)

    Atzeni, F.; Bendtzen, K.; Bobbio-Pallavicini, F.

    2008-01-01

    /inflammatory conditions, and current therapies have the aim of providing adequate (low) compensatory doses, the timing of GC administration, such as during the nocturnal turning-on phase of tumour necrosis factor (TNF) secretion, can be extremely important. The use of the lowest possible GC dose, at night......, and for the shortest possible time should therefore greatly reduce the risk of infections. Infection is a major co-morbidity in rheumatoid arthritis (RA), and conventional disease-modifying anti-rheumatic drugs (DMARDs) can increase the risk of their occurrence, including tuberculosis. TNF-alpha plays a key role...

  4. Dumping convention

    International Nuclear Information System (INIS)

    Roche, P.

    1992-01-01

    Sea dumping of radioactive waste has, since 1983, been precluded under a moratorium established by the London Dumping Convention. Pressure from the nuclear industry to allow ocean dumping of nuclear waste is reported in this article. (author)

  5. Treatment patterns in disease-modifying therapy for patients with multiple sclerosis in the United States.

    Science.gov (United States)

    Bonafede, Machaon M; Johnson, Barbara H; Wenten, Madé; Watson, Crystal

    2013-10-01

    Patients with multiple sclerosis (MS) whose disease activity is inadequately controlled with a platform therapy (interferon beta or glatiramer acetate [GA]) may switch to another platform therapy or escalate therapy to natalizumab or fingolimod, which were approved in the US in 2006 and 2010, respectively. The objective of this study was to describe treatment patterns in patients with multiple sclerosis (MS) in the United States who were followed for 2 years after initiating a disease-modifying therapy (DMT). A retrospective observational cohort study was conducted to examine treatment patterns of initial DMT use (on initial therapy for 2 years with and without gaps of ≥ 60 days, medication switching, and discontinuation) among patients with MS who initiated a platform therapy (interferon-β or glatiramer acetate) or natalizumab between January 1, 2007, and September 30, 2009; the first DMT claim was the index. Eligible patients were identified in the MarketScan Commercial and Medicare Supplemental databases based on continuous enrollment for 6 months before (preindex period) and 24 months after their index date, with a diagnosis of MS and no claim for a previous DMT in the 6-month preindex period. Demographics at index and clinical characteristics during the preindex period were also analyzed. A total of 6181 MS patients were included, with 5735 (92.8%) starting on platform therapy. Natalizumab initiators were more likely to stay on index therapy (32.3% vs 16.9%, P treatment gaps of ≥ 60 days (44.8% vs 55.3%, P treatment (13.9% vs 19.1%, P = 0.007) and took longer to switch (400.9 days vs 330.7 days, P treatment gaps, and switch less than platform initiators in the 2 years after treatment initiation. Switching between platform therapies is common despite evidence that MS patients on platform therapy may benefit from switching to natalizumab. © 2013 Elsevier HS Journals, Inc. All rights reserved.

  6. Management of coccidioidomycosis in patients receiving biologic response modifiers or disease-modifying antirheumatic drugs.

    Science.gov (United States)

    Taroumian, Sara; Knowles, Susan L; Lisse, Jeffrey R; Yanes, James; Ampel, Neil M; Vaz, Austin; Galgiani, John N; Hoover, Susan E

    2012-12-01

    Coccidioidomycosis (valley fever) is an endemic fungal infection of the American Southwest, an area with a large population of patients with rheumatic diseases. There are currently no guidelines for management of patients who develop coccidioidomycosis while under treatment with biologic response modifiers (BRMs) or disease-modifying antirheumatic drugs (DMARDs). We conducted a retrospective study of how both concurrent diseases were managed and the patient outcomes at 2 centers in Tucson, Arizona. A retrospective chart review identified patients who developed coccidioidomycosis during treatment with DMARDs or BRMs. Patients were seen at least once in a university-affiliated or Veterans Affairs outpatient rheumatology clinic in Tucson, Arizona, between 2007 and 2009. Forty-four patients were identified. Rheumatologic treatment included a BRM alone (n = 11), a DMARD alone (n = 8), or combination therapy (n = 25). Manifestations of coccidioidomycosis included pulmonary infection (n = 29), disseminated disease (n = 9), and asymptomatic positive coccidioidal serologies (n = 6). After the diagnosis of coccidioidomycosis, 26 patients had BRMs and DMARDs stopped, 8 patients had BRMs stopped but DMARD therapy continued, and 10 patients had no change in their immunosuppressive therapy. Forty-one patients had antifungal therapy initiated for 1 month or longer. Followup data were available for 38 patients. BRM and/or DMARD therapy was continued or resumed in 33 patients, only 16 of whom continued concurrent antifungal therapy. None of the patients have had subsequent dissemination or complications of coccidioidomycosis. Re-treating rheumatic disease patients with a BRM and/or a DMARD after coccidioidomycosis appears to be safe in some patients. We propose a management strategy based on coccidioidomycosis disease activity. Copyright © 2012 by the American College of Rheumatology.

  7. Therapeutic compliance of first line disease-modifying therapies in patients with multiple sclerosis. COMPLIANCE Study.

    Science.gov (United States)

    Saiz, A; Mora, S; Blanco, J

    2015-05-01

    Non-adherence to disease-modifying therapies (DMTs) in multiple sclerosis may be associated with reduced efficacy. We assessed compliance, the reasons for non-compliance, treatment satisfaction, and quality of life (QoL) of patients treated with first-line therapies. A cross-sectional, multicenter study was conducted that included relapsing multiple sclerosis patients. Compliance in the past month was assessed using Morisky-Green test. Seasonal compliance and reasons for non-compliance were assessed by an ad-hoc questionnaire. Treatment satisfaction and QoL were evaluated by means of TSQM and PRIMUS questionnaires. A total of 220 patients were evaluated (91% relapsing-remitting); the mean age was 39.1 years, 70% were female, and the average time under treatment was 5.4 years. Subcutaneous interferon (IFN) β-1b was used in 23% of the patients, intramuscular IFN β-1a in 21%, subcutaneous IFN β-1a in 37%, and with glatiramer acetate in 19%. The overall compliance was 75%, with no significant differences related to the therapy, and 81% did not report any seasonal variation. Compliant patients had significantly lower disability scores and time of diagnosis, and greater satisfaction with treatment and its effectiveness. Discomfort and flu-like symptoms were the most frequent reasons for non-compliance. The satisfaction and QoL were associated with less disability and number of therapeutic switches. The rate of compliance, satisfaction and QoL in multiple sclerosis patients under DMTs is high, especially for those newly diagnosed, less disabled, and with fewer therapeutic switches. Discomfort and flu-like symptoms associated with injected therapies significantly affect adherence. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  8. Environmental enrichment imparts disease-modifying and transgenerational effects on genetically-determined epilepsy and anxiety.

    Science.gov (United States)

    Dezsi, Gabi; Ozturk, Ezgi; Salzberg, Michael R; Morris, Margaret; O'Brien, Terence J; Jones, Nigel C

    2016-09-01

    The absence epilepsies are presumed to be caused by genetic factors, but the influence of environmental exposures on epilepsy development and severity, and whether this influence is transmitted to subsequent generations, is not well known. We assessed the effects of environmental enrichment on epilepsy and anxiety outcomes in multiple generations of GAERS - a genetic rat model of absence epilepsy that manifests comorbid elevated anxiety-like behaviour. GAERS were exposed to environmental enrichment or standard housing beginning either prior to, or after epilepsy onset, and underwent EEG recordings and anxiety testing. Then, we exposed male GAERS to early enrichment or standard housing and generated F1 progeny, which also underwent EEG recordings. Hippocampal CRH mRNA expression and DNA methylation were assessed using RT-PCR and pyrosequencing, respectively. Early environmental enrichment delayed the onset of epilepsy in GAERS, and resulted in fewer seizures in adulthood, compared with standard housed GAERS. Enrichment also reduced the frequency of seizures when initiated in adulthood. Anxiety levels were reduced by enrichment, and these anti-epileptogenic and anxiolytic effects were heritable into the next generation. We also found reduced expression of CRH mRNA in GAERS exposed to enrichment, but this was not due to changes in DNA methylation. Environmental enrichment produces disease-modifying effects on genetically determined absence epilepsy and anxiety, and these beneficial effects are transferable to the subsequent generation. Reduced CRH expression was associated with these phenotypic improvements. Environmental stimulation holds promise as a naturalistic therapy for genetically determined epilepsy which may benefit subsequent generations. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. ANALYSIS OF DISEASE MODIFYING DRUGS ADMINISTRATION FREGUENCY AND CAUSES OF THEIR WITHDRAWAL IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    E V Pavlova

    2000-01-01

    Full Text Available Aim of studdy: To assess the frequency of practical application of different basic drugs in rheumatoid arthritis (RA. Material and methods: Tlxe study was conducted basing of questionner of pts and analysis of ycases by randomized sampling among 103 consequent pts (M:F= 13:90 with reliable RA (ARA, 1987 in rheumatologic department of Clinical Hospital Nol in Ekaterinburg. 74% of pts under study demonstrated systemic manifestations: anemia (in 47 pts, lymphadenopathy (in 34, rheumatoid nodules (in 15, Sjogren s syndrome (in 4, nephropathy (in 4, vascular disturbances including Raynaud s phenomenon, capillarites (by 1 pt. Results: In the course of disease basic therapy was prescribed to 88 out of103 (85.4% pts and one and the same patient could take different basic drugs. Aminochinoline drugs prevailed, after them more frequent were immunodepressants and gold preparations. More rarely pts had sulfasalazin, cuprenil and wobenzym. In general, in 133 out of 184 cases of prescribing basic drugs they were canceled. The reason for cancellation were: prevalently absence of the drug in the pharmaceutical stores (in 48 cases averagely in 8 months of taking the drug; then they insufficient efficacy (44 cases averagely in 1.3 year. In 18 cases pts themselves stopped treatment averagely in 3.5 months of drug taking. Conclusion: In the majority of cases of basic drugs cancellation in RA the cause is their absence in sail especially on free of charge prescription. Cases ofself-cancellation of the drug demonstrate the need of explaining to pts the necessity> of long-term taking disease-modifying drugs.

  10. Patient perspectives on switching disease-modifying therapies in the NARCOMS registry.

    Science.gov (United States)

    Salter, Amber R; Marrie, Ruth Ann; Agashivala, Neetu; Belletti, Daniel A; Kim, Edward; Cutter, Gary R; Cofield, Stacey S; Tyry, Tuula

    2014-01-01

    The evolving landscape of disease-modifying therapies (DMTs) for multiple sclerosis raises important questions about why patients change DMTs. Physicians and patients could benefit from a better understanding of the reasons for switching therapy. To investigate the reasons patients switch DMTs and identify characteristics associated with the decision to switch. The North American Research Committee on Multiple Sclerosis (NARCOMS) Registry conducted a supplemental survey among registry participants responding to the 2011 update survey. The supplemental survey investigated reasons for switching DMT, origin of the discussion of DMT change, and which factors influenced the decision. Chi-square tests, Fisher's exact tests, and logistic regression were used for the analyses. Of the 691 eligible candidates, 308 responded and met the inclusion criteria (relapsing disease course, switched DMT after September 2010). The responders were 83.4% female, on average 52 years old, with a median (interquartile range) Patient-Determined Disease Steps score of 4 (2-5). The most recent prior therapy included first-line injectables (74.5%), infusions (18.1%), an oral DMT (3.4%), and other DMTs (4.0%). The discussion to switch DMT was initiated almost equally by physicians and participants. The primary reason for choosing the new DMT was based most frequently on physician's recommendation (24.5%) and patient perception of efficacy (13.7%). Participants frequently initiated the discussion regarding changing DMT, although physician recommendations regarding the specific therapy were still weighed highly. Long-term follow-up of these participants will provide valuable information on their disease trajectory, satisfaction with, and effectiveness of their new medication.

  11. Disease-modifying effect of atipamezole in a model of post-traumatic epilepsy.

    Science.gov (United States)

    Nissinen, Jari; Andrade, Pedro; Natunen, Teemu; Hiltunen, Mikko; Malm, Tarja; Kanninen, Katja; Soares, Joana I; Shatillo, Olena; Sallinen, Jukka; Ndode-Ekane, Xavier Ekolle; Pitkänen, Asla

    2017-10-01

    Treatment of TBI remains a major unmet medical need, with 2.5 million new cases of traumatic brain injury (TBI) each year in Europe and 1.5 million in the USA. This single-center proof-of-concept preclinical study tested the hypothesis that pharmacologic neurostimulation with proconvulsants, either atipamezole, a selective α 2 -adrenoceptor antagonist, or the cannabinoid receptor 1 antagonist SR141716A, as monotherapy would improve functional recovery after TBI. A total of 404 adult Sprague-Dawley male rats were randomized into two groups: sham-injured or lateral fluid-percussion-induced TBI. The rats were treated with atipamezole (started at 30min or 7 d after TBI) or SR141716A (2min or 30min post-TBI) for up to 9 wk. Total follow-up time was 14 wk after treatment initiation. Outcome measures included motor (composite neuroscore, beam-walking) and cognitive performance (Morris water-maze), seizure susceptibility, spontaneous seizures, and cortical and hippocampal pathology. All injured rats exhibited similar impairment in the neuroscore and beam-walking tests at 2 d post-TBI. Atipamezole treatment initiated at either 30min or 7 d post-TBI and continued for 9 wk via subcutaneous osmotic minipumps improved performance in both the neuroscore and beam-walking tests, but not in the Morris water-maze spatial learning and memory test. Atipamezole treatment initiated at 7 d post-TBI also reduced seizure susceptibility in the pentylenetetrazol test 14 wk after treatment initiation, although it did not prevent the development of epilepsy. SR141716A administered as a single dose at 2min post-TBI or initiated at 30min post-TBI and continued for 9 wk had no recovery-enhancing or antiepileptogenic effects. Mechanistic studies to assess the α 2 -adrenoceptor subtype specificity of the disease-modifying effects of atipametzole revealed that genetic ablation of α 2A -noradrenergic receptor function in Adra2A mice carrying an N79P point mutation had antiepileptogenic effects

  12. Patient perspectives on switching disease-modifying therapies in the NARCOMS registry

    Directory of Open Access Journals (Sweden)

    Salter AR

    2014-07-01

    Full Text Available Amber R Salter,1 Ruth Ann Marrie,2,3 Neetu Agashivala,4 Daniel A Belletti,4 Edward Kim,4 Gary R Cutter,1 Stacey S Cofield,1 Tuula Tyry51Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA; 2Department of Internal Medicine, 3Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada; 4Novartis Pharmaceutical Corporation, East Hanover, NJ, USA; 5Division of Neurology, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USAIntroduction: The evolving landscape of disease-modifying therapies (DMTs for multiple sclerosis raises important questions about why patients change DMTs. Physicians and patients could benefit from a better understanding of the reasons for switching therapy. Purpose: To investigate the reasons patients switch DMTs and identify characteristics associated with the decision to switch.Method: The North American Research Committee on Multiple Sclerosis (NARCOMS Registry conducted a supplemental survey among registry participants responding to the 2011 update survey. The supplemental survey investigated reasons for switching DMT, origin of the discussion of DMT change, and which factors influenced the decision. Chi-square tests, Fisher’s exact tests, and logistic regression were used for the analyses. Results: Of the 691 eligible candidates, 308 responded and met the inclusion criteria (relapsing disease course, switched DMT after September 2010. The responders were 83.4% female, on average 52 years old, with a median (interquartile range Patient-Determined Disease Steps score of 4 (2–5. The most recent prior therapy included first-line injectables (74.5%, infusions (18.1%, an oral DMT (3.4%, and other DMTs (4.0%. The discussion to switch DMT was initiated almost equally by physicians and participants. The primary reason for choosing the new DMT was based most frequently on physician’s recommendation (24.5% and patient perception of efficacy (13.7%. Conclusion

  13. Disease modifying and antiangiogenic activity of 2-Methoxyestradiol in a murine model of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Moore Elizabeth G

    2009-05-01

    study parameters and prevented neovascularization into the joint. Examination of gene expression on dissected hind limbs from mice treated for 5 or 14 days with 2ME2 showed inhibition of inflammatory cytokine message for IL-1β, TNF-α, IL-6 and IL-17, as well as the angiogenic cytokines, VEGF and FGF-2. Conclusion These data demonstrate that in the CAIA mouse model of RA, 2ME2 has disease modifying activity that is at least partially attributable to the inhibition of neovascular development. Further, the data suggests new mechanistic points of intervention for 2ME2 in RA, specifically inhibition of inflammatory mediators and osteoclast activity.

  14. Cognitive enhancers (Nootropics). Part 3: drugs interacting with targets other than receptors or enzymes. Disease-modifying drugs. Update 2014.

    Science.gov (United States)

    Froestl, Wolfgang; Pfeifer, Andrea; Muhs, Andreas

    2014-01-01

    Scientists working in the field of Alzheimer's disease and, in particular, cognitive enhancers, are very productive. The review "Drugs interacting with Targets other than Receptors or Enzymes. Disease-modifying Drugs" was accepted in October 2012. In the last 20 months, new targets for the potential treatment of Alzheimer's disease were identified. Enormous progress was realized in the pharmacological characterization of natural products with cognitive enhancing properties. This review covers the evolution of research in this field through May 2014.

  15. Towards the concept of disease-modifier in post-stroke or vascular cognitive impairment: a consensus report.

    Science.gov (United States)

    Bordet, Régis; Ihl, Ralf; Korczyn, Amos D; Lanza, Giuseppe; Jansa, Jelka; Hoerr, Robert; Guekht, Alla

    2017-05-24

    Vascular cognitive impairment (VCI) is a complex spectrum encompassing post-stroke cognitive impairment (PSCI) and small vessel disease-related cognitive impairment. Despite the growing health, social, and economic burden of VCI, to date, no specific treatment is available, prompting the introduction of the concept of a disease modifier. Within this clinical spectrum, VCI and PSCI remain advancing conditions as neurodegenerative diseases with progression of both vascular and degenerative lesions accounting for cognitive decline. Disease-modifying strategies should integrate both pharmacological and non-pharmacological multimodal approaches, with pleiotropic effects targeting (1) endothelial and brain-blood barrier dysfunction; (2) neuronal death and axonal loss; (3) cerebral plasticity and compensatory mechanisms; and (4) degenerative-related protein misfolding. Moreover, pharmacological and non-pharmacological treatment in PSCI or VCI requires valid study designs clearly stating the definition of basic methodological issues, such as the instruments that should be used to measure eventual changes, the biomarker-based stratification of participants to be investigated, and statistical tests, as well as the inclusion and exclusion criteria that should be applied. A consensus emerged to propose the development of a disease-modifying strategy in VCI and PSCI based on pleiotropic pharmacological and non-pharmacological approaches.

  16. The effect of comedication with conventional synthetic disease modifying antirheumatic drugs on TNF inhibitor drug survival in patients with ankylosing spondylitis and undifferentiated spondyloarthritis

    DEFF Research Database (Denmark)

    Lie, Elisabeth; Kristensen, Lars Erik; Forsblad-d'Elia, Helena

    2015-01-01

    on patients with a clinical diagnosis of AS or uSpA starting treatment with adalimumab, etanercept or infliximab as their first TNFi during 2003-2010 were retrieved from the Swedish national biologics register and linked to national population based registers. Five-year drug survival was analysed by Cox......, and the associations were retained when adjusting for erythrocyte sedimentation rate, C-reactive protein, patient global, swollen joints, uveitis, psoriasis and inflammatory bowel disease. CONCLUSIONS: In this large register study of patients with AS and uSpA, use of csDMARD comedication was associated with better 5...

  17. Efficacy and safety of Tofacitinib in patients with active rheumatoid arthritis resistant to conventional therapy: Preliminary results of an open-label clinical trial

    Directory of Open Access Journals (Sweden)

    E. L. Luchikhina

    2016-01-01

    Full Text Available Despite the advances in the therapy of rheumatoid arthritis (RA, which are associated with the use of biological anti-rheumatic drugs, the problemof effective treatment of RA is not still solved. Inclusion of new methods in treatment strategies, in particular the so-called «small molecules», i.e. synthetic compounds acting on intracellular signaling pathways, such as Tofacitinib (TOFA approved for use in rheumatologic practice, is very important.Objective: to evaluate the efficacy and safety of therapy with TOFA in combination with synthetic disease-modifying anti-rheumatic drugs (s-DMARDs, primarily methotrexate (MTX in in patients with active RA in real clinical practice.Subjects and methods. This ongoing open-label trial is a part of the scientific program «Russian Investigation of Methotrexate and Biologics in Early Active Inflammatory Arthritis» (REMARCA that explores the possibility of adapting the «treat-to-target» strategy in real prac-tice in Russia. The study included RA patients with moderate to high disease activity despite treatment with MTX or other DMARDs. A total of 41 patients with RA were included (8 males, 33 females; mean age 52.6±14.2 years, disease duration 47.2±49.7 months, 82.9% RF+ and 80.5% anti-CCP+,DAS28-ESR 5.45±0.95, SDAI 30.2±12.2. All the patients had previously received s-DMARDs; 12 (29.3% patients also had biological DMARDs (1 to 4 biologics. Oral TOFA 5 mg in combination with MTX or leflunomide was administered twice daily to 40 and 1 patients, respectively, with the possibility of increasing the dose up to 10 mg BID. To date, 37 and 12 patients received TOFA for 3 and 6 months, respectively.Results. TOFA was used as a second-line drug (after s-DMARDs failure in 29 (70.7%, as a third line drug (after s-DMARDs and biologics failure in 12 (29.3% patients. The dose was escalated to 10 mg BID in 13 (31.2% patients, on the average, 11.2±1.7 weeks after treatment initiation. TOFA was not

  18. Delayed wound healing and postoperative surgical site infections in patients with rheumatoid arthritis treated with or without biological disease-modifying antirheumatic drugs.

    Science.gov (United States)

    Tada, Masahiro; Inui, Kentaro; Sugioka, Yuko; Mamoto, Kenji; Okano, Tadashi; Kinoshita, Takuya; Hidaka, Noriaki; Koike, Tatsuya

    2016-06-01

    Biological disease-modifying antirheumatic drugs (bDMARDs) have become more popular for treating rheumatoid arthritis (RA). Whether or not bDMARDs increase the postoperative risk of surgical site infection (SSI) has remained controversial. We aimed to clarify the effects of bDMARDs on the outcomes of elective orthopedic surgery. We used multivariate logistic regression analysis to analyze risk factors for SSI and delayed wound healing among 227 patients with RA (mean age, 65.0 years; disease duration, 16.9 years) after 332 elective orthopedic surgeries. We also attempted to evaluate the effects of individual medications on infection. Rates of bDMARD and conventional synthetic DMARD (csDMARD) administration were 30.4 and 91.0 %, respectively. Risk factors for SSI were advanced age (odds ratio [OR], 1.11; P = 0.045), prolonged surgery (OR, 1.02; P = 0.03), and preoperative white blood cell count >10,000/μL (OR, 3.66; P = 0.003). Those for delayed wound healing were advanced age (OR, 1.16; P = 0.001), prolonged surgery (OR, 1.02; P = 0.007), preoperative white blood cell count >10,000/μL (OR, 4.56; P = 0.02), and foot surgery (OR, 6.60; P = 0.001). Risk factors for SSI and medications did not significantly differ. No DMARDs were risk factors for any outcome examined. Biological DMARDs were not risk factors for postoperative SSI. Foot surgery was a risk factor for delayed wound healing.

  19. Efficacy of VX-509 (decernotinib) in combination with a disease-modifying antirheumatic drug in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Genovese, Mark C.; Yang, Fang; Østergaard, Mikkel

    2016-01-01

    Objective To assess early effects on joint structures of VX-509 in combination with stable disease-modifying antirheumatic drug (DMARD) therapy using MRI in adults with rheumatoid arthritis (RA). Methods This phase II, placebo-controlled, double-blind, dose-ranging study randomised patients with RA......), and the RA MRI scoring (RAMRIS) system. Results ACR20 response at week 12 was 63.6%, 60.0% and 60.0% in the VX-509 100-mg, 200-mg and 300-mg groups, respectively, compared with 25.0% in the placebo group. DAS28-CRP scores decreased in a dose-dependent manner with increasing VX-509 doses. Decreases in RAMRIS...... to a DMARD alone. MRI responses were detected at week 12. Treatment was generally well tolerated. Trial registration number NCT01754935; results....

  20. A novel approach to delayed-start analyses for demonstrating disease-modifying effects in Alzheimer's disease.

    Directory of Open Access Journals (Sweden)

    Hong Liu-Seifert

    Full Text Available One method for demonstrating disease modification is a delayed-start design, consisting of a placebo-controlled period followed by a delayed-start period wherein all patients receive active treatment. To address methodological issues in previous delayed-start approaches, we propose a new method that is robust across conditions of drug effect, discontinuation rates, and missing data mechanisms. We propose a modeling approach and test procedure to test the hypothesis of noninferiority, comparing the treatment difference at the end of the delayed-start period with that at the end of the placebo-controlled period. We conducted simulations to identify the optimal noninferiority testing procedure to ensure the method was robust across scenarios and assumptions, and to evaluate the appropriate modeling approach for analyzing the delayed-start period. We then applied this methodology to Phase 3 solanezumab clinical trial data for mild Alzheimer's disease patients. Simulation results showed a testing procedure using a proportional noninferiority margin was robust for detecting disease-modifying effects; conditions of high and moderate discontinuations; and with various missing data mechanisms. Using all data from all randomized patients in a single model over both the placebo-controlled and delayed-start study periods demonstrated good statistical performance. In analysis of solanezumab data using this methodology, the noninferiority criterion was met, indicating the treatment difference at the end of the placebo-controlled studies was preserved at the end of the delayed-start period within a pre-defined margin. The proposed noninferiority method for delayed-start analysis controls Type I error rate well and addresses many challenges posed by previous approaches. Delayed-start studies employing the proposed analysis approach could be used to provide evidence of a disease-modifying effect. This method has been communicated with FDA and has been

  1. Cerivastatin Nano-Liposome as a Potential Disease Modifying Approach for the Treatment of Pulmonary Arterial Hypertension.

    Science.gov (United States)

    Lee, Young; Pai, S Balakrishna; Bellamkonda, Ravi V; Thompson, David H; Singh, Jaipal

    2018-04-25

    In this study, we have investigated nano-liposome as an approach to tailor the pharmacology of cerivastatin as a disease modifying drug for pulmonary arterial hypertension (PAH). Cerivastatin encapsulated liposomes with an average diameter of 98±27 nm were generated by thin film and freeze-thaw process. The nano-liposomes demonstrated sustained drug release kinetics in vitro and inhibited proliferation of pulmonary artery smooth muscle cells with significantly less cellular cytotoxicity as compared to free cerivastatin. When delivered by inhalation to a rat model of monocrotalin induced PAH, cerivastatin significantly reduced pulmonary artery pressure from 55.13±9.82 mmHg to 35.56±6.59 mmHg (P < 0.001) and diminished pulmonary artery wall thickening. Echocardiography showed that cerivastatin significantly reduced right ventricle thickening (0.34±0.02 cm monocrotalin vs. 0.26±0.02 cm cerivastatin; P < 0.001) and increased pulmonary artery acceleration time (13.98±1.14 ms monocrotalin vs. 21.07±2.80 ms cerivastatin; P < 0.001). Nano-liposomal cerivastatin was equally effective or slightly better than cerivastatin in reducing pulmonary artery pressure (67.06±13.64 mmHg monocrotalin; 46.31±7.64 mmHg cerivastatin vs. 37.32±9.50 mmHg liposomal cerivastatin) and improving parameters of right ventricular function as measured by increasing pulmonary artery acceleration time (24.68±3.92 ms monocrotalin; 32.59±6.10 ms cerivastatin vs. 34.96±7.51 ms liposomal cerivastatin). More importantly, the rate and magnitude of toxic cerivastatin metabolite lactone generation from the intratracheally administered nano-liposomes was significantly lower as compared to intravenously administered free cerivastatin. These studies show that nano-liposome encapsulation improved in vitro and in vivo pharmacological and safety profile of cerivastatin and may represent a safer approach as a disease modifying therapy for PAH. The American Society for Pharmacology and Experimental

  2. Clinical Trials for Disease-Modifying Therapies in Alzheimer's Disease: A Primer, Lessons Learned, and a Blueprint for the Future.

    Science.gov (United States)

    Cummings, Jeffrey; Ritter, Aaron; Zhong, Kate

    2018-03-16

    Alzheimer's disease (AD) has no currently approved disease-modifying therapies (DMTs), and treatments to prevent, delay the onset, or slow the progression are urgently needed. A delay of 5 years if available by 2025 would decrease the total number of patients with AD by 50% in 2050. To meet the definition of DMT, an agent must produce an enduring change in the course of AD; clinical trials of DMTs have the goal of demonstrating this effect. AD drug discovery entails target identification followed by high throughput screening and lead optimization of drug-like compounds. Once an optimized agent is available and has been assessed for efficacy and toxicity in animals, it progresses through Phase I testing with healthy volunteers, Phase II learning trials to establish proof-of-mechanism and dose, and Phase III confirmatory trials to demonstrate efficacy and safety in larger populations. Phase III is followed by Food and Drug Administration review and, if appropriate, market access. Trial populations include cognitively normal at-risk participants in prevention trials, mildly impaired participants with biomarker evidence of AD in prodromal AD trials, and subjects with cognitive and functional impairment in AD dementia trials. Biomarkers are critical in trials of DMTs, assisting in participant characterization and diagnosis, target engagement and proof-of-pharmacology, demonstration of disease-modification, and monitoring side effects. Clinical trial designs include randomized, parallel group; delayed start; staggered withdrawal; and adaptive. Lessons learned from completed trials inform future trials and increase the likelihood of success.

  3. Needle-free and microneedle drug delivery in children: a case for disease-modifying antirheumatic drugs (DMARDs).

    Science.gov (United States)

    Shah, Utpal U; Roberts, Matthew; Orlu Gul, Mine; Tuleu, Catherine; Beresford, Michael W

    2011-09-15

    Parenteral routes of drug administration have poor acceptability and tolerability in children. Advances in transdermal drug delivery provide a potential alternative for improving drug administration in this patient group. Issues with parenteral delivery in children are highlighted and thus illustrate the scope for the application of needle-free and microneedle technologies. This mini-review discusses the opportunities and challenges for providing disease-modifying antirheumatic drugs (DMARDs) currently prescribed to paediatric rheumatology patients using such technologies. The aim is to raise further awareness of the need for age-appropriate formulations and drug delivery systems and stimulate exploration of these options for DMARDs, and in particular, rapidly emerging biologics on the market. The ability of needle-free and microneedle technologies to deliver monoclonal antibodies and fusion proteins still remains largely untested. Such an understanding is crucial for future drug design opportunities. The bioavailability, safety and tolerance of delivering biologics into the viable epidermis also need to be studied. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. Analysis of recent failures of disease modifying therapies in Alzheimer's disease suggesting a new methodology for future studies.

    Science.gov (United States)

    Amanatkar, Hamid Reza; Papagiannopoulos, Bill; Grossberg, George Thomas

    2017-01-01

    Pharmaceutical companies and the NIH have invested heavily in a variety of potential disease-modifying therapies for Alzheimer's disease (AD) but unfortunately all double-blind placebo-controlled Phase III studies of these drugs have failed to show statistically significant results supporting their clinical efficacy on cognitive measures. These negative results are surprising as most of these medications have the capability to impact the biomarkers which are associated with progression of Alzheimer's disease. Areas covered: This contradiction prompted us to review all study phases of Intravenous Immunoglobulin (IVIG), Bapineuzumab, Solanezumab, Avagacestat and Dimebolin to shed more light on these recent failures. We critically analyzed these studies, recommending seven lessons from these failures which should not be overlooked. Expert commentary: We suggest a new methodology for future treatment research in Alzheimer's disease considering early intervention with more focus on cognitive decline as a screening tool, more sophisticated exclusion criteria with more reliance on biomarkers, stratification of subjects based on the rate of cognitive decline aiming less heterogeneity, and a longer study duration with periodic assessment of cognition and activities of daily living during the study and also after a washout period.

  5. Sequencing of disease-modifying therapies for relapsing-remitting multiple sclerosis: a theoretical approach to optimizing treatment.

    Science.gov (United States)

    Grand'Maison, Francois; Yeung, Michael; Morrow, Sarah A; Lee, Liesly; Emond, Francois; Ward, Brian J; Laneuville, Pierre; Schecter, Robyn

    2018-04-18

    Multiple sclerosis (MS) is a chronic disease which usually begins in young adulthood and is a lifelong condition. Individuals with MS experience physical and cognitive disability resulting from inflammation and demyelination in the central nervous system. Over the past decade, several disease-modifying therapies (DMTs) have been approved for the management of relapsing-remitting MS (RRMS), which is the most prevalent phenotype. The chronic nature of the disease and the multiple treatment options make benefit-risk-based sequencing of therapy essential to ensure optimal care. The efficacy and short- and long-term risks of treatment differ for each DMT due to their different mechanism of action on the immune system. While transitioning between DMTs, in addition to immune system effects, factors such as age, disease duration and severity, disability status, monitoring requirements, preference for the route of administration, and family planning play an important role. Determining a treatment strategy is therefore challenging as it requires careful consideration of the differences in efficacy, safety and tolerability, while at the same time minimizing risks of immune modulation. In this review, we discuss a sequencing approach for treating RRMS, with importance given to the long-term risks and individual preference when devising a treatment plan. Evidence-based strategies to counter breakthrough disease are also addressed.

  6. Pregnancy and the Use of Disease-Modifying Therapies in Patients with Multiple Sclerosis: Benefits versus Risks

    Directory of Open Access Journals (Sweden)

    Raed Alroughani

    2016-01-01

    Full Text Available The burden of multiple sclerosis (MS in women of childbearing potential is increasing, with peak incidence around the age of 30 years, increasing incidence and prevalence, and growing female : male ratio. Guidelines recommend early use of disease-modifying therapies (DMTs, which are contraindicated or recommended with considerable caution, during pregnancy/breastfeeding. Many physicians are reluctant to prescribe them for a woman who is/is planning to be pregnant. Interferons are not absolutely contraindicated during pregnancy, since interferon-β appears to lack serious adverse effects in pregnancy, despite a warning in its labelling concerning risk of spontaneous abortion. Glatiramer acetate, natalizumab, and alemtuzumab also may not induce adverse pregnancy outcomes, although natalizumab may induce haematologic abnormalities in newborns. An accelerated elimination procedure is needed for teriflunomide if pregnancy occurs on treatment or if pregnancy is planned. Current evidence supports the contraindication for fingolimod during pregnancy; data on other DMTs remains limited. Increased relapse rates following withdrawal of some DMTs in pregnancy are concerning and require further research. The postpartum period brings increased risk of disease reactivation that needs to be carefully addressed through effective communication between treating physicians and mothers intending to breastfeed. We address the potential for use of the first- and second-line DMTs in pregnancy and lactation.

  7. Cognitive enhancers (nootropics). Part 3: drugs interacting with targets other than receptors or enzymes. disease-modifying drugs.

    Science.gov (United States)

    Froestl, Wolfgang; Pfeifer, Andrea; Muhs, Andreas

    2013-01-01

    Cognitive enhancers (nootropics) are drugs to treat cognition deficits in patients suffering from Alzheimer's disease, schizophrenia, stroke, attention deficit hyperactivity disorder, or aging. Cognition refers to a capacity for information processing, applying knowledge, and changing preferences. It involves memory, attention, executive functions, perception, language, and psychomotor functions. The term nootropics was coined in 1972 when memory enhancing properties of piracetam were observed in clinical trials. In the meantime, hundreds of drugs have been evaluated in clinical trials or in preclinical experiments. To classify the compounds, a concept is proposed assigning drugs to 19 categories according to their mechanism(s) of action, in particular drugs interacting with receptors, enzymes, ion channels, nerve growth factors, re-uptake transporters, antioxidants, metal chelators, and disease modifying drugs, meaning small molecules, vaccines, and monoclonal antibodies interacting with amyloid-β and tau. For drugs, whose mechanism of action is not known, they are either classified according to structure, e.g., peptides, or their origin, e.g., natural products. The review covers the evolution of research in this field over the last 25 years.

  8. Long-term changes in ADAS-cog: what is clinically relevant for disease modifying trials in Alzheimer?

    Science.gov (United States)

    Vellas, B; Andrieu, S; Cantet, C; Dartigues, J F; Gauthier, S

    2007-01-01

    With the development of long-term disease modifying trials, changes in ADAS-Cog at 18 months will rise certainly many questions. We decided to look in the Real.fr study at the links between changes in cognition, ADAS-Cog and function. A total of 346 Alzheimer's patients with ADAS-cog at entry and at 18 months. were eligible for this analysis. These patients were on average 77.44 years old and 254 (72.36%) were women. The great majority lived at home and about 93% were treated with a cholinesterase inhibitor at baseline. Thirty three patients (9%) had a gain of more than 2 points at the ADAS-cog at 18 months (Group I, improvement); 130 (38%) were considered as stable, the reference group (Group II ) characterized by a stability at the ADAS-cog: decline of 2 points to gain of 2 points, 112 subjects (32%) had a moderate decline between 2 and 7 at the ADAScog (Group III) and finally 71 subjects (21%) had a severe impairment more than seven points at the ADAS-cog. A loss of one Basic ADL is certainly highly relevant, and such a change was found at 18 months in more than half of the subjects, which is not surprising for a long-term evolution in mild to moderate AD. An impairment of more than 7 points at the ADAS-cog was found in 21% of the subjects at 18 months and was associated with loss.

  9. Oral disease-modifying therapies for multiple sclerosis in the Middle Eastern and North African (MENA) region: an overview.

    Science.gov (United States)

    Deleu, Dirk; Mesraoua, Boulenouar; Canibaño, Beatriz; Melikyan, Gayane; Al Hail, Hassan; El-Sheikh, Lubna; Ali, Musab; Al Hussein, Hassan; Ibrahim, Faiza; Hanssens, Yolande

    2018-06-18

    The introduction of new disease-modifying therapies (DMTs) for remitting-relapsing multiple sclerosis (RRMS) has considerably transformed the landscape of therapeutic opportunities for this chronic disabling disease. Unlike injectable drugs, oral DMTs promote patient satisfaction and increase therapeutic adherence. This article reviews the salient features about the mode of action, efficacy, safety, and tolerability profile of approved oral DMTs in RRMS, and reviews their place in clinical algorithms in the Middle East and North Africa (MENA) region. A systematic review was conducted using a comprehensive search of MEDLINE, PubMed, Cochrane Database of Systematic Reviews (period January 1, 1995-January 31, 2018). Additional searches of the American Academy of Neurology and European Committee for Treatment and Research in Multiple Sclerosis abstracts from 2012-2017 were performed, in addition to searches of the Food and Drug Administration and European Medicines Agency websites, to obtain relevant safety information on these DMTs. Four oral DMTs: fingolimod, teriflunomide, dimethyl fumarate, and cladribine have been approved by the regulatory agencies. Based on the number needed to treat (NNT), the potential role of these DMTs in the management of active and highly active or rapidly evolving RRMS is assessed. Finally, the place of the oral DMTs in clinical algorithms in the MENA region is reviewed.

  10. The impact of adjusted work conditions and disease-modifying drugs on work ability in multiple sclerosis.

    Science.gov (United States)

    Wickström, Anne; Fagerström, Maria; Wickström, Lucas; Granåsen, Gabriel; Dahle, Charlotte; Vrethem, Magnus; Sundström, Peter

    2017-07-01

    Multiple sclerosis (MS) is a neurological disorder that causes significantly reduced ability to work, and the Expanded Disability Status Scale (EDSS) is one of the main predictors for reduced work ability. To investigate how work requirements, flexible work conditions and disease-modifying drugs (DMDs) influence the work ability in relation to different EDSS grades in two MS populations. Work ability was studied in two MS populations: one in the southern and one in the northern part of Sweden, both demographically similar. In the latter population, more active work-promoting interventions have been practised and second-generation DMDs have been widely used from the onset of disease for several years. The proportion of MS patients who participated in the workforce or studied was significantly higher in the northern compared with the southern population ( p work conditions and were able to work more hours per week. Higher EDSS was associated with lower reduction in number of worked hours per week in the northern population ( p = 0.042). Our data indicated that treatment strategy and adjusted work conditions have impact on work ability in MS.

  11. Antidepressant Drug Treatment in Association with Multiple Sclerosis Disease-Modifying Therapy: Using Explorys in the MS Population.

    Science.gov (United States)

    Mirsky, Matthew M; Marrie, Ruth Ann; Rae-Grant, Alexander

    2016-01-01

    Background: The Explorys Enterprise Performance Management (EPM) database contains de-identified clinical data for 50 million patients. Multiple sclerosis (MS) disease-modifying therapies (DMTs), specifically interferon beta (IFNβ) treatments, may potentiate depression. Conflicting data have emerged, and a large-scale claims-based study by Patten et al. did not support such an association. This study compares the results of Patten et al. with those using the EPM database. Methods: "Power searches" were built to test the relationship between antidepressant drug use and DMT in the MS population. Searches were built to produce a cohort of individuals diagnosed as having MS in the past 3 years taking a specific DMT who were then given any antidepressant drug. The antidepressant drug therapy prevalence was tested in the MS population on the following DMTs: IFNβ-1a, IFNβ-1b, combined IFNβ, glatiramer acetate, natalizumab, fingolimod, and dimethyl fumarate. Results: In patients with MS, the rate of antidepressant drug use in those receiving DMTs was 40.60% to 44.57%. The rate of antidepressant drug use for combined IFNβ DMTs was 41.61% (males: 31.25%-39.62%; females: 43.10%-47.33%). Antidepressant drug use peaked in the group aged 45 to 54 years for five of six DMTs. Conclusions: We found no association between IFNβ treatment and antidepressant drug use in the MS population compared with other DMTs. The EPM database has been validated against the Patten et al. data for future use in the MS population.

  12. Anakinra as first-line disease-modifying therapy in systemic juvenile idiopathic arthritis: report of forty-six patients from an international multicenter series

    NARCIS (Netherlands)

    Nigrovic, Peter A.; Mannion, Melissa; Prince, Femke H. M.; Zeft, Andrew; Rabinovich, C. Egla; van Rossum, Marion A. J.; Cortis, Elisabetta; Pardeo, Manuela; Miettunen, Paivi M.; Janow, Ginger; Birmingham, James; Eggebeen, Aaron; Janssen, Erin; Shulman, Andrew I.; Son, Mary Beth; Hong, Sandy; Jones, Karla; Ilowite, Norman T.; Cron, Randy Q.; Higgins, Gloria C.

    2011-01-01

    To examine the safety and efficacy of the interleukin-1 (IL-1) receptor antagonist anakinra as first-line therapy for systemic juvenile idiopathic arthritis (JIA). Patients with systemic JIA receiving anakinra as part of initial disease-modifying antirheumatic drug (DMARD) therapy were identified

  13. Early cost-utility analysis of general and cerebrospinal fluid-specific Alzheimer's disease biomarkers for hypothetical disease-modifying treatment decision in mild cognitive impairment

    NARCIS (Netherlands)

    Handels, Ron L. H.; Joore, Manuela A.; Tran-Duy, An; Wimo, Anders; Wolfs, Claire A. G.; Verhey, Frans R. J.; Severens, Johan L.

    Introduction: The study aimed to determine the room for improvement of a perfect cerebrospinal fluid (CSF) biomarker and the societal incremental net monetary benefit of CSF in subjects with mild cognitive impairment (MCI) assuming a hypothetical disease-modifying Alzheimer's disease (AD) treatment.

  14. Efficacy of biological disease-modifying antirheumatic drugs: a systematic literature review informing the 2013 update of the EULAR recommendations for the management of rheumatoid arthritis

    NARCIS (Netherlands)

    Nam, Jackie L.; Ramiro, Sofia; Gaujoux-Viala, Cecile; Takase, Kaoru; Leon-Garcia, Mario; Emery, Paul; Gossec, Laure; Landewe, Robert; Smolen, Josef S.; Buch, Maya H.

    2014-01-01

    To update the evidence for the efficacy of biological disease-modifying antirheumatic drugs (bDMARD) in patients with rheumatoid arthritis (RA) to inform the European League Against Rheumatism(EULAR) Task Force treatment recommendations. Medline, Embase and Cochrane databases were searched for

  15. [Acupuncture Therapy versus Disease-modifying Antirheumatic Drugs for the Treatment of Ankylosing Spondylitis--a Meta-analysis].

    Science.gov (United States)

    Lv, Zheng-tao; Zhou, Xiang; Chen, An-min

    2015-01-01

    We conducted a meta-analysis evaluating the efficacy and safety of acupuncture compared to disease-modifying antirheumatic drugs in patients with ankylosing spondylitis. Four databases including Pubmed, EMBASE, Cochrane library, and ISI Web of Science were searched in December 2014, taking also the reference section into account. Randomized controlled trials that aimed to assess the efficacy of acupuncture therapy were identified. The inclusion criteria for the outcome measurements were the clinical effect, ESR, occipital wall test, chest expansion, CRP and finger ground distance. Finally, six studies met these inclusion criteria. Two reviewers screened each article independently and were blinded to the findings of each other. We analyzed data from 6 RCTs involving 541 participants. Acupuncture therapy could further improve the clinical effect (OR = 3.01; 95% CI, 1.48-6.13; P = 0.002) and reduce ESR level (SMD = -0.77; 95% CI, -1.46 to -0.08; P = 0.03) compared to DMARDs; a combination of acupuncture and DMARDs could further improve clinical effect (OR = 3.20, 95% CI, 1.36-7.54; P = 0.008), occipital-wall distance (SMD = -0.84; 95% CI, -1.37 to -0.31; P = 0.002), chest expansion (SMD = 0.38; 95% CI, 0.16-0.60; P = 0.0009), and finger-ground distance (SMD = -0.48; 95% CI, -0.87 to -0.09; P = 0.02) as compared to DMARDs treatment alone. Our findings support that acupuncture therapy could be an option to relieve symptoms associated with AS. These results should be interpreted cautiously due to the generally poor methodological qualities of the included trials. © 2015 S. Karger GmbH, Freiburg.

  16. Biomarker-driven phenotyping in Parkinson disease: a translational missing link in disease-modifying clinical trials

    Science.gov (United States)

    Espay, Alberto J.; Schwarzschild, Michael A.; Tanner, Caroline M.; Fernandez, Hubert H; Simon, David K.; Leverenz, James B.; Merola, Aristide; Chen-Plotkin, Alice; Brundin, Patrik; Kauffman, Marcelo A.; Erro, Roberto; Kieburtz, Karl; Woo, Daniel; Macklin, Eric A.; Standaert, David G.; Lang, Anthony E.

    2016-01-01

    Past clinical trials of putative neuroprotective therapies have targeted Parkinson disease (PD) as a single pathogenic disease entity. From an Oslerian clinico-pathologic perspective, the wide complexity of PD converges into Lewy bodies and justifies a reductionist approach to PD: a single-mechanism therapy can affect most of those sharing the classic pathologic hallmark. From a systems-biology perspective, PD is a group of disorders that, while related by sharing the feature of nigral dopamine-neuron degeneration, exhibit unique genetic, biological and molecular abnormalities, which probably respond differentially to a given therapeutic approach, particularly for strategies aimed at neuroprotection. Under this model, only biomarker-defined, homogenous subtypes of PD are likely to respond optimally to therapies proven to affect the biological processes within each subtype. Therefore, we suggest that precision medicine applied to PD requires a reevaluation of the biomarker-discovery effort. This effort is currently centered on correlating biological measures to clinical features of PD and on identifying factors that predict whether various prodromal states will convert into the classical movement disorder. We suggest, instead, that subtyping of PD requires the reverse view, where abnormal biological signals (i.e., biomarkers) rather than clinical definitions are used to define disease phenotypes. Successful development of disease-modifying strategies will depend on how relevant the specific biological processes addressed by an intervention are to the pathogenetic mechanisms in the subgroup of targeted patients. This precision-medicine approach will likely yield smaller but well-defined subsets of PD amenable to successful neuroprotection. PMID:28233927

  17. Clinically isolated syndrome. Prognostic markers for conversion to multiple sclerosis and initiation of disease-modifying therapy

    International Nuclear Information System (INIS)

    Kohriyama, Tatsuo

    2011-01-01

    Eighty-five percent of patients with multiple sclerosis (MS) initially present with a single demyelinating event, referred to as a clinically isolated syndrome (CIS) of the optic nerves, brainstem, or spinal cord. Following the onset of CIS, 38 to 68% of patients develop clinically definite MS (CDMS). Clinically silent brain lesions are seen on MRI in 50 to 80% of patients with CIS at first clinical presentation and 56 to 88% of CIS patients with abnormal MRI are at high risk of conversion to CDMS. Axonal damage, that is considered to underlie the development of persistent disability in MS, occurs in the CIS stage. Treatment with disease-modifying therapies (DMTs), that might prevent axonal damage and result in slowing the progression of disability, should be initiated early during the disease course. Clinical trials demonstrated that early treatment of CIS patients with the standard dose of interferon beta (IFNβ) significantly reduced the risk of progression to CDMS by 44 to 50%. After 5 years of follow-up, the results of the IFNβ treatment extension studies confirmed that the risk of conversion to CDMS was significantly reduced by 35 to 37% in patients receiving early treatment compared to that in those receiving delayed treatment. However, not every patient with CIS will progress to CDMS; the IFNβ treatment is appropriately indicated for CIS patients who are diagnosed with MS by McDonald diagnostic criteria based on MRI findings of dissemination in space and time and are at high risk for conversion to CDMS. Development of more reliable prognostic markers will enable DMTs to be targeted for those who are most likely to benefit. (author)

  18. Disease-modifying effect of anthraquinone prodrug with boswellic acid on collagenase-induced osteoarthritis in Wistar rats.

    Science.gov (United States)

    Dhaneshwar, Suneela; Dipmala, Patil; Abhay, Harsulkar; Prashant, Bhondave

    2013-08-01

    Diacerein and its active metabolite rhein are promising disease modifying agents for osteoarthritis (OA). Boswellic acid is an active ingredient of Gugglu; a herbal medicine commonly administered in osteoarthritis. Both of them possess excellent anti-inflammatory and anti-arthritic activities. It was thought interesting to conjugate rhein and boswellic acid into a mutual prodrug (DSRB) and evaluate its efficacy on collagenase-induced osteoarthritis in rats wherein the conjugate, rhein, boswellic acid and their physical mixture, were tested based on various parameters. Oral administration of 3.85 mg of rhein, 12.36 mg of boswellic acid and 15.73 mg of DSRB which would release equimolar amounts of rhein and boswellic acid, exhibited significant restoration in rat body weight as compared to the untreated arthritic control group. Increase in knee diameter (mm), due to edema was observed in group injected with collagenase, which reduced significantly with the treatment of conjugate. The hematological parameters (Hb, RBC, WBC and ESR) and biochemical parameters (CRP, SALP, SGOT and SGPT) in the osteoarthritic rats were significantly brought back to normal values on treatment with conjugate. It also showed better anti-ulcer activity than rhein. Further the histopathological studies revealed significant anti-arthritic activity of conjugate when compared with the arthritic control group. In conclusion, the conjugate at the specified dose level of 15.73 mg/kg, p. o. (BID) showed reduction in knee diameter and it could significantly normalize the hematological and biochemical abnormalities in collagenase-induced osteoarthritis in rats. Further the histopathological studies confirmed the additive anti-arthritic effect of DSRB as compared to plain rhein.

  19. The Effect of Disease-Modifying Drugs on Brain Atrophy in Relapsing-Remitting Multiple Sclerosis: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Pierre Branger

    Full Text Available The quantification of brain atrophy in relapsing-remitting multiple sclerosis (RRMS may serve as a marker of disease progression and treatment response. We compared the association between first-line (FL or second-line (SL disease-modifying drugs (DMDs and brain volume changes over time in RRMS.We reviewed clinical trials in RRMS between January 1, 1995 and June 1, 2014 that assessed the effect of DMDs and reported data on brain atrophy in Medline, Embase, the Cochrane database and meeting abstracts. First, we designed a meta-analysis to directly compare the percentage brain volume change (PBVC between FLDMDs and SLDMDs at 24 months. Second, we conducted an observational and longitudinal linear regression analysis of a 48-month follow-up period. Sensitivity analyses considering PBVC between 12 and 48 months were also performed.Among the 272 studies identified, 117 were analyzed and 35 (18,140 patients were included in the analysis. Based on the meta-analysis, atrophy was greater for the use of an FLDMD than that of an SLDMD at 24 months (primary endpoint mean difference, -0.86; 95% confidence interval: -1.57--0.15; P = 0.02. Based on the linear regression analysis, the annual PBVC significantly differed between SLDMDs and placebo (-0.27%/y and -0.50%/y, respectively, P = 0.046 but not between FLDMDs (-0.33%/y and placebo (P = 0.11 or between FLDMDs and SLDMDs (P = 0.49. Based on sensitivity analysis, the annual PBVC was reduced for SLDMDs compared with placebo (-0.14%/y and -0.56%/y, respectively, P<0.001 and FLDMDs (-0.46%/y, P<0.005, but no difference was detected between FLDMDs and placebo (P = 0.12.SLDMDs were associated with reduced PBVC slope over time in RRMS, regardless of the period considered. These results provide new insights into the mechanisms underlying atrophy progression in RRMS.

  20. Real-World Adherence and Persistence to Oral Disease-Modifying Therapies in Multiple Sclerosis Patients Over 1 Year.

    Science.gov (United States)

    Johnson, Kristen M; Zhou, Huanxue; Lin, Feng; Ko, John J; Herrera, Vivian

    2017-08-01

    Disease-modifying therapies (DMTs) are indicated to reduce relapse rates and slow disease progression for relapsing-remitting multiple sclerosis (MS) patients when taken as prescribed. Nonadherence or non-persistence in the real-world setting can lead to greater risk for negative clinical outcomes. Although previous research has demonstrated greater adherence and persistence to oral DMTs compared with injectable DMTs, comparisons among oral DMTs are lacking. To compare adherence, persistence, and time to discontinuation among MS patients newly prescribed the oral DMTs fingolimod, dimethyl fumarate, or teriflunomide. This retrospective study used MarketScan Commercial and Medicare Supplemental claims databases. MS patients with ≥ 1 claim for specified DMTs from April 1, 2013, to June 30, 2013, were identified. The index drug was defined as the first oral DMT within this period. To capture patients newly initiating index DMTs, patients could not have a claim for their index drugs in the previous 12 months. Baseline characteristics were described for patients in each treatment cohort. Adherence, as measured by medication possession ratio (MPR) and proportion of days covered (PDC); persistence (30-day gap allowed); and time to discontinuation over a 12-month follow-up period were compared across treatment cohorts. Adjusted logistic regression models were used to examine adherence, and Cox regression models estimated risk of discontinuation. 1,498 patients newly initiated oral DMTs and met study inclusion criteria: fingolimod (n = 185), dimethyl fumarate (n = 1,160), and teriflunomide (n = 143). Patients were similar across most baseline characteristics, including region, relapse history, and health care resource utilization. Statistically significant differences were observed across the treatment cohorts for age, gender, previous injectable/infused DMT use, and comorbidities. Adherence and time to discontinuation were adjusted for age, gender, region, previous oral

  1. Identification and Prioritization of Important Attributes of Disease-Modifying Drugs in Decision Making among Patients with Multiple Sclerosis: A Nominal Group Technique and Best-Worst Scaling.

    Science.gov (United States)

    Kremer, Ingrid E H; Evers, Silvia M A A; Jongen, Peter J; van der Weijden, Trudy; van de Kolk, Ilona; Hiligsmann, Mickaël

    2016-01-01

    Understanding the preferences of patients with multiple sclerosis (MS) for disease-modifying drugs and involving these patients in clinical decision making can improve the concordance between medical decisions and patient values and may, subsequently, improve adherence to disease-modifying drugs. This study aims first to identify which characteristics-or attributes-of disease-modifying drugs influence patients´ decisions about these treatments and second to quantify the attributes' relative importance among patients. First, three focus groups of relapsing-remitting MS patients were formed to compile a preliminary list of attributes using a nominal group technique. Based on this qualitative research, a survey with several choice tasks (best-worst scaling) was developed to prioritize attributes, asking a larger patient group to choose the most and least important attributes. The attributes' mean relative importance scores (RIS) were calculated. Nineteen patients reported 34 attributes during the focus groups and 185 patients evaluated the importance of the attributes in the survey. The effect on disease progression received the highest RIS (RIS = 9.64, 95% confidence interval: [9.48-9.81]), followed by quality of life (RIS = 9.21 [9.00-9.42]), relapse rate (RIS = 7.76 [7.39-8.13]), severity of side effects (RIS = 7.63 [7.33-7.94]) and relapse severity (RIS = 7.39 [7.06-7.73]). Subgroup analyses showed heterogeneity in preference of patients. For example, side effect-related attributes were statistically more important for patients who had no experience in using disease-modifying drugs compared to experienced patients (p decision making would be needed and requires eliciting individual preferences.

  2. A short history of anti-rheumatic therapy - VII. Biological agents

    Directory of Open Access Journals (Sweden)

    B. Gatto

    2011-11-01

    Full Text Available The introduction of biological agents has been a major turning-point in the treatment of rheumatic diseases, particularly in rheumatoid arthritis. This review describes the principle milestones that have led, through the knowledge of the structure and functions of nucleic acids, to the development of production techniques of the three major families of biological agents: proteins, monoclonal antibodies and fusion proteins. A brief history has also been traced of the cytokines most involved in the pathogenesis of inflammatory rheumatic diseases (IL-1 and TNF and the steps which have led to the use of the main biological drugs in rheumatology: anakinra, infliximab, adalimumab, etanercept and rituximab.

  3. Osteoporosis in Rheumatic Diseases: Anti-rheumatic Drugs and the Skeleton.

    Science.gov (United States)

    Dubrovsky, Alanna M; Lim, Mie Jin; Lane, Nancy E

    2018-05-01

    Osteoporosis in rheumatic diseases is a very well-known complication. Systemic inflammation results in both generalized and localized bone loss and erosions. Recently, increased knowledge of inflammatory process in rheumatic diseases has resulted in the development of potent inhibitors of the cytokines, the biologic DMARDs. These treatments reduce systemic inflammation and have some effect on the generalized and localized bone loss. Progression of bone erosion was slowed by TNF, IL-6 and IL-1 inhibitors, a JAK inhibitor, a CTLA4 agonist, and rituximab. Effects on bone mineral density varied between the biological DMARDs. Medications that are approved for the treatment of osteoporosis have been evaluated to prevent bone loss in rheumatic disease patients, including denosumab, cathepsin K, bisphosphonates, anti-sclerostin antibodies and parathyroid hormone (hPTH 1-34), and have some efficacy in both the prevention of systemic bone loss and reducing localized bone erosions. This article reviews the effects of biologic DMARDs on bone mass and erosions in patients with rheumatic diseases and trials of anti-osteoporotic medications in animal models and patients with rheumatic diseases.

  4. A short history of anti-rheumatic therapy. III. Non steroidal anti-inflammatory drugs

    Directory of Open Access Journals (Sweden)

    P. Marson

    2011-06-01

    Full Text Available The chemical advances of the 20th century led to the synthesis of non steroidal anti-inflammatory drugs (NSAIDs, beginning from phenylbutazone and indomethacin and continuing with other new drugs, including ibuprofen, diclofenac, naproxen, piroxicam and, more recently, the highly selective COX-2 inhibitors (coxibs. This progress derived from the discovery of the mechanism of action of these drugs: the inhibition of synthesis of prostaglandins due to the cycloxigenase enzyme system, according to the experimental contributions of John R. Vane.

  5. Chemical Weapons Convention

    National Research Council Canada - National Science Library

    1997-01-01

    On April 29, 1997, the Convention on the Prohibition of the Development, Production, Stockpiling, and Use of Chemical Weapons and on Their Destruction, known as the Chemical Weapons Convention (CWC...

  6. The Hague Judgments Convention

    DEFF Research Database (Denmark)

    Nielsen, Peter Arnt

    2011-01-01

    The Hague Judgments Convention of 2005 is the first global convention on international jurisdiction and recognition and enforcement of judgments in civil and commercial matters. The author explains the political and legal background of the Convention, its content and certain crucial issues during...

  7. Tocilizumab in patients with active rheumatoid arthritis and inadequate response to disease-modifying antirheumatic drugs or tumor necrosis factor inhibitors: subanalysis of Spanish results of an open-label study close to clinical practice.

    Science.gov (United States)

    Álvaro-Gracia, José M; Fernández-Nebro, Antonio; García-López, Alicia; Guzmán, Manuel; Blanco, Francisco J; Navarro, Francisco J; Bustabad, Sagrario; Armendáriz, Yolanda; Román-Ivorra, José A

    2014-01-01

    To analyze the Spanish experience in an international study which evaluated tocilizumab in patients with rheumatoid arthritis (RA) and an inadequate response to conventional disease-modifying antirheumatic drugs (DMARDs) or tumor necrosis factor inhibitors (TNFis) in a clinical practice setting. Subanalysis of 170 patients with RA from Spain who participated in a phase IIIb, open-label, international clinical trial. Patients presented inadequate response to DMARDs or TNFis. They received 8mg/kg of tocilizumab every 4 weeks in combination with a DMARD or as monotherapy during 20 weeks. Safety and efficacy of tocilizumab were analyzed. Special emphasis was placed on differences between failure to a DMARD or to a TNFi and the need to switch to tocilizumab with or without a washout period in patients who had previously received TNFi. The most common adverse events were infections (25%), increased total cholesterol (38%) and transaminases (15%). Five patients discontinued the study due to an adverse event. After six months of tocilizumab treatment, 71/50/30% of patients had ACR 20/50/70 responses, respectively. A higher proportion of TNFi-naive patients presented an ACR20 response: 76% compared to 64% in the TNFi group with previous washout and 66% in the TNFi group without previous washout. Safety results were consistent with previous results in patients with RA and an inadequate response to DMARDs or TNFis. Tocilizumab is more effective in patients who did not respond to conventional DMARDs than in patients who did not respond to TNFis. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  8. Autoimmune-autoinflammatory rheumatoid arthritis overlaps: a rare but potentially important subgroup of diseases.

    Science.gov (United States)

    Savic, Sinisa; Mistry, Anoop; Wilson, Anthony G; Barcenas-Morales, Gabriela; Doffinger, Rainer; Emery, Paul; McGonagle, Dennis

    2017-01-01

    At the population level, rheumatoid arthritis (RA) is generally viewed as autoimmune in nature with a small subgroup of cases having a palindromic form or systemic autoinflammatory disorder (SAID) phenotype. Herein, we describe resistant cases of classical autoantibody associated RA that had clinical, genetic and therapeutic responses indicative of coexistent autoinflammatory disease. Five patients with clinically overlapping features between RA and SAID including polysynovitis and autoantibody/shared epitope positivity, and who had abrupt severe self-limiting attacks including fevers and serositis, are described. Mutations or single nucleotide polymorphisms in recognised autoinflammatory pathways were evident. Generally, these cases responded poorly to conventional Disease-modifying anti-rheumatic drugs (DMARD) treatment with some excellent responses to colchicine or interleukin 1 pathway blockade. A subgroup of RA cases have a mixed autoimmune-autoinflammatory phenotype and genotype with therapeutic implications.

  9. Type 1 Diabetes TrialNet: A Multifaceted Approach to Bringing Disease-Modifying Therapy to Clinical Use in Type 1 Diabetes.

    Science.gov (United States)

    Bingley, Polly J; Wherrett, Diane K; Shultz, Ann; Rafkin, Lisa E; Atkinson, Mark A; Greenbaum, Carla J

    2018-04-01

    What will it take to bring disease-modifying therapy to clinical use in type 1 diabetes? Coordinated efforts of investigators involved in discovery, translational, and clinical research operating in partnership with funders and industry and in sync with regulatory agencies are needed. This Perspective describes one such effort, Type 1 Diabetes TrialNet, a National Institutes of Health-funded and JDRF-supported international clinical trials network that emerged from the Diabetes Prevention Trial-Type 1 (DPT-1). Through longitudinal natural history studies, as well as trials before and after clinical onset of disease combined with mechanistic and ancillary investigations to enhance scientific understanding and translation to clinical use, TrialNet is working to bring disease-modifying therapies to individuals with type 1 diabetes. Moreover, TrialNet uses its expertise and experience in clinical studies to increase efficiencies in the conduct of trials and to reduce the burden of participation on individuals and families. Herein, we highlight key contributions made by TrialNet toward a revised understanding of the natural history of disease and approaches to alter disease course and outline the consortium's plans for the future. © 2018 by the American Diabetes Association.

  10. Design, Synthesis, and Biological Evaluation of 2-(Benzylamino-2-HydroxyalkylIsoindoline-1,3-Diones Derivatives as Potential Disease-Modifying Multifunctional Anti-Alzheimer Agents

    Directory of Open Access Journals (Sweden)

    Dawid Panek

    2018-02-01

    Full Text Available The complex nature of Alzheimer’s disease calls for multidirectional treatment. Consequently, the search for multi-target-directed ligands may lead to potential drug candidates. The aim of the present study is to seek multifunctional compounds with expected activity against disease-modifying and symptomatic targets. A series of 15 drug-like various substituted derivatives of 2-(benzylamino-2-hydroxyalkylisoindoline-1,3-diones was designed by modification of cholinesterase inhibitors toward β-secretase inhibition. All target compounds have been synthesized and tested against eel acetylcholinesterase (eeAChE, equine serum butyrylcholinesterase (eqBuChE, human β-secretase (hBACE-1, and β-amyloid (Aβ-aggregation. The most promising compound, 12 (2-(5-(benzylamino-4-hydroxypentylisoindoline-1,3-dione, displayed inhibitory potency against eeAChE (IC50 = 3.33 μM, hBACE-1 (43.7% at 50 μM, and Aβ-aggregation (24.9% at 10 μM. Molecular modeling studies have revealed possible interaction of compound 12 with the active sites of both enzymes—acetylcholinesterase and β-secretase. In conclusion: modifications of acetylcholinesterase inhibitors led to the discovery of a multipotent anti-Alzheimer’s agent, with moderate and balanced potency, capable of inhibiting acetylcholinesterase, a symptomatic target, and disease-modifying targets: β-secretase and Aβ-aggregation.

  11. Systematic review and network meta-analysis of combination and monotherapy treatments in disease-modifying antirheumatic drug-experienced patients with rheumatoid arthritis: analysis of American College of Rheumatology criteria scores 20, 50, and 70

    Science.gov (United States)

    Orme, Michelle E; MacGilchrist, Katherine S; Mitchell, Stephen; Spurden, Dean; Bird, Alex

    2012-01-01

    Background Biologic disease-modifying antirheumatic drugs (bDMARDs) extend the treatment choices for rheumatoid arthritis patients with suboptimal response or intolerance to conventional DMARDs. The objective of this systematic review and meta-analysis was to compare the relative efficacy of EU-licensed bDMARD combination therapy or monotherapy for patients intolerant of or contraindicated to continued methotrexate. Methods Comprehensive, structured literature searches were conducted in Medline, Embase, and the Cochrane Library, as well as hand-searching of conference proceedings and reference lists. Phase II or III randomized controlled trials reporting American College of Rheumatology (ACR) criteria scores of 20, 50, and 70 between 12 and 30 weeks’ follow-up and enrolling adult patients meeting ACR classification criteria for rheumatoid arthritis previously treated with and with an inadequate response to conventional DMARDs were eligible. To estimate the relative efficacy of treatments whilst preserving the randomized comparisons within each trial, a Bayesian network meta-analysis was conducted in WinBUGS using fixed and random-effects, logit-link models fitted to the binomial ACR 20/50/70 trial data. Results The systematic review identified 10,625 citations, and after a review of 2450 full-text papers, there were 29 and 14 eligible studies for the combination and monotherapy meta-analyses, respectively. In the combination analysis, all licensed bDMARD combinations had significantly higher odds of ACR 20/50/70 compared to DMARDs alone, except for the rituximab comparison, which did not reach significance for the ACR 70 outcome (based on the 95% credible interval). The etanercept combination was significantly better than the tumor necrosis factor-α inhibitors adalimumab and infliximab in improving ACR 20/50/70 outcomes, with no significant differences between the etanercept combination and certolizumab pegol or tocilizumab. Licensed-dose etanercept, adalimumab

  12. Rheumatoid arthritis in the United Arab Emirates

    NARCIS (Netherlands)

    Badsha, Humeira; Kong, Kok Ooi; Tak, Paul P.

    2008-01-01

    Studies have shown that patients with rheumatoid arthritis (RA) in the Middle East have delayed diagnosis and low disease-modifying anti-rheumatic drug (DMARD) utilization. We describe the characteristics and treatments of consecutive RA patients presenting to a new musculoskeletal clinic in Dubai,

  13. Efficacy and safety of biological and targeted-synthetic DMARDs: a systematic literature review informing the 2016 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis

    NARCIS (Netherlands)

    Sepriano, Alexandre; Regel, Andrea; van der Heijde, Désirée; Braun, Jürgen; Baraliakos, Xenofon; Landewé, Robert; van den Bosch, Filip; Falzon, Louise; Ramiro, Sofia

    2017-01-01

    To update the evidence for the efficacy and safety of (b)biological and (ts)targeted-synthetic disease-modifying anti-rheumatic drugs (DMARDs) in patients with axial spondyloarthritis (axSpA) to inform the 2016 update of the Assessment of SpondyloArthritis international Society/European League

  14. Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: a randomized controlled trial.

    NARCIS (Netherlands)

    Zwikker, H.E.; Ende, C.H. van den; Lankveld, W.G. van; Broeder, A.A. den; Hoogen, F.H. van den; Mosselaar, B. van de; Dulmen, S. van; Bemt, B.J. van den

    2014-01-01

    Objective: To assess the effect of a group-based intervention on the balance between necessity beliefs and concern beliefs about medication and on medication non-adherence in patients with rheumatoid arthritis (RA). Methods: Non-adherent RA patients using disease-modifying anti-rheumatic drugs

  15. Convention on nuclear safety

    International Nuclear Information System (INIS)

    1994-01-01

    The Convention on Nuclear Safety was adopted on 17 June 1994 by Diplomatic Conference convened by the International Atomic Energy Agency at its Headquarters from 14 to 17 June 1994. The Convention will enter into force on the ninetieth day after the date of deposit with the Depository (the Agency's Director General) of the twenty-second instrument of ratification, acceptance or approval, including the instruments of seventeen States, having each at leas one nuclear installation which has achieved criticality in a reactor core. The text of the Convention as adopted is reproduced in the Annex hereto for the information of all Member States

  16. Minamata Convention on Mercury

    Science.gov (United States)

    On November 6, 2013 the United States signed the Minamata Convention on Mercury, a new multilateral environmental agreement that addresses specific human activities which are contributing to widespread mercury pollution

  17. Climate change convention

    International Nuclear Information System (INIS)

    Russell, D.

    1992-01-01

    Principles that guide Canada's Green Plan with respect to global warming are outlined. These include respect for nature, meeting environmental goals in an economically beneficial manner, efficient use of resources, shared responsibilities, federal leadership, and informed decision making. The policy side of the international Framework Convention on Climate Change is then discussed and related to the Green Plan. The Convention has been signed by 154 nations and has the long-term objective of stabilizing anthropogenic greenhouse gas concentrations in the atmosphere at levels that prevent dangerous interference with the climate system. Some of the Convention's commitments toward achieving that objective are only applicable to the developed countries. Five general areas of commitment are emissions reductions, assistance to developing countries, reporting requirements, scientific and socioeconomic research, and education. The most controversial area is that of limiting emissions. The Convention has strong measures for public accountability and is open to future revisions. Canada's Green Plan represents one country's response to the Convention commitments, including a national goal to stabilize greenhouse gas emissions at the 1990 level by the year 2000

  18. Tritium and OSPAR convention

    International Nuclear Information System (INIS)

    2009-01-01

    The missions and the organisation of the OSPAR convention on protection of the NE Atlantic marine environment are given. The OSPAR strategy for the radioactive substances is stated. The results of work programme of the radioactive Substances committee are described and the consensus reached by contracting parties on the appropriate arrangements for this radionuclide is presented. (authors)

  19. Revised C++ coding conventions

    CERN Document Server

    Callot, O

    2001-01-01

    This document replaces the note LHCb 98-049 by Pavel Binko. After a few years of practice, some simplification and clarification of the rules was needed. As many more people have now some experience in writing C++ code, their opinion was also taken into account to get a commonly agreed set of conventions

  20. Global climate convention

    International Nuclear Information System (INIS)

    Simonis, U.E.

    1991-01-01

    The effort of negotiate a global convention on climate change is one of mankind's great endeavours - and a challenge to economists and development planners. The inherent linkages between climate and the habitability of the earth are increasingly well recognized, and a convention could help to ensure that conserving the environment and developing the economy in the future must go hand in hand. Due to growing environmental concern the United Nations General Assembly has set into motion an international negotiating process for a framework convention on climate change. One the major tasks in these negotiations is how to share the duties in reducing climate relevant gases, particularly carbon dioxide (CO 2 ), between the industrial and the developing countries. The results and proposals could be among the most far-reaching ever for socio-economic development, indeed for global security and survival itself. While the negotiations will be about climate and protection of the atmosphere, they will be on fundamental global changes in energy policies, forestry, transport, technology, and on development pathways with low greenhouse gas emissions. Some of these aspects of a climate convention, particularly the distributional options and consequences for the North-South relations, are addressed in this chapter. (orig.)

  1. Tofacitinib 5 mg Twice Daily in Patients with Rheumatoid Arthritis and Inadequate Response to Disease-Modifying Antirheumatic Drugs: A Comprehensive Review of Phase 3 Efficacy and Safety.

    Science.gov (United States)

    Bird, Paul; Bensen, William; El-Zorkany, Bassel; Kaine, Jeffrey; Manapat-Reyes, Bernadette Heizel; Pascual-Ramos, Virginia; Witcombe, David; Soma, Koshika; Zhang, Richard; Thirunavukkarasu, Krishan

    2018-05-24

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We performed a comprehensive review of phase 3 studies of tofacitinib 5 mg twice daily (BID) (approved dose in many countries) in patients with moderate to severe RA and inadequate response to prior disease-modifying antirheumatic drugs. A search of PubMed and ClinicalTrials.gov identified 5 studies: ORAL Solo (NCT00814307), ORAL Sync (NCT00856544), ORAL Standard (included adalimumab 40 mg once every 2 weeks; NCT00853385), ORAL Scan (NCT00847613), and ORAL Step (NCT00960440). Efficacy and safety data for tofacitinib 5 mg BID, placebo, and adalimumab were analyzed. Across the 5 studies, 1216 patients received tofacitinib 5 mg BID, 681 received placebo, and 204 received adalimumab. At month 3, tofacitinib demonstrated significantly higher 20%, 50%, and 70% improvement in American College of Rheumatology response criteria (ACR20, ACR50, and ACR70, respectively) response rates, greater improvement in Health Assessment Questionnaire-Disability Index, and a higher proportion of Disease Activity Score-defined remission than placebo. Frequencies of adverse events (AEs), serious AEs, and discontinuations due to AEs were similar for tofacitinib and placebo at month 3; serious infection events were more frequent for tofacitinib. In ORAL Standard, although not powered for formal comparisons, tofacitinib and adalimumab had numerically similar efficacy and AEs; serious AEs and serious infection events were more frequent with tofacitinib. Tofacitinib 5 mg BID reduced RA signs and symptoms and improved physical function versus placebo in patients with inadequate response to prior disease-modifying antirheumatic drugs. Tofacitinib 5 mg BID had a consistent, manageable safety profile across studies, with no new safety signals identified.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where

  2. An evaluation of adherence in patients with multiple sclerosis newly initiating treatment with a self-injectable or an oral disease-modifying drug

    Directory of Open Access Journals (Sweden)

    Munsell M

    2016-12-01

    Full Text Available Michael Munsell,1 Molly Frean,1 Joseph Menzin,1 Amy L Phillips2 1Boston Health Economics, Inc., Waltham, MA, USA; 2Health Economics & Outcomes Research, EMD Serono Inc., Rockland, MA, USA Objective: As the multiple sclerosis (MS disease-modifying drug (DMD treatment options have expanded to include oral therapies, it is important to understand whether route of administration is associated with DMD adherence. The objective of this study was to compare adherence to DMDs in patients with MS newly initiating treatment with a self-injectable versus an oral DMD. Methods: This retrospective database study used IMS Health Real World Data Adjudicated Claims – US data between July 1, 2010 and June 30, 2014. Adherence was measured by medication possession ratio (MPR, calculated as the total number of treated days divided by the total number of days from the first treated day until the end of 12-month follow-up. A binary measure representing adherence (MPR ≥0.8 versus nonadherence (MPR <0.8 to therapy was used. Logistic regression evaluated the likelihood of adherence to index DMD type (self-injectable vs oral. Covariates included patient baseline characteristics (ie, age, sex, comorbidities and index DMD type. Results: The analysis included 7,207 self-injectable and 1,175 oral DMD-treated patients with MS. In unadjusted analyses, the proportion of patients adherent to therapy (MPR ≥0.8 did not differ significantly between the self-injectable (54.1% and the oral DMD cohorts (53.0%; P=0.5075. After controlling for covariates, index DMD type was not a significant predictor of adherence (odds ratio [OR] 1.062; 95% confidence interval [CI]: 0.937–1.202; P=0.3473. Higher likelihood of adherence was associated with male sex (OR 1.20; 95% CI: 1.085–1.335; P=0.0005 and age groups older than 18–34 years (ORs 1.220–1.331; P<0.01. Depression was associated with a lower likelihood of adherence (OR 0.618; 95% CI: 0.511–0.747; P<0.0001. Conclusion: Male

  3. Conventions and Institutional Logics

    DEFF Research Database (Denmark)

    Westenholz, Ann

    Two theoretical approaches – Conventions and Institutional Logics – are brought together and the similarities and differences between the two are explored. It is not the intention to combine the approaches, but I would like to open both ‘boxes’ and make them available to each other with the purpose...... of creating a space for dialog. Both approaches were developed in the mid-1980s as a reaction to rational-choice economic theory and collectivistic sociological theory. These two theories were oversimplifying social life as being founded either in actor-micro level analyses or in structure-macro level...... analyses. The theoretical quest of both Conventions and Institutional Logics has been to understand the increasing indeterminacy, uncertainty and ambiguity in people’s lives where a sense of reality, of value, of moral, of feelings is not fixed. Both approaches have created new theoretical insights...

  4. Manado Convention Centre (Megastructures)

    OpenAIRE

    Anggianto, Rio M; Rate, Johannes Van

    2013-01-01

    Proyek Manado Convention Center ini pada dasarnya merupakan wadah atau sarana komunikasi antara dua pihak dengan penerapkan berbagai metode komunikasi langsung tatap muka baik itu dari perorangan terhadap kelompok, kelompok terhadap kelompok atau kelompok terhadap masyarakat. Dan pada era kini hal ini menjadi suatu kebutuhan yang dianganggap penting. Kota Manado seringkali menjadi tuan rumah suatu konverensi dengan jumlah peserta yang tergolong besar karena cakupannya sampai manca negara....

  5. The conventional quark picture

    International Nuclear Information System (INIS)

    Dalitz, R.H.

    1976-01-01

    For baryons, mesons and deep inelastic phenomena the ideas and the problems of the conventional quark picture are pointed out. All observed baryons fit in three SU(3)-multiplets which cluster into larger SU(6)-multiplets. No mesons are known which have quantum numbers inconsistent with belonging to a SU(3) nonet or octet. The deep inelastic phenomena are described in terms of six structure functions of the proton. (BJ) [de

  6. A qualitative study assessing patient perspectives in the process of decision-making on disease modifying therapies (DMT's) in multiple sclerosis (MS).

    Science.gov (United States)

    Ceuninck van Capelle, Archibald de; Meide, Hanneke van der; Vosman, Frans J H; Visser, Leo H

    2017-01-01

    Physicians commonly advise patients to begin disease modifying therapies (DMT's) shortly after the establishment of a diagnosis of Multiple Sclerosis (MS) to prevent further relapses and disease progression. However, little is known about the meaning for patients going through the process of the diagnosis of MS and of making decisions on DMT's in early MS. To explore the patient perspective on using DMT's for MS. Methods: Ten participants with a recent (approach. The analysis revealed the following themes: (1) Constant confrontation with the disease, (2) Managing inevitable decline, (3) Hope of delaying the progression of the disease, and, (4) The importance of social support. The themes show that patients associate the recommendation to begin DMT's (especially injectable DMT's) with views about their bodies as well as their hopes about the future. Both considering and adhering to treatment are experienced by patients as not only matters of individual and rational deliberation, but also as activities that are lived within a web of relationships with relatives and friends. From the patient perspective, the use of DMT's is not a purely rational and individual experience. More attention to the use of DMT's as relational and lived phenomena will improve the understanding of the process of decision-making for DMT's in MS.

  7. Influence of Anti-TNF and Disease Modifying Antirheumatic Drugs Therapy on Pulmonary Forced Vital Capacity Associated to Ankylosing Spondylitis: A 2-Year Follow-Up Observational Study

    Directory of Open Access Journals (Sweden)

    Alberto Daniel Rocha-Muñoz

    2015-01-01

    Full Text Available Objective. To evaluate the effect of anti-TNF agents plus synthetic disease modifying antirheumatic drugs (DMARDs versus DMARDs alone for ankylosing spondylitis (AS with reduced pulmonary function vital capacity (FVC%. Methods. In an observational study, we included AS who had FVC% <80% at baseline. Twenty patients were taking DMARDs and 16 received anti-TNF + DMARDs. Outcome measures: changes in FVC%, BASDAI, BASFI, 6-minute walk test (6MWT, Borg scale after 6MWT, and St. George’s Respiratory Questionnaire at 24 months. Results. Both DMARDs and anti-TNF + DMARDs groups had similar baseline values in FVC%. Significant improvement was achieved with anti-TNF + DMARDs in FVC%, at 24 months, when compared to DMARDs alone (P=0.04. Similarly, patients in anti-TNF + DMARDs group had greater improvement in BASDAI, BASFI, Borg scale, and 6MWT when compared to DMARDs alone. After 2 years of follow-up, 14/16 (87.5% in the anti-TNF + DMARDs group achieved the primary outcome: FVC% ≥80%, compared with 11/20 (55% in the DMARDs group (P=0.04. Conclusions. Patients with anti-TNF + DMARDs had a greater improvement in FVC% and cardiopulmonary scales at 24 months compared with DMARDs. This preliminary study supports the fact that anti-TNF agents may offer additional benefits compared to DMARDs in patients with AS who have reduced FVC%.

  8. Strategic interaction and conventions

    Directory of Open Access Journals (Sweden)

    Espinosa, María Paz

    2012-03-01

    Full Text Available The scope of the paper is to review the literature that employs coordination games to study social norms and conventions from the viewpoint of game theory and cognitive psychology. We claim that those two alternative approaches are in fact complementary, as they provide different insights to explain how people converge to a unique system of self-fulfilling expectations in presence of multiple, equally viable, conventions. While game theory explains the emergence of conventions relying on efficiency and risk considerations, the psychological view is more concerned with frame and labeling effects. The interaction between these alternative (and, sometimes, competing effects leads to the result that coordination failures may well occur and, even when coordination takes place, there is no guarantee that the convention eventually established will be the most efficient.

    El objetivo de este artículo es presentar la literatura que emplea los juegos de coordinación para el estudio de normas y convenciones sociales, que se han analizado tanto desde el punto de vista de la teoría de juegos como de la psicología cognitiva. Argumentamos en este trabajo que estos dos enfoques alternativos son en realidad complementarios, dado que ambos contribuyen al entendimiento de los procesos mediante los cuales las personas llegan a coordinarse en un único sistema de expectativas autorrealizadas, en presencia de múltiples convenciones todas ellas igualmente viables. Mientras que la teoría de juegos explica la aparición de convenciones basándose en argumentos de eficiencia y comportamientos frente al riesgo, el enfoque de la psicología cognitiva utiliza en mayor medida consideraciones referidas al entorno y naturaleza de las decisiones. La interacción entre estos efectos diferentes (y en ocasiones, rivales desemboca con frecuencia en fallos de coordinación y, aun cuando la coordinación se produce, no hay garantía de que la convención en vigor sea la m

  9. Digitization of conventional radiographs

    International Nuclear Information System (INIS)

    Wenz, W.; Buitrago-Tellez, C.; Blum, U.; Hauenstein, K.H.; Gufler, H.; Meyer, E.; Ruediger, K.

    1992-01-01

    The diagnostic value of a digitization system for analogue films based on a charge-coupled-device (CCD) scanner with adjustable resolution of 2.5 or 5 lp/mm was assessed. Some 110 skeletal radiographs, 50 contrast studies, including 25 of patients with Crohn's disease, and 70 abdominal plain films before and after successful lithotripsy for renal stones were digitized. Receiver operating characteristic (ROC) studies showed improved detection of cortical and trabecular defects with contrast-optimized digitized films. Edge enhancement algorithms yielded no additional information. Inflammatory lesions of Crohn's disease were detected equally well by conventional films and digitized images. A statistically significant improvement (p [de

  10. Conventional RF system design

    International Nuclear Information System (INIS)

    Puglisi, M.

    1994-01-01

    The design of a conventional RF system is always complex and must fit the needs of the particular machine for which it is planned. It follows that many different design criteria should be considered and analyzed, thus exceeding the narrow limits of a lecture. For this reason only the fundamental components of an RF system, including the generators, are considered in this short seminar. The most common formulas are simply presented in the text, while their derivations are shown in the appendices to facilitate, if desired, a more advanced level of understanding. (orig.)

  11. Conventional magnets. Pt. 1

    International Nuclear Information System (INIS)

    Marks, N.

    1994-01-01

    The design and construction of conventional, steel-cored, direct-current magnets are discussed. Laplace's equation and the associated cylindrical harmonic solutions in two dimensions are established. The equations are used to define the ideal pole shapes and required excitation for dipole, quadrupole and sextupole magnets. Standard magnet geometries are then considered and criteria determining the coil design are presented. The use of codes for predicting flux density distributions and the iterative techniques used for pole face design are then discussed. This includes a description of the use of two-dimensional codes to generate suitable magnet end geometries. Finally, standard constructional techniques for cores and coils are described. (orig.)

  12. Comparison of preferences of healthcare professionals and MS patients for attributes of disease-modifying drugs: A best-worst scaling.

    Science.gov (United States)

    Kremer, Ingrid E H; Evers, Silvia M A A; Jongen, Peter J; Hiligsmann, Mickaël

    2018-02-01

    The choice between disease-modifying drugs (DMDs) for the treatment of multiple sclerosis (MS) becomes more often a shared decision between the patient and the neurologist and MS nurse. This study aimed to assess which DMD attributes are most important for the healthcare professionals in selecting a DMD for a patient. Subsequently, within this perspective, the neurologists' and nurses' perspectives were compared. Lastly, the healthcare professionals' perspective was compared with the patients' perspective to detect any differences that may need attention in the communication about DMDs. A best-worst scaling (BWS) was conducted among 27 neurologists and 33 MS nurses treating patients with MS to determine the importance of 27 DMD attributes. These attributes were identified through three focus groups with MS patients in a previous study (N=19). Relative importance scores (RISs) were estimated for each attribute. Multivariable linear regression analyses were used to compare the different perspectives. According to the neurologists and nurses, safety of the DMD was the most important DMD attribute in the treatment decision, closely followed by effect on disability progression, quality of life and relapse rate. Patients with MS agreed with the importance of the last three attributes, but valued safety significantly lower (b=-2.59, P<.001). This study suggests that, overall, neurologists and nurses regard the same DMD attributes as important as MS patients with the notable exception of safety. This study provides valuable information for the development of interventions to support shared decision making and highlights which attributes of DMDs may need additional attention. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  13. The effect of disease modifying therapies on brain atrophy in patients with relapsing-remitting multiple sclerosis: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Georgios Tsivgoulis

    Full Text Available The aim of the present meta-analysis was to evaluate the effect of disease-modifying drugs (DMD on brain atrophy in patients with relapsing-remitting multiple sclerosis (RRMS using available randomized-controlled trial (RCT data.We conducted a systematic review and meta-analysis according to PRISMA guidelines of all available RCTs of patients with RRMS that reported data on brain volume measurements during the study period.We identified 4 eligible studies, including a total of 1819 RRMS patients (71% women, mean age 36.5 years, mean baseline EDSS-score: 2.4. The mean percentage change in brain volume was found to be significantly lower in DMD versus placebo subgroup (standardized mean difference: -0.19; 95%CI: -0.27--0.11; p<0.001. We detected no evidence of heterogeneity between estimates (I2 = 30%, p = 0.19 nor publication bias in the Funnel plots. Sensitivity analyses stratifying studies according to brain atrophy neuroimaging protocol disclosed no evidence of heterogeneity (p = 0.16. In meta-regression analyses, the percentage change in brain volume was found to be inversely related with duration of observation period in both DMD (meta-regression slope = -0.03; 95% CI: -0.04--0.02; p<0.001 and placebo subgroups (meta-regression slope = -0.05; 95% CI: -0.06--0.04; p<0.001. However, the rate of percentage brain volume loss over time was greater in placebo than in DMD subgroup (p = 0.017, ANCOVA.DMD appear to be effective in attenuating brain atrophy in comparison to placebo and their benefit in delaying the rate of brain volume loss increases linearly with longer treatment duration.

  14. The prevalence of injection-site reactions with disease-modifying therapies and their effect on adherence in patients with multiple sclerosis: an observational study

    Directory of Open Access Journals (Sweden)

    Beer Karsten

    2011-11-01

    Full Text Available Abstract Background Interferon beta (IFNβ and glatiramer acetate (GA are administered by subcutaneous (SC or intramuscular (IM injection. Patients with multiple sclerosis (MS often report injection-site reactions (ISRs as a reason for noncompliance or switching therapies. The aim of this study was to compare the proportion of patients on different formulations of IFNβ or GA who experienced ISRs and who switched or discontinued therapy because of ISRs. Methods The Swiss MS Skin Project was an observational multicenter study. Patients with MS or clinically isolated syndrome who were on the same therapy for at least 2 years were enrolled. A skin examination was conducted at the first study visit and 1 year later. Results The 412 patients enrolled were on 1 of 4 disease-modifying therapies for at least 2 years: IM IFNβ-1a (n = 82, SC IFNβ-1b (n = 123, SC IFNβ-1a (n = 184, or SC GA (n = 23. At first evaluation, ISRs were reported by fewer patients on IM IFNβ-1a (13.4% than on SC IFNβ-1b (57.7%; P P P = not significant [NS]. No patient on IM IFNβ-1a missed a dose in the previous 4 weeks because of ISRs, compared with 5.7% of patients on SC IFNβ-1b (P = 0.044, 7.1% of patients on SC IFNβ-1a (P = 0.011, and 4.3% of patients on SC GA (P = NS. Primary reasons for discontinuing or switching therapy were ISRs or lack of efficacy. Similar patterns were observed at 1 year. Conclusions Patients on IM IFNβ-1a had fewer ISRs and were less likely to switch therapies than patients on other therapies. This study may have implications in selecting initial therapy or, for patients considering switching or discontinuing therapy because of ISRs, selecting an alternative option.

  15. The Cost-effectiveness of Sequences of Biological Disease-modifying Antirheumatic Drug Treatment in England for Patients with Rheumatoid Arthritis Who Can Tolerate Methotrexate.

    Science.gov (United States)

    Stevenson, Matt D; Wailoo, Allan J; Tosh, Jonathan C; Hernandez-Alava, Monica; Gibson, Laura A; Stevens, John W; Archer, Rachel J; Simpson, Emma L; Hock, Emma S; Young, Adam; Scott, David L

    2017-07-01

    To ascertain whether strategies of treatment with a biological disease-modifying antirheumatic drug (bDMARD) are cost-effective in an English setting. Results are presented for those patients with moderate to severe rheumatoid arthritis (RA) and those with severe RA. An economic model to assess the cost-effectiveness of 7 bDMARD was developed. A systematic literature review and network metaanalysis was undertaken to establish relative clinical effectiveness. The results were used to populate the model, together with estimates of Health Assessment Questionnaire (HAQ) score following European League Against Rheumatism response; annual costs, and utility, per HAQ band; trajectory of HAQ for patients taking bDMARD; and trajectory of HAQ for patients using nonbiologic therapy (NBT). Results were presented as those associated with the strategy with the median cost-effectiveness. Supplementary analyses were undertaken assessing the change in cost-effectiveness when only patients with the most severe prognoses taking NBT were provided with bDMARD treatment. The costs per quality-adjusted life-year (QALY) values were compared with reported thresholds from the UK National Institute for Health and Care Excellence of £20,000 to £30,000 (US$24,700 to US$37,000). In the primary analyses, the cost per QALY of a bDMARD strategy was £41,600 for patients with severe RA and £51,100 for those with moderate to severe RA. Under the supplementary analyses, the cost per QALY fell to £25,300 for those with severe RA and to £28,500 for those with moderate to severe RA. The cost-effectiveness of bDMARD in RA in England is questionable and only meets current accepted levels in subsets of patients with the worst prognoses.

  16. Efficacy and safety of golimumab as add-on therapy to disease-modifying antirheumatic drugs in rheumatoid arthritis: results of the GO-MORE study in Spain.

    Science.gov (United States)

    Alonso, Alberto; González, Carlos M; Ballina, Javier; García Vivar, María L; Gómez-Reino, Juan J; Marenco, Jose Luis; Fernández-Nebro, Antonio; Ordás, Carmen; Cea-Calvo, Luis; Arteaga, María J; Sanmartí, Raimon

    2015-01-01

    To assess the efficacy and safety of golimumab in the 140 patients included in Spain as the first part of the GO-MORE trial, a multinational study involving patients with active rheumatoid arthritis (RA) despite treatment with different disease-modifying antirheumatic drugs (DMARDs). The patients received subcutaneous golimumab 50mg once a month during 6 months. The primary endpoint was the percentage of individuals with a good or moderate EULAR DAS28-ESR response after 6 months of treatment. A total of 140 patients were included. Of these, 76.4% had very active disease (DAS28-ESR>5.1). 76.4% were taking methotrexate, 40.0% other DMARDs in monotherapy or combined, and 65.0% received corticosteroids. After 6 months, 82.9% of the patients showed a good or moderate EULAR response, 41.4% had low disease activity, and 30.7% were in remission. The percentage of responders one month after the first dose was 69.3%. The efficacy was similar in patients treated with methotrexate or other DMARDs, with different methotrexate doses, with or without corticosteroids, or in subjects who had failed one or more DMARDs. The response to golimumab was observed from the first dose. Golimumab was well tolerated and its safety profile was consistent with the findings of previous studies. Serious adverse events were reported in 11 patients (7.9%). The addition of subcutaneous golimumab 50 mg once a month to different DMARDs in patients with active RA yielded a moderate or good response after 6 months in 82.9% of the cases. The response was observed early, from the start of the second month, after a single dose of golimumab. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  17. ESD and the Rio Conventions

    Science.gov (United States)

    Sarabhai, Kartikeya V.; Ravindranath, Shailaja; Schwarz, Rixa; Vyas, Purvi

    2012-01-01

    Chapter 36 of Agenda 21, a key document of the 1992 Earth Summit, emphasised reorienting education towards sustainable development. While two of the Rio conventions, the Convention on Biological Diversity (CBD) and the United Nations Framework Convention on Climate Change (UNFCCC), developed communication, education and public awareness (CEPA)…

  18. Retrospective US database analysis of persistence with glatiramer acetate vs. available disease-modifying therapies for multiple sclerosis: 2001-2010.

    Science.gov (United States)

    Oleen-Burkey, MerriKay; Cyhaniuk, Anissa; Swallow, Eric

    2014-01-14

    Long-term persistence to treatment for chronic disease is difficult for patients to achieve, regardless of the disease or medication being used. The objective of this investigation was to examine treatment persistence with glatiramer acetate (GA) relative to available disease-modifying therapies (DMT) for multiple sclerosis (MS) over 12-, 24- and 36-month periods. Data from Clinformatics™ for DataMart affiliated with OptumInsight was used to identify patients using DMT between 2001 and 2010. Patients with 12, 24, and 36 months of follow-up were included. Persistence was defined as continuous use of the same DMT for the duration of follow-up regardless of treatment gaps. Regimen changes including re-initiation of therapy following gaps of 15 days or more, switching therapy, and DMT discontinuation were investigated. Descriptive statistics were used to summarize the results. Cohorts of GA users with 12 months (n = 12,144), 24 months (n = 7,386) and 36 months (n = 4,693) of follow-up were identified. Persistence rates with GA were 80% for all time periods; discontinuation rates declined over time while switching increased modestly. In contrast, the full DMT-treated cohorts showed persistent rates of 68.3% at 12 months (n = 35,312), 53.9% at 24 months (n = 21,927), and 70.1% at 36 months (n = 14,343). As with these full DMT-treated cohorts, the proportion of GA users remaining on their initial therapy without a gap of 15 days or more decreased with length of follow-up. However, the proportion of GA users with a gap in treatment who re-initiated GA increased over time (64.4% at 12 months; 75.1% at 24 months, and 80.1% at 36 months) while those in the full DMT-treated cohorts re-initiated therapy at rates of only 50-60%. Persistence rates for GA were 80% for the 12-, 24- and 36-month time periods in contrast with the full DMT-treated cohorts whose persistence rates never exceeded 70.0%. Although there were more gaps in therapy of 15 days or more with all DMT over time

  19. Systematic review and meta-analysis of serious infections with tofacitinib and biologic disease-modifying antirheumatic drug treatment in rheumatoid arthritis clinical trials.

    Science.gov (United States)

    Strand, Vibeke; Ahadieh, Sima; French, Jonathan; Geier, Jamie; Krishnaswami, Sriram; Menon, Sujatha; Checchio, Tina; Tensfeldt, Thomas G; Hoffman, Elaine; Riese, Richard; Boy, Mary; Gómez-Reino, Juan J

    2015-12-15

    were 2.21 (0.60, 8.14) and 2.02 (0.56, 7.28), respectively. Risk differences (95% CIs) versus placebo for tofacitinib 5 and 10 mg BID were 0.38% (-0.24%, 0.99%) and 0.40% (-0.22%, 1.02%), respectively. In interventional studies, the risk of serious infections with tofacitinib is comparable to published rates for biologic disease-modifying antirheumatic drugs in patients with moderate to severely active RA.

  20. Application of the Aarhus Convention

    Directory of Open Access Journals (Sweden)

    Tubić Bojan

    2011-01-01

    Full Text Available Convention on access to information, public participation in decision-making and access to justice in environmental matters (Aarhus Convention has been adopted in 1998 and entered into force three years later. It envisages three elements for strengthening democratic procedures in decision-making: access to information, public participation and access to justice. At the first meeting of the Member States the Aarhus Convention Compliance Committee was founded. The European Union is a party of the Convention and it has implemented the provisions in its legal order. After entering into force of the Convention, several Directives that regulate these issues in the EU have been enacted. Republic of Serbia has ratified the Convention in 2009 and it is currently in the process of its implementation by involving private subjects in decision-making on environmental issues.

  1. Understanding the conventional arms trade

    Science.gov (United States)

    Stohl, Rachel

    2017-11-01

    The global conventional arms trade is worth tens of billions of dollars every year and is engaged in by every country in the world. Yet, it is often difficult to control the legal trade in conventional arms and there is a thriving illicit market, willing to arm unscrupulous regimes and nefarious non-state actors. This chapter examines the international conventional arms trade, the range of tools that have been used to control it, and challenges to these international regimes.

  2. Comparison of Conventional and Semi-Conventional Management ...

    African Journals Online (AJOL)

    Comparison of Conventional and Semi-Conventional Management Systems on the Performance and Carcass Yield of Broiler Chickens. ... TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL · RESOURCES ... Journal Home > Vol 20, No 1 (2018) >. Log in or ...

  3. Towards a Theory of Convention

    DEFF Research Database (Denmark)

    Hansen, Pelle Guldborg

    2006-01-01

    Some thirty years ago Lewis published his Convention: A philosophical Study (Lewis 1969). Besides exciting the logical community by providing the seminal analysis work on common knowledge, it also laid the foundations for the formal approach to the study of social conventions by means of game the...

  4. Revision of the Paris Convention and the Brussels Supplementary Convention

    International Nuclear Information System (INIS)

    Busekist, Otto von.

    1977-01-01

    The Paris Convention and the Brussels Supplementary Convention have in substance remained unchanged since their adoption in 1960 and 1963, respectively. During that period, nuclear industry and technology have developed considerably while the financial and monetary bases of the Conventions have been shattered. The amounts of liability and compensation have been eroded by inflation, and the gold-based unit of account in which these amounts are expressed has lost its original meaning after the abolition of the official gold price. The question of revising the Conventions, in particular of raising those amounts and of replacing the unit of account, is therefore being studied by the Group of Governmental Experts on Third party Liability in the Field of Nuclear Energy of the OECD Nuclear Energy Agency. (auth.) [fr

  5. The nuclear liability conventions revised

    International Nuclear Information System (INIS)

    Reyners, P.

    2004-01-01

    The signature on 12 February 2004 of the Protocols amending respectively the 1960 Paris Convention and the 1963 Brussels Supplementary Convention was the second step of the process of modernisation of the international nuclear liability regime after the adoption in September 1997 of a Protocol revising the 1963 Vienna Convention and of a new Convention on Supplementary Compensation for Nuclear Damage. The common objective of the new instruments is to provide more funds to compensate a larger number of potential victims in respect of a broader range of damage. Another goal of the revision exercise was to maintain the compatibility between the Paris and Vienna based systems, a commitment enshrined in the 1988 Joint Protocol, as well as to ascertain that Paris/Brussels countries could also become a Party to the Convention on Supplementary Compensation. However, while generally consistent vis a vis the Joint Protocol, the provisions of the Paris and Vienna Conventions, as revised, differ on some significant aspects. Another remaining issue is whether the improved international nuclear liability regime will succeed in attracting in the future a larger number of countries, particularly outside Europe, and will so become truly universal. Therefore, the need for international co-operation to address these issues, to facilitate the adoption of new implementing legislation and to ensure that this special regime keeps abreast of economic and technological developments, is in no way diminished after the revision of the Conventions.(author)

  6. EFFECTS OF SYNTHETIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS, BIOLOGICAL AGENTS, AND PSYCHOPHARMACOTHERAPY ON THE MENTAL DISORDERS IN PATIENTS WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    A. A. Abramkin

    2017-01-01

    Full Text Available Mental disorders (MDs of the anxiety-depressive spectrum (ADS and cognitive impairment (CI are characteristic of the majority of patients with rheumatoid arthritis (RA; however, the effects of disease-modifying antirheumatic drugs (DMARDs, biological agents (BAs, and their combinations with psychopharmacological drugs (PPDs on these abnormalities have been insufficiently studied. Objective: to investigate trends in the incidence of MDs in RA patients receiving different treatment regimens.Subjects and methods. The investigation included 128 RA patients (13% men and 87% women who fulfilled the 1987 American College of Rheumatology criteria; their mean age was 47.4±0.9 years; the median duration of RA was 96 [48; 228] months. RA activity was found to be high, moderate, and low in 48, 56, and 24 patients, respectively. DAS28 averaged 5.34±0.17. 80% of the patients received DMARDs. MDs were diagnosed based on ICD-10 coding, by using a semi-structured interview and scales, such as the Hospital Anxiety and Depression Scale, the Hamilton Anxiety Scale, and the Montgomery-Asberg Depression Rating Scale. Clinical and psychological procedures were used to diagnose CI. At the study inclusion stage, ADS disorders were detected in 123 (96.1% patients; CI was found in 88 (68.7%. Forty-one (32.1% patients were diagnosed with major depression (an obvious or moderate depressive episode, 53 (41.4% patients had minor depression (a mild depressive episode and dysthymia, and 29 (22.6% had anxiety disorders (ADs (adjustment disorders with anxiety symptoms, as well as generalized anxiety disorder. The dynamics of MDs was estimated in 112 (87.5% of the 128 patients and in 83 (64.8% at one- and five-year follow-ups, respectively. The following groups were identified according to the performed therapy: 1 synthetic DMARDs (n = 39; 2 synthetic DMARDs + PPDs (n = 43; 3 BAs + DMARDs (n = 32; 4 BAs + DMARDs + PPDs (n = 9.Results and discussion. In Group 1, the

  7. Unexpected exacerbations following initiation of disease-modifying drugs in neuromyelitis optica spectrum disorder: Which factor is responsible, anti-aquaporin 4 antibodies, B cells, Th1 cells, Th2 cells, Th17 cells, or others?

    Science.gov (United States)

    Kira, Jun-Ichi

    2017-08-01

    Some disease-modifying drugs for multiple sclerosis, which mainly act on T cells, are ineffective for neuromyelitis optica spectrum disorder and induce unexpected relapses. These include interferon beta, glatiramer acetate, fingolimod, natalizumab, and alemtuzumab. The cases reported here suggest that dimethyl fumarate, which reduces the number of Th1 and Th17 cells and induces IL-4-producing Th2 cells, is also unsuitable for neuromyelitis optica spectrum disorder, irrespective of anti-aquaporin 4 IgG serostatus. Although oral dimethyl fumarate with manageable adverse effects is easy to initiate in the early course of multiple sclerosis, special attention should be paid for atypical demyelinating cases.

  8. Ofatumumab, a human anti-CD20 monoclonal antibody, for treatment of rheumatoid arthritis with an inadequate response to one or more disease-modifying antirheumatic drugs: results of a randomized, double-blind, placebo-controlled, phase I/II study

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Baslund, Bo; Rigby, William

    2010-01-01

    To investigate the safety and efficacy of ofatumumab, a novel human anti-CD20 monoclonal antibody (mAb), in patients with active rheumatoid arthritis (RA) whose disease did not respond to > or = 1 disease-modifying antirheumatic drug....

  9. The evolution of development conventions

    Directory of Open Access Journals (Sweden)

    Fabio Stefano Erber

    2012-04-01

    Full Text Available This paper presents a conceptual view on development and its translation into development policies. It argues that society's perception of development is structured by conventions, which provide a view of the past, present and future and, at the same time, allows a certain hierarchy of problems and solutions to such problems. The prevalence of a specific convention depends on the international conditions faced by this society and on the distribution of economic and political power within that society. Therefore, in complex societies there is always a struggle for hegemony between competing development conventions.

  10. Evolutionary Games and Social Conventions

    DEFF Research Database (Denmark)

    Hansen, Pelle Guldborg

    2007-01-01

    -defined metaphors of individual learning and social imitation processes, from which a revised theory of convention may be erected (see Sugden 2004, Binmore 1993 and Young 1998). This paper makes a general argument in support of the evolutionary turn in the theory of convention by a progressive exposition of its...... in Aumann (1976) and which, together with the assumptions of perfect rationality, came to be defining of classical game theory. However, classical game theory is currently undergoing severe crisis as a tool for exploring social phenomena; a crisis emerging from the problem of equilibrium selection around......Some thirty years ago Lewis published his Convention: A Philosophical Study (Lewis, 2002). This laid the foundation for a game-theoretic approach to social conventions, but became more famously known for its seminal analysis of common knowledge; the concept receiving its canonical analysis...

  11. The efficacy and tolerability of leflunomide (Arava® in therapy for psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Vladimir Vasilyevich Badokin

    2013-01-01

    Full Text Available The paper gives data on differentiated disease-modifying anti-rheumatic therapy for psoriatic arthritis (PsA. When performing the therapy, account must be taken of the presence and magnitude of the major manifestations of this disease: the pattern of arthritis and spondylosis, the number of inflamed entheses, the number of swollen fingers or toes, the pattern of psoriasis in terms of its extent and stage, the presence and magnitude of systemic manifestations and the functional state of involved organs. There are data on the biological activity of leflunomide, its effect on the main manifestations of PsA with an analysis of its efficacy and tolerability, as well as the results of a comparative investigation of disease-modifying anti-rheumatic drugs used for the therapy of this disease.

  12. Coexisting ankylosing spondylitis and rheumatoid arthritis: a case report with literature review.

    Science.gov (United States)

    Guo, Ying-Ying; Yang, Li-Li; Cui, Hua-Dong; Zhao, Shuai; Zhang, Ning

    2011-10-01

    A 30-year-old female patient with coexisting ankylosing spondylitis and rheumatoid arthritis was diagnosed and treated. The human leukocyte antigen (HLA)-B27 is a predisposing factor of ankylosing spondylitis and HLA-DR4 is a predisposing factor of rheumatoid arthritis. This patient was HLA-B27 and HLA-DR4 positive, and ankylosing spondylitis manifested before rheumatoid arthritis. After disease modifying anti-rheumatic drugs successfully arrested ankylosing spondylitis activity the patient conceived and delivered a healthy baby. One year later, she developed peripheral polyarthritis and was diagnosed with rheumatoid arthritis. We hypothesized that pregnancy may be one of the environmental factors that can activate rheumatoid arthritis, and that disease modifying anti-rheumatic drugs play an important role in keeping the disease under control.

  13. Paris convention - Decisions, recommendations, interpretations

    International Nuclear Information System (INIS)

    1990-01-01

    This booklet is published in a single edition in English and French. It contains decisions, recommendations and interpretations concerning the 1960 Paris Convention on Third Party Liability in the Field of Nuclear Energy adopted by the OECD Steering Committee and the OECD Council. All the instruments are set out according to the Article of the Convention to which they relate and explanatory notes are added where necessary [fr

  14. Use of etanercept in a patient with rheumatoid arthritis on hemodialysis.

    Science.gov (United States)

    Sugioka, Yuko; Inui, Kentaro; Koike, Tatsuya

    2008-01-01

    Disease-modifying anti-rheumatic drugs (DMARDs) are typically used for the therapy of rheumatoid arthritis (RA), but most have some nephrotoxicity. In several clinical studies, etanercept had fewer adverse effects on renal function than other DMARDs. We report the case of a 64-year-old woman with RA and renal insufficiency on hemodialysis treated using etanercept therapy. This case suggests that etanercept therapy might be effective in the short term for such patients.

  15. Drug: D07478 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available D07478 Drug Aurotioprol; Allochrysine (TN) ... C3H6AuO4S2.Na ... Anti-inflammatory ... DG01912 ... Gold... preparations ... DG01985 ... Disease modifying anti-rheumatic drugs (DMARDs) ... DG01912 ... Gold preparat...ions ATC code: M01CB05 ... Gold preparation ... CAS: 27279-43-2 PubChem: 96024436 NIKKAJI: J35.087G ...

  16. Changing clinical patterns in rheumatoid arthritis management over two decades:Sequential observational studies

    OpenAIRE

    Mian, Aneela N; Ibrahim, Fowzia; Scott, Ian C; Bahadur, Sardar; Filkova, Maria; Pollard, Louise; Steer, Sophia; Kingsley, Gabrielle H; Scott, David L; Galloway, James

    2016-01-01

    BACKGROUND: Rheumatoid arthritis (RA) treatment paradigms have shifted over the last two decades. There has been increasing emphasis on combination disease modifying anti-rheumatic drug (DMARD) therapy, newer biologic therapies have become available and there is a greater focus on achieving remission. We have evaluated the impact of treatment changes on disease activity scores for 28 joints (DAS28) and disability measured by the health assessment questionnaire scores (HAQ).METHODS: Four cross...

  17. Improving healthcare consumer effectiveness: An Animated, Self-serve, Web-based Research Tool (ANSWER) for people with early rheumatoid arthritis

    OpenAIRE

    Li, Linda C; Adam, Paul; Townsend, Anne F; Stacey, Dawn; Lacaille, Diane; Cox, Susan; McGowan, Jessie; Tugwell, Peter; Sinclair, Gerri; Ho, Kendall; Backman, Catherine L

    2009-01-01

    Abstract Background People with rheumatoid arthritis (RA) should use DMARDs (disease-modifying anti-rheumatic drugs) within the first three months of symptoms in order to prevent irreversible joint damage. However, recent studies report the delay in DMARD use ranges from 6.5 months to 11.5 months in Canada. While most health service delivery interventions are designed to improve the family physician's ability to refer to a rheumatologist and prescribe treatments, relatively little has been do...

  18. Novel versus conventional antipsychotic drugs.

    Science.gov (United States)

    Love, R C

    1996-01-01

    Novel antipsychotic agents differ from conventional ones in several key characteristics, including effectiveness, adverse reactions, and receptor-binding profile. Most of the newer agents have an affinity for the serotonin 5HT2 receptor that is at least 10 times greater than that for the dopamine D2 receptor. This increased affinity for the serotonin receptor may be responsible for another distinguishing characteristic of novel antipsychotic agents--decreased frequency of extrapyramidal side effects. These side effects, which include pseudoparkinsonism, acute dystonias, and akathisia, frequently are the reason for noncompliance with conventional drug therapy. The newer drugs are often effective in patients resistant to treatment with conventional agents. They also appear to reduce the negative symptoms of schizophrenia in many patients.

  19. The prospect of conventional disarmament

    International Nuclear Information System (INIS)

    Adeniji, O.

    1989-01-01

    The prospect of conventional disarmament in Europe holds out great consequences not only for the continent but also for the entire world. The arms race both in its nuclear and conventional aspects has been the single most important element of the destabilizing factors in international relations since 1945. Though initially borne out of the ideological division of Europe and the consequent quest for strategic military superiority, it soon developed a technological momentum of its own, becoming more the cause than the effect of the distrust in the relationship of the two alliances. The issue of conventional weapons was raised for negotiations side by side with that of nuclear weapons when the United Nations took up the question of disarmament in 1946. Due, however, to the unforeseen and most dangerous advance in nuclear weaponry, the fear engendered shifted all attention at the multilateral level to nuclear weapons. Except in Europe where the Mutual and Balanced Force Reduction Talks in Central Europe were initiated, conventional weapons disarmament did not attract multilateral attention again until the First Special Session of the United nations General Assembly Devoted to Disarmament in 1978. The Final Document of the Special Session did accord highest priority to negotiations on nuclear weapons. However, it also affirmed that side by side with negotiations on nuclear weapons, the limitation and gradual reduction of armed forces and conventional weapons should be resolutely pursued within the framework of general and complete disarmament. States with the largest military arsenals, it was stated, had a special responsibility in pursuing conventional armaments reduction. Underscoring the central role of Europe further, the Final Document postulated that the achievement of a more stable situation at a lower level of military potential would contribute toward strengthening of security in Europe and constitute a significant step toward international peace and security

  20. Conventional imaging in paediatric uroradiology

    International Nuclear Information System (INIS)

    Riccabona, M.; Lindbichler, F.; Sinzig, M.

    2002-01-01

    Objective: To briefly describe basic conventional imaging in paediatric uroradiology. Method: The state of the art performance of standard imaging techniques (intravenous urography (IVU), voiding cystourethrography (VCU), and ultrasound (US)) is described, with emphasis on technical aspects, indications, and patient preparation such as adequate hydration. Only basic applications as used in routine clinical work are included. Result and conclusion: Conventional imaging methods are irreplaceable. They cover the majority of daily clinical routine queries, with consecutive indication of more sophisticated modalities in those patients who need additional imaging for establishing the final diagnosis or outlining therapeutic options

  1. Conventional imaging in paediatric uroradiology

    Energy Technology Data Exchange (ETDEWEB)

    Riccabona, M. E-mail: michael.riccabona@kfunigraz.ac.at; Lindbichler, F.; Sinzig, M

    2002-08-01

    Objective: To briefly describe basic conventional imaging in paediatric uroradiology. Method: The state of the art performance of standard imaging techniques (intravenous urography (IVU), voiding cystourethrography (VCU), and ultrasound (US)) is described, with emphasis on technical aspects, indications, and patient preparation such as adequate hydration. Only basic applications as used in routine clinical work are included. Result and conclusion: Conventional imaging methods are irreplaceable. They cover the majority of daily clinical routine queries, with consecutive indication of more sophisticated modalities in those patients who need additional imaging for establishing the final diagnosis or outlining therapeutic options.

  2. The European Convention on bioethics.

    Science.gov (United States)

    Byk, C

    1993-03-01

    Benefiting from a widely recognised experience of the field of bioethics, the Council of Europe which represents all the democratic countries of Europe, has embarked on the ambitious task of drafting a European Convention on bioethics. The purpose of this text is to set out fundamental values, such as respect for human dignity, free informed consent and non-commercialisation of the human body. In addition to this task, protocols will provide specific standards for the different fields concerned with the application of biomedical sciences. The convention and the first two protocols (human experiments and organ transplants) are due to be ready for signature by mid 1994.

  3. Conventional and unconventional political participation

    International Nuclear Information System (INIS)

    Opp, K.D.

    1985-01-01

    A non-recursive model is proposed and empirically tested with data of opponents of nuclear power. In explaining conventional and unconventional participation the theory of collective action is applied and modified in two respects: the perceived influence on the elimination of collective evils are taken into account; the selective incentives considered are non-material ones. These modifications proved to be valid: the collective good variables and non-material incentives were important determinants for the two forms of participation. Another result was that there is a reciprocal causal relationship between conventional and unconventional participation. (orig./PW) [de

  4. Grounding Damage to Conventional Vessels

    DEFF Research Database (Denmark)

    Lützen, Marie; Simonsen, Bo Cerup

    2003-01-01

    The present paper is concerned with rational design of conventional vessels with regard to bottom damage generated in grounding accidents. The aim of the work described here is to improve the design basis, primarily through analysis of new statistical data for grounding damage. The current regula...

  5. Conventional and Non-Conventional Yeasts in Beer Production

    Directory of Open Access Journals (Sweden)

    Angela Capece

    2018-06-01

    Full Text Available The quality of beer relies on the activity of fermenting yeasts, not only for their good fermentation yield-efficiency, but also for their influence on beer aroma, since most of the aromatic compounds are intermediate metabolites and by-products of yeast metabolism. Beer production is a traditional process, in which Saccharomyces is the sole microbial component, and any deviation is considered a flaw. However, nowadays the brewing sector is faced with an increasing demand for innovative products, and it is diffusing the use of uncharacterized autochthonous starter cultures, spontaneous fermentation, or non-Saccharomyces starters, which leads to the production of distinctive and unusual products. Attempts to obtain products with more complex sensory characteristics have led one to prospect for non-conventional yeasts, i.e., non-Saccharomyces yeasts. These generally are characterized by low fermentation yields and are more sensitive to ethanol stress, but they provide a distinctive aroma and flavor. Furthermore, non-conventional yeasts can be used for the production of low-alcohol/non-alcoholic and light beers. This review aims to present the main findings about the role of traditional and non-conventional yeasts in brewing, demonstrating the wide choice of available yeasts, which represents a new biotechnological approach with which to target the characteristics of beer and to produce different or even totally new beer styles.

  6. The marked and rapid therapeutic effect of tofacitinib in combination with subcutaneous methotrexate in a rheumatoid arthritis patient with poor prognostic factors who is resistant to standard disease-modifying antirheumatic drugs and biologicals: A clinical case

    Directory of Open Access Journals (Sweden)

    N. V. Demidova

    2016-01-01

    Full Text Available Today, it is generally accepted that it is necessary to achieve clinical remission in rheumatoid arthritis (RA or as minimum a low disease activity. The paper describes a clinical case of a female patient diagnosed with RA who was observed to have inefficiency of standard disease-modifying antirheumatic therapy with methotrexate 25 mg/week, secondary inefficiency of tumor necrosis factor-α inhibitors (adalimumab, and inefficiency/poor tolerance of the interlukin-6 receptor antagonist tocilizumab. This determined the need to use fofacitinib (TOFA, a drug with another mechanism of action. TOFA is the first agent from a new group of immunomodulatory and anti-inflammatory drugs, intracellular kinase inhibitors. Disease remission could be achieved during therapy with TOFA, which enables one to consider this synthetic drug as a therapy option that potentially competes with therapy with biologicals.

  7. Quasisymmetry equations for conventional stellarators

    International Nuclear Information System (INIS)

    Pustovitov, V.D.

    1994-11-01

    General quasisymmetry condition, which demands the independence of B 2 on one of the angular Boozer coordinates, is reduced to two equations containing only geometrical characteristics and helical field of a stellarator. The analysis is performed for conventional stellarators with a planar circular axis using standard stellarator expansion. As a basis, the invariant quasisymmetry condition is used. The quasisymmetry equations for stellarators are obtained from this condition also in an invariant form. Simplified analogs of these equations are given for the case when averaged magnetic surfaces are circular shifted torii. It is shown that quasisymmetry condition can be satisfied, in principle, in a conventional stellarator by a proper choice of two satellite harmonics of the helical field in addition to the main harmonic. Besides, there appears a restriction on the shift of magnetic surfaces. Thus, in general, the problem is closely related with that of self-consistent description of a configuration. (author)

  8. PROJECT: RECOMMENDATIONS ON TREATMENT OF RHEUMATOID ARTHRITIS DEVELOPED BY ALL-RUSSIAN PUBLIC ORGANIZATION «ASSOCIATION OF RHEUMATOLOGISTS OF RUSSIA» – 2014 (PART 1

    Directory of Open Access Journals (Sweden)

    E. L. Nasonov

    2015-01-01

    Full Text Available Authors report new recommendations of All-Russian Public Organization «Association of Rheumatologists of Russia» (ARR on treatment of rheumatoid arthritis (RA, which adapts contemporary concept accepted in the respective field of pharmacotherapy known as «Treat to Target». According to it, the main objective of RA pharmacotherapy is a remission (or low disease activity. To achieve it, disease modifying anti-rheumatic drugs (DMARD should be administered to all RA patients as early as possible, with efficacy monitoring and therapy correction according to the disease activity. Special attention has been paid to the use of methotrexate (MTX as «the gold standard» of RA pharmacotherapy and the key component of «Treat to Target» strategy. Early MTX administration (including subcutaneous injections should become an obligatory component of RA treatment at all stages of the disease. If MTX is not efficient or not well tolerated (including subcutaneous form of the drug as monotherapy or combined with conventional DMARD, biological agents should be used. Those include TNFα inhibitors, antagonist of interleukin-6 receptor (Tocilizumab, anti-B-cell drugs (Rituximab and agents blocking T-cell activation (Abatacept. Tofacitinib therapy (JAK inhibitor is indicated in patients who are resistant to conventional DMARDs and biologics. All biologics and Tofacitinib are more effective in combination with MTX (or other DMARD. 

  9. PROJECT: RECOMMENDATIONS ON TREATMENT OF RHEUMATOID ARTHRITIS DEVELOPED BY ALL-RUSSIAN PUBLIC ORGANIZATION «ASSOCIATION OF RHEUMATOLOGISTS OF RUSSIA» – 2014 (PART 1

    Directory of Open Access Journals (Sweden)

    E. L. Nasonov

    2016-01-01

    Full Text Available Authors report new recommendations of All-Russian Public Organization «Association of Rheumatologists of Russia» (ARR on treatment of rheumatoid arthritis (RA, which adapts contemporary concept accepted in the respective field of pharmacotherapy known as «Treat to Target». According to it, the main objective of RA pharmacotherapyis a remission (or low disease activity. To achieve it, disease modifying anti-rheumatic drugs (DMARD should be administered to all RA patients as early as possible, with efficacy monitoring and therapy correction according to the disease activity. Special attention has been paid to the use of methotrexate (MTX as «the gold standard» of RA pharmacotherapy and the key component of «Treat to Target» strategy. Early MTX administration (including subcutaneous injections should become an obligatory component of RA treatment at all stages of the disease. If MTX is not efficient or not well tolerated (including subcutaneous form of the drug as monotherapy or combined with conventional DMARD, biological agents should be used. Those include TNFα inhibitors, antagonist of interleukin-6 receptor (Tocilizumab, anti-B-cell drugs  Rituximab and agents blocking T-cell activation (Abatacept. Tofacitinib therapy (JAK inhibitor is indicated in patients who are resistant to conventional DMARDs and biologics. All biologics and Tofacitinib are more effective in combination with MTX (or other DMARD.

  10. Dilution Confusion: Conventions for Defining a Dilution

    Science.gov (United States)

    Fishel, Laurence A.

    2010-01-01

    Two conventions for preparing dilutions are used in clinical laboratories. The first convention defines an "a:b" dilution as "a" volumes of solution A plus "b" volumes of solution B. The second convention defines an "a:b" dilution as "a" volumes of solution A diluted into a final volume of "b". Use of the incorrect dilution convention could affect…

  11. Apocryphal Angels in Nun Convents

    Directory of Open Access Journals (Sweden)

    Mario Ávila Vivar

    2018-01-01

    Full Text Available The preponderance of studies about viceregal angelic series, and the widespread belief that the representation of apocryphal angels is a specific peculiarity of viceregal angelology, have created such a close relation between it and the apocryphal angels, that they are even considered as synonymous. However, both the texts and the presence of this angels in the spanish convents of the XVII century, evidence that the apocryphal angels appeared and they were represented in Spain long before that in its american viceregal. Therefore, it is here where their origins and their meaning should be sought.

  12. Diverticular Disease: Reconsidering Conventional Wisdom

    Science.gov (United States)

    Peery, Anne F.; Sandler, Robert S.

    2013-01-01

    Colonic diverticula are common in developed countries and complications of colonic diverticulosis are responsible for a significant burden of disease. Several recent publications have called into question long held beliefs about diverticular disease. Contrary to conventional wisdom, studies have not shown that a high fiber diet protects against asymptomatic diverticulosis. The risk of developing diverticulitis among individuals with diverticulosis is lower than the 10–25% commonly quoted, and may be as low as 1% over 11 years. Nuts and seeds do not increase the risk of diverticulitis or diverticular bleeding. It is unclear whether diverticulosis, absent diverticulitis or overt colitis, is responsible for chronic gastrointestinal symptoms or worse quality of life. The role of antibiotics in acute diverticulitis has been challenged by a large randomized trial that showed no benefit in selected patients. The decision to perform elective surgery should be made on a case-by-case basis and not routinely after a second episode of diverticulitis, when there has been a complication, or in young people. A colonoscopy should be performed to exclude colon cancer after an attack of acute diverticulitis but may not alter outcomes among individuals who have had a colonoscopy prior to the attack. Given these surprising findings, it is time to reconsider conventional wisdom about diverticular disease. PMID:23669306

  13. Implementing the chemical weapons convention

    Energy Technology Data Exchange (ETDEWEB)

    Kellman, B.; Tanzman, E. A.

    1999-12-07

    In 1993, as the CWC ratification process was beginning, concerns arose that the complexity of integrating the CWC with national law could cause each nation to implement the Convention without regard to what other nations were doing, thereby causing inconsistencies among States as to how the CWC would be carried out. As a result, the author's colleagues and the author prepared the Manual for National Implementation of the Chemical Weapons Convention and presented it to each national delegation at the December 1993 meeting of the Preparatory Commission in The Hague. During its preparation, the Committee of CWC Legal Experts, a group of distinguished international jurists, law professors, legally-trained diplomats, government officials, and Parliamentarians from every region of the world, including Central Europe, reviewed the Manual. In February 1998, they finished the second edition of the Manual in order to update it in light of developments since the CWC entered into force on 29 April 1997. The Manual tries to increase understanding of the Convention by identifying its obligations and suggesting methods of meeting them. Education about CWC obligations and available alternatives to comply with these requirements can facilitate national response that are consistent among States Parties. Thus, the Manual offers options that can strengthen international realization of the Convention's goals if States Parties act compatibly in implementing them. Equally important, it is intended to build confidence that the legal issues raised by the Convention are finite and addressable. They are now nearing competition of an internet version of this document so that interested persons can access it electronically and can view the full text of all of the national implementing legislation it cites. The internet address, or URL, for the internet version of the Manual is http: //www.cwc.ard.gov. This paper draws from the Manual. It comparatively addresses approximately thirty

  14. Implementing the chemical weapons convention

    International Nuclear Information System (INIS)

    Kellman, B.; Tanzman, E. A.

    1999-01-01

    In 1993, as the CWC ratification process was beginning, concerns arose that the complexity of integrating the CWC with national law could cause each nation to implement the Convention without regard to what other nations were doing, thereby causing inconsistencies among States as to how the CWC would be carried out. As a result, the author's colleagues and the author prepared the Manual for National Implementation of the Chemical Weapons Convention and presented it to each national delegation at the December 1993 meeting of the Preparatory Commission in The Hague. During its preparation, the Committee of CWC Legal Experts, a group of distinguished international jurists, law professors, legally-trained diplomats, government officials, and Parliamentarians from every region of the world, including Central Europe, reviewed the Manual. In February 1998, they finished the second edition of the Manual in order to update it in light of developments since the CWC entered into force on 29 April 1997. The Manual tries to increase understanding of the Convention by identifying its obligations and suggesting methods of meeting them. Education about CWC obligations and available alternatives to comply with these requirements can facilitate national response that are consistent among States Parties. Thus, the Manual offers options that can strengthen international realization of the Convention's goals if States Parties act compatibly in implementing them. Equally important, it is intended to build confidence that the legal issues raised by the Convention are finite and addressable. They are now nearing competition of an internet version of this document so that interested persons can access it electronically and can view the full text of all of the national implementing legislation it cites. The internet address, or URL, for the internet version of the Manual is http: //www.cwc.ard.gov. This paper draws from the Manual. It comparatively addresses approximately thirty

  15. Conventional power sources for colliders

    International Nuclear Information System (INIS)

    Allen, M.A.

    1987-07-01

    At SLAC we are developing high peak-power klystrons to explore the limits of use of conventional power sources in future linear colliders. In an experimental tube we have achieved 150 MW at 1 μsec pulse width at 2856 MHz. In production tubes for SLAC Linear Collider (SLC) we routinely achieve 67 MW at 3.5 μsec pulse width and 180 pps. Over 200 of the klystrons are in routine operation in SLC. An experimental klystron at 8.568 GHz is presently under construction with a design objective of 30 MW at 1 μsec. A program is starting on the relativistic klystron whose performance will be analyzed in the exploration of the limits of klystrons at very short pulse widths

  16. Laparoscopic splenectomy using conventional instruments

    Directory of Open Access Journals (Sweden)

    Dalvi A

    2005-01-01

    Full Text Available INTRODUCTION : Laparoscopic splenectomy (LS is an accepted procedure for elective splenectomy. Advancement in technology has extended the possibility of LS in massive splenomegaly [Choy et al., J Laparoendosc Adv Surg Tech A 14(4, 197-200 (2004], trauma [Ren et al., Surg Endosc 15(3, 324 (2001; Mostafa et al., Surg Laparosc Endosc Percutan Tech 12(4, 283-286 (2002], and cirrhosis with portal hypertension [Hashizume et al., Hepatogastroenterology 49(45, 847-852 (2002]. In a developing country, these advanced gadgets may not be always available. We performed LS using conventional and reusable instruments in a public teaching the hospital without the use of the advanced technology. The technique of LS and the outcome in these patients is reported. MATERIALS AND METHODS : Patients undergoing LS for various hematological disorders from 1998 to 2004 were included. Electrocoagulation, clips, and intracorporeal knotting were the techniques used for tackling short-gastric vessels and splenic pedicle. Specimen was delivered through a Pfannensteil incision. RESULTS : A total of 26 patients underwent LS. Twenty-two (85% of patients had spleen size more than 500 g (average weight being 942.55 g. Mean operative time was 214 min (45-390 min. The conversion rate was 11.5% ( n = 3. Average duration of stay was 5.65 days (3-30 days. Accessory spleen was detected and successfully removed in two patients. One patient developed subphrenic abscess. There was no mortality. There was no recurrence of hematological disease. CONCLUSION : Laparoscopic splenectomy using conventional equipment and instruments is safe and effective. Advanced technology has a definite advantage but is not a deterrent to the practice of LS.

  17. Paris Convention on third party liability in the field of nuclear energy and Brussels Convention Supplementary to the Paris Convention

    International Nuclear Information System (INIS)

    1989-01-01

    This new bilingual (English and French) edition of the 1960 Paris Convention and 1963 Brussels Supplementary Convention incorporates the provisions of the Protocols which amended each of them on two occasions, in 1964 and 1982. The Expose des motifs to the Paris Convention, as revised in 1982 is also included in this pubication. (NEA) [fr

  18. The disease modifying osteoarthritis drug (DMOAD)

    DEFF Research Database (Denmark)

    Qvist, Per; Bay-Jensen, Anne-Christine; Christiansen, Claus

    2008-01-01

    and with DMOADs in particular, and we advance the need for a new development paradigm for DMOADs. Two central elements in this paradigm are a stronger focus on the biology of the joint and the application of new and more sensitive biomarkers allowing redesign of clinical trials in osteoarthritis....

  19. The expert meeting dedicated to the discussion of results of a local open-label multicenter observational study of the efficiency and safety of tofacitinib in patients with active rheumatoid arthritis with the inefficiency of disease-modifying antirheumatic drugs and to the elaboration of recommendations for the use for tofacitinib in the therapy of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    2016-01-01

    Full Text Available The expert meeting dedicated to the discussion of results of a local open-label multicenter observational study of the efficiency and safety of tofacitinib in patients with active rheumatoid arthritis with the inefficiency of disease-modifying antirheumatic drugs and to the elaboration of recommendations for the use for tofacitinib in the therapy of rheumatoid arthritis.

  20. Conventional and advanced liquid biofuels

    Directory of Open Access Journals (Sweden)

    Đurišić-Mladenović Nataša L.

    2016-01-01

    Full Text Available Energy security and independence, increase and fluctuation of the oil price, fossil fuel resources depletion and global climate change are some of the greatest challanges facing societies today and in incoming decades. Sustainable economic and industrial growth of every country and the world in general requires safe and renewable resources of energy. It has been expected that re-arrangement of economies towards biofuels would mitigate at least partially problems arised from fossil fuel consumption and create more sustainable development. Of the renewable energy sources, bioenergy draws major and particular development endeavors, primarily due to the extensive availability of biomass, already-existence of biomass production technologies and infrastructure, and biomass being the sole feedstock for liquid fuels. The evolution of biofuels is classified into four generations (from 1st to 4th in accordance to the feedstock origin; if the technologies of feedstock processing are taken into account, than there are two classes of biofuels - conventional and advanced. The conventional biofuels, also known as the 1st generation biofuels, are those produced currently in large quantities using well known, commercially-practiced technologies. The major feedstocks for these biofuels are cereals or oleaginous plants, used also in the food or feed production. Thus, viability of the 1st generation biofuels is questionable due to the conflict with food supply and high feedstocks’ cost. This limitation favoured the search for non-edible biomass for the production of the advanced biofuels. In a general and comparative way, this paper discusses about various definitions of biomass, classification of biofuels, and brief overview of the biomass conversion routes to liquid biofuels depending on the main constituents of the biomass. Liquid biofuels covered by this paper are those compatible with existing infrastructure for gasoline and diesel and ready to be used in

  1. [Investigation of the clinical usefullness of leukocytapheresis on rheumatoid arthritis resistant to or failed with the other treatments].

    Science.gov (United States)

    Sawada, Jin; Kimoto, Osamu; Suzuki, Daisuke; Shimoyama, Kumiko; Ogawa, Noriyoshi

    2009-12-01

    To examine therapeutic effect of leukocytapheresis (LCAP) for rheumatoid arthritis (RA) resistant to various treatments. Thirteen patients with RA (mean age : 60.8+/-11.4, male : female=5 : 8), 1 who were resistant to disease-modifying anti-rheumatic drugs (DMARDs) and biologics, or 2 who failed with those medicines because of side effects or complications. We performed LCAP, which was carried out once a week for a total of five sessions, with a throughput of about 0.1 L/kg. Before and after LCAP, we evaluated the effect of LCAP therapy. DAS28 (CRP) score was 5.70+/-1.12 before LCAP, 4.57+/-1.19 (P<0.05) just after the final LCAP and 4.83+/-1.35 (P<0.05) about 4 weeks after LCAP. DAS28 score decreased in all patients after LCAP. No serious adverse events were observed except temporary anemia. LCAP therapy may be useful and safe for patients with RA resistant to conventional medication. Patients who show good clinical response by LCAP needs to be clarified.

  2. Can cardiovascular magnetic resonance prompt early cardiovascular/rheumatic treatment in autoimmune rheumatic diseases? Current practice and future perspectives.

    Science.gov (United States)

    Mavrogeni, Sophie I; Sfikakis, Petros P; Dimitroulas, Theodoros; Koutsogeorgopoulou, Loukia; Katsifis, Gikas; Markousis-Mavrogenis, George; Kolovou, Genovefa; Kitas, George D

    2018-06-01

    Life expectancy in autoimmune rheumatic diseases (ARDs) remains lower compared to the general population, due to various comoborbidities. Cardiovascular disease (CVD) represents the main contributor to premature mortality. Conventional and biologic disease-modifying antirheumatic drugs (DMARDs) have considerably improved long-term outcomes in ARDs not only by suppressing systemic inflammation but also by lowering CVD burden. Regarding atherosclerotic disease prevention, EULAR has recommended tight disease control accompanied by regular assessment of traditional CVD risk factors and lifestyle changes. However, this approach, although rational and evidence-based, does not account for important issues such as myocardial inflammation and the long asymptomatic period that usually proceeds clinical manifestations of CVD disease in ARDs before or after the diagnosis of systemic disease. Cardiovascular magnetic resonance (CMR) can offer reliable, reproducible and operator independent information regarding myocardial inflammation, ischemia and fibrosis. Some studies suggest a role for CMR in the risk stratification of ARDs and demonstrate that oedema/fibrosis visualisation with CMR may have the potential to inform cardiac and rheumatic treatment modification in ARDs with or without abnormal routine cardiac evaluation. In this review, we discuss how CMR findings could influence anti-rheumatic treatment decisions targeting optimal control of both systemic and myocardial inflammation irrespective of clinical manifestations of cardiac disease. CMR can provide a different approach that is very promising for risk stratification and treatment modification; however, further studies are needed before the inclusion of CMR in the routine evaluation and treatment of patients with ARDs.

  3. A practical approach to vaccination of patients with autoimmune inflammatory rheumatic diseases in Australia.

    Science.gov (United States)

    Wong, Peter K K; Bagga, Hanish; Barrett, Claire; Hanrahan, Paddy; Johnson, Doug; Katrib, Amel; Leder, Karin; Marabani, Mona; Pentony, Peta; Riordan, John; White, Ray; Young, Laurel

    2017-05-01

    Autoimmune inflammatory rheumatic diseases (AIIRD), such as rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis are often complicated by infection, which results in significant morbidity and mortality. The increased risk of infection is probably due to a combination of immunosuppressive effects of the AIIRD, comorbidities and the use of immunosuppressive conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) and more recently, targeted synthetic DMARDs and biologic DMARDs that block specific pro-inflammatory enzymes, cytokines or cell types. The use of these various DMARDs has revolutionised the treatment of AIIRD. This has led to a marked improvement in quality of life for AIIRD patients, who often now travel for prolonged periods. Many infections are preventable with vaccination. However, as protective immune responses induced by vaccination may be impaired by immunosuppression, where possible, vaccination may need to be performed prior to initiation of immunosuppression. Vaccination status should also be reviewed when planning overseas travel. Limited data regarding vaccine efficacy in patients with AIIRD make prescriptive guidelines difficult. However, a vaccination history should be part of the initial work-up in all AIIRD patients. Those caring for AIIRD patients should regularly consider vaccination to prevent infection within the practicalities of routine clinical practice. © 2017 Royal Australasian College of Physicians.

  4. Ultrasound-detected bone erosion is a relapse risk factor after discontinuation of biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis whose ultrasound power Doppler synovitis activity and clinical disease activity are well controlled.

    Science.gov (United States)

    Kawashiri, Shin-Ya; Fujikawa, Keita; Nishino, Ayako; Okada, Akitomo; Aramaki, Toshiyuki; Shimizu, Toshimasa; Umeda, Masataka; Fukui, Shoichi; Suzuki, Takahisa; Koga, Tomohiro; Iwamoto, Naoki; Ichinose, Kunihiro; Tamai, Mami; Mizokami, Akinari; Nakamura, Hideki; Origuchi, Tomoki; Ueki, Yukitaka; Aoyagi, Kiyoshi; Maeda, Takahiro; Kawakami, Atsushi

    2017-05-25

    In the present study, we explored the risk factors for relapse after discontinuation of biologic disease-modifying antirheumatic drug (bDMARD) therapy in patients with rheumatoid arthritis (RA) whose ultrasound power Doppler (PD) synovitis activity and clinical disease activity were well controlled. In this observational study in clinical practice, the inclusion criteria were based on ultrasound disease activity and clinical disease activity, set as low or remission (Disease Activity Score in 28 joints based on erythrocyte sedimentation rate Ultrasound was performed in 22 joints of bilateral hands at discontinuation for evaluating synovitis severity and presence of bone erosion. Patients with a maximum PD score ≤1 in each joint were enrolled. Forty patients with RA were consecutively recruited (November 2010-March 2015) and discontinued bDMARD therapy. Variables at the initiation and discontinuation of bDMARD therapy that were predictive of relapse during the 12 months after discontinuation were assessed. The median patient age was 54.5 years, and the median disease duration was 3.5 years. Nineteen (47.5%) patients relapsed during the 12 months after the discontinuation of bDMARD therapy. Logistic regression analysis revealed that only the presence of bone erosion detected by ultrasound at discontinuation was predictive of relapse (OR 8.35, 95% CI 1.78-53.2, p = 0.006). No clinical characteristics or serologic biomarkers were significantly different between the relapse and nonrelapse patients. The ultrasound synovitis scores did not differ significantly between the groups. Our findings are the first evidence that ultrasound bone erosion may be a relapse risk factor after the discontinuation of bDMARD therapy in patients with RA whose PD synovitis activity and clinical disease activity are well controlled.

  5. Efficacy and safety of tofacitinib for active rheumatoid arthritis with an inadequate response to methotrexate or disease-modifying antirheumatic drugs: a meta-analysis of randomized controlled trials

    Science.gov (United States)

    Song, Gwan Gyu; Bae, Sang-Cheol

    2014-01-01

    Background/Aims The aim of this study was to assess the efficacy and safety of tofacitinib (5 and 10 mg twice daily) in patients with active rheumatoid arthritis (RA). Methods A systematic review of randomized controlled trials (RCTs) that examined the efficacy and safety of tofacitinib in patients with active RA was performed using the Medline, Embase, and Cochrane Controlled Trials Register databases as well as manual searches. Results Five RCTs, including three phase-II and two phase-III trials involving 1,590 patients, met the inclusion criteria. The three phase-II RCTs included 452 patients with RA (144 patients randomized to 5 mg of tofacitinib twice daily, 156 patients randomized to 10 mg of tofacitinib twice daily, and 152 patients randomized to placebo) who were included in this meta-analysis. The American College of Rheumatology 20% response rate was significantly higher in the tofacitinib 5- and 10-mg groups than in the control group (relative risk [RR], 2.445; 95% confidence interval [CI], 1.229 to 4.861; p = 0.011; and RR, 2.597; 95% CI, 1.514 to 4.455; p = 0.001, respectively). The safety outcomes did not differ between the tofacitinib 5- and 10-mg groups and placebo groups with the exception of infection in the tofacitinib 10-mg group (RR, 2.133; 95% CI, 1.268 to 3.590; p = 0.004). The results of two phase-III trials (1,123 patients) confirmed the findings in the phase-II studies. Conclusions Tofacitinib at dosages of 5 and 10 mg twice daily was found to be effective in patients with active RA that inadequately responded to methotrexate or disease-modifying antirheumatic drugs, and showed a manageable safety profile. PMID:25228842

  6. 15 CFR 742.18 - Chemical Weapons Convention (CWC or Convention).

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Chemical Weapons Convention (CWC or... REGULATIONS CONTROL POLICY-CCL BASED CONTROLS § 742.18 Chemical Weapons Convention (CWC or Convention). States... Use of Chemical Weapons and on Their Destruction, also known as the Chemical Weapons Convention (CWC...

  7. Human rights and conventionality control in Mexico

    Directory of Open Access Journals (Sweden)

    Azul América Aguiar-Aguilar

    2014-12-01

    Full Text Available The protection of human rights in Mexico has, de jure, suffered an important change in the last years, given a new judicial interpretation delivered by the National Supreme Court of Justice that allows the use of conventionality control, which means, that it allows federal and state judges to verify the conformity of domestic laws with those established in the Inter-American Convention of Human Rights. To what extent domestic actors are protecting human rights using this new legal tool called conventionality control? In this article I explore whom and how is conventionality control being used in Mexico. Using N-Vivo Software I reviewed concluded decisions delivered by intermediate level courts (Collegiate Circuit Courts in three Mexican states. The evidence points that conventionality control is a very useful tool especially to defenders, who appear in sentences claiming compliance with the commitments Mexico has acquired when this country ratified the Convention.

  8. Merchant shipping (Safety Convention) Act 1977

    International Nuclear Information System (INIS)

    1977-01-01

    When this Act comes into force, it will enable the United Kingdom to ratify and to give effect to the 1974 International Convention for the Safety of Life at Sea (the SOLAS Convention) which replaces the SOLAS Convention of 1960. Under the Act, the Secretary of State may make such rules as he considers appropriate regarding ships provided with nuclear power plants in accordance with Chapter VIII of the Annex to the 1974 Convention and to Recommendations attached to it, dealing with nuclear ships, and insofar as those provisions have not been implemented by the Merchant Shipping Acts 1894 to 1974. (NEA) [fr

  9. Computer Understanding of Conventional Metaphoric Language

    National Research Council Canada - National Science Library

    Martin, James H

    1990-01-01

    .... This approach asserts that the interpretation of conventional metaphoric language should proceed through the direct application of specific knowledge about the metaphors in the language. MIDAS...

  10. The climate change convention and human health.

    Science.gov (United States)

    Rowbotham, E J

    1995-01-01

    The United Nations Framework Convention on Climate Change, signed at Rio in June 1992, is intended to minimize climate change and its impact. Much of its text is ambiguous and it is not specifically directed to health considerations. It is, however, recognized that adverse effects of climate change on health are a concern of humankind, and health is an integral part of the Convention. The Convention includes commitments by the developed countries to reduce emissions of greenhouse gases and to increase public awareness of these commitments. The significance of the Convention in these respects is discussed critically and future developments considered.

  11. The protocol amending the 1963 Vienna Convention

    International Nuclear Information System (INIS)

    Lamm, V.

    2006-01-01

    Technically the Vienna Convention was revised by the adoption of the protocol to amend the instrument. and according to Article 19 of the protocol 'A State which is Party to this Protocol but not to the 1963 Vienna Convention shall be bound by the provisions of that Convention as amended by this Protocol in relation to other States Parties hereto, and failing an expression of a different intention by that State at the time of deposit of an instrument referred to in Article 20 shall be bound by the provisions of the 1963 Vienna Convention in relation to States which are only Parties thereto'. This solution has created a special situation, because after the entry into force of the protocol there will be living together or operating in practice 'two' Vienna Conventions, notably the convention's original text of 1963 and its new version as amended by the protocol. After the protocol has come into force, a state may only accede to the amended version, but in the inter se relations of the States Party to the 'old' Vienna Convention the provisions of that convention will remain in force until such time as they have acceded to the new protocol. This rather complicated situation is nevertheless understandable and is fully in accord with Article 40 of the 1969 Vienna Convention on the Law of Treaties, which provides for the amendment of multilateral treaties. In 1989 the negotiations on the revision of the Vienna Convention had begun with the aim of strengthening the existing nuclear liability regime and of improving the situation of potential victims of nuclear accidents. The Protocol to Amend the Vienna Convention serves those purposes; it also reflects a good compromise, since it is the outcome of a negotiation process in which experts from both nuclear and non-nuclear states, from Contacting Parties and non-Contracting Parties were very active. That affords some assurance that the compromise solution reached is acceptable to all States participating in the adoption of

  12. 7 CFR 58.316 - Conventional churns.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Conventional churns. 58.316 Section 58.316 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....316 Conventional churns. Churns shall be constructed of aluminum, stainless steel or equally corrosion...

  13. Influence of Kosher (Shechita) and conventional slaughter ...

    African Journals Online (AJOL)

    Influence of Kosher (Shechita) and conventional slaughter techniques on shear force, drip and cooking loss of beef. ... South African Journal of Animal Science ... force values for meat samples from cattle slaughtered by the Kosher method compared to those from cattle slaughtered by the conventional slaughter method.

  14. Comparison of community managed projects and conventional ...

    African Journals Online (AJOL)

    Comparison of community managed projects and conventional approaches in rural water supply of Ethiopia. ... African Journal of Environmental Science and Technology ... This study aimed to compare Community Managed Projects (CMP) approach with the conventional approaches (Non-CMP) in the case of Ethiopia.

  15. Suction v. conventional curettage in incomplete abortion

    African Journals Online (AJOL)

    Suction v. conventional curettage in incomplete abortion. A randomised controlled trial. D. A. A. VERKUYL, C. A. CROWTHER .Abstract This randomised controlled trial of 357 patients who had had an incomplete abortion compared suction curettage with conventional curettage for evacuation ofthe uterus. The 179 patients ...

  16. numerical assessment of conventional regulation effectiveness

    African Journals Online (AJOL)

    Benkoussas B, Djedjig R, and Vauquelin O

    2016-05-01

    May 1, 2016 ... The effectiveness of an underground smoke control system mainly depends on fire safety engineering that is ... In the same context, this work aims firstly, at investigating the effectiveness of conventional regulation applied to .... 5a). Fig.4. Station smoke behavior for conventional ventilation regulation. Fig.5a.

  17. AECT Convention, Orlando, Florida 2008 Report

    Science.gov (United States)

    Vega, Eddie

    2009-01-01

    This article presents several reports that highlight the events at the 2008 Association for Educational Communications and Technology (AECT) International Convention in Orlando, Florida. At the annual convention this year, the Multimedia Production Division goal was to continue to share information about the latest tools in multimedia production,…

  18. The effect of tofacitinib on function and quality of life indicators in patients with rheumatoid arthritis resistant to synthetic and biological disease-modifying antirheumatic drugs in real clinical practice: Results of a multicenter observational study

    Directory of Open Access Journals (Sweden)

    D. E. Karateev

    2017-01-01

    Full Text Available Tofacitinib (TOFA, a representative of a new class of targeted synthetic disease-modifying antirheumatic drugs (s-DMARD, is a promising drug for treating rheumatoid arthritis (RA and other immune inflammatory diseases.Objective: to evaluate the efficiency and safety of therapy with TOFA in combination with methotrexate (MTX and other s-DMARDs in real clinical practice in patients with active RA and previous ineffective therapy.Patients and methods. A 6-month Russian multicenter study of function and quality of life enrolled 101 patients with resistant RA: 18 men and 83 women; mean age, 51.03±11.28 years; mean disease duration, 105.4±81.43 months; rheumatoid factor-positive individuals (89.1%; and anticyclic citrullinated peptide antibody-positive ones (74.7%. 93 (92,1% of these patients completed a 24-week study. TOFA was used as both second-line drug (after failure of therapy with s-DMARD (n=74 and as a third-line drug (after failure of therapy with s-DMARDs and biological agents (BAs (n=74. The tools RAPID3, HAQ, and EQ-5D were used to determine disease outcomes from a patient's assessment.Results. All the three tools demonstrated significant positive changes at 3–6 months following therapy initiation. RAPID3 scores for the status of a patient achieving a low disease activity or remission coincided with the mean DAS28-ESR and SDAI scores in 60% and 68% of cases, respectively. The achievement rates of the minimally clinically significant improvement (ΔHAQ≥0.22 and functional remission (HAQ≤0.5 at 6 months of TOFA therapy were 79.6 and 30.1%, respectively. The mean change value in EQ-5D scores over 6 months was -0.162±0.21. There were no significant between the groups of patients who used TOFA as a second- or third-line agent in the majority of indicators, except EQ-5D scores at 6 months.Conclusions. The results of our multicenter study using considerable Russian material confirmed the pronounced positive effect of TOFA used

  19. Auranofin, an Anti-Rheumatic Gold Compound, Modulates Apoptosis by Elevating the Intracellular Calcium Concentration ([Ca{sup 2+}]{sub i}) in MCF-7 Breast Cancer Cells

    Energy Technology Data Exchange (ETDEWEB)

    Varghese, Elizabeth; Büsselberg, Dietrich, E-mail: dib2015@qatar-med.cornell.edu [Weil Cornell Medical College in Qatar, Qatar Foundation-Education City, P.O. Box 24144 Doha (Qatar)

    2014-11-06

    Auranofin, a transition metal complex is used for the treatment of rheumatoid arthritis but is also an effective anti-cancer drug. We investigate the effects of Auranofin in inducing cell death by apoptosis and whether these changes are correlated to changes of intracellular calcium concentration ([Ca{sup 2+}]{sub i}) in breast cancer cells (MCF-7). Cytotoxicity of Auranofin was evaluated using MTS assay and the Trypan blue dye exclusion method. With fluorescent dyes SR-FLICA and 7-AAD apoptotic death and necrotic death were differentiated by Flow cytometry. A concentration dependent decrease in the viability occurred and cells were shifted to the apoptotic phase. Intracellular calcium ([Ca{sup 2+}]{sub i}) was recorded using florescence microscopy and a calcium sensitive dye (Fluo-4 AM) with a strong negative correlation (r = −0.713) to viability. Pharmacological modulators 2-APB (50 μM), Nimodipine (10 μM), Caffeine (10 mM), SKF 96365(20 μM) were used to modify calcium entry and release. Auranofin induced a sustained increase of [Ca{sup 2+}]{sub i} in a concentration and time dependent manner. The use of different blockers of calcium channels did not reveal the source for the rise of [Ca{sup 2+}]{sub i}. Overall, elevation of [Ca{sup 2+}]{sub i} by Auranofin might be crucial for triggering Ca{sup 2+}-dependent apoptotic pathways. Therefore, in anti-cancer therapy, modulating [Ca{sup 2+}]{sub i} should be considered as a crucial factor for the induction of cell death in cancer cells.

  20. Efficacy and Safety of Vaccination in Pediatric Patients with Systemic Inflammatory Rheumatic Diseases: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Sandra Sousa

    2017-01-01

    Full Text Available Introduction: Children and adolescents with systemic rheumatic diseases have an increased risk of infections. Although some infections are vaccine-preventable, immunization among patients with juvenile rheumatic diseases is suboptimal, partly due to some doubts that still persist regarding its efficacy and safety in this patient population. Objectives: To review the available evidence regarding the immunological response and the safety of vaccination in children and adolescents with systemic inflammatory rheumatic diseases (SIRD. Methods: A systematic review of the current literature until December 2014 using MEDLINE, EMBASE and abstracts from the American College of Rheumatology and European League Against Rheumatism congresses (2011-2014, complemented by hand search was performed. Eligible studies were identified and efficacy (seroprotection and/or seroconversion and safety (reactions to vaccine and relapse of rheumatic disease outcomes were extracted and summarized according to the type of vaccine. Results: Twenty-eight articles concerning vaccination in pediatric patients with SIRDs were found, that included almost 2100 children and adolescents, comprising nearly all standard vaccinations of the recommended immunization schedule. Children with SIRDs generally achieved seroprotection and seroconversion; nevertheless, the antibody levels were often lower when compared with healthy children. Glucocorticoids and conventional disease-modifying anti-rheumatic drugs do not seem to significantly hamper the immune responses, whereas TNF inhibitors may reduce antibody production, particularly in response to pneumococcal conjugate, influenza, meningococcal C and hepatitis A vaccine. There were no serious adverse events, nor evidence of a relevant worsening of the underlying rheumatic disease. Concerning live attenuated vaccines, the evidence is scarce, but no episodes of overt disease were reported, even in patients under biological therapy

  1. Efficacy and Safety of Vaccination in Pediatric Patients with Systemic Inflammatory Rheumatic Diseases: a systematic review of the literature.

    Science.gov (United States)

    Sousa, Sandra; Duarte, Ana Catarina; Cordeiro, Inês; Ferreira, Joana; Gonçalves, Maria João; Meirinhos, Tiago; Rocha, Teresa Martins; Romão, Vasco C; Santos, Maria José

    2017-01-01

    Children and adolescents with systemic rheumatic diseases have an increased risk of infections. Although some infections are vaccine-preventable, immunization among patients with juvenile rheumatic diseases is suboptimal, partly due to some doubts that still persist regarding its efficacy and safety in this patient population. To review the available evidence regarding the immunological response and the safety of vaccination in children and adolescents with systemic inflammatory rheumatic diseases (SIRD). A systematic review of the current literature until December 2014 using MEDLINE, EMBASE and abstracts from the American College of Rheumatology and European League Against Rheumatism congresses (2011-2014), complemented by hand search was performed. Eligible studies were identified and efficacy (seroprotection and/or seroconversion) and safety (reactions to vaccine and relapse of rheumatic disease) outcomes were extracted and summarized according to the type of vaccine. Twenty-eight articles concerning vaccination in pediatric patients with SIRDs were found, that included almost 2100 children and adolescents, comprising nearly all standard vaccinations of the recommended immunization schedule. Children with SIRDs generally achieved seroprotection and seroconversion; nevertheless, the antibody levels were often lower when compared with healthy children. Glucocorticoids and conventional disease-modifying anti-rheumatic drugs do not seem to significantly hamper the immune responses, whereas TNF inhibitors may reduce antibody production, particularly in response to pneumococcal conjugate, influenza, meningococcal C and hepatitis A vaccine. There were no serious adverse events, nor evidence of a relevant worsening of the underlying rheumatic disease. Concerning live attenuated vaccines, the evidence is scarce, but no episodes of overt disease were reported, even in patients under biological therapy. Existing literature demonstrates that vaccines are generally well

  2. Digital vs. conventional implant impressions: efficiency outcomes.

    Science.gov (United States)

    Lee, Sang J; Gallucci, German O

    2013-01-01

    The aim of this pilot study was to evaluate the efficiency, difficulty and operator's preference of a digital impression compared with a conventional impression for single implant restorations. Thirty HSDM second year dental students performed conventional and digital implant impressions on a customized model presenting a single implant. The outcome of the impressions was evaluated under an acceptance criteria and the need for retake/rescan was decided. The efficiency of both impression techniques was evaluated by measuring the preparation, working, and retake/scan time (m/s) and the number of retakes/rescans. Participants' perception on the level of difficulty for the both impressions was assessed with a visual analogue scale (VAS) questionnaire. Multiple questionnaires were obtained to assess the participants' perception on preference, effectiveness and proficiency. Mean total treatment time was of 24:42 m/s for conventional and 12:29 m/s for digital impressions (P impressions (P impression (P impression technique and 30.63 (±17.57) for digital impression technique (P = 0.006). Sixty percent of the participants preferred the digital impression, 7% the conventional impression technique and 33% preferred either technique. Digital impressions resulted in a more efficient technique than conventional impressions. Longer preparation, working, and retake time were consumed to complete an acceptable conventional impression. Difficulty was lower for the digital impression compared with the conventional ones when performed by inexperienced second year dental students. © 2012 John Wiley & Sons A/S.

  3. Convention on supplementary compensation for nuclear damage

    International Nuclear Information System (INIS)

    Chinese Nuclear Society, Beijing; U.S. Nuclear Energy Institute

    2000-01-01

    The Contracting parties recognize the importance of the measures provided in the Vienna Convention on Civil Liability for Nuclear Damage and the Paris Convention on Third party liability in the Field of Nuclear Energy as well as in national legislation on compensation for nuclear damage consistent with the principles of these conventions. The Contracting parties desire to establish a worldwide liability regime to supplement and enhance these measures with a view to increasing the amount of compensation for nuclear damage and encourage regional and global co-operation to promote a higher level of nuclear safety in accordance with the principle of international partnership and solidarity

  4. National report of Brazil. Nuclear Safety Convention

    International Nuclear Information System (INIS)

    1998-09-01

    This document represents the national report prepared as a fulfillment of the brazilian obligations related to the Convention on Nuclear Safety. In chapter 2 some details are given about the existing nuclear installations. Chapter 3 provides details about the legislation and regulations, including the regulatory framework and the regulatory body. Chapter 4 covers general safety considerations as described in articles 10 to 16 of the Convention. Chapter 5 addresses to the safety of the installations during siting, design, construction and operation. Chapter 6 describes planned activities to further enhance nuclear safety. Chapter 7 presents the final remarks related to the degree of compliance with the Convention obligations

  5. French Economics of Convention and Economic Sociology

    DEFF Research Database (Denmark)

    Jagd, Søren

    foundation of markets and of money may be an occasion for economic sociology to focus even more on elaborating on the institutional void created by traditional economic theory. A second point is that economic sociology could benefit from the perspective of a plurality of forms of coordination involved......The French Economics of convention tradition has developed to be an influential research tradition situated in the area between economics and sociology. The aim of the paper is to explore some of the themes that may be common to economics of conventions and economic sociology by looking more...... closely into three recent texts from the economics of convention tradition discussing, in slightly different ways, differences and similarities between economics of convention and economic sociology. It is argued that André Orléan’s point that a common aim could be to ‘denaturalise’ the institutional...

  6. Numerical assessment of conventional regulation effectiveness for ...

    African Journals Online (AJOL)

    ... depends on fire safety engineering that is provided, and which is generally established using smoke spread field and temperature distribution predictions. ... conventional regulation; ventilation strategies; smoke temperature; smoke barriers ...

  7. Convention on supplementary compensation for nuclear damage

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-07-22

    The document reproduces the text of the Convention on Supplementary Compensation for Nuclear Damage which was adopted on 12 September 1997 by a Diplomatic Conference held between 8-12 September 1997 in Vienna

  8. Foster parenting, human imprinting and conventional handling ...

    African Journals Online (AJOL)

    p2492989

    Foster parenting, human imprinting and conventional handling affects survival and early .... bird may subsequently direct its sexual attention to those humans on whom it was imprinted (Bubier et al., ..... The mind through chicks' eyes: memory,.

  9. Convention on supplementary compensation for nuclear damage

    International Nuclear Information System (INIS)

    1998-01-01

    The document reproduces the text of the Convention on Supplementary Compensation for Nuclear Damage which was adopted on 12 September 1997 by a Diplomatic Conference held between 8-12 September 1997 in Vienna

  10. Medan Convention & Exhibition Center (Arsitektur Ekspresionisme)

    OpenAIRE

    Iskandar, Nurul Auni

    2015-01-01

    Medan is one of the third largest city in Indonesia, which is currently being developed, and a city with lots of activities. In the city of Medan has a high investment opportunities for a convention, because of its strategic position in Southeast Asia and also supported by the facility and the potential for tourism in North Sumatra, Medan city has the potential for industrial MICE (Meeting, Incentive, Conference, Exhibition). The construction of Medan Convention & Exhibition Cente...

  11. Technical Efficiency Performance of Conventional Banks

    OpenAIRE

    Endri, Endri

    2012-01-01

    This study aims to measure the performance of the technical efficiency of the conventional commercial banks during the period 2008-2009 by using non-parametric method of Data Envelopment Analysis (DEA). Test results showed that the total of all conventional commercial banks during the period 2008-2009 has not shown that optimal performance in which the level of technical efficiency is still below 100 percent. Appalling conditions, the efficiency of national banks experienced a decline of 73.5...

  12. Association between use of disease-modifying antirheumatic drugs and diabetes in patients with ankylosing spondylitis, rheumatoid arthritis, or psoriasis/psoriatic arthritis: a nationwide, population-based cohort study of 84,989 patients

    Directory of Open Access Journals (Sweden)

    Chen HH

    2017-05-01

    Full Text Available Hsin-Hua Chen,1–7 Der-Yuan Chen,1–6 Chi-Chen Lin,1,2 Yi-Ming Chen,1–4 Kuo-Lung Lai,3,4 Ching-Heng Lin1 1Department of Medical Research, Taichung Veterans General Hospital, 2Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, 3School of Medicine, National Yang-Ming University, Taipei, 4Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, 5School of Medicine, Chung-Shan Medical University, 6Department of Medical Education, Taichung Veterans General Hospital, Taichung, 7Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan Purpose: The aim of this study is to investigate the association between the use of disease-modifying antirheumatic drugs (DMARDs and diabetes mellitus (DM in patients with ankylosing spondylitis (AS, rheumatoid arthritis (RA, or psoriasis/psoriatic arthritis (PS/PSA.Patients and methods: This retrospective cohort study used a nationwide, population-based administrative database to enroll 84,989 cases with AS, RA, or PS/PSA who initiated treatment with anti-tumor necrosis factor (anti-TNF drugs or nonbiologic DMARDs. Multivariable analysis was used to estimate the effect of different therapies on the risk of DM.Results: The incidence rates of DM per 1,000 person-years were 8.3 for users of anti-TNF drugs, 13.3 for users of cyclosporine (CSA, 8.4 for users of hydroxychloroquine (HCQ, and 8.1 for users of other nonbiologic DMARDs. Compared with the users of nonbiologic DMARDs, the multivariate-adjusted hazard ratios (aHRs for DM were significantly lower for those who used anti-TNF drugs with HCQ (aHR: 0.49, 95% confidence interval [CI]: 0.36–0.66 and those who used HCQ alone (aHR: 0.70, 95% CI: 0.63–0.78, but not for those who used anti-TNFs without HCQ (aHR: 1.23, 95% CI: 0.94–1.60 or CSA (aHR: 1.14, 95% CI: 0.77–1

  13. Use of tofacitinib in real clinical practice to treat patients with rheumatoid arthritis resistant to synthetic and biological disease-modifying antirheumatic drugs: Results of a multicenter observational study

    Directory of Open Access Journals (Sweden)

    D. E. Karateev

    2016-01-01

    Full Text Available Tofacitinib (TOFA, a member of a new class of targeted synthetic disease-modifying antirheumatic drugs (DMARDs, is a promising medication for the treatment of rheumatoid arthritis (RA and other immunoinflammatory diseases. The paper describes the Russian experi-ence with TOFA used to treat severe RA.Patients and methods. 101 RA patients (18 men and 83 women; mean age, 51.03±11.28 years; mean disease duration, 105.4±81.43 months who were positive for rheumatoid factor (89.1% and anti-cyclic citrullinated peptide antibodies (74.7% and resistant to therapy with synthetic DMARDs (sDMARDs (80.2% and biological agents (19.8% were given TOFA at a dose of 5 mg twice daily, which could be doubled if necessary. TOFA was used alone (n=9 or in combination with methotrexate (MT (n=75 or other sDMARDs (n=17. The achievement of low disease activity (LDA and clinical remission at 3 and 6 months of treatment by DAS28-ESR SDAI, and CDAI scores, and the indices of safety and tolerability were assessed.Results. A total of 93 (92.1% of the 101 patients completed a 24-week period of the investigation. 8 (7.9% patients prematurely discontinued TOFA after an average of 2.75±0.71 months. At the end of the study, the patients achieved the primary endpoint (LDA including remission in terms of DAS28-ESR ≤3.2 (34.7%, SDAI ≤11 (47.5%, and CDAI ≤10 (48.5% and the secondary endpoints (clinical remission in terms of DAS28-ESR ≤2.6 (17.8%, SDAI ≤3.3 (8.9%, and CDAI ≤2.8 (6.9%. When TOFA was combined with MT, the discontinuation rate for the former was significantly lower (2.7% than when TOFA was used in combination with other sDMARDs (29.4% or alone (11.1%; p<0.01. At 3 and 6 months of follow-up, LDA was achieved more frequently when TOFA was combined with MT than when other treatment regimens were used. Fatal outcomes and serious adverse events (AEs, as AEs previously undescribed in the literature, were not seen during a follow-up within

  14. Transfrontier nuclear civil liability without international conventions

    International Nuclear Information System (INIS)

    Dogauchi, M.

    1992-01-01

    Japan is not a contracting party of any international convention in the field of nuclear civil liability, and neither are other east Asian countries who have or will soon have nuclear plants. Therefore, the ordinary rules on private international law will play an important role in dealing with transfrontier nuclear civil liability. Above all, the problems on judicial jurisdiction and governing law are crucial points. With regard to the relations between the above countries and the countries whose legal systems are within the framework of Paris or Vienna Conventions, geographical scopes of these conventions are to be considered. There are two different parts in the international civil liability conventions: uniform civil liability law and mutual funds. As to the first, it is important that, even without the conventions, the basic structure of the nuclear civil liability laws in non-member countries are almost the same with those of members. In any event, considering that the establishment of a single international regime to cover all countries will be hardly possible, legal consequences under the private international law will be explored. (author)

  15. Compact Ignition Tokamak conventional facilities optimization

    International Nuclear Information System (INIS)

    Commander, J.C.; Spang, N.W.

    1987-01-01

    A high-field ignition machine with liquid-nitrogen-cooled copper coils, designated the Compact Ignition Tokamak (CIT), is proposed for the next phase of the United States magnetically confined fusion program. A team of national laboratory, university, and industrial participants completed the conceptual design for the CIT machine, support systems and conventional facilities. Following conceptual design, optimization studies were conducted with the goal of improving machine performance, support systems design, and conventional facilities configuration. This paper deals primarily with the conceptual design configuration of the CIT conventional facilities, the changes that evolved during optimization studies, and the revised changes resulting from functional and operational requirements (F and ORs). The CIT conventional facilities conceptual design is based on two premises: (1) satisfaction of the F and ORs developed in the CIT building and utilities requirements document, and (2) the assumption that the CIT project will be sited at the Princeton Plasma Physics Laboratory (PPPL) in order that maximum utilization can be made of existing Tokamak Fusion Test Reactor (TFTR) buildings and utilities. The optimization studies required reevaluation of the F and ORs and a second look at TFTR buildings and utilities. Some of the high-cost-impact optimization studies are discussed, including the evaluation criteria for a change from the conceptual design baseline configuration. The revised conventional facilities configuration are described and the estimated cost impact is summarized

  16. Conventions and workflows for using Situs

    International Nuclear Information System (INIS)

    Wriggers, Willy

    2012-01-01

    Recent developments of the Situs software suite for multi-scale modeling are reviewed. Typical workflows and conventions encountered during processing of biophysical data from electron microscopy, tomography or small-angle X-ray scattering are described. Situs is a modular program package for the multi-scale modeling of atomic resolution structures and low-resolution biophysical data from electron microscopy, tomography or small-angle X-ray scattering. This article provides an overview of recent developments in the Situs package, with an emphasis on workflows and conventions that are important for practical applications. The modular design of the programs facilitates scripting in the bash shell that allows specific programs to be combined in creative ways that go beyond the original intent of the developers. Several scripting-enabled functionalities, such as flexible transformations of data type, the use of symmetry constraints or the creation of two-dimensional projection images, are described. The processing of low-resolution biophysical maps in such workflows follows not only first principles but often relies on implicit conventions. Situs conventions related to map formats, resolution, correlation functions and feature detection are reviewed and summarized. The compatibility of the Situs workflow with CCP4 conventions and programs is discussed

  17. The protocol amending the 1963 Vienna Convention

    International Nuclear Information System (INIS)

    Lamm, V.

    1998-01-01

    In the first stage of the revision process, the only goal was to amend certain provisions of the Vienna Convention. Later, in what might be called the second stage, the question was seriously raised of establishing a new supplementary convention by which additional funds were to be provided by the international community of States. Most experts felt that the nuclear liability regime of the Vienna Convention, as amended, would really serve the interests of potential victims of nuclear incidents only if it were supported by an international supplementary fund providing additional compensation for nuclear damage to that provided by the operator. Thus, the Standing Committee started to consider the establishment, under the Vienna Convention, of a mechanism for mobilizing additional funds for compensation of nuclear damage. During the negotiations it was deemed necessary to establish a separate treaty for such a supplementary fund, and indeed, efforts were undertaken to draw up such an instrument concurrently with the revision of the Vienna Convention. (K.A.)

  18. Economic Sociology and Economics of Convention

    DEFF Research Database (Denmark)

    Jagd, Søren

    This paper is part of a larger exploration of the French Economics of Convention tradition. The aim of the paper is to explore potential themes of common interest to economic sociology and Economics of Conventions. The paper is in two parts. First, I summarise the main theoretical features of EC...... the institutional framework of social action. Second, I explore two issues raised by economics of conventions that may be particularly important to consider for economic sociology. The first issue is the explicit exploration of the consequences of a plurality of forms of justification suggested by Luc Boltanski...... and Laurent Thévenot in ‘économie de la grandeur’. This perspective has already been taken up in economic sociology in David Stark’s notion of a ‘Sociology of Worth’. The second issue, recently suggested by André Orléan, is the need to denaturalise economic theory and economic action to demonstrate the social...

  19. Economics of Convention and New Economic Sociology

    DEFF Research Database (Denmark)

    Jagd, Søren

    2007-01-01

    The aim of the article is to explore potential common themes in economic sociology and economics of conventions. The article explores two issues raised by economics of conventions that may be of particular importance to economic sociology. First, the explicit exploration of the consequences...... of a plurality of forms of justification, as elaborated in économie de la grandeur. This perspective was recently taken up in economic sociology by David Stark's introduction of the notion ‘sociology of worth'. The second issue, recently suggested by André Orléan, is the need to denaturalize economic theory...... and economic action to demonstrate the social constructed nature of economic action. It is argued that these two issues demonstrate that a fruitful dialogue is indeed possible between economic sociology and economics of convention and should be encouraged....

  20. Prerequisites for a nuclear weapons convention

    International Nuclear Information System (INIS)

    Liebert, W.

    1999-01-01

    A Nuclear Weapons Convention (NWC) would prohibit the research, development, production, testing, stockpiling, transfer, use and threat of use of nuclear weapons and would serve their total elimination.' In this fashion it follows the model laid out by the biological and chemical weapons conventions. The NWC would encompass a few other treaties and while replacing them should learn from their experiences. The Nuclear Weapons Convention should at some given point in the future replace the Non-Proliferation Treaty (NPT) and so resolve its contradictions and shortcomings. The main objectives of an NWC Would be: reduction of the nuclear arsenals of the 'five' nuclear weapons powers down to zero within a set of fixed periods of time; elimination of stockpiles of weapons-usable materials and, where existent, nuclear warheads in de-facto nuclear weapon and threshold states; providing assurance that all states will retain their non-nuclear status forever

  1. HMB-45 reactivity in conventional uterine leiomyosarcomas.

    Science.gov (United States)

    Simpson, Karen W; Albores-Saavedra, Jorge

    2007-01-01

    We studied the human melanoma black-45 (HMB-45) reactivity in 25 uterine leiomyosarcomas including 23 conventional and 2 myxoid variants. Eleven tumors were poorly differentiated, and 14 were well to moderately differentiated. Nine uterine leiomyosarcomas labeled with HMB-45 in 10% or less of the tumor cells. Six were poorly differentiated and 3 were well differentiated. Our study indicates that 36% of conventional leiomyosarcomas focally express HMB-45. HMB-45 reactivity was more common in the poorly differentiated than in the well-differentiated group of leiomyosarcomas. In light of our findings and of those recently reported in the literature, we believe that the term PEComa should not be used for uterine leiomyosarcomas with clear cells or for conventional leiomyosarcomas that stain positively with HMB-45.

  2. Communicating novel and conventional scientific metaphors

    DEFF Research Database (Denmark)

    Knudsen, Sanne

    2005-01-01

    . But we still need empirical studies of the career of metaphors in scientific discourse and of the communicative strategies identifying a given metaphor as either novel or conventional. This paper presents a case study of the discursive development of the metaphor of "the genetic code" from......Metaphors are more popular than ever in the study of scientific reasoning and culture because of their innovative and generative powers. It is assumed, that novel scientific metaphors become more clear and well-defined, as they become more established and conventional within the relevant discourses...... the introduction of the metaphor to it was established as an entire network of interrelated conventional metaphors. Not only do the strategies in communicating the metaphor change as the metaphor becomes more established within the discourse, but the genres in which the metaphor is developed and interpreted...

  3. Digital hilar tomography. Comparison with conventional technique

    International Nuclear Information System (INIS)

    Schaefer, C.B.; Braunschweig, R.; Teufl, F.; Kaiser, W.; Claussen, C.D.

    1993-01-01

    The aim of the following study was to compare conventional hilar tomography and digital hilar tomography. 20 patients were examined both with conventional and digital hilar tomography using the same tomographic technique and the identical exposure dose. All patients underwent computed tomography of the chest as a golden standard. The digital technique, especially the edge-enhanced image version, showed superior image quality. ROC-analysis by 4 readers found equal diagnostic performance without any statistical difference. Digital hilar tomography shows a superior and constant image quality and lowers the rate of re-exposure. Therefore, digital hilar tomography is the preferable method. (orig.) [de

  4. Archaeology and the World Heritage Convention

    Directory of Open Access Journals (Sweden)

    Henry Cleere

    2003-10-01

    Full Text Available International efforts to designate outstanding examples of the world's cultural and natural heritage began after the Second World War. The World Heritage Convention was signed at the General Conference of UNESCO in 1972 and the first cultural sites were selected in 1978. Now over 600 have been inscribed on the World Heritage List. The author, who is an honorary visiting professor at the Institute, acted as an advisor to the World Heritage Committee from 1992 to 2002 and here describes how the Convention came into being and discusses the representation of archaeological sites on the List.

  5. Convention on nuclear safety. Final act

    International Nuclear Information System (INIS)

    1994-01-01

    The Diplomatic Conference, which was convened by the International Atomic Energy Agency at its Headquarters from 14 to 17 June 1994, adopted the Convention on Nuclear Safety reproduced in document INFCIRC/449 and the Final Act of the Conference. The text of the Final Act of the Conference, including an annexed document entitled ''Some clarification with respect to procedural and financial arrangements, national reports, and the conduct of review meetings, envisaged in the Convention on Nuclear Safety'', is reproduced in the Attachment hereto for the information of all Member States

  6. Control of non-conventional synchronous motors

    CERN Document Server

    Louis, Jean-Paul

    2013-01-01

    Classical synchronous motors are the most effective device to drive industrial production systems and robots with precision and rapidity. However, numerous applications require efficient controls in non-conventional situations. Firstly, this is the case with synchronous motors supplied by thyristor line-commutated inverters, or with synchronous motors with faults on one or several phases. Secondly, many drive systems use non-conventional motors such as polyphase (more than three phases) synchronous motors, synchronous motors with double excitation, permanent magnet linear synchronous motors,

  7. Comparative Effectiveness of Conventional Rote Learning and ...

    African Journals Online (AJOL)

    This study investigated the relative effectiveness of Mnemonics technique (MNIT) and conventional rote learning technique (CRL) on the teaching-learning of physical features (Geography). A pre-test and post-test control group design was adopted for the study. A sample of ninety SS I students was randomly selected out of ...

  8. Conflict and convention in dynamic networks.

    Science.gov (United States)

    Foley, Michael; Forber, Patrick; Smead, Rory; Riedl, Christoph

    2018-03-01

    An important way to resolve games of conflict (snowdrift, hawk-dove, chicken) involves adopting a convention: a correlated equilibrium that avoids any conflict between aggressive strategies. Dynamic networks allow individuals to resolve conflict via their network connections rather than changing their strategy. Exploring how behavioural strategies coevolve with social networks reveals new dynamics that can help explain the origins and robustness of conventions. Here, we model the emergence of conventions as correlated equilibria in dynamic networks. Our results show that networks have the tendency to break the symmetry between the two conventional solutions in a strongly biased way. Rather than the correlated equilibrium associated with ownership norms (play aggressive at home, not away), we usually see the opposite host-guest norm (play aggressive away, not at home) evolve on dynamic networks, a phenomenon common to human interaction. We also show that learning to avoid conflict can produce realistic network structures in a way different than preferential attachment models. © 2017 The Author(s).

  9. Analysis of the London dumping convention

    International Nuclear Information System (INIS)

    Nauke, M.K.

    1983-05-01

    This report gives an in-depth review of the provisions of the London Dumping Convention and of its origins in the context of the international legal framework for controlling all aspects of marine pollution. Particular attention is paid to the provisions concerning radioactive waste. (NEA) [fr

  10. The Burning Plasma Experiment conventional facilities

    International Nuclear Information System (INIS)

    Commander, J.C.

    1991-01-01

    The Burning Program Plasma Experiment (BPX) is phased to start construction of conventional facilities in July 1994, in conjunction with the conclusion of the Tokamak Fusion Test Reactor (TFTR) project. This paper deals with the conceptual design of the BPX Conventional Facilities, for which Functional and Operational Requirements (F ampersand ORs) were developed. Existing TFTR buildings and utilities will be adapted and used to satisfy the BPX Project F ampersand ORs to the maximum extent possible. However, new conventional facilities will be required to support the BPX project. These facilities include: The BPX building; Site improvements and utilities; the Field Coil Power Conversion (FCPC) building; the TFTR modifications; the Motor Generation (MG) building; Liquid Nitrogen (LN 2 ) building; and the associated Instrumentation and Control (I ampersand C) systems. The BPX building will provide for safe and efficient shielding, housing, operation, handling, maintenance and decontamination of the BPX and its support systems. Site improvements and utilities will feature a utility tunnel which will provide a space for utility services--including pulse power duct banks and liquid nitrogen coolant lines. The FCPC building will house eight additional power supplied for the Toroidal Field (TF) coils. The MG building will house the two MG sets larger than the existing TFTR MG sets. This paper also addresses the conventional facility cost estimating methodology and the rationale for the construction schedule developed. 6 figs., 1 tab

  11. Electric and Conventional Vehicle Driving Patterns

    DEFF Research Database (Denmark)

    Krogh, Benjamin Bjerre; Andersen, Ove; Torp, Kristian

    2014-01-01

    The electric vehicle (EV) is an interesting vehicle type that can reduce the dependence on fossil fuels, e.g., by using electricity from wind turbines. A significant disadvantage of EVs is a very limited range, typically less than 200 km. This paper compares EVs to conventional vehicles (CVs...

  12. Teaching effectiveness and students' performance in conventional ...

    African Journals Online (AJOL)

    There has been a proliferation of coaching centres in Lagos State. These run side-by-side conventional schools offering general education. Stakeholders in the education industry have raised questions on the relevance of these coaching centres particularly in terms of students' academic performance, teaching ...

  13. Fracture healing: direct magnification versus conventional radiography

    International Nuclear Information System (INIS)

    Link, T.M.; Kessler, T.; Lange, T.; Overbeck, J.; Fiebich, M.; Peters, P.E.

    1994-01-01

    The aim of the study was to evaluate the potential of magnification radiography in diagnosing fracture healing and assessing its complications. Seventy-three patients with fractures or who had undergone osteotomy were radiographed with both conventional (non-magnified) and magnification (5-fold) techniques. Since 10 patients were radiographed twice and 1 three times, 83 radiographs using each technique were obtained. All radiographs were analysed and the findings correlated with the patients' follow-up studies. The microfocal X-ray unit used for magnification radiography had a focal spot size of 20-130 μm. As an imaging system, digital luminescence radiography was employed with magnification, while normal film-screen systems were used with conventional radiography. Magnification radiography proved superior to conventional radiography in 47% of cases: endosteal and periosteal callus formations were seen earlier and better in 26 cases, and osseous union could be evaluated with greater certainty in 33 cases. In 49% of cases magnification radiography was equal and in 4% inferior to conventional radiography. Additionally an ''inter-observer analysis'' was carried out. Anatomical and pathological structures were classified into one of four grades. Results were significantly (P < 0.01) better using magnification radiography. We conclude that the magnification technique is a good method for monitoring fracture healing in its early stages. (orig.)

  14. James Madison and the Constitutional Convention.

    Science.gov (United States)

    Scanlon, Thomas M.

    1987-01-01

    Part 1 of this three-part article traces James Madison's life and focuses primarily on those events that prepared him for leadership in the U.S. Constitutional Convention of 1787. It describes his early love of learning, education, and public service efforts. Part 2 chronicles Madison's devotion to study and preparation prior to the Constitutional…

  15. The role of regional pollution conventions

    International Nuclear Information System (INIS)

    Haywar, P.

    1989-01-01

    Within the last 12 years a number of regional pollution conventions and action plans have been negotiated to protect the world's seas from pollution. This paper traces the development of this activity and points out the specific role of regional, as opposed to global, pollution conventions. Chief among the functions of regional conventions is the specific legal framework they provide for a particular geographical region. They also provide a forum for neighboring states to develop a coherent policy for a particular regional sea, as well as being the means of establishing regional control over potentially polluting activities. Regional agreements also constitute a suitable framework for monitoring the input of pollutants to the marine environment and assessing their effects. In addition, they provide a forum for the exchange of scientific and technical information and for developing cooperation between states. The paper concludes by summarizing the most important functions of a regional convention and suggesting that, with increasing industrialization and pollution stress, there will continue to be a need for action to be taken at the regional level

  16. Non conventional energy sources and energy conservation

    International Nuclear Information System (INIS)

    Bueno M, F.

    1995-01-01

    Geographically speaking, Mexico is in an enviable position. Sun, water, biomass and geothermal fields main non conventional energy sources with commercial applications, are presents and in some cases plentiful in national territory. Moreover the coastal tidal power which is in research stage in several countries. Non conventional energy sources are an alternative which allow us to reduce the consumption of hydrocarbons or any other type of primary energetic, are not by oneself choices for the energy conservation, but energy replacements. At the beginning of this year, CONAE created the Direction of Non conventional Energy Sources, which main objective is to promote and impulse programs inclined towards the application of systems based in renewable energy sources. The research centers represent a technological and consultative support for the CONAE. They have an infrastructure developed along several years of continuous work. The non conventional energy sources will be a reality at the same time that their cost be equal or lower than the cost for the traditional generating systems. CONAE (National Commission for Energy Conservation). (Author)

  17. Comparison of membrane bioreactor technology and conventional ...

    African Journals Online (AJOL)

    The purpose of this paper was to review the use of membrane bioreactor technology as an alternative for treating the discharged effluent from a bleached kraft mill by comparing and contrasting membrane bioreactors with conventional activated sludge systems for wastewater treatment. There are many water shortage ...

  18. The Conventional and Unconventional about Disability Conventions: A Reflective Analysis of United Nations Convention on the Rights of Persons with Disabilities

    Science.gov (United States)

    Umeasiegbu, Veronica I.; Bishop, Malachy; Mpofu, Elias

    2013-01-01

    This article presents an analysis of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in relation to prior United Nations conventions on disability and U.S. disability policy law with a view to identifying the conventional and also the incremental advances of the CRPD. Previous United Nations conventions related to…

  19. International antiterrorist conventions concerning the safety of air transport

    Directory of Open Access Journals (Sweden)

    Jacek BARCIK

    2008-01-01

    Full Text Available In this article the international law regulations are presented concerning the civilian safety of the air transport. The history concerning air terrorism and international antiterrorist conventions was described in detail, involving The Chicago Convention, The Tokyo Convention, The Hague Convention and Montreal Convention.

  20. Risk of malignancy in patients with rheumatic disorders

    Directory of Open Access Journals (Sweden)

    Wong Victor Tak-lung

    2016-12-01

    Full Text Available Patients with autoimmune rheumatic diseases including rheumatoid arthritis (RA, systemic lupus erythematosus (SLE, Sjogren’s syndrome (SS, and inflammatory myositis are at increased risk of developing malignancies. Treatment of these conditions, including disease-modifying anti-rheumatic drugs (DMARDs and biologic therapies, are also associated with increased risk of malignancies.Cancer adds to the disease burden in these patients, affecting their quality of life and life expectancy. The decision in choosing immunosuppressive agents in these rheumatic diseases should take into account the disease severity, expectation for disease control, comorbidities, as well asthe side effects including risks of cancer.

  1. The unappreciated slowness of conventional tourism

    Directory of Open Access Journals (Sweden)

    G.R. Larsen

    2016-05-01

    Full Text Available Most tourists are not consciously engaging in ‘slow travel’, but a number of travel behaviours displayed by conventional tourists can be interpreted as slow travel behaviour. Based on Danish tourists’ engagement with the distances they travel across to reach their holiday destination, this paper explores unintended slow travel behaviours displayed by these tourists. None of the tourists participating in this research were consciously doing ‘slow travel’, and yet some of their most valued holiday memories are linked to slow travel behaviours. Based on the analysis of these unintended slow travel behaviours, this paper will discuss the potential this insight might hold for promotion of slow travel. If unappreciated and unintentional slow travel behaviours could be utilised in the deliberate effort of encouraging more people to travel slow, ‘slow travel’ will be in a better position to become integrated into conventional travel behaviour.

  2. Air pollution: UNCED convention on climate change

    International Nuclear Information System (INIS)

    Pieri, M.

    1992-01-01

    In addition to United Nations papers delineating the Organization's convention on climate change and strategies concerning the protection of the earth's atmosphere, this booklet presents four papers expressing the views of Italian and American strategists. The central theme is the establishment of current global air pollution trends, the determination of suitable air pollution limits, and the preparation of feasible socio-economic strategies to allow industrialized and developing countries to work together effectively to achieve the proposed global air quality goals

  3. Non-conventional mesons at PANDA

    International Nuclear Information System (INIS)

    Giacosa, Francesco

    2015-01-01

    Non-conventional mesons, such as glueballs and tetraquarks, will be in the focus of the PANDA experiment at the FAIR facility. In this lecture we recall the basic properties of QCD and describe some features of unconventional states. We focus on the search of the not-yet discovered glueballs and the use of the extended Linear Sigma Model for this purpose, and on the already discovered but not-yet understood X, Y, Z states. (paper)

  4. Kuala Namu Convention And Exhibition Centre

    OpenAIRE

    Gustriana, Trisna

    2017-01-01

    Aerotropolis area development that is expected to accommodate the development of business and commercial appeal and this is the chance for the designer to be able to take advantage of the situation and condition of land as well as possible. So that the revolutionary changes but is able to embrace all stakeholders is the solution needed to development Aerotropolis. Kuala Namu's Convention and Exhibition Center is expected to be a solution for regional development of Kuala Namu a...

  5. The Aarhus Convention: A new regional convention on citizens' environmental rights

    International Nuclear Information System (INIS)

    Wates, J.

    2000-01-01

    The UN ECE Convention on Access to Information, Public Participation in Decision-making and Access to Justice in Environmental Matters had been adopted at Arhus, Denmark, at the Fourth Ministerial Conference in the 'Environment for Europe' process, and signed by thirty-five countries and the European Community. This paper summarises the main features of the Convention and briefly discusses its relevance to radioactive waste management issues. It then describes some of the activities currently being undertaken under the auspices of the Convention. (author)

  6. A complementary conventional analysis for channelized reservoirs

    International Nuclear Information System (INIS)

    Escobar Freddy Humberto; Montealegre M, Matilde

    2007-01-01

    Many well pressure data coming from long and narrow reservoirs which result from either fluvial deposition of faulting connote be completely interpreted by conventional analysis since some flow regimes are not conventionally recognized yet in the oil literature. This narrow geometry allows for the simultaneous development of two linear flow regimes coming from each one of the lateral sides of the system towards the well. This has been called dual linear flow regime. If the well is off-centered with regards to the two lateral boundaries, then, and of the linear flow regimes vanishes and, than, two possibilities con be presented. Firstly, if the closer lateral boundary is close to flow the unique linear flow persists along the longer lateral boundary. It has been called single linear flow. Following this, either steady or pseudo-steady states will develop. Secondly, if a constant - pressure closer lateral boundary is dealt with, then parabolic flow develops along the longer lateral boundary. Steady state has to be developed once the disturbance reaches the farther boundary. This study presents new equations for conventional analysis for the dual linear, linear and parabolic flow regimes recently introduced to the oil literature. The equations were validated by applying them to field and simulated examples

  7. Fuzzy logic control to be conventional method

    Energy Technology Data Exchange (ETDEWEB)

    Eker, Ilyas [University of Gaziantep, Gaziantep (Turkey). Department of Electrical and Electronic Engineering; Torun, Yunis [University of Gaziantep, Gaziantep (Turkey). Technical Vocational School of Higher Education

    2006-03-01

    Increasing demands for flexibility and fast reactions in modern process operation and production methods result in nonlinear system behaviour of partly unknown systems, and this necessitates application of alternative control methods to meet the demands. Fuzzy logic (FL) control can play an important role because knowledge based design rules can easily be implemented in systems with unknown structure, and it is going to be a conventional control method since the control design strategy is simple and practical and is based on linguistic information. Computational complexity is not a limitation any more because the computing power of computers has been significantly improved even for high speed industrial applications. This makes FL control an important alternative method to the conventional PID control method for use in nonlinear industrial systems. This paper presents a practical implementation of the FL control to an electrical drive system. Such drive systems used in industry are composed of masses moving under the action of position and velocity dependent forces. These forces exhibit nonlinear behaviour. For a multi-mass drive system, the nonlinearities, like Coulomb friction and dead zone, significantly influence the operation of the systems. The proposed FL control configuration is based on speed error and change of speed error. The feasibility and effectiveness of the control method are experimentally demonstrated. The results obtained from conventional FL control, fuzzy PID and adaptive FL control are compared with traditional PID control for the dynamic responses of the closed loop drive system. (author)

  8. Fuzzy logic control to be conventional method

    International Nuclear Information System (INIS)

    Eker, Ilyas; Torun, Yunis

    2006-01-01

    Increasing demands for flexibility and fast reactions in modern process operation and production methods result in nonlinear system behaviour of partly unknown systems, and this necessitates application of alternative control methods to meet the demands. Fuzzy logic (FL) control can play an important role because knowledge based design rules can easily be implemented in systems with unknown structure, and it is going to be a conventional control method since the control design strategy is simple and practical and is based on linguistic information. Computational complexity is not a limitation any more because the computing power of computers has been significantly improved even for high speed industrial applications. This makes FL control an important alternative method to the conventional PID control method for use in nonlinear industrial systems. This paper presents a practical implementation of the FL control to an electrical drive system. Such drive systems used in industry are composed of masses moving under the action of position and velocity dependent forces. These forces exhibit nonlinear behaviour. For a multi-mass drive system, the nonlinearities, like Coulomb friction and dead zone, significantly influence the operation of the systems. The proposed FL control configuration is based on speed error and change of speed error. The feasibility and effectiveness of the control method are experimentally demonstrated. The results obtained from conventional FL control, fuzzy PID and adaptive FL control are compared with traditional PID control for the dynamic responses of the closed loop drive system

  9. PUBLIC POLICY VIOLATION UNDER NEW YORK CONVENTION

    Directory of Open Access Journals (Sweden)

    Michelle Ayu Chinta Kristy

    2013-04-01

    Full Text Available The increasing number of the use of arbitration in Asia has highlighted the significant influence of the recognition and enforcement of arbitral awards. The New York Convention currently becomes the most widely accepted convention to which the courts would refer when recognizing and enforcing foreign arbitral awards. This article would firstly provide a comparative study of the court’s interpretation towards public policy as mentioned under Article V (2 b of the New York Convention between non-arbitration-friendly-law Indonesia and arbitration-friendly-law China. Subsequently, it will discuss whether uniformity in interpreting and reserving public policy is required or not. Peningkatan jumlah penggunaan lembaga arbitrasi di Asia mendorong peningkatan signifikansi pengakuan dan pelaksanaan putusan arbitrasi asing. Konvensi New York saat ini menjadi konvensi yang diterima secara luas dimana dijadikan referensi oleh pengadilan dalam hal pengakuan dan pelaksanaan putusan arbitrasi asing. Artikel ini akan pertama-tama membahas studi perbandingan atas interpretasi pengadilan mengenai penggunaan kebijakan publik sebagaimana tertera pada Pasal V (2 b Konvensi New York antara Indonesia yang hukumnya tidak mendukung dan China dengan hukum yang mendukung pengakuan dan pelaksanaan putusan arbitrasi asing. Apakah keseragaman antar negara dalam menginterpretasi dan menggunakan kebijakan publik diperlukan atau tidak dibahas pada diskusi selanjutnya.

  10. Effectiveness of the Convention on Nuclear Safety

    International Nuclear Information System (INIS)

    Schwarz, G.

    2016-01-01

    The Convention on Nuclear Safety (CNS) has been established after the Chernobyl accident with the primary objective of achieving and maintaining a high level of nuclear safety worldwide, through the enhancement of national measures and international cooperation. The CNS is an incentive convention. It defines the basic safety standard which shall be met by the Contracting Parties. The verification of compliance is based on a self-assessment by the Countries and a Peer Review by the other Contracting Parties. As of July 2015, there are 78 Contracting Parties. Among the Contracting Parties of the Convention are all countries operating nuclear power plants except the Islamic Republic of Iran and Taiwan, all countries constructing nuclear power plants, all countries having nuclear power plants in long term shutdown and all countries having signed contracts for the construction of nuclear power plants. The National Reports under the CNS therefore cover almost all nuclear power plants of the world. The peer review of reports, questions and answers that are exchanged in connection with the Review Meetings provided a unique overview of nuclear safety provisions and issues in countries planning or operating nuclear power plants. This is especially important for neighbouring countries to those operating nuclear power plants.

  11. Metal ion implantation: Conventional versus immersion

    International Nuclear Information System (INIS)

    Brown, I.G.; Anders, A.; Anders, S.; Dickinson, M.R.; MacGill, R.A.

    1994-01-01

    Vacuum-arc-produced metal plasma can be used as the ion feedstock material in an ion source for doing conventional metal ion implantation, or as the immersing plasma for doing plasma immersion ion implantation. The basic plasma production method is the same in both cases; it is simple and efficient and can be used with a wide range of metals. Vacuum arc ion sources of different kinds have been developed by the authors and others and their suitability as a metal ion implantation tool has been well established. Metal plasma immersion surface processing is an emerging tool whose characteristics and applications are the subject of present research. There are a number of differences between the two techniques, both in the procedures used and in the modified surfaces created. For example, the condensibility of metal plasma results in thin film formation and subsequent energetic implantation is thus done through the deposited layer; in the usual scenario, this recoil implantation and the intermixing it produces is a feature of metal plasma immersion but not of conventional energetic ion implantation. Metal plasma immersion is more suited (but not limited) to higher doses (>10 17 cm -2 ) and lower energies (E i < tens of keV) than the usual ranges of conventional metal ion implantation. These and other differences provide these vacuum-arc-based surface modification tools with a versatility that enhances the overall technological attractiveness of both

  12. Measures to implement the Chemical Weapons Convention

    Energy Technology Data Exchange (ETDEWEB)

    Tanzman, E.; Kellman, B.

    1999-11-05

    This seminar is another excellent opportunity for those involved in preventing chemical weapons production and use to learn from each other about how the Chemical Weapons Convention (CWC) can become a foundation of arms control in Africa and around the world. The author is grateful to the staff of the Organization for the Prohibition of Chemical Weapons (OPCW) for inviting him to address this distinguished seminar. The views expressed in this paper are those of the authors alone, and do not represent the position of the government of the US nor or of any other institution. In 1993, as the process of CWC ratification was beginning, concerns arose that the complexity of integrating the treaty with national law would cause each nation to implement the Convention without regard to what other nations were doing, thereby causing inconsistencies among States Parties in how the Convention would be carried out. As a result the Manual for National Implementation of the Chemical Weapons Convention was prepared and presented it to each national delegation at the December 1993 meeting of the Preparatory Commission in The Hague. During its preparation, the Manual was reviewed by the Committee of Legal Experts on National Implementation of the Chemical Weapons Convention, a group of distinguished international jurists, law professors, legally-trained diplomats, government officials, and Parliamentarians from every region of the world, including Mica. In February 1998, the second edition of the Manual was published in order to update it in light of developments since the CWC entered into force on 29 April 1997. The second edition 1998 clarified the national implementation options to reflect post-entry-into-force thinking, added extensive references to national implementing measures that had been enacted by various States Parties, and included a prototype national implementing statute developed by the authors to provide a starting point for those whose national implementing

  13. Measures to implement the Chemical Weapons Convention

    International Nuclear Information System (INIS)

    Tanzman, E.; Kellman, B.

    1999-01-01

    This seminar is another excellent opportunity for those involved in preventing chemical weapons production and use to learn from each other about how the Chemical Weapons Convention (CWC) can become a foundation of arms control in Africa and around the world. The author is grateful to the staff of the Organization for the Prohibition of Chemical Weapons (OPCW) for inviting him to address this distinguished seminar. The views expressed in this paper are those of the authors alone, and do not represent the position of the government of the US nor or of any other institution. In 1993, as the process of CWC ratification was beginning, concerns arose that the complexity of integrating the treaty with national law would cause each nation to implement the Convention without regard to what other nations were doing, thereby causing inconsistencies among States Parties in how the Convention would be carried out. As a result the Manual for National Implementation of the Chemical Weapons Convention was prepared and presented it to each national delegation at the December 1993 meeting of the Preparatory Commission in The Hague. During its preparation, the Manual was reviewed by the Committee of Legal Experts on National Implementation of the Chemical Weapons Convention, a group of distinguished international jurists, law professors, legally-trained diplomats, government officials, and Parliamentarians from every region of the world, including Mica. In February 1998, the second edition of the Manual was published in order to update it in light of developments since the CWC entered into force on 29 April 1997. The second edition 1998 clarified the national implementation options to reflect post-entry-into-force thinking, added extensive references to national implementing measures that had been enacted by various States Parties, and included a prototype national implementing statute developed by the authors to provide a starting point for those whose national implementing

  14. The sustainability transition. Beyond conventional development

    Energy Technology Data Exchange (ETDEWEB)

    Raskin, P; Chadwick, M; Jackson, T; Leach, G

    1996-10-01

    This paper synthesizes findings of the first phase in SEI`s PoleStar Project - a project aimed at developing long-term strategies and policies for sustainable development. Taking a global and long-range perspective, the paper aims to describe a theoretical framework for addressing sustainability, to identify emerging issues and outline directions for future action. The paper begins by setting today`s development and environmental challenges in historical context, and describing the scenario method for envisioning and evaluating alternative futures, and identifying propitious areas for policy and action. It next summarizes a detailed scenario based on conventional development assumptions, and discusses the implications of this scenario for demographic and economic patterns, energy and water resources, land resources and agriculture, and pollution loads and the environment to the year 2050. The conventional scenario relies in part on the sectorally-oriented work discussed in Papers 3 through 6 of the PoleStar Project report series, and makes use of the PoleStar System, software designed for integrated resource, environment and socio-economic accounting and scenario analysis (described in Paper 2). The paper then examines the critical risks to social, resource and environmental systems lying ahead on the conventional development path. Finally, the paper surveys the requirements for sustainability across a number of policy dimensions, and raises key questions for the future. The PoleStar Project is proceeding to examine a range of alternative development scenarios, in the context of the work of the regionally-diverse Global Scenario Group, convened by SEI. The hope remains to offer wise counsel for a transition to an equitable, humane and sustainable future for the global community. 144 refs, 30 figs, 9 tabs

  15. The sustainability transition. Beyond conventional development

    International Nuclear Information System (INIS)

    Raskin, P.; Chadwick, M.; Jackson, T.; Leach, G.

    1996-01-01

    This paper synthesizes findings of the first phase in SEI's PoleStar Project - a project aimed at developing long-term strategies and policies for sustainable development. Taking a global and long-range perspective, the paper aims to describe a theoretical framework for addressing sustainability, to identify emerging issues and outline directions for future action. The paper begins by setting today's development and environmental challenges in historical context, and describing the scenario method for envisioning and evaluating alternative futures, and identifying propitious areas for policy and action. It next summarizes a detailed scenario based on conventional development assumptions, and discusses the implications of this scenario for demographic and economic patterns, energy and water resources, land resources and agriculture, and pollution loads and the environment to the year 2050. The conventional scenario relies in part on the sectorally-oriented work discussed in Papers 3 through 6 of the PoleStar Project report series, and makes use of the PoleStar System, software designed for integrated resource, environment and socio-economic accounting and scenario analysis (described in Paper 2). The paper then examines the critical risks to social, resource and environmental systems lying ahead on the conventional development path. Finally, the paper surveys the requirements for sustainability across a number of policy dimensions, and raises key questions for the future. The PoleStar Project is proceeding to examine a range of alternative development scenarios, in the context of the work of the regionally-diverse Global Scenario Group, convened by SEI. The hope remains to offer wise counsel for a transition to an equitable, humane and sustainable future for the global community. 144 refs, 30 figs, 9 tabs

  16. Alternative Fuels Data Center: Conventional Natural Gas Production

    Science.gov (United States)

    Conventional Natural Gas Production to someone by E-mail Share Alternative Fuels Data Center : Conventional Natural Gas Production on Facebook Tweet about Alternative Fuels Data Center: Conventional Natural Gas Production on Twitter Bookmark Alternative Fuels Data Center: Conventional Natural Gas Production

  17. Einstein Synchronisation and the Conventionality of Simultaneity

    OpenAIRE

    Mladen Domazet

    2006-01-01

    Despite a broad-range title the paper settles for the related issue of whether the Special Theory of Relativity (STR) necessarily advocates the demise of an ontological difference between past and future events, between past and future in general. In the jargon of H. Stein: are we forced, within the framework of the STR, to choose only between ‘solipsism’ and ‘determinism’ exclusively? A special emphasis is placed on the role that the conventionality of simultaneity plays in the STR with rega...

  18. Standardizing Naming Conventions in Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Santanam, Lakshmi [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Hurkmans, Coen [Department of Radiation Oncology, Catharina Hospital, Eindhoven (Netherlands); Mutic, Sasa [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Vliet-Vroegindeweij, Corine van [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Brame, Scott; Straube, William [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Galvin, James [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Tripuraneni, Prabhakar [Department of Radiation Oncology, Scripps Clinic, LaJolla, CA (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Bosch, Walter, E-mail: wbosch@radonc.wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Advanced Technology Consortium, Image-guided Therapy QA Center, St. Louis, MO (United States)

    2012-07-15

    Purpose: The aim of this study was to report on the development of a standardized target and organ-at-risk naming convention for use in radiation therapy and to present the nomenclature for structure naming for interinstitutional data sharing, clinical trial repositories, integrated multi-institutional collaborative databases, and quality control centers. This taxonomy should also enable improved plan benchmarking between clinical institutions and vendors and facilitation of automated treatment plan quality control. Materials and Methods: The Advanced Technology Consortium, Washington University in St. Louis, Radiation Therapy Oncology Group, Dutch Radiation Oncology Society, and the Clinical Trials RT QA Harmonization Group collaborated in creating this new naming convention. The International Commission on Radiation Units and Measurements guidelines have been used to create standardized nomenclature for target volumes (clinical target volume, internal target volume, planning target volume, etc.), organs at risk, and planning organ-at-risk volumes in radiation therapy. The nomenclature also includes rules for specifying laterality and margins for various structures. The naming rules distinguish tumor and nodal planning target volumes, with correspondence to their respective tumor/nodal clinical target volumes. It also provides rules for basic structure naming, as well as an option for more detailed names. Names of nonstandard structures used mainly for plan optimization or evaluation (rings, islands of dose avoidance, islands where additional dose is needed [dose painting]) are identified separately. Results: In addition to its use in 16 ongoing Radiation Therapy Oncology Group advanced technology clinical trial protocols and several new European Organization for Research and Treatment of Cancer protocols, a pilot version of this naming convention has been evaluated using patient data sets with varying treatment sites. All structures in these data sets were

  19. 9th Structural Engineering Convention 2014

    CERN Document Server

    2015-01-01

    The book presents research papers presented by academicians, researchers, and practicing structural engineers from India and abroad in the recently held Structural Engineering Convention (SEC) 2014 at Indian Institute of Technology Delhi during 22 – 24 December 2014. The book is divided into three volumes and encompasses multidisciplinary areas within structural engineering, such as earthquake engineering and structural dynamics, structural mechanics, finite element methods, structural vibration control, advanced cementitious and composite materials, bridge engineering, and soil-structure interaction. Advances in Structural Engineering is a useful reference material for structural engineering fraternity including undergraduate and postgraduate students, academicians, researchers and practicing engineers.

  20. National Convention on Family Life Education.

    Science.gov (United States)

    1973-12-01

    This secretarial report gives brief comments on some discussion of topics at the National Convention on Family Life Education. Discussion included: 1) legalized prostitution as a means to reduce venereal disease; 2) family life education promotion by government and civic groups; 3) more authority for the Population Council; 4) more liberal abortion legislation than previously; 5) statutory notification of veneral disease by medical practitioners; 6) compensatory measures for working women with young children, and 7) the need for modernization of legislation pertaining to child health, adoption, paternity, the Persons Act, infant life preservation, drugs, age of consent, and the age of minority.

  1. Standardizing Naming Conventions in Radiation Oncology

    International Nuclear Information System (INIS)

    Santanam, Lakshmi; Hurkmans, Coen; Mutic, Sasa; Vliet-Vroegindeweij, Corine van; Brame, Scott; Straube, William; Galvin, James; Tripuraneni, Prabhakar; Michalski, Jeff; Bosch, Walter

    2012-01-01

    Purpose: The aim of this study was to report on the development of a standardized target and organ-at-risk naming convention for use in radiation therapy and to present the nomenclature for structure naming for interinstitutional data sharing, clinical trial repositories, integrated multi-institutional collaborative databases, and quality control centers. This taxonomy should also enable improved plan benchmarking between clinical institutions and vendors and facilitation of automated treatment plan quality control. Materials and Methods: The Advanced Technology Consortium, Washington University in St. Louis, Radiation Therapy Oncology Group, Dutch Radiation Oncology Society, and the Clinical Trials RT QA Harmonization Group collaborated in creating this new naming convention. The International Commission on Radiation Units and Measurements guidelines have been used to create standardized nomenclature for target volumes (clinical target volume, internal target volume, planning target volume, etc.), organs at risk, and planning organ-at-risk volumes in radiation therapy. The nomenclature also includes rules for specifying laterality and margins for various structures. The naming rules distinguish tumor and nodal planning target volumes, with correspondence to their respective tumor/nodal clinical target volumes. It also provides rules for basic structure naming, as well as an option for more detailed names. Names of nonstandard structures used mainly for plan optimization or evaluation (rings, islands of dose avoidance, islands where additional dose is needed [dose painting]) are identified separately. Results: In addition to its use in 16 ongoing Radiation Therapy Oncology Group advanced technology clinical trial protocols and several new European Organization for Research and Treatment of Cancer protocols, a pilot version of this naming convention has been evaluated using patient data sets with varying treatment sites. All structures in these data sets were

  2. Unconventional applications of conventional intrusion detection sensors

    International Nuclear Information System (INIS)

    Williams, J.D.; Matter, J.C.

    1983-01-01

    A number of conventional intrusion detection sensors exists for the detection of persons entering buildings, moving within a given volume, and crossing a perimeter isolation zone. Unconventional applications of some of these sensors have recently been investigated. Some of the applications which are discussed include detection on the edges and tops of buildings, detection in storm sewers, detection on steam and other types of large pipes, and detection of unauthorized movement within secure enclosures. The enclosures can be used around complicated control valves, electrical control panels, emergency generators, etc

  3. Standardizing naming conventions in radiation oncology.

    Science.gov (United States)

    Santanam, Lakshmi; Hurkmans, Coen; Mutic, Sasa; van Vliet-Vroegindeweij, Corine; Brame, Scott; Straube, William; Galvin, James; Tripuraneni, Prabhakar; Michalski, Jeff; Bosch, Walter

    2012-07-15

    The aim of this study was to report on the development of a standardized target and organ-at-risk naming convention for use in radiation therapy and to present the nomenclature for structure naming for interinstitutional data sharing, clinical trial repositories, integrated multi-institutional collaborative databases, and quality control centers. This taxonomy should also enable improved plan benchmarking between clinical institutions and vendors and facilitation of automated treatment plan quality control. The Advanced Technology Consortium, Washington University in St. Louis, Radiation Therapy Oncology Group, Dutch Radiation Oncology Society, and the Clinical Trials RT QA Harmonization Group collaborated in creating this new naming convention. The International Commission on Radiation Units and Measurements guidelines have been used to create standardized nomenclature for target volumes (clinical target volume, internal target volume, planning target volume, etc.), organs at risk, and planning organ-at-risk volumes in radiation therapy. The nomenclature also includes rules for specifying laterality and margins for various structures. The naming rules distinguish tumor and nodal planning target volumes, with correspondence to their respective tumor/nodal clinical target volumes. It also provides rules for basic structure naming, as well as an option for more detailed names. Names of nonstandard structures used mainly for plan optimization or evaluation (rings, islands of dose avoidance, islands where additional dose is needed [dose painting]) are identified separately. In addition to its use in 16 ongoing Radiation Therapy Oncology Group advanced technology clinical trial protocols and several new European Organization for Research and Treatment of Cancer protocols, a pilot version of this naming convention has been evaluated using patient data sets with varying treatment sites. All structures in these data sets were satisfactorily identified using this

  4. RF torch discharge combined with conventional burner

    International Nuclear Information System (INIS)

    Janca, J.; Tesar, C.

    1996-01-01

    The design of the combined flame-rf-plasma reactor and experimental examination of this reactor are presented. For the determination of the temperature in different parts of the combined burner plasma the methods of emission spectroscopy were used. The temperatures measured in the conventional burner reach the maximum temperature 1900 K but in the burner with the superimposed rf discharge the neutral gas temperature substantially increased up to 2600 K but also the plasma volume increases substantially. Consequently, the resident time of reactants in the reaction zone increases

  5. Conventional myelography - evaluation of risk and benefit

    International Nuclear Information System (INIS)

    Hentschel, F.

    1989-01-01

    While the benefit and methodic risk of conventional myelography (KMG) are known, a radiation risk of 0.04 to 0.9 annual radiation-induced cancers can be estimated for all inhabitants of the GDR, dependent on the investigated region and the technique used. An optimized technique can reduce the radiation burden to 50 or 25%. With comparable values of benefit and radiation risk spinal CT and KMG are not contradictory but complementary investigations. Alternative methods (MRT, US) must not be discussed from the standpoint of radiation burden, but according to their availability and their methodic limitations. (author)

  6. Arthritis: Conventional and Advanced Radiological Imaging

    Directory of Open Access Journals (Sweden)

    Adviye Ergun

    2014-06-01

    Full Text Available Arthritides are acute or chronic inflammation of one or more joints. The most common types of arthritis are osteoarthritis and rheumatoid arthritis, but there are more than 100 different forms. Right and early diagnosis is extremely important for the prevention of eventual structural and functional disability of the affected joint. Imaging findings, especially those of advanced level imaging, play a major role in diagnosis and monitor the progression of arthritis or its response to therapy. The objective of the review is to discuss the findings of conventional and advanced radiological imaging of most common arthritides and to present a simplified approach for their radiological evaluation.

  7. Adding intelligence to conventional industrial robots

    International Nuclear Information System (INIS)

    Harrigan, R.W.

    1993-01-01

    Remote systems are needed to accomplish many tasks such as the clean up of waste sites in which the exposure of personnel to radiation, chemical, explosive, and other hazardous constituents is unacceptable. In addition, hazardous operations which in the past have been completed by technicians are under increased scrutiny due to high costs and low productivity associated with providing protective clothing and environments. Traditional remote operations have, unfortunately, proven to also have very low productivity when compare with unencumbered human operators. However, recent advances in the integration of sensors and computing into the control of conventional remotely operated industrial equipment has shown great promise for providing systems capable of solving difficult problems

  8. Guidelines regarding National Reports under the Convention on Nuclear Safety

    International Nuclear Information System (INIS)

    2013-01-01

    These Guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention on Nuclear Safety (hereinafter called the Convention), are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties regarding material that may be useful to include in the National Reports required under Article 5 of the Convention and thereby to facilitate the most efficient review of implementation by the Contracting Parties of their obligations under the Convention.

  9. Indonesia Interest in International Labor Organization (ILO) Convention No.189

    OpenAIRE

    Jamaan, Ahmad; Anugrah, Debora Panca

    2014-01-01

    This research aims to analyze, Indonesia Interest in ILO convention No. 189 on Decent Works for Domestic Workers. Indonesia has massive number of domestic workers caused by low quality of education. Therefore, Indonesia agreed on creation of ILO Convention No.189 in protecting their society that works as domestic workers. However, in the early of ILO Convention No.189 agreement creation in 2011, Indonesia has not ratified this Convention to 2013. If Indonesia has ratified this convention prev...

  10. Implementation of the Aarhus convention - A survey

    Directory of Open Access Journals (Sweden)

    Marina Malis Sazdovska

    2016-11-01

    Full Text Available Legislation on global and regional level in the field of environmental protection is characterized by the adoption of international conventions and agreements that attempt to regulate this matter legally. As an extremely important area, which exceeds the boundaries of nation-state and as a global environmental problem, the issues of environmental protection are a major concern to international organizations. It is directly linked to reducing the jurisdiction of the States and transfer of competences to international organizations and institutions in order to solve the problems in a global experience. In order to overcome the problems regarding the implementation of international documents, the creation of certain policies by international organizations and institutions is required to promote the idea of environmental protection as a basic mo$ o of the global world. Taking into account the recommendations of Brundtland Commission, humanity has a moral obligation to preserve natural resources for future generations. Main objective of this article is the presentation of research on the implementation of the Aarhus Convention and the proposal of measures for the creation of ideas and policies on improving access to information in the field. The research is done with the students from the faculty of Security which accessed the information in environmental matters.

  11. Future directions conventional oil supply, Western Canada

    International Nuclear Information System (INIS)

    Campbell, G.R.; Hayward, J.

    1997-01-01

    The history of the Canadian oil industry was briefly sketched and the future outlook for crude oil and natural gas liquids in western Canada was forecast. The historical review encompassed some of the significant events in history of the Canadian oil industry, including the Leduc discovery in 1947, the Swan Hills discovery in 1957, the start of commercial production from the Athabasca oil sands in 1967, the discovery of the Hibernia oilfield offshore Newfoundland in 1979, and the onset of the use of horizontal production wells in western Canada in 1987. The resource base, supply costs, and the technology that is being developed to reduce costs and to improve recovery, were reviewed. Future oil prices were predicted, taking into account the costs associated with technological developments. It was suggested that the character of the industry is undergoing a change from an industry dominated by conventional supply to a mixed industry with increasing volume of heavy oil, primary bitumen, synthetic oil and frontier supply replacing 'conventional' light crude oil. Projections into the future are subject to uncertainty both on the supply as well as on the demand side. The potential impact of technology can significantly affect demand, and technological developments can yield additional supplies which exceed current expectations. 10 figs

  12. Non-conventional energy and propulsion methods

    International Nuclear Information System (INIS)

    Valone, T.

    1991-01-01

    From the disaster of the Space Shuttle, Challenger, to the Kuwaiti oil well fires, we are reminded constantly of our dependence on dangerous, combustible fuels for energy and propulsion. Over the past ten years, there has been a considerable production of new and exciting inventions which defy conventional analysis. The term non-conventional was coined in 1980 by a Canadian engineer to designate a separate technical discipline for this type of endeavor. Since then, several conferences have been devoted solely to these inventions. Integrity Research Corp., an affiliate of the Institute, has made an effort to investigate each viable product, develop business plans for several to facilitate development and marketing, and in some cases, assign an engineering student intern to building a working prototype. Each inventor discussed in this presentation has produced a unique device for free energy generation or highly efficient force production. Included in this paper is also a short summary for non-specialists explaining the physics of free energy generation along with a working definition. The main topics of discussion include: space power, inertial propulsion, kinetobaric force, magnetic motors, thermal fluctuations, over-unity hat pumps, ambient temperature superconductivity and nuclear battery

  13. The Chemical Weapons Convention -- Legal issues

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-08-01

    The Chemical Weapons Convention (CWC) offers a unique challenge to the US system of constitutional law. Its promise of eliminating what is the most purely genocidal type of weapon from the world`s arsenals as well as of destroying the facilities for producing these weapons, brings with it a set of novel legal issues. The reservations about the CWC expressed by US business people are rooted in concern about safeguarding confidential business information and protecting the constitutional right to privacy. The chief worry is that international verification inspectors will misuse their power to enter commercial property and that trade secrets or other private information will be compromised as a result. It has been charged that the Convention is probably unconstitutional. The author categorically disagrees with that view and is aware of no scholarly writing that supports it. The purpose of this presentation is to show that CWC verification activities can be implemented in the US consistently with the traditional constitutional regard for commercial and individual privacy. First, he very briefly reviews the types of verification inspections that the CWC permits, as well as some of its specific privacy protections. Second, he explains how the Fourth Amendment right to privacy works in the context of CWC verification inspections. Finally, he reviews how verification inspections can be integrated into these constitutional requirements in the SU through a federal implementing statute.

  14. Technological advancements revitalize conventional oil sector

    International Nuclear Information System (INIS)

    Thomson, L.

    2000-01-01

    Maturing reserves in the Western Canada Sedimentary Basin is resulting in a gradual shift of focus from huge new discoveries and wildcat gushers to developing new technologies for exploration and enhanced recovery techniques of production, keeping costs down and reducing environmental impacts, as a means of keeping conventional oil plays a viable force in the oil and gas industry. The value in refocusing efforts towards technology development is given added weight by a recent announcement by the Petroleum Communication Foundation, which stated that in addition to the oil sands and offshore oil and gas developments, one of the country's largest undeveloped oil resource is the 70 per cent of discovered crude oil in western Canadian pools that cannot be recovered by current conventional production techniques. Therefore, development of new technologies to exploit these currently unrecoverable resources is a matter of high priority. To remain competitive, the new techniques must also lower the cost of recovering oil from these sources, given that the cost of oil production in Canada is already higher than that in most other competing countries

  15. Accuracy of Digital vs. Conventional Implant Impressions

    Science.gov (United States)

    Lee, Sang J.; Betensky, Rebecca A.; Gianneschi, Grace E.; Gallucci, German O.

    2015-01-01

    The accuracy of digital impressions greatly influences the clinical viability in implant restorations. The aim of this study is to compare the accuracy of gypsum models acquired from the conventional implant impression to digitally milled models created from direct digitalization by three-dimensional analysis. Thirty gypsum and 30 digitally milled models impressed directly from a reference model were prepared. The models were scanned by a laboratory scanner and 30 STL datasets from each group were imported to an inspection software. The datasets were aligned to the reference dataset by a repeated best fit algorithm and 10 specified contact locations of interest were measured in mean volumetric deviations. The areas were pooled by cusps, fossae, interproximal contacts, horizontal and vertical axes of implant position and angulation. The pooled areas were statistically analysed by comparing each group to the reference model to investigate the mean volumetric deviations accounting for accuracy and standard deviations for precision. Milled models from digital impressions had comparable accuracy to gypsum models from conventional impressions. However, differences in fossae and vertical displacement of the implant position from the gypsum and digitally milled models compared to the reference model, exhibited statistical significance (p<0.001, p=0.020 respectively). PMID:24720423

  16. The EU Arbitration Convention : An evaluating assessment of the governance and functioning of the EU Arbitration Convention

    NARCIS (Netherlands)

    Pit, Harm Mark

    2017-01-01

    The EU Arbitration Convention An evaluating assessment of the governance and functioning of the EU Arbitration Convention Summary for non-experts The EU Arbitration Convention is a convention between EU Member States to eliminate double taxation arising from – for tax purposes – transfer pricing

  17. Reframing less conventional speech to disrupt conventions of "compulsory fluency": A conversation analysis approach

    Directory of Open Access Journals (Sweden)

    Camille Duque

    2018-05-01

    Full Text Available Our purpose is to illuminate compliances with, and resistances to, what we are calling "compulsory fluency" which we define as conventions for what constitutes competent speech. We achieve our purpose through a study of day-to-day communication between a woman with less conventional speech and her support providing family members and friends. Drawing from McRuer's (2006 compulsory ablebodiedness and Kafer's (2013 compulsory able-mindedness, we use "compulsory fluency" to refer to a form of articulation that is standardized and idealized and imposed on all speakers including those whose speech is less conventional. We see compulsory fluency as central to North American conceptions of personhood which are tied to individual ability to speak for one's self (Brueggemann, 2005. In this paper, we trace some North American principles for linguistic competence to outline widely held ideals of receptive and expressive language use, namely, conventions for how language should be understood and expressed. Using Critical Disability Studies (Goodley, 2013; McRuer, 2006 together with a feminist framework of relational autonomy (Nedelsky, 1989, our goal is to focus on experiences of people with less conventional speech and draw attention to power in communication as it flows in idiosyncratic and intersubjective fashion (Mackenzie & Stoljar, 2000; Westlund, 2009. In other words, we use a critical disability and feminist framing to call attention to less conventional forms of communication competence and, in this process, we challenge assumptions about what constitutes competent speech. As part of a larger qualitative study, we conduct a conversation analysis informed by Rapley and Antaki (1996 to examine day-to-day verbal, vocal and non-verbal communications of a young woman who self identifies as "having autism" - pseudonym Addison - in interaction with her support-providing family members and friends. We illustrate a multitude of Addison's compliances with

  18. Supersymmetry Parameter Analysis : SPA Convention and Project

    CERN Document Server

    Aguilar-Saavedra, J A; Allanach, Benjamin C; Arnowitt, R; Baer, H A; Bagger, J A; Balázs, C; Barger, V; Barnett, M; Bartl, Alfred; Battaglia, M; Bechtle, P; Belyaev, A; Berger, E L; Blair, G; Boos, E; Bélanger, G; Carena, M S; Choi, S Y; Deppisch, F; Desch, Klaus; Djouadi, A; Dutta, B; Dutta, S; Díaz, M A; Eberl, H; Ellis, Jonathan Richard; Erler, Jens; Fraas, H; Freitas, A; Fritzsche, T; Godbole, Rohini M; Gounaris, George J; Guasch, J; Gunion, J F; Haba, N; Haber, Howard E; Hagiwara, K; Han, L; Han, T; He, H J; Heinemeyer, S; Hesselbach, S; Hidaka, K; Hinchliffe, Ian; Hirsch, M; Hohenwarter-Sodek, K; Hollik, W; Hou, W S; Hurth, Tobias; Jack, I; Jiang, Y; Jones, D R T; Kalinowski, Jan; Kamon, T; Kane, G; Kang, S K; Kernreiter, T; Kilian, W; Kim, C S; King, S F; Kittel, O; Klasen, M; Kneur, J L; Kovarik, K; Kraml, Sabine; Krämer, M; Lafaye, R; Langacker, P; Logan, H E; Ma, W G; Majerotto, Walter; Martyn, H U; Matchev, K; Miller, D J; Mondragon, M; Moortgat-Pick, G; Moretti, S; Mori, T; Moultaka, G; Muanza, S; Mukhopadhyaya, B; Mühlleitner, M M; Nauenberg, U; Nojiri, M M; Nomura, D; Nowak, H; Okada, N; Olive, Keith A; Oller, W; Peskin, M; Plehn, T; Polesello, G; Porod, Werner; Quevedo, Fernando; Rainwater, D L; Reuter, J; Richardson, P; Rolbiecki, K; de Roeck, A; Weber, Ch.

    2006-01-01

    High-precision analyses of supersymmetry parameters aim at reconstructing the fundamental supersymmetric theory and its breaking mechanism. A well defined theoretical framework is needed when higher-order corrections are included. We propose such a scheme, Supersymmetry Parameter Analysis SPA, based on a consistent set of conventions and input parameters. A repository for computer programs is provided which connect parameters in different schemes and relate the Lagrangian parameters to physical observables at LHC and high energy e+e- linear collider experiments, i.e., masses, mixings, decay widths and production cross sections for supersymmetric particles. In addition, programs for calculating high-precision low energy observables, the density of cold dark matter (CDM) in the universe as well as the cross sections for CDM search experiments are included. The SPA scheme still requires extended efforts on both the theoretical and experimental side before data can be evaluated in the future at the level of the d...

  19. For a convention for nuclear weapon elimination

    International Nuclear Information System (INIS)

    2008-03-01

    This document contains two texts linked with the project of an international convention for the elimination of nuclear weapons (the text of this project has been sent to the UN General Secretary and is part of an international campaign to abolish nuclear weapons, ICAN). These two texts are contributions presented in London at the Global Summit for a Nuclear Weapon-free World. The first one calls into question the deterrence principle and the idea of a nuclear weapon-based security. It calls for different forms of action to promote a nuclear weapon-free world. The second text stresses the role and the responsibility of states with nuclear weapons in nuclear disarmament and in the reinforcement of the nuclear non proliferation treaty (NPT)

  20. Muzzle shunt augmentation of conventional railguns

    International Nuclear Information System (INIS)

    Parker, J.V.

    1991-01-01

    This paper reports on augmentation which is a technique for reducing the armature current and hence the armature power dissipation in a plasma armature railgun. In spite of the advantages, no large augmented railguns have been built, primarily due to the mechanical and electrical complexity introduced by the extra conductors required. it is possible to achieve some of the benefits of augmentation in a conventional railgun by diverting a fraction φ of the input current through a shunt path at the muzzle of the railgun. In particular, the relation between force and armature current is the same as that obtained in an n-turn, series-connected augmented railgun with n = 1/(1 - φ). The price of this simplification is a reduction in electrical efficiency and some additional complexity in the external electrical system

  1. Conventional radiology: fixed installations in medical environment

    International Nuclear Information System (INIS)

    2010-01-01

    This document presents the different procedures, the different types of specific hazards, the analysis of risks, their assessment and the preventive methods with regard to radioprotection in the case of fixed conventional radiology equipment in medical environment. It indicates and describes the concerned personnel, the course of procedures, the hazards, the identification of the risk associated with ionizing radiation, the risk assessment and the determination of exposure levels (definition of regulated areas, personnel categories), the strategy aimed at controlling the risk (risk reduction, technical measures concerning the installation or the personnel, teaching and information, prevention, incident), the different measures of medical monitoring, the assessment of risk control, and other risks. An appendix proposes an example of workstation assessment

  2. Rhegmatogenous retinal detachment and conventional surgical treatment.

    Science.gov (United States)

    Golubovic, M

    2013-01-01

    The aim of the paper was to present the efficacy and indications for application of conventional surgical treatment of retinal detachment by using external implants, that is,application of encircling band and buckle. This study comprised patients from the University Eye Clinic in Skopje. A total of 33 patients were diagnosed and surgically treated in the period between May 2010 and August 2011. Conventional surgery was applied in smaller number of patients whose changes of the vitreous body were manifested by detachment of posterior hyaloid membrane, syneresis, with appearance of a small number of pigment cells in the vitreous body and synchysis, and the very retina was with fresh detachment without folds or epiretinal changes (that is, PVR A grade). There were a larger number of patients with more distinct proliferative changes of the vitreous body and of the retina, grades PVR B to C1-C2, and who also underwent the same surgical approach. Routine ophthalmologic examinations were performed, including: determination of visual acuity by Snellen's optotypes, determination of eye pressure with Schiotz's tonometer, examination of anterior segment on biomicroscopy, indirect biomicroscopy of posterior eye segment (vitreous body and retina) and examination on biomicroscopy with Goldmann prism, B scan echography of the eyes before and after surgical treatment. Conventional treatment was used by external application of buckle or application of buckle and encircling band. In case of one break, radial buckle was applied and in case of multiple breaks in one quadrant limbus parallel buckle was applied. Besides buckle, encircling band was applied in patients with total or subtotal retinal detachment with already present distinct changes in the vitreous body (PVR B or C1-C2) and degenerative changes in the vitreous body. Breaks were closed with cryopexy. The results obtained have shown that male gender was predominant and that the disease was manifested in younger male adults

  3. Technologies for the future : conventional recovery enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Isaacs, E. [Alberta Energy Research Inst., Edmonton, AB (Canada)

    2005-07-01

    This conference presentation examined Alberta's oil production and water use; global finding and development costs across continents; and current trends for conventional oil. The presentation examined opportunities for testing new technologies for enhanced oil recovery (EOR) and provided several tables of data on EOR production in the United States. The evolution of United States EOR production, and the number of EOR projects in Canada were also addressed. The presentation also discussed where EOR goes from here as well as the different EOR mechanisms to alter phase behaviour and to alter relative flow. It also discussed chemical methods and major challenges for chemical EOR and examined EOR technologies needing a major push in the Western Canada Sedimentary Basin. Lessons learned from the Joffre site regarding carbon dioxide miscible flood were revealed along with how coal gasification produces substitute natural gas and carbon dioxide for EOR. Suggestions for research and technology and enhanced water management were included. tabs., figs.

  4. Limitation and reduction of conventional arms

    International Nuclear Information System (INIS)

    Chervov, N.

    1989-01-01

    We are living at a time when war between East and West---not only nuclear but also conventional war--- is totally senseless. It cannot solve any problem---political, economic, or other. From the military point of view, war between East and West is madness. Calculations show that after 20 days of conventional warfare Europe could become another Hiroshima. Therefore we must work out forms of long-term cooperation. Before it is too late, we must radically reduce our military potentials and rethink our military doctrines. The reduction by 500,000 men is for the USSR no simple solution. But that step may become a model for further actions by East and West. The West's proposal that armed forces should be reduced to the level of 95 percent of NATO's armed forces is not a solution. Both sides---the Warsaw Treaty Organization and NATO---must be deprived of the capacity to launch a sudden attack; they must be deprived of their attack potential. The USSR initiative shows the true way toward that goal. What is happening in connection with our decision is not always correctly interpreted in the West, and so I should like to draw attention to some distinctive features of the Soviet armed forces reductions and, first of all, their scale (equivalent to the Bundeswehr of the Federal Republic of Germany). With respect to Europe, Soviet troops are to be reduced in the German Democratic Republic, Czechoslovakia, Hungary, Poland, and the European part of the Soviet Union---a total of 240,000 men, 10,000 tanks, 9,500 artillery systems, and 800 combat aircraft

  5. Innovation and the Development Convention in Brazil

    Directory of Open Access Journals (Sweden)

    Fabio Stefano Erber

    2004-01-01

    means to achieving fast and stable economic growth. Nonetheless, the degree of endogenous technical innovation in Brazil remains very low. This paper explores the conjecture that the latter result is a consequence of the hegemonic view of development. The first section presents some quantitative and qualitative data to support our assertion about the innovativeness of the Brazilian economy. The second section argues that the “view of development” may be profitably treated as a “convention”, a set of beliefs shared by decision-makers and used to identify the main issues which a development strategy has to tackle and the appropriate means to address such issues. A development convention contains also a “negative” agenda — issues and solutions which should be avoided. The same section then analyses the development convention which was hegemonic from the nineties to the date of the paper (2002 and the implications of its positive and negative agendas for technological development, assuming such convention had worked as its supporters supposed it would. It argues that the theoretical results are consistent with the facts described in the first section. The last section comments the actual working of the development convention, arguing that it stressed the main technological features present in the “pure form” of the convention and concludes with a brief discussion of the role of innovation in a new development convention which seemed to be arising at that time.

  6. Analysis of non-melanoma skin cancer across the tofacitinib rheumatoid arthritis clinical programme.

    Science.gov (United States)

    Curtis, Jeffrey R; Lee, Eun Bong; Martin, George; Mariette, Xavier; Terry, Ketti K; Chen, Yan; Geier, Jamie; Andrews, John; Kaur, Mandeep; Fan, Haiyun; Nduaka, Chudy I

    2017-01-01

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We evaluated the incidence of non-melanoma skin cancer (NMSC) across the tofacitinib RA development programme. NMSC events (through August 2013) were identified in patients receiving tofacitinib in two Phase (P)1, eight P2, six P3 and two long-term extension (LTE) studies. In P123 studies, tofacitinib was administered at various doses (1-30 mg twice daily [BID], 20 mg once daily), as monotherapy or with conventional synthetic disease-modifying anti-rheumatic drugs, mainly methotrexate. In LTE studies, patients from qualifying P123 studies received tofacitinib 5 or 10 mg BID. Crude incidence rates (IRs; patients with events/100 patient-years) for first NMSC event were evaluated across doses and over time. In the overall population, comprising data from 18 studies (15,103 patient-years), 83 of 6092 tofacitinib-treated patients had NMSC events. The IR for NMSC (0.55 [95% confidence interval, 0.45-0.69] overall population) was stable up to 84 months of observation. IRs for tofacitinib 5 and 10 mg BID in combined P123 trials were 0.61 (0.34-1.10) and 0.47 (0.24-0.90), respectively. Corresponding IRs for LTE studies were 0.41 (0.26-0.66) and 0.79 (0.60-1.05). The IR for NMSC across the tofacitinib RA clinical development programme was low and remained stable over time. The IR for NMSC in LTE studies was numerically but not significantly higher with tofacitinib 10 versus 5 mg BID; an inverse dose relationship was observed in P123 trials. Longer follow-up is required to confirm these results.

  7. Cost-effectiveness of sequenced treatment of rheumatoid arthritis with targeted immune modulators.

    Science.gov (United States)

    Jansen, Jeroen P; Incerti, Devin; Mutebi, Alex; Peneva, Desi; MacEwan, Joanna P; Stolshek, Bradley; Kaur, Primal; Gharaibeh, Mahdi; Strand, Vibeke

    2017-07-01

    To determine the cost-effectiveness of treatment sequences of biologic disease-modifying anti-rheumatic drugs or Janus kinase/STAT pathway inhibitors (collectively referred to as bDMARDs) vs conventional DMARDs (cDMARDs) from the US societal perspective for treatment of patients with moderately to severely active rheumatoid arthritis (RA) with inadequate responses to cDMARDs. An individual patient simulation model was developed that assesses the impact of treatments on disease based on clinical trial data and real-world evidence. Treatment strategies included sequences starting with etanercept, adalimumab, certolizumab, or abatacept. Each of these treatment strategies was compared with cDMARDs. Incremental cost, incremental quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated for each treatment sequence relative to cDMARDs. The cost-effectiveness of each strategy was determined using a US willingness-to-pay (WTP) threshold of $150,000/QALY. For the base-case scenario, bDMARD treatment sequences were associated with greater treatment benefit (i.e. more QALYs), lower lost productivity costs, and greater treatment-related costs than cDMARDs. The expected ICERs for bDMARD sequences ranged from ∼$126,000 to $140,000 per QALY gained, which is below the US-specific WTP. Alternative scenarios examining the effects of homogeneous patients, dose increases, increased costs of hospitalization for severely physically impaired patients, and a lower baseline Health Assessment Questionnaire (HAQ) Disability Index score resulted in similar ICERs. bDMARD treatment sequences are cost-effective from a US societal perspective.

  8. Disease activity in and quality of life of patients with psoriatic arthritis mutilans: the Nordic PAM Study.

    Science.gov (United States)

    Lindqvist, U; Gudbjornsson, B; Iversen, L; Laasonen, L; Ejstrup, L; Ternowitz, T; Ståhle, M

    2017-11-01

    To describe the social status and health-related quality of life of patients with psoriatic arthritis mutilans (PAM) in the Nordic countries. Patients with at least one mutilated joint confirmed by radiology were studied. Disease activity involving joints and skin, physician-assessed disease activity, and patient's education and work status were recorded. Data from the 36-item Short Form Health Survey, Health Assessment Questionnaire and Dermatology Life Quality Index questionnaire were gathered and correlated with disease duration, pain, and general well-being (visual analogue scale). The controls were 58 Swedish patients with long-standing psoriatic arthritis sine PAM. Sixty-seven patients were included. Patients with PAM had a protracted disease history (33 ± 14 years) and disease onset at a relatively early age (30 ± 12 years). Overall inflammatory activity at inclusion was mild to moderate. The mean number of mutilated joints was 8.2 and gross deformity was found in 16% of patients. Forty per cent were treated with biological and 32% with conventional synthetic disease-modifying anti-rheumatic drugs. Forty-two per cent had retired early or were on sick leave. Impaired functional capacity with little or no ability to perform self-care or everyday tasks was reported by 21% of the patients. Patients between 45 and 60 years of age reported the most impaired quality of life in comparison to the control group. PAM seriously affects social functioning. Whether early recognition of PAM and new forms of therapy can improve disease outcome and quality of life remains to be studied.

  9. The impact of targeted Rheumatoid Arthritis pharmacological treatment on mental health: A systematic review and network meta-analysis.

    Science.gov (United States)

    Matcham, Faith; Galloway, James; Hotopf, Matthew; Roberts, Emmert; Scott, Ian C; Steer, Sophia; Norton, Sam

    2018-06-06

    Rheumatoid Arthritis (RA) pharmacotherapy may impact mental health (MH) outcomes by improving pain and stiffness; and potentially via targeting inflammatory processes common to RA and depression. The objectives of this review were to i) ascertain the frequency of MH assessment in RA pharmacotherapy trials; ii) quantify the efficacy of RA pharmacotherapy efficacy on MH outcomes; iii) explore the clinical and demographic factors related to MH outcomes. CENTRAL, PsychINFO, Web of Science, Medline, Embase and CINAHL were systematically searched from inception to March 2017 for randomised trials of disease-modifying anti-rheumatic drugs (DMARDs) in adult RA patients. The primary outcome was MH; self-reported physical health was extracted as a secondary outcome. Pairwise meta-analysis (PMA) created pooled effect sizes and 95%CIs for comparisons of all treatments versus comparators (active or placebo). Network meta-analysis (NMA) provided effect size estimates of targeted biologic DMARDs (bDMARDs) versus conventional synthetic DMARDs (csDMARDs) using indirect comparisons of different treatment modalities. 71 eligible studies were identified. 57 studies were included in the PMA, representing 23,535 patients. bDMARDs showed small effects on MH (standardised mean difference (SMD) versus csDMARDs = 0.19 to 0.30), and moderate effects on self-reported physical health (SMD versus csDMARDs = 0.46 to 0.50), with NMA determining no significant differences in effectiveness between bDMARD mode of action on either outcome. Effective pharmacotherapy alone is unlikely to substantially improve MH outcomes for most RA patients. Integrated MH care provided within routine clinical practice is essential to optimise mental and physical health outcomes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Biomass energy conversion: conventional and advanced technologies

    Energy Technology Data Exchange (ETDEWEB)

    Young, B C; Hauserman, W B [Energy and Environmental Research Center, University of North Dakota, Grand Forks, ND (United States)

    1995-12-01

    Increasing interest in biomass energy conversion in recent years has focused attention on enhancing the efficiency of technologies converting biomass fuels into heat and power, their capital and operating costs and their environmental emissions. Conventional combustion systems, such as fixed-bed or grate units and entrainment units, deliver lower efficiencies (<25%) than modem coal-fired combustors (30-35%). The gasification of biomass will improve energy conversion efficiency and yield products useful for heat and power generation and chemical synthesis. Advanced biomass gasification technologies using pressurized fluidized-bed systems, including those incorporating hot-gas clean-up for feeding gas turbines or fuel cells, are being demonstrated. However, many biomass gasification processes are derivatives of coal gasification technologies and do not exploit the unique properties of biomass. This paper examines some existing and upcoming technologies for converting biomass into electric power or heat. Small-scale 1-30 MWe units are emphasized, but brief reference is made to larger and smaller systems, including those that bum coal-biomass mixtures and gasifiers that feed pilot-fuelled diesel engines. Promising advanced systems, such as a biomass integrated gasifier/gas turbine (BIG/GT) with combined-cycle operation and a biomass gasifier coupled to a fuel cell, giving cycle efficiencies approaching 50% are also described. These advanced gasifiers, typically fluid-bed designs, may be pressurized and can use a wide variety of biomass materials to generate electricity, process steam and chemical products such as methanol. Low-cost, disposable catalysts are becoming available for hot-gas clean-up (enhanced gas composition) for turbine and fuel cell systems. The advantages, limitations and relative costs of various biomass gasifier systems are briefly discussed. The paper identifies the best known biomass power projects and includes some information on proposed and

  11. Biomass energy conversion: conventional and advanced technologies

    International Nuclear Information System (INIS)

    Young, B.C.; Hauserman, W.B.

    1995-01-01

    Increasing interest in biomass energy conversion in recent years has focused attention on enhancing the efficiency of technologies converting biomass fuels into heat and power, their capital and operating costs and their environmental emissions. Conventional combustion systems, such as fixed-bed or grate units and entrainment units, deliver lower efficiencies (<25%) than modem coal-fired combustors (30-35%). The gasification of biomass will improve energy conversion efficiency and yield products useful for heat and power generation and chemical synthesis. Advanced biomass gasification technologies using pressurized fluidized-bed systems, including those incorporating hot-gas clean-up for feeding gas turbines or fuel cells, are being demonstrated. However, many biomass gasification processes are derivatives of coal gasification technologies and do not exploit the unique properties of biomass. This paper examines some existing and upcoming technologies for converting biomass into electric power or heat. Small-scale 1-30 MWe units are emphasized, but brief reference is made to larger and smaller systems, including those that bum coal-biomass mixtures and gasifiers that feed pilot-fuelled diesel engines. Promising advanced systems, such as a biomass integrated gasifier/gas turbine (BIG/GT) with combined-cycle operation and a biomass gasifier coupled to a fuel cell, giving cycle efficiencies approaching 50% are also described. These advanced gasifiers, typically fluid-bed designs, may be pressurized and can use a wide variety of biomass materials to generate electricity, process steam and chemical products such as methanol. Low-cost, disposable catalysts are becoming available for hot-gas clean-up (enhanced gas composition) for turbine and fuel cell systems. The advantages, limitations and relative costs of various biomass gasifier systems are briefly discussed. The paper identifies the best known biomass power projects and includes some information on proposed and

  12. NESTA Revolutionizing Teacher's Experiences at NSTA Conventions

    Science.gov (United States)

    Ireton, F.

    2002-05-01

    National Science Teachers Association (NSTA) conventions are traditionally composed of short workshops, half or full day workshops, and lectures on science teaching or education research. Occasional science lectures such as the AGU lecture offer science content information. The National Earth Science Teachers Association (NESTA) will join the National Association of Geoscience Teachers (NAGT), American Geophysical Union (AGU), and the American Geological Institute (AGI) to bring teachers a suite of exciting and informative events at the (NSTA) 2002 convention. Events begin with a guided learning field trip to Mission Trails Regional Park and Torrey Pines State Reserve where Earth and space science teachers experience a model of constructivist leaning techniques. Most field trips are a "show and tell" experience, designed to transmit knowledge from the field trip leader to the field trip participants. In the "guided learning" environment, the leader serves as a facilitator, asking questions, guiding participants to discover concepts for themselves. Participants examine selected processes and features that constitute a constructivist experience in which knowledge acquired at any given location builds on knowledge brought to the site. Employing this strategy involves covering less breadth but greater depth, modeling the concept of "less is more." On Thursday NESTA will host two Share-a-thons. These are not what a person would think of as a traditional workshop where presenter makes a presentation then the participants work on an activity. They could be called the flea market of teaching ideas. Tables are set around the perimeter of a room where the presenters are stationed. Teachers move from table to table picking up information and watching short demonstrations. The Earth and Space Science Resource Day on Friday will focus on teachers needs. Starting with breakfast, teachers will hear from Soames Summerhays, Naturalist and President of Summerhays Films, about how he

  13. The peritoneal fibrinolytic response to conventional and laparoscopic colonic surgery

    NARCIS (Netherlands)

    Brokelman, Walter; Holmdahl, Lena; Falk, Peter; Klinkenbijl, Jean; Reijnen, Michel

    2009-01-01

    Laparoscopic surgery is considered to induce less peritoneal trauma than conventional surgery. The peritoneal plasmin system is important in the processes of peritoneal healing and adhesion formation. The present study assessed the peritoneal fibrinolytic response to laparoscopic and conventional

  14. Transportation management and security during the 2004 Democratic National Convention

    Science.gov (United States)

    2005-01-05

    The transportation operations plan for the 2004 Democratic National Convention (DNC) in Boston, Massachusetts, was not a typical transportation plan driven by goals such as mobility and air quality. The DNC was the first national political convention...

  15. Uncertainty, Conventions and Co-ordination in the Business Enterprise

    DEFF Research Database (Denmark)

    Jagd, Søren

    The paper presents the basic propositions of convention theory with special consideration to the analysis of uncertainty, the role of institutions and conventions, and the implications this perspective has for the analysis of the business enterprise......The paper presents the basic propositions of convention theory with special consideration to the analysis of uncertainty, the role of institutions and conventions, and the implications this perspective has for the analysis of the business enterprise...

  16. Guidelines regarding National Reports under the Convention on Nuclear Safety

    International Nuclear Information System (INIS)

    2011-01-01

    These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention on Nuclear Safety (hereinafter called the Convention), are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties regarding material that it may be useful to include in the National Reports required under Article 5 and thereby to facilitate the most efficient review of implementation by the Contracting Parties of their obligations under the Convention [es

  17. Guidelines regarding National Reports under the Convention on Nuclear Safety

    International Nuclear Information System (INIS)

    2011-01-01

    These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention on Nuclear Safety (hereinafter called the Convention), are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties regarding material that it may be useful to include in the National Reports required under Article 5 and thereby to facilitate the most efficient review of implementation by the Contracting Parties of their obligations under the Convention

  18. Protecting Bone Health in Pediatric Rheumatic Diseases: Pharmacological Considerations.

    Science.gov (United States)

    Zhang, Yujuan; Milojevic, Diana

    2017-06-01

    Bone health in children with rheumatic conditions may be compromised due to several factors related to the inflammatory disease state, delayed puberty, altered life style, including decreased physical activities, sun avoidance, suboptimal calcium and vitamin D intake, and medical treatments, mainly glucocorticoids and possibly some disease-modifying anti-rheumatic drugs. Low bone density or even fragility fractures could be asymptomatic; therefore, children with diseases of high inflammatory load, such as systemic onset juvenile idiopathic arthritis, juvenile dermatomyositis, systemic lupus erythematosus, and those requiring chronic glucocorticoids may benefit from routine screening of bone health. Most commonly used assessment tools are laboratory testing including serum 25-OH-vitamin D measurement and bone mineral density measurement by a variety of methods, dual-energy X-ray absorptiometry as the most widely used. Early disease control, use of steroid-sparing medications such as disease-modifying anti-rheumatic drugs and biologics, supplemental vitamin D and calcium, and promotion of weight-bearing physical activities can help optimize bone health. Additional treatment options for osteoporosis such as bisphosphonates are still controversial in children with chronic rheumatic diseases, especially those with decreased bone density without fragility fractures. This article reviews common risk factors leading to compromised bone health in children with chronic rheumatic diseases and discusses the general approach to prevention and treatment of bone fragility.

  19. Conventional - Frontier and east coast supply

    International Nuclear Information System (INIS)

    Morrell, G.R.

    1998-01-01

    An assessment of frontier basins in Canada with proven potential for petroleum resources was provided. A prediction of which frontier basin will become a major supplier of conventional light oil was made by examining where companies are investing in frontier exploration today. Frontier land values for five active frontier areas were discussed. These included the Grand Banks of Newfoundland, Nova Scotia Offshore, Western Newfoundland, the southern Northwest Territories and the Central Mackenzie Valley. The focus of this presentation was on three of these regions which are actually producing: Newfoundland's Grand Banks, offshore Nova Scotia and the Mackenzie Valley. Activities in each of these areas were reviewed. The Canada-Newfoundland Offshore Petroleum Board has listed Hibernia's reserves at 666 million barrels. The Sable Offshore Energy Project on the continental shelf offshore Nova Scotia proposes to develop 5.4 tcf of gas plus 75 million barrels of NGLs over a project life of 14 years. In the Mackenzie Valley there are at least three petroleum systems, including the 235 million barrel pool at Norman Wells. 8 refs., 1 tab., 3 figs

  20. Retrieval of buried waste using conventional equipment

    International Nuclear Information System (INIS)

    Valentich, D.J.

    1994-01-01

    A field test was conducted to determine the effectiveness of using conventional type construction equipment for the retrieval of buried transuranic (TRU) waste. A cold (nonhazardous and nonradioactive test pit 841 m 3 in volume) was constructed with boxes and drums filled with simulated waste materials, such as metal, plastic, wood, concrete, and sludge. Large objects, including truck beds, vessels, vaults, pipes, and beams were also placed in the pit. These materials were intended to simulate the type of waste found in existing TRU buried waste pits and trenches. A series of commercially available equipment items, such as excavators and tracked loaders outfitted with different end effectors, were used to remove the simulated waste. Work was performed from both the abovegrade and belowgrade positions. During the demonstration, a number of observations, measurements, and analyses were performed to determine which equipment was the most effective in removing the waste. The retrieval rates for the various excavation techniques were recorded. The inherent dust control capabilities of the excavation methods used were also observed

  1. Challenging convention: symbolic interactionism and grounded theory.

    Science.gov (United States)

    Newman, Barbara

    2008-01-01

    Not very much is written in the literature about decisions made by researchers and the justifications on method as a result of a particular clinical problem, together with an appropriate and congruent theoretical perspective, particularly for Glaserian grounded theory. I contend the utilisation of symbolic interactionism as a theoretical perspective to inform and guide the evolving research process and analysis of data when using classic or Glaserian grounded theory (GT) method, is not always appropriate. Within this article I offer an analysis of the key issues to be addressed when contemplating the use of Glaserian GT and the utilisation of an appropriate theoretical perspective, rather than accepting convention of symbolic interactionism (SI). The analysis became imperative in a study I conducted that sought to explore the concerns, adaptive behaviours, psychosocial processes and relevant interactions over a 12-month period, among newly diagnosed persons with end stage renal disease, dependent on haemodialysis in the home environment for survival. The reality of perception was central to the end product in the study. Human ethics approval was granted by six committees within New South Wales Health Department and one from a university.

  2. Non-conventional fuel tax credit

    International Nuclear Information System (INIS)

    Soeoet, P.M.

    1988-01-01

    Coal-seam methane, along with certain other non-conventional fuels, is eligible for a tax credit. This production tax credit allowed coal-seam methane producers to receive $0.7526 per million Btu of gas sold during 1986. In 1987, this credit rose to $0.78 per million Btu. The tax credit is a very significant element of the economic analysis of current coal-seam methane projects. In today's spot market, gas prices are around $1.50 per million Btu. Allowing for costs of production, the gas producer will net more income from the tax credit than from the sale of the gas. The Crude Oil Windfall Profit Tax Act of 1980 is the source of this tax credit. There were some minor changes made by subsequent legislation, but most of the tax credit has remained intact. Wells must be drilled by 1990 to qualify for the tax credit but the production from such wells is eligible for the tax credit until 2001. Projections have been made, showing that the tax credit should increase to $0.91 per million Btu for production in 1990 and $1.34 per million Btu in 2000. Variables which may decrease the tax credit from these projections are dramatically lower oil prices or general economic price deflation

  3. The Convention on the Recognition and Enforcement of Foreign ...

    African Journals Online (AJOL)

    The Convention on the Recognition and Enforcement of Foreign Arbitral Awards, often referred to as the New York Convention, has established itself as a regulatory and enforcement instrument which is crucial to international trade. This is evident from the fact that more than 150 countries have so far ratified the convention.

  4. Trends, Fashions, Patterns, Norms, Conventions...and Hypertext Too.

    Science.gov (United States)

    Amitay, Einat

    2001-01-01

    Outlines the theory behind the formation of language conventions, then reveals conventions evolving in the community of people writing hypertext on the Web. Demonstrates how these conventions can be used to augment and shift the meaning of already published hypertexts. Describes the system called InCommonSense, which reuses particular hypertext…

  5. Comparison of single-port and conventional laparoscopic abdominoperineal resection

    DEFF Research Database (Denmark)

    Nerup, Nikolaj; Rosenstock, Steffen; Bulut, Orhan

    2018-01-01

    with conventional laparoscopy and 12 with SP surgery. RESULTS: Patients' characteristics were in general comparable, but patients in the conventional laparoscopy-group had a significantly higher American Society of Anesthesiologists-score. The operative time was slightly shorter in the conventional laparoscopy...

  6. Assessment of undiscovered conventional oil and gas resources of Thailand

    Science.gov (United States)

    Schenk, Chris

    2011-01-01

    The U.S. Geological Survey estimated mean volumes of 1.6 billion barrels of undiscovered conventional oil and 17 trillion cubic feet of undiscovered conventional natural gas in three geologic provinces of Thailand using a geology-based methodology. Most of the undiscovered conventional oil and gas resource is estimated to be in the area known as offshore Thai Basin province.

  7. 30 CFR 75.206 - Conventional roof support.

    Science.gov (United States)

    2010-07-01

    ... HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Roof Support § 75.206 Conventional roof support. (a) Except in anthracite mines using non-mechanized mining systems, when conventional roof support... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Conventional roof support. 75.206 Section 75...

  8. Minamata Convention on Mercury. Reporting obligations of the Parties to the Convention and the sources of data existing in Poland

    Directory of Open Access Journals (Sweden)

    Strzelecka-Jastrząb Ewa

    2018-01-01

    Full Text Available After that, when more than 60 years ago in the Japanese city of Minamata there was caused a mass poisoning of residents by seafood contaminated with mercury, Minamata Convention on Mercury came into force on August 16, 2017. To date, the Convention has been signed by 128 States, the signatories of the Convention and ratified by 83 States - Parties to the Convention. The Convention imposes a number of obligations on the Parties to the Convention, including the reporting obligation. The paper analyses the reporting obligations of the Parties to the Convention, which are in force after the entry into force of the Convention, pursuant to the provisions contained therein. In addition, the existing sources of quantitative data on mercury in Poland are characterized.

  9. Conventional treatment planning optimization using simulated annealing

    International Nuclear Information System (INIS)

    Morrill, S.M.; Langer, M.; Lane, R.G.

    1995-01-01

    Purpose: Simulated annealing (SA) allows for the implementation of realistic biological and clinical cost functions into treatment plan optimization. However, a drawback to the clinical implementation of SA optimization is that large numbers of beams appear in the final solution, some with insignificant weights, preventing the delivery of these optimized plans using conventional (limited to a few coplanar beams) radiation therapy. A preliminary study suggested two promising algorithms for restricting the number of beam weights. The purpose of this investigation was to compare these two algorithms using our current SA algorithm with the aim of producing a algorithm to allow clinically useful radiation therapy treatment planning optimization. Method: Our current SA algorithm, Variable Stepsize Generalized Simulated Annealing (VSGSA) was modified with two algorithms to restrict the number of beam weights in the final solution. The first algorithm selected combinations of a fixed number of beams from the complete solution space at each iterative step of the optimization process. The second reduced the allowed number of beams by a factor of two at periodic steps during the optimization process until only the specified number of beams remained. Results of optimization of beam weights and angles using these algorithms were compared using a standard cadre of abdominal cases. The solution space was defined as a set of 36 custom-shaped open and wedged-filtered fields at 10 deg. increments with a target constant target volume margin of 1.2 cm. For each case a clinically-accepted cost function, minimum tumor dose was maximized subject to a set of normal tissue binary dose-volume constraints. For this study, the optimized plan was restricted to four (4) fields suitable for delivery with conventional therapy equipment. Results: The table gives the mean value of the minimum target dose obtained for each algorithm averaged over 5 different runs and the comparable manual treatment

  10. Conventions for reporting and displaying overflight observations

    International Nuclear Information System (INIS)

    McFarland, B.; Murphy, J.; Simecek-Beatty, D.

    1993-01-01

    During the critical initial phases of an oil spill response, as observations and reports come in from different agencies and companies, descriptions and representations can vary widely. These apparently conflicting reports can cause unnecessary confusion, wasting valuable time and resources. As the number of open-quotes expertsclose quotes and the amount of open-quotes necessaryclose quotes information multiply, the potential for information overload also increases. Important information that needs to be presented can be lost in the flood of information that is available. For many years the National Oceanic and Atmospheric Administration (NOAA), in support of the US Coast Guard, has coordinated scientific input concerning the tracking and prediction of the transport of oil spilled in the marine environment. This role frequently involves recording visual or remote sensing observations from multiple platforms and observers, and displaying the information in a clear format, which needs to be rapidly available and unambiguous. Simple graphic products help identify conflicting views of information and allow responders to quickly build a open-quotes graphic consensusclose quotes of the situation. To this end the authors have developed in-house guidelines for presentation of crucial response information. Because correctly designed graphics can clearly and rapidly transmit large amounts of information, these guidelines focus on the graphic presentation of information. Some of these same conventions and criteria are being applied in evaluating and developing information acquisition and display tools. This poster presentation includes examples of the hardware and software used by Genwest and NOAA for the rapid display of response information

  11. Biodegradable and compostable alternatives to conventional plastics

    Science.gov (United States)

    Song, J. H.; Murphy, R. J.; Narayan, R.; Davies, G. B. H.

    2009-01-01

    Packaging waste forms a significant part of municipal solid waste and has caused increasing environmental concerns, resulting in a strengthening of various regulations aimed at reducing the amounts generated. Among other materials, a wide range of oil-based polymers is currently used in packaging applications. These are virtually all non-biodegradable, and some are difficult to recycle or reuse due to being complex composites having varying levels of contamination. Recently, significant progress has been made in the development of biodegradable plastics, largely from renewable natural resources, to produce biodegradable materials with similar functionality to that of oil-based polymers. The expansion in these bio-based materials has several potential benefits for greenhouse gas balances and other environmental impacts over whole life cycles and in the use of renewable, rather than finite resources. It is intended that use of biodegradable materials will contribute to sustainability and reduction in the environmental impact associated with disposal of oil-based polymers. The diversity of biodegradable materials and their varying properties makes it difficult to make simple, generic assessments such as biodegradable products are all ‘good’ or petrochemical-based products are all ‘bad’. This paper discusses the potential impacts of biodegradable packaging materials and their waste management, particularly via composting. It presents the key issues that inform judgements of the benefits these materials have in relation to conventional, petrochemical-based counterparts. Specific examples are given from new research on biodegradability in simulated ‘home’ composting systems. It is the view of the authors that biodegradable packaging materials are most suitable for single-use disposable applications where the post-consumer waste can be locally composted. PMID:19528060

  12. Joint implementation in the climate change convention

    International Nuclear Information System (INIS)

    Merkus, H.; Heintz, R.

    1994-01-01

    The United Nations Climate Change Convention offers developed countries the possibility to realize a part of their obligations elsewhere via financing of emission reduction activities. This so-called joint implementation (JI) enlarges the effectiveness of the international climate change policy. It is assumed that the marginal costs of the emission reductions differ between countries. The application of JI has benefits, but also bears risks. With regard to potential nett benefits and costs/risks it is of interest to distinguish between micro-effects (on a project level), macro-effects (on a national level) and global effects, focusing on JI between OECD countries and developing countries. Five comments on this tripartite are made: (1) it is important to gain insight in the JI potential; (2) JI can contribute to projects of a high development priority; (3) there is a chance that parties, involved in JI, claim more reductions (credits) than take place in reality (double counting); (4) there exists the risk of a delay of technological progress; and (5) the danger exists that JI causes a minor stimulus for developing countries to accept emission reduction obligations. A functional JI-system demands criteria that limits the risks and optimize the benefits. The main criteria concern verification of realized emission reductions; an acceptable balance between measures in one's own country and JI, for which three mechanisms are briefly discussed (partial credit entry, funds, and separated targets); and additionality of JI-financing. Side criteria are the monitoring, verification and control of the possession of the credits. Finally attention is paid to the role of the government in JI and further developments and chances for JI. 7 refs

  13. Gravitational collapse of conventional polytropic cylinder

    Science.gov (United States)

    Lou, Yu-Qing; Hu, Xu-Yao

    2017-07-01

    In reference to general polytropic and conventional polytropic hydrodynamic cylinders of infinite length with axial uniformity and axisymmetry under self-gravity, the dynamic evolution of central collapsing mass string in free-fall dynamic accretion phase is re-examined in details. We compare the central mass accretion rate and the envelope mass infall rate at small radii. Among others, we correct mistakes and typos of Kawachi & Hanawa (KH hereafter) and in particular prove that their key asymptotic free-fall solution involving polytropic index γ in the two power exponents is erroneous by analytical analyses and numerical tests. The correct free-fall asymptotic solutions at sufficiently small \\hat{r} (the dimensionless independent self-similar variable) scale as {˜ } -|ln \\hat{r}|^{1/2} in contrast to KH's ˜ -|ln \\hat{r}|^{(2-γ )/2} for the reduced bulk radial flow velocity and as {˜ } \\hat{r}^{-1}|ln \\hat{r}|^{-1/2} in contrast to KH's {˜ } \\hat{r}^{-1} |ln \\hat{r}|^{-(2-γ )/2} for the reduced mass density. We offer consistent scenarios for numerical simulation code testing and theoretical study on dynamic filamentary structure formation and evolution as well as pertinent stability properties. Due to unavoidable Jeans instabilities along the cylinder, such collapsing massive filaments or strings can further break up into clumps and segments of various lengths as well as clumps embedded within segments and evolve into chains of gravitationally collapsed objects (such as gaseous planets, brown dwarfs, protostars, white dwarfs, neutron stars, black holes in a wide mass range, globular clusters, dwarf spheroidals, galaxies, galaxy clusters and even larger mass reservoirs etc.) in various astrophysical and cosmological contexts as articulated by Lou & Hu recently. As an example, we present a model scheme for comparing with observations of molecular filaments for forming protostars, brown dwarfs and gaseous planets and so forth.

  14. Biodegradable and compostable alternatives to conventional plastics.

    Science.gov (United States)

    Song, J H; Murphy, R J; Narayan, R; Davies, G B H

    2009-07-27

    Packaging waste forms a significant part of municipal solid waste and has caused increasing environmental concerns, resulting in a strengthening of various regulations aimed at reducing the amounts generated. Among other materials, a wide range of oil-based polymers is currently used in packaging applications. These are virtually all non-biodegradable, and some are difficult to recycle or reuse due to being complex composites having varying levels of contamination. Recently, significant progress has been made in the development of biodegradable plastics, largely from renewable natural resources, to produce biodegradable materials with similar functionality to that of oil-based polymers. The expansion in these bio-based materials has several potential benefits for greenhouse gas balances and other environmental impacts over whole life cycles and in the use of renewable, rather than finite resources. It is intended that use of biodegradable materials will contribute to sustainability and reduction in the environmental impact associated with disposal of oil-based polymers. The diversity of biodegradable materials and their varying properties makes it difficult to make simple, generic assessments such as biodegradable products are all 'good' or petrochemical-based products are all 'bad'. This paper discusses the potential impacts of biodegradable packaging materials and their waste management, particularly via composting. It presents the key issues that inform judgements of the benefits these materials have in relation to conventional, petrochemical-based counterparts. Specific examples are given from new research on biodegradability in simulated 'home' composting systems. It is the view of the authors that biodegradable packaging materials are most suitable for single-use disposable applications where the post-consumer waste can be locally composted.

  15. The semantics of Chemical Markup Language (CML): dictionaries and conventions

    Science.gov (United States)

    2011-01-01

    The semantic architecture of CML consists of conventions, dictionaries and units. The conventions conform to a top-level specification and each convention can constrain compliant documents through machine-processing (validation). Dictionaries conform to a dictionary specification which also imposes machine validation on the dictionaries. Each dictionary can also be used to validate data in a CML document, and provide human-readable descriptions. An additional set of conventions and dictionaries are used to support scientific units. All conventions, dictionaries and dictionary elements are identifiable and addressable through unique URIs. PMID:21999509

  16. The semantics of Chemical Markup Language (CML): dictionaries and conventions.

    Science.gov (United States)

    Murray-Rust, Peter; Townsend, Joe A; Adams, Sam E; Phadungsukanan, Weerapong; Thomas, Jens

    2011-10-14

    The semantic architecture of CML consists of conventions, dictionaries and units. The conventions conform to a top-level specification and each convention can constrain compliant documents through machine-processing (validation). Dictionaries conform to a dictionary specification which also imposes machine validation on the dictionaries. Each dictionary can also be used to validate data in a CML document, and provide human-readable descriptions. An additional set of conventions and dictionaries are used to support scientific units. All conventions, dictionaries and dictionary elements are identifiable and addressable through unique URIs.

  17. Nuclear liability: Joint protocol relating to the application of the Vienna Convention and the Paris Convention, 1988

    International Nuclear Information System (INIS)

    1989-10-01

    The Joint Protocol Relating to the Application of the Vienna Convention and the Paris Convention was adopted by the Conference on the Relationship between the Paris Convention and the Vienna Convention, which met in Vienna, at the Headquarters of the International Atomic Energy Agency on 21 September 1988. The Joint Protocol establishes a link between the Paris Convention on Third Party Liability in the Field of Nuclear Energy of 1960 and the Vienna Convention on Civil Liability for Nuclear Damage of 1963. The Joint Protocol will extend to the States adhering to it the coverage of the two Conventions. It will also resolve potential conflicts of law, which could result from the simultaneous application of the two Conventions to the same nuclear accident. The Conference on the Relationship between the Paris Convention and the Vienna Convention was jointly organized by the International Atomic Energy Agency and the OECD Nuclear Energy Agency. This publication contains the text of the Final Act of the Conference in the six authentic languages, the Joint Protocol Relating to the Application of the Vienna Convention and the Paris Convention, also in the six authentic languages and an explanatory note, prepared by the IAEA and NEA Secretariats, providing background information on the content of the Joint Protocol

  18. The economics of developing non-conventional reserves

    International Nuclear Information System (INIS)

    Kuuskraa, V.A.

    1997-01-01

    A fact-based perspective on the economics of non-conventional natural gas reserves such as coalbed methane, gas shales and tight gas was presented. Traditionally, tax credits stimulate the development of non-conventional gas. Although tax credits for non-conventional gas development stopped at the end of 1992, because of improved technologies, improved finding rates and well productivities, non-conventional reserves continue to play a major role in the U.S. gas drilling development. Non-conventional reserves account for three out of five gas wells drilled in the U.S. The non-conventional gas industry competes directly with the conventional natural gas industry. This paper examined how well non-conventional gas compares to the current replacement costs of conventional natural gas. Investment costs for a non-conventional operation were studied, illustrated by an overview of the costs and economics of non-conventional reserves in the San Juan coal basin, the Piceance tight gas basin and the Michigan and Ft. Worth gas shales basins. 9 tabs

  19. The dependence of Islamic and conventional stocks: A copula approach

    Science.gov (United States)

    Razak, Ruzanna Ab; Ismail, Noriszura

    2015-09-01

    Recent studies have found that Islamic stocks are dependent on conventional stocks and they appear to be more risky. In Asia, particularly in Islamic countries, research on dependence involving Islamic and non-Islamic stock markets is limited. The objective of this study is to investigate the dependence between financial times stock exchange Hijrah Shariah index and conventional stocks (EMAS and KLCI indices). Using the copula approach and a time series model for each marginal distribution function, the copula parameters were estimated. The Elliptical copula was selected to present the dependence structure of each pairing of the Islamic stock and conventional stock. Specifically, the Islamic versus conventional stocks (Shariah-EMAS and Shariah-KLCI) had lower dependence compared to conventional versus conventional stocks (EMAS-KLCI). These findings suggest that the occurrence of shocks in a conventional stock will not have strong impact on the Islamic stock.

  20. Unbiased quantitative testing of conventional orthodontic beliefs.

    Science.gov (United States)

    Baumrind, S

    1998-03-01

    This study used a preexisting database to test in hypothesis from the appropriateness of some common orthodontic beliefs concerning upper first molar displacement and changes in facial morphology associated with conventional full bonded/banded treatment in growing subjects. In an initial pass, the author used data from a stratified random sample of 48 subjects drawn retrospectively from the practice of a single, experienced orthodontist. This sample consisted of 4 subgroups of 12 subjects each: Class I nonextraction, Class I extraction, Class II nonextraction, and Class II extraction. The findings indicate that, relative to the facial profile, chin point did not, on average, displace anteriorly during treatment, either overall or in any subgroup. Relative to the facial profile, Point A became significantly less prominent during treatment, both overall and in each subgroup. The best estimate of the mean displacement of the upper molar cusp relative to superimposition on Anterior Cranial Base was in the mesial direction in each of the four subgroups. In only one extraction subject out of 24 did the cusp appear to be displaced distally. Mesial molar cusp displacement was significantly greater in the Class II extraction subgroup than in the Class II nonextraction subgroup. Relative to superimposition on anatomical "best fit" of maxillary structures, the findings for molar cusp displacement were similar, but even more dramatic. Mean mesial migration was highly significant in both the Class II nonextraction and Class II extraction subgroups. In no subject in the entire sample was distal displacement noted relative to this superimposition. Mean increase in anterior Total Face Height was significantly greater in the Class II extraction subgroup than in the Class II nonextraction subgroup. (This finding was contrary to the author's original expectation.) The generalizability of the findings from the initial pass to other treated growing subjects was then assessed by

  1. Distance Education at Conventional Universities in Germany

    Directory of Open Access Journals (Sweden)

    Hans-Henning Kappel

    2002-01-01

    Full Text Available Germany’s educational system has undergone a series of transformations during the last 40 years. In recent years, marked increases in enrolment have occurred. In response, admission requirements have been relaxed and new universities have been established.Academic distance education in the former Federal Republic of Germany (West Germany was ushered in by the educational radio broadcasts around the end of the 1960s. Aside from the formation of the FernUniversität (Open University in West Germany in 1975, there were significant developments in distance education occurring at the major universities in the German Democratic Republic (East Germany. After German reunification in 1990, the new unitary state launched programs to advance the development of distance education programs at conventional universities.Germany’s campus-based universities (Präsenzuniversitäten created various entities, including central units and consortia of universities to design and market distance education programs. Hybridisation provides the necessary prerequisites for dual mode delivery, such as basic and continuing education programs, as well as for the combination of distance and campus-based education (Präsenzstudium. Hybridisation also has also opened the door for the creation of new programs.Following an initial phase in which distance education research is expected to centralize a trend towards decentralisation is likely to follow. The German Association for Distance Education (AG-F offers a viable research network in distance education. Two dual mode case studies are also be surveyed: The Master of Arts degree, offered by the University of Koblenz-Landau, with Library Science as the second major, and the University of Kaiserslautern, where basic education will continue to be captured within the domain of the Präsenzstudium or campus-based education.The area in which distance education is flourishing most is within the field of academic continuing

  2. Safeguards for a nuclear weapon convention

    International Nuclear Information System (INIS)

    Fischer, D.

    1999-01-01

    An NDT presupposes a fundamental commitment by all parties to its final objective and hence requires a high and sustained level of confidence amongst all states concerned. The appropriate format for an Nuclear Disarmament Treaty (NDT) would probably be a multilateral treaty open to all states. The treaty must necessarily include the five nuclear weapon states and a procedure would have to be found for securing the ratification of the threshold states without conferring upon them the status of nuclear weapon states. While the IAEA may well be able to carry out the safeguards tasks required by an NDT it would probably be necessary to establish a new international organization to verify the elimination of all nuclear weapons. The experience of UNSCOM and the IAEA in Iraq, and of the IAEA in the DPRK, have shown how difficult the verification of international obligations is in the absence of a commitment to disarm, while the experience of the INF and START treaties, and of the IAEA in South Africa have shown how much simpler it is when the parties concerned are fully committed to the process. Verifying and safeguarding an NDT would be largely an extrapolation of activities already carried out by the nuclear weapon states under the INF and START treaties and by the IAEA in the routine application of safeguards as well as in its less routine work in Iraq, South Africa and the DPRK. Both the verification and safeguarding tasks would be made very much easier if it were possible to bring down to a few hundred the number of nuclear warheads remaining in the hands of any avowed nuclear weapon state, and to conclude a cutoff convention. Experience is needed to show whether the additional safeguards authority accorded to the IAEA by 'programme 93+2' will enable it to effectively safeguard the facilities that would be decommissioned as a result of an NDT and those that would remain in operation to satisfy civilian needs. Subject to this rider and on condition that the IAEA

  3. Update on the use of steroids in rheumatoid arthritis.

    Science.gov (United States)

    García-Magallón, Blanca; Silva-Fernández, Lucía; Andreu-Sánchez, José Luis

    2013-01-01

    Corticosteroids are a mainstay in the therapy of rheumatoid arthritis (RA). In recent years, a number of high-quality controlled clinical trials have shown their effect as a disease-modifying anti-rheumatic drug (DMARD) and a favourable safety profile in recent-onset RA. Despite this, they are more frequently used as bridge therapy while other DMARDs initiate their action than as true disease-modifying agents. Low-dose corticosteroid use during the first two years of disease slows radiologic damage and reduces the need of biologic therapy aimed at reaching a state of clinical remission in recent-onset RA. Thus, their systematic use in this clinical scenario should be considered. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  4. The framework convention on climate change a convention for sustainable energy development

    Energy Technology Data Exchange (ETDEWEB)

    Hassing, P.; Mendis, M.S.; Menezes, L.M.; Gowen, M.M.

    1996-12-31

    In 1992, over 165 countries signed the United Nation`s Framework Convention on Climate Change (FCCC). These countries have implicitly agreed to alter their `anthropogenic activities` that increase the emissions of greenhouse gases (GHGs) into the atmosphere and deplete the natural sinks for these same greenhouse gases. The energy sector is the major source of the primary anthropogenic GHGs, notably carbon dioxide and methane. The Organization for Economic Co-operation and Development (OECD) countries presently account for the major share of GHG emissions from the energy sector. However, the developing countries are also rapidly increasing their contribution to global GHG emissions as a result of their growing consumption of fossil-based energy. Implementation of this global climate change convention, if seriously undertaken by the signatory countries, will necessitate changes in the energy mix and production processes in both the OECD and developing countries. International actions also will be needed to put the world on a sustainable energy path. By adoption of the FCCC, representatives of the world`s populations have indicated their desire to move toward such a path. The Conference of Parties to the Convention has just concluded its second meeting, at which the Parties endorsed a U.S. proposal that legally binding and enforceable emissions targets be adopted. It is clearly evident that the FCCC, as presently operating, cannot achieve the objective of stabilizing GHG concentrations in the atmosphere unless it adopts a major protocol to significantly reduce anthropogenic GHG emissions. As demonstrated here, a good starting point in determining the steps the Parties to the FCCC should take in designing a protocol is to remember that the primary source of anthropogenic GHG emissions is the consumption of fossil fuels and the future growth of GHG emissions will derive primarily from the ever-increasing demand for and consumption of these fuels.

  5. Roselle improvement through conventional and mutation breeding

    International Nuclear Information System (INIS)

    Mohamad Omar; Mohd Nazir Basiran; Azhar Mohamad; Shuhaimi Shamsuddin

    2002-01-01

    Roselle (Hibiscus sabdariffa L.) from Malvaceae family is relatively a new crop in Malaysia. The origin is not fully known but believed to be from West Africa, although the plant is found native from India to Malaysia. The calyxes, stems and leaves are acid and closely resemble the cranberry (Vaccinium spp.) in flavour. Anthocyanins, which are now receiving a growing importance as natural food colorant, are responsible for the red to purple color of the calyx and other parts of the plant. The calyxes from the flowers are processed to produce juice for drink containing very high vitamin C (ascorbic acid), and also into jam, jelly and dried products. Interestingly, many other parts of the plant are also claimed to have various medicinal values. Presently, roselle is planted in Terengganu (175 ha in 2002) on bris soils, but its planting has spread to some parts of Kelantan, Pahang, Johor and also Sarawak. The number of roselle varieties available for planting is very limited; however, the effort carried out for roselle improvement thus far is equally very limited. There has been very little serious conventional breeding attempted, although varietal evaluation has had been carried out, particularly in form of agronomic trials. Since 1999, several studies on induced mutations have been attempted at UKM. A preliminary polyploidization study was conducted to determine the effects of colchicine concentrations of 0%, 0.04%, 0.08%, 0.12% and 0.16% and soaking times of 2 and 4 hours at room temperature (30 degree C) on 2-day old germinated seeds on morpho-agronomic traits (e.g. number of branches, internode length, leaf length, leaf width, number of flowers and days to flowering), ploidy level and pollen grain size in treated and also derived generations. Flow cytometric analyses of nuclear DNA AT content of leaf samples using LB01 lysis buffer and DNA specific fluorochrome DAPI (4',6-diamidino-2-phenylindole) staining were carried out using a flow cytometer at MINT, Bangi

  6. Are nuclear ships environmentally safer than conventionally powered ships

    International Nuclear Information System (INIS)

    Bone, C.A.; Molgaard, C.A.; Helmkamp, J.C.; Golbeck, A.L.

    1988-01-01

    An epidemiologic analysis was conducted to determine if risk of hospitalization varied by age, ship type, or occupation between nuclear and conventional powered ship crews in the U.S. Navy. Study cohorts consisted of all male enlisted personnel who served exclusively aboard conventional or nuclear powered aircraft carriers and cruisers during the years 1975-1979; cases were those men hospitalized during this period (N = 48,242). Conventional ship personnel showed significantly elevated rates of injury and disease when compared to nuclear ship personnel. The largest relative risks by age occurred for conventional ship crewmen less than 30 years old. Seaman, logistics (supply), and healthcare personnel serving aboard conventional ships comprised the occupational groups exhibiting the highest hospitalization rate differentials. The results strongly suggest that nuclear ships provide a healthier, safer working and living environment than conventional ships

  7. International nuclear liability conventions: status and possible changes

    International Nuclear Information System (INIS)

    Reyners, Patrick.

    1978-01-01

    The table of ratifications and accessions annexed to this paper shows that despite the considerable progress achieved these past years and the entry into force of the Vienna Convention, the number of Contracting Parties to the Nuclear Civil Liability Conventions remains insufficient. The adaptation of the first of these Conventions - the Paris Convention - as well as its Brussels Supplementary Convention to the technical and economic developments which have taken place since their adoption should provide the means for encouraging their implementation at international level. The main amendments which are envisaged are replacement of the present unit of account by the Special Drawing Right, the increase of the amounts of liability and compensation and finally, the technical scope of the Paris Convention. (NEA) [fr

  8. Beyond the conventional: meeting the challenges of landscape governance within the European Landscape Convention?

    Science.gov (United States)

    Scott, Alister

    2011-10-01

    Academics and policy makers seeking to deconstruct landscape face major challenges conceptually, methodologically and institutionally. The meaning(s), identity(ies) and management of landscape are controversial and contested. The European Landscape Convention provides an opportunity for action and change set within new governance agendas addressing interdisciplinarity and spatial planning. This paper critically reviews the complex web of conceptual and methodological frameworks that characterise landscape planning and management and then focuses on emerging landscape governance in Scotland within a mixed method approach involving policy analyses, semi-structured interviews and best practice case studies. Using Dower's (2008) criteria from the Articles of the European Landscape Convention, the results show that whilst some progress has been made in landscape policy and practice, largely through the actions of key individuals and champions, there are significant institutional hurdles and resource limitations to overcome. The need to mainstream positive landscape outcomes requires a significant culture change where a one-size-fits-all approach does not work. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Effects of feeding high protein or conventional canola meal on dry cured and conventionally cured bacon.

    Science.gov (United States)

    Little, K L; Bohrer, B M; Stein, H H; Boler, D D

    2015-05-01

    Objectives were to compare belly, bacon processing, bacon slice, and sensory characteristics from pigs fed high protein canola meal (CM-HP) or conventional canola meal (CM-CV). Soybean meal was replaced with 0 (control), 33, 66, or 100% of both types of canola meal. Left side bellies from 70 carcasses were randomly assigned to conventional or dry cure treatment and matching right side bellies were assigned the opposite treatment. Secondary objectives were to test the existence of bilateral symmetry on fresh belly characteristics and fatty acid profiles of right and left side bellies originating from the same carcass. Bellies from pigs fed CM-HP were slightly lighter and thinner than bellies from pigs fed CM-CV, yet bacon processing, bacon slice, and sensory characteristics were unaffected by dietary treatment and did not differ from the control. Furthermore, testing the existence of bilateral symmetry on fresh belly characteristics revealed that bellies originating from the right side of the carcasses were slightly (P≤0.05) wider, thicker, heavier and firmer than bellies from the left side of the carcass. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Guidelines regarding National Reports under the Convention on Nuclear Safety

    International Nuclear Information System (INIS)

    1999-01-01

    These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties regarding material which it may be useful to include in the national reports required by Article 5 and thereby to facilitate the most efficient review of implementation by the Contracting Parties of their obligations under the Convention

  11. Guidelines regarding national reports under the convention on nuclear safety

    International Nuclear Information System (INIS)

    1998-01-01

    These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties regarding material which it may be useful to include in the national reports required by Article 5 and thereby to facilitate the most efficient review of implementation by the Contracting Parties of their obligations under the Convention

  12. Guidelines regarding National Reports under the Convention on Nuclear Safety

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-10-15

    These guidelines, established by the Contracting Parties pursuant to Article 22 of the Convention, are intended to be read in conjunction with the text of the Convention. Their purpose is to provide guidance to the Contracting Parties regarding material which it may be useful to include in the national reports required by Article 5 and thereby to facilitate the most efficient review of implementation by the Contracting Parties of their obligations under the Convention.

  13. Ambiguities and conventions in the perception of visual art.

    Science.gov (United States)

    Mamassian, Pascal

    2008-09-01

    Vision perception is ambiguous and visual arts play with these ambiguities. While perceptual ambiguities are resolved with prior constraints, artistic ambiguities are resolved by conventions. Is there a relationship between priors and conventions? This review surveys recent work related to these ambiguities in composition, spatial scale, illumination and color, three-dimensional layout, shape, and movement. While most conventions seem to have their roots in perceptual constraints, those conventions that differ from priors may help us appreciate how visual arts differ from everyday perception.

  14. Convention on Contracts for the International Sale of Goods (CISG)

    DEFF Research Database (Denmark)

    Lookofsky, Joseph

    Also sometimes referred to as the Vienna Sales Convention, the Convention on Contracts for the International Sale of Goods (CISG) regulates the rights of buyers and sellers in international sales. The Convention, which first entered into effect in 1988, is the first sales law treaty to win...... with international sales contracts and sales contract disputes will obtain an excellent overview of the Convention, as well as valuable information as to all its 101 Articles, compromising key topic areas such as the following: • Determining when the CISG applies; • Freedom of contract under Article 6...

  15. Convention on Contracts for the International Sale of Goods (CISG)

    DEFF Research Database (Denmark)

    Lookofsky, Joseph

    Also sometimes referred to as the Vienna Sales Convention, the Convention on Contracts for the International Sale of Goods (CISG) regulates the rights of buyers and sellers in international sales. The Convention, which first entered into effect in 1988, is the first sales law treaty to win....... With this monograph as their guide, lawyers and scholars who deal with international sales contracts and sales contract disputes will obtain an excellent overview of the Convention, as well as valuable information as to all its 101 Articles, compromising key topic areas such as the following: • Determining when...

  16. The convention on environmental impact assessment in a transboundary context

    International Nuclear Information System (INIS)

    Schrage, W.

    2000-01-01

    The ECE Convention on Environmental Impact Assessment in a Transboundary Context (EIA Convention) is the first multilateral treaty to specify the procedural rights and duties of Parties with regard to transboundary impacts of proposed activities and to provide procedures, in a transboundary context, for the consideration of environmental impacts in decision-making. The EIA Convention, elaborated under the auspices of the United Nations Economic Commission for Europe (ECE), was adopted at Espoo, Finland, in February 1991. Obligations stipulated, and measures and procedures provided for in this Convention are described. (author)

  17. Conventional breeding strategies to enhance the sustainability of ...

    African Journals Online (AJOL)

    Conventional breeding strategies to enhance the sustainability of Musa biodiversity conservation for endemic cultivars. M Pillay, R Ssebuliba, J Hartman, D Vuylsteke, D Talengera, W Tushemereirwe ...

  18. Military Technology and Conventional Weapons Export Controls: The Wassenaar Arrangement

    National Research Council Canada - National Science Library

    Grimmett, Richard F

    2006-01-01

    This report provides background on the Wassenaar Arrangement, which was formally established in July 1996 as a multilateral arrangement aimed at controlling exports of conventional weapons and related...

  19. Gold Finger: Metal Jewellery as a Disease Modifying Antirheumatic Therapy!

    Directory of Open Access Journals (Sweden)

    T. Hlaing

    2009-01-01

    Full Text Available Polyarticular psoriatic arthritis is a chronic, progressive and disabling auto-immune disease often affecting the small joints of the hands in a symmetrical fashion. The disease can progress rapidly causing joint swelling and damaging cartilage and bone around the joints resulting in severe deformities. We report a very unusual case of a 49-year-old woman who presented with polyarticular psoriatic arthritis affecting all proximal interphalangeal (PIP joints of both hands except the left ring finger PIP joint. On clinical examination there was no evidence of arthritis in the left ring finger PIP joint. We confirmed the paucity of joint damage in the PIP joint of the left ring finger using more modern imaging modalities such as musculoskeletal ultrasound and MRI scan of the small joints of the hands. All other PIP joints in both hands demonstrated advanced degrees of joint damage secondary to chronic psoriatic inflammatory arthritis. We postulated that wearing a gold wedding ring has helped protecting the PIP joint of the left ring finger from the damaging effect of inflammatory arthritis. The possible mechanisms by which metal jewellery (gold ring confer protection to adjacent joints was discussed.

  20. An overview of the biological disease modifying drugs available for ...

    African Journals Online (AJOL)

    transcription factors AP-1 and NF-κB to the cell nucleus, as shown in Figure ... of naïve T cells requires the CD80/86 costimulatory molecules on .... arthritis: abridged Cochrane systematic review and network meta-analysis. Br ... N. Engl J Med.

  1. Transposition into swiss law of the Paris convention and the Brussels supplementary convention, as amended

    International Nuclear Information System (INIS)

    Tami, R.; Daina, S.

    2004-01-01

    Apart from the considerable increase in the amounts of cover, two basic factors lie behind the Swiss government decision to propose shortly to parliament a draft revised L.R.C.N.(federal act on nuclear third party liability). These are, firstly, that the revised Paris/Brussels system still incorporates the principle of the limited liability of the operator of a nuclear installation but now contains a minimum liability amount (liability threshold) and no longer a maximum amount (liability ceiling), and secondly, that the States parties are allowed to provide in their national legislation for the unlimited liability of operators. One of the aims of ratifying the revised conventions is to enable most victims to obtain fair compensation on an egalitarian basis for damage caused by a nuclear incident, and also to join an international system for compensating nuclear damage based on solidarity between states, most of them nuclear. (N.C.)

  2. Defect Detectability Improvement for Conventional Friction Stir Welds

    Science.gov (United States)

    Hill, Chris

    2013-01-01

    This research was conducted to evaluate the effects of defect detectability via phased array ultrasound technology in conventional friction stir welds by comparing conventionally prepped post weld surfaces to a machined surface finish. A machined surface is hypothesized to improve defect detectability and increase material strength.

  3. 7 CFR 7.10 - Conduct of county convention.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Conduct of county convention. 7.10 Section 7.10 Agriculture Office of the Secretary of Agriculture SELECTION AND FUNCTIONS OF AGRICULTURAL STABILIZATION AND... other purpose. (e) The county committee shall give advance public notice of the county convention which...

  4. Islamic vs. conventional banks : Business models, efficiency and stability

    NARCIS (Netherlands)

    Beck, T.H.L.; Demirgüc-Kunt, A.; Merrouche, O.

    2013-01-01

    How different are Islamic banks from conventional banks? Does the recent crisis justify a closer look at the Sharia-compliant business model for banking? When comparing conventional and Islamic banks, controlling for time-variant country-fixed effects, we find few significant differences in business

  5. Interactive Translation Prediction versus Conventional Post-editing in Practice

    DEFF Research Database (Denmark)

    Sanchis-Trilles, German; Alabau, Vicent; Buck, Christian

    2014-01-01

    We conducted a field trial in computer-assisted professional translation to compare Interactive Translation Prediction (ITP) against conventional post- editing (PE) of machine translation (MT) output. In contrast to the conventional PE set-up, where an MT system first produces a static translatio...

  6. Convention on nuclear safety. Rules of procedure and financial rules

    International Nuclear Information System (INIS)

    1999-01-01

    The document is the first revision of the Rules of Procedures and Financial Rules that apply mutatis mutandis to any meetings of the Contracting Parties to the Convention on Nuclear Safety (INFCIRC/573), convened in accordance with the Chapter 3 of the Convention

  7. Moral, Conventional, and Personal Rules: The Perspective of Foster Youth

    Science.gov (United States)

    Mullins, David; Tisak, Marie S.

    2006-01-01

    Forty-five foster youth (9-13 year old and 14-17 year olds) were asked to evaluate moral, conventional, and personal rules and violations by providing judgments and reasons. The results suggest that foster youths' judgments distinguished between the moral, conventional, and personal domains. However, in providing reasons to support their judgments…

  8. Reichenbach and the conventionality of distant simultaneity in perspective

    NARCIS (Netherlands)

    Dieks, D.G.B.J.

    2008-01-01

    We take another look at Reichenbach’s 1920 conversion to conventionalism, with a special eye to the background of his ‘conventionality of distant simultaneity’ thesis. We argue that elements of Reichenbach earlier neo-Kantianism can still be discerned in his later work and, related to this, that his

  9. 26 CFR 521.103 - Scope of the convention.

    Science.gov (United States)

    2010-04-01

    ... convention, to be accomplished on a reciprocal basis, are to avoid double taxation upon major items of income... looking to the avoidance of double taxation and fiscal evasion. (b) The specific classes of income from... UNDER TAX CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents of...

  10. Stakeholder involvement in international conventions governing civil nuclear activities

    International Nuclear Information System (INIS)

    Emmerechts, Sam

    2017-01-01

    Mr Emmerechts explained that international conventions have varying positions on stakeholders and their involvement depending upon the intent of the legislator and the field they cover, ranging from a narrow to a broad interpretation. He addressed stakeholder involvement in two other international conventions governing civil nuclear activities, namely the Convention on Nuclear Safety, and the Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management (the Joint Convention), both concluded under the auspices of the International Atomic Energy Agency (IAEA). He noted that the Convention on Nuclear Safety remains a 'traditional' international legal instrument, focusing on governments and governmental bodies as the main stakeholders and limiting obligations regarding the involvement of the public and intergovernmental organisations to their receiving information and observing. Likewise, the Joint Convention limits obligations regarding public involvement to access to information, notably as to the siting of proposed facilities. However, he noted that in the European Union, the Directive on Nuclear Safety (2014/87/Euratom) and the Directive for the Safe Management of Spent Fuel and Radioactive Waste (2011/70/Euratom) have more advanced public participation requirements in nuclear decision making. Mr Emmerechts explained that the substantial differences between nuclear legislation and the Aarhus and Espoo Conventions with regards to public involvement requirements could partly be explained by the technicality of nuclear information and by issues related to nuclear security

  11. Imaging in hematology. Part 1: Ultrasonography and conventional radiology

    International Nuclear Information System (INIS)

    Zhechev, Y.

    2003-01-01

    Applications of conventional ultrasonography techniques (B-mode or real time) in oncohematology are presented. The newer adaptations (in particular colour Doppler) provide incremental advantages that support their inclusion in the imaging techniques available to modern hematology. Conventional radiologic studies include chest and bone X-ray, gastrointestinal contrast examination and bipedal lymphangiography

  12. Conventional and anomalous quantum Rabi oscillations in graphene

    International Nuclear Information System (INIS)

    Khan, Enamullah; Kumar, Vipin; Kumar, Upendra; Setlur, Girish S.

    2014-01-01

    We study the non linear response of graphene in presence of quantum field in two different regimes. Far from resonance, using our new technique asymptotic rotating wave approximation (ARWA), we obtained that the matter field interaction leads to the slow oscillations like conventional Rabi oscillations observed in conventional semiconductors using well known rotating wave approximation (RWA). The Rabi frequency obtained in both the regimes

  13. Knowing linguistic conventions | Robinson | South African Journal of ...

    African Journals Online (AJOL)

    These are three standard accounts of the epistemic status of linguistic conventions, which all play into the first camp: (1) knowledge by intuition, (2) inferential a priori knowledge and (3) a posteriori knowledge. I give reasons why these accounts should be rejected. I then argue that linguistic conventions, if conceived of as ...

  14. Convention on nuclear safety. Rules of procedure and financial rules

    International Nuclear Information System (INIS)

    1998-01-01

    The document presents the Rules of Procedure and Financial Rules that apply mutatis mutandis to any meeting of the Contracting Parties to the Convention on Nuclear Safety (INFCIRC/449) convened in accordance with Chapter 3 of the Convention. It includes four parts: General provisions, Preparatory process for review meetings, Review meetings, and Amendment and interpretation of rules

  15. Convention on Nuclear Safety. Rules of procedure and financial rules

    International Nuclear Information System (INIS)

    2002-01-01

    The document is the second revision of the Rules of Procedures and Financial Rules that apply mutatis mutandis to any meetings of the Contracting Parties to the Convention on Nuclear Safety (INFCIRC/573), convened in accordance with the Chapter 3 of the Convention

  16. Functional MRI of Conventional and Anomalous Metaphors in Mandarin Chinese

    Science.gov (United States)

    Ahrens, Kathleen; Liu, Ho-Ling; Lee, Chia-Ying; Gong, Shu-Ping; Fang, Shin-Yi; Hsu, Yuan-Yu

    2007-01-01

    This study looks at whether conventional and anomalous metaphors are processed in different locations in the brain while being read when compared with a literal condition in Mandarin Chinese. We find that conventional metaphors differ from the literal condition with a slight amount of increased activation in the right inferior temporal gyrus. In…

  17. 19 CFR 114.2 - Customs Conventions and Agreements.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Customs Conventions and Agreements. 114.2 Section 114.2 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CARNETS General Provisions § 114.2 Customs Conventions and Agreements. The...

  18. National nuclear safety report 1998. Convention on nuclear safety

    International Nuclear Information System (INIS)

    1998-01-01

    The Argentine Republic subscribed the Convention on Nuclear Safety, approved by a Diplomatic Conference in Vienna, Austria, in June 17th, 1994. According to the provisions in Section 5th of the Convention, each Contracting Party shall submit for its examination a National Nuclear Safety Report about the measures adopted to comply with the corresponding obligations. This Report describes the actions that the Argentine Republic is carrying on since the beginning of its nuclear activities, showing that it complies with the obligations derived from the Convention, in accordance with the provisions of its Article 4. The analysis of the compliance with such obligations is based on the legislation in force, the applicable regulatory standards and procedures, the issued licenses, and other regulatory decisions. The corresponding information is described in the analysis of each of the Convention Articles constituting this Report. The present National Report has been performed in order to comply with Article 5 of the Convention on Nuclear Safety, and has been prepared as much as possible following the Guidelines Regarding National Reports under the Convention on Nuclear Safety, approved in the Preparatory Meeting of the Contracting Parties, held in Vienna in April 1997. This means that the Report has been ordered according to the Articles of the Convention on Nuclear Safety and the contents indicated in the guidelines. The information contained in the articles, which are part of the Report shows the compliance of the Argentine Republic, as a contracting party of such Convention, with the obligations assumed

  19. Comparative evaluation of organic and conventional farming on ...

    African Journals Online (AJOL)

    Five samples of organic fruits with seal certification, organic fruits without seal certification and conventional fruits were acquired from supermarkets and farm in Rio de Janeiro, Brazil. Organic lime and orange showed higher mean values of acidity, being 4.5 and 34.8% higher, when compared to conventional fruit, ...

  20. Revision of the Paris and Brussels Conventions of Nuclear Liability

    International Nuclear Information System (INIS)

    Reyners, P.

    2002-01-01

    The Contracting Parties to the 1960 Paris Convention on Third Party Liability in the Field of Nuclear Energy and to the 1963 Brussels Convention Supplementary to the Paris Convention, have concluded this Spring four years of negotiation on the revision of these instruments. This exercise was itself started as a logical consequence of the adoption in 1997 of a revised Vienna Convention on Civil Liability for Nuclear Damage and of a Convention on Supplementary Compensation for Nuclear Damage. The Contracting Parties have concluded that the existing regime established by these Conventions remains viable and sound but that it also warrants improvements to ensure that greater financial security will be available to compensate a potentially larger number of victims in respect of a broader range of nuclear damage. A number of more technical amendments have also been agreed, in particular to ensure compatibility with other existing Conventions in this field. When the revised Paris and Brussels Conventions come into force, the total amount of funds available for compensation, provided by the liable nuclear operator and by the States concerned, will be 1.5 billion euros. (author)

  1. The Vienna Conventions on Early Notification and Assistance

    International Nuclear Information System (INIS)

    Cameron, P.

    1988-01-01

    Following the Chernobyl accident, the IAEA established and opened for signature on 26th September 1986 two Conventions, on Early Notification of a Nuclear Accident and on Assistance in Case of a Nuclear Accident or Radiological Emergency respectively. This chapter describes the Conventions and their origins (NEA) [fr

  2. Comparison of landscape features in organic and conventional farming systems.

    NARCIS (Netherlands)

    Mansvelt, van J.D.; Stobbelaar, D.J.; Hendriks, K.

    1998-01-01

    Four organic (biodynamic) farms coupled with conventional farms from their neighbourhood in The Netherlands, Germany and Sweden, and 3 organic farms and 4 conventional farms from the West Friesean region in The Netherlands were evaluated to compare their impact on landscape diversity. Materials used

  3. Digital luminescence radiography and conventional radiography in abdominal contrast examinations

    International Nuclear Information System (INIS)

    Krug, B.; Harnischmacher, U.; Krahe, T.; Fischbach, R.; Altenburg, A.; Krings, F.

    1995-01-01

    In 326 patients abdominal contrast radiographs were compared to digital luminescence radiographs (DLR) and conventional screen-film system ones. The digital exposure dose was 50% of the conventional. In DLR, 2 different types of postprocessed images were obtained from each data set. A display with low spatial frequency enhancement filtered to look like a conventional radiograph was compared to a display with high spatial frequency enhancement. Conventional and DLR images were evaluated randomly and separately by 4 radiologists by means of a questionnaire. DLR proved to be diagnostically equivalent to the conventional technique with the exception of a slightly diminished visibility of the mucosal pattern. High spatial frequency enhancement did not provide additional diagnostic information and should be dispensed with in abdominal examinations. (orig.)

  4. INTEREST RATES AND CURRENCIES EFFECTS ON ISLAMIC AND CONVENTIONAL BONDS

    Directory of Open Access Journals (Sweden)

    Ghazali Syamni

    2011-09-01

    Full Text Available Bond markets have not been well developed in emerging countries. Realizing its important role, especially after the 1997 crises and the islamic economics development, emerging countries have started to develop such markets. This research examines the effect of interest rates and currencies on Islamic and conventional bonds in Bursa Malaysia. The analysis on Islamic bonds shows that interest rates and currencies do not influence Islamic bonds, which supports the prohibition of interest in Islam. The analysis on conventional bonds finds evidence that both interest rates and currencies affect conventional bond. It also finds evidence of a negative association between interest rates and a conventional bond. Keywords: Interest rate, currency, conventional bond, Islamic bond JEL classification numbers: G11, G12, G15

  5. Environmental impact of non-conventional energy sources

    International Nuclear Information System (INIS)

    Abbasi, S.A.; Abbasi, Naseema; Nipaney, P.C.; Ramasamy, E.V.

    1995-01-01

    Whereas the global attention has always been focused on the adverse environmental impacts of conventional energy sources, only a few studies have been conducted on the clean environment image of the non-conventional energy sources, particularly the renewable ones. The question whether the non-conventional sources are really as benign as they are made out to be is addressed in the present paper in the background of a classical paradigm developed by Lovin which had postulated the hard (malignant) and soft (benign) energy concepts in the first place. It then assesses the likely environmental impacts of several major non-conventional energy sources and comes up with the note of caution that in many cases the adverse impacts may not be insubstantial; indeed in some cases they can be as strongly negative as the impacts of the conventional energy sources. (author). 31 refs

  6. Profit-based conventional resource scheduling with renewable energy penetration

    Science.gov (United States)

    Reddy, K. Srikanth; Panwar, Lokesh Kumar; Kumar, Rajesh; Panigrahi, B. K.

    2017-08-01

    Technological breakthroughs in renewable energy technologies (RETs) enabled them to attain grid parity thereby making them potential contenders for existing conventional resources. To examine the market participation of RETs, this paper formulates a scheduling problem accommodating energy market participation of wind- and solar-independent power producers (IPPs) treating both conventional and RETs as identical entities. Furthermore, constraints pertaining to penetration and curtailments of RETs are restructured. Additionally, an appropriate objective function for profit incurred by conventional resource IPPs through reserve market participation as a function of renewable energy curtailment is also proposed. The proposed concept is simulated with a test system comprising 10 conventional generation units in conjunction with solar photovoltaic (SPV) and wind energy generators (WEG). The simulation results indicate that renewable energy integration and its curtailment limits influence the market participation or scheduling strategies of conventional resources in both energy and reserve markets. Furthermore, load and reliability parameters are also affected.

  7. Amendment of APPRE for Ratification of the International Conventions

    International Nuclear Information System (INIS)

    Yoo, Ho Sik; Kwak, Sung Woo; Chang, Sung Soon; Seo, Hyung Min; Lee, Jeong Hoon; Lee, Jeong Ho

    2010-01-01

    Both the international community and the IAEA have been making efforts to strengthen the global regime on nuclear security. As a result of these efforts, two conventions regarding nuclear security were issued by the UN and IAEA. The International Convention for the Suppression of Acts of Nuclear Terrorism (NTC) and the Amendment to Convention of Physical Protection of Nuclear Material (CPPNMNF). The NTC entered into force in 2007, but the CPPNMNF still has not yet been enacted. In the work plan released after the 2010 Nuclear Security Summit (which was held in Washington D.C) these conventions were mentioned as important tools against nuclear terrorism. The purpose of these conventions was to prevent malicious acts against radioactive materials and nuclear facilities. The article also specifies strong penal provisions. Many countries which had ratified these conventions had to revise or change their domestic acts or laws in order conform to these new international regimes. The ROK signed these two conventions in 2005: however, it has not ratified them yet. The government has a plan to ratify them before the 2012 Nuclear Security Summit, which will be held in the ROK. Each article in the conventions should be reviewed thoroughly in terms of their effects on the domestic legal and institutional systems. The penal provisions regulating the conventions should especially be carefully scrutinized since their effects are considerable. In this paper, we compared the penal provisions in the conventions with the ROK's laws and selected the provisions that are not specified in the ROK's legal system. The proposed articles for amendment to the APPRE are also suggested

  8. Tailings dams from the perspective of conventional dam engineering

    International Nuclear Information System (INIS)

    Szymanski, M.B.

    1999-01-01

    A guideline intended for conventional dams such as hydroelectric, water supply, flood control, or irrigation is used sometimes for evaluating the safety of a tailings dam. Differences between tailings dams and conventional dams are often substantial and, as such, should not be overlooked when applying the techniques or safety requirements of conventional dam engineering to tailings dams. Having a dam safety evaluation program developed specifically for tailings dams is essential, if only to reduce the chance of potential errors or omissions that might occur when relying on conventional dam engineering practice. This is not to deny the merits of using the Canadian Dam Safety Association Guidelines (CDSA) and similar conventional dam guidelines for evaluating the safety of tailings dams. Rather it is intended as a warning, and as a rationale underlying basic requirement of tailings dam emgineering: specific experience in tailings dams is essential when applying conventional dam engineering practice. A discussion is included that focuses on the more remarkable tailings dam safety practics. It is not addressed to a technical publications intended for such dams, or significantly different so that the use of conventional dam engineering practice would not be appropriate. The CDSA Guidelines were recently revised to include tailings dams. But incorporating tailings dams into the 1999 revision of the CDSA Guidelines is a first step only - further revision is necessary with respect to tailings dams. 11 refs., 2 tabs

  9. The 1968 Brussels convention and liability for nuclear damage

    International Nuclear Information System (INIS)

    Sands, Ph.; Galizzi, P.

    2000-01-01

    The legal regime governing civil liability for transboundary nuclear damage is expressly addressed by two instruments adopted in the 1960's: the 1960 Paris Convention on Third Party Liability in the Field of Nuclear Energy and the 1963 Vienna Convention on Civil Liability for Nuclear Damage These establish particular rules governing the jurisdiction of national courts and other matters, including channelling of liability to nuclear operators, definitions of nuclear damage, the applicable standard of care, and limitations on liability. Another instrument - the 1968 Brussels Convention on Jurisdiction and the Enforcement of Judgements in Civil and Commercial Matters (hereinafter referred to as 'the Brussels Convention') - which is not often mentioned in the nuclear context will nevertheless also be applicable in certain cases. It is premised upon different rules as to forum and applicable law, and presents an alternate vision of the appropriate arrangements governing civil liability for nuclear damage. In this paper we consider the relative merits and demerits of the Brussels Convention from the perspective of non-nuclear states which might suffer damage as a result of a nuclear accident in another state. We conclude that in the context of the applicability of the Brussels Convention the dedicated nuclear liability conventions present few attractions to non-nuclear states in Europe. We focus in particular on issues relating to jurisdiction and applicable law, and do so by reference to a hypothetical accident in the United Kingdom which has transboundary effects in Ireland. (author)

  10. Comparing the profitability of organic and conventional broiler production

    Directory of Open Access Journals (Sweden)

    F Cobanoglu

    2014-03-01

    Full Text Available Recently, organic broiler chicken production has received more attention worldwide. This study has carried out an economic analysis to compare the profitability of organic versus conventional growing systems per unit of broiler meat production. To achieve this goal, 400 slow-growing broiler chickens (Hubbard Red-JA were reared in an organic production system, and the same number of fast-growing birds (Ross-308 in a conventional system. The profitability was deduced with an economic analysis that compared total costs and net income. Results showed that organic broiler meat can cost from 70% to 86% more with respect to variable and fixed costs when compared with conventional production. The main reasons for the higher cost of organic broiler meat were feed, labor, certification, and outdoor area maintenance. The proportion of fixed costs in total costs was 1.54% in the conventional system and 7.48% in the organic system. The net income per kg of chicken meat in the organic system was € 0.75, which is 180% higher than chicken meat grown in a conventional system (€ 0.27; however, the price of organic broiler meat sold in the present study was twice as high as that obtained for conventional broilers. In conclusion, organic broiler meat production was more profitable than conventional rearing.

  11. Comparing the profitability of organic and conventional broiler production

    Directory of Open Access Journals (Sweden)

    F Cobanoglu

    2014-12-01

    Full Text Available Organic broiler chicken production has recently received more attention worldwide. This study carried out an economic analysis to compare the profitability of organic versus conventional growing systems per unit of broiler meat production. In this study, 400 slow-growing broilers (Hubbard Red-JA were reared in an organic production system and the same number of fast-growing broilers (Ross-308 were reared in a conventional system. Profitability was deduced from an economic analysis that compared total costs and net income. Results showed that organic broiler meat can cost from 70% to 86% more with respect to variable and fixed costs when compared with conventional production. The main reasons for the higher cost of organic broiler meat were feed, labor, certification, and outdoor area maintenance. The proportion of fixed costs in total costs was 1.54% in the conventional system and 7.48% in the organic system. The net income per kg of chicken meat in the organic system was €0.75, which is 180% higher compared with the conventional system (€0.27; however, organic broiler meat was sold at a twice as high price than the conventional one. In conclusion, organic broiler meat production was more economical than conventional rearing.

  12. Reversing the conventional leather processing sequence for cleaner leather production.

    Science.gov (United States)

    Saravanabhavan, Subramani; Thanikaivelan, Palanisamy; Rao, Jonnalagadda Raghava; Nair, Balachandran Unni; Ramasami, Thirumalachari

    2006-02-01

    Conventional leather processing generally involves a combination of single and multistep processes that employs as well as expels various biological, inorganic, and organic materials. It involves nearly 14-15 steps and discharges a huge amount of pollutants. This is primarily due to the fact that conventional leather processing employs a "do-undo" process logic. In this study, the conventional leather processing steps have been reversed to overcome the problems associated with the conventional method. The charges of the skin matrix and of the chemicals and pH profiles of the process have been judiciously used for reversing the process steps. This reversed process eventually avoids several acidification and basification/neutralization steps used in conventional leather processing. The developed process has been validated through various analyses such as chromium content, shrinkage temperature, softness measurements, scanning electron microscopy, and physical testing of the leathers. Further, the performance of the leathers is shown to be on par with conventionally processed leathers through bulk property evaluation. The process enjoys a significant reduction in COD and TS by 53 and 79%, respectively. Water consumption and discharge is reduced by 65 and 64%, respectively. Also, the process benefits from significant reduction in chemicals, time, power, and cost compared to the conventional process.

  13. Substitutes or Complements? Diagnosis and Treatment with non-Conventional and Conventional Medicine

    Directory of Open Access Journals (Sweden)

    Aida Isabel Tavares

    2015-04-01

    Full Text Available Background Portugal has a strong tradition of conventional western healthcare. So it provides a natural case study for the relationship between Complementary/Alternative Medicine (CAM and Western Medicine (WM. This work aims to test the relationship between CAM and WM users in the diagnosis and treatment stages and to estimate the determinants of CAM choice. Methods The forth Portuguese National Health Survey is employed to estimate two single probit models and obtain the correlation between the consumption of CAM and WM medicines in the diagnosis and treatment stages. Results Firstly, both in the diagnosis and the treatment stage, CAM and WM are seen to be complementary choices for individuals. Secondly, self-medication also shows complementarity with the choice of CAM treatment. Thirdly, education has a non-linear relationship with the choice of CAM. Finally, working status, age, smoking and chronic disease are determinant factors in the decision to use CAM. Conclusion The results of this work are relevant to health policy-makers and for insurance companies. Patients need freedom of choice and, for the sake of safety and efficacy of treatment, WM and CAM healthcare ought to be provided in a joint and integrated health system.

  14. IAEA Director General welcomes landmark convention to combat nuclear terrorism

    International Nuclear Information System (INIS)

    2005-01-01

    Full text: IAEA Director General Mohamed ElBaradei welcomed the adoption of an International convention against nuclear terrorism. 'This is a landmark achievement which will bolster global efforts to combat nuclear terrorism,' Dr. ElBaradei said. 'It will be a key part of international efforts to prevent terrorists from gaining access to nuclear weapons'. The United Nations General Assembly adopted the convention, The International Convention for the Suppression of Acts of Nuclear Terrorism, on 13 April 2005. The Convention strengthens the global legal framework to counter terrorist threats. Based on a proposal by the Russian Federation in 1998, the Convention focuses on criminal offences related to nuclear terrorism and covers a broad range of possible targets, including nuclear reactors as well as nuclear material and radioactive substances. Under its provisions, alleged offenders - for example any individual or group that unlawfully and intentionally possesses or uses radioactive material with the intent to cause harm - must be either extradited or prosecuted. States are also encouraged to cooperate with each other in connection with criminal investigations and extradition proceedings. The Convention further requires that any seized nuclear or radiological material be held in accordance with IAEA safeguards, and handled in keeping with the IAEA's health, safety and physical protection standards. Dr. ElBaradei also recalled that the Agency is in the process of amending the Convention on the Physical Protection of Nuclear Material, in order to broaden its scope, and in so doing, strengthen the current legal framework for securing nuclear material against illicit uses. A conference will be held from 4 to 8 July in Vienna to consider and adopt the amendments. The Convention opens for signature in September this year. Dr ElBaradei urged all States to 'sign and ratify the Convention without delay so nuclear terrorism will have no chance'. (IAEA)

  15. The climate change convention: What role can business play?

    International Nuclear Information System (INIS)

    Zammit Cutajar, M.

    1994-01-01

    The development, content, and some implications of the United Nations Framework Convention on Climate Change are treated briefly. The Climate Change Convention commits those developed countries which have ratified it to limit their emissions of greenhouse gases. While this Convention is an agreement among Governments, and is not directly binding on companies, individuals or organizations, business people and others need to understand it and be prepared for the national initiatives that will follow its ratification. New opportunities are being created for energy-efficient firms, and for new technologies and products. (author)

  16. Patient radiation dose in conventional and xerographic cephalography

    International Nuclear Information System (INIS)

    Copley, R.L.; Glaze, S.A.; Bushong, S.C.; West, D.C.

    1979-01-01

    A comparison of the radiation doses for xeroradiographic and conventional film screen cephalography was made. Alderson tissue-equivalent phantoms were used for patient simulation. An optimum technique in terms of patient dose and image quality indicated that the dose for the Xerox process ranged from five to eleven times greater than that for the conventional process for entrance and exit exposures, respectively. This dose, however, falls within an acceptable range for other dental and medical radiation doses. It is recommended that conventional cephalography be used for routine purposes and that xeroradiography be reserved for situations requiring the increased image quality that the process affords

  17. The history of double tax conventions in Croatia

    Directory of Open Access Journals (Sweden)

    Hrvoje Arbutina

    2014-06-01

    Full Text Available After a short introduction, the authors briefly describe the national experience in handling the problems of international double taxation through double tax conventions. This chapter is divided according to stages in the history of double tax conventions identified. The authors analyse the goals of tax treaty policies in differentiated stages with a survey of the economic implications. Special focus is placed on inter-country influences and the impact on and of international institutions and organisations through an examination of the influence of bilateral tax treaties on model tax conventions and vice versa. The fifth chapter presents concluding observations.

  18. Conventional diagnostic imaging of the temporal bone. A historical review

    International Nuclear Information System (INIS)

    Canigiani, G.

    1997-01-01

    The Viennese Medical School played an important role in the development of radiological examinations and signs of the temporal bone with conventional X-rays. Famous pioneers include E.G. Mayer (1893-1969) and L. Psenner (1910-1986). Nowadays conventional X-rays and tomography have lost their important role in diagnostic radiology of the temporal bone, but the basic principles established in those early years of radiology are still used now. This statement is correct not only for conventional X-rays, but particularly for 'poly'-tomography in comparison with CT. (orig.) [de

  19. Brazil and the UN framework convention on climate change

    International Nuclear Information System (INIS)

    Marques De Souza, J.A.

    1996-01-01

    Due to a high share (96%) of hydropower generation in its electricity production, Brazil emits relatively small amounts of CO 2 . It is argued that, because developed countries are responsible for some 65% of the global emissions of GHGs, they should start to reduce their greenhouse gas emission, which follows also directly from the Framework Convention on Climate Change. After ratification of the Convention Brazil has taken all steps to implement the Convention and to assess its greenhouse gas emissions. Various advisory and co-ordinating bodies have been installed by decree in mid 1994. (author). 1 fig., 1 tab

  20. Soil Microbial Activity in Conventional and Organic Agricultural Systems

    Directory of Open Access Journals (Sweden)

    Romero F.V. Carneiro

    2009-06-01

    Full Text Available The aim of this study was to evaluate microbial activity in soils under conventional and organic agricultural system management regimes. Soil samples were collected from plots under conventional management (CNV, organic management (ORG and native vegetation (AVN. Soil microbial activity and biomass was significantly greater in ORG compared with CNV. Soil bulk density decreased three years after adoption of organic system. Soil organic carbon (SOC was higher in the ORG than in the CNV. The soil under organic agricultural system presents higher microbial activity and biomass and lower bulk density than the conventional agricultural system.

  1. Conventional radiology in the bony compromise of Langerhans cells Histiocytosis

    International Nuclear Information System (INIS)

    Morales, Nilson; Gonzalez, Claudia Patricia; Melendez, Patricia; Terselich, Gretty

    1999-01-01

    We present a descriptive study of 47 patients who attended the National Cancer Institute in Bogota, Colombia with pathological diagnosis of Langerhans cell histiocytosis. We reviewed the most frequent conventional x-ray findings

  2. REMOVAL OF URANIUM FROM DRINKING WATER BY CONVENTIONAL TREATMENT METHODS

    Science.gov (United States)

    The USEPA currently does not regulate uranium in drinking water but will be revising the radionuclide regulations during 1989 and will propose a maximum contaminant level for uranium. The paper presents treatment technology information on the effectiveness of conventional method...

  3. Environmental impact assessment of conventional and organic milk production

    NARCIS (Netherlands)

    Boer, de I.J.M.

    2003-01-01

    Organic agriculture addresses the public demand to diminish environmental pollution of agricultural production. Until now, however, only few studies tried to determine the integrated environmental impact of conventional versus organic production using life cycle assessment (LCA). The aim of this

  4. Third National Report on compliance with the Joint Convention Obligations

    International Nuclear Information System (INIS)

    2008-09-01

    The Joint Convention on the Safety of Spent Fuel Management and the Safety of Radioactive Waste Management, hereinafter referred to as the 'Joint Convention', is the result of international discussions that followed the adoption of the Convention on Nuclear Safety, in 1994. France signed the Joint Convention at the General Conference of the International Atomic Energy Agency (IAEA) held on 29 September 1997, the very first day the Joint Convention was opened for signature. She approved it on 22 February 2000 and filed the corresponding instruments with the IAEA on 27 April 2000. The Joint Convention entered into force on 18 June 2001. For many years, France has been taking an active part in the pursuit of international actions to reinforce nuclear safety and considers the Joint Convention to be a key step in that direction. The fields covered by the Joint Convention have long been part of the French approach to nuclear safety. This report is the third one of its kind. It is published in accordance with Article 32 of the Joint Convention and presents the measures taken by France to meet each of her obligations set out in the Convention. The facilities and the radioactive materials covered by this Convention are quite diversified in nature and are controlled in France by different regulatory authorities. Above a specific threshold of radioactive content, a facility is referred to as a 'basic nuclear facility' (installation nucleaire de base - INB) and placed under the control of the Nuclear Safety Authority (Autorite de surete nucleaire - ASN). Below that threshold and provided that the facility involved is subject to the nomenclature of classified facilities for other purposes than their radioactive materials, any facility may be considered as a 'classified facility on environmental-protection grounds' (installation classee pour la protection de l'environnement - ICPE) and placed under the control of the Ministry for the Environment. Facilities that contain only

  5. Gun barrel erosion - Comparison of conventional and LOVA gun propellants

    NARCIS (Netherlands)

    Hordijk, A.C.; Leurs, O.

    2006-01-01

    The research department Energetic Materials within TNO Defence, Security and Safety is involved in the development and (safety and insensitive munitions) testing of conventional (nitro cellulose based) and thermoplastic elastomer (TPE) based gun propellants. Recently our testing capabilities have

  6. Diagnostic accuracy of the combined use of conventional ...

    African Journals Online (AJOL)

    Ahmad Hafez Afifi

    2016-03-10

    Mar 10, 2016 ... conventional sonography and sonoelastography in differentiating benign and ... Common presentation of cancer thyroid is solid solitary nodule and ..... and Itoh,9 was useful for comparing breast ultrasound and elastographic ...

  7. Application of international maritime protection conventions to radioactive pollution

    International Nuclear Information System (INIS)

    Stein, R.M.; Walden, R.M.

    1975-01-01

    The application of international maritime protection conventions to radioactive pollution is discussed with particular emphasis on the 1972 London Convention on prevention of marine pollution by dumping of wastes and other matter. Under that Convention, wastes are divided into three categories according to their radioactivity. High level wastes, whose dumping is prohibited, and low level wastes which require a special dumping permit are studied on the basis of definitions established by the International Atomic Energy Agency. Mention is made of the IAEA-recommended procedures for issue of the specific dumping as well as of the exceptions provided for ships and aircraft enjoying State immunity and cases of force majeure or emergencies. Also dealt with are the other international Conventions applying to prevention of radioactive marine pollution [fr

  8. China's Foreign Conventional Arms Acquisitions: Background and Analysis

    National Research Council Canada - National Science Library

    Kan, Shirley; Bolkcom, Christopher; O'Rourke, Ronald

    2001-01-01

    This CRS Report examines the major, foreign conventional weapon systems that China has acquired or has committed to acquire since 1990, with particular attention to implications for U.S. security concerns...

  9. Therapeutic Cancer Vaccines in Combination with Conventional Therapy

    DEFF Research Database (Denmark)

    Andersen, Mads Hald; Junker, N.; Ellebaek, E.

    2010-01-01

    The clinical efficacy of most therapeutic vaccines against cancer has not yet met its promise. Data are emerging that strongly support the notion that combining immunotherapy with conventional therapies, for example, radiation and chemotherapy may improve efficacy. In particular combination...

  10. Therapeutic cancer vaccines in combination with conventional therapy

    DEFF Research Database (Denmark)

    Andersen, Mads Hald; Junker, Niels; Ellebaek, Eva

    2010-01-01

    The clinical efficacy of most therapeutic vaccines against cancer has not yet met its promise. Data are emerging that strongly support the notion that combining immunotherapy with conventional therapies, for example, radiation and chemotherapy may improve efficacy. In particular combination...

  11. [NY Convention, Ethiopia's Course of Action Ahead], Amharic

    African Journals Online (AJOL)

    Fekadu_P_G

    Foreign Arbitral Awards: Advantages, Disadvantages and ... The Convention on the Recognition and Enforcement of Foreign Arbitral. Awards ..... also, on the application of the party claiming enforcement of the award, order the other party to.

  12. Orthodontic intrusion : Conventional and mini-implant assisted intrusion mechanics

    Directory of Open Access Journals (Sweden)

    Anup Belludi

    2012-01-01

    intrusion has revolutionized orthodontic anchorage and biomechanics by making anchorage perfectly stable. This article addresses various conventional clinical intrusion mechanics and especially intrusion using mini-implants that have proven effective over the years for intrusion of maxillary anteriors.

  13. The raw milk quality from organic and conventional agriculture

    Directory of Open Access Journals (Sweden)

    Juraj Čuboň

    2008-01-01

    Full Text Available In the experiment the parameters of milk quality from organic and conventional dairy farm were analyzed. The number of somatic cells was 219. 103 . ml−1 in the organic milk and 242. 103 . ml−1 in the conventional milk. It seems that conditions of organic farming could be able to have a positive effect of health of mammary gland. We found the highest number of somatic cells at the end of the year (336.103 . ml−1 in organic milk in December, respectively 336.103 . ml−1 in conventional milk in November. The total bacteria count was higher in organic milk (86.103 CFU . ml−1 than conventional (51.103 CFU . ml−1 likewise the number of coliform bacteria. Number of coliform bacteria was by conventional milk under 1000 CFU . ml−1 for all samples. The highest number of coliform bacteria in organic milk was achieved in February (1000 CFU . ml−1. We found higher content of fat (4.23 g . 100g−1 and protein (3.41 g . 100g−1 by organic milk in comparison with the conventional milk (4.11 g . 100g−1, resp. 3.39 g . 100g−1. The higher content of protein and fat in organic milk and the higher protein content in conventional milk were determined in December. The heat resistance was determined by 96 % ethanol required to coagulation of 2 ml of milk. The conventional milk has significantly lower heat resistance (1.38 ml than the organic one (1.86 ml. Better heat stability by organic milk and higher content of Ca (144.29 mg . 100g−1 correspond with higher technological quality of organic milk.

  14. Specific features of human rights guaranteed by the Aarhus Convention

    Directory of Open Access Journals (Sweden)

    Etinski Rodoljub

    2013-01-01

    Full Text Available The Aarhus Convention legally articulates basic human needs to live in the environment adequate for human health and well-being and to engage in protection and improvement of the environment. It recognized and protected a general human right to adequate environment and three particular rights in environmental matters - to information, to public participation in decision-making and to justice. The Aarhus Convention introduced innovative approach to human rights protection in relation to transboundary issues and legal standing.

  15. The history of double tax conventions in Croatia

    OpenAIRE

    Hrvoje Arbutina; Nataša Žunić Kovačević

    2014-01-01

    After a short introduction, the authors briefly describe the national experience in handling the problems of international double taxation through double tax conventions. This chapter is divided according to stages in the history of double tax conventions identified. The authors analyse the goals of tax treaty policies in differentiated stages with a survey of the economic implications. Special focus is placed on inter-country influences and the impact on and of international institutions and...

  16. Impact of replacement of conventional Recloser with PulseCloser

    OpenAIRE

    Olgert Metko; Rajmonda Bualoti; Engjell Zeqo

    2011-01-01

    Conventional recloser stresses the circuit with current fault every time they reclose into a fault. After clearing a fault, a conventional recloser simply recloses the interrupters to continuously test the presence of the fault. If the fault is still there, the interrupters are tripped again. Then, after a time delay, the interrupters are reclosed. During reclosing operation of Automatic Recloser, including the faster recloser one, powerful transient processes occurs and significant amount of...

  17. Panorama 2017 - New conventional oil and gas discoveries

    International Nuclear Information System (INIS)

    Hureau, Geoffroy; Vially, Roland

    2017-01-01

    In 2016, spending on exploration is expected to decline by approximately 35% for the second consecutive year (total exploration-production is down 24%). However, volumes discovered through conventional exploration should only fall by 25% due to several significant discoveries, particularly in Alaska and West Africa. The largest discovery in 2016 was an unconventional Permian shale basin in the United States, which could alone contain as many hydrocarbons as all of the year's conventional discoveries combined

  18. 1987 Annual convention of the Austrian Physical Society

    International Nuclear Information System (INIS)

    1987-09-01

    This is the pre-convention program of the annual convention to be held in September 1987. The divisions 1) general, 2) nuclear - and particle physics, 3) high-polymer physics have 124 contributions with abstracts, 75 of them of INIS interest. Another 22 contributions from the divisions, 4) atomic -, nuclear - and plasma physics, 5) solid state physics and 6) vocational training, are announced ty titles only. (G.Q.)

  19. Convention on the physical protection of nuclear material

    International Nuclear Information System (INIS)

    1982-01-01

    The document presents the original draft for a Convention on the Physical Protection of Nuclear Material, full reports of all the discussions held by representatives of Member States at meetings called by the IAEA, texts of written comments provided by Member States and the final agreed text of the Convention, list of original signatory States and status of the list of signatory States at the date of publication

  20. Digital Versus Conventional Impressions in Fixed Prosthodontics: A Review.

    Science.gov (United States)

    Ahlholm, Pekka; Sipilä, Kirsi; Vallittu, Pekka; Jakonen, Minna; Kotiranta, Ulla

    2018-01-01

    To conduct a systematic review to evaluate the evidence of possible benefits and accuracy of digital impression techniques vs. conventional impression techniques. Reports of digital impression techniques versus conventional impression techniques were systematically searched for in the following databases: Cochrane Central Register of Controlled Trials, PubMed, and Web of Science. A combination of controlled vocabulary, free-text words, and well-defined inclusion and exclusion criteria guided the search. Digital impression accuracy is at the same level as conventional impression methods in fabrication of crowns and short fixed dental prostheses (FDPs). For fabrication of implant-supported crowns and FDPs, digital impression accuracy is clinically acceptable. In full-arch impressions, conventional impression methods resulted in better accuracy compared to digital impressions. Digital impression techniques are a clinically acceptable alternative to conventional impression methods in fabrication of crowns and short FDPs. For fabrication of implant-supported crowns and FDPs, digital impression systems also result in clinically acceptable fit. Digital impression techniques are faster and can shorten the operation time. Based on this study, the conventional impression technique is still recommended for full-arch impressions. © 2016 by the American College of Prosthodontists.

  1. Choledochal cyst: Comparison of MR and conventional cholangiography

    International Nuclear Information System (INIS)

    Kim, S.H.; Lim, J.H.; Yoon, H.-K.; Han, B.K.; Lee, S.K.; Kim, Y.I.

    2000-01-01

    AIMS: To assess the diagnostic value of magnetic resonance (MR) cholangiography versus conventional cholangiography in patients with choledochal cyst and to determine whether MR cholangiography can be considered an alternative to conventional cholangiography. MATERIALS AND METHODS: Thirteen patients with choledochal cyst were examined by MR cholangiography and conventional cholangiograms. Magnetic resonance cholangiography employed T2-weighted axial and coronal fast spin-echo, single and multislab single-shot fast spin-echo sequences, including source images with maximum intensity projections. The diagnostic value of MR cholangiography and conventional cholangiograms was assessed and compared using the criteria of depiction of morphology, anomalous pancreaticobiliary duct union and demonstration of complications such as stones. A four-point diagnostic scale was applied to the delineation of the ductal anatomy with the Wilcoxon signed-ranks test and McNemar's test used for statistical analysis. RESULTS: The depiction of the choledochal cyst was significantly better with MR cholangiography than with conventional cholangiography (P 0.03). The detection rate of an anomalous pancreaticobiliary duct union was not significantly different with either method (P = 0.641), nor was the detection rate of bile duct stones (P = 0.375). CONCLUSION: Magnetic resonance cholangiography provides data equivalent to or superior to those from conventional cholangiography in evaluating choledochal cyst. Magnetic resonance cholangiography is recommended as a non-invasive examination of choice for the evaluation of choledochal cyst. Kim, S.H. (2000). Clinical Radiology 55, 378-383

  2. 10 CFR Appendix I to Subpart B of... - Uniform Test Method for Measuring the Energy Consumption of Conventional Ranges, Conventional...

    Science.gov (United States)

    2010-01-01

    ... PROGRAM FOR CONSUMER PRODUCTS Test Procedures Pt. 430, Subpt. B, App. I Appendix I to Subpart B of Part... between the center and the corners of the conventional gas oven on the diagonals of a horizontal plane...

  3. Digital versus conventional implant impressions for edentulous patients: accuracy outcomes.

    Science.gov (United States)

    Papaspyridakos, Panos; Gallucci, German O; Chen, Chun-Jung; Hanssen, Stijn; Naert, Ignace; Vandenberghe, Bart

    2016-04-01

    To compare the accuracy of digital and conventional impression techniques for completely edentulous patients and to determine the effect of different variables on the accuracy outcomes. A stone cast of an edentulous mandible with five implants was fabricated to serve as master cast (control) for both implant- and abutment-level impressions. Digital impressions (n = 10) were taken with an intraoral optical scanner (TRIOS, 3shape, Denmark) after connecting polymer scan bodies. For the conventional polyether impressions of the master cast, a splinted and a non-splinted technique were used for implant-level and abutment-level impressions (4 cast groups, n = 10 each). Master casts and conventional impression casts were digitized with an extraoral high-resolution scanner (IScan D103i, Imetric, Courgenay, Switzerland) to obtain digital volumes. Standard tessellation language (STL) datasets from the five groups of digital and conventional impressions were superimposed with the STL dataset from the master cast to assess the 3D (global) deviations. To compare the master cast with digital and conventional impressions at the implant level, analysis of variance (ANOVA) and Scheffe's post hoc test was used, while Wilcoxon's rank-sum test was used for testing the difference between abutment-level conventional impressions. Significant 3D deviations (P impressions (P > 0.001). Digital implant impressions are as accurate as conventional implant impressions. The splinted, implant-level impression technique is more accurate than the non-splinted one for completely edentulous patients, whereas there was no difference in the accuracy at the abutment level. The implant angulation up to 15° did not affect the accuracy of implant impressions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. International convention for the suppression of acts of nuclear terrorism

    International Nuclear Information System (INIS)

    Jankowitsch-Prevor, O.

    2005-01-01

    The Preamble, composed of 13 paragraphs and drafted in the usual style of a General Assembly resolution, is aimed at placing the convention in a number of relevant contexts. First, the convention is linked to the issue of the maintenance of international peace and security through a reference to the purposes of the United Nations under Article 1 of the Charter. Next, it is presented as being a further step in the decisions, measures and instruments developed by the United Nations over the past ten years with the common objective of eliminating international terrorism in all its forms. Lastly, the convention is placed in its specific nuclear context through a number of references. In its third paragraph, the Preamble contains a reference to the principle recognizing 'the right of all states to develop and apply nuclear energy for peaceful purposes and their legitimate interests in the potential benefits to be derived from the peaceful application of nuclear energy'. This paragraph is identical to the first paragraph of the Preamble of the CPPNM, and the same principle is stated again in the first paragraph of the Preamble of the Amendment to the CPPNM, and constitutes a kind of general statement in favour of the peaceful use of nuclear energy and technology, without explicit reservations concerning non-proliferation, the safety and security of nuclear facilities or the management of radioactive waste. A draft amendment presented by the United States delegation in the final phase of work that suggested adding the phrase 'while recognizing that the goals of peaceful utilisation should not be used as a cover for proliferation' to the sentence cited above, was apparently not retained. Next, the Preamble mentions the 1980 Convention on the Physical Protection of Nuclear Material, and in the tenth paragraph the threat that 'acts of nuclear terrorism may result in the gravest consequences and may pose a threat to international peace and security'. Paragraph 11 of the

  5. Microbial analysis of meatballs cooled with vacuum and conventional cooling.

    Science.gov (United States)

    Ozturk, Hande Mutlu; Ozturk, Harun Kemal; Koçar, Gunnur

    2017-08-01

    Vacuum cooling is a rapid evaporative cooling technique and can be used for pre-cooling of leafy vegetables, mushroom, bakery, fishery, sauces, cooked food, meat and particulate foods. The aim of this study was to apply the vacuum cooling and the conventional cooling techniques for the cooling of the meatball and to show the vacuum pressure effect on the cooling time, the temperature decrease and microbial growth rate. The results of the vacuum cooling and the conventional cooling (cooling in the refrigerator) were compared with each other for different temperatures. The study shows that the conventional cooling was much slower than the vacuum cooling. Moreover, the microbial growth rate of the vacuum cooling was extremely low compared with the conventional cooling. Thus, the lowest microbial growth occurred at 0.7 kPa and the highest microbial growth was observed at 1.5 kPa for the vacuum cooling. The mass loss ratio for the conventional cooling and vacuum cooling was about 5 and 9% respectively.

  6. Implications of the Law of the Sea Convention

    International Nuclear Information System (INIS)

    Brewer, W.C. Jr.

    1989-01-01

    This paper reports that protection and preservation of the marine environment from wastes and toxic substances was an early concern of the Third United Nations Conference on the Law of the Sea, and the subject is extensively dealt with in the text of the Convention, adopted on 30 April 1982. The environmental provisions of the Convention are intended to serve as an umbrella treaty that states general goals, delimits the power and geographical jurisdiction of states in dealing with environmental problems, and requires states to cooperate through regional and global organizations in the development of standards. The most complex provisions of the environmental text deal with vessel discharges, reflecting the high degree of public interest in oil pollution, whereas the ocean dumping provisions rely largely on the standards of the London Dumping Convention. Pollution carried by air and rivers and wastes from seabed mining within national jurisdiction are treated briefly. The International Seabed Authority, created elsewhere in the Convention to regulate seabed mining, is granted power to regulate pollution from such mining beyond national jurisdiction. Overall, the most important contribution made by the Law of the Sea Convention to the protection of the marine environment is the obligation of states to bring national marine pollution laws up to global standards

  7. The nuclear safety convention. Results for Argentine as contracting party

    International Nuclear Information System (INIS)

    Caruso, Gustavo

    2002-01-01

    A powerful mechanism for increasing safety worldwide is through the development and adoption of legally binding Safety Conventions. Since 1986 four Conventions were ratified in the areas of Nuclear, Radiation and Waste Safety. The Nuclear Safety Convention establishes an international co-operation mechanism to maintain safety nuclear installations, focused on: to achieve and maintain a high level of nuclear safety worldwide through the enhancement of national measures and international co-operation including, where appropriate, safety-related technical co-operation; to establish and maintain effective defences in nuclear installations against potential radiological hazards in order to protect individuals, society and the environment from harmful effects of ionizing radiation from such installations and to prevent accidents with radiological consequences and to mitigate such consequences should they occur. Each contracting party shall take, within the framework of its national law, the legislative, regulatory and administrative measures and other steps necessary for implementing its obligations under this Convention. Moreover, each contracting parties shall submit for review prior to each review meeting, a National Report on the measures it has taken to implement each of the obligations of the Convention. The contracting parties concluded that the review process had proven to be of great value to their national nuclear safety programmes. (author)

  8. A comparison of piezosurgery with conventional techniques for internal osteotomy.

    Science.gov (United States)

    Koçak, I; Doğan, R; Gökler, O

    2017-06-01

    To compare conventional osteotomy with the piezosurgery medical device, in terms of postoperative edema, ecchymosis, pain, operation time, and mucosal integrity, in rhinoplasty patients. In this prospective study, 49 rhinoplasty patients were randomly divided into two groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. For all patients, the total duration of the operation was recorded, and photographs were taken and scored for ecchymosis and edema on postoperative days 2, 4, and 7. In addition, pain level was evaluated on postoperative day 2, and mucosal integrity was assessed on day 4. All scoring and evaluation was conducted by a physician who was blinded to the osteotomy procedure. In the piezosurgery group, edema scores on postoperative day 2 and ecchymosis scores on postoperative days 2, 4, and 7 were significantly lower than in the conventional osteotomy group (p piezosurgery group than in the conventional osteotomy group (p piezosurgery group. When total operation duration was compared, there was no significant difference between the groups (p > 0.05). Piezosurgery is a safe osteotomy method, with less edema (in the early postoperative period) and ecchymosis compared with conventional osteotomy, as well as less pain, a similar operation duration, and no mucosal damage.

  9. Determinants of Liquidity Risk in Indonesian Islamic and Conventional Banks

    Directory of Open Access Journals (Sweden)

    Raditya Sukmana

    2016-07-01

    Full Text Available The purpose of the study is to examine the causes of the liquidity risk  in Islamic and conventional banks in Indonesia using panel data regression method. The study found the significant and positive relation of ROA and NPF with the liquidity risk, whereas the negative and significant relation of CAR with the liquidity risk in Indonesian Conventional Banks. Meanwhile in Islamic banks, CAR result significantly positive effect on liquidity risk, while ROA shows negative and significant result. Possible explanation for this is that, given the huge profit by the conventional banks, it has more chance to allocate it as liquidity reserve as well as increasing the facilities (improvement on technology. When the NPL is high, conventional banks will increase the liquid assets as a buffer. Unlike that of conventional banks, the Islamic banks in Indonesia might allocate capital as liquidity reserves and might allocate ROA in fixed assets or financing or technology. The result confirm that the role of capital and bank’s performance in indeed important to the banking liquidityDOI: 10.15408/aiq.v8i2.2871

  10. Transport of nuclear material under the 1971 Brussels Convention

    International Nuclear Information System (INIS)

    Lagorce, M.

    1975-01-01

    The legal regime in force before entry into force of the 1971 Brussels Convention relating to civil liability for the maritime carriage of nuclear material created serious difficulties for maritime carriers, regarding both the financial risks entailed and restrictions on enjoyment of the rights granted by civil liability conventions. The 1971 Convention exonerates from liability any person likely to be held liable for nuclear damage under maritime law, provided another person is liable under the nuclear conventions or an equivalent national law. A problem remaining is that of compensation of nuclear damage to the means of transport for countries not having opted for re-inclusion of such damage in the nuclear law regime; this does not apply however to countries having ratified the Convention to date. A feature of the latter is that it establishes as extensively as possible the priority of nuclear law over maritime law. Furthermore the new regime continues to preserve efficiently the interests of victims of nuclear incidents. It is therefore to be hoped that insurers will no longer hesitate to cover international maritime carriage of nuclear material [fr

  11. Alberta's conventional oil supply: How much? How long?

    International Nuclear Information System (INIS)

    Heath, M.

    1992-01-01

    To assess the future conventional crude oil supply potential in Alberta, a modelling system was designed with the capacity to determine the fraction of existing and potential reserves which could prove technically, economically and/or commercially viable over time. The reference case analysis described assumed constant real oil prices and fiscal burdens, capital and operating costs. Reserve additions from new pool discoveries were summed with reserves from existing pools to arrive at an estimate of the potential supply of established reserves in each play area. The established reserves from all plays were then totalled to provide the provincial conventional oil resource potential. Alberta's recoverable conventional crude oil reserves were shown to be declining at about 2 percent per year. However, even with declining recoverable reserves and relatively low prices, the results of the study indicated that the conventional oil industry remained a major revenue generator for the province and would continue to be so over the next 15 to 20 years. Improved operating efficiencies, cost reductions, reasonable prices and cooperation between industry and government were shown to be necessary to assure the continued viability of Alberta's conventional oil industry. figs., tabs., 11 refs

  12. Conventional natural gas resources of the Western Canada Sedimentary Basin

    International Nuclear Information System (INIS)

    Bowers, B.

    1999-01-01

    The use of decline curve analysis to analyse and extrapolate the production performance of oil and gas reservoirs was discussed. This mathematical analytical tool has been a valid method for estimating the conventional crude oil resources of the Western Canada Sedimentary Basin (WCSB). However, it has failed to provide a generally acceptable estimate of the conventional natural gas resources of the WCSB. This paper proposes solutions to this problem and provides an estimate of the conventional natural gas resources of the basin by statistical analysis of the declining finding rates. Although in the past, decline curve analysis did not reflect the declining finding rates of natural gas in the WCSB, the basin is now sufficiently developed that estimates of conventional natural gas resources can be made by this analytical tool. However, the analysis must take into account the acceleration of natural gas development drilling that has occurred over the lifetime of the basin. It was concluded that ultimate resources of conventional marketable natural gas of the WCSB estimated by decline analysis amount to 230 tcf. It was suggested that further research be done to explain why the Canadian Gas Potential Committee (CGPC) estimate for Alberta differs from the decline curve analysis method. 6 refs., 35 figs

  13. Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases: a systematic review and meta-analysis.

    Science.gov (United States)

    Lupoli, Roberta; Pizzicato, Paolo; Scalera, Antonella; Ambrosino, Pasquale; Amato, Manuela; Peluso, Rosario; Di Minno, Matteo Nicola Dario

    2016-12-13

    In this study, we evaluated the impact of obesity and/or overweight on the achievement of minimal disease activity (MDA) in patients with psoriatic arthritis (PsA) and patients with rheumatoid arthritis (RA) receiving an anti-rheumatic treatment. Obesity can be considered a low-grade, chronic systemic inflammatory disease and some studies suggested that obese patients with rheumatic diseases exhibit a lower rate of low disease activity achievement during treatment with anti-rheumatic drugs. A systematic search was performed in major electronic databases (PubMed, Web of Science, Scopus, Embase) to identify studies reporting MDA achievement in obese and/or overweight patients with RA or PsA and in normal-weight RA or PsA control subjects. Results were expressed as Odds Ratios (ORs) with pertinent 95% Confidence Intervals (95%CIs). We included 17 studies (10 on RA and 7 on PsA) comprising a total of 6693 patients (1562 with PsA and 5131 with RA) in the analysis. The MDA achievement rate was significantly lower in obese patients than in normal-weight subjects (OR 0.447, 95% CI 0.346-0.577, p rheumatic diseases receiving treatment with traditional or biologic disease-modifying antirheumatic drugs.

  14. Convention Theory in the Anglophone Agro-food Literature

    DEFF Research Database (Denmark)

    Ponte, Stefano

    2016-01-01

    In the past two decades, convention theory has been applied in various branches of agro-food studies, providing analytical and theoretical insight for examining alternative food networks, coordination and governance in agro-food value chains, and the so-called 'quality turn' in food production...... and consumption. In this article, I examine convention theory applications in the Anglophone literature on agro-food studies through the review of 51 relevant contributions. I highlight how CT has helped explain different modes of organization and coordination of agro-food operations in different places, and how...... (Salais and Storper, 1992; Storper and Salais, 1997); and another applying the 'orders of worth' approach of Boltanski and Thevenot (1991[2006]) and further elaborations of 'quality conventions'. After tracing broad trajectories and the significance of new developments in this literature, I highlight its...

  15. World Engineer’s Convention 2011: Engineers Power the World

    CERN Multimedia

    Yi Ling Hwong (Knowledge Transfer) and Katarina Anthony

    2011-01-01

    Can the increasing global energy consumption be met without intensifying global warming? Do the necessary technical solutions exist, and is the switch to a low-carbon energy supply feasible and financially viable? These crucial questions and many others were dealt with at the 2011World Engineer’s Convention (WEC). CERN was invited to participate in the event, highlighting its significant contribution to global engineering with an exhibition space devoted to the LHC on the convention floor and a keynote speech delivered by CERN’s Director-General.   From 4 – 9 September 2011, more than 2000 engineers and researchers, as well as politicians and business representatives from about 100 countries gathered at the 2011World Engineer’s Convention (WEC). Held in Geneva, Switzerland, they met to discuss solutions for a sustainable energy future. Discussions looked at the development of engineering solutions through a variety of approaches, with ...

  16. Convention on the Physical Protection of Nuclear Material

    International Nuclear Information System (INIS)

    1980-01-01

    The convention on the Physical Protection of Nuclear Material is composed of the text of 23 articles, annex 1 showing the levels of physical protection and annex 2 which is the categorization list of nuclear material. The text consists of definitions (article 1), the scope of applications (2), liability of protecting nuclear material during international transport (3 and 4), duty of mutual cooperation (5 and 6), responsibility for criminal punishment (7 to 13), and final provisions (14 to 23). It is to be noted that the nuclear material for military purposes and domestic nuclear facilities are excluded in the connection. After the brief description of the course leading to the establishment of the convention, individual articles and annexes and the respective Japanese version, and the explanation based on the intergovernmental meeting discussion on the draft convention are described. (J.P.N.)

  17. Advances in Neuroscience and the Biological and Toxin Weapons Convention

    Science.gov (United States)

    Dando, Malcolm

    2011-01-01

    This paper investigates the potential threat to the prohibition of the hostile misuse of the life sciences embodied in the Biological and Toxin Weapons Convention from the rapid advances in the field of neuroscience. The paper describes how the implications of advances in science and technology are considered at the Five Year Review Conferences of the Convention and how State Parties have developed their appreciations since the First Review Conference in 1980. The ongoing advances in neurosciences are then assessed and their implications for the Convention examined. It is concluded that State Parties should consider a much more regular and systematic review system for such relevant advances in science and technology when they meet at the Seventh Review Conference in late 2011, and that neuroscientists should be much more informed and engaged in these processes of protecting their work from malign misuse. PMID:21350673

  18. CT and conventional radiographic techniques in interstitial pulmonary disease

    International Nuclear Information System (INIS)

    Leipner, N.; Schueller, H.; Uexkuell-Gueldenband, V. v.; Schlolaut, K.H.; Overlack, A.; Bonn Univ.

    1988-01-01

    One hundred and sixty-four patients with pulmonary fibrosis were examined by CT and by conventional radiological methods. Sixty patients had asbestosis, thirty-nine silicosis, forty sarcoidosis and twenty-five had idiopathic pulmonary fibrosis. CT is superior to conventional radiography in evaluating interstitial pulmonary changes, particularly of the pleura and the lung parenchyma. In sixty-nine patients there were some findings which could only be demonstrated by CT. In asbestosis, silicosis and sarcoidosis the CT classification of the lung parenchyma which we have suggested produces significantly better correlation with vital capacity than can be achieved from conventional chest films, according to the guidelines of the I.L.O. (orig./GDG) [de

  19. Fifth national report of Brazil for the nuclear safety convention

    International Nuclear Information System (INIS)

    2010-01-01

    This Fifth National Report is a new update to include relevant information for the period of 2007/2009. This document represents the national report prepared as a fulfillment of the Brazilian obligations related to the Convention on Nuclear Safety. In chapter 2 some details are given about the existing nuclear installations. Chapter 3 provides details about the legislation and regulations, including the regulatory framework and the regulatory body. Chapter 4 covers general safety considerations as described in articles 10 to 16 of the Convention. Chapter 5 addresses to the safety of the installations during siting, design, construction and operation. Chapter 6 describes planned activities to further enhance nuclear safety. Chapter 7 presents the final remarks related to the degree of compliance with the Convention obligations

  20. Ideal and conventional feedback systems for RWM suppression

    International Nuclear Information System (INIS)

    Pustovitov, V.D.

    2002-01-01

    Feedback suppression of resistive wall modes (RWM) is studied analytically using a model based on a standard cylindrical approximation. Two feedback systems are compared: 'ideal', creating only the field necessary for RMW suppression, and 'conventional', like that used in the DIII-D tokamak and considered as a candidate for ITER. The widespread opinion that the feedback with poloidal sensors is better than that with radial sensors is discussed. It is shown that the 'conventional' feedback with radial sensors can be effective only in a limited range, while using the input signal from internal poloidal sensors allows easy fulfilment of the stability criterion. This is a property of the 'conventional' feedback, but the 'ideal' feedback would stabilise RWM in both cases. (author)

  1. Ideal and conventional feedback systems for RWM suppression

    Energy Technology Data Exchange (ETDEWEB)

    Pustovitov, V.D.

    2002-01-01

    Feedback suppression of resistive wall modes (RWM) is studied analytically using a model based on a standard cylindrical approximation. Two feedback systems are compared: 'ideal', creating only the field necessary for RMW suppression, and 'conventional', like that used in the DIII-D tokamak and considered as a candidate for ITER. The widespread opinion that the feedback with poloidal sensors is better than that with radial sensors is discussed. It is shown that the 'conventional' feedback with radial sensors can be effective only in a limited range, while using the input signal from internal poloidal sensors allows easy fulfilment of the stability criterion. This is a property of the 'conventional' feedback, but the 'ideal' feedback would stabilise RWM in both cases. (author)

  2. Dural ectasia and conventional radiography in the Marfan lumbosacral spine

    International Nuclear Information System (INIS)

    Ahn, N.U.; Nallamshetty, L.; Ahn, U.M.; Buchowski, J.M.; Kebaish, K.M.; Sponseller, P.D.; Rose, P.S.; Garrett, E.S.

    2001-01-01

    Objective. To determine how well conventional radiographic findings can predict the presence of dural ectasia in Marfan patients.Design and patients. Twelve Marfan patients without dural ectasia and 21 Marfan patients with dural ectasia were included in the study. Five radiographic measurements were made of the lumbosacral spine: interpediculate distance, scalloping value, sagittal canal diameter, vertebral body width, and transverse process width.Results. The following measurements were significantly larger in patients with dural ectasia: interpediculate distances at L3-L4 levels (P 38.0 mm, sagittal diameter at S1 >18.0 mm, or scalloping value at L5 >5.5 mm.Conclusion. Dural ectasia in Marfan syndrome is commonly associated with several osseous changes that are observable on conventional radiographs of the lumbosacral spine. Conventional radiography can detect dural ectasia in patients with Marfan syndrome with a very high specificity (91.7%) but a low sensitivity (57.1%). (orig.)

  3. PAPNET-assisted primary screening of conventional cervical smears.

    Science.gov (United States)

    Cenci, M; Nagar, C; Vecchione, A

    2000-01-01

    The PAPNET System is the only device with a neural-network-based-artificial intelligence to detect and show the images of abnormal cells on the monitor to be evaluated in an interactive way. We effectively used the PAPNET in rescreening of conventional cervical smears and we detected its advantages and its disadvantages. In this paper, we report our results from PAPNET-assisted primary screening performed on 20,154 conventional smears. The smears were classified as Negative or as Review. The Negative cases were rapidly rescreened mainly near the coverslip edges, which are the slide areas not analyzed by automated devices because of focusing problems. The Review cases were fully reanalyzed by the optic microscope. In summary, 140 positive smears were detected: 57 cases showed changes due to HPV, 63 LSIL, 15 HSIL, and 5 carcinomas. Therefore, the PAPNET System was confirmed as useful in primary screening of conventional cervical samples as well as rescreening.

  4. A proposed structure for an international convention on climate change

    International Nuclear Information System (INIS)

    Nitze, W.A.

    1991-01-01

    In this chapter, the author recommends a framework convention that will stimulate policy changes without expensive emission reductions in the short term. A central task for a climate convention will be to provide the international community with a permanent mechanism for coordinating its efforts to deal with climate change. The convention should go beyond organizational structure to establish a process for updating the parties' understanding of the science and potential impacts of climate change and for building consensus on policy responses. Each party must then be required to prepare and distribute its own national plan for reducing greenhouse gas emissions and for adapting to future change while achieving its development objectives. A set of targets and timetables for the reduction of greenhouse gas reductions is presented

  5. Comparative study between computed radiography and conventional radiography

    International Nuclear Information System (INIS)

    Noorhazleena Azaman; Khairul Anuar Mohd Salleh; Sapizah Rahim; Shaharudin Sayuti; Arshad Yassin; Abdul Razak Hamzah

    2010-01-01

    In Industrial Radiography, there are many criteria that need to be considered based on established standards to accept or reject the radiographic film. For conventional radiography, we need to consider the optical density by using the densitometer when viewing the film on the viewer. But in the computed radiography (CR) we need to evaluate and performed the analysis from the quality of the digital image through grey value. There are many factors that affected the digital image quality. One of the factors which are affected to the digital image quality in the image processing is grey value that related to the contrast resolution. In this work, we performed grey value study measurement on digital radiography systems and compared it with exposed films in conventional radiography. The test sample is a steel step wedge. We found out the contrast resolution is higher in Computed Radiography compared with Conventional Radiography. (author)

  6. Stability of Brillouin flow in planar, conventional, and inverted magnetrons

    International Nuclear Information System (INIS)

    Simon, D. H.; Lau, Y. Y.; Greening, G.; Wong, P.; Gilgenbach, R. M.; Hoff, B. W.

    2015-01-01

    The Brillouin flow is the prevalent flow in crossed-field devices. We systematically study its stability in the conventional, planar, and inverted magnetron geometry. To investigate the intrinsic negative mass effect in Brillouin flow, we consider electrostatic modes in a nonrelativistic, smooth bore magnetron. We found that the Brillouin flow in the inverted magnetron is more unstable than that in a planar magnetron, which in turn is more unstable than that in the conventional magnetron. Thus, oscillations in the inverted magnetron may startup faster than the conventional magnetron. This result is consistent with simulations, and with the negative mass property in the inverted magnetron configuration. Inclusion of relativistic effects and electromagnetic effects does not qualitatively change these conclusions

  7. Financing options to develop non-conventional reserves

    International Nuclear Information System (INIS)

    Tricoli, C.

    1997-01-01

    The economics of non-conventional natural gas reserves such as coalbed methane, gas shales and tight gas were discussed, with special reference to financing options to develop such reserves. Before 1992, tax credits were used to stimulate the development of non-conventional gas. The requirements for section 29 tax credits, the objectives of investors and producers, and the methods used to monetize section 29 tax credits, such as public royalty trusts, partnership structures, and up-front payment mechanisms were described. The capital gains implications of gas sales were also reviewed. It was noted that in the absence of tax credits, financing the development of non-conventional reserves must undergo the same economic scrutiny as any other oil and gas project

  8. Comparing the force ripple during asynchronous and conventional stimulation.

    Science.gov (United States)

    Downey, Ryan J; Tate, Mark; Kawai, Hiroyuki; Dixon, Warren E

    2014-10-01

    Asynchronous stimulation has been shown to reduce fatigue during electrical stimulation; however, it may also exhibit a force ripple. We quantified the ripple during asynchronous and conventional single-channel transcutaneous stimulation across a range of stimulation frequencies. The ripple was measured during 5 asynchronous stimulation protocols, 2 conventional stimulation protocols, and 3 volitional contractions in 12 healthy individuals. Conventional 40 Hz and asynchronous 16 Hz stimulation were found to induce contractions that were as smooth as volitional contractions. Asynchronous 8, 10, and 12 Hz stimulation induced contractions with significant ripple. Lower stimulation frequencies can reduce fatigue; however, they may also lead to increased ripple. Future efforts should study the relationship between force ripple and the smoothness of the evoked movements in addition to the relationship between stimulation frequency and NMES-induced fatigue to elucidate an optimal stimulation frequency for asynchronous stimulation. © 2014 Wiley Periodicals, Inc.

  9. Convention on Nuclear Safety. Second National Report, October 2001

    International Nuclear Information System (INIS)

    2001-01-01

    The present document is the second Spanish national report prepared in order to comply with the obligations deriving from the convention on Nuclear Safety, made in Vienna on 20th September 1994. This convention was signed by Spain on 15th October 1994 and ratified by way of an instrument issued by the Ministry of Foreign Affairs, signed by H. M. the King on 19th June 1995. The convention, which entered into force on 24th October 1996, following ratification by a minimum number of countries, as set out in articles 20, 21 and 22 includes 51 countries and Euratom, in addition to Spain. The first review meeting, organised in accordance with chapter 3 of the Convention, was held in vienna in April 1999. Spain was represented by the CSN, the State organisation solely responsible for nuclear safety, both for the drawing up of the national report and for participation in the meeting held between the parties. In accordance with article 21, the second review meeting has been scheduled for April 2002, also in Vienna. At the review meeting, the countries party to the Convention review the national reports required by article 5, Spain submitted its first national report in September 1998. The present document is an update of that first report, and is to be submitted by 15th October 2001, as agreed on during the first review meeting. This report will be reviewed by the interested countries, which will forward their comments and questions. In April 2002, the Spanish report and the questions received will be subjected to the review process contemplated by the convention, along with the reports submitted by the other countries

  10. National report of Brazil: nuclear safety convention - September 1998

    International Nuclear Information System (INIS)

    1998-09-01

    This National Report was prepared by a group composed of representatives of the various Brazilian organizations with responsibilities in the field of nuclear safety, aiming the fulfilling the Convention of Nuclear Energy obligations. The Report contains a description of the Brazilian policy and programme on the safety of nuclear installations, and an article by article description of the measures Brazil is undertaking in order to implement the obligations described in the Convention. The last chapter describes plans and future activities to further enhance the safety of nuclear installations in Brazil

  11. Use of non-conventional energy sources for power generation

    International Nuclear Information System (INIS)

    Umapathaiah, R.; Sharma, N.D.

    1999-01-01

    India being a developing country, cannot afford to meet the power and energy demand only from conventional sources. Power generation can be augmented by using non-conventional energy sources. Sufficient importance must be given for recovery of energy from industrial/urban waste. Solar heating system must replace industrial and domestic sectors. Solar photovoltaic, biogas plant, biomass based gasified system must also be given sufficient place in energy sector. More thrust has to be given for generation of power by using sugar cane which is a perennial source

  12. National report of Brazil: nuclear safety convention - September 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-09-01

    This National Report was prepared by a group composed of representatives of the various Brazilian organizations with responsibilities in the field of nuclear safety, aiming the fulfilling the Convention of Nuclear Energy obligations. The Report contains a description of the Brazilian policy and programme on the safety of nuclear installations, and an article by article description of the measures Brazil is undertaking in order to implement the obligations described in the Convention. The last chapter describes plans and future activities to further enhance the safety of nuclear installations in Brazil.

  13. Nuclear damage under the 1997 protocol: conventional thinking?

    International Nuclear Information System (INIS)

    Warren, G.

    2000-01-01

    This communication expresses the critical point of view of nuclear insurers about the international civil liability system and tackles questions about the current revision of this system. After having examined the nuclear risk nature in the insurance point of view and remind the objective of nuclear conventions in this context, the author expresses the opinion that compensation means, planned by these conventions, can be suitable to limited nuclear accident but would be insufficient to face the consequences of a serious nuclear accident. (N.C.)

  14. U.S. Perspectives on the Joint Convention

    International Nuclear Information System (INIS)

    Strosnider, J.; Federline, M.; Camper, L.; Abu-Eid, R.; Gnugnoli, G.; Gorn, J.; Bubar, P.; Tonkay, D.

    2006-01-01

    The Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management (Joint Convention) is an international convention, under the auspices of the International Atomic Energy Agency (IAEA). It is a companion to a suite of international conventions on nuclear safety and physical security, which serve to promote a global culture for the safe use of radioactive materials. Although the U.S. was the first nation to sign the Joint Convention on September 29, 1997, the ratification process was a challenging experience for the U.S., in the face of legislative priorities dominated by concerns for national security and threats from terrorism after September 11, 2001. Notwithstanding these prevailing circumstances, the U.S. ratified the Joint Convention in 2003, just prior to the First Review Meeting of the Contracting Parties, and participated fully therein. For the United States, participation as a Contracting Party provides many benefits. These range from working with other Parties to harmonize international approaches to achieve strong and effective nuclear safety programs on a global scale, to stimulating initiatives to improve safety systems within our own domestic programs, to learning about technical innovations by other Parties that can be useful to U.S. licensees, utilities, and industry in managing safety and its associated costs in our waste management activities. The Joint Convention process also provides opportunities to identify future areas of bilateral and multilateral technical and regulatory cooperation with other Parties, as well as an opportunity for U.S. vendors and suppliers to broaden their market to include foreign clients for safety improvement equipment and services. The Joint Convention is consistent with U.S. foreign policy considerations to support, as a priority, the strengthening of the worldwide safety culture in the use of nuclear energy. Because of its many benefits, we believe it is important to take

  15. World Trade Organization, ILO conventions, and workers' compensation.

    Science.gov (United States)

    LaDou, Joseph

    2005-01-01

    The World Trade Organization, the World Bank, and the International Monetary Fund can assist in the implementation of ILO Conventions relating to occupational safety and health in developing countries. Most countries that seek to trade globally receive permission to do so from the WTO. If the WTO required member countries to accept the core ILO Conventions relating to occupational safety and health and workers' compensation, it could accomplish something that has eluded international organizations for decades. International workers' compensation standards are seldom discussed, but may at this time be feasible. Acceptance of a minimum workers' compensation insurance system could be a requirement imposed on applicant nations by WTO member states.

  16. An alternative to conventional babbitt metal-lined generator pads

    Energy Technology Data Exchange (ETDEWEB)

    Puuska, H. [Imatra Hydroelectric Power Plant (Finland)

    1996-08-01

    The generator refurbishment of the Imatra Hydroelectric Power Plant Unit 1 in Finland is described. The generator work called for installation of a new cooling system for the generator thrust bearing. The considerations leading to the decision to replace the conventional babbitt metal-lined pads with elastic metal-plastic coated thrust bearing pads and the installation of the new pads are outlined in the article. Results of the trial run are summarized; the end temperature of the unit was more than 20C lower than for units equipped with conventional babbitted bearings.

  17. Analysis of Drying Process Quality in Conventional Dry-Kilns

    OpenAIRE

    Sedlar Tomislav; Pervan Stjepan

    2010-01-01

    This paper presents testing results of drying quality in a conventional dry kiln. Testing is based on a new methodology that will show the level of success of the drying process management by analyzing the quality of drying process in a conventional dry kiln, using a scientifi cally improved version of the check list in everyday practical applications. A company that specializes in lamel and classic parquet production was chosen so as to verify the new testing methodology. A total of 56 m3 of...

  18. 48th Annual Convention of Computer Society of India

    CERN Document Server

    Avadhani, P; Udgata, Siba; Lakshminarayana, Sadasivuni; ICT and Critical Infrastructure

    2014-01-01

      This volume contains 85 papers presented at CSI 2013: 48th Annual Convention of Computer Society of India with the theme “ICT and Critical Infrastructure”. The convention was held during 13th –15th December 2013 at Hotel Novotel Varun Beach, Visakhapatnam and hosted by Computer Society of India, Vishakhapatnam Chapter in association with Vishakhapatnam Steel Plant, the flagship company of RINL, India. This volume contains papers mainly focused on Data Mining, Data Engineering and Image Processing, Software Engineering and Bio-Informatics, Network Security, Digital Forensics and Cyber Crime, Internet and Multimedia Applications and E-Governance Applications.

  19. Comparison Of Conventional And Recycled “Green” Office Paper

    Directory of Open Access Journals (Sweden)

    Klemen Možina

    2011-05-01

    Full Text Available To confront with the market need, we have to find alternative in respond to enormous necessity and application ofoffice paper. Therefore, one way in dealing with the problem is to replace or just decrease the use of paper madeentirely from primary components, mainly wood fibbers (deciduous and conifer. We analysed mechanical, optical,structural and microscopic properties. Experiments were performed on three conventional and three recycled officepapers reachable on the market. Results, obtained from measurements, confirm presumption, that mechanical andsurface properties of recycled office paper can be collated and they discern from conventional office paper.

  20. Discrete event simulation versus conventional system reliability analysis approaches

    DEFF Research Database (Denmark)

    Kozine, Igor

    2010-01-01

    Discrete Event Simulation (DES) environments are rapidly developing and appear to be promising tools for building reliability and risk analysis models of safety-critical systems and human operators. If properly developed, they are an alternative to the conventional human reliability analysis models...... and systems analysis methods such as fault and event trees and Bayesian networks. As one part, the paper describes briefly the author’s experience in applying DES models to the analysis of safety-critical systems in different domains. The other part of the paper is devoted to comparing conventional approaches...

  1. Distinguishing and diagnosing contemporary and conventional features of dental erosion.

    Science.gov (United States)

    Bassiouny, Mohamed A

    2014-01-01

    The vast number and variety of erosion lesions encountered today require reconsideration of the traditional definition. Dental erosion associated with modern dietary habits can exhibit unique features that symbolize a departure from the decades-old conventional image known as tooth surface loss. The extent and diversity of contemporary erosion lesions often cause conflicting diagnoses. Specific examples of these features are presented in this article. The etiologies, genesis, course of development, and characteristics of these erosion lesions are discussed. Contemporary and conventional erosion lesions are distinguished from similar defects, such as mechanically induced wear, carious lesions, and dental fluorosis, which affect the human dentition.

  2. U.S. Continuing Involvement with the Joint Convention

    International Nuclear Information System (INIS)

    Stewart, L.; Tonkay, D.; Regnier, E.; Schultheisz, D.; Gnugnoli, G.

    2009-01-01

    The Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management (Joint Convention) is an international convention, under the auspices of the International Atomic Energy Agency (IAEA). It is a companion to a suite of international conventions on nuclear safety and physical security, which serve to promote a global culture for the safe use of radioactive materials. The Joint Convention is an official international treaty, and as such, there are obligations on the part of the United States. Those nations having ratified the Joint Convention are designated as 'Contracting Parties.' Nations that are not IAEA Member States may also become Contracting Parties to the Joint Convention, although none has done so. The primary obligations are threefold. The first is to prepare a national report, which addresses the national safety program in radioactive waste management, spent nuclear fuel management, and disused sealed sources. As the U.S. prepares a national report, other Contracting Parties to the Joint Convention also prepare their national reports, which leads to the second obligation on the part of the Contracting Parties. This is the obligation to review other countries' national reports. The last specific obligation is to actively participate in the triennial peer review meeting, referred to as the Review Meeting of the Contracting Parties. The U.S. ratified the Joint Convention in 2003, just prior to the First Review Meeting of the Contracting Parties, and has participated fully therein in the ensuing Review Meetings. Because of the benefits in active participation, it is important for the U.S. to maintain its leadership role in promoting its ratification in the global setting, as well as in more focused regions. Because of the important benefits associated with active participation, the U.S. has strongly supported a Regional Conference Initiative outreach program to increase membership. To launch the Initiative, the U

  3. Vienna Convention and Its Revision and convention on Supplementary Compensation for Nuclear Damage on September 12, 1997

    International Nuclear Information System (INIS)

    Soljan, V.

    1998-01-01

    After Chernobyl, the perception of common interest in modernization of the international regime that regulate various aspects of nuclear energy, has been evident among states with nuclear power plants as well as those likely to be involved in or affected by a nuclear incident. The adoption of the protocol Amending the Vienna Convention on Civil liability for Nuclear Damage, 1963 and the Convention on Supplementary Compensation for nuclear damage in September 1997, represents important part of the entire result that has been achieved from the 1986. This article gives a brief survey on the background of the process of modernization of the international regime of liability for nuclear damage and examines solutions contained in the provisions of the conventions. (author)

  4. IAEA supports regional seas conventions and action plans

    International Nuclear Information System (INIS)

    2000-01-01

    The document informs about the 3rd Global Meeting of Regional Seas Conventions and Action Plans held in Monaco in November 2000 at the IAEA's Marine Environmental Laboratory (IAEA-MEL). The meeting assembled a number of marine environmental experts from several UN bodies to reinforce activities to protect the marine environment

  5. Conventions and nomenclature for double diffusion encoding NMR and MRI

    DEFF Research Database (Denmark)

    Shemesh, Noam; Jespersen, Sune N; Alexander, Daniel C

    2015-01-01

    , such as double diffusion encoding (DDE) NMR and MRI, may provide novel quantifiable metrics that are less easily inferred from conventional diffusion acquisitions. Despite the growing interest on the topic, the terminology for the pulse sequences, their parameters, and the metrics that can be derived from them...

  6. Selections from the ABC 2011 Annual Convention, Montreal, Canada

    Science.gov (United States)

    Whalen, D. Joel; Andersen, Ken; Campbell, Gloria; Crenshaw, Cheri; Cross, Geoffrey A.; Grinols, Anne Bradstreet; Hildebrand, John; Newman, Amy; Ortiz, Lorelei A.; Paulson, Edward; Phillabaum, Melinda; Powell, Elizabeth A.; Sloan, Ryan

    2012-01-01

    The 12 Favorite Assignments featured in this article were presented at the 2011 Annual Convention of the Association for Business Communication (ABC), Montreal, Canada. A variety of learning objectives are featured: delivering bad news, handling difficult people, persuasion, reporting financial analysis, electronic media, face-to-face…

  7. Tool for efficient intermodulation analysis using conventional HB packages

    OpenAIRE

    Vannini, G.; Filicori, F.; Traverso, P.

    1999-01-01

    A simple and efficient approach is proposed for the intermodulation analysis of nonlinear microwave circuits. The algorithm, which is based on a very mild assumption about the frequency response of the linear part of the circuit, allows for a reduction in computing time and memory requirement. Moreover. It can be easily implemented using any conventional tool for harmonic-balance circuit analysis

  8. Conventional external beam radiotherapy for central nervous system malignancies

    International Nuclear Information System (INIS)

    Halperin, E.C.; Burger, P.C.

    1985-01-01

    Fractionated external beam photon radiotherapy is an important component of the clinical management of malignant disease of the central nervous system. The practicing neurologist or neurosurgeon frequently relies on the consultative and treatment skills of a radiotherapist. This article provides a review for the nonradiotherapist of the place of conventional external beam radiotherapy in neuro-oncology. 23 references

  9. The Transmission of Monetary Policy through Conventional and Islamic Banks

    NARCIS (Netherlands)

    Zaheer, S.; Ongena, S.; van Wijnbergen, S.J.G.

    2011-01-01

    We investigate the differences in banks’ responses to monetary policy shocks across bank size, liquidity, and type, i.e., conventional versus Islamic, in Pakistan between 2002:II to 2010:I. We find that following a monetary contraction, small banks with liquid balance sheets cut their lending less

  10. Coherent states for oscillators of non-conventional statistics

    International Nuclear Information System (INIS)

    Dao Vong Duc; Nguyen Ba An

    1998-12-01

    In this work we consider systematically the concept of coherent states for oscillators of non-conventional statistics - parabose oscillator, infinite statistics oscillator and generalised q-deformed oscillator. The expressions for the quadrature variances and particle number distribution are derived and displayed graphically. The obtained results show drastic changes when going from one statistics to another. (author)

  11. Vienna convention on civil liability for nuclear damage

    International Nuclear Information System (INIS)

    1996-01-01

    The Vienna Convention on Civil Liability for Nuclear Damage was adopted on 21 May 1963 and was opened for signature on the same day. It entered into force on 12 November 1977, i.e. three months after the date of deposit with the Director General of the fifth instrument of ratification, in accordance with Article 23

  12. The Use of Hyper-Reference and Conventional Dictionaries.

    Science.gov (United States)

    Aust, Ronald; And Others

    1993-01-01

    Describes a study of 80 undergraduate foreign language learners that compared the use of a hyper-reference source incorporating an electronic dictionary and a conventional paper dictionary. Measures of consultation frequency, study time, efficiency, and comprehension are examined; bilingual and monolingual dictionary use is compared; and further…

  13. Susceptibility of green and conventional building materials to microbial growth.

    Science.gov (United States)

    Mensah-Attipoe, J; Reponen, T; Salmela, A; Veijalainen, A-M; Pasanen, P

    2015-06-01

    Green building materials are becoming more popular. However, little is known about their ability to support or limit microbial growth. The growth of fungi was evaluated on five building materials. Two green, two conventional building materials and wood as a positive control were selected. The materials were inoculated with Aspergillus versicolor, Cladosporium cladosporioides and Penicillium brevicompactum, in the absence and presence of house dust. Microbial growth was assessed at four different time points by cultivation and determining fungal biomass using the N-acetylhexosaminidase (NAHA) enzyme assay. No clear differences were seen between green and conventional building materials in their susceptibility to support microbial growth. The presence of dust, an external source of nutrients, promoted growth of all the fungal species similarly on green and conventional materials. The results also showed a correlation coefficient ranging from 0.81 to 0.88 between NAHA activity and culturable counts. The results suggest that the growth of microbes on a material surface depends on the availability of organic matter rather than the classification of the material as green or conventional. NAHA activity and culturability correlated well indicating that the two methods used in the experiments gave similar trends for the growth of fungi on material surfaces. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Why doesn't conventional IVF work in the horse?

    NARCIS (Netherlands)

    Leemans, Bart; Gadella, Bart M; Stout, Tom Arjun Edgar; De Schauwer, Catharina; Nelis, Hilde Maria; Hoogewijs, Maarten; Van Soom, Ann

    2016-01-01

    In contrast to man and many other mammalian species, conventional in vitro fertilization (IVF) with horse gametes is not reliably successful. The apparent inability of stallion spermatozoa to penetrate the zona pellucida in vitro is most likely due to incomplete activation of spermatozoa

  15. Construction Management for Conventional Facilities of Proton Accelerator

    International Nuclear Information System (INIS)

    Kim, Jun Yeon; Cho, Jang Hyung; Cho, Sung Won

    2013-01-01

    Proton Engineering Frontier Project, puts its aim to building 100MeV 20mA linear proton accelerator which is national facility for NT, BT, IT, and future technologies, expected to boost up the national industry competitiveness. This R and D, Construction Management is in charge of the supportive works such as site selection, architecture and engineering of conventional facilities, and overall construction management. The major goals of this work are as follows: At first, architecture and engineering of conventional facilities. Second, construction management, supervision and inspection on construction of conventional facilities. Lastly, cooperation with the project host organization, Gyeongju city, for adjusting technically interrelated work during construction. In this research, We completed the basic, detail, and field changed design of conventional facilities. Acquisition of necessary construction and atomic license, radiation safety analysis, site improvement, access road construction were successfully done as well. Also, we participated in the project host related work as follows: Project host organization and site selection, construction technical work for project host organization and procedure management, etc. Consequently, we so fulfilled all of the own goals which were set up in the beginning of this construction project that we could made contribution for installing and running PEFP's developed 100MeV 20mA linear accelerator

  16. Clearance of building structures for conventional non-nuclear reuse

    International Nuclear Information System (INIS)

    Buss, K.; Boehringer, S.

    1998-01-01

    At the example of a fuel assembly plant the strategy of control measurements on building surfaces, which shall be conventionally reused after their clearance, is regarded. Based on the given clearance levels the used measuring methods, especially with regard of possibly covered or intruded uranium contamination, are shown. The possibility of using the in-situ-γ-spectroscopy is discussed. (orig.) [de

  17. The transmission of monetary policy through conventional and Islamic banks

    NARCIS (Netherlands)

    Zaheer, S.; Ongena, S.; van Wijnbergen, S.J.G.

    2013-01-01

    We investigate the differences in banks’ responses to monetary policy shocks across bank size, liquidity, and type—i.e., conventional versus Islamic—in Pakistan between 2002:Q2 and 2010:Q1. We find that following a monetary contraction, small banks with liquid balance sheets cut their lending less

  18. The transmission of monetary policy through conventional and islamic banks

    NARCIS (Netherlands)

    Zaheer, S.; Ongena, S.; van Wijnbergen, S.

    2012-01-01

    We investigate the differences in banks' responses to monetary policy shocks across bank size, liquidity, and type, i.e., conventional versus Islamic, in Pakistan between 2002:II to 2010:I. We find that following a monetary contraction, small banks with liquid balance sheets cut their lending less

  19. Parosteal lipoma - a case report: conventional radiology, CT and MRI

    International Nuclear Information System (INIS)

    Albuquerque, Silvio Cavalcanti; Nascimento, Edilene Cristina do; Silva, Ivone Martins da

    1996-01-01

    The authors report a case parosteal lipoma, a rare benign tumor, associated with exostosis, in proximal radius. The diagnosis aspects in conventional radiology, computed tomography and magnetic resonance imaging are presented, as well as a review of the medical literature about the case. (author). 7 refs., 3 figs

  20. Effects Of Using Non-Conventional Feedstuffs On The Productivity ...

    African Journals Online (AJOL)

    This study examines effects of privately producing layers mash by including such non-conventional feedstuff as cassava, brewers dried grain, etc on the productivity, cost and profit of poultry (eggs) farms. Primary data was collected from three categories of farms – 12” convcentional feedstuff users“ (CFU), ...

  1. Isospectrality of conventional and new extended potentials, second ...

    Indian Academy of Sciences (India)

    2015-11-27

    Home; Journals; Pramana – Journal of Physics; Volume 73; Issue 2. Isospectrality of conventional and new extended potentials, ... Proceedings of the International Workshop/Conference on Computational Condensed Matter Physics and Materials Science (IWCCMP-2015). Posted on November 27, 2015. Guest Editors: ...

  2. Assessment of Conventional Teaching Procedures: Implications for Gifted Learners

    Science.gov (United States)

    Alenizi, Mogbel Aid K.

    2016-01-01

    The present research aims to assess the conventional teaching procedures in the development of mathematical skills of the students with learning difficulties. The study group was made up of all the children with academic learning disorders in KSA. The research questions have been scrutinized from the averages and the standard deviation of the…

  3. Preserving Musicality through Pictures: A Linguistic Pathway to Conventional Notation

    Science.gov (United States)

    Nordquist, Alice L.

    2016-01-01

    The natural musicality so often present in children's singing can begin to fade as the focus of a lesson shifts to the process of reading and writing conventional notation symbols. Approaching the study of music from a linguistic perspective preserves the pace and flow that is inherent in spoken language and song. SongWorks teaching practices…

  4. 40. annual convention 1990 of the Austrian physical society

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    Titles and abstracts of the 1990 Convention of the Austrian Physical Society, 17-21 September 1990 at Salzburg, Austria, are given. The topical sections are: 1. Atomic, Molecular- and Plasma Physics; 2. Solid State Physics; 3. Polymer Physics; 4. Nuclear- and Particle Physics; 5. Medical Physics and Biophysics. There are alltogether 193 contributions, 61 thereof of INIS interest

  5. The struggle for textual conventions in a language support programme

    African Journals Online (AJOL)

    In this article, the writer explores the experience of a group of South African learners with regard to a language support course that aims to facilitate their struggle to master English textual conventions in discipline specific contexts. The academic context of this study was that of a nursing science degree programme where ...

  6. Selections from the ABC 2012 Annual Convention, Honolulu, Hawaii

    Science.gov (United States)

    Whalen, D. Joel

    2013-01-01

    The 13 Favorite Assignments featured here were presented at the 2012 Association for Business Communication (ABC) Annual Convention, Honolulu, Hawaii. A variety of learning objectives are featured, including the following: enhancing resume's visual impact, interpersonal skills, social media, team building, web design, community service projects,…

  7. 46 CFR 91.60-40 - Duration of Convention certificates.

    Science.gov (United States)

    2010-10-01

    ... VESSELS INSPECTION AND CERTIFICATION Certificates Under International Convention for Safety of Life at Sea... period of not more than 60 months. (1) A Cargo Ship Safety Construction Certificate. (2) A Cargo Ship Safety Equipment Certificate. (3) A Safety Management Certificate. (4) A Cargo Ship Safety Radio...

  8. Non-Conventional Methodologies in the Synthesis of 1-Indanones

    Directory of Open Access Journals (Sweden)

    Manuela Oliverio

    2014-04-01

    Full Text Available 1-Indanones have been successfully prepared by means of three different non-conventional techniques, namely microwaves, high-intensity ultrasound and a Q-tube™ reactor. A library of differently substituted 1-indanones has been prepared via one-pot intramolecular Friedel-Crafts acylation and their efficiency and “greenness” have been compared.

  9. Comparative Cost/Benefit of Alternative/Conventional Feedstuff in ...

    African Journals Online (AJOL)

    benefit of the use of conventional (corn/soya bean based) and alternative (less of corn and soya bean substituted with agro-allied and industrial by-products) feedstuffs. Completely randomized design was used and the experiment conducted for a ...

  10. A comparison of EEG spectral entropy with conventional quantitative ...

    African Journals Online (AJOL)

    A comparison of EEG spectral entropy with conventional quantitative EEG at varying depths of sevoflurane anaesthesia. PR Bartel, FJ Smith, PJ Becker. Abstract. Background and Aim: Recently an electroencephalographic (EEG) spectral entropy module (M-ENTROPY) for an anaesthetic monitor has become commercially ...

  11. Conventional versus virtual radiographs of the injured pelvis and acetabulum

    Energy Technology Data Exchange (ETDEWEB)

    Bishop, Julius A.; Rao, Allison J.; Pouliot, Michael A.; Bellino, Michael [Stanford University School of Medicine, Department of Orthopaedic Surgery, Stanford, CA (United States); Beaulieu, Christopher [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2015-09-15

    Evaluation of the fractured pelvis or acetabulum requires both standard radiographic evaluation as well as computed tomography (CT) imaging. The standard anterior-posterior (AP), Judet, and inlet and outlet views can now be simulated using data acquired during CT, decreasing patient discomfort, radiation exposure, and cost to the healthcare system. The purpose of this study is to compare the image quality of conventional radiographic views of the traumatized pelvis to virtual radiographs created from pelvic CT scans. Five patients with acetabular fractures and ten patients with pelvic ring injuries were identified using the orthopedic trauma database at our institution. These fractures were evaluated with both conventional radiographs as well as virtual radiographs generated from a CT scan. A web-based survey was created to query overall image quality and visibility of relevant anatomic structures. This survey was then administered to members of the Orthopaedic Trauma Association (OTA). Ninety-seven surgeons completed the acetabular fracture survey and 87 completed the pelvic fracture survey. Overall image quality was judged to be statistically superior for the virtual as compared to conventional images for acetabular fractures (3.15 vs. 2.98, p = 0.02), as well as pelvic ring injuries (2.21 vs. 1.45, p = 0.0001). Visibility ratings for each anatomic landmark were statistically superior with virtual images as well. Virtual radiographs of pelvic and acetabular fractures offer superior image quality, improved comfort, decreased radiation exposure, and a more cost-effective alternative to conventional radiographs. (orig.)

  12. Antioxidant activity in selected Slovenian organic and conventional crops

    Directory of Open Access Journals (Sweden)

    Manca KNAP

    2015-12-01

    Full Text Available The demand for organically produced food is increasing. There is widespread belief that organic food is substantially healthier and safer than conventional food. According to literature organic food is free of phytopharmaceutical residues, contain less nitrates and more antioxidants. The aim of the present study was to verify if there are any differences in the antioxidant activity between selected Slovenian organic and conventional crops. Method of DPPH (2,2-diphenyl-1-picryhydrazyl was used to determine the antioxidant activity of 16 samples from organic and conventional farms. The same varieties of crops were analysed. DPPH method was employed to measure the antioxidant activity of polar antioxidants (AAp and antioxidant activity of fraction in ethyl acetate soluble antioxidants (EA AA. Descriptive statistics and variance analysis were used to describe differences between farming systems. Estimated differences between interactions for the same crop and different farming practice were mostly not statistically significant except for the AAp for basil and beetroot. Higher statistically significant values were estimated for conventional crops. For the EA AA in broccoli, cucumber, rocket and cherry statistically significant higher values were estimated for organic production.

  13. Conventional and serological detection of Fasciolosis in ruminants ...

    African Journals Online (AJOL)

    The study was conducted to determined seasonal prevalence of fasciolosis and compare between its conventional diagnosis and serological identification in ruminants slaughtered at Maiduguri abattoir, northeastern Nigeria. Nine hundred samples each of faeces and blood; that is 300 each from cattle, sheep and goats was ...

  14. Vachellia karroo leaf meal: a promising non-conventional feed ...

    African Journals Online (AJOL)

    Vachellia karroo leaf meal: a promising non-conventional feed resource for improving goat production in low-input farming systems of Southern Africa. ... Vachellia karroo possesses desirable fatty acid profiles, and high protein and mineral contents that can improve animal performance. Presently, the use of V. karroo for ...

  15. Access to justice in the Convention on Rights system

    NARCIS (Netherlands)

    Gerards, J.H.; Glas, L.R.

    2017-01-01

    The numerous reforms to the Convention system of the past two decades have unquestionably had an effect on applicants’ means to access justice in the system. It is, however, open to question how these changes should be evaluated: with reference to the individual right to petition, or with reference

  16. National report of Brazil on nuclear safety convention - introduction

    International Nuclear Information System (INIS)

    1998-01-01

    This document was prepared for fulfilling the Brazilian obligations under the Convention on Nuclear Safety. Chapter 1 presents some historical aspects of the Brazilian nuclear policy, targets to be attained for increasing the nuclear energy contribution for the national production of electric energy

  17. Training Needs Analysis: Weaknesses in the Conventional Approach.

    Science.gov (United States)

    Leat, Michael James; Lovel, Murray Jack

    1997-01-01

    Identification of the training and development needs of administrative support staff is not aided by conventional performance appraisal, which measures summary or comparative effectiveness. Meaningful diagnostic evaluation integrates three levels of analysis (organization, task, and individual), using behavioral expectation scales. (SK)

  18. A prompt start: Implementing the framework convention on climate change

    International Nuclear Information System (INIS)

    Chayes, A.; Skolnikoff, E.B.; Victor, D.G.

    1992-01-01

    A Framework Convention on Climate Change is under active negotiation in the United Nations with the expectation it will be ready for Signature at the Rio Conference this June. Under the most optimistic projections, a Convention will not come into force and be an effective instrument for months, probably years. In recognition of the several institutional tasks that will be of crucial importance whatever the detailed content of the Convention a small group of high international organizations involved in the negotiations was convened at the Rockefeller Foundation's Conference Center at Bellagio in January. The discussions at Bellagio on the need for a Prompt Start on these institutional tasks benefitted from earlier meetings at Harvard in March and at Bermuda in May, 1991, that the co-organizers convened to discuss these and related aspects of the negotiations on a Climate Convention. Those meetings were attended by members of the academic community, officials from the United Nations, and representatives of governments involved in the negotiations

  19. National Ignition Facility system design requirements conventional facilities SDR001

    International Nuclear Information System (INIS)

    Hands, J.

    1996-01-01

    This System Design Requirements (SDR) document specifies the functions to be performed and the minimum design requirements for the National Ignition Facility (NIF) site infrastructure and conventional facilities. These consist of the physical site and buildings necessary to house the laser, target chamber, target preparation areas, optics support and ancillary functions

  20. Single-incision laparoscopic surgery and conventional laparoscopic ...

    African Journals Online (AJOL)

    Indications for surgery included grades II-III varicocele or ipsilateral testicular hypotrophy. The SIL-V procedure was performed in 44 patients with roticulating and conventional 5 mm instruments. Testicular vessels were isolated “en bloc,” clipped and cut. Operating time, visual analogue scale and post-operative results were ...