WorldWideScience

Sample records for current scientific evidence

  1. Current Scientific Evidence for a Polarized Cardiovascular Endurance Training Model.

    Science.gov (United States)

    Hydren, Jay R; Cohen, Bruce S

    2015-12-01

    Recent publications have provided new scientific evidence for a modern aerobic or cardiovascular endurance exercise prescription that optimizes the periodization cycle and maximizes potential endurance performance gains in highly trained individuals. The traditional threshold, high volume, and high-intensity training models have displayed limited improvement in actual race pace in (highly) trained individuals while frequently resulting in overreaching or overtraining (physical injury and psychological burnout). A review of evidence for replacing these models with the proven polarized training model seems warranted. This review provides a short history of the training models, summarizes 5 key studies, and provides example training programs for both the pre- and in-season periods. A polarized training program is characterized by an undulating nonlinear periodization model with nearly all the training time spent at a "light" (≤13) and "very hard" (≥17) pace with very limited time at "hard" (14-16) or race pace (6-20 Rating of Perceived Exertion [RPE] scale). To accomplish this, the polarization training model has specific high-intensity workouts separated by one or more long slow distance workouts, with the exercise intensity remaining below ventilatory threshold (VT) 1 and/or blood lactate of less than 2 mM (A.K.A. below race pace). Effect sizes for increasing aerobic endurance performance for the polarized training model are consistently superior to that of the threshold training model. Performing a polarized training program may be best accomplished by: going easy on long slow distance workouts, avoiding "race pace" and getting after it during interval workouts.

  2. Concussions: What a neurosurgeon should know about current scientific evidence and management strategies

    Science.gov (United States)

    Neal, Matthew T.; Wilson, Jonathan L.; Hsu, Wesley; Powers, Alexander K.

    2012-01-01

    Background: There has been a tremendous amount of interest focused on the topic of concussions over the past few decades. Neurosurgeons are frequently consulted to manage patients with mild traumatic brain injuries (mTBI) that have radiographic evidence of cerebral injury. These injuries share significant overlap with concussions, injuries that typically do not reveal radiographic evidence of structural injury, in the realms of epidemiology, pathophysiology, outcomes, and management. Further, neurosurgeons often manage patients with extracranial injuries that have concomitant concussions. In these cases, neurosurgeons are often the only “concussion experts” that patients encounter. Results: The literature has been reviewed and data have been synthesized on the topic including sections on historical background, epidemiology, pathophysiology, diagnostic advances, clinical sequelae, and treatment suggestions, with neurosurgeons as the intended target audience. Conclusions: Neurosurgeons should have a fundamental knowledge of the scientific evidence that has developed regarding concussions and be prepared to guide patients with treatment plans. PMID:22439107

  3. Historical and cultural aspects of the pineal gland: comparison between the theories provided by Spiritism in the 1940s and the current scientific evidence.

    Science.gov (United States)

    Lucchetti, Giancarlo; Daher, Jorge C; Iandoli, Decio; Gonçalves, Juliane P B; Lucchetti, Alessandra L G

    2013-01-01

    Significance has been attached to the pineal gland in numerous different cultures and beliefs. One religion that has advanced the role of the pineal gland is Spiritism. The objective of the present study was to compile information on the pineal gland drawing on the books of Francisco Cândido Xavier written through psychography and to carry out a critical analysis of their scientific bases by comparing against evidence in the current scientific literature. A systematic search using the terms "pineal gland" and "epiphysis" was conducted of 12 works allegedly dictated by the spirit "André Luiz". All information on the pineal having potential correlation with the field of medicine and current studies was included. Specialists in the area were recruited to compile the information and draw parallels with the scientific literature. The themes related to the pineal gland were: mental health, reproductive function, endocrinology, relationship with physical activity, spiritual connection, criticism of the theory that the organ exerts no function, and description of a hormone secreted by the gland (reference alluding to melatonin, isolated 13 years later). The historical background for each theme was outlined, together with the theories present in the Spiritist books and in the relevant scientific literature. The present article provides an analysis of the knowledge the scientific community can acquire from the history of humanity and from science itself. The process of formulating hypotheses and scientific theories can benefit by drawing on the cultural aspects of civilization, taking into account so-called non-traditional reports and theories.

  4. Current scientific evidence for integrated community case management (iCCM in Africa: Findings from the iCCM Evidence Symposium

    Directory of Open Access Journals (Sweden)

    Theresa Diaz

    2014-11-01

    Full Text Available In March 2014, over 400 individuals from 35 countries in sub-Saharan Africa and 59 international partner organizations gathered in Accra, Ghana for an integrated Community Case Management (iCCM Evidence Review Symposium. The objective was 2-fold: first, to review the current state of the art of iCCM implementation and second, to assist African countries to integrate lessons learned and best practices presented during the symposium into their programmes. Based on the findings from the symposium this supplement includes a comprehensive set of articles that provide the latest evidence for improving iCCM programs and ways to better monitor and evaluate such programs

  5. Scientific Evidence for Hydrostatic Shock

    CERN Document Server

    Courtney, Michael

    2008-01-01

    This paper reviews the scientific support for a ballistic pressure wave radiating outward from a penetrating projectile and causing injury and incapacitation. This phenomenon is known colloquially as "hydrostatic shock." The idea apparently originates with Col. Frank Chamberlin, a World War II trauma surgeon and wound ballistics researcher. The paper reviews claims that hydrostatic shock is a myth and considers supporting evidence through parallels with blast, describing the physics of the pressure wave, evidence for remote cerebral effects, and remote effects in the spine and other internal organs. Finally, the review considers the levels of energy transfer required for the phenomenon to be readily observed.

  6. Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence.

    Science.gov (United States)

    Mipatrini, Daniele; Stefanelli, Paola; Severoni, Santino; Rezza, Giovanni

    2017-03-01

    The decline of immunization rates in countries of origin of migrants and refugees, along with risky conditions during the journey to Europe, may threaten migrants' health. We performed a systematic review of the scientific literature in order to assess the frequency of vaccine preventable diseases, and vaccination coverage among migrants and refugees in Europe. To this end, Medline and Cochrane databases were considered. After the screening and the selection process, 58 papers were included in the review. We focused on the following vaccine-preventable diseases: hepatitis B, measles, rubella, mumps, tetanus, poliomyelitis, pertussis, diphtheria, meningitis, and varicella. The results were presented as a qualitative synthesis. In summary, several studies highlighted that migrants and refugees have lower immunization rates compared to European-born individuals. Firstly, this is due to low vaccination coverage in the country of origin. Then, several problems may limit migrants' access to vaccination in Europe: (i) migrants are used to move around the continent, and many vaccines require multiple doses at regular times; (ii) information on the immunization status of migrants is often lacking; (iii) hosting countries face severe economic crises; (iv) migrants often refuse registration with medical authorities for fear of legal consequences and (v) the lack of coordination among public health authorities of neighboring countries may determine either duplications or lack of vaccine administration. Possible strategies to overcome these problems include tailoring immunization services on the specific needs of the target population, developing strong communication campaigns, developing vaccination registers, and promoting collaboration among public health authorities of European Countries.

  7. Fever management: Evidence vs current practice.

    Science.gov (United States)

    El-Radhi, A Sahib Mehdi

    2012-12-08

    Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department. Parents are concerned about fever and it's potential complications. The biological value of fever (i.e., whether it is beneficial or harmful) is disputed and it is being vigorously treated with the belief of preventing complications such as brain injury and febrile seizures. The practice of alternating antipyretics has become widespread at home and on paediatric wards without supporting scientific evidence. There is still a significant contrast between the current concept and practice, and the scientific evidence. Why is that the case in such a common complaint like fever The article will discuss the significant contrast between the current concepts and practice of fever management on one hand, and the scientific evidence against such concepts and practice.

  8. Guidelines for the Design and Conduct of Clinical Studies in Knee Articular Cartilage Repair: International Cartilage Repair Society Recommendations Based on Current Scientific Evidence and Standards of Clinical Care.

    Science.gov (United States)

    Mithoefer, Kai; Saris, Daniel B F; Farr, Jack; Kon, Elizaveta; Zaslav, Kenneth; Cole, Brian J; Ranstam, Jonas; Yao, Jian; Shive, Matthew; Levine, David; Dalemans, Wilfried; Brittberg, Mats

    2011-04-01

    To summarize current clinical research practice and develop methodological standards for objective scientific evaluation of knee cartilage repair procedures and products. A comprehensive literature review was performed of high-level original studies providing information relevant for the design of clinical studies on articular cartilage repair in the knee. Analysis of cartilage repair publications and synopses of ongoing trials were used to identify important criteria for the design, reporting, and interpretation of studies in this field. Current literature reflects the methodological limitations of the scientific evidence available for articular cartilage repair. However, clinical trial databases of ongoing trials document a trend suggesting improved study designs and clinical evaluation methodology. Based on the current scientific information and standards of clinical care, detailed methodological recommendations were developed for the statistical study design, patient recruitment, control group considerations, study endpoint definition, documentation of results, use of validated patient-reported outcome instruments, and inclusion and exclusion criteria for the design and conduct of scientifically sound cartilage repair study protocols. A consensus statement among the International Cartilage Repair Society (ICRS) and contributing authors experienced in clinical trial design and implementation was achieved. High-quality clinical research methodology is critical for the optimal evaluation of current and new cartilage repair technologies. In addition to generally applicable principles for orthopedic study design, specific criteria and considerations apply to cartilage repair studies. Systematic application of these criteria and considerations can facilitate study designs that are scientifically rigorous, ethical, practical, and appropriate for the question(s) being addressed in any given cartilage repair research project.

  9. Current evidence for osteoarthritis treatments.

    Science.gov (United States)

    Anandacoomarasamy, Ananthila; March, Lyn

    2010-02-01

    Osteoarthritis (OA) is the most common form of arthritis and the leading cause of chronic disability among older people. The burden of the disease is expected to rise with an aging population and the increasing prevalence of obesity. Despite this, there is as yet no cure for OA. However, in recent years, a number of potential therapeutic advances have been made, in part due to improved understanding of the underlying pathophysiology. This review provides the current evidence for symptomatic management of OA including nonpharmacological, pharmacological and surgical approaches. The current state of evidence for disease-modifying therapy in OA is also reviewed.

  10. Admissibility of scientific evidence post-Daubert.

    Science.gov (United States)

    Masten, J; Strzelczyk, J J

    2001-12-01

    Proof of medical causation is the key element in cases involving alleged radiation injury. Until 1993, the use of scientific testimony in the courtroom was governed by the Frye doctrine requiring that a theory be "generally accepted" before it can be the basis of an expert's opinion. Applying that rule trial courts adopted a "let it all in" approach resulting in a near overdose of pseudoscience presented to juries. With its decision in Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 113 S. Ct. 2786 (1993), the U.S. Supreme Court announced a new five-factor, non-exclusive test for federal district courts to consider when assessing the opinion of scientific experts. The Court further directed that the trial courts, acting as a gatekeeper for expert evidence, must evaluate whether there is an adequate "fit" between the expert's data and the opinion offered. This article examines how the Daubert standard has been implemented in federal court to combat junk science. Examples from recent case law dealing with operational health physics issues are presented as an illustration of the use of the five-factor test to challenge questionable testimony on causation. Guidance is offered to prospective expert witnesses in radiation-related litigation to insure that proposed testimony will be admissible in district court.

  11. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations.

    Science.gov (United States)

    Reed, Geoffrey M; Drescher, Jack; Krueger, Richard B; Atalla, Elham; Cochran, Susan D; First, Michael B; Cohen-Kettenis, Peggy T; Arango-de Montis, Iván; Parish, Sharon J; Cottler, Sara; Briken, Peer; Saxena, Shekhar

    2016-10-01

    In the World Health Organization's forthcoming eleventh revision of the International Classification of Diseases and Related Health Problems (ICD-11), substantial changes have been proposed to the ICD-10 classification of mental and behavioural disorders related to sexuality and gender identity. These concern the following ICD-10 disorder groupings: F52 Sexual dysfunctions, not caused by organic disorder or disease; F64 Gender identity disorders; F65 Disorders of sexual preference; and F66 Psychological and behavioural disorders associated with sexual development and orientation. Changes have been proposed based on advances in research and clinical practice, and major shifts in social attitudes and in relevant policies, laws, and human rights standards. This paper describes the main recommended changes, the rationale and evidence considered, and important differences from the DSM-5. An integrated classification of sexual dysfunctions has been proposed for a new chapter on Conditions Related to Sexual Health, overcoming the mind/body separation that is inherent in ICD-10. Gender identity disorders in ICD-10 have been reconceptualized as Gender incongruence, and also proposed to be moved to the new chapter on sexual health. The proposed classification of Paraphilic disorders distinguishes between conditions that are relevant to public health and clinical psychopathology and those that merely reflect private behaviour. ICD-10 categories related to sexual orientation have been recommended for deletion from the ICD-11.

  12. Disorders related to sexuality and gender identity in the ICD‐11: revising the ICD‐10 classification based on current scientific evidence, best clinical practices, and human rights considerations

    Science.gov (United States)

    Reed, Geoffrey M.; Drescher, Jack; Krueger, Richard B.; Atalla, Elham; Cochran, Susan D.; First, Michael B.; Cohen‐Kettenis, Peggy T.; Arango‐de Montis, Iván; Parish, Sharon J.; Cottler, Sara; Briken, Peer; Saxena, Shekhar

    2016-01-01

    In the World Health Organization's forthcoming eleventh revision of the International Classification of Diseases and Related Health Problems (ICD‐11), substantial changes have been proposed to the ICD‐10 classification of mental and behavioural disorders related to sexuality and gender identity. These concern the following ICD‐10 disorder groupings: F52 Sexual dysfunctions, not caused by organic disorder or disease; F64 Gender identity disorders; F65 Disorders of sexual preference; and F66 Psychological and behavioural disorders associated with sexual development and orientation. Changes have been proposed based on advances in research and clinical practice, and major shifts in social attitudes and in relevant policies, laws, and human rights standards. This paper describes the main recommended changes, the rationale and evidence considered, and important differences from the DSM‐5. An integrated classification of sexual dysfunctions has been proposed for a new chapter on Conditions Related to Sexual Health, overcoming the mind/body separation that is inherent in ICD‐10. Gender identity disorders in ICD‐10 have been reconceptualized as Gender incongruence, and also proposed to be moved to the new chapter on sexual health. The proposed classification of Paraphilic disorders distinguishes between conditions that are relevant to public health and clinical psychopathology and those that merely reflect private behaviour. ICD‐10 categories related to sexual orientation have been recommended for deletion from the ICD‐11. PMID:27717275

  13. The effect of scientific evidence on conservation practitioners' management decisions.

    Science.gov (United States)

    Walsh, Jessica C; Dicks, Lynn V; Sutherland, William J

    2015-02-01

    A major justification of environmental management research is that it helps practitioners, yet previous studies show it is rarely used to inform their decisions. We tested whether conservation practitioners focusing on bird management were willing to use a synopsis of relevant scientific literature to inform their management decisions. This allowed us to examine whether the limited use of scientific information in management is due to a lack of access to the scientific literature or whether it is because practitioners are either not interested or unable to incorporate the research into their decisions. In on-line surveys, we asked 92 conservation managers, predominantly from Australia, New Zealand, and the United Kingdom, to provide opinions on 28 management techniques that could be applied to reduce predation on birds. We asked their opinions before and after giving them a summary of the literature about the interventions' effectiveness. We scored the overall effectiveness and certainty of evidence for each intervention through an expert elicitation process-the Delphi method. We used the effectiveness scores to assess the practitioners' level of understanding and awareness of the literature. On average, each survey participant changed their likelihood of using 45.7% of the interventions after reading the synopsis of the evidence. They were more likely to implement effective interventions and avoid ineffective actions, suggesting that their intended future management strategies may be more successful than current practice. More experienced practitioners were less likely to change their management practices than those with less experience, even though they were not more aware of the existing scientific information than less experienced practitioners. The practitioners' willingness to change their management choices when provided with summarized scientific evidence suggests that improved accessibility to scientific information would benefit conservation management

  14. Evidence of forensic scientific opinion and the rules for admissibility

    National Research Council Canada - National Science Library

    Heydon, JD

    2015-01-01

    Possible methods for the exclusion of unreliable forensic scientific evidence - irrelevance - probative value exceeding prejudicial effect - categories of automatic inadmissibility - whether existing...

  15. Students' abilities to critique scientific evidence when reading and writing scientific arguments

    Science.gov (United States)

    Knight, Amanda M.

    Scientific arguments are used to persuade others for explanations that make sense of the natural world. Over time, through the accumulation of evidence, one explanation for a scientific phenomenon tends to take precedence. In science education, arguments make students' thinking and reasoning visible while also supporting the development of their conceptual, procedural, and epistemic knowledge. As such, argumentation has become a goal within recent policy documents, including the Next Generation Science Standards, which, in turn, presents a need for comprehensive, effective, and scalable assessments. This dissertation used assessments that measure students' abilities to critique scientific evidence, which is measured in terms of the form of justification and the support of empirical evidence, when reading and writing scientific arguments. Cognitive interviews were then conducted with a subset of the students to explore the criteria they used to critique scientific evidence. Specifically, the research investigated what characteristics of scientific evidence the students preferred, how they critiqued both forms of justification and empirical evidence, and whether the four constructs represented four separate abilities. Findings suggest that students' prioritized the type of empirical evidence to the form of justification, and most often selected relevant-supporting justifications. When writing scientific arguments, most students constructed a justified claim, but struggled to justify their claims with empirical evidence. In comparison, when reading scientific arguments, students had trouble locating a justification when it was not empirical data. Additionally, it was more difficult for students to critique than identify or locate empirical evidence, and it was more difficult for students to identify than locate empirical evidence. Findings from the cognitive interviews suggest that students with more specific criteria tended to have more knowledge of the construct

  16. Masturbation: Scientific Evidence and Islam's View.

    Science.gov (United States)

    Hoseini, Sayed Shahabuddin

    2013-04-23

    Masturbation is the stimulation of sexual organs usually to the point of orgasm with an essential autoerotic component. Due to the high prevalence of this sexual behavior, it was and still is a matter of debate if masturbation is a normal action without any side effects and even if it is advantageous or it is associated with side effects necessitating public education how to avoid it. In addition, it is a common question if masturbation is religiously lawful or not. In this study, I assess the results of scientific studies about this sexual behavior and also shed some light on the Islam's view about it.

  17. Scientific evidence of the homeopathic epistemological model

    Directory of Open Access Journals (Sweden)

    Marcus Zulian Teixeira

    2011-03-01

    Full Text Available Homeopathy is based on principles and a system of knowledge different from the ones supporting the conventional biomedical model: this epistemological conflict is the underlying reason explaining why it is so difficult to accept by present-day scientific reason. To legitimize homeopathy according to the standards of the latter, research must confirm the validity of its basic assumptions: principle of therapeutic similitude, trials of medicines on healthy individuals, individualized prescriptions and use of high dilutions. Correspondingly, basic research must supply experimental data and models to substantiate these principles of homeopathy, whilst clinical trials aim at confirming the efficacy and effectiveness of homeopathy in the treatment of disease. This article discusses the epistemological model of homeopathy relating its basic assumptions with data resulting from different fields of modern experimental research and supporting its therapeutic use on the outcomes of available clinical trials. In this regard, the principle of individualization of treatment is the sine qua non condition to make therapeutic similitude operative and consequently for homeopathic treatment to exhibit clinical efficacy and effectiveness.

  18. Standardized description of scientific evidence using the Evidence Ontology (ECO).

    Science.gov (United States)

    Chibucos, Marcus C; Mungall, Christopher J; Balakrishnan, Rama; Christie, Karen R; Huntley, Rachael P; White, Owen; Blake, Judith A; Lewis, Suzanna E; Giglio, Michelle

    2014-01-01

    The Evidence Ontology (ECO) is a structured, controlled vocabulary for capturing evidence in biological research. ECO includes diverse terms for categorizing evidence that supports annotation assertions including experimental types, computational methods, author statements and curator inferences. Using ECO, annotation assertions can be distinguished according to the evidence they are based on such as those made by curators versus those automatically computed or those made via high-throughput data review versus single test experiments. Originally created for capturing evidence associated with Gene Ontology annotations, ECO is now used in other capacities by many additional annotation resources including UniProt, Mouse Genome Informatics, Saccharomyces Genome Database, PomBase, the Protein Information Resource and others. Information on the development and use of ECO can be found at http://evidenceontology.org. The ontology is freely available under Creative Commons license (CC BY-SA 3.0), and can be downloaded in both Open Biological Ontologies and Web Ontology Language formats at http://code.google.com/p/evidenceontology. Also at this site is a tracker for user submission of term requests and questions. ECO remains under active development in response to user-requested terms and in collaborations with other ontologies and database resources. Database URL: Evidence Ontology Web site: http://evidenceontology.org.

  19. Presenting Global Warming and Evolution as Public Health Issues to Encourage Acceptance of Scientific Evidence

    Science.gov (United States)

    Stover, Shawn K.; McArthur, Laurence B.; Mabry, Michelle L.

    2013-01-01

    Although evidence supporting anthropogenic global warming and evolution by natural selection is considerable, the public does not embrace these concepts. The current study explores the hypothesis that individuals will become more receptive to scientific viewpoints if evidence for evolution and implications of global warming are presented as issues…

  20. Bridging Ayurveda with evidence-based scientific approaches in medicine.

    Science.gov (United States)

    Patwardhan, Bhushan

    2014-01-01

    This article reviews contemporary approaches for bridging Ayurveda with evidence-based medicine. In doing so, the author presents a pragmatic assessment of quality, methodology and extent of scientific research in Ayurvedic medicine. The article discusses the meaning of evidence and indicates the need to adopt epistemologically sensitive methods and rigorous experimentation using modern science. The author critically analyzes the status of Ayurvedic medicine based on personal observations, peer interactions and published research. This review article concludes that traditional knowledge systems like Ayurveda and modern scientific evidence-based medicine should be integrated. The author advocates that Ayurvedic researchers should develop strategic collaborations with innovative initiatives like 'Horizon 2020' involving predictive, preventive and personalized medicine (PPPM).

  1. The effect of scientific evidence on conservation practitioners’ management decisions

    Science.gov (United States)

    Walsh, Jessica C; Dicks, Lynn V; Sutherland, William J

    2015-01-01

    A major justification of environmental management research is that it helps practitioners, yet previous studies show it is rarely used to inform their decisions. We tested whether conservation practitioners focusing on bird management were willing to use a synopsis of relevant scientific literature to inform their management decisions. This allowed us to examine whether the limited use of scientific information in management is due to a lack of access to the scientific literature or whether it is because practitioners are either not interested or unable to incorporate the research into their decisions. In on-line surveys, we asked 92 conservation managers, predominantly from Australia, New Zealand, and the United Kingdom, to provide opinions on 28 management techniques that could be applied to reduce predation on birds. We asked their opinions before and after giving them a summary of the literature about the interventions’ effectiveness. We scored the overall effectiveness and certainty of evidence for each intervention through an expert elicitation process—the Delphi method. We used the effectiveness scores to assess the practitioners’ level of understanding and awareness of the literature. On average, each survey participant changed their likelihood of using 45.7% of the interventions after reading the synopsis of the evidence. They were more likely to implement effective interventions and avoid ineffective actions, suggesting that their intended future management strategies may be more successful than current practice. More experienced practitioners were less likely to change their management practices than those with less experience, even though they were not more aware of the existing scientific information than less experienced practitioners. The practitioners’ willingness to change their management choices when provided with summarized scientific evidence suggests that improved accessibility to scientific information would benefit conservation

  2. Preventing obesity by bacteriotherapy in indian Pima community: scientific evidences

    Directory of Open Access Journals (Sweden)

    Silvia Llorens-Folgado

    2017-05-01

    Full Text Available Intestinal microbiota (MI imbalance affects obesity development. Strategies to treat obesity involving to restore this balance, by manipulation of the MI. The effectiveness of fecal transplantation (FT in certain pathologies, supports as an alternative therapy. The community of Pima Indians (PI are a benchmark in the study of the etiology of diabetes mellitus type II and obesity. FT was analyzed as a preventive strategy in the development of obesity in PI. To do this, scientific evidence was collected through a qualitative systematic review from 2000 to 2013. The results showed an increase of 112% in the number of scientific publications that associate health to MI. 13% relate an association of MI with obesity. No studies of the MI composition for PI were found. Regarding the FT, was found that this was the treatment less used to restore microbiota. It was concluded that there is a growing scientific interest in the study of MI and two research gaps were evident: the MI composition for PI and studies about the use of FT to determine its effectiveness as a preventive therapy of obesity.

  3. Current evidence supporting "letrozole" for ovulation induction

    Directory of Open Access Journals (Sweden)

    Sujata Kar

    2013-01-01

    Full Text Available Aromatase inhibitor "letrozole" was first introduced as a potential ovulation induction (OI drug almost a decade back. Large number of studies has been published using letrozole for OI: In polycystic ovary syndrome (PCOS women, clomiphene citrate (CC resistant women, for intrauterine insemination and also in various protocols of mild stimulation for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI. Letrozole appears to be a good option, with its oral route of administration, cost, shorter half-life and negligible side effects. However, the verdict on efficacy and safety of letrozole is still uncertain. This review explores the current scientific data supporting letrozole for OI.

  4. [Scientific evidence and the cost of innovations in the health-care system].

    Science.gov (United States)

    Porzsolt, Franz; Schreyögg, Jonas

    2009-08-01

    When depicting the relationship between evidence and the cost of an innovation in the health-care system, the overall risks of assessment, the redistribution of risks in a regulated market, and the ethical consequences must first be taken into account. There are also evidence-based criteria and economic considerations which are relevant when calculating the cost of an innovation. These topics can indicate, but not exhaustively deal with the complicated relationship between scientific evidence and calculating the cost of an innovation in the health-care system. The following three statements summarize the current considerations in the continuing discussion of this topic: *Scientific evidence undoubtedly exists which should be taken into consideration when calculating the cost of an innovation in the health-care system. *The existing scientific evidence is, however, not sufficient to reach such a decision. Additional information about the benefit perceived by the patient is required. *No standardized method exists to measure this additional information. Therefore, a definition problem also exists in the health-care system when setting a price according to scientific evidence.

  5. From scientifically based research to evidence based learning

    Directory of Open Access Journals (Sweden)

    Rosa Cera

    2016-02-01

    Full Text Available This essay is a reflection on the peculiarities of the scientifically based research and on the distinctive elements of the EBL (evidence based learning, methodology used in the study on the “Relationship between Metacognition, Self-efficacy and Self-regulation in Learning”. The EBL method, based on the standardization of data, explains how the students’ learning experience can be considered as a set of “data” and can be used to explain how and when the research results can be considered generalizable and transferable to other learning situations. The reflections present in this study have also allowed us to illustrate the impact that its results have had on the micro and macro level of reality. They helped to fill in the gaps concerning the learning/teaching processes, contributed to the enrichment of the scientific literature on this subject and allowed to establish standards through rigorous techniques such as systematic reviews and meta-analysis.

  6. Brazilian scientific evidence on Fournier’s gangrene

    Directory of Open Access Journals (Sweden)

    Érick Igor dos Santos

    2015-02-01

    Full Text Available The objective of this study was to describe the Brazilian scientific reports published over the past twenty years on Fournier’s gangrene. It is an integrative review conducted through incursions in the LILACS, MEDLINE, BDENF and Coleciona SUS databases with the descriptor ‘Fournier’s Gangrene’. Texts published between January 1994 and July 2014, in Portuguese, and freely available online were selected. According to the 14 articles found, the main symptoms of Fournier’s gangrene include discomfort with painful sensations, high fever, edema, malaise, and sweating. In most cases erythema and blistering are observed, evolving into a wound. The clinical profile assists in the selection of empirical antimicrobial therapy even before the culture results. It was concluded that early diagnosis and appropriate and aggressive treatment are crucial in patient prognosis. There is still a shortage of Brazilian scientific production with a high power of evidence on the subject.

  7. Consumer perception versus scientific evidence of farmed and wild fish

    DEFF Research Database (Denmark)

    Verbeke, Wim; Sioen, Isabelle; Brunsø, Karen

    2007-01-01

    capture fisheries. The consumer's subjective point of view is of overriding importance for the production system and product acceptance as well as for future market success. In this paper consumer perception in Belgium is explored and compared against scientific evidence of farmed versus wild fish....... Primary data were collected through a consumer survey (April 2003) and focus group discussions (May 2004) with Belgian consumers. The majority of the consumer sample reported no perceived differences between farmed versus wild fish. However, mean perception scores were slightly in favour of wild fish...

  8. Consumer perception versus scientific evidence of farmed and wild fish

    DEFF Research Database (Denmark)

    Verbeke, Wim; Sioen, Isabelle; Brunsø, Karen

    2007-01-01

    capture fisheries. The consumer's subjective point of view is of overriding importance for the production system and product acceptance as well as for future market success. In this paper consumer perception in Belgium is explored and compared against scientific evidence of farmed versus wild fish......The increasing number of marketable fish being supplied from aquaculture is a response to the increasing demand for healthy food and is filling the gap left by depleting natural fish stocks. Little is known about the awareness and perception of the consumer in terms of farmed fish versus fish from...

  9. Why are physicians not persuaded by scientific evidence? A grounded theory interview study.

    Science.gov (United States)

    Sekimoto, Miho; Imanaka, Yuichi; Kitano, Nobuko; Ishizaki, Tatsuro; Takahashi, Osamu

    2006-07-27

    The government-led "evidence-based guidelines for cataract treatment" labelled pirenoxine and glutathione eye drops, which have been regarded as the standard care for cataracts in Japan, as lacking evidence of effectiveness, causing great upset among ophthalmologists and professional ophthalmology societies. This study investigated the reasons why such "scientific evidence of treatment effectiveness" is not easily accepted by physicians, and thus, why they do not change their clinical practices to reflect such evidence. We conducted a qualitative study based on grounded theory to explore physicians' awareness of "scientific evidence" and evidence-supported treatment in relation to pirenoxine and glutathione eye drops, and to identify current barriers to the implementation of evidence-based policies in clinical practice. Interviews were conducted with 35 ophthalmologists and 3 general practitioners on their prescribing behaviours, perceptions of eye drop effectiveness, attitudes toward the eye drop guideline recommendations, and their perceptions of "scientific evidence." Although few physicians believed that eye drops are remarkably effective, the majority of participants reported that they prescribed eye drops to patients who asked for them, and that such patients accounted for a considerable proportion of those with cataracts. Physicians seldom attempted to explain to patients the limitations of effectiveness or to encourage them to stop taking the eye drops. Physicians also acknowledged the benefits of prescribing such drugs, which ultimately outweighed any uncertainty of their effectiveness. These benefits included economic incentives and a desire to be appreciated by patients. Changes in clinical practice were considered to bring little benefit to physicians or patients. Government approval, rarity of side effects, and low cost of the drops also encouraged prescription. Physicians occasionally provide treatment without expecting remarkable therapeutic

  10. Why are physicians not persuaded by scientific evidence? A grounded theory interview study

    Directory of Open Access Journals (Sweden)

    Ishizaki Tatsuro

    2006-07-01

    Full Text Available Abstract Background The government-led "evidence-based guidelines for cataract treatment" labelled pirenoxine and glutathione eye drops, which have been regarded as the standard care for cataracts in Japan, as lacking evidence of effectiveness, causing great upset among ophthalmologists and professional ophthalmology societies. This study investigated the reasons why such "scientific evidence of treatment effectiveness" is not easily accepted by physicians, and thus, why they do not change their clinical practices to reflect such evidence. Methods We conducted a qualitative study based on grounded theory to explore physicians' awareness of "scientific evidence" and evidence-supported treatment in relation to pirenoxine and glutathione eye drops, and to identify current barriers to the implementation of evidence-based policies in clinical practice. Interviews were conducted with 35 ophthalmologists and 3 general practitioners on their prescribing behaviours, perceptions of eye drop effectiveness, attitudes toward the eye drop guideline recommendations, and their perceptions of "scientific evidence." Results Although few physicians believed that eye drops are remarkably effective, the majority of participants reported that they prescribed eye drops to patients who asked for them, and that such patients accounted for a considerable proportion of those with cataracts. Physicians seldom attempted to explain to patients the limitations of effectiveness or to encourage them to stop taking the eye drops. Physicians also acknowledged the benefits of prescribing such drugs, which ultimately outweighed any uncertainty of their effectiveness. These benefits included economic incentives and a desire to be appreciated by patients. Changes in clinical practice were considered to bring little benefit to physicians or patients. Government approval, rarity of side effects, and low cost of the drops also encouraged prescription. Conclusion Physicians occasionally

  11. SEE: structured representation of scientific evidence in the biomedical domain using Semantic Web techniques.

    Science.gov (United States)

    Bölling, Christian; Weidlich, Michael; Holzhütter, Hermann-Georg

    2014-01-01

    Accounts of evidence are vital to evaluate and reproduce scientific findings and integrate data on an informed basis. Currently, such accounts are often inadequate, unstandardized and inaccessible for computational knowledge engineering even though computational technologies, among them those of the semantic web, are ever more employed to represent, disseminate and integrate biomedical data and knowledge. We present SEE (Semantic EvidencE), an RDF/OWL based approach for detailed representation of evidence in terms of the argumentative structure of the supporting background for claims even in complex settings. We derive design principles and identify minimal components for the representation of evidence. We specify the Reasoning and Discourse Ontology (RDO), an OWL representation of the model of scientific claims, their subjects, their provenance and their argumentative relations underlying the SEE approach. We demonstrate the application of SEE and illustrate its design patterns in a case study by providing an expressive account of the evidence for certain claims regarding the isolation of the enzyme glutamine synthetase. SEE is suited to provide coherent and computationally accessible representations of evidence-related information such as the materials, methods, assumptions, reasoning and information sources used to establish a scientific finding by adopting a consistently claim-based perspective on scientific results and their evidence. SEE allows for extensible evidence representations, in which the level of detail can be adjusted and which can be extended as needed. It supports representation of arbitrary many consecutive layers of interpretation and attribution and different evaluations of the same data. SEE and its underlying model could be a valuable component in a variety of use cases that require careful representation or examination of evidence for data presented on the semantic web or in other formats.

  12. Scientific evidence on the usefulness of intraarticular hyaluronic acid injection in the management of temporomandibular dysfunction

    OpenAIRE

    Escoda Francolí, Jaume; Vázquez Delgado, Eduardo; Gay Escoda, Cosme

    2010-01-01

    Hyaluronic acid (HA) is found in high concentrations in cartilage and synovial fluid, and is an important component of the extracellular matrixes- exerting joint lubrication and buffering actions thanks to its viscoelastic properties. The present study examines the scientific evidence found in the current literature on the usefulness of the intraarticular injection of HA in patients with temporomandibular dysfunction. A literature search was made up until May 2008 in the following databases: ...

  13. Scientific evidence of dockworker illness to nursing clinical reasoning.

    Science.gov (United States)

    Almeida, Marlise Capa Verde de; Cezar-Vaz, Marta Regina

    2016-04-01

    To identify scientific evidence of occupational illness of dockworkers published in the literature. systematic review of the literature, developed according to the Cochrane method. The databases searched were: Cochrane, LILACS, MEDLINE/PubMed, CINAHL and SciELO. Studies from 1988 to 2014 were selected. The data were analyzed according to the level of evidence and Strengthening the Reporting of Observational Studies in Epidemiology. We included 14 studies, in which 11 (78.6%) were from international journals. The year of 2012 showed greater number of studies. All studies were classified as: Level of Evidence 4, highlighting lung cancer, musculoskeletal and ischemic diseases, causal link in chemical risks. The development of preventive measures should especially include chemical exposure of workers applying the clinical reasoning of nurses' environmental knowledge to care for illnesses. Identificar evidências científicas de adoecimento ocupacional do trabalhador portuário publicadas na literatura. Revisão sistemática da literatura, construída conforme o método Cochrane. As bases de dados pesquisadas foram Cochrane, LILACS, MEDLINE/PubMed, CINAHL e SciELO. Foram selecionados artigos publicados de 1988 a 2014. Os dados foram analisados conforme o Nível de Evidência e Strengthening the Reporting of Observational Studies in Epidemiology. Foram selecionadas 14 publicações, das quais 11 (78,6%) de revistas internacionais. O ano de 2012 reuniu maior número de publicações no período de estudo. Todas as publicações pertenciam ao Nível de Evidência 4, destacando o câncer pulmonar, doenças osteomusculares e isquêmicas, com nexo causal nos riscos químicos. A elaboração de medidas preventivas deve prever especialmente a exposição química do trabalhador, aplicando ao raciocínio clínico do enfermeiro um conhecimento ambiental para a assistência aos adoecimentos.

  14. Current clinical evidence on pioglitazone pharmacogenomics

    Directory of Open Access Journals (Sweden)

    Marina eKawaguchi-Suzuki

    2013-11-01

    Full Text Available Pioglitazone is the most widely used thiazolidinedione and acts as an insulin-sensitizer through activation of the Peroxisome Proliferator-Activated Receptor-γ (PPARγ. Pioglitazone is approved for use in the management of type 2 diabetes mellitus, but its use in other therapeutic areas is increasing due to pleiotropic effects. In this hypothesis article, the current clinical evidence on pioglitazone pharmacogenomics is summarized and related to variability in pioglitazone response. How genetic variation in the human genome affects the pharmacokinetics and pharmacodynamics of pioglitazone was examined. For pharmacodynamic effects, hypoglycemic and anti-atherosclerotic effects, risks of fracture or edema, and the increase in body mass index in response to pioglitazone based on genotype were examined. The genes CYP2C8 and PPARG are the most extensively studied to date and selected polymorphisms contribute to respective variability in pioglitazone pharmacokinetics and pharmacodynamics. We hypothesized that genetic variation in pioglitazone pathway genes contributes meaningfully to the clinically observed variability in drug response. To test the hypothesis that genetic variation in PPARG associates with variability in pioglitazone response, we conducted a meta-analysis to synthesize the currently available data on the PPARG p.Pro12Ala polymorphism. The results showed that PPARG 12Ala carriers had a more favorable change in fasting blood glucose from baseline as compared to patients with the wild-type Pro12Pro genotype (p=0.018. Unfortunately, findings for many other genes lack replication in independent cohorts to confirm association; further studies are needed. Also, the biological functionality of these polymorphisms is unknown. Based on current evidence, we propose that pharmacogenomics may provide an important tool to individualize pioglitazone therapy and better optimize therapy in patients with T2DM or other conditions for which pioglitazone

  15. [Scientific Evidence on Preventive Interventions in Childhood Obesity].

    Science.gov (United States)

    Alba-Martín, Raquel

    The increasing prevalence of obesity or overweight at all ages, their associated morbidity and mortality associated, and the increased perception of the problem by the society have generated several hypotheses in response to the scientific and the international community. Investigate the preventive interventions in childhood obesity so far. Integrative review during the study period from April 2013 to November 2014. The MEDLINE international database was used, including PubMed, the Cochrane Library (Issue 4 2002), the national database Isooc (CSIC) national database, as well as the Internet. The review included health articles published in Spanish and English between 1990 and 2014 that focused on or included education, prevention, diagnostic, and treatment of obesity interventions. Of the 726 articles identified, 34 of most relevant (peer reviewed) were selected. It was noted that there is limited generisable evidence on interventions that could be implemented in Primary Care or referral services available, although numerous studies suggest that improvements in the overweight are possible. Despite the abundant literature and that many institutions place childhood obesity as one of the priorities of Public Health, we face the paradox that the evidence on cost-effectiveness of prevention interventions is sparse. Knowing these gaps in knowledge should lead to filling them with rigorous and well-designed studies. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  16. Racism and Health I: Pathways and Scientific Evidence.

    Science.gov (United States)

    Williams, David R; Mohammed, Selina A

    2013-08-01

    This article reviews the scientific research that indicates that despite marked declines in public support for negative racial attitudes in the United States, racism, in its multiple forms, remains embedded in American society. The focus of the article is on the review of empirical research that suggests that racism adversely affects the health of non-dominant racial populations in multiple ways. First, institutional racism developed policies and procedures that have reduced access to housing, neighborhood and educational quality, employment opportunities and other desirable resources in society. Second, cultural racism, at the societal and individual level, negatively affects economic status and health by creating a policy environment hostile to egalitarian policies, triggering negative stereotypes and discrimination that are pathogenic and fostering health damaging psychological responses such as stereotype threat and internalized racism. Finally, a large and growing body of evidence indicates that experiences of racial discrimination are an important type of psychosocial stressor that can lead to adverse changes in health status and altered behavioural patterns that increase health risks.

  17. The childhood immunization schedule and safety: stakeholder concerns, scientific evidence, and future studies

    National Research Council Canada - National Science Library

    Board on Population Health and Public Health Practice; Institute of Medicine; Committee on the Assessment of Studies of Health Outcomes Related to the Recommended Childhood Immunization Schedule

    2013-01-01

    "The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies reviews scientific findings and stakeholders concerns related to the safety of the recommended childhood immunization schedule...

  18. Teaching the Scientific Method Using Current News Articles

    Science.gov (United States)

    Palmer, Laura K.; Mahan, Carolyn G.

    2013-01-01

    We describe a short (less than 50 minutes) activity using news articles from sources such as "Science Daily" to teach students the steps of the scientific method and the difference between primary and secondary literature sources. The flexibility in choosing news articles to examine allowed us to tailor the activity to the specific interests of…

  19. Evidence for current diagnostic criteria of diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Ritesh; Kumar[1; Lakshmana; Perumal; Nandhini[1; Sadishkumar; Kamalanathan[1; Jayaprakash; Sahoo[1; Muthupillai; Vivekanadan[1

    2016-01-01

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies.The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications.

  20. Evidence for current diagnostic criteria of diabetes mellitus

    Science.gov (United States)

    Kumar, Ritesh; Nandhini, Lakshmana Perumal; Kamalanathan, Sadishkumar; Sahoo, Jayaprakash; Vivekanadan, Muthupillai

    2016-01-01

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies. The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications. PMID:27660696

  1. Conservation, biodiversity and infectious disease: scientific evidence and policy implications

    Science.gov (United States)

    Young, Hillary S.; Wood, Chelsea L.; Kilpatrick, A. Marm; Lafferty, Kevin D.; Nunn, Charles L.; Vincent, Jeffrey R.

    2017-01-01

    Habitat destruction and infectious disease are dual threats to nature and people. The potential to simultaneously advance conservation and human health has attracted considerable scientific and popular interest; in particular, many authors have justified conservation action by pointing out potential public health benefits . One major focus of this debate—that biodiversity conservation often decreases infectious disease transmission via the dilution effect—remains contentious. Studies that test for a dilution effect often find a negative association between a diversity metric and a disease risk metric, but how such associations should inform conservation policy remains unclear for several reasons. For one, diversity and infection risk have many definitions, making it possible to identify measures that conform to expectations. Furthermore, the premise that habitat destruction consistently reduces biodiversity is in question, and disturbance or conservation can affect disease in many ways other than through biodiversity change. To date, few studies have examined the broader set of mechanisms by which anthropogenic disturbance or conservation might increase or decrease infectious disease risk to human populations. Due to interconnections between biodiversity change, economics and human behaviour, moving from ecological theory to policy action requires understanding how social and economic factors affect conservation.This Theme Issue arose from a meeting aimed at synthesizing current theory and data on ‘biodiversity, conservation and infectious disease’ (4–6 May 2015). Ecologists, evolutionary biologists, economists, epidemiologists, veterinary scientists, public health professionals, and conservation biologists from around the world discussed the latest research on the ecological and socio-economic links between conservation, biodiversity and infectious disease, and the open questions and controversies in these areas. By combining ecological understanding

  2. Pseudomonas aeruginosa infection in patients with cystic fibrosis: scientific evidence regarding clinical impact, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Luiz Vicente Ribeiro Ferreira da Silva Filho

    2013-06-01

    Full Text Available Evidence-based techniques have been increasingly used in the creation of clinical guidelines and the development of recommendations for medical practice. The use of levels of evidence allows the reader to identify the quality of scientific information that supports the recommendations made by experts. The objective of this review was to address current concepts related to the clinical impact, diagnosis, and treatment of Pseudomonas aeruginosa infections in patients with cystic fibrosis. For the preparation of this review, the authors defined a group of questions that would be answered in accordance with the principles of PICO–an acronym based on questions regarding the Patients of interest, Intervention being studied, Comparison of the intervention, and Outcome of interest. For each question, a structured review of the literature was performed using the Medline database in order to identify the studies with the methodological design most appropriate to answering the question. The questions were designed so that each of the authors could write a response. A first draft was prepared and discussed by the group. Recommendations were then made on the basis of the level of scientific evidence, in accordance with the classification system devised by the Oxford Centre for Evidence-Based Medicine, as well as the level of agreement among the members of the group.

  3. The educational research and the “evidence-based scientific research” movement

    Directory of Open Access Journals (Sweden)

    Antonio Chizzotti

    2015-07-01

    Full Text Available This paper analyzes a movement of criticism towards humanities and educational research. The ‘evidence-based scientific research’ movement proclaims itself fit to raise the educational research to scientific level and criticizes severely the scientific production in the area, on the presumption of the exemplary validity of experimental research to achieve scientific forum and conduct public policies for education on the basis of scientific evidence. The movement admits an exemplary model of the research derived from the medical area and adopts the experimental and quasi-experimental research as single pattern of investigation, of positivist extraction, unaware of the advances of qualitative research in the humanities and in education.

  4. Complementary spiritist therapy: systematic review of scientific evidence.

    Science.gov (United States)

    Lucchetti, Giancarlo; Lucchetti, Alessandra L Granero; Bassi, Rodrigo M; Nobre, Marlene Rossi Severino

    2011-01-01

    Spiritism is the third most common religion in Brazil, and its therapies have been used by millions worldwide. These therapies are based on therapeutic resources including prayer, laying on of hands, fluidotherapy (magnetized water), charity/volunteering, spirit education/moral values, and disobsession (spirit release therapy). This paper presents a systematic review of the current literature on the relationship among health outcomes and 6 predictors: prayer, laying on of hands, magnetized/fluidic water, charity/volunteering, spirit education (virtuous life and positive affect), and spirit release therapy. All articles were analyzed according to inclusion/exclusion criteria, Newcastle-Ottawa and Jadad score. At present, there is moderate to strong evidence that volunteering and positive affect are linked to better health outcomes. Furthermore, laying on of hands, virtuous life, and praying for oneself also seem to be associated to positive findings. Nevertheless, there is a lack of studies on magnetized water and spirit release therapy. In summary, science is indirectly demonstrating that some of these therapies can be associated to better health outcomes and that other therapies have been overlooked or poorly investigated. Further studies in this field could contribute to the disciplines of Complementary and Alternative Medicine by investigating the relationship between body, mind, and soul/spirit.

  5. Complementary Spiritist Therapy: Systematic Review of Scientific Evidence

    Directory of Open Access Journals (Sweden)

    Giancarlo Lucchetti

    2011-01-01

    Full Text Available Spiritism is the third most common religion in Brazil, and its therapies have been used by millions worldwide. These therapies are based on therapeutic resources including prayer, laying on of hands, fluidotherapy (magnetized water, charity/volunteering, spirit education/moral values, and disobsession (spirit release therapy. This paper presents a systematic review of the current literature on the relationship among health outcomes and 6 predictors: prayer, laying on of hands, magnetized/fluidic water, charity/volunteering, spirit education (virtuous life and positive affect, and spirit release therapy. All articles were analyzed according to inclusion/exclusion criteria, Newcastle-Ottawa and Jadad score. At present, there is moderate to strong evidence that volunteering and positive affect are linked to better health outcomes. Furthermore, laying on of hands, virtuous life, and praying for oneself also seem to be associated to positive findings. Nevertheless, there is a lack of studies on magnetized water and spirit release therapy. In summary, science is indirectly demonstrating that some of these therapies can be associated to better health outcomes and that other therapies have been overlooked or poorly investigated. Further studies in this field could contribute to the disciplines of Complementary and Alternative Medicine by investigating the relationship between body, mind, and soul/spirit.

  6. Scope for rotavirus vaccination in India: revisiting the scientific evidence.

    Science.gov (United States)

    Neogi, Sutapa Bandyopadhyay; Hasan, Habib; Sheikh, Kabir; Zodpey, Sanjay

    2011-10-01

    Rotavirus vaccines have been developed to prevent deaths resulting from severe diarrhea of rotavirus origin. The use of vaccines as an intervention at scale to prevent and control the burden of rotavirus diarrhea is supported by the argument that prevailing public health measures such as hygiene and sanitation, breast feeding and use of ORS have failed to prevent severe dehydration resulting from diarrhea. The article reviews the existing evidence on the rationale of using rotavirus vaccine as against the feasibility of scaling it up in developing countries like India. The vaccines currently available may not cover the strains circulating in Indian population. The diversity of Rotavirus infection in the country is tremendous and since the safety, immunogenicity and efficacy data has not been collected for India, there is first a need to conduct studies to measure the extent of protection and cross-protection provided by the available vaccines for local strains, before venturing into Rotavirus vaccination program. The potential benefits of immunization have to be first vetted against the risks involved by the policymakers and other stakeholders.

  7. Dental movement acceleration: Literature review by an alternative scientific evidence method

    Science.gov (United States)

    Camacho, Angela Domínguez; Cujar, Sergio Andres Velásquez

    2014-01-01

    The aim of this study was to analyze the majority of publications using effective methods to speed up orthodontic treatment and determine which publications carry high evidence-based value. The literature published in Pubmed from 1984 to 2013 was reviewed, in addition to well-known reports that were not classified under this database. To facilitate evidence-based decision making, guidelines such as the Consolidation Standards of Reporting Trials, Preferred Reporting items for systematic Reviews and Meta-analyses, and Transparent Reporting of Evaluations with Non-randomized Designs check list were used. The studies were initially divided into three groups: local application of cell mediators, physical stimuli, and techniques that took advantage of the regional acceleration phenomena. The articles were classified according to their level of evidence using an alternative method for orthodontic scientific article classification. 1a: Systematic Reviews (SR) of randomized clinical trials (RCTs), 1b: Individual RCT, 2a: SR of cohort studies, 2b: Individual cohort study, controlled clinical trials and low quality RCT, 3a: SR of case-control studies, 3b: Individual case-control study, low quality cohort study and short time following split mouth designs. 4: Case-series, low quality case-control study and non-systematic review, and 5: Expert opinion. The highest level of evidence for each group was: (1) local application of cell mediators: the highest level of evidence corresponds to a 3B level in Prostaglandins and Vitamin D; (2) physical stimuli: vibratory forces and low level laser irradiation have evidence level 2b, Electrical current is classified as 3b evidence-based level, Pulsed Electromagnetic Field is placed on the 4th level on the evidence scale; and (3) regional acceleration phenomena related techniques: for corticotomy the majority of the reports belong to level 4. Piezocision, dentoalveolar distraction, alveocentesis, monocortical tooth dislocation and ligament

  8. 78 FR 6056 - Smokeless Tobacco Product Warning Statements; Request for Comments and Scientific Evidence

    Science.gov (United States)

    2013-01-29

    ... format, type size, and text of any other disclosures required under the Federal Food, Drug, and Cosmetic... Statements; Request for Comments and Scientific Evidence AGENCY: Food and Drug Administration, HHS. ACTION... docket to obtain comments, supported by scientific evidence, regarding what changes to the...

  9. Promoting Scientific Faculties: Does It Work? Evidence from Italy

    Science.gov (United States)

    Maestri, Virginia

    2013-01-01

    In reaction to the OECD-wide declining trend in scientific enrollments, the Italian government launched a policy in 2005 to promote the study of science at the university. The policy promoted extra-curricular activities for secondary school students in Chemistry, Physics, Math and Materials Science. This article evaluates the policy impact on…

  10. Nanotechnology and human health: Scientific evidence and risk governance

    DEFF Research Database (Denmark)

    . As complexity and uncertainty are large, risk assessment is challenging, and formulation of evidence-based policies and regulations elusive. Innovative models and frameworks for risk assessment and risk governance are being developed and applied to organize the available evidence on biological and health...

  11. Scientific Evidence on the Supportive Cancer Care with Chinese Medicine

    Directory of Open Access Journals (Sweden)

    William CS CHO

    2010-03-01

    Full Text Available Complementary and alternative medicine has been increasingly utilized by cancer patients in developed countries. Among the various forms of complementary and alternative medicine, Traditional Chinese Medicine is one of the few that has a well constructed theoretical framework and established treatment approaches for diseases including cancer. Recent research has revealed growing evidence suggesting that Traditional Chinese Medicine is effective in the supportive care of cancer patients during and after major conventional cancer treatments. This paper succinctly summarizes some published clinical evidence and meta-analyses which support the usage of various Traditional Chinese Medicine treatment strategies including Chinese herbal medicine, acupuncture and Qigong in supportive cancer care.

  12. Current clinical evidence on topiramate pharmacokinetics

    Directory of Open Access Journals (Sweden)

    Jakovljević Mihajlo

    2009-01-01

    Full Text Available Topiramate is biochemically classified as a fructopyranose sulphamate. Discovered as early as 1979, during middle 1980's it was approved in many countries for the treatment of epilepsies and migraine prevention. More recently, in the experimental stage, possible new indications have been disclosed: treatment of obesity, bipolar disorder, also cessation of smoking, neuropathic pain, cerebral pseudotumour, bulimia, periventricular leucomalatia in preterm infants and alcohol addiction. Most epileptologists consider it to be the first choice antiepileptic drug in severe pharmacoresistant epilepsies. A substantial corpus of evidence in paediatric population has been accumulated that confirms its efficiency in the treatment of generalised tonic-clonic seizures, Lenox-Gestaut syndrome, partial, absence and combined seizures. Having a unique monosaccharide chemical structure among other anticonvulsant drugs, characterizes it with special pharmacokinetic features. This substance exhibits a low interindividual variability in plasma levels and hence it features predictable pharmacokinetics. A steady state plasma concentration of topiramate increases linearly with higher dosages. Serum protein binding is approximately 15%, and biologic half-life in healthy volunteers is considered to range from 20 to 30 hours. Mean expected distribution volume rates from 0.55-0.8 l/kg, and accordingly, the drug shows a low and saturable binding capacity toward erythrocytes. It has not been present at the market for a sufficiently long time that would enable us to speak about a significant accumulation of data on its metabolism based on post-registration 4th stage clinical trials. For this purpose, we have done a literature review in order to summarise so far reported experience on topiramate pharmacokinetics in patients and healthy adults. Deeper understanding of its pharmacokinetic profile could enable a better technological design of the produced drug and the choice of

  13. What Constitutes Science and Scientific Evidence: Roles of Null Hypothesis Testing

    Science.gov (United States)

    Chang, Mark

    2017-01-01

    We briefly discuss the philosophical basis of science, causality, and scientific evidence, by introducing the hidden but most fundamental principle of science: the similarity principle. The principle's use in scientific discovery is illustrated with Simpson's paradox and other examples. In discussing the value of null hypothesis statistical…

  14. MMR vaccine and autism: an update of the scientific evidence.

    Science.gov (United States)

    DeStefano, Frank; Thompson, William W

    2004-02-01

    An hypothesis published in 1998 suggested that measles-mumps-rubella vaccine may cause autism as a result of persistent measles virus infection of the gastrointestinal tract. Results of early studies were not supportive and in 2001 a review by the Institute of Medicine concluded that the evidence favors the rejection of a causal relationship at the population level between measles-mumps-rubella vaccine and autistic spectrum disorder. Studies published since the Institute of Medicine report have continued not to find an increased risk of autistic spectrum disorder associated with measles-mumps-rubella. The vaccine also has not been found to be associated with a unique syndrome of developmental regression and gastrointestinal disorders. The evidence now is convincing that the measles-mumps-rubella vaccine does not cause autism or any particular subtypes of autistic spectrum disorder.

  15. Clinical utility of eslicarbazepine: current evidence

    Directory of Open Access Journals (Sweden)

    Zaccara G

    2015-02-01

    Full Text Available Gaetano Zaccara,1 Fabio Giovannelli,1,2 Massimo Cincotta,1 Alessia Carelli,3 Alberto Verrotti31Department of Medicine, Unit of Neurology, Florence Health Authority, Florence, Italy; 2Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA, University of Florence, Florence, Italy; 3Department of Pediatrics, University of Perugia, Perugia, ItalyAbstract: Eslicarbazepine acetate (ESL is a new antiepileptic drug whose mechanism of action is blockade of the voltage-gated sodium channel (VGSC. However, in respect to carbamazepine and oxcarbazepine, the active ESL metabolite (eslicarbazepine affects slow inactivation of VGSC and has a similar affinity for the inactivated state and a lower affinity for the resting state of the channel. This new antiepileptic drug has been recently approved in Europe (trade name Zebinix and in the United States (trade name Stedesa for adjunctive treatment in adult subjects with partial-onset seizures, with or without secondary generalization. Following oral administration, ESL is rapidly and extensively metabolized by hepatic esterases to eslicarbazepine. This active metabolite has a linear pharmacokinetic profile, a low binding to plasma proteins (<40%, and a half-life of 20–24 hours and is mainly excreted by kidneys in an unchanged form or as glucuronide conjugates. ESL is administered once a day and has a low potential for drug–drug interactions. Efficacy and safety of this drug in patients with focal seizures have been assessed in four randomized clinical trials, and responder rates (percentage of patients with a ≥50% improvement of their seizures ranged between 17% and 43%. Adverse events were usually mild to moderate, and the most common were dizziness, somnolence, diplopia, abnormal coordination, blurred vision, vertigo, headache, fatigue, nausea, and vomiting. ESL may be considered an interesting alternative to current antiepileptic drugs for the treatment of drug-resistant focal

  16. The nutritional and toxicological value of organic vegetables: consumer perception versus scientific evidence

    OpenAIRE

    Hoefkens, Christine; Verbeke, Wim; Aertsens, Joris; Mondelaers, Koen; Van Camp, John

    2009-01-01

    Purpose - The present study aims to explore and compare consumer perception and scientific evidence related to food quality and food safety aspects of organic versus conventional vegetables. Design/methodology/approach - Primary data on consumer perception were gathered in 2006-2007 through a consumer survey with Flemish adults (n = 529) and compared with scientific evidence from literature. Consumers of organic and conventional vegetables were selected by means of a convenience sampling p...

  17. Collation of Scientific Evidence on Consumer Acceptance of New Food Technologies

    DEFF Research Database (Denmark)

    Fischer, A. R. H; van Trijp, H. C. M.; Hofenk,, D.

    The current report investigates consumer acceptance of new food technologies by reviewing the scientific literature. The review is organised along three routes to consumer acceptance of new technologies: The consumer benefit road: the central road of technology features influencing experienced...... not directly influence perceived product characteristics, but results in novel retail and caterer business models, product placement and customer relation services. The available literature on 4 types of novel food technologies Mild processing technologies; Electromagnetic methods; Texturizing technologies......; and Novel packaging and storage technologies is reviewed along these roads. The results show that research remains fragmented in approach and usually adopts the point of view of a single road to consumer acceptance of a novel technology. Nevertheless by combining the available evidence recommendation can...

  18. Cosmetic mesotherapy: between scientific evidence, science fiction, and lucrative business.

    Science.gov (United States)

    Atiyeh, Bishara S; Ibrahim, Amir E; Dibo, Saad A

    2008-11-01

    Mesotherapy, originally conceived in Europe, is a minimally invasive technique that consists of the intra- or subcutaneous injection of variable mixtures of natural plant extracts, homeopathic agents, pharmaceuticals, vitamins, and other bioactive substances in microscopic quantities through dermal multipunctures. Its application in cosmetic medicine and surgery is gaining in popularity and acceptance and is rapidly growing in profile at an alarming rate. Despite their attraction as purported rejuvenating and ''fat-dissolving'' injections, the safety and efficacy of these novel cosmetic treatments remain ambiguous, making mesotherapy vulnerable to criticism by the generally more skeptical medical community. The technique is shrouded in mystery and the controversy surrounding it pertains to its efficacy and potential adverse effects that are subject of much concern. As with any new technology, it is important to assess the benefits, safety, experience, and standardization of mesotherapy. More studies are necessary before it can be advocated as a safe and effective treatment for body contouring and facial rejuvenation. Although the claims made about mesotherapy may be hard to believe at face value, we must be cautious about rejecting new ideas. Just as absence of proof is not proof of absence, lack of scientific validation is not proof that it does not work.

  19. Complementary Spiritist Therapy: Systematic Review of Scientific Evidence

    OpenAIRE

    2011-01-01

    Spiritism is the third most common religion in Brazil, and its therapies have been used by millions worldwide. These therapies are based on therapeutic resources including prayer, laying on of hands, fluidotherapy (magnetized water), charity/volunteering, spirit education/moral values, and disobsession (spirit release therapy). This paper presents a systematic review of the current literature on the relationship among health outcomes and 6 predictors: prayer, laying on of hands, magnetized/fl...

  20. Fostering Scientific Reasoning in Education--Meta-Analytic Evidence from Intervention Studies

    Science.gov (United States)

    Engelmann, Katharina; Neuhaus, Birgit J.; Fischer, Frank

    2016-01-01

    Scientific reasoning skills are not just for researchers, they are also increasingly relevant for making informed decisions in our everyday lives. How can these skills be facilitated? The current state of research on supporting scientific reasoning includes intervention studies but lacks an integrated analysis of the approaches to foster…

  1. Ancient scientific basis of the "great serpent" from historical evidence

    Science.gov (United States)

    Stothers, Richard B.

    2004-01-01

    Zoological data and a growing mythology contributed to ancient Western knowledge about large serpents. Yet little modern attention has been paid to the sources, transmission, and receipt in the early Middle Ages of the ancients' information concerning "dragons" and "sea serpents." Real animals--primarily pythons and whales--lie behind the ancient stories. Other animals, conflations of different animals, simple misunderstandings, and willful exaggerations are found to account for the fanciful embellishments, but primitive myths played no significant role in this process during classical times. The expedition of Alexander the Great into India (327-325 B.C.) and the Bagradas River incident in North Africa (256 B.C.) had enormous repercussions on the development of serpent lore. Credible evidence is found for the presence of ancient populations of pythons living along the North African coast west of Egypt and along the coast of the Arabian Sea between the Indus River and the Strait of Hormuz--places where they no longer exist today. The maximum sizes of ancient pythons may have been greater than those of today's specimens.

  2. Frames of scientific evidence: How journalists represent the (un)certainty of molecular medicine in science television programs.

    Science.gov (United States)

    Ruhrmann, Georg; Guenther, Lars; Kessler, Sabrina Heike; Milde, Jutta

    2015-08-01

    For laypeople, media coverage of science on television is a gateway to scientific issues. Defining scientific evidence is central to the field of science, but there are still questions if news coverage of science represents scientific research findings as certain or uncertain. The framing approach is a suitable framework to classify different media representations; it is applied here to investigate the frames of scientific evidence in film clips (n=207) taken from science television programs. Molecular medicine is the domain of interest for this analysis, due to its high proportion of uncertain and conflicting research findings and risks. The results indicate that television clips vary in their coverage of scientific evidence of molecular medicine. Four frames were found: Scientific Uncertainty and Controversy, Scientifically Certain Data, Everyday Medical Risks, and Conflicting Scientific Evidence. They differ in their way of framing scientific evidence and risks of molecular medicine. © The Author(s) 2013.

  3. Collation of Scientific Evidence on Consumer Acceptance of New Food Technologies: Three roads to consumer choice

    NARCIS (Netherlands)

    Fischer, A.R.H.; Trijp, van J.C.M.; Hofenk, D.J.B.; Ronteltap, A.; Tudoran, A.A.

    2012-01-01

    The current report investigates consumer acceptance of new food technologies by reviewing the scientific literature. The review is organised along three routes to consumer acceptance of new technologies: The consumer benefit road: the central road of technology features influencing experienced

  4. Examining the impact of sexism on evaluations of social scientific evidence in discrimination litigation.

    Science.gov (United States)

    Kim, Anita; Tidwell, Natasha

    2014-12-01

    The present 2 studies involved undergraduate participants and investigated whether various types of sexism and other correlated predictors, such as political conservatism and scientific discounting, can predict people's evaluations of social science research on sex stereotypes, sexism, and sex discrimination. In Study 1, participants high in hostile sexism, scientific discounting, and/or political conservatism were more critical of scientific studies that provided evidence for sexism than identical studies showing null results. Study 2 showed that participants high in modern sexism, hostile sexism, and political conservatism evaluated social scientific studies more negatively; in addition, assessments of social scientific evidence quality mediated the effect of modern sexism on admissibility ratings (b = -0.15, z = -4.16, p = .00). Overall, these results suggest that sexist beliefs can bias one's judgments of social scientific evidence. Future research should explore whether the same psychological processes operate for judges and jurors as they evaluate the admissibility of evidence and examine ways to attenuate the effect of sexism on evaluations.

  5. Identifying scientific artefacts in biomedical literature: the Evidence Based Medicine use case.

    Science.gov (United States)

    Hassanzadeh, Hamed; Groza, Tudor; Hunter, Jane

    2014-06-01

    Evidence Based Medicine (EBM) provides a framework that makes use of the current best evidence in the domain to support clinicians in the decision making process. In most cases, the underlying foundational knowledge is captured in scientific publications that detail specific clinical studies or randomised controlled trials. Over the course of the last two decades, research has been performed on modelling key aspects described within publications (e.g., aims, methods, results), to enable the successful realisation of the goals of EBM. A significant outcome of this research has been the PICO (Population/Problem-Intervention-Comparison-Outcome) structure, and its refined version PIBOSO (Population-Intervention-Background-Outcome-Study Design-Other), both of which provide a formalisation of these scientific artefacts. Subsequently, using these schemes, diverse automatic extraction techniques have been proposed to streamline the knowledge discovery and exploration process in EBM. In this paper, we present a Machine Learning approach that aims to classify sentences according to the PIBOSO scheme. We use a discriminative set of features that do not rely on any external resources to achieve results comparable to the state of the art. A corpus of 1000 structured and unstructured abstracts - i.e., the NICTA-PIBOSO corpus - is used for training and testing. Our best CRF classifier achieves a micro-average F-score of 90.74% and 87.21%, respectively, over structured and unstructured abstracts, which represents an increase of 25.48 percentage points and 26.6 percentage points in F-score when compared to the best existing approaches.

  6. Cognitive deficits in schizophrenia: an updated metanalysis of the scientific evidence

    Directory of Open Access Journals (Sweden)

    Fioravanti Mario

    2012-06-01

    Full Text Available Abstract Background This is an update of a previous meta-analysis published in 2005. Methods It includes the data published up to march 2010 for a total of 247 papers and 18,300 cases. Cognitive deficits are examined in 5 different domains: Memory functioning (128 studies, Global cognitive functioning (131 studies, Language (70 studies, Executive function (67 studies, Attention (76 studies. Only controlled studies were included: patients vs. normal subjects. Results Results evidence that in all domains and in all different analyses performed within each domain, patients show a significant reduction of cognitive efficiency with respect to normal subjects. The between studies heterogeneity is very high in almost all domains. There are various sources of this heterogeneity (age, sex, sample size, type of patients, and type of measurement which contribute to the high degree of not-overlapping information offered by the single studies. Conclusions Our results, based on the current scientific evidence, confirm the previous findings that there is a generalized impairment of various cognitive functions in patients with schizophrenia when compared to normal cases. The modalities with which these results are obtained have not changed over the years and the more recent studies do not modify the high heterogeneity previously found between the studies. This reduces the methodological quality of the results. In order to improve the methodological quality of the studies performed in the field of cognitive deficits of patients with schizophrenia, various factors should be taken into account and better managed in designing future studies.

  7. Delusions About Evidence: On Why Scientific Evidence Should Not Be the Main Concern in Socioscientific Decision-Making

    DEFF Research Database (Denmark)

    Nielsen, Jan Alexis

    2013-01-01

    making is a process of deliberation in which persons distribute relative weights to multifarious and incommensurate factors—a process, that is, in which scientific evidence has no privileged role. Accordingly, science educators ought to focus on the quality with which students discuss the relative...

  8. The use of preliminary scientific evidence in public health: a case study of XMRV.

    Directory of Open Access Journals (Sweden)

    Kumanan Wilson

    2014-04-01

    Full Text Available Kumanan Wilson and colleagues explain how the rapid response to XMRV as a novel pathogen has highlighted some challenges pertaining to policy-making and editorial responsibilities. The impact on policy and the propagation of the initial scientific information may not cease if the evidence is disproven and retracted from the peer-reviewed literature, which creates a challenge for regulators and scientific journals. Please see later in the article for the Editors' Summary.

  9. The use of preliminary scientific evidence in public health: a case study of XMRV.

    Science.gov (United States)

    Wilson, Kumanan; Atkinson, Katherine; Keelan, Jennifer

    2014-04-01

    Kumanan Wilson and colleagues explain how the rapid response to XMRV as a novel pathogen has highlighted some challenges pertaining to policy-making and editorial responsibilities. The impact on policy and the propagation of the initial scientific information may not cease if the evidence is disproven and retracted from the peer-reviewed literature, which creates a challenge for regulators and scientific journals. Please see later in the article for the Editors' Summary.

  10. Secondary school physics teachers' conceptions of scientific evidence: An exploratory case study

    Science.gov (United States)

    Taylor, Joseph A.; Dana, Thomas M.

    2003-10-01

    This article describes an exploratory case study of secondary school physics teachers' conceptions of scientific evidence. The nature of teachers' conceptions of evidence was derived from an analysis of data collected from 1 preservice and 2 in-service teachers. Each teacher responded to a series of research prompts in multiple interviews and handwritten tasks. In these research prompts, the teachers thought aloud while designing experiments and critically evaluating student-collected data as presented in hypothetical classroom scenarios. Spoken and written data were recorded. The data set was coded and analyzed using standard qualitative analysis techniques. Data from this study suggest that, while contemplating the reliability and validity of hypothetical student-generated scientific evidence, the teachers frequently intertwined conceptions of evidence with subject matter concepts centrally relevant to the hypothetical investigation. Data also indicate that the relationship between subject matter knowledge and conceptions of evidence was more pronounced for some conceptions of evidence than for others. Results suggest that a fuller study is warranted. Suggestions for future research include exploring such relationships in other physics content areas as well as other scientific disciplines. Implications for science teacher education suggest that science and science methods courses should encourage preservice teachers to engage in original scientific research, as well as participate in peer review and critique.

  11. Homosexuality and scientific evidence: On suspect anecdotes, antiquated data, and broad generalizations.

    Science.gov (United States)

    Kinney, Robert L

    2015-11-01

    The American Psychiatric Association and the American Psychological Association have suggested for many years now that there is significant empirical evidence supporting the claim that homosexuality is a normal variant of human sexual orientation as opposed to a mental disorder. This paper summarizes and analyzes that purported scientific evidence and explains that much (if not all) of the evidence is irrelevant and does not support the homosexuality-is-not-a-mental-disorder claim. As a result of their deficiencies and arbitrariness, the credibility those two groups that are typically deemed authoritative and trustworthy is called into question. Lay summary: At one time, homosexuality was considered to be mentally disordered. Since the 1970s, however, major medical associations in the U.S. have labeled homosexuality as a normal counterpart of heterosexuality. Those medical associations have proposed that their homosexuality-is-normal claim is based on "scientific evidence." This article critically reviews that "scientific evidence" and finds that much of their literature does not support the claim that homosexuality is normal. This article suggests that instead of supporting their claim with scientific evidence, those major medical associations arbitrarily label homosexuality as normal.

  12. Delusions About Evidence: On Why Scientific Evidence Should Not Be the Main Concern in Socioscientific Decision-Making

    DEFF Research Database (Denmark)

    Nielsen, Jan Alexis

    2013-01-01

    This article takes issue with the widespread assumption that students’ socioscientific decisions ought to be evidence based. On the basis of a careful conceptual analysis, it is argued that it is misleading to think in terms of evidence in socioscientific decision making because such decision...... making is a process of deliberation in which persons distribute relative weights to multifarious and incommensurate factors—a process, that is, in which scientific evidence has no privileged role. Accordingly, science educators ought to focus on the quality with which students discuss the relative...

  13. Authorization of Animal Experiments Is Based on Confidence Rather than Evidence of Scientific Rigor.

    Science.gov (United States)

    Vogt, Lucile; Reichlin, Thomas S; Nathues, Christina; Würbel, Hanno

    2016-12-01

    experiments are lacking important information about experimental conduct that determines the scientific validity of the findings, which may be critical for the weight attributed to the benefit of the research in the harm-benefit analysis. Similar to manuscripts getting accepted for publication despite poor reporting of measures against bias, applications for animal experiments may often be approved based on implicit confidence rather than explicit evidence of scientific rigor. Our findings shed serious doubt on the current authorization procedure for animal experiments, as well as the peer-review process for scientific publications, which in the long run may undermine the credibility of research. Developing existing authorization procedures that are already in place in many countries towards a preregistration system for animal research is one promising way to reform the system. This would not only benefit the scientific validity of findings from animal experiments but also help to avoid unnecessary harm to animals for inconclusive research.

  14. Quick evidence reviews using Epistemonikos: a thorough, friendly and current approach to evidence in health

    Directory of Open Access Journals (Sweden)

    Gabriel Rada

    2014-07-01

    Full Text Available Those who make decisions on healthcare should do so informed by the best scientific evidence at one’s disposal. During the last few years, it has become undeniable that identifying and synthesizing all scientific studies that respond a question constitutes an unapproachable challenge for a clinician. The quantity of information has increased excessively, some facts are not available, investigations are of either bad quality or even fraudulent, and the methods for achieving a combination and synthesis of all studies are each time more sophisticated. Moreover, if this inaccurate process is carried out, there exists a high risk of arriving at a biased conclusion.

  15. Measuring the perceived uncertainty of scientific evidence and its relationship to engagement with science.

    Science.gov (United States)

    Retzbach, Joachim; Otto, Lukas; Maier, Michaela

    2016-08-01

    Many scholars have argued for the need to communicate openly not only scientific successes to the public but also limitations, such as the tentativeness of research findings, in order to enhance public trust and engagement. Yet, it has not been quantitatively assessed how the perception of scientific uncertainties relates to engagement with science on an individual level. In this article, we report the development and testing of a new questionnaire in English and German measuring the perceived uncertainty of scientific evidence. Results indicate that the scale is reliable and valid in both language versions and that its two subscales are differentially related to measures of engagement: Science-friendly attitudes were positively related only to 'subjectively' perceived uncertainty, whereas interest in science as well as behavioural engagement actions and intentions were largely uncorrelated. We conclude that perceiving scientific knowledge to be uncertain is only weakly, but positively related to engagement with science.

  16. Scientific Data and Its Limits: Rethinking the Use of Evidence in Local Climate Change Policy

    Science.gov (United States)

    Pearce, Warren

    2014-01-01

    Climate policy is typically seen as informed by scientific evidence that anthropogenic carbon emissions require reducing in order to avoid dangerous consequences. However, agreement on these matters has not translated into effective policy. Using interviews with local authority officials in the UK's East Midlands region, this paper argues that the…

  17. Scientifically Based Research and Evidence-Based Education: A Federal Policy Context.

    Science.gov (United States)

    Smith, Anne

    2003-01-01

    This article provides a look at the federal policy context for the scientifically based research (SBR) and evidence-based education (EBE) initiatives by sharing U.S. Department of Education presentations and related publications about SBR and EBE. It discusses the impact of these policy initiatives on special education research activities.…

  18. Scientific reasoning in kindergarten: Cognitive factors in experimentation and evidence evaluation

    NARCIS (Netherlands)

    Graaf, J. van der; Segers, P.C.J.; Verhoeven, L.T.W.

    2016-01-01

    The aim of the present study was to investigate the role of cognitive factors in two core components of scientific reasoning: experimentation and evidence evaluation. Measures of visuospatial and verbal working memory, inhibition, cognitive flexibility, vocabulary, grammatical ability, and spatial v

  19. Scientific reasoning in kindergarten: Cognitive factors in experimentation and evidence evaluation

    NARCIS (Netherlands)

    Graaf, J. van der; Segers, P.C.J.; Verhoeven, L.T.W.

    2016-01-01

    The aim of the present study was to investigate the role of cognitive factors in two core components of scientific reasoning: experimentation and evidence evaluation. Measures of visuospatial and verbal working memory, inhibition, cognitive flexibility, vocabulary, grammatical ability, and spatial v

  20. Level of evidence and citation index in current neurosurgical publications.

    Science.gov (United States)

    Rothoerl, Ralf D; Klier, Joerg; Woertgen, Chris; Brawanski, A

    2003-10-01

    Systematic clinical reviews or meta-analyses offer scientifically valid sources of clinical information. They provide information in a concise form and can contribute to clinical quality management. Such studies, however, are only able to reflect the quality of the articles reviewed. The aim of this study was to evaluate the quality of the neurosurgical literature according to evidence-based medicine (EBM) standards. We reviewed all articles published in 1999 in three major neurosurgical journals. These articles were subdivided according to the level of evidence (LOE) scale (from 0 to V), article type, and citation index. Nine hundred eighty-two articles were published in these journals in 1999. Of these, 346 (35%) were clinical studies, 287 (29%) case reports, 153 (16%) experimental studies, 122 (13%) technical reports, and 74 ( 8%) other types. Subdivision according to LOE was: Ia 0.3%, Ib 2.5%, IIa 0.2%, IIb 4.3%, IIc 9.5%, IIIa 0.1%, IIIb 3.9%, IV 22.4%, and V 1.6%. Fifty-five percent of all published studies were case reports, experimental studies, technical reports, or others and thus could not be subdivided according to the EBM standards. The number of articles published with high LOE seems to be rather low in 1999. If these data reflect overall publication practice, it seems unclear whether enough articles with high LOE are published to propose scientifically sound clinical treatment suggestions according to EBM standards.

  1. [Evidence-Based Knowledge Translation: From Scientific Evidence to Clinical Nursing Practice].

    Science.gov (United States)

    Chen, Kee-Hsin; Kao, Ching-Chiu; Chen, Chiehfeng

    2016-12-01

    In 1992, Gordon Guyatt coined the term "evidence-based medicine", which has since attracted worldwide attention. In 2007, the Institute of Medicine's Roundtable on Evidence-Based Medicine set the goal that 90% of clinical decisions would be supported by accurate, timely, and up-to-date clinical information and would reflect the best available evidence by 2020. However, the chasm between knowing and doing remains palpable. In 2000, the Canadian Institute of Health Research applied the term "knowledge translation" to describe the bridge that is necessary to cross the gap between research knowledge and clinical practice. The present paper outlines the conceptual framework, barriers, and promotion strategies for evidence-based knowledge translation and shares clinical experience related to overcoming the seven layers of leakage (aware, accepted, applicable, able, acted on, agreed, and adhered to). We hope that this paper can enhance the public well-being and strengthen the future health care system.

  2. The History of Liquid Ear Acupuncture and the Current Scientific State of the Art.

    Science.gov (United States)

    Litscher, Daniela; Litscher, Gerhard

    2016-06-01

    This short review article presents a current overview of existing publications and scientific results regarding liquid (ear) acupuncture. The injection of liquids into defined acupuncture points of the ear is not a method commonly used in the Western world. The term liquid acupuncture has different definitions, which makes understanding each definition and differentiating one from the other difficult. General terms like pharmacopuncture, homeosiniatry, and liquid acupuncture, which all describe the method of injecting different kinds of drugs into a defined body acupuncture point, are used. This article presents the history of liquid acupuncture, as well as the current scientific state of the art, from the point of view of two European researchers. Some articles are discussed and a few practical examples are presented.

  3. Collation of Scientific Evidence on Consumer Acceptance of New Food Technologies: Three roads to consumer choice

    NARCIS (Netherlands)

    Fischer, A.R.H.; Trijp, van J.C.M.; Hofenk, D.J.B.; Ronteltap, A.; Tudoran, A.A.

    2012-01-01

    The current report investigates consumer acceptance of new food technologies by reviewing the scientific literature. The review is organised along three routes to consumer acceptance of new technologies: The consumer benefit road: the central road of technology features influencing experienced produ

  4. Management and prevention of neonatal anemia: current evidence and guidelines.

    Science.gov (United States)

    von Lindern, Jeannette S; Lopriore, Enrico

    2014-04-01

    Neonatal anemia is a common disorder, particularly in (very) preterm neonates. Management of neonatal anemia is based principally on red blood cell (RBC) transfusion. Although the use of blood products is nowadays widespread in neonatal medicine, evidence on the potential benefit is extremely limited. Recent studies suggest that RBC transfusions in newborns may be associated with an increased risk for necrotizing enterocolitis, transfer of infectious agents and negative effects on neurodevelopmental outcome. Whether the benefits of RBC transfusions outweigh the risks is controversial and requires further studies. In this review, we summarize the current evidence on the management of neonatal anemia and compare the various international guidelines. In addition, we discuss the various strategies to prevent neonatal anemia and reduce the need for RBC transfusions and discuss important trials currently enrolling patients to improve the management in neonatal anemia.

  5. A new method of CCD dark current correction via extracting the dark information from scientific images

    CERN Document Server

    Ma, Bin; Hu, Yi; Liu, Qiang; Wang, Lifan; Wei, Peng

    2014-01-01

    We have developed a new method to correct dark current at relatively high temperatures for Charge-Coupled Device (CCD) images when dark frames cannot be obtained on the telescope. For images taken with the Antarctic Survey Telescopes (AST3) in 2012, due to the low cooling efficiency, the median CCD temperature was -46$^\\circ$C, resulting in a high dark current level of about 3$e^-$/pix/sec, even comparable to the sky brightness (10$e^-$/pix/sec). If not corrected, the nonuniformity of the dark current could even overweight the photon noise of the sky background. However, dark frames could not be obtained during the observing season because the camera was operated in frame-transfer mode without a shutter, and the telescope was unattended in winter. Here we present an alternative, but simple and effective method to derive the dark current frame from the scientific images. Then we can scale this dark frame to the temperature at which the scientific images were taken, and apply the dark frame corrections to the s...

  6. Current Evidence on Atypical Odontalgia: Diagnosis and Clinical Management

    OpenAIRE

    Yoshihiro Abiko; Hirofumi Matsuoka; Itsuo Chiba; Akira Toyofuku

    2012-01-01

    Patients with atypical odontalgia (AO) complain of medically unexplained toothache. No evidence-based diagnostic criteria or treatment guidelines are yet available. The present paper addresses seven clinical questions about AO based on current knowledge in the literature and discusses diagnostic criteria and guidelines for treatment and management. The questions are (i) What is the prevalence of AO in the community? (ii) What psychological problems are experienced by patients with AO? (iii) A...

  7. The current state of evidence-based pediatric surgery.

    Science.gov (United States)

    Ostlie, Daniel J; St Peter, Shawn D

    2010-10-01

    The efficiency of medical care in the United States has become intensely scrutinized with expectations from patients, families, payors, lawmakers, and, currently, the President. The most effective vehicle to bring more efficient care is the employment of evidence-based medicine whenever possible. Evidence-based medicine is dependent on best evidence, and best evidence is generated from prospective trials. To evaluate current state of evidence based practice in pediatric surgery we reviewed the literature for trials conducted in our field the past 10 years. All randomized controlled trials from January 1999 through December 2009 published in the English literature were identified through a literature search using PubMed (www.pubmed.com). We included only those in pediatric general surgery excluding transplant, oncology, and the other nongeneral subspecialties. The search criteria produced 56 manuscripts, of which 51 described appropriate randomization techniques. A definitive trial design with a sample size calculation was utilized in only 19 studies (34%). A statistically significant difference between treatment arms was identified in 29 of the 56 (52%) trials. There were 26 different journals of publication, with the Journal of Pediatric Surgery being most common (20) followed by Pediatric Surgery International (7). The combined total publications from January 1999 through December 2009 for the 26 journals these randomized trials represent 0.04% of all publications. Appendicitis was the most common condition that was studied (n = 10) followed by pyloric stenosis (n = 4). Trials originated in 19 different countries led by the United States (28%), United Kingdom (14%), and Turkey (12%). There was a generally progressive increase in published trials from 1999 to 2009, however, the percentage of prospective articles published in pediatric surgery was similar to a previous review published in 1999. The current state of evidence-based surgery in pediatric surgery has

  8. Image guided robotic surgery: Current evidence for effectiveness in urology

    Directory of Open Access Journals (Sweden)

    Anum Pervez

    2014-12-01

    Full Text Available Objectives: Discussion of the evolution of image guided surgery (IGS and its fundamental components and current evidence for effectiveness of IGS in clinical urology. Methods: Literature search for image-guided robotic urology. Results: Current literature in image-guided robotic urology with its use in robot assisted radical prostatectomy and robot assisted partial nephrectomy are shown. Conclusions: Image guided surgery can be a useful aid to improve visualisation of anatomy and subsurface structures during minimally invasive surgery. Soft-tissue deformation makes it difficult to implement IGS in urology but current studies have shown an attempt to address this issue. The feasibility of IGS requires randomised control trials assessing in particular its accuracy and affect on clinical outcome.

  9. [Current state of digestive system robotic surgery in the light of evidence based medicine].

    Science.gov (United States)

    Ortiz Oshiro, Elena; Fernández-Represa, Jesús Alvarez

    2009-03-01

    The incorporation of robotics in minimally invasive surgery has had mixed reception in the different fields of digestive surgery. Nowadays we are exposed to a continuous stream of publications on robotic approach techniques and outcomes, which do not always provide objective criteria and whose value, through scientific evidence analysis, is sometimes arguable. With the aim of shedding light on current knowledge on digestive robotic surgery and giving an update of its possibilities, the authors analyse the abundant literature available on the different digestive robotic surgery procedures, and sum up their own experience.

  10. [Current state of the scientific activity of the Aachen group concerning number processing].

    Science.gov (United States)

    Rohlfs-Domínguez, P

    The research group from Willmes and colleagues is one of the most advanced research groups in cognitive neuroscience. The use and nature of the numeric magnitude representation constitutes one of the study objects of the mentioned research group. This mental representation provokes a great controversy among the members of the scientific community studying number processing and arithmetic. As a consequence, there are several different theoretical models concerning number processing. In this work, we have reviewed some of the scientific studies realized by the Aachen group concerning number processing, with the aim to expound the current state of its activity. In the works from Willmes and colleagues, we can notice a logic sequence, regarding the formulation of work hypothesis. The course of evolution of their activity starts studying number processing and arithmetic on German listener population and continues with a progressive integration of the German deaf population into their work. There is, as well, an emergent trend in this group to research number processing at the classroom. This means to examine the underlying mental representations in the education field. The information included in the studies analyzed here, leads to several scientific questions which need to be researched in future studies, and questions and complements what has been supported by other research groups.

  11. Emergency Department Triage Scales and Their Components: A Systematic Review of the Scientific Evidence

    Directory of Open Access Journals (Sweden)

    Jonsson Håkan

    2011-06-01

    Full Text Available Abstract Emergency department (ED triage is used to identify patients' level of urgency and treat them based on their triage level. The global advancement of triage scales in the past two decades has generated considerable research on the validity and reliability of these scales. This systematic review aims to investigate the scientific evidence for published ED triage scales. The following questions are addressed: 1. Does assessment of individual vital signs or chief complaints affect mortality during the hospital stay or within 30 days after arrival at the ED? 2. What is the level of agreement between clinicians' triage decisions compared to each other or to a gold standard for each scale (reliability? 3. How valid is each triage scale in predicting hospitalization and hospital mortality? A systematic search of the international literature published from 1966 through March 31, 2009 explored the British Nursing Index, Business Source Premier, CINAHL, Cochrane Library, EMBASE, and PubMed. Inclusion was limited to controlled studies of adult patients (≥15 years visiting EDs for somatic reasons. Outcome variables were death in ED or hospital and need for hospitalization (validity. Methodological quality and clinical relevance of each study were rated as high, medium, or low. The results from the studies that met the inclusion criteria and quality standards were synthesized applying the internationally developed GRADE system. Each conclusion was then assessed as having strong, moderately strong, limited, or insufficient scientific evidence. If studies were not available, this was also noted. We found ED triage scales to be supported, at best, by limited and often insufficient evidence. The ability of the individual vital signs included in the different scales to predict outcome is seldom, if at all, studied in the ED setting. The scientific evidence to assess interrater agreement (reliability was limited for one triage scale and insufficient or

  12. Current Treatment of Toxoplasma Retinochoroiditis: An Evidence-Based Review

    Directory of Open Access Journals (Sweden)

    Meredith Harrell

    2014-01-01

    Full Text Available Objective. To perform an evidence-based review of treatments for Toxoplasma retinochoroiditis (TRC. Methods. A systematic literature search was performed using the PubMed database and the key phrase “ocular toxoplasmosis treatment” and the filter for “controlled clinical trial” and “randomized clinical trial” as well as OVID medline (1946 to May week 2 2014 using the keyword ‘‘ocular toxoplasmosis’’. The included studies were used to evaluate the various treatment modalities of TRC. Results. The electronic search yielded a total of 974 publications of which 44 reported on the treatment of ocular toxoplasmosis. There were 9 randomized controlled studies and an additional 3 comparative studies on the treatment of acute TRC with systemic or intravitreous antibiotics or on reducing the recurrences of TRC. Endpoints of studies included visual acuity improvement, inflammatory response, lesion size changes, recurrences of lesions, and adverse effects of medications. Conclusions. There was conflicting evidence as to the effectiveness of systemic antibiotics for TRC. There is no evidence to support that one antibiotic regimen is superior to another so choice needs to be informed by the safety profile. Intravitreous clindamycin with dexamethasone seems to be as effective as systemic treatments. There is currently level I evidence that intermittent trimethoprim-sulfamethoxazole prevents recurrence of the disease.

  13. Current evidence and insights about genetics in thoracic aorta disease.

    Science.gov (United States)

    Bisleri, Gianluigi; Bagozzi, Lorenzo; Muneretto, Claudio

    2013-01-01

    Thoracic aortic aneurysms have been historically considered to be caused by etiologic factors similar to those implied in abdominal aortic aneurysms. However, during the past decade, there has been increasing evidence that almost 20% of thoracic aortic aneurysms may be associated with a genetic disease, often within a syndromic or familial disorder. Moreover, the presence of congenital anomalies, such as bicuspid aortic valve, may have a unique common genetic underlying cause. Finally, also sporadic forms have been found to be potentially associated with genetic disorders, as highlighted by the analysis of rare variants and expression of specific microRNAs. We therefore sought to perform a comprehensive review of the role of genetic causes in the development of thoracic aortic aneurysms, by analyzing in detail the current evidence of genetic alterations in syndromes such as Marfan, Loeys-Dietz, and Ehler-Danlos, familial or sporadic forms, or forms associated with bicuspid aortic valve.

  14. Current Evidence and Insights about Genetics in Thoracic Aorta Disease

    Directory of Open Access Journals (Sweden)

    Gianluigi Bisleri

    2013-01-01

    Full Text Available Thoracic aortic aneurysms have been historically considered to be caused by etiologic factors similar to those implied in abdominal aortic aneurysms. However, during the past decade, there has been increasing evidence that almost 20% of thoracic aortic aneurysms may be associated with a genetic disease, often within a syndromic or familial disorder. Moreover, the presence of congenital anomalies, such as bicuspid aortic valve, may have a unique common genetic underlying cause. Finally, also sporadic forms have been found to be potentially associated with genetic disorders, as highlighted by the analysis of rare variants and expression of specific microRNAs. We therefore sought to perform a comprehensive review of the role of genetic causes in the development of thoracic aortic aneurysms, by analyzing in detail the current evidence of genetic alterations in syndromes such as Marfan, Loeys-Dietz, and Ehler-Danlos, familial or sporadic forms, or forms associated with bicuspid aortic valve.

  15. Sports injury prevention in your pocket?! Prevention apps assessed against the available scientific evidence: a review.

    Science.gov (United States)

    van Mechelen, Daan M; van Mechelen, Willem; Verhagen, Evert A L M

    2014-06-01

    High costs and personal burden follow sports and physical activity-related injuries (SPRI). The last decades' knowledge on how to prevent SPRIs has grown. Past years' eHealth is emerging and mobile applications (apps) helping to prevent SPRIs are appearing. To review the content of iPhone and iPad apps containing a claim to prevent sports and physical activity-related injuries and to appraise this claim against best available scientific evidence. The US iTunes App Store was searched using the keywords 'injury', 'prevention' and 'rehabilitation'. Apps within the categories 'health & fitness', 'sports' and 'medical' containing a preventive claim in the app name, description or screenshots were included. Claims were extracted and a search for best available evidence was performed. Eighteen apps met our inclusion criteria. Four of these apps contained claims for which evidence was available: three apps covered ankle sprains and provided information on taping or neuromuscular training. Of these three apps, one app also provided information on prevention of dental injury with mouth guards. One app provided a routine to prevent anterior cruciate ligament injury. The main focus of the five apps was running injury prevention; for their content evidence of absence of efficacy was found. For nine apps no evidence supporting their content was found. f 18 apps included, only four contained claims that could be supported by available literature and five apps contained false claims. This lack of scientifically sound apps provides an opportunity for caretakers to develop apps with evidence-based claims to prevent SPRIs.

  16. Implementation methodology of practices based on scientific evidence for assistance in natural delivery: a pilot study

    Directory of Open Access Journals (Sweden)

    Clodoaldo Tentes Côrtes

    2015-10-01

    Full Text Available AbstractOBJECTIVEPresenting methodology for transferring knowledge to improve maternal outcomes in natural delivery based on scientific evidence.METHOD: An intervention study conducted in the maternity hospital of Itapecerica da Serra, SP, with 50 puerperal women and 102 medical records from July to November 2014. The PACES tool from Joanna Briggs Institute, consisting of pre-clinical audit (phase 1, implementation of best practice (phase 2 and Follow-up Clinical Audit (phase 3 was used. Data were analyzed by comparing results of phases 1 and 3 with Fisher's exact test and a significance level of 5%.RESULTSThe vertical position was adopted by the majority of puerperal women with statistical difference between phases 1 and 3. A significant increase in bathing/showering, walking and massages for pain relief was found from the medical records. No statistical difference was found in other practices and outcomes. Barriers and difficulties in the implementation of evidence-based practices have been identified. Variables were refined, techniques and data collection instruments were verified, and an intervention proposal was made.CONCLUSIONThe study found possibilities for implementing a methodology of practices based on scientific evidence for assistance in natural delivery.

  17. EVIDENCES OF SCIENTIFIC MIRACLE OF AL-QUR’AN IN THE MODERN ERA

    Directory of Open Access Journals (Sweden)

    Dwi Sukmanila Sayska

    2016-05-01

    Full Text Available One of the miracles of al-Qur’an is i’jaz ilmi, it’s meant the information of al-Qur’an about science which is then able revealed and proven in accordance with the development of science. I’jaz ilmi does not present itself, but should be explored and researched, so that the evidence of i’jaz ilmi can be more and more and grow over time. Scientists gave the parable is like a spring that never runs dry. Every time always comes new discoveries and scientific provisions which already hinted at al-Qur’an for 14 centuries ago as evidence of i’jaz. I’jaz ilmi later became a effective propaganda media, especially among scientists. Many cases found confession of scientists when they were able to prove the truth of which is informed by al-Qur’an. In addition, evidence of ilmi i’jaz is able to ward off external oblique view of Islam that al-Qur’an is man work, because when they know that what is described by al- Qur’an has been proved by modern scientific discoveries, and eventually they acknowledges that al-Qur’an is really the word of God

  18. Current Evidence on Atypical Odontalgia: Diagnosis and Clinical Management

    Directory of Open Access Journals (Sweden)

    Yoshihiro Abiko

    2012-01-01

    Full Text Available Patients with atypical odontalgia (AO complain of medically unexplained toothache. No evidence-based diagnostic criteria or treatment guidelines are yet available. The present paper addresses seven clinical questions about AO based on current knowledge in the literature and discusses diagnostic criteria and guidelines for treatment and management. The questions are (i What is the prevalence of AO in the community?\t(ii What psychological problems are experienced by patients with AO? (iii Are there any comorbidities of AO? (iv Is local anesthesia effective for the relief of pain in AO? (v Are there any characteristic symptoms of AO other than spontaneous pain? (vi Are antidepressants effective for treatment of AO? (vii Are anticonvulsants effective for treatment of AO? Our literature search provided answers for these questions; however, there is insufficient evidence-based data to establish guidelines for the diagnosis and treatment of AO. Overall, some diagnostic criteria for neuropathic pain and persistent dentoalveolar pain disorder may be applied to AO patients. The patient's psychogenic background should always be considered in the treatment and/or management of AO. The clinicians may need to treat AO patients using Patient-Oriented Evidence that Matters approach.

  19. Current Evidence on Atypical Odontalgia: Diagnosis and Clinical Management

    Science.gov (United States)

    Abiko, Yoshihiro; Matsuoka, Hirofumi; Chiba, Itsuo; Toyofuku, Akira

    2012-01-01

    Patients with atypical odontalgia (AO) complain of medically unexplained toothache. No evidence-based diagnostic criteria or treatment guidelines are yet available. The present paper addresses seven clinical questions about AO based on current knowledge in the literature and discusses diagnostic criteria and guidelines for treatment and management. The questions are (i) What is the prevalence of AO in the community? (ii) What psychological problems are experienced by patients with AO? (iii) Are there any comorbidities of AO? (iv) Is local anesthesia effective for the relief of pain in AO? (v) Are there any characteristic symptoms of AO other than spontaneous pain? (vi) Are antidepressants effective for treatment of AO? (vii) Are anticonvulsants effective for treatment of AO? Our literature search provided answers for these questions; however, there is insufficient evidence-based data to establish guidelines for the diagnosis and treatment of AO. Overall, some diagnostic criteria for neuropathic pain and persistent dentoalveolar pain disorder may be applied to AO patients. The patient's psychogenic background should always be considered in the treatment and/or management of AO. The clinicians may need to treat AO patients using Patient-Oriented Evidence that Matters approach. PMID:22844283

  20. Selection of a method to rate the strength of scientific evidence for AORN recommendations.

    Science.gov (United States)

    Steelman, Victoria M; Pape, Theresa; King, Cecil A; Graling, Paula; Gaberson, Kathleen B

    2011-04-01

    The use of scientific evidence to support national recommendations about clinical decisions has become an expectation of multidisciplinary health care organizations. The objectives of this project were to identify the most applicable evidence-rating method for perioperative nursing practice, evaluate the reliability of this method for perioperative nursing recommendations, and identify barriers and facilitators to adoption of this method for AORN recommendations. A panel of perioperative nurse experts evaluated 46 evidence-rating systems for quality, quantity, and consistency. We rated the methods that fully covered all three domains on five aspects of applicability to perioperative nursing practice recommendations. The Oncology Nursing Society's method was rated highest for all five aspects of applicability, and interrater reliability of this method for perioperative recommendations was 100%. Potential barriers to implementation of the rating method include knowledge deficit, staff resources, resistance to change, and fear of showing that lower levels of evidence support some recommendations. Facilitators included education, resource allocation, and starting small. Barriers and facilitators will be considered by the implementation team that will develop a plan to achieve integration of evidence rating into AORN documents. The AORN Board of Directors approved adoption of this method in June 2010. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  1. Scientific evidence-based effects of hydrotherapy on various systems of the body

    Directory of Open Access Journals (Sweden)

    A Mooventhan

    2014-01-01

    Full Text Available The use of water for various treatments (hydrotherapy is probably as old as mankind. Hydrotherapy is one of the basic methods of treatment widely used in the system of natural medicine, which is also called as water therapy, aquatic therapy, pool therapy, and balneotherapy. Use of water in various forms and in various temperatures can produce different effects on different system of the body. Many studies/reviews reported the effects of hydrotherapy only on very few systems and there is lack of studies/reviews in reporting the evidence-based effects of hydrotherapy on various systems. We performed PubMed and PubMed central search to review relevant articles in English literature based on "effects of hydrotherapy/balneotherapy" on various systems of the body. Based on the available literature this review suggests that the hydrotherapy has a scientific evidence-based effect on various systems of the body.

  2. The importance of scientific evaluation of biological evidence--data from eight years of case review.

    Science.gov (United States)

    Coyle, Heather Miller

    2012-12-01

    In 2009, the National Research Council published a report stating that the addition of more science and technology into the field of forensic science in the United States would be of great benefit to the judicial system. As a starting point to address this NRC report, one needs to make an assessment of the system. One factor that is continuously requested is an estimate of an error rate. In any given scientific area of forensics that is difficult to quantitate except by external review and audits. After eight years of requested defense review of cases with biological and DNA evidence, most cases appear to be scientifically sound in test methods and procedures. However, there were some cases where errors in the forensic science process did occur. This article takes information compiled from those eight years of defense review and summarizes the cases where errors have been discovered and discusses the scientific implications of these errors. The scope of this article is limited to crime scene collection and forensic science laboratory testing of biological materials for body fluid identification and DNA individualization to a source. The greatest value of defense review comes from (a) providing effective balance and independent oversight to the judicial process and (b) collecting data into a format that can be useful as a guide in training programs.

  3. Scientific Evidence as Content Knowledge: A Replication Study with English and Turkish Pre-Service Primary Teachers

    Science.gov (United States)

    Roberts, Ros; Sahin-Pekmez, Esin

    2012-01-01

    Pre-service teachers around the world need to develop their content knowledge of scientific evidence to meet the requirements of recent school curriculum developments which prepare pupils to be scientifically literate. This research reports a replication study in Turkey of an intervention originally carried out with pre-service primary teachers in…

  4. Evidences of a coastal current in the Campeche Bank

    Science.gov (United States)

    Gomez-Valdes, J.; Ruiz-Castillo, E.; Rioja-Nieto, R.

    2013-12-01

    The Campeche Bank is the largest continental shelf of the Gulf of Mexico. It is located at the north edge of the Yucatan peninsula. In this paper, we present some evidences of a coastal current that flows westward trough the bank. The analysis of the climatology of sea surface temperature obtained from a 23-year record of Advanced Very High Resolution (AVHRR) data unveiled an alongshore cold-water band which origin is in the Yucatan Channel. The cold-water band, which is visible from May to October, is in the coastal zone where turbulence is the dominant mixing mechanism. In addition, shipboard observations were carried out in September 2002, April 2005, August 2007, and July 2009 in order to observe the temporal and spatial variability of the water mass structure in the bank. Under the assumption of geostrophy, a westward flow trough the bank is deduced from the conductivity-temperature-depth (CTD) data. The westward current occurs in the entire water column with a velocity of the order of 20 cm/s at 10 m depth. The most likely forcing mechanism for this coastal current is the wind. The analysis of the climatology of sea surface winds obtained from a 23-year record of cross-calibrated, multiplatform (CCMP) data revealed a strong semiannual fluctuation of the trade winds over the bank. From May to October the trade winds are parallel to the coast and in the rest of the year its direction changes. The relationship between current and wind is examined using coastal continental shelf models. SST mean in the Campeche Bank. Solid lines indicate isobaths.

  5. Current evidence and applications of photodynamic therapy in dermatology

    Science.gov (United States)

    Wan, Marilyn T; Lin, Jennifer Y

    2014-01-01

    In photodynamic therapy (PDT) a photosensitizer – a molecule that is activated by light – is administered and exposed to a light source. This leads both to destruction of cells targeted by the particular type of photosensitizer, and immunomodulation. Given the ease with which photosensitizers and light can be delivered to the skin, it should come as no surprise that PDT is an increasingly utilized therapeutic in dermatology. PDT is used commonly to treat precancerous cells, sun-damaged skin, and acne. It has reportedly also been used to treat other conditions including inflammatory disorders and cutaneous infections. This review discusses the principles behind how PDT is used in dermatology, as well as evidence for current applications of PDT. PMID:24899818

  6. Medicinal plants used to treat snakebite in Central America: Review and assessment of scientific evidence.

    Science.gov (United States)

    Giovannini, Peter; Howes, Melanie-Jayne R

    2017-03-06

    Every year between 1.2 and 5.5 million people worldwide are victims of snakebites, with about 400,000 left permanently injured. In Central America an estimated 5500 snakebite cases are reported by health centres, but this is likely to be an underestimate due to unreported cases in rural regions. The aim of this study is to review the medicinal plants used traditionally to treat snakebites in seven Central American countries: Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama. A literature search was performed on published primary data on medicinal plants of Central America and those specifically pertaining to use against snakebites. Plant use reports for traditional snakebite remedies identified in primary sources were extracted and entered in a database, with data analysed in terms of the most frequent numbers of use reports. The scientific evidence that might support the local uses of the most frequently reported species was also examined. A total of 260 independent plant use reports were recorded in the 34 sources included in this review, encompassing 208 species used to treat snakebite in Central America. Only nine species were reported in at least three studies: Cissampelos pareira L., Piper amalago L., Aristolochia trilobata L., Sansevieria hyacinthoides (L.) Druce, Strychnos panamensis Seem., Dorstenia contrajerva L., Scoparia dulcis L., Hamelia patens Jacq., and Simaba cedron Planch. Genera with the highest number of species used to treat snakebite were Piper, Aristolochia, Hamelia, Ipomoea, Passiflora and Peperomia. The extent of the scientific evidence available to understand any pharmacological basis for their use against snakebites varied between different plant species. At least 208 plant species are traditionally used to treat snakebite in Central America but there is a lack of clinical research to evaluate their efficacy and safety. Available pharmacological data suggest different plant species may target different symptoms of

  7. DNA evidence: current perspective and future challenges in India.

    Science.gov (United States)

    Verma, Sunil K; Goswami, Gajendra K

    2014-08-01

    Since the discovery of DNA fingerprinting technology in 1985 it has been used extensively as evidence in the court of law world-wide to establish the individual identity both in civil and criminal matters. In India, the first case of parentage dispute solved by the use of DNA fingerprinting technology was in 1989. Since then till date, the DNA technology has been used not only to resolve the cases of paternity and maternity disputes, but also for the establishment of individual identity in various criminal cases and for wildlife forensic identification. Since last half a decade, India is exercising to enact legislation on the use of DNA in the judicial realm and the draft 'Human DNA Bill-2012' is pending in the parliament. Largely, the promoters of forensic DNA testing have anticipated that DNA tests are nearly infallible and DNA technology could be the greatest single advance step in search for truth, conviction of the perpetrator, and acquittal of the innocent. The current article provides a comprehensive review on the status of DNA testing in India and elucidates the consequences of the admissibility of DNA as 'evidence' in the judicial dominion. In this backdrop of civil and criminal laws and changing ethical and societal attitudes, it is concluded that the DNA legislation in India and world-wide needs to be designed with utmost care.

  8. Migraine and Risk of Stroke: Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Sadeghi

    2014-07-01

    Full Text Available Context Migraine is a kind of primary headache that affects 10% to 20% of people worldwide. Recent studies have shown that migraines can be involved in strokes incidences, especially ischemic strokes.Hence, the current study aimed to review evidence in relation to migraine and risk of stroke. Evidence Acquisition A literature search was done for related articles dated between 1993 and 2013 on PubMed, Science Direct, Embase, Web of Science and Scopus for both English and non-English language articles by entering “migraine”, “migraine with aura”, “headache” and “ischemic and hemorrhagic stroke” as keywords. Results In most evaluated studies, there was a positive association between migraine with aura (MA and strokes incidences, especially ischemic strokes. Moreover, patients with high frequency of migraine attacks had greater odds of having a stroke compared with those who had low frequency of migraine attacks. Also, the association between migraine and stroke was more significant in subjects under 45 years old. Some migraine symptoms such as vomiting and nausea had a protective role in the development of ischemic strokes. Conclusions Migraine, especially MA, is a risk factor for incidences of strokes, especially ischemic strokes. However, due to conflicting results on the association between different types of migraine and stroke, more studies are needed in this field.

  9. Vascular interventional radiology. Current evidence in endovascular surgery. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Cowling, Mark G. (ed.) [Univ. Hospital North Staffordshire, Stoke-on-Trent (United Kingdom). Dept. of Radiology

    2012-11-01

    Succinct chapters that will allow readers to identify quickly the information that they need. Ideally sized book for storage and use in the interventional suite. Contains sufficient detail for trainees in endovascular therapy/interventional radiology to gain a thorough grasp of the relevant issues. Fully updated to reflect recent advances. This new edition of Vascular Interventional Radiology: Current Evidence in Endovascular Surgery provides a thorough yet succinct and accessible review of the latest knowledge in the field of endovascular surgery. All chapters have been updated to reflect the advances that have occurred during the past five years, and new chapters are included on carotid artery stenting and day case intervention. The chapter on lower limb veno-occlusive disease has been expanded to include management of deep venous thrombosis. Among the other topics considered are the endovascular treatment options in different arterial territories, aneurysm repair techniques, and the management of venous stenosis and venous insufficiency. The aim throughout is to tackle issues of evidence-based practice in order to assist trainees and experienced practitioners in making and implementing treatment decisions. This book will be an invaluable source of information for both interventional radiologists and vascular surgeons with an interest in endovascular techniques.

  10. New Ways of Delivering Marine Scientific Evidence for Policy Needs in the UK

    Science.gov (United States)

    Dorrington, T.

    2016-12-01

    The UK Department for Environment, Food, and Rural Affairs (Defra) is responsible for safeguarding the natural environment, supporting a world-leading food and farming industry, and sustaining a thriving rural economy. This includes the marine environment which makes a significant contribution to the economy of the UK through fisheries, aquaculture, transport, leisure and recreation, energy (including renewable), coastal tourism, and naval defence. The overall vision for the Defra marine programme is to therefore achieve clean, healthy, safe, productive and biologically diverse oceans and seas. In order to attain this it is essential that the decisions that government makes can be justified and that these decisions use the best available evidence and allow for any uncertainty. However, reductions across the budgets of departments such as Defra means that new ways of delivering evidence for policy needs must be sought. To do this we must consider marine monitoring efficiencies including the use of novel technologies, more integrated monitoring programmes, and greater collaboration with the research councils, industry, and academia. We must also seek to leverage other sources of funding from the European Union and other international partners. This presentation will address the main policy drivers (e.g. EU Marine Strategy Framework Directive) and future needs of the marine programme, the Defra Evidence Action Plan (EAP), and how we plan to use new avenues of gaining high quality marine scientific evidence in an era of declining budgets.

  11. [Handbook for the preparation of evidence-based documents. Tools derived from scientific knowledge].

    Science.gov (United States)

    Carrión-Camacho, M R; Martínez-Brocca, M A; Paneque-Sánchez-Toscano, I; Valencia-Martín, R; Palomino-García, A; Muñoz-Durán, C; Tamayo-López, M J; González-Eiris-Delgado, C; Otero-Candelera, R; Ortega-Ruiz, F; Sobrino-Márquez, J M; Jiménez-García-Bóveda, R; Fernández-Quero, M; Campos-Pareja, A M

    2013-01-01

    This handbook is intended to be an accessible, easy-to-consult guide to help professionals produce or adapt Evidence-Based Documents. Such documents will help standardize both clinical practice and decision-making, the quality always being monitored in such a way that established references are complied with. Evidence-Based Health Care Committee, a member of "Virgen del Rocío" University Hospital quality structure, proposed the preparation of a handbook to produce Evidence-Based Documents including: a description of products, characteristics, qualities, uses, methodology of production, and application scope of every one of them. The handbook consists of seven Evidence-Based tools, one chapter on critical analysis methodology of scientific literature, one chapter with internet resources, and some appendices with different assessment tools. This Handbook provides general practitioners with a great opportunity to improve quality and as a guideline to standardize clinical healthcare, and managers with a strategy to promote and encourage the development of documents in an effort to reduce clinical practice variability, as well as giving patients the opportunity of taking part in planning their own care. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

  12. Materials and techniques for coiling of cerebral aneurysms: how much scientific evidence do we have?

    Energy Technology Data Exchange (ETDEWEB)

    Kurre, W.; Berkefeld, J. [University of Frankfurt, Department of Neuroradiology, Frankfurt (Germany)

    2008-11-15

    Since coils were approved for aneurysm treatment, materials and techniques developed rapidly. It still remains an open question whether one material or method is superior. This article reviews the literature on various coil types and treatment approaches assessing the scientific evidence of its use. Studies on aneurysm treatment with Guglielmi detachable platinum coils, bioactive coils, hydrogel coated coils, and complex designs as well as balloon- and stent-assisted techniques were retrieved by a PubMed database search from 1990 until May 2008. Data were analyzed in terms of aneurysm occlusion, permanent morbidity and mortality, recanalization, and retreatment. We also assessed the level of evidence of the published studies. Only the International Subarachnoid Aneurysm Trial provides level I evidence proving the superiority of endovascular over surgical therapy in ruptured aneurysms. Randomized trials comparing bioactive or hydrogel coated devices with bare coils are ongoing. Other studies were based on registries or case series mainly conducted without control groups. Morbidity, mortality, and initial occlusion rates appear similar for all devices. No clear evidence exists for the superiority of bioactive- or hydrocoils regarding long-term stability. It remains ambiguous whether morbidity and mortality rises with the use of balloons and stents. There is no evidence that routine use of balloons improves treatment durability. Mid-term results of stent-assisted coiling of complex aneurysms appear favorable. There is a lack of studies with a high level of evidence comparing different coiling materials and techniques. Case series and registries were not able to prove the superiority of any device or method. (orig.)

  13. [Assessment of the quality of scientific evidence in Anales Españoles de Pediatría].

    Science.gov (United States)

    González De Dios, J

    2001-04-01

    Evidence-based medicine is a new scientific paradigm that aims to use medical literature more effectively in guiding medical practice. The aim of this study was to assess the quality of scientific evidence in Spanish pediatric articles. Original articles published in Anales Españoles de Pediatría during a 6.5year period (n733) were compared with those published in Pediatrics during a 1.5year period (n300). The quality of scientific evidence in Anales was high in only 3% of original articles (randomized clinical trials). It was average in 30.4% (non-randomized clinical trials, cohort studies, case-control studies) and poor in 66.6% (descriptive studies, case reports, etc.). Only 10.2% of articles used appropriate methodological concepts according to evidence-based medicine. These concepts were mainly "soft" (odds ratio, relative risk, confidence interval) and no "hard" concepts (number needed to treat, likelihood ratio, odds pretest) were detected. The pediatric specialty showing the highest quality of scientific evidence, greatest use of appropriate methodological concepts and greatest statistical accessibility was pneumology. The first step in improving the quality of scientific evidence would be to establish collaboration between epidemiologists and/or biostatisticians. The evidence-based bibliometric indicators found in Pediatrics serve as a gold standard for Anales.

  14. Sublingual administration of tacrolimus: current trends and available evidence.

    Science.gov (United States)

    Doligalski, Christina Teeter; Liu, Esther C; Sammons, Chelsea M; Silverman, Andrew; Logan, Angela Tong

    2014-11-01

    Widespread anecdotal use of sublingual tacrolimus administration has arisen, although little literature exists to guide practice. Given the paucity of data, we conducted a survey to evaluate the practice of sublingual tacrolimus administration at transplant centers across the United States and evaluated the literature that is currently available. A 10-question online survey assessing the current state of sublingual tacrolimus use was distributed to pharmacists at transplant centers that each performed more than 100 solid organ transplantations in 2013. In addition, a literature review was performed by searching the PubMed database to identify available evidence for the sublingual administration of tacrolimus. The online survey was completed by 59 (65.6%) of the 90 targeted transplant centers, representing 51.3% of all solid organ transplantations performed in 2013. Sublingual administration of tacrolimus was used in all solid organ transplant populations, with ~67% of lung transplant centers using this route for tacrolimus. The most common dose conversion was 2 mg oral to 1 mg sublingual, with 92% of centers opening oral capsules and administering the contents sublingually. Home use of sublingual administration and use in the pediatric population was uncommon. Seven peer-reviewed reports and one abstract were identified in the literature review. Seven of the eight publications reported favorably on sublingual administration, although no consistent dose conversion or method of administration was elucidated. The majority of the transplant centers surveyed found sublingual tacrolimus a viable alternative when oral administration is unavailable. A large robust prospective evaluation of sublingual administration of tacrolimus is imperative to provide the most effective care to solid organ transplant recipients and to ensure optimal safety for both patients and providers who administer the drug.

  15. Fish, Mercury, Selenium and Cardiovascular Risk: Current Evidence and Unanswered Questions

    Directory of Open Access Journals (Sweden)

    Dariush Mozaffarian

    2009-06-01

    Full Text Available Controversy has arisen among the public and in the media regarding the health effects of fish intake in adults. Substantial evidence indicates that fish consumption reduces coronary heart disease mortality, the leading cause of death in developed and most developing nations. Conversely, concerns have grown regarding potential effects of exposure to mercury found in some fish. Seafood species are also rich in selenium, an essential trace element that may protect against both cardiovascular disease and toxic effects of mercury. Such protective effects would have direct implications for recommendations regarding optimal selenium intake and for assessing the potential impact of mercury exposure from fish intake in different populations. Because fish consumption appears to have important health benefits in adults, elucidating the relationships between fish intake, mercury and selenium exposure, and health risk is of considerable scientific and public health relevance. The evidence for health effects of fish consumption in adults is reviewed, focusing on the strength and consistency of evidence and relative magnitudes of effects of omega-3 fatty acids, mercury, and selenium. Given the preponderance of evidence, the focus is on cardiovascular effects, but other potential health effects, as well as potential effects of polychlorinated biphenyls and dioxins in fish, are also briefly reviewed. The relevant current unanswered questions and directions of further research are summarized.

  16. [Hierarchy of evidence: levels of evidence and grades of recommendation from current use].

    Science.gov (United States)

    Manterola, Carlos; Asenjo-Lobos, Claudla; Otzen, Tamara

    2014-12-01

    There are multiple proposals and classifications that hierarchize evidence, which may confuse those who are dedicated to generate it both in health technology assessments, as for the development of clinical guidelines, etc. The aim of this manuscript is to describe the most commonly used classifications of levels of evidence and grades of recommendation, analyzing their main differences and applications so that the user can choose the one that better suits your needs and take this health decisions basing their practice on the best available evidence. A systematic literature search was performed in PubMed and MEDLINE databases and in Google, Yahoo and Ixquick search engines. A wealth of information concerning levels of evidence and degrees recommendation was obtained. It was summarized the information of the 11 proposals more currently used (CTFPHC, Sackett, USPSTF, CEBM, GRADE, SIGN, NICE, NHMRC, PCCRP, ADA y ACCF/AHA), between which it emphasizes the GRADE WORKING GROUP, incorporated by around 90 national and international organizations such as the World Health Organization, The Cochrane Library, American College of Physicians, American Thoracic Society, UpToDate, etc.; and locally by the Ministry of Health to create clinical practice guidelines.

  17. Foot and ankle fractures during childhood: review of the literature and scientific evidence for appropriate treatment

    Directory of Open Access Journals (Sweden)

    Stefan Rammelt

    Full Text Available ABSTRACT Foot and ankle fractures represent 12% of all pediatric fractures. Malleolar fractures are the most frequent injuries of the lower limbs. Hindfoot and midfoot fractures are rare, but inadequate treatment for these fractures may results in compartment syndrome, three-dimensional deformities, avascular necrosis and early post-traumatic arthritis, which have a significant impact on overall foot and ankle function. Therefore, the challenges in treating these injuries in children are to achieve adequate diagnosis and precise treatment, while avoiding complications. The objective of the treatment is to restore normal anatomy and the correct articular relationship between the bones in this region. Moreover, the treatment needs to be planned according to articular involvement, lower-limb alignment, ligament stability and age. This article provides a review on this topic and presents the scientific evidence for appropriate treatment of these lesions.

  18. Social values and scientific evidence: the case of the HPV vaccines.

    Science.gov (United States)

    Intemann, Kristen; de Melo-Martín, Inmaculada

    2010-01-06

    Several have argued that the aims of scientific research are not always independent of social and ethical values. Yet this is often assumed only to have implications for decisions about what is studied, or which research projects are funded, and not for methodological decisions or standards of evidence. Using the case of the recently developed HPV vaccines, we argue that the social aims of research can also play important roles in justifying decisions about (1) how research problems are defined in drug development, (2) evidentiary standards used in testing drug "success", and (3) clinical trial methodology. As a result, attending to the social aims at stake in particular research contexts will produce more rational methodological decisions as well as more socially relevant science.

  19. 26th Hohenheim Concensus Conference, September 11, 2010 Scientific substantiation of health claims: Evidence-based nutrition

    NARCIS (Netherlands)

    Biesalski, H.K.; Aggett, P.J.; Anton, R.; Bernstein, P.S.; Blumberg, J.; Heaney, R.P.; Henry, J.; Nolan, J.M.; Richardson, D.P.; Ommen, van B.; Witkamp, R.F.; Rijkers, G.T.; Zollner, I.

    2011-01-01

    Objective The objective was to define the term evidence based nutrition on the basis of expert discussions and scientific evidence. Methods and procedures The method used is the established Hohenheim Consensus Conference. The term “Hohenheim Consensus Conference” defines conferences dealing with nut

  20. 26th Hohenheim Consensus Conference, September 11, 2010 Scientific substantiation of health claims : Evidence-based nutrition

    NARCIS (Netherlands)

    Biesalski, Hans Konrad; Aggett, Peter J.; Anton, Robert; Bernstein, Paul S.; Blumberg, Jeffrey; Heaney, Robert P.; Henry, Jeya; Nolan, John M.; Richardson, David P.; van Ommen, Ben; Witkamp, Renger F.; Rijkers, Ger T.; Zoellner, Iris

    2011-01-01

    Objective: The objective was to define the term evidence based nutrition on the basis of expert discussions and scientific evidence. Methods and procedures: The method used is the established Hohenheim Consensus Conference. The term "Hohenheim Consensus Conference" defines conferences dealing with n

  1. 26th Hohenheim Consensus Conference, September 11, 2010 Scientific substantiation of health claims: Evidence-based nutrition

    NARCIS (Netherlands)

    Biesalski, H.K.; Aggett, P.J.; Anton, R.; Bernstein, P.S.; Blumberg, J.; Heaney, R.P.; Henry, J.; Nolan, J.M.; Richardson, D.P.; Ommen, B. van; Witkamp, R.F.; Rijkers, G.T.; Zöllner, I.

    2011-01-01

    Objective: The objective was to define the term evidence based nutrition on the basis of expert discussions and scientific evidence. Methods and procedures: The method used is the established Hohenheim Consensus Conference. The term "Hohenheim Consensus Conference" defines conferences dealing with n

  2. Preventing skin cancer through reduction of indoor tanning: current evidence.

    Science.gov (United States)

    Watson, Meg; Holman, Dawn M; Fox, Kathleen A; Guy, Gery P; Seidenberg, Andrew B; Sampson, Blake P; Sinclair, Craig; Lazovich, DeAnn

    2013-06-01

    Exposure to ultraviolet radiation from indoor tanning devices (tanning beds, booths, and sun lamps) or from the sun contributes to the risk of skin cancer, including melanoma, which is the type of skin cancer responsible for most deaths. Indoor tanning is common among certain groups, especially among older adolescents and young adults, adolescent girls and young women, and non-Hispanic whites. Increased understanding of the health risks associated with indoor tanning has led to many efforts to reduce use. Most environmental and systems efforts in the U.S. (e.g., age limits or requiring parental consent/accompaniment) have occurred at the state level. At the national level, the U.S. Food and Drug Administration and the Federal Trade Commission regulate indoor tanning devices and advertising, respectively. The current paper provides a brief review of (1) the evidence on indoor tanning as a risk factor for skin cancer; (2) factors that may influence use of indoor tanning devices at the population level; and (3) various environmental and systems options available for consideration when developing strategies to reduce indoor tanning. This information provides the context and background for the companion paper in this issue of the American Journal of Preventive Medicine, which summarizes highlights from an informal expert meeting convened by the CDC in August 2012 to identify opportunities to prevent skin cancer by reducing use of indoor tanning devices.

  3. Current evidence on perinatal home visiting and intimate partner violence.

    Science.gov (United States)

    Sharps, Phyllis W; Campbell, Jacquelyn; Baty, Marguerite L; Walker, Keisha S; Bair-Merritt, Megan H

    2008-01-01

    To describe current evidence on home visiting interventions for pregnant or postpartum women with specific intimate partner violence assessment and content. Online bibliographic databases including PubMed, CINAHL Plus, and Web of Science and a hand search of bibliographies of relevant articles. Original research and intervention studies were included that contained (a) a well-described prenatal and/or postpartum home visitation; (b) an assessment of perinatal intimate partner violence; and (c) quantitative data describing health outcomes for the women and their infants. The search yielded 128 articles, and 8 relevant articles met all of the inclusion criteria. Nonresearch, nonintervention, and international articles were excluded. No perinatal home visiting interventions were designed to address intimate partner violence. Programs that screened for intimate partner violence found high rates, and the presence of intimate partner violence limited the ability of the intervention to improve maternal and child outcomes. Perinatal home visitation programs likely improve pregnancy and infant outcomes. Home visiting interventions addressing intimate partner violence in nonperinatal population groups have been effective in minimizing intimate partner violence and improving outcomes. This suggests that perinatal home visiting programs adding specific intimate partner violence interventions may reduce intimate partner violence and improve maternal and infant health. Continued rigorous research is needed.

  4. Targeted temperature management: Current evidence and practices in critical care

    Directory of Open Access Journals (Sweden)

    Saurabh Saigal

    2015-01-01

    Full Text Available Targeted temperature management (TTM in today′s modern era, especially in intensive care units represents a promising multifaceted therapy for a variety of conditions. Though hypothermia is being used since Hippocratic era, the renewed interest of late has been since early 21 st century. There have been multiple advancements in this field and varieties of cooling devices are available at present. TTM requires careful titration of its depth, duration and rewarming as it is associated with side-effects. The purpose of this review is to find out the best evidence-based clinical practice criteria of therapeutic hypothermia in critical care settings. TTM is an unique therapeutic modality for salvaging neurological tissue viability in critically ill patients viz. Post-cardiac arrest, traumatic brain injury (TBI, meningitis, acute liver failure and stroke. TTM is standard of care in post-cardiac arrest situations; there has been a lot of controversy of late regarding temperature ranges to be used for the same. In patients with TBI, it reduces intracranial pressure, but has not shown any favorable neurologic outcome. Hypothermia is generally accepted treatment for hypoxic ischemic encephalopathy in newborns. The current available technology to induce and maintain hypothermia allows for precise temperature control. Future studies should focus on optimizing hypothermic treatment to full benefit of our patients and its application in other clinical scenarios.

  5. Infant Nutrition and Later Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Caroline Fall

    2012-07-01

    Full Text Available There is a growing recognition of the need for a lifecourse approach to understanding the aetiology of adult disease, and there is now significant evidence that links patterns of infant feeding to differences in health outcomes, both in the short and longer term. Breastfeeding is associated with lower rates of infection in infancy; in high-income populations, it is associated with reductions in blood pressure and total blood cholesterol, and lower risks of obesity and diabetes in adult life. Breastfeeding rates are suboptimal in many countries, and strategies to promote breastfeeding could therefore confer important benefits for health at a population level. However, there are particular challenges in defining nutritional exposures in infancy, including marked social gradients in initiation and duration of breastfeeding. In recent studies of low and middle-income populations of children and young adults, where the influences on infant feeding practice differ, beneficial effects of breastfeeding on blood pressure, BMI and risk of diabetes have not been confirmed, and further information is needed. Little is currently known about the long-term consequences of differences in the timing and nature of the weaning diet. Future progress will depend on new studies that provide detailed prospective data on duration and exclusivity of breastfeeding together with appropriate characterisation of the weaning diet.

  6. Medicinal mushroom science: Current perspectives, advances, evidences, and challenges

    Directory of Open Access Journals (Sweden)

    Solomon P Wasser

    2014-12-01

    Full Text Available The main target of the present review is to draw attention to the current perspectives, advances, evidences, challenges, and future development of medicinal mushroom science in the 21 st century. Medicinal mushrooms and fungi are thought to possess approximately 130 medicinal functions, including antitumor, immunomodulating, antioxidant, radical scavenging, cardiovascular, anti-hypercholesterolemic, antiviral, antibacterial, anti-parasitic, antifungal, detoxification, hepatoprotective, and antidiabetic effects. Many, if not all, higher Basidiomycetes mushrooms contain biologically active compounds in fruit bodies, cultured mycelium, and cultured broth. Special attention is paid to mushroom polysaccharides. The data on mushroom polysaccharides and different secondary metabolites are summarized for approximately 700 species of higher hetero- and homobasidiomycetes. Numerous bioactive polysaccharides or polysaccharide-protein complexes from the medicinal mushrooms described appear to enhance innate and cell-mediated immune responses, and exhibit antitumor activities in animals and humans. Whilst the mechanism of their antitumor actions is still not completely understood, stimulation and modulation of key host immune responses by these mushroom compounds appear central. Polysaccharides and low-molecular-weight secondary metabolites are particularly important due to their antitumor and immunostimulating properties. Several of the mushroom compounds have been subjected to Phase I, II, and III clinical trials, and are used extensively and successfully in Asia to treat various cancers and other diseases. Special attention is given to many important unsolved problems in the study of medicinal mushrooms.

  7. The state of scientific evidence on air pollution and human health in Nepal.

    Science.gov (United States)

    Gurung, Anobha; Bell, Michelle L

    2013-07-01

    Air pollution has been linked to acute and chronic health effects. However, the majority of evidence is based in North America and Europe, with a growing number of studies in Asia and Latin America. Nepal is one of the many South Asian countries where little such research has been conducted. We summarized the state of scientific evidence and identify research gaps based on the existing literature on air pollution and human health in Nepal. We performed a systematic literature search to identify relevant studies. Studies were categorized as those that estimate: (1) health impacts of indoor air pollution, (2) health impacts of outdoor air pollution, (3) health burdens from outdoor air pollution in Nepal based on existing concentration-response relationships from elsewhere, or (4) exposure and air quality but do not link to health. We identified 89 studies, of which 23 linked air pollution to health impacts. The remainder focused on exposure and air quality, demonstrating high pollution levels. The few health studies focused mainly on indoor air (n=15), especially in rural areas and during cooking. Direct exposure measurements were for short time periods; most studies used indirect exposure methods (e.g., questionnaire). Most health studies had small sample sizes with almost all focusing on respiratory health. Although few studies have examined air pollution and health in Nepal, the existing studies indicate high pollution levels and suggest large health impacts. Nepal's dearth of scientific research on air pollution and health is not unique and likely is similar to that of many other developing regions. Future research with larger studies and more health outcomes is needed. Key challenges include data availability.

  8. A Delphi Technology Foresight Study: Mapping Social Construction of Scientific Evidence on Metagenomics Tests for Water Safety.

    Science.gov (United States)

    Birko, Stanislav; Dove, Edward S; Özdemir, Vural

    2015-01-01

    Access to clean water is a grand challenge in the 21st century. Water safety testing for pathogens currently depends on surrogate measures such as fecal indicator bacteria (e.g., E. coli). Metagenomics concerns high-throughput, culture-independent, unbiased shotgun sequencing of DNA from environmental samples that might transform water safety by detecting waterborne pathogens directly instead of their surrogates. Yet emerging innovations such as metagenomics are often fiercely contested. Innovations are subject to shaping/construction not only by technology but also social systems/values in which they are embedded, such as experts' attitudes towards new scientific evidence. We conducted a classic three-round Delphi survey, comprised of 107 questions. A multidisciplinary expert panel (n = 24) representing the continuum of discovery scientists and policymakers evaluated the emergence of metagenomics tests. To the best of our knowledge, we report here the first Delphi foresight study of experts' attitudes on (1) the top 10 priority evidentiary criteria for adoption of metagenomics tests for water safety, (2) the specific issues critical to governance of metagenomics innovation trajectory where there is consensus or dissensus among experts, (3) the anticipated time lapse from discovery to practice of metagenomics tests, and (4) the role and timing of public engagement in development of metagenomics tests. The ability of a test to distinguish between harmful and benign waterborne organisms, analytical/clinical sensitivity, and reproducibility were the top three evidentiary criteria for adoption of metagenomics. Experts agree that metagenomic testing will provide novel information but there is dissensus on whether metagenomics will replace the current water safety testing methods or impact the public health end points (e.g., reduction in boil water advisories). Interestingly, experts view the publics relevant in a "downstream capacity" for adoption of metagenomics rather

  9. A Delphi Technology Foresight Study: Mapping Social Construction of Scientific Evidence on Metagenomics Tests for Water Safety.

    Directory of Open Access Journals (Sweden)

    Stanislav Birko

    Full Text Available Access to clean water is a grand challenge in the 21st century. Water safety testing for pathogens currently depends on surrogate measures such as fecal indicator bacteria (e.g., E. coli. Metagenomics concerns high-throughput, culture-independent, unbiased shotgun sequencing of DNA from environmental samples that might transform water safety by detecting waterborne pathogens directly instead of their surrogates. Yet emerging innovations such as metagenomics are often fiercely contested. Innovations are subject to shaping/construction not only by technology but also social systems/values in which they are embedded, such as experts' attitudes towards new scientific evidence. We conducted a classic three-round Delphi survey, comprised of 107 questions. A multidisciplinary expert panel (n = 24 representing the continuum of discovery scientists and policymakers evaluated the emergence of metagenomics tests. To the best of our knowledge, we report here the first Delphi foresight study of experts' attitudes on (1 the top 10 priority evidentiary criteria for adoption of metagenomics tests for water safety, (2 the specific issues critical to governance of metagenomics innovation trajectory where there is consensus or dissensus among experts, (3 the anticipated time lapse from discovery to practice of metagenomics tests, and (4 the role and timing of public engagement in development of metagenomics tests. The ability of a test to distinguish between harmful and benign waterborne organisms, analytical/clinical sensitivity, and reproducibility were the top three evidentiary criteria for adoption of metagenomics. Experts agree that metagenomic testing will provide novel information but there is dissensus on whether metagenomics will replace the current water safety testing methods or impact the public health end points (e.g., reduction in boil water advisories. Interestingly, experts view the publics relevant in a "downstream capacity" for adoption of

  10. [Workplace violence in Latin America: A review of the scientific evidence].

    Science.gov (United States)

    Ansoleaga, Elisa; Gómez-Rubio, Constanza; Mauro, Amalia

    2015-01-01

    Workplace Violence has acquired social relevance given the evidence regarding there its health consequences. Has identified various effects such as mood disorders and sleep disorders, hostility, isolation, insecurity, among others. To describe and analyze scientific evidence published on workplace violence in studies in Latin American countries between 2009 and 2014. A descriptive and quantitative study. A search was made on the basis of Academic Search Complete (EBSCOhost) Academic Source Premier, PSICODOC, Scielo.org, JSTOR and SCOPUS. And indexed empirical studies were considered. We worked with 46 selected articles. The studies showed a higher amount of psychological violence at work, with a potential risk in women and health professionals. Also, the analysis categories were the most reported behaviors that express violence, health implications and facilitators. The literature on the study of workplace violence in Latin America is recent. Items are descriptive, interpretative studies with insufficient or analytical nature. Health personnel, particularly women, have conditions of vulnerability, with relevance with regard to sexual harassment, wage inequality and bullying.

  11. Application of lipoarabinomannan antigen in tuberculosis diagnostics: current evidence.

    Science.gov (United States)

    Sarkar, Pronoti; Biswas, Debasis; Sindhwani, Girish; Rawat, Jagdish; Kotwal, Aarti; Kakati, Barnali

    2014-03-01

    Tests based on the detection of mycobacterial lipoarabinomannan (LAM) antigen in urine have emerged as potential point-of-care tests for tuberculosis (TB). We aimed to assimilate the current evidence regarding the diagnostic performance of LAM assays and to ascertain their clinical indication in settings with high and low prevalence of HIV-TB co-infection. Owing to suboptimal sensitivity, the urinary LAM assays are unsuitable as general screening tests for TB. However, unlike traditional diagnostic methods, they demonstrate improved sensitivity in HIV-TB co-infection which further increases with low CD4 counts. Accordingly, these assays are indicated as rule-in tests for TB in patients with advanced HIV-induced immunosuppression, and facilitate the early initiation of antituberculous treatment in them. They also offer incremental sensitivity and specificity when used as adjunct tests to smear microscopy and chest radiography in HIV-TB co-infection. They obviate the biohazards associated with sputum samples and provide an alternative diagnostic tool in sputum-scarce patients. Notwithstanding these advantages, the specificity of these assays is variable, which is mostly attributable to misclassification bias and cross-reactivity with non-tuberculous mycobacteria or other commensal flora. Furthermore, the inability to detect low titres of antigen in HIV-uninfected patients makes these assays unsuitable for use in settings with a low HIV prevalence. Future research targeted towards inclusion of specific monoclonal antibodies and more sensitive immunoassay platforms might help to improve the diagnostic performance of these assays and extend their applicability to the general population of patients with TB.

  12. Mitochondrial dysfunction in psychiatric morbidity: current evidence and therapeutic prospects

    Directory of Open Access Journals (Sweden)

    Toker L

    2015-09-01

    Full Text Available Lilach Toker,1 Galila Agam2,3 1Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; 2Department of Clinical Biochemistry and Pharmacology, Ben-Gurion University of the Negev, Beer-Sheva, Israel; 3Mental Health Center, Beer-Sheva, Israel Abstract: Cumulating evidence for the involvement of mitochondrial dysfunction in psychiatric disorders leaves little to no doubt regarding the involvement of this pathology in mood disorders. However, mitochondrial abnormalities are also observed in a wide range of disorders spanning from cancer and diabetes to various neurodegenerative and neurodevelopmental disorders such as Parkinson’s, Alzheimer’s, Huntington’s, autism, and amyotrophic lateral sclerosis. The apparent lack of specificity questions the role of mitochondrial dysfunction in psychiatric disorders, in general, and in mood disorders, in particular. Is mitochondrial dysfunction a general phenomenon, simplistically rendering brain cells to be more vulnerable to a variety of disease-specific perturbations? Or is it an epiphenomenon induced by various disease-specific factors? Or possibly, the severity and the anatomical region of the dysfunction are the ones responsible for the distinct features of the disorders. Whichever of the aforementioned ones, if any, is correct, “mitochondrial dysfunction” became more of a cliché than a therapeutic target. In this review, we summarize current studies supporting the involvement of mitochondrial dysfunction in different psychiatric disorders. We address the question of specificity and causality of the different findings and provide an alternative explanation for some of the aforementioned questions. Keywords: bipolar disorder, psychiatric disorders, schizophrenia, Stanley Foundation Brain Collection

  13. Preanalytical Phase – an updated review of the current evidence

    OpenAIRE

    Simundic, Ana-Maria

    2014-01-01

    European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working group for preanalytical phase (WG-PRE) has recently launched a series of conferences on preanalytical phase. First such meeting was held in Parma (Italy) in the spring of 2011 and the second one took place in Zagreb (Croatia) during 1-2 March 2013. The Zagreb audience had the opportunity to enjoy a focused and challenging scientific program as well as to participate actively in interactive e-voting sessions. S...

  14. Current Evidence Supporting the Link Between Dietary Fatty Acids and Cardiovascular Disease.

    Science.gov (United States)

    Hammad, Shatha; Pu, Shuaihua; Jones, Peter J

    2016-05-01

    Lack of consensus exists pertaining to the scientific evidence regarding effects of various dietary fatty acids on cardiovascular disease (CVD) risk. The objective of this article is to review current evidence concerning cardiovascular health effects of the main dietary fatty acid types; namely, trans (TFA), saturated (SFA), polyunsaturated (PUFA; n-3 PUFA and n-6 PUFA), and monounsaturated fatty acids (MUFA). Accumulating evidence shows negative health impacts of TFA and SFA; both may increase CVD risk. Policies have been proposed to reduce TFA and SFA consumption to less than 1 and 7 % of energy intake, respectively. Cardiovascular health might be promoted by replacing SFA and TFA with n-6 PUFA, n-3 PUFA, or MUFA; however, the optimal amount of PUFA or MUFA that can be used to replace SFA and TFA has not been defined yet. Evidence suggests of the potential importance of restricting n-6 PUFA up to 10 % of energy and obtaining an n-6/n-3 ratio as close as possible to unity, along with a particular emphasis on consuming adequate amounts of essential fatty acids. The latest evidence shows cardioprotective effects of MUFA-rich diets, especially when MUFA are supplemented with essential fatty acids; namely, docosahexaenoic acid. MUFA has been newly suggested to be involved in regulating fat oxidation, energy metabolism, appetite sensations, weight maintenance, and cholesterol metabolism. These favorable effects might implicate MUFA as the preferable choice to substitute for other fatty acids, especially given the declaration of its safety for up to 20 % of total energy.

  15. Synchronous international scientific mobility in the space of affiliations: evidence from Russia.

    Science.gov (United States)

    Markova, Yulia V; Shmatko, Natalia A; Katchanov, Yurij L

    2016-01-01

    The article presents a survey of Russian researchers' synchronous international scientific mobility as an element of the global system of scientific labor market. Synchronous international scientific mobility is a simultaneous holding of scientific positions in institutions located in different countries. The study explores bibliometric data from the Web of Science Core Collection and socio-economic indicators for 56 countries. In order to examine international scientific mobility, we use a method of affiliations. The paper introduces a model of synchronous international scientific mobility. It enables to specify country's involvement in the international division of scientific labor. Synchronous international scientific mobility is a modern form of the international division of labor in science. It encompasses various forms of part-time, temporary and remote employment of scientists. The analysis reveals the distribution of Russian authors in the space of affiliations, and directions of upward/downward international scientific mobility. The bibliometric characteristics of mobile authors are isomorphic to those of receiver country authors. Synchronous international scientific mobility of Russian authors is determined by differences in scientific impacts between receiver and donor countries.

  16. Milk and acid-base balance: proposed hypothesis versus scientific evidence.

    Science.gov (United States)

    Fenton, Tanis R; Lyon, Andrew W

    2011-10-01

    Recently the lay press has claimed a hypothetical association among dairy product consumption, generation of dietary acid, and harm to human health. This theoretical association is based on the idea that the protein and phosphate in milk and dairy products make them acid-producing foods, which cause our bodies to become acidified, promoting diseases of modern civilization. Some authors have suggested that dairy products are not helpful and perhaps detrimental to bone health because higher osteoporotic fracture incidence is observed in countries with higher dairy product consumption. However, scientific evidence does not support any of these claims. Milk and dairy products neither produce acid upon metabolism nor cause metabolic acidosis, and systemic pH is not influenced by diet. Observations of higher dairy product intake in countries with prevalent osteoporosis do not hold when urban environments are compared, likely due to physical labor in rural locations. Milk and other dairy products continue to be a good source of dietary protein and other nutrients. Key teaching points: Measurement of an acidic pH urine does not reflect metabolic acidosis or an adverse health condition. The modern diet, and dairy product consumption, does not make the body acidic. Alkaline diets alter urine pH but do not change systemic pH. Net acid excretion is not an important influence of calcium metabolism. Milk is not acid producing. Dietary phosphate does not have a negative impact on calcium metabolism, which is contrary to the acid-ash hypothesis.

  17. POSITIVE PSYCHOLOGY AND ITS ENEMIES: A REPLY BASED ON SCIENTIFIC EVIDENCE

    Directory of Open Access Journals (Sweden)

    Carmelo Vázquez

    2013-05-01

    Full Text Available Positive psychology has been the subject of passionate attacks. Its novelty, its scientific scope, its intentions and even the honesty of its followers have been questioned. Furthermore, by extension, the concern of psychology on a whole with human well-being has been placed in doubt. In this review, we offer an answer to some disproportionate criticism and make an overview of the existing overwhelming evidence derived from the active, robust research agenda on positive emotions and cognitions (e.g., optimism and their relationship to health and psychological wellness. Psychology cannot ignore a growing general movement in social sciences and in political and economic discussion that places psychological well-being in the legitimate focus of attention. In this regard, positive psychology is contributing, with the best standard tools psychological research, to articulate and support a good part of the research in and promotion of those crucial issues. Finally, it is argued that, based on a true and respectful academic dialogue, psychology must inevitably and fluently integrate the focus on positive functioning for a more inclusive explanation of human nature.

  18. Integrating nutrition and child development interventions: scientific basis, evidence of impact, and implementation considerations.

    Science.gov (United States)

    Black, Maureen M; Pérez-Escamilla, Rafael; Rao, Sylvia Fernandez

    2015-11-01

    The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children's linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5.

  19. Postpartum family planning: current evidence on successful interventions

    Directory of Open Access Journals (Sweden)

    Blazer C

    2016-04-01

    Full Text Available Cassandra Blazer, Ndola Prata Bixby Center for Population, Health, and Sustainability, School of Public Health, University of California, Berkeley, CA, USA Abstract: We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations. Keywords: postpartum period, family planning, birth spacing, interventions, systematic review, contraception, less developed countries

  20. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

    OpenAIRE

    Thorning, Tanja Kongerslev; Raben, Anne; Thorning, Tine; Soedamah-Muthu, Sabita S; Givens, Ian; Astrup, Arne

    2016-01-01

    Background: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat.Objective: This review aimed to assess the scientific evidence mainly from meta-analyses of observational studies and randomised controlled trials, on dairy intake and risk of obesity, type 2 diabetes, cardiovascular disease, osteoporosis, cancer, and all-cause mortality.Results: The most recent evid...

  1. Poststroke Fatigue: Emerging Evidence and Approaches to Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    Science.gov (United States)

    Hinkle, Janice L; Becker, Kyra J; Kim, Jong S; Choi-Kwon, Smi; Saban, Karen L; McNair, Norma; Mead, Gillian E

    2017-07-01

    At least half of all stroke survivors experience fatigue; thus, it is a common cause of concern for patients, caregivers, and clinicians after stroke. This scientific statement provides an international perspective on the emerging evidence surrounding the incidence, prevalence, quality of life, and complex pathogenesis of poststroke fatigue. Evidence for pharmacological and nonpharmacological interventions for management are reviewed, as well as the effects of poststroke fatigue on both stroke survivors and caregivers. © 2017 American Heart Association, Inc.

  2. Developing resident learning profiles: Do scientific evidence epistemology beliefs, EBM self-efficacy beliefs and EBM skills matter?

    Science.gov (United States)

    Robert, Nancy J.

    This study investigated resident scientific evidence epistemology beliefs, evidence based medicine (EBM) self-efficacy beliefs, and EBM skills. A convenience sample of fifty-one residents located in six U.S. based residency programs completed an online instrument. Hofer's epistemology survey questionnaire was modified to test responses based on four types of scientific evidence encountered in medical practice (Clinical Trial Phase 1, Clinical Trial Phase 3, Meta-analysis and Qualitative). It was hypothesized that epistemology beliefs would differ based on the type of scientific evidence considered. A principal components analysis produced a two factor solution that was significant across type of scientific evidence suggesting that when evaluating epistemology beliefs context does matter. Factor 1 is related to the certainty of research methods and the certainty of medical conclusions and factor 2 denotes medical justification. For each type of scientific evidence, both factors differed on questions comprising the factor structure with significant differences found for the factor 1 and 2 questions. A justification belief case problem using checklist format was triangulated with the survey results, and as predicted the survey and checklist justification z scores indicated no significant differences, and two new justification themes emerged. Modified versions of Finney and Schraw's statistical self-efficacy and skill instruments produced expected significant EBM score correlations with unexpected results indicating that the number of EBM and statistics courses are not significant for EBM self-efficacy and skill scores. The study results were applied to the construction of a learning profile that provided residents belief and skill feedback specific to individual learning needs. The learning profile design incorporated core values related to 'Believer' populations that focus on art, harmony, tact and diplomacy. Future research recommendations include testing context

  3. Current Efforts in European Projects to Facilitate the Sharing of Scientific Observation Data

    Science.gov (United States)

    Bredel, Henning; Rieke, Matthes; Maso, Joan; Jirka, Simon; Stasch, Christoph

    2017-04-01

    This presentation is intended to provide an overview of currently ongoing efforts in European projects to facilitate and promote the interoperable sharing of scientific observation data. This will be illustrated through two examples: a prototypical portal developed in the ConnectinGEO project for matching available (in-situ) data sources to the needs of users and a joint activity of several research projects to harmonise the usage of the OGC Sensor Web Enablement standards for providing access to marine observation data. ENEON is an activity initiated by the European ConnectinGEO project to coordinate in-situ Earth observation networks with the aim to harmonise the access to observations, improve discoverability, and identify/close gaps in European earth observation data resources. In this context, ENEON commons has been developed as a supporting Web portal for facilitating discovery, access, re-use and creation of knowledge about observations, networks, and related activities (e.g. projects). The portal is based on developments resulting from the European WaterInnEU project and has been extended to cover the requirements for handling knowledge about in-situ earth observation networks. A first prototype of the portal was completed in January 2017 which offers functionality for interactive discussion, information exchange and querying information about data delivered by different observation networks. Within this presentation, we will introduce the presented prototype and initiate a discussion about potential future work directions. The second example concerns the harmonisation of data exchange in the marine domain. There are many organisation who operate ocean observatories or data archives. In recent years, the application of the OGC Sensor Web Enablement (SWE) technology has become more and more popular to increase the interoperability between marine observation networks. However, as the SWE standards were intentionally designed in a domain independent manner

  4. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

    NARCIS (Netherlands)

    Thorning, Tanja Kongerslev; Raben, Anne; Tholstrup, Tine; Soedamah-muthu, Sabita S.; Givens, Ian; Astrup, Arne

    2016-01-01

    Background: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat.
    Objective: This review aimed to assess the scientific evidence mainly from meta-analyses of observa

  5. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

    NARCIS (Netherlands)

    Thorning, Tanja Kongerslev; Raben, Anne; Tholstrup, Tine; Soedamah-muthu, Sabita S.; Givens, Ian; Astrup, Arne

    2016-01-01

    Background: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat.
    Objective: This review aimed to assess the scientific evidence mainly from meta-analyses of

  6. Scientific reasoning in early and middle childhood: the development of domain-general evidence evaluation, experimentation, and hypothesis generation skills.

    Science.gov (United States)

    Piekny, Jeanette; Maehler, Claudia

    2013-06-01

    According to Klahr's (2000, 2005; Klahr & Dunbar, 1988) Scientific Discovery as Dual Search model, inquiry processes require three cognitive components: hypothesis generation, experimentation, and evidence evaluation. The aim of the present study was to investigate (a) when the ability to evaluate perfect covariation, imperfect covariation, and non-covariation evidence emerges, (b) when experimentation emerges, (c) when hypothesis generation skills emerge, and (d), whether these abilities develop synchronously during childhood. We administered three scientific reasoning tasks referring to the three components to 223 children of five age groups (from age 4.0 to 13.5 years). Our results show that the three cognitive components of domain-general scientific reasoning emerge asynchronously. The development of domain-general scientific reasoning begins with the ability to handle unambiguous data, progresses to the interpretation of ambiguous data, and leads to a flexible adaptation of hypotheses according to the sufficiency of evidence. When children understand the relation between the level of ambiguity of evidence and the level of confidence in hypotheses, the ability to differentiate conclusive from inconclusive experiments accompanies this development. Implications of these results for designing science education concepts for young children are briefly discussed. © 2012 The British Psychological Society.

  7. STUDY OF CURRENT APPROACHES FOR WEB PUBLISHING OF OPEN SCIENTIFIC DATA

    Directory of Open Access Journals (Sweden)

    D. I. Mouromtsev

    2015-11-01

    Full Text Available Subject of Study. The subject of study of this work is closely related to the development of tools and technologies for Internet publishing of open data in machine-readable formats with regard to data of universities, educational and research organizations and scientific laboratories. We analyze the trends in the publishing formats most commonly used including not only popular formats such as pdf, csv, excel, but also the Semantic Web formats such as RDF. The paper describes the way of scientific data publication in semantic formats on the example of import and convertation of the information from University database. Methods. We describe the methods of publication for scientific open data in the network consisting of a set of transformations of the original data sets to the final semantic representation. These transformation steps include data upload from a relational database, data mapping on the ontological model (schema and the generation of a set of RDF-triples corresponding to the initial database fragment. A description is given to the popular open data publishing systems, such as CKAN, VIVO, and others. OpenLink Virtuoso system is selected as the primary storage and data publication. The description of RDF data model is used as a way of presenting open data of ITMO University. Main Results. The authors have described the methods of scientific open data publication and identified their shortcomings. To demonstrate the efficiency of the proposed method of university open data publication, a software prototype has been developed available online at: http://lod.ifmo.ru/. The example of the system usage is also given. Practical Relevance. Implementation of the proposed approach will improve significantly the effect of the publication of university open data and make it available for third-party applications, such as applications for information retrieval about educational activities and research results, analysis of scientific activities in

  8. Current evidence on dietary pattern and cognitive function.

    Science.gov (United States)

    Cheung, Bernice H K; Ho, Ivan C H; Chan, Ruth S M; Sea, Mandy M M; Woo, Jean

    2014-01-01

    With global aging population, age-related cognitive decline becomes epidemic. Lifestyle-related factor is one of the key preventative measures. Dietary pattern analysis which considers dietary complexity has recently used to examine the linkage between nutrition and cognitive function. A priori approach defines dietary pattern based on existing knowledge. Results of several dietary pattern scores were summarized. The heterogeneity of assessment methods and outcome measurements lead to inconsistent results. Posteriori approach derives a dietary pattern independently of the existing nutrition-disease knowledge. It showed a dietary pattern abundant with plant-based food, oily fish, lower consumption of processed food, saturated fat, and simple sugar which appears to be beneficial to cognitive health. Despite inconclusive evidence from both approaches, diet and exercise, beneficial for other diseases, remains to be the two key modifiable factors for cognitive function. Large-scale prospective studies in multiethics population are required to provide stronger evidence in the future.

  9. Current Evidence and Insights about Genetics in Thoracic Aorta Disease

    OpenAIRE

    2013-01-01

    Thoracic aortic aneurysms have been historically considered to be caused by etiologic factors similar to those implied in abdominal aortic aneurysms. However, during the past decade, there has been increasing evidence that almost 20% of thoracic aortic aneurysms may be associated with a genetic disease, often within a syndromic or familial disorder. Moreover, the presence of congenital anomalies, such as bicuspid aortic valve, may have a unique common genetic underlying cause. Finally, also s...

  10. Capnography during cardiopulmonary resuscitation: Current evidence and future directions

    Directory of Open Access Journals (Sweden)

    Bhavani Shankar Kodali

    2014-01-01

    Full Text Available Capnography continues to be an important tool in measuring expired carbon dioxide (CO 2 . Most recent Advanced Cardiac Life Support (ACLS guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR. Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO 2 (PETCO 2 and cardiac output that can indicate the return of spontaneous circulation (ROSC. Additional evidence favoring the use of capnography during CPR includes definitive proof of correct placement of the endotracheal tube and possible prediction of patient survival following cardiac arrest, although the latter will require further investigations. There is emerging evidence that PETCO 2 values can guide the initiation of extracorporeal life support (ECLS in refractory cardiac arrest (RCA. There is also increasing recognition of the value of capnography in intensive care settings in intubated patients. Future directions include determining the outcomes based on capnography waveforms PETCO 2 values and determining a reasonable duration of CPR. In the future, given increasing use of capnography during CPR large databases can be analyzed to predict outcomes.

  11. [A review of current concepts in evidence-based radiology].

    Science.gov (United States)

    Roldán-Valadez, Ernesto; Lee, Angel; Jiménez-Corona, Aída; Vega-González, Iván; Martínez-López, Manuel; Vázquez-LaMadrid, Jorge

    2007-01-01

    It has been noted that "Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. " Evidence-based medicine (EBM) is defined as the process of systematically finding, critically appraising, and using contemporary research published in the medical literature as a basis to make decisions regarding individual patient care and health care policy. In radiology, including its diagnostic and interventional aspects, the principles and practice of EBM have not been thoroughly studied. In this brief review article, we describe key aspects of evidence-based radiology (EBR), concepts and steps followed in EBM and meta-analysis. The skills required to practice EBR are identified, and the roles of EBR in radiologic practice, education, and research are discussed. The application of EBM principles to diagnostic imaging facilitates the interpretation of imaging studies and produces a sound and comprehensive radiologic evaluation. This review could be useful for radiologists and clinicians at any stage of their training or career. It encourages the practice of EBM and EBR especially in developing countries.

  12. Rendering clinical psychology an evidence-based scientific discipline: a case study.

    Science.gov (United States)

    St Stoyanov, Drozdstoj; Machamer, Peter K; Schaffner, Kenneth F

    2012-02-01

    Both modern neuroscience and clinical psychology taken as separate fields have failed to reveal the explanatory mechanisms underlying mental disorders. The evidence acquired inside the mono-disciplinary matrices of neurobiology, clinical psychology and psychopathology are deeply insufficient in terms of their validity, reliability and utility. Further, no effective trans-disciplinary connections have been developed between them. In this context, our case study aims at illustrating some specific facets of clinical psychology as a crucial discipline for explaining and understanding mental disorder. The methods employed in clinical psychology are scrutinized using the exemplar case of the Minnesota Multiphasic Personality Inventory (MMPI). We demonstrate that a clinical interview and a clinical psychological rating scale consist of the same kind of cognitive content. The provisional difference can be described in terms of its having two comparable complementary cognitive structures. The test is composed of self-evaluation reports (items) formulated as questions or statements. The psychopathological structured interview is formulated in terms of subjective experience indicated as symptoms (these are self-reports recorded by the physician), complemented with the so-called 'signs' or the presumably 'objective' observations of the overt behaviours of the patient. However, the cognitive content of clinical judgment is beyond any doubt as subjective as the narrative of the patient. None of the components of the structured psychopathological interview is independent of the inter-subjective system created in the situation of clinical assessment. Therefore, the protocols from various clinicians that serve to sustain the reliability claim of the 'scientific' Diagnostic Statistical Manual of Mental Disorders cannot be regarded as independent measurements of the cognitive content and value of the psychological rating scales or vice versa. © 2011 Blackwell Publishing Ltd.

  13. Integrating Nutrition and Child Development Interventions: Scientific Basis, Evidence of Impact, and Implementation Considerations123

    Science.gov (United States)

    Black, Maureen M; Pérez-Escamilla, Rafael; Fernandez Rao, Sylvia

    2015-01-01

    The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children’s linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5. PMID:26875208

  14. The Intertemporal Approach to the Current Account: Evidence for Chile

    Directory of Open Access Journals (Sweden)

    Sergio A. Salas Landeau

    2002-03-01

    Full Text Available This paper studies the existence of "excess" current-account imbalances in Chile in the 1960-1999 period. This phenomenon is modelled using present value tests that allow for variable interest rates and exchange rate fluctuations. Despite its simplicity, most of the observed imbalances in the current account are accounted for by the model. Results suggest that using models where agents behave as forward-looking rational agents, is a valid framework. Moreover, the analysis highlights the rel-evance of variable interest rates and exchange rates. Results also imply that capital controls, that were widely used in the period under study, were not effective.

  15. Current State of Terminology in Lithuania: Scientific Research, Management and Education

    Directory of Open Access Journals (Sweden)

    Albina Auksoriūtė

    2016-12-01

    Full Text Available Current State of Terminology in Lithuania: Scientific Research, Management and Education The article discusses the current state of terminology in Lithuania, presents terminological research carried out in the last five years, analyses ways of Lithuanian terminology management, and briefly overviews terminological education and teaching in Lithuania. Lithuanian terminological research is mostly carried out at the Institute of the Lithuanian Language and at universities and other research institutes. The largest part of terminological research is carried out at the Centre of Terminology of the Institute of the Lithuanian Language, which researches Lithuanian terminology and terminography, analyses the use of Lithuanian terminology in different fields. Three ways of terminology management are discussed: terminography, creation of term banks and databases and standardisation of terms. The number of term dictionaries published in Lithuania is rather considerable – over 600. The most productive period for publishing term dictionaries is from 1990 up to date. Between 1990–2013 more than 420 term dictionaries and special encyclopaedias were published. The main and most important terminology database in Lithuania is the Term Bank of the Republic of Lithuania (lt Lietuvos Respublikos terminų bankas, further – LTB, initiated in 2004. This bank is created as a common information system of state institutions administered by the State Commission of the Lithuanian Language (further – Language Commission. There are more than 237,000 term entries in LTB. The article discusses two more terminology databases containing Lithuanian terminology sources – IATE and EUROTERMBANK. The Lithuanian Standards Board, in addition to other work, prepares Lithuanian standards of terms and offers these terms to the Language Commission for evaluation. Since 2000, the Lithuanian Standards Board has been creating a database of standardised terms which currently contains

  16. Assessing the risks and benefits of herbal medicine: an overview of scientific evidence.

    Science.gov (United States)

    Barrett, B; Kiefer, D; Rabago, D

    1999-07-01

    The use of herbal medicine is widespread and growing, with as many as 3 in 10 Americans using botanical remedies in a given year. Because many herbal medicines have significant pharmacological activity, and thus potential adverse effects and drug interactions, healthcare professionals must be familiar with this therapeutic modality. This article summarizes the history and current use of plant-based medicine and highlights the evidence of the risks and benefits associated with 6 plants: echinacea, garlic, ginger, ginkgo, St John's wort, and valerian. Therapies outside the medical mainstream tend to suffer from a dearth of research and critical evaluation. Critics and supporters alike note the conceptual and practical difficulties in studying many complementary and alternative therapies such as acupuncture, homeopathy, and meditation. Herbal medicine, however, lends itself well to standard evaluation methods. This article summarizes and evaluates evidence from randomized controlled trials and meta-analyses. We present the results of meta-analyses and subsequent randomized controlled trials for garlic and St John's wort; a comprehensive critical review and subsequent randomized controlled trials for ginkgo; and summaries of all identified randomized controlled trials for echinacea, ginger, and valerian.

  17. Herbal Medicine for the Treatment of Vascular Dementia: An Overview of Scientific Evidence

    Science.gov (United States)

    Liu, Jianxun; Bilinski, Kellie; Xu, Li; Seto, Sai W.

    2016-01-01

    Dementia is a leading cause of mental and physical disability. Vascular dementia (VaD) is the second most common cause of dementia after Alzheimer's disease (AD) constituting 10–15% of the dementia population. Currently there are no approved pharmaceutical options for VaD and the conventional anti-AD therapies provide only modest, short-term relief of symptoms associated with VaD. Herbal medicines have been used for the management of dementia-like symptoms for centuries and may provide viable therapies for VaD due to their multicomponent and multitarget approach. This review is designed to provide an updated overview on the current status of herbal medicine research, with an emphasis on Chinese herbal medicine, for the treatment of VaD or dementia. A case study is also provided to demonstrate the development process of a novel standardized complex herbal formulation for VaD. The article reveals some preliminary evidence to support the use of single and complex herbal preparations for VaD and dementia. Multiple issues in relation to clinical and preclinical research have been identified and future research directions are discussed. PMID:28115971

  18. Herbal Medicine for the Treatment of Vascular Dementia: An Overview of Scientific Evidence

    Directory of Open Access Journals (Sweden)

    Dennis Chang

    2016-01-01

    Full Text Available Dementia is a leading cause of mental and physical disability. Vascular dementia (VaD is the second most common cause of dementia after Alzheimer’s disease (AD constituting 10–15% of the dementia population. Currently there are no approved pharmaceutical options for VaD and the conventional anti-AD therapies provide only modest, short-term relief of symptoms associated with VaD. Herbal medicines have been used for the management of dementia-like symptoms for centuries and may provide viable therapies for VaD due to their multicomponent and multitarget approach. This review is designed to provide an updated overview on the current status of herbal medicine research, with an emphasis on Chinese herbal medicine, for the treatment of VaD or dementia. A case study is also provided to demonstrate the development process of a novel standardized complex herbal formulation for VaD. The article reveals some preliminary evidence to support the use of single and complex herbal preparations for VaD and dementia. Multiple issues in relation to clinical and preclinical research have been identified and future research directions are discussed.

  19. Revisiting reflexology: Concept, evidence, current practice, and practitioner training.

    Science.gov (United States)

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-10-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

  20. Voice rest after vocal fold surgery: current practice and evidence.

    Science.gov (United States)

    Coombs, A C; Carswell, A J; Tierney, P A

    2013-08-01

    Voice rest is commonly recommended after vocal fold surgery, but there is a lack of evidence base and no standard protocol. The aim of this study was to establish common practice regarding voice rest following vocal fold surgery. An online survey was circulated via e-mail invitation to members of the ENT UK Expert Panel between October and November 2011. The survey revealed that 86.5 per cent of respondents agreed that 'complete voice rest' means no sound production at all, but there was variability in how 'relative voice rest' was defined. There was no dominant type of voice rest routinely recommended after surgery for laryngeal papillomatosis or intermediate pathologies. There was considerable variability in the duration of voice rest recommended, with no statistically significant, most popular response (except for malignant lesions). Surgeons with less than 10 years of experience were more likely to recommend fewer days of voice rest. There is a lack of consistency in advice given to patients after vocal fold surgery, in terms of both type and length of voice rest. This may arise from an absence of robust evidence on which to base practice.

  1. Revisiting reflexology: Concept, evidence, current practice, and practitioner training

    Directory of Open Access Journals (Sweden)

    Nurul Haswani Embong

    2015-10-01

    Full Text Available Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

  2. Ebola Virus Shedding and Transmission: Review of Current Evidence.

    Science.gov (United States)

    Vetter, Pauline; Fischer, William A; Schibler, Manuel; Jacobs, Michael; Bausch, Daniel G; Kaiser, Laurent

    2016-10-15

     The magnitude of the 2013-2016 Ebola virus disease outbreak in West Africa was unprecedented, with >28 500 reported cases and >11 000 deaths. Understanding the key elements of Ebola virus transmission is necessary to implement adequate infection prevention and control measures to protect healthcare workers and halt transmission in the community.  We performed an extensive PubMed literature review encompassing the period from discovery of Ebola virus, in 1976, until 1 June 2016 to evaluate the evidence on modes of Ebola virus shedding and transmission.  Ebola virus has been isolated by cell culture from blood, saliva, urine, aqueous humor, semen, and breast milk from infected or convalescent patients. Ebola virus RNA has been noted in the following body fluids days or months after onset of illness: saliva (22 days), conjunctiva/tears (28 days), stool (29 days), vaginal fluid (33 days), sweat (44 days), urine (64 days), amniotic fluid (38 days), aqueous humor (101 days), cerebrospinal fluid (9 months), breast milk (16 months [preliminary data]), and semen (18 months). Nevertheless, the only documented cases of secondary transmission from recovered patients have been through sexual transmission. We did not find strong evidence supporting respiratory or fomite-associated transmission. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  3. Scientific Evidence in the Study and Treatment of Addictive Behaviours in Psychosocial Intervention. Journal on Equality and Quality of Life

    Directory of Open Access Journals (Sweden)

    Itziar Iruarrizaga Díez

    2010-02-01

    Full Text Available In Spain, the importance and relevance of substance dependence and other addictive behaviours has generated great interest among the scientific community. Since its creation in 1992, Psychosocial Intervention. Journal on Equality and Quality of Life has transmitted the needs and training demands of psychologists, paying special attention to those aspects related to prevention, health outcomes and psychosocial factors involved in the onset and maintenance of drug addiction, psychosocial intervention and the treatment of addictive behaviours. As an introduction to this report on the Scientific evidence in the study and treatment of addictive behaviours, all topics covered by this journal throughout the years will be addressed.

  4. Computer simulation, rhetoric, and the scientific imagination how virtual evidence shapes science in the making and in the news

    CERN Document Server

    Roundtree, Aimee Kendall

    2013-01-01

    Computer simulations help advance climatology, astrophysics, and other scientific disciplines. They are also at the crux of several high-profile cases of science in the news. How do simulation scientists, with little or no direct observations, make decisions about what to represent? What is the nature of simulated evidence, and how do we evaluate its strength? Aimee Kendall Roundtree suggests answers in Computer Simulation, Rhetoric, and the Scientific Imagination. She interprets simulations in the sciences by uncovering the argumentative strategies that underpin the production and disseminati

  5. Screening for prostate cancer: the current evidence and guidelines controversy.

    Science.gov (United States)

    Gomella, Leonard G; Liu, Xiaolong S; Trabulsi, Edouard J; Kelly, Wm Kevin; Myers, Ronald; Showalter, Timothy; Dicker, Adam; Wender, Richard

    2011-10-01

    Prostate cancer presents a global public health dilemma. While screening with prostate specific antigen (PSA) has led to more men diagnosed with prostate cancer than in previous years, the potential for negative effects from over-diagnosis and treatment cannot be ignored. We reviewed Medline for recent articles that discuss clinical trials, evidence based recommendations and guidelines from major medical organizations in the United States and worldwide concerning prostate cancer screening. Results from the European Randomized Screening for Prostate Cancer (ERSPC), the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, and Göteborg Swedish trials regarding prostate screening are controversial with the ERSPC and Göteborg showing a reduction in prostate cancer mortality and the PLCO trial showing no benefit. Recommendations from the American Urological Association (AUA), Japanese Urological Association (JUA), and National Comprehensive Cancer Network (NCCN) have recommended that all men obtain a baseline PSA beginning at age 40. The American Cancer Society (ACS) stratifies screening recommendations based on age and risk, but states that screening should take place only after an informed discussion between provider and patient. The United States Preventative Health Service Task Force (USPSTF) states that evidence is insufficient to assess the risks and benefits of prostate cancer screening in men younger than 75 years. Other major international health organizations offer a similar reserved approach or recommend against screening for prostate cancer. Most groups indicate that screening to determine who should undergo prostate biopsy typically includes both a serum PSA and digital rectal examination, with the latest ACS publications noting that the rectal exam is optional. A common theme from all groups is that an informed discussion with the patients is strongly recommended and that screening does increase the number of men diagnosed with non

  6. Climate change and respiratory health: current evidence and knowledge gaps.

    Science.gov (United States)

    Takaro, Tim K; Knowlton, Kim; Balmes, John R

    2013-08-01

    Climate change is a key driver of the accelerating environmental change affecting populations around the world. Many of these changes and our response to them can affect respiratory health. This is an expert opinion review of recent peer-reviewed literature, focused on more recent medical journals and climate-health relevant modeling results from non-biomedical journals pertaining to climate interactions with air pollution. Global health impacts in low resource countries and migration precipitated by environmental change are addressed. The major findings are of respiratory health effects related to heat, air pollution, shifts in infectious diseases and allergens, flooding, water, food security and migration. The review concludes with knowledge gaps and research need that will support the evidence-base required to address the challenges ahead.

  7. Cellular phones and their hazards: the current evidence.

    Science.gov (United States)

    Munshi, Anusheel; Jalali, Rakesh

    2002-01-01

    The past decade has seen an exponential increase globally in the use of cellular phones (popularly known as mobile or cell phones). These phones are convenient and trendy. Discarding the wire means that the communication is through electromagnetic waves, which could have potential hazards. Alarmist reports in the lay press and high profile lawsuits, particularly in the West, have attracted attention to the possible harmful effects of cellular phones. Adverse effects investigated by various clinical trials include the possible link to increased risk of vehicular accidents, leukaemias, sleep disturbances and the more serious brain tumours. Available level II evidence suggests that the only proven side-effect is an increased risk of vehicular accidents. So far, all studies have consistently negated any association between cellular phones and brain tumours. Yet, the final word remains to be said.

  8. Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective.

    Science.gov (United States)

    Fiore, Marco; Leone, Sebastiano

    2016-09-14

    Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease (ESLD); spontaneous fungal peritonitis (SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients, not even the antifungals used for the prophylaxis, neither optimal treatment. We reviewed, in order to focus the epidemiology, characteristics, and, considering the high mortality rate of SFP, the use of optimal empirical antifungal therapy the current literature.

  9. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

    DEFF Research Database (Denmark)

    Thorning, Tanja Kongerslev; Raben, Anne; Tholstrup, Tine;

    2016-01-01

    BACKGROUND: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat. OBJECTIVE: This review aimed to assess the scientific evidence mainly from meta-analyses of observat......BACKGROUND: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat. OBJECTIVE: This review aimed to assess the scientific evidence mainly from meta...... to dairy products in the nutrition recommendations in several countries. However, nutritionally, cow's milk and plant-based drinks are completely different foods, and an evidence-based conclusion on the health value of the plant-based drinks requires more studies in humans. CONCLUSION: The totality...... of available scientific evidence supports that intake of milk and dairy products contribute to meet nutrient recommendations, and may protect against the most prevalent chronic diseases, whereas very few adverse effects have been reported....

  10. Medical ozone is now ready for a scientific challenge: current status and future perspectives

    Directory of Open Access Journals (Sweden)

    Gregorio Martinez-Sanchez

    2012-06-01

    Full Text Available The aim of the present review is to clarify some of the basic mechanisms underlying ozone therapy. Indeed, after its empiric use started at the beginning of the last century, science is now ready to give a chance to the more and more medical doctors working in this field. Unfortunately, the lack of a full recognition by the health authorities and some ostracism against it is, up to date, the major obstacle for its full medical acceptance. Anyway, in the last years and thanks to the contributions of several scientists, most of the mechanisms characterizing the bio-humoral activity of ozone have been scientifically outlined. The built up of randomized clinical studies is going on slowly despite the lack of funds and the difficulties bound mainly to the huge variability of the ozone action. The thousand and thousand medical doctors involved in the use of ozone as emerging therapy, must be fully educated about the properties of this gas in the aim to counteract scientifically the criticisms of colleagues devoted to other field of medicine and not expert of the ozone pharmacological properties. Is for this reason that we encourage all the professionals to deeply increase the knowledge related to the scientific data produced and published on the international literatures in the field of the ozone therapy. For the future we suggest the use of ozone not in alternative but as a complement of the most appropriate pharmacological treatments also in the aim to reduce some side effects derived from a chronic drug use. The lack of a well-defined binding site for the ozone molecule could suggest the introduction of virtual receptors for the supposed biological activity of ozone acting mostly throughout second messengers pathways. [J Exp Integr Med 2012; 2(3.000: 193-196

  11. Preservice teachers' discursive approaches to constructing scientific arguments from evidence to claim

    Science.gov (United States)

    Gilles, Brent David

    Scientific argumentation has recently become required in K-12 classrooms, but preservice teachers often do not have prior experiences with this practice. The lack of prior experiences has made engaging in argumentation during inquiry-based content courses a priority for science teacher educators because of its importance in science education. Previous research has not examined how preservice teachers construct arguments in classroom interactions. A discourse analysis of twenty-one preservice teachers was conducted to study how preservice teachers constructed arguments within small group activities. Specifically, I drew upon discursive psychology (Potter & Wetherell, 1987) and conversation analysis (Sacks, 1972) to consider how preservice teachers' talk functioned to build arguments, as well as how their talk evolved over the course of the four targeted activities. Findings indicated that the preservice teachers oriented towards institutional norms in constructing arguments. These norms shaped the ways that arguments were constructed. The construction of arguments also included negotiating epistemic authority. This authority was used by a member of the group to take up a leadership position, which they used to direct the group's actions. However, there were moments that other group members attempted to take up epistemic stances, which created instances where members used various talk moves (e.g., overlapping speech, ignoring, and holding the conversational floor) to implicitly disagree with each other. As the activities progressed the students spontaneously adopted asynchronous online collaborative tools that seemed to shape their discourse by decreasing conceptually rich talk. The transition from talk to text also coincided with an increased reliance on the teacher, which changed from focusing on expectations of the assignment to how evidence should be organized. Overall, the findings demonstrated how preservice teachers used discourse, specifically talk, to

  12. Micronutrients and Leptospirosis: A Review of the Current Evidence

    Science.gov (United States)

    Herman, Heather S.; Mehta, Saurabh; Cárdenas, Washington B.; Stewart-Ibarra, Anna M.

    2016-01-01

    Background Leptospirosis is one of the most widespread zoonoses and represents a major threat to human health. Due to the high burden of disease, limitations in diagnostics, and limited coverage and availability of effective human and veterinary vaccines, leptospirosis remains an important neglected zoonotic disease. Improved surveillance and identification of modifiable risk factors for leptospirosis are urgently needed to inform preventive interventions and reduce the risk and severity of Leptospira infection. Methodology/Principal Findings This review was conducted to examine the evidence that links micronutrient status and Leptospira infection. A total of 56 studies were included in this review: 28 in vitro, 17 animal, and 11 observational human studies. Findings indicated that Leptospira infection is associated with higher iron and calcium concentrations and hypomagnesemia. Conclusions/Significance Few prospective studies and no randomized trials have been conducted to date to examine the potential role of micronutrients in Leptospira infection. The limited literature in this area constrains our ability to make specific recommendations; however, the roles of iron, calcium, and magnesium in leptospirosis represent important areas for future research. The role of micronutrients in leptospirosis risk and severity needs to be elucidated in larger prospective human studies to inform public health interventions. PMID:27387046

  13. Target Therapies for Uterine Carcinosarcomas: Current Evidence and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Salvatore Giovanni Vitale

    2017-05-01

    Full Text Available Carcinosarcomas (CS in gynecology are very infrequent and represent only 2–5% of uterine cancers. Despite surgical cytoreduction and subsequent chemotherapy being the primary treatment for uterine CS, the overall five-year survival rate is 30 ± 9% and recurrence is extremely common (50–80%. Due to the poor prognosis of CS, new strategies have been developed in the last few decades, targeting known dysfunctional molecular pathways for immunotherapy. In this paper, we aimed to gather the available evidence on the latest therapies for the treatment of CS. We performed a systematic review using the terms “uterine carcinosarcoma”, “uterine Malignant Mixed Müllerian Tumors”, “target therapies”, “angiogenesis therapy”, “cancer stem cell therapy”, “prognostic biomarker”, and “novel antibody-drug”. Based on our results, the differential expression and accessibility of epithelial cell adhesion molecule-1 on metastatic/chemotherapy-resistant CS cells in comparison to normal tissues and Human Epidermal Growth Factor Receptor 2 (HER2 open up new possibilities in the field of target therapy. Nevertheless, future investigations are needed to clarify the impact of these new therapies on survival rate and medium-/long-term outcomes.

  14. HDL and glucose metabolism: current evidence and therapeutic potential.

    Science.gov (United States)

    Siebel, Andrew L; Heywood, Sarah Elizabeth; Kingwell, Bronwyn A

    2015-01-01

    High-density lipoprotein (HDL) and its principal apolipoprotein A-I (ApoA-I) have now been convincingly shown to influence glucose metabolism through multiple mechanisms. The key clinically relevant observations are that both acute HDL elevation via short-term reconstituted HDL (rHDL) infusion and chronically raising HDL via a cholesteryl ester transfer protein (CETP) inhibitor reduce blood glucose in individuals with type 2 diabetes mellitus (T2DM). HDL may mediate effects on glucose metabolism through actions in multiple organs (e.g., pancreas, skeletal muscle, heart, adipose, liver, brain) by three distinct mechanisms: (i) Insulin secretion from pancreatic beta cells, (ii) Insulin-independent glucose uptake, (iii) Insulin sensitivity. The molecular mechanisms appear to involve both direct HDL signaling actions as well as effects secondary to lipid removal from cells. The implications of glucoregulatory mechanisms linked to HDL extend from glycemic control to potential anti-ischemic actions via increased tissue glucose uptake and utilization. Such effects not only have implications for the prevention and management of diabetes, but also for ischemic vascular diseases including angina pectoris, intermittent claudication, cerebral ischemia and even some forms of dementia. This review will discuss the growing evidence for a role of HDL in glucose metabolism and outline related potential for HDL therapies.

  15. Anesthesia and cancer recurrences: The current knowledge and evidence

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2015-01-01

    Full Text Available Surgical removal of solid tumors is of utmost importance as total resection can be curative. The surgical insult however itself may result in tumor micrometastasis coupled with depression of cell-mediated immunity culminating in tumor recurrence. Recent research suggests that few anesthetic agents or procedures can influence pathophysiology of metastasis in the postoperative period. Whereas opioids and volatile anesthetics have been implicated in angiogenesis and immunosuppression, evidences accumulated over the recent years have undoubtedly highlighted the attenuation of immunosuppression by regional anesthetic agents thereby making it superior over general anesthesia in preventing cancer recurrence. As anesthetic drugs are given at that time when patient is at the maximum risk of spread of metastasis, thus an understanding of the effect of anesthesia drugs and their impact on tumor metastasis is important so that appropriate anesthetic strategy can be made to improve long term survival in these patients. The purpose of the present review is therefore to emphasize the pivotal role of various anesthetic agents and anesthesia techniques in preventing tumor recurrence after surgery.

  16. Botulinum toxins: Pharmacology and its current therapeutic evidence for use

    Directory of Open Access Journals (Sweden)

    Muthane U

    2003-10-01

    Full Text Available Botulinum toxins are, as a group, among the most potent neuromuscular toxins known, yet they are clinically useful in the management of conditions associated with muscular and glandular over-activity. Botulinum toxins act by preventing release of acetylcholine into the neuromuscular junction. While botulinum toxin type A is commonly available, different manufacturers produce specific products, which are not directly interchangeable and should not be considered as generically equivalent formulations. Type B is also available in the market. Each formulation of botulinum toxin is unique with distinct dosing, efficacy and safety profiles for each use to which it is applied. Botulinum toxin type A is the treatment of choice based on its depth of evidence in dystonias and most other conditions. Botulinum toxin type A is established as useful in the management of spasticity, tremors, headache prophylaxis and several other neurological conditions. Active research is underway to determine the parameters for which the type B toxin can be used in these conditions, as covered in this review. Botulinum toxin use has spread to several fields of medicine.

  17. Dietary copper and human health: Current evidence and unresolved issues.

    Science.gov (United States)

    Bost, Muriel; Houdart, Sabine; Oberli, Marion; Kalonji, Esther; Huneau, Jean-François; Margaritis, Irène

    2016-05-01

    Although copper (Cu) is recognized as an essential trace element, uncertainties remain regarding Cu reference values for humans, as illustrated by discrepancies between recommendations issued by different national authorities. This review examines human studies published since 1990 on relationships between Cu intake, Cu balance, biomarkers of Cu status, and health. It points out several gaps and unresolved issues which make it difficult to assess Cu requirements. Results from balance studies suggest that daily intakes below 0.8 mg/day lead to net Cu losses, while net gains are consistently observed above 2.4 mg/day. However, because of an incomplete collection of losses in all studies, a precise estimation of Cu requirements cannot be derived from available data. Data regarding the relationship between Cu intake and potential biomarkers are either too preliminary or inconclusive because of low specificity or low sensitivity to change in dietary Cu over a wide range of intakes. Results from observation and intervention studies do not support a link between Cu and a risk of cardiovascular disease, cognitive decline, arthritis or cancer for intakes ranging from 0.6 to 3mg/day, and limited evidence exists for impaired immune function in healthy subjects with a very low (0.38 mg/day) Cu intake. However, data from observation studies should be regarded with caution because of uncertainties regarding Cu concentration in various foods and water. Further studies that accurately evaluate Cu exposure based on reliable biomarkers of Cu status are needed.

  18. Finding current evidence: search strategies and common databases.

    Science.gov (United States)

    Gillespie, Lesley Diane; Gillespie, William John

    2003-08-01

    With more than 100 orthopaedic, sports medicine, or hand surgery journals indexed in MEDLINE, it is no longer possible to keep abreast of developments in orthopaedic surgery by reading a few journals each month. Electronic resources are easier to search and more current than most print sources. We provide a practical approach to finding useful information to guide orthopaedic practice. We focus first on where to find the information by providing details about many useful databases and web links. Sources for identifying guidelines, systematic reviews, and randomized controlled trials are identified. The second section discusses how to find the information, from the first stage of formulating a question and identifying the concepts of interest, through to writing a simple strategy. Sources for additional self-directed learning are provided.

  19. Immunotherapy in prostate cancer: review of the current evidence.

    Science.gov (United States)

    Fernández-García, E M; Vera-Badillo, F E; Perez-Valderrama, B; Matos-Pita, A S; Duran, I

    2015-05-01

    Prostate cancer is the most common male malignancy in the Western world. Once it metastasizes, it is incurable. The current gold standard for metastatic disease is the combined docetaxel/prednisone regimen. Prostate cancer shows several characteristics that make it a suitable candidate for immunotherapy, as recently exemplified by the approval of sipuleucel-T, the first vaccine to treat any malignancy. Here, we review different tumor-associated antigen immunotherapy strategies currently being investigated, from a humanized radiolabeled monoclonal antibody (J-591) that targets radiation into tumor cells, moving on to vaccines and through to immunomodulator agents such as anti-CPLA-4 and anti-PD-1 monoclonal antibodies that activate T-cell responses via immune checkpoint inhibition. We explore different opinions on the best approach to integrate immunotherapy into existing standard therapies, such as androgen-deprivation therapy, radiotherapy or chemotherapy, and review different combination sequences, patient types and time points during the course of the disease to achieve a lasting immune response. We present data from recent phase III clinical trials that call for a change in trial endpoint design with immunotherapy agents, from the traditional tumor progression to overall survival and how such trials should include immune response measurements as secondary or intermediate endpoints to help identify patient clinical benefit in the earlier phases of treatment. Finally, we join in the recent questioning on the validity of RECIST criteria to measure response to immunotherapeutic agents, as initial increases in the size of tumors/lymph nodes, which are part of a normal immune response, could be categorized as disease progression under RECIST.

  20. Program experience with micronutrient powders and current evidence.

    Science.gov (United States)

    Rah, Jee Hyun; dePee, Saskia; Kraemer, Klaus; Steiger, Georg; Bloem, Martin W; Spiegel, Paul; Wilkinson, Caroline; Bilukha, Oleg

    2012-01-01

    The efficacy of micronutrient powders (MNP) in the treatment of anemia in moderately anemic children aged 6-24 mo has been clearly demonstrated. The evidence of the effectiveness of MNP in large-scale programs, however, is scarce. This article describes the program experience and findings of large-scale MNP distribution in refugee camps and in an emergency context in Bangladesh, Nepal, and Kenya. The MNP contained 15-16 micronutrients as per the WHO/World Food Programme/UNICEF joint statement, whereas the iron content was reduced to 2.5 mg from NaFeEDTA in a malaria-endemic area in Kenya. Hundreds of thousands of children aged 6-59 mo and pregnant and lactating women were targeted to consume MNP either daily or every other day over an extended period of time. Extensive social marketing campaigns were undertaken to promote regular use of the product. A number of studies were embedded in the programs to assess the impact of MNP on the nutritional status of target beneficiaries. Some improvements in anemia prevalence estimates were observed in particular subgroups, but other results did not show significant improvements. A significant decrease in the prevalence of stunting was observed in Nepal and Kenya but not in Bangladesh. Diarrhea episodes decreased significantly among children receiving MNP in Nepal. A key challenge is to ensure high MNP acceptance and adherence among beneficiaries. Investigation of non-nutritional causes of anemia is warranted in settings with high compliance but no improvement in hemoglobin status. Further investigation into the most appropriate manner to use MNP in malaria endemic settings is warranted.

  1. The current state of evidence regarding the health effects of wifi communication systems Sistemas de comunicación wifi y efectos sobre la salud. El estado de las evidencias actuales Sistemas de comunicação wifi e efeitos na saúde: O estado atual da evidência

    National Research Council Canada - National Science Library

    Francisco Vargas Marcos

    2012-01-01

    ...) emitted by wifi telecommunication systems. These reports have generated demands for information, which the relevant environmental health authorities have to deal with in a transparent, clear and effective way, based on current scientific evidence...

  2. Gastroenteric pathology and probiotics: from myth to scientific evidence. Current aspects.

    Science.gov (United States)

    Caramia, G

    2009-09-01

    Starting from Metchnikoff's theory of cell-mediated immunity and work on lactobacillus over 100 years ago, more and more applications for probiotics have been developed. Research into the health properties of probiotics has focused primarily on two areas: the interaction between intestinal microflora and enterocytes and the immune system and the use of probiotic products in the treatment of gastrointestinal diseases in adults and children. This review examines recent studies on the clinical use of monostrain and multistrain probiotic products in gastroenterology. The most widely studied strains are lactobacilli and yeasts, specifically, Lacto-bacillus rhamnosus GG and Saccharomices boulardii; the gastrointestinal disorders most commonly treated with probiotics are inflammatory bowel disease and dysbiosis, both of which clinically manifest as diarrhea.

  3. Bariatric emergencies: current evidence and strategies of management

    Science.gov (United States)

    2013-01-01

    Background The demand for bariatric surgery is increasing and the postoperative complications are seen more frequently. The aim of this paper is to review the current outcomes of bariatric surgery emergencies and to formulate a pathway of safe management. Methods The PubMed and Google search for English literatures relevant to emergencies of bariatric surgery was made, 6358 articles were found and 90 papers were selected based on relevance, power of the study, recent papers and laparoscopic workload. The pooled data was collected from these articles that were addressing the complications and emergency treatment of bariatric patients. 830,998 patients were included in this review. Results Bariatric emergencies were increasingly seen in the Accident and Emergency departments, the serious outcomes were reported following complex operations like gastric bypass but also after gastric band and the causes were technical errors, suboptimal evaluation, failure of effective communication with bariatric teams who performed the initial operation, patients factors, and delay in the presentation. The mortality ranged from 0.14%-2.2% and increased for revisional surgery to 6.5% (p = 0.002). Inspite of this, mortality following bariatric surgery is still less than that of control group of obese patients (p = value 0.01). Conclusions Most mortality and catastrophic outcomes following bariatric surgery are preventable. The awareness of bariatric emergencies and its effective management are the gold standards for best outcomes. An algorithm is suggested and needs further evaluation. PMID:24373182

  4. [The Problems with Domestic Introduction of rTMS from the Three Viewpoints of Scientific Evidence, Specialty and Social Responsibility].

    Science.gov (United States)

    Shinosaki, Kazuhiro

    2015-01-01

    The domestic introduction of rTMS is expected as a new treatment option for treatment-resistant depression. I discussed some problems with the introduction from three viewpoints : scientific evidence, specialty, and social responsibility. I surveyed scientific evidence for rTMS regarding the action mechanism, effectiveness, side effects, and its positioning in the treatment guidelines. To secure the quality of rTMS treatment, I proposed rTMS guidelines, nurturing of the specialists, and a center hospital plan, and pointed out some medium-term problems after its introduction and the consistency of rTMS treatment and standard depression treatment. From the viewpoint of social responsibility, rTMS treatment should be a medical service covered by health insurance to avoid its misuse. We should prepare to overcome the public suspicion of brain stimulation treatment for mental disease.

  5. Measuring currents in submarine canyons: technological and scientific progress in the past 30 years

    Science.gov (United States)

    Xu, J. P.

    2011-01-01

    The development and application of acoustic and optical technologies and of accurate positioning systems in the past 30 years have opened new frontiers in the submarine canyon research communities. This paper reviews several key advancements in both technology and science in the field of currents in submarine canyons since the1979 publication of Currents in Submarine Canyons and Other Sea Valleys by Francis Shepard and colleagues. Precise placements of high-resolution, high-frequency instruments have not only allowed researchers to collect new data that are essential for advancing and generalizing theories governing the canyon currents, but have also revealed new natural phenomena that challenge the understandings of the theorists and experimenters in their predictions of submarine canyon flow fields. Baroclinic motions at tidal frequencies, found to be intensified both up canyon and toward the canyon floor, dominate the flow field and control the sediment transport processes in submarine canyons. Turbidity currents are found to frequently occur in active submarine canyons such as Monterey Canyon. These turbidity currents have maximum speeds of nearly 200 cm/s, much smaller than the speeds of turbidity currents in geological time, but still very destructive. In addition to traditional Eulerian measurements, Lagrangian flow data are essential in quantifying water and sediment transport in submarine canyons. A concerted experiment with multiple monitoring stations along the canyon axis and on nearby shelves is required to characterize the storm-trigger mechanism for turbidity currents.

  6. The origin of the warped heliospheric current sheet. Scientific technical report

    Energy Technology Data Exchange (ETDEWEB)

    Wilcox, J.M.; Scherrer, P.H.; Hoeksema, J.T.

    1980-03-01

    The warped heliospheric current sheet in early 1976 is calculated from the observed photospheric magnetic field using a potential field method. Comparisons with measurements of the interplanetary magnetic field polarity in early 1976 obtained at several locations in the heliosphere at Helios I, Helios II, Pioneer XI and Earth show a rather detailed agreement between the computed current sheet and the observations. It appears that the large-scale structure of the warped heliospheric current sheet is determined by the structure of the photospheric magnetic field, and that 'ballerina skirt' effects may add small-scale ripples.

  7. Evidencia científica en medicina: ¿única alternativa? Scientific evidence in medicine: the only alternative?

    Directory of Open Access Journals (Sweden)

    Juan José Sarrado

    2004-06-01

    Full Text Available El presente artículo pretende reflexionar acerca del momento actual de las ciencias médicas, incorporando una discusión crítica respecto de la atomización del conocimiento que el pragmatismo de la evidencia científica puede comportar. Propone integrar las aportaciones de las metodologías cuantitativa y cualitativa de las ciencias de la salud, recurriendo a diseños cualicuantitativos que aborden la complejidad del ser humano y de sus referentes axiológicos y socioculturales. Los autores defienden y argumentan la necesidad de que la investigación en salud contemple 5 dimensiones útiles para la toma de decisiones, abordando el objeto de estudio sin prescindir del sujeto y de sus circunstancias poliédricas y complejas. La medicina ha de considerar ineludiblemente el conocimiento tecnológico y técnico, pero dicha capacitación no debe eludir las necesarias competencias relacionales y comunicacionales. La actualización cientificomédica implica un constante maridaje entre rigor técnico y mejora de vínculos entre las personas implicadas (profesionales de la salud y ciudadanía, con una actitud cuidadosa y afable. La animación comunitaria y el establecimiento paulatino de complicidades se erigen en la base de un modelo sanitario integrador, de raigambre biopsicosocial, tanto teórico como práctico.The present article aims to reflect on the current situation of medical sciences by incorporating a critical discussion of knowledge atomization, which can be a consequence of the pragmatism of scientific evidence. The article proposes to integrate the contributions of quantitative and qualitative methodologies in health sciences, paying attention to qualitative and quantitative designs that take into account the complexity of human beings and their axiological, social, and cultural referents. The authors defend and argue for the need for health research to contemplate five useful dimensions for decision-making, approaching the object of the

  8. Current Status and Future Prospects of Clinical Psychology: Toward a Scientifically Principled Approach to Mental and Behavioral Health Care.

    Science.gov (United States)

    Baker, Timothy B; McFall, Richard M; Shoham, Varda

    2008-11-01

    The escalating costs of health care and other recent trends have made health care decisions of great societal import, with decision-making responsibility often being transferred from practitioners to health economists, health plans, and insurers. Health care decision making increasingly is guided by evidence that a treatment is efficacious, effective-disseminable, cost-effective, and scientifically plausible. Under these conditions of heightened cost concerns and institutional-economic decision making, psychologists are losing the opportunity to play a leadership role in mental and behavioral health care: Other types of practitioners are providing an increasing proportion of delivered treatment, and the use of psychiatric medication has increased dramatically relative to the provision of psychological interventions. Research has shown that numerous psychological interventions are efficacious, effective, and cost-effective. However, these interventions are used infrequently with patients who would benefit from them, in part because clinical psychologists have not made a convincing case for the use of these interventions (e.g., by supplying the data that decision makers need to support implementation of such interventions) and because clinical psychologists do not themselves use these interventions even when given the opportunity to do so. Clinical psychologists' failure to achieve a more significant impact on clinical and public health may be traced to their deep ambivalence about the role of science and their lack of adequate science training, which leads them to value personal clinical experience over research evidence, use assessment practices that have dubious psychometric support, and not use the interventions for which there is the strongest evidence of efficacy. Clinical psychology resembles medicine at a point in its history when practitioners were operating in a largely prescientific manner. Prior to the scientific reform of medicine in the early 1900s

  9. Pharmacological and analytical aspects of withaferin A:A concise report of current scientific literature

    Institute of Scientific and Technical Information of China (English)

    Kanika Patel; Ravi B Singh; Dinesh K Patel

    2013-01-01

    Withaferin A is an important phytoconstituents of Withania somnifera (W. Somnifera) belonging to the category of withanolides, that are a group of naturally occurring C28-steroidal lactone triterpenoids. Withaferin A has been used in the traditional and indigenous system of medicine for the treatment of various disorders. In view of its unique therapeutic potential, it has gained much attention in the modern science. In the couple of the years, Withaferin A has been scientifically validated for different pharmacological activities including anti-cancer, adaptogenic, anti-stress, anti-convulsant, immunomodulatory, neurological, anti-inflammatory, anti-tumor, cardioprotective, and neuroprotective activities. Pharmacological and analytical aspects of Withaferin A were highlighted in the present article. From the literature review it was found that Withaferin A has a very impressive pharmacological profile especially against cancer and could be useful for the development of the new drug in the future for the treatment of cancer and other metabolic disorders.

  10. What Is (Or Should Be) Scientific Evidence Use in K-12 Classrooms?

    Science.gov (United States)

    McNeill, Katherine L.; Berland, Leema

    2017-01-01

    Research and reform efforts frequently identify evidence as an essential component of science classroom instruction to actively engage students in science practices. Despite this agreement on the primacy of evidence, there is a lack of consensus around what counts as "evidence" in k-12 classrooms (e.g., ages 5-18): scholarship and…

  11. [The representation of scientific publications of RAMS in WEB of science: evaluation of current indicators and prospects of their increasing].

    Science.gov (United States)

    Starodubtsev, V I; Kuznetsov, S L; Kurakova, N G; Tsvetkova, L A

    2012-01-01

    The contribution scientific publications of Russian Academy of Medical Sciences (RAMS) in the national publication stream, indexed by Web of Science over the past thirty years, was estimated. The indicators of publication activity that are necessary for the institutions of RAMS to achieve in short-term period the conformity with bibliometric indicators, established by Presidential Decree of May 7, 2012 (to increase the share of Russian publications in Web of Science to 2.44% in 2015) were calculated. It is shown that the current structure of global science, where publications in medicine make up for approximately one third of scientific publications in the world, set for RAMS scientists particularly difficult task: to double in three years the number of publications in Web of Sci. In the article are proposed the priorities and the necessary steps to fulfill this task.

  12. Training Scientific Thinking Skills: Evidence from an MCAT[superscript 2015]-Aligned Classroom Module

    Science.gov (United States)

    Stevens, Courtney; Witkow, Melissa R.

    2014-01-01

    The present study reports on the development and evaluation of a classroom module to train scientific thinking skills. The module was implemented in two of four parallel sections of introductory psychology. To assess learning, a passage-based question set from the medical college admissions test (MCAT[superscript 2015]) preview guide was included…

  13. Letter to the editor: Taking into account scientific evidence showing the benefits of 100% fruit juice

    Science.gov (United States)

    In their recent commentary, Wojcicki and Heyman suggested that 100% fruit juice consumption is linked to childhood obesity and should be eliminated from the United States Department of Agriculture Food Programs. This recommendation is unsupported by the scientific literature, which has failed to sho...

  14. Establishing Trustworthiness When Students Read Multiple Documents Containing Conflicting Scientific Evidence

    Science.gov (United States)

    Bråten, Ivar; Braasch, Jason L. G.; Strømsø, Helge I.; Ferguson, Leila E.

    2015-01-01

    Students read six documents that varied in terms of their perspectives on a scientific issue and the trustworthiness of the source features. After reading, students wrote essays, rank-ordered the documents according to perceived trustworthiness, and provided reasons for their rank-order decisions. Students put the most trust in a textbook and a…

  15. Talking Relative Age Effects: A Fictional Analysis Based on Scientific Evidence

    Science.gov (United States)

    Roberts, Simon J.

    2014-01-01

    During the past 30 years, there has been a considerable amount of scientific attention dedicated to the reported age discrimination which occurs in youth and elite sport. The purpose of this paper is to examine the notion of relative age effects (RAEs) through a slightly different lens. This paper therefore presents a fictional conversation…

  16. Evidence for Family Engagement in Scientific Reasoning at Interactive Animal Exhibits

    Science.gov (United States)

    Kisiel, James; Rowe, Shawn; Vartabedian, Melanie Ani; Kopczak, Charles

    2012-01-01

    While the opportunity to engage in scientific reasoning has been identified as an important aspect of informal science learning (National Research Council, 2009), most studies have examined this strand of science learning within the context of physics-based science exhibits. Few have examined the presence of such activity in conjunction with live…

  17. Pharmacologically screened aphrodisiac plant-A review of current scientific literature

    Institute of Scientific and Technical Information of China (English)

    Patel DK; Kumar R; Prasad SK; Hemalatha S

    2011-01-01

    Substances which are used to treat sexual dysfunction or to improve sexual behavior and satisfaction in humans and animals are called ‘aphrodisiac’. Uses of plant material to treat sexual disorder is a long back history in the different system of medicine and it was practiced by different type of vaidyas and traditional healer in almost all the countries in the world, like China, India, Egypt, Rome and Greek. Even though there was an unavailability of the scientific data, these substances have been used as aphrodisiac. During the historic times Lytta vesicatoria,Tribulus terrestris, Ptychopetalum olacoides, Crocus sativus, Bufo marinus, Myristica fragrans, Theobroma cocao and other plants have been investigated for its aphrodisiac activity by in vivo and in vitro model. Even though the study showed positive response to a particular substance, there is always a need to run the clinical trial before administering the tested drug in human being. The present review article summarizes the plant material which has been tested for its aphrodisiac activity in different experimental model (in vitro, in vivo on animal models, or in human clinical trials) and comply its claim in the different system of medicine. A brief overview about the data of percentage study in the last eighteen years duration on aphrodisiac activity of plant material was done on the basis of the CAB abstract database.

  18. Isaac Newton's scientific method turning data into evidence about gravity and cosmology

    CERN Document Server

    Harper, William L.

    2014-01-01

    Isaac Newton's Scientific Method examines Newton's argument for universal gravity and his application of it to resolve the problem of deciding between geocentric and heliocentric world systems by measuring masses of the sun and planets. William L. Harper suggests that Newton's inferences from phenomena realize an ideal of empirical success that is richer than prediction. Any theory that can achieve this rich sort of empirical success must not only be able to predict the phenomena it purports to explain, but also have those phenomena accurately measure the parameters which explain them. Harper explores the ways in which Newton's method aims to turn theoretical questions into ones which can be answered empirically by measurement from phenomena, and to establish that propositions inferred from phenomena are provisionally accepted as guides to further research. This methodology, guided by its rich ideal of empirical success, supports a conception of scientific progress that does not require construing it as progr...

  19. My Precious! The Location and Diffusion of Scientific Research: Evidence from the Synchrotron Diamond Light Source

    OpenAIRE

    2013-01-01

    We analyze the impact of the establishment of a GBP 380 million basic scientific research facility in the UK on the geographical distribution of related research. We investigate whether the siting of the Diamond Light Source, a 3rd generation synchrotron light source, in Oxfordshire induced a clustering of related research in its geographic proximity. To account for the potentially endogenous location choice of the synchrotron, we exploit the availability of a 'runner-up' site near Manchester...

  20. Theory and data interactions of the scientific mind: evidence from the molecular and the cognitive laboratory.

    Science.gov (United States)

    Fugelsang, Jonathan A; Stein, Courtney B; Green, Adam E; Dunbar, Kevin N

    2004-06-01

    A number of researchers and scholars have stressed the importance of disconfirmation in the quest for the development of scientific knowledge (e.g., Popper, 1959). Paradoxically, studies examining human reasoning in the laboratory have typically found that people display a confirmation bias in that they are more likely to seek out and attend to data consistent rather than data inconsistent with their initial theory (Wason, 1968). We examine the strategies that scientists and students use to evaluate data that are either consistent or inconsistent with their expectations. First, we present findings from scientists reasoning "live" in their laboratory meetings. We show that scientists often show an initial reluctance to consider inconsistent data as "real." However, this initial reluctance is often overcome with repeated observations of the inconsistent data such that they modify their theories to account for the new data. We further examine these issues in a controlled scientific causal thinking simulation specifically developed to examine the reasoning strategies we observed in the natural scientific environment. Like the scientists, we found that participants in our simulation initially displayed a propensity to discount data inconsistent with a theory provided. However, with repeated observations of the inconsistent data, the students, like the scientists, began to see the once anomalous data as "real" and the initial bias to discount that data was significantly diminished.

  1. Current concepts on posterior meniscal root lesion: A treatment algorithm based on the currently available evidence

    Directory of Open Access Journals (Sweden)

    Guan-Yang Song

    2014-07-01

    Full Text Available Meniscal root lesion is defined as an avulsion of the tibial insertion of the meniscus or a radial tear close to the meniscal insertion, which is commonly observed at the posterior region in the clinical practice. Although a number of biomechanical and clinical studies have shown the importance of the integrity of the posterior meniscal roots, the appropriate treatment is still controversial. The purposes of this review are to develop a current understanding of how the posterior meniscal root functions and to review the available treatment options for posterior meniscal root lesion.

  2. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

    Science.gov (United States)

    Thorning, Tanja Kongerslev; Raben, Anne; Tholstrup, Tine; Soedamah-Muthu, Sabita S.; Givens, Ian; Astrup, Arne

    2016-01-01

    Background There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat. Objective This review aimed to assess the scientific evidence mainly from meta-analyses of observational studies and randomised controlled trials, on dairy intake and risk of obesity, type 2 diabetes, cardiovascular disease, osteoporosis, cancer, and all-cause mortality. Results The most recent evidence suggested that intake of milk and dairy products was associated with reduced risk of childhood obesity. In adults, intake of dairy products was shown to improve body composition and facilitate weight loss during energy restriction. In addition, intake of milk and dairy products was associated with a neutral or reduced risk of type 2 diabetes and a reduced risk of cardiovascular disease, particularly stroke. Furthermore, the evidence suggested a beneficial effect of milk and dairy intake on bone mineral density but no association with risk of bone fracture. Among cancers, milk and dairy intake was inversely associated with colorectal cancer, bladder cancer, gastric cancer, and breast cancer, and not associated with risk of pancreatic cancer, ovarian cancer, or lung cancer, while the evidence for prostate cancer risk was inconsistent. Finally, consumption of milk and dairy products was not associated with all-cause mortality. Calcium-fortified plant-based drinks have been included as an alternative to dairy products in the nutrition recommendations in several countries. However, nutritionally, cow's milk and plant-based drinks are completely different foods, and an evidence-based conclusion on the health value of the plant-based drinks requires more studies in humans. Conclusion The totality of available scientific evidence supports that intake of milk and dairy products contribute to meet nutrient recommendations, and may protect against the most prevalent chronic diseases

  3. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

    Directory of Open Access Journals (Sweden)

    Tanja Kongerslev Thorning

    2016-11-01

    Full Text Available Background: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat. Objective: This review aimed to assess the scientific evidence mainly from meta-analyses of observational studies and randomised controlled trials, on dairy intake and risk of obesity, type 2 diabetes, cardiovascular disease, osteoporosis, cancer, and all-cause mortality. Results: The most recent evidence suggested that intake of milk and dairy products was associated with reduced risk of childhood obesity. In adults, intake of dairy products was shown to improve body composition and facilitate weight loss during energy restriction. In addition, intake of milk and dairy products was associated with a neutral or reduced risk of type 2 diabetes and a reduced risk of cardiovascular disease, particularly stroke. Furthermore, the evidence suggested a beneficial effect of milk and dairy intake on bone mineral density but no association with risk of bone fracture. Among cancers, milk and dairy intake was inversely associated with colorectal cancer, bladder cancer, gastric cancer, and breast cancer, and not associated with risk of pancreatic cancer, ovarian cancer, or lung cancer, while the evidence for prostate cancer risk was inconsistent. Finally, consumption of milk and dairy products was not associated with all-cause mortality. Calcium-fortified plant-based drinks have been included as an alternative to dairy products in the nutrition recommendations in several countries. However, nutritionally, cow's milk and plant-based drinks are completely different foods, and an evidence-based conclusion on the health value of the plant-based drinks requires more studies in humans. Conclusion: The totality of available scientific evidence supports that intake of milk and dairy products contribute to meet nutrient recommendations, and may protect against the most

  4. Music therapy with disorders of consciousness: current evidence and emergent evidence-based practice.

    Science.gov (United States)

    Magee, Wendy L; O'Kelly, Julian

    2015-03-01

    Patients with prolonged disorders of consciousness (PDOC) stemming from acquired brain injury present one of the most challenging clinical populations in neurological rehabilitation. Because of the complex clinical presentation of PDOC patients, treatment teams are confronted with many medicolegal, ethical, philosophical, moral, and religious issues in day-to-day care. Accurate diagnosis is of central concern, relying on creative approaches from skilled clinical professionals using combined behavioral and neurophysiological measures. This paper presents the latest evidence for using music as a diagnostic tool with PDOC, including recent developments in music therapy interventions and measurement. We outline standardized clinical protocols and behavioral measures to produce diagnostic outcomes and examine recent research illustrating a range of benefits of music-based methods at behavioral, cardiorespiratory, and cortical levels using video, electrocardiography, and electroencephalography methods. These latest developments are discussed in the context of evidence-based practice in rehabilitation with clinical populations. © 2014 New York Academy of Sciences.

  5. Hybrid regimes of knowledge? Challenges for constructing scientific evidence in the context of the GMO-debate.

    Science.gov (United States)

    Böschen, Stefan

    2009-07-01

    Over the last two decades, there has been a remarkable shift of attention to the scientific and political fundamentals of the precautionary principle. The application of this principle has become a main strategy of coping with the different forms and problems related to non-knowledge. Thus, societies are increasingly confronted with the challenging and hitherto unresolved problem of political and technological decision-making under conditions of diverging framings of non-knowledge. At present, there seems to be no generally accepted scientific or institutional approach. This is why the fundamental question of how different scientific actors define and construct evidence is not answered yet. Hence, this paper is based on the consideration that the conflicts in risk policy concerning genetically modified organisms (GMO) depend on the unresolved conflicts about the diverging scientific strategies and structures of evidence-making between the epistemic cultures involved. Thus, this study investigates two questions: (1) do the epistemic strategies of evidence-making differ systematically with the scientific actors involved in the GMO-debate? (2) What consequences emerge considering institutionalized procedures of decision-making? This article is based on a secondary analysis of findings and perspectives reported in the literature and on the methods of qualitative social empirical research, i.e., interviews with experts. A total number of 34 interviews were conducted to explore the different strategies of handling non-knowledge and constructing evidence. Actors from science, administration, business and NGOs were interviewed. In this way, typical epistemic cultures can be described. An epistemic culture is the constellation of methodological strategies, theoretical assumptions and practical-experimental settings which define in every speciality the ways how we know what we know. There are two main results. Firstly, it was worked out that the epistemic cultures involved

  6. Deep brain stimulation for Parkinson disease in Australia: current scientific and clinical status.

    Science.gov (United States)

    Poortvliet, P C; Silburn, P A; Coyne, T J; Chenery, H J

    2015-02-01

    There is currently no cure for Parkinson disease (PD). Disease management is directed primarily at motor symptom relief, but the impact of non-motor symptoms associated with PD should not be underestimated. Medical and surgical treatment options aim to increase functional independence and quality of life. Deep brain stimulation (DBS) has proven to be a safe, effective and cost-efficient surgical treatment option. In 2009, the Australian referral guidelines, developed to provide a synopsis of DBS therapy for PD, were introduced, and since then novel findings have been reported regarding the timing of intervention, target selection and symptom management. Our aim is to provide an update of DBS for PD in Australia. Intervention at earlier stages of the disease can potentially improve quality of life over a longer period with greater possibilities for meaningful social and professional contributions. For less responsive motor symptoms (e.g. freezing of gait, postural instability), the pedunculopontine nucleus has emerged as a promising new surgical target. Traditional PD treatment is focused on improvement of motor symptoms, but the disorder is also characterised by non-motor symptoms, often undiagnosed or undisclosed, that have the potential to impact quality of life to a greater extent than motor symptoms. It is essential to identify and routinely monitor for non-motor symptoms as they can emerge at all stages of the disease or can result from treatment. Many of these current advances require long-term monitoring of treatment outcomes to improve future clinical practice, refine patient selection and ensure best patient outcomes.

  7. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence

    DEFF Research Database (Denmark)

    Thorning, Tanja Kongerslev; Raben, Anne; Tholstrup, Tine

    2016-01-01

    BACKGROUND: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat. OBJECTIVE: This review aimed to assess the scientific evidence mainly from meta-analyses of observat......BACKGROUND: There is scepticism about health effects of dairy products in the public, which is reflected in an increasing intake of plant-based drinks, for example, from soy, rice, almond, or oat. OBJECTIVE: This review aimed to assess the scientific evidence mainly from meta......-analyses of observational studies and randomised controlled trials, on dairy intake and risk of obesity, type 2 diabetes, cardiovascular disease, osteoporosis, cancer, and all-cause mortality. RESULTS: The most recent evidence suggested that intake of milk and dairy products was associated with reduced risk of childhood...... obesity. In adults, intake of dairy products was shown to improve body composition and facilitate weight loss during energy restriction. In addition, intake of milk and dairy products was associated with a neutral or reduced risk of type 2 diabetes and a reduced risk of cardiovascular disease...

  8. [The history of Mindfulness put to the test of current scientific data: unresolved questions].

    Science.gov (United States)

    Trousselard, M; Steiler, D; Claverie, D; Canini, F

    2014-12-01

    The first part of this paper describes the long history of the concept of Mindfulness. Contrary to the belief that Mindfulness only has Buddhist and Hindu origins, it is also rooted in Jewish, Islamic and Christian religions. Furthermore, western philosophers have described a mindful path to become more aware of thoughts, feelings, and bodily sensations. Mindfulness can be considered as a universal human ability embodied to foster clear thinking and open-heartedness. As such, this form of being requires no particular religious or cultural belief system. The current acceptance of what a mindful path is, refers to a psychological quality that involves bringing one's complete attention to present experience on a moment-to-moment basis, in a particular way: in the present moment, and nonjudgmentally. Although such a definition is well accepted in France, the French translation for Mindfulness is not easy to use: being conscious and being aware are translated with the same French word. The French language fails to clearly separate the dimensional attributes of a mindful subject from the ways for developing mindfulness through formal meditation practice. In line with this conception, stability and assessments of Mindfulness mainly were examined. How this disposition allows the development of concentration, attention and acceptance moment by moment in a nonjudgmental way is described in the second part. Particular attention is paid to its positive effects in several aspects of mental and physical health. In particular, positive effects on the ability to cope with stress are described from a physiological point of view. Third, this article intends to present neurobiological aspects currently proposed to explain the benefits of Mindfulness meditation. Modifications of cerebral networks and neurobiological functioning are described in relation to expertise in meditation practice. The hypothesis of the role of meditation on neuroplasticity is also discussed. Furthermore, the

  9. Current use of medical eponyms – a need for global uniformity in scientific publications

    Directory of Open Access Journals (Sweden)

    Arora Nalini

    2009-03-01

    Full Text Available Abstract Background Although eponyms are widely used in medicine, they arbitrarily alternate between the possessive and nonpossessive forms. As very little is known regarding extent and distribution of this variation, the present study was planned to assess current use of eponymous term taking "Down syndrome" and "Down's syndrome" as an example. Methods This study was carried out in two phases – first phase in 1998 and second phase in 2008. In the first phase, we manually searched the terms "Down syndrome" and "Down's syndrome" in the indexes of 70 medical books, and 46 medical journals. In second phase, we performed PubMed search with both the terms, followed by text-word search for the same. Results In the first phase, there was an overall tilt towards possessive form – 62(53.4% "Down's syndrome" versus 54(46.6% "Down syndrome." However, the American publications preferred the nonpossesive form when compared with their European counterpart (40/50 versus 14/66; P Conclusion Inconsistency in the use of medical eponyms remains a major problem in literature search. Because of linguistic simplicity and technical advantages, the nonpossessive form should be used uniformly worldwide.

  10. Educating physicians in evidence based medicine: current practices and curricular strategies

    NARCIS (Netherlands)

    Maggio, L.A.

    2015-01-01

    Evidence based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of EBM is an expectation of professional healthcare and requisite component in many medical school curricula. Yet, despite

  11. Educating physicians in evidence based medicine: current practices and curricular strategies

    NARCIS (Netherlands)

    Maggio, L.A.

    2015-01-01

    Evidence based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of EBM is an expectation of professional healthcare and requisite component in many medical school curricula. Yet, despite

  12. Statistics and evidence-based veterinary medicine: answers to 21 common statistical questions that arise from reading scientific manuscripts.

    Science.gov (United States)

    Evans, Richard B; O'Connor, Annette

    2007-05-01

    Evidence-based veterinary medicine relies critically on the scientific validity of research. A component of validity is the statistical design and subsequent analysis of data collected during the study. Correct statistical design reduces bias and improves generalizability, and correct analysis leads to appropriate inferences. Inference is the art and science of making correct decisions based on data. Because veterinarians are responsible for the medical care of their patents, it is also their responsibility to understand inferences about treatments presented in papers. This article is designed to assist veterinarians with the interpretation and understanding of statistics presented in papers.

  13. Advancing the Scientific Foundation for Evidence-Based Practice in Clinical Child and Adolescent Psychology.

    Science.gov (United States)

    Roberts, Michael C; Blossom, Jennifer B; Evans, Spencer C; Amaro, Christina M; Kanine, Rebecca M

    2016-05-24

    Evidence-based practice (EBP) has become a central focus in clinical child and adolescent psychology. As originally defined, EBP in psychology is the integration of the best available research evidence, patient characteristics, and clinical expertise. Although evidence-based perspectives have garnered widespread acceptance in recent years, there has also been some confusion and disagreement about the 3-part definition of EBP, particularly the role of research. In this article, we first provide a brief review of the development of EBP in clinical child and adolescent psychology. Next, we outline the following 4 points to help clarify the understanding of EBP: (a) knowledge should not be confused with epistemic processes, (b) research on clinician and client factors is needed for EBP, (c) research on assessment is needed for EBP, and (d) the 3-part conceptualization of EBP can serve as a useful framework to guide research. Based on these principles, we put forth a slightly revised conceptualization of EBP, in which the role of research is expanded and more clearly operationalized. Finally, based on our review of the literature, we offer illustrative examples of specific directions for future research to advance the evidence base for EBP in clinical child and adolescent psychology.

  14. The South African legislative environment, in critical need of scientific evidence based alignment for airborne control

    CSIR Research Space (South Africa)

    Fleming, EJ

    2014-07-01

    Full Text Available Review of evidence based research indicates that there are best practice principles that can be applied to the design of the built environment with regard to the reduction of the risk of cross infection from airborne diseases in health facilities...

  15. A critical analysis of the scientific evidence behind international guidelines related to cardiac arrhythmias

    NARCIS (Netherlands)

    Roos, M.; Brodbeck, J.; Sarkozy, A.; Chierchia, G.B.; Asmundis, C. de; Brugada, P.

    2011-01-01

    BACKGROUND: Guidelines have become very important in assisting with decision making in clinical practice. However, few studies have analyzed the level of evidence (LOE) underlying guidelines critically. This study aims to assess the accuracy of the referenced literature that has led to recommendatio

  16. Improve nursing in evidence-based practice: How Chinese nurses' read and comprehend scientific literature

    Directory of Open Access Journals (Sweden)

    Fei-Fei Huang

    2017-07-01

    Conclusions: The survey of the current status of literature education among Chinese nurses suggests that providing protected time, training for critical thinking, and incentive mechanisms will help improve nurses' engagement in literature and create a culture of academic inquiry.

  17. Sudden Cardiac Risk Stratification with Electrocardiographic Indices - A Review on Computational Processing, Technology Transfer, and Scientific Evidence

    Directory of Open Access Journals (Sweden)

    Francisco Javier eGimeno-Blanes

    2016-03-01

    Full Text Available Great effort has been devoted in recent years to the development of sudden cardiac risk predictors as a function of electric cardiac signals, mainly obtained from the electrocardiogram (ECG analysis. But these prediction techniques are still seldom used in clinical practice, partly due to its limited diagnostic accuracy and to the lack of consensus about the appropriate computational signal processing implementation. This paper addresses a three-fold approach, based on ECG indexes, to structure this review on sudden cardiac risk stratification. First, throughout the computational techniques that had been widely proposed for obtaining these indexes in technical literature. Second, over the scientific evidence, that although is supported by observational clinical studies, they are not always representative enough. And third, via the limited technology transfer of academy-accepted algorithms, requiring further meditation for future systems. We focus on three families of ECG derived indexes which are tackled from the aforementioned viewpoints, namely, heart rate turbulence, heart rate variability, and T-wave alternans. In terms of computational algorithms, we still need clearer scientific evidence, standardizing, and benchmarking, siting on advanced algorithms applied over large and representative datasets. New scenarios like electronic health recordings, big data, long-term monitoring, and cloud databases, will eventually open new frameworks to foresee suitable new paradigms in the near future.

  18. Sudden Cardiac Risk Stratification with Electrocardiographic Indices - A Review on Computational Processing, Technology Transfer, and Scientific Evidence.

    Science.gov (United States)

    Gimeno-Blanes, Francisco J; Blanco-Velasco, Manuel; Barquero-Pérez, Óscar; García-Alberola, Arcadi; Rojo-Álvarez, José L

    2016-01-01

    Great effort has been devoted in recent years to the development of sudden cardiac risk predictors as a function of electric cardiac signals, mainly obtained from the electrocardiogram (ECG) analysis. But these prediction techniques are still seldom used in clinical practice, partly due to its limited diagnostic accuracy and to the lack of consensus about the appropriate computational signal processing implementation. This paper addresses a three-fold approach, based on ECG indices, to structure this review on sudden cardiac risk stratification. First, throughout the computational techniques that had been widely proposed for obtaining these indices in technical literature. Second, over the scientific evidence, that although is supported by observational clinical studies, they are not always representative enough. And third, via the limited technology transfer of academy-accepted algorithms, requiring further meditation for future systems. We focus on three families of ECG derived indices which are tackled from the aforementioned viewpoints, namely, heart rate turbulence (HRT), heart rate variability (HRV), and T-wave alternans. In terms of computational algorithms, we still need clearer scientific evidence, standardizing, and benchmarking, siting on advanced algorithms applied over large and representative datasets. New scenarios like electronic health recordings, big data, long-term monitoring, and cloud databases, will eventually open new frameworks to foresee suitable new paradigms in the near future.

  19. Does Scientific Evidence for the Use of Natural Products in the Treatment of Oral Candidiasis Exist? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Gabriela Lacet Silva Ferreira

    2015-01-01

    Full Text Available In view of the limitations of antifungal agents used in the treatment of oral candidiasis and the wide variety of natural products that have been studied as treatment of this disease, this systematic literature review proposed to evaluate whether scientific evidence attesting to the efficacy of natural products in the treatment of this disease exists. A systematic search in PubMed, MEDLINE, SciELO, Lilacs, and Cochrane Library databases was accomplished using the associations among the keywords Candida albicans, phytotherapy, biological products, denture stomatitis, and oral candidiasis in both English and Portuguese. Four independent observers evaluated the methodological quality of the resulting articles. Three studies were included for detailed analysis and evaluated according to the analysis protocol based on the CONSORT (Consolidated Standards of Reporting Trials 2010 statement. The tested products were different in all studies. Two studies mentioned random samples, but no study described the sample allocation. No study mentioned sample calculations, a prior pilot study, or examiner calibration, and only one trial reported sample losses. Differences between the tested products and the methodological designs among these studies did not allow the existence of scientific evidence related to the effectiveness of these products for the proposed subjects to be confirmed.

  20. Therapeutic use of prebiotics, probiotics, and postbiotics to prevent necrotizing enterocolitis: what is the current evidence?

    Science.gov (United States)

    Patel, Ravi Mangal; Denning, Patricia Wei

    2013-03-01

    Necrotizing enterocolitis (NEC) is a leading cause of neonatal morbidity and mortality, and preventive therapies that are both effective and safe are urgently needed. Current evidence from therapeutic trials suggests that probiotics are effective in decreasing NEC in preterm infants, and probiotics are currently the most promising therapy for this devastating disease. However, concerns regarding safety and optimal dosing have limited the widespread adoption of routine clinical use of probiotics in preterm infants. This article summarizes the current evidence regarding the use of probiotics, prebiotics, and postbiotics in the preterm infant, including their therapeutic role in preventing NEC.

  1. Acceleromyography for use in scientific and clinical practice: a systematic review of the evidence

    DEFF Research Database (Denmark)

    Claudius, C.; Viby-Mogensen, J.

    2008-01-01

    This systematic review describes the evidence on the use of acceleromyography for perioperative neuromuscular monitoring in clinical practice and research. The review documents that although acceleromyography is widely used in research, it cannot be used interchangeably with mechanomyography and ...... paralysis. A train-of-four ratio of 1.0 predicts with a high predictive value recovery of pulmonary and upper airway function from neuromuscular blockade Udgivelsesdato: 2008/6...

  2. Herbal medicines for wound healing among tribal people in Southern India: Ethnobotanical and Scientific evidences

    Directory of Open Access Journals (Sweden)

    M Ayyanar

    2009-09-01

    Full Text Available Summary: Results of an ethnobotanical study of wound healing treatments among the tribal people of Tirunelveli hills in southern India are presented. A total of 46 plants belonging to 44 genera and 26 families have been documented for their therapeutic use against wounds and related injuries such as cuts, burns, bruises caused by external injury, boils, sores, abscess and wounds created during delivery. Leaves were the most frequently utilized plant part and most herbal remedies are prepared as paste and applied externally; in some cases medicinal preparations were also administered orally. Of the plants collected in the present study none of the plants have been reported to have such specific wound healing compounds except Areca catechu and Scoparia dulcis. The present study suggested that further clinical experimentation is needed to scientifically evaluate these widely used herbal remedies for possible bioactive effects. Industrial Relevance: The study of ethnomedical systems and herbal medicines as therapeutic agents of a paramount importance in addressing health problems of traditional communities and third world countries as well as industrialized societies. Of the reported plants,  Acalypha indica, Anacardium occidentale, Areca catechu, Calotropis gigantea, Cissampelos pareira, Cleome viscosa, Eupatorium odoratum, Euphorbia hirta, Ficus racemosa, Ixora coccinia, Morinda pubescens, Opuntia dillenii, Pongamia pinnata, Scoparia dulcis and Vitex altissima were studied in animal models for wound healing, analgesic and anti-inflammatory activity on the basis of their use in traditional medicine as wound healers and these plants can be used to formulate drugs in pharmaceutical companies.

  3. Dietary fats and health: dietary recommendations in the context of scientific evidence.

    Science.gov (United States)

    Lawrence, Glen D

    2013-05-01

    Although early studies showed that saturated fat diets with very low levels of PUFAs increase serum cholesterol, whereas other studies showed high serum cholesterol increased the risk of coronary artery disease (CAD), the evidence of dietary saturated fats increasing CAD or causing premature death was weak. Over the years, data revealed that dietary saturated fatty acids (SFAs) are not associated with CAD and other adverse health effects or at worst are weakly associated in some analyses when other contributing factors may be overlooked. Several recent analyses indicate that SFAs, particularly in dairy products and coconut oil, can improve health. The evidence of ω6 polyunsaturated fatty acids (PUFAs) promoting inflammation and augmenting many diseases continues to grow, whereas ω3 PUFAs seem to counter these adverse effects. The replacement of saturated fats in the diet with carbohydrates, especially sugars, has resulted in increased obesity and its associated health complications. Well-established mechanisms have been proposed for the adverse health effects of some alternative or replacement nutrients, such as simple carbohydrates and PUFAs. The focus on dietary manipulation of serum cholesterol may be moot in view of numerous other factors that increase the risk of heart disease. The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs, which are discussed here. This review calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs, for which mechanisms for adverse health effects are lacking.

  4. Clarifying anti-reflexivity: conservative opposition to impact science and scientific evidence

    Science.gov (United States)

    Dunlap, Riley E.

    2014-01-01

    The recent study reported by McCright et al (2013 Environ. Res. Lett. 8 044029) extends current research on conservatives’ distrust of science by distinguishing between public trust in production versus impact scientists (i.e. those whose work yields new technologies and marketable products versus those assessing the health and environmental impacts of such technologies and products). As expected, they find that conservatives are significantly less trustful of impact scientists but somewhat more trustful of production scientists. In the process they provide support for the Anti-Reflexivity Thesis, a perspective that attributes conservatives’ (and Republicans’) denial of anthropogenic climate change (ACC) and other environmental problems and attacks on climate/environmental science to their staunch commitment to protecting the current system of economic production. McCright et al’s innovative study deserves replication, and their approach should prove useful in accounting for divergent views of ACC. It is also important to keep in mind that anti-reflexivity is an institutional and structural issue, becoming more consequential when it is employed by political elites such as the George W Bush Administration in the US. Institutional anti-reflexivity is further illustrated by the widespread denial of ACC and a range of other problems among current Republican members of the US Congress.

  5. Liposomal formulations of amphotericin B: differences according to the scientific evidence.

    Science.gov (United States)

    Azanza, José Ramón; Sádada, Belén; Reis, Joana

    2015-12-01

    This article presents an overview of the characteristics of liposomes as drug carriers, particularly in relation to liposomal formulations of amphotericin B. General features regarding structure, liposome-cell interactions, stability, encapsulation of active substances and elimination of liposomes are described. Up to the present time extensive efforts to produce similar or bioequivalent products of amphotericin B formulations, in particular in the case of liposomal amphotericin B, have been unsuccessful in spite of having a very similar composition and even an apparently identical manufacturing process. Guidelines for the development of generic liposomal formulations developed by the FDA and EMA are also summarized. Based on the available evidence of the composition of liposomes, any differences in the manufacturing process even if the same lipid composition is used may result in different final products. Therefore, it seems unreasonable to infer that all amphotericin B liposomal formulations are equal in efficacy and safety.

  6. Characteristics and evidence of nursing scientific production for medication errors at the hospital environment

    Directory of Open Access Journals (Sweden)

    Lolita Dopico da Silva

    2012-06-01

    Full Text Available This study aimed to identify the characteristics of nurses’ publications about medication errors. It was used an Integrative methodology review covering January 2005 to October 2010 with "medication errors" and "nursing" descriptors and it was also collected data from electronic databases via “Capes Portal”. Results show four categories, the conduct of health professionals in medication errors, types and rates of errors, medication system weaknesses, and barriers to error. Discussion of the prevalent practice was not to notify the error. The prevalent error type was administration and error rates which ranged from 14.8 to 56.7%. Ilegible handwriting, communication failures among professionals, and lack of technical knowledge were weaknesses. Among the barriers, the civility from patient, nurses and technology were evident. Advances in researches for testing barriers were found and some gaps were apparent concerning lack of study that address pharmacodynamics or pharmacokinetic aspects of drugs involved in errors.

  7. Evidence for breathing modes in direct current, pulsed, and high power impulse magnetron sputtering plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Yuchen [State Key Lab for Materials Processing and Die & Mold Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan 430074 (China); Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720 (United States); Zhou, Xue [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720 (United States); Department of Electrical Engineering, Harbin Institute of Technology, Harbin 150000 (China); Liu, Jason X. [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720 (United States); Department of Physics, University of California, Berkeley, Berkeley, California 94720 (United States); Anders, André, E-mail: aanders@lbl.gov [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720 (United States)

    2016-01-18

    We present evidence for breathing modes in magnetron sputtering plasmas: periodic axial variations of plasma parameters with characteristic frequencies between 10 and 100 kHz. A set of azimuthally distributed probes shows synchronous oscillations of the floating potential. They appear most clearly when considering the intermediate current regime in which the direction of azimuthal spoke motion changes. Breathing oscillations were found to be superimposed on azimuthal spoke motion. Depending on pressure and current, one can also find a regime of chaotic fluctuations and one of stable discharges, the latter at high current. A pressure-current phase diagram for the different situations is proposed.

  8. Scientific evidence is just the starting point:A generalizable process for developing sports injury prevention interventions

    Institute of Scientific and Technical Information of China (English)

    Alex Donaldson; David G. Lloyd; Belinda J. Gabbe; Jill Cook; Warren Young; Peta White; Caroline F. Finch

    2016-01-01

    Background: The 2 most cited sports injury prevention research frameworks incorporate intervention development, yet little guidance is available in the sports science literature on how to undertake this complex process. This paper presents a generalizable process for developing implementable sports injury prevention interventions, including a case study applying the process to develop a lower limb injury prevention exercise training program (FootyFirst) for community Australian football. Methods: The intervention development process is underpinned by 2 complementary premises:(1) that evidence-based practice integrates the best available scientific evidence with practitioner expertise and end user values and (2) that research evidence alone is insufficient to develop implementable interventions. Results: The generalizable 6-step intervention development process involves (1) compiling research evidence, clinical experience, and knowledge of the implementation context;(2) consulting with experts;(3) engaging with end users;(4) testing the intervention;(5) using theory;and (6) obtaining feedback from early implementers. Following each step, intervention content and presentation should be revised to ensure that the final intervention includes evidence-informed content that is likely to be adopted, properly implemented, and sustained over time by the targeted intervention deliverers. For FootyFirst, this process involved establishing a multidisciplinary intervention development group, conducting 2 targeted literature reviews, undertaking an online expert consensus process, conducting focus groups with program end users, testing the program multiple times in different contexts, and obtaining feedback from early implementers of the program. Conclusion: This systematic yet pragmatic and iterative intervention development process is potentially applicable to any injury prevention topic across all sports settings and levels. It will guide researchers wishing to undertake

  9. Current evidence on whether perinatal risk factors influence coeliac disease is circumstantial.

    Science.gov (United States)

    Mårild, Karl; Ludvigsson, Jonas F; Størdal, Ketil

    2016-04-01

    Coeliac disease is triggered by an interplay of environmental and genetic factors and is one of the most prevalent autoimmune diseases in children, occurring in about 1% of Europeans. Over the last few decades, there has been a growing interest in the role of the perinatal environment in coeliac disease and this review discusses the growing body of literature on coeliac disease and perinatal risk factors. There is still only circumstantial evidence that the perinatal environment influences coeliac disease development. Large-scale cohort studies and emerging scientific concepts, such as epigenetics, may help us establish the role of these environmental factors. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  10. The internet racing ahead of the scientific evidence: the case of "liberation treatment" for multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Yára Dadalti Fragoso

    2011-06-01

    Full Text Available Multiple sclerosis (MS is a chronic neurological disease that typically affects young adults. A recent publication suggested that MS might originate from insufficient blood drainage in certain areas of the central nervous system. The condition was named chronic cerebrospinal venous insufficiency (CCSVI. Other papers have not confirmed these findings and, therefore, the matter remains controversial. Nineteen months after the original publication on CCSVI and MS, another 22 papers have been published addressing the matter. No clinical trials have been carried out on the subject and there is no evidence-based indication to perform surgical vascular procedures in MS patients. However, over the same nineteen-month period, the internet discussion on the subject of CCSVI and MS has led to countless websites advertising treatment using vascular surgery for patients with MS all over the world. The treatment based on the CCSVI theory has appealingly been called "liberation treatment", thus making it difficult to explain to patients why a treatment that has been highly praised (on the internet cannot be recommended based on partial medical results that await confirmation.

  11. Review of Scientific Evidence of Medicinal Convoy Plants in Traditional Persian Medicine.

    Science.gov (United States)

    Sadati, Seyede Nargess; Ardekani, Mohammad Reza Shams; Ebadi, Nastaran; Yakhchali, Maryam; Dana, Azadeh Raees; Masoomi, Fatemeh; Khanavi, Mahnaz; Ramezany, Farid

    2016-01-01

    One concept used in traditional Persian medicine (TPM) for multidrug therapy is that of the convoy drug (Mobadregh). According to TPM texts, convoy drugs are substances (or drugs), which facilitate the access of drugs or foods to the whole body or to specific organs. This study reviewed some convoy drugs presented in TPM, their biological effects, and their probable interactions with main drugs, considering the increased absorption through inhibition of P-glycoprotein (P-gp) efflux function, bioavailability-enhancing effects, and decreased metabolism of the main drug using electronic databases including PubMed, Scopus, ScienceDirect, and Google Scholar in November and December, 2013. Recent studies have proven the beneficial effects of Crocus sativus L. (saffron) and camphor on the heart and brain, the cerebral therapeutic effects of Asarum europaeum (hazelwort), the hepatoprotective effects of Cichorium intybus (chicory), and Apium graveolens (celery) seeds, and the diuretic effects of Cinnamomum zeylanicum (cinnamon), and Cucumis melo (melon) seeds. The effects of vinegar in targeting the liver and brain have also been demonstrated. An evaluation of the results demonstrated that the suggested convoy drugs, including Piper nigrum (black pepper), Piper longum (long pepper), red wine, Camellia sinensis (tea), hazelwort, Mentha longifolia (pennyroyal), Anethum graveolens (dill), Foeniculum vulgare (fennel), cinnamon, and Sassafras albidum (sassafras) can increase the bioavailability of coadministered drugs by inhibition of P-gp or cytochrome P450s (CYP450s) or both of them. This evidence could be a good basis for the use of these agents as convoys in TPM.

  12. Rééducation Posturale Globale in musculoskeletal diseases: scientific evidence and clinical practice

    Directory of Open Access Journals (Sweden)

    D. Tosarelli

    2011-09-01

    Full Text Available Several studies on the treatment of musculoskeletal diseases with physiotherapy and clinical experiences on the basis of a method called Rééducation Posturale Globale (RPG, have highlighted the usefulness of this treatment. Although such treatment technique is commonly used in physical therapy practice, only few studies support its therapeutic effectiveness. Objective: To search the literature for evidence of RPG effectiveness, in order to identify the most appropriate therapeutic contexts for its use. Methods: A review of the literature through the following databases: PubMed, Embase, Cinahl, Pedro, and Medscape. The keywords used for the search in the databases are: Rééducation Posturale Globale, Souchard, Posture, and Manual Therapy. The following clinical studies were selected: randomized controlled studies, non-randomized controlled studies, observation studies, and case reports, in English, Spanish, Portuguese, and Italian. Results: Out of 18 studies found, 9 were analyzed: 2 randomized controlled studies, 2 non-randomized controlled studies, 3 non-controlled studies, and 2 case reports. Conclusions: The RPG method has been shown to be an effective treatment technique for musculoskeletal diseases, in particular for ankylosing spondylitis, acute and chronic low back pain, and lumbar discherniation. Although the scarcity of rigorous experimental trials on a large scale does not allow the drawing of undisputable conclusions, the results gathered up to now are an encouragement to carry on research in the field of conservative treatment.

  13. Mobilization and Manipulation of the Cervical Spine in Patients with Cervicogenic Headache: Any Scientific Evidence?

    Science.gov (United States)

    Garcia, Jodan D; Arnold, Stephen; Tetley, Kylie; Voight, Kiel; Frank, Rachael Anne

    2016-01-01

    Cervical mobilization and manipulation are frequently used to treat patients diagnosed with cervicogenic headache (CEH); however, there is conflicting evidence on the efficacy of these manual therapy techniques. The purpose of this review is to investigate the effects of cervical mobilization and manipulation on pain intensity and headache frequency, compared to traditional physical therapy interventions in patients diagnosed with CEH. A total of 66 relevant studies were originally identified through a review of the literature, and the 25 most suitable articles were fully evaluated via a careful review of the text. Ultimately, 10 studies met the inclusion criteria: (1) randomized controlled trial (RCT) or open RCT; the study contained at least two separate groups of subjects that were randomly assigned either to a cervical spine mobilization or manipulation or a group that served as a comparison; (2) subjects must have had a diagnosis of CEH; (3) the treatment group received either spinal mobilization or spinal manipulation, while the control group received another physical therapy intervention or placebo control; and (4) the study included headache pain and frequency as outcome measurements. Seven of the 10 studies had statistically significant findings that subjects who received mobilization or manipulation interventions experienced improved outcomes or reported fewer symptoms than control subjects. These results suggest that mobilization or manipulation of the cervical spine may be beneficial for individuals who suffer from CEH, although heterogeneity of the studies makes it difficult to generalize the findings.

  14. Stroke treatment in Stroke Unit: from scientific evidences to clinical practice

    Directory of Open Access Journals (Sweden)

    Michele Stornello

    2013-04-01

    Full Text Available Background: In themanagement of stroke disease, evidences fromthe literature demonstrate that the introduction of stroke units, hospital wards with dedicated beds providing intensive care within 48 hours of symptoms’ onset, produced a real improvement in the outcome, reducing in-hospital fatality cases and increasing the proportion of patients independently living in long term follow-up. Discussion: The article focuses on stroke disease-management, suggesting a stroke integrated approach for the admission of patients on dedicated beds, in order to extend the ‘‘stroke care’’ approach outcomes to as many hospitals as possible in Italy. This approach implies the set up of a stroke network for an effective patients’ stratification according to the severity of the illness at debut; the set up of an integrated team of specialists in hospital management of the acute phase (first 48 hours and a timely rehabilitation treatment. Ultimately the hospital should be organized according to department’s semi-intensive areas in order to assure to the patients, in the early stage of the disease, a timely high intensity care aimed to improve the long term outcome.

  15. Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there?

    Science.gov (United States)

    Fioravanti, Antonella; Cantarini, Luca; Guidelli, Giacomo Maria; Galeazzi, Mauro

    2011-01-01

    Spa therapy represents a popular treatment for many rheumatic diseases. The mechanisms by which immersion in mineral or thermal water or the application of mud alleviates suffering in rheumatic diseases are not fully understood. The net benefit is probably the result of a combination of factors, with mechanical, thermal and chemical effects among the most prominent ones. Buoyancy, immersion, resistance and temperature all play important roles. According to the gate theory, pain relief may be due to the pressure and temperature of the water on skin; hot stimuli may influence muscle tone and pain intensity, helping to reduce muscle spasm and to increase the pain threshold. Mud-bath therapy increases plasma β-endorphin levels and secretion of corticotrophin, cortisol, growth hormone and prolactin. It has recently been demonstrated that thermal mud-pack therapy induces a reduction in the circulating levels of prostaglandin E2 (PGE2), leukotriene B4 (LTB4), interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α), important mediators of inflammation and pain. Spa therapy has been found to cause an increase in insulin-like growth factor-1 (IGF1), which stimulates cartilage metabolism, and transforming growth factor-β (TGF-β). There is also evidence of the positive action of mud-packs and thermal baths on the oxidant/antioxidant system, with a reduction in the release of reactive oxygen (ROS) and nitrogen (RNS) species. Overall, thermal stress has an immunosuppressive effect. Many other non-specific factors may also contribute to the beneficial effects observed after spa therapy in some rheumatic diseases, including effects on cardiovascular risk factors, and changes in the environment, pleasant surroundings and the absence of work duties.

  16. Review of scientific evidence of medicinal convoy plants in traditional Persian medicine

    Directory of Open Access Journals (Sweden)

    Seyede Nargess Sadati

    2016-01-01

    Full Text Available One concept used in traditional Persian medicine (TPM for multidrug therapy is that of the convoy drug (Mobadregh. According to TPM texts, convoy drugs are substances (or drugs, which facilitate the access of drugs or foods to the whole body or to specific organs. This study reviewed some convoy drugs presented in TPM, their biological effects, and their probable interactions with main drugs, considering the increased absorption through inhibition of P-glycoprotein (P-gp efflux function, bioavailability-enhancing effects, and decreased metabolism of the main drug using electronic databases including PubMed, Scopus, ScienceDirect, and Google Scholar in November and December, 2013. Recent studies have proven the beneficial effects of Crocus sativus L. (saffron and camphor on the heart and brain, the cerebral therapeutic effects of Asarum europaeum (hazelwort, the hepatoprotective effects of Cichorium intybus (chicory, and Apium graveolens (celery seeds, and the diuretic effects of Cinnamomum zeylanicum (cinnamon, and Cucumis melo (melon seeds. The effects of vinegar in targeting the liver and brain have also been demonstrated. An evaluation of the results demonstrated that the suggested convoy drugs, including Piper nigrum (black pepper, Piper longum (long pepper, red wine, Camellia sinensis (tea, hazelwort, Mentha longifolia (pennyroyal, Anethum graveolens (dill, Foeniculum vulgare (fennel, cinnamon, and Sassafras albidum (sassafras can increase the bioavailability of coadministered drugs by inhibition of P-gp or cytochrome P450s (CYP450s or both of them. This evidence could be a good basis for the use of these agents as convoys in TPM.

  17. Friend or foe? The current epidemiologic evidence on selenium and human cancer risk.

    Science.gov (United States)

    Vinceti, Marco; Crespi, Catherine M; Malagoli, Carlotta; Del Giovane, Cinzia; Krogh, Vittorio

    2013-01-01

    Scientific opinion on the relationship between selenium and the risk of cancer has undergone radical change over the years, with selenium first viewed as a possible carcinogen in the 1940s then as a possible cancer preventive agent in the 1960s-2000s. More recently, randomized controlled trials have found no effect on cancer risk but suggest possible low-dose dermatologic and endocrine toxicity, and animal studies indicate both carcinogenic and cancer-preventive effects. A growing body of evidence from human and laboratory studies indicates dramatically different biological effects of the various inorganic and organic chemical forms of selenium, which may explain apparent inconsistencies across studies. These chemical form-specific effects also have important implications for exposure and health risk assessment. Overall, available epidemiologic evidence suggests no cancer preventive effect of increased selenium intake in healthy individuals and possible increased risk of other diseases and disorders.

  18. Therapeutic Use of Prebiotics, Probiotics, and Postbiotics to Prevent Necrotizing Enterocolitis: What is the Current Evidence?

    OpenAIRE

    2013-01-01

    Necrotizing enterocolitis (NEC) is a leading cause of neonatal morbidity and mortality and preventative therapies that are both effective and safe are urgently needed. Current evidence from therapeutic trials suggests that probiotics are effective in decreasing NEC in preterm infants and probiotics are currently the most promising therapy on the horizon for this devastating disease. However, concerns regarding safety and optimal dosing have limited the widespread adoption of routine clinical ...

  19. Rip current evidence by hydrodynamic simulations, bathymetric surveys and UAV observation

    Science.gov (United States)

    Benassai, Guido; Aucelli, Pietro; Budillon, Giorgio; De Stefano, Massimo; Di Luccio, Diana; Di Paola, Gianluigi; Montella, Raffaele; Mucerino, Luigi; Sica, Mario; Pennetta, Micla

    2017-09-01

    The prediction of the formation, spacing and location of rip currents is a scientific challenge that can be achieved by means of different complementary methods. In this paper the analysis of numerical and experimental data, including RPAS (remotely piloted aircraft systems) observations, allowed us to detect the presence of rip currents and rip channels at the mouth of Sele River, in the Gulf of Salerno, southern Italy. The dataset used to analyze these phenomena consisted of two different bathymetric surveys, a detailed sediment analysis and a set of high-resolution wave numerical simulations, completed with Google EarthTM images and RPAS observations. The grain size trend analysis and the numerical simulations allowed us to identify the rip current occurrence, forced by topographically constrained channels incised on the seabed, which were compared with observations.

  20. Venous hemodynamic changes in lower limb venous disease: the UIP consensus according to scientific evidence.

    Science.gov (United States)

    Lee, Byung B; Nicolaides, Andrew N; Myers, Kenneth; Meissner, Mark; Kalodiki, Evi; Allegra, Claudio; Antignani, Pier L; Bækgaard, Niels; Beach, Kirk; Belcaro, Giovanni; Black, Stephen; Blomgren, Lena; Bouskela, Eliete; Cappelli, Massimo; Caprini, Joseph; Carpentier, Patrick; Cavezzi, Attilio; Chastanet, Sylvain; Christenson, Jan T; Christopoulos, Demetris; Clarke, Heather; Davies, Alun; Demaeseneer, Marianne; Eklöf, Bo; Ermini, Stefano; Fernández, Fidel; Franceschi, Claude; Gasparis, Antonios; Geroulakos, George; Gianesini, Sergio; Giannoukas, Athanasios; Gloviczki, Peter; Huang, Ying; Ibegbuna, Veronica; Kakkos, Stavros K; Kistner, Robert; Kölbel, Tilo; Kurstjens, Ralph L; Labropoulos, Nicos; Laredo, James; Lattimer, Christopher R; Lugli, Marzia; Lurie, Fedor; Maleti, Oscar; Markovic, Jovan; Mendoza, Erika; Monedero, Javier L; Moneta, Gregory; Moore, Hayley; Morrison, Nick; Mosti, Giovanni; Nelzén, Olle; Obermayer, Alfred; Ogawa, Tomohiro; Parsi, Kurosh; Partsch, Hugo; Passariello, Fausto; Perrin, Michel L; Pittaluga, Paul; Raju, Seshadri; Ricci, Stefano; Rosales, Antonio; Scuderi, Angelo; Slagsvold, Carl E; Thurin, Anders; Urbanek, Tomasz; M VAN Rij, Andre; Vasquez, Michael; Wittens, Cees H; Zamboni, Paolo; Zimmet, Steven; Ezpeleta, Santiago Z

    2016-06-01

    There are excellent guidelines for clinicians to manage venous diseases but few reviews to assess their hemodynamic background. Hemodynamic concepts that evolved in the past have largely remained unchallenged in recent decades, perhaps due to their often complicated nature and in part due to emergence of new diagnostic techniques. Duplex ultrasound scanning and other imaging techniques which evolved in the latter part of the 20th century have dominated investigation. They have greatly improved our understanding of the anatomical patterns of venous reflux and obstruction. However, they do not provide the physiological basis for understanding the hemodynamics of flow, pressure, compliance and resistance. Hemodynamic investigations appear to provide a better correlation with post-treatment clinical outcome and quality of life than ultrasound findings. There is a far better prospect for understanding the complete picture of the patient's disability and response to management by combining ultrasound with hemodynamic studies. Accordingly, at the instigation of Dr Angelo Scuderi, the Union Internationale de Phlebologie (UIP) executive board commissioned a large number of experts to assess all aspects of management for venous disease by evidence-based principles. These included experts from various member societies including the European Venous Forum (EVF), American Venous Forum (AVF), American College of Phlebology (ACP) and Cardiovascular Disease Educational and Research Trust (CDERT). Their aim was to confirm or dispel long-held hemodynamic principles and to provide a comprehensive review of venous hemodynamic concepts underlying the pathophysiology of lower limb venous disorders, their usefulness for investigating patients and the relevant hemodynamic changes associated with various forms of treatment. Chapter 1 is devoted to basic hemodynamic concepts and normal venous physiology. Chapter 2 presents the mechanism and magnitude of hemodynamic changes in acute deep vein

  1. A prospective multiple case study of the impact of emerging scientific evidence on established colorectal cancer screening programs: a study protocol.

    Science.gov (United States)

    Geddie, Hannah; Dobrow, Mark J; Hoch, Jeffrey S; Rabeneck, Linda

    2012-06-01

    Health-policy decision making is a complex and dynamic process, for which strong evidentiary support is required. This includes scientifically produced research, as well as information that relates to the context in which the decision takes place. Unlike scientific evidence, this "contextual evidence" is highly variable and often includes information that is not scientifically produced, drawn from sources such as political judgement, program management experience and knowledge, or public values. As the policy decision-making process is variable and difficult to evaluate, it is often unclear how this heterogeneous evidence is identified and incorporated into "evidence-based policy" decisions. Population-based colorectal cancer screening poses an ideal context in which to examine these issues. In Canada, colorectal cancer screening programs have been established in several provinces over the past five years, based on the fecal occult blood test (FOBT) or the fecal immunochemical test. However, as these programs develop, new scientific evidence for screening continues to emerge. Recently published randomized controlled trials suggest that the use of flexible sigmoidoscopy for population-based screening may pose a greater reduction in mortality than the FOBT. This raises the important question of how policy makers will address this evidence, given that screening programs are being established or are already in place. This study will examine these issues prospectively and will focus on how policy makers monitor emerging scientific evidence and how both scientific and contextual evidence are identified and applied for decisions about health system improvement. This study will employ a prospective multiple case study design, involving participants from Ontario, Alberta, Manitoba, Nova Scotia, and Quebec. In each province, data will be collected via document analysis and key informant interviews. Documents will include policy briefs, reports, meeting minutes, media

  2. Ethics issues in scientific data and service provision: evidence and challenges for the European Plate Observing System (EPOS)

    Science.gov (United States)

    Cocco, Massimo; Freda, Carmela; Haslinger, Florian; Consortium, Epos

    2016-04-01

    Addressing Ethics issues is nowadays a relevant challenge for any initiative, program or project dealing with scientific data and products provision, access to services for scientific purposes and communication with different stakeholders, including society. This is corroborated by the evidence that Ethics has very high priority in EU funded research. Indeed, all the activities carried out under Horizon 2020 must comply with ethical principles and national, Union and international legislation. This implies that "For all activities funded by the European Union, Ethics is an integral part of research from beginning to end, and ethical compliance is seen as pivotal to achieve real research excellence." Here, we present the experience of EPOS, a public pan-European research infrastructure. EPOS aims at integrating data, data products, services and software (DDSS) for solid Earth science generated and provided by monitoring networks, observing systems and facilities belonging to European countries. EPOS fosters the integrated use of multidisciplinary solid Earth data to improve the understanding of physical and chemical processes controlling earthquakes, volcanic eruptions, tsunamis as well as those driving tectonics and surface dynamics. The EPOS integration plan will make significant contributions to understanding and mitigating geo-hazards, yielding data for hazard assessment, data products for engaging different stakeholders, and services for training, education and communication to society. Numerous national research infrastructures engaged in EPOS are deployed for the monitoring of areas prone to geo-hazards and for the surveillance of the national territory including areas used for exploiting geo-resources. The EPOS community is therefore already trained to provide services to public (civil defence agencies, local and national authorities) and private (petroleum industry, mining industry, geothermal companies, aviation security) stakeholders. Our ability to

  3. Evidence of current impact of climate change on life : A walk from genes to the biosphere

    NARCIS (Netherlands)

    Penuelas, Josep; Sardans, Jordi; Estiarte, Marc; Ogaya, Roma; Carnicer, Jofre; Coll, Marta; Barbeta, Adria; Rivas-Ubach, Albert; Llusia, Joan; Garbulsky, Martin; Filella, Iolanda; Jump, Alistair S.

    We review the evidence of how organisms and populations are currently responding to climate change through phenotypic plasticity, genotypic evolution, changes in distribution and, in some cases, local extinction. Organisms alter their gene expression and metabolism to increase the concentrations of

  4. Key scientific challenges in current rechargeable non-aqueous Li-O2 batteries: experiment and theory.

    Science.gov (United States)

    Bhatt, Mahesh Datt; Geaney, Hugh; Nolan, Michael; O'Dwyer, Colm

    2014-06-28

    Rechargeable Li-air (henceforth referred to as Li-O2) batteries provide theoretical capacities that are ten times higher than that of current Li-ion batteries, which could enable the driving range of an electric vehicle to be comparable to that of gasoline vehicles. These high energy densities in Li-O2 batteries result from the atypical battery architecture which consists of an air (O2) cathode and a pure lithium metal anode. However, hurdles to their widespread use abound with issues at the cathode (relating to electrocatalysis and cathode decomposition), lithium metal anode (high reactivity towards moisture) and due to electrolyte decomposition. This review focuses on the key scientific challenges in the development of rechargeable non-aqueous Li-O2 batteries from both experimental and theoretical findings. This dual approach allows insight into future research directions to be provided and highlights the importance of combining theoretical and experimental approaches in the optimization of Li-O2 battery systems.

  5. A prospective multiple case study of the impact of emerging scientific evidence on established colorectal cancer screening programs: a study protocol

    Directory of Open Access Journals (Sweden)

    Geddie Hannah

    2012-06-01

    Full Text Available Abstract Background Health-policy decision making is a complex and dynamic process, for which strong evidentiary support is required. This includes scientifically produced research, as well as information that relates to the context in which the decision takes place. Unlike scientific evidence, this “contextual evidence” is highly variable and often includes information that is not scientifically produced, drawn from sources such as political judgement, program management experience and knowledge, or public values. As the policy decision-making process is variable and difficult to evaluate, it is often unclear how this heterogeneous evidence is identified and incorporated into “evidence-based policy” decisions. Population-based colorectal cancer screening poses an ideal context in which to examine these issues. In Canada, colorectal cancer screening programs have been established in several provinces over the past five years, based on the fecal occult blood test (FOBT or the fecal immunochemical test. However, as these programs develop, new scientific evidence for screening continues to emerge. Recently published randomized controlled trials suggest that the use of flexible sigmoidoscopy for population-based screening may pose a greater reduction in mortality than the FOBT. This raises the important question of how policy makers will address this evidence, given that screening programs are being established or are already in place. This study will examine these issues prospectively and will focus on how policy makers monitor emerging scientific evidence and how both scientific and contextual evidence are identified and applied for decisions about health system improvement. Methods This study will employ a prospective multiple case study design, involving participants from Ontario, Alberta, Manitoba, Nova Scotia, and Quebec. In each province, data will be collected via document analysis and key informant interviews. Documents will include

  6. Therapeutic Use of Prebiotics, Probiotics, and Postbiotics to Prevent Necrotizing Enterocolitis: What is the Current Evidence?

    Science.gov (United States)

    Patel, Ravi Mangal; Denning, Patricia Wei

    2013-01-01

    Synopsis Necrotizing enterocolitis (NEC) is a leading cause of neonatal morbidity and mortality and preventative therapies that are both effective and safe are urgently needed. Current evidence from therapeutic trials suggests that probiotics are effective in decreasing NEC in preterm infants and probiotics are currently the most promising therapy on the horizon for this devastating disease. However, concerns regarding safety and optimal dosing have limited the widespread adoption of routine clinical use of probiotics in preterm infants. In addition, prebiotics and postbiotics may be potential alternatives or adjunctive therapies to the administration of live microorganisms, although studies demonstrating their clinical efficacy in preventing NEC are lacking. This review summarizes the current evidence regarding the use of probiotics, prebiotics and postbiotics in the preterm infant, including its therapeutic role in preventing NEC. PMID:23415261

  7. An evidence-based environmental perspective of manufactured silver nanoparticle in syntheses and applications: a systematic review and critical appraisal of peer-reviewed scientific papers.

    Science.gov (United States)

    Tolaymat, Thabet M; El Badawy, Amro M; Genaidy, Ash; Scheckel, Kirk G; Luxton, Todd P; Suidan, Makram

    2010-02-01

    Most recently, renewed interest has arisen in manufactured silver nanomaterials because of their unusually enhanced physicochemical properties and biological activities compared to the bulk parent materials. A wide range of applications has emerged in consumer products ranging from disinfecting medical devices and home appliances to water treatment. Because the hypothesized mechanisms that govern the fate and transport of bulk materials may not directly apply to materials at the nanoscale, there are great concerns in the regulatory and research communities about potential environmental impacts associated with the use of silver nanoparticles. In particular, the unlimited combinations of properties emerging from the syntheses and applications of silver nanoparticles are presenting an urgent need to document the predominant salt precursors, reducing agents and stabilizing agents utilized in the synthesis processes of silver nanoparticles to guide the massive efforts required for environmental risk assessment and management. The primary objective of this study is to present an evidence-based environmental perspective of silver nanoparticle properties in syntheses and applications. The following specific aims are designed to achieve the study objective: Aim 1--to document the salt precursors and agents utilized in synthesizing silver nanoparticles; Aim 2--to determine the characteristics of silver nanoparticles currently in use in the scientific literature when integrated in polymer matrices to form nanocomposites and combined with other metal nanoparticles to form bimetallic nanoparticles; Aim 3--to provide a summary of the morphology of silver nanoparticles; and (4) Aim 4--to provide an environmental perspective of the evidence presented in Aims 1 to 3. A comprehensive electronic search of scientific databases was conducted in support of the study objectives. Specific inclusion criteria were applied to gather the most pertinent research articles. Data and information

  8. Body image disturbance in children and adolescents with eating disorders. Current evidence and future directions.

    Science.gov (United States)

    Legenbauer, Tanja; Thiemann, Pia; Vocks, Silja

    2014-01-01

    Body image is multifaceted and incorporates perceptual, affective, and cognitive components as well as behavioral features. Only few studies have examined the character of body-image disturbance in children/adolescents with eating disorders. It is unknown whether body-image disturbances in children/adolescent with eating disturbances are comparable to those of adult patients with eating disorders. Body-image disturbance might differ quantitatively and qualitatively according to the cognitive developmental status and the age of the individual. This paper provides an overview of the current evidence for body-image disturbance in children/adolescents with eating disorders, and how they compare with those adults with eating disorders. Current evidence indicates that older adolescent patients show similar deficits as adult patients with eating disorders, in particular for the attitudinal body-image component. However, evidence for a perceptual body-image disturbance in adolescent patients, in particular anorexia nervosa, is not conclusive. Reliable statements for childhood can hardly be made because clinical studies are not available. Investigations of body-image disturbance in children have focused on the predictive value for eating disorders. Limitations of the current evidence are discussed, and future directions for research and therapy are indicated.

  9. A three-phase model proposal for the evolution of scientific communication: from first print periodicals to current electronic communication system

    Directory of Open Access Journals (Sweden)

    Patrícia Bertin

    Full Text Available Scientific communication has undergone deep transformations, since the emergence of Internet. Aiming to provide further thought on the evolution of scientific communication, this paper features a historical overview of the scientific communication advances over the last twenty years through a three-phase model for the evolution of the electronic journal and the preprints services, and presents Brazilian contemporary panorama for scientific communication. The three-phase model presented in this work is an adaptation of that one proposed by Tenopir et al. (2003 to describe the patterns of journal use by scientists since 1990. The early evolutionary phase followed the emergence of the first digital journals and the creation of repositories in the Web for publishing preliminary versions of scientific literature on the author’s initiative; by that time, most academics reproved electronic publishing initiatives. From 1996 and forward, in the consolidation phase, electronic journals were commonly identical to their print counterparts; the acceptance of the electronic format began to increase, and preprint services got underway in several disciplines. The advanced evolutionary phase started with the world discussion on open access to scientific information. The comparison of the current electronic journal with that viewed by enthusiasts in the first years of the 1990s shows that some aspects still remain to be improved in electronic formal and informal communication, towards effective dissemination of scientific information.

  10. Analysis on the Current State of Performance Appraisal for Scientific Workers in Agricultural Sci-entific Institute%农业科研机构科研人员绩效考核现状分析

    Institute of Scientific and Technical Information of China (English)

    孔怡; 武晓亮; 蔚承祥; 苏波; 马刚

    2014-01-01

    绩效考核工作是现代人力资源管理工作中的一项重要内容[1]。文章主要阐述了农业科研机构科研人员绩效考核的现状,分析了现行农业科研人员绩效考核工作中存在的问题,以期为建立科学合理的农业科研人员绩效考核体系提供参考。%Performance appraisal is an important part of human resource management. In order to provide reference to build a more scientific performance appraisal system of agricultural scientific workers, in this article, we elaborated the state, and analyzed the problems of the current performance appraisal of agricul-tural scientific workers.

  11. Event-based versus process-based informed consent to address scientific evidence and uncertainties in ionising medical imaging.

    Science.gov (United States)

    Recchia, Virginia; Dodaro, Antonio; Braga, Larissa

    2013-10-01

    Inappropriate ionising medical imaging has been escalating in the last decades. This trend leads to potential damage to health and has been associated to bioethical and legal issues of patient autonomy. While the doctrine underlines the importance of using informed consent to improve patient autonomy and physician-patient communication, some researchers have argued that it often falls short of this aim. There are basically two different informed consent practices. The first - the so-called "event-based model" - regards informed consent as a passive signature of a standard unreadable template, performed only once in each medical pathway. The second - the so-called "process-based model" - integrates information into the continuing dialogue between physician and patient, vital for diagnosis and treatment. Current medical behaviour often embraces the event-based model, which is considered ineffective and contributes to inappropriateness. We sought, in this review, to analyse from juridical and communication standpoints whether process-based informed consent can deal with scientific uncertainties in radiological decision-making. The informed consent is still a distinctive process in defence of both patients' and physicians' health and dignity in rule-of-law states and consequently in curtailing the abuse of ionising medical radiation. • Inappropriate ionising medical imaging is widespread and increasing worldwide. • This trend leads to noteworthy damage to health and is linked to the issue of patient autonomy. • Some authors have argued that informed consent often falls short of improving patient autonomy. • Process-based informed consent can deal with scientific uncertainties to contrast inappropriateness. • Informed consent is still a distinctive process in defence of both patients and physicians.

  12. Cognitive behavioral therapy in anxiety disorders: current state of the evidence.

    Science.gov (United States)

    Otte, Christian

    2011-01-01

    A plethora of studies have examined the efficacy and effectiveness of cognitive-behavioral therapy (CBT) for adult anxiety disorders. In recent years, several meta-analyses have been conducted to quantitatively review the evidence of CBT for anxiety disorders, each using different inclusion criteria for studies, such as use of control conditions or type of study environment. This review aims to summarize and to discuss the current state of the evidence regarding CBT treatment for panic disorder, generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Overall, CBT demonstrates both efficacy in randomized controlled trials and effectiveness in naturalistic settings in the treatment of adult anxiety disorders. However, due to methodological issues, the magnitude of effect is currently difficult to estimate. In conclusion, CBT appears to be both efficacious and effective in the treatment of anxiety disorders, but more high-quality studies are needed to better estimate the magnitude of the effect.

  13. Ethical and Scientific Issues Surrounding Solid Organ Transplantation in Hiv-Positive Patients: Absence of Evidence Is Not Evidence of Absence

    Directory of Open Access Journals (Sweden)

    Timothy Christie

    2006-01-01

    Full Text Available End-stage liver disease is emerging as a leading cause of death among HIV-positive patients. Historically, an HIV diagnosis was a contraindication for a liver transplant; however, because of the efficacy of highly active antiretroviral therapy (HAART, HIV-positive patients have one-year, two-year, and three-year post-transplantation survival rates similar to that of HIV-negative patients. Based on this evidence, HIV-positive patients are now considered eligible for transplantation. However, newly emerging guidelines include the stipulation that HIV-positive patients must be on HAART to be placed on a waiting list for transplantation. The purpose of the present paper is to evaluate the scientific and ethical probity of requiring HIV-positive patients to be on HAART as a condition for being on a liver transplant waiting list. It is argued that the emphasis should be placed on the probability of post-transplantation HAART tolerance, and that concerns about pretransplantation HAART tolerance are of secondary importance.

  14. The first step in the development of text mining technology for cancer risk assessment: identifying and organizing scientific evidence in risk assessment literature

    Directory of Open Access Journals (Sweden)

    Sun Lin

    2009-09-01

    Full Text Available Abstract Background One of the most neglected areas of biomedical Text Mining (TM is the development of systems based on carefully assessed user needs. We have recently investigated the user needs of an important task yet to be tackled by TM -- Cancer Risk Assessment (CRA. Here we take the first step towards the development of TM technology for the task: identifying and organizing the scientific evidence required for CRA in a taxonomy which is capable of supporting extensive data gathering from biomedical literature. Results The taxonomy is based on expert annotation of 1297 abstracts downloaded from relevant PubMed journals. It classifies 1742 unique keywords found in the corpus to 48 classes which specify core evidence required for CRA. We report promising results with inter-annotator agreement tests and automatic classification of PubMed abstracts to taxonomy classes. A simple user test is also reported in a near real-world CRA scenario which demonstrates along with other evaluation that the resources we have built are well-defined, accurate, and applicable in practice. Conclusion We present our annotation guidelines and a tool which we have designed for expert annotation of PubMed abstracts. A corpus annotated for keywords and document relevance is also presented, along with the taxonomy which organizes the keywords into classes defining core evidence for CRA. As demonstrated by the evaluation, the materials we have constructed provide a good basis for classification of CRA literature along multiple dimensions. They can support current manual CRA as well as facilitate the development of an approach based on TM. We discuss extending the taxonomy further via manual and machine learning approaches and the subsequent steps required to develop TM technology for the needs of CRA.

  15. Documentation panels: Evidence of scientific literacy in a primary multi age classroom: Teaching at the edge of magic

    Science.gov (United States)

    Garhart Kohn, Charlene

    This project is the result of a question I raised about using documentation panels in my classroom; it is teacher research. Teacher researchers participate in their own inquiries, participating as both teacher and researcher in the study. Teacher research provides practitioners a method for investigating a question or wondering that arises from the classroom. This project aims to explicate the science learning demonstrated by 5, 6, 7, and 8 year old students through the use of student created documentation panels while at the same time providing me with an insightful and critical look at my pedagogy. Within the context of my primary multi age classroom setting I investigate my use of nonfiction texts to teach emergent and early literacy skills, discuss why I encourage classroom discourse among my students, posit the need to establish criteria for completing best quality work, and argue for the inclusion of science in an integrated curriculum. I analyze the visual and conversational texts of the documentation panels for evidence of science knowledge as noted in the National Science Standards for students in Kindergarten through grade two. I create categories connecting the visual text to the Science Standards including, picture glossaries; life cycles; simples, scale, and analytic diagrams; various types of maps including bird's eye view and elevations. The categories created to connect the conversational text to the Science Standards include use of content vocabulary, approximations of vocabulary, discussion of scientific concepts and processes, an analysis of student generated kinesis, and examination of the narrative stories some students tell as they talk about science. Linking the documentation panels to the National Science Standards provides evidence of science knowledge in young students in this class.

  16. Evidence for large-area superemission into a high-current glow discharge

    Science.gov (United States)

    Hartmann, W.; Dominic, V.; Kirkman, G. F.; Gundersen, M. A.

    1988-10-01

    This letter presents evidence for large-area (≊1 cm2) cathode superemission (˜10 000 A/cm2) into a high-current glow discharge in a pseudospark or back lighted thyratron switch. Cathodes studied with a scannning electron microscope following operation at 6-8 kA, ≊1 μs pulse length, and 105 pulses in a low-pressure H2 discharge show evidence of melting of a thin surface layer within a radius of ˜4 mm, indicating that the discharge is a superdense glow with a cross-sectional area of the order of 1 cm2, rather than an arc. Further supporting evidence is provided by streak camera data. An ion beam present during the avalanche phase of the discharge is responsible for heating the cathode surface resulting in a significant field-enhanced thermionic emission.

  17. Asthma and obesity in children: current evidence and potential systems biology approaches.

    Science.gov (United States)

    Frey, U; Latzin, P; Usemann, J; Maccora, J; Zumsteg, U; Kriemler, S

    2015-01-01

    Both obesity and asthma are highly prevalent, complex diseases modified by multiple factors. Genetic, developmental, lung mechanical, immunological and behavioural factors have all been suggested as playing a causal role between the two entities; however, their complex mechanistic interactions are still poorly understood and evidence of causality in children remains scant. Equally lacking is evidence of effective treatment strategies, despite the fact that imbalances at vulnerable phases in childhood can impact long-term health. This review is targeted at both clinicians frequently faced with the dilemma of how to investigate and treat the obese asthmatic child and researchers interested in the topic. Highlighting the breadth of the spectrum of factors involved, this review collates evidence regarding the investigation and treatment of asthma in obese children, particularly in comparison with current approaches in 'difficult-to-treat' childhood asthma. Finally, the authors propose hypotheses for future research from a systems-based perspective.

  18. Current knowledge on evidence-based shockwave treatments for shoulder pathology.

    Science.gov (United States)

    Moya, Daniel; Ramón, Silvia; Guiloff, Leonardo; Gerdesmeyer, Ludger

    2015-12-01

    Shoulder pain is one of the most common musculoskeletal pathologies. Treatment by ESWT (extracorporeal shockwave therapy) has emerged as an alternative when conservative treatment fails in rotator cuff calcific tendinopathy, prior to invasive procedures. The clinical efficacy of ESWT in non-calcific tendinopathy remains controversial. The good results in the treatment of rotator cuff calcifications, have led to indications of ESWT being expanded to other shoulder pathologies. We review the current state of indications and evidence based practice.

  19. Quantized current blockade and hydrodynamic correlations in biopolymer translocation through nanopores: evidence from multiscale simulations

    CERN Document Server

    Bernaschi, Massimo; Succi, Sauro; Fyta, Maria; Kaxiras, Efthimios

    2008-01-01

    We present a detailed description of biopolymer translocation through a nanopore in the presence of a solvent, using an innovative multi-scale methodology which treats the biopolymer at the microscopic scale as combined with a self-consistent mesoscopic description for the solvent fluid dynamics. We report evidence for quantized current blockade depending on the folding configuration and offer detailed information on the role of hydrodynamic correlations in speeding-up the translocation process.

  20. Current status of pediatric kidney transplantation in China: data analysis of Chinese Scientific Registry of Kidney Transplantation

    Institute of Scientific and Technical Information of China (English)

    Liu Longshan; Zhang Huanxi; Fu Qian; Chen Liping; Sun Chuanhou; Xiong Yunyi; Shi Bingyi

    2014-01-01

    Background Kidney transplantation (KTx) is the primary therapy for children with renal failure.Unlike KTx in adult patients,it is commonly agreed that pediatric KTx in China is far behind that of America.There has been no systematic analysis of Chinese pediatric KTx reported.This study aimed to demonstrate the current status of pediatric KTx in China.Methods Registry data of pediatric KTx (1983-2012) from Chinese Scientific Registry of Kidney Transplantation (CSRKT) were retrospectively analyzed.Results There were 851 pediatric KTx from 102 transplant units.The recipients were (15.4±2.5) years of age,93.9% of who were over 10 years old.Chronic glomerulonephritis and pyelonephritis accounted for 75.6% of recognized primary diseases.Allografts were from deceased donors (72.2%) or living donation (27.7%).The patient survival for 1,3,5,and 10 years was 96.9%,94.2%,92.3%,and 92.3% and the graft survival was 94.6%,91.4%,86.3%,and 79.2%,respectively.The majority of post-transplant complications were acute rejection and infections.Annual transplant reached the peak in 2008 (n=114),and decreased sharply in 2006 (n=41) and 2010 (n=57).The percentage of pediatric KTx in total KTx was highest in 2007 (1.95%) and decreased to trough level in 2010 (1.0%).Living donation increased by 32.5-folds from 2004 to 2008 and then decreased by 86.6% till 2010.The percentage of living donation in pediatric or total KTx dynamically changed in a similar manner,while living donation ratio in pediatric KTx was much higher.Conclusions Kidney transplant can provide long-term benefits to pediatric recipients.Rejection and infections are worthy of concern during follow-up.Pediatric kidney transplant in China is very much lagging behind that in developed countries.Living donation played an important role in its development in the past decades.New strategies for implementation are encouraged to increase the priority of uremic children in organ allocation so as to

  1. Current status of pediatric kidney transplantation in China: data analysis of Chinese Scientific Registry of Kidney Transplantation.

    Science.gov (United States)

    Liu, Longshan; Zhang, Huanxi; Fu, Qian; Chen, Liping; Sun, Chuanhou; Xiong, Yunyi; Shi, Bingyi; Wang, Changxi

    2014-01-01

    Kidney transplantation (KTx) is the primary therapy for children with renal failure. Unlike KTx in adult patients, it is commonly agreed that pediatric KTx in China is far behind that of America. There has been no systematic analysis of Chinese pediatric KTx reported. This study aimed to demonstrate the current status of pediatric KTx in China. Registry data of pediatric KTx (1983-2012) from Chinese Scientific Registry of Kidney Transplantation (CSRKT) were retrospectively analyzed. There were 851 pediatric KTx from 102 transplant units. The recipients were (15.4±2.5) years of age, 93.9% of who were over 10 years old. Chronic glomerulonephritis and pyelonephritis accounted for 75.6% of recognized primary diseases. Allografts were from deceased donors (72.2%) or living donation (27.7%). The patient survival for 1, 3, 5, and 10 years was 96.9%, 94.2%, 92.3%, and 92.3% and the graft survival was 94.6%, 91.4%, 86.3%, and 79.2%, respectively. The majority of post-transplant complications were acute rejection and infections. Annual transplant reached the peak in 2008 (n = 114), and decreased sharply in 2006 (n = 41) and 2010 (n = 57). The percentage of pediatric KTx in total KTx was highest in 2007 (1.95%) and decreased to trough level in 2010 (1.0%). Living donation increased by 32.5-folds from 2004 to 2008 and then decreased by 86.6% till 2010. The percentage of living donation in pediatric or total KTx dynamically changed in a similar manner, while living donation ratio in pediatric KTx was much higher. Kidney transplant can provide long-term benefits to pediatric recipients. Rejection and infections are worthy of concern during follow-up. Pediatric kidney transplant in China is very much lagging behind that in developed countries. Living donation played an important role in its development in the past decades. New strategies for implementation are encouraged to increase the priority of uremic children in organ allocation so as to promote its progress in China.

  2. Direct Evidence for Neutrino Flavor Transformation from Neutral-Current Interactions in the Sudbury Neutrino Observatory

    CERN Document Server

    Ahmad, Q R; Andersen, T C; Anglin, J D; Barton, J C; Beier, E W; Bercovitch, M; Bigu, J; Biller, S D; Black, R A; Blevis, I; Boardman, R J; Boger, J; Bonvin, E; Boulay, M G; Bowler, M G; Bowles, T J; Brice, S J; Browne, M C; Bullard, T V; Buhler, G; Cameron, J; Chan, Y D; Chen, H H; Chen, M; Chen, X; Cleveland, B T; Clifford, E T H; Cowan, J H M; Cowen, D F; Cox, G A; Dai, X; Dalnoki-Veress, F; Davidson, W F; Doe, P J; Doucas, G; Dragowsky, M R; Duba, C A; Duncan, F A; Dunford, M; Dunmore, J A; Earle, E D; Elliott, S R; Evans, H C; Ewan, G T; Farine, J; Fergani, H; Ferraris, A P; Ford, R J; Formaggio, J A; Fowler, M M; Frame, K; Frank, E D; Frati, W; Gagnon, N; Germani, J V; Gil, S; Graham, K; Grant, D R; Hahn, R L; Hallin, A L; Hallman, E D; Hamer, A S; Hamian, A A; Handler, W B; Haq, R U; Hargrove, C K; Harvey, P J; Hazama, R; Heeger, K M; Heintzelman, W J; Heise, J; Helmer, R L; Hepburn, J D; Heron, H; Hewett, J L; Hime, A; Howe, M; Hykawy, J G; Isaac, M C P; Jagam, P; Jelley, N A; Jillings, C; Jonkmans, G; Kazkaz, K; Keener, P T; Klein, J R; Knox, A B; Komar, R J; Kouzes, R; Kutter, T; Kyba, C C M; Law, J; Lawson, I T; Lay, M; Lee, H W; Lesko, K T; Leslie, J R; Levine, I; Locke, W; Luoma, S; Lyon, J; Majerus, S; Mak, H B; Maneira, J; Manor, J; Marino, A D; McCauley, N; McDonald, A B; McDonald, D S; McFarlane, K; McGregor, G; Meijer-Drees, R; Miin, C; Miller, G G; Milton, G; Moffat, B A; Moorhead, M E; Nally, C W; Neubauer, M S; Newcomer, F M; Ng, H S; Noble, A J; Norman, E B; Novikov, V M; O'Neill, M; Okada, C E; Ollerhead, R W; Omori, Mamoru; Orrell, J L; Oser, S M; Poon, A W P; Radcliffe, T J; Roberge, A; Robertson, B C; Robertson, R G H; Rosendahl, S S E; Rowley, J K; Rusu, V L; Saettler, E; Schaffer, K K; Schwendener, M H; Schülke, A; Seifert, H; Shatkay, M; Simpson, J J; Sims, C J; Sinclair, D; Skensved, P; Smith, A R; Smith, M W E; Spreitzer, T; Starinsky, N; Steiger, T D; Stokstad, R G; Stonehill, L C; Storey, R S; Sur, B; Tafirout, R; Tagg, N; Tanner, N W; Taplin, R K; Thorman, M; Thornewell, P M; Trent, P T; Tserkovnyak, Y; Van Berg, R; Van de Water, R G; Virtue, C J; Waltham, C E; Wang, J X; Wark, D L; West, N; Wilhelmy, J B; Wilkerson, J F; Wilson, J R; Wittich, P; Wouters, J M; Yeh, M

    2002-01-01

    Observations of neutral current neutrino interactions on deuterium in the Sudbury Neutrino Observatory are reported. Using the neutral current, elastic scattering, and charged current reactions and assuming the standard 8B shape, the electron-neutrino component of the 8B solar flux is 1.76 +/-0.05(stat.)+/-0.09(syst.) x10^6/(cm^2 s), for a kinetic energy threshold of 5 MeV. The non-electron neutrino component is 3.41+/-0.45(stat.)+0.48,-0.45(syst.) x10^6/(cm^2 s), 5.3 standard deviations greater than zero, providing strong evidence for solar electron neutrino flavor transformation. The total flux measured with the NC reaction is 5.09 +0.44,-0.43(stat.)+0.46,-0.43(syst.)x10^6/(cm^2 s), consistent with solar models.

  3. Chest Pain of Suspected Cardiac Origin: Current Evidence-based Recommendations for Prehospital Care

    Directory of Open Access Journals (Sweden)

    P. Brian Savino

    2015-12-01

    Full Text Available Introduction: In the United States, emergency medical services (EMS protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of chest pain of suspected cardiac origin and to compare these recommendations against the current protocols used by the 33 EMS agencies in the state of California. Methods: We performed a literature review of the current evidence in the prehospital treatment of chest pain and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the chest pain protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were use of supplemental oxygen, aspirin, nitrates, opiates, 12-lead electrocardiogram (ECG, ST segment elevation myocardial infarction (STEMI regionalization systems, prehospital fibrinolysis and β-blockers. Results: The protocols varied widely in terms of medication and dosing choices, as well as listed contraindications to treatments. Every agency uses oxygen with 54% recommending titrated dosing. All agencies use aspirin (64% recommending 325mg, 24% recommending 162mg and 15% recommending either, as well as nitroglycerin and opiates (58% choosing morphine. Prehospital 12- Lead ECGs are used in 97% of agencies, and all but one agency has some form of regionalized care for their STEMI patients. No agency is currently employing prehospital fibrinolysis or β-blocker use. Conclusion: Protocols for chest pain of suspected cardiac origin vary widely across California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols.

  4. Is Parental Alienation Disorder a Valid Concept? Not According to Scientific Evidence. A Review of "Parental Alienation, DSM-5 and ICD-11" by William Bernet

    Science.gov (United States)

    Pepiton, M. Brianna; Alvis, Lindsey J.; Allen, Kenneth; Logid, Gregory

    2012-01-01

    This article reviews a recent book arguing how a concept known as parental alienation syndrome--now parental alienation disorder--should be included in official psychiatric/psychological and medical classification diagnostic manuals. Anecdotal cases and opinion are presented as research and scientific evidence, and stories are presented as…

  5. Representation and misrepresentation of scientific evidence in contemporary tobacco regulation: a review of tobacco industry submissions to the UK Government consultation on standardised packaging.

    Directory of Open Access Journals (Sweden)

    Selda Ulucanlar

    2014-03-01

    Full Text Available Standardised packaging (SP of tobacco products is an innovative tobacco control measure opposed by transnational tobacco companies (TTCs whose responses to the UK government's public consultation on SP argued that evidence was inadequate to support implementing the measure. The government's initial decision, announced 11 months after the consultation closed, was to wait for 'more evidence', but four months later a second 'independent review' was launched. In view of the centrality of evidence to debates over SP and TTCs' history of denying harms and manufacturing uncertainty about scientific evidence, we analysed their submissions to examine how they used evidence to oppose SP.We purposively selected and analysed two TTC submissions using a verification-oriented cross-documentary method to ascertain how published studies were used and interpretive analysis with a constructivist grounded theory approach to examine the conceptual significance of TTC critiques. The companies' overall argument was that the SP evidence base was seriously flawed and did not warrant the introduction of SP. However, this argument was underpinned by three complementary techniques that misrepresented the evidence base. First, published studies were repeatedly misquoted, distorting the main messages. Second, 'mimicked scientific critique' was used to undermine evidence; this form of critique insisted on methodological perfection, rejected methodological pluralism, adopted a litigation (not scientific model, and was not rigorous. Third, TTCs engaged in 'evidential landscaping', promoting a parallel evidence base to deflect attention from SP and excluding company-held evidence relevant to SP. The study's sample was limited to sub-sections of two out of four submissions, but leaked industry documents suggest at least one other company used a similar approach.The TTCs' claim that SP will not lead to public health benefits is largely without foundation. The tools of Better

  6. Representation and misrepresentation of scientific evidence in contemporary tobacco regulation: a review of tobacco industry submissions to the UK Government consultation on standardised packaging.

    Science.gov (United States)

    Ulucanlar, Selda; Fooks, Gary J; Hatchard, Jenny L; Gilmore, Anna B

    2014-03-01

    Standardised packaging (SP) of tobacco products is an innovative tobacco control measure opposed by transnational tobacco companies (TTCs) whose responses to the UK government's public consultation on SP argued that evidence was inadequate to support implementing the measure. The government's initial decision, announced 11 months after the consultation closed, was to wait for 'more evidence', but four months later a second 'independent review' was launched. In view of the centrality of evidence to debates over SP and TTCs' history of denying harms and manufacturing uncertainty about scientific evidence, we analysed their submissions to examine how they used evidence to oppose SP. We purposively selected and analysed two TTC submissions using a verification-oriented cross-documentary method to ascertain how published studies were used and interpretive analysis with a constructivist grounded theory approach to examine the conceptual significance of TTC critiques. The companies' overall argument was that the SP evidence base was seriously flawed and did not warrant the introduction of SP. However, this argument was underpinned by three complementary techniques that misrepresented the evidence base. First, published studies were repeatedly misquoted, distorting the main messages. Second, 'mimicked scientific critique' was used to undermine evidence; this form of critique insisted on methodological perfection, rejected methodological pluralism, adopted a litigation (not scientific) model, and was not rigorous. Third, TTCs engaged in 'evidential landscaping', promoting a parallel evidence base to deflect attention from SP and excluding company-held evidence relevant to SP. The study's sample was limited to sub-sections of two out of four submissions, but leaked industry documents suggest at least one other company used a similar approach. The TTCs' claim that SP will not lead to public health benefits is largely without foundation. The tools of Better Regulation

  7. [Psiconeurophysiologic bases of the placebo-nocebo phenomenon: scientific evidences that value the humanization of the doctor-patient relationship].

    Science.gov (United States)

    Teixeira, Marcus Zulian

    2009-01-01

    Aspect quite valued in the medical systems of all of the times, the doctor-patient relationship assumed secondary importance in the current biomedical model, depriving the modern therapeutic arsenal of a psyconeurophisiological intervention capable to complement the resolution of many organic disturbances. With the intention of rescuing this and other benefits, countless proposed by the humanization of the medicine have been appearing in the several sections of the health, remaining to scientific thought accept that this subjective relational increment can increase the effectiveness of the conventional treatments. Working as sensitization element, the recent experimental studies illustrate the possible benefits or harms that a doctor-patient relationship more or less humanized can provoke in the evolution of the diseases. Uniting the theories of classical conditioning and conscious expectation, the researches suggest that the doctor's posture, permeated by positive or negative manifestations (comments, suggestions, attitudes etc.), it can exercise similar influences in the patients' psyche, unchaining favorable or unfavorable neurophysiologic answers, acting as therapeutic or iatrogenic instrument, respectively.

  8. [Evaluation of scientific production in different subareas of Public Health: limits of the current model and contributions to the debate].

    Science.gov (United States)

    Iriart, Jorge Alberto Bernstein; Deslandes, Suely Ferreira; Martin, Denise; Camargo Jr, Kenneth Rochel de; Carvalho, Marilia Sá; Coeli, Cláudia Medina

    2015-10-01

    The aim of this study was to discuss the limits of the quantitative evaluation model for scientific production in Public Health. An analysis of the scientific production of professors from the various subareas of Public Health was performed for 2010-2012. Distributions of the mean annual score for professors were compared according to subareas. The study estimated the likelihood that 60% of the professors in the graduate studies programs scored P50 (Very Good) or higher in their area. Professors of Epidemiology showed a significantly higher median annual score. Graduate studies programs whose faculty included at least 60% of Epidemiology professors and fewer than 10% from the subarea Social and Human Sciences in Health were significantly more likely to achieve a "Very Good" classification. The observed inequalities in scientific production between different subareas of Public Health point to the need to rethink their evaluation in order to avoid reproducing iniquities that have harmful consequences for the field's diversity.

  9. Breast-Feeding Analgesia in Infants: An Update on the Current State of Evidence.

    Science.gov (United States)

    Benoit, Britney; Martin-Misener, Ruth; Latimer, Margot; Campbell-Yeo, Marsha

    To provide an updated synthesis of the current state of the evidence for the effectiveness of breast-feeding and expressed breast milk feeding in reducing procedural pain in preterm and full-term born infants. A systematic search of key electronic databases (PubMed, CINAHL, EMBASE) was completed. Of the 1032 abstracts screened, 21 were found eligible for inclusion. Fifteen studies reported on the use of breast-feeding or expressed breast milk in full-term infants and 6 reported on preterm infants. Direct breast-feeding was more effective than maternal holding, maternal skin-to-skin contact, topical anesthetics, and music therapy, and was as or more effective than sweet tasting solutions in full-term infants. Expressed breast milk was not consistently found to reduce pain response in full-term or preterm infants. Studies generally had moderate to high risk of bias. There is sufficient evidence to recommend direct breast-feeding for procedural pain management in full-term infants. Based on current evidence, expressed breast milk alone should not be considered an adequate intervention.

  10. Can scientific evidence support using Bangladeshi traditional medicinal plants in the treatment of diarrhoea? A review on seven plants.

    Science.gov (United States)

    Wangensteen, Helle; Klarpås, Line; Alamgir, Mahiuddin; Samuelsen, Anne B C; Malterud, Karl E

    2013-05-22

    Diarrhoea is a common disease which causes pain and may be deadly, especially in developing countries. In Bangladesh, diarrhoeal diseases affect thousands of people every year, and children are especially vulnerable. Bacterial toxins or viral infections are the most common cause of the disease. The diarrhoea outbreaks are often associated with flood affected areas with contaminated drinking water and an increased risk of spreading the water-borne disease. Not surprisingly, plants found in the near surroundings have been taken into use by the local community as medicine to treat diarrhoeal symptoms. These plants are cheaper and more easily available than conventional medicine. Our question is: What is the level of documentation supporting the use of these plants against diarrhoea and is their consumption safe? Do any of these plants have potential for further exploration? In this review, we have choosen seven plant species that are used in the treatment of diarrhoea; Diospyros peregrina, Heritiera littoralis, Ixora coccinea, Pongamia pinnata, Rhizophora mucronata, Xylocarpus granatum, and Xylocarpus moluccensis. Appearance and geographical distribution, traditional uses, chemical composition, and biological studies related to antidiarrhoeal activity will be presented. This review reveals that there is limited scientific evidence supporting the traditional use of these plants. Most promising are the barks from D. peregrina, X. granatum and X. moluccensis which contain tannins and have shown promising results in antidiarrhoeal mice models. The leaves of P. pinnata also show potential. We suggest these plants should be exploited further as possible traditional herbal remedies against diarrhoea including studies on efficacy, optimal dosage and safety.

  11. Complementary Medicine, Exercise, Meditation, Diet, and Lifestyle Modification for Anxiety Disorders: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    J. Sarris

    2012-01-01

    Full Text Available Use of complementary medicines and therapies (CAM and modification of lifestyle factors such as physical activity, exercise, and diet are being increasingly considered as potential therapeutic options for anxiety disorders. The objective of this metareview was to examine evidence across a broad range of CAM and lifestyle interventions in the treatment of anxiety disorders. In early 2012 we conducted a literature search of PubMed, Scopus, CINAHL, Web of Science, PsycInfo, and the Cochrane Library, for key studies, systematic reviews, and metaanalyses in the area. Our paper found that in respect to treatment of generalized anxiety or specific disorders, CAM evidence revealed current support for the herbal medicine Kava. One isolated study shows benefit for naturopathic medicine, whereas acupuncture, yoga, and Tai chi have tentative supportive evidence, which is hampered by overall poor methodology. The breadth of evidence does not support homeopathy for treating anxiety. Strong support exists for lifestyle modifications including adoption of moderate exercise and mindfulness meditation, whereas dietary improvement, avoidance of caffeine, alcohol, and nicotine offer encouraging preliminary data. In conclusion, certain lifestyle modifications and some CAMs may provide a beneficial role in the treatment of anxiety disorders.

  12. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas.

    Science.gov (United States)

    Hoffman, Aubri S; Volk, Robert J; Saarimaki, Anton; Stirling, Christine; Li, Linda C; Härter, Martin; Kamath, Geetanjali R; Llewellyn-Thomas, Hilary

    2013-01-01

    In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension-the delivery of patient decision aids on the Internet-is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. As of 2012, the updated theoretical rationale and emerging evidence suggest potential benefits to delivering patient decision aids on the Internet. However, additional research is needed to identify best practices and quality metrics for Internet-based development, evaluation, and dissemination, particularly in the areas of interactivity, multimedia components, socially-generated information, and implementation strategies.

  13. A Systemic View of the Learning and Differentiation of Scientific Concepts: The Case of Electric Current and Voltage Revisited

    Science.gov (United States)

    Koponen, Ismo T.; Kokkonen, Tommi

    2014-01-01

    In learning conceptual knowledge in physics, a common problem is the incompleteness of a learning process, where students' personal, often undifferentiated concepts take on more scientific and differentiated form. With regard to such concept learning and differentiation, this study proposes a systemic view in which concepts are considered as…

  14. Omega-3 Fatty Acids in Modern Parenteral Nutrition: A Review of the Current Evidence.

    Science.gov (United States)

    Klek, Stanislaw

    2016-03-07

    Intravenous lipid emulsions are an essential component of parenteral nutrition regimens. Originally employed as an efficient non-glucose energy source to reduce the adverse effects of high glucose intake and provide essential fatty acids, lipid emulsions have assumed a larger therapeutic role due to research demonstrating the effects of omega-3 and omega-6 polyunsaturated fatty acids (PUFA) on key metabolic functions, including inflammatory and immune response, coagulation, and cell signaling. Indeed, emerging evidence suggests that the effects of omega-3 PUFA on inflammation and immune response result in meaningful therapeutic benefits in surgical, cancer, and critically ill patients as well as patients requiring long-term parenteral nutrition. The present review provides an overview of the mechanisms of action through which omega-3 and omega-6 PUFA modulate the immune-inflammatory response and summarizes the current body of evidence regarding the clinical and pharmacoeconomic benefits of intravenous n-3 fatty acid-containing lipid emulsions in patients requiring parenteral nutrition.

  15. Foot orthoses for pediatric flexible flatfoot: evidence and current practices among Canadian physical therapists.

    Science.gov (United States)

    Kane, Kyra

    2015-01-01

    This study aimed to examine the evidence for flatfoot intervention in children with gross motor delay of neurological origin, and to understand how physical therapists use foot orthoses (FOs) to treat this population. Thirty-four physical therapists employed in Canadian publicly funded pediatric centers were surveyed to explore current practices and beliefs related to FOs. Responses are discussed in the context of the research literature. Objective physical examination and differentiation between developmental and pathological flatfeet can help clinicians to identify suitable FO candidates, monitor foot posture over time, and evaluate treatment effectiveness. An evidence-informed approach to assessment and intervention has the potential to improve clinical outcomes for clients with pediatric flatfoot.

  16. Whole dairy matrix or single nutrients in assessment of health effects: current evidence and knowledge gaps.

    Science.gov (United States)

    Thorning, Tanja Kongerslev; Bertram, Hanne Christine; Bonjour, Jean-Philippe; de Groot, Lisette; Dupont, Didier; Feeney, Emma; Ipsen, Richard; Lecerf, Jean Michel; Mackie, Alan; McKinley, Michelle C; Michalski, Marie-Caroline; Rémond, Didier; Risérus, Ulf; Soedamah-Muthu, Sabita S; Tholstrup, Tine; Weaver, Connie; Astrup, Arne; Givens, Ian

    2017-04-12

    Foods consist of a large number of different nutrients that are contained in a complex structure. The nature of the food structure and the nutrients therein (i.e., the food matrix) will determine the nutrient digestion and absorption, thereby altering the overall nutritional properties of the food. Thus, the food matrix may exhibit a different relation with health indicators compared to single nutrients studied in isolation. The evidence for a dairy matrix effect was presented and discussed by an expert panel at a closed workshop, and the following consensus was reached: 1) Current evidence does not support a positive association between intake of dairy products and risk of cardiovascular disease (i.e., stroke and coronary heart disease) and type 2 diabetes. In contrast, fermented dairy products, such as cheese and yogurt, generally show inverse associations. 2) Intervention studies have indicated that the metabolic effects of whole dairy may be different than those of single dairy constituents when considering the effects on body weight, cardiometabolic disease risk, and bone health. 3) Different dairy products seem to be distinctly linked to health effects and disease risk markers. 4) Different dairy structures and common processing methods may enhance interactions between nutrients in the dairy matrix, which may modify the metabolic effects of dairy consumption. 5) In conclusion, the nutritional values of dairy products should not be considered equivalent to their nutrient contents but, rather, be considered on the basis of the biofunctionality of the nutrients within dairy food structures. 6) Further research on the health effects of whole dairy foods is warranted alongside the more traditional approach of studying the health effects of single nutrients. Future diet assessments and recommendations should carefully consider the evidence of the effects of whole foods alongside the evidence of the effects of individual nutrients. Current knowledge gaps and

  17. Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Taraka V. Gadiraju

    2015-10-01

    Full Text Available Fried food consumption and its effects on cardiovascular disease are still subjects of debate. The objective of this review was to summarize current evidence on the association between fried food consumption and cardiovascular disease, diabetes, hypertension and obesity and to recommend directions for future research. We used PubMed, Google Scholar and Medline searches to retrieve pertinent publications. Most available data were based on questionnaires as a tool to capture fried food intakes, and study design was limited to case-control and cohort studies. While few studies have reported a positive association between frequencies of fried food intake and risk of coronary artery disease, heart failure, diabetes or hypertension, other investigators have failed to confirm such an association. There is strong evidence suggesting a higher risk of developing chronic disease when fried foods are consumed more frequently (i.e., four or more times per week. Major gaps in the current literature include a lack of detailed information on the type of oils used for frying foods, stratification of the different types of fried food, frying procedure (deep and pan frying, temperature and duration of frying, how often oils were reused and a lack of consideration of overall dietary patterns. Besides addressing these gaps, future research should also develop tools to better define fried food consumption at home versus away from home and to assess their effects on chronic diseases. In summary, the current review provides enough evidence to suggest adverse health effects with higher frequency of fried food consumption. While awaiting confirmation from future studies, it may be advisable to the public to consume fried foods in moderation while emphasizing an overall healthy diet.

  18. Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence.

    Science.gov (United States)

    Gadiraju, Taraka V; Patel, Yash; Gaziano, J Michael; Djoussé, Luc

    2015-10-06

    Fried food consumption and its effects on cardiovascular disease are still subjects of debate. The objective of this review was to summarize current evidence on the association between fried food consumption and cardiovascular disease, diabetes, hypertension and obesity and to recommend directions for future research. We used PubMed, Google Scholar and Medline searches to retrieve pertinent publications. Most available data were based on questionnaires as a tool to capture fried food intakes, and study design was limited to case-control and cohort studies. While few studies have reported a positive association between frequencies of fried food intake and risk of coronary artery disease, heart failure, diabetes or hypertension, other investigators have failed to confirm such an association. There is strong evidence suggesting a higher risk of developing chronic disease when fried foods are consumed more frequently (i.e., four or more times per week). Major gaps in the current literature include a lack of detailed information on the type of oils used for frying foods, stratification of the different types of fried food, frying procedure (deep and pan frying), temperature and duration of frying, how often oils were reused and a lack of consideration of overall dietary patterns. Besides addressing these gaps, future research should also develop tools to better define fried food consumption at home versus away from home and to assess their effects on chronic diseases. In summary, the current review provides enough evidence to suggest adverse health effects with higher frequency of fried food consumption. While awaiting confirmation from future studies, it may be advisable to the public to consume fried foods in moderation while emphasizing an overall healthy diet.

  19. Screening for Maternal Thyroid Dysfunction in Pregnancy: A Review of the Clinical Evidence and Current Guidelines

    Directory of Open Access Journals (Sweden)

    Donny L. F. Chang

    2013-01-01

    Full Text Available Observational studies have demonstrated that maternal thyroid dysfunction and thyroid autoimmunity in pregnancy may be associated with adverse obstetric and fetal outcomes. Treatment of overt maternal hyperthyroidism and overt hypothyroidism clearly improves outcomes. To date there is limited evidence that levothyroxine treatment of pregnant women with subclinical hypothyroidism, isolated hypothyroxinemia, or thyroid autoimmunity is beneficial. Therefore, there is ongoing debate regarding the need for universal screening for thyroid dysfunction during pregnancy. Current guidelines differ; some recommend an aggressive case-finding approach, whereas others advocate testing only symptomatic women or those with a personal history of thyroid disease or other associated medical conditions.

  20. Clostridium difficile infection in children with inflammatory bowel disease: current evidence.

    Science.gov (United States)

    Banaszkiewicz, Aleksandra; Pituch, Hanna

    2014-01-01

    Inflammatory bowel disease (IBD) is a chronic, immune-mediated disease of the gastrointestinal tract that develops in genetically susceptible individuals. Questions about the role of infections in the development and exacerbations of inflammatory bowel disease remain unanswered. Among numerous bacteria that have been linked to IBD, the most frequently associated is Clostridium difficile. Clinical symptoms of C. difficile infection and an exacerbation of inflammatory bowel disease are often indistinguishable. In cases of diarrhea in patients with IBD and C. difficile infection, antibiotic treatment is recommended. This review attempts to summarize C. difficile infection's epidemiology and clinical features and describes current evidence on treatment of C. difficile infection in children with IBD.

  1. Cytidine 5'-Diphosphocholine (Citicoline) in Glaucoma: Rationale of Its Use, Current Evidence and Future Perspectives.

    Science.gov (United States)

    Roberti, Gloria; Tanga, Lucia; Michelessi, Manuele; Quaranta, Luciano; Parisi, Vincenzo; Manni, Gianluca; Oddone, Francesco

    2015-11-30

    Cytidine 5'-diphosphocholine or citicoline is an endogenous compound that acts in the biosynthetic pathway of phospholipids of cell membranes, particularly phosphatidylcholine, and it is able to increase neurotrasmitters levels in the central nervous system. Citicoline has shown positive effects in Parkinson's disease and Alzheimer's disease, as well as in amblyopia. Glaucoma is a neurodegenerative disease currently considered a disease involving ocular and visual brain structures. Neuroprotection has been proposed as a valid therapeutic option for those patients progressing despite a well-controlled intraocular pressure, the main risk factor for the progression of the disease. The aim of this review is to critically summarize the current evidence about the effect of citicoline in glaucoma.

  2. Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Perspective on Current Evidence and Clinical Knowledge

    Directory of Open Access Journals (Sweden)

    Ali Habib

    2012-01-01

    Full Text Available This paper reviews the current published data regarding open transforaminal lumbar interbody fusion (TLIF in relation to minimally invasive transforaminal lumbar interbody fusion (MI-TLIF. Introduction. MI-TLIF, a modern method for lumbar interbody arthrodesis, has allowed for a minimally invasive method to treat degenerative spinal pathologies. Currently, there is limited literature that compares TLIF directly to MI-TLIF. Thus, we seek to discuss the current literature on these techniques. Methods. Using a PubMed search, we reviewed recent publications of open and MI-TLIF, dating from 2002 to 2012. We discussed these studies and their findings in this paper, focusing on patient-reported outcomes as well as complications. Results. Data found in 14 articles of the literature was analyzed. Using these reports, we found mean follow-up was 20 months. The mean patient study size was 52. Seven of the articles directly compared outcomes of open TLIF with MI-TLIF, such as mean duration of surgery, length of post-operative stay, blood loss, and complications. Conclusion. Although high-class data comparing these two techniques is lacking, the current evidence supports MI-TLIF with outcomes comparable to that of the traditional, open technique. Further prospective, randomized studies will help to further our understanding of this minimally invasive technique.

  3. Does breastfeeding influence the risk of developing diabetes mellitus in children? A review of current evidence

    Directory of Open Access Journals (Sweden)

    Patricia Feliciano Pereira

    2014-01-01

    Full Text Available OBJECTIVE: The aim of this study was to perform a review to investigate the influence of breastfeeding as a protective agent against the onset of diabetes in children. SOURCES: Non-systematic review of SciELO, LILACS, MEDLINE, Scopus, and VHL databases, and selection of the 52 most relevant studies. A total of 21 articles, specifically on the topic, were analyzed (nine related to type 1 diabetes and 12 to type 2 diabetes. DATA SYNTHESIS: The duration and exclusivity of breastfeeding, as well as the early use of cow's milk, have been shown to be important risk factors for developing diabetes. It is believed that human milk contains substances that promote the maturation of the immune system, which protect against the onset of type 1 diabetes. Moreover, human milk has bioactive substances that promote satiety and energy balance, preventing excess weight gain during childhood, thus protecting against the development of type 2 diabetes. Although the above mentioned benefits have not been observed by some researchers, inaccuracies on dietary habit reports during childhood and the presence of interfering factors have been considered responsible for the lack of identification of beneficial effects. CONCLUSION: Given the scientific evidence indicated in most published studies, it is believed that the lack of breastfeeding can be a modifiable risk factor for both type 1 and type 2 diabetes. Strategies aiming at the promotion and support of breastfeeding should be used by trained healthcare professionals in order to prevent the onset of diabetes.

  4. Cellulite treatment: evidence and ethics, brief history, and emphasis on current practices including liposuction

    Science.gov (United States)

    de Riese, Cornelia

    2005-04-01

    According to Taber's Cyclopedic Medical Dictionary "cellulite" is defined as: "a non-technical term for subcutaneous deposits of fat, especially in the buttocks, legs, and thighs." These deposits result in puckered, dimply skin and they are a cause for major aesthetic concerns in affected patients. The etiology of this condition is still unclear. Female predilection is witnessed in clinical practice as it is reported in the literature. It remains a subject for further studies whether it is a structural problem of connective tissue or as suggested probably related to hormonal causes. Magnetic resonance imaging may provide some answers to these questions. Not knowing what is causing this nuisance makes it almost impossible to treat. No wonder that there is little scientific validation to support any of the many treatments that are advertised on the Internet or in women's magazines. This review focuses on mechanical and microinvasive interventions that claim to alleviate "cellulite": lipoplasty, liposcultpure, liposuction, subcision, and laser. Among the parameters analyzed are the proposed modes of action of these techniques as well as adverse events and complications that may occur. Of special interest will be the evidence that backs these procedures. Extracting reliable data is hampered by methodical problems with the design of most of the published trials. In essence, at this time there is no "cure" for cellulite. Safe treatment recommendations are related to healthy life style choices that include toning exercises, dietary changes, and weight loss.

  5. Current Thoughts on Fat Grafting: Using the Evidence to Determine Fact or Fiction.

    Science.gov (United States)

    Sinno, Sammy; Wilson, Stelios; Brownstone, Nicholas; Levine, Steven M

    2016-03-01

    Autologous fat grafting is an increasingly popular procedure used for facial rejuvenation and body contouring. The purpose of this article is to perform an evidence-based review to determine fact from fiction for the hot topics in autologous fat grafting. A comprehensive literature search was performed. The following key words were then searched: "fat grafting," "autologous fat grafting," "autologous fat transfer," "lipotransfer," "liposculping," and "lipofilling." The authors then assessed each modality individually for the level of evidence that exists and whether the majority of evidence supports or refutes it. A review of the literature demonstrated that there is no standard test for determining fat viability or volume augmentation after grafting. Furthermore, there is no difference in cell viability seen between syringe aspiration and liposuction pump aspiration harvest techniques (Level II). The decision to wash or centrifuge the fat plays very little role in fat graft survival (Level III). There is no difference between cell viability as a function of harvest location (Level IV). Nearly all studies show no significant effect of local anesthesia on adipocyte cells (Level IV). There are excellent data that support the fact that low-shear devices maintain fat structural integrity (Level IV). There is quality evidence that supports longevity of fat grafted to the breast (Level III). Two studies support large-volume fat grafting longevity but fail to prove their results using objective measures or with sufficiently large sample sizes (Level IV). External preexpansion devices improve total graft survival rate (Level IV). There is quality evidence to support that fat should be injected soon after harvesting, as properties of fat begin to change after processing (Level IV). Microneedling (preconditioning) before fat grafting has been demonstrated to improve fat survival (Level III). Currently, the highest levels of evidence derive from human studies of clinical

  6. Specification of laboratory animal use in scientific articles: current low detail in the journals' instructions for authors and some proposals.

    Science.gov (United States)

    Alfaro, V

    2005-09-01

    The scientific article communicates results of research to other investigators; therefore, it must contain a complete description of the experiment to help other researchers when designing their future investigations. However, poorly detailed data on laboratory animal use is given in published articles. Despite the well-known and important contribution of the International Committee of Medical Journal Editors (ICMJE) to standardize scientific writing and submission of manuscripts to biomedical journals, no specific instructions on the reporting of animal use are given in the ICMJE Uniform Requirements and, therefore, most journals do not detail this to the authors. Individual efforts from groups like the Working Committee for the Biological Characterizations of Laboratory Animals, the Boyd Group, or the Committee on Publication Ethics are commendable. These contributions should be incorporated into the ICMJE Uniform Requirements and, later, into the Instructions for Authors of peer-reviewed journals. This would be the only efficient way to instruct authors on how to report laboratory animal use in their submitted manuscripts. The present article relates some proposals for helping authors when reporting animal use in scientific articles. These proposals are not only based on previous guidelines for animal specifications, but also on Instructions for Authors from journals specialized in Laboratory Animal Science. These proposals are classified into major and minor issues, and they are located in the corresponding parts of the article, as defined by the Introduction, Methods, Results, and Discussion (IMRAD) method. (c) 2005 Prous Science. All rights reserved.

  7. Do we have enough evidence for minimally-invasive cardiac surgery? A critical review of scientific and non-scientific information.

    Science.gov (United States)

    Doenst, Torsten; Lamelas, Joseph

    2017-08-01

    Reducing surgical trauma by minimizing skin incisions has transformed abdominal surgery resulting in significant improvements in outcome. In cardiac surgery, such efforts have also been made, but similar benefits could not be demonstrated. In addition, any potential benefit comes at the cost of increased cardiopulmonary bypass and clamp times, leading to questions regarding the safety of minimally invasive cardiac surgery (MICS). Nevertheless, outcomes have been equivalent to matched sternotomy cases and there is no doubt that the number of patients undergoing minimally-invasive mitral or aortic procedures is slowly increasing. To date almost half of all isolated mitral cases in Germany and roughly one fourth in the USA are performed through a minimized access. These numbers were less than half 10 years ago. So how can this development be justified, if the evidence for it seems to be questionable or even missing? We will attempt to provide some answers to this question by critically reviewing the available publications and by looking at the topic from other perspectives, including from a competitive and a patient standpoint. We will conclude that there is enough evidence to support minimally-invasive access as the primary approach to a valve in the majority of patients. We will further suggest that modern cardiac surgery may have difficulties to prevail in its full width, if these novel techniques are not embraced. Finally, we will demonstrate that minimally invasive cardiac surgery is associated with substantial improvements in patient care, however, in areas that are unlikely to be tested with randomized controlled trials.

  8. Subcutaneous immunoglobulin therapy for inflammatory neuropathy: current evidence base and future prospects.

    Science.gov (United States)

    Rajabally, Yusuf A

    2014-06-01

    Intravenous immunoglobulin therapy is of proven effect in chronic inflammatory neuropathies, including chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). In more recent years, there have been a number of anecdotal case reports and small series, followed by a few trials of variable design, of subcutaneous immunoglobulin therapy in these neuropathies. To date, limited evidence suggests that the subcutaneous route may be a more clinically effective, better-tolerated, at least cost-equivalent and a more patient-friendly option than the still more used intravenous alternative. Long-term efficacy is not as yet established in neuropathic indications by randomised controlled clinical trial evidence, and it is likely that the subcutaneous route may not be suitable in all cases with some hints to this effect appearing from the limited data available to date. Further studies are ongoing, including those of dose comparison, and more are likely to be planned in future. The literature on the use of subcutaneous immunoglobulin therapy in chronic inflammatory neuropathy is reviewed here. The current use in clinical practice, day-to-day benefits, including quality of life measures and health economics as published thus far, are evaluated. The limitations of this form of treatment in CIDP and MMN are also analysed in the light of current literature and taking into account the remaining unknowns. Future prospects and research with this mode of immunoglobulin therapy administration are discussed.

  9. Vitamin E in Sarcopenia: Current Evidences on Its Role in Prevention and Treatment

    Directory of Open Access Journals (Sweden)

    Shy Cian Khor

    2014-01-01

    Full Text Available Sarcopenia is a geriatric syndrome that is characterized by gradual loss of muscle mass and strength with increasing age. Although the underlying mechanism is still unknown, the contribution of increased oxidative stress in advanced age has been recognized as one of the risk factors of sarcopenia. Thus, eliminating reactive oxygen species (ROS can be a strategy to combat sarcopenia. In this review, we discuss the potential role of vitamin E in the prevention and treatment of sarcopenia. Vitamin E is a lipid soluble vitamin, with potent antioxidant properties and current evidence suggesting a role in the modulation of signaling pathways. Previous studies have shown its possible beneficial effects on aging and age-related diseases. Although there are evidences suggesting an association between vitamin E and muscle health, they are still inconclusive compared to other more extensively studied chronic diseases such as neurodegenerative diseases and cardiovascular diseases. Therefore, we reviewed the role of vitamin E and its potential protective mechanisms on muscle health based on previous and current in vitro and in vivo studies.

  10. Vitamin E in Sarcopenia: Current Evidences on Its Role in Prevention and Treatment

    Science.gov (United States)

    Abdul Karim, Norwahidah; Wan Ngah, Wan Zurinah

    2014-01-01

    Sarcopenia is a geriatric syndrome that is characterized by gradual loss of muscle mass and strength with increasing age. Although the underlying mechanism is still unknown, the contribution of increased oxidative stress in advanced age has been recognized as one of the risk factors of sarcopenia. Thus, eliminating reactive oxygen species (ROS) can be a strategy to combat sarcopenia. In this review, we discuss the potential role of vitamin E in the prevention and treatment of sarcopenia. Vitamin E is a lipid soluble vitamin, with potent antioxidant properties and current evidence suggesting a role in the modulation of signaling pathways. Previous studies have shown its possible beneficial effects on aging and age-related diseases. Although there are evidences suggesting an association between vitamin E and muscle health, they are still inconclusive compared to other more extensively studied chronic diseases such as neurodegenerative diseases and cardiovascular diseases. Therefore, we reviewed the role of vitamin E and its potential protective mechanisms on muscle health based on previous and current in vitro and in vivo studies. PMID:25097722

  11. Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review

    Directory of Open Access Journals (Sweden)

    Patrícia do Carmo Silva Parreira

    2014-03-01

    Full Text Available Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the addition of Kinesio Taping to other interventions more effective than other interventions alone in people with musculoskeletal conditions? Design: Systematic review of randomised trials. Participants: People with musculoskeletal conditions. Intervention: Kinesio Taping was compared with sham taping/placebo, no treatment, exercises, manual therapy and conventional physiotherapy. Outcome measures: Pain intensity, disability, quality of life, return to work, and global impression of recovery. Results: Twelve randomised trials involving 495 participants were included in the review. The effectiveness of the Kinesio Taping was tested in participants with: shoulder pain in two trials; knee pain in three trials; chronic low back pain in two trials; neck pain in three trials; plantar fasciitis in one trial; and multiple musculoskeletal conditions in one trial. The methodological quality of eligible trials was moderate, with a mean of 6.1 points on the 10-point PEDro Scale score. Overall, Kinesio Taping was no better than sham taping/placebo and active comparison groups. In all comparisons where Kinesio Taping was better than an active or a sham control group, the effect sizes were small and probably not clinically significant or the trials were of low quality. Conclusion: This review provides the most updated evidence on the effectiveness of the Kinesio Taping for musculoskeletal conditions. The current evidence does not support the use of this intervention in these clinical populations. PROSPERO registration: CRD42012003436. [Parreira PdCS, Costa LdCM, Hespanhol Junior LC, Lopes AD, Costa LOP (2014 Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. Journal of Physiotherapy 60: 31–39

  12. Calcium hydroxide: study based on scientific evidences Hidróxido de cálcio: estudo baseado em evidências científicas

    Directory of Open Access Journals (Sweden)

    Carlos Estrela

    2003-12-01

    Full Text Available The characteristics of calcium hydroxide come from its dissociation into calcium and hydroxyl ions. The action of these ions on tissues and bacteria explains the biological and antimicrobial properties of this substance. Under the conditions of this retrospective of literature, based on scientific evidences, it is possible to state that: 1. Dentin is considered the best pulpal protective, and calcium hydroxide has proved, through numerous studies, its capability of inducing the formation of a mineralized bridge over pulpal tissue. 2. It is necessary, whenever possible, to provide time for calcium hydroxide paste to manifest its potential of action on the microorganisms present in endodontic infections. The maintenance of a high concentration of hydroxyl ions can change bacteria enzymatic activity and promote its inactivation. 3. The site of action of hydroxyl ions of calcium hydroxide includes the enzymes in the cytoplasmic membrane. This medication has a large scope of action, and therefore is effective on a wide range of microorganisms, regardless their metabolic capability. In microbial world, cytoplasmic membranes are similar, irrespective from microorganisms morphological, tinctorial and respiratory characteristics, which means that this medication has a similar effect on aerobic, anaerobic, Gram-positive and Gram-negative bacteria. 4. Calcium hydroxide as temporary dressing used between appointments promotes better results on the periapical healing process than the treatment in one appointment.As características do hidróxido de cálcio se desenvolvem a partir da dissociação em íons cálcio e hidroxila. A ação desses íons nos tecidos e bactérias explica as características biológicas e antimicrobianas dessa substância. Por meio desta retrospectiva da literatura, baseada em evidências científicas, é possível afirmar que: 1. A dentina é considerada a melhor proteção pulpar, e o hidróxido de cálcio provou, através de

  13. Plantar fasciitis – to jab or to support? A systematic review of the current best evidence

    Directory of Open Access Journals (Sweden)

    Uden H

    2011-05-01

    Full Text Available Hayley Uden1, Eva Boesch1, Saravana Kumar1,21Division of Health Sciences, 2International Centre for Allied Health Evidence, University of South Australia, North Terrace, Adelaide, South Australia, AustraliaBackground: Plantar fasciitis is a common condition routinely managed by podiatrists in the community and is widely treated conservatively. Two commonly used treatments for plantar fasciitis are customized functional foot orthoses and corticosteroid injections. While common to clinical practice, the evidence base underpinning these treatment strategies is unknown. Therefore, the aim of this systematic review was to assess the effectiveness and safety of customized functional foot orthoses and corticosteroid injections in the treatment of plantar fasciitis.Methods: A systematic literature search was conducted. Experimental studies, in English, from 1998 to 2010 were accepted for inclusion in this review. The PEDro quality assessment tool and the National Health and Medical Research Council's hierarchy of evidence were used to assess the quality of the included studies.Results: Six randomized controlled trials which met the selection criteria were included in this review. Four reported on customized functional foot orthoses and 2 on corticosteroid injections. Current best available evidence highlights that both customized functional foot orthoses and corticosteroid injections can lead to a decrease in pain associated with plantar fasciitis. Additionally, customized functional foot orthoses may also provide an additional benefit in terms of increased functional ability in patients with plantar fasciitis. Corticosteroid injections may have side effects, especially pain (from the injection.Conclusion: Both customized functional foot orthoses and corticosteroid injections can lead to reduction in pain associated with plantar fasciitis. While customized functional foot orthoses may increase the functional outcomes in patients with plantar fasciitis

  14. Direct Evidence for Neutrino Flavor Transformation from Neutral-Current Interactions in SNO

    Science.gov (United States)

    McDonald, A. B.; Ahmad, Q. R.; Allen, R. C.; Andersen, T. C.; Anglin, J. D.; Barton, J. C.; Beier, E. W.; Bercovitch, M.; Bigu, J.; Biller, S. D.; Black, R. A.; Blevis, I.; Boardman, R. J.; Boger, J.; Bonvin, E.; Boulay, M. G.; Bowler, M. G.; Bowles, T. J.; Brice, S. J.; Browne, M. C.; Bullard, T. V.; Bühler, G.; Cameron, J.; Chan, Y. D.; Chen, H. H.; Chen, M.; Chen, X.; Cleveland, B. T.; Clifford, E. T. H.; Cowan, J. H. M.; Cowen, D. F.; Cox, G. A.; Dai, X.; Dalnoki-Veress, F.; Davidson, W. F.; Doe, P. J.; Doucas, G.; Dragowsky, M. R.; Duba, C. A.; Duncan, F. A.; Dunford, M.; Dunmore, J. A.; Earle, E. D.; Elliott, S. R.; Evans, H. C.; Ewan, G. T.; Farine, J.; Fergani, H.; Ferraris, A. P.; Ford, R. J.; Formaggio, J. A.; Fowler, M. M.; Frame, K.; Frank, E. D.; Frati, W.; Gagnon, N.; Germani, J. V.; Gil, S.; Graham, K.; Grant, D. R.; Hahn, R. L.; Hallin, A. L.; Hallman, E. D.; Hamer, A. S.; Hamian, A. A.; Handler, W. B.; Haq, R. U.; Hargrove, C. K.; Harvey, P. J.; Hazama, R.; Heeger, K. M.; Heintzelman, W. J.; Heise, J.; Helmer, R. L.; Hepburn, J. D.; Heron, H.; Hewett, J.; Hime, A.; Howe, M.; Hykawy, J. G.; Isaac, M. C. P.; Jagam, P.; Jelley, N. A.; Jillings, C.; Jonkmans, G.; Kazkaz, K.; Keener, P. T.; Klein, J. R.; Knox, A. B.; Komar, R. J.; Kouzes, R.; Kutter, T.; Kyba, C. C. M.; Law, J.; Lawson, I. T.; Lay, M.; Lee, H. W.; Lesko, K. T.; Leslie, J. R.; Levine, I.; Locke, W.; Luoma, S.; Lyon, J.; Majerus, S.; Mak, H. B.; Maneira, J.; Manor, J.; Marino, A. D.; McCauley, N.; McDonald, D. S.; McFarlane, K.; McGregor, G.; Meijer Drees, R.; Mifflin, C.; Miller, G. G.; Milton, G.; Moffat, B. A.; Moorhead, M.; Nally, C. W.; Neubauer, M. S.; Newcomer, F. M.; Ng, H. S.; Noble, A. J.; Norman, E. B.; Novikov, V. M.; O'Neill, M.; Okada, C. E.; Ollerhead, R. W.; Omori, M.; Orrell, J. L.; Oser, S. M.; Poon, A. W. P.; Radcliffe, T. J.; Roberge, A.; Robertson, B. C.; Robertson, R. G. H.; Rosendahl, S. S. E.; Rowley, J. K.; Rusu, V. L.; Saettler, E.; Schaffer, K. K.; Schwendener, M. H.; Schülke, A.; Seifert, H.; Shatkay, M.; Simpson, J. J.; Sims, C. J.; Sinclair, D.; Skensved, P.; Smith, A. R.; Smith, M. W. E.; Spreitzer, T.; Starinsky, N.; Steiger, T. D.; Stokstad, R. G.; Stonehill, L. C.; Storey, R. S.; Sur, B.; Tafirout, R.; Tagg, N.; Tanner, N. W.; Taplin, R. K.; Thorman, M.; Thornewell, P. M.; Trent, P. T.; Tserkovnyak, Y. I.; van Berg, R.; van de Water, R. G.; Virtue, C. J.; Waltham, C. E.; Wang, J.-X.; Wark, D. L.; West, N.; Wilhelmy, J. B.; Wilkerson, J. F.; Wilson, J. R.; Wittich, P.; Wouters, J. M.; Yeh, M.

    2002-12-01

    The Sudbury Neutrino Observatory (SNO) is a 1,000 tonne heavy water Cerenkov-based neutrino detector situated 2,000 meters underground in INCO's Creighton Mine near Sudbury, Ontario, Canada. For the neutrinos from 8B decay in the Sun SNO observes the Charged Current neutrino reaction sensitive only to electron neutrinos and others (Neutral Current and Elastic Scattering) sensitive to all active neutrino types and thereby can search for direct evidence of neutrino flavor change. Using these reactions and assuming the standard 8B shape, the ve component of the 8B solar flux is φe = 1.76- 0.05+0.05(stat.)- 0.09+0.09 (syst.) × 106 cm-2s-1 for a kinetic energy threshold of 5 MeV. The non-ve component is fgr μτ = 3.41- 0.45+0.45(stat.)- 0.45+0.48 (syst.) × 106 cm-2s-1, 5.3σ greater than zero, providing strong evidence for solar ve flavor transformation. The total flux measured with the NC reaction is fgr NC = 5.09- 0.43+0.44(stat.)- 0.43+0.46 (syst.) × 106 cm-2s-1, consistent with solar models. For charged current events, assuming an undistorted 8B spectrum, the night minus day rate is 14.0% +/- 6.3%-1.4+1.5% of the average rate. If the total flux of active neutrinos is additionally constrained to have no asymmetry, the ve asymmetry is found to be 7.0% +/- 4.9%-1.2+1.3%. A global solar neutrino analysis in terms of matter-enhanced oscillations of two active flavors strongly favors the Large Mixing Angle (LMA) solution.

  15. Scapulothoracic bursitis and snapping scapula syndrome: a critical review of current evidence.

    Science.gov (United States)

    Warth, Ryan J; Spiegl, Ulrich J; Millett, Peter J

    2015-01-01

    Symptomatic scapulothoracic disorders, such as painful scapular crepitus and/or bursitis, are uncommon; however, they can produce significant pain and disability in many patients. To review the current knowledge pertaining to snapping scapula syndrome and to identify areas of further research that may be helpful to improve clinical outcomes and patient satisfaction. Systematic review. We performed a preliminary search of the PubMed and Embase databases using the search terms "snapping scapula," "scapulothoracic bursitis," "partial scapulectomy," and "superomedial angle resection" in September 2013. All nonreview articles related to the topic of snapping scapula syndrome were included. The search identified a total of 167 unique articles, 81 of which were relevant to the topic of snapping scapula syndrome. There were 36 case series of fewer than 10 patients, 16 technique papers, 11 imaging studies, 9 anatomic studies, and 9 level IV outcomes studies. The level of evidence obtained from this literature search was inadequate to perform a formal systematic review or meta-analysis. Therefore, a critical review of current evidence is presented. Snapping scapula syndrome, a likely underdiagnosed condition, can produce significant shoulder dysfunction in many patients. Because the precise origin is typically unknown, specific treatments that are effective for some patients may not be effective for others. Nevertheless, bursectomy with or without partial scapulectomy is currently the most effective primary method of treatment in patients who fail nonoperative therapy. However, many patients experience continued shoulder disability even after surgical intervention. Future studies should focus on identifying the modifiable factors associated with poor outcomes after operative and nonoperative management for snapping scapula syndrome in an effort to improve clinical outcomes and patient satisfaction. © 2014 The Author(s).

  16. Direct Evidence for Neutrino Flavor Transformation from Neutral-Current Interactions in the Sudbury Neutrino Observatory

    Science.gov (United States)

    Ahmad, Q. R.; Allen, R. C.; Andersen, T. C.; Anglin, J. D.; Barton, J. C.; Beier, E. W.; Bercovitch, M.; Bigu, J.; Biller, S. D.; Black, R. A.; Blevis, I.; Boardman, R. J.; Boger, J.; Bonvin, E.; Boulay, M. G.; Bowler, M. G.; Bowles, T. J.; Brice, S. J.; Browne, M. C.; Bullard, T. V.; Bühler, G.; Cameron, J.; Chan, Y. D.; Chen, H. H.; Chen, M.; Chen, X.; Cleveland, B. T.; Clifford, E. T.; Cowan, J. H.; Cowen, D. F.; Cox, G. A.; Dai, X.; Dalnoki-Veress, F.; Davidson, W. F.; Doe, P. J.; Doucas, G.; Dragowsky, M. R.; Duba, C. A.; Duncan, F. A.; Dunford, M.; Dunmore, J. A.; Earle, E. D.; Elliott, S. R.; Evans, H. C.; Ewan, G. T.; Farine, J.; Fergani, H.; Ferraris, A. P.; Ford, R. J.; Formaggio, J. A.; Fowler, M. M.; Frame, K.; Frank, E. D.; Frati, W.; Gagnon, N.; Germani, J. V.; Gil, S.; Graham, K.; Grant, D. R.; Hahn, R. L.; Hallin, A. L.; Hallman, E. D.; Hamer, A. S.; Hamian, A. A.; Handler, W. B.; Haq, R. U.; Hargrove, C. K.; Harvey, P. J.; Hazama, R.; Heeger, K. M.; Heintzelman, W. J.; Heise, J.; Helmer, R. L.; Hepburn, J. D.; Heron, H.; Hewett, J.; Hime, A.; Howe, M.; Hykawy, J. G.; Isaac, M. C.; Jagam, P.; Jelley, N. A.; Jillings, C.; Jonkmans, G.; Kazkaz, K.; Keener, P. T.; Klein, J. R.; Knox, A. B.; Komar, R. J.; Kouzes, R.; Kutter, T.; Kyba, C. C.; Law, J.; Lawson, I. T.; Lay, M.; Lee, H. W.; Lesko, K. T.; Leslie, J. R.; Levine, I.; Locke, W.; Luoma, S.; Lyon, J.; Majerus, S.; Mak, H. B.; Maneira, J.; Manor, J.; Marino, A. D.; McCauley, N.; McDonald, A. B.; McDonald, D. S.; McFarlane, K.; McGregor, G.; Meijer Drees, R.; Mifflin, C.; Miller, G. G.; Milton, G.; Moffat, B. A.; Moorhead, M.; Nally, C. W.; Neubauer, M. S.; Newcomer, F. M.; Ng, H. S.; Noble, A. J.; Norman, E. B.; Novikov, V. M.; O'Neill, M.; Okada, C. E.; Ollerhead, R. W.; Omori, M.; Orrell, J. L.; Oser, S. M.; Poon, A. W.; Radcliffe, T. J.; Roberge, A.; Robertson, B. C.; Robertson, R. G.; Rosendahl, S. S.; Rowley, J. K.; Rusu, V. L.; Saettler, E.; Schaffer, K. K.; Schwendener, M. H.; Schülke, A.; Seifert, H.; Shatkay, M.; Simpson, J. J.; Sims, C. J.; Sinclair, D.; Skensved, P.; Smith, A. R.; Smith, M. W.; Spreitzer, T.; Starinsky, N.; Steiger, T. D.; Stokstad, R. G.; Stonehill, L. C.; Storey, R. S.; Sur, B.; Tafirout, R.; Tagg, N.; Tanner, N. W.; Taplin, R. K.; Thorman, M.; Thornewell, P. M.; Trent, P. T.; Tserkovnyak, Y. I.; van Berg, R.; van de Water, R. G.; Virtue, C. J.; Waltham, C. E.; Wang, J.-X.; Wark, D. L.; West, N.; Wilhelmy, J. B.; Wilkerson, J. F.; Wilson, J. R.; Wittich, P.; Wouters, J. M.; Yeh, M.

    2002-07-01

    Observations of neutral-current [nu] interactions on deuterium in the Sudbury Neutrino Observatory are reported. Using the neutral current (NC), elastic scattering, and charged current reactions and assuming the standard (sup 8)B shape, the [nu]e component of the (sup 8)B solar flux is [phi]e=1.76(sup +0.05)-0.05( stat)(sup +0.09)-0.09( syst) x10(sup 6) cm(sup -2) s(sup -1) for a kinetic energy threshold of 5 MeV. The non-[nu]e component is [phi][mu][tau]=3.41(sup +0.45)-0.45)(stat(sup +0.48)-0.45)(syst x10(sup 6) cm(sup -2) s(sup -1) , 5.3[sigma] greater than zero, providing strong evidence for solar [nu]e flavor transformation. The total flux measured with the NC reaction is [phi]NC=5.09(sup +0.44)(sub -0.43 )(stat)(sup +0.46)(sub -0.43 )(syst) x10(sup 6) cm(sup -2) s(sup -1) , consistent with solar models.

  17. Direct evidence for neutrino flavor transformation from neutral-current interactions in the Sudbury Neutrino Observatory.

    Science.gov (United States)

    Ahmad, Q R; Allen, R C; Andersen, T C; D Anglin, J; Barton, J C; Beier, E W; Bercovitch, M; Bigu, J; Biller, S D; Black, R A; Blevis, I; Boardman, R J; Boger, J; Bonvin, E; Boulay, M G; Bowler, M G; Bowles, T J; Brice, S J; Browne, M C; Bullard, T V; Bühler, G; Cameron, J; Chan, Y D; Chen, H H; Chen, M; Chen, X; Cleveland, B T; Clifford, E T H; Cowan, J H M; Cowen, D F; Cox, G A; Dai, X; Dalnoki-Veress, F; Davidson, W F; Doe, P J; Doucas, G; Dragowsky, M R; Duba, C A; Duncan, F A; Dunford, M; Dunmore, J A; Earle, E D; Elliott, S R; Evans, H C; Ewan, G T; Farine, J; Fergani, H; Ferraris, A P; Ford, R J; Formaggio, J A; Fowler, M M; Frame, K; Frank, E D; Frati, W; Gagnon, N; Germani, J V; Gil, S; Graham, K; Grant, D R; Hahn, R L; Hallin, A L; Hallman, E D; Hamer, A S; Hamian, A A; Handler, W B; Haq, R U; Hargrove, C K; Harvey, P J; Hazama, R; Heeger, K M; Heintzelman, W J; Heise, J; Helmer, R L; Hepburn, J D; Heron, H; Hewett, J; Hime, A; Howe, M; Hykawy, J G; Isaac, M C P; Jagam, P; Jelley, N A; Jillings, C; Jonkmans, G; Kazkaz, K; Keener, P T; Klein, J R; Knox, A B; Komar, R J; Kouzes, R; Kutter, T; Kyba, C C M; Law, J; Lawson, I T; Lay, M; Lee, H W; Lesko, K T; Leslie, J R; Levine, I; Locke, W; Luoma, S; Lyon, J; Majerus, S; Mak, H B; Maneira, J; Manor, J; Marino, A D; McCauley, N; McDonald, A B; McDonald, D S; McFarlane, K; McGregor, G; Meijer Drees, R; Mifflin, C; Miller, G G; Milton, G; Moffat, B A; Moorhead, M; Nally, C W; Neubauer, M S; Newcomer, F M; Ng, H S; Noble, A J; Norman, E B; Novikov, V M; O'Neill, M; Okada, C E; Ollerhead, R W; Omori, M; Orrell, J L; Oser, S M; Poon, A W P; Radcliffe, T J; Roberge, A; Robertson, B C; Robertson, R G H; Rosendahl, S S E; Rowley, J K; Rusu, V L; Saettler, E; Schaffer, K K; Schwendener, M H; Schülke, A; Seifert, H; Shatkay, M; Simpson, J J; Sims, C J; Sinclair, D; Skensved, P; Smith, A R; Smith, M W E; Spreitzer, T; Starinsky, N; Steiger, T D; Stokstad, R G; Stonehill, L C; Storey, R S; Sur, B; Tafirout, R; Tagg, N; Tanner, N W; Taplin, R K; Thorman, M; Thornewell, P M; Trent, P T; Tserkovnyak, Y I; Van Berg, R; Van de Water, R G; Virtue, C J; Waltham, C E; Wang, J-X; Wark, D L; West, N; Wilhelmy, J B; Wilkerson, J F; Wilson, J R; Wittich, P; Wouters, J M; Yeh, M

    2002-07-01

    Observations of neutral-current nu interactions on deuterium in the Sudbury Neutrino Observatory are reported. Using the neutral current (NC), elastic scattering, and charged current reactions and assuming the standard 8B shape, the nu(e) component of the 8B solar flux is phis(e) = 1.76(+0.05)(-0.05)(stat)(+0.09)(-0.09)(syst) x 10(6) cm(-2) s(-1) for a kinetic energy threshold of 5 MeV. The non-nu(e) component is phi(mu)(tau) = 3.41(+0.45)(-0.45)(stat)(+0.48)(-0.45)(syst) x 10(6) cm(-2) s(-1), 5.3sigma greater than zero, providing strong evidence for solar nu(e) flavor transformation. The total flux measured with the NC reaction is phi(NC) = 5.09(+0.44)(-0.43)(stat)(+0.46)(-0.43)(syst) x 10(6) cm(-2) s(-1), consistent with solar models.

  18. Intravenous immunoglobulin for the treatment of Alzheimer's disease: current evidence and considerations

    Directory of Open Access Journals (Sweden)

    Schindowski C

    2014-09-01

    Full Text Available Christina Schindowski,1,* Jürgen Zimmermann,2,* Katharina Schindowski3  1Vivantes Klinikum am Urban Hospital, Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Berlin, Germany; 2Thermofisher Scientific, Langenselbold, Germany; 3Institute of Applied Biotechnology, Faculty for Biotechnology, Biberach University of Applied Sciences, Biberach/Riss, Germany *These authors contributed equally to this work Abstract: Alzheimer's disease (AD is a devastating neurodegenerative form of dementia with increasing incidence rates in most countries. AD is characterized by amyloid plaques and neurofibrillary tangles in the brains of AD individuals accompanied by global neuronal loss. The peptide amyloid-β (Aβ aggregates to amyloid plaques in AD brains. As a result, many therapeutic approaches target Aβ. Human plasma and the plasma product intravenous immunoglobulin (IVIG contain naturally-occurring anti-Aβ antibodies (Nabs-Aβ that appear to reduce risks of developing AD. IVIG sequesters Aβ and thus interferes with AD progression. This study reviews the role of different Aβ species, Nabs-Aβ, preclinical data, and clinical studies of IVIG as potential AD treatments. The focus of this study is the outcomes of a recent Gammaglobulin Alzheimer's Partnership Phase III trial that did not reach primary endpoints, as well as efforts to compare IVIG with current anti-Aβ monoclonals such as bapineuzumab, solanezumab, and BIIB037. Moreover, this study critically examines current market and ethical consequences of potential off-label uses of IVIG, limits in IVIG supply, and subsequent challenges. Keywords: IVIG, amyloid-beta, Nabs-Aβ, Gammagard®, efficacy, target, market

  19. Current state of musculoskeletal ultrasound training and implementation in Europe: results of a survey of experts and scientific societies

    DEFF Research Database (Denmark)

    Naredo, Esperanza; D'Agostino, Maria A; Conaghan, Philip G

    2010-01-01

    To document the current state of musculoskeletal US (MSUS) training and extent of implementation among rheumatologists in the member countries of EULAR.......To document the current state of musculoskeletal US (MSUS) training and extent of implementation among rheumatologists in the member countries of EULAR....

  20. Level of clinical evidence presented at the International Society for Hip Arthroscopy Annual Scientific Meeting over 5 years (2010–2014)

    Science.gov (United States)

    Kay, Jeffrey; de SA, Darren; Shallow, Scott; Simunovic, Nicole; Safran, Marc R.; Philippon, Marc J.; Ayeni, Olufemi R.

    2015-01-01

    The International Society for Hip Arthroscopy (ISHA) Annual Scientific Meeting is at the forefront of informing today’s orthopaedic surgeons and society of the rapid advances in the exponentially growing field of hip arthroscopy. The purpose of this study was to evaluate and observe any trends in the level of clinical evidence in the papers and posters presented at the ISHA Annual Scientific Meeting from 2010 to 2014. The online abstracts of the paper and poster presentations presented at the ISHA Annual Scientific Meetings were independently evaluated by two reviewers (582 total resulting presentations). Two reviewers screened these results for clinical studies and graded the quality of evidence from level I (i.e. randomized trials) to IV (i.e. case series) based on the American Academy of Orthopaedic Surgeons classification system. Four hundred and twenty-eight presentations met the inclusion criteria and were evaluated. Overall, 10.1% of the presentations were level I, 12.8% were level II, 30.1% were level III and 47.0% were level IV evidence. Over time, from 2010 to 2014, we observed an increase in the percentage of level II paper presentations, an increase in the proportion of level III poster presentations, and a decrease in the proportion of both level IV paper and poster presentations. Significant non-random improvement in the level of evidence presented was noted for the poster presentations (P = 0.012) but not for the paper presentations (P = 0.61) over the study period. Statistical trends demonstrate ISHA’s increased awareness and commitment to presenting higher quality evidence as the availability of this evidence increases. PMID:27011857

  1. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

    Science.gov (United States)

    2013-01-01

    Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and

  2. Does breastfeeding influence the risk of developing diabetes mellitus in children? A review of current evidence.

    Science.gov (United States)

    Pereira, Patrícia Feliciano; Alfenas, Rita de Cássia G; Araújo, Raquel Maria A

    2014-01-01

    The aim of this study was to perform a review to investigate the influence of breastfeeding as a protective agent against the onset of diabetes in children. non-systematic review of SciELO, LILACS, MEDLINE, Scopus, and VHL databases, and selection of the 52 most relevant studies. A total of 21 articles, specifically on the topic, were analyzed (nine related to type 1 diabetes and 12 to type 2 diabetes). The duration and exclusivity of breastfeeding, as well as the early use of cow's milk, have been shown to be important risk factors for developing diabetes. It is believed that human milk contains substances that promote the maturation of the immune system, which protect against the onset of type 1 diabetes. Moreover, human milk has bioactive substances that promote satiety and energy balance, preventing excess weight gain during childhood, thus protecting against the development of type 2 diabetes. Although the above mentioned benefits have not been observed by some researchers, inaccuracies on dietary habit reports during childhood and the presence of interfering factors have been considered responsible for the lack of identification of beneficial effects. Given the scientific evidence indicated in most published studies, it is believed that the lack of breastfeeding can be a modifiable risk factor for both type 1 and type 2 diabetes. Strategies aiming at the promotion and support of breastfeeding should be used by trained healthcare professionals in order to prevent the onset of diabetes. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  3. Current Evidence on the Use of Antifilarial Agents in the Management of bancroftian Filariasis

    Directory of Open Access Journals (Sweden)

    Sumadhya Deepika Fernando

    2011-01-01

    Full Text Available Many trials have explored the efficacy of individual drugs and drug combinations to treat bancroftian filariasis. This narrative review summarizes the current evidence for drug management of bancroftian filariasis. Diethylcarbamazine (DEC remains the prime antifilarial agent with a well-established microfilaricidal and some macrofilaricidal effects. Ivermectin (IVM is highly microfilaricidal but minimally macrofilaricidal. The role of albendazole (ALB in treatment regimens is not well established though the drug has a microfilaricidal effect. The combination of DEC+ALB has a better long-term impact than IVM+ALB. Recent trials have shown that doxycycline therapy against Wolbachia, an endosymbiotic bacterium of the parasite, is capable of reducing microfilaria rates and adult worm activity. Followup studies on mass drug administration (MDA are yet to show a complete interruption of transmission, though the infection rates are reduced to a very low level.

  4. Evidence for enhancement of critical current by intergrain Ag in YBaCuO-Ag ceramics

    Energy Technology Data Exchange (ETDEWEB)

    Dwir, B.; Affronte, M.; Pavuna, D.

    1989-07-24

    We report the evidence for enhancement of critical current density /ital J//sub /ital c// by /similar to/50%, which occurs when /similar to/10 wt. % Ag is added to Y/sub 1/Ba/sub 2/Cu/sub 3/O/sub 7/minus//delta// ceramics. The maximal /ital J//sub /ital c// (/similar to/700 A/cm/sup 2/ at /ital T/=77 K) appears simultaneously with maximum YBaCuO compactness in the samples. The silver fills the intergranular space (holes) without Cu substitution, and the critical temperature /ital T//sub /ital c// is not reduced from the bulk value (/similar to/91 K). Normal-state resistivity of Ag-YBaCuO samples is decreased by an order of magnitude, and samples exhibit improved contact resistance and resistance to water. While the critical density is improved by adding /similar to/10 wt. % Ag, it decreases at higher Ag concentrations.

  5. Troponin elevations in patients with chronic cardiovascular disease: An analysis of current evidence and significance.

    Science.gov (United States)

    Martin, Archer K; Malhotra, Anita K; Sullivan, Breandan L; Ramakrishna, Harish

    2016-01-01

    Serum troponin elevation above the 99th percentile of the upper reference limit in healthy subjects (troponin laboratory assays) is required to establish the diagnosis the diagnosis of myocardial necrosis in acute cardiovascular syndromes, as well as guide prognosis and therapy. In the perioperative period, for patients with cardiac disease undergoing noncardiac surgery, it is a particularly critical biomarker universally used to assess the myocardial damage. The value of troponin testing and elevation (as well as its significance) in patients with chronic cardiac valvular, vascular, and renal disease is relatively less well understood. This evidence-based review seeks to examine the currently available data assessing the significance of troponin elevation in certain chronic valvular and other disease states.

  6. Cognitive rehabilitation after severe acquired brain injury: current evidence and future directions.

    Science.gov (United States)

    De Luca, Rosaria; Calabrò, Rocco Salvatore; Bramanti, Placido

    2016-07-25

    Severe acquired brain injury (SABI) is damage to the brain, occurring after birth from traumatic or non-traumatic causes, and often resulting in deterioration of physical, cognitive, and emotional functions. Cognitive rehabilitation (CR) is aimed to help brain-injured or otherwise cognitively impaired individuals to restore normal functioning, or to compensate for cognitive deficits. Over the last years, the development of new technologies in the field of CR has led to a growing use of computer-based cognitive tools in patients with SABI. This review aims to investigate the efficacy of CR in individuals suffering from SABI, and evaluates the role of virtual reality and other innovative technologies in improving behavioural and functional outcomes. The current evidence for CR in the treatment of SABI-related deficits does not allow conclusive results to be achieved and further research is needed to identity the patient and treatment factors that contribute to successful outcomes.

  7. Prevention of Post-Traumatic Stress Disorder After Trauma: Current Evidence and Future Directions.

    Science.gov (United States)

    Qi, Wei; Gevonden, Martin; Shalev, Arieh

    2016-02-01

    Post-traumatic stress disorder (PTSD) is a frequent, tenacious, and disabling consequence of traumatic events. The disorder's identifiable onset and early symptoms provide opportunities for early detection and prevention. Empirical findings and theoretical models have outlined specific risk factors and pathogenic processes leading to PTSD. Controlled studies have shown that theory-driven preventive interventions, such as cognitive behavioral therapy (CBT), or stress hormone-targeted pharmacological interventions, are efficacious in selected samples of survivors. However, the effectiveness of early clinical interventions remains unknown, and results obtained in aggregates (large groups) overlook individual heterogeneity in PTSD pathogenesis. We review current evidence of PTSD prevention and outline the need to improve the disorder's early detection and intervention in individual-specific paths to chronic PTSD.

  8. Collectivism and coping: current theories, evidence, and measurements of collective coping.

    Science.gov (United States)

    Kuo, Ben C H

    2013-01-01

    A burgeoning body of cultural coping research has begun to identify the prevalence and the functional importance of collective coping behaviors among culturally diverse populations in North America and internationally. These emerging findings are highly significant as they evidence culture's impacts on the stress-coping process via collectivistic values and orientation. They provide a critical counterpoint to the prevailing Western, individualistic stress and coping paradigm. However, current research and understanding about collective coping appear to be piecemeal and not well integrated. To address this issue, this review attempts to comprehensively survey, summarize, and evaluate existing research related to collective coping and its implications for coping research with culturally diverse populations from multiple domains. Specifically, this paper reviews relevant research and knowledge on collective coping in terms of: (a) operational definitions; (b) theories; (c) empirical evidence based on studies of specific cultural groups and broad cultural values/dimensions; (d) measurements; and (e) implications for future cultural coping research. Overall, collective coping behaviors are conceived as a product of the communal/relational norms and values of a cultural group across studies. They also encompass a wide array of stress responses ranging from value-driven to interpersonally based to culturally conditioned emotional/cognitive to religion- and spirituality-grounded coping strategies. In addition, this review highlights: (a) the relevance and the potential of cultural coping theories to guide future collective coping research; (b) growing evidence for the prominence of collective coping behaviors particularly among Asian nationals, Asian Americans/Canadians and African Americans/Canadians; (c) preference for collective coping behaviors as a function of collectivism and interdependent cultural value and orientation; and (d) six cultural coping scales. This

  9. Evidence of current impact of climate change on life: a walk from genes to the biosphere.

    Science.gov (United States)

    Peñuelas, Josep; Sardans, Jordi; Estiarte, Marc; Ogaya, Romà; Carnicer, Jofre; Coll, Marta; Barbeta, Adria; Rivas-Ubach, Albert; Llusià, Joan; Garbulsky, Martin; Filella, Iolanda; Jump, Alistair S

    2013-08-01

    We review the evidence of how organisms and populations are currently responding to climate change through phenotypic plasticity, genotypic evolution, changes in distribution and, in some cases, local extinction. Organisms alter their gene expression and metabolism to increase the concentrations of several antistress compounds and to change their physiology, phenology, growth and reproduction in response to climate change. Rapid adaptation and microevolution occur at the population level. Together with these phenotypic and genotypic adaptations, the movement of organisms and the turnover of populations can lead to migration toward habitats with better conditions unless hindered by barriers. Both migration and local extinction of populations have occurred. However, many unknowns for all these processes remain. The roles of phenotypic plasticity and genotypic evolution and their possible trade-offs and links with population structure warrant further research. The application of omic techniques to ecological studies will greatly favor this research. It remains poorly understood how climate change will result in asymmetrical responses of species and how it will interact with other increasing global impacts, such as N eutrophication, changes in environmental N : P ratios and species invasion, among many others. The biogeochemical and biophysical feedbacks on climate of all these changes in vegetation are also poorly understood. We here review the evidence of responses to climate change and discuss the perspectives for increasing our knowledge of the interactions between climate change and life.

  10. Smoke exposure as a risk factor for asthma in childhood: a review of current evidence.

    Science.gov (United States)

    Ferrante, Giuliana; Antona, Roberta; Malizia, Velia; Montalbano, Laura; Corsello, Giovanni; La Grutta, Stefania

    2014-01-01

    Asthma is a common chronic multifactorial disease that affects >300 million people worldwide. Outdoor and indoor pollution exposure has been associated with respiratory health effects in adults and children. Smoking still represents a huge public health problem and millions of children suffer the detrimental effects of passive smoke exposure. This study was designed to review the current evidences on exposure to passive smoke as a risk factor for asthma onset in childhood. A review of the most recent studies on this topic was undertaken to provide evidence about the magnitude of the effect of passive smoking on the risk of incidence of asthma in children. The effects of passive smoking are different depending on individual and environmental factors. Environmental tobacco smoke (ETS) is one of the most important indoor air pollutants and can interact with other air pollutants in eliciting respiratory outcomes during childhood. The increased risk of respiratory outcomes in children exposed to prenatal and early postnatal passive smoke might be caused by an adverse effect on both the immune system and the structural and functional development of the lung; this may explain the subsequent increased risk of incident asthma. The magnitude of the exposure is quite difficult to precisely quantify because it is significantly influenced by the child's daily activities. Because exposure to ETS is a likely cause for asthma onset in childhood, there is a strong need to prevent infants and children from breathing air contaminated with tobacco smoke.

  11. Role of Environmental Chemicals in Obesity: A Systematic Review on the Current Evidence

    Directory of Open Access Journals (Sweden)

    Roya Kelishadi

    2013-01-01

    Full Text Available The purpose of this paper is to systematically review the experimental and human studies on obesogenic chemicals and their mechanisms of action to provide a comprehensive view on the multifactorial aspects of obesity. The literatures were searched in available databases. The relevant papers were selected in three phases. After quality assessment, two reviewers extracted the data while another checked their extracted data. In this review, we summarized information regarding environmental chemicals that can be associated with obesity. Most evidence comes from experimental and laboratory studies; however a growing number of human studies also support the role of obesogenic chemicals. The current evidence proposes that the systemic responses to exposure to environmental factors could potentially increase the risk of excess weight. The effects of exposure to these chemicals are of crucial importance during developmental phases of life, when preprogramming for an adipogenic outcome may occur. By considering the adverse transgenerational effects of obesogen chemicals on human health, the global obesity epidemic should be considered as a multifactorial complex disorder necessitating the emphasis of public health interventions for environmental protection.

  12. Effects of exercise training on chronic inflammation in obesity : current evidence and potential mechanisms.

    Science.gov (United States)

    You, Tongjian; Arsenis, Nicole C; Disanzo, Beth L; Lamonte, Michael J

    2013-04-01

    Chronic, systemic inflammation is an independent risk factor for several major clinical diseases. In obesity, circulating levels of inflammatory markers are elevated, possibly due to increased production of pro-inflammatory cytokines from several tissues/cells, including macrophages within adipose tissue, vascular endothelial cells and peripheral blood mononuclear cells. Recent evidence supports that adipose tissue hypoxia may be an important mechanism through which enlarged adipose tissue elicits local tissue inflammation and further contributes to systemic inflammation. Current evidence supports that exercise training, such as aerobic and resistance exercise, reduces chronic inflammation, especially in obese individuals with high levels of inflammatory biomarkers undergoing a longer-term intervention. Several studies have reported that this effect is independent of the exercise-induced weight loss. There are several mechanisms through which exercise training reduces chronic inflammation, including its effect on muscle tissue to generate muscle-derived, anti-inflammatory 'myokine', its effect on adipose tissue to improve hypoxia and reduce local adipose tissue inflammation, its effect on endothelial cells to reduce leukocyte adhesion and cytokine production systemically, and its effect on the immune system to lower the number of pro-inflammatory cells and reduce pro-inflammatory cytokine production per cell. Of these potential mechanisms, the effect of exercise training on adipose tissue oxygenation is worth further investigation, as it is very likely that exercise training stimulates adipose tissue angiogenesis and increases blood flow, thereby reducing hypoxia and the associated chronic inflammation in adipose tissue of obese individuals.

  13. Omega-3 Fatty Acids in Modern Parenteral Nutrition: A Review of the Current Evidence

    Directory of Open Access Journals (Sweden)

    Stanislaw Klek

    2016-03-01

    Full Text Available Intravenous lipid emulsions are an essential component of parenteral nutrition regimens. Originally employed as an efficient non-glucose energy source to reduce the adverse effects of high glucose intake and provide essential fatty acids, lipid emulsions have assumed a larger therapeutic role due to research demonstrating the effects of omega-3 and omega-6 polyunsaturated fatty acids (PUFA on key metabolic functions, including inflammatory and immune response, coagulation, and cell signaling. Indeed, emerging evidence suggests that the effects of omega-3 PUFA on inflammation and immune response result in meaningful therapeutic benefits in surgical, cancer, and critically ill patients as well as patients requiring long-term parenteral nutrition. The present review provides an overview of the mechanisms of action through which omega-3 and omega-6 PUFA modulate the immune-inflammatory response and summarizes the current body of evidence regarding the clinical and pharmacoeconomic benefits of intravenous n-3 fatty acid-containing lipid emulsions in patients requiring parenteral nutrition.

  14. Agomelatine beyond Borders: Current Evidences of Its Efficacy in Disorders Other than Major Depression

    Directory of Open Access Journals (Sweden)

    Domenico De Berardis

    2015-01-01

    Full Text Available Agomelatine, a melatonergic antidepressant with a rapid onset of action, is one of the most recent drugs in the antidepressant category. Agomelatine’s antidepressant actions are attributed to its sleep-promoting and chronobiotic actions mediated by MT1 and MT2 receptors present in the suprachiasmatic nucleus, as well as to its effects on the blockade of 5-HT2c receptors. Blockade of 5-HT2c receptors causes release of both noradrenaline and dopamine at the fronto-cortical dopaminergic and noradrenergic pathways. The combined actions of agomelatine on MT1/MT2 and 5-HT2c receptors facilitate the resynchronization of altered circadian rhythms and abnormal sleep patterns. Agomelatine appeared to be effective in treating major depression. Moreover, evidence exists that points out a possible efficacy of such drug in the treatment of bipolar depression, anxiety disorders, alcohol dependence, migraines etc. Thus, the aim of this narrative review was to elucidate current evidences on the role of agomelatine in disorders other than major depression.

  15. Tratamento da pré-eclâmpsia baseado em evidências Pre-eclampsia treatment according to scientific evidence

    Directory of Open Access Journals (Sweden)

    Carlos Noronha Neto

    2010-09-01

    Full Text Available As síndromes hipertensivas na gestação merecem especial destaque no cenário da saúde pública mundial. Atualmente, respondem como terceira causa de mortalidade materna no mundo e primeira no Brasil. Do ponto de vista prático, a pré-eclâmpsia continua sendo uma síndrome que leva a graves repercussões maternas e fetais, conhecendo-se ainda pouco sobre sua etiologia. Atualmente, tem-se discutido a melhor terapêutica para os quadros de pré-eclâmpsia em diversos momentos do ciclo gravídico-puerperal, visando sempre à redução de altos índices de morbimortalidade materna e fetal. O parto, considerando-se a fisiopatologia do evento, representa a melhor forma de tratamento. O uso de sulfato de magnésio é recomendado em todos os casos de pré-eclâmpsia grave e eclâmpsia para prevenção e tratamento das crises convulsivas. Da mesma forma, o tratamento dos picos hipertensivos é recomendado. Hidralazina, nifedipina e labetalol têm sido as drogas mais utilizadas com essa finalidade, mas seu uso dependente da familiaridade do médico assistente. A corticoterapia antenatal está indicada sempre que existe risco iminente de prematuridade entre a 24º e 34º semana. Em contrapartida, não há evidências suficientes para recomendar repouso e administração de expansores plasmáticos de rotina, assim como há necessidade urgente de ensaios clínicos randomizados para determinar se o tratamento anti-hipertensivo de manutenção nas gestantes apresenta benefícios ou riscos para mães e fetos, em todas as formas clínicas da doença, em particular nos casos de pré-eclâmpsia pura.Hypertensive disorders in pregnancy deserve special attention in the setting of global public health. Currently, they represent the third cause of maternal mortality in the world and first in Brazil. From a practical standpoint, pre-eclampsia remains a syndrome that leads to serious repercussions on maternal and fetal mortality and its etiology is not well known

  16. Anti-Oxidative and Anti-Inflammatory Effects of Ginger in Health and Physical Activity: Review of Current Evidence

    National Research Council Canada - National Science Library

    Nafiseh Shokri Mashhadi; Reza Ghiasvand; Gholamreza Askari; Mitra Hariri; Leila Darvishi; Mohammad Reza Mofid

    2013-01-01

    .... The health-promoting perspective of ginger is attributed to its rich phytochemistry. This study aimed to review the current evidence on ginger effects as an anti-inflammatory and anti-oxidative. Methods...

  17. Fatty acid and vitamin interventions in adults with schizophrenia: a systematic review of the current evidence.

    Science.gov (United States)

    Chia, Siok Ching; Henry, Jeyakumar; Mok, Yee Ming; Honer, William G; Sim, Kang

    2015-12-01

    Current psychopharmacological approaches to reduce psychotic phenomenology in schizophrenia are associated with adverse effects including extrapyramidal and metabolic side effects. In view of the emerging data on nutritional supplementation interventions in schizophrenia which are not entirely consistent, we aimed to review existent studies focusing on fatty acid and vitamin interventions and summarise current evidence on such nutritional supplementations in schizophrenia. We searched the digital databases (ScienceDirect, Scopus, SpringerLINK, PubMed/Medline) for relevant studies pertaining to fatty acid and vitamin supplementation interventions in the management of psychotic symptoms in schizophrenia up to February 2015. Overall, there were more studies conducted on fatty acid over vitamin supplementations in patients with schizophrenia. There were more positive findings in support of fatty acid supplementation compared with vitamin supplementation in the context of specific intervention features (dose of nutrient supplementation, single versus combination nutritional interventions, specific antipsychotic), subject features (older age, long duration of illness, baseline polyunsaturated fatty acid levels) and clinical outcomes (improvements of psychotic symptoms and/or extrapyramidal side effects from antipsychotics). However, investigations of both supplementation modalities were limited by relatively small study sample sizes, short study duration, which precluded further segmentation of impact on more diverse patient subtypes and symptom profiles. Future studies may consider examining larger samples over a longer time period, recruiting younger subjects with shorter duration of illness, examination of different clinical features including specific cognitive domains, and use of single versus combination nutritional interventions.

  18. Treatment of gastric outlet obstruction that results fromunresectable gastric cancer: Current evidence

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Malignant gastric outlet obstruction (GOO) is a commoncondition that results from locally advanced malignanciesin the upper gastrointestinal tract, such aspancreatic, gastric, and other carcinomas. Two typesof procedures for malignant GOO, namely, gastrojejunostomy(GJ) with laparotomy or a laparoscopicapproach and endoscopic stenting (ES), are currentlyavailable. Although numerous previous reports haveclarified the benefits and drawbacks of each procedure,whether GJ or ES should be used in patients with GOOthat results from gastric cancer who may have a longerlife expectancy than patients with other malignancieshas not been determined. In this review, which focuseson gastric cancer-induced GOO, we analyzed the twosystematic reviews and a meta-analysis that comparedGJ and ES and outlined the current status of GOOtreatment. We also provide an updated review thatincludes laparoscopic GJ. Various data from 13 studiesin one review and 6 studies in another review wereanalyzed. Although the main results of the presentreview indicated that both GJ and ES were efficacioustreatments in patients with GOO that resulted fromgastric cancer, current evidence suggests that GJ maybe the preferable procedure given its good performancestatus and improved prognosis in gastric cancer patients.

  19. Direct evidence for local oscillatory current sources and intracortical phase gradients in turtle visual cortex.

    Science.gov (United States)

    Prechtl, J C; Bullock, T H; Kleinfeld, D

    2000-01-18

    Visual stimuli induce oscillations in the membrane potential of neurons in cortices of several species. In turtle, these oscillations take the form of linear and circular traveling waves. Such waves may be a consequence of a pacemaker that emits periodic pulses of excitation that propagate across a network of excitable neuronal tissue or may result from continuous and possibly reconfigurable phase shifts along a network with multiple weakly coupled neuronal oscillators. As a means to resolve the origin of wave propagation in turtle visual cortex, we performed simultaneous measurements of the local field potential at a series of depths throughout this cortex. Measurements along a single radial penetration revealed the presence of broadband current sources, with a center frequency near 20 Hz (gamma band), that were activated by visual stimulation. The spectral coherence between sources at two well-separated loci along a rostral-caudal axis revealed the presence of systematic timing differences between localized cortical oscillators. These multiple oscillating current sources and their timing differences in a tangential plane are interpreted as the neuronal activity that underlies the wave motion revealed in previous imaging studies. The present data provide direct evidence for the inference from imaging of bidirectional wave motion that the stimulus-induced electrical waves in turtle visual cortex correspond to phase shifts in a network of coupled neuronal oscillators.

  20. A comunidade científica, o Estado e as universidades, no atual estágio de desenvolvimento científico tecnológico Scientific community, State and universities in the current stage of scientific technological development

    Directory of Open Access Journals (Sweden)

    Michelangelo Giotto Santoro Trigueiro

    2001-12-01

    Full Text Available O trabalho discute a relação entre a comunidade científica, o Estado e a universidade no contexto atual do desenvolvimento científico-tecnológico. Enfatiza a dimensão política das transformações recentes, sobretudo no tocante aos sistemas decisórios, contrapondo momento mais verticalizado com cenário mais democratizado, e as conseqüências das transformações políticas contemporâneas, na sociedade brasileira. Procura analisar as mútuas correlações entre o Estado, as universidades e as comunidades científicas, a partir do entendimento da especificidade de cada um destes atores na condução do desenvolvimento científico-tecnológico nacional. A esse respeito, é analisado todo um conjunto de ações que se coadunam com o novo modo de produção do conhecimento, buscando destacar a natureza controversa e polêmica da inserção do Estado e o caráter conservador da comunidade científica, bem como a resistência da universidade na proposição de novas linhas de atuação no enfrentamento dos desafios trazidos pela ciência e tecnologias contemporâneas.This article discusses the relationship between scientific community, the State and university in the current circumstances of scientific-technological development. It stresses the political dimension of recent changes, specially regarding decision systems, comparing a more vertical moment and a more democratic scenario and the consequences of contemporary political changes in Brazilian society. It examines mutual relations between the State, universities and the scientific community, based on the understanding of each of those actors' specificities in advancing national scientific-technological development. A whole set of actions is examined in accordance with knowledge's new mode of production in order to highlight the controversial nature of the State and the conservative character of the scientific community as well as the resistance of the university in proposing new lines

  1. Representation and Misrepresentation of Scientific Evidence in Contemporary Tobacco Regulation: A Review of Tobacco Industry Submissions to the UK Government Consultation on Standardised Packaging

    Science.gov (United States)

    Ulucanlar, Selda; Fooks, Gary J.; Hatchard, Jenny L.; Gilmore, Anna B.

    2014-01-01

    Background Standardised packaging (SP) of tobacco products is an innovative tobacco control measure opposed by transnational tobacco companies (TTCs) whose responses to the UK government's public consultation on SP argued that evidence was inadequate to support implementing the measure. The government's initial decision, announced 11 months after the consultation closed, was to wait for ‘more evidence’, but four months later a second ‘independent review’ was launched. In view of the centrality of evidence to debates over SP and TTCs' history of denying harms and manufacturing uncertainty about scientific evidence, we analysed their submissions to examine how they used evidence to oppose SP. Methods and Findings We purposively selected and analysed two TTC submissions using a verification-oriented cross-documentary method to ascertain how published studies were used and interpretive analysis with a constructivist grounded theory approach to examine the conceptual significance of TTC critiques. The companies' overall argument was that the SP evidence base was seriously flawed and did not warrant the introduction of SP. However, this argument was underpinned by three complementary techniques that misrepresented the evidence base. First, published studies were repeatedly misquoted, distorting the main messages. Second, ‘mimicked scientific critique’ was used to undermine evidence; this form of critique insisted on methodological perfection, rejected methodological pluralism, adopted a litigation (not scientific) model, and was not rigorous. Third, TTCs engaged in ‘evidential landscaping’, promoting a parallel evidence base to deflect attention from SP and excluding company-held evidence relevant to SP. The study's sample was limited to sub-sections of two out of four submissions, but leaked industry documents suggest at least one other company used a similar approach. Conclusions The TTCs' claim that SP will not lead to public health benefits is largely

  2. Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: a quality dimension of the International Patient Decision Aid Standards.

    Science.gov (United States)

    Montori, Victor M; LeBlanc, Annie; Buchholz, Angela; Stilwell, Diana L; Tsapas, Apostolos

    2013-01-01

    Patients and clinicians expect patient decision aids to be based on the best available research evidence. Since 2005, this expectation has translated into a quality dimension of the International Patient Decision Aid Standards. We reviewed the 2005 standards and the available literature on the evidence base of decision aids as well as searched for parallel activities in which evidence is brought to bear to inform clinical decisions. In conducting this work, we noted emerging and research issues that require attention and may inform this quality dimension in the future. This dimension requires patient decision aids to be based on research evidence about the relevant options and the nature and likelihood of their effect on outcomes that matter to patients. The synthesis of evidence should be comprehensive and up-to-date, and the evidence itself subject to critical appraisal. Ethical (informed patient choice), quality-of-care (patient-centered care), and scientific (evidence-based medicine) arguments justify this requirement. Empirical evidence suggests that over two thirds of available decision aids are based on high-quality evidence syntheses. Emerging issues identified include the duties of developers regarding the conduct of systematic reviews, the impact of comparative effectiveness research, their link with guidelines based on the same evidence, and how to present the developers' confidence in the estimates to the end-users. Systematic application of the GRADE system, common in contemporary practice guideline development, could enhance satisfaction of this dimension. While theoretical and practical issues remained to be addressed, high-quality patient decision aids should adhere to this dimension requiring they be based on comprehensive and up-to-date summaries of critically appraised evidence.

  3. The 'antisocial' person: an insight in to biology, classification and current evidence on treatment

    Directory of Open Access Journals (Sweden)

    Rajapakse Senaka

    2010-07-01

    Full Text Available Abstract Background This review analyses and summarises the recent advances in understanding the neurobiology of violence and empathy, taxonomical issues on defining personality disorders characterised by disregard for social norms, evidence for efficacy of different treatment modalities and ethical implications in defining 'at-risk' individuals for preventive interventions. Methods PubMed was searched with the keywords 'antisocial personality disorder', 'dissocial personality disorder' and 'psychopathy'. The search was limited to articles published in English over the last 10 years (1999 to 2009 Results Both diagnostic manuals used in modern psychiatry, the Diagnostic and Statistical Manual published by the American Psychiatric Association and the International Classification of Diseases published by the World Health Organization, identify a personality disorder sharing similar traits. It is termed antisocial personality disorder in the diagnostic and statistical manual and dissocial personality disorder in the International Classification of Diseases. However, some authors query the ability of the existing manuals to identify a special category termed 'psychopathy', which in their opinion deserves special attention. On treatment-related issues, many psychological and behavioural therapies have shown success rates ranging from 25% to 62% in different cohorts. Multisystemic therapy and cognitive behaviour therapy have been proven efficacious in many trials. There is no substantial evidence for the efficacy of pharmacological therapy. Currently, the emphasis is on early identification and prevention of antisocial behaviour despite the ethical implications of defining at-risk children. Conclusions Further research is needed in the areas of neuroendocrinological associations of violent behaviour, taxonomic existence of psychopathy and efficacy of treatment modalities.

  4. Assessing the Effect of Waterpipe Smoking on Cancer Outcome - a Systematic Review of Current Evidence

    Science.gov (United States)

    Awan, Kamran Habib; Siddiqi, Kamran; Patil, Shankargouda; Hussain, Quratul Ann

    2017-02-01

    Background: Waterpipe smoking (WPS) is widely believed to be a safe and hazard-free tobacco habit. However, a number of studies have indicated that exposure to several toxicants and carcinogens through WPS is strongly related to serious health hazards. The current paper presents a narrative review on the effects of WPS on cancer outcome. Methods: The addressed focused question was “Is there an association between waterpipe smoking and cancer outcome?” PubMed, Medline, EMBASE, ISI Web of Science and the Cochrane databases were searched until June 2015 using the key words “Waterpipe”, “Hookah”, “Narghileh”, “Shisha”, “Hubbly Bubbly” “cancer” in various combinations. Letters to the Editor, review articles, case-reports and unpublished articles were excluded. Results: A total of 16 studies were included: six on lung cancer, three on oesophageal cancer, two on gastric cancer, two on bladder cancer, and one each on nasopharyngeal, pancreatic and prostate cancers. Our search did not yield any study that evaluated the risk of oral cancer in WPS users. The available evidence showed a significant association of WPS with lung cancer (UOR 6.0, 95% CI 1.78–20.26); however, no association was observed with bladder, nasopharyngeal, pancreatic and prostate cancers. Gastric (OR 3.4, 95% CI 1.7-7.1) and oesophageal cancers (OR 1.85, 95% CI 1.41-2.44) were observed to have weak associations with WPS. Conclusion: Regardless of the limitations, there is sufficient evidence to suggest associations of WPS with cancer, particularly in the lung. Future well-designed studies are required to identify and quantify with confidence all the health effects of this form of smoking. Creative Commons Attribution License

  5. Non-medical prescribing by physiotherapists: issues reported in the current evidence.

    Science.gov (United States)

    Morris, Joanne H; Grimmer, Karen

    2014-02-01

    Physiotherapists should be proactive in preparing themselves to participate in innovative models of health care, which are emerging from the healthcare workforce reforms in Australia. One challenging outcome of workforce change is physiotherapy (non-medical) prescribing (NMP), which is part of the extension of scope of physiotherapy practice. This paper summarises the current evidence base for Australian physiotherapists seeking to obtain prescribing rights. A targeted literature review was undertaken through EBSCO Host, Cochrane, Medline, SportsDiscus, Cinahl, Healthsource and Google.com using broad search terms to identify peer-reviewed and grey literature pertaining to NMP by physiotherapists, nationally and internationally. No critical appraisal was undertaken however literature was structured into the NHMRC hierarchy of evidence. Themes raised in the included literature were reported descriptively. There were six relevant peer-reviewed articles, of hierarchy levels III_3 and IV. There was however, comprehensive and recent grey literature to inform Australian physiotherapy NMP initiatives. Themes included the need for standard National action in relation to legislative and regulatory/registration issues, appropriate education, credentialing and supervisory requirements for physiotherapy prescribing. Many lessons can be learnt from the literature, including the importance of planned, uniform National action (rather than piecemeal state-by-state initiatives). Essential elements include appropriate training and skills-based recognition within the discipline and the broader health team, and the need to overtly demonstrate effectiveness and safety. Regularly-evaluated service-delivery models which support NMP by physiotherapists are further required, to demonstrate efficiency, timeliness, patient centredness and equity. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  6. Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS).

    Science.gov (United States)

    Lefaucheur, Jean-Pascal; Antal, Andrea; Ayache, Samar S; Benninger, David H; Brunelin, Jérôme; Cogiamanian, Filippo; Cotelli, Maria; De Ridder, Dirk; Ferrucci, Roberta; Langguth, Berthold; Marangolo, Paola; Mylius, Veit; Nitsche, Michael A; Padberg, Frank; Palm, Ulrich; Poulet, Emmanuel; Priori, Alberto; Rossi, Simone; Schecklmann, Martin; Vanneste, Sven; Ziemann, Ulf; Garcia-Larrea, Luis; Paulus, Walter

    2017-01-01

    A group of European experts was commissioned by the European Chapter of the International Federation of Clinical Neurophysiology to gather knowledge about the state of the art of the therapeutic use of transcranial direct current stimulation (tDCS) from studies published up until September 2016, regarding pain, Parkinson's disease, other movement disorders, motor stroke, poststroke aphasia, multiple sclerosis, epilepsy, consciousness disorders, Alzheimer's disease, tinnitus, depression, schizophrenia, and craving/addiction. The evidence-based analysis included only studies based on repeated tDCS sessions with sham tDCS control procedure; 25 patients or more having received active treatment was required for Class I, while a lower number of 10-24 patients was accepted for Class II studies. Current evidence does not allow making any recommendation of Level A (definite efficacy) for any indication. Level B recommendation (probable efficacy) is proposed for: (i) anodal tDCS of the left primary motor cortex (M1) (with right orbitofrontal cathode) in fibromyalgia; (ii) anodal tDCS of the left dorsolateral prefrontal cortex (DLPFC) (with right orbitofrontal cathode) in major depressive episode without drug resistance; (iii) anodal tDCS of the right DLPFC (with left DLPFC cathode) in addiction/craving. Level C recommendation (possible efficacy) is proposed for anodal tDCS of the left M1 (or contralateral to pain side, with right orbitofrontal cathode) in chronic lower limb neuropathic pain secondary to spinal cord lesion. Conversely, Level B recommendation (probable inefficacy) is conferred on the absence of clinical effects of: (i) anodal tDCS of the left temporal cortex (with right orbitofrontal cathode) in tinnitus; (ii) anodal tDCS of the left DLPFC (with right orbitofrontal cathode) in drug-resistant major depressive episode. It remains to be clarified whether the probable or possible therapeutic effects of tDCS are clinically meaningful and how to optimally perform t

  7. Current Scientific Impact of Ss Cyril and Methodius University of Skopje, Republic of Macedonia in the Scopus Database (1960-2014)

    OpenAIRE

    2015-01-01

    Aim: The aim of this study was to analyze current scientific impact of Ss Cyril and Methodius University of Skopje, Republic of Macedonia in the Scopus Database (1960-2014). Material and Methods: Affiliation search of the Scopus database was performed on November 23, 2014 in order to identify published papers from the Ss Cyril and Methodius University of Skopje (UC&M), Republic of Macedonia. A total number of 3960 articles (3055 articles from UC&M, 861 articles from Faculty of Medicine, U...

  8. Current Evidence for a Role of the Kynurenine Pathway of Tryptophan Metabolism in Multiple Sclerosis.

    Science.gov (United States)

    Lovelace, Michael D; Varney, Bianca; Sundaram, Gayathri; Franco, Nunzio F; Ng, Mei Li; Pai, Saparna; Lim, Chai K; Guillemin, Gilles J; Brew, Bruce J

    2016-01-01

    The kynurenine pathway (KP) is the major metabolic pathway of the essential amino acid tryptophan (TRP). Stimulation by inflammatory molecules, such as interferon-γ (IFN-γ), is the trigger for induction of the KP, driving a complex cascade of production of both neuroprotective and neurotoxic metabolites, and in turn, regulation of the immune response and responses of brain cells to the KP metabolites. Consequently, substantial evidence has accumulated over the past couple of decades that dysregulation of the KP and the production of neurotoxic metabolites are associated with many neuroinflammatory and neurodegenerative diseases, including Parkinson's disease, AIDS-related dementia, motor neurone disease, schizophrenia, Huntington's disease, and brain cancers. In the past decade, evidence of the link between the KP and multiple sclerosis (MS) has rapidly grown and has implicated the KP in MS pathogenesis. KP enzymes, indoleamine 2,3-dioxygenase (IDO-1) and tryptophan dioxygenase (highest expression in hepatic cells), are the principal enzymes triggering activation of the KP to produce kynurenine from TRP. This is in preference to other routes such as serotonin and melatonin production. In neurological disease, degradation of the blood-brain barrier, even if transient, allows the entry of blood monocytes into the brain parenchyma. Similar to microglia and macrophages, these cells are highly responsive to IFN-γ, which upregulates the expression of enzymes, including IDO-1, producing neurotoxic KP metabolites such as quinolinic acid. These metabolites circulate systemically or are released locally in the brain and can contribute to the excitotoxic death of oligodendrocytes and neurons in neurological disease principally by virtue of their agonist activity at N-methyl-d-aspartic acid receptors. The latest evidence is presented and discussed. The enzymes that control the checkpoints in the KP represent an attractive therapeutic target, and consequently several KP

  9. Current evidence for a role of the Kynurenine pathway of tryptophan metabolism in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Michael D. Lovelace

    2016-08-01

    Full Text Available The kynurenine pathway (KP is the major metabolic pathway of the essential amino acid tryptophan (TRP. Stimulation by inflammatory molecules such as interferon-γ (IFN-γ is the trigger for induction of the KP, driving a complex cascade of production of both neuroprotective and neurotoxic metabolites and in turn, regulation of the immune response and responses of brain cells to the KP metabolites. Consequently, substantial evidence has accumulated over the past couple of decades that dysregulation of the KP and the production of neurotoxic metabolites are associated with many neuroinflammatory and neurodegenerative diseases, including Parkinson’s disease, AIDS-related dementia, motor neurone disease (MND, schizophrenia, Huntington’s disease and brain cancers. In the past decade, evidence of the link between the KP and multiple sclerosis (MS has rapidly grown and has implicated the KP in MS pathogenesis. KP enzymes indoleamine 2,3-dioxygenase (IDO-1 and tryptophan dioxygenase (TDO; highest expression in hepatic cells are the principal enzymes triggering activation of the KP to produce kynurenine from TRP. This is in preference to other routes such as serotonin and melatonin production. In neurological disease, degradation of the blood-brain-barrier (BBB, even if transient, allows the entry of blood monocytes into the brain parenchyma. Like microglia and macrophages, these cells are highly responsive to IFN-γ, which upregulates the expression of enzymes including IDO-1, producing neurotoxic KP metabolites such as quinolinic acid (QUIN. These metabolites circulate systemically or are released locally in the brain, and can contribute to the excitotoxic death of oligodendrocytes and neurons in neurological disease principally by virtue of their agonist activity at NMDA receptors. The latest evidence is presented and discussed. The enzymes that control the checkpoints in the KP represent an attractive therapeutic target, and consequently several

  10. Brain PET imaging in obesity and food addiction: current evidence and hypothesis.

    Science.gov (United States)

    Iozzo, Patricia; Guiducci, Letizia; Guzzardi, Maria Angela; Pagotto, Uberto

    2012-01-01

    The ongoing epidemics of obesity is one main health concern of the present time. Overeating in some obese individuals shares similarities with the loss of control and compulsive behavior observed in drug-addicted subjects, suggesting that obesity may involve food addiction. Here, we review the contributions provided by the use of positron emission tomography to the current understanding of the cerebral control of obesity and food intake in humans. The available studies have shown that multiple areas in the brain are involved with the reward properties of food, such as prefrontal, orbitofrontal, somatosensory cortices, insula, thalamus, hypothalamus, amygdala, and others. This review summarizes the current evidence, supporting the concepts that i) regions involved in the somatosensory response to food sight, taste, and smell are activated by palatable foods and may be hyperresponsive in obese individuals, ii) areas controlling executive drive seem to overreact to the anticipation of pleasure during cue exposure, and iii) those involved in cognitive control and inhibitory behavior may be resistant to the perception of reward after food exposure in obese subjects. All of these features may stimulate, for different reasons, ingestion of highly palatable and energy-rich foods. Though these same regions are similarly involved in drug abusers and game-addicted individuals, any direct resemblance may be an oversimplification, especially as the heterogeneities between studies and the prevalent exclusion of sensitive groups still limit a coherent interpretation of the findings. Further work is required to comprehensively tackle the multifaceted phenotype of obesity and identify the role of food dependency in its pathophysiology. Copyright © 2012 S. Karger GmbH, Freiburg.

  11. Current Evidence for Developmental, Structural, and Functional Brain Defects following Prenatal Radiation Exposure

    Directory of Open Access Journals (Sweden)

    Tine Verreet

    2016-01-01

    Full Text Available Ionizing radiation is omnipresent. We are continuously exposed to natural (e.g., radon and cosmic and man-made radiation sources, including those from industry but especially from the medical sector. The increasing use of medical radiation modalities, in particular those employing low-dose radiation such as CT scans, raises concerns regarding the effects of cumulative exposure doses and the inappropriate utilization of these imaging techniques. One of the major goals in the radioprotection field is to better understand the potential health risk posed to the unborn child after radiation exposure to the pregnant mother, of which the first convincing evidence came from epidemiological studies on in utero exposed atomic bomb survivors. In the following years, animal models have proven to be an essential tool to further characterize brain developmental defects and consequent functional deficits. However, the identification of a possible dose threshold is far from complete and a sound link between early defects and persistent anomalies has not yet been established. This review provides an overview of the current knowledge on brain developmental and persistent defects resulting from in utero radiation exposure and addresses the many questions that still remain to be answered.

  12. Current Evidence for Developmental, Structural, and Functional Brain Defects following Prenatal Radiation Exposure

    Science.gov (United States)

    Verreet, Tine; Quintens, Roel; Baatout, Sarah; Benotmane, Mohammed A.

    2016-01-01

    Ionizing radiation is omnipresent. We are continuously exposed to natural (e.g., radon and cosmic) and man-made radiation sources, including those from industry but especially from the medical sector. The increasing use of medical radiation modalities, in particular those employing low-dose radiation such as CT scans, raises concerns regarding the effects of cumulative exposure doses and the inappropriate utilization of these imaging techniques. One of the major goals in the radioprotection field is to better understand the potential health risk posed to the unborn child after radiation exposure to the pregnant mother, of which the first convincing evidence came from epidemiological studies on in utero exposed atomic bomb survivors. In the following years, animal models have proven to be an essential tool to further characterize brain developmental defects and consequent functional deficits. However, the identification of a possible dose threshold is far from complete and a sound link between early defects and persistent anomalies has not yet been established. This review provides an overview of the current knowledge on brain developmental and persistent defects resulting from in utero radiation exposure and addresses the many questions that still remain to be answered. PMID:27382490

  13. Modifiable factors in the management of glaucoma: a systematic review of current evidence.

    Science.gov (United States)

    Hecht, Idan; Achiron, Asaf; Man, Vitaly; Burgansky-Eliash, Zvia

    2017-04-01

    Primary open angle glaucoma is a chronic optic neuropathy affecting millions of people worldwide and represents a major public health issue. Environmental factors, behaviors, and diet are intimately related to patient health and may play a role in the pathogenesis and progression of glaucoma. This study aims to review the literature, focusing on the last three years, regarding modifiable lifestyle interventions in the management of primary open angle glaucoma. Electronic databases were searched for studies published between January 2013 and July 2016 on the topic of lifestyle interventions in primary open angle glaucoma. Sleeping with the head elevated and avoiding the worst eye-dependent side during sleep may slightly lower intraocular pressure and reduce visual field loss. Some food supplements and moderate aerobic exercise may also reduce intraocular pressure up to 2.0 and 3.0 mmHg, respectively. Frequency of coffee intake may be associated with disease progression. Potential negative effects are associated with weight-lifting and yoga exercises. Certain lifestyle habits could influence glaucoma progression, yet no specific interventions are currently supported by robust evidence. Awareness of the possible influences of certain habits should help guide clinical advice and is important to help patients avoid adverse outcomes and take an active role in the management of their disease.

  14. Flavanols and Anthocyanins in Cardiovascular Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Sonia de Pascual-Teresa

    2010-04-01

    Full Text Available Nowadays it is accepted that natural flavonoids present in fruits and plant-derived-foods are relevant, not only for technological reasons and organoleptic properties, but also because of their potential health-promoting effects, as suggested by the available experimental and epidemiological evidence. The beneficial biological effects of these food bioactives may be driven by two of their characteristic properties: their affinity for proteins and their antioxidant activity. Over the last 15 years, numerous publications have demonstrated that besides their in vitro antioxidant capacity, certain phenolic compounds, such as anthocyanins, catechins, proanthocyanidins, and other non coloured flavonoids, may regulate different signaling pathways involved in cell survival, growth and differentiation. In this review we will update the knowledge on the cardiovascular effects of anthocyanins, catechins and proanthocyanidins, as implied by the in vitro and clinical studies on these compounds. We also review the available information on the structure, distribution and bioavailability of flavanols (monomeric catechins and proanthocyanidins and anthocyanins, data necessary in order to understand their role in reducing risk factors and preventing cardiovascular health problems through different aspects of their bioefficacy on vascular parameters (platelet agregation, atherosclerosis, blood pressure, antioxidant status, inflammation-related markers, etc., myocardial conditions, and whole-body metabolism (serum biochemistry, lipid profile, highlighting the need for better-designed clinical studies to improve the current knowledge on the potential health benefits of these flavonoids to cardiovascular and metabolic health.

  15. Clinical utility of trabectedin for the treatment of ovarian cancer: current evidence

    Directory of Open Access Journals (Sweden)

    Mascilini F

    2014-07-01

    Full Text Available Floriana Mascilini,* Giulia Amadio,* Maria Grazia Di Stefano, Manuela Ludovisi, Alessia Di Legge, Carmine Conte, Rosa De Vincenzo, Caterina Ricci, Valeria Masciullo, Vanda Salutari, Giovanni Scambia, Gabriella FerrandinaGynecologic Oncology Unit, Department of Oncology, Catholic University of Rome, Italy  *These authors contributed equally to this work Abstract: Among the pharmaceutical options available for treatment of ovarian cancer, attention has been increasingly focused on trabectedin (ET-743, a drug which displays a unique mechanism of action and has been shown to be active in several human malignancies. Currently, single agent trabectedin is approved for treatment of patients with advanced soft tissue sarcoma after failure of anthracyclines and ifosfamide, and in association with pegylated liposomal doxorubicin for treatment of patients with relapsed partially platinum-sensitive ovarian cancer. This review aims at summarizing the available evidence about the clinical role of trabectedin in the management of patients with epithelial ovarian cancer. Novel perspectives coming from a better understanding of trabectedin mechanisms of action and definition of patients subgroups likely susceptible to benefit of trabectedin treatment are also presented. Keywords: ET-743, ovarian cancer, clinical trials

  16. Antibiotics versus appendectomy in the management of acute appendicitis: a review of the current evidence

    Science.gov (United States)

    Fitzmaurice, Gerard J.; McWilliams, Billy; Hurreiz, Hisham; Epanomeritakis, Emanuel

    2011-01-01

    Background Acute appendicitis remains the most common cause of the acute abdomen in young adults, and the mainstay of treatment in most centres is an appendectomy. However, treatment for other intra-abdominal inflammatory processes, such as diverticulitis, consists initially of conservative management with antibiotics. The aim of this study was to determine the role of antibiotics in the management of acute appendicitis and to assess if appendectomy remains the gold standard of care. Methods A literature search using MEDLINE and the Cochrane Library identified studies published between 1999 and 2009, and we reviewed all relevant articles. The articles were critiqued using the Public Health Resource Unit (2006) appraisal tools. Results Our search yielded 41 papers, and we identified a total of 13 papers within the criteria specified. All of these papers, while posing pertinent questions and demonstrating the role of antibiotics as a bridge to surgery, failed to adequately justify their findings that antibiotics could be used as a definitive treatment of acute appendicitis. Conclusion Appendectomy remains the gold standard of treatment for acute appendicitis based on the current evidence. PMID:21651835

  17. The Role of Adiponectin in Cancer: A Review of Current Evidence

    Science.gov (United States)

    Dalamaga, Maria; Diakopoulos, Kalliope N.

    2012-01-01

    Excess body weight is associated not only with an increased risk of type 2 diabetes and cardiovascular disease (CVD) but also with various types of malignancies. Adiponectin, the most abundant protein secreted by adipose tissue, exhibits insulin-sensitizing, antiinflammatory, antiatherogenic, proapoptotic, and antiproliferative properties. Circulating adiponectin levels, which are determined predominantly by genetic factors, diet, physical activity, and abdominal adiposity, are decreased in patients with diabetes, CVD, and several obesity-associated cancers. Also, adiponectin levels are inversely associated with the risk of developing diabetes, CVD, and several malignancies later in life. Many cancer cell lines express adiponectin receptors, and adiponectin in vitro limits cell proliferation and induces apoptosis. Recent in vitro studies demonstrate the antiangiogenic and tumor growth-limiting properties of adiponectin. Studies in both animals and humans have investigated adiponectin and adiponectin receptor regulation and expression in several cancers. Current evidence supports a role of adiponectin as a novel risk factor and potential diagnostic and prognostic biomarker in cancer. In addition, either adiponectin per se or medications that increase adiponectin levels or up-regulate signaling pathways downstream of adiponectin may prove to be useful anticancer agents. This review presents the role of adiponectin in carcinogenesis and cancer progression and examines the pathophysiological mechanisms that underlie the association between adiponectin and malignancy in the context of a dysfunctional adipose tissue in obesity. Understanding of these mechanisms may be important for the development of preventive and therapeutic strategies against obesity-associated malignancies. PMID:22547160

  18. How Is Working Memory Training Likely to Influence Academic Performance? Current Evidence and Methodological Considerations.

    Science.gov (United States)

    Bergman Nutley, Sissela; Söderqvist, Stina

    2017-01-01

    Working memory (WM) is one of our core cognitive functions, allowing us to keep information in mind for shorter periods of time and then work with this information. It is the gateway that information has to pass in order to be processed consciously. A well-functioning WM is therefore crucial for a number of everyday activities including learning and academic performance (Gathercole et al., 2003; Bull et al., 2008), which is the focus of this review. Specifically, we will review the research investigating whether improving WM capacity using Cogmed WM training can lead to improvements on academic performance. Emphasis is given to reviewing the theoretical principles upon which such investigations rely, in particular the complex relation between WM and mathematical and reading abilities during development and how these are likely to be influenced by training. We suggest two possible routes in which training can influence academic performance, one through an effect on learning capacity which would thus be evident with time and education, and one through an immediate effect on performance on reading and mathematical tasks. Based on the theoretical complexity described we highlight some methodological issues that are important to take into consideration when designing and interpreting research on WM training and academic performance, but that are nonetheless often overlooked in the current research literature. Finally, we will provide some suggestions for future research for advancing the understanding of WM training and its potential role in supporting academic attainment.

  19. Incretin-based therapies in prediabetes: Current evidence and future perspectives

    Institute of Scientific and Technical Information of China (English)

    Georgios; S; Papaetis

    2014-01-01

    The prevalence of type 2 diabetes(T2D) is evolving globally at an alarming rate. Prediabetes is an intermediate state of glucose metabolism that exists between normal glucose tolerance(NGT) and the clinical entity of T2 D. Relentless β-cell decline and failure is responsible for the progression from NGT to prediabetes and eventually T2 D. The huge burden resulting from the complications of T2 D created the need of therapeutic strategies in an effort to prevent or delay its development. The beneficial effects of incretin-based therapies, dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1(GLP-1) receptor agonists, on β-cell function in patients with T2 D, together with their strictly glucose-depended mechanism of action, suggested their possible use in individuals with prediabetes when greater β-cell mass and function are preserved and the possibility of β-cell salvage is higher. The present paper summarizes the main molecular intracellular mechanisms through which GLP-1 exerts its activity on β-cells. It also explores the current evidence of incretin based therapies when administered in a prediabetic state, both in animal models and in humans. Finally it discusses the safety of incretin-based therapies as well as their possible role in order to delay or prevent T2 D.

  20. Percutaneous patent foramen ovale occlusion: current evidence and evolving clinical practice.

    Science.gov (United States)

    Leong, Ming Chern; Uebing, Anselm; Gatzoulis, Michael A

    2013-11-15

    Patent foramen ovale (PFO) has long been implicated with cryptogenic stroke, migraine and decompression illness. PFO is common and its implicated pathologies cause devastating neurological sequelae; and hence have drawn the attention of medical practitioners across disciplines. The pathogenesis is hypothesized to be caused by micro-emboli or neuro-hormones which would otherwise being filtered by the lungs, astraying into the systemic circulation via the atrial communication especially during Valsalva maneuver. Treatment options have been proposed; among others are medical therapy, PFO closure or both. While medical therapy as secondary prevention is being adopted by most centers in the world, PFO closure is performed in selected patients only. The reason being is that most studies linking PFO to these pathologies are observational in nature. And these associations do not equate to a firm cause and effect relationship. For causal relationship to be established, good quality prospective data is required. Recently, there has been emergence of new prospective trials which improve the understanding of PFO closure in these pathologies. This article reviews the associations between PFO and the three main implicated pathologies as well as the evidence for PFO closure in the current era.

  1. Evidence for improvement of critical current by Ag in YBaCuO-Ag thick films

    Science.gov (United States)

    Dwir, B.; Kellett, B.; Mieville, L.; Pavuna, D.

    1991-04-01

    The evidence is reported for enhancement of critical current density J(c) in YBa2Cu3O(7-delta) thick films with the addition of Ag, which is correlated with improvements in structural properties. An improvement of 50 percent in J(c) (up to about 500 A/sq cm at T = 4.2 K) was obtained in films made from YBCO + 60 wt pct Ag powder, fabricated by the spin-on technique on (100) SrTiO3, which is correlated with improvements in structure. The resulting films are 10 microns thick, uniform, partially textured, and show good adherence. The critical temperature Tc is improved by the addition of Ag, and a reduction in the density of microcracks and in the amount of secondary phases in the sintered films was observed. Normal-state resistivity is reduced by almost three orders of magnitude, making these films potentially useful for electronic applications in interconnects and novel hybrid circuits.

  2. Evidence for improvement of critical current by Ag in YBaCuO-Ag thick films

    Energy Technology Data Exchange (ETDEWEB)

    Dwir, B.; Kellett, B.; Mieville, L.; Pavuna, D. (Institute of Micro- and Opto-electronics, Department of Physics, Swiss Federal Institute of Technology, CH-1015 Lausanne, Switzerland (CH))

    1991-04-15

    The evidence is reported for enhancement of critical current density {ital J}{sub {ital c}} in YBa{sub 2}Cu{sub 3}O{sub 7{minus}{delta}} thick films with the addition of Ag, which is correlated with improvements in structural properties. An improvement of 50% in {ital J}{sub {ital c}} (up to {similar to}500 A/cm{sup 2} at {ital T}=4.2 K) was obtained in films made from YBCO+60wt % Ag powder, fabricated by the spin-on technique on (100) SrTiO{sub 3}, which is correlated with improvements in structure. The resulting films are 10 {mu}m thick, uniform, partially textured, and show good adherence. The critical temperature {ital T}{sub {ital c}} is improved by the addition of Ag, and a reduction in the density of microcracks and in the amount of secondary phases in the sintered films was observed. Normal-state resistivity is reduced by almost three orders of magnitude, making these films potentially useful for electronic applications in interconnects and novel hybrid circuits.

  3. How Is Working Memory Training Likely to Influence Academic Performance? Current Evidence and Methodological Considerations

    Science.gov (United States)

    Bergman Nutley, Sissela; Söderqvist, Stina

    2017-01-01

    Working memory (WM) is one of our core cognitive functions, allowing us to keep information in mind for shorter periods of time and then work with this information. It is the gateway that information has to pass in order to be processed consciously. A well-functioning WM is therefore crucial for a number of everyday activities including learning and academic performance (Gathercole et al., 2003; Bull et al., 2008), which is the focus of this review. Specifically, we will review the research investigating whether improving WM capacity using Cogmed WM training can lead to improvements on academic performance. Emphasis is given to reviewing the theoretical principles upon which such investigations rely, in particular the complex relation between WM and mathematical and reading abilities during development and how these are likely to be influenced by training. We suggest two possible routes in which training can influence academic performance, one through an effect on learning capacity which would thus be evident with time and education, and one through an immediate effect on performance on reading and mathematical tasks. Based on the theoretical complexity described we highlight some methodological issues that are important to take into consideration when designing and interpreting research on WM training and academic performance, but that are nonetheless often overlooked in the current research literature. Finally, we will provide some suggestions for future research for advancing the understanding of WM training and its potential role in supporting academic attainment.

  4. Prehospital Care for the Adult and Pediatric Seizure Patient: Current Evidence-based Recommendations

    Science.gov (United States)

    Silverman, Eric C.; Sporer, Karl A.; Lemieux, Justin M.; Brown, John F.; Koenig, Kristi L.; Gausche-Hill, Marianne; Rudnick, Eric M.; Salvucci, Angelo A.; Gilbert, Greg H.

    2017-01-01

    Introduction We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of adult and pediatric patients with a seizure and to compare these recommendations against the current protocol used by the 33 emergency medical services (EMS) agencies in California. Methods We performed a review of the evidence in the prehospital treatment of patients with a seizure, and then compared the seizure protocols of each of the 33 EMS agencies for consistency with these recommendations. We analyzed the type and route of medication administered, number of additional rescue doses permitted, and requirements for glucose testing prior to medication. The treatment for eclampsia and seizures in pediatric patients were analyzed separately. Results Protocols across EMS Agencies in California varied widely. We identified multiple drugs, dosages, routes of administration, re-dosing instructions, and requirement for blood glucose testing prior to medication delivery. Blood glucose testing prior to benzodiazepine administration is required by 61% (20/33) of agencies for adult patients and 76% (25/33) for pediatric patients. All agencies have protocols for giving intramuscular benzodiazepines and 76% (25/33) have protocols for intranasal benzodiazepines. Intramuscular midazolam dosages ranged from 2 to 10 mg per single adult dose, 2 to 8 mg per single pediatric dose, and 0.1 to 0.2 mg/kg as a weight-based dose. Intranasal midazolam dosages ranged from 2 to 10 mg per single adult or pediatric dose, and 0.1 to 0.2 mg/kg as a weight-based dose. Intravenous/intrasosseous midazolam dosages ranged from 1 to 6 mg per single adult dose, 1 to 5 mg per single pediatric dose, and 0.05 to 0.1 mg/kg as a weight-based dose. Eclampsia is specifically addressed by 85% (28/33) of agencies. Forty-two percent (14/33) have a protocol for administering magnesium sulfate, with intravenous dosages ranging from 2 to 6 mg, and 58% (19/33) allow benzodiazepines to be administered

  5. New drugs targeting the cardiac ultra-rapid delayed-rectifier current (I Kur): rationale, pharmacology and evidence for potential therapeutic value.

    Science.gov (United States)

    Ford, John W; Milnes, James T

    2008-08-01

    There is a clear unmet medical need for new pharmacologic therapies for the treatment of atrial fibrillation (AF) with improved efficacy and safety. This article reviews the development of new and novel Kv1.5/ultra-rapid delayed-rectifier current (I Kur) inhibitors and presents evidence that Kv1.5 modulation provides an atrial-selective mechanism for treating AF. Academia and industry have invested heavily in Kv1.5 (>500 scientific publications and >50 patents published since 1993); however, to realize the full value of this therapeutic drug target, clinical efficacy and safety data are required for a selective Kv1.5 modulator. The reward for demonstrating clinical efficacy and safety in a pivotal Phase 3 trial, on regulatory approval, is "first in class" status.

  6. ARE SPANKING INJUNCTIONS SCIENTIFICALLY SUPPORTED?

    National Research Council Canada - National Science Library

    Robert E. Larzelere; Diana Baumrind

    2010-01-01

      Larzelere and Baumrind summarize the scientific evidence on child outcomes of spanking, emphasizing causal evidence under conditions considered most appropriate for its use by parents and psychologists...

  7. Evidence-based practice in the social sciences? A scale of causality, interventions, and possibilities for scientific proof

    NARCIS (Netherlands)

    Tellings, A.E.J.M.

    2017-01-01

    This article discusses Evidence-Based Practice (EBP) in the social sciences. After a brief outline of the discussion, the work of William Herbert Dray (1921-2009) is examined. Dray, partly following Collingwood, worked on different forms of causality and methodology in historical explanation (in

  8. Evolution of an Evidence Collaboration: From Initial Goals to Current Initiatives.

    Science.gov (United States)

    Giambra, Barbara K; Clark, Eloise; Busch, Melida D; Gerhardt, Wendy Engstrom

    2015-01-01

    Best practices based on evidence are needed by every clinician to provide safe, effective, patient-centered care. Determining best practice for a given situation can be difficult. Ideally, the clinician understands how to critically appraise the relevant research, and integrates high-quality research with interdisciplinary clinical expertise and patient and family values and preferences to choose best care for an individual or family. At our organization, we are taking the integration of research, clinical expertise, and patient/family preferences and values to the next level by aligning the evidence work of multiple functional areas and disciplines to improve the safety and effectiveness of clinical practice. The Evidence Collaboration, an interdisciplinary community of practice, has evolved to meet the challenges of helping novices and experts of all disciplines identify, critically appraise, synthesize, and disseminate evidence to inform best practices for patients and families, staff, and institutional processes. By creating a common language for evidence work, resources such as the Let Evidence Guide Every New Decision system, and templates for dissemination, the Evidence Collaboration has moved the organizational culture toward one that encourages the use of evidence in all decisions. Our progress continues as we strive to include patients and families in the decisions about best practices based on evidence.

  9. Towards Evidence-Based Initial Teacher Education in Singapore: A Review of Current Literature

    Science.gov (United States)

    Low, Ee-Ling; Hui, Chenri; Taylor, Peter G.; Ng, Pak Tee

    2012-01-01

    Initial teacher education (ITE) in Singapore is shifting towards evidence-based practice. Despite a clear policy orientation, ITE in Singapore has not yet produced the evidence base that it is anticipating. This paper presents an analytical review of previous research into ITE in Singapore and makes comparisons to the larger international context.…

  10. Evidence of Effectiveness of Current Therapies to Prevent and Treat Early Childhood Caries

    DEFF Research Database (Denmark)

    Twetman, Svante; Dhar, Vineet

    2015-01-01

    and Evaluation) system. RESULTS: There was moderate and limited quality of evidence in support of fluoride toothpaste and fluoride varnish for ECC prevention, while the evidence for fluoride tablets/drops was insufficient. The support for the use of silver diamine fluoride, xylitol, chlorhexidine varnish...

  11. Observational evidence for remote forcing of the west India coastal current

    Digital Repository Service at National Institute of Oceanography (India)

    Shetye, S.R.; Suresh, I.; Shankar, D.; Sundar, D.; Jayakumar, S.; Mehra, P.; Desai, R.G.P.; Pednekar, P.S.

    remote and local forcing in observations. Using field measurements (current, sea level, and wind) for a month during March-April 2003 off Goa in the near-coast regime of the West India Coastal Current (WICC), we show that the current was driven by local...

  12. Dietary supplementation in patients with alcoholic liver disease:a review on current evidence

    Institute of Scientific and Technical Information of China (English)

    Zeinab Ghorbani; Masoomeh Hajizadeh; Azita Hekmatdoost

    2016-01-01

    BACKGROUND: Alcoholic liver disease (ALD) is one of the main causes of liver disease worldwide. Although the patho-genesis of ALD has not yet been well elucidated, the oxidative metabolites of ethanol such as acetaldehyde and reactive oxy-gen species play a pivotal role in the clinical and pathological spectrum of the disease. This review summarizes the existing evidences on dietary supplements considered to have antioxi-dant, and/or anti-inlfammatory properties, and their role in the management of ALD and the proposed mechanisms. DATA SOURCES: The present study reviewed all studies pub-lished in PubMed, ScienceDirect and Scopus, from 1959 to 2015, indicating the role of different dietary supplementation in attenuation of many pathophysiological processes involved in development and progression of ALD. Full-texts of citations were used except for those that were published in languages other than English. RESULTS: Signiifcant progress has been made to understand the key events and molecular players for the onset and pro-gression of ALD from both experimental and clinical studies;however, there is no successful treatment currently available. The present review discussed the role of a variety of dietary supplements (e.g. vitamin A, carotenoids, vitamins B3, C and E, in addition to antioxidants and anti-inlfammatory agents) in treating ALD. It has been shown that supplementation with some carotenoids, vitamin B3, vitamin C, silymarin, curcumin, probiotics, zinc, S-adenosylmethionine and garlic may have potential beneifcial effects in animal models of ALD; however, the number of clinical studies is very limited. In addition, sup-plementation should be accompanied with alcohol cessation. CONCLUSIONS: Since oxidative stress and inlfammation are involved in the pathogenesis of ALD, dietary supplements that can modulate these pathologies could be useful in the treat-ment of ALD. In addition to alcohol cessation, these supple-ments have shown beneifcial effects on animal

  13. Genesis and development of the “medical fact”. Thought style and scientific evidence in the epistemology of Ludwik Fleck

    Directory of Open Access Journals (Sweden)

    Sofia Siwecka

    2011-12-01

    Full Text Available A diagnosis based exclusively on the so-called scientifi c evidence does not take into account the problem of the theoryladenness,widely debated in Twentieth Century epistemology. The theory of knowledge developed by Ludwik Fleck,physician and philosopher active in the 30s, can still be useful for shedding light on how psychiatric diagnoses areinfl uenced by a specifi c thought style that directs the observations and affects the development of knowledge and theformation of connections between concepts.

  14. Difference of Sodium Currents between Pediatric and Adult Human Atrial Myocytes: Evidence for Developmental Changes of Sodium Channels

    Directory of Open Access Journals (Sweden)

    Benzhi Cai, Xiaoqin Mu, Dongmei Gong, Shulin Jiang, Jianping Li, Qingxin Meng, Yunlong Bai, Yanju Liu, Xinyue Wang, Xueying Tan, Baofeng Yang, Yanjie Lu

    2011-01-01

    Full Text Available Voltage-gated calcium currents and potassium currents were shown to undergo developmental changes in postnatal human and animal cardiomocytes. However, so far, there is no evidence whether sodium currents also presented the developmental changes in postnatal human atrial cells. The aim of this study was to observe age-related changes of sodium currents between pediatric and adult atrial myocytes. Human atrial myocytes were acutely isolated and the whole-cell patch clamp technique was used to record sodium currents isolated from pediatric and adult atrial cardiomocytes. The peak amplitude of sodium currents recorded in adult atrial cells was significantly larger than that in pediatric atrial myocytes. However, there was no significant difference of the activation voltage for peak sodium currents between two kinds of atrial myocytes. The time constants for the activation and inactivation of sodium currents were smaller in adult atria than pediatric atria. The further study revealed that the voltage-dependent inactivation of sodium currents were more slow in adult atrial cardiomyocytes than pediatric atrial cells. A significant difference was also observed in the recovery process of sodium channel from inactivation. In summary, a few significant differences were demonstrated in sodium currents characteristics between pediatric and adult atrial myocytes, which indicates that sodium currents in human atria also undergo developmental changes.

  15. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  16. Aripiprazole in the maintenance treatment of bipolar disorder: a critical review of the evidence and its dissemination into the scientific literature.

    Directory of Open Access Journals (Sweden)

    Alexander C Tsai

    2011-05-01

    Full Text Available BACKGROUND: Aripiprazole, a second-generation antipsychotic medication, has been increasingly used in the maintenance treatment of bipolar disorder and received approval from the U.S. Food and Drug Administration for this indication in 2005. Given its widespread use, we sought to critically review the evidence supporting the use of aripiprazole in the maintenance treatment of bipolar disorder and examine how that evidence has been disseminated in the scientific literature. METHODS AND FINDINGS: We systematically searched multiple databases to identify double-blind, randomized controlled trials of aripiprazole for the maintenance treatment of bipolar disorder while excluding other types of studies, such as open-label, acute, and adjunctive studies. We then used a citation search to identify articles that cited these trials and rated the quality of their citations. Our evidence search protocol identified only two publications, both describing the results of a single trial conducted by Keck et al., which met criteria for inclusion in this review. We describe four issues that limit the interpretation of that trial as supporting the use of aripiprazole for bipolar maintenance: (1 insufficient duration to demonstrate maintenance efficacy; (2 limited generalizability due to its enriched sample; (3 possible conflation of iatrogenic adverse effects of abrupt medication discontinuation with beneficial effects of treatment; and (4 a low overall completion rate. Our citation search protocol yielded 80 publications that cited the Keck et al. trial in discussing the use of aripiprazole for bipolar maintenance. Of these, only 24 (30% mentioned adverse events reported and four (5% mentioned study limitations. CONCLUSIONS: A single trial by Keck et al. represents the entirety of the literature on the use of aripiprazole for the maintenance treatment of bipolar disorder. Although careful review identifies four critical limitations to the trial's interpretation

  17. How current are leading evidence-based medical textbooks? An analytic survey of four online textbooks.

    Science.gov (United States)

    Jeffery, Rebecca; Navarro, Tamara; Lokker, Cynthia; Haynes, R Brian; Wilczynski, Nancy L; Farjou, George

    2012-12-10

    The consistency of treatment recommendations of evidence-based medical textbooks with more recently published evidence has not been investigated to date. Inconsistencies could affect the quality of medical care. To determine the frequency with which topics in leading online evidence-based medical textbooks report treatment recommendations consistent with more recently published research evidence. Summarized treatment recommendations in 200 clinical topics (ie, disease states) covered in four evidence-based textbooks--UpToDate, Physicians' Information Education Resource (PIER), DynaMed, and Best Practice--were compared with articles identified in an evidence rating service (McMaster Premium Literature Service, PLUS) since the date of the most recent topic updates in each textbook. Textbook treatment recommendations were compared with article results to determine if the articles provided different, new conclusions. From these findings, the proportion of topics which potentially require updating in each textbook was calculated. 478 clinical topics were assessed for inclusion to find 200 topics that were addressed by all four textbooks. The proportion of topics for which there was 1 or more recently published articles found in PLUS with evidence that differed from the textbooks' treatment recommendations was 23% (95% CI 17-29%) for DynaMed, 52% (95% CI 45-59%) for UpToDate, 55% (95% CI 48-61%) for PIER, and 60% (95% CI 53-66%) for Best Practice (χ(2) (3)=65.3, P<.001). The time since the last update for each textbook averaged from 170 days (range 131-209) for DynaMed, to 488 days (range 423-554) for PIER (P<.001 across all textbooks). In online evidence-based textbooks, the proportion of topics with potentially outdated treatment recommendations varies substantially.

  18. Evidence-based practice in Occupational Health Psychology. Current status and further developments

    Directory of Open Access Journals (Sweden)

    Maricutoiu, Laurentiu P.

    2012-04-01

    Full Text Available The present paper discusses the status of evidence-based practice in Occupational Health Psychology (OHP. After several searches on large online databases, we have found that OHP papers that discuss interventions are less than 10% of the overall literature. Furthermore, quantitative reviews research that reports interventions on major OHP topics are generally absent. In the last part of the paper, we formulate some reccomendations for increasing the number of papers relevant for evidence-based practice in OHP.

  19. Evidence for a distinct light-induced calcium-dependent potassium current in Hermissenda crassicornis.

    Science.gov (United States)

    Blackwell, K T

    2000-01-01

    A model of phototransduction is developed as a first step toward a model for investigating the critical interaction of light and turbulence stimuli within the type B photoreceptor of Hermissenda crassicronis. The model includes equations describing phototransduction, release of calcium from intracellular stores, and other calcium regulatory mechanisms, as well as equations describing ligand-gating of a rhabdomeric sodium current. The model is used to determine the sources of calcium in the soma, whether calcium or IP3 is a plausible ligand of the light-induced sodium current, and whether the light-induced potassium current is equivalent to the calcium-dependent potassium current activated by light-induced calcium release. Simulations show that the early light-induced calcium elevation is due to influx through voltage-dependent channels, whereas the later calcium elevation is due to release from intracellular stores. Simulations suggest that the ligand of the fast, light-induced sodium current is IP3 but that there is a smaller, prolonged component of the light-induced sodium current that is activated by calcium. In the model, the calcium-dependent potassium current, located in the soma, is activated only slightly by light-induced calcium elevation, leading to the prediction that a calcium-dependent potassium current, active at resting potential, is located in the rhabdomere and is responsible for the light-induced potassium current.

  20. A Novel Wide-Area Backup Protection Based on Fault Component Current Distribution and Improved Evidence Theory

    Directory of Open Access Journals (Sweden)

    Zhe Zhang

    2014-01-01

    Full Text Available In order to solve the problems of the existing wide-area backup protection (WABP algorithms, the paper proposes a novel WABP algorithm based on the distribution characteristics of fault component current and improved Dempster/Shafer (D-S evidence theory. When a fault occurs, slave substations transmit to master station the amplitudes of fault component currents of transmission lines which are the closest to fault element. Then master substation identifies suspicious faulty lines according to the distribution characteristics of fault component current. After that, the master substation will identify the actual faulty line with improved D-S evidence theory based on the action states of traditional protections and direction components of these suspicious faulty lines. The simulation examples based on IEEE 10-generator-39-bus system show that the proposed WABP algorithm has an excellent performance. The algorithm has low requirement of sampling synchronization, small wide-area communication flow, and high fault tolerance.

  1. Managing caries: the need to close the gap between the evidence base and current practice.

    Science.gov (United States)

    Schwendicke, F; Doméjean, S; Ricketts, D; Peters, M

    2015-11-13

    Underpinned by a changing knowledge of the aetiology of caries and its sequelae, and assisted by established and advancing dental materials, there is growing evidence supporting less invasive management of dental caries based on the principles of minimal intervention dentistry. This narrative review assesses both the evidence and the adoption of less invasive caries management strategies and describes ways in which the gap between evidence and practice might be overcome. While there is increasing data supporting less invasive management of carious lesions, these are not standard in most dental practices worldwide. Usually, clinical studies focused on efficacy as outcome, and did not take into consideration the views and priorities of other stakeholders, such as primary care dentists, educators, patients and those financing services. Involving these stakeholders into study design and demonstrating the broader advantages of new management strategies might improve translation of research into practice. In theory, clinical dentists can rely on a growing evidence in cariology regarding less invasive management options. In practice, further factors seem to impede adoption of these strategies. Future research should address these factors by involving major stakeholders and investigating their prioritised outcomes to narrow or close the evidence gap.

  2. Interaction of pyroclastic density currents with human settlements: Evidence from ancient Pompeii

    Science.gov (United States)

    Gurioli, Lucia; Pareschi, M. Teresa; Zanella, Elena; Lanza, Roberto; Deluca, Enrico; Bisson, Marina

    2005-06-01

    Integrating field observations and rock-magnetic measurements, we report how a turbulent pyroclastic density current interacted with and moved through an urban area. The data are from the most energetic, turbulent pyroclastic density current of the A.D. 79 eruption of Vesuvius, Italy, which partially destroyed the Roman city of Pompeii. Our results show that the urban fabric was able to divide the lower portion of the current into several streams that followed the city walls and the intracity roads. Vortices, revealed by upstream particle orientations and decreases in deposit temperature, formed downflow of obstacles or inside cavities. Although these perturbations affected only the lower part of the current and were localized, they could represent, in certain cases, cooler zones within which chances of human survival are increased. Our integrated field data for pyroclastic density current temperature and flow direction, collected for the first time across an urban environment, enable verification of coupled thermodynamic numerical models and their hazard simulation abilities.

  3. Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy.

    Science.gov (United States)

    Gerdesmeyer, Ludger; Mittermayr, Rainer; Fuerst, Martin; Al Muderis, Munjed; Thiele, Richard; Saxena, Amol; Gollwitzer, Hans

    2015-12-01

    Chronic Achilles tendinopathy has been described as the most common overuse injury in sports medicine. Several treatment modalities such as activity modification, heel lifts, arch supports, stretching exercises, nonsteroidal anti-inflammatories, and eccentric loading are known as standard treatment mostly without proven evidence. After failed conservative therapy, invasive treatment may be considered. Extracorporeal shock wave therapy (ESWT) has been successfully used in soft-tissue pathologies like lateral epicondylitis, plantar fasciitis, tendinopathy of the shoulder and also in bone and skin disorders. Conclusive evidence recommending ESWT as a treatment for Achilles tendinopathy is still lacking. In plantar fasciitis as well as in calcific shoulder tendinopathy shock wave therapy is recently the best evaluated treatment option. This article analysis the evidence based literature of ESWT in chronic Achilles tendinopathy. Recently published data have shown the efficacy of focused and radial extracorporeal shock wave therapy. Copyright © 2015 IJS Publishing Group Limited. All rights reserved.

  4. CURRENT EVIDENCE REGARDING THE EFFICACY OF PROPHYLACTIC ANTIBIOTICS IN THE MANAGEMENT OF FACIAL FRACTURES

    Directory of Open Access Journals (Sweden)

    Anilkumar

    2016-03-01

    Full Text Available Fractures of the facial region are commonly treated by surgeons operating in the head and neck. Antibiotic prophylaxis is used by these surgeons to decrease the rate of infections, however the role of prophylactic antibiotics remains controversial. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery and third molar surgeries. Unfortunately there is little evidence regarding the efficacy of prophylactic antibiotics in the management of facial fractures. In numerous cases no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. The aim of this paper is to present the available evidence regarding the efficacy of prophylactic antibiotics in the management of facial fractures.

  5. Is Current Account of Turkey Sustainable ? Evidence from Nonlinear Unit Root Tests

    Directory of Open Access Journals (Sweden)

    Serkan Taştan

    2015-09-01

    Full Text Available In this paper, current account sustainability of Turkey is analyzed in a nonlinear framework. Various nonlinear unit root tests have been used to test for structural break, sign and size nonlinearity. We have tested structural break and size nonlinearity separately and structural break-sign and size-sign nonlinearities simultaneously. Only considering the size nonlinearity, we have found that the current account of Turkey is sustainable. Thus, the size nonlinearity, in other words the speed of reversion to equilibrium, is essential for the current account sustainability of Turkey. We have also found that the speed of adjustment towards equilibrium is symmetric, while considering size and sign nonlinearities simultaneously.

  6. "EUROPART". Airborne particles in the indoor environment. A European interdisciplinary review of scientific evidence on associations between exposure to particles in buildings and health effects

    DEFF Research Database (Denmark)

    Schneider, T.; Sundell, Jan; Bischof, W.

    2003-01-01

    The relevance of particle mass, surface area or number concentration as risk indicators for health effects in non-industrial buildings has been assessed by a European interdisciplinary group of researchers (called EUROPART) by reviewing papers identified in Medline, Toxline, and OSH. Studies...... dealing with dermal effects or cancer or specifically addressing environmental tobacco smoke, house dust-mite, cockroach or animal allergens, microorganisms and pesticides were excluded. A total of 70 papers were reviewed, and eight were identified for the final review: Five experimental studies involving...... mainly healthy subjects, two cross-sectional office studies and one longitudinal study among elderly on cardiovascular effects. From most studies, no definite conclusions could be drawn. Overall, the group concluded that there is inadequate scientific evidence that airborne, indoor particulate mass...

  7. Europart - Airborne particles in the indoor environment. A European interdisciplinary review of scientific evidence on associations between exposure to particles in buildings and health effects

    DEFF Research Database (Denmark)

    Schneider, T.; Sundell, Jan; Bischof, W.

    2002-01-01

    The relevance of particle mass, surface area or number concentration as risk indicators for health effects in non-industrial buildings has been assessed by a European interdisciplinary group of researchers by reviewing papers identified in Medline, Toxline, and OSH. Studies dealing with dermal...... effects or cancer or specifically addressing environmental tobacco smoke, major allergens, and pesticides were excluded. Seventy-six papers were identified for evaluation and eight of these were judged to be conclusive and included in the final review: five experimental studies, two cross-sectional office...... studies, and a longitudinal study among elderly with cardiovascular conditions. Given the limited and inconclusive scientific evidence, the group concluded that indoor particulate mass or number concentrations cannot be used as generally applicable risk indicators of health effects in non...

  8. Current Evidence on Treatment of Patients With Chronic Systolic Heart Failure and Renal Insufficiency

    NARCIS (Netherlands)

    Damman, Kevin; Tang, W. H. Wilson; Felker, G. Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J. V.

    2014-01-01

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients

  9. Type 2 Endoleaks Post-EVAR: Current Evidence for Rupture Risk, Intervention and Outcomes of Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Raymond, E-mail: rchung@doctors.org.uk; Morgan, Robert A., E-mail: Robert.Morgan@stgeorges.nhs.uk [St. George’s Healthcare NHS Trust, Radiology, Ground Floor, St. James Wing (United Kingdom)

    2015-06-15

    Type 2 endoleaks (EL2) are the most commonly encountered endoleaks following EVAR. Despite two decades of experience, there remains considerable variation in the management of EL2 with controversies ranging from if to treat, when to treat and how to treat. Here, we summarise the available evidence, describe the treatment techniques available and offer guidelines for management.

  10. Management of Child and Adolescent Eating Disorders: The Current Evidence Base and Future Directions

    Science.gov (United States)

    Gowers, Simon; Bryant-Waugh, Rachel

    2004-01-01

    Although eating disorders in children and adolescents remain a serious cause of morbidity and mortality, the evidence base for effective interventions is surprisingly weak. The adult literature is growing steadily, but this is mainly with regard to psychological therapies for bulimia nervosa and to some extent in the field of pharmacotherapy. This…

  11. Evidence of Effectiveness of Current Therapies to Prevent and Treat Early Childhood Caries

    DEFF Research Database (Denmark)

    Twetman, Svante; Dhar, Vineet

    2015-01-01

    PURPOSE: The purpose of this paper was to systematically review the quality of evidence related to self-applied and professionally applied fluorides, antimicrobial agents, fissure sealants, temporary restorations, and restorative care for the prevention and management of early childhood caries (E...

  12. A review of current evidence for the causal impact of attentional bias on fear and anxiety

    NARCIS (Netherlands)

    van Bockstaele, B.; Verschuere, B.; Tibboel, H.; de Houwer, J.; Crombez, G.; Koster, E.H.W.

    2014-01-01

    Prominent cognitive theories postulate that an attentional bias toward threatening information contributes to the etiology, maintenance, or exacerbation of fear and anxiety. In this review, we investigate to what extent these causal claims are supported by sound empirical evidence. Although differen

  13. Management of Child and Adolescent Eating Disorders: The Current Evidence Base and Future Directions

    Science.gov (United States)

    Gowers, Simon; Bryant-Waugh, Rachel

    2004-01-01

    Although eating disorders in children and adolescents remain a serious cause of morbidity and mortality, the evidence base for effective interventions is surprisingly weak. The adult literature is growing steadily, but this is mainly with regard to psychological therapies for bulimia nervosa and to some extent in the field of pharmacotherapy. This…

  14. Reproducibility of current classifications of endometrial endometrioid glandular proliferations : further evidence supporting a simplified classification

    NARCIS (Netherlands)

    Ordi, Jaume; Bergeron, Christine; Hardisson, David; McCluggage, W. Glenn; Hollema, Harry; Felix, Ana; Soslow, Robert A.; Oliva, Esther; Tavassoli, Fattaneh A.; Alvarado-Cabrero, Isabel; Wells, Michael; Nogales, Francisco F.

    2014-01-01

    AimsTo compare the reproducibility of the current (2003) World Health Organization (WHO), endometrial intraepithelial neoplasia (EIN) and European Working Group (EWG) classifications of endometrial endometrioid proliferations. Methods and resultsNine expert gynaecological pathologists from Europe an

  15. Current Scientific and Regulatory Approaches for Development of Orally Inhaled and Nasal Drug Products: Overview of the IPAC-RS/University of Florida Orlando Inhalation Conference.

    Science.gov (United States)

    Hochhaus, Guenther; Davis-Cutting, Craig; Oliver, Martin; Lee, Sau L; Lyapustina, Svetlana

    2015-09-01

    This article summarizes discussions at the March 2014 conference organized by the University of Florida (UF) and International Pharmaceutical Aerosol Consortium on Regulation and Science (IPAC-RS), entitled "Orlando Inhalation Conference: Approaches in International Regulation." The special focus of the conference was on global scientific and regulatory issues associated with the testing and demonstration of equivalence for the registration of orally inhaled drug products (OIDPs) in the United States, Europe, Brazil, China, and India. The scope included all types of OIDPs throughout their lifecycle, e.g., innovator/brand-name products, generics, modifications due to lifecycle management, device changes, etc. Details were presented for the U.S. "weight of evidence approach" for registration of generic products (which includes demonstration of in vitro and in vivo equivalence, as well as quantitative and qualitative sameness, and device similarity). The European "stepwise" approach was elucidated, and the thinking of regulatory agencies in the major emerging markets was clarified. The conference also highlighted a number of areas that would benefit from further research and discussion, especially around patient/device interface and human factor studies, statistical methods and criteria for demonstrating equivalence, the relative roles of in vivo and in vitro tests, and appropriate designs and metrics for in vivo studies of inhaled drugs.

  16. Web 2.0 for health promotion: reviewing the current evidence.

    Science.gov (United States)

    Chou, Wen-ying Sylvia; Prestin, Abby; Lyons, Claire; Wen, Kuang-yi

    2013-01-01

    As Web 2.0 and social media make the communication landscape increasingly participatory, empirical evidence is needed regarding their impact on and utility for health promotion. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched 4 medical and social science databases for literature (2004-present) on the intersection of Web 2.0 and health. A total of 514 unique publications matched our criteria. We classified references as commentaries and reviews (n = 267), descriptive studies (n = 213), and pilot intervention studies (n = 34). The scarcity of empirical evidence points to the need for more interventions with participatory and user-generated features. Innovative study designs and measurement methods are needed to understand the communication landscape and to critically assess intervention effectiveness. To address health disparities, interventions must consider accessibility for vulnerable populations.

  17. Current evidence supporting fertility and pregnancy among young survivors of breast cancer.

    Science.gov (United States)

    Meneses, Karen; Holland, Aimee Chism

    2014-01-01

    Approximately 6% of invasive breast cancer is diagnosed in women younger than age 40 of age childbearing potential. Cancer-directed therapies can cause hormonal and anatomical changes that negatively affect the reproductive potential of young survivors of breast cancer. Recent national guidelines on fertility preservation are widely available. However, gaps in care exist in the interdisciplinary evidence-based management of young survivors of breast cancer with fertility and parenting concerns after cancer treatment.

  18. A review of current evidence for the causal impact of attentional bias on fear and anxiety.

    Science.gov (United States)

    Van Bockstaele, Bram; Verschuere, Bruno; Tibboel, Helen; De Houwer, Jan; Crombez, Geert; Koster, Ernst H W

    2014-05-01

    Prominent cognitive theories postulate that an attentional bias toward threatening information contributes to the etiology, maintenance, or exacerbation of fear and anxiety. In this review, we investigate to what extent these causal claims are supported by sound empirical evidence. Although differences in attentional bias are associated with differences in fear and anxiety, this association does not emerge consistently. Moreover, there is only limited evidence that individual differences in attentional bias are related to individual differences in fear or anxiety. In line with a causal relation, some studies show that attentional bias precedes fear or anxiety in time. However, other studies show that fear and anxiety can precede the onset of attentional bias, suggesting circular or reciprocal causality. Importantly, a recent line of experimental research shows that changes in attentional bias can lead to changes in anxiety. Yet changes in fear and anxiety also lead to changes in attentional bias, which confirms that the relation between attentional bias and fear and anxiety is unlikely to be unidirectional. Finally, a similar causal relation between interpretation bias and anxiety has been documented. In sum, there is evidence in favor of causality, yet a strict unidirectional cause-effect model is unlikely to hold. The relation between attentional bias and fear and anxiety is best described as a bidirectional, maintaining, or mutually reinforcing relation.

  19. B-vitamins and bone in health and disease: the current evidence.

    Science.gov (United States)

    Clarke, M; Ward, M; Strain, J J; Hoey, L; Dickey, W; McNulty, H

    2014-05-01

    Osteoporosis, a metabolic skeletal disease characterised by decreased bone mass and increased fracture risk, is a growing public health problem. Among the various risk factors for osteoporosis, calcium and vitamin D have well-established protective roles, but it is likely that other nutritional factors are also implicated. This review will explore the emerging evidence supporting a role for certain B-vitamins, homocysteine and the 677 C → T polymorphism in the gene encoding the folate-metabolising enzyme methylenetetrahydrofolate reductase, in bone health and disease. The evidence, however, is not entirely consistent and as yet no clear mechanism has been defined to explain the potential link between B-vitamins and bone health. Coeliac disease, a common condition of malabsorption, induced by gluten ingestion in genetically susceptible individuals, is associated with an increased risk both of osteoporosis and inadequate B-vitamin status. Given the growing body of evidence linking low bone mineral density and/or increased fracture risk with low B-vitamin status and elevated homocysteine, optimal B-vitamin status may play an important protective role against osteoporosis in coeliac disease; to date, no trial has addressed this possible link.

  20. Current Evidence regarding Prophylactic Antibiotics in Head and Neck and Maxillofacial Surgery

    Directory of Open Access Journals (Sweden)

    Kilian Kreutzer

    2014-01-01

    Full Text Available Antibiotic prophylaxis is commonly used to decrease the rate of infections in head and neck surgery. The aim of this paper is to present the available evidence regarding the application of antibiotic prophylaxis in surgical procedures of the head and neck region in healthy patients. A systemic literature review based on Medline and Embase databases was performed. All reviews and meta-analyses based on RCTs in English from 2000 to 2013 were included. Eight out of 532 studies fulfilled all requirements. Within those, only seven different operative procedures were analyzed. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery, and operative tooth extractions. Unfortunately, little high-level evidence exists regarding the use of prophylactic antibiotics in head and neck surgery. In numerous cases, no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. Antibiotics are often given unnecessarily and are administered too late and for too long. Furthermore, little research has been performed on the large number of routine cases in the above-mentioned areas of specialization within the last few years, although questions arising with respect to the treatment of high-risk patients or of specific infections are discussed on a broad base.

  1. How to prevent burnout in cardiologists? A review of the current evidence, gaps, and future directions.

    Science.gov (United States)

    Panagioti, Maria; Geraghty, Keith; Johnson, Judith

    2017-07-04

    Burnout is rising in all physicians, and cardiologists are not an exemption. Cardiology is a very popular specialty among medical students as it is associated with outstanding training standards and high prestige and income. In this review, we critically summarize the evidence on consequences, causes, and evidence-based interventions for burnout with a view toward recommending the best strategies for promoting wellness in cardiologists. Only a handful of studies have examined burnout specifically in cardiologists. Evidence therefore was mainly extrapolated by larger studies in all physicians and other physician specialties. Burnout in cardiologists has serious negative personal and professional consequences and is associated with suboptimal healthcare outcomes for patients. Burnout in cardiologists is primarily driven by professional and healthcare system demands and inefficiencies such as excessive workload and role complexity, training and certification demands, inefficient compensation models and lack of resources, computerization, and loss of autonomy. Moreover, loss of connectedness with patients, difficulties in balancing work and personal life and overvaluing compulsiveness and perfectionism in medical practice further increase the risk for burnout. Burnout among cardiologists may be best mitigated by organizational strategies complemented by individual stress reduction and reflection techniques under the resilience-based approach. Large-scale strategies are needed to mitigate burnout and promote physician wellness as a shared responsibility of healthcare systems and individuals and be committed in creating a new culture in medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Evidence for neutral-current diffractive neutral pion production from hydrogen in neutrino interactions on hydrocarbon

    CERN Document Server

    Wolcott, J; Altinok, O; Bercellie, A; Betancourt, M; Bodek, A; Bravar, A; Budd, H; Cai, T; Carneiro, M F; Chvojka, J; Devan, J; Dytman, S A; Diaz, G A; Eberly, B; Endress, E; Felix, J; Fields, L; Galindo, R; Gallagher, H; Golan, T; Gran, R; Harris, D A; Higuera, A; Hurtado, K; Kiveni, M; Kleykamp, J; Kordosky, M; Le, T; Maher, E; Manly, S; Mann, W A; Marshall, C M; Caicedo, D A Martinez; McFarland, K S; McGivern, C L; McGowan, A M; Messerly, B; Miller, J; Mislivec, A; Morfin, J G; Mousseau, J; Naples, D; Nelson, J K; Norrick, A; Nuruzzaman,; Paolone, V; Park, J; Patrick, C E; Perdue, G N; Rakotondravohitra, L; Ramirez, M A; Ray, H; Ren, L; Rimal, D; Rodrigues, P A; Ruterbories, D; Schellman, H; Schmitz, D W; Salinas, C J Solano; Sanchez, S F; Tagg, N; Tice, B G; Valencia, E; Walton, T; Wospakrik, M; Zhang, D

    2016-01-01

    The MINERvA experiment observes an excess of events containing electromagnetic showers relative to the expectation from Monte Carlo simulations in neutral-current neutrino interactions with mean beam energy of 4.5 GeV on a hydrocarbon target. The excess is characterized and found to be consistent with neutral-current neutral pion production with a broad energy distribution peaking at 7 GeV and a total cross section of 0.26 +- 0.02 (stat) +- 0.08 (sys) x 10^{-39} cm^{2}. The angular distribution, electromagnetic shower energy, and spatial distribution of the energy depositions of the excess are consistent with expectations from neutrino neutral-current diffractive neutral pion production from hydrogen in the hydrocarbon target. These data comprise the first direct experimental observation and constraint for a reaction that poses an important background process in neutrino oscillation experiments searching for muon neutrino to electron neutrino oscillations.

  3. The promise of ketamine for treatment-resistant depression: current evidence and future directions

    Science.gov (United States)

    DeWilde, Kaitlin E.; Levitch, Cara F.; Murrough, James W.; Mathew, Sanjay J.; Iosifescu, Dan V.

    2014-01-01

    Major depressive disorder (MDD) is one of the most disabling diseases worldwide and is a significant public health threat. Current treatments for MDD primarily consist of monoamine-targeting agents and have limited efficacy. However, the glutamate neurotransmitter system has recently come into focus as a promising alternative for novel antidepressant treatments. We review the current data on the glutamate NMDA receptor antagonist ketamine, which has been shown in clinical trials to act as a rapid antidepressant in MDD. We also examine ketamine efficacy on dimensions of psychopathology, including anhedonia, cognition, and suicidality, consistent with the NIMH Research Domain Criteria (RDoC) initiative. Other aspects of ketamine reviewed in this paper include safety and efficacy, different administration methods, and the risks of misuse of ketamine outside of medical settings. Finally, we conclude with a discussion of other glutamatergic agents other than ketamine currently being tested as novel antidepressants. PMID:25649308

  4. Conventional and/or laparoscopic rectal cancer surgery: what is the current evidence?

    Directory of Open Access Journals (Sweden)

    Mik Michal

    2016-09-01

    Full Text Available Despite many years of experience with laparoscopic procedures in rectal cancer, the superiority of minimally invasive approaches has been questioned especially in recent years. This article is a short review of the current knowledge about laparoscopic approaches in comparison to conventional modalities in patients with rectal cancer. To present the current state of the knowledge, we focused on reports that were published in the last few years and compared them to multicenter trials and meta-analyses published last year. Our analysis mainly applied to the primary end-points of these trials. We also included expert opinions that have been published in the last several months.

  5. Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments

    NARCIS (Netherlands)

    Schirmer, Stephan H.; Baumhaekel, Magnus; Neuberger, Hans-Ruprecht; Hohnloser, Stefan H.; van Gelder, Isabelle C.; Lip, Gregory Y. H.; Boehm, Michael

    2010-01-01

    Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using aspirin or vitamin K antagonists (VKA) is currently prescribed for prevention for ischemic stroke in patients with AF. A narrow therapeutic range and the need

  6. Evidence for two separate heliospheric current sheets of cylindrical shape during MID-2012

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Y.-M. [Space Science Division, Naval Research Laboratory, Washington, DC 20375 (United States); Young, P. R. [College of Science, George Mason University, Fairfax, VA 22030 (United States); Muglach, K., E-mail: yi.wang@nrl.navy.mil, E-mail: pyoung@ssd5.nrl.navy.mil, E-mail: karin.muglach@nasa.gov [Code 674, NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States)

    2014-01-01

    During the reversal of the Sun's polar fields at sunspot maximum, outward extrapolations of magnetograph measurements often predict the presence of two or more current sheets extending into the interplanetary medium, instead of the single heliospheric current sheet (HCS) that forms the basis of the standard 'ballerina skirt' picture. By comparing potential-field source-surface models of the coronal streamer belt with white-light coronagraph observations, we deduce that the HCS was split into two distinct structures with circular cross sections during mid-2012. These cylindrical current sheets were centered near the heliographic equator and separated in longitude by roughly 180°; a corresponding four-sector polarity pattern was observed at Earth. Each cylinder enclosed a negative-polarity coronal hole that was identifiable in extreme ultraviolet images and gave rise to a high-speed stream. The two current sheet systems are shown to be a result of the dominance of the Sun's nonaxisymmetric quadrupole component, as the axial dipole field was undergoing its reversal during solar cycle 24.

  7. Evidence for Two Separate Heliospheric Current Sheets of Cylindrical Shape During Mid-2012

    Science.gov (United States)

    Wang, Y.-M.; Young, P. R.; Muglach, K.

    2014-01-01

    During the reversal of the Sun's polar fields at sunspot maximum, outward extrapolations of magnetograph measurements often predict the presence of two or more current sheets extending into the interplanetary medium, instead of the single heliospheric current sheet (HCS) that forms the basis of the standard "ballerina skirt" picture. By comparing potential-field source-surface models of the coronal streamer belt with white-light coronagraph observations, we deduce that the HCS was split into two distinct structures with circular cross sections during mid-2012. These cylindrical current sheets were centered near the heliographic equator and separated in longitude by roughly 180° a corresponding four-sector polarity pattern was observed at Earth. Each cylinder enclosed a negative-polarity coronal hole that was identifiable in extreme ultraviolet images and gave rise to a high-speed stream. The two current sheet systems are shown to be a result of the dominance of the Sun's nonaxisymmetric quadrupole component, as the axial dipole field was undergoing its reversal during solar cycle 24.

  8. Is C-50 a superaromat? Evidence from electronic structure and ring current calculations

    NARCIS (Netherlands)

    Matias, Ana Sanz; Havenith, Remco W. A.; Alcami, Manuel; Ceulemans, Arnout

    2016-01-01

    The fullerene-50 is a 'magic number' cage according to the 2(N + 1)(2) rule. For the three lowest isomers of C-50 with trigonal and pentagonal symmetries, we calculate the sphericity index, the spherical parentage of the occupied p-orbitals, and the current density in an applied magnetic field. The

  9. Dietary prevention of allergic disease in children : Are current recommendations really based on good evidence?

    NARCIS (Netherlands)

    Brand, Paul L. P.; Vlieg-Boerstra, Berber J.; Dubois, Anthony E. J. .

    2007-01-01

    We provide a critical appraisal of the literature on the effects of dietary prevention of atopic disease in children. In our view, currently available studies suffer from lack of blinding which is a major problem if the primary end point is subjective (Such as the diagnosis of eczema). In addition,

  10. Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation Current Clinical Evidence and Future Developments

    NARCIS (Netherlands)

    Schirmer, Stephan H.; Baumhaekel, Magnus; Neuberger, Hans-Ruprecht; Hohnloser, Stefan H.; van Gelder, Isabelle C.; Lip, Gregory Y. H.; Boehm, Michael

    2010-01-01

    Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for ischemic stroke. Antithrombotic therapy using aspirin or vitamin K antagonists (VKA) is currently prescribed for prevention for ischemic stroke in patients with AF. A narrow therapeutic range and the need

  11. Mindfulness-Based Cognitive Therapy: Further Issues in Current Evidence and Future Research

    Science.gov (United States)

    Williams, J. Mark G.; Russell, Ian; Russell, Daphne

    2008-01-01

    The authors respond to the article by H. F. Coelho, P. H. Canter, and E. Ernst (2007), which reviewed the current status of mindfulness-based cognitive therapy (MBCT). First, they clarify the randomization procedures in the 2 main MBCT trials. Second, they report posttreatment and follow-up data to show that trial participants allocated to…

  12. Anti-Oxidative and Anti-Inflammatory Effects of Ginger in Health and Physical Activity: Review of Current Evidence

    OpenAIRE

    Nafiseh Shokri Mashhadi; Reza Ghiasvand; Gholamreza Askari; Mitra Hariri; Leila Darvishi; Mohammad Reza Mofid

    2013-01-01

    Background: Ginger (Zingiber officinale Rosc.) belongs to the family Zingiberaceae. The health-promoting perspective of ginger is attributed to its rich phytochemistry. This study aimed to review the current evidence on ginger effects as an anti-inflammatory and anti-oxidative. Methods: We searched MEDLINE for related publications using “ginger” and “anti-oxidative” and “ginger” and “anti-inflammatory” as keywords. This search had considered Papers that had been published between 2000 and 201...

  13. Extensional scientific realism vs. intensional scientific realism.

    Science.gov (United States)

    Park, Seungbae

    2016-10-01

    Extensional scientific realism is the view that each believable scientific theory is supported by the unique first-order evidence for it and that if we want to believe that it is true, we should rely on its unique first-order evidence. In contrast, intensional scientific realism is the view that all believable scientific theories have a common feature and that we should rely on it to determine whether a theory is believable or not. Fitzpatrick argues that extensional realism is immune, while intensional realism is not, to the pessimistic induction. I reply that if extensional realism overcomes the pessimistic induction at all, that is because it implicitly relies on the theoretical resource of intensional realism. I also argue that extensional realism, by nature, cannot embed a criterion for distinguishing between believable and unbelievable theories.

  14. ILSI Brazil International Workshop on Functional Foods: a narrative review of the scientific evidence in the area of carbohydrates, microbiome, and health

    Directory of Open Access Journals (Sweden)

    Marie E. Latulippe

    2013-02-01

    Full Text Available To stimulate discussion around the topic of ‘carbohydrates’ and health, the Brazilian branch of the International Life Sciences Institute held the 11th International Functional Foods Workshop (1–2 December 2011 in which consolidated knowledge and recent scientific advances specific to the relationship between carbohydrates and health were presented. As part of this meeting, several key points related to dietary fiber, glycemic response, fructose, and impacts on satiety, cognition, mood, and gut microbiota were realized: 1 there is a need for global harmonization of a science-based fiber definition; 2 low-glycemic index foods can be used to modulate the postprandial glycemic response and may affect diabetes and cardiovascular outcomes; 3 carbohydrate type may influence satiety and satiation; glycemic load and glycemic index show links to memory, mood, and concentration; 4 validated biomarkers are needed to demonstrate the known prebiotic effect of carbohydrates; 5 negative effects of fructose are not evident when human data are systematically reviewed; 6 new research indicates that diet strongly influences the microbiome; and 7 there is mounting evidence that the intestinal microbiota has the ability to impact the gut–brain axis. Overall, there is much promise for development of functional foods that impact the microbiome and other factors relevant to health, including glycemic response (glycemic index/glycemic load, satiety, mood, cognition, and weight management.

  15. ILSI Brazil International Workshop on Functional Foods: a narrative review of the scientific evidence in the area of carbohydrates, microbiome, and health.

    Science.gov (United States)

    Latulippe, Marie E; Meheust, Agnès; Augustin, Livia; Benton, David; Berčík, Přemysl; Birkett, Anne; Eldridge, Alison L; Faintuch, Joel; Hoffmann, Christian; Jones, Julie Miller; Kendall, Cyril; Lajolo, Franco; Perdigon, Gabriela; Prieto, Pedro Antonio; Rastall, Robert A; Sievenpiper, John L; Slavin, Joanne; de Menezes, Elizabete Wenzel

    2013-01-01

    To stimulate discussion around the topic of 'carbohydrates' and health, the Brazilian branch of the International Life Sciences Institute held the 11th International Functional Foods Workshop (1-2 December 2011) in which consolidated knowledge and recent scientific advances specific to the relationship between carbohydrates and health were presented. As part of this meeting, several key points related to dietary fiber, glycemic response, fructose, and impacts on satiety, cognition, mood, and gut microbiota were realized: 1) there is a need for global harmonization of a science-based fiber definition; 2) low-glycemic index foods can be used to modulate the postprandial glycemic response and may affect diabetes and cardiovascular outcomes; 3) carbohydrate type may influence satiety and satiation; glycemic load and glycemic index show links to memory, mood, and concentration; 4) validated biomarkers are needed to demonstrate the known prebiotic effect of carbohydrates; 5) negative effects of fructose are not evident when human data are systematically reviewed; 6) new research indicates that diet strongly influences the microbiome; and 7) there is mounting evidence that the intestinal microbiota has the ability to impact the gut-brain axis. Overall, there is much promise for development of functional foods that impact the microbiome and other factors relevant to health, including glycemic response (glycemic index/glycemic load), satiety, mood, cognition, and weight management.

  16. Regional heterogeneity in consumption due to current income shocks: New evidence from the Permanent Income Hypothesis

    DEFF Research Database (Denmark)

    Mitze, Timo

    In the light of new theoretical and empirical work on the Permanent Income Hypothesis we tackle earlier findings for German data, which reject its validity given a large fraction of liquidity constrained consumers. Starting from a standard short run approach we do not find evidence for excess...... borrow from the literature on Poolability tests and search for macro regional clusters with similar adjustment paths. The findings show that for the sample of West German states between 1970 and 2006 both for short and long run parameters the assumption of poolability of the data cannot be rejected...

  17. Working conditions and health among employees at information technology - enabled services: A review of current evidence

    Directory of Open Access Journals (Sweden)

    Kesavachandran C

    2006-07-01

    Full Text Available Workers in information technology (IT - enabled services like business process outsourcing and call centers working with visual display units are reported to have various health and psycho social disorders. Evidence from previously published studies in peer- reviewed journals and internet sources were examined to explore health disorders and psycho-social problems among personnel employed in IT-based services, for a systematic review on the topic. In addition, authors executed a questionnaire- based pilot study. The available literature and the pilot study, both suggest health disorders and psychosocial problems among workers of Business Process Outsourcing. The details are discussed in the review.

  18. The Scientific Case against Astrology.

    Science.gov (United States)

    Kelly, Ivan

    1980-01-01

    Discussed is the lack of a scientific foundation and scientific evidence favoring astrology. Included are several research studies conducted to examine astrological tenets which yield generally negative results. (Author/DS)

  19. Current Evidence on the Socket-Shield Technique: A Systematic Review.

    Science.gov (United States)

    Gharpure, Amit Srikant; Bhatavadekar, Neel B

    2016-11-29

    The recently popularised socket shield technique involves intentional retention of a thin buccal section of the remnant root at the time of immediate implant placement to preserve the buccal crestal bone from resorption. The objective of this systematic review was to assess the literature available on the socket-shield technique and weigh its biological plausibility and long-term clinical prognosis. A Systematic Search was performed in PubMed-Medline, Embase, Web of Knowledge, Google Scholar and Cochrane Central for clinical/ animal studies up to May 2016 without restrictions of language, duration, and follow-up. The literature search revealed that 15 out of 16 articles available were case reports and series, with 12 out of 16 having less than 12 months duration. Animal histological evidence demonstrated the formation of PDL and/or cementum on the implant surfaces in contact with/ in proximity to the socket-shield. Some clinical reports indicated stable results at 12 months; however, a few studies also reported infection and resorption of the socket-shield and bone loss. It would be difficult to predict the long -term success of this technique until high-quality evidence becomes available. Given some negative results, clinicians are recommended to use this technique with caution.

  20. Fasting therapy for treating and preventing disease - current state of evidence.

    Science.gov (United States)

    Michalsen, Andreas; Li, Chenying

    2013-01-01

    Periods of deliberate fasting with restriction of solid food intake are practiced worldwide, mostly based on traditional, cultural or religious reasons. There is large empirical and observational evidence that medically supervised modified fasting (fasting cure, 200-500 kcal nutritional intake per day) with periods of 7-21 days is efficacious in the treatment of rheumatic diseases, chronic pain syndromes, hypertension, and metabolic syndrome. The beneficial effects of fasting followed by vegetarian diet in rheumatoid arthritis are confirmed by randomized controlled trials. Further beneficial effects of fasting are supported by observational data and abundant evidence from experimental research which found caloric restriction and intermittent fasting being associated with deceleration or prevention of most chronic degenerative and chronic inflammatory diseases. Intermittent fasting may also be useful as an accompanying treatment during chemotherapy of cancer. A further beneficial effect of fasting relates to improvements in sustainable lifestyle modification and adoption of a healthy diet, possibly mediated by fasting-induced mood enhancement. Various identified mechanisms of fasting point to its potential health-promoting effects, e.g., fasting-induced neuroendocrine activation and hormetic stress response, increased production of neurotrophic factors, reduced mitochondrial oxidative stress, general decrease of signals associated with aging, and promotion of autophagy. Fasting therapy might contribute to the prevention and treatment of chronic diseases and should be further evaluated in controlled clinical trials and observational studies.

  1. Central retinal vein occlusion: A review of current Evidence-based treatment options

    Directory of Open Access Journals (Sweden)

    Amy Patel

    2016-01-01

    Full Text Available A central retinal vein occlusion (CRVO can induce an ischemic and hypoxic state with resulting sequelae of macular edema and neovascularization. Many treatment options have been studied. Our review aims to investigate the safety and efficacy of the multiple treatment options of CRVO. A PubMed and Cochrane literature search was performed. Well-controlled randomized clinical trials that demonstrated strong level 1 evidence-based on the rating scale developed by the British Centre for Evidence-Based Medicine were included. Seven clinical trials met inclusion criteria to be included in this review. These included studies that investigated the safety and efficacy of retinal photocoagulation (1 study, intravitreal steroid treatment (2 studies, and antivascular endothelial growth factor treatment (4 studies for the treatment of CRVO. In addition, studies evaluating surgical treatment options for CRVO were also included. Many treatment modalities have been demonstrated to be safe and efficacious in the treatment of CRVO. These treatment options offer therapeutic benefits for patients and clinically superior visual acuity and perhaps the quality of life after suffering from a CRVO.

  2. Epigenetics of Posttraumatic Stress Disorder: Current Evidence, Challenges, and Future Directions.

    Science.gov (United States)

    Zannas, Anthony S; Provençal, Nadine; Binder, Elisabeth B

    2015-09-01

    Posttraumatic stress disorder (PTSD) is a stress-related psychiatric disorder that is thought to emerge from complex interactions among traumatic events and multiple genetic factors. Epigenetic regulation lies at the heart of these interactions and mediates the lasting effects of the environment on gene regulation. An increasing body of evidence in human subjects with PTSD supports a role for epigenetic regulation of distinct genes and pathways in the pathogenesis of PTSD. The role of epigenetic regulation is further supported by studies examining fear conditioning in rodent models. Although this line of research offers an exciting outlook for future epigenetic research in PTSD, important limitations include the tissue specificity of epigenetic modifications, the phenomenologic definition of the disorder, and the challenge of translating molecular evidence across species. These limitations call for studies that combine data from postmortem human brain tissue and animal models, assess longitudinal epigenetic changes in living subjects, and examine dimensional phenotypes in addition to diagnoses. Moreover, examining the environmental, genetic, and epigenetic factors that promote resilience to trauma may lead to important advances in the field. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. Low-grade inflammation, diet composition and health: current research evidence and its translation.

    Science.gov (United States)

    Minihane, Anne M; Vinoy, Sophie; Russell, Wendy R; Baka, Athanasia; Roche, Helen M; Tuohy, Kieran M; Teeling, Jessica L; Blaak, Ellen E; Fenech, Michael; Vauzour, David; McArdle, Harry J; Kremer, Bas H A; Sterkman, Luc; Vafeiadou, Katerina; Benedetti, Massimo Massi; Williams, Christine M; Calder, Philip C

    2015-10-14

    The importance of chronic low-grade inflammation in the pathology of numerous age-related chronic conditions is now clear. An unresolved inflammatory response is likely to be involved from the early stages of disease development. The present position paper is the most recent in a series produced by the International Life Sciences Institute's European Branch (ILSI Europe). It is co-authored by the speakers from a 2013 workshop led by the Obesity and Diabetes Task Force entitled 'Low-grade inflammation, a high-grade challenge: biomarkers and modulation by dietary strategies'. The latest research in the areas of acute and chronic inflammation and cardiometabolic, gut and cognitive health is presented along with the cellular and molecular mechanisms underlying inflammation-health/disease associations. The evidence relating diet composition and early-life nutrition to inflammatory status is reviewed. Human epidemiological and intervention data are thus far heavily reliant on the measurement of inflammatory markers in the circulation, and in particular cytokines in the fasting state, which are recognised as an insensitive and highly variable index of tissue inflammation. Potential novel kinetic and integrated approaches to capture inflammatory status in humans are discussed. Such approaches are likely to provide a more discriminating means of quantifying inflammation-health/disease associations, and the ability of diet to positively modulate inflammation and provide the much needed evidence to develop research portfolios that will inform new product development and associated health claims.

  4. Do current clinical trials meet society's needs?: a critical review of recent evidence.

    Science.gov (United States)

    Pocock, Stuart J; Gersh, Bernard J

    2014-10-14

    This paper describes some important controversies regarding the current state of clinical trials research in cardiology. Topics covered include the inadequacy of trial research on medical devices, problems with industry-sponsored trials, the lack of head-to-head trials of new effective treatments, the need for wiser handling of drug safety issues, the credibility (or lack thereof) of trial reports in medical journals, problems with globalization of trials, the role of personalized (stratified) medicine in trials, the need for new trials of old drugs, the need for trials of treatment withdrawal, the importance of pragmatic trials of treatment strategies, and the limitations of observational comparative effectiveness studies. All issues are illustrated by recent topical trials in cardiology. Overall, we explore the extent to which clinical trials, as currently practiced, are successful in meeting society's expectations.

  5. Scientific publication

    Directory of Open Access Journals (Sweden)

    Getulio Teixeira Batista

    2007-06-01

    Full Text Available The necessary work for developing a scientific publication is sometimes underestimated and requires the effective participation of many players to obtain a result in good standard. Initially it depends upon the determination of the authors that decide to write the scientific article. Scientific writing is a very challenging and time consuming task, but at the same time essential for any scientist. A published scientific article is unquestionably one of the main indicators of scientific production, especially if published in a qualified scientific journal with highly qualified editorial committee and strict peer review procedure. By looking at evaluation criteria for scientific production of the several Thematic Scientific Committees of the Brazilian Council for Scientific and Technological Development (CNPq it becomes clear publications in scientific journals that has certified quality is the most important item in the evaluation of a scientist production.

  6. Natural history of intraductal papillary mucinous neoplasms (IPMN): current evidence and implications for management.

    Science.gov (United States)

    Bassi, Claudio; Sarr, Michael G; Lillemoe, Keith D; Reber, Howard A

    2008-04-01

    Intraductal papillary mucinous neoplasms (IPMNs) show varying degrees of dysplasia throughout the neoplasm that can range from adenoma to invasive carcinoma, with dysplastic changes of borderline neoplasms and carcinoma in situ in between. An understanding of the natural history, and especially the required time to transform into either carcinoma in situ or an invasive adenocarcinoma, is critically important for management policy. This topic serves as the rationale for the present analysis. At the beginning of February 2007, using the key word "IPMN" in PubMed, we initially selected 119 publications using the principal criteria as defined by the WHO classification. We identified 20 appropriate original reports and one consensus paper. Neither randomized control trials (RCT) or systematic reviews of RCTs (level 1 evidence) nor cohort studies or reviews of cohort studies (level 2 evidence) have been published. Only one report fit the criteria for level 3 evidence (case control study). Nineteen papers satisfied criteria for level 4 (cases series) and two for level 5 (expert opinion publication). After additional review and analysis, we considered only six reports to be "cornerstone papers" of merit for the final review. Clues to the natural history of IPMNs can be gained by using several methods to examine the articles: (a) to verify different prognoses between main and side branch duct subtypes; (b) to compare the average age of patients with benign vs. malignant IPMNs; (c) to summarize the findings of nonoperative, observational studies based on follow up by clinical, biochemical, and imaging techniques without operative resection; (d) to determine the prognostic importance of the status of the resection margin; and (e) to follow patients clinically after surgical resection. Although important aspects of the natural history of IPMN are still unknown, the following conclusions can be drawn: (1) Branch-duct IPMNs are less aggressive than main-duct IPMNs. (2

  7. A fractal model for nuclear organization: current evidence and biological implications.

    Science.gov (United States)

    Bancaud, Aurélien; Lavelle, Christophe; Huet, Sébastien; Ellenberg, Jan

    2012-10-01

    Chromatin is a multiscale structure on which transcription, replication, recombination and repair of the genome occur. To fully understand any of these processes at the molecular level under physiological conditions, a clear picture of the polymorphic and dynamic organization of chromatin in the eukaryotic nucleus is required. Recent studies indicate that a fractal model of chromatin architecture is consistent with both the reaction-diffusion properties of chromatin interacting proteins and with structural data on chromatin interminglement. In this study, we provide a critical overview of the experimental evidence that support a fractal organization of chromatin. On this basis, we discuss the functional implications of a fractal chromatin model for biological processes and propose future experiments to probe chromatin organization further that should allow to strongly support or invalidate the fractal hypothesis.

  8. The interactions of anticancer agents with tea catechins: current evidence from preclinical studies.

    Science.gov (United States)

    Shang, Weihu; Lu, Weidong; Han, Mei; Qiao, Jinping

    2014-01-01

    Tea catechins exhibit a broad range of pharmacological activities that impart beneficial effects on human health. Epigallocatechin-3-gallate (EGCG), one of the major tea catechins, has been widely associated with cancer prevention and treatment. In addition, tea catechins in combination with anticancer drugs are being evaluated as a new cancer treatment strategy. However, the interactions of anticancer drugs with tea catechins are largely unknown. Accumulated data indicate significant interactions between anticancer drugs and tea catechins, such as synergistic tumor inhibition or antagonist activity. Therefore, it is critical to understand comprehensively the effects of tea catechins on anticancer drugs. Focusing on evidence from preclinical studies, this paper will review the interactions between anticancer drugs and tea catechins, including pharmacodynamics and pharmacokinetics effects. We hope that by detailing the interactions between anticancer drugs and tea catechins, more attention will be directed to this important therapeutic combination in the future.

  9. Regional heterogeneity in consumption due to current income shocks: New evidence from the Permanent Income Hypothesis

    DEFF Research Database (Denmark)

    Mitze, Timo

    In the light of new theoretical and empirical work on the Permanent Income Hypothesis we tackle earlier findings for German data, which reject its validity given a large fraction of liquidity constrained consumers. Starting from a standard short run approach we do not find evidence for excess...... interpret this specification as a solution to a consumer’s optimization problem with habit persistence. Different from earlier findings changes of income growth measuring the excess sensitivity of consumption with respect to income changes and thus the degree of liquidity constrained households turn....... However, we find a clear distinction in the short run path of the East German states since 1991 (which nevertheless converge to the same long run co-integration as the Western counter...

  10. Riboflavin status, MTHFR genotype and blood pressure: current evidence and implications for personalised nutrition.

    Science.gov (United States)

    McAuley, E; McNulty, H; Hughes, C; Strain, J J; Ward, M

    2016-08-01

    Clinical deficiency of the B-vitamin riboflavin (vitamin B2) is largely confined to developing countries; however accumulating evidence indicates that suboptimal riboflavin status is a widespread problem across the developed world. Few international data are available on riboflavin status as measured by the functional biomarker, erythrocyte glutathione reductase activation coefficient, considered to be the gold standard index. One important role of riboflavin in the form of flavin dinucleotide is as a co-factor for the folate-metabolising enzyme methylenetetrahydrofolate reductase (MTHFR). Homozygosity for the common C677T polymorphism in MTHFR, affecting over 10 % of the UK and Irish populations and up to 32 % of other populations worldwide, has been associated with an increased risk of CVD, and more recently with hypertension. This review will explore available studies reporting riboflavin status worldwide, the interaction of riboflavin with the MTHFR C677T polymorphism and the potential role of riboflavin in personalised nutrition. Evidence is accumulating for a novel role of riboflavin as an important modulator of blood pressure (BP) specifically in individuals with the MTHFR 677TT genotype, with results from a number of recent randomised controlled trials demonstrating that riboflavin supplementation can significantly reduce systolic BP by 5-13 mmHg in these genetically at risk adults. Studies are however required to investigate the BP-lowering effect of riboflavin in different populations and in response to doses higher than 1·6 mg/d. Furthermore, work focusing on the translation of this research to health professionals and patients is also required.

  11. Electrostatic Solitary Waves in the Solar Wind: Evidence for Instability at Solar Wind Current Sheets

    Science.gov (United States)

    Malaspina, David M.; Newman, David L.; Wilson, Lynn Bruce; Goetz, Keith; Kellogg, Paul J.; Kerstin, Kris

    2013-01-01

    A strong spatial association between bipolar electrostatic solitary waves (ESWs) and magnetic current sheets (CSs) in the solar wind is reported here for the first time. This association requires that the plasma instabilities (e.g., Buneman, electron two stream) which generate ESWs are preferentially localized to solar wind CSs. Distributions of CS properties (including shear angle, thickness, solar wind speed, and vector magnetic field change) are examined for differences between CSs associated with ESWs and randomly chosen CSs. Possible mechanisms for producing ESW-generating instabilities at solar wind CSs are considered, including magnetic reconnection.

  12. CANCER IMMUNOLOGY AND IMMUNOTHERAPY – UNDERSTANDING AND ADAPTATION THE CURRENT EVIDENCE TO OPTIMIZE PATIENT THERAPY OUTCOMES.

    Directory of Open Access Journals (Sweden)

    Orlin Savov

    2015-11-01

    Full Text Available The aim of this publication includes the try to act as intermediary to the readers, which should be able to understand: - The description of the cancer immunotherapy mechanisms in the context of current therapy decisions for the treatment of cancer - The including criteria for those patients with cancer who could be appropriate candidates for immunotherapy - And to optimize patient outcomes by using best practices to manage the adverse events associated with immunotherapy treatment More than 15 promising immunotherapy approaches being tested in clinical trials with appropriate patients and colleagues for enrollment and peer-to-peer education purposes, respectively.

  13. Current trends in the global tourism industry: evidence from the United States

    Directory of Open Access Journals (Sweden)

    Nejdet Delener

    2010-10-01

    Full Text Available Tourism is one of the largest U.S. industries, serving millions of international and domestic tourists yearly. Tourists visit the U.S. to see natural wonders, cities, historic landmarks, and entertainment venues. Americans seek similar attractions as well as recreation and vacation areas. Tourism competes in the global market, so it is important to understand current trends in the U.S. travel industry. Therefore, this article offers insight into important trends and suggests strategies for policy makers involved in the travel and tourism industry.

  14. Endovascular Treatment For Acute Anterior Circulation Ischemic Stroke - New Evidence And Current Status

    Directory of Open Access Journals (Sweden)

    KA Salam

    2016-07-01

    Full Text Available Endovascular mechanical treatment can remove large proximal clots rapidly and result in higher rates of reperfusion than IV rt-PA alone. Three initial trials of endovascular therapies in 2013 did not show a benefit for thrombectomy over IV rt-PA. But in 2015, 5 trials from around the world, namely MR CLEAN, EXTEND-IA, ESCAPE, SWIFT-PRIME, and REVASCAT, advanced the scope of endovascular therapy for acute ischemic stroke. We review these trials and discuss how they have shaped the current status of endovascular therapy in acute ischaemic stroke.

  15. Applying Scientific Standards to Social and Forensic Evidence%科学标准在社会和法庭科学证据中的应用

    Institute of Scientific and Technical Information of China (English)

    MicheleTaruffo; 郑飞

    2011-01-01

    在当今的司法程序中越来越多地应用科学技术来证明争议事实,但这种应用也存在一些争议和问题。有关证据和证明程序规则的存在.在本质上,并没有同科学证据的应用和采纳在任何方式上存在冲突。相反,如果存在非认知性的程序规则,其结果是这样的规则应该被撤销。除了物理、化学、工程学和遗传学等“解释性科学”得以广泛应用之外,心理学、社会学、历史学、人类学和人类文化学等“理解性科学”也逐渐在司法程序中开始应用。关于法庭科学证据的可靠性存在多种多样的问题,当新的法庭科学证据获取方法被发现和采用时.如果它们不遵循科学有效性的标准,那么它们将不能在司法程序中被采信为证据。%In the modem judicial proceedings, the use of science and technology as a method of proof of the facts in issue is growing day by day, but there are still controversies and problems over such application. The existence of procedural regulations about evidence and proof does not conflict per se in any way with the utility and the admissibility of scientific evidence. On the contrary, if there are antiepistemic procedural roles the conse- quence should be that such rules deserve to be set aside. Not only the so-called "sciences of the explanation" such as physics, chemistry, engineering and genetics are widely used in judicial contexts, but also the so-called "sciences of the comprehension" such as psychology, sociology, history, anthropology and ethnology are also grad- ually used in the judicial proceedings. There are diversified problems existing in the reliability of forensic evidence. When new methods of forensic evidence are discovered and proposed: if they do not comply with the standards of scientific validity, they should not be admitted as evidence in a judicial proceeding.

  16. Structured exercise interventions for type 2 diabetes mellitus: Strength of current evidence

    Directory of Open Access Journals (Sweden)

    Mohammed Ejas Hussain

    2011-07-01

    Full Text Available Exercise, along with medical nutrition therapy and pharmacological interventions, is an important component in the clinical management of type 2 diabetes mellitus (T2D. Current clinical guidelines on type 2 diabetes provide no detailed information on the modalities of effective exercise intervention in the treatment of type 2 diabetes. Both endurance and resistance types of exercise seem to be equally effective in improving metabolic control in patients with type 2 diabetes. Determining the best method of providing exercise is clinically relevant to this population. This paper reviews the epidemiology of diabetes and problems of physical function associated with type 2 diabetes and discuss the benefits of exercise therapy on the parameters of glycemic control and function in type 2 diabetes patients, with special reference to Asian Indians. Based on the currently available literature, it is concluded that type 2 diabetes patients should be encouraged to participate in specifically designed exercise intervention programs. Attention should be paid to the avoidance of cardiovascular and musculoskeletal deconditioning. More clinical research is warranted to establish the efficacy of different dosages of exercise intervention in a holistic approach for type 2 diabetes subpopulations within different stages of the disease and various levels of co-morbidity.

  17. Subtidal currents over the central California slope: Evidence for offshore veering of the undercurrent and for direct, wind-driven slope currents

    Science.gov (United States)

    Noble, M.A.; Ramp, S.R.

    2000-01-01

    In February 1991, an array of six current-meter moorings was deployed for one year across the central California outer shelf and slope. The main line of the array extended 30 km offshore of the shelf break, out to water depths of 1400 m. A more sparsely-instrumented line, displaced 30 km to the northwest, extended 14 km offshore. Though shorter, the northern line spanned similar water depths because the gradient of the topography steepened in the northern region. A poleward flow pattern, typical of the California undercurrent, was seen across both lines in the array over most of the year. The poleward flow was surface intensified. In general, the portion of the undercurrent that crossed the southern line had larger amplitudes and penetrated more deeply into the water column than the portion that crossed the northern line. Transport over the year ranged from 0 to 2.5 Sverdrups (Sv) poleward across the southern line; 0 to 1 Sv poleward across the northern line. We suggest the difference in transport was caused by topographic constraints, which tended to force the poleward flow offshore of the northern measurement sites. The slope of the topography steepened too abruptly to allow the poleward flow to follow isobaths when currents were strong. When current velocities lessened, a more coherent flow pattern was seen across both lines in the array. In general, the poleward flow patterns in the undercurrent were not affected by local winds or by the local alongshore pressure gradient. Nor was a strong seasonal pattern evident. Rather unexpectedly, a small but statistically significant fraction of the current variance over the mid- and outer slope was driven by the surface wind stress. An alongshelf wind stress caused currents to flow along the slope, parallel to the wind field, down to depths of 400 m below the surface and out to distances of 2 Rossby radii past the shelf break. The transfer functions were weak, 3-4 cm/s per dyn cm-2, but comparable to wind-driven current

  18. Medicina Baseada em Evidências: a arte de aplicar o conhecimento científico na prática clínica Evidence-Based Medicine: the art of applying the scientific knowledge in the clinical practice

    Directory of Open Access Journals (Sweden)

    A.A. Lopes

    2000-09-01

    Full Text Available Este artigo foi escrito com o objetivo de descrever o conceito de Medicina Baseada em Evidências (MBE e as competências necessárias para a sua prática. MBE deve ser vista como a integração da experiência clínica com a capacidade de analisar e aplicar racionalmente a informação científica ao cuidar de pacientes. A aplicação de métodos e estratégias para fortalecer o alicerce científico do médico, sem desprezar os valores humanitários da profissão, deverá contribuir para a melhoria da qualidade da assistência médica que é oferecida no Brasil. As Escolas e Associações Médicas podem desempenhar importantes papéis na promoção da MBE.This article was written with the objective of describing the concept of Evidence Based Medicine (EBM and the competences required for its practice. EBM should be viewed as an integration of clinical experience with the ability to analyze and rationally apply the scientific information while taking care of patients. The application of methods and strategies to enhance the scientific background of the physician while taking into account the humanitarian values of the medical profession should contribute to improve the quality of the medical care that is offered in Brazil. The Medical Schools and Associations may play important roles in the promotion of EBM.

  19. Current Situations of Competitive Scientific Research Projects for Agri-scientific Research Institutions: A Case Study of Tropical Crops Genetic Resources Institute of Chinese Academy of Tropical Agricultural Sciences

    Institute of Scientific and Technical Information of China (English)

    Haiyan; LUO; Qingqun; YAO; Lizhen; CHEN; Yu; ZHENG

    2015-01-01

    This paper collected and arranged competitive scientific research projects undertaken by Tropical Crops Genetic Resources Institute of Chinese Academy of Tropical Agricultural Sciences in 2003-2014. Through statistical analysis on quantity of projects,funded amount,age of person responsible,professional title of person responsible,academic degree of person responsible,research object,it discussed relevant characteristics and rules. Finally,it came up with pertinent measures and recommendations,in the hope of providing services for decision-making and scientific and technological management.

  20. Ortodontia baseada em evidência científica: incorporando ciência na prática clínica Scientific evidence-based orthodontics: incorporating science within clinic practice

    Directory of Open Access Journals (Sweden)

    Maria Tereza Scardua Mariano

    2009-06-01

    Full Text Available O objetivo deste artigo é despertar o ortodontista e conscientizá-lo sobre a importância da tomada de decisão baseada em evidência científica no cuidado aos pacientes. Serão descritos os passos essenciais para a prática da Odontologia baseada em evidência (OBE, assim como os princípios da ciência e da pesquisa. Existem caminhos adequados para a busca da informação de qualidade, sendo esses a única garantia de encontrar artigos válidos. Na seleção de artigos científicos, o primeiro passo é definir o seu desenho, pois para cada dúvida clínica há um delineamento adequado capaz de respondê-la. Dessa maneira, questões sobre tratamento, etiologia, diagnóstico, prognóstico ou prevenção só podem ser respondidas por um artigo que tenha sido delineado para tal. O conhecimento da alocação randomizada, do mascaramento e do grupo-controle é fundamental para que possamos realizar uma leitura crítica dos artigos científicos, reconhecendo os que merecem credibilidade. Em meio a tantas publicações, precisamos definir, com segurança, o que deve ser incorporado ao nosso conhecimento e o que deve ser incorporado à prática clínica, mudando a nossa conduta. Desse modo, poderemos oferecer aos nossos pacientes opções terapêuticas mais consistentes e previsíveis.The aim of this article is to warn the orthodontist about the importance of making decision based on scientific evidence when taking care of the patients. It describes the main steps for the Dentistry practices based in evidence (EBD as well as the science and research principles. There are adequate ways for the search of quality information. While selecting the scientific articles, the first step would be defining its design, since for each question there is an adequate delineation able to answer it. Questions about treatment, etiology, diagnostic, prognostic or prevention could be answered in the article if it has been delineated for that. Understanding the meaning

  1. Physical therapies in the management of osteoarthritis: current state of the evidence.

    Science.gov (United States)

    Bennell, Kim L; Buchbinder, Rachelle; Hinman, Rana S

    2015-05-01

    This review considers the role of physical therapies in osteoarthritis management, highlighting key findings from systematic reviews and randomized controlled trials published in the last 2 years. Three new trials question the role of manual therapy for hip and knee osteoarthritis. No between-group differences in outcome were detected between a multimodal programme including manual therapy and home exercise, and placebo in one trial; a second trial found no benefit of adding manual therapy to an exercise programme, while a third trial reported marginal benefits over usual care that were of doubtful importance. Recent trials have also found no or uncertain clinical benefits of transcutaneous electrical nerve stimulation (TENS) or acupuncture, or of valgus braces or lateral wedge insoles for pain and function in knee osteoarthritis. Available evidence suggests a small to moderate effect of exercise in comparison with not exercising for hip or knee osteoarthritis, although optimum exercise prescription and dosage are unclear. One trial also observed a delay in joint replacement in people with hip osteoarthritis. Two trials have reported conflicting findings about the effects of exercise for hand osteoarthritis. Other than exercise, recent data suggest that the role of physical therapies in the treatment of osteoarthritis appears limited.

  2. Sublingual immunotherapy in allergic asthma: Current evidence and needs to meet

    Directory of Open Access Journals (Sweden)

    Incorvaia Cristoforo

    2010-01-01

    Full Text Available Allergen-specific immunotherapy is aimed at modifying the natural history of allergy by inducing tolerance to the causative allergen. In its traditional, subcutaneous form, immunotherapy has complete evidence of efficacy in allergic asthma. However, subcutaneous immunotherapy (SCIT has a major flaw in side effects, and especially in possible anaphylactic reactions, and this prompted the search for safer ways of administration of allergen extracts. Sublingual immunotherapy (SLIT has met such need while maintaining a clinical efficacy comparable to SCIT. In fact, the safety profile, as outlined by a systematic revision of the available literature, was substantially free from serious systemic reactions. A number of meta-analyses clearly showed that SLIT is effective in allergic rhinitis by significantly reducing the clinical symptoms and the use of anti-allergic drugs, while the efficacy in allergic asthma is still debated, with some meta-analyses showing clear effectiveness but other giving contrasting results. Besides the efficacy on symptoms, the preventive activity and the cost-effectiveness are important outcomes of SLIT in asthma. The needs to meet include more data on efficacy in house dust mite asthma, optimal techniques of administration and, as previously done with SCIT, introduction of adjuvants able to enhance the immunologic response and use of recombinant allergens.

  3. Techniques of tumour bed boost irradiation in breast conserving therapy: Current evidence and suggested guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Jalali, Rakesh; Singh, Suruchi; Budrukkar, Ashwini [Tata Memorial Hospital, Mumbai (India)

    2007-10-15

    Breast conservation surgery followed by external beam radiotherapy to breast has become the standard of care in management of early carcinoma breast. A boost to the tumour bed after whole breast radiotherapy is employed in view of the pattern of tumour bed recurrences in the index quadrant and was particularly considered in patients with some adverse histopathological characteristics such as positive margins, extensive intraductal carcinoma (EIC), lymphovascular invasion (LVI), etc. There is however, now, a conclusive evidence of improvement in local control rates after a boost radiotherapy dose in patients even without such factors and for all age groups. The maximum absolute reduction of local recurrences by the addition of boost is especially seen in young premenopausal patients. At the same time, the addition of boost is associated with increased risk of worsening of cosmesis and no clear cut survival advantage. Radiological modalities such as fluoroscopy, ultrasound and CT scan have aided in accurate delineation of tumour bed with increasing efficacy. A widespread application of these techniques might ultimately translate into improved local control with minimal cosmetic deficit. The present article discusses the role of radiotherapy boost and the means to delineate and deliver the same, identify the high risk group, optimal technique and the doses and fractionations to be used. It also discusses the extent of adverse cosmetic outcome after boost delivery, means to minimise it and relevance of tumour bed in present day scenario of advanced radiotherapy delivery techniques like (IMRT)

  4. Urbanization and non-communicable disease in Southeast Asia: a review of current evidence.

    Science.gov (United States)

    Angkurawaranon, C; Jiraporncharoen, W; Chenthanakij, B; Doyle, P; Nitsch, D

    2014-10-01

    Non-communicable diseases (NCDs) have been highlighted as a major public health issue in the Southeast (SE) Asian region. One of the major socio-environmental factors that are considered to be associated with such a rise in NCDs is urbanization. Urbanization is associated with behavioural changes such as eating an unhealthy diet, and a decrease in physical activities, which may result in associated obesity. The SE Asian region also has a substantive burden of infectious disease such as HIV and malaria, which may modify associations between urbanization and development of NCDs. A systematic review was conducted until April 2013. Using four databases: EMBASE, PubMed, GlobalHealth and DigitalJournal, the systematic review pools existing evidence on urban-rural gradients in NCD prevalence/incidence. The study found that in SE Asia, urban exposure was positively associated with coronary heart disease, diabetes and respiratory diseases in children. Urban exposure was negatively associated with rheumatic heart diseases. The stages of economic development may also modify the association between urbanization and NCDs such as diabetes. There was pronounced heterogeneity between associations. It is recommended that future studies examine the major constituents of NCDs separately and also focus on the interplay between lifestyle and infectious risk factors for NCDs. Prospective studies are needed to understand the diverse causal pathways between urbanization and NCDs in SE Asia.

  5. [Non-celiac gluten sensitivity: a critical review of current evidence].

    Science.gov (United States)

    Molina-Infante, Javier; Santolaria, Santos; Montoro, Miguel; Esteve, María; Fernández-Bañares, Fernando

    2014-01-01

    Non-celiac gluten sensitivity (NCGS) is an emerging disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food in non-celiac patients. Its prevalence has been estimated to be six to ten-times higher than that of celiac disease (CD). A gluten-free diet is the most widely recommended therapy, but the causative agent remains unknown and there are no consensus diagnostic criteria. Recent studies on NCGS have included patients with possibly overlooked minor CD and diarrhea-predominant irritable bowel syndrome without self-reported gluten intolerance, but showing a response to a gluten-free diet. Furthermore, FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) have recently been postulated as the culprit component for NCGS in wheat, instead of gluten. This review updates evidence on the pathophysiology of NCGS and the efficacy of different dietary interventions in its treatment, stressing the need for proper screening for CD before a diagnosis of NCGS is made. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  6. Current Evidence of Chinese Herbal Constituents with Effects on NMDA Receptor Blockade

    Directory of Open Access Journals (Sweden)

    David T. Yew

    2013-08-01

    Full Text Available NMDA receptor (NMDA-R is an important molecular entity governing a wide range of functions in the central nervous system. For example, the NMDA-R is involved in memory and cognition, and impairment of both (as in Alzheimer’s Disease is attributed to NMDA-mediated neurotoxicity. With greater understanding of the NMDA-R structure, antagonists with varying degrees of binding-site and subtype selectivity have been developed and put into clinical use. Discovery of target-specific Chinese herbs have also been made in parallel. This article provides an overview of the known active sites on the NMDA-R, followed by a discussion of the relevant herbs and their constituents. Experimental evidence supporting the inhibitory role of the herbal compounds on the NMDA-R is highlighted. For some of the compounds, potential research directions are also proposed to further elucidate the underlying mechanisms of the herbs. It is envisaged that future investigations based on the present data will allow more clinically relevant herbs to be identified.

  7. B-Vitamins and Bone Health–A Review of the Current Evidence

    Science.gov (United States)

    Dai, Zhaoli; Koh, Woon-Puay

    2015-01-01

    Because of ongoing global ageing, there is a rapid worldwide increase in incidence of osteoporotic fractures and the resultant morbidity and mortality associated with these fractures are expected to create a substantial economic burden. Dietary modification is one effective approach for prevention of osteoporosis in the general population. Recently, B vitamins have been investigated for their possible roles in bone health in human studies. In this review, we provide different lines of evidence and potential mechanisms of individual B vitamin in influencing bone structure, bone quality, bone mass and fracture risk from published peer-reviewed articles. These data support a possible protective role of B vitamins, particularly, B2, B6, folate and B12, in bone health. However, results from the clinical trials have not been promising in supporting the efficacy of B vitamin supplementation in fracture reduction. Future research should continue to investigate the underlying mechanistic pathways and consider interventional studies using dietary regimens with vitamin B enriched foods to avoid potential adverse effects of high-dose vitamin B supplementation. In addition, observational and interventional studies conducted in Asia are limited and thus require more attention due to a steep rise of osteoporosis and hip fracture incidence projected in this part of the world. PMID:25961321

  8. B-vitamins and bone health--a review of the current evidence.

    Science.gov (United States)

    Dai, Zhaoli; Koh, Woon-Puay

    2015-05-07

    Because of ongoing global ageing, there is a rapid worldwide increase in incidence of osteoporotic fractures and the resultant morbidity and mortality associated with these fractures are expected to create a substantial economic burden. Dietary modification is one effective approach for prevention of osteoporosis in the general population. Recently, B vitamins have been investigated for their possible roles in bone health in human studies. In this review, we provide different lines of evidence and potential mechanisms of individual B vitamin in influencing bone structure, bone quality, bone mass and fracture risk from published peer-reviewed articles. These data support a possible protective role of B vitamins, particularly, B2, B6, folate and B12, in bone health. However, results from the clinical trials have not been promising in supporting the efficacy of B vitamin supplementation in fracture reduction. Future research should continue to investigate the underlying mechanistic pathways and consider interventional studies using dietary regimens with vitamin B enriched foods to avoid potential adverse effects of high-dose vitamin B supplementation. In addition, observational and interventional studies conducted in Asia are limited and thus require more attention due to a steep rise of osteoporosis and hip fracture incidence projected in this part of the world.

  9. The relationship between the nucleolus and cancer: Current evidence and emerging paradigms.

    Science.gov (United States)

    Orsolic, Ines; Jurada, Deana; Pullen, Nick; Oren, Moshe; Eliopoulos, Aristides G; Volarevic, Sinisa

    2016-06-01

    The nucleolus is the most prominent nuclear substructure assigned to produce ribosomes; molecular machines that are responsible for carrying out protein synthesis. To meet the increased demand for proteins during cell growth and proliferation the cell must increase protein synthetic capacity by upregulating ribosome biogenesis. While larger nucleolar size and number have been recognized as hallmark features of many tumor types, recent evidence has suggested that, in addition to overproduction of ribosomes, decreased ribosome biogenesis as well as qualitative changes in this process could also contribute to tumor initiation and cancer progression. Furthermore, the nucleolus has become the focus of intense attention for its involvement in processes that are clearly unrelated to ribosome biogenesis such as sensing and responding to endogenous and exogenous stressors, maintenance of genome stability, regulation of cell-cycle progression, cellular senescence, telomere function, chromatin structure, establishment of nuclear architecture, global regulation of gene expression and biogenesis of multiple ribonucleoprotein particles. The fact that dysregulation of many of these fundamental cellular processes may contribute to the malignant phenotype suggests that normal functioning of the nucleolus safeguards against the development of cancer and indicates its potential as a therapeutic approach. Here we review the recent advances made toward understanding these newly-recognized nucleolar functions and their roles in normal and cancer cells, and discuss possible future research directions.

  10. Current evidence for the role of complement in the pathogenesis of Shiga toxin haemolytic uraemic syndrome.

    Science.gov (United States)

    Keir, Lindsay S; Saleem, Moin A

    2014-10-01

    Shiga toxin-associated haemolytic uraemic syndrome (Stx HUS) is the leading cause of paediatric acute kidney injury. This toxin-mediated disease carries a significant morbidity and mortality but has no direct treatments. Rare familial atypical HUS (aHUS) is now understood to result from over-activation of the alternative complement pathway causing glomerular endothelial damage. By understanding the pathogenic mechanisms of this disease, the monoclonal antibody eculizumab, which blocks the final common pathway of complement, is now being used to treat aHUS. For this reason, clinicians and scientists are studying the role of the alternative complement pathway in Stx HUS with the aim of targeting treatment in a similar way. There is some evidence suggesting that complement plays a role in the pathogenesis of Stx HUS, but other mechanisms may also be important. Clinically, modulating the complement system using plasma exchange provides no proven benefit in Stx HUS, and the use of eculizumab has provided conflicting results. Understanding the local effect of Stx on the glomerulus, in particular regulation of the complement and coagulation systems, may lead to advances in defining the precise pathogenesis of this disease. Then, targeted treatment strategies could be devised and clinical trials undertaken.

  11. WD40-repeat proteins in plant cell wall formation: current evidence and research prospects

    Directory of Open Access Journals (Sweden)

    Gea eGuerriero

    2015-12-01

    Full Text Available The metabolic complexity of living organisms relies on supramolecular protein structures which ensure vital processes, such as signal transduction, transcription, translation and cell wall synthesis. In eukaryotes WD40-repeat (WDR proteins often function as molecular hubs mediating supramolecular interactions. WDR proteins may display a variety of interacting partners and participate in the assembly of complexes involved in distinct cellular functions. In plants, the formation of lignocellulosic biomass involves extensive synthesis of cell wall polysaccharides, a process that requires the assembly of large transmembrane enzyme complexes, intensive vesicle trafficking, interactions with the cytoskeleton, and coordinated gene expression. Because of their function as supramolecular hubs, WDR proteins could participate in each or any of these steps, although to date only few WDR proteins have been linked to the cell wall by experimental evidence. Nevertheless, several potential cell wall-related WDR proteins were recently identified using in silico aproaches, such as analyses of co-expression, interactome and conserved gene neighbourhood. Notably, some WDR genes are frequently genomic neighbours of genes coding for GT2-family polysaccharide synthases in eukaryotes, and this WDR-GT2 collinear microsynteny is detected in diverse taxa. In angiosperms, two WDR genes are collinear to cellulose synthase genes, CESAs, whereas in ascomycetous fungi several WDR genes are adjacent to chitin synthase genes, chs. In this Perspective we summarize and discuss experimental and in silico studies on the possible involvement of WDR proteins in plant cell wall formation. The prospects of biotechnological engineering for enhanced biomass production are discussed.

  12. PLASMA OXYTOCIN CONCENTRATION AND DEPRESSIVE SYMPTOMS: A REVIEW OF CURRENT EVIDENCE AND DIRECTIONS FOR FUTURE RESEARCH.

    Science.gov (United States)

    Massey, Suena H; Backes, Katherine A; Schuette, Stephanie A

    2016-04-01

    There is substantial recent interest in the role of oxytocin in social and affiliative behaviors-animal models of depression have suggested a link between oxytocin and mood. We reviewed literature to date for evidence of a potential relationship between peripheral oxytocin concentration and depressive symptoms in humans. Pubmed(®) and PsychINFO(®) were searched for biomedical and social sciences literature from 1960 to May 19, 2015 for empirical articles in English involving human subjects focused on the relationship between peripheral oxytocin concentration and depressive symptoms, excluding articles on the oxytocin receptor gene, or involving exogenous (i.e. intranasal) administration of oxytocin. Eight studies meeting criteria were identified and formally reviewed. Studies of pregnant women suggested an inverse relationship between oxytocin level and depressive symptom severity. Findings in nonpregnant women were broadly consistent with the role of oxytocin release in response to stress supported by animal studies. The relationship between oxytocin and depression in men appeared to be in the opposite direction, possibly reflecting the influence of gonadal hormones on oxytocinergic functioning found in other mammalian species. Overall, small sample sizes, heterogeneity in study designs, and other methodological limitations may account for inconsistent findings. Future research utilizing reliable oxytocin measurement protocols including measurements across time, larger sample sizes, and sample homogeneity with respect to multiple possible confounders (age, gender, race and ethnicity, ovarian status among women, and psychosocial context) are needed to elucidate the role of oxytocin in the pathogenesis of depression, and could guide the design of novel pharmacologic agents.

  13. Current perspectives on therapeutic ultrasound in the management of chronic wounds: a review of evidence

    Directory of Open Access Journals (Sweden)

    Conner-Kerr T

    2017-07-01

    Full Text Available Teresa Conner-Kerr,1 Mary Ellen Oesterle2 1College of Health Sciences & Professions, 2Department of Physical Therapy, University of North Georgia, Dahlonega, GA, USA Abstract: Although therapeutic ultrasound has been in existence since the 1930s, questions remain as to its effectiveness in promoting tissue healing in various injured tissues. These tissues include soft tissues such as skin, tendons, ligaments, bursae, joint capsules and muscles. Limited evidence exists to support a role for therapeutic ultrasound in closed, soft tissue lesions. However, an evolving literature provides support for the role of therapeutic ultrasound in the treatment of chronic wounds, acute injuries such as fractures and split thickness graft donor sites as well as in the modulation of wound-related pain. Modern technology that uses low-frequency (kilohertz, long wave ultrasound appears promising compared to older, higher frequency ultrasound (megahertz devices. These newer devices appear to have positive effects on healing rates in various wound types, pain levels and the modulation of proinflammatory cytokines. Keywords: low-frequency ultrasound, non-contact ultrasound, KHz, acoustic, healing, cavitation

  14. Evidence-based medicine in bovine, equine and canine reproduction: quality of current literature.

    Science.gov (United States)

    Simoneit, C; Heuwieser, W; Arlt, S

    2011-10-01

    The objective was to evaluate deficits and differences of published literature on reproduction in cattle, horses, and dogs. A literature search was conducted in the databases Medline and Veterinary Science. Approximately five times more articles on clinical bovine reproduction (n = 25 910) were found compared to canine (n = 5 015) and equine (n = 5 090) reproduction. For the evaluation of the literature, a checklist was used. A subset of 600 articles published between 1999 and 2008 was randomly selected. After applying exclusion criteria, a total of 268 trials (86 for cattle, 99 for horses, and 83 for dogs) were evaluated and used for further analysis. For the field of canine and equine reproduction, there were fewer clinical trials with a control group compared to bovine reproduction (cattle 66%, horses 41%, and dogs 41%). For all three species investigated, few publications were identified (4%) with the highest level of evidence, i.e., controlled, randomized, and blinded trials, or meta-analyses. In cattle 33% of the publications were graded adequate to draw sound conclusions; however, only 7 and 11% were graded adequate in dogs and horses, respectively. Therefore, the veterinarian should always assess the quality of information before implementing results into practice to provide best available care for the animals. In conclusion, improvement of the quality of well-designed, conducted and reported clinical trails in animal reproduction is required.

  15. Appraisal of biochemical classes of radioprotectors: evidence, current status and guidelines for future development.

    Science.gov (United States)

    Mishra, Krishnanand; Alsbeih, Ghazi

    2017-10-01

    The search for efficient radioprotective agents to protect from radiation-induced toxicity, due to planned or accidental radiation exposure, is still ongoing worldwide. Despite decades of research and development of widely different biochemical classes of natural and derivative compounds, a safe and effective radioprotector is largely unmet. In this comprehensive review, we evaluated the evidence for the radioprotective performance of classical thiols, vitamins, minerals, dietary antioxidants, phytochemicals, botanical and bacterial preparations, DNA-binding agents, cytokines, and chelators including adaptogens. Where radioprotection was demonstrated, the compounds have shown moderate dose modifying factors ranging from 1.1 to 2.7. To date, only few compounds found way to clinic with limited margin of dose prescription due to side effects. Most of these compounds (amifostine, filgratism, pegfilgrastim, sargramostim, palifermin, recombinant salmonella flagellin, Prussian blue, potassium iodide) act primarily via scavenging of free radicals, modulation of oxidative stress, signal transduction, cell proliferation or enhance radionuclide elimination. However, the gain in radioprotection remains hampered with low margin of tolerance. Future development of more effective radioprotectors requires an appropriate nontoxic compound, a model system and biomarkers of radiation exposure. These are important to test the effectiveness of radioprotection on physiological tissues during radiotherapy and field application in cases of nuclear eventualities.

  16. Prostate-specific antigen: does the current evidence support its use in prostate cancer screening?

    LENUS (Irish Health Repository)

    Duffy, Michael J

    2012-02-01

    Although widely used, the value of prostate-specific antigen (PSA) in screening asymptomatic men for prostate cancer is controversial. Reasons for the controversy relate to PSA being less than an ideal marker in detecting early prostate cancer, the possibility that screening for prostate cancer may result in the overdetection and thus overtreatment of indolent disease and the lack of clarity as to the definitive or best treatment for men diagnosed with localized prostate cancer. Although the results from some randomized prospective trials suggest that screening with PSA reduces mortality from prostate cancer, the overall benefit was modest. It is thus currently unclear as to whether the modest benefit of reduced mortality outweighs the harms of overdetection and overtreatment. Thus, prior to undergoing screening for prostate cancer, men should be informed of the risks and benefits of early detection. Newly emerging markers that may complement PSA in the early detection of prostate cancer include specific isoforms of PSA and PCA3.

  17. No evidence for adaptation of current egg drop syndrome 1976 viruses to chickens.

    Science.gov (United States)

    Tsukamoto, K; Kuwabara, M; Kaneko, M; Mase, M; Imai, K

    2004-01-01

    In order to determine whether the current field strains of egg drop syndrome (EDS) 1976 viruses adapt to chickens, we compared the growth efficiency of three Japanese field strains (PA-1/79, AWI/98, Gifu/01) in chicken and duck embryo liver cells. The growth efficiency in chicken or duck embryo liver cells was almost similar in these strains. The fiber protein may carry the type-specific antigen and the hemagglutination activity, and hexon protein may contain the subgroup-specific antigenic determinants. Therefore, the fiber head and hexon loop 1 DNA domain sequences of the six Japanese field strains UPA-1/79, ME/80, 44/81, Kyoto/91, AWI/98, Gifu/01) were compared, but these DNA domains were identical among the six field strains. Our data suggested that the EDS virus was maintained without discernible changes for the last two decades in the field.

  18. Hyponatremia in the neurocritical care patient: An approach based on current evidence.

    Science.gov (United States)

    Manzanares, W; Aramendi, I; Langlois, P L; Biestro, A

    2015-05-01

    In the neurocritical care setting, hyponatremia is the commonest electrolyte disorder, which is associated with significant morbimortality. Cerebral salt wasting and syndrome of inappropriate antidiuretic hormone have been classically described as the 2 most frequent entities responsible of hyponatremia in neurocritical care patients. Nevertheless, to distinguish between both syndromes is usually difficult and useless as volume status is difficult to be determined, underlying pathophysiological mechanisms are still not fully understood, fluid restriction is usually contraindicated in these patients, and the first option in the therapeutic strategy is always the same: 3% hypertonic saline solution. Therefore, we definitively agree with the current concept of "cerebral salt wasting", which means that whatever is the etiology of hyponatremia, initially in neurocritical care patients the treatment will be the same: hypertonic saline solution. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  19. The flow structure of pyroclastic density currents: evidence from particle models and large-scale experiments

    Science.gov (United States)

    Dellino, Pierfrancesco; Büttner, Ralf; Dioguardi, Fabio; Doronzo, Domenico Maria; La Volpe, Luigi; Mele, Daniela; Sonder, Ingo; Sulpizio, Roberto; Zimanowski, Bernd

    2010-05-01

    Pyroclastic flows are ground hugging, hot, gas-particle flows. They represent the most hazardous events of explosive volcanism, one striking example being the famous historical eruption of Pompeii (AD 79) at Vesuvius. Much of our knowledge on the mechanics of pyroclastic flows comes from theoretical models and numerical simulations. Valuable data are also stored in the geological record of past eruptions, i.e. the particles contained in pyroclastic deposits, but they are rarely used for quantifying the destructive potential of pyroclastic flows. In this paper, by means of experiments, we validate a model that is based on data from pyroclastic deposits. It allows the reconstruction of the current's fluid-dynamic behaviour. We show that our model results in likely values of dynamic pressure and particle volumetric concentration, and allows quantifying the hazard potential of pyroclastic flows.

  20. Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

    Energy Technology Data Exchange (ETDEWEB)

    Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng (Univ. of Florida Proton Therapy Inst., Jacksonville, Florida (United States)), e-mail: menden@shands.ufl.edu

    2011-08-15

    There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

  1. Evidence of underground electric current generation during the 2009 L'Aquila earthquake: Real or instrumental?

    Science.gov (United States)

    Masci, F.; Thomas, J. N.

    2016-06-01

    We investigate magnetic effects in correspondence of the Mw6.1 L'Aquila earthquake. Magnetic and seismic records are analyzed. Rapid and distinct changes and an offset can be seen in magnetic field components after the main shock. We show that these effects result from electromagnetic induction due to the movement of the sensors through the Earth's magnetic field and from a permanent displacement of the sensors from their original position caused by the passing seismic waves. A transient signal in total field data from an overhauser magnetometer apparently occurs in correspondence with the earthquake. Our analysis shows that the transient was not observed by other sensors that were operating in close proximity to the overhauser. Thus, the transient signal in the total magnetic field data, and the offset in the magnetic field components, cannot be associated with a hypothetical underground electric current generated by the earthquake, as suggested by Nenovski (2015).

  2. Current thinking in qualitative research: evidence-based practice, moral philosophies, and political struggle.

    Science.gov (United States)

    Papadimitriou, Christina; Magasi, Susan; Frank, Gelya

    2012-01-01

    In this introduction to the special issue on current thinking in qualitative research and occupational therapy and science, the authors focus on the importance of rigorous qualitative research to inform occupational therapy practice. The authors chosen for this special issue reflect a "second generation of qualitative researchers" who are critical, theoretically sophisticated, methodologically productive, and politically relevant to show that working with disabled clients is political work. Three themes emerged across the articles included in this special issue: (1) recognizing and addressing social justice issues; (2) learning from clients' experiences; and (3) critically reframing occupational therapy's role. These themes can inform occupational therapy practice, research, and education to reflect a more client-centered and politically engaging approach. Copyright 2012, SLACK Incorporated.

  3. Radiation as an immunological adjuvant: current evidence on dose and fractionation

    Directory of Open Access Journals (Sweden)

    Sandra eDemaria

    2012-10-01

    Full Text Available Ionizing radiation to a cancer site has the ability to convert the irradiated tumor in an immunogenic hub. However, radiation is a complex modifier of the tumor microenvironment and, by itself, is seldom sufficient to induce a therapeutically significant anti-tumor immune response, since it can also activate immune suppressive pathways. While several combinations of local radiation and immunotherapy have been shown in pre-clinical models to induce powerful anti-tumor immunity, the optimal strategy to achieve this effect remains to be defined. When used in vivo, radiation effects on tumors depend on the dose per fraction applied, the number of fractions used, and the total dose. Moreover, the interplay of these three variables is contingent upon the tumor setting studied, both in preclinical and clinical applications. To enable repair of the collateral damage to the normal tissue, radiation is usually given in multiple fractions, usually of 2 Gy. Generally, the use of larger fractions is limited to sterotactic applications, whereby optimal immobilization reduces inter and intra-fraction movement and permits a very conformal delivery of dose to the target, with optimal exclusion of normal tissue. Translation of the partnership of radiation and immunotherapy to the clinic requires a careful consideration of the radiation regimens used. To date, little is known on whether different dose/fractionation regimens have a specific impact on the anti-tumor immune response. Most experiments combining the two modalities were conducted with single fractions of radiotherapy. However, there is at least some evidence that when combined with some specific immunotherapy approaches, the ability of radiation to promote anti-tumor immunity is dependent on the dose and fractionation employed. We critically review the available in vitro and in vivo data on this subject and discuss the potential impact of fractionation on the ability of radiation to synergize with

  4. Donor human milk for preterm infants: current evidence and research directions.

    Science.gov (United States)

    Arslanoglu, Sertac; Corpeleijn, Willemijn; Moro, Guido; Braegger, Christian; Campoy, Cristina; Colomb, Virginie; Decsi, Tamas; Domellöf, Magnus; Fewtrell, Mary; Hojsak, Iva; Mihatsch, Walter; Mølgaard, Christian; Shamir, Raanan; Turck, Dominique; van Goudoever, Johannes

    2013-10-01

    The Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition aims to document the existing evidence of the benefits and common concerns deriving from the use of donor human milk (DHM) in preterm infants. The comment also outlines gaps in knowledge and gives recommendations for practice and suggestions for future research directions. Protection against necrotizing enterocolitis is the major clinical benefit deriving from the use of DHM when compared with formula. Limited data also suggest unfortified DHM to be associated with improved feeding tolerance and with reduced cardiovascular risk factors during adolescence. Presence of a human milk bank (HMB) does not decrease breast-feeding rates at discharge, but decreases the use of formula during the first weeks of life. This commentary emphasizes that fresh own mother's milk (OMM) is the first choice in preterm infant feeding and strong efforts should be made to promote lactation. When OMM is not available, DHM is the recommended alternative. When neither OMM nor DHM is available, preterm formula should be used. DHM should be provided from an established HMB, which follows specific safety guidelines. Storage and processing of human milk reduces some biological components, which may diminish its health benefits. From a nutritional point of view, DHM, like HM, does not meet the requirements of preterm infants, necessitating a specific fortification regimen to optimize growth. Future research should focus on the improvement of milk processing in HMB, particularly of heat treatment; on the optimization of HM fortification; and on further evaluation of the potential clinical benefits of processed and fortified DHM.

  5. Perioperative management of haemophilia B: A critical appraisal of the evidence and current practices.

    Science.gov (United States)

    Neufeld, E J; Solimeno, L; Quon, D; Walsh, C; Seremetis, S; Cooper, D; Iyer, N N; Hoxer, C S; Giangrande, P

    2017-07-27

    While there is substantial literature addressing the principles of general management of haemophilia, literature on perioperative management of haemostasis is scarce. The aim of this study was to better understand perioperative management among congenital haemophilia B patients (without inhibitors) and to gain insights into real-world surgical practices. A systematic literature review, with an emphasis on haemophilia B, was conducted using EMBASE(®) , Medline(®) and the Cochrane Library. Studies from 1974 to June 2015 were accessed, and 132 studies were eligible for the full-study review. An international expert panel with five haematologists and one surgeon reviewed the resulting literature and provided further insights. The literature review revealed that documented experience in the perioperative management of bleeding risk in haemophilia B patients is relatively scarce. Therefore, the review was amended to provide a comprehensive overview of the perioperative management for haemophilia A and B patients; the expert panel applied a particular focus to haemophilia B. Several gaps were identified in the literature including the lack of consensus on defining surgery in terms of bleeding risk, optimal factor levels during surgery and lack of robust evidence on surgical outcomes. The ensuing discussions with the expert panel provided validation of some of the results from the systematic literature review and proposed future directions for perioperative management. Suggestions included collaboration with haemophilia treatment centres (HTCs) to collect real-world data on perioperative management, establishing the need for optimal factor level monitoring practice, and the appropriate adoption of extended half-life products in clinical settings. © 2017 John Wiley & Sons Ltd.

  6. Reply to "Critical assessment of the current state of scientific knowledge, terminology, and research needs concerning the ecological effects of elevated atmospheric nitrogen deposition in China"

    Science.gov (United States)

    Gu, Fengxue; Zhang, Yuandong; Huang, Mei; Tao, Bo; Yan, Huimin; Guo, Rui; Li, Jie

    2017-03-01

    In their assessment, Pan et al. (2016) criticize that our estimation of 2.32 g N m-2 yr-1 in 2010 underestimates the total nitrogen (N) deposition amounts by a factor around two by comparing with the estimation of Xu et al. (2015). Our paper entitled "Nitrogen deposition and its effect on carbon storage in Chinese forests during 1981-2010" aims to evaluate the influence of elevated N deposition in China on carbon storage in forest ecosystems by using a process-based model. As limited by observed N deposition dataset availability, we developed a simple algorithm to evaluate the temporal and spatial variations in N deposition based on the relationships among N deposition, precipitation, N fertilizer use, and fuel consumption with reference to the method of Lin et al. (2000). Our results show that the rate of N deposition increased by 0.058 g N m-2 yr-1 between 1981 and 2010. The N deposition rate in 2010 was 2.32 g N m-2 yr-1, and it showed a large spatial variation from 0 to 0.25 g N m-2 yr-1 on the northwestern Qinghai-Tibet Plateau to over 4.5 g N m-2 yr-1 in the southeastern China. We really underestimated the total N deposition in China because we were lack of dry deposition observation dataset in our research. However, we think Pan et al. (2016) overestimated the difference between our estimation and that in Xu et al. (2015). It should be encouraged to discuss the past and current status of N deposition in China based on both observation and simulation. All comments, assessments and suggestions contribute to promote the scientific understanding of N deposition and its influence on ecosystems.

  7. Current Scientific Impact of Ss Cyril and Methodius University of Skopje, Republic of Macedonia in the Scopus Database (1960-2014).

    Science.gov (United States)

    Spiroski, Mirko

    2015-03-15

    The aim of this study was to analyze current scientific impact of Ss Cyril and Methodius University of Skopje, Republic of Macedonia in the Scopus Database (1960-2014). Affiliation search of the Scopus database was performed on November 23, 2014 in order to identify published papers from the Ss Cyril and Methodius University of Skopje (UC&M), Republic of Macedonia. A total number of 3960 articles (3055 articles from UC&M, 861 articles from Faculty of Medicine, UC&M, and 144 articles from Faculty of Pharmacy, UC&M) were selected for analysis (1960-2014). SCImago Journal Rank (SJR), Source Normalized Impact per Paper (SNIP) and h-index were calculated from the Scopus database. The number of published papers was sharply increased with maximum of 379 papers in 2012 year. The largest number of papers has been published in Macedonian Journal of Medical Sciences, Journal of Molecular Structure, Lecture Notes in Computer Science, Acta Pharmecutica, and Macedonian Journal of Chemistry and Chemical Engineering. The biggest SJR and SNIP has journal Nephrology Dialysis Transplantation. First three places of the top ten authors belong to Dimirovski GM, Gavrilovska L, and Gusev M. Top three places based on Scopus h-index (total number of published papers) belong to Kocarev L, Stafilov T, and Polenakovic M. The majority of papers originate from UC&M, but significant numbers of papers are affiliated to Faculty of Medicine, Faculty of Pharmacy, and Institute of Chemistry as members of UC&M, as well as Macedonian Academy of Sciences and Arts. Articles are the most dominant type of documents followed by conference papers, and review articles. Medicine is the most represented subject. Officials of the Ss Cyril and Methodius University of Skopje should undertake more effective and proactive policies for journal publishers and their Editorial Boards in order to include more journals from UC&M in the Scopus database.

  8. Current Scientific Impact of Ss Cyril and Methodius University of Skopje, Republic of Macedonia in the Scopus Database (1960-2014

    Directory of Open Access Journals (Sweden)

    Mirko Spiroski

    2015-01-01

    Full Text Available Aim: The aim of this study was to analyze current scientific impact of Ss Cyril and Methodius University of Skopje, Republic of Macedonia in the Scopus Database (1960-2014. Material and Methods: Affiliation search of the Scopus database was performed on November 23, 2014 in order to identify published papers from the Ss Cyril and Methodius University of Skopje (UC&M, Republic of Macedonia. A total number of 3960 articles (3055 articles from UC&M, 861 articles from Faculty of Medicine, UC&M, and 144 articles from Faculty of Pharmacy, UC&M were selected for analysis (1960-2014. SCImago Journal Rank (SJR, Source Normalized Impact per Paper (SNIP and h-index were calculated from the Scopus database. Results: The number of published papers was sharply increased with maximum of 379 papers in 2012 year. The largest number of papers has been published in Macedonian Journal of Medical Sciences, Journal of Molecular Structure, Lecture Notes in Computer Science, Acta Pharmecutica, and Macedonian Journal of Chemistry and Chemical Engineering. The biggest SJR and SNIP has journal Nephrology Dialysis Transplantation. First three places of the top ten authors belong to Dimirovski GM, Gavrilovska L, and Gusev M. Top three places based on Scopus h-index (total number of published papers belong to Kocarev L, Stafilov T, and Polenakovic M. The majority of papers originate from UC&M, but significant numbers of papers are affiliated to Faculty of Medicine, Faculty of Pharmacy, and Institute of Chemistry as a members of UC&M, as well as Macedonian Academy of Sciences and Arts. Articles are the most dominant type of documents followed by conference papers, and review articles. Medicine is the most represented subject. Conclusion: Officials of the Ss Cyril and Methodius University of Skopje should undertake more effective and proactive policies for journal publishers and their Editorial Boards in order to include more journals from UC&M in the Scopus database.

  9. Neurocognitive and Social Cognitive Approaches for Improving Functional Outcome in Early Psychosis: Theoretical Considerations and Current State of Evidence

    Directory of Open Access Journals (Sweden)

    Cali F. Bartholomeusz

    2012-01-01

    Full Text Available Improving functional outcome, in addition to alleviating psychotic symptoms, is now a major treatment objective in schizophrenia research. Given the large body of evidence suggesting pharmacological treatments generally have minimal effects on indices of functioning, research has turned to psychosocial rehabilitation programs. Among these, neurocognitive and social cognitive interventions are at the forefront of this field and are argued to target core deficits inherent to the schizophrenia illness. However, to date, research trials have primarily focused on chronic schizophrenia populations, neglecting the early psychosis groups who are often as severely impaired in social and occupational functioning. This theoretical paper will outline the rationale for investigating adjunctive cognitive-based interventions in the early phases of psychotic illness, critically examine the current approach strategies used in these interventions, and assess the evidence supporting certain training programs for improving functional outcome in early psychosis. Potential pathways for future research will be discussed.

  10. Autonomic nervous system dysfunction in obesity and Prader-Willi syndrome: current evidence and implications for future obesity therapies.

    Science.gov (United States)

    Haqq, A M; DeLorey, D S; Sharma, A M; Freemark, M; Kreier, F; Mackenzie, M L; Richer, L P

    2011-08-01

    The autonomic nervous system (ANS) controls essential functions like breathing, heart rate, digestion, body temperature and hormone levels. Evidence suggests that ANS dysfunction is associated with adult and childhood obesity and plays a role in the distribution of total body fat and the development of obesity-related complications in humans. This review summarizes our current understanding of ANS involvement in the pathogenesis of obesity and Prader-Willi syndrome. Available evidence of ANS dysfunction in the control of energy balance is limited and, in some cases, contradictory. Further investigation in this area is warranted in order to better understand the important contributions of the ANS to regulation of body fat, development of obesity and its comorbidities. Results from these studies will guide the development of novel obesity therapeutics targeting specific ANS dysfunction.

  11. Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

    Directory of Open Access Journals (Sweden)

    Trefoux Bourdet A

    2015-03-01

    Full Text Available Alice Trefoux Bourdet, Dominique Luton, Martin Koskas Department of Obstetrics and Gynecology, Bichat University Hospital, Paris Diderot University, Paris, France Abstract: Uterine myoma is the most common benign uterine tumor in women of reproductive age and occurs in 20%–25% of the worldwide population. No currently approved medical treatment is able to completely eliminate fibroids. Surgery, particularly hysterectomy, predominates as the treatment strategy of choice, even though it is associated with risks and complications and causes infertility. Until recently, gonadotropin-releasing hormone agonists were the only available drugs for the preoperative treatment of fibroids. However, ulipristal acetate (UPA, an oral selective progesterone receptor modulator, was recently licensed in Europe for the same indication. Recent studies have demonstrated the efficacy and safety of UPA in the medical management of fibroids before surgery, with a better tolerability profile than leuprolide acetate. Analyzing the literature, we identified new management strategies involving UPA and surgery, considering advantages of both medical and surgical therapy. The advent of UPA will undoubtedly modify the surgical approach to fibroids, but the heterogeneity of these possible indications now requires various original clinical studies to identify the optimal indications for UPA in patients with symptomatic fibroid(s. Keywords: uterine fibroids, medical treatment, selective progesterone receptor modulator, ulipristal acetate, surgery

  12. Ayurveda and botanical drugs for epilepsy: Current evidence and future prospects.

    Science.gov (United States)

    Sriranjini, Sitaram Jaideep; Sandhya, Kumar; Mamta, Vernekar Sanjeeva

    2015-11-01

    The understanding of epilepsy has progressed since its earliest impression as a disease associated with paranormal and superstitious beliefs. Landmark advances have been made in deciphering the pathophysiological substrates involved in the disease process, and treatment advances have contributed significantly to ameliorating the seizures. However, disease-modifying agents are yet to be discovered. Ayurveda is a system of medicine that stresses a holistic approach to disease, and treatment is focused on disease modification and symptom management. Herbs form the core of Ayurveda medicine; though many of them have been studied for their anticonvulsant activity, very few actually mention the reference of these herbs in Ayurveda literature. Other therapeutic interventions used in Ayurveda are relatively unexplored, and future research will need to focus on this. The current manuscript briefly discusses the understanding of epilepsy as per Ayurveda and reviews herbs that have been studied for their anticonvulsant activity mentioned in Ayurveda literature. This article is part of a Special Issue entitled "Botanicals for Epilepsy".

  13. Anti-angiogenesis in hepatocellular carcinoma treatment: Current evidence and future perspectives

    Institute of Scientific and Technical Information of China (English)

    Martin-Walter Welker; Joerg Trojan

    2011-01-01

    Hepatocellular carcinoma (HCC) is among the most common cancer diseases worldwide. Arterial hypervascularisation is an essential step for HCC tumorigenesis and can be targeted by transarterial chemoembolization (TACE). This interventional method is the standard treatment for patients with intermediate stage HCC, but is also applied as "bridging" therapy for patients awaiting liver transplantation in many centers worldwide. Usually the devascularization effect induced by TACE is transient, consequently resulting in repeated cycles of TACE every 4-8 wk. Despite documented survival benefits, TACE can also induce the up-regulation of proangiogenic and growth factors, which might contribute to accelerated progression in patients with incomplete response. In 2007, sorafenib, a multi-tyrosine kinase and angiogenesis inhibitor, was approved as the first systemic treatment for advanced stage HCC. Other active targeted compounds, either inhibitors of angiogenesis and/or growth factors, are currently being investigated in numerous clinical trials. To overcome revascularisation or tumor progression under TACE treatment it seems therefore attractive to combine TACE with systemic targeted agents, which might theoretically block the effects of proangiogenic and growth factors. Over the last 12 mo, several retrospective or prospective cohort studies combining TACE and sorafenib have been published. Nevertheless, robust results of the efficacy and tolerability of such combination strategies as proven by randomized, controlled trials are awaited in the next two years.

  14. Targeting the Glutamatergic System to Treat Pathological Gambling: Current Evidence and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Mauro Pettorruso

    2014-01-01

    Full Text Available Pathological gambling or gambling disorder has been defined by the DSM-5 as a behavioral addiction. To date, its pathophysiology is not completely understood and there is no FDA-approved treatment for gambling disorders. Glutamate is the principal excitatory neurotransmitter in the nervous system and it has been recently involved in the pathophysiology of addictive behaviors. In this paper, we review the current literature on a class of drugs that act as modulating glutamate system in PG. A total of 19 studies have been included, according to inclusion and exclusion criteria. Clinical trial and case series using glutamatergic drugs (N-acetylcysteine, memantine, amantadine, topiramate, acamprosate, baclofen, gabapentin, pregabalin, and modafinil will be presented to elucidate the effectiveness on gambling behaviors and on the related clinical dimensions (craving, withdrawal, and cognitive symptoms in PG patients. The results have been discussed to gain more insight in the pathophysiology and treatment of PG. In conclusion, manipulation of glutamatergic neurotransmission appears to be promising in developing improved therapeutic agents for the treatment of gambling disorders. Further studies are required. Finally, we propose future directions and challenges in this research area.

  15. Isavuconazole for the treatment of invasive aspergillosis and mucormycosis: current evidence, safety, efficacy, and clinical recommendations

    Science.gov (United States)

    Natesan, Suganthini Krishnan; Chandrasekar, Pranatharthi H

    2016-01-01

    The majority of invasive mold infections diagnosed in immunocompromised cancer patients include invasive aspergillosis (IA) and mucormycosis. Despite timely and effective therapy, mortality remains considerable. Antifungal agents currently available for the management of these serious infections include triazoles, polyenes, and echinocandins. Until recently, posaconazole has been the only triazole with a broad spectrum of anti-mold activity against both Aspergillus sp. and mucorales. Other clinically available triazoles voriconazole and itraconazole, with poor activity against mucorales, have significant drug interactions in addition to a side effect profile inherent for all triazoles. Polyenes including lipid formulations pose a problem with infusion-related side effects, electrolyte imbalance, and nephrotoxicity. Echinocandins are ineffective against mucorales and are approved as salvage therapy for refractory IA. Given that all available antifungal agents have limitations, there has been an unmet need for a broad-spectrum anti-mold agent with a favorable profile. Following phase III clinical trials that started in 2006, isavuconazole (ISZ) seems to fit this profile. It is the first novel triazole agent recently approved by the United States Food and Drug Administration (FDA) for the treatment of both IA and mucormycosis. This review provides a brief overview of the salient features of ISZ, its favorable profile with regard to spectrum of antifungal activity, pharmacokinetic and pharmacodynamic parameters, drug interactions and tolerability, clinical efficacy, and side effects. PMID:27994475

  16. Factors Influencing Adult Physical Health after Controlling for Current Health Conditions: Evidence from a British Cohort

    Science.gov (United States)

    Cheng, Helen; Furnham, Adrian

    2013-01-01

    This study explored a longitudinal data set of 6875 British adults examining the effects of parental social status (measured at birth), cognitive ability (at age 11 yrs), personality traits, education and occupational attainment on physical health and functioning (all measured at age 50 yrs), after taking account of current health conditions (number of illness). Correlation analysis showed that parental social class, childhood cognitive ability, education and occupation, and two personality traits (Emotional Stability/Neuroticism, and Conscientiousness) were all significantly associated with adult physical health variables. Structural equation modelling showed that health conditions and personality traits were significantly, and inversely, associated with physical health (indicated by good daily physical functioning, relative absence of pain, perceived health, and low level of limitations at work due to physical health). Parental social status, childhood intelligence, educational and occupational attainment were all modestly, but significantly and directly, associated with adult physical health. The effect of childhood intelligence on adult physical health was, in part, mediated through Emotional Stability and Conscientiousness. After controlling for health conditions Emotional Stability was the strongest predictor of physical health. Implications and limitations are discussed. PMID:23826090

  17. Clinical significance of nutritional status in patients with atrial fibrillation: An overview of current evidence.

    Science.gov (United States)

    Anaszewicz, Marzena; Budzyński, Jacek

    2017-05-01

    Obesity is a well-known atherosclerosis risk factor; however, its role and the importance of undernutrition in atrial fibrillation (AF) pathogenesis are still not well understood. The aim of this study was to present the current state of knowledge on this issue in different groups of patients. Systematic review of papers published between 1980 and 2016. The literature shows contradicting views regarding the impact of nutritional status on the risk, course, and complications of AF. On the one hand, it has been revealed that overweight, obesity, and high birth mass increase the risk of AF, and that their reduction is linked to an improved course of AF and reduced all-cause and cardiovascular mortality. On the other hand, a so-called obesity paradox has been found, which shows lower all-cause mortality in overweight patients with AF compared to those of normal weight or who are underweight. It has also been shown, although based on a small number of studies, that the relationship between nutritional status and risk of AF and its complication may be U-shaped, which means that not only patients with obesity, but also individuals with underweight, cachexia, and low birth weight may have an increased risk and poor outcome of AF. The relationship between patients' nutritional status and the course of AF has become clearer but it requires further studies examining the importance of weight reduction on AF course. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  18. Factors influencing adult physical health after controlling for current health conditions: evidence from a british cohort.

    Directory of Open Access Journals (Sweden)

    Helen Cheng

    Full Text Available This study explored a longitudinal data set of 6875 British adults examining the effects of parental social status (measured at birth, cognitive ability (at age 11 yrs, personality traits, education and occupational attainment on physical health and functioning (all measured at age 50 yrs, after taking account of current health conditions (number of illness. Correlation analysis showed that parental social class, childhood cognitive ability, education and occupation, and two personality traits (Emotional Stability/Neuroticism, and Conscientiousness were all significantly associated with adult physical health variables. Structural equation modelling showed that health conditions and personality traits were significantly, and inversely, associated with physical health (indicated by good daily physical functioning, relative absence of pain, perceived health, and low level of limitations at work due to physical health. Parental social status, childhood intelligence, educational and occupational attainment were all modestly, but significantly and directly, associated with adult physical health. The effect of childhood intelligence on adult physical health was, in part, mediated through Emotional Stability and Conscientiousness. After controlling for health conditions Emotional Stability was the strongest predictor of physical health. Implications and limitations are discussed.

  19. School Social Work in the United States: Current Evidence and Future Directions

    Directory of Open Access Journals (Sweden)

    Stone, Susan

    2015-02-01

    Full Text Available This paper surveys the historical and school institutional factors that shape current workforce, programmatic, and practice trends related to school social work in America. A key strand developed throughout is that the field of practice appears to be at a crossroads. It is suggested that this field of practice may be enhanced by placing the central focus on schools as organisations and school-community relations as key targets of intervention.Este artículo examina los factores históricos e institucionales que perfilan al personal docente, las tendencias en las programaciones y las prácticas que se desarrollan en la actualidad en el ámbito del trabajo social en la escuela en los Estados Unidos de América. Un aspecto clave derivado de este examen es que la profesión parece estar en una encrucijada. Se sugiere como alternativa a esta situación, centrar la atención y los objetivos fundamentales de intervención en las escuelas como organizaciones, y en las relaciones que se generan entre las escuelas y la comunidad.

  20. Biologic therapy with or without topical treatment in psoriasis: what does the current evidence say?

    Science.gov (United States)

    Jensen, J Daniel; Delcambre, Macey Renault; Nguyen, Gloria; Sami, Naveed

    2014-10-01

    Biologic therapy represents a relatively new class of drugs which have revolutionized the treatment of psoriasis and are used with increasing frequency in order to control this chronic, systemic inflammatory disease. However, it is unclear what role there is for combination therapy of biologics with traditional topical agents. The purpose of this article is to assess the literature on the role of topical agents as adjuvants to biological treatments in the treatment of psoriasis and identify areas for further research. A MEDLINE search was performed in order to identify English-language publications from 1996 to 2014 examining combination biologic therapy with topical medications in the treatment of psoriasis. Data from these clinical studies are summarized and the outcomes are discussed. In general, the addition of adjuvant topical therapy to systemic biologic therapy allowed for a reduction in dosage and side effects of both agents, maintenance of initial response to biologics, treatment of recalcitrant lesions in partial responders, and potential acceleration of response to biologic therapies. The current data, though limited, suggest that using topical therapies as adjunct treatment to biologics is a well tolerated and effective means of controlling psoriasis and improving quality of life for patients. However, the treating physician should remain attentive to signs of adverse events and seek opportunities to reduce the dose or treatment frequency during chronic use.

  1. Is Parkinson’s Disease Truly a Prion-Like Disorder? An Appraisal of Current Evidence

    Directory of Open Access Journals (Sweden)

    Aneesha Chauhan

    2015-01-01

    Full Text Available Parkinson’s disease (PD is the world’s second most common neurodegenerative disease and most common movement disorder. Characterised by a loss of dopaminergic neurons and the development of intraneuronal inclusions known as Lewy bodies, it has classically been thought of as a cell-autonomous disease. However, in 2008, two groups reported the startling observation of Lewy bodies within embryonic neuronal grafts transplanted into PD patients little more than a decade previously, suggesting that PD pathology can be propagated to neighbouring cells and calling basic assumptions of our understanding of the disease into question. Subsequent research has largely served to confirm this interpretation, pointing towards a prion-like intercellular transfer of misfolded α-synuclein, the main component of Lewy bodies, as central to PD. This shift in thinking offers a revolutionary approach to PD treatment, potentially enabling a transition from purely symptomatic therapy to direct targeting of the pathology that drives disease progression. In this short review, we appraise current experimental support for PD as a prion-like disease, whilst highlighting areas of controversy or inconsistency which must be resolved. We also offer a brief discussion of the therapeutic implications of these discoveries.

  2. Is Africa’s current growth reducing inequality? Evidence from some selected african countries

    Directory of Open Access Journals (Sweden)

    Alege P.O.

    2015-06-01

    Full Text Available Is Africa’s current growth reducing inequality? What are the implications of growth on output performances in Africa? Does the effect of Africa’s growth on sectorial output have any implication for inequality in Africa? The study investigates the effect of shocks on a set of macroeconomic variables on inequality (measured by life expectancy and the implication of this on sectors that are perceived to provide economic empowerment in form of employment for people living in the African countries in our sample. Studies already find that growth in many African countries has not been accompanied with significant improvement in employment. Therefore inequality is subject to a counter cyclical trend in production levels when export destination countries experience a recession. The study also provides insight on the effect of growth on sectorial output for three major sectors in the African economy with the intent of analyzing the impact of growth on sectorial development. The method used in this study is Panel Vector Autoregressive (PVAR estimation and the obvious advantage of this method lies in the fact that it allows us to capture both static and dynamic interdependencies and to treat the links across units in an unrestricted fashion. Data is obtained from World Bank (WDI Statistics for the period 1985 to 2012 (28 years for 10 African Countries. Our main findings confirm strong negative relationship between GDP growth and life expectancy and also for GDP and the services and manufacturing sector considering the full sample.

  3. Large dunes on the outer shelf off the Zambezi Delta, Mozambique: evidence for the existence of a Mozambique Current

    Science.gov (United States)

    Flemming, Burghard W.; Kudrass, Hermann-Rudolf

    2017-06-01

    studies comparing the application of slippage and non-slippage approaches—they suggest that, when applying partial slippage, a western boundary current can exist simultaneously with the southward migrating eddies. Considering the evidence presented in this paper, it is concluded that a quasi-persistent, though seasonally variable Mozambique Current does exist.

  4. 减盐防控高血压的科学证据和实践%Scientific Evidence and Practice in Salt Intake Reducing for Hypertension Control

    Institute of Scientific and Technical Information of China (English)

    徐海泉; 徐建伟; 马冠生

    2012-01-01

    大量动物实验和流行病学研究表明,过量的食盐摄入是导致血压升高的主要因素之一。人群干预研究和发达国家的减盐行动表明,人群中减盐是预防高血压最具成本效益的措施。本文总结了减盐防控高血压的科学证据和国际减盐行动,指出了我国开展减盐防控高血压工作的必要性。%The large number of animal experiments and epidemiological studies showed that excessive salt intake was one of the main factors leading to high blood pressure. Salt reduction action and population intervention research in developed countries showed that less salt was the most cost-crowd effective measures to prevent high blood pressure. This paper summarized the scientific evidence of the prevention and control of hypertension in salt reduction and international salt reduction actions, and pointed out the necessity for our country to reduce salt intake and control hypertension.

  5. PRESCRIBING OF ANTIHYPERTENSIVE AGENTS IN PUBLIC PRIMARY CARE CLINICS – IS IT IN ACCORDANCE WITH CURRENT EVIDENCE?

    Directory of Open Access Journals (Sweden)

    SAJARI J

    2010-01-01

    Full Text Available Background: Large population surveys in Malaysia have consistently shown minimal improvement of blood pressure control rates over the last 10 years. Poor adherence to antihypertensive medication has been recognized as a major reason for poor control of hypertension. This study aimed to describe the prescribing pattern of antihypertensive agents in 2 public primary care clinics and assess its appropriateness in relation to current evidence and guidelines. Methods: A cross-sectional survey to describe the prescribing pattern of antihypertensive agents was carried out in 2 publicprimary care clinics in Selangor from May to June 2009. Hypertensive patients on pharmacological treatment for ≥1 year who attended the clinics within the study period of 7 weeks were selected. Appropriate use of antihypertensive agents was defined based on current evidence and the recommendations by the Malaysian Clinical Practice Guidelines (CPG on the Management of Hypertension, 2008. Data were obtained from patients’ medical records and were analysed using the SPSS software version 16.0. Results: A total of 400 hypertensive patients on treatment were included. Mean age was 59.5 years (SD ±10.9, range 28 to91 years, of which 52.8% were females and 47.2% were males. With regards to pharmacotherapy, 45.7% were on monotherapy,43.3% were on 2 agents and 11.0% were on ≥3 agents. Target blood pressure of <140/90mmHg was achieved in 51.4% of patients on monotherapy, and 33.2% of patients on combination of ≥2 agents. The commonest monotherapy agents being prescribed were β-blockers (atenolol or propranolol, followed by the short-acting calcium channel blocker (nifedipine. The commonest combination of 2-drug therapy prescribed was β-blockers and short-acting calcium channel blocker. Conclusion: This study shows that the prescribing pattern of antihypertensive agents in the 2 primary care clinics was not in accordance with current evidence and guidelines.

  6. Observational evidence of seasonality in the timing of loop current eddy separation

    Science.gov (United States)

    Hall, Cody A.; Leben, Robert R.

    2016-12-01

    Observational datasets, reports and analyses over the time period from 1978 through 1992 are reviewed to derive pre-altimetry Loop Current (LC) eddy separation dates. The reanalysis identified 20 separation events in the 15-year record. Separation dates are estimated to be accurate to approximately ± 1.5 months and sufficient to detect statistically significant LC eddy separation seasonality, which was not the case for previously published records because of the misidentification of separation events and their timing. The reanalysis indicates that previously reported LC eddy separation dates, determined for the time period before the advent of continuous altimetric monitoring in the early 1990s, are inaccurate because of extensive reliance on satellite sea surface temperature (SST) imagery. Automated LC tracking techniques are used to derive LC eddy separation dates in three different altimetry-based sea surface height (SSH) datasets over the time period from 1993 through 2012. A total of 28-30 LC eddy separation events were identified in the 20-year record. Variations in the number and dates of eddy separation events are attributed to the different mean sea surfaces and objective-analysis smoothing procedures used to produce the SSH datasets. Significance tests on various altimetry and pre-altimetry/altimetry combined date lists consistently show that the seasonal distribution of separation events is not uniform at the 95% confidence level. Randomization tests further show that the seasonal peak in LC eddy separation events in August and September is highly unlikely to have occurred by chance. The other seasonal peak in February and March is less significant, but possibly indicates two seasons of enhanced probability of eddy separation centered near the spring and fall equinoxes. This is further quantified by objectively dividing the seasonal distribution into two seasons using circular statistical techniques and a k-means clustering algorithm. The estimated

  7. Isavuconazole for the treatment of invasive aspergillosis and mucormycosis: current evidence, safety, efficacy, and clinical recommendations

    Directory of Open Access Journals (Sweden)

    Natesan SK

    2016-12-01

    Full Text Available Suganthini Krishnan Natesan,1,2 Pranatharthi H Chandrasekar1 1Division of Infectious Diseases, Department of Internal Medicine, Wayne State University, 2John D Dingell VA Medical Center, Detroit, MI, USA Abstract: The majority of invasive mold infections diagnosed in immunocompromised cancer patients include invasive aspergillosis (IA and mucormycosis. Despite timely and effective therapy, mortality remains considerable. Antifungal agents currently available for the management of these serious infections include triazoles, polyenes, and echinocandins. Until recently, posaconazole has been the only triazole with a broad spectrum of anti-mold activity against both Aspergillus sp. and mucorales. Other clinically available triazoles voriconazole and itraconazole, with poor activity against mucorales, have significant drug interactions in addition to a side effect profile inherent for all triazoles. Polyenes including lipid formulations pose a problem with infusion-related side effects, electrolyte imbalance, and nephrotoxicity. Echinocandins are ineffective against mucorales and are approved as salvage therapy for refractory IA. Given that all available antifungal agents have limitations, there has been an unmet need for a broad-spectrum anti-mold agent with a favorable profile. Following phase III clinical trials that started in 2006, isavuconazole (ISZ seems to fit this profile. It is the first novel triazole agent recently approved by the United States Food and Drug Administration (FDA for the treatment of both IA and mucormycosis. This review provides a brief overview of the salient features of ISZ, its favorable profile with regard to spectrum of antifungal activity, pharmacokinetic and pharmacodynamic parameters, drug interactions and tolerability, clinical efficacy, and side effects. Keywords: isavuconazole, aspergillosis, mucormycosis, efficacy, antifungal therapy, novel azole, tolerability, drug interactions

  8. Extended Lymphadenectomy and "Mesopancreas" Excision during Pancreatoduodenectomy for Cancer; is it worth it? Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Elissaios Kontis

    2016-03-01

    Full Text Available Pancreatic cancer is a malignancy with overall poor prognosis. Surgery is the only treatment modality, which could provide cure. Therefore every effort possible should be made for pancreatectomy to achieve R0 resection. However, even after R0 resection, the survival outcomes are still far behind from other solid intrabdominal tumors. Extended lymphadenectomy and “mesopancreas” excision are the two main factors where focus has been given, in order to improve the outcomes of pancreatectomy for pancreatic head cancer. We present an up to date comprehensive review of the current evidence on the topics of extended lymphadenectomy and “mesopancreas” excision during pancreatoduodenectomy for cancer.

  9. The effectiveness of current approaches to workplace stress management in the nursing profession: an evidence based literature review

    Science.gov (United States)

    Mimura, C; Griffiths, P

    2003-01-01

    The effectiveness of current approaches to workplace stress management for nurses was assessed through a systematic review. Seven randomised controlled trials and three prospective cohort studies assessing the effectiveness of a stress management programmes were identified and reviewed. The quality of research identified was weak. There is more evidence for the effectiveness of programmes based on providing personal support than environmental management to reduce stressors. However, since the number and quality of studies is low, the question as to which, if any, approach is more effective cannot be answered definitively. Further research is required before clear recommendations for the use of particular interventions for nursing work related stress can be made. PMID:12499451

  10. The Current Status of Nurse-Administered Propofol Sedation in Endoscopy: An Evidence-Based Practice Nurse Fellowship Project.

    Science.gov (United States)

    Rivera, Beth

    2015-01-01

    The Society for Gastroenterology Nurses and Associates (SGNA) launched a nurse fellowship program in 2011 to promote evidence-based practice. Each accepted applicant was challenged to select a relevant topic, explore the current research, and translate this information to daily practice. The author, an SGNA Fellow, selected the topic, nurse-administered propofol sedation, that has been a prevailing subject in endoscopy for many years. A significant amount of literature has been written on the drug's safety and efficacy. This article explores a brief history of the practice and the future of this controversial drug for procedural sedation. A review of current literature is explored with an emphasis on the past 5 years as well as a discussion on regulatory limitations that have been placed on the practice of non-anesthesiologist-administered propofol sedation.

  11. Cytidine 5′-Diphosphocholine (Citicoline) in Glaucoma: Rationale of Its Use, Current Evidence and Future Perspectives

    Science.gov (United States)

    Roberti, Gloria; Tanga, Lucia; Michelessi, Manuele; Quaranta, Luciano; Parisi, Vincenzo; Manni, Gianluca; Oddone, Francesco

    2015-01-01

    Cytidine 5′-diphosphocholine or citicoline is an endogenous compound that acts in the biosynthetic pathway of phospholipids of cell membranes, particularly phosphatidylcholine, and it is able to increase neurotrasmitters levels in the central nervous system. Citicoline has shown positive effects in Parkinson’s disease and Alzheimer’s disease, as well as in amblyopia. Glaucoma is a neurodegenerative disease currently considered a disease involving ocular and visual brain structures. Neuroprotection has been proposed as a valid therapeutic option for those patients progressing despite a well-controlled intraocular pressure, the main risk factor for the progression of the disease. The aim of this review is to critically summarize the current evidence about the effect of citicoline in glaucoma. PMID:26633368

  12. Cytidine 5′-Diphosphocholine (Citicoline in Glaucoma: Rationale of Its Use, Current Evidence and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Gloria Roberti

    2015-11-01

    Full Text Available Cytidine 5′-diphosphocholine or citicoline is an endogenous compound that acts in the biosynthetic pathway of phospholipids of cell membranes, particularly phosphatidylcholine, and it is able to increase neurotrasmitters levels in the central nervous system. Citicoline has shown positive effects in Parkinson’s disease and Alzheimer’s disease, as well as in amblyopia. Glaucoma is a neurodegenerative disease currently considered a disease involving ocular and visual brain structures. Neuroprotection has been proposed as a valid therapeutic option for those patients progressing despite a well-controlled intraocular pressure, the main risk factor for the progression of the disease. The aim of this review is to critically summarize the current evidence about the effect of citicoline in glaucoma.

  13. Sofosbuvir for the treatment of chronic hepatitis C: between current evidence and future perspectives

    Directory of Open Access Journals (Sweden)

    Degasperi E

    2014-04-01

    Full Text Available Elisabetta Degasperi, Alessio AghemoDivision of Gastroenterology and Hepatology, AM and M Migliavacca Center, Fondazione IRCCS Ca' Granda Maggiore Hospital, University of Milan, Milan, ItalyAbstract: In recent years, clinical research in the field of new treatments for chronic hepatitis C (HCV has been devoted to developing regimens based on direct-acting antivirals (DAAs, with the goal of increasing treatment efficacy and improving tolerability and safety. This can be achieved by Peginterferon (PegIFN-free anti-HCV regimens, as PegIFN is responsible for many side effects and limits treatment access due to contraindications in some patient categories. Sofosbuvir (SOF is the first compound to enter the market with IFN-free combination regimens; it belongs to the nucleotide inhibitors of viral polymerase NS5B and acts as a chain terminator during the HCV replication process, exhibiting pan-genotypic antiviral activity with a high barrier to resistance. Clinical trials in HCV genotype 2/3 patients have demonstrated optimal efficacy in HCV-2, where the combination SOF/ribavirin (Rbv for 12 weeks resulted in >90% sustained virological response (SVR rates, while HCV-3 patients with advanced liver fibrosis and previous failure to PegIFN plus Rbv therapy still require individualized and optimized treatment strategies. Historically difficult-to-treat genotypes HCV-1, -4–6 can benefit from reduced duration of PegIFN plus SOF and Rbv, while IFN-free regimens in these patients will be based on SOF in combination with other DAA classes. Due to an optimal tolerability and safety profile with no significant drug-to-drug interactions, SOF is currently undergoing clinical trials in the setting of pre- and post-liver transplantation and HIV-coinfected patients, with the objective to address the until now unmet need for safe and efficient treatment in these populations. This article provides an overview of SOF features and the main clinical trials, discussing

  14. Infections and urolithiasis: current clinical evidence in prophylaxis and antibiotic therapy.

    Science.gov (United States)

    Zanetti, Giampaolo; Paparella, Stefano; Trinchieri, Alberto; Prezioso, Domenico; Rocco, Francesco; Naber, Kurt G

    2008-03-01

    Urinary tract infections and urosepsis are complications which can precede or follow a kidney stone treatment. Often the stones themselves are the source of infection, whether they are infection stones or not. Systemic infections are difficult to foresee, and neither a pre-operative negative urine culture nor an antibiotic prophylaxis avoid infectious complications for certain. The primary predictive risk factors of urosepsis are: patient conditions, urinary tract infection or a history of recurrent infections, characteristics of the stone, and anatomy of the urinary tract. Infection stones are still a matter of debate, concerning both the aetiology of the disease and its treatment. Positive cultures are not only found with struvite stones, but also with apatite and calcium oxalate stones. Currently, a long-term antibiotic therapy is advised in patients affected by infection stones. Antibiotic therapy should prevent not only septic complications but also recurrence or re-growth of stones after treatment. Different antibiotic modalities are recommended, sometimes together with urease inhibitors. Mid-stream urine culture is the easiest available pre-treatment parameter notwithstanding its poor predictive value. In case of suspected or proven urinary infection, an appropriate antibiotic therapy should always be administered prior to surgical procedure. There is, however, controversy regarding the antibiotic use, its role, expediency, and duration of prophylaxis in relation to the various surgical procedures, and the way infectious complications are considered and classified. When antibiotic prophylaxis is considered, its duration should be clearly established prior to surgery; duration may vary depending on the type of surgery or the type of antibiotic. Furthermore, prophylaxis should be administered only for a limited amount of time. In infection stones, in immuno-compromised patients or in patients with anatomical anomalies or diabetes, the risk of post

  15. Does deforestation promote or inhibit malaria transmission in the Amazon? A systematic literature review and critical appraisal of current evidence.

    Science.gov (United States)

    Tucker Lima, Joanna M; Vittor, Amy; Rifai, Sami; Valle, Denis

    2017-06-05

    Considerable interest in the relationship between biodiversity and disease has recently captured the attention of the research community, with important public policy implications. In particular, malaria in the Amazon region is often cited as an example of how forest conservation can improve public health outcomes. However, despite a growing body of literature and an increased understanding of the relationship between malaria and land use / land cover change (LULC) in Amazonia, contradictions have emerged. While some studies report that deforestation increases malaria risk, others claim the opposite. Assessing malaria risk requires examination of dynamic processes among three main components: (i) the environment (i.e. LULC and landscape transformations), (ii) vector biology (e.g. mosquito species distributions, vector activity and life cycle, plasmodium infection rates), and (iii) human populations (e.g. forest-related activity, host susceptibility, movement patterns). In this paper, we conduct a systematic literature review on malaria risk and deforestation in the Amazon focusing on these three components. We explore key features that are likely to generate these contrasting results using the reviewed articles and our own data from Brazil and Peru, and conclude with suggestions for productive avenues in future research.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Authors.

  16. Does deforestation promote or inhibit malaria transmission in the Amazon? A systematic literature review and critical appraisal of current evidence

    Science.gov (United States)

    Tucker Lima, Joanna M.; Vittor, Amy; Rifai, Sami

    2017-01-01

    Considerable interest in the relationship between biodiversity and disease has recently captured the attention of the research community, with important public policy implications. In particular, malaria in the Amazon region is often cited as an example of how forest conservation can improve public health outcomes. However, despite a growing body of literature and an increased understanding of the relationship between malaria and land use / land cover change (LULC) in Amazonia, contradictions have emerged. While some studies report that deforestation increases malaria risk, others claim the opposite. Assessing malaria risk requires examination of dynamic processes among three main components: (i) the environment (i.e. LULC and landscape transformations), (ii) vector biology (e.g. mosquito species distributions, vector activity and life cycle, plasmodium infection rates), and (iii) human populations (e.g. forest-related activity, host susceptibility, movement patterns). In this paper, we conduct a systematic literature review on malaria risk and deforestation in the Amazon focusing on these three components. We explore key features that are likely to generate these contrasting results using the reviewed articles and our own data from Brazil and Peru, and conclude with suggestions for productive avenues in future research. This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. PMID:28438914

  17. Hepatitis B Vaccination in Bangladesh: a Suggestion Based on Current Evidence

    Directory of Open Access Journals (Sweden)

    Shafquat Mohammed Rafiq

    2006-12-01

    Full Text Available IntroductionThe hepatitis B virus (HBV causes up to a million deaths worldwide and 16 million health care related infections in the tropics each year(1,2, and over 350 million become chronically infected carriers who have no significant liver disease; approximately three quarters of them are in Asia and the western pacific region(3,4. HBV infection is a potentially life threatening condition as many of the affected individuals progress to chronic hepatitis,cirrhosis and hepatocellular carcinoma (HCC(3. In infants and children, acute hepatitis B infection is nearly always asymptomatic, whereas in adults it is usually the opposite. But on the other hand, the risk of becoming chronic carriage is much greater in children than in adults; as many as 90% of infants born to Hepatitis B e Antigen (HBeAg positive mothers become carriers themselves and, therefore, in long term are more likely to developchronic liver disease(5. Currently, though several antiviral drugs are used,there is no reliable curative treatment for HBV once it has been acquired and prevention by universal immunization remains the strategy for reducing the number of acute infections, chronic carriage and the long-term burden from diseases such as HCC(4,6. In 1991, in an attempt to reduce the global impact of HBV infection, WHO recommended that hepatitis B vaccination should be integrated into national immunization programs in all countries(7.Some Asian countries, for instance, Thailand, haveadopted the policy of immunizing children universally against the disease as early as 1992, however many others lagged behind(4.The true prevalence of Hepatitis B in Bangladesh is yet to be ascertained by a reliable study. Data available from different studies show that it ranges between 0.8 and 5.4% depending on the study design, samples and laboratory methods used(8-10.These data were based on detection of HBsAg antigen; the rates would have been higher, had they been based on anti-HBc antibody(11

  18. Physical Exercise for the Treatment of Neuropsychiatric Disturbances in Alzheimer's Dementia: Possible Mechanisms, Current Evidence and Future Directions.

    Science.gov (United States)

    Matura, Silke; Carvalho, André F; Alves, Gilberto S; Pantel, Johannes

    2016-01-01

    Behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric or non-cognitive symptoms are common and often distressing features of Alzheimer's Dementia. BPSD significantly increase patient suffering, early institutionalization and caregiver's burden. The clinical management of BPSD is dominated by a pharmacological approach, although these medications often come with serious adverse side-effects. There are only few nonpharmacological treatment strategies for BPSD. A substantial amount of intervention studies that have investigated non-pharmacological treatment options for BPSD have focused on physical exercise. Although these studies are very heterogeneous in terms of type and severity of dementia, as well as type and duration of the exercise intervention, the overall picture shows a positive effect of physical exercise in alleviating BPSD. There is evidence that numerous mechanisms contribute to the positive effect of physical exercise on BPSD. No attempt has been undertaken so far to give an overview of the existing knowledge regarding these mechanisms. Therefore, the current review aims to integrate the existing evidence on psychological and neurobiological mechanisms that contribute to the beneficial effects of physical exercise in ameliorating BPSD in Alzheimer's dementia. A discussion of psychological mechanisms such as improved sleep and stress reduction will be followed by a discussion of neurobiological mechanisms including the exercise induced change in neurotransmitter concentrations, increased synthesis of neurotrophins and immune activation. The review closes with recommendations for future research to overcome the shortcomings of existing studies and broaden the current knowledge on the positive effects of physical exercise on BPSD.

  19. Efficacy and safety of haloperidol for in-hospital delirium prevention and treatment: A systematic review of current evidence.

    Science.gov (United States)

    Schrijver, E J M; de Graaf, K; de Vries, O J; Maier, A B; Nanayakkara, P W B

    2016-01-01

    Haloperidol is generally considered the drug of choice for in-hospital delirium management. We conducted a systematic review to evaluate the evidence for the efficacy and safety of haloperidol for the prevention and treatment of delirium in hospitalized patients. PubMed, Embase, Cumulative Index to Nursing and Allied Health (CINAHL), PsycINFO, and the Cochrane Library were systematically searched up to April 21, 2015. We included English full-text randomized controlled trials using haloperidol for the prevention or treatment of delirium in adult hospitalized patients reporting on delirium incidence, duration, or severity as primary outcome. Quality of evidence was graded. Meta-analysis was not conducted because of between-study heterogeneity. Twelve studies met our inclusion criteria, four prevention and eight treatment trials. Methodological limitations decreased the graded quality of included studies. Results from placebo-controlled prevention studies suggest a haloperidol-induced protective effect for delirium in older patients scheduled for surgery: two studies reported a significant reduction in ICU delirium incidence and one study found a significant reduction in delirium severity and duration. Although placebo-controlled trials are missing, pharmacological treatment of established delirium reduced symptom severity. Haloperidol administration was not associated with treatment-limiting side-effects, but few studies used a systematic approach to identify adverse events. Although results on haloperidol for delirium management seem promising, current prevention trials lack external validity and treatment trials did not include a placebo arm on top of standard nonpharmacological care. We therefore conclude that the current use of haloperidol for in-hospital delirium is not based on robust and generalizable evidence. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  20. Microtubules in basalt glass from Hawaii Scientific Driling Project #2 phase 1 core and Hilina slope, Hawaii: evidence of the occurrence and behavior of endolithic microorganisms.

    Science.gov (United States)

    Walton, A W

    2008-08-01

    Elongate, fine tubes, approximately 1 microm wide and up to 200 microm long, extend from fractured surfaces, vesicle walls, and internal fractures into fragments of basalt glass in samples from the Hawaii Scientific Drilling Project #2 phase 1 (HSDP #2(1)) core and the Hilina slope, Hawaii. Several features indicate that these tubes are microbial endolithic microborings: the tubes resemble many described microborings from oceanic basalt glass, their formation is postdepositional but restricted to certain but different ranges of time in the two sets of samples, and they are not uniformly distributed throughout glass fragments. Microtubules record several characteristic behaviors including boring into glass, mining, seeking olivine, and avoiding plagioclase. They also are highly associated with a particular form of glass-replacing smectite. Evidence of behavior should join morphological and geochemical criteria in indicating microbial alteration of basalt glass. In some samples, steeply conical tubes, approximately 10-20 microm in diameter tapering to 1 microm and commonly filled with smectite, appear to be modifications or elaborations of the microtubules. These also curve toward olivine and are associated with replacement smectite. In HSDP #2(1) samples, microtubules initiated at margins of shards before palagonite replaced those margins and are preserved during palagonitization. In fact, microtubules appear to have provided routes that enhanced the efficiency of water's reaching of unaltered glass. In Hilina Slope samples, the microtubules appear to postdate palagonitization because they initiate at the boundary between palagonite and unaltered sideromelane. Preservation of microtubules during palagonitization in samples together with recognition of other associated characteristics representing behavior suggests that such features may be recognizable in more heavily altered ancient rocks.

  1. Virtual reconstruction of the roman villa in La Quintilla (Lorca based on the existing physical evidence and related scientific comparisons as a reference

    Directory of Open Access Journals (Sweden)

    Sebastián F. Ramallos Asensio

    2013-11-01

    Full Text Available The virtual reconstruction of archaeological sites using computer graphics is a very important tool for the verification or refutation of hypotheses in scientific research. It also is an excellent way to spread awareness Heritage with realistic images of scientific rigor.

  2. Maternal nutritional status, C(1) metabolism and offspring DNA methylation: a review of current evidence in human subjects.

    Science.gov (United States)

    Dominguez-Salas, Paula; Cox, Sharon E; Prentice, Andrew M; Hennig, Branwen J; Moore, Sophie E

    2012-02-01

    Evidence is growing for the long-term effects of environmental factors during early-life on later disease susceptibility. It is believed that epigenetic mechanisms (changes in gene function not mediated by DNA sequence alteration), particularly DNA methylation, play a role in these processes. This paper reviews the current state of knowledge of the involvement of C1 metabolism and methyl donors and cofactors in maternal diet-induced DNA methylation changes in utero as an epigenetic mechanism. Methyl groups for DNA methylation are mostly derived from the diet and supplied through C1 metabolism by way of choline, betaine, methionine or folate, with involvement of riboflavin and vitamins B6 and B12 as cofactors. Mouse models have shown that epigenetic features, for example DNA methylation, can be altered by periconceptional nutritional interventions such as folate supplementation, thereby changing offspring phenotype. Evidence of early nutrient-induced epigenetic change in human subjects is scant, but it is known that during pregnancy C1 metabolism has to cope with high fetal demands for folate and choline needed for neural tube closure and normal development. Retrospective studies investigating the effect of famine or season during pregnancy indicate that variation in early environmental exposure in utero leads to differences in DNA methylation of offspring. This may affect gene expression in the offspring. Further research is needed to examine the real impact of maternal nutrient availability on DNA methylation in the developing fetus.

  3. Reliability of Growth Indicators and Efficiency of Functional Treatment for Skeletal Class II Malocclusion: Current Evidence and Controversies

    Science.gov (United States)

    2017-01-01

    Current evidence on the reliability of growth indicators in the identification of the pubertal growth spurt and efficiency of functional treatment for skeletal Class II malocclusion, the timing of which relies on such indicators, is highly controversial. Regarding growth indicators, the hand and wrist (including the sole middle phalanx of the third finger) maturation method and the standing height recording appear to be most reliable. Other methods are subjected to controversies or were showed to be unreliable. Main sources of controversies include use of single stages instead of ossification events and diagnostic reliability conjecturally based on correlation analyses. Regarding evidence on the efficiency of functional treatment, when treated during the pubertal growth spurt, more favorable response is seen in skeletal Class II patients even though large individual responsiveness remains. Main sources of controversies include design of clinical trials, definition of Class II malocclusion, and lack of inclusion of skeletal maturity among the prognostic factors. While no growth indicator may be considered to have a full diagnostic reliability in the identification of the pubertal growth spurt, their use may still be recommended for increasing efficiency of functional treatment for skeletal Class II malocclusion. PMID:28168195

  4. Bibliometric analysis of scientific articles on evidence-based nursing of burn in the mainland of China%我国内地烧伤循证护理研究文献计量学分析

    Institute of Scientific and Technical Information of China (English)

    岳丽青; 皮曦晴; 范学工

    2016-01-01

    掌握,增强烧伤专业护理的科学性和有效性.%Objective To analyze the current research status of evidence-based nursing of burn in the mainland of China,in order to provide basis for the improvement of scientificity of burn nursing practice.Methods Chinese scientific articles on evidence-based nursing of burn in the mainland of China published from January 1997 to December 2015 were retrieved from Chinese Biology Medicine disc,Chinese Journals Full-text Database,Wanfang Database,and VIP Database.From the results retrieved,date with regard to publication year,region of affiliation of the first author,journal distribution,literature type,literature quality assessment,topic of evidence-based research,fund program support,implementation of evidencebased practice steps,and language and quantity of reference.Data were processed with Microsoft Excel software.Results A total of 50 articles conforming to the criteria were retrieved.(1) Articles about evidence-based nursing of burn arose in 2004.Compared with that in the previous year,there was no obvious increase in the number of relevant articles in each year from 2004 to 2011.The number of literature in 2012 was obviously increased than that in each year from 2004 to 2011,while the number of literature in each year from 2012 to 2015 was not obviously increased compared with that in the previous year.(2) The regions of affiliation of the first author were distributed in 13 provinces,3 minority autonomous regions,and 3 municipalities,with the largest distribution in East China,and Northwest China and Southwest China in the follow.(3) The articles were published in 32 domestic journals,with 9 (28.12%) nursing journals,5 (15.62%) burn medical related journals,and 18 (56.25%) other journals.Twenty (40%) articles were published in Source Journal for Chinese Scientific and Technical Papers.(4) Regarding the literature type,31 (62%) articles dealt with clinical experiences,17 (34%) articles dealt with

  5. Evidence Locator: sources of evidence-based dentistry information.

    Science.gov (United States)

    Frantsve-Hawley, Julie

    2008-09-01

    Multiple resources are available to help practitioners access the latest scientific evidence. Evidence-based dentistry (EBD) is an approach to clinical decision making that incorporates the most current and comprehensive scientific evidence with the practitioner's judgment and the patient's needs and preferences. One challenge in implementing this approach is access to evidence, and there are multiple online resources that can be used in this endeavor. This article presents the Evidence Locator, a list of Web sites that provide access to "secondary sources" of evidence. Such "secondary sources" are typically summaries of systematic reviews and evidence-based clinical recommendations or guidelines. Also presented is a list of other Web sites that may be useful to the practitioner in implementing EBD.

  6. Scientific news

    NARCIS (Netherlands)

    NN,

    1994-01-01

    The Rijksherbarium/Hortus Botanicus acquired funds through NWO (Netherlands Organisation for Scientific Research) to participate in a 7-year interdisciplinary cooperative programme of Indonesian and Dutch scientific institutions aiming at research in Irian Jaya, Cenderawasih province (the Bird’s Hea

  7. Haunted by the ghost in the machine. Commentary on "The spirituality of human consciousness: a Catholic evaluation of some current neuro-scientific interpretations".

    Science.gov (United States)

    Miller, James B

    2012-09-01

    Metaphysical and epistemological dualism informs much contemporary discussion of the relationships of science and religion, in particular in relation to the neurosciences and the religious understanding of the human person. This dualism is a foundational artifact of modern culture; however, contemporary scientific research and historical theological scholarship encourage a more holistic view wherein human personhood is most fittingly u