WorldWideScience

Sample records for current scientific evidence

  1. [Phytotherapy in urology. Current scientific evidence of its application in benign prostatic hyperplasia and prostate adenocarcinoma].

    Science.gov (United States)

    Morán, E; Budía, A; Broseta, E; Boronat, F

    2013-02-01

    To evaluate the usefulness of phytotherapy in the treatment of the benign prostatic hyperplasia (BPH) and prostatic adenocarcinoma (ADCP). Systematic review of the evidence published until January 2011 using the following scientific terms: phytotherapy, benign prostate hyperplasia, prostatic adenocarcinoma, prostate cancer and the scientific names of compounds following the rules of the International Code of Botanical Nomenclature. The databases used were Medline and The Cochrane Library. We included articles published until January 2011 written in English and Spanish. We included studies in vitro/in vivo on animal models or human beings. Exclusion criteria were literature not in English and Spanish or articles with serious methodological flaws. We included 65 articles of which 40 met the inclusion criteria. BPH: the most studied products are serenoa repens and pygeum africanum. There are many studies in favour of the use of phytotherapy but its conclusions are inconsistent due to the small number of patients, the lack of control with placebo or short follow-up. However the use of these products is common in our environment. ADCP: there is no evidence to recommend phytotherapy in the treatment of the ADCP. There are works on prevention but only at experimental level so there is no evidence for its recommendation. The scientific evidence on the use of phytotherapy in prostatic pathology is conclusive not recommend ing the use of it for BPH or the ADCP. Copyright © 2012 AEU. Published by Elsevier España. All rights reserved.

  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. A brief review of current scientific evidence involving aromatherapy use for nausea and vomiting.

    Science.gov (United States)

    Lua, Pei Lin; Zakaria, Noor Salihah

    2012-06-01

    The objective of this study was to compile existing scientific evidence regarding the effects of essential oils (EOs) administered via inhalation for the alleviation of nausea and vomiting. CINAHL, PubMed, and EBSCO Host and Science Direct databases were searched for articles related to the use of EOs and/or aromatherapy for nausea and vomiting. Only articles using English as a language of publication were included. Eligible articles included all forms of evidence (nonexperimental, experimental, case report). Interventions were limited to the use of EOs by inhalation of their vapors to treat symptoms of nausea and vomiting in various conditions regardless of age group. Studies where the intervention did not utilize EOs or were concerned with only alcohol inhalation and trials that combined the use of aromatherapy with other treatments (massage, relaxations, or acupressure) were excluded. Five (5) articles met the inclusion criteria encompassing trials with 328 respondents. Their results suggest that the inhaled vapor of peppermint or ginger essential oils not only reduced the incidence and severity of nausea and vomiting but also decreased antiemetic requirements and consequently improved patient satisfaction. However, a definitive conclusion could not be drawn due to methodological flaws in the existing research articles and an acute lack of additional research in this area. The existing evidence is encouraging but yet not compelling. Hence, further well-designed large trials are needed before confirmation of EOs effectiveness in treating nausea and vomiting can be strongly substantiated.

  4. 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.

  5. Does Current Scientific Evidence Support a Link Between Light at Night and Breast Cancer Among Female Night-Shift Nurses?

    Science.gov (United States)

    Dickerman, Barbra; Liu, Jianghong

    2014-01-01

    Breast cancer is increasingly prevalent in industrialized regions of the world, and exposure to light at night (LAN) has been proposed as a potential risk factor. Epidemiological observations have documented an increased breast cancer risk among female night-shift workers, and strong experimental evidence for this relationship has also been found in rodent models. Indirect support for the LAN hypothesis comes from studies involving blind women, sleep duration, bedroom light levels, and community nighttime light levels. This article reviews the literature, discusses possible mechanisms of action, and provides recommendations for occupational health nursing research, practice, and education. Research is needed to further explore the relationship between exposure to LAN and breast cancer risk and elucidate the mechanisms underlying this relationship before interventions can be designed for prevention and mitigation of breast cancer. PMID:22658734

  6. Predicting future discoveries from current scientific literature.

    Science.gov (United States)

    Petrič, Ingrid; Cestnik, Bojan

    2014-01-01

    Knowledge discovery in biomedicine is a time-consuming process starting from the basic research, through preclinical testing, towards possible clinical applications. Crossing of conceptual boundaries is often needed for groundbreaking biomedical research that generates highly inventive discoveries. We demonstrate the ability of a creative literature mining method to advance valuable new discoveries based on rare ideas from existing literature. When emerging ideas from scientific literature are put together as fragments of knowledge in a systematic way, they may lead to original, sometimes surprising, research findings. If enough scientific evidence is already published for the association of such findings, they can be considered as scientific hypotheses. In this chapter, we describe a method for the computer-aided generation of such hypotheses based on the existing scientific literature. Our literature-based discovery of NF-kappaB with its possible connections to autism was recently approved by scientific community, which confirms the ability of our literature mining methodology to accelerate future discoveries based on rare ideas from existing literature.

  7. 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

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

    Science.gov (United States)

    Hoseini, Sayed Shahabuddin

    2017-12-01

    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.

  9. Anticancer effects of Ganoderma lucidum: a review of scientific evidence.

    Science.gov (United States)

    Yuen, John W M; Gohel, Mayur Danny I

    2005-01-01

    "Lingzhi" (Ganoderma lucidum), a popular medicinal mushroom, has been used in China for longevity and health promotion since ancient times. Investigations into the anticancer activity of lingzhi have been performed in both in vitro and in vivo studies, supporting its application for cancer treatment and prevention. The proposed anticancer activity of lingzhi has prompted its usage by cancer patients. It remains debatable as to whether lingzhi is a food supplement for health maintenance or actually a therapeutic "drug" for medical proposes. Thus far there has been no report of human trials using lingzhi as a direct anticancer agent, despite some evidence showing the usage of lingzhi as a potential supplement to cancer patients. Cellular immune responses and mitogenic reactivity of cancer patients have been enhanced by lingzhi, as reported in two randomized and one nonrandomized trials, and the quality of life of 65% of lung cancer patients improved in one study. The direct cytotoxic and anti-angiogenesis mechanisms of lingzhi have been established by in vitro studies; however, clinical studies should not be neglected to define the applicable dosage in vivo. At present, lingzhi is a health food supplement to support cancer patients, yet the evidence supporting the potential of direct in vivo anticancer effects should not be underestimated. Lingzhi or its products can be classified as an anticancer agent when current and more direct scientific evidence becomes available.

  10. 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…

  11. Herbal Supplements for Prostate Enlargement: Current State of the Evidence.

    Science.gov (United States)

    Nabavizadeh, Reza; Zangi, Mahdi; Kim, Michelle M; Yavari Bejestani, Maryam; Tabatabaei, Shahin

    2018-02-01

    To provide a comprehensive review of the current state of herbal supplement market for lower urinary tract symptoms (LUTS) and correlate the ingredients of each product with available scientific evidence. Twenty-seven products from Amazon.com that were advertised as herbal supplements for LUTS and had listed their active ingredients were selected. Active ingredients were reviewed on Google Scholar. Product price, warranty, and consumer review information were also collected. A total of 58 unique active ingredients were identified. The mean number of ingredients was 8.26 (standard deviation 5.25). Whereas 17 (63%) products had an ingredient with a systematic review to support their use, 20 (74%) had an ingredient with conflicting evidence based on systematic reviews. Out of the supplements that contained ingredients supported by literature, all (100%) products simultaneously had other ingredients with no, conflicting, or refuting evidence. There was no (0%) product that contained only scientifically proven ingredients. There is no scientific study to evaluate these supplements as a whole. Despite the widespread use of herbal supplements for LUTS, there is scant scientific evidence to support their safety and efficacy. Lack of adequate regulation and government support for research and development are some of the factors that disincentivize researchers to study safety and efficacy of these products. We encourage physicians to warn their patients on the lack of adequate evidence to support the safety and efficacy of many of these supplements. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Empirical Evidence or Intuition? An Activity Involving the Scientific Method

    Science.gov (United States)

    Overway, Ken

    2007-01-01

    Students need to have basic understanding of scientific method during their introductory science classes and for this purpose an activity was devised which involved a game based on famous Monty Hall game problem. This particular activity allowed students to banish or confirm their intuition based on empirical evidence.

  13. 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).

  14. 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

  15. [Scientific evidence on the legalization of abortion in Mexico City].

    Science.gov (United States)

    Gayón-Vera, Eduardo

    2010-03-01

    On April 24 2007, abortion before 12 weeks became legal in Mexico City. The arguments for this decision were: diminish the maternal morbidity and mortality, avoid a "severe health problem" and accomplish the women's physical, mental and social well being. To analyze the scientific evidences that support or reject this arguments. Retrospective study realized by bibliographic search of electronic data basis and Internet portals of interested groups. Mexico is considered by the World Health Organization, one of the countries in the world with low maternal mortality rates (abortion". In the hospitals of the Mexican Institute of Social Security, maternal deaths as consequence of induced abortions were, approximately, three every year. The evidences used as arguments in favor of abortion come from studies performed in Sub-Saharan African countries, which do not apply to Mexico. The scientific evidences show that induced abortion has important psychological sequels in women, a higher frequency of illegal drug abuse, alcoholism, child abuse, low birth weight in the following pregnancy, greater risk of subsequent miscarriage and greater mortality rate. There are no scientific evidences to support the arguments used for the legal approval of abortion in Mexico City.

  16. Reading for tracing evidence: developing scientific knowledge through science text

    Science.gov (United States)

    Probosari, R. M.; Widyastuti, F.; Sajidan, S.; Suranto, S.; Prayitno, B. A.

    2018-05-01

    The purposes of this study were to investigate students’ learning progression on reading activity, science concept comprehension and how they imply it in scientific communication in the classroom. Fifty-nine biology education students participated in this study. This classroom research was developed to portray students’ reading activity, factors affecting reading comprehension, and the development of reading motivation. Qualitative analysis was used to describe the whole activities, involve the instruction, process and the product of reading activity. The result concluded that each student has their own way in interpreting the information from scientific text, but generally, they can filter and apply it in their argument as a part of reasoning and evidence. The findings can be used to direct reading activity to the goal of inquiry in order to support the nature of reading as evidence.

  17. 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.

  18. [Project evidência [evidence]: research and education about accessing scientific databases in Azores].

    Science.gov (United States)

    Soares, Hélia; Pereira, Sandra M; Neves, Ajuda; Gomes, Amy; Teixeira, Bruno; Oliveira, Carolina; Sousa, Fábio; Tavares, Márcio; Tavares, Patrícia; Dutra, Raquel; Pereira, Hélder Rocha

    2013-04-01

    Project Evidência [Evidence] intends to promote the use of scientific databases among nurses. This study aims to design educational interventions that facilitate nurses' access to these databases, to determine nurses' habits regarding the use of scientific databases, and to determine the impact that educational interventions on scientific databases have on Azorean nurses who volunteered for this project. An intervention project was conducted, and a quantitative descriptive survey was designed to evaluate the impact two and five months after the educational intervention. This impact was investigated considering certain aspects, namely, the nurses' knowledge, habits and reasons for using scientific databases. A total of 192 nurses participated in this study, and the primary results indicate that the educational intervention had a positive impact based not only on the increased frequency of using platforms or databases of scientific information (DSIs) s but also on the competence and self-awareness regarding its use and consideration of the reasons for accessing this information.

  19. Current eugenics: A brand new challenge for scientific disciplines

    Directory of Open Access Journals (Sweden)

    María de las Mercedes O´Lery

    2006-01-01

    Full Text Available Until now, the parameters that distinguish the current eugenic practices form those encased in classic eugenics have been the private, individual and therapeutic characteristics of the first as opposed to the collective, coercive and improvement nature of the second. However, the present ethical debate over biotechnologies (particularly, criticism of liberal eugenics by such authors as Jürgen Habermas has given rise to the need to consider, in the future, genetic treatment as an object of the redistribution in order to avoid the discrimination implied in the impossibility of access to such treatment. The present paper attempts to show that this pretension would lead to the future dissolution of those very characteristics of current eugenics that distinguish it from the classic form. we therefore propose an epistemological analysis of present and/or future scientific practices in order to redefine those parameters that prevent their identification with the eugenic movement of the past century.

  20. Scientific evidence of dockworker illness to nursing clinical reasoning

    Directory of Open Access Journals (Sweden)

    Marlise Capa Verde de Almeida

    2016-04-01

    Full Text Available Abstract OBJECTIVE To identify scientific evidence of occupational illness of dockworkers published in the literature. METHOD 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. RESULTS 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. CONCLUSION The development of preventive measures should especially include chemical exposure of workers applying the clinical reasoning of nurses' environmental knowledge to care for illnesses.

  1. 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.

  2. 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.

  3. Expert opinions and scientific evidence for colonoscopy key performance indicators.

    Science.gov (United States)

    Rees, Colin J; Bevan, Roisin; Zimmermann-Fraedrich, Katharina; Rutter, Matthew D; Rex, Douglas; Dekker, Evelien; Ponchon, Thierry; Bretthauer, Michael; Regula, Jaroslaw; Saunders, Brian; Hassan, Cesare; Bourke, Michael J; Rösch, Thomas

    2016-12-01

    Colonoscopy is a widely performed procedure with procedural volumes increasing annually throughout the world. Many procedures are now performed as part of colorectal cancer screening programmes. Colonoscopy should be of high quality and measures of this quality should be evidence based. New UK key performance indicators and quality assurance standards have been developed by a working group with consensus agreement on each standard reached. This paper reviews the scientific basis for each of the quality measures published in the UK standards. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. 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.

  5. 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

  6. History of Aral Sea level variability and current scientific debates

    Science.gov (United States)

    Cretaux, Jean-François; Letolle, René; Bergé-Nguyen, Muriel

    2013-11-01

    The Aral Sea has shrunk drastically over the past 50 years, largely due to water abstraction from the Amu Darya and Syr Darya rivers for land irrigation. Over a longer timescale, Holocene palaeolimnological reconstruction of variability in water levels of the Aral Sea since 11,700 BP indicates a long history of alternating phases of regression and transgression, which have been attributed variously to climate, tectonic and anthropogenic forcing. The hydrological history of the Aral Sea has been investigated by application of a variety of scientific approaches, including archaeology, palaeolimnological palaeoclimate reconstruction, geophysics, sedimentology, and more recently, space science. Many issues concerning lake level variability over the Holocene and more recent timescales, and the processes that drive the changes, are still a matter for active debate. Our aim in this article is to review the current debates regarding key issues surrounding the causes and magnitude of Aral Sea level variability on a variety of timescales from months to thousands of years. Many researchers have shown that the main driving force of Aral Sea regressions and transgressions is climate change, while other authors have argued that anthropogenic forcing is the main cause of Aral Sea water level variations over the Holocene. Particular emphasis is made on contributions from satellite remote sensing data in order to improve our understanding of the influence of groundwater on the current hydrological water budget of the Aral Sea since 2005. Over this period of time, water balance computation has been performed and has shown that the underground water inflow to the Aral Sea is close to zero with an uncertainty of 3 km3/year.

  7. Complementary medicine for axial spondyloarthritis: is there any scientific evidence?

    Science.gov (United States)

    Danve, Abhijeet; Deodhar, Atul

    2018-04-09

    Majority of patients with axial spondyloarthritis (axSpA) report use of complementary and alternative medicine (CAM) therapies before and even after the diagnosis, due to perceived efficacy and wide-spread belief that these modalities lack side effects. In this review, we describe the available scientific evidence for the CAM therapies in axSpA. Clinical trials of the CAM therapies in axSpA are generally hampered by small sample size, short duration, difficulties in blinding, lack of control groups and strong placebo effect. Nonetheless, exercise programs like Pilates and mind-body techniques such as Tai Chi may have favorable effect on the disease activity and function. Although not yet confirmed, the modulation of the microbiome with the help of probiotics or fecal transplant has face validity given the evolving scientific rationale. Diet has only limited role in the management of axSpA. Deep tissue massage, omega-3 fatty acids and Stanger bath were found to be useful in small studies. CAM therapies are not always entirely well tolerated, particularly the manipulative techniques like chiropractic and Tui-na in patients with advanced disease and osteoporosis. There are no trials of yoga in axSpA despite the wider acceptance and use of yoga as an effective mind-body technique. Larger and better quality clinical trials of CAM therapies are needed to confirm their efficacy and safety in the management of axSpA and to include them in the 'mainstream' medicine.

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

    DEFF Research Database (Denmark)

    Verbeke, Wim; Sioen, Isabelle; Brunsø, Karen

    2007-01-01

    . 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......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...... 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...

  9. 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.

  10. [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.

  11. Somatosensory tinnitus: Current evidence and future perspectives

    Science.gov (United States)

    Greco, Antonio; Turchetta, Rosaria; Altissimi, Giancarlo; de Vincentiis, Marco; Cianfrone, Giancarlo

    2017-01-01

    In some individuals, tinnitus can be modulated by specific maneuvers of the temporomandibular joint, head and neck, eyes, and limbs. Neuroplasticity seems to play a central role in this capacity for modulation, suggesting that abnormal interactions between the sensory modalities, sensorimotor systems, and neurocognitive and neuroemotional networks may contribute to the development of somatosensory tinnitus. Current evidence supports a link between somatic disorders and higher modulation of tinnitus, especially in patients with a normal hearing threshold. Patients with tinnitus who have somatic disorders seems to have a higher chance of modulating their tinnitus with somatic maneuvers; consistent improvements in tinnitus symptoms have been observed in patients with temporomandibular joint disease following targeted therapy for temporomandibular disorders. Somatosensory tinnitus is often overlooked by otolaryngologists and not fully investigated during the diagnostic process. Somatic disorders, when identified and treated, can be a valid therapeutic target for tinnitus; however, somatic screening of subjects for somatosensory tinnitus is imperative for correct selection of patients who would benefit from a multidisciplinary somatic approach. PMID:28553764

  12. Somatosensory tinnitus: Current evidence and future perspectives.

    Science.gov (United States)

    Ralli, Massimo; Greco, Antonio; Turchetta, Rosaria; Altissimi, Giancarlo; de Vincentiis, Marco; Cianfrone, Giancarlo

    2017-06-01

    In some individuals, tinnitus can be modulated by specific maneuvers of the temporomandibular joint, head and neck, eyes, and limbs. Neuroplasticity seems to play a central role in this capacity for modulation, suggesting that abnormal interactions between the sensory modalities, sensorimotor systems, and neurocognitive and neuroemotional networks may contribute to the development of somatosensory tinnitus. Current evidence supports a link between somatic disorders and higher modulation of tinnitus, especially in patients with a normal hearing threshold. Patients with tinnitus who have somatic disorders seems to have a higher chance of modulating their tinnitus with somatic maneuvers; consistent improvements in tinnitus symptoms have been observed in patients with temporomandibular joint disease following targeted therapy for temporomandibular disorders. Somatosensory tinnitus is often overlooked by otolaryngologists and not fully investigated during the diagnostic process. Somatic disorders, when identified and treated, can be a valid therapeutic target for tinnitus; however, somatic screening of subjects for somatosensory tinnitus is imperative for correct selection of patients who would benefit from a multidisciplinary somatic approach.

  13. 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.

  14. 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.

  15. 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…

  16. Refining Current Scientific Priorities and Identifying New Scientific Gaps in HIV-Related Heart, Lung, Blood, and Sleep Research.

    Science.gov (United States)

    Twigg, Homer L; Crystal, Ronald; Currier, Judith; Ridker, Paul; Berliner, Nancy; Kiem, Hans-Peter; Rutherford, George; Zou, Shimian; Glynn, Simone; Wong, Renee; Peprah, Emmanuel; Engelgau, Michael; Creazzo, Tony; Colombini-Hatch, Sandra; Caler, Elisabet

    2017-09-01

    The National Heart, Lung, and Blood Institute (NHLBI) AIDS Program's goal is to provide direction and support for research and training programs in areas of HIV-related heart, lung, blood, and sleep (HLBS) diseases. To better define NHLBI current HIV-related scientific priorities and with the goal of identifying new scientific priorities and gaps in HIV-related HLBS research, a wide group of investigators gathered for a scientific NHLBI HIV Working Group on December 14-15, 2015, in Bethesda, MD. The core objectives of the Working Group included discussions on: (1) HIV-related HLBS comorbidities in the antiretroviral era; (2) HIV cure; (3) HIV prevention; and (4) mechanisms to implement new scientific discoveries in an efficient and timely manner so as to have the most impact on people living with HIV. The 2015 Working Group represented an opportunity for the NHLBI to obtain expert advice on HIV/AIDS scientific priorities and approaches over the next decade.

  17. Developing Traditional Chinese Medicine in the Era of Evidence-Based Medicine: Current Evidences and Challenges

    Science.gov (United States)

    Fung, Foon Yin; Linn, Yeh Ching

    2015-01-01

    Evidence-based medicine (EBM), by integrating individual clinical expertise with the best available clinical evidence from systematic research, has in recent years been established as the standard of modern medical practice for greater treatment efficacy and safety. Traditional Chinese Medicine (TCM), on the other hand, evolved as a system of medical practice from ancient China more than 2000 years ago based on empirical knowledge as well as theories and concepts which are yet to be mapped by scientific equivalents. Despite the expanding TCM usage and the recognition of its therapeutic benefits worldwide, the lack of robust evidence from the EBM perspective is hindering acceptance of TCM by the Western medicine community and its integration into mainstream healthcare. For TCM to become an integral component of the healthcare system so that its benefits can be rationally harnessed in the best interests of patients, it is essential for TCM to demonstrate its efficacy and safety by high-level evidence in accordance with EBM, though much debate remains on the validity and feasibility of applying the EBM model on this traditional practice. This review aims to discuss the current status of research in TCM, explore the evidences available on its efficacy and safety, and highlight the issues and challenges faced in applying EBM to TCM. PMID:25949261

  18. An Integrative Review of Scientific Evidence for Reconnective Healing

    Science.gov (United States)

    Trent, Natalie L.

    2017-01-01

    Abstract Background: Biofield therapies offer a novel, non-invasive approach to treating chronic diseases based on assessing and adjusting an individual's physiological and emotional responses through their bio-energetic field. Reconnective Healing™ (RH) is defined as: “…not just energy healing, but instead a more comprehensive spectrum of healing composed of energy, light, and information.” Objectives: Several biofield therapies, such as Reiki, Therapeutic Touch and Johrei, have already been reviewed in the literature but RH has received little attention even though it is taught and practiced worldwide. This review provides a critical assessment of RH as a healing modality. Methods: Scientific research articles published in peer-reviewed journals addressing RH were identified using relevant databases and archives. Information was extracted from each article that met selection criteria for evaluation of quality of reporting and design. This review summarizes and critically evaluates the five currently published peer-reviewed research papers involving RH and assesses whether RH provides consistent physiological outcomes between the studies. Results: These results, taken together, suggest: (i) exposure of a healer or healee to RH, either directly or indirectly, amplifies their degree of autonomic arousal and energy, (ii) RH can reduce pain and improve range of motion in people with shoulder limitations, and (iii) when individuals experience RH as a group, their autonomic nervous systems simultaneously show sudden similar responses consistent with the idea that RH is mitigated by entrainment of biofields. Conclusions: Since these studies are extremely varied in design it is not possible at this point to reach conclusions about the general effectiveness of RH. More clinical and physiological research performed on different populations under a range of conditions is needed in order to support this healthcare approach. PMID:28654301

  19. 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

  20. Current Evidence Supporting Obstetric Fistula Prevention Strategies ...

    African Journals Online (AJOL)

    Evidences from the articles were linked to prevention strategies retrieved from grey literature. The strategies were classified using an innovative target-focused method. Gaps in the literature show the need for fistula prevention research to aim at systematically measuring incidence and prevalence of the disease, identify the ...

  1. Strengthen scientific evidence and its use to inform policy ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The project will deliver an expanded resource pool of climate scientists, negotiators, and ... dialogues, six national adaptation documents, and two scientific papers. ... Adaptation strategies for two Colombian cities were discussed at ADAPTO's ... International Water Resources Association, in close collaboration with IDRC, ...

  2. 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…

  3. European Union research in support of environment and health: Building scientific evidence base for policy.

    Science.gov (United States)

    Karjalainen, Tuomo; Hoeveler, Arnd; Draghia-Akli, Ruxandra

    2017-06-01

    Opinion polls show that the European Union citizens are increasingly concerned about the impact of environmental factors on their health. In order to respond and provide solid scientific evidence for the numerous policies related to the protection of human health and the environment managed at the Union level, the European Union made a substantial investment in research and innovation in the past two decades through its Framework Programmes for Research and Technological Development, including the current programme, Horizon 2020, which started in 2014. This policy review paper analysed the portfolio of forty collaborative projects relevant to environment and health, which received a total amount of around 228 million euros from the EU. It gives details on their contents and general scientific trends observed, the profiles of the participating countries and institutions, and the potential policy implications of the results obtained. The increasing knowledge base is needed to make informed policy decisions in Europe and beyond, and should be useful to many stakeholders including the scientific community and regulatory authorities. Copyright © 2017. Published by Elsevier Ltd.

  4. 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.

  5. [Evidence-based medicine: modern scientific methods for determining usefulness].

    Science.gov (United States)

    Schmidt, J G

    1999-01-01

    For quite some time, clinical epidemiology has introduced the art of critical appraisal of evidence as well as the methods of how to design sound clinical studies and trials. Almost unnoticed by most medical institutions a new hierarchy of evidence has emerged which puts well thought out trials, able to document unbiased treatment benefit in terms of patient suffering, above pathophysiological theory. Many controlled trials have shown, in the meantime, that the control of laboratory or other kind of pathologies and the correction of anatomical abnormalities do not necessarily mean a benefit for the patient. Concepts relating to this dissection of evidence include: Surrogate fallacy ("cosmetics" of laboratory results or ligament or cartilage "cosmetics" in surgery), confounding (spurious causal relationships), selection bias (comparison with selected groups) as well as lead-time bias (mistaking earlier diagnosis as increase of survival), length bias (overlooking differences in the aggressiveness of diseases as determinants of disease stage distributions) and overdiagnosis bias (mistaking the increasing detection of clinically silent pathologies as improvement of prognosis). Moreover, absolute instead of relative risk reduction needs to be used to measure patient benefit. The incorporation of decision-analysis and of the concepts or clinical epidemiology will improve the efficiency and quality of medicine much more effectively than the sole focus on technical medical performance. Evidence based medicine is the systematic and critical appraisal of medical interventions, based on the understanding how to avoid the fallacies and biases mentioned.

  6. The treatment process of understanding scientific texts: A necessity in the current Cuban university

    Directory of Open Access Journals (Sweden)

    Yanet María Guerra Santana

    2016-06-01

    Full Text Available This work has as main purpose to emphasize the need for treatment of the process of understanding scientific texts in the university today, for the development of science and technology has placed at the forefront in every race the problem of processing scientific information. The ability to produce scientific texts has been somewhat spontaneity in the curriculum of professional training in Cuban university, which has resulted in some professionals do not yet have linguistic, discursive and strategic " tools " best to communicate the style of science, hence the study of the process of understanding of scientific texts in undergraduate currently constitute a need in our universities.

  7. 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…

  8. 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.

  9. 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...... be made how the different roads contribute to consumer acceptance or rejection of a novel food technology dependent on technology characteristics. A checklist for the introduction of novel food technologies taking account of all the roads and the technology is presented at the end of this report.......; 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...

  10. Expert consensus on scientific evidence available on the use of botulinum toxin in overactive bladder.

    Science.gov (United States)

    Esteban, M; Salinas, J; Arlandis, S; Díez, J; Jiménez, M; Rebassa, M; Angulo, J C

    2014-05-01

    Overactive bladder (OAB) is a pathology impairing patients' quality of life and with a high percentage of patients who are refractory to medication. In this paper, technical opinion of an «expert panel» is assessed in order to gain the most reliable professional consensus on scientific evidence available on the criteria of use of Onabotulinumtoxin A (OnabotA) in OAB. according to DELPHI method, 42 panelists answered a survey of 93 items divided into four strategic areas including clinical criteria and recommendations in order to improve, at different levels, the current approach to patients with OAB. The recent advances in the field, areas of controversy and their real application possibilities in the different areas of our health care system were taken into consideration. Two rounds of the questionnaire were completed by all experts. In the first round, a criteria consensus was reached for 64 of 93 (68.8%) questions analyzed; in the second round the consensus reached was for 83 items evaluated (89.25%). An agreement among panelist was reached for: 1) definition, classification, detection and differential diagnosis; 2) medical treatment; 3) surgical treatment; 4) role of OnabotA in the treatment of OAB. the consensus is broadly in line with the latest scientific evidence on OAB. The panelists believe that it is necessary to propose a change in the current definition of OAB and that it seems necessary to improve the screening tools too. Medical treatment of OAB must be tailored to each patient, staged and progressive. The use of OnabotA (Botox(®)) could imply therapeutic advantages with respect to other treatments, and positions itself as a safe and effective alternative to treat drug refractory OAB. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

  11. Cannabis and joints: scientific evidence for the alleviation of osteoarthritis pain by cannabinoids.

    Science.gov (United States)

    O'Brien, Melissa; McDougall, Jason J

    2018-04-07

    Cannabis has been used for millennia to treat a multitude of medical conditions including chronic pain. Osteoarthritis (OA) pain is one of the most common types of pain and patients often turn to medical cannabis to manage their symptoms. While the majority of these reports are anecdotal, there is a growing body of scientific evidence which supports the analgesic potential of cannabinoids to treat OA pain. OA pain manifests as a combination of inflammatory, nociceptive, and neuropathic pain, each requiring modality-specific analgesics. The body's innate endocannabinoid system (ECS) has been shown to ameliorate all of these pain subtypes. This review summarizes the components of the ECS and details the latest research pertaining to plant-based and man-made cannabinoids for the treatment of OA pain. Recent pre-clinical evidence supporting a role for the ECS to control OA pain is described as well as current clinical evidence of the efficacy of cannabinoids for treating OA pain in mixed patient populations. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Medical marijuana: the conflict between scientific evidence and political ideology. Part one of two.

    Science.gov (United States)

    Cohen, Peter J

    2009-01-01

    Whether "medical marijuana" (Cannabis sativa used to treat a wide variety of pathologic states) should be accorded the status of a legitimate pharmaceutical agent has long been a contentious issue. Is it a truly effective drug that is arbitrarily stigmatized by many and criminalized by the federal government? Or is it without any medical utility, its advocates hiding behind a screen of misplaced (or deliberately misleading) compassion for the ill? Should Congress repeal its declaration that smoked marijuana is without "current medical benefit"? Should cannabis be approved for medical use by a vote of the people as already has been done in 13 states? Or should medical marijuana be scientifically evaluated for safety and efficacy as any other new investigational drug? How do the competing--and sometimes antagonistic--roles of science, politics and prejudice affect society's attempts to answer this question? This article examines the legal, political, policy, and ethical problems raised by the recognition of medical marijuana by over one-fourth of our states although its use remains illegal under federal law. Although draconian punishment can be imposed for the "recreational" use of marijuana, I will not address the contentious question of whether to legalize or decriminalize the use of marijuana solely for its psychotropic effects, a fascinating and important area of law and policy that is outside the scope of this paper. Instead, the specific focus of this article will be on the conflict between the development of policies based on evidence obtained through the use of scientific methods and those grounded on ideological and political considerations that have repeatedly entered the longstanding debate regarding the legal status of medical marijuana. I will address a basic question: Should the approval of medical marijuana be governed by the same statute that applies to all other drugs or pharmaceutical agents, the Food, Drug, and Cosmetic Act (FD&C Act), after the

  13. Secondary school physics teachers' conceptions of scientific evidence: A collective case study

    Science.gov (United States)

    Taylor, Joseph A.

    Engaging secondary school students in inquiry-oriented tasks that more closely simulate the scholarly activities of scientists has been recommended as a way to improve scientific literacy. Two tasks that are frequently recommended include students' design of original experiments, and students' evaluation of scientific evidence and conclusions. Yet, little is known about teachers' conceptions of experimentation. The principal aim of this study, therefore, was to describe the nature of prospective and practicing physics teachers' conceptions of scientific evidence. More specifically, the following research questions guided this study: (1) What types of issues related to the measurement reliability and experimental validity of scientific evidence do practicing and prospective physics teachers think about when designing experiments? (2) When presented with hypothetical scenarios that describe unsound experimental procedures or poorly supported conclusions (or both), what concerns will prospective and practicing physics teachers raise? And (3) When the participants' responses to parallel research prompts are compared across protocols, what similarities and differences exist? The nature of the teacher-participants' conceptions was described from an analysis of data collected from research prompts such as interviews and hand written artifacts. In these research prompts, the teachers "thought aloud" while designing experiments and critically evaluated student-collected evidence presented in hypothetical classroom scenarios. The data from this study suggested that the three teachers, while contemplating the reliability and validity of scientific evidence, frequently used their conceptions of evidence in conjunction with specific subject matter conceptions. The data also indicated that the relationship between subject matter knowledge and conceptions of evidence was more pronounced for some conceptions of evidence than for others. Suggestions for future research included

  14. Sulfonylureas in type 2 diabetes mellitus: current evidence, conflicts ...

    African Journals Online (AJOL)

    Introduction: We sought to explore the current state of evidence on sulfonylurea therapy in type 2 diabetes mellitus (T2DM) and critically examine the recommendations of major practice guidelines,and the overall ramifications of the issues thereof in current clinical practice. Method: We searched PUBMED, MEDLINE and ...

  15. 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…

  16. 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.

  17. 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

  18. 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. PsycINFO Database Record (c) 2014 APA, all rights reserved.

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

    OpenAIRE

    Kinney, Robert L.

    2015-01-01

    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 resul...

  20. Current Situation of Scientific Research at the University of Jordan from the Viewpoint of Graduate Students

    Directory of Open Access Journals (Sweden)

    Atif Omar Bin Tareef

    2017-05-01

    Full Text Available This study aimed to identify the current status of scientific research at the University of Jordan as perceived by graduate students and the differences between students of science and humanities faculties, and to identify their opinions regarding ways to improve scientific research at the University of Jordan. The study followed a descriptive methodology based on a survey that was developed specifically for the purpose of this study. The survey consisted of 40 items covering 5 themes, and was distributed to a sample of 104 male and female participants representing science and humanities faculties. The data were analyzed, using the two-way ANOVA, the standard deviation and means. In addition, students’ opinions and obstacles to effective participation of graduate students were categorized. The results showed significant differences between students’ assessment of the status of scientific research in science and humanities faculties, which was (3.2 for students in humanities faculties and (2.8 for students in science faculties. The difference also appeared in all the five domains of the scientific research, while there was no presence of gender effect, neither was there effect for the interaction between the variables (gender and the faculty. The study recommended to provide financial support to scientific research, and to establish a refereed scientific Journal for publishing students’ innovative ideas and research projects. Keywords: Scientific research, Graduate students.

  1. 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.

  2. To What Extent Does Current Scientific Research and Textbook Content Align? A Methodology and Case Study

    Science.gov (United States)

    Bierema, Andrea M.-K.; Schwartz, Renee S.; Gill, Sharon A.

    2017-01-01

    Recent calls for reform in education recommend science curricula to be based on central ideas instead of a larger number of topics and for alignment between current scientific research and curricula. Because alignment is rarely studied, especially for central ideas, we developed a methodology to discover the extent of alignment between primary…

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

    Science.gov (United States)

    Nathues, Christina; Würbel, Hanno

    2016-01-01

    animal 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. PMID:27911892

  4. Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016.

    Science.gov (United States)

    Bikson, Marom; Grossman, Pnina; Thomas, Chris; Zannou, Adantchede Louis; Jiang, Jimmy; Adnan, Tatheer; Mourdoukoutas, Antonios P; Kronberg, Greg; Truong, Dennis; Boggio, Paulo; Brunoni, André R; Charvet, Leigh; Fregni, Felipe; Fritsch, Brita; Gillick, Bernadette; Hamilton, Roy H; Hampstead, Benjamin M; Jankord, Ryan; Kirton, Adam; Knotkova, Helena; Liebetanz, David; Liu, Anli; Loo, Colleen; Nitsche, Michael A; Reis, Janine; Richardson, Jessica D; Rotenberg, Alexander; Turkeltaub, Peter E; Woods, Adam J

    2016-01-01

    This review updates and consolidates evidence on the safety of transcranial Direct Current Stimulation (tDCS). Safety is here operationally defined by, and limited to, the absence of evidence for a Serious Adverse Effect, the criteria for which are rigorously defined. This review adopts an evidence-based approach, based on an aggregation of experience from human trials, taking care not to confuse speculation on potential hazards or lack of data to refute such speculation with evidence for risk. Safety data from animal tests for tissue damage are reviewed with systematic consideration of translation to humans. Arbitrary safety considerations are avoided. Computational models are used to relate dose to brain exposure in humans and animals. We review relevant dose-response curves and dose metrics (e.g. current, duration, current density, charge, charge density) for meaningful safety standards. Special consideration is given to theoretically vulnerable populations including children and the elderly, subjects with mood disorders, epilepsy, stroke, implants, and home users. Evidence from relevant animal models indicates that brain injury by Direct Current Stimulation (DCS) occurs at predicted brain current densities (6.3-13 A/m(2)) that are over an order of magnitude above those produced by conventional tDCS. To date, the use of conventional tDCS protocols in human trials (≤40 min, ≤4 milliamperes, ≤7.2 Coulombs) has not produced any reports of a Serious Adverse Effect or irreversible injury across over 33,200 sessions and 1000 subjects with repeated sessions. This includes a wide variety of subjects, including persons from potentially vulnerable populations. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. 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…

  6. A new method of CCD dark current correction via extracting the dark Information from scientific images

    Science.gov (United States)

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

    2014-07-01

    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°C, resulting in a high dark current level of about 3e-/pix/sec, even comparable to the sky brightness (10e-/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 scientific images. We have applied this method to the AST3 data, and demonstrated that it can reduce the noise to a level roughly as low as the photon noise of the sky brightness, solving the high noise problem and improving the photometric precision. This method will also be helpful for other projects that suffer from similar issues.

  7. An evidence-based patient-centered method makes the biopsychosocial model scientific.

    Science.gov (United States)

    Smith, Robert C; Fortin, Auguste H; Dwamena, Francesca; Frankel, Richard M

    2013-06-01

    To review the scientific status of the biopsychosocial (BPS) model and to propose a way to improve it. Engel's BPS model added patients' psychological and social health concerns to the highly successful biomedical model. He proposed that the BPS model could make medicine more scientific, but its use in education, clinical care, and, especially, research remains minimal. Many aver correctly that the present model cannot be defined in a consistent way for the individual patient, making it untestable and non-scientific. This stems from not obtaining relevant BPS data systematically, where one interviewer obtains the same information another would. Recent research by two of the authors has produced similar patient-centered interviewing methods that are repeatable and elicit just the relevant patient information needed to define the model at each visit. We propose that the field adopt these evidence-based methods as the standard for identifying the BPS model. Identifying a scientific BPS model in each patient with an agreed-upon, evidence-based patient-centered interviewing method can produce a quantum leap ahead in both research and teaching. A scientific BPS model can give us more confidence in being humanistic. In research, we can conduct more rigorous studies to inform better practices. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Consumer perception versus scientific evidence about health benefits and safety risks from fish consumption.

    Science.gov (United States)

    Verbeke, Wim; Sioen, Isabelle; Pieniak, Zuzanna; Van Camp, John; De Henauw, Stefaan

    2005-06-01

    To investigate the gap between consumer perception and scientific evidence related to health benefits and safety risks from fish consumption. Consumer perceptions from a cross-sectional survey in March 2003 in Belgium were compared with scientific evidence based on a literature review. A quota sampling procedure was used with age as quota control variable. Subjects completed a self-administered questionnaire including health benefit beliefs from fish, fish content and effect beliefs for nutrients and harmful substances. Adults (n=429), who were the main person responsible for food purchasing in the household (284 women; 145 men), aged 18-83 years, from different regional, education, family size and income groups. Fish is predominantly perceived as a healthy food that reduces risk for coronary heart disease, which corroborates scientific evidence. This perception is stronger among women than among men. In contrast with scientific evidence, 46% of the consumers believe that fish contains dietary fibre, whereas less than one-third is aware that fish contains omega-3 fatty acids and that this nutrient has a positive impact on human health. The gap between perception and evidence is larger among consumers with lower education. In general, consumers are better aware of the content and effect of harmful substances than of nutrients in fish. Despite conclusive evidence about the content and positive effect of omega-3 fatty acids in fish, related consumer awareness and beliefs are poor and often wrong. This study exemplifies the need for nutrition education and more effective communication about the health benefits of fish consumption.

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

    Directory of Open Access Journals (Sweden)

    Daniela Litscher

    2016-06-01

    Full Text Available 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.

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

    OpenAIRE

    Daniela Litscher; Gerhard Litscher

    2016-01-01

    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 descri...

  11. Male circumcision for HIV prevention: current evidence and implementation in sub-Saharan Africa

    Science.gov (United States)

    2011-01-01

    Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major role in HIV transmission in sub-Saharan Africa. Here, we provide a critical evaluation of the state of the current evidence for male circumcision in reducing HIV infection in light of established transmission drivers, provide an update on programmes now in place in this region, and explain why policies based on established scientific evidence should be prioritized. We conclude that the evidence supports the need to accelerate the implementation of medical male circumcision programmes for HIV prevention in generalized heterosexual epidemics, as well as in countering the growing heterosexual transmission in countries where HIV prevalence is presently low. PMID:22014096

  12. Korean consumers' perceptions of health/functional food claims according to the strength of scientific evidence.

    Science.gov (United States)

    Kim, Ji Yeon; Kang, Eun Jin; Kwon, Oran; Kim, Gun-Hee

    2010-10-01

    In this study, we investigated that consumers could differentiate between levels of claims and clarify how a visual aid influences consumer understanding of the different claim levels. We interviewed 2,000 consumers in 13 shopping malls on their perception of and confidence in different levels of health claims using seven point scales. The average confidence scores given by participants were 4.17 for the probable level and 4.07 for the possible level; the score for the probable level was significantly higher than that for the possible level (P consumers understand the strength of scientific evidence behind those claims. Moreover, when a visual aid was included, consumers perceived the scientific levels more clearly and had greater confidence in their meanings than when a visual aid was not included. Although this result suggests that consumers react differently to different claim levels, it is not yet clear whether consumers understand the variations in the degree of scientific support.

  13. The current evidence and implications of lingual orthodontics

    Directory of Open Access Journals (Sweden)

    Pratap Saini

    2016-01-01

    Full Text Available The purpose of this review is to investigate the current evidence and implications of lingual orthodontics. The electronic database search was done on PubMed, Cochrane Library, Embase, EBSCOhost, Web of Knowledge, and Google Scholar reporting on appliance design, bonding, and laboratory setup, biomechanics, survey studies, case reports, and treatment outcomes to find the current evidence of lingual orthodontics. The evidence available on lingual orthodontics traces a very clear and predictable pattern. The 80′s was devoted to the limitation and progression of the concept; the 90′s to the comparison between labial and lingual and the evolution of laboratory technique and bracket system. The last decade focuses on innovations, the predictability of outcomes, the impact of white spot lesion, and the patient acceptability. This review also shows that biomechanical principles of lingual orthodontics are well understood and established today, any case that can be treated with labial orthodontic appliance, can also be treated effectively with lingual orthodontic appliance as the completely customized lingual appliance can provide predetermined treatment outcome.

  14. 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.

  15. Kale (Brassica oleracea var. acephala) as a superfood: Review of the scientific evidence behind the statement.

    Science.gov (United States)

    Šamec, Dunja; Urlić, Branimir; Salopek-Sondi, Branka

    2018-03-20

    Kale (Brassica oleracea var. acephala) is a cruciferous vegetable, characterized by leaves along the stem, which, in recent years, have gained a great popularity as a ´superfood´. Consequently, in a popular culture it is listed in many ´lists of the healthiest vegetables´. Without the doubt, a scientific evidences support the fact that cruciferous vegetables included in human diet can positively affect health and well-being, but remains unclear why kale is declared superior in comparison with other cruciferous. It is questionable if this statement about kale is triggered by scientific evidence or by some other factors. Our review aims to bring an overview of kale's botanical characteristics, agronomic requirements, contemporary and traditional use, macronutrient and phytochemical content and biological activity, in order to point out the reasons for tremendous kale popularity.

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

    Science.gov (United States)

    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. PMID:24453931

  17. Addressing unwarranted clinical variation: A rapid review of current evidence.

    Science.gov (United States)

    Harrison, Reema; Manias, Elizabeth; Mears, Stephen; Heslop, David; Hinchcliff, Reece; Hay, Liz

    2018-05-15

    Unwarranted clinical variation (UCV) can be described as variation that can only be explained by differences in health system performance. There is a lack of clarity regarding how to define and identify UCV and, once identified, to determine whether it is sufficiently problematic to warrant action. As such, the implementation of systemic approaches to reducing UCV is challenging. A review of approaches to understand, identify, and address UCV was undertaken to determine how conceptual and theoretical frameworks currently attempt to define UCV, the approaches used to identify UCV, and the evidence of their effectiveness. Rapid evidence assessment (REA) methodology was used. A range of text words, synonyms, and subject headings were developed for the major concepts of unwarranted clinical variation, standards (and deviation from these standards), and health care environment. Two electronic databases (Medline and Pubmed) were searched from January 2006 to April 2017, in addition to hand searching of relevant journals, reference lists, and grey literature. Results were merged using reference-management software (Endnote) and duplicates removed. Inclusion criteria were independently applied to potentially relevant articles by 3 reviewers. Findings were presented in a narrative synthesis to highlight key concepts addressed in the published literature. A total of 48 relevant publications were included in the review; 21 articles were identified as eligible from the database search, 4 from hand searching published work and 23 from the grey literature. The search process highlighted the voluminous literature reporting clinical variation internationally; yet, there is a dearth of evidence regarding systematic approaches to identifying or addressing UCV. Wennberg's classification framework is commonly cited in relation to classifying variation, but no single approach is agreed upon to systematically explore and address UCV. The instances of UCV that warrant investigation and

  18. From empiricism to scientific evidence: The value of proverbs in food and nutrition

    Directory of Open Access Journals (Sweden)

    Paloma Celada

    2018-03-01

    Full Text Available Our life is full of sayings, which reflect the tradition of millennia and speak in the mouth of experience, and this is even more evident when it comes to nutrition or food, which is the link between health, disease, food security and happiness. In this short paper we have reviewed some central proverbs that are part of our daily work, its meaning and the scientific evidence and studies that endorse or deny such aphorisms. A total of 55 have been collected, which we believe to be very relevant, since a higher number of them would probably tire the reader and make our effort vain.

  19. Intermittent fasting and cardiovascular disease: current evidence and unresolved questions.

    Science.gov (United States)

    Tinsley, Grant M; Horne, Benjamin D

    2018-01-01

    Intermittent fasting has produced a variety of beneficial health effects in animal models, although high-quality research in humans has been limited. This special report examines current evidences for intermittent fasting in humans, discusses issues that require further examination, and recommends new research that can improve the knowledge base in this emerging research area. While potentially useful for health improvement, intermittent fasting requires further study prior to widespread implementation for health purposes. Randomized, longer-term studies are needed to determine whether using intermittent fasting as a lifestyle rather than a diet is feasible and beneficial for the health of some members of the human population.

  20. Integrative Therapies and Pediatric Inflammatory Bowel Disease: The Current Evidence.

    Science.gov (United States)

    Misra, Sanghamitra M

    2014-08-25

    Inflammatory bowel disease (IBD) primarily describes two distinct chronic conditions with unknown etiology, ulcerative colitis (UC) and Crohn's disease (CD). UC is limited to the colon, while CD may involve any portion of the gastrointestinal tract from mouth to anus. These diseases exhibit a pattern of relapse and remission, and the disease processes are often painful and debilitating. Due to the chronic nature of IBD and the negative side effects of many of the conventional therapies, many patients and their families turn to complementary and alternative medicine (CAM) for symptom relief. This article focuses on the current available evidence behind CAM/integrative therapies for IBD.

  1. Herbs with potential nephrotoxic effects according to traditional Persian medicine: Review and assessment of scientific evidence.

    Science.gov (United States)

    Kolangi, Fatemeh; Memariani, Zahra; Bozorgi, Mahboubeh; Mozaffarpur, Seyyed Ali; Mirzapour, Mohaddeseh

    2018-04-03

    The increased use of herbal remedies particularly in patients with kidney diseases indicated the importance of studies which focused on nephrotoxic plants. The present study aimed to review and assess the kidney-damaging herbs mentioned in the Persian medicine [PM] books. The main PM books were searched for nephrotoxic herbs and their relevant reformers traditionally proposed for preventing renal damage. PubMed, Scopus and Google Scholar were investigated for evaluation of the scientific evidence relating to the nephrotoxicity of herbs. A total of 64 plants with kidney damage potential and their reformer medicaments were recorded in 7 sources included in this review. Allium schoenoprasum and Marrubium vulgare were the most repeated and emphasized nephrotoxic plants in PM books, but there was not any relevant scientific evidence. Despite the lack of clinical studies, some evidence was found for 38% of plants that were related to renal damage. The most repeated reformers for reducing the renal side effects mainly consisted of gum tragacanth, gum Arabic, mastic gum, anise, jujube and honey and some evidence was found for their nephroprotective activities. The present study reviewed and assessed the herbs with adverse renal effects in the main PM books. Some evidence was in line with the potential nephrotoxicity of plants and their ‎reformers. Despite the lack of clinical research for evaluation of their renal damage, the herbs may be focused in term of their nephrotoxicity; and there is a need for further studies on the scientific basis of their nephrotoxicity. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  2. [Bibliometric analysis of scientific articles on evidence-based nursing of burn in the mainland of China].

    Science.gov (United States)

    Yue, L Q; Pi, X Q; Fan, X G

    2016-07-20

    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. 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 evidence-based practice steps, and language and quantity of reference. Data were processed with Microsoft Excel software. 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 scientific research, and 2 (4%) articles dealt with case report

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

    OpenAIRE

    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 product attributes; the technology apprehension road: a socio-political road where unfamiliarity and dread may lead to negative technologyattitudes, which may create categorical rejection of any product ...

  4. Culture, mind, and the brain: current evidence and future directions.

    Science.gov (United States)

    Kitayama, Shinobu; Uskul, Ayse K

    2011-01-01

    Current research on culture focuses on independence and interdependence and documents numerous East-West psychological differences, with an increasing emphasis placed on cognitive mediating mechanisms. Lost in this literature is a time-honored idea of culture as a collective process composed of cross-generationally transmitted values and associated behavioral patterns (i.e., practices). A new model of neuro-culture interaction proposed here addresses this conceptual gap by hypothesizing that the brain serves as a crucial site that accumulates effects of cultural experience, insofar as neural connectivity is likely modified through sustained engagement in cultural practices. Thus, culture is "embrained," and moreover, this process requires no cognitive mediation. The model is supported in a review of empirical evidence regarding (a) collective-level factors involved in both production and adoption of cultural values and practices and (b) neural changes that result from engagement in cultural practices. Future directions of research on culture, mind, and the brain are discussed.

  5. Animal Research on Nicotine Reduction: Current Evidence and Research Gaps.

    Science.gov (United States)

    Smith, Tracy T; Rupprecht, Laura E; Denlinger-Apte, Rachel L; Weeks, Jillian J; Panas, Rachel S; Donny, Eric C; Sved, Alan F

    2017-09-01

    A mandated reduction in the nicotine content of cigarettes may improve public health by reducing the prevalence of smoking. Animal self-administration research is an important complement to clinical research on nicotine reduction. It can fill research gaps that may be difficult to address with clinical research, guide clinical researchers about variables that are likely to be important in their own research, and provide policy makers with converging evidence between clinical and preclinical studies about the potential impact of a nicotine reduction policy. Convergence between clinical and preclinical research is important, given the ease with which clinical trial participants can access nonstudy tobacco products in the current marketplace. Herein, we review contributions of preclinical animal research, with a focus on rodent self-administration, to the science of nicotine reduction. Throughout this review, we highlight areas where clinical and preclinical research converge and areas where the two differ. Preclinical research has provided data on many important topics such as the threshold for nicotine reinforcement, the likelihood of compensation, moderators of the impact of nicotine reduction, the impact of environmental stimuli on nicotine reduction, the impact of nonnicotine cigarette smoke constituents on nicotine reduction, and the impact of nicotine reduction on vulnerable populations. Special attention is paid to current research gaps including the dramatic rise in alternative tobacco products, including electronic nicotine delivery systems (ie, e-cigarettes). The evidence reviewed here will be critical for policy makers as well as clinical researchers interested in nicotine reduction. This review will provide policy makers and clinical researchers interested in nicotine reduction with an overview of the preclinical animal research conducted on nicotine reduction and the regulatory implications of that research. The review also highlights the utility of

  6. 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

  7. Arthroplasty knee registry of Catalonia: What scientific evidence supports the implantation of our prosthesis?

    Science.gov (United States)

    Samaniego Alonso, R; Gaviria Parada, E; Pons Cabrafiga, M; Espallargues Carreras, M; Martinez Cruz, O

    2018-02-28

    In our environment, it is increasingly necessary to perform an activity based on scientific evidence and the field of prosthetic surgery should be governed by the same principles. The national arthroplasty registries allow us to obtain a large amount of data in order to evaluate this technique. The aim of our study is to analyse the scientific evidence that supports the primary total knee arthroplasties implanted in Catalonian public hospitals, based on the Arthoplasty Registry of Catalonia (RACat) MATERIAL AND METHODS: A review of the literature was carried out on knee prostheses (cruciate retaining, posterior stabilized, constricted and rotational) recorded in RACat between the period 2005-2013 in the following databases: Orthopedic Data Evaluation Panel, PubMed, TripDatabase and Google Scholar. The prostheses implanted in fewer than 10 units (1,358 prostheses corresponding to 62 models) were excluded. 41,947 prostheses (96.86%) were analysed out of 43,305 implanted, corresponding to 74 different models. In 13 models (n = 4,715) (11.24%) no clinical evidence to support their use was found. In the remaining 36 models (n = 13,609) (32.45%), level iv studies were the most predominant evidence. There was a significant number of implanted prostheses (11.24%) for which no clinical evidence was found. The number of models should be noted, 36 out of 110, with fewer than 10 units implanted. The use of arthroplasty registries has proved an extremely useful tool that allows us to analyse and draw conclusions in order to improve the efficiency of this surgical technique. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Using scientific evidence to inform public policy on the long distance transportation of animals: role of the European Food Safety Authority.

    Science.gov (United States)

    Ribò, Oriol; Candiani, Denise; Aiassa, Elisa; Correia, Sandra; Afonso, Ana; De Massis, Fabrizio; Serratosa, Jordi

    2008-01-01

    The authors review the work of the previous Scientific Committee on Animal Health and Animal Welfare and the current European Food Safety Authority (EFSA) in providing scientific advice on the welfare aspects of animal transport and the impact of this advice on the European Union (EU) regulatory framework. Through its Protocol on the Protection and Welfare of Animals, the Treaty of Amsterdam obliges European institutions to pay full regard to the welfare requirements of animals when formulating and implementing EU legislation. Regulation 1/2005 states that EU legislation should be amended to take into account new scientific evidence. Provisions for poultry, cats and dogs take into account the recommendations included in EFSA's Scientific Opinion which considers different species (poultry, deer, rabbits, dogs and cats, fish and exotic animals). Examples of the effect of the scientifically based conclusions and recommendations from the Scientific Opinion on the measures in Regulation 1/2005 are summarised and show the impact of scientific evidence on EU legislation.

  9. Using scientific evidence to inform public policy on the long distance transportation of animals: role of the European Food Safety Authority

    Directory of Open Access Journals (Sweden)

    Oriol Ribò

    2008-03-01

    Full Text Available The authors review the work of the previous Scientific Committee on Animal Health and Animal Welfare and the current European Food Safety Authority (EFSA in providing scientific advice on the welfare aspects of animal transport and the impact of this advice on the European Union (EU regulatory framework. Through its Protocol on the Protection and Welfare of Animals, the Treaty of Amsterdam obliges European institutions to pay full regard to the welfare requirements of animals when formulating and implementing EU legislation. Regulation 1/2005 states that EU legislation should be amended to take into account new scientific evidence. Provisions for poultry, cats and dogs take into account the recommendations included in EFSA's Scientific Opinion which considers different species (poultry, deer, rabbits, dogs and cats, fish and exotic animals. Examples of the effect of the scientifically based conclusions and recommendations from the Scientific Opinion on the measures in Regulation 1/2005 are summarised and show the impact of scientific evidence on EU legislation.

  10. Robotic general surgery: current practice, evidence, and perspective.

    Science.gov (United States)

    Jung, M; Morel, P; Buehler, L; Buchs, N C; Hagen, M E

    2015-04-01

    Robotic technology commenced to be adopted for the field of general surgery in the 1990s. Since then, the da Vinci surgical system (Intuitive Surgical Inc, Sunnyvale, CA, USA) has remained by far the most commonly used system in this domain. The da Vinci surgical system is a master-slave machine that offers three-dimensional vision, articulated instruments with seven degrees of freedom, and additional software features such as motion scaling and tremor filtration. The specific design allows hand-eye alignment with intuitive control of the minimally invasive instruments. As such, robotic surgery appears technologically superior when compared with laparoscopy by overcoming some of the technical limitations that are imposed on the surgeon by the conventional approach. This article reviews the current literature and the perspective of robotic general surgery. While robotics has been applied to a wide range of general surgery procedures, its precise role in this field remains a subject of further research. Until now, only limited clinical evidence that could establish the use of robotics as the gold standard for procedures of general surgery has been created. While surgical robotics is still in its infancy with multiple novel systems currently under development and clinical trials in progress, the opportunities for this technology appear endless, and robotics should have a lasting impact to the field of general surgery.

  11. Health literacy, emotionality, scientific evidence: Elements of an effective communication in public health.

    Science.gov (United States)

    Biasio, Luigi Roberto; Carducci, Annalaura; Fara, Gaetano Maria; Giammanco, Giuseppe; Lopalco, Pier Luigi

    2018-01-30

    The importance of healthcare providers' communication abilities is still underestimated. Informing the population on the basis of documented evidence is essential but not enough to induce a change in the beliefs of who is doubtful or does not accept preventive interventions, such as vaccination. Lining up the offer of prevention to the knowledge of the citizens, also improving Health Literacy skills, is a critical step toward their empowerment and behavior change. The 2017 Erice Declaration was drafted to propose to the Institutions and the scientific community the main goals to improve communication and counteract Vaccine Hesitancy, at a very critical time, when mandatory vaccination was introduced in Italy.

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

    Science.gov (United States)

    Mooventhan, A; Nivethitha, L

    2014-05-01

    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.

  13. Transcranial Direct Current Stimulation in Substance Use Disorders: A Systematic Review of Scientific Literature.

    Science.gov (United States)

    Lupi, Matteo; Martinotti, Giovanni; Santacroce, Rita; Cinosi, Eduardo; Carlucci, Maria; Marini, Stefano; Acciavatti, Tiziano; di Giannantonio, Massimo

    2017-09-01

    New treatment options such as noninvasive brain stimulation have been recently explored in the field of substance use disorders (SUDs), including transcranial direct current stimulation (tDCS). In light of this, we have performed a review of the scientific literature to assess efficacy and technical and methodological issues resulting from applying tDCS to the field of SUDs. Our analysis highlighted the following selection criteria: clinical studies on tDCS and SUDs (alcohol, caffeine, cannabis, cocaine, heroin, methamphetamine, and nicotine). Study selection, data analysis, and reporting were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Exclusion criteria were as follows: clinical studies about tDCS among behavioral addiction; review and didactic articles; physiopathological studies; and case reports. Eighteen scientific papers were selected out of 48 articles. Among these, 16 studied the efficacy of tDCS applied to the dorsolateral prefrontal cortex, and 8 suggested the efficacy of tDCS in reducing substance craving. In light of these data, it is premature to conclude that tDCS over the dorsolateral prefrontal cortex is a very efficient technique in reducing craving. Small sample size, different stimulation protocols, and study duration were the main limitations. However, the efficacy of tDCS in treating SUDs requires further investigation.

  14. The nature of the scientific evidence leading to drug withdrawals for pharmacovigilance reasons in France.

    Science.gov (United States)

    Olivier, Pascale; Montastruc, Jean-Louis

    2006-11-01

    Because of design, objectives and number of included subjects, clinical studies are insufficient to assess the safety of new drugs. Sometimes, serious adverse drug reactions (ADRs) led to withdrawal of the drug from the market after their approval. The objective of our study was to determine the scientific evidences leading to drug withdrawal for pharmacovigilance reasons in France. Data coming from French Health Products Safety Agency, literature and Toulouse Pharmacovigilance Center allowed to identify all drugs withdrawn from the French market for pharmacovigilance reasons from 1998 to 2004. We classified data according to their study design (Randomized Clinical Trial [RCT], case serie or case report, case-control study, cohort study, observational study, animal study), the organ/system affected and the type of ADR. A total of 21 drugs were withdrawn for safety reasons between 1998 and 2004 in France. The most frequent ADRs were hepatic (n = 7), cardiovascular (n = 4) or neurological (n = 3) ones. Eleven withdrawals were due to type-B ('unexpected') reactions (52%). For 19 out of 21 drugs, scientific evidence leading to drug withdrawal came from spontaneous case reports (or case series). Among these, case reports were the sole evidence in 12 cases. Withdrawals were based on evidence from case reports in combination with case-control or cohort study in four cases, in combination with observational study in two cases or in combination with animal study in two other cases. In only one case, a RCT supported the decision. This study underlines the importance of spontaneous case reports in detecting signals and supporting withdrawal of drug for pharmacovigilance reasons in France. Health authorities suffer from lack of comparative data resource. In this perspective, a pharmaco-epidemiological population-based database could represent a helpful tool to both generate and test safety hypotheses.

  15. 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

  16. 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.

  17. [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.

  18. 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. Published by Elsevier Inc.

  19. 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.

  20. Adjuvant chemotherapy for gastric cancer: Current evidence and future challenges

    Science.gov (United States)

    Miceli, Rosalba; Tomasello, Gianluca; Bregni, Giacomo; Di Bartolomeo, Maria; Pietrantonio, Filippo

    2014-01-01

    Gastric cancer still represents one of the major causes of cancer mortality worldwide. Patients survival is mainly related to stage, with a high proportion of patients with metastatic disease at presentation. Thus, the cure rate largely depend upon surgical resection. Despite the additional, albeit small, benefit of adjuvant chemotherapy has been clearly demonstrated, no general consensus has been reached on the best treatment option. Moreover, the narrow therapeutic index of adjuvant chemotherapy (i.e., limited survival benefit with considerable toxicity) requires a careful assessment of expected risks and benefits for individual patients. Treatment choices vary widely based on the different geographic areas, with chemotherapy alone more often preferred in Europe or Asia and chemoradiotherapy in the United States. In the present review we discuss the current evidence and future challenges regarding adjuvant chemotherapy in curatively resected gastric cancer with particular emphasis on the recently completed landmark studies and meta-analyses. The most recent patient-level meta-analysis demonstrated the benefit of adjuvant chemotherapy over curative surgery; the same Authors also showed that disease-free survival may be used as a surrogate end-point for overall survival. We finally discuss future research issues such as the need of economic evaluations, development of prognostic or predictive biomarkers, and the unmet clinical need of trials comparing perioperative chemotherapy with adjuvant treatment. PMID:24782604

  1. 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.

  2. Rating the strength of scientific evidence: relevance for quality improvement programs.

    Science.gov (United States)

    Lohr, Kathleen N

    2004-02-01

    To summarize an extensive review of systems for grading the quality of research articles and rating the strength of bodies of evidence, and to highlight for health professionals and decision-makers concerned with quality measurement and improvement the available "best practices" tools by which these steps can be accomplished. Drawing on an extensive review of checklists, questionnaires, and other tools in the field of evidence-based practice, this paper discusses clinical, management, and policy rationales for rating strength of evidence in a quality improvement context, and documents best practices methods for these tasks. After review of 121 systems for grading the quality of articles, 19 systems, mostly specific, met a priori scientific standards for grading systematic reviews, randomized controlled trials, observational studies, and diagnostic tests; eight systems (of 40 reviewed) met similar standards for rating the overall strength of evidence. All can be used as is or adapted for particular types of evidence reports or systematic reviews. Formally grading study quality and rating overall strength of evidence, using sound instruments and procedures, can produce reasonable levels of confidence about the science base for parts of quality improvement programs. With such information, health care professionals and administrators concerned with quality improvement can understand better the level of science (versus only clinical consensus or opinion) that supports practice guidelines, review criteria, and assessments that feed into quality assurance and improvement programs. New systems are appearing and research is needed to confirm the conceptual and practical underpinnings of these grading and rating systems, but the need for those developing systematic reviews, practice guidelines, and quality or audit criteria to understand and undertake these steps is becoming increasingly clear.

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

    International Nuclear Information System (INIS)

    Kurre, W.; Berkefeld, J.

    2008-01-01

    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.)

  4. Alcohol-induced blackout as a criminal defense or mitigating factor: an evidence-based review and admissibility as scientific evidence.

    Science.gov (United States)

    Pressman, Mark R; Caudill, David S

    2013-07-01

    Alcohol-related amnesia--alcohol blackout--is a common claim of criminal defendants. The generally held belief is that during an alcohol blackout, other cognitive functioning is severely impaired or absent. The presentation of alcohol blackout as scientific evidence in court requires that the science meets legal reliability standards (Frye, FRE702/Daubert). To determine whether "alcohol blackout" meets these standards, an evidence-based analysis of published scientific studies was conducted. A total of 26 empirical studies were identified including nine in which an alcohol blackout was induced and directly observed. No objective or scientific method to verify the presence of an alcoholic blackout while it is occurring or to confirm its presence retrospectively was identified. Only short-term memory is impaired and other cognitive functions--planning, attention, and social skills--are not impaired. Alcoholic blackouts would not appear to meet standards for scientific evidence and should not be admissible. © 2013 American Academy of Forensic Sciences.

  5. Medical marijuana: the conflict between scientific evidence and political ideology. Part two of two.

    Science.gov (United States)

    Cohen, Peter J

    2009-01-01

    In Part I of this article, I examined the role of the Food and Drug Administration (FDA) in drug approval and then detailed the known risks of medical marijuana (any form of Cannabis sativa used--usually by smoking--to treat a wide variety of pathologic states and diseases). Part II of the article will begin by reviewing the benefits of Cannabis sativa as documented by well designed scientific studies that have been published in the peer-reviewed literature. I will then propose that ability of scientists to conduct impartial studies designed to answer the question of marijuana's role in medical therapy has been greatly hampered by political considerations. I will posit that in spite of the considerable efforts of policymakers, it is becoming apparent that marijuana's benefits should be weighed against its well-described risks. I will conclude that political advocacy is a poor substitute for dispassionate analysis and that neither popular votes nor congressional "findings" should be permitted to trump scientific evidence in deciding whether or not marijuana is an appropriate pharmaceutical agent to use in modern medical practice. Whether or not marijuana is accepted as a legitimate medical therapy should remain in the hands of the usual drug-approval process and that the statutory role of the Food and Drug Administration should be dispositive.

  6. Current biomedical scientific impact (2013) of institutions, academic journals and researchers in the Republic of Macedonia.

    Science.gov (United States)

    Spiroski, Mirko

    2014-01-01

    To analyse current ranking (2013) of institutions, journals and researchers in the Republic of Macedonia. the country rankings of R. Macedonia were analyzed with SCImago Country & Journal Rank (SJR) for subject area Medicine in the years 1996-2013, and ordered by H-index. SCImago Institutions Rankings for 2013 was used for the scientific impact of biomedical institutions in the Republic of Macedonia. Journal metrics from Elsevier for the Macedonian scholarly journals for the period 2009-2013 were performed. Source Normalized Impact per Paper (SNIP), the Impact per Publication (IPP), and SCImago Journal Rank (SJR) were analysed. Macedonian scholarly biomedical journals included in Google Scholar metrics (2013, 2012) were analysed with h5-index and h5-median (June 2014). A semantic analysis of the PubMed database was performed with GoPubMed on November 2, 2014 in order to identify published papers from the field of biomedical sciences affiliated with the country of Macedonia. Harzing's Publish or Perish software was used for author impact analysis and the calculation of the Hirsh-index based on Google Scholar query. The rank of subject area Medicine of R. Macedonia according to the SCImago Journal & Country Rank (SJR) is 110th in the world and 17th in Eastern Europe. Of 20 universities in Macedonia, only Ss Cyril and Methodius University, Skopje, and the University St Clement of Ohrid, Bitola, are listed in the SCImago Institutions Rankings (SIR) for 2013. A very small number of Macedonian scholarly journals is included in Web of Sciences (2), PubMed (1), PubMed Central (1), SCOPUS (6), SCImago (6), and Google Scholar metrics (6). The rank of Hirsh index (h-index) was different from the rank of number of abstracts indexed in PubMed for the top 20 authors from R. Macedonia. The current biomedical scientific impact (2013) of institutions, academic journals and researchers in R. Macedonia is very low. There is an urgent need for organized measures to improve the quality

  7. 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

  8. 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

  9. Evidence for parity nonconservation in the weak neutral current

    International Nuclear Information System (INIS)

    Benvenuti, A.; Cline, D.; Messing, F.; Ford, W.; Imlay, R.; Ling, T.Y.; Mann, A.K.; Reeder, D.D.; Rubbia, C.; Stefanski, R.; Sulak, L.; Wanderer, P.

    1976-01-01

    Measurements of R/sup nu/ and R/sup nu-bar/, the ratios of neutral current to charged current ν and nu-bar cross sections, yield neutral current rates for ν and nu-bar that are consistent with a pure V-A interaction but 3 standard deviations from pure V or pure A, indicating the presence of parity nonconservation in the weak neutral current

  10. 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

  11. How does the entrepreneurial orientation of scientists affect their scientific performance? Evidence from the Quadrant Model

    OpenAIRE

    Naohiro Shichijo; Silvia Rita Sedita; Yasunori Baba

    2013-01-01

    Using Stokes's (1997) "quadrant model of scientific research", this paper deals with how the entrepreneurial orientation of scientists affects their scientific performance by considering its impact on scientific production (number of publications), scientific prestige (number of forward citations), and breadth of research activities (interdisciplinarity). The results of a quantitative analysis applied to a sample of 1,957 scientific papers published by 66 scientists active in advanced materia...

  12. [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.

  13. [Controversies about instrumented surgery and pain relief in degenerative lumbar spine pain. Results of scientific evidence].

    Science.gov (United States)

    Robaina-Padrón, F J

    2007-10-01

    Investigation and development of new techniques for intrumented surgery of the spine is not free of conflicts of interest. The influence of financial forces in the development of new technologies an its immediately application to spine surgery, shows the relationship between the published results and the industry support. Even authors who have defend eagerly fusion techniques, it have been demonstrated that them are very much involved in the revision of new articles to be published and in the approval process of new spinal technologies. When we analyze the published results of spine surgery, we must bear in mind what have been call in the "American Stock and Exchange" as "the bubble of spine surgery". The scientific literature doesn't show clear evidence in the cost-benefit studies of most instrumented surgical interventions of the spine compare with the conservative treatments. It has not been yet demonstrated that fusion surgery and disc replacement are better options than the conservative treatment. It's necessary to point out that at present "there are relationships between the industry and back pain, and there is also an industry of the back pain". Nonetheless, the "market of the spine surgery" is growing up because patients are demanding solutions for their back problems. The tide of scientific evidence seams to go against the spinal fusions in the degenerative disc disease, discogenic pain and inespecific back pain. After decades of advances in this field, the results of spinal fusions are mediocre. New epidemiological studies show that "spinal fusion must be accepted as a non proved or experimental method for the treatment of back pain". The surgical literature on spinal fusion published in the last 20 years following the Cochrane's method establish that: 1- this is at least incomplete, not reliable and careless; 2- the instrumentation seems to slightly increase the fusion rate; 3- the instrumentation doesn't improve the clinical results in general, lacking

  14. [Transformations in the management of diabetes: an analysis of the scientific evidence published by two scientific societies (1980-2010)].

    Science.gov (United States)

    Perner, Mónica Serena

    2013-12-01

    The aim of this study was to describe and analyze changes in the definition of diabetes as a disease and the relationship between these changes and subsequent modifications in the therapeutic management of the disease. A content analysis was performed using articles, guidelines, and consensuses published by the Argentina Diabetes Society and the Latin American Diabetes Association between 1980 and 2010. The different classifications, values used to define a person as diabetic, and treatments were assessed and the changes and modifications discovered were critically analyzed using categories such as medicalization, risk and lifestyles. As a result of the analysis we can observe how the growing process of medicalization, the dependence on the scientific knowledge of central countries, the interests of the pharmaceutical industry, and the crucial role played by pharmacological treatments are all inscribed within the management of diabetes, which can be made visible through the changes that have taken place over the last 30 years.

  15. 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

  16. Postpartum family planning: current evidence on successful interventions.

    Science.gov (United States)

    Blazer, Cassandra; Prata, Ndola

    2016-01-01

    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.

  17. Evidence for intrinsic critical current density in high Tc superconductors

    International Nuclear Information System (INIS)

    Freltoft, T.; Minnhagen, P.; Jeldtoft Jensen, H.

    1991-01-01

    We present measurements of the voltage-current characteristics of high quality epitaxial YBaCuO films in zero magnetic field. According to the predictions of a current induced vortex pair breaking picture the voltage should follow the functional form V∝I(I-I c ) a-1 . An analysis designed to test this functional behavior is carried out. Consistency is found. (orig.)

  18. Public policy and the social determinants of health: the challenge of the production and use of scientific evidence

    Directory of Open Access Journals (Sweden)

    Alberto Pellegrini Filho

    2011-01-01

    Full Text Available This article serves as an introduction to the others published in this thematic issue of the Cadernos de Saúde Pública. The author makes a brief historical review of the concepts, approaches and methodologies used to study the relationships between social determinants and health outcomes. By analyzing the current global movement around social determinants of health he emphasizes that the distinctive feature of this movement is the explicit commitment to action through intersectoral public policies that are based on evidence and implemented with the support and participation of broad segments of society. As this special issue of the Cadernos de Saúde Pública is dedicated to presenting the results of research related to social determinants of health, the author focuses on an analysis of the difficulties in the production and use of scientific evidence that supports the definition, implementation and evaluation of policies to combat health inequities through action on social determinants of health. To conclude, he presents some recommendations for overcoming these difficulties.

  19. Current Account Adjustment: Some New Theory and Evidence

    OpenAIRE

    Jiandong Ju; Shang-Jin Wei

    2007-01-01

    This paper aims to provide a theory of current account adjustment that generalizes the textbook version of the intertemporal approach to current account and places domestic labor market institutions at the center stage. In general, in response to a shock, an economy adjusts through a combination of a change in the composition of goods trade (i.e., intra-temporal trade channel) and a change in the current account (i.e., intertemporal trade channel). The more rigid the labor market, the slower ...

  20. Rebalancing; Evidence from Current Account Adjustment in Europe

    OpenAIRE

    Ruben V Atoyan; Jonathan F Manning; Jesmin Rahman

    2013-01-01

    After the 2003-2007 economic boom, European countries with large pre-crisis current account imbalances are undergoing adjustments. Countries are adjusting at different paces and ways reflecting the source and magnitude of imbalances, availability of financing, competitiveness of the tradable sector and external environment. While emerging European countries with large pre-crisis imbalances and a fixed exchange rate regime have seen sharp current account adjustments and a rebound in growth, ad...

  1. Sugars and health: a review of current evidence and future policy.

    Science.gov (United States)

    Evans, Charlotte Elizabeth Louise

    2017-08-01

    The automation of the process of extracting sugars in the 1900s reduced cost and increased availability of sugars leading to a dramatic rise in consumption, which reached a peak in the 1970s. There are different definitions for sugars not naturally available in foods, and free sugars is the term used by WHO. The epidemiological evidence of the associations between sugars and obesity and type 2 diabetes mellitus is fairly strong and consistent, particularly for sugar sweetened drinks in adults. The Department of Health in the UK and many other countries have recently updated their recommendations for free sugars as a result of this scientific evidence. In the UK the recommended amount of free sugars is currently 5 % of energy (reduced from 10 %), which is difficult to meet and very different from current British dietary patterns. Reducing intakes of free sugars is a challenge and will necessitate a range of different actions and policies. Public Health England has put forward eight suggestions but the four most likely to improve dietary behaviour based on available evidence are social marketing, reduction of marketing of high sugar foods and drinks to children, reformulation and reductions in portion size and a sugar excise tax. Any action taken needs to be evaluated to check inequalities are not widened. The new childhood obesity strategy has incorporated some but not all of these strategies and may not go far enough. It is likely that government policies alone will not be sufficient and a change in the food culture is necessary to see real progress.

  2. Preventive dentistry: practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines.

    Science.gov (United States)

    Frame, P S; Sawai, R; Bowen, W H; Meyerowitz, C

    2000-02-01

    and polishing to prevent periodontal disease in low-risk persons. There is no scientific evidence that dental examinations, including scaling and polishing, at 6 month intervals, as recommended by the dentists surveyed in this study, is superior to annual or less frequent examinations for low-risk populations. There is also no evidence that in-office fluoride applications offer incremental benefit over less costly methods of delivering fluoride for low-risk populations.

  3. Current status of evidence-based sports medicine.

    Science.gov (United States)

    Harris, Joshua D; Cvetanovich, Gregory; Erickson, Brandon J; Abrams, Geoffrey D; Chahal, Jaskarndip; Gupta, Anil K; McCormick, Frank M; Bach, Bernard R

    2014-03-01

    The purpose of this investigation is to determine the proportion of sports medicine studies that are labeled as Level I Evidence in 5 journals and compare the quality of surgical and nonsurgical studies using simple quality assessment tools (Consolidated Standards of Reporting Trials [CONSORT] and Jadad). By use of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines over the prior 2 years in the top 5 (citation and impact factor based) sports medicine journals, only Level I Evidence studies were eligible for inclusion and were analyzed. All study types (therapeutic, prognostic, diagnostic, and economic) were analyzed. Study quality was assessed with the level of evidence, Jadad score, and CONSORT 2010 guidelines. Study demographic data were compared among journals and between surgical and nonsurgical studies by use of χ(2), 1-way analysis of variance, and 2-sample Z tests. We analyzed 190 Level I Evidence studies (10% of eligible studies) (119 randomized controlled trials [RCTs]). Therapeutic, nonsurgical, single-center studies from the United States were the most common studies published. Sixty-two percent of studies reported a financial conflict of interest. The knee was the most common body part studied, and track-and-field/endurance sports were the most common sports analyzed. Significant differences (P journals reviewed. Overall, the Jadad and CONSORT scores were 2.71 and 77%, respectively. No differences (P > .05) were shown among journals based on the proportion of Level I studies or appropriate randomization. Significant strengths and limitations of RCTs were identified. This study showed that Level I Evidence and RCTs comprise 10% and 6% of contemporary sports medicine literature, respectively. Therapeutic, nonsurgical, single-center studies are the most common publications with Level I Evidence. Significant differences across sports medicine journals were found in study quality. Surgical studies appropriately described

  4. 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.

  5. 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.

  6. 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.

  7. Evidence based policy making in the European Union. The role of the scientific community

    Energy Technology Data Exchange (ETDEWEB)

    Majcen, Spela [Euro-Mediterranean Univ. (EMUNI), Portoroz (Slovenia)

    2017-03-15

    In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).

  8. Evidence based policy making in the European Union: the role of the scientific community.

    Science.gov (United States)

    Majcen, Špela

    2017-03-01

    In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).

  9. [Therapeutic potential of Hibiscus sabdariffa: a review of the scientific evidence].

    Science.gov (United States)

    Guardiola, Soledad; Mach, Núria

    2014-05-01

    Infusion of Hibiscus sabdariffa (H. sabdariffa) is a very popular drink in many parts of the world. Its phytochemical composition is associated to antioxidant, hypotensive, and antiatherosclerotic effects. However, the molecular mechanisms involved in these processes are not well known. The aim of this review was to report the scientific evidence supporting that regular use of H. sabdariffa decreases oxidative stress, atherosclerosis, lipid profile, and blood pressure. A search of recent publications was made in the following specialized electronic databases: Elsevier Journal, SciELO, FSTA, Science Direct, Springer Link, and NCBI. Results of research conducted in clinical trials in humans and in animal models and cell cultures were recorded. Keywords used included Hibiscus sabdariffa, oxidative stress, polyphenols, hypertension, atherosclerosis, and lipid profile. Results of the different articles suggested a possible therapeutic effect of H. sabdariffa extracts on oxidative stress, lipid profile, hypertension, and atherosclerosis thanks to its composition rich in phenolic compounds. Anthocyanins significantly decrease LDL oxidation, inhibit adipogenesis by regulating adipogenic signaling pathways and transcription factors, and modulate gene expression of certain microRNAs. No adverse events or side effects were reported. Further more homogeneous, placebo-controlled studies in humans are needed to state that H. sabdariffa has therapeutic efficacy in humans. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  10. 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.

  11. Potential Use of Euphorbia hirta for Dengue: A Systematic Review of Scientific Evidence

    Directory of Open Access Journals (Sweden)

    Sashini D. Perera

    2018-01-01

    Full Text Available Euphorbia hirta commonly known as Tawa-Tawa is a plant used in folklore medicine in the Philippines for the treatment of dengue. Though, E. hirta has been extensively investigated for numerous bioactivities, limited studies have been conducted on the antidengue activity. Thus, the present study provides a comprehensive review of studies conducted on the antidengue activity of E. hirta. A systematic literature survey was carried out in scientific databases, PubMed®, Scopus, and Google Scholar, for research carried on the antidengue activity of E. hirta. The literature search identified a total of 867 articles: databases PubMed = 6, Scopus SciVerse® = 423, and Google Scholar = 437; one additional article was identified by searching reference lists. Eight full papers were entitled to the review; out of those, two studies focused on ethnobotanical surveys, three on animal experiments, one on human trial, and two on in vitro antiviral activities, and one was computational study. The available evidence conclusively demonstrates the potential of E. hirta against dengue as it holds significant antiviral and platelet increasing activities. However, the number of studies conducted to validate its antidengue activity was found to be inadequate. Hence, well-controlled clinical trials and contemporary pharmacological approaches including activity guided fractionation and elucidation of the mode of action are encouraged to establish the use of E. hirta for dengue.

  12. Evidence based policy making in the European Union. The role of the scientific community

    International Nuclear Information System (INIS)

    Majcen, Spela

    2017-01-01

    In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).

  13. Chemonucleolysis and intradiscal electrothermal therapy: What is the current evidence?

    International Nuclear Information System (INIS)

    Relder-Puig, Rosemarie; Gyimesi, M.; Mittermayr, T.; Geiger-Gritsch, S.

    2009-01-01

    We evaluated the efficacy and safety of chemonucleolysis and intradiscal electrothermal therapy (IDET) on the basis of the data presented in recently published papers with respect to pain relief, function, and complication rates. Detailed searches for English and German articles published between 2003 and 2008 were performed in a number of electronic databases. Further publications were identified by manual search. For summarizing the evidence, we considered only systematic reviews and controlled studies. The internal validity of reviews and studies was judged by two authors independently. Data extraction was performed by one author, and the extracted data was checked for completeness and correctness by a second author. The evidence of the efficacy of chemonucleolysis using chymopapain or collagenase is summarized in two recent, high-quality systematic reviews. We found 5 controlled studies evaluating nucleolysis using an oxygen-ozone mixture (O 2 O 3 -nucleolysis). Some of those studies were of limited methodological quality, but all showed the efficacy of O 2 O 3 -nucleolysis in comparison to microdiscectomy or the use of alternative substances. There is hardly any data regarding O 2 O 3 -nucleolysis complications. Regarding IDET, the authors of the 6 identified systematic reviews come to different conclusions about the efficacy of the procedure. The results of the 3 included controlled IDET studies, of which 2 are of high methodological quality, are also conflicting. The complication rates range from 0 to 15%. In summary, the evidence of efficacy is presently more compelling for chemonucleolysis than for IDET. This may also be because indications for chemonucleolysis are more firmly established. However, safety aspects should be better evaluated and presented in the literature. (orig.)

  14. 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.

  15. 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. © 2014 Elsevier Inc. All rights reserved.

  16. Benefits of donor human milk for preterm infants: current evidence.

    Science.gov (United States)

    Bertino, Enrico; Giuliani, Francesca; Occhi, Luciana; Coscia, Alessandra; Tonetto, Paola; Marchino, Federica; Fabris, Claudio

    2009-10-01

    It's undoubted that optimum nutrition for term infants is breastfeeding, exclusive for the first six months, then followed by a complementary diet and carried on, if possible, for the first year of life or even more. During the last decades several data confirmed the great advantages of fresh mother's milk use also for feeding very low and extremely low birthweight preterm infants. When mother's milk is unavailable or in short supply, pasteurized donor breast milk is widely used in neonatal intensive care units. Pasteurization partially affects nutritional and immunological properties of breast milk, however it is known that pasteurized milk maintains some biological properties and clinical benefits. The substantial benefits of mother's own milk feeding of preterm infants are supported by strong evidence. However, there is increasing evidence also on specific benefits of donor breast milk. Future research is needed to compare formula vs. nutrient fortified donor breast milk, to compare formula and DM as supplements to maternal milk rather than as sole diet and to compare effects of different methods of heat treatments on donor human milk quality.

  17. 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.

  18. 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.

  19. Value of Travel Time Reliability: A review of current evidence

    OpenAIRE

    Carlos Carrion; David Levinson

    2010-01-01

    Travel time reliability is a fundamental factor in travel behavior. It represents the temporal uncertainty experienced by users in their movement between any two nodes in a network. The importance of the time reliability depends on the penalties incurred by the users. In road networks, travelers consider the existence of a trip travel time uncertainty in different choice situations (departure time, route, mode, and others). In this paper, a systematic review of the current state of research i...

  20. 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.

  1. 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

  2. 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

  3. Social class and prosocial behavior: current evidence, caveats, and questions.

    Science.gov (United States)

    Piff, Paul K; Robinson, Angela R

    2017-12-01

    This review synthesizes research on social class and prosocial behavior. Individuals of lower social class display increased attention to others and greater sensitivity to others' welfare compared to individuals of higher social class, who exhibit more self-oriented patterns of social cognition. As a result, lower-class individuals are more likely to engage in other-beneficial prosocial behavior, whereas higher-class individuals are more prone to engage in self-beneficial behavior. Although the extant evidence indicates that higher social class standing may tend to undermine prosocial impulses, we propose that the effects of social class on prosocial behavior may also depend on three crucial factors: motivation, identity, and inequality. We discuss how and why these factors may moderate class differences in prosociality and offer promising lines of inquiry for future research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  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

  5. 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

    2013-01-01

    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,…

  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. 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.

  8. Evaluation of Student Models on Current Socio-Scientific Topics Based on System Dynamics

    Science.gov (United States)

    Nuhoglu, Hasret

    2014-01-01

    This study aims to 1) enable primary school students to develop models that will help them understand and analyze a system, through a learning process based on system dynamics approach, 2) examine and evaluate students' models related to socio-scientific issues using certain criteria. The research method used is a case study. The study sample…

  9. 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

  10. Team working in intensive care: current evidence and future endeavors.

    Science.gov (United States)

    Richardson, Joanne; West, Michael A; Cuthbertson, Brian H

    2010-12-01

    It has recently been argued that the future of intensive care medicine will rely on high quality management and teamwork. Therefore, this review takes an organizational psychology perspective to examine the most recent research on the relationship between teamwork, care processes, and patient outcomes in intensive care. Interdisciplinary communication within a team is crucial for the development of negotiated shared treatment goals and short-team patient outcomes. Interventions for maximizing team communication have received substantial interest in recent literature. Intensive care coordination is not a linear process, and intensive care teams often fail to discuss how to implement goals, trigger and align activities, or reflect on their performance. Despite a move toward interdisciplinary team working, clinical decision-making is still problematic and continues to be perceived as a top-down and authoritative process. The topic of team leadership in intensive care is underexplored and requires further research. Based on findings from the most recent research evidence in medicine and management, four principles are identified for improving the effectiveness of team working in intensive care: engender professional efficacy, create stable teams and leaders, develop trust and participative safety, and enable frequent team reflexivity.

  11. 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.

  12. Candidate genes for COPD: current evidence and research

    Directory of Open Access Journals (Sweden)

    Kim WJ

    2015-10-01

    Full Text Available Woo Jin Kim,1 Sang Do Lee2 1Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, 2Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea Abstract: COPD is a common complex disease characterized by progressive airflow limitation. Several genome-wide association studies (GWASs have discovered genes that are associated with COPD. Recently, candidate genes for COPD identified by GWASs include CHRNA3/5 (cholinergic nicotine receptor alpha 3/5, IREB2 (iron regulatory binding protein 2, HHIP (hedgehog-interacting protein, FAM13A (family with sequence similarity 13, member A, and AGER (advanced glycosylation end product–specific receptor. Their association with COPD susceptibility has been replicated in multiple populations. Since these candidate genes have not been considered in COPD, their pathological roles are still largely unknown. Herein, we review some evidences that they can be effective drug targets or serve as biomarkers for diagnosis or subtyping. However, more study is required to understand the functional roles of these candidate genes. Future research is needed to characterize the effect of genetic variants, validate gene function in humans and model systems, and elucidate the genes’ transcriptional and posttranscriptional regulatory mechanisms. Keywords: chronic obstructive pulmonary disease, genetics, genome-wide association study

  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. Local air quality management: some evidence of current practices

    Energy Technology Data Exchange (ETDEWEB)

    Beattie, Clare; Newton, Alex; Longhurst, Jim [University of the West of England, Air Quality Research Group, Bristol (United Kingdom)

    1998-12-01

    The recent legislative changes, notably the Environment Act 1995 and resultant National Air Quality Strategy have brought new powers and obligations to local authorities to reach specified air quality standards and objectives. Initially this will involve local authorities carrying out a review and assessment of air quality in their locality by December 1999. This paper will outline a project currently being undertaken within the University of the West of England investigating how this legislation is being put into practice and present the results from a nation-wide questionnaire survey of environmental health officers. The study found that local authorities are still at an early stage of the process. It seems probable that one possible barrier to the implementation of Air Quality Management will be communication and cooperation within local authorities. (Author)

  15. Radiation and breast cancer: a review of current evidence

    International Nuclear Information System (INIS)

    Ronckers, Cécile M; Erdmann, Christine A; Land, Charles E

    2005-01-01

    This paper summarizes current knowledge on ionizing radiation-associated breast cancer in the context of established breast cancer risk factors, the radiation dose–response relationship, and modifiers of dose response, taking into account epidemiological studies and animal experiments. Available epidemiological data support a linear dose–response relationship down to doses as low as about 100 mSv. However, the magnitude of risk per unit dose depends strongly on when radiation exposure occurs: exposure before the age of 20 years carries the greatest risk. Other characteristics that may influence the magnitude of dose-specific risk include attained age (that is, age at observation for risk), age at first full-term birth, parity, and possibly a history of benign breast disease, exposure to radiation while pregnant, and genetic factors

  16. 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

    , 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...... 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.......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...

  17. 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.

  18. Examination of the "CSI Effect" on Perceptions of Scientific and Testimonial Evidence in a Hong Kong Chinese Sample.

    Science.gov (United States)

    Hui, Cora Y T; Lo, T Wing

    2017-05-01

    Television is a powerful medium through which to convey information and messages to the public. The recent proliferation of forensic science and criminal justice information throughout all forms of media, coupled with raised expectations toward forensic evidence, has led some to suspect that a "CSI effect" ( Crime Scene Investigation effect) is taking place. The present study contributes to the literature addressing the CSI effect in two ways. First, it examines whether the CSI effect exists in the Chinese population of Hong Kong. Second, using a mock-jury paradigm, it empirically examines a more integrative perspective of the CSI effect. It was found that, although the amount of media coverage involving forensic evidence does influence participants' perception of legal evidence to some degree, such a perception does not affect participants' legal decision making. Viewers of forensic dramas were not more likely to convict the defendant when forensic evidence was presented and not less likely to convict when only testimonial evidence was presented. The only significant predictor of the defendant's culpability when scientific evidence was presented was participants' ratings of the reliability of scientific evidence. Results from the present study lend no support to the existence of the CSI effect in Hong Kong.

  19. 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.

  20. 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

  1. 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 mak...

  2. The current mexican outlook of scientific cooperation with selected countries inside APEC: China, South Korea, Latin America and European Union

    Directory of Open Access Journals (Sweden)

    Jürgen Haberleithner

    2013-12-01

    Full Text Available In Mexico the Law on International Cooperation for Development came into force in 2011. The main objective of this instrument was to create a legal framework for all the cooperation activities in Mexico, such as International Scientific Cooperation. In order to understand this emerging process, it is necessary to analyze the current status of Scientific Cooperation between Mexico and other countries and regions in the world. Mexico has cooperation agreements and contracts at bilateral, trilateral and multilateral levels, which also include the subject Research & Development (R & D –a key indicator of the economic competitiveness of a country–. The analysis includes relevant countries for Mexico, such as China, South Korea and other countries within Apec, Latin America and the European Union. We therefore try to give an overview of the current situation and of potential medium- term prospects.

  3. 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

  4. Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis?

    Science.gov (United States)

    Henrotin, Yves; Mobasheri, Ali; Marty, Marc

    2012-01-30

    Glucosamine in its acetylated form is a natural constituent of some glycosaminoglycans (for example, hyaluronic acid and keratan sulfate) in the proteoglycans found in articular cartilage, intervertebral disc and synovial fluid. Glucosamine can be extracted and stabilized by chemical modification and used as a drug or a nutraceutical. It has been approved for the treatment of osteoarthritis (OA) in Europe to promote cartilage and joint health and is sold over the counter as a dietary supplement in the United States. Various formulations of glucosamine have been tested, including glucosamine sulfate and glucosamine hydrochloride. In vitro and in vivo studies have uncovered glucosamine's mechanisms of action on articular tissues (cartilage, synovial membrane and subchondral bone) and justified its efficacy by demonstrating structure-modifying and anti-inflammatory effects at high concentrations. However, results from clinical trials have raised many concerns. Pharmacokinetic studies have shown that glucosamine is easily absorbed, but the current treatment doses (for example, 1,500 mg/day) barely reach the required therapeutic concentration in plasma and tissue. The symptomatic effect size of glucosamine varies greatly depending on the formulation used and the quality of clinical trials. Importantly, the effect size reduces when evidence is accumulated chronologically and evidence for the structure-modifying effects of glucosamine are sparse. Hence, glucosamine was at first recommended by EULAR and OARSI for the management of knee pain and structure improvement in OA patients, but not in the most recent NICE guidelines. Consequently, the published recommendations for the management of OA require revision. Glucosamine is generally safe and although there are concerns about potential allergic and salt-related side effects of some formulations, no major adverse events have been reported so far. This paper examines all the in vitro and in vivo evidence for the mechanism

  5. Current knowledge from experimental works with radioprotective drugs from the viewpoint of latest scientific research

    International Nuclear Information System (INIS)

    Skalka, J.

    2008-01-01

    The protection of both human and animal population against a radiation impairment proves to be an impulse for continuous intensive searching for plants with radioprotective properties, identification of their radioprotective components and examination of their effects both in vivo an in vitro. I am presenting the results as well as knowledge of a latest scientific research in this field with testing the following plants: Vigna radiata, Mentha piperita, Citrus aurantium var. amara, Syzygium cumini, Tinospora cordifolia, Aegle marmelos, Phyllanthus amarus, Aloe vera, Angelica sinensis, Rosemarinus officinalis, Panax ginseng, Hippophae rhamnoides, Ocimum sanctum, Crataegus microphylla. (authors)

  6. 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…

  7. [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.

  8. Current Evidence for Clinical Efficacy of Platelet Rich Plasma in Aesthetic Surgery: A Systematic Review.

    Science.gov (United States)

    Frautschi, Russell S; Hashem, Ahmed M; Halasa, Brianna; Cakmakoglu, Cagri; Zins, James E

    2017-03-01

    Platelet rich plasma (PRP) has attracted attention in a number of surgical fields due to a wide variety of potential clinical benefits. Yet PRP has not gained wide popularity in aesthetic surgery as a result of uncertainty surrounding objective clinical evidence. We aim to describe the current applications, define preparation and activation, explore effectiveness, and propose a classification system to facilitate comparisons across studies. A comprehensive review of the literature regarding the use of platelet rich plasma in aesthetic surgery was performed. Data gathered included: PRP application, study type, subject number, centrifugation, anticoagulation, activation, PRP composition, and outcomes. Thirty-eight reports were identified. Applications included injection into aging skin (29%), scalp alopecia (26%), lipofilling (21%), fractional laser (13%), and facial surgery (11%). The majority of studies (53%) were case series without controls. Leucocytes were sparsely defined (32%). The concentration of injected and/or baseline platelets was rarely clarified (18%). The mechanism of activation was described in 27 studies (71%), while anticoagulation was uncommonly elucidated (47%). While most studies (95%) claim effectiveness, objective measures were only utilized in 17 studies (47%). Current studies produce context-dependent results with a lack of consistent reporting of PRP preparation, composition, and activation in aesthetic applications, making meaningful meta-analysis unrealistic. Thus the method of PRP preparation warrants increased attention. We recommend a set of descriptors, FIT PAAW (described below), to produce scientifically grounded conclusions, facilitating a clearer understanding of the situations in which PRP is effective. 4 © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  9. What is the current state of scientific knowledge with regard to seasonal and decadal forecasting?

    International Nuclear Information System (INIS)

    Smith, Doug M; Scaife, Adam A; Kirtman, Ben P

    2012-01-01

    Environmental factors, such as the frequency, intensity and duration of extreme weather events, are important drivers of migration and displacement of people. There is therefore a growing need for regional climate predictions for the coming seasons to decades. This paper reviews the current state of the art of seasonal to decadal climate prediction, focusing on the potential sources of skill, forecasting techniques, current capability and future prospects. (letter)

  10. 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

  11. Gender gaps and scientific productivity in middle-income countries: Evidence from Mexico - prepared for the Institutions for Development Department

    OpenAIRE

    Rivera León, Lorena; Mairesse, Jacques; Cowan, Robin

    2017-01-01

    This paper provides evidence of the existence and determinants of the publication productivity gender gap in Mexico at the individual level, and its consequences for the Mexican scientific system and productivity at both the individual discipline and the aggregate levels. The paper specifies and performs a panel data econometric analysis based on a sample of Mexican researchers who are members of the National System of Researchers (SNI) of Mexico in the period 2002-13. It corrects for a selec...

  12. Does the scientific evidence support the advertising claims made for products containing Lactobacillus casei and Bifidobacterium lactis? A systematic review.

    Science.gov (United States)

    Meléndez-Illanes, Lorena; González-Díaz, Cristina; Chilet-Rosell, Elisa; Álvarez-Dardet, Carlos

    2016-09-01

    To analyse the scientific evidence that exists for the advertising claims made for two products containing Lactobacillus casei and Bifidobacterium lactis and to conduct a comparison between the published literature and what is presented in the corporate website. Systematic review, using Medline through Pubmed and Embase. We included human clinical trials that exclusively measured the effect of Lactobacillus casei or Bifidobacterium lactis on a healthy population, and where the objective was related to the health claims made for certain products in advertising. We assessed the levels of evidence and the strength of the recommendation according to the classification criteria established by the Oxford Centre for Evidence Based Medicine (CEBM). We also assessed the outcomes of the studies published on the website that did not appear in the search. Of the 440 articles identified, 16 met the inclusion criteria. Only four (25%) of these presented a level of evidence of 1b and a recommendation grade of A, all corresponding to studies on product containing Bifidobacterium lactis, and only 12 of the 16 studies were published on the corporate website (47). There is insufficient scientific evidence to support the health claims made for these products, especially in the case of product containing Lactobacillus casei. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. 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…

  14. 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…

  15. 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…

  16. INFRASTRUCTURE OF INNOVATIVE ENTREPRENEURSHIP IN RUSSIA IN SCIENTIFIC AND EDUCATIONAL SPHERES: ASSESSMENT OF ITS CURRENT STATE

    Directory of Open Access Journals (Sweden)

    Cheremisina T. P.

    2014-09-01

    Full Text Available In the midst of the global financial crisis (2007-2009 World Economic Forum has recognized Russia's economy as being on the brink of innovative stage of development. Only in 2010, the negative impact of the crisis has manifested itself with a sharp drop in competitiveness of economy, especially in the areas where the innovative potential of the country was being formed. The domain of science and education form the infrastructure basis of innovative entrepreneurship, and in Russia, until recently, levels of these, though falling, were still recognized as high. Therefore, it is very important today to raise and strengthen the competitiveness of science and professional education, i.e. the sphere wherein the human capital necessary for innovation and for stimulation of innovative entrepreneurship, is formed. In 2010-2012, the Government of the Russian Federation implemented a program to stimulate innovative entrepreneurship based on accelerated infrastructure development in the spheres of science and education, and in 2013 began to reform science. Within the scope of this study are the 2007-2013 changes in the infrastructure of innovative entrepreneurship in scientific and educational spheres and their evaluation. The purpose of the study is to determine the most urgent and pressing issues requiring priority innovative solutions to increase the country's innovation potential. For evaluation, the methodology and tools used by the Global Competitiveness Index IEF are used. The choice of this methodology is justified not only by the close relationship between the respective competitiveness of the economies and their potentials for innovation, but also due to public confidence in this rating as a useful tool for analysts to identify the weaknesses in national competitiveness and to identify priority areas for action to improve it and to accelerate economic growth. The conclusions of the evaluation conducted in this study relate to inertia in scientific

  17. The need to redefine the environment in the current scientific debate

    International Nuclear Information System (INIS)

    Gazzano, Ines; Achkar, Marcel

    2013-01-01

    In the last four decades the environmental thinking has generated a rich theoretical production, forcing the transformation of the group of scientific thought; focusing on theoretical concerns in areas of disciplinary borders, leading to the continuous redefinition of the object of environmental issues in order to orientate interventions. Object that has mutated from the naive definition of environment, environmental system, socio-environmental system, complex system, integrating also operational aspects like: multi scale and inter-disciplinary. Theoretical efforts, articulated with the development of practical aspects helped to progress to understand the environmental object from classical perspectives, built on paradigms of modernity, which in recent years reached a point of exhaustion. The search for a solution to this problem lies in the limit of overcoming the dualistic postulate, attempting the unification of society nature. It is from this problem identification, and trying to connect major theoretical contributions in the discussions which are more or less diffused on the environment, complex systems and trans disciplinary science, that it is proposed a conceptual construction of the environmental system, which enables its redefinition and a new self-referentially, as a condition for a new reading, interpretation and action in specific territories.

  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. Beyond black lung: scientific evidence of health effects from coal use in electricity generation.

    Science.gov (United States)

    Buchanan, Susan; Burt, Erica; Orris, Peter

    2014-08-01

    While access to electricity affects health positively, combustion of coal in power plants causes well-documented adverse health effects. We review respiratory, cardiovascular, reproductive, and neurologic health outcomes associated with exposure to coal-fired power plant emissions. We also discuss population-level health effects of coal combustion and its role in climate change. Our review of scientific studies suggests that those we present here can be used to inform energy policy.

  20. 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

  1. 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

  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

    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. 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. 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. 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

  3. 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

  4. 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...

  5. Do you do Damon®? What is the current evidence base underlying the philosophy of this appliance system?

    Science.gov (United States)

    Wright, Natasha; Modarai, Faranak; Cobourne, Martyn T; Dibiase, Andrew T

    2011-09-01

    Self-ligating bracket systems are increasing in popularity amongst orthodontists. This reflects their high quality engineering, improved reliability and relative ease of use. However, it might also be related to claims of superior function made by the manufacturers of these appliances. In particular, the Damon(®) appliance system claims to offer significant advantages to both orthodontist and patient over conventional-ligation and other forms of self-ligated appliances. We have reviewed current literature relating to use of the Damon(®) appliance system. There is some evidence to suggest this appliance may lead to reductions in chairside time for the orthodontist, particularly those experienced with this system, in comparison to conventional-ligation. However, evidence that pain experience is reduced for the patient when using Damon(®) brackets is not conclusive. In the presence of identical archwire sequences, there is no evidence that Damon(®) brackets can align teeth faster or in a qualitatively differently manner, when compared with conventional-ligation. There is no high quality evidence that treatment with the Damon(®) appliance takes place more rapidly or leads to a superior occlusal or aesthetic result. Indeed, the best available evidence would suggest there is no difference in treatment outcome or time, at least in extraction cases. There is no evidence that treatment with the Damon(®) appliance is more stable. Claims relating to improved clinical performance of the Damon(®) appliance system are currently being made to orthodontists and patients that are not substantiated in the scientific literature.

  6. [Complementary medicine for low back pain : what is the scientific evidence ?

    Science.gov (United States)

    Aveni, Éléonore; Berna, Chantal; Rodondi, Pierre-Yves

    2017-06-21

    Complementary medicines are frequently used by chronic pain patients. It is a challenge for the primary care physician to provide objective information based on the scientific literature. Meta-analyses have shown favourable effects of acupuncture, therapeutic massage and osteopathy for patients with acute low back pain. Concerning chronic low back pain, meta-analyses have shown positive results with acupuncture, osteopathy, yoga and tai-chi. Other therapies have shown positive effects, but further trials are necessary to fully validate them. This article reviews the literature supporting the most studied complementary medicines.

  7. 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.

  8. The Tobacco Industry’s Abuse of Scientific Evidence and Activities to Recruit Scientists During Tobacco Litigation

    Directory of Open Access Journals (Sweden)

    Sungkyu Lee

    2016-01-01

    Full Text Available South Korea’s state health insurer, the National Health Insurance Service (NHIS, is in the process of a compensation suit against tobacco industry. The tobacco companies have habitually endeavored to ensure favorable outcomes in litigation by misusing scientific evidence or recruiting scientists to support its interests. This study analyzed strategies that tobacco companies have used during the NHIS litigation, which has been receiving world-wide attention. To understand the litigation strategies of tobacco companies, the present study reviewed the existing literature and carried out content analysis of petitions, preparatory documents, and supporting evidence submitted to the court by the NHIS and the tobacco companies during the suit. Tobacco companies misrepresented the World Health Organization (WHO report’s argument and misused scientific evidence, and removed the word “deadly” from the title of the citation. Tobacco companies submitted the research results of scientists who had worked as a consultant for the tobacco industry as evidence. Such litigation strategies employed by the tobacco companies internationally were applied similarly in Korean lawsuits. Results of tobacco litigation have a huge influence on tobacco control policies. For desirable outcomes of the suits, healthcare professionals need to pay a great deal of attention to the enormous volume of written opinions and supporting evidence that tobacco companies submit. They also need to face the fact that the companies engage in recruitment of scientists. Healthcare professionals should refuse to partner with tobacco industry, as recommended by Article 5.3 of the WHO Framework Convention on Tobacco Control.

  9. Insufficient scientific evidence for efficacy of widely used electrotherapy, laser therapy, and ultrasound treatment in physiotherapy

    NARCIS (Netherlands)

    Bouter, L M

    2000-01-01

    The Dutch Health Council recently published a report on the efficacy of electrotherapy, laser therapy and ultrasound treatment for musculoskeletal disorders. The assessment was based on three systematic reviews, including 169 randomized clinical trials, and focused on a best-evidence synthesis.

  10. 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.

  11. 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.

  12. 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.

  13. Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

    Science.gov (United States)

    Hill, Jonathan C.; Foster, Nadine E.; Protheroe, Joanne

    2017-01-01

    Background & aims Musculoskeletal pain, the most common cause of disability globally, is most frequently managed in primary care. People with musculoskeletal pain in different body regions share similar characteristics, prognosis, and may respond to similar treatments. This overview aims to summarise current best evidence on currently available treatment options for the five most common musculoskeletal pain presentations (back, neck, shoulder, knee and multi-site pain) in primary care. Methods A systematic search was conducted. Initial searches identified clinical guidelines, clinical pathways and systematic reviews. Additional searches found recently published trials and those addressing gaps in the evidence base. Data on study populations, interventions, and outcomes of intervention on pain and function were extracted. Quality of systematic reviews was assessed using AMSTAR, and strength of evidence rated using a modified GRADE approach. Results Moderate to strong evidence suggests that exercise therapy and psychosocial interventions are effective for relieving pain and improving function for musculoskeletal pain. NSAIDs and opioids reduce pain in the short-term, but the effect size is modest and the potential for adverse effects need careful consideration. Corticosteroid injections were found to be beneficial for short-term pain relief among patients with knee and shoulder pain. However, current evidence remains equivocal on optimal dose, intensity and frequency, or mode of application for most treatment options. Conclusion This review presents a comprehensive summary and critical assessment of current evidence for the treatment of pain presentations in primary care. The evidence synthesis of interventions for common musculoskeletal pain presentations shows moderate-strong evidence for exercise therapy and psychosocial interventions, with short-term benefits only from pharmacological treatments. Future research into optimal dose and application of the most

  14. Analysis of Orthopedic Resident Ability to Apply Levels of Evidence Criteria to Scientific Articles.

    Science.gov (United States)

    Grandizio, Louis C; Shim, Stephanie S; Graham, Jove; Costopoulos, Callista; Cush, Gerard; Klena, Joel C

    2016-01-01

    In the era of evidence-based medicine, understanding study design and levels of evidence (LoE) criteria is an important component of resident education and aids practicing surgeons in making informed clinical decisions. The purpose of this study is to analyze the ability of orthopedic residents to accurately determine LoE criteria for published articles compared with medical students. Basic science article. Geisinger Medical Center (Danville, PA), tertiary referral center. Overall, 25 U.S. orthopedic residents and 15 4th year medical students interviewing for a residency position in orthopedic surgery voluntarily participated and provided baseline demographic information. A total of 15 articles from the American Volume of Journal of Bone and Joint Surgery were identified. Study participants were provided with the article title, the abstract, and the complete methods section. The assigned LoE designation was withheld and access to the LoE criteria used by Journal of Bone and Joint Surgery was provided. Each participant was assigned a study type and LoE designation for each article. There were more correct responses regarding the article type (67%) than for LoE designation (39%). For LoE, the intraclass correlation coefficient was 0.30. The percentage of correct responses for article type and LoE increased with more years of training (p = 0.005 and p = 0.002). Although residents had a higher proportion of correct LoE responses overall than medical students, this difference did not reach statistical significance (42% vs. 35%, p = 0.07). Although improvements in accurately determining both article type and LoE were seen among residents with increasing years of training, residents were unable to demonstrate a statistically significant improvement for determining LoE or article type when compared with medical students. Strategies to improve resident understanding of LoE guidelines need to be incorporated into orthopedic residencies, especially when considering the

  15. Scientific Evidence for Different Options for GDM Screening and Management: Controversies and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Claudia Caissutti

    2017-01-01

    Full Text Available Background. Gestational diabetes (GDM affects up to 7% of pregnant women and is associated with several maternal and perinatal morbidities. International organizations suggest several different recommendations regarding how to screen and to manage GDM. Objective. We aimed to analyze the most important and employed guidelines about screening and management of GDM and we investigated existing related literature. Results. We found several different criteria for screening for GDM, for monitoring GDM, and for starting pharmacological therapy. When using IADPSG criteria, GDM rate increased, perinatal outcomes improved, and screening became cost-effective. Compared to no treatment, treatment of women meeting criteria for GDM by IADPSG criteria but not by other less strict criteria has limited evidence for an effect on adverse pregnancy outcomes.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    G. Benassai

    2017-09-01

    Full Text Available 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.

  18. Male circumcision to prevent syphilis in 1855 and HIV in 1986 is supported by the accumulated scientific evidence to 2015: Response to Darby.

    Science.gov (United States)

    Morris, Brian J; Wamai, Richard G; Krieger, John N; Banerjee, Joya; Klausner, Jeffrey D

    2017-10-01

    An article by Darby disparaging male circumcision (MC) for syphilis prevention in Victorian times (1837-1901) and voluntary medical MC programs for HIV prevention in recent times ignores contemporary scientific evidence. It is one-sided and cites outlier studies as well as claims by MC opponents that support the author's thesis, but ignores high quality randomised controlled trials and meta-analyses. While we agree with Darby that risky behaviours contribute to syphilis and HIV epidemics, there is now compelling evidence that MC helps reduce both syphilis and HIV infections. Although some motivations for MC in Victorian times were misguided, others, such as protection against syphilis, penile cancer, phimosis, balanitis and poor hygiene have stood the test of time. In the absence of a cure or effective prophylactic vaccine for HIV, MC should help lower heterosexually acquired HIV, especially when coupled with other interventions such as condoms and behaviour. This should save lives, as well as reducing costs and suffering. In contrast to Darby, our evaluation of the evidence leads us to conclude that MC would likely have helped reduce syphilis in Victorian times and, in the current era, will help lower both syphilis and HIV, so improving global public health.

  19. 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.

  20. 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.

  1. 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.

  2. The complementary medicine (CAM) for the treatment of chronic pain: scientific evidence regarding the effects of healing touch massage.

    Science.gov (United States)

    Marletta, Giuseppe; Canfora, Angela; Roscani, Francesco; Cernicchiaro, Lucia; Cutrera, Maria; Russo, Marianna; Artioli, Giovanna; Sarli, Leopoldo

    2015-09-09

    Evidence-based medicine offers effective pathways of pharmacological treatment for chronic pain that may compromise the quality of life of patients; this is one of the main reasons why more and more people resort to traditional and complementary approaches, to try to maintain or regain their health. The effectiveness of the various forms of complementary treatments often cannot be proven objectively, which is why, given the need to find more concrete evidence of the effectiveness of complementary therapies with particular reference to the method of healing touch massage, a review of the literature was conducted in order to gather evidence of the efficacy of the specific method regarding pain and other health outcomes of patients with malignant disease to support a proposal for improvement, based on the practice of healing touch massage conducted by nurses. Systematic review. There are several examples (in some cases specifically regarding patients with tumors) of the positive effects of healing touch massage on pain, anxiety and fatigue, and also on biochemical parameters. The way to full recognition by both the institutional and the scientific community seems to promise fairly well, although it should be noted that the achievement of this goal will require further research avoiding the limitations of previous studies.

  3. Industrial stakes and scientific challenges associated to current fleet and new generation of reactors for a utility

    International Nuclear Information System (INIS)

    Jean-Michel, Delbecq

    2004-01-01

    Energy supply sustainability and nuclear energy are major issues for the 21st century. EDF strategy is to keep the nuclear option open in the energy mix of the future. To achieve this, in a context of electricity market liberalization, nuclear energy must remain safe, clean and competitive. The main axes of EDF strategy are to operate durably its current fleet, to improve nuclear fuel efficiency, to pursue the development of efficient solutions for a good management of high level waste, to prepare the near future with new LWR design to be ready in time for nuclear power replacement of current PWRs and to prepare the long term future by taking an active part in the Generation IV program. This strategy implies a strong R and D effort in many fields. A special focus is made on thermal hydraulics developments by EDF in cooperation with its national and international partners. For an optimum use of nuclear fuel as well as for plant lifetime management and for preparing future nuclear systems, high performance numerical simulation is an indispensable and strategic tool. The necessary evolutions in EDF tools are to-day well engaged: more basic physics, 3D simulations, multi-physics and multi-scale coupling for a more realistic representation of ''reality'' and for enhanced accuracy. EDF R and D Division has structured its R and D in this field around six scientific challenges. This 5 to 10 years long effort, shared with its partners, will lead to an advanced numerical toolbox in 2010. (author)

  4. Current status of the scientific study of the personality disorders: an overview of epidemiological, longitudinal, experimental psychopathology, and neurobehavioral perspectives.

    Science.gov (United States)

    Lenzenweger, Mark F

    2010-08-01

    Research on the nature and development of personality disorders has grown immensely over the past thirty years. A selective summary overview is given of the current status of the scientific study of the personality disorders from several perspectives, including the epidemiological, longitudinal, experimental psychopathology, and neurobehavioral perspectives. From this research, we now know that approximately 10 percent of the general population suffer from a diagnosable personality disorder. Moreover, contrary to nearly a century of theory and clinical pedagogy, modern longitudinal studies clearly suggest that personality disorders decrease in severity over time. The mechanisms by which this change occurs are not understood at present, though it is not likely that change in underlying normal personality systems drives the change in personality disorder. The methods of the experimental psychopathology laboratory, including neuroimaging approaches, are being brought to bear on the nature of personality disorders in efforts to relate neurobiological and neurocognitive functions to personality disorder symptomatology. A model that links personality disorder feature development to underlying, interacting brain-based neurobehavioral systems is reviewed in brief. Current issues and findings illustrative of these developments are given using borderline personality disorder as an exemplar. Finally, areas of intersection between psychoanalytic treatment approaches and the growing science of personality disorder are highlighted.

  5. The Current Evidence for Hayek’s Cultural Group Selection Theory

    Directory of Open Access Journals (Sweden)

    Brad Lowell Stone

    2010-12-01

    Full Text Available In this article I summarize Friedrich Hayek’s cultural group selection theory and describe the evidence gathered by current cultural group selection theorists within the behavioral and social sciences supporting Hayek’s main assertions. I conclude with a few comments on Hayek and libertarianism.

  6. 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

  7. Executive Summary of the NHLBI Workshop Report: Leveraging Current Scientific Advancements to Understand Sarcoidosis Variability and Improve Outcomes.

    Science.gov (United States)

    Maier, Lisa A; Crouser, Elliott D; Martin, William J; Eu, Jerry

    2017-12-01

    Sarcoidosis is a systemic granulomatous disease that primarily affects the lung; it is associated with significant disparities, more commonly impacting those in the prime of their lives (age 20-50 yr, with a second peak after age 60 yr), black individuals, and women. However, the burden of disease, the ability to diagnose and prognose organ involvement and course, as well as specific treatment options, management options, and disease pathogenesis remain poorly understood. As a result, the National Heart, Lung, and Blood Institute undertook a sarcoidosis workshop, "Leveraging Current Scientific Advancements to Understand Sarcoidosis Variability and Improve Outcomes," to help address these issues by defining the scientific and clinical priorities to improve sarcoidosis care. The overarching recommendations from this workshop are outlined in the following summary and detailed in the accompanying articles. The recommendations included establishing collaborations and networks to conduct research based on consensus definitions of disease phenotypes and standards of care, and to provide clinical outreach to areas with a burden of disease to improve care. These collaborative networks would also serve as the hub to conduct clinical trials of devastating phenotypes (e.g., cardiac, neurologic, and fibrotic disease) not only for treatment but to enhance our understanding of the burden of disease. In addition, the networks would be used to leverage state-of-the-art "omics" and systems biology research, as well as other studies to advance understanding of disease pathogenesis, and development of biomarkers and therapeutic targets, with a goal to translate this information to improve care of individuals with sarcoidosis.

  8. 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. PMID:27041871

  9. 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

  10. Scientific evidence and the toxic tort. A socio-legal study of the issues, expert evidence and judgement in Reay and Hope v. British Nuclear Fuels plc

    International Nuclear Information System (INIS)

    Harrison, R.J.

    1999-01-01

    Providing a socio-legal analysis of the issues, expert evidence and judgment in Reay and Hope v BNFL plc., the thesis offers an insight into the complexity of the toxic tort. Starting with an overview of the history of Sellafield, the thesis reflects on the scientific and epidemiological concerns surrounding the link between childhood cancer and nuclear installations. Drawing on scientific knowledge and epistemological considerations, the thesis moves on to the difficulties of verifying causation in science and the problems of establishing causation in law. Outlining the role of the expert witness and scientific expert evidence, the thesis proceeds with a case analysis, before broaching the thorny issue of judicial decision making and in particular, the difference between the 'discovery' and 'justification' process. Moving on to the Judgment in Reay and Hope, attention is given to the potential application of probability theory to the judicial decision making process. Lasting just short of one hundred days and including the testimony of numerous scientific experts, Reay and Hope marked new ground in a number of ways; it was the first personal injury claim to test the concept of genetic damage from radiation; the only time that a Queen's Bench Division Judge had been allocated a full-time judicial assistant, and one of the first trials to endorse a satellite video link for examination of international expert witnesses. As far as judicial management is concerned, the case was a forerunner in having Counsels' Opening Statements in writing in advance of the trial, as well as having written daily submissions of key issues from plaintiffs and defendants upon conclusion of oral evidence. The circumstances that led to the trial relate to events in excess of thirty to forty years ago when the fathers of Dorothy Reay and Vivien Hope were employed by the Defendants and their predecessors (the United Kingdom Atomic Energy Authority) as fitters for the Sellafield Plant

  11. Scientific evidence and the toxic tort. A socio-legal study of the issues, expert evidence and judgement in Reay and Hope v. British Nuclear Fuels plc

    Energy Technology Data Exchange (ETDEWEB)

    Harrison, R.J

    1999-07-01

    Providing a socio-legal analysis of the issues, expert evidence and judgment in Reay and Hope v BNFL plc., the thesis offers an insight into the complexity of the toxic tort. Starting with an overview of the history of Sellafield, the thesis reflects on the scientific and epidemiological concerns surrounding the link between childhood cancer and nuclear installations. Drawing on scientific knowledge and epistemological considerations, the thesis moves on to the difficulties of verifying causation in science and the problems of establishing causation in law. Outlining the role of the expert witness and scientific expert evidence, the thesis proceeds with a case analysis, before broaching the thorny issue of judicial decision making and in particular, the difference between the 'discovery' and 'justification' process. Moving on to the Judgment in Reay and Hope, attention is given to the potential application of probability theory to the judicial decision making process. Lasting just short of one hundred days and including the testimony of numerous scientific experts, Reay and Hope marked new ground in a number of ways; it was the first personal injury claim to test the concept of genetic damage from radiation; the only time that a Queen's Bench Division Judge had been allocated a full-time judicial assistant, and one of the first trials to endorse a satellite video link for examination of international expert witnesses. As far as judicial management is concerned, the case was a forerunner in having Counsels' Opening Statements in writing in advance of the trial, as well as having written daily submissions of key issues from plaintiffs and defendants upon conclusion of oral evidence. The circumstances that led to the trial relate to events in excess of thirty to forty years ago when the fathers of Dorothy Reay and Vivien Hope were employed by the Defendants and their predecessors (the United Kingdom Atomic Energy Authority) as fitters for

  12. Current therapeutic interventions in the glycation pathway: evidence from clinical studies.

    Science.gov (United States)

    Engelen, L; Stehouwer, C D A; Schalkwijk, C G

    2013-08-01

    The increased formation of advanced glycation endproducts (AGEs) constitutes a potential mechanism of hyperglycaemia-induced micro- and macrovascular disease in diabetes. In vitro and animal experiments have shown that various interventions can inhibit formation and/or actions of AGEs, in particular the specific AGE inhibitor aminoguanidine and the AGEs crosslink breaker alagebrium, and the B vitamins pyridoxamine and thiamine, and the latter's synthetic derivative, benfotiamine. The potential clinical value of these interventions, however, remains to be established. The present review provides, from the clinical point of view, an overview of current evidence on interventions in the glycation pathway relating to (i) the clinical benefits of specific AGE inhibitors and AGE breakers and (ii) the potential AGE-inhibiting effects of therapies developed for purposes unrelated to the glycation pathway. We found that safety and/or efficacy in clinical studies with the specific AGE inhibitor, aminoguanidine and the AGE breaker, alagebrium, appeared to be a concern. The clinical evidence on the potential AGE-inhibiting effects of B vitamins is still limited. Finally, current evidence for AGE inhibition by therapies developed for purposes unrelated to glycation is limited due to a large heterogeneity in study designs and/or measurement techniques, which have often been sub-optimal. We conclude that, clinical evidence on interventions to inhibit formation and/or action of AGEs is currently weak and unconvincing. © 2012 Blackwell Publishing Ltd.

  13. Current practice patterns of drain usage amongst UK and Irish surgeons performing bilateral breast reductions: Evidence down the drain.

    Science.gov (United States)

    Sugrue, Conor M; McInerney, Niall; Joyce, Cormac W; Jones, Deidre; Hussey, Alan J; Kelly, Jack L; Kerin, Michael J; Regan, Padraic J

    2015-01-01

    Bilateral breast reduction (BBR) is one of the most frequently performed female breast operations. Despite no evidence supporting efficacy of drain usage in BBRs, postoperative insertion is common. Recent high quality evidence demonstrating potential harm from drain use has subsequently challenged this traditional practice. The aim of this study is to assess the current practice patterns of drains usage by Plastic & Reconstructive and Breast Surgeons in UK and Ireland performing BBRs. An 18 question survey was created evaluating various aspects of BBR practice. UK and Irish Plastic & Reconstructive and Breast Surgeons were invited to participate by an email containing a link to a web-based survey. Statistical analysis was performed with student t-test and chi-square test. Two hundred and eleven responding surgeons were analysed, including 80.1% (171/211) Plastic Surgeons and 18.9% (40/211) Breast Surgeons. Of the responding surgeons, 71.6% (151/211) routinely inserted postoperative drains, for a mean of 1.32 days. Drains were used significantly less by surgeons performing ≥20 BBRs (p = 0.02). With the majority of BBRs performed as an inpatient procedure, there was a trend towards less drain usage in surgeons performing this procedure as an outpatient; however, this was not statistically significant (p = 0.07). Even with the high level of evidence demonstrating the safety of BBR without drains, they are still routinely utilised. In an era of evidence- based medicine, surgeons performing breast reductions must adopt the results from scientific research into their clinical practice.

  14. 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

  15. 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

  16. Evidence for Anomalous Effects on the Current Evolution in Tokamak Operating Scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Casper, T; Jayakumar, R; Allen, S; Holcomb, C; Makowski, M; Pearlstein, L; Berk, H; Greenfield, C; Luce, T; Petty, C; Politzer, P; Wade, M; Murakami, M; Kessel, C

    2006-10-03

    Alternatives to the usual picture of advanced tokamak (AT) discharges are those that form when anomalous effects alter the plasma current and pressure profiles and those that achieve stationary characteristics through mechanisms so that a measure of desired AT features is maintained without external current-profile control. Regimes exhibiting these characteristics are those where the safety factor (q) evolves to a stationary profile with the on-axis and minimum q {approx} 1 and those with a deeply hollow current channel and high values of q. Operating scenarios with high fusion performance at low current and where the inductively driven current density achieves a stationary configuration with either small or non-existing sawteeth may enhance the neutron fluence per pulse on ITER and future burning plasmas. Hollow current profile discharges exhibit high confinement and a strong ''box-like'' internal transport barrier (ITB). We present results providing evidence for current profile formation and evolution exhibiting features consistent with anomalous effects or with self-organizing mechanisms. Determination of the underlying physical processes leading to these anomalous effects is important for scaling of current experiments for application in future burning plasmas.

  17. Evidence and effects of a wave-driven nonlinear current in the equatorial electrojet

    Directory of Open Access Journals (Sweden)

    M. Oppenheim

    1997-07-01

    Full Text Available Ionospheric two-stream waves and gradient-drift waves nonlinearly drive a large-scale (D.C. current in the E-region ionosphere. This current flows parallel to, and with a comparable magnitude to, the fundamental Pedersen current. Evidence for the existence and magnitude of wave-driven currents derives from a theoretical understanding of E-region waves, supported by a series of nonlinear 2D simulations of two-stream waves and by data collected by rocket instruments in the equatorial electrojet. Wave-driven currents will modify the large-scale dynamics of the equatorial electrojet during highly active periods. A simple model shows how a wave-driven current appreciably reduces the horizontally flowing electron current of the electrojet. This reduction may account for the observation that type-I radar echoes almost always have a Doppler velocity close to the acoustic speed, and also for the rocket observation that electrojet regions containing gradient-drift waves do not appear also to contain horizontally propagating two-stream waves. Additionally, a simple model of a gradient-drift instability shows that wave-driven currents can cause nonsinusoidal electric fields similar to those measured in situ.

  18. Can suitable candidates for levodopa/carbidopa intestinal gel therapy be identified using current evidence?

    Directory of Open Access Journals (Sweden)

    Maria José Catalán

    2017-09-01

    In recent years, strong evidence has supported the use of LCIG in treating motor fluctuations associated with APD, and several clinical studies provide emerging evidence for additional benefits of LCIG treatment in certain patients. This article provides an overview of the published literature on the benefits, limitations, and drawbacks of LCIG in relation to PD symptoms, the psychosocial impact of the disease, and the quality of life of patients, with the aim of determining candidates for whom treatment with LCIG would be beneficial. According to current evidence, patients with APD (defined as inability to achieve optimal control of the disease with conventional oral treatment, a relatively well-preserved cognitive-behavioral status, and good family/caregiver would count as suitable candidates for LCIG treatment. Contraindications in the opinion of the authors are severe dementia and active psychosis.

  19. Current management of hypertrophic cardiomyopathy: evidence in pathophysiology, diagnosis and treatment

    International Nuclear Information System (INIS)

    Quesada Mena, Luis Diego

    2013-01-01

    Available literary evidence is reviewed on the current management of hypertrophic cardiomyopathy. The bibliographical search is carried out in physical and online texts, cardiology journals, databases (MEDLINE), original studies, reviews and metaanalysis. Literature in English and Spanish is included from the first descriptions of the disease in the fifties, until the date of the investigation. Clinical management of patients is compared and recommendations published by consensus groups of international associations [es

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

    International Nuclear Information System (INIS)

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

    2010-01-01

    Background: 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. Objectives: 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. Methods: 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Tolaymat, Thabet M., E-mail: tolaymat.thabet@epa.gov [USEPA Office of Research and Development, National Risk Management Laboratory, 26 West Martin Luther King Drive, Cincinnati, OH 45224 (United States); El Badawy, Amro M. [Dept. of Civil and Environmental Engineering, University of Cincinnati, Cincinnati, OH (United States); Genaidy, Ash [WorldTek Inc, Cincinnati, OH (United States); Scheckel, Kirk G.; Luxton, Todd P. [USEPA Office of Research and Development, National Risk Management Laboratory, 26 West Martin Luther King Drive, Cincinnati, OH 45224 (United States); Suidan, Makram [Dept. of Civil and Environmental Engineering, University of Cincinnati, Cincinnati, OH (United States)

    2010-02-01

    Background: 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. Objectives: 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. Methods: 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

  2. ICU nurses' oral-care practices and the current best evidence.

    Science.gov (United States)

    DeKeyser Ganz, Freda; Fink, Naomi Farkash; Raanan, Ofra; Asher, Miriam; Bruttin, Madeline; Nun, Maureen Ben; Benbinishty, Julie

    2009-01-01

    The purpose of this study was to describe the oral-care practices of ICU nurses, to compare those practices with current evidence-based practice, and to determine if the use of evidence-based practice was associated with personal demographic or professional characteristics. A national survey of oral-care practices of ICU nurses was conducted using a convenience sample of 218 practicing ICU nurses in 2004-05. The survey instrument included questions about demographic and professional characteristics and a checklist of oral-care practices. Nurses rated their perceived level of priority concerning oral care on a scale from 0 to 100. A score was computed representing the sum of 14 items related to equipment, solutions, assessments, and techniques associated with the current best evidence. This score was then statistically analyzed using ANOVA to determine differences of EBP based on demographic and professional characteristics. The most commonly used equipment was gauze pads (84%), followed by tongue depressors (55%), and toothbrushes (34%). Chlorhexidine was the most common solution used (75%). Less than half (44%) reported brushing their patients' teeth. The majority performed an oral assessment before beginning oral care (71%); however, none could describe what assessment tool was used. Only 57% of nurses reported documenting their oral care. Nurses rated oral care of intubated patients with a priority of 67+/-27.1. Wide variations were noted within and between units in terms of which techniques, equipment, and solutions were used. No significant relationships were found between the use of an evidence-based protocol and demographic and professional characteristics or with the priority given to oral care. While nurses ranked oral care a high priority, many did not implement the latest evidence into their current practice. The level of research utilization was not related to personal or professional characteristics. Therefore attempts should be made to encourage all

  3. 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.

  4. 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.

  5. [New Scientific Evidence-based Public Health Guidelines and Practical Manual for Prevention of Sick House Syndrome].

    Science.gov (United States)

    Kishi, Reiko; Yoshino, Hiroshi; Araki, Atsuko; Saijo, Yasuaki; Azuma, Kenichi; Kawai, Toshio; Yamato, Hiroshi; Osawa, Haruki; Shibata, Eiji; Tanaka, Masatoshi; Masuchi, Ayumi; Minatoya, Machiko; Ait Bamai, Yu

    2018-01-01

    Recently, we have published a book containing evidence-based public health guidelines and a practical manual for the prevention of sick house syndrome. The manual is available through the homepage of the Ministry of Health, Labour and Welfare (http://www.mhlw.go.jp/file/06-Seisakujouhou-11130500-Shokuhinanzenbu/0000155147.pdf). It is an almost completely revised version of the 2009 version. The coauthors are 13 specialists in environmental epidemiology, exposure sciences, architecture, and risk communication. Since the 1970s, health problems caused by indoor chemicals, biological pollution, poor temperature control, humidity, and others in office buildings have been recognized as sick building syndrome (SBS) in Western countries, but in Japan it was not until the 1990s that people living in new or renovated homes started to describe a variety of nonspecific subjective symptoms such as eye, nose, and throat irritation, headache, and general fatigue. These symptoms resembled SBS and were designated "sick house syndrome (SHS)." To determine the strategy for prevention of SHS, we conducted a nationwide epidemiological study in six cities from 2003-2013 by randomly sampling 5,709 newly built houses. As a result 1,479 residents in 425 households agreed to environmental monitoring for indoor aldehydes and volatile organic compounds (VOCs). After adjustment for possible risk factors, some VOCs and formaldehyde were dose-dependently shown to be significant risk factors. We also studied the dampness of the houses, fungi, allergies, and others. This book is fully based on the scientific evidence collected through these studies and other newly obtained information, especially from the aspect of architectural engineering. In addition to SHS, we included chapters on recent information about "multi-chemical sensitivity."

  6. 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.

  7. Metastatic non-small cell lung cancer Current treatment based on evidence (ONCOL Group)

    International Nuclear Information System (INIS)

    Castro, Carlos; Cardona, Andres Felipe; Reveiz, Ludovic; Serrano, Silvia Juliana; Carranza, Hernan; Vargas, Carlos Alberto; Reguart, Noemi; Campo, Felipe; Ospina, Edgar Guillermo; Sanchez, Oswaldo; Torres, Diana; Otero, Jorge Miguel

    2010-01-01

    to perform a review of evidence about the treatment of non-small cell lung cancer (NSCLC). Source of data: the information was obtained from searches conducted in Medline, CCTR, Biosis, Embase, Lilacs and CINHAL. We also collected the most representative references presented during the last five years at Asco, ESMO and IASLC. Data extraction: data were extracted by associate members to the ONCOL Group. The collection of information did not follow a uniform strategy. Results of data synthesis: therapy for NSCLC can prolong survival and improve quality of life, but the majority of advanced stage patients dies due to disease progression within 2 years, meaning that there is room for improvement. The standard chemotherapy for NSCLC involves one of a number of platinum-based doublets that have been shown to improve survival when compared with single agents or best supportive care. These doublets are generally comparable in terms of efficacy, differing primarily in their toxicity profiles. However, encouraging new options may be approaching, including therapies targeted to specific patient subpopulations, and the use of combinations of current and new drugs to produce synergistic effects. This review present a detailed analysis of current evidence regarding the treatment of NSCLC based on a representative case series. This review didn't conduct a systematic evaluation of the evidence. Conclusion: medical therapy for NSCLC produces positive changes in main outcomes, including quality of life

  8. 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.

  9. Sixty years of fear appeal research: current state of the evidence.

    Science.gov (United States)

    Ruiter, Robert A C; Kessels, Loes T E; Peters, Gjalt-Jorn Y; Kok, Gerjo

    2014-04-01

    Fear arousal is widely used in persuasive campaigns and behavioral change interventions. Yet, experimental evidence argues against the use of threatening health information. The authors reviewed the current state of empirical evidence on the effectiveness of fear appeals. Following a brief overview of the use of fear arousal in health education practice and the structure of effective fear appeals according to two main theoretical frameworks-protection motivation theory and the extended parallel process model-the findings of six meta-analytic studies in the effectiveness of fear appeals are summarized. It is concluded that coping information aimed at increasing perceptions of response effectiveness and especially self-efficacy is more important in promoting protective action than presenting threatening health information aimed at increasing risk perceptions and fear arousal. Alternative behavior change methods than fear appeals should be considered. © 2014 The Authors. International Journal of Psychology published by John Wiley © Sons Ltd on behalf of International Union of Psychological Science.

  10. 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.

  11. 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

  12. 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

  13. 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…

  14. [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, 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.

  15. 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

  16. Scientific support for overcoming the effects of the Chernobyl accident in the Republic of Belarus: current state and prospects

    International Nuclear Information System (INIS)

    Shevchuk, V.E.; Gurachevskij, V.L.; Lugovskaya, O.M.; Poplyko, I.Ya.

    2005-01-01

    The paper gives a brief review of research studies dealing with the Chernobyl accident in the Republic of Belarus. The the main scientific outcomes of the studies conducted for the period of 2001-2005 under the State Program, and the Program of joint activity of Union State for elimination of the effects of the Chernobyl accident, and State Scientific and Technical Programs aimed at production of instruments of radiation monitoring are presented. Objectives of the research activity for impending period are stated. (authors)

  17. 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.

  18. Current evidence on physiological activity and expected health effects of kombucha fermented beverage.

    Science.gov (United States)

    Vīna, Ilmāra; Semjonovs, Pāvels; Linde, Raimonds; Deniņa, Ilze

    2014-02-01

    Consumption of kombucha fermented tea (KT) has always been associated with different health benefits. Many personal experiences and testimonials of KT drinkers are available throughout the world on the ability of KT to protect against a vast number of metabolic and infectious diseases, but very little scientific evidence is available that validates the beneficial effects of KT. The aim of this review is to give an overview of the recent studies in search of experimental confirmation of the numerous KT health-promoting aspects cited previously. Analysis of the literature data is carried out in correspondence to the recent concepts of health protection's requirements. Attention is given to the active compounds in KT, responsible for the particular effect, and to the mechanisms of their actions. It is shown that KT can efficiently act in health prophylaxis and recovery due to four main properties: detoxification, antioxidation, energizing potencies, and promotion of depressed immunity. The recent experimental studies on the consumption of KT suggest that it is suitable for prevention against broad-spectrum metabolic and infective disorders. This makes KT attractive as a fermented functional beverage for health prophylaxis.

  19. 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.

  20. Cost-effectiveness of particle therapy: Current evidence and future needs

    International Nuclear Information System (INIS)

    Pijls-Johannesma, Madelon; Pommier, Pascal; Lievens, Yolande

    2008-01-01

    Purpose: Questions are being raised regarding the cost of particle therapy (PT), and with them criticism that PT is too expensive to allow the expected gain in effectiveness. This paper aims to get more insight in the cost and cost-effectiveness of particle therapy and to discuss a future strategy that allows for critical assessment of this health technology. Material and methods: A systematic literature review based on an earlier published comprehensive review was performed and updated until June 1st 2008. Besides, current business plans of PT projects were examined. Additionally, results retrieved from a cost-simulation tool developed under auspice of the ENLIGHT were discussed. Results: The current literature on cost-effectiveness of PT is scarce, non-comparable, and largely not performed according to standard health technology assessment criteria. Besides, different perspectives for cost evaluations have been used, making it difficult to compare and to determine the relative impact in terms of costs for this new treatment modality. Conclusions: Evidence on the cost-effectiveness of PT is scarce. Adequate reimbursement is necessary to support such innovative yet costly treatments. For now, model-based economic evaluations performed at least from a health care perspective may help us to gain evidence-based insight into cost-effectiveness

  1. 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.

  2. 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.

    2013-01-01

    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. PMID:23698166

  3. 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.

  4. Can Scientific Evidence Support Using Bangladeshi Traditional Medicinal Plants in the Treatment of Diarrhoea? A Review on Seven Plants

    Directory of Open Access Journals (Sweden)

    Karl E. Malterud

    2013-05-01

    Full Text Available 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.

  5. 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. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. The Built Environment and Child Health: An Overview of Current Evidence.

    Science.gov (United States)

    Gascon, Mireia; Vrijheid, Martine; Nieuwenhuijsen, Mark J

    2016-09-01

    Urbanization and the shaping of the built environment have provided a number of socioeconomic benefits, but they have also brought unwanted side effects on health. We aimed to review the current epidemiological evidence of the associations between the built environment, closely related exposures, and child health. We focused on growth and obesity, neuropsychological development, and respiratory and immune health. We used existing review articles and supplemented these with relevant work published and not included in existing reviews. The present review shows that there is good evidence for an association between air pollution and fetal growth restriction and respiratory health, whereas for other exposure and outcome combinations, further evidence is needed. Future studies should make efforts to integrate the different built environment features and to include the evaluation of environments other than home, as well as accessibility, qualitative and perception assessment of the built environment, and, if possible, with improved and standardized tools to facilitate comparability between studies. Efforts are also needed to conduct longitudinal and intervention studies and to understand potential mechanisms behind the associations observed. Finally, studies in low- and middle-income countries are needed.

  7. Renal denervation in the management of resistant hypertension: current evidence and perspectives.

    Science.gov (United States)

    Jin, Yu; Persu, Alexandre; Staessen, Jan A

    2013-09-01

    Catheter-based renal denervation has emerged as a novel treatment modality for resistant hypertension. This review summarizes the current evidence on this procedure in treatment of resistant hypertension, limitations of available evidence and questions to be answered. The SYMPLICITY studies showed that renal denervation is feasible in treating resistant hypertension, but failed to provide conclusive evidence on the size and durability of the antihypertensive, renal and sympatholytic effects, as well as the long-term safety. The definition of resistant hypertension was loose in the SYMPLICITY studies and the management of resistant hypertension was suboptimal. Future studies should have a randomized design and enroll truly resistant hypertension patients by excluding secondary hypertension, white-coat hypertension and nonadherent patients. Questions to be addressed by the ongoing and future trials include the long-term efficacy and safety of this procedure, identification of responders and uncovering of the underlying mechanisms. Only well-designed, randomized clinical trials addressing the limitations of the SYMPLICITY studies will be able to demonstrate whether renal denervation is an efficacious treatment modality in resistant hypertension and in which patients. For now, renal denervation remains an experimental procedure and should only be offered to truly resistant hypertensive patients in a research context after careful selection.

  8. 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

  9. 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…

  10. Bipolar disorder and complementary medicine: current evidence, safety issues, and clinical considerations.

    Science.gov (United States)

    Sarris, Jerome; Lake, James; Hoenders, Rogier

    2011-10-01

    Bipolar disorder (BD) is a debilitating syndrome that is often undiagnosed and undertreated. Population surveys show that persons with BD often self-medicate with complementary and alternative medicine (CAM) or integrative therapies in spite of limited research evidence supporting their use. To date, no review has focused specifically on nonconventional treatments of BD. The study objectives were to present a review of nonconventional (complementary and integrative) interventions examined in clinical trials on BD, and to offer provisional guidelines for the judicious integrative use of CAM in the management of BD. PubMed, CINAHL,(®) Web of Science, and Cochrane Library databases were searched for human clinical trials in English during mid-2010 using Bipolar Disorder and CAM therapy and CAM medicine search terms. Effect sizes (Cohen's d) were also calculated where data were available. Several positive high-quality studies on nutrients in combination with conventional mood stabilizers and antipsychotic medications in BD depression were identified, while branched-chain amino acids and magnesium were effective (small studies) in attenuating mania in BD. In the treatment of bipolar depression, evidence was mixed regarding omega-3, while isolated studies provide provisional support for a multinutrient formula, n-acetylcysteine, and l-tryptophan. In one study, acupuncture was found to have favorable but nonsignificant effects on mania and depression outcomes. Current evidence supports the integrative treatment of BD using combinations of mood stabilizers and select nutrients. Other CAM or integrative modalities used to treat BD have not been adequately explored to date; however, some early findings are promising. Select CAM and integrative interventions add to established conventional treatment of BD and may be considered when formulating a treatment plan. It is hoped that the safety issues and clinical considerations addressed in this article may encourage the practice

  11. 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).

  12. Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care

    Directory of Open Access Journals (Sweden)

    Ashley Sanello

    2018-03-01

    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 a patient with an acute change in mental status 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 a patient with altered mental status (AMS and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the AMS protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were patient assessment, point-of-care tests, supplemental oxygen, use of standardized scoring, evaluating for causes of AMS, blood glucose evaluation, toxicological treatment, and pediatric evaluation and management. Results: Protocols across 33 EMS agencies in California varied widely. All protocols call for a blood glucose check, 21 (64% suggest treating adults at <60mg/dL, and half allow for the use of dextrose 10%. All the protocols recommend naloxone for signs of opioid overdose, but only 13 (39% give specific parameters. Half the agencies (52% recommend considering other toxicological causes of AMS, often by using the mnemonic AEIOU TIPS. Eight (24% recommend a 12-lead electrocardiogram; others simply suggest cardiac monitoring. Fourteen (42% advise supplemental oxygen as needed; only seven (21% give specific parameters. In terms of considering various etiologies of AMS, 25 (76% give instructions to consider trauma, 20 (61% to consider stroke, and 18 (55% to consider seizure. Twenty-three (70% of the agencies have separate pediatric AMS protocols; others include pediatric considerations within the adult protocol. Conclusion: Protocols

  13. Advanced electrical current measurements of microdischarges: evidence of sub-critical pulses and ion currents in barrier discharge in air

    Science.gov (United States)

    Synek, Petr; Zemánek, Miroslav; Kudrle, Vít; Hoder, Tomáš

    2018-04-01

    Electrical current measurements in corona or barrier microdischarges are a challenge as they require both high temporal resolution and a large dynamic range of the current probe used. In this article, we apply a simple self-assembled current probe and compare it to commercial ones. An analysis in the time and frequency domain is carried out. Moreover, an improved methodology is presented, enabling both temporal resolution in sub-nanosecond times and current sensitivity in the order of tens of micro-amperes. Combining this methodology with a high-tech oscilloscope and self-developed software, a unique statistical analysis of currents in volume barrier discharge driven in atmospheric-pressure air is made for over 80 consecutive periods of a 15 kHz applied voltage. We reveal the presence of repetitive sub-critical current pulses and conclude that these can be identified with the discharging of surface charge microdomains. Moreover, extremely low, long-lasting microsecond currents were detected which are caused by ion flow, and are analysed in detail. The statistical behaviour presented gives deeper insight into the discharge physics of these usually undetectable current signals.

  14. Categorization of psychoactive substances into "hard drugs" and "soft drugs": a critical review of terminology used in current scientific literature.

    Science.gov (United States)

    Janik, Peter; Kosticova, Michaela; Pecenak, Jan; Turcek, Michal

    2017-11-01

    Precise terminology and definitions are important components of scientific language. Although the terms "hard drugs" and "soft drugs" are used widely by professionals, neither the International Classification of Diseases nor the Diagnostic and Statistical Manual classify psychoactive substances into the categories "hard" and "soft." To analyze the occurrence of the terms "hard drugs" and "soft drugs" in recent scientific literature and to establish the degree of consensus in labeling psychoactive substances as "hard" or "soft." A critical review of scientific papers listed in PubMed and Scopus between 2011 and 2015. Three hundred thirty-four articles were initially identified as potentially relevant for review, 132 of which were included in the final analysis. One hundred twenty-four articles used the term "hard drugs" and 84.7% provided examples of substances considered "hard." Forty-four articles used the term "soft drugs" and 90.9% provided examples of substances considered "soft." Citations of relevant articles supporting categorization as "hard" or "soft" were not given in 90% of the articles. The authors often provided no or only very sparse information on their reasons for considering specific drugs as "hard" or "soft." Although it initially appeared that there is substantial agreement as to which psychoactive substances should be regarded as "hard" and "soft," closer inspection shows that the dividing line is blurred without clear criteria for categorization. At this time, it remains uncertain whether these terms should persist in the scientific literature. We therefore recommend these terms should be avoided or, if used, be clearly and precisely defined.

  15. 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.

  16. Newborn screening for proximal urea cycle disorders: Current evidence supporting recommendations for newborn screening.

    Science.gov (United States)

    Merritt, J Lawrence; Brody, Linnea L; Pino, Gisele; Rinaldo, Piero

    2018-04-20

    Current newborn screening (NBS) for urea cycle disorders (UCD) is incomplete as only distal UCDs are included in most NBS programs by measuring elevated amino acid concentrations. NBS for the proximal UCDs involves the detection in NBS spots of low citrulline values, a finding which is often overlooked because it is considered to be inadequate. We retrospectively analyzed NBS blood spots from known UCD patients comparing the utility of the Region 4 Stork (R4S) interpretive tools to conventional cutoff based interpretation. This study shows the utility of R4S tools in detecting all UCDs, and provides evidence to support the nomination to add proximal UCDs to the recommended uniform screening panel. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Review of Virtual Reality Treatment in Psychiatry: Evidence Versus Current Diffusion and Use.

    Science.gov (United States)

    Mishkind, Matthew C; Norr, Aaron M; Katz, Andrea C; Reger, Greg M

    2017-09-18

    This review provides an overview of the current evidence base for and clinical applications of the use of virtual reality (VR) in psychiatric practice, in context of recent technological developments. The use of VR in psychiatric practice shows promise with much of the research demonstrating clinical effectiveness for conditions including post-traumatic stress disorder, anxiety and phobias, chronic pain, rehabilitation, and addictions. However, more research is needed before the use of VR is considered a clinical standard of practice in some areas. The recent release of first generation consumer VR products signals a change in the viability of further developing VR systems and applications. As applications increase so will the need for good quality research to best understand what makes VR effective, and when VR is not appropriate for clinical services. As the field progresses, it is hopeful that the flexibility afforded by this technology will yield superior outcomes and a better understanding of the underlying mechanisms impacting those outcomes.

  18. Tranexamic acid for the management of uterine fibroid tumors: A systematic review of the current evidence

    Science.gov (United States)

    Peitsidis, Panagiotis; Koukoulomati, Anna

    2014-01-01

    AIM: To conduct a detailed systematic review of the current evidence on the administration and efficacy of tranexamic acid in patients with menorrhagia due to uterine fibroids. METHODS: We conducted an electronic search on the following databases PubMed and Medline (1950-2013); (1980-2013); Cochrane library (1993-2013). RESULTS: A total of 36 articles were retrieved after the initial electronic search. Careful assessment of the retrieved studies led to the final selection of 5 articles for inclusion in the review. CONCLUSION: Tranexamic acid may reduce blood loss perioperatively in myomectomies. It may reduce the menorrhagia in patients with fibroids, however a stratification of fibroids by size and location is required to define the responses. It is safe in general, with mild adverse effects observed in some cases. More studies with a double-blind randomized design and larger numbers of participants are necessary to reach more precise and safe conclusions. PMID:25516866

  19. Treatment of intracerebral haemorrhage with tranexamic acid – A review of current evidence and ongoing trials

    DEFF Research Database (Denmark)

    Law, Zhe Kang; Meretoja, Atte; Engelter, Stefan T

    2017-01-01

    Purpose Haematoma expansion is a devastating complication of intracerebral haemorrhage (ICH) with no established treatment. Tranexamic acid had been an effective haemostatic agent in reducing post-operative and traumatic bleeding. We review current evidence examining the efficacy of tranexamic acid...... in improving clinical outcome after ICH. Method We searched MEDLINE, EMBASE, CENTRAL and clinical trial registers for studies using search strategies incorporating the terms ‘intracerebral haemorrhage’, ‘tranexamic acid’ and ‘antifibrinolytic’. Authors of ongoing clinical trials were contacted for further...... details. Findings We screened 268 publications and retrieved 17 articles after screening. Unpublished information from three ongoing clinical trials was obtained. We found five completed studies. Of these, two randomised controlled trials (RCTs) comparing intravenous tranexamic acid to placebo (n = 54...

  20. [Effort-reward imbalance at work and depression: current research evidence].

    Science.gov (United States)

    Siegrist, J

    2013-01-01

    In view of highly prevalent stressful conditions in modern working life, in particular increasing work pressure and job insecurity, it is of interest to know whether specific constellations of an adverse psychosocial work environment increase the risk of depressive disorder among employed people. This contribution gives a short overview of current research evidence based on an internationally established work stress model of effort-reward imbalance. Taken together, results from seven prospective epidemiological investigations demonstrate a two-fold elevated relative risk of incident depressive disorder over a mean observation period of 2.7 years among exposed versus non-exposed employees. Additional findings from experimental and quasi-experimental studies point to robust associations of effort-reward imbalance at work with proinflammatory cytokines and markers of reduced immune competence. These latter markers may indicate potential psychobiological pathways. In conclusion, incorporating this new knowledge into medical treatment and preventive efforts seems well justified.

  1. 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

  2. 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.

  3. The role of massage in sports performance and rehabilitation: current evidence and future direction.

    Science.gov (United States)

    Brummitt, Jason

    2008-02-01

    Massage is a popular treatment choice of athletes, coaches, and sports physical therapists. Despite its purported benefits and frequent use, evidence demonstrating its efficacy is scarce. To identify current literature relating to sports massage and its role in effecting an athlete's psychological readiness, in enhancing sports performance, in recovery from exercise and competition, and in the treatment of sports related musculoskeletal injuries. Electronic databases were used to identify papers relevant to this review. The following keywords were searched: massage, sports injuries, athletic injuries, physical therapy, rehabilitation, delayed onset muscle soreness, sports psychology, sports performance, sports massage, sports recovery, soft tissue mobilization, deep transverse friction massage, pre-event, and post exercise. RESEARCH STUDIES PERTAINING TO THE FOLLOWING GENERAL CATEGORIES WERE IDENTIFIED AND REVIEWED: pre-event (physiological and psychological variables), sports performance, recovery, and rehabilitation. Despite the fact clinical research has been performed, a poor appreciation exists for the appropriate clinical use of sports massage. Additional studies examining the physiological and psychological effects of sports massage are necessary in order to assist the sports physical therapist in developing and implementing clinically significant evidence based programs or treatments.

  4. Current Scientific Approaches to Decision Making in Complex Systems: 3. Volume 1. Conference Proceedings. Third Conference, Richmond, Surrey, England, 6-8 August 1978

    Science.gov (United States)

    1980-01-01

    good decisions. What usually prevents him from implementing those rational decisions is either an overstrong conflict, leading to behavioural paralysis...of Prosocial Behaviour in the group situation. It assumes a typology of people, and attempts to show sequentially how people are influenced in their...COVERED CURRENT SCIENTIFIC APPROACHES TO DECISION MAKING IN COMPLEX SYSTEMS: III. Volume I, Conference Proceedings 6. PERFORMING ORG. REPORT NUMBER 7

  5. Scientific basis and engineering design to accommodate disruption and halo current loads for the DIII-D tokamak

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, P.M.; Bozek, A.S.; Hollerbach, M.A.; Humphreys, D.A.; Luxon, J.L.; Reis, E.E.; Schaffer, M.J.

    1996-10-01

    Plasma disruptions and halo current events apply sudden impulsive forces to the interior structures and vacuum vessel walls of tokamaks. These forces arise when induced toroidal currents and attached poloidal halo currents in plasma facing components interact with the poloidal and toroidal magnetic fields respectively. Increasing understanding of plasma disruptions and halo current events has been developed from experiments on DIII-D and other machines. Although the understanding has improved, these events must be planned for in system design because there is no assurance that these events can be eliminated in the operation of tokamaks. Increased understanding has allowed an improved focus of engineering designs.

  6. Scientific basis and engineering design to accommodate disruption and halo current loads for the DIII-D tokamak

    International Nuclear Information System (INIS)

    Anderson, P.M.; Bozek, A.S.; Hollerbach, M.A.; Humphreys, D.A.; Luxon, J.L.; Reis, E.E.; Schaffer, M.J.

    1996-10-01

    Plasma disruptions and halo current events apply sudden impulsive forces to the interior structures and vacuum vessel walls of tokamaks. These forces arise when induced toroidal currents and attached poloidal halo currents in plasma facing components interact with the poloidal and toroidal magnetic fields respectively. Increasing understanding of plasma disruptions and halo current events has been developed from experiments on DIII-D and other machines. Although the understanding has improved, these events must be planned for in system design because there is no assurance that these events can be eliminated in the operation of tokamaks. Increased understanding has allowed an improved focus of engineering designs

  7. Evidence-based practice in physical therapy in Austria: current state and factors associated with EBP engagement.

    Science.gov (United States)

    Diermayr, Gudrun; Schachner, Herbert; Eidenberger, Margit; Lohkamp, Monika; Salbach, Nancy M

    2015-12-01

    Research examining the use of evidence-based practice (EBP) in physical therapy in many countries has revealed positive attitudes, varying degrees of EBP use and barriers at practitioner, patient and organizational levels. In contrast to these countries, Austria does not have an academic or research tradition in physical therapy. Engagement in EBP in countries such as Austria is unknown. The objectives of the study were to describe the current state of EBP engagement and identify factors associated with EBP engagement among Austrian physical therapists (PTs). A cross-sectional online survey was conducted. Existing questionnaires and the theory of planned behaviour guided questionnaire development. Face and content validity and ease of use of the questionnaire were evaluated in pilot tests. Item-level response frequencies and percentages were determined. Simple and multiple regressions were used to identify factors associated with EBP engagement. The final sample size was 588 (response rate: 17.5%). Ten percent of participants fully agreed that they regularly use guidelines and standardized assessment tools in clinical practice. While 49.9% reported not using electronic databases for literature searching, 41.9% reported reading research articles 2-5 times per month. Most frequently cited barriers to EBP engagement were lack of scientific skills, lack of time and insufficient organizational support. Research awareness, attitude, behavioural control, involvement in research and degree level were final correlates of EBP engagement. Austrian PTs show a low level of engagement in EBP. Initiatives to advance EBP in Austria and other countries with no academic or research tradition should primarily target practitioner-level factors. © 2015 John Wiley & Sons, Ltd.

  8. "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...... or number concentrations can be used as generally applicable risk indicators of health effects in non-industrial buildings and consequently that there is inadequate scientific evidence for establishing limit values or guidelines for particulate mass or number concentrations....

  9. 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

  10. 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.

  11. Extraperitoneal Robotic-Assisted Para-Aortic Lymphadenectomy in Gynecologic Cancer Staging: Current Evidence.

    Science.gov (United States)

    Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Signorelli, Mauro; Chiappa, Valentina; Sabatucci, Ilaria; Scaffa, Cono; Lorusso, Domenica; Raspagliesi, Francesco

    2016-01-01

    We reviewed the current evidence on the safety, effectiveness, and applicability of extraperitoneal robotic-assisted para-aortic lymphadenectomy (ExtRA-PAL) as the staging procedure of gynecologic malignancies. PubMed (MEDLINE), Scopus, Web of Science databases, and ClinicalTrials.gov were searched for original studies reporting outcomes of ExtRA-PAL. Quality of the included studies and their level of recommendation were assessed using the Grading of Recommendations, Assessment, Development, and Evaluation and the American College of Obstetricians and Gynecologists guidelines, respectively. Overall, 62 studies were identified; after a process of evidence acquisition 5 original investigations were available for this review that included 98 patients undergoing ExtRA-PAL. The main surgical indication was staging for cervical cancer (n = 71, 72%). The mean (SD) number of para-aortic node yielded was 15.4 (±4.7) nodes. Blood transfusion and intraoperative complication rates were 2% and 6%, respectively. ExtRA-PAL was completed in 88 patients (90%). Six (6%) and 4 (4%) patients had conversion to other minimally invasive procedures and open surgery, respectively. Success rate was 99% among patients undergoing ExtRA-PAL without concomitant procedures. Overall, mean (SD) length of hospital stay was 2.8 (±0.5) days. Twenty-four patients (24%) developed postoperative events. According to the Clavien-Dindo grading system, grades IIIa and IIIb morbidity rates were 12% and 2%, respectively. No grades IV and V morbidity occurred. ExtRA-PAL is associated with a high success rate and a relative low morbidity rate. However, because of the limited data on this issue, further studies are warranted to assess the long-term effectiveness of this procedure. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  12. 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

  13. 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.

  14. Article Title: Physical activity in adolescents. Is there scientific evidence of how physical exercise affects sleep in the adolescent population?

    Directory of Open Access Journals (Sweden)

    Joaquín Reverter-Masia

    2017-07-01

    Full Text Available Abstract: Insomnia is a very common pediatric condition that causes a serious impact on psychophysical performance. The present paper, based on the scientific literature, aims to analyze some questions about how physical activity affects sleep in the adolescent population. Finally, some general and useful recommendations are established for professionals working in this population group.

  15. Rehabilitation for post-stroke cognitive impairment: an overview of recommendations arising from systematic reviews of current evidence.

    Science.gov (United States)

    Gillespie, David C; Bowen, Audrey; Chung, Charlie S; Cockburn, Janet; Knapp, Peter; Pollock, Alex

    2015-02-01

    Although cognitive impairments are common following stroke, there is considerable uncertainty about the types of interventions that can reduce activity restrictions and improve quality of life. Indeed, a recent project to identify priorities for research into life after stroke determined that the top priority for patients, carers and health professionals was how to improve cognitive impairments. To provide an overview of the evidence for the effectiveness of cognitive rehabilitation for patients with stroke and to determine the main gaps in the current evidence base. Evidence was synthesised for the six Cochrane reviews relating to rehabilitation for post-stroke cognitive impairment and any subsequently published randomized controlled trials to February 2012. Data arising from 44 trials involving over 1500 patients was identified. Though there was support for the effectiveness of cognitive rehabilitation for some cognitive impairments, significant gaps were found in the current evidence base. All of the Cochrane reviews identified major limitations within the evidence they identified. There is currently insufficient research evidence, or evidence of insufficient quality, to support clear recommendations for clinical practice. Recommendations are made as to the research required to strengthen the evidence base, and so facilitate the delivery of effective interventions to individuals with cognitive impairment after stroke. © The Author(s) 2014.

  16. 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.

  17. Laparoscopic Pediatric Inguinal Hernia Repair: Overview of "True Herniotomy" Technique and Review of Current Evidence.

    Science.gov (United States)

    Feehan, Brendan P; Fromm, David S

    2017-05-01

    Inguinal hernia repair is one of the most commonly performed operations in the pediatric population. While the majority of pediatric surgeons routinely use laparoscopy in their practices, a relatively small number prefer a laparoscopic inguinal hernia repair over the traditional open repair. This article provides an overview of the three port laparoscopic technique for inguinal hernia repair, as well as a review of the current evidence with respect to visualization and identification of hernias, recurrence rates, operative times, complication rates, postoperative pain, and cosmesis. The laparoscopic repair presents a viable alternative to open repair and offers a number of benefits over the traditional approach. These include superior visualization of the relevant anatomy, ability to assess and repair a contralateral hernia, lower rates of metachronous hernia, shorter operative times in bilateral hernia, and the potential for lower complication rates and improved cosmesis. This is accomplished without increasing recurrence rates or postoperative pain. Further research comparing the different approaches, including standardization of techniques and large randomized controlled trials, will be needed to definitively determine which is superior. Copyright© South Dakota State Medical Association.

  18. Role of pelvic and para-aortic lymphadenectomy in endometrial cancer: Current evidence

    Science.gov (United States)

    Bogani, Giorgio; Dowdy, Sean C.; Cliby, William A.; Ghezzi, Fabio; Rossetti, Diego; Mariani, Andrea

    2015-01-01

    The aim of the present review is to summarize the current evidence on the role of pelvic and para-aortic lymphadenectomy in endometrial cancer. In 1988, the International Federation of Obstetrics and Gynecology recommended surgical staging for endometrial cancer patients. However, 25 years later, the role of lymph node dissection remains controversial. Although the findings of two large independent randomized trials suggested that pelvic lymphadenectomy provides only adjunctive morbidity with no clear influence on survival outcomes, the studies have many pitfalls that limit interpretation of the results. Theoretically, lymphadenectomy may help identify patients with metastatic dissemination, who may benefit from adjuvant therapy, thus reducing radiation-related morbidity. Also, lymphadenectomy may eradicate metastatic disease. Because lymphatic spread is relatively uncommon, our main effort should be directed at identifying patients who may potentially benefit from lymph node dissection, thus reducing the rate of unnecessary treatment and associated morbidity. This review will discuss the role of lymphadenectomy in endometrial cancer, focusing on patient selection, extension of the surgical procedure, postoperative outcomes, quality of life and costs. The need for new surgical studies and efficacious systemic drugs is recommended. PMID:24472047

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

    Science.gov (United States)

    Papaetis, Georgios S

    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 T2D. Relentless β-cell decline and failure is responsible for the progression from NGT to prediabetes and eventually T2D. The huge burden resulting from the complications of T2D 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 T2D, 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 T2D. PMID:25512784

  20. 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

    2011-10-01

    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. 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. 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. Appendectomy remains the gold standard of treatment for acute appendicitis based on the current evidence.

  1. 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

  2. The territorial approach to EU cohesion policy: Current issues and evidence from Greece

    Directory of Open Access Journals (Sweden)

    Thoidou Elisavet

    2011-01-01

    Full Text Available The importance attributed to the territorial dimension of the European Union cohesion policy steadily influences its successive reforms and adaptations, while in recent years there has been an evolution in the way this particular dimension of cohesion policy is perceived. Important evidence for this is the way in which the Community Strategic Guidelines on cohesion 2007-13 take account of the territorial dimension of cohesion policy. This paper discusses the territorial approach to cohesion policy in relation to both policy and practice. Specifically, it examines the territorial dimension of regional development planning in Greece as it has emerged in the relevant official documents, namely the successive three Community Support Frameworks since 1989 and the National Strategic Reference Framework for the current 2007-13 period. The territorial dimension of the organization of the planning system is also considered in an effort to understand limitations and prospects, in light of the importance of the territorial approach to cohesion policy post-2013.

  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. Role of oral zinc supplementation for reduction of neonatal hyperbilirubinemia: a systematic review of current evidence.

    Science.gov (United States)

    Sharma, Deepak; Farahbakhsh, Nazanin; Sharma, Pradeep; Shastri, Sweta

    2017-08-01

    Neonatal hyperbilirubinemia is frequently seen condition in the NICU. Oral zinc has been tried for the prevention of hyperbilirubinemia. To evaluate the role of oral zinc supplementation for reduction of neonatal hyperbilirubinemia in term and preterm infants. The literature search was done for various randomized control trial (RCT) by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Scopus, Index Copernicus, African Index Medicus (AIM), Thomson Reuters (ESCI), Chemical Abstracts Service (CAS) and other data base. This review included six RCT that fulfilled inclusion criteria. One study evaluated the role of zinc in very low birth weight (VLBW) infants and remaining enrolled neonates  ≥35 weeks of gestation. The dose of zinc varied from 5 to 20 mg/day and duration from 5-7 days. All the studies used zinc sulfate, only one study used zinc gluconate. The total neonates enrolled in these different RCT are 749. Role of zinc in the prevention of neonatal hyperbilirubinemia is not supported by the current evidence. Only one study was able to show reduction in the mean TSB level and requirement of phototherapy with zinc, and the remaining studies did not report any positive effect. None of the studies showed any effect on the duration of phototherapy, incidence of phototherapy, age of starting of phototherapy and any serious adverse effect.

  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

    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

  6. Professional Development for Sessional Staff in Higher Education: A Review of Current Evidence

    Science.gov (United States)

    Hitch, Danielle; Mahoney, Paige; Macfarlane, Susie

    2018-01-01

    The aim of this study was to provide an integrated review of evidence published in the past decade around professional development for sessional staff in higher education. Using the Integrating Theory, Evidence and Action method, the review analysed recent evidence using the three principles of the Benchmarking Leadership and Advancement of…

  7. 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

  8. Prehospital Care for the Adult and Pediatric Seizure Patient: Current Evidence Based Recommendations

    Directory of Open Access Journals (Sweden)

    Eric C. Silverman

    2017-04-01

    Full Text Available 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

  9. Belford proactive flood solutions: scientific evidence to influence local and national policy by multi-purpose runoff management

    Science.gov (United States)

    Wilkinson, M.; Quinn, P. F.; Jonczyk, J.

    2010-12-01

    overall travel time of the flood peak in the catchment by 33%. The current maximum flood storage capacity of all the features stands at around 15,000 m3. The evidence also suggests that a dam like in-stream mitigation measure can significantly reduce sediment load. Other benefits of some mitigation features include large increase in the population of water voles over the past two years. The scheme also acts as a demonstration site for interested stakeholders where they can learn about this approach to flood risk management and see the multipurpose benefits. As the project has progressed and lessons have been learnt, it has been possible to develop a runoff management toolkit for implementing these mitigation measures in other catchments of similar size. Already, the local Environment Agency has utilised the tools and recently applied similar mitigation measures to other catchments. On-going modelling exercises in the project are using the data to explore the up-scaling of the features to larger catchments.

  10. Conceptual representations in mind and brain: theoretical developments, current evidence and future directions.

    Science.gov (United States)

    Kiefer, Markus; Pulvermüller, Friedemann

    2012-07-01

    Conceptual representations in long-term memory crucially contribute to perception and action, language and thought. However, the precise nature of these conceptual memory traces is discussed controversially. In particular, the grounding of concepts in the sensory and motor brain systems is the focus of a current debate. Here, we review theoretical accounts of the structure and neural basis of conceptual memory and evaluate them in light of recent empirical evidence. Models of conceptual processing can be distinguished along four dimensions: (i) amodal versus modality-specific, (ii) localist versus distributed, (iii) innate versus experience-dependent, and (iv) stable versus flexible. A systematic review of behavioral and neuroimaging studies in healthy participants along with brain-damaged patients will then be used to evaluate the competing theoretical approaches to conceptual representations. These findings indicate that concepts are flexible, distributed representations comprised of modality-specific conceptual features. Conceptual features are stored in distinct sensory and motor brain areas depending on specific sensory and motor experiences during concept acquisition. Three important controversial issues are highlighted, which require further clarification in future research: the existence of an amodal conceptual representation in the anterior temporal lobe, the causal role of sensory and motor activation for conceptual processing and the grounding of abstract concepts in perception and action. We argue that an embodiment view of conceptual representations realized as distributed sensory and motor cell assemblies that are complemented by supramodal integration brain circuits may serve as a theoretical framework to guide future research on concrete and abstract concepts. Copyright © 2011 Elsevier Srl. All rights reserved.

  11. Promoting Undergraduate Surgical Education: Current Evidence and Students' Views on ESMSC International Wet Lab Course.

    Science.gov (United States)

    Sideris, Michail; Papalois, Apostolos; Theodoraki, Korina; Dimitropoulos, Ioannis; Johnson, Elizabeth O; Georgopoulou, Efstratia-Maria; Staikoglou, Nikolaos; Paparoidamis, Georgios; Pantelidis, Panteleimon; Tsagkaraki, Ismini; Karamaroudis, Stefanos; Potoupnis, Michael E; Tsiridis, Eleftherios; Dedeilias, Panagiotis; Papagrigoriadis, Savvas; Papalois, Vassilios; Zografos, Georgios; Triantafyllou, Aggeliki; Tsoulfas, Georgios

    2017-04-01

    Undergraduate Surgical Education is becoming an essential element in the training of the future generation of safe and efficient surgeons. Essential Skills in the Management of Surgical Cases (ESMSC), is an international, joint applied surgical science and simulation-based learning wet lab course. We performed a review of the existing literature on the topic of undergraduate surgical education. Following that, we analyzed the feedback questionnaire received 480 from 2 recent series of ESMSC courses (May 2015, n = 49 and November 2015, n = 40), in order to evaluate European Union students' (UK, Germany, Greece) views on the ESMSC course, as well as on the undergraduate surgical education. Results Using a 10 point graded scale, the overall ESMSC concept was positively evaluated, with a mean score of 9.41 ± 0.72 (range: 8-10) and 8.94 ± 1.1 (range: 7-10). The majority of delegates from both series [9.86 ± 0.43 (range: 8-10) and 9.58 ± 0.91 (range: 6-10), respectively] believed that ESMSC should be incorporated in the undergraduate surgical curriculum. Comparison of responses from the UK to the Greek Medical Student, as well as the findings from the third and fourth year versus the fifth and sixth year Medical Students, revealed no statistically significant differences pertaining to any of the questions (p > 0.05). Current evidence in the literature supports the enhancement of surgical education through the systematic use of various modalities that provide Simulation-Based Training (SBT) hands-on experience, starting from the early undergraduate level. The findings of the present study are in agreement with these previous reports.

  12. Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    Hayes, Sharonne N; Kim, Esther S H; Saw, Jacqueline; Adlam, David; Arslanian-Engoren, Cynthia; Economy, Katherine E; Ganesh, Santhi K; Gulati, Rajiv; Lindsay, Mark E; Mieres, Jennifer H; Naderi, Sahar; Shah, Svati; Thaler, David E; Tweet, Marysia S; Wood, Malissa J

    2018-05-08

    Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with female sex, pregnancy, and physical and emotional stress triggers; and concurrent systemic arteriopathies, particularly fibromuscular dysplasia, highlight the differences in clinical characteristics of SCAD compared with atherosclerotic disease. Recent insights into the causes of, clinical course of, treatment options for, outcomes of, and associated conditions of SCAD and the many persistent knowledge gaps are presented. © 2018 American Heart Association, Inc.

  13. 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.…

  14. 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...... 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-industrial...

  15. Does Joint Fact-finding work for Water-energy-food Nexus Issues? A Role of Scientific Evidence in Policy Process

    Science.gov (United States)

    Baba, K.

    2014-12-01

    A quite famous phrase in risk management "How safe is enough safe?" implies there exists a framing gap among experts, the general public and stakeholders. Scientific evidence that experts provide usually contains uncertainty, while the public tends to have the other type of qualitative local knowledge. As there is no zero-risk society, we have to build consensus on acceptable level of risk and trade-offs of risks based on expert knowledge and local knowledge. Therefore having a dialogue among them in the early stage of the policy process such as problem definition and agenda setting is essential to cultivate trust and to integrate their knowledge. To this end, we especially pay attention to Joint Fact-finding (JFF). The tentative definition of JFF is that a promising strategy for experts, decision makers, and key public rights-holders and stakeholders from opposing sides of an issue to work together to resolve or narrow factual disputes over public policy issues. JFF process usually begins with identifying stakeholders and holding interviews with them to determine their interests. We call this step stakeholder analysis. Then we define the scope of the study including the required scientific evidence and the preliminary list of experts. After that, stakeholders jointly select experts to participate in the study, then they work together on what they would like to clear about scientific evidence. They finally get the common understanding and findings through these collaboration. We applied the stakeholder analysis to the issue of groundwater in Obama City and the issues of hot spring water and geothermal power in Beppu City in Japan. We drew conclusions from these case studies to some extent but at the same time we found that the analysis method has a limitation in applying it to multiple nexus issues because the method based on stakeholders' cognition. For example, in Obama case, we identified a lack of cooperation among stakeholders that especially agricultural

  16. 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...

  17. 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.

  18. Exploring high school students' use of theory and evidence in an everyday context: the role of scientific thinking in environmental science decision-making

    Science.gov (United States)

    Yang, Fang-Ying

    2004-11-01

    This study examined 10th-grade students' use of theory and evidence in evaluating a socio-scientific issue: the use of underground water, after students had received a Science, Technology and Society-oriented instruction. Forty-five male and 45 female students from two intact, single-sex, classes participated in this study. A flow-map method was used to assess the participants' conceptual knowledge. The reasoning mode was assessed using a questionnaire with open-ended questions. Results showed that, although some weak to moderate associations were found between conceptual organization in memory and reasoning modes, the students' ability to incorporate theory and evidence was in general inadequate. It was also found that students' reasoning modes were consistent with their epistemological perspectives. Moreover, male and female students appear to have different reasoning approaches.

  19. 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.

  20. Does oxygen limit thermal tolerance in arthropods? A critical review of current evidence.

    Science.gov (United States)

    Verberk, Wilco C E P; Overgaard, Johannes; Ern, Rasmus; Bayley, Mark; Wang, Tobias; Boardman, Leigh; Terblanche, John S

    2016-02-01

    Over the last decade, numerous studies have investigated the role of oxygen in setting thermal tolerance in aquatic animals, and there has been particular focus on arthropods. Arthropods comprise one of the most species-rich taxonomic groups on Earth, and display great diversity in the modes of ventilation, circulation, blood oxygen transport, with representatives living both in water (mainly crustaceans) and on land (mainly insects). The oxygen and capacity limitation of thermal tolerance (OCLTT) hypothesis proposes that the temperature dependent performance curve of animals is shaped by the capacity for oxygen delivery in relation to oxygen demand. If correct, oxygen limitation could provide a mechanistic framework to understand and predict both current and future impacts of rapidly changing climate. In arthropods, most studies testing the OCLTT hypothesis have considered tolerance to thermal extremes. These studies likely operate from the philosophical viewpoint that if the model can predict these critical thermal limits, then it is more likely to also explain loss of performance at less extreme, non-lethal temperatures, for which much less data is available. Nevertheless, the extent to which lethal temperatures are influenced by limitations in oxygen supply remains unresolved. Here we critically evaluate the support and universal applicability for oxygen limitation being involved in lethal temperatures in crustaceans and insects. The relatively few studies investigating the OCLTT hypothesis at low temperature do not support a universal role for oxygen in setting the lower thermal limits in arthropods. With respect to upper thermal limits, the evidence supporting OCLTT is stronger for species relying on underwater gas exchange, while the support for OCLTT in air-breathers is weak. Overall, strongest support was found for increased anaerobic metabolism close to thermal maxima. In contrast, there was only mixed support for the prediction that aerobic scope

  1. Current evidence of percutaneous nucleoplasty for the cervical herniated disk: a systematic review.

    Science.gov (United States)

    Wullems, Jorgen A; Halim, Willy; van der Weegen, Walter

    2014-07-01

    Although percutaneous cervical nucleoplasty (PCN) has been shown to be both safe and effective, its application is still debated. PCN applied in disk herniation has not been systematically reviewed before, resulting in a limited insight into its effectiveness and safety, and the quality of available evidence. Therefore, we systematically reviewed the evidence on the efficacy and safety of PCN in patients with a (contained) herniated disk. MEDLINE, EMBASE, and the Cochrane Library (Central Register of Controlled Trials) were searched for randomized controlled trials (RCTs) and nonrandomized studies using the following keywords: "Nucleoplasty," "Cervical," "Hernia," "Herniation," "Prolapse," "Protrusion," "Intervertebral disk," and "Percutaneous disk decompression." First, all articles were appraised for methodological quality, and then, RCTs were graded for the level of evidence according a best-evidence synthesis, because a meta-analysis was not possible. Finally, the RCTs' applicability and clinical relevance also was assessed. Of 75 identified abstracts, 10 full-text articles were included (3 RCTs and 7 nonrandomized studies). These studies represented a total of 1021 patients: 823 patients (≥ 892 disks) were treated by PCN. All studies showed low methodological quality, except for two. The level of evidence of the RCTs was graded as moderate, with low to moderate applicability and clinical relevance. All included studies showed PCN to be an effective and safe procedure in the treatment of (contained) herniated disks at short-, mid-, and long-term follow-up. However, the level of evidence is moderate and shows only low to moderate applicability and clinical relevance. © 2013 World Institute of Pain.

  2. Respiratory medicines for children: current evidence, unlicensed use and research priorities

    DEFF Research Database (Denmark)

    Smyth, A R; Barbato, A; Beydon, N

    2010-01-01

    deficiency. We hope that this summary of the evidence for respiratory medicines in children, highlighting gaps and research priorities, will be useful for the pharmaceutical industry, the paediatric committee of the European Medicines Agency, academic investigators and the lay public.......This European Respiratory Society task force has reviewed the evidence for paediatric medicines in respiratory disease occurring in adults and children. We describe off-licence use, research priorities and ongoing studies. Off-licence and off-label prescribing in children is widespread...

  3. 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.

  4. A Novel Wide-Area Backup Protection Based on Fault Component Current Distribution and Improved Evidence Theory

    Science.gov (United States)

    Zhang, Zhe; Kong, Xiangping; Yin, Xianggen; Yang, Zengli; Wang, Lijun

    2014-01-01

    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. PMID:25050399

  5. Evidence for neutral neutrino current coupling to right-handed quarks

    International Nuclear Information System (INIS)

    Allaby, J.V.; Amaldi, U.; Barbiellini, G.; Baubillier, M.; Bergsma, F.; Capone, A.; Flegel, W.; Lanceri, L.; Metcalf, M.; Nieuwenhuis, C.; Pain, R.; Panman, J.; Winter, K.; Abt, I.; Blobel, V.; Buengener, A.; Buesser, F.W.; Gall, P.D.; Hebbeker, T.; Niebergall, F.; Staehelin, P.; Borgia, B.; Diemoz, M.; Dionisi, C.; Dore, U.; Ferroni, F.; Longo, E.; Loverre, P.F.; Luminari, L.; Monacelli, P.; Morganti, S.; De Notaristefani, F.; Santacesaria, R.; Santoni, C.; Rome-1 Univ.

    1989-01-01

    Differential cross sections dσ/dy have been measured in semileptonic neutral- and charged-current reactions induced by neutrinos and antineutrinos. The comparison of the neutral- and the charged-current differential cross sections allows the direct determination of the chiral coupling of the neutral (νanti ν) current to left- and right-handed quarks. The result, with a value of g R 2 =0.042±0.010, is the first direct determination, with a significance of more than four standard deviations, of a non-zero value of g R . (orig.)

  6. 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.

  7. 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...

  8. 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…

  9. Bayesian evidences for dark energy models in light of current observational data

    Science.gov (United States)

    Lonappan, Anto. I.; Kumar, Sumit; Ruchika; Dinda, Bikash R.; Sen, Anjan A.

    2018-02-01

    We do a comprehensive study of the Bayesian evidences for a large number of dark energy models using a combination of latest cosmological data from SNIa, CMB, BAO, strong lensing time delay, growth measurements, measurements of Hubble parameter at different redshifts and measurements of angular diameter distance by Megamaser Cosmology Project. We consider a variety of scalar field models with different potentials as well as different parametrizations for the dark energy equation of state. Among 21 models that we consider in our study, we do not find strong evidences in favor of any evolving dark energy model compared to Λ CDM . For the evolving dark energy models, we show that purely nonphantom models have much better evidences compared to those models that allow both phantom and nonphantom behaviors. Canonical scalar field with exponential and tachyon field with square potential have highest evidences among all the models considered in this work. We also show that a combination of low redshift measurements decisively favors an accelerating Λ CDM model compared to a nonaccelerating power law model.

  10. Evidence-Based Practices in Special Education: Current Assumptions and Future Considerations

    Science.gov (United States)

    Russo-Campisi, Jacqueline

    2017-01-01

    Background: The research on evidence-based practices (EBP) in special education has shifted over the last decade from identifying efficacious interventions to exploring issues that impede implementation in the classroom. Common barriers to implementation include absence of training and resources, limited collaboration between researchers and…

  11. 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.

    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

  12. Threatening communication: diffusing the scientific evidence on fear appeal effectiveness among intervention developers and other groups of key actors

    OpenAIRE

    Kok, Gerjo; Verboon, Peter; Ruiter, Robert; Peters, Gjalt

    2017-01-01

    BACKGROUND: Threat-based (fear-appeal) interventions are often ineffective yet popular. The current paper reports the evaluation of an intervention that was designed to discourage using threatening communication and that targeted those responsible for this popularity (intervention developers, campaign leaders, policy makers, politicians, scientists and advertising professionals). METHODS: Of the 153 participants who started, 102 completed both the first phase and the six-week follow-up measur...

  13. Traditional scientific data vs. uncoordinated citizen science effort: A review of the current status and comparison of data on avifauna in Southern Brazil.

    Science.gov (United States)

    Klemann-Junior, Louri; Villegas Vallejos, Marcelo Alejandro; Scherer-Neto, Pedro; Vitule, Jean Ricardo Simões

    2017-01-01

    Data generated by citizen science is particularly valuable in ecological research. If used discerningly with data from traditional scientific references, citizen science can directly contribute to biogeography knowledge and conservation policies by increasing the number of species records in large geographic areas. Considering the current level of knowledge on south Brazilian avifauna, the large volume of data produced by uncoordinated citizen science effort (CS), and the growing need for information on changes in abundance and species composition, we have compiled an updated, general list of bird species occurrence within the state of Paraná. We have listed extinct, invasive and recently-colonizing species as well as indicator species of the state's vegetation types. We further assess the degree of knowledge of different regions within the state based on data from traditional scientific references, and the effect of including CS data in the same analysis. We have compiled data on 766 bird species, based on 70,346 individual records from traditional scientific references, and 79,468 from CS. Extinct and invasive species were identified by comparing their occurrence and abundance over a series of three time periods. Indicator species analysis pointed to the existence of three areas with bird communities typically found within the state: the Semideciduous Tropical Forest, the Tropical Rainforest and the junction of Grassland and Araucaria Moist Forest. We used rarefaction to measure sampling sufficiency, and found that rarefaction curves reached stabilization for all vegetation types except in Savanna. We observed differences in the level of knowledge of bird biodiversity among the microregions of the state, but including CS data, these differences were mitigated. The same effect was observed in other exploratory analyzes conducted here, emphasizing the fundamental importance of including CS data in macroecological studies. Production of easily accessible data and

  14. Evidence-based medicine is affordable: the cost-effectiveness of current compared with optimal treatment in rheumatoid and osteoarthritis.

    Science.gov (United States)

    Andrews, Gavin; Simonella, Leonardo; Lapsley, Helen; Sanderson, Kristy; March, Lyn

    2006-04-01

    To determine the cost-effectiveness of averting the burden of disease. We used secondary population data and metaanalyses of various government-funded services and interventions to investigate the costs and benefits of various levels of treatment for rheumatoid arthritis (RA) and osteoarthritis (OA) in adults using a burden of disease framework. Population burden was calculated for both diseases in the absence of any treatment as years lived with disability (YLD), ignoring the years of life lost. We then estimated the proportion of burden averted with current interventions, the proportion that could be averted with optimally implemented current evidence-based guidelines, and the direct treatment cost-effectiveness ratio in dollars per YLD averted for both treatment levels. The majority of people with arthritis sought medical treatment. Current treatment for RA averted 26% of the burden, with a cost-effectiveness ratio of dollar 19,000 per YLD averted. Optimal, evidence-based treatment would avert 48% of the burden, with a cost-effectiveness ratio of dollar 12,000 per YLD averted. Current treatment of OA in Australia averted 27% of the burden, with a cost-effectiveness ratio of dollar 25,000 per YLD averted. Optimal, evidence-based treatment would avert 39% of the burden, with an unchanged cost-effectiveness ratio of dollar 25,000 per YLD averted. While the precise dollar costs in each country will differ, the relativities at this level of coverage should remain the same. There is no evidence that closing the gap between evidence and practice would result in a drop in efficiency.

  15. The Role of Forensic Botany in Solving a Case: Scientific Evidence on the Falsification of a Crime Scene.

    Science.gov (United States)

    Aquila, Isabella; Gratteri, Santo; Sacco, Matteo A; Ricci, Pietrantonio

    2018-05-01

    Forensic botany can provide useful information for pathologists, particularly on crime scene investigation. We report the case of a man who arrived at the hospital and died shortly afterward. The body showed widespread electrical lesions. The statements of his brother and wife about the incident aroused a large amount of suspicion in the investigators. A crime scene investigation was carried out, along with a botanical morphological survey on small vegetations found on the corpse. An autopsy was also performed. Botanical analysis showed some samples of Xanthium spinosum, thus leading to the discovery of the falsification of the crime scene although the location of the true crime scene remained a mystery. The botanical analysis, along with circumstantial data and autopsy findings, led to the discovery of the real crime scene and became crucial as part of the legal evidence regarding the falsity of the statements made to investigators. © 2017 American Academy of Forensic Sciences.

  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. Respiratory medicines for children: current evidence, unlicensed use and research priorities

    DEFF Research Database (Denmark)

    Smyth, A R; Barbato, A; Beydon, N

    2010-01-01

    deficiency. We hope that this summary of the evidence for respiratory medicines in children, highlighting gaps and research priorities, will be useful for the pharmaceutical industry, the paediatric committee of the European Medicines Agency, academic investigators and the lay public.......This European Respiratory Society task force has reviewed the evidence for paediatric medicines in respiratory disease occurring in adults and children. We describe off-licence use, research priorities and ongoing studies. Off-licence and off-label prescribing in children is widespread...... and potentially harmful. Research areas in asthma include novel formulations and regimens, and individualised prescribing. In cystic fibrosis, future studies will focus on screened infants and robust outcome measures are needed. Other areas include new enzyme and antibiotic formulations and the basic defect...

  18. Current Evidence regarding Prophylactic Antibiotics in Head and Neck and Maxillofacial Surgery

    Science.gov (United States)

    2014-01-01

    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. PMID:25110703

  19. Using Integrative Medicine in Pain Management: An Evaluation of Current Evidence.

    Science.gov (United States)

    Lin, Yuan-Chi; Wan, Limeng; Jamison, Robert N

    2017-12-01

    Complementary medicine therapies are frequently used to treat pain conditions such as headaches and neck, back, and joint pain. Chronic pain, described as pain lasting longer than 3-6 months, can be a debilitating condition that has a significant socioeconomic impact. Pharmacologic approaches are often used for alleviating chronic pain, but recently there has been a reluctance to prescribe opioids for chronic noncancer pain because of concerns about tolerance, dependence, and addiction. As a result, there has been increased interest in integrative medicine strategies to help manage pain and to reduce reliance on prescription opioids to manage pain. This article offers a brief critical review of integrative medical therapies used to treat chronic pain, including nutritional supplements, yoga, relaxation, tai chi, massage, spinal manipulation, and acupuncture. The goal of this article is to identify those treatments that show evidence of efficacy and to identify gaps in the literature where additional studies and controlled trials are needed. An electronic search of the databases of PubMed, The Cochrane Library, EMBASE, PsycINFO, and Science Citation Index Expanded was conducted. Overall, weak positive evidence was found for yoga, relaxation, tai chi, massage, and manipulation. Strong evidence for acupuncture as a complementary treatment for chronic pain that has been shown to decrease the usage of opioids was found. Few studies were found in which integrative medicine approaches were used to address opioid misuse and abuse among chronic pain patients. Additional controlled trials to address the use of integrative medicine approaches in pain management are needed.

  20. 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

    2018-01-01

    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 © 2018 Elsevier Inc. All rights reserved.

  1. Review: Alterations in placental glycogen deposition in complicated pregnancies: Current preclinical and clinical evidence.

    Science.gov (United States)

    Akison, Lisa K; Nitert, Marloes Dekker; Clifton, Vicki L; Moritz, Karen M; Simmons, David G

    2017-06-01

    Normal placental function is essential for optimal fetal growth. Transport of glucose from mother to fetus is critical for fetal nutrient demands and can be stored in the placenta as glycogen. However, the function of this glycogen deposition remains a matter of debate: It could be a source of fuel for the placenta itself or a storage reservoir for later use by the fetus in times of need. While the significance of placental glycogen remains elusive, mounting evidence indicates that altered glycogen metabolism and/or deposition accompanies many pregnancy complications that adversely affect fetal development. This review will summarize histological, biochemical and molecular evidence that glycogen accumulates in a) placentas from a variety of experimental rodent models of perturbed pregnancy, including maternal alcohol exposure, glucocorticoid exposure, dietary deficiencies and hypoxia and b) placentas from human pregnancies with complications including preeclampsia, gestational diabetes mellitus and intrauterine growth restriction (IUGR). These pregnancies typically result in altered fetal growth, developmental abnormalities and/or disease outcomes in offspring. Collectively, this evidence suggests that changes in placental glycogen deposition is a common feature of pregnancy complications, particularly those associated with altered fetal growth. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  2. The counterfeit anti-malarial is a crime against humanity: a systematic review of the scientific evidence.

    Science.gov (United States)

    Karunamoorthi, Kaliyaperumal

    2014-06-02

    The counterfeiting of anti-malarials represents a form of attack on global public health in which fake and substandard anti-malarials serve as de facto weapons of mass destruction, particularly in resource-constrained endemic settings, where malaria causes nearly 660,000 preventable deaths and threatens millions of lives annually. It has been estimated that fake anti-malarials contribute to nearly 450,000 preventable deaths every year. This crime against humanity is often underestimated or ignored. This study attempts to describe and characterize the direct and indirect effects of counterfeit anti-malarials on public health, clinical care and socio-economic conditions. A search was performed using key databases, WHO documents, and English language search engines. Of 262 potential articles that were identified using a fixed set of criteria, a convenience sample of 105 appropriate articles was selected for this review. Artemisinin-based combination therapy (ACT) is an important tool in the fight against malaria, but a sizable number of patients are unable to afford to this first-line treatment. Consequently, patients tend to procure cheaper anti-malarials, which may be fake or substandard. Forensic palynology reveals that counterfeits originate in Asia. Fragile drug regulations, ineffective law-enforcement agencies and corruption further burden ailing healthcare facilities. Substandard/fake anti-malarials can cause (a) economic sabotage; (b) therapeutic failure; (c) increased risk of the emergence and spread of resistant strains of Plasmodium falciparum and Plasmodium vivax; (d) an undermining of trust/confidence in healthcare stakeholders/systems; and, (e) serious side effects or death. Combating counterfeit anti-malarials is a complex task due to limited resources and poor techniques for the detection and identification of fake anti-malarials. This situation calls for sustainable, global, scientific research and policy change. Further, responsible stakeholders in

  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. Current Account Balance and Export Performances: Evidence Based on New EU Countries

    Directory of Open Access Journals (Sweden)

    Bogdan Željko

    2017-11-01

    Full Text Available In this paper, we investigate whether the differences in the current account balance and export performances for a new EU countries are a result of exchange rate policies. The analysis shows that countries with a flexible exchange rate have better export performances and the current account balance in the pre-crisis period. The obtained results show that movements in the current account balance are mainly driven by domestic variables. In the countries with a flexible exchange rate, real and nominal depreciation affects export positively although the magnitude of these effects is tiny and limited to the crisis period. These results point to a higher significance of non-price competitiveness on export which should be a future research topic.

  5. 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.

  6. Income Inequality and Health Status in the United States: Evidence from the Current Population Survey.

    Science.gov (United States)

    Mellor, Jennifer M.; Milyo, Jeffrey

    2002-01-01

    Current Population Survey data on self-reported health status and income for the general population and those in poverty were analyzed. No consistent association was found between income inequality and individual health status. Previous findings of such an association were attributed to ecological fallacy or failure to control for individual…

  7. Current Guidelines Have Limited Applicability to Patients with Comorbid Conditions: A Systematic Analysis of Evidence-Based Guidelines

    Science.gov (United States)

    Lugtenberg, Marjolein; Burgers, Jako S.; Clancy, Carolyn; Westert, Gert P.; Schneider, Eric C.

    2011-01-01

    Background Guidelines traditionally focus on the diagnosis and treatment of single diseases. As almost half of the patients with a chronic disease have more than one disease, the applicability of guidelines may be limited. The aim of this study was to assess the extent that guidelines address comorbidity and to assess the supporting evidence of recommendations related to comorbidity. Methodology/Principal Findings We conducted a systematic analysis of evidence-based guidelines focusing on four highly prevalent chronic conditions with a high impact on quality of life: chronic obstructive pulmonary disease, depressive disorder, diabetes mellitus type 2, and osteoarthritis. Data were abstracted from each guideline on the extent that comorbidity was addressed (general comments, specific recommendations), the type of comorbidity discussed (concordant, discordant), and the supporting evidence of the comorbidity-related recommendations (level of evidence, translation of evidence). Of the 20 guidelines, 17 (85%) addressed the issue of comorbidity and 14 (70%) provided specific recommendations on comorbidity. In general, the guidelines included few recommendations on patients with comorbidity (mean 3 recommendations per guideline, range 0 to 26). Of the 59 comorbidity-related recommendations provided, 46 (78%) addressed concordant comorbidities, 8 (14%) discordant comorbidities, and for 5 (8%) the type of comorbidity was not specified. The strength of the supporting evidence was moderate for 25% (15/59) and low for 37% (22/59) of the recommendations. In addition, for 73% (43/59) of the recommendations the evidence was not adequately translated into the guidelines. Conclusions/Significance Our study showed that the applicability of current evidence-based guidelines to patients with comorbid conditions is limited. Most guidelines do not provide explicit guidance on treatment of patients with comorbidity, particularly for discordant combinations. Guidelines should be more

  8. 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...

  9. Current evidence on antenatal care provision for women with intellectual disabilities: A systematic review.

    Science.gov (United States)

    Homeyard, Claire; Montgomery, Elsa; Chinn, Deborah; Patelarou, Evridiki

    2016-01-01

    changing attitudes, alongside integration, more independent living and recognition of rights to family life have meant a steady rise in women with intellectual disabilities becoming pregnant. However, existing evidence shows that women with intellectual disabilities are less likely to seek or attend for regular antenatal care. This population experiences poorer maternal wellbeing and worse pregnancy outcomes compared to the general population, including preterm and low-birthweight babies. to identify and review the existing evidence on the provision of antenatal care among women with intellectual disabilities. a systematic search strategy was formulated using key Medical Sub-Headings terms and related text words for pregnancy, antenatal care and intellectual disability. Comprehensive searches dating back to 1980 using pre-determined criteria followed by a hand search of reference lists and citations were undertaken. Data were extracted using a data extraction form and methodological quality assessed using the framework developed by Caldwell et al. (2011). A three stage textual narrative synthesis was used to integrate the findings from the included studies. searches identified 16 papers that met the inclusion criteria. A majority of the papers focused on women's experience of pregnancy and antenatal care with a paucity of papers identified on midwives knowledge and experience. The four broad themes of the analysis and synthesis performed included: In the Family Way ('I've a baby inside. I've got a life inside of me.׳); Knowledge and advocacy ('...everyone was looking at one another and no one was talking to me...'); Midwives educational needs ('...helpful to have guidance...') and Midwives Attitudes ('...women with [intellectual disabilities]...should not be pregnant'). significant gaps in the evidence base were apparent, however evidence was identified which showed that intellectually disabled pregnant women struggle to understand antenatal information

  10. Integrating Radiology and Anatomy Teaching in Medical Education in the UK--The Evidence, Current Trends, and Future Scope.

    Science.gov (United States)

    Heptonstall, N B; Ali, T; Mankad, K

    2016-04-01

    This review article presents the current evidence of the importance of integrating radiology and anatomy in medical education in the UK, a recommendation by a number of key anatomy, education, and radiology organizations. Current evidence highlights that on average only 5% of total teaching time in medical education is dedicated to radiology. Often, radiology teaching does not adequately fulfill students' learning needs and potentially leaves them underprepared for medical practice. Benefits of integrating radiology and anatomy include improved clinical application of anatomy, an increase in student's interest in anatomy, and ultimately improved radiological interpretation. Various modalities exist for the integration of radiology and anatomy, facilitated by the vast portability of radiological images. It appears that combining radiological resources with traditional anatomy teaching methodology in a blended approach is most beneficial. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  11. Retrieving current and wind vectors from ATI SAR data: airborne evidence and inversion strategy

    Science.gov (United States)

    Martin, Adrien; Gommenginger, Christine; Chapron, Bertrand; Marquez, José; Doody, Sam

    2017-04-01

    Conventional and along-track interferometric (ATI) Synthetic Aperture Radar (SAR) sense the motion of the ocean surface by measuring the Doppler shift of reflected signals. Together with the water displacement associated with ocean currents, the SAR measurements are also affected by a Wind-wave induced Artefact Surface Velocity (WASV) caused by the velocity of Bragg scatterers and the orbital velocity of ocean surface gravity waves. The WASV has been modelled theoretically in past studies but has been estimated empirically only once using Envisat ASAR. Here we propose, firstly, to evaluate this WASV from airborne ATI SAR data, secondly, to validate the airborne retrieved surface current after correction of the WASV against HF radar measurements and thirdly to examine the best inversion strategy for a an Ocean Surface Current (OSC) satellite mission to retrieve accurately both the ocean surface current vector (OSCV) and the wind vector in the frame of an OSC satellite mission. The airborne ATI SAR data were acquired in the tidally dominated Irish Sea using a Wavemill-type dual-beam SAR interferometer. A comprehensive collection of airborne Wavemill data acquired in a star pattern over a well-instrumented site made it possible to estimate the magnitude and dependence on azimuth and incidence angle of the WASV. The airborne results compare favourably with those reported for Envisat ASAR, empirical model, which has been used to correct for it. Validation of the current retrieval capabilities of the proof-of-concept has been conducted against HF radar giving a precisions typically better than 0.1 m/s for surface current speed and 7° for direction. Comparisons with POLCOMS (1.8 km) indicate that the model reproduces well the overall temporal evolution but does not capture the high spatial variability of ocean surface currents at the maximum ebb flow. Airborne retrieved currents highlight a short-scale spatial variability up to 100m related to bathymetry channels, which

  12. The Acute Relationships Between Affect, Physical Feeling States, and Physical Activity in Daily Life: A Review of Current Evidence

    OpenAIRE

    Liao, Yue; Shonkoff, Eleanor T.; Dunton, Genevieve F.

    2015-01-01

    Until recently, most studies investigating the acute relationships between affective and physical feeling states and physical activity were conducted in controlled laboratory settings, whose results might not translate well to everyday life. This review was among the first attempts to synthesize current evidence on the acute (e.g., within a few hours) relationships between affective and physical feeling states and physical activity from studies conducted in free-living, naturalistic settings ...

  13. Epicardial fat and atrial fibrillation: current evidence, potential mechanisms, clinical implications, and future directions.

    Science.gov (United States)

    Wong, Christopher X; Ganesan, Anand N; Selvanayagam, Joseph B

    2017-05-01

    Obesity is increasingly recognized as a major modifiable determinant of atrial fibrillation (AF). Although body mass index and other clinical measures are useful indications of general adiposity, much recent interest has focused on epicardial fat, a distinct adipose tissue depot that can be readily assessed using non-invasive imaging techniques. A growing body of data from epidemiological and clinical studies has demonstrated that epicardial fat is consistently associated with the presence, severity, and recurrence of AF across a range of clinical settings. Evidence from basic science and translational studies has also suggested that arrhythmogenic mechanisms may involve adipocyte infiltration, pro-fibrotic, and pro-inflammatory paracrine effects, oxidative stress, and other pathways. Despite these advances, however, significant uncertainty exists and many questions remain unanswered. In this article, we review our present understanding of epicardial fat, including its classification and quantification, existing evidence implicating its role in AF, potential mechanisms, implications for clinicians, and future directions for research. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  14. A Review of Current Evidence of Olmesartan Medoxomil Mimicking Symptoms of Celiac Disease.

    Science.gov (United States)

    Sanford, Michele L; Nagel, Angela K

    2015-04-01

    Objective:To review the evidence of an association between olmesartan medoxomil and symptoms mimicking celiac disease.Data Sources:Literature was searched in PubMed (1965-November 2013) using the key words or MeSH terms olmesartan, enteropathy, celiac disease, sprue, and diarrhea. References from the Food and Drug Administration (FDA) and Dipiro's Pharmacotherapy eighth edition textbook were also reviewed.Data Synthesis:There have been recent implications of olmesartan medoxomil being linked to symptoms mimicking celiac disease. Investigators first identified the association in 22 patients who presented with presumed refractory celiac disease. Upon further evaluation, it was discovered that these symptoms improved when olmesartan was discontinued. In response to this report, additional case studies have been published. DeGaetani et al also further analyzed patients with seronegative villous atrophy from the Celiac Disease Center and found that olmesartan accounted for 22% of previously unclassified sprue cases. Conversely, the authors of the ROADMAP trial, which compared olmesartan to placebo, found no significant differences in the incidence of gastrointestinal adverse effects.Conclusions:There is growing evidence supporting the association between olmesartan and sprue-like symptoms; however, further research is warranted. These symptoms can be life threatening and clinicians should be aware of the potential association.

  15. Comparison of consumer information on the internet to the current evidence base for minimally invasive parathyroidectomy.

    Science.gov (United States)

    McLean, Timothy; Delbridge, Leigh

    2010-06-01

    The Internet is increasingly used as a source of health information by patients. Under these circumstances, the opportunity exists for Internet sites ostensibly providing patient information to act to promote surgical referrals based on exaggerated claims. This study aims to assess quantitatively and qualitatively the Internet-based consumer health information for minimally invasive parathyroidectomy (MIP) techniques. This is a prospective analysis of Internet web sites. Descriptive information about specific published claims on each of the web sites was documented and compared to the published evidence base. Web sites were then rated using a validated composite score (CS) tool and an MIP score tool developed specifically for the study. The search yielded 308 web sites, which, after assessment by the inclusion criteria left 44 unique web sites suitable for analysis. "Exaggerated," "misleading," or "false" claims were present in 27.3% of the web sites analyzed. The false claims category had a high negative item-total correlation with the overall score, and accuracy was found to have a statistically significant (p < 0.05) negative correlation with quality. However, analysis performed for country of origin and the organization responsible for the web site found no significant difference. Web sites offering information in relation to MIP have a surprisingly high rate of claims that are not in accord with the evidence. Such claims may be posted to attract surgical referrals. It is difficult for consumers to differentiate quality consumer health web sites from poor ones as there are no hard and fast rules to differentiate them.

  16. Evidence based guidelines and current practice for physiotherapy management of knee osteoarthritis.

    Science.gov (United States)

    Walsh, Nicola E; Hurley, Michael V

    2009-03-01

    To document physiotherapy provision for patients with knee osteoarthritis (OA) in relation to the United Kingdom (UK) recently published National Institute of health and Clinical Excellence (NICE) guidelines for osteoarthritis. Questionnaire survey of chartered physiotherapists. 300 postal questionnaires were distributed to Physiotherapy Departments requesting information regarding source of referrals, treatment aims, preferred methods of treatment and service delivery. Responses were received from 83 physiotherapists (28 %), predominantly working in the UK National Health Service. Approximately equal numbers of referrals came from primary and secondary care. Aims of physiotherapy management were to; encourage self-management; increase strength and range of movement; reduce pain; and improve function. To achieve these, exercise was utilised by 100% of practitioners, often supplemented with electrotherapeutic modalities (66%), manual therapy (64%) and acupuncture (60%). The majority of patients received individual treatment for a total contact time of 1-2 hours, whilst most group interventions lasted 5-6 hours. Approximately half (54%) of respondents reported using outcome measures to determine treatment efficacy. Although knee OA is usually managed in primary care, the similar number of referrals from primary and secondary care may suggest a deviation from evidence-based management guidelines. The guidelines' recommendations of exercise, patient education and self-management are observed by physiotherapists, but other modalities are often used despite poor or no research evidence supporting their efficacy. Whether any of these interventions are clinically beneficial is speculative as treatment outcomes were frequently under-evaluated.

  17. The fetal programming of food preferences: current clinical and experimental evidence.

    Science.gov (United States)

    Dalle Molle, R; Bischoff, A R; Portella, A K; Silveira, P P

    2015-09-28

    Increased energy consumption is one of the major factors implicated in the epidemic of obesity. There is compelling evidence, both clinical and experimental, that fetal paucity of nutrients may have programming effects on feeding preferences and behaviors that can contribute to the development of diseases. Clinical studies in different age groups show that individuals born small for their gestational age (SGA) have preferences towards highly caloric foods such as carbohydrates and fats. Some studies have also shown altered eating behaviors in SGA children. Despite an apparent discrepancy in different age groups, all studies seem to converge to an increased intake of palatable foods in SGA individuals. Small nutrient imbalances across lifespan increase the risk of noncommunicable diseases in adult life. Homeostatic factors such as altered responses to leptin and insulin and alterations in neuropeptides associated with appetite and satiety are likely involved. Imbalances between homeostatic and hedonic signaling are another proposed mechanism, with the mesocorticolimbic dopaminergic pathway having differential reward and pleasure responses when facing palatable foods. Early exposure to undernutrition also programs hypothalamic-pituitary-adrenal axis, with SGA having higher levels of cortisol in different ages, leading to chronic hyperactivity of this neuroendocrine axis. This review summarizes the clinical and experimental evidence related to fetal programming of feeding preferences by SGA.

  18. An overview of current research on EU ETS: Evidence from its operating mechanism and economic effect

    International Nuclear Information System (INIS)

    Zhang, Yue-Jun; Wei, Yi-Ming

    2010-01-01

    The European Union Emissions Trading Scheme (EU ETS) is supposed to be an important mechanism for addressing climate change. Up to now, the theoretical foundation of EU ETS has been widely acknowledged, but empirical research on its current situation has only been published recently or is forthcoming. Therefore, this paper is aimed to summarize the main arguments of empirical studies on the EU ETS, in terms of two aspects, i.e., the operating mechanism and economic effect of the EU ETS, which are two crucial topics and have been attached much attention. Based on the shortcomings of current research and future requirements of the EU ETS evolution, finally, we also present some further directions of the EU ETS research. Overall, the research overview here may be helpful to recognize the features of the EU ETS and its effect on others. (author)

  19. Discharge current measurements on Venera 13 & 14 - Evidence for charged aerosols in the Venus lower atmosphere?

    Science.gov (United States)

    Lorenz, Ralph D.

    2018-06-01

    Measurements of discharge currents on the Venera 13 and 14 landers during their descent in the lowest 35 km of the Venus atmosphere are interpreted as driven either by an ambient electric field, or by deposition of charge from aerosols. The latter hypothesis is favored (`triboelectric charging' in aeronautical parlance), and would entail an aerosol opacity and charge density somewhat higher than that observed in Saharan dust transported over long distances on Earth.

  20. Using scientific evidence to improve hospital library services: Southern Chapter/Medical Library Association journal usage study.

    Science.gov (United States)

    Dee, C R; Rankin, J A; Burns, C A

    1998-07-01

    Journal usage studies, which are useful for budget management and for evaluating collection performance relative to library use, have generally described a single library or subject discipline. The Southern Chapter/Medical Library Association (SC/MLA) study has examined journal usage at the aggregate data level with the long-term goal of developing hospital library benchmarks for journal use. Thirty-six SC/MLA hospital libraries, categorized for the study by size as small, medium, or large, reported current journal title use centrally for a one-year period following standardized data collection procedures. Institutional and aggregate data were analyzed for the average annual frequency of use, average costs per use and non-use, and average percent of non-used titles. Permutation F-type tests were used to measure difference among the three hospital groups. Averages were reported for each data set analysis. Statistical tests indicated no significant differences between the hospital groups, suggesting that benchmarks can be derived applying to all types of hospital libraries. The unanticipated lack of commonality among heavily used titles pointed to a need for uniquely tailored collections. Although the small sample size precluded definitive results, the study's findings constituted a baseline of data that can be compared against future studies.

  1. Can Mindfulness Training Improve Medication Adherence? Integrative Review of the Current Evidence and Proposed Conceptual Model.

    Science.gov (United States)

    Salmoirago-Blotcher, Elena; Carey, Michael P

    Medication adherence is a complex, multi-determined behavior that is often influenced by system- (e.g., cost), drug- (e.g., regimen complexity), and patient-related (e.g., depression) factors. System-level approaches (e.g., making medications more affordable) are critically important but do not address patient-level factors that can undermine adherence. In this paper, we identify patient-level determinants of non-adherence and discuss whether mindfulness-training approaches that target these determinants can help to improve adherence to medical treatment. We highlight two chronic medical conditions (viz., heart failure and HIV) where poor adherence is a significant concern, and examine the evidence regarding the use of mindfulness interventions to improve medication adherence in these two conditions. We also discuss the theoretical underpinnings of mindfulness training with respect to medication adherence, and conclude by suggesting directions for future research. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Mesenchymal Stem Cells and Cutaneous Wound Healing: Current Evidence and Future Potential

    Directory of Open Access Journals (Sweden)

    M. Isakson

    2015-01-01

    Full Text Available Human skin is a remarkable organ that sustains insult and injury throughout life. The ability of skin to expeditiously repair wounds is paramount to survival. With an aging global population, coupled with a rise in the prevalence of conditions such as diabetes, chronic wounds represent a significant biomedical burden. Mesenchymal stem cells (MSC, a progenitor cell population of the mesoderm lineage, have been shown to be significant mediators in inflammatory environments. Preclinical studies of MSC in various animal wound healing models point towards a putative therapy. This review examines the body of evidence suggesting that MSC accelerate wound healing in both clinical and preclinical studies and also the possible mechanisms controlling its efficacy. The delivery of a cellular therapy to the masses presents many challenges from a safety, ethical, and regulatory point of view. Some of the issues surrounding the introduction of MSC as a medicinal product are also delineated in this review.

  3. Treatment decision-making processes in the systemic treatment of ovarian cancer: review of the scientific evidence.

    Science.gov (United States)

    Luketina, Hrvoje; Fotopoulou, Christina; Luketina, Ruzica-Rosalia; Pilger, Adak; Sehouli, Jalid

    2012-09-01

    The systemic treatment of epithelial ovarian cancer (OC) is one of the cornerstones in the multimodal management of advanced OC in both primary and recurrent stages of this disease. In most situations various treatment options are available but only few data exists about the treatment decision-making process. Therefore, we conducted a review of the current literature regarding the decision-making process concerning the systemic therapy in patients with advanced ovarian cancer. The electronic database MEDLINE (PubMed) was systematically reviewed for studies that evaluate the treatment decision-making processes in patients with advanced OC. The PubMed database was searched in detail for all titles and abstracts of potentially relevant studies published between 1995 and 2011. An initial search identified 15 potentially relevant studies, but only seven met all inclusion criteria. Factors that influence treatment decisions in patients with OC include not only rational arguments and medical reasons, but also individual attitudes, fears, existential questions, various projections resulting from the physician patient relationship and the social environment. The physician's personal experience with OC treatment seems to be an important factor, followed by previous personal experience with medical issues, and the fear of side-effects and future metastases. Family and self-support organisations also seem to play a significant role in the treatment decision-making process. This review underlines the need for more research activities to explore the treatment decision-making process to enable the best individual support for patients in treatment decision-making. It is a challenge for clinicians to determine the individual information needs of women with OC and to involve them during the decision-making process to the extent they wish.

  4. Key factors influencing the incidence of hemolysis: A critical appraisal of current evidence.

    Science.gov (United States)

    McCaughey, Euan James; Vecellio, Elia; Lake, Rebecca; Li, Ling; Burnett, Leslie; Chesher, Douglas; Braye, Stephen; Mackay, Mark; Gay, Stephanie; Badrick, Tony; Westbrook, Johanna; Georgiou, Andrew

    2017-01-01

    Hemolysis is a leading cause of pre-analytical laboratory errors. The identification of contributing factors is an important step towards the development of effective practices to reduce and prevent hemolysis. We performed a review of PUBMED, Embase, Medline and CINAHL to identify articles published between January 2000 and August 2016 that identified factors influencing in vitro hemolysis rates. The 40 studies included in this review provide excellent evidence that hemolysis rates are higher in Emergency Departments (EDs), for non-antecubital draws, for specimens drawn using an intravenous catheter compared to venipuncture and for samples transported by pneumatic tube compared to by hand. There is also good evidence that hemolysis rates are higher when specimens are not collected by professional phlebotomists, larger volume specimen tubes are used, specimen tubes are filled less than halfway and tourniquet time is greater than one minute. The results of this review suggest that hospitals and clinical laboratories should consider deploying phlebotomists in EDs, drawing all blood through a venipuncture, using the antecubital region as the optimum blood collection site and transporting specimens by laboratory assistant/other personnel, or if this in not practical, ensuring that pneumatic transport systems are validated, maintained and monitored. Studies also recommend making hemolysis a hospital-wide issue and ensuring high-quality staff training and adherence to standard operating procedures to reduce hemolysis rates. Awareness of the factors that influence hemolysis rates, and adoption of strategies to mitigate these risk factors, is an important step towards creating quality practices to reduce hemolysis rates and improve the quality of patient care.

  5. Physical activity in the treatment of the adulthood overweight and obesity: current evidence and research issues.

    Science.gov (United States)

    Wing, R R

    1999-11-01

    The purpose of this paper is to review the evidence on the role of physical activity in the treatment of adult overweight and obesity. Three specific questions are addressed: (1) Does exercise alone produce weight loss? (2) Does exercise in combination with diet produce greater weight loss than diet only? and (3) Does exercise in combination with diet produce better maintenance of weight loss than diet alone? The literature initially identified by the Expert Panel on Clinical Guidelines for the Treatment of Obesity, three key meta analyses, and additional literature searches were used to identify randomized trials related to the three aforementioned topics. These articles were reviewed and tabulated. Six of 10 randomized studies found significantly greater weight loss in exercise alone versus no treatment controls. The magnitude of the effect averaged 1-2 kg. Only 2 of 13 studies found significant differences in initial weight loss for diet plus exercise versus diet only, although almost all studies pointed in this direction. Six studies were identified with maintenance periods of at least 1 yr. In two of the six there were significant long term differences favoring diet plus exercise, but in every study considered the direction of the difference favored diet plus exercise. Other strong evidence showing benefits of exercise for long-term weight loss comes from correlational analyses which consistently find that those individuals who report the greatest exercise have the best maintenance of weight loss. Randomized trials consistently show benefits of exercise for weight loss, but the effects are often modest. This may result from small sample sizes, short study duration, and poor adherence to the exercise prescriptions. To better define the doses and types of exercise that will promote long-term weight loss, it is necessary to develop better ways to measure exercise and promote adherence to exercise.

  6. 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.

  7. 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.

  8. 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.

  9. Current evidence on the potential therapeutic applications of transcranial magnetic stimulation in multiple sclerosis: A systematic review of the literature.

    Science.gov (United States)

    León Ruiz, M; Sospedra, M; Arce Arce, S; Tejeiro-Martínez, J; Benito-León, J

    2018-06-10

    A growing number of studies have evaluated the effects of transcranial magnetic stimulation (TMS) for the symptomatic treatment of multiple sclerosis (MS). We performed a PubMed search for articles, recent books, and recommendations from the most relevant clinical practice guidelines and scientific societies regarding the use of TMS as symptomatic treatment in MS. Excitatory electromagnetic pulses applied to the affected cerebral hemisphere allow us to optimise functional brain activity, including the transmission of nerve impulses through the demyelinated corticospinal pathway. Various studies into TMS have shown statistically significant improvements in spasticity, fatigue, lower urinary tract dysfunction, manual dexterity, gait, and cognitive deficits related to working memory in patients with MS; however, the exact level of evidence has not been defined as the results have not been replicated in a sufficient number of controlled studies. Further well-designed, randomised, controlled clinical trials involving a greater number of patients are warranted to attain a higher level of evidence in order to recommend the appropriate use of TMS in MS patients across the board. TMS acts as an adjuvant with other symptomatic and immunomodulatory treatments. Additional studies should specifically investigate the effect of conventional repetitive TMS on fatigue in these patients, something that has yet to see the light of day. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. 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.

  11. Hematopoietic cell transplantation in Fanconi anemia: current evidence, challenges and recommendations.

    Science.gov (United States)

    Ebens, Christen L; MacMillan, Margaret L; Wagner, John E

    2017-01-01

    Hematopoietic cell transplantation for Fanconi Anemia (FA) has improved dramatically over the past 40 years. With an enhanced understanding of the intrinsic DNA-repair defect and pathophysiology of hematopoietic failure and leukemogenesis, sequential changes to conditioning and graft engineering have significantly improved the expectation of survival after allogeneic hematopoietic cell transplantation (alloHCT) with incidence of graft failure decreased from 35% to 40% to <10%. Today, five-year overall survival exceeds 90% in younger FA patients with bone marrow failure but remains about 50% in those with hematologic malignancy. Areas covered: We review the evolution of alloHCT contributing to decreased rates of transplant related complications; highlight current challenges including poorer outcomes in cases of clonal hematologic disorders, alloHCT impact on endocrine function and intrinsic FA risk of epithelial malignancies; and describe investigational therapies for prevention and treatment of the hematologic manifestations of FA. Expert commentary: Current methods allow for excellent survival following alloHCT for FA associated BMF irrespective of donor hematopoietic cell source. Alternative curative approaches, such as gene therapy, are being explored to eliminate the risks of GVHD and minimize therapy-related adverse effects.

  12. Chromium VI and stomach cancer: a meta-analysis of the current epidemiological evidence.

    Science.gov (United States)

    Welling, Roberta; Beaumont, James J; Petersen, Scott J; Alexeeff, George V; Steinmaus, Craig

    2015-02-01

    Chromium VI (hexavalent chromium, Cr(VI)) is an established cause of lung cancer, but its association with gastrointestinal cancer is less clear. The goal of this study was to examine whether the current human epidemiological research on occupationally inhaled Cr(VI) supports the hypothesis that Cr(VI) is associated with human stomach cancer. Following a thorough literature search and review of individual studies, we used meta-analysis to summarise the current epidemiological literature on inhaled Cr(VI) and stomach cancer, explore major sources of heterogeneity, and assess other elements of causal inference. We identified 56 cohort and case-control studies and 74 individual relative risk (RR) estimates on stomach cancer and Cr(VI) exposure or work in an occupation associated with high Cr(VI) exposure including chromium production, chrome plating, leather work and work with Portland cement. The summary RR for all studies combined was 1.27 (95% CI 1.18 to 1.38). In analyses limited to only those studies identifying increased risks of lung cancer, the summary RR for stomach cancer was higher (RR=1.41, 95% CI 1.18 to 1.69). Overall, these results suggest that Cr(VI) is a stomach carcinogen in humans, which is consistent with the tumour results reported in rodent studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Aripiprazole for relapse prevention and craving in alcohol use disorder: current evidence and future perspectives.

    Science.gov (United States)

    Martinotti, Giovanni; Orsolini, Laura; Fornaro, Michele; Vecchiotti, Roberta; De Berardis, Domenico; Iasevoli, Felice; Torrens, Marta; Di Giannantonio, Massimo

    2016-06-01

    Among other approaches, the modulation of the dopaminergic pathway has been advocated in the therapeutic management of Alcohol Use Disorders (AUD). A potential avenue toward the modulation of the dopaminergic pathway across varying substance disorders seems to be provided by aripiprazole, a second-generation antipsychotic characterized by a peculiar pharmacodynamics signature. In this review, the authors provided a qualitative synthesis and a critical perspective on the efficacy of aripiprazole in relapse prevention and craving in AUD. A systematic search was carried out through MEDLINE/Embase/PsycINFO/Cochrane Library from inception until September 2015, combining free terms and MESH headings for the topics of AUD and aripiprazole as following: (((Alcohol use Disorder) OR (Alcohol use)) AND aripiprazole). Based both on a qualitative synthesis and a critical interpretation of the evidence, the authors submit that aripiprazole would promote alcohol abstinence and reduce the alcohol seeking behaviour possibly via dopaminergic and serotoninergic modulations at the fronto-subcortical circuits underpinning alcohol reward and craving, impulsive behaviour as well as reduce alcohol-related anxiety/low mood and anhedonia. However, due to the lack of published studies, a conclusive statement about any direct effect of aripiprazole in the prevention of craving and/or alcohol consumption is not possible.

  14. Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications.

    Science.gov (United States)

    Cumming, Oliver; Cairncross, Sandy

    2016-05-01

    Stunting is a complex and enduring challenge with far-reaching consequences for those affected and society as a whole. To accelerate progress in eliminating stunting, broader efforts are needed that reach beyond the nutrition sector to tackle the underlying determinants of undernutrition. There is growing interest in how water, sanitation and hygiene (WASH) interventions might support strategies to reduce stunting in high-burden settings, such as South Asia and sub-Saharan Africa. This review article considers two broad questions: (1) can WASH interventions make a significant contribution to reducing the global prevalence of childhood stunting, and (2) how can WASH interventions be delivered to optimize their effect on stunting and accelerate progress? The evidence reviewed suggests that poor WASH conditions have a significant detrimental effect on child growth and development resulting from sustained exposure to enteric pathogens but also due to wider social and economic mechanisms. Realizing the potential of WASH to reduce stunting requires a redoubling of efforts to achieve universal access to these services as envisaged under the Sustainable Development Goals. It may also require new or modified WASH strategies that go beyond the scope of traditional interventions to specifically address exposure pathways in the first 2 years of life when the process of stunting is concentrated. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

  15. Role of ultrasound for central catheter tip localization in neonates: a review of the current evidence.

    Science.gov (United States)

    Sharma, Deepak; Farahbakhsh, Nazanin; Tabatabaii, Seyyed Ahmad

    2018-02-15

    Central catheters are known as "life lines" in intensive care units and are used frequently in neonatal intensive care unit (NICU) for multiple indications. The central catheters used in NICU includes umbilical venous catheter (UVC), umbilical arterial catheter (UAC) and peripherally inserted central catheter (PICC) lines. The tip of these central lines needs to be in a correct position as malpositioned central line tips lead to many neonatal complications. Radiograph either abdomen or chest is the most widely used modality for locating the tip of the central catheter. There are many disadvantages of radiographic confirmation of tip position and recently ultrasound (USG)/echocardiography has been used for localization of catheter tip. USG provides real-time assessment of the tip position with other added advantages like no radiation exposure, need for minimal training for performing USG, minimal handling of the neonate, identification of migration of central lines and making repositioning of central lines under USG guidance. The present evidence supports the use of USG/Echo for localization of central catheter tip and USG has shown to have good sensitivity, specificity, positive predictive value and negative predictive value when compared with a radiograph. In this review, we discuss about the role of USG/Echo in the identification of tip of central catheters in neonatal care.

  16. Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications

    Science.gov (United States)

    Cairncross, Sandy

    2016-01-01

    Abstract Stunting is a complex and enduring challenge with far‐reaching consequences for those affected and society as a whole. To accelerate progress in eliminating stunting, broader efforts are needed that reach beyond the nutrition sector to tackle the underlying determinants of undernutrition. There is growing interest in how water, sanitation and hygiene (WASH) interventions might support strategies to reduce stunting in high‐burden settings, such as South Asia and sub‐Saharan Africa. This review article considers two broad questions: (1) can WASH interventions make a significant contribution to reducing the global prevalence of childhood stunting, and (2) how can WASH interventions be delivered to optimize their effect on stunting and accelerate progress? The evidence reviewed suggests that poor WASH conditions have a significant detrimental effect on child growth and development resulting from sustained exposure to enteric pathogens but also due to wider social and economic mechanisms. Realizing the potential of WASH to reduce stunting requires a redoubling of efforts to achieve universal access to these services as envisaged under the Sustainable Development Goals. It may also require new or modified WASH strategies that go beyond the scope of traditional interventions to specifically address exposure pathways in the first 2 years of life when the process of stunting is concentrated. PMID:27187910

  17. Use of dark chocolate for diabetic patients: a review of the literature and current evidence.

    Science.gov (United States)

    Shah, Syed Raza; Alweis, Richard; Najim, Najla Issa; Dharani, Amin Muhammad; Jangda, Muhammad Ahmed; Shahid, Maira; Kazi, Ahmed Nabeel; Shah, Syed Arbab

    2017-10-01

    Dietary changes are a major lifestyle factor that can influence the progression of chronic diseases such as diabetes. Recently, flavanols, a subgroup of plant-derived phytochemicals called flavonoids, have gained increasing attention, due to studies showing an inverse correlation between dietary intake of flavanols and incidence of diabetes. Flavanoids in the cocoa plant may ameliorate insulin resistance by improving endothelial function, altering glucose metabolism, and reducing oxidative stress. Oxidative stress has been proposed as the main culprit for insulin resistance. The well-established effects of cocoa on endothelial function also points to a possible effect on insulin sensitivity. The relationship between insulin resistance and endothelial function is a reciprocal one. Overall, the evidence from these studies suggests that cocoa may be useful in slowing the progression to type 2 diabetes and ameliorating insulin resistance in metabolic syndrome. Additionally, results from several small studies indicate that cocoa may also have therapeutic potential in preventing cardiovascular complications in diabetic patients. Studies highlighting the potential of cocoa-containing diets, in large-randomized controlled trials should be performed which might give us a better opportunity to analyze the potential health-care benefit for reducing the risk of complications in diabetic patients at molecular level.

  18. 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

  19. [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.

  20. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. 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.

  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. 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.

  4. Dietary transition and obesity in selected Arabicspeaking countries: a review of the current evidence.

    Science.gov (United States)

    Aboul-Enein, B H; Bernstein, J; Neary, A C

    2017-01-23

    Escalating obesity rates have become a significant public health problem in the Middle East and North Africa (MENA) region and have been associated with shifts towards a westernized diet. This integrative review aimed to examine the current dietary trends and transitions and their association with obesity in Arabic-speaking countries of the MENA region. Relevant databases were searched for studies in MENA countries between 1998 and 2014 that investigated obesity trends and changes in dietary patterns at the regional level in all age groups. A total of 39 articles fulfilled the inclusion criteria. All the articles noted that obesity was increasingly prevalent and that there was a significant dietary shift away from traditional dietary patterns; 51% reported a shift towards a westernized diet and half found that the western diet was correlated with increased obesity. Culturally relevant dietary health education and health promotion strategies are warranted to address both the dietary shifts towards the westernized diet and the increasing obesity.

  5. Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

    International Nuclear Information System (INIS)

    Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng

    2011-01-01

    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

  6. 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

  7. Dronedarone: current evidence for its safety and efficacy in the management of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Patrick A Schweizer

    2011-01-01

    Full Text Available Patrick A Schweizer, Rüdiger Becker, Hugo A Katus, Dierk ThomasDepartment of Cardiology, Medical University Hospital, Heidelberg, GermanyAbstract: Atrial fibrillation (AF is the most common sustained arrhythmia. Management of AF includes rate control, rhythm control if necessary, prevention of thromboembolic events, and treatment of the underlying disease. Rate control is usually achieved by pharmacological suppression of calcium currents or by applying β-blockers or digitalis compounds. In contrast, the number of compounds available for rhythm control is still limited. Class Ic agents increase mortality in patients with structural heart disease, and amiodarone harbors an extensive side effect profile despite its efficacy in maintaining sinus rhythm. Furthermore, rhythm control by these compounds has not been shown to reduce patient mortality. Dronedarone is a new antiarrhythmic drug that has been developed to provide rhythm and rate control in AF patients with fewer side effects compared with amiodarone. This review primarily focuses on clinical trials evaluating efficacy and safety of the novel drug. Conclusions from these studies are critically reviewed, and recommendations for clinical practice are discussed. Dronedarone significantly reduced the incidence of hospitalization due to cardiovascular events or death in high-risk patients with atrial fibrillation (ATHENA trial. However, dronedarone was less efficient than amiodarone in maintaining normal sinus rhythm (DIONYSOS trial and is contraindicated in severe or deteriorating heart failure (ANDROMEDA trial. In summary, dronedarone represents a valuable addition to the limited spectrum of antiarrhythmic drugs and is currently recommended in patients with paroxysmal and persistent AF to achieve rate and rhythm control, excluding cases of severe or unstable congestive heart failure.Keywords: dronedarone, atrial fibrillation, antiarrhythmic therapy

  8. 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

    2017-11-01

    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.

  9. 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.

  10. Magnetic Resonance Imaging in Aneurysmal Subarachnoid Hemorrhage: Current Evidence and Future Directions.

    Science.gov (United States)

    Nelson, Sarah E; Sair, Haris I; Stevens, Robert D

    2018-04-09

    Aneurysmal subarachnoid hemorrhage (aSAH) is associated with an unacceptably high mortality and chronic disability in survivors, underscoring a need to validate new approaches for treatment and prognosis. The use of advanced imaging, magnetic resonance imaging (MRI) in particular, could help address this gap given its versatile capacity to quantitatively evaluate and map changes in brain anatomy, physiology and functional activation. Yet there is uncertainty about the real value of brain MRI in the clinical setting of aSAH. In this review, we discuss current and emerging MRI research in aSAH. PubMed was searched from inception to June 2017, and additional studies were then chosen on the basis of relevance to the topics covered in this review. Available studies suggest that brain MRI is a feasible, safe, and valuable testing modality. MRI detects brain abnormalities associated with neurologic examination, outcomes, and aneurysm treatment and thus has the potential to increase knowledge of aSAH pathophysiology as well as to guide management and outcome prediction. Newer pulse sequences have the potential to reveal structural and physiological changes that could also improve management of aSAH. Research is needed to confirm the value of MRI-based biomarkers in clinical practice and as endpoints in clinical trials, with the goal of improving outcome for patients with aSAH.

  11. 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.

  12. 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.

  13. Benign prostatic hyperplasia and lower urinary tract symptoms. A review of current evidence.

    Science.gov (United States)

    Carrero-López, V M; Cózar-Olmo, J M; Miñana-López, B

    2016-06-01

    The treatment of benign prostatic hyperplasia (BPH) is changing due to a greater understanding of the disease and the development of the functional concept of lower urinary tract symptoms (LUTS). To describe the current state of BPH and the diagnosis and treatment of LUTS. We summarise the issues presented and debated by a group of expert urologists during the First UROVI Congress, sponsored by the Spanish Urological Association. LUTS encompasses filling, voiding and postvoiding symptoms that affect patients' quality of life. The aetiological diagnosis is an important element in starting the most ideal treatment. For this reason, new alternative therapies (both pharmacological and surgical) are needed to help individually address the symptoms in the various patient profiles. There is now a new combination of drugs (6mg of solifenacin and 0.4mg of the tamsulosin oral controlled absorption system) for treating moderate to severe filling symptoms and emptying symptoms associated with BPH in patients who do not respond to monotherapy. Furthermore, new surgical techniques that are increasingly less invasive help provide surgical options for older patients and those with high comorbidity. The availability of drugs that can act on the various LUTS helps integrate the pathophysiological paradigm into the functional one, providing more appropriate treatment for our patients. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  14. Factors influencing adult physical health after controlling for current health conditions: evidence from a british cohort.

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    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.

  15. 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". Copyright © 2015 Elsevier Inc. All rights reserved.

  16. 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.

  17. Current evidence for the use of N-acetylcysteine following liver resection.

    Science.gov (United States)

    Kemp, Richard; Mole, Jonathan; Gomez, Dhanny

    2017-11-13

    N-acetylcysteine (NAC) has many uses in medicine; notable in the management of paracetamol toxicity, acute liver failure and liver surgery. The aim of this review was to critically appraise the published literature for the routine use of NAC in liver resection surgery. An electronic search was performed of EBSCOhost (Medline and CINAHL database), PubMed and the Cochrane Library for the period 1990-2016. MeSH headings: 'acetyl-cysteine', 'liver resection' and 'hepatectomy' were used to identify all relevant articles published in English. Following the search criteria used, three articles were included. Two of these studies were randomized controlled trials. All the studies collated data on morbidity and mortality. All three studies did not show a significant difference in overall complications rates in patients that underwent hepatic resection that had NAC infusion compared with patients that did not. In one study, NAC administration was associated with a higher frequency of grade A post-hepatectomy liver failure. In another study, a significantly higher incidence of delirium was observed in the NAC group, which led to the trial to be terminated early. The current published data do not support the routine use of NAC following liver resection. © 2017 Royal Australasian College of Surgeons.

  18. Scientific Evidence Supporting Policy Change: A Study on Secondhand Smoke Exposure in Non-smoking Areas of PC Rooms in Korea.

    Science.gov (United States)

    Hong, Soon-Yeol; Lim, Min Kyung; Yun, E Hwa; Park, Eun Young; Jeong, Bo Yoon; Yang, Wonho; Lee, Do-Hoon

    2016-04-01

    The objective of this study was to measure secondhand smoke (SHS) exposure in personal computer (PC) rooms with the purpose of determining the strength of scientific evidence supporting the legislative ban on smoking in PC rooms located in the Republic of Korea. From June to September 2012, particulate matter (PM2.5) and air nicotine concentration (ANC) were measured in the smoking and non-smoking areas of PC rooms in Goyang City, Korea. In 28 randomly sampled PC rooms, field investigators completed an observational questionnaire on building characteristics, smoking policies, and evidence of smoking. The geometric means (GM) of PM2.5 and ANC in smoking and non-smoking areas were compared. Evidence of smoking was identified in both the smoking and non-smoking areas of all PC rooms. The GMs of PM2.5 and ANC in both areas were high and did not differ significantly (174.77 μg/m(3) and 48.95 μg/m(3) in smoking areas; 93.38 μg/m(3) and 41.30 μg/m(3) in non-smoking areas). Overall PM2.5 concentrations were 5.5-fold higher than those listed in the World Health Organization guidelines. This study supported previous reports that a partial smoking ban did not protect individuals from SHS exposure. Furthermore, the results from our study suggest how research can support policy. Countries in which smoke-free policies are not yet comprehensive may find our results useful.

  19. 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

  20. PD-1 and PD-L1 as emerging therapeutic targets in gastric cancer: current evidence

    Directory of Open Access Journals (Sweden)

    Tran PN

    2017-05-01

    Full Text Available Phu N Tran,1* Sarmen Sarkissian,1* Joseph Chao,2 Samuel J Klempner3,4 1Division of Hematology-Oncology, University of California Irvine, Orange, 2Department of Medical Oncology and Developmental Therapeutics, City of Hope, Duarte, 3Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 4The Angeles Clinic and Research Institute, Los Angeles, CA, USA *These authors contributed equally to this work Abstract: Gastric adenocarcinoma is a leading cause of global cancer-related morbidity and mortality, and new therapeutic approaches are needed. Despite the improved outcomes with monoclonal antibodies targeting human epidermal growth factor receptor 2 and vascular endothelial growth factor receptor 2, durable responses are uncommon. Targeting immune checkpoints including PD-1, PD-L1 and CTLA-4 have led to improved survival across several tumor types, frequently characterized by prolonged benefit in responding patients. Tumoral and lymphocyte-derived immunohistochemical staining for PD-1, PD-L1, and tumor mutational burden have shown potential as predictive response biomarkers in several tumor types. Optimal incorporation of immune-mediated therapies into gastric cancer (GC is an area of intense ongoing investigation and benefit has been demonstrated in smaller studies of advanced patients. Important questions of biomarker selection, roles for molecular characterization, optimal combinatorial approaches, and therapeutic sequencing remain. In this study, current data are reviewed for immune checkpoint inhibitors in GC, and putative biomarkers, ongoing trials, and future considerations are discussed. Keywords: immunotherapy, stomach cancer, checkpoint inhibitor, nivolumab, pembrolizumab, tumor mutational burden

  1. 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

  2. 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.

  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

    2018-02-01

    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. 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. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. 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

  6. 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)

  7. Phytochemical Properties and Nutrigenomic Implications of Yacon as a Potential Source of Prebiotic: Current Evidence and Future Directions

    Directory of Open Access Journals (Sweden)

    Yang Cao

    2018-04-01

    Full Text Available The human gut is densely populated with diverse microbial communities that are essential to health. Prebiotics and fiber have been shown to possess the ability to modulate the gut microbiota. One of the plants being considered as a potential source of prebiotic is yacon. Yacon is an underutilized plant consumed as a traditional root-based fruit in South America. Yacon mainly contains fructooligosaccharides (FOS and inulin. Therefore, it has bifidogenic benefits for gut health, because FOS are not easily broken down by digestive enzymes. Bioactive chemical compounds and extracts isolated from yacon have been studied for their various nutrigenomic properties, including as a prebiotic for intestinal health and their antimicrobial and antioxidant effects. This article reviewed scientific studies regarding the bioactive chemical compounds and nutrigenomic properties of extracts and isolated compounds from yacon. These findings may help in further research to investigate yacon-based nutritional products. Yacon can be considered a potential prebiotic source and a novel functional food. However, more detailed epidemiological, animal, and human clinical studies, particularly mechanism-based and phytopharmacological studies, are lacking for the development of evidence-based functional food products.

  8. Phytochemical Properties and Nutrigenomic Implications of Yacon as a Potential Source of Prebiotic: Current Evidence and Future Directions

    Science.gov (United States)

    Cao, Yang; Zhang, Hongxia; Jin, Yifan; Zhang, Yihe; Hayford, Frank

    2018-01-01

    The human gut is densely populated with diverse microbial communities that are essential to health. Prebiotics and fiber have been shown to possess the ability to modulate the gut microbiota. One of the plants being considered as a potential source of prebiotic is yacon. Yacon is an underutilized plant consumed as a traditional root-based fruit in South America. Yacon mainly contains fructooligosaccharides (FOS) and inulin. Therefore, it has bifidogenic benefits for gut health, because FOS are not easily broken down by digestive enzymes. Bioactive chemical compounds and extracts isolated from yacon have been studied for their various nutrigenomic properties, including as a prebiotic for intestinal health and their antimicrobial and antioxidant effects. This article reviewed scientific studies regarding the bioactive chemical compounds and nutrigenomic properties of extracts and isolated compounds from yacon. These findings may help in further research to investigate yacon-based nutritional products. Yacon can be considered a potential prebiotic source and a novel functional food. However, more detailed epidemiological, animal, and human clinical studies, particularly mechanism-based and phytopharmacological studies, are lacking for the development of evidence-based functional food products. PMID:29649123

  9. 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.

  10. Phytochemical Properties and Nutrigenomic Implications of Yacon as a Potential Source of Prebiotic: Current Evidence and Future Directions.

    Science.gov (United States)

    Cao, Yang; Ma, Zheng Feei; Zhang, Hongxia; Jin, Yifan; Zhang, Yihe; Hayford, Frank

    2018-04-12

    The human gut is densely populated with diverse microbial communities that are essential to health. Prebiotics and fiber have been shown to possess the ability to modulate the gut microbiota. One of the plants being considered as a potential source of prebiotic is yacon. Yacon is an underutilized plant consumed as a traditional root-based fruit in South America. Yacon mainly contains fructooligosaccharides (FOS) and inulin. Therefore, it has bifidogenic benefits for gut health, because FOS are not easily broken down by digestive enzymes. Bioactive chemical compounds and extracts isolated from yacon have been studied for their various nutrigenomic properties, including as a prebiotic for intestinal health and their antimicrobial and antioxidant effects. This article reviewed scientific studies regarding the bioactive chemical compounds and nutrigenomic properties of extracts and isolated compounds from yacon. These findings may help in further research to investigate yacon-based nutritional products. Yacon can be considered a potential prebiotic source and a novel functional food. However, more detailed epidemiological, animal, and human clinical studies, particularly mechanism-based and phytopharmacological studies, are lacking for the development of evidence-based functional food products.

  11. 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.

  12. 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.

  13. Shared scientific thinking in everyday parent-child activity

    Science.gov (United States)

    Crowley, Kevin; Callanan, Maureen A.; Jipson, Jennifer L.; Galco, Jodi; Topping, Karen; Shrager, Jeff

    2001-11-01

    Current accounts of the development of scientific reasoning focus on individual children's ability to coordinate the collection and evaluation of evidence with the creation of theories to explain the evidence. This observational study of parent-child interactions in a children's museum demonstrated that parents shape and support children's scientific thinking in everyday, nonobligatory activity. When children engaged an exhibit with parents, their exploration of evidence was observed to be longer, broader, and more focused on relevant comparisons than children who engaged the exhibit without their parents. Parents were observed to talk to children about how to select and encode appropriate evidence and how to make direct comparisons between the most informative kinds of evidence. Parents also sometimes assumed the role of explainer by casting children's experience in causal terms, connecting the experience to prior knowledge, or introducing abstract principles. We discuss these findings with respect to two dimensions of children's scientific thinking: developments in evidence collection and developments in theory construction.

  14. Scientific computing

    CERN Document Server

    Trangenstein, John A

    2017-01-01

    This is the third of three volumes providing a comprehensive presentation of the fundamentals of scientific computing. This volume discusses topics that depend more on calculus than linear algebra, in order to prepare the reader for solving differential equations. This book and its companions show how to determine the quality of computational results, and how to measure the relative efficiency of competing methods. Readers learn how to determine the maximum attainable accuracy of algorithms, and how to select the best method for computing problems. This book also discusses programming in several languages, including C++, Fortran and MATLAB. There are 90 examples, 200 exercises, 36 algorithms, 40 interactive JavaScript programs, 91 references to software programs and 1 case study. Topics are introduced with goals, literature references and links to public software. There are descriptions of the current algorithms in GSLIB and MATLAB. This book could be used for a second course in numerical methods, for either ...

  15. Transcranial direct current stimulation in obsessive-compulsive disorder: emerging clinical evidence and considerations for optimal montage of electrodes.

    Science.gov (United States)

    Senço, Natasha M; Huang, Yu; D'Urso, Giordano; Parra, Lucas C; Bikson, Marom; Mantovani, Antonio; Shavitt, Roseli G; Hoexter, Marcelo Q; Miguel, Eurípedes C; Brunoni, André R

    2015-07-01

    Neuromodulation techniques for obsessive-compulsive disorder (OCD) treatment have expanded with greater understanding of the brain circuits involved. Transcranial direct current stimulation (tDCS) might be a potential new treatment for OCD, although the optimal montage is unclear. To perform a systematic review on meta-analyses of repetitive transcranianal magnetic stimulation (rTMS) and deep brain stimulation (DBS) trials for OCD, aiming to identify brain stimulation targets for future tDCS trials and to support the empirical evidence with computer head modeling analysis. Systematic reviews of rTMS and DBS trials on OCD in Pubmed/MEDLINE were searched. For the tDCS computational analysis, we employed head models with the goal of optimally targeting current delivery to structures of interest. Only three references matched our eligibility criteria. We simulated four different electrodes montages and analyzed current direction and intensity. Although DBS, rTMS and tDCS are not directly comparable and our theoretical model, based on DBS and rTMS targets, needs empirical validation, we found that the tDCS montage with the cathode over the pre-supplementary motor area and extra-cephalic anode seems to activate most of the areas related to OCD.

  16. Practical considerations on the introduction of sacubitril/valsartan in clinical practice: Current evidence and early experience.

    Science.gov (United States)

    Farmakis, Dimitrios; Bistola, Vassiliki; Karavidas, Apostolos; Parissis, John

    2016-11-15

    The combination of neprilysin inhibitor sacubitril with the angiotensin II receptor 1 blocker valsartan is the first agent from the angiotensin receptor neprilysin inhibitors (ARNI) class authorized for clinical use in heart failure (HF) patients with reduced ejection fraction (HFrEF). Sacubitril/valsartan resulted in 20% reduction in the incidence rate of death or HF hospitalization compared to enalapril in symptomatic HFrEF patients in the seminal PARADIGM-HF trial. As a result, the recently updated European and American HF guidelines granted this agent a class IB indication for the treatment of ambulatory/chronic symptomatic HFrEF patients. However, translating the positive results of trials into true clinical benefit is often challenging. This is particularly true in the case of sacubitril/valsartan, as HF is a heterogeneous syndrome including many severely ill patients who are prone to decompensation, while this new agent comes to replace a cornerstone of current evidence-based HF therapy. In the present paper, we address a number of practical issues regarding the introduction of sacubitril/valsartan and propose an algorithm based on available evidence and early clinical experience. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Psychopharmacological and Other Treatments in Preschool Children with Attention-Deficit/Hyperactivity Disorder: Current Evidence and Practice

    Science.gov (United States)

    Arnold, L. Eugene; Anthony, Bruno J.

    2008-01-01

    Abstract Objective This article reviews rational approaches to treating attention-deficit/hyperactivity disorder (ADHD) in preschool children, including pharmacological and nonpharmacological treatments. Implications for clinical practice are discussed. Data Sources We searched MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health, Educational Resources Information Center, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects for relevant literature published in English from 1967 to 2007 on preschool ADHD. We also reviewed the references cited in identified reports. Study Selection Studies were reviewed if the sample included at least some children younger than 6 years of age or attending kindergarten, the study participants had a diagnosis of ADHD or equivalent symptoms, received intervention aimed at ADHD symptoms, and included a relevant outcome measure. Data Extraction Studies were reviewed for type of intervention and outcome relevant to ADHD and were rated for the level of evidence for adequacy of the data to inform clinical practice. Conclusions The current level of evidence for adequacy of empirical data to inform clinical practice for short-term treatment of ADHD in preschool children is Level A for methylphenidate and Level B for parent behavior training, child training, and additive-free elimination diet. PMID:18844482

  18. Claim Assessment Profile: A Method for Capturing Healthcare Evidence in the Scientific Evaluation and Review of Claims in Health Care (SEaRCH).

    Science.gov (United States)

    Hilton, Lara; Jonas, Wayne B

    2017-02-01

    Grounding health claims in an evidence base is essential for determining safety and effectiveness. However, it is not appropriate to evaluate all healthcare claims with the same methods. "Gold standard" randomized controlled trials may skip over important qualitative and observational data about use, benefits, side effects, and preferences, issues especially salient in research on complementary and integrative health (CIH) practices. This gap has prompted a move toward studying treatments in their naturalistic settings. In the 1990s, a program initiated under the National Institutes of Health was designed to provide an outreach to CIH practices for assessing the feasibility of conducting retrospective or prospective evaluations. The Claim Assessment Profile further develops this approach, within the framework of Samueli Institute's Scientific Evaluation and Review of Claims in Health Care (SEaRCH) method. The goals of a Claim Assessment Profile are to clarify the elements that constitute a practice, define key outcomes, and create an explanatory model of these impacts. The main objective is to determine readiness and capacity of a practice to engage in evaluation of effectiveness. This approach is informed by a variety of rapid assessment and stakeholder-driven methods. Site visits, structured qualitative interviews, surveys, and observational data on implementation provide descriptive data about the practice. Logic modeling defines inputs, processes, and outcome variables; Path modeling defines an analytic map to explore. The Claim Assessment Profile is a rapid assessment of the evaluability of a healthcare practice. The method was developed for use on CIH practices but has also been applied in resilience research and may be applied beyond the healthcare sector. Findings are meant to provide sufficient data to improve decision-making for stakeholders. This method provides an important first step for moving existing promising yet untested practices into

  19. Elastic wave velocities, chemistry and modal mineralogy of crustal rocks sampled by the Outokumpu scientific drill hole: Evidence from lab measurements and modeling

    Science.gov (United States)

    Kern, H.; Mengel, K.; Strauss, K. W.; Ivankina, T. I.; Nikitin, A. N.; Kukkonen, I. T.

    2009-07-01

    The Outokumpu scientific deep drill hole intersects a 2500 m deep Precambrian crustal section comprising a 1300 m thick biotite-gneiss series (mica schists) at top, followed by a 200 m thick meta-ophiolite sequence, underlain again by biotite gneisses (mica schists) (500 m thick) with intercalations of amphibolite and meta-pegmatoids (pegmatitic granite). From 2000 m downward the dominating rock types are meta-pegmatoids (pegmatitic granite). Average isotropic intrinsic P- and S-wave velocities and densities of rocks were calculated on the basis of the volume fraction of the constituent minerals and their single crystal properties for 29 core samples covering the depth range 198-2491 m. The modal composition of the rocks is obtained from bulk rock (XRF) and mineral chemistry (microprobe), using least squares fitting. Laboratory seismic measurements on 13 selected samples representing the main lithologies revealed strong anisotropy of P- and S-wave velocities and shear wave splitting. Seismic anisotropy is strongly related to foliation and is, in particular, an important property of the biotite gneisses, which dominate the upper and lower gneiss series. At in situ conditions, velocity anisotropy is largely caused by oriented microcracks, which are not completely closed at the pressures corresponding to the relatively shallow depth drilled by the borehole, in addition to crystallographic preferred orientation (CPO) of the phyllosilicates. The contribution of CPO to bulk anisotropy is confirmed by 3D velocity calculations based on neutron diffraction texture measurements. For vertical incidence of the wave train, the in situ velocities derived from the lab measurements are significantly lower than the measured and calculated intrinsic velocities. The experimental results give evidence that the strong reflective nature of the ophiolite-derived rock assemblages is largely affected by oriented microcracks and preferred crystallographic orientation of major minerals, in

  20. 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.

  1. Evidence for a current sheet forming in the wake of a coronal mass ejection from multi-viewpoint coronagraph observations

    Science.gov (United States)

    Patsourakos, S.; Vourlidas, A.

    2011-01-01

    sheets. Therefore, our multi-viewpoint observations supply strong evidence that the observed post-CME ray is indeed related to a post-CME current sheet. Movies are only available in electronic form at http://www.aanda.org

  2. MANAGEMENT OF DIABETES DURING AIR TRAVEL: A SYSTEMATIC LITERATURE REVIEW OF CURRENT RECOMMENDATIONS AND THEIR SUPPORTING EVIDENCE.

    Science.gov (United States)

    Pavela, James; Suresh, Rahul; Blue, Rebecca S; Mathers, Charles H; Belalcazar, L Maria

    2018-02-01

    Individuals with diabetes are increasingly seeking pretravel advice, but updated professional recommendations remain scant. We performed a systematic review on diabetes management during air travel to summarize current recommendations, assess supporting evidence, and identify areas of future research. A systematic review of the English literature on diabetes management during air travel was undertaken utilizing PubMed and MEDLINE. Publications regarding general travel advice; adjustment of insulin and noninsulin therapies; and the use of insulin pumps, glucometers and subcutaneous glucose sensors at altitude were included. Gathered information was used to create an updated summary of glucose-lowering medication adjustment during air travel. Sixty-one publications were identified, most providing expert opinion and few offering primary data (47 expert opinion, 2 observational studies, 2 case reports, 10 device studies). General travel advice was uniform, with increasing attention to preflight security. Indications for oral antihyperglycemic therapy adjustments varied. There were few recommendations on contemporary agents and on nonhypoglycemic adverse events. There was little consensus on insulin adjustment protocols, many antedating current insulin formulations. Most publications advocated adjusting insulin pump time settings after arrival; however, there was disagreement on timing and rate adjustments. Glucometers and subcutaneous glucose sensors were reported to be less accurate at altitude, but not to an extent that would preclude their clinical use. Recommendations for diabetes management during air travel vary significantly and are mostly based on expert opinion. Data from systematic investigation on glucose-lowering medication adjustment protocols may support the development of a future consensus statement. CSII = continuous subcutaneous insulin infusion (device) DPP-4 = dipeptidyl peptidase 4 EGA = error grid analysis GDH = glucose dehydrogenase GOX = glucose

  3. Previous success and current body condition determine breeding propensity in Lesser Scaup: evidence for the individual heterogeneity hypothesis

    Science.gov (United States)

    Warren, Jeffrey M.; Cutting, Kyle A.; Takekawa, John Y.; De La Cruz, Susan E. W.; Williams, Tony D.; Koons, David N.

    2014-01-01

    The decision to breed influences an individual's current and future reproduction, and the proportion of individuals that breed is an important determinant of population dynamics. Age, experience, individual quality, and environmental conditions have all been demonstrated to influence breeding propensity. To elucidate which of these factors exerts the greatest influence on breeding propensity in a temperate waterfowl, we studied female Lesser Scaup (Aythya affinis) breeding in southwestern Montana. Females were captured during the breeding seasons of 2007–2009, and breeding status was determined on the basis of (1) presence of an egg in the oviduct or (2) blood plasma vitellogenin (VTG) levels. Presence on the study site in the previous year, a proxy for adult female success, was determined with stable isotope signatures of a primary feather collected at capture. Overall, 57% of females had evidence of breeding at the time of capture; this increased to 86% for females captured on or after peak nest initiation. Capture date and size-adjusted body condition positively influenced breeding propensity, with a declining body-condition threshold through the breeding season. We did not detect an influence of age on breeding propensity. Drought conditions negatively affected breeding propensity, reducing the proportion of breeding females to 0.85 (SE = 0.05) from 0.94 (SE = 0.03) during normal-water years. A female that was present in the previous breeding season was 5% more likely to breed than a female that was not present then. The positive correlation between age and experience makes it difficult to differentiate the roles of age, experience, and individual quality in reproductive success in vertebrates. Our results indicate that individual quality, as expressed by previous success and current body condition, may be among the most important determinants of breeding propensity in female Lesser Scaup, providing further support for the individual heterogeneity hypothesis.

  4. 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 understood as an emergent phenomenon of, but not simply reducible to, evolutionary and developmental neurobiology.

  5. Current strategies for monitoring men with localised prostate cancer lack a strong evidence base: observational longitudinal study.

    Science.gov (United States)

    Metcalfe, C; Tilling, K; Davis, M; Lane, J A; Martin, R M; Kynaston, H; Powell, P; Neal, D E; Hamdy, F; Donovan, J L

    2009-08-04

    The UK National Institute for Health and Clinical Excellence (NICE) guidance recommends conservative management of men with 'low-risk' localised prostate cancer, monitoring the disease using prostate-specific antigen (PSA) kinetics and re-biopsy. However, there is little evidence of the changes in PSA level that should alert to the need for clinical re-assessment. This study compares the alerts resulting from PSA kinetics and a novel longitudinal reference range approach, which incorporates age-related changes, during the monitoring of 408 men with localised prostate cancer. Men were monitored by regular PSA tests over a mean of 2.9 years, recording when a man's PSA doubling time fell below 2 years, PSA velocity exceeded 2 ng ml(-1) per year, or when his upper 10% reference range was exceeded. Prostate-specific antigen doubling time and PSA velocity alerted a high proportion of men initially but became unresponsive to changes with successive tests. Calculating doubling time using recent PSA measurements reduced the decline in response. The reference range method maintained responsiveness to changes in PSA level throughout the monitoring. The increasing unresponsiveness of PSA kinetics is a consequence of the underlying regression model. Novel methods are needed for evaluation in cohorts currently being managed by monitoring. Meanwhile, the NICE guidance should be cautious.

  6. Psycho-social influences upon older women's decision to attend cervical screening: A review of current evidence.

    Science.gov (United States)

    Hope, Kirsty A; Moss, Esther; Redman, Charles W E; Sherman, Susan M

    2017-08-01

    Cervical cancer is the fourth most common cancer in women worldwide (WHO, 2016). In many developed countries the incidence of cervical cancer has been significantly reduced by the introduction of organised screening programmes however, in the UK, a fall in screening coverage is becoming a cause for concern. Much research attention has been afforded to younger women but age stratified mortality and incidence data suggest that older women's screening attendance is also worthy of study. This paper provides a review of current evidence concerning the psycho-social influences that older women experience when deciding whether to attend cervical screening. Few studies have focussed on older women and there are significant methodological issues with those that have included them in their samples. Findings from these studies indicate several barriers which may deter older women from screening, such as embarrassment and logistical issues. Drivers to screening include reassurance and a sense of obligation. Physical, social and emotional changes that occur as women age may also have an impact on attendance. This review concludes that there is a clear need for better understanding of the perceptions of older women specifically with regard to cervical cancer and screening. Future research should inform the design of targeted interventions and provision of information to enable informed decision-making regarding cervical screening among older women. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Anti EGFR therapy in the treatment of non-metastatic head and neck squamous cell carcinoma: The current evidence

    Directory of Open Access Journals (Sweden)

    Rony Benson

    2016-09-01

    Full Text Available Head and neck squamous cell carcinoma (HNSCC accounts for a large oncologic burden in the developing countries. In patients with locally advanced head and neck cancer multimodality treatment is warranted. Radiation therapy with concurrent chemotherapy has long been considered the standard for patients with disease involving the oropharynx, larynx and hypopharynx. However, addition of chemotherapy to radiotherapy increases treatment related toxicity by many folds and compliance rates decrease. In this context a systemic therapy, which when used concurrent with radiation with favorable toxicity profile is of great importance for improving disease control in locally advanced HNSCC. Anti-epithelial growth factor receptor targeted therapy emerged as a potential treatment option. In recent years many trials were conducted to find the optimum treatment option with the combination of these targeted agents. The initial trials showed excellent results with minimal morbidity and led to great enthusiasm across the globe to incorporate these regimens as a standard of care. However, subsequently many trials failed to maintain such results and now there is little agreement to the initial results achieved with these drugs. Based on the current evidence we cannot recommend the replacement of cisplatin with targeted therapy in concurrent setting. It may be considered in patients with altered renal parameters, hypersensitivity or intolerance to cisplatin. The addition of targeted therapy in addition to chemotherapy in the concurrent setting can’t also be recommended as the benefit is doubtful and is associated with a significant increase in toxicity.

  8. Processes of conscious and unconscious memory: evidence from current research on dissociation of memories within a test.

    Science.gov (United States)

    Cheng, Chao-Ming; Huang, Chin-Lan

    2011-01-01

    The processes of conscious memory (CM) and unconscious memory (UM) are explored, based on the results of the current and previous studies in which the 2 forms of memory within a test were separated by either the process dissociation or metacognition-based dissociation procedure. The results assessing influences of shallow and deep processing, association, and self-generation on CM in explicit and implicit tests are taken as evidence that CM in a test is driven not only conceptually but also by the driving nature of the test, and CM benefits from an encoding condition to the extent that information processing for CM recapitulates that engaged in the encoding condition.Those influences on UM in explicit and implicit tests are taken to support the view that UM in a test is driven by the nature of the test itself, and UM benefits from an encoding condition to the extent that the cognitive environments at test and at study match to activate the same type of information (e.g., visual, lexical, or semantic) about memory items or the same content of a preexisting association or categorical structure.

  9. Current evidence for the use of coffee and caffeine to prevent age-related cognitive decline and Alzheimer's disease.

    Science.gov (United States)

    Carman, A J; Dacks, P A; Lane, R F; Shineman, D W; Fillit, H M

    2014-04-01

    Although nothing has been proven conclusively to protect against cognitive aging, Alzheimer's disease or related dementias, decades of research suggest that specific approaches including the consumption of coffee may be effective. While coffee and caffeine are known to enhance short-term memory and cognition, some limited research also suggests that long-term use may protect against cognitive decline or dementia. In vitro and pre-clinical animal models have identified plausible neuroprotective mechanisms of action of both caffeine and other bioactive components of coffee, though epidemiology has produced mixed results. Some studies suggest a protective association while others report no benefit. To our knowledge, no evidence has been gathered from randomized controlled trials. Although moderate consumption of caffeinated coffee is generally safe for healthy people, it may not be for everyone, since comorbidities and personal genetics influence potential benefits and risks. Future studies could include short-term clinical trials with biomarker outcomes to validate findings from pre-clinical models and improved epidemiological studies that incorporate more standardized methods of data collection and analysis. Given the enormous economic and emotional toll threatened by the current epidemic of Alzheimer's disease and other dementias, it is critically important to validate potential prevention strategies such as coffee and caffeine.

  10. Role of VEGF, Nitric Oxide and sympathetic neurotransmitters in the pathogenesis of tendinopathy: a review of the current evidences

    Directory of Open Access Journals (Sweden)

    Sebastiano Vasta

    2016-08-01

    Full Text Available Chronic tendinopathy is a painful common condition affecting athletes as well as the general population undergoing to tendon overuse. Although its huge prevalence, little is known about tendinopathy pathogenesis, and even cloudier is its treatment.Traditionally, tendinopathy has been defined as a lack of tendon ability to overcome stressing stimuli with appropriate adaptive changes. Histologic studies have demonstrated the absence of inflammatory infiltrates, as a consequence conventional antinflammatory drugs have shown little or no effectiveness in treating tendinopathies. New strategies should be therefore identified to address chronic tendon disorders. Angiofibroblastic changes have been highlighted as the main feature of tendinopathy, and vascular endothelial growth factor (VEGF has been demonstrated as one of the key molecules involved in vascular hyperplasia. More recently, attention has been focused on new peptides such as Substance P, nitric oxide and calcitonin gene-related peptide. Those new findings support the idea of a nerve-mediated disregulation of tendon metabolism. Each of those molecules could be a target for new treatment options. This study aimed to systematically review the current available clinical and basic science in order to summarize the latest evidences on the pathophysiology and its effect on treatment of chronic tendinopathy, and to spread suggestions for future research on its treatment.

  11. Estudos de revisão sistemática: um guia para síntese criteriosa da evidência científica Systematic review studies: a guide for careful synthesis of the scientific evidence

    Directory of Open Access Journals (Sweden)

    RF Sampaio

    2007-02-01

    : Systematic reviews require straightforward questions, search strategy definition, establishment of study inclusion and exclusion criteria and careful analysis of the selected literature. The development process for reviews of this type includes characterization of each selected study, evaluation of their quality, identification of important concepts, comparison of statistical analyses used and conclusions regarding what the literature tells us about a specific intervention. Such reviews also suggest problems/questions that need further investigation. Systematic review studies follow the structure of original articles. CONCLUSION: Good systematic reviews are important resources, in the light of the accelerated growth of scientific information. These studies help in producing syntheses of the evidence available in the literature on specific interventions, and may help clinicians and researchers in their work process.

  12. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017.

    Science.gov (United States)

    Einarson, Thomas R; Acs, Annabel; Ludwig, Craig; Panton, Ulrik H

    2018-06-08

    Cardiovascular disease (CVD) is a common comorbidity in type 2 diabetes (T2DM). CVD's prevalence has been growing over time. To estimate the current prevalence of CVD among adults with T2DM by reviewing literature published within the last 10 years (2007-March 2017). We searched Medline, Embase, and proceedings of major scientific meetings for original research documenting the prevalence of CVD in T2DM. CVD included stroke, myocardial infarction, angina pectoris, heart failure, ischemic heart disease, cardiovascular disease, coronary heart disease, atherosclerosis, and cardiovascular death. No restrictions were placed on country of origin or publication language. Two reviewers independently searched for articles and extracted data, adjudicating results through consensus. Data were summarized descriptively. Risk of bias was examined by applying the STROBE checklist. We analyzed data from 57 articles with 4,549,481 persons having T2DM. Europe produced the most articles (46%), followed by the Western Pacific/China (21%), and North America (13%). Overall in 4,549,481 persons with T2DM, 52.0% were male, 47.0% were obese, aged 63.6 ± 6.9 years old, with T2DM duration of 10.4 ± 3.7 years. CVD affected 32.2% overall (53 studies, N = 4,289,140); 29.1% had atherosclerosis (4 studies, N = 1153), 21.2% had coronary heart disease (42 articles, N = 3,833,200), 14.9% heart failure (14 studies, N = 601,154), 14.6% angina (4 studies, N = 354,743), 10.0% myocardial infarction (13 studies, N = 3,518,833) and 7.6% stroke (39 studies, N = 3,901,505). CVD was the cause of death in 9.9% of T2DM patients (representing 50.3% of all deaths). Risk of bias was low; 80 ± 12% of STROBE checklist items were adequately addressed. Globally, overall CVD affects approximately 32.2% of all persons with T2DM. CVD is a major cause of mortality among people with T2DM, accounting for approximately half of all deaths over the study period. Coronary artery

  13. Método Mãe Canguru: aplicação no Brasil, evidências científicas e impacto sobre o aleitamento materno Kangaroo Mother Care: scientific evidences and impact on breastfeeding

    Directory of Open Access Journals (Sweden)

    Sonia Isoyama Venancio

    2004-11-01

    Full Text Available OBJETIVO: Descrever o histórico do Método Mãe Canguru e apresentar evidências científicas sobre os benefícios dessa prática para os bebês de baixo peso no tocante a morbimortalidade, desenvolvimento psicoafetivo, neurossensorial e amamentação. FONTES DE DADOS: Foram consultadas publicações sobre o Método Mãe Canguru abrangendo o período de 1983 até 2004, identificadas nas bases de dados MEDLINE e Lilacs, bem como livros, teses e publicações técnicas do Ministério da Saúde. SÍNTESE DOS DADOS: Desde sua primeira descrição, o Método Mãe Canguru tem sido amplamente estudado. A análise de experimentos randomizados mostrou que o mesmo consiste em fator de proteção para a amamentação exclusiva no momento da alta hospitalar (RR 0,41; IC95% 0,25-0,68. O método também está associado a redução do risco de infecção hospitalar com 41 semanas de idade gestacional corrigida (RR 0,49; IC95% 0,25-0,93; redução de enfermidades graves (RR 0,30; IC95% 0,14-0,67; redução de infecções do trato respiratório inferior aos 6 meses (RR 0,37; IC95% 0,15-0,89; e maior ganho ponderal diário (diferença de médias de 3,6 g/dia; IC95% 0,8-6,4. O desenvolvimento psicomotor foi semelhante entre bebês submetidos ao Método Mãe Canguru e controles aos 12 meses, e não houve evidências de impacto sobre a mortalidade infantil. CONCLUSÃO: Há evidências de impacto positivo do Método Mãe Canguru sobre a prática da amamentação. Embora o método pareça reduzir a morbidade infantil, as evidências são ainda insuficientes para que o mesmo seja recomendado rotineiramente. Por outro lado, não existem relatos sobre efeitos deletérios da aplicação do método. Há a necessidade de se realizar estudos sobre a efetividade, aplicabilidade e aceitabilidade do Método Mãe Canguru em nosso meio.OBJECTIVE: To describe the history of the Kangaroo Mother Care and present scientific evidence about benefits of this practice on morbidity and

  14. Modern scientific evidence pertaining to criminal investigations in the Chosun dynasty era (1392-1897 A.C.E.) in Korea.

    Science.gov (United States)

    Nam, Yun Sik; Won, Sung-Ok; Lee, Kang-Bong

    2014-07-01

    A guidebook detailing the process of forensic investigation was written in 1440 A.C.E. It outlines the fundamentals and details of each element of criminal investigation during the era of the Chosun dynasty in Korea. Because this old guidebook was written in terms of personal experience rather than on scientific basis, it includes many fallacies from the perspective of modern forensic science. However, the book describes methods to form a scientific basis for the experiments performed. We demonstrate the modern scientific basis for ancient methods to monitor trace amounts of blood and detect lethal arsenic poisoning from a postmortem examination as described in this old forensic guidebook. Traces of blood and arsenic poisoning were detected according to the respective color changes of brownish red, due to the reaction of ferric ions in blood with acetic ions of vinegar, and dark blue, due to the reaction of silver with arsenic sulfide. © 2014 American Academy of Forensic Sciences.

  15. Developmental outcome of low birth-weight and preterm newborns: a re-view of current evidence

    Directory of Open Access Journals (Sweden)

    Farin Soleimani

    2013-12-01

    Full Text Available Low birth weight (LBW and preterm birth are one the most important causes of death in the world and therefore are considered as one of the major health problems. Global statistics demonstrates an increase in the prevalence of low birth weight in the developing countries. Low birth weight infants are exposed to complications such as major neurosensory impairements, cerebral palsy, cognitive and language delays, neuromotor developmental delay, blindness and hearing loss, behavioral and psychosocial disorders, learning difficulties and dysfunction in scholastic performances. The majority of infant's death and developmental disorders were due to disorders relating to prematurity and unspecified low birth weight. Infants weighing less than 2500 g, is a major determinant of both neonatal and infant mortality rates and, together with congenital anomalies (e.g., cardiac, central nervous system, and respiratory, contributes significantly to childhood morbidity. Various studies indicate that low birth weight infants are suffering from physiological and psychosocial disabilities, two to three times more than the other children. At school age, preterm and low birth weight infants have poorer physical growth, cognitive function, and school performance. These disadvantages appear to persist into adulthood and therefore have broad implications for society. Although the survival rates have increased dramatically and the incidence of morbidities has decreased, the complications are still considered to be associated with economical and social burdens. Most children with Low birth weight suffer from multiple disabilities. Therefore, they need special and consistent care. On demand of reducing the infant mortality rate, the need to decrease the complications in low birth weight and preterm infants should be considered by the policy makers in health care system. In this review article, we assessed current evidences on developmental outcomes of low birth weight and

  16. Guidance for Substantiating the Evidence for Beneficial Effects of Probiotics: Current Status and Recommendations for Future Research1–3,

    NARCIS (Netherlands)

    Rijkers, G.T.; Bengmark, S.; Enck, P.; Haller, D.; Herz, U.; Kalliomäki, M.; Kudo, S.; Lenoi-Winkoop, I.; Mercenier, A.M.E.; Myllyluoma, E.; Rabot, S.; Rafter, J.; Szajewska, H.; Watzl, B.; Wells, J.; Wolvers, D.; Antoine, J.M.

    2010-01-01

    Probiotic bacteria are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. There is a growing interest in probiotics within the scientific community, with consumers, and in the food industry. The interactions between the gut and intestinal microbiota

  17. eHealth effectiveness : does scientific literature provide evidence of the effectiveness of eHealth and what does that mean?

    NARCIS (Netherlands)

    Schurer, Margreet; Velthuijsen, Hugo

    Although the scientific literature consists of over 10,000 papers on eHealth, remarkably few applications are consistently being used in the healthcare domain. Numerous reasons for this lack of progression have been noted, one of these being the objection of medical professionals to the introduction

  18. Scientific Misconduct.

    Science.gov (United States)

    Goodstein, David

    2002-01-01

    Explores scientific fraud, asserting that while few scientists actually falsify results, the field has become so competitive that many are misbehaving in other ways; an example would be unreasonable criticism by anonymous peer reviewers. (EV)

  19. Conceptions of end users in current smart grid research and opportunities for further social scientific research on users in smart grids

    DEFF Research Database (Denmark)

    Larsen, Lars Ege

    of existing knowledge and seeing new possibilities for social scientific research where knowledge gaps appear. Different user representations and user roles are found through a content analysis of project related documents from a selection of European and North American smart grid projects. It is argued......Many resources have been put into preparing our energy provision systems for a future with more distributed and intermittent energy production. Especially in Europe and the US a large amount of public research funds has gone to the research field of smart grids. Within policy communities and smart...... grid research communities there is a consensus that a changed user-system relation where users become sensitive to system level constraints is a key element of smart grids. However, the way this sensitivity is conceptualized and the nature of claims differs from one project to the other and sometimes...

  20. Role of amino acid supplementation in the prevention of necrotizing enterocolitis in preterm neonates - a review of current evidences.

    Science.gov (United States)

    Garg, Bhawan Deep; Kabra, Nandkishor S

    2018-09-01

    Necrotizing enterocolitis (NEC) is one of the most common acute and fatal gastrointestinal emergency in very low birth weight (VLBW) preterm neonates with mortality range from 15 to 30%. NEC is likely due to multifactorial process such as oxidative injury, ischemic necrosis, and over-reactive inflammatory response to intestinal microbes. To evaluate the role of amino acid supplementation for reduction of neonatal NEC in preterm neonates. The literature search was done for various randomized control trial (RCT) by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Scopus, Index Copernicus, African Index Medicus (AIM), Thomson Reuters (ESCI), Chemical Abstracts Service (CAS) and other database. This review included 15 RCTs that fulfilled inclusion criteria. The total neonates enrolled in these different RCT are 3424 (amino acid group 1711 and control 1713). Almost all participating neonates were of VLBW or extremely low birth weight (ELBW). In two trials, birth weight was between 1500-2000 grams. The intervention was started within first few days after birth and continued up to 30th day of postnatal age in most of the trials. In two trials, intervention was continued up to 120th day of postnatal age. Arginine, glutamine and N-acetyl cysteine (NAC) were used at the dose of 1.5 mol/kg/day (261 mg/kg/day), 0.3 grams/kg/day and 16-32 mg/kg/day, respectively. Role of amino acid in the prevention of neonatal NEC is not exclusively supported by the current evidence. Only three studies were able to show reduction in the incidence of NEC with amino acid supplementation (arginine, glutamine), and the remaining studies did not report any positive effect. Amino acid supplementation was not associated with significant reduction in mortality due to any causes. However, arginine supplementation was associated with significant reduction in mortality due to NEC. Two studies on glutamine were reported significant reduction in

  1. Transcranial Direct Current Stimulation in Patients with Prolonged Disorders of Consciousness: Combined Behavioral and Event-Related Potential Evidence

    Directory of Open Access Journals (Sweden)

    Ye Zhang

    2017-11-01

    Full Text Available BackgroundThe electrophysiological evidence supporting the therapeutic efficacy of multiple transcranial direct current stimulation (tDCS sessions on consciousness improvement in patients with prolonged disorders of consciousness (DOCs has not been firmly established.ObjectivesTo assess the effects of repeated tDCS in patients with prolonged DOCs by Coma Recovery Scale-Revised (CRS-R score and event-related potential (ERP.MethodUsing a sham-controlled randomized double-blind design, 26 patients were randomly assigned to either a real [five vegetative state (VS and eight minimally conscious state (MCS patients] or sham (six VS and seven MCS patients stimulation group. The patients in the real stimulation group underwent 20 anodal tDCS sessions of the left dorsolateral prefrontal cortex (DLPFC over 10 consecutive working days. The CRS-R score and P300 amplitude and latency in a hierarchical cognitive assessment were recorded to evaluate the consciousness level before tDCS and immediately after the 20 sessions.ResultsThe intra-group CRS-R analysis revealed a clinically significant improvement in the MCS patients in the real stimulation group. The inter-group CRS-R analysis showed a significant difference in CRS-R between VS and MCS patients at baseline in both the real and sham stimulation groups. The intra-group ERP analysis revealed a significant increase in P300 amplitude after tDCS in the MCS patients in the real stimulation group, but no significant differences in P300 latency. For the inter-group ERP analysis, we observed significant differences regarding the presence of P300 at baseline between the VS and MCS patients in both groups.ConclusionThe repeated anodal tDCS of the left DLPFC could produce clinically significant improvements in MCS patients. The observed tDCS-related consciousness improvements might be related to improvements in attention resource allocation (reflected by the P300 amplitude. The findings support the use of tDCS in

  2. What goes up... gravity and scientific method

    CERN Document Server

    Kosso, Peter

    2017-01-01

    The concept of gravity provides a natural phenomenon that is simultaneously obvious and obscure; we all know what it is, but rarely question why it is. The simple observation that 'what goes up must come down' contrasts starkly with our current scientific explanation of gravity, which involves challenging and sometimes counterintuitive concepts. With such extremes between the plain and the perplexing, gravity forces a sharp focus on scientific method. Following the history of gravity from Aristotle to Einstein, this clear account highlights the logic of scientific method for non-specialists. Successive theories of gravity and the evidence for each are presented clearly and rationally, focusing on the fundamental ideas behind them. Using only high-school level algebra and geometry, the author emphasizes what the equations mean rather than how they are derived, making this accessible for all those curious about gravity and how science really works.

  3. Scientific evidence for health effects attributed to the consumption of probiotics and prebiotics: an update for current perspectives and future challenges.

    Science.gov (United States)

    Martinez, Rafael Chacon Ruiz; Bedani, Raquel; Saad, Susana Marta Isay

    2015-12-28

    Probiotics and prebiotics, mainly commercialised as food ingredients and also as supplements, are considered highly profitable niche markets. However, in recent years, the food industry has suffered from a series of health claim restrictions on probiotics and prebiotics in many parts of the world, including those made by the European Food Safety Authority. Therefore, we reviewed the core benefits of probiotic and prebiotic consumption on health. A number of studies have examined the prevention and/or management of intestinal infections, respiratory tract infections, CVD, osteoporosis, urogenital infections, cavities, periodontal disease and halitosis, allergic reactions, inflammatory bowel disease and irritable bowel syndrome and Helicobacter pylori gastric infections. In fact, a deeper understanding of the mechanisms involved in human microbiota and immune system modulation by probiotics and prebiotics relies on continuous efforts to establish suitable biomarkers of health and diseases risk factors for the design of clinical trials required for health claim approval. In spite of the promising results, the performance of large, long-term, well-planned, well-aligned clinical studies is crucial to provide more reliability and a more solid basis for the outcomes achieved and to support the potential use of probiotics and prebiotics in clinical practice.

  4. The Effect of Transcranial Direct Current Stimulation (tDCS) Electrode Size and Current Intensity on Motor Cortical Excitability: Evidence From Single and Repeated Sessions.

    Science.gov (United States)

    Ho, Kerrie-Anne; Taylor, Janet L; Chew, Taariq; Gálvez, Verònica; Alonzo, Angelo; Bai, Siwei; Dokos, Socrates; Loo, Colleen K

    2016-01-01

    Current density is considered an important factor in determining the outcomes of tDCS, and is determined by the current intensity and electrode size. Previous studies examining the effect of these parameters on motor cortical excitability with small sample sizes reported mixed results. This study examined the effect of current intensity (1 mA, 2 mA) and electrode size (16 cm(2), 35 cm(2)) on motor cortical excitability over single and repeated tDCS sessions. Data from seven studies in 89 healthy participants were pooled for analysis. Single-session data were analyzed using mixed effects models and repeated-session data were analyzed using mixed design analyses of variance. Computational modeling was used to examine the electric field generated. The magnitude of increases in excitability after anodal tDCS was modest. For single-session tDCS, the 35 cm(2) electrodes produced greater increases in cortical excitability compared to the 16 cm(2) electrodes. There were no differences in the magnitude of cortical excitation produced by 1 mA and 2 mA tDCS. The repeated-sessions data also showed that there were greater increases in excitability with the 35 cm(2) electrodes. Further, repeated sessions of tDCS with the 35 cm(2) electrodes resulted in a cumulative increase in cortical excitability. Computational modeling predicted higher electric field at the motor hotspot for the 35 cm(2) electrodes. 2 mA tDCS does not necessarily produce larger effects than 1 mA tDCS in healthy participants. Careful consideration should be given to the exact positioning, size and orientation of tDCS electrodes relative to cortical regions. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Would science serve decision-making to adapt the impact of climate change? Introduction to Climate Change Adaptation – scientific evidence, assessment framework and decision-making

    Directory of Open Access Journals (Sweden)

    Gin-Rong Liu Peiwen Lu

    2017-01-01

    Full Text Available We live in challenging times with a heightened sense of uncertainty and unpredictability. Climate change, with its impact on disruptive events as well as gradual trends, has been addressed in scientific studies and become increasingly important in policymaking. This rises up a great need on scientific integration and knowledge transformation. The Taiwan Integrated Research Programme on Climate Change Adaptation Technology (TaiCCAT is formed under this concern. Directing by the Ministry of Science and Technology (MOST, it carries a strong intention to explore and to conduct adequate knowledge of climate change and adaptation strategies for decision-making supports. The TaiCCAT highly recommends the approach of cross-disciplinary collaboration from environmental studies to adaptation governance. The result can therefore be more contributive to reflect the complexity of the changing world.

  6. ILSI Brazil International Workshop on Functional Foods: a narrative review of the scientific evidence in the area of carbohydrates, microbiome, and health

    OpenAIRE

    Marie E. Latulippe; Agnès Meheust; Livia Augustin; David Benton; Přemysl Berčík; Anne Birkett; Alison L. Eldridge; Joel Faintuch; Christian Hoffmann; Julie Miller Jones; Cyril Kendall; Franco Lajolo; Gabriela Perdigon; Pedro Antonio Prieto; Robert A. Rastall

    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 (12 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 g...

  7. The current state of Bayesian methods in medical product development: survey results and recommendations from the DIA Bayesian Scientific Working Group.

    Science.gov (United States)

    Natanegara, Fanni; Neuenschwander, Beat; Seaman, John W; Kinnersley, Nelson; Heilmann, Cory R; Ohlssen, David; Rochester, George

    2014-01-01

    Bayesian applications in medical product development have recently gained popularity. Despite many advances in Bayesian methodology and computations, increase in application across the various areas of medical product development has been modest. The DIA Bayesian Scientific Working Group (BSWG), which includes representatives from industry, regulatory agencies, and academia, has adopted the vision to ensure Bayesian methods are well understood, accepted more broadly, and appropriately utilized to improve decision making and enhance patient outcomes. As Bayesian applications in medical product development are wide ranging, several sub-teams were formed to focus on various topics such as patient safety, non-inferiority, prior specification, comparative effectiveness, joint modeling, program-wide decision making, analytical tools, and education. The focus of this paper is on the recent effort of the BSWG Education sub-team to administer a Bayesian survey to statisticians across 17 organizations involved in medical product development. We summarize results of this survey, from which we provide recommendations on how to accelerate progress in Bayesian applications throughout medical product development. The survey results support findings from the literature and provide additional insight on regulatory acceptance of Bayesian methods and information on the need for a Bayesian infrastructure within an organization. The survey findings support the claim that only modest progress in areas of education and implementation has been made recently, despite substantial progress in Bayesian statistical research and software availability. Copyright © 2013 John Wiley & Sons, Ltd.

  8. The terms 'current scientific knowledge', and 'precautionary measures to provide protection' in the provisions governing the licensing procedure under the Atomic Energy Act

    International Nuclear Information System (INIS)

    Renneberg, W.

    1986-01-01

    Under the Atomic Energy Act, a licence may be granted for a nuclear installation provided that 'every precaution which is necessary in the light of existing scientific knowledge and technology has been taken to provide adequate protection against damage due to the erection or operation of the installation' (section 7, sub-sec. (2), no. 3 of the Atomic Energy Act). This condition can be split off into two specific problem fields, and for each a rather unspecific legal concept is to be more exactly defined. The author explains the technique of the law hitherto applied in the weighting and evaluation of hazards and risks and comes to the conclusion that the technique adopted has been subject to pre-legal appraisals: the result in terms of the law is not the final step in the process of legal evaluation, but quite to the contrary, the legal technique applied has been derived from the wanted result. This, the author says, is a crisis of legitimation of the law. (HSCH) [de

  9. Delirium in Hospitalized Patients: Implications of Current Evidence on Clinical Practice and Future Avenues for Research—A Systematic Evidence Review

    Science.gov (United States)

    Khan, Babar A.; Zawahiri, Mohammed; Campbell, Noll L.; Fox, George C.; Weinstein, Eric J.; Nazir, Arif; Farber, Mark O.; Buckley, John D.; MacLullich, Alasdair; (UK), MRCP; Boustani, Malaz A.

    2013-01-01

    BACKGROUND Despite the significant burden of delirium among hospitalized adults, critical appraisal of systematic data on delirium diagnosis, pathophysiology, treatment, prevention, and outcomes is lacking. PURPOSE To provide evidence-based recommendations for delirium care to practitioners, and identify gaps in delirium research. DATA SOURCES Medline, PubMed, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) information systems fromJanuary 1966 to April 2011. STUDY SELECTION All published systematic evidence reviews (SERs) on delirium were evaluated. DATA EXTRACTION Three reviewers independently extracted the data regarding delirium risk factors, diagnosis, prevention, treatment, and outcomes, and critically appraised each SER as good, fair, or poor using the United States Preventive Services Task Force criteria. DATA SYNTHESIS Twenty-two SERs graded as good or fair provided the data. Age, cognitive impairment, depression, anticholinergic drugs, and lorazepam use were associated with an increased risk for developing delirium. The Confusion Assessment Method (CAM) is reliable for delirium diagnosis outside of the intensive care unit. Multicomponent nonpharmacological interventions are effective in reducing delirium incidence in elderly medical patients. Low-dose haloperidol has similar efficacy as atypical antipsychotics for treating delirium. Delirium is associated with poor outcomes independent of age, severity of illness, or dementia. CONCLUSION Delirium is an acute, preventable medical condition with short- and long-term negative effects on a patient’s cognitive and functional states. PMID:22684893

  10. The link between motor and cognitive development in children born preterm and/or with low birth weight : A review of current evidence

    NARCIS (Netherlands)

    Oudgenoeg-Paz, Ora; Mulder, Hanna; Jongmans, Marian J.; van der Ham, Ineke J.M.; Van der Stigchel, Stefan

    2017-01-01

    The current review focuses on evidence for a link between early motor development and later cognitive skills in children born preterm or with Low Birth Weight (LBW). Studies with term born children consistently show such a link. Motor and cognitive impairments or delays are often seen in children

  11. Scientific communication

    Directory of Open Access Journals (Sweden)

    Aleksander Kobylarek

    2017-09-01

    Full Text Available The article tackles the problem of models of communication in science. The formal division of communication processes into oral and written does not resolve the problem of attitude. The author defines successful communication as a win-win game, based on the respect and equality of the partners, regardless of their position in the world of science. The core characteristics of the process of scientific communication are indicated , such as openness, fairness, support, and creation. The task of creating the right atmosphere for science communication belongs to moderators, who should not allow privilege and differentiation of position to affect scientific communication processes.

  12. Scientific millenarianism

    International Nuclear Information System (INIS)

    Weinberg, A.M.

    1997-01-01

    Today, for the first time, scientific concerns are seriously being addressed that span future times--hundreds, even thousands, or more years in the future. One is witnessing what the author calls scientific millenarianism. Are such concerns for the distant future exercises in futility, or are they real issues that, to the everlasting gratitude of future generations, this generation has identified, warned about and even suggested how to cope with in the distant future? Can the four potential catastrophes--bolide impact, CO 2 warming, radioactive wastes and thermonuclear war--be avoided by technical fixes, institutional responses, religion, or by doing nothing? These are the questions addressed in this paper

  13. Scientific meetings

    International Nuclear Information System (INIS)

    1973-01-01

    One of the main aims of the IAEA is to foster the exchange of scientific and technical information and one of the main ways of doing this is to convene international scientific meetings. They range from large international conferences bringing together several hundred scientists, smaller symposia attended by an average of 150 to 250 participants and seminars designed to instruct rather than inform, to smaller panels and study groups of 10 to 30 experts brought together to advise on a particular programme or to develop a set of regulations. The topics of these meetings cover every part of the Agency's activities and form a backbone of many of its programmes. (author)

  14. Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion.

    Science.gov (United States)

    Barton, C J; Bonanno, D R; Carr, J; Neal, B S; Malliaras, P; Franklyn-Miller, A; Menz, H B

    2016-05-01

    Running-related injuries are highly prevalent. Synthesise published evidence with international expert opinion on the use of running retraining when treating lower limb injuries. Mixed methods. A systematic review of clinical and biomechanical findings related to running retraining interventions were synthesised and combined with semistructured interviews with 16 international experts covering clinical reasoning related to the implementation of running retraining. Limited evidence supports the effectiveness of transition from rearfoot to forefoot or midfoot strike and increase step rate or altering proximal mechanics in individuals with anterior exertional lower leg pain; and visual and verbal feedback to reduce hip adduction in females with patellofemoral pain. Despite the paucity of clinical evidence, experts recommended running retraining for: iliotibial band syndrome; plantar fasciopathy (fasciitis); Achilles, patellar, proximal hamstring and gluteal tendinopathy; calf pain; and medial tibial stress syndrome. Tailoring approaches to each injury and individual was recommended to optimise outcomes. Substantial evidence exists for the immediate biomechanical effects of running retraining interventions (46 studies), including evaluation of step rate and strike pattern manipulation, strategies to alter proximal kinematics and cues to reduce impact loading variables. Our synthesis of published evidence related to clinical outcomes and biomechanical effects with expert opinion indicates running retraining warrants consideration in the treatment of lower limb injuries in clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Features of Mobile Diabetes Applications: Review of the Literature and Analysis of Current Applications Compared Against Evidence-Based Guidelines

    Science.gov (United States)

    Fernandez-Luque, Luis; Årsand, Eirik; Hartvigsen, Gunnar

    2011-01-01

    = 101) were (1) insulin and medication recording, 63 (62%), (2) data export and communication, 61 (60%), (3) diet recording, 47 (47%), and (4) weight management, 43 (43%). From the literature search (n = 26), the most prevalent features were (1) PHR or Web server synchronization, 18 (69%), (2) insulin and medication recording, 17 (65%), (3) diet recording, 17 (65%), and (4) data export and communication, 16 (62%). Interestingly, although clinical guidelines widely refer to the importance of education, this is missing from the top functionalities in both cases. Conclusions While a wide selection of mobile applications seems to be available for people with diabetes, this study shows there are obvious gaps between the evidence-based recommendations and the functionality used in study interventions or found in online markets. Current results confirm personalized education as an underrepresented feature in diabetes mobile applications. We found no studies evaluating social media concepts in diabetes self-management on mobile devices, and its potential remains largely unexplored. PMID:21979293

  16. Training the Next Generation of School Psychologists to Deliver Evidence Based Mental Health Practices: Current Challenges and Future Directions

    Science.gov (United States)

    Shernoff, Elisa S.; Bearman, Sarah Kate; Kratochwill, Thomas R.

    2017-01-01

    School psychologists are uniquely positioned to support the delivery of evidence-based mental health practices (EBMHPs) to address the overwhelming mental health needs of children and youth. Graduate training programs can promote EBMHPs in schools by ensuring school psychologists enter the workplace prepared to deliver and support high-quality,…

  17. Choosing an Advanced Therapy in Parkinson's Disease; is it an Evidence-Based Decision in Current Practice?

    NARCIS (Netherlands)

    Nijhuis, F.A.; Heek, J. van; Bloem, B.R.; Post, B.; Faber, M.J.

    2016-01-01

    BACKGROUND: In advanced Parkinson's disease (PD), neurologists and patients face a complex decision for an advanced therapy. When choosing a treatment, the best available evidence should be combined with the professional's expertise and the patient's preferences. OBJECTIVE: The objective of this

  18. Manejo da asma aguda em adultos na sala de emergência: evidências atuais Management of acute asthma in adults in the emergency room: current evidence

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Roth Dalcin

    2009-01-01

    Full Text Available Asma é uma doença com uma alta prevalência em nosso meio e ao redor do mundo. Embora novas opções terapêuticas tenham sido recentemente desenvolvidas, parece haver um aumento mundial na sua morbidade e mortalidade. Em muitas instituições, as exacerbações asmáticas ainda se constituem em uma emergência médica muito comum. As evidências têm demonstrado que o manejo da asma aguda na sala de emergência concentra decisões cruciais que podem determinar o desfecho desta situação clínica. Nesta revisão, enfocaremos a avaliação e o tratamento do paciente com asma aguda na sala de emergência, descrevendo uma estratégia apropriada para o seu manejo. Serão consideradas as seguintes etapas: diagnóstico, avaliação da gravidade, tratamento, avaliação das complicações, decisão sobre onde se realizará o tratamento adicional e orientações por ocasião da alta da emergência. Espera-se que estas recomendações contribuam para que o médico clínico tome as decisões apropriadas durante o manejo da asma aguda na sala de emergência.Asthma is a disease with high prevalence in our country and worldwide. Although new therapeutic approaches have been developed recently, there seems to be a global increase in morbidity and mortality from asthma. In many institutions, asthma exacerbation is still a common medical emergency. Clinical evidence demonstrates that management of acute asthma in the emergency room entails crucial decisions that could determine the clinical outcome. In this review, the authors focus on assessment and treatment of patients with acute asthma and outline an appropriate management strategy. Diagnosis, severity assessment, treatment, complications, decision about where additional treatment will take place and orientations on discharge from the emergency will be considered. It is expected that these recommendations will help physicians to make the appropriate decisions about care of acute asthma in the emergency

  19. From Folklore to Scientific Evidence: Breast-Feeding and Wet-Nursing in Islam and the Case of Non-Puerperal Lactation

    Science.gov (United States)

    Moran, Lia; Gilad, Jacob

    2007-01-01

    Breast-feeding practice has an important medical and socio-cultural role. It has many anthropological aspects concerning the “power structures” that find their expression in breast-feeding and the practices that formed around it, both socially, scientifically, and legally-speaking. Breast-feeding has been given much attention by religions and taboos, folklore, and misconception abound around it making it a topic of genuine curiosity. This paper aims at expanding the spectrum of folklore associated with breast-feeding. The paper deals with historical, religious, and folkloristic aspects of breast-feeding, especially wet-nursing, in Islam and focuses on an intriguing Islamic tale on breast-feeding - lactation by non-pregnant women (or non-puerperal lactation). Apparently, accounts of non-puerperal lactation are not restricted to Islam but have been documented in various societies and religions throughout centuries. Two medical situations - hyperprolactinemia and induced lactation, appear as possible explanations for this phenomenon. This serves as an excellent example for the value of utilizing contemporary scientific knowledge in order to elucidate the origin, anthropology and evolvement of ancient myth and superstition. PMID:23675050

  20. Hyaluronic acid for the treatment of osteoarthritis in all joints except the knee: what is the current evidence?

    Science.gov (United States)

    Colen, Sascha; Haverkamp, Daniel; Mulier, Michiel; van den Bekerom, Michel P J

    2012-04-01

    The use of intra-articular hyaluronic acid (HA) is a well known treatment in patients with knee osteoarthritis (OA). In other joints, less evidence is available about the efficacy of treatment with intra-articular HA. HA is also used intra-articularly in the metatarsophalangeal-1 joint, the ankle, the hip, the sacroiliac joint, the facet joints, the carpometacarpal-1 joint, the shoulder and the temporo-mandibular joint. In this systematic review we include all prospective studies about the effects of intra-articular HA in the above-mentioned joints. Its use in the knee joint, however, will be discussed in a separate article in this journal. A systematic review was conducted using databases including MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Clinical Trial Register, and EMBASE. After performing a solid systematic review using a rigid methodology and trying to pool the outcomes of different studies, we noticed that, compared with baseline, there is statistical evidence for a positive effect of intra-articular HA. However, there is limited evidence HA is superior to placebo and no evidence that intra-articular HA is better than corticosteroids or other conservative therapies. Our recommendation for future research is that one should focus on adequately powered randomized trials comparing HA treatment with other types of intra-articular or conservative treatment. We think it is useless to further perform and publish (large) non-comparative prospective studies about the use of HA in the treatment of problems caused by OA. It is well perceived that HA exerts positive effects in the treatment of OA, but up to now there is no (strong) evidence available that HA is superior to other treatments of OA such as corticosteroids, physiotherapy or other conservative measures.

  1. Systematic analysis of the quality of the scientific evidence and conflicts of interest in osteoarthritis of the hip and knee practice guidelines.

    Science.gov (United States)

    Feuerstein, Joseph D; Pelsis, Jonathan R; Lloyd, Samuel; Cheifetz, Adam S; Stone, Kevin R

    2016-02-01

    To determine the validity of the hip and knee osteoarthritis guidelines. A systematic search of PubMed using a combination of Mesh and text terms with limitations to guidelines was performed to identify hip and knee osteoarthritis guidelines. The study was performed from April 17, 2014 to October 1, 2014. Guidelines were reviewed for graded levels of evidence, methods used to grade the evidence, and disclosures of conflicts of interest. Additionally, guidelines were also assessed for key quality measures using the AGREE II system for assessing the quality of guidelines. A total of 13 guidelines relevant to the diagnosis and/or treatment of hip/knee osteoarthritis was identified. The 180 recommendations reviewed were supported by 231 pieces of evidence. In total, 35% (n = 80; range: 0-26) were supported by level A evidence, 15% (n = 35; range: 0-10) were by level B, and 50% (n = 116; range: 0-62) were by level C. Median age of the guidelines was 4 years (±4.8; range: 0-16) with no comments on planned updates. In total, 31% of the guidelines included patients in the development process. Only one guideline incorporated cost consideration, and only 15% of the guidelines addressed the surgical management of osteoarthritis. Additionally, 46% of guidelines did not comment on conflicts of interest (COI). When present, there was an average 29.8 COI. Notably, 82% of the COI were monetary support/consulting. In total, 50% of the hip/knee osteoarthritis guideline recommendations are based on lower quality evidence. Nearly half the guidelines fail to disclose relevant COI and when disclosed, multiple potential COI are present. Future hip/knee osteoarthritis guideline development committees should strive to improve the transparency and quality of evidence used to formulate practice guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Mean reversion in the current account of forty-eight african countries: Evidence from the Panel SURADF test

    Science.gov (United States)

    Chu, Hsiao-Ping; Chang, Tsangyao; Chang, Hsu-Ling; Su, Chi-Wei; Yuan, Young

    2007-10-01

    Here, the Panel seemingly unrelated regressions augmented Dickey-Fuller test (SURADF) test, first introduced and advanced by Breuer et al. [Misleading inferences from panel unit-root tests with an illustration from purchasing power parity, Rev. Int. Econ. 9(3) (2001) 482-493], is used to investigate the mean-reverting behavior of the current account of 48 African countries during the 1980-2004 periods. The empirical results from numerous panel-based unit root tests, conducted earlier, indicated that the current account of each of these countries is stationary; however, when Breuer et al.'s (2001) Panel SURADF test is conducted, it is found that a unit root exists in the current account of 11 of the countries studied. These results have one extremely important policy implication for the 48 African countries studied: the current account deficit of most is sustainable, and thus signifying that those nations should have no incentive to default on their international debt.

  3. Preventing statistical errors in scientific journals.

    NARCIS (Netherlands)

    Nuijten, M.B.

    2016-01-01

    There is evidence for a high prevalence of statistical reporting errors in psychology and other scientific fields. These errors display a systematic preference for statistically significant results, distorting the scientific literature. There are several possible causes for this systematic error

  4. The Revista Scientific

    Directory of Open Access Journals (Sweden)

    Oscar Antonio Martínez Molina

    2017-02-01

    Full Text Available The Revista Scientific aims to publish quality papers that include the perspective of analysis in educational settings. Together with www.indtec.com.ve, this electronic publication aims to promote and disseminate, with seriousness and rigor, the academic production in this field. Editorial of the new stage Revista Scientific was created with the aim of constituting a reference space for scientific research in the field of research analysis that is carried out within the universities in Latin America, once the distribution list hosted on the INDTEC platform (http://www.indtec.com.ve is consolidated as a space for dissemination and development of new ideas and initiatives. The first presentation of INDTEC Magazine was held in August 2016 in Venezuela. Thanks to the support of the INDTEC platform, SCIENTIFIC Magazine has been able to develop from the cooperative work of the people who make up its Editorial Committee, Academic Committee and Scientific Committee in Electronic Edition, and of the referees of each one of the numbers. Part of the success is due to the motivation of its co-editors and excellent professionals from different parts of the world: Argentina, Belgium, Colombia, Cuba, Ecuador, Spain, Mexico, Venezuela, which form the various committees, with enthusiasm and joy participating in this project (whose organizational structure is presented in this edition and continues in increcendo. Also, the strategy adopted to edit a monographic number from the various events organized in the framework of the universities, has contributed to provide SCIENTIFIC with a point value speaker of intellectual progress in the field of education. SCIENTIFIC Magazine is currently indexed in ISI, International Scientific Indexing, Dubai - UAE; ROAD, the Directory of Open Access Scholarly Resources (ISSN International Center, France; REVENCYT-ULA, Venezuela; Google Scholar (Google Scholar, International Index; Published in Calaméo; ISSUU; Academia

  5. Evolution and variation of the Tsushima warm current during the late Quaternary: Evidence from planktonic foraminifera, oxygen and carbon isotopes

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The evolution and variation history of the Tsushima warm current during the late Quaternary was reconstructed based on the quantitative census data of planktonic foraminiferal fauna, together with oxygen and carbon isotope records of mixed layer dweller G. ruber and thermocline dweller N. dutertrei in piston core CSH1 and core DGKS9603 collected separately from the Tsushima warm current and the Kuroshio dominated area. The result showed that the Tsushima warm current vanished in the lowstand period during 40―24 cal ka BP, while the Kuroshio still flowed across the Okinawa Trough, arousing strong upwelling in the northern Trough. Meanwhile, the influence of freshwater greatly increased in the northern Okinawa Trough, as the broad East China Sea continental shelf emerged. The freshwater reached its maximum during the last glacial maximum (LGM), when the upwelling obviously weakened for the lowest sea-level and the depression of the Kuroshio. The modern Tsushima warm current began its development since 16 cal ka BP, and the impact of the Kuroshio increased in the middle and north- ern Okinawa Trough synchronously during the deglaciation and gradually evolved as the main water source of the Tsushima current. The modern Tsushima current finally formed at about 8.5 cal ka BP, since then the circulation structure has been relatively stable. The water of the modern Tsushima cur- rent primarily came from the Kuroshio axis. A short-term wiggle of the current occurred at about 3 cal ka BP, probably for the influences from the enhancement of the winter monsoon and the depression of the Kuroshio. The cold water masses greatly strengthened during the wiggle.

  6. Nutrition (Micronutrients) in Child Growth and Development: A Systematic Review on Current Evidence, Recommendations and Opportunities for Further Research.

    Science.gov (United States)

    Yakoob, Mohammad Yawar; Lo, Clifford W

    2017-10-01

    An important aspect of malnutrition is deficiency of different micronutrients during pregnancy or early childhood. We systematically reviewed the role of nutrition in child growth (weight or height gain) and development. A comprehensive literature search was done on PubMed/Cochrane Library browsing through 38,795 abstracts until December 31, 2016 to select systematic reviews/meta-analyses and individual randomized controlled trials (RCTs) of micronutrient supplementation. Micronutrients studied included iron, iodine, folate, zinc, calcium, magnesium, selenium, vitamin D, vitamin A, vitamin B complex, and multiple micronutrients. We summarize evidence with details and results of RCTs, highlight strengths/weaknesses, and critically interpret findings. Effects of breastfeeding-promotion, food-supplementation (complementary and school feeding), conditional-cash-transfers, and integrated nutrition/psychosocial interventions are discussed. Based on this evidence we make policy and programmatic recommendations for supplementation to mothers and children at high-risk of deficiency.

  7. The current status of evidence for and against postnatal oogenesis in mammals: a case of ovarian optimism versus pessimism?

    Science.gov (United States)

    Tilly, Jonathan L; Niikura, Yuichi; Rueda, Bo R

    2009-01-01

    Whether or not oogenesis continues in the ovaries of mammalian females during postnatal life was heavily debated from the late 1800s through the mid-1900s. However, in 1951 Lord Solomon Zuckerman published what many consider to be a landmark paper summarizing his personal views of data existing at the time for and against the possibility of postnatal oogenesis. In Zuckerman's opinion, none of the evidence he considered was inconsistent with Waldeyer's initial proposal in 1870 that female mammals cease production of oocytes at or shortly after birth. This conclusion rapidly became dogma, and remained essentially unchallenged until just recently, despite the fact that Zuckerman did not offer a single experiment proving that adult female mammals are incapable of oogenesis. Instead, 20 years later he reemphasized that his conclusion was based solely on an absence of data he felt would be inconsistent with the idea of a nonrenewable oocyte pool provided at birth. However, in the immortal words of Carl Sagan, an "absence of evidence is not evidence of absence." Indeed, building on the efforts of a few scientists who continued to question this dogma after Zuckerman's treatise in 1951, we reported several data sets in 2004 that were very much inconsistent with the widely held belief that germ cell production in female mammals ceases at birth. Perhaps not surprisingly, given the magnitude of the paradigm shift being proposed, this work reignited a vigorous debate that first began more than a century ago. Our purpose here is to review the experimental evidence offered in recent studies arguing support for and against the possibility that adult mammalian females replenish their oocyte reserve. "Never discourage anyone who continually makes progress, no matter how slow."-Plato (427-347 BC).

  8. Achieving good oral health in children: the importance of a current, relevant and unbiased evidence base in paediatric dentistry.

    Science.gov (United States)

    Clarkson, J E; Bonetti, D; Worthington, H

    2013-06-01

    The Cochrane Collaboration was founded in 1993 as an international, non-profit and independent organisation dedicated to making up-to-date, accurate and reliable information about healthcare readily available. This paper discusses how the Cochrane Oral Health Group reviews have contributed to the oral health evidence base used in the development of many international and U.K. dental guidance documents, particularly in the field of paediatric dentistry.

  9. Testing for causality between the foreign direct investment, current account deficit, GDP and total credit: Evidence from G7

    Directory of Open Access Journals (Sweden)

    Akbas Yusuf Ekrem

    2013-01-01

    Full Text Available In this study, countries were analyzed between 1990 and 2011 in order to determine whether a causal relationship exists among current account deficit, GDP, foreign direct investment, and total credits of G7. Analysis took into account the cross-sectional dependence and was applied to test the causality among the variables form the panel. Firstly, panel unit root tests were used for determining stationary of variables. As a result of the panel unit root tests, it was found that GDP and foreign direct investment have a stationary structure and that total credits and current account deficit contain unit root. In order to see whether there is a long-term relationship among the variables or not, the panel co-integration test was used. As a result of the test, it was concluded that there is a co-integration relationship among the series. The possibility of a causal relationship was analyzed among the variables using the causality test developed by Elena Ivona Dumitrescu and Christophe Hurlin (2012. Results of the analysis showed a unidirectional causal relationship from current account deficit and foreign direct investment to GDP. Bidirectional causality was found between current account deficit and total credits. Finally, a unidirectional relationship was found from foreign direct investment to current account deficit and total credits.

  10. Thrombolytic treatment in the oldest-old patient with acute ischemic stroke: an update on current evidence

    Directory of Open Access Journals (Sweden)

    Fabiola Maioli

    2013-09-01

    Full Text Available The incidence of ischemic stroke rises exponentially with age, with a steep increase in the age interval between 75 and 85 years. Thrombolytic therapy restores cerebral blood flow in patients with acute ischemic stroke of any etiology by using drugs that dissolve blood clots. Infusion for 1 h of alteplase at the dose of 0.9 mg/kg within 3 h of the start of the symptoms is associated to a 30% increase in the likelihood of gaining a favorable outcome with respect to placebo. There is strong evidence that selected patients with ischemic stroke may benefit from intravenous thrombolysis when treated within 3 h. The aim of the study was to evaluate available evidence for the efficacy and safety of thrombolytic therapy in patients with ischemic stroke aged 80 years and over. Compared to younger stroke patients treated with thrombolytic therapy, those aged 80 years and over have higher acute mortality due to symptomatic intracranial hemorrhage. However, functional outcome at six months is significantly better for over-80-year-olds than younger patients. There is a need for screening tools that take into account pre-stroke functional and cognitive status that are able to identify those over-80-year-old patients with ischemic stroke who can most benefit from thrombolytic treatment. Available evidence supports further recruitment of oldest-old patients into ongoing trials of thrombolysis.

  11. Usage of Bone Replacement Grafts in Periodontics and Oral Implantology and Their Current Levels of Clinical Evidence - A Systematic Assessment.

    Science.gov (United States)

    Salem, Daliah; Natto, Zuhair; Elangovan, Satheesh; Karimbux, Nadeem

    2016-08-01

    The aim of this review is to evaluate the levels of clinical evidence for bone replacement grafts available in the United States for periodontics and oral implantology purposes. A search was performed using PubMed, the Cochrane Library, and Google Scholar for articles relating to the use of bone replacement grafts in implant and/or periodontics by two independent reviewers. Articles unrelated to the topic, not involving patients, not including abstracts, or in languages other than English were excluded. Selected articles were graded according to "levels of evidence" based on guidelines originally introduced by Wright et al. (2003). There was limited published peer-reviewed clinical literature available regarding US commercially available bone replacement grafts in periodontics and oral implantology. Of 144 bone replacement grafts available in the United States according to Avila-Ortiz et al. (2013), only 52 met the inclusion criteria. The majority of materials used were allografts (26 of 93 available in the United States), followed by alloplasts (15 of 30) and xenografts (11 of 21). Dental providers should be aware of the limited evidence that qualified for a strong rating supporting the clinical efficacy of these materials for periodontics and oral implantology purposes using the inclusion criteria selected in this study.

  12. Fundamentación Científica de la Psiquiatría Cubana Actual Current Cuban Psychiatry: Its scientific foundation

    Directory of Open Access Journals (Sweden)

    Liuba Y Peña Galbán

    2007-08-01

    Full Text Available Se realiza un análisis metodológico conceptual de la Psiquiatría como ciencia partiendo de los criterios de los psiquiatras cubanos, coincidiendo en que es una rama de las Ciencias Médicas, en la cual el objeto de estudio es la enfermedad mental o el proceso salud enfermedad mental y sus acciones es el diagnóstico, tratamiento, etiopatogenia, rehabilitación y prevención de las mismas, así como su estudio epidemiológico y que incluye el carácter social e interdisciplinario. A partir de la reorientación de la Psiquiatría hacia la comunidad se hace una reflexión del significado e implicaciones de la misma. Se argumenta como en Cuba se aplica el Modelo de la Atención Comunitaria de Salud Mental a través de los Centros comunitarios de Salud Mental que constituyen la piedra angular del modelo cubano de atención comunitaria, con los que constituye la Psiquiatría comunitaria el nuevo paradigma de la Psiquiatría cubana actual. Se reconoce que el fundamento filosófico que sustenta a la Psiquiatría cubana actual es la teoría Marxista LeninistaA conceptual and methodological analysis of Psychiatry as a science is made, taking the Cuban psychiatrists' criteria as a starting point, referring to it as a branch of the Medical Sciences, in which the object of study is the mental illness or the process health-mental illness, being its actions the diagnosis, treatment, ethiology and pathogenesis, rehabilitation and prevention, as well as its epidemiological study that is related to the social and interdisciplinary levels. Starting with redirecting Psychiatry towards the community, a reflection is made of the meaning and implications of this science. It is documented the application of the Community Mental Health Attention Model that is applied through the community Centers of Mental Health, which constitute the cornerstone of the Cuban model of community attention. Thus, community Psychiatry represents the new paradigm of current Cuban

  13. Evidence of a New Current-Induced Magnetoelectric Effect in a Toroidal Magnetic Ordered State of UNi4B

    Science.gov (United States)

    Saito, Hiraku; Uenishi, Kenta; Miura, Naoyuki; Tabata, Chihiro; Hidaka, Hiroyuki; Yanagisawa, Tatsuya; Amitsuka, Hiroshi

    2018-03-01

    Magnetization measurements under direct electric current were performed in a toroidal magnetic ordered state of UNi4B to test a recent theoretical prediction of current-induced magnetization in a metallic system lacking local-inversion symmetry. We found that electric current parallel to [2\\bar{1}\\bar{1}0] and [0001] in the hexagonal 4-index notation induces a uniform magnetization along the [01\\bar{1}0] direction. The observed behavior of the induced magnetization is essentially consistent with the theoretical prediction; however, it also shows an inconsistency suggesting that the antiferromagnetic state of UNi4B could not be simply regarded as a uniform toroidal order in the ideal honeycomb layered structure.

  14. Non-surgical management of a pediatric "intoed" gait pattern - a systematic review of the current best evidence.

    Science.gov (United States)

    Uden, Hayley; Kumar, Saravana

    2012-01-01

    An intoed gait pattern is one of the most common referrals for children to an orthopedic consultation. Parental concern as to the aesthetics of the child's gait pattern and/or its symptomatic nature will primarily drive these referrals during a child's early developmental years. Whilst some of these referrals prove to be the result of a normal growth variant, some children will present with a symptomatic intoed gait pattern. Various treatments, both conservative and surgical, have been proposed including: braces, wedges, stretches and exercises, shoe modifications, and surgical procedures. However, which treatments are effective and justified in the management of this condition is not clear within the literature. The aim of this systematic review was to therefore identify and critique the best available evidence for the non-surgical management of an intoed gait pattern in a pediatric population. A systematic review was conducted of which only experimental studies investigating a management option for an intoeing gait pattern were included. Studies needed to be written in English, pertaining to a human pediatric population, and published within a peer reviewed journal. Electronic databases were searched: Ovid (Medline), EMBASE, AMED, PubMed, SportDiscus, CINAHL, and Cochrane Library. The National Health and Medical Research Council's designation of levels of hierarchy and the Critical Appraisal Skills Programme cohort studies critical appraisal tool were used. Five level IV studies were found. The studies were of varied quality and with mixed results. Gait plates, physiologic/standardized shoes, and orthotic devices (with gate plate extension) were shown to produce a statistically significant improvement to an intoed gait pattern. Shoe wedges, torqheels, and a leather counter splint were not able to reduce an intoed gait pattern. There is limited evidence to inform the non-surgical management of a pediatric intoed gait pattern. The body of evidence that does exist

  15. Evidence of transcranial direct current stimulation-generated electric fields at subthalamic level in human brain in vivo.

    Science.gov (United States)

    Chhatbar, Pratik Y; Kautz, Steven A; Takacs, Istvan; Rowland, Nathan C; Revuelta, Gonzalo J; George, Mark S; Bikson, Marom; Feng, Wuwei

    2018-03-13

    Transcranial direct current stimulation (tDCS) is a promising brain modulation technique for several disease conditions. With this technique, some portion of the current penetrates through the scalp to the cortex and modulates cortical excitability, but a recent human cadaver study questions the amount. This insufficient intracerebral penetration of currents may partially explain the inconsistent and mixed results in tDCS studies to date. Experimental validation of a transcranial alternating current stimulation-generated electric field (EF) in vivo has been performed on the cortical (using electrocorticography, ECoG, electrodes), subcortical (using stereo electroencephalography, SEEG, electrodes) and deeper thalamic/subthalamic levels (using DBS electrodes). However, tDCS-generated EF measurements have never been attempted. We aimed to demonstrate that tDCS generates biologically relevant EF as deep as the subthalamic level in vivo. Patients with movement disorders who have implanted deep brain stimulation (DBS) electrodes serve as a natural experimental model for thalamic/subthalamic recordings of tDCS-generated EF. We measured voltage changes from DBS electrodes and body resistance from tDCS electrodes in three subjects while applying direct current to the scalp at 2 mA and 4 mA over two tDCS montages. Voltage changes at the level of deep nuclei changed proportionally with the level of applied current and varied with different tDCS montages. Our findings suggest that scalp-applied tDCS generates biologically relevant EF. Incorporation of these experimental results may improve finite element analysis (FEA)-based models. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. The glenoid track: a review of the clinical relevance, method of calculation and current evidence behind this method

    Energy Technology Data Exchange (ETDEWEB)

    Younan, Yara; Wong, Philip K.; Umpierrez, Monica; Gonzalez, Felix; Singer, Adam Daniel [Emory University Hospital, Department of Radiology and Imaging Sciences, Section of Musculoskeletal Imaging, Atlanta, GA (United States); Karas, Spero [Emory University Hospital, Department of Orthopedic Surgery, Atlanta, GA (United States); Jose, Jean [University of Miami, Department of Radiology, Miami, FL (United States)

    2017-12-15

    In the setting of bipolar bone injury, orthopedic surgeons are currently making use of the glenoid track method to guide surgical management. Using preoperative CT or MR imaging, this method allows the identification of patients who are more likely to fail a primary capsuloligamentous Bankart repair. As the glenoid track method becomes increasingly used in preoperative planning, it is important for the radiologist to become familiar with its concept and method of calculation. This review article aims to concisely summarize the current literature and the clinical implications of the glenoid track method. (orig.)

  17. Evidence of the Current Collector Effect: Study of the SOFC Cathode Material Ca3Co4O9+d

    NARCIS (Netherlands)

    Rolle, A.; Thoréton, V.; Rozier, P.; Capoen, E.; Mentré, O.; Boukamp, Bernard A.; Daviero-Minaud, S.

    2012-01-01

    In the study of the performance of solid oxide fuel cell (SOFC) electrodes, the possible influence of the applied current collector is often not mentioned or recognized. In this article, as part of an optimization study of the potentially attractive Ca3Co4O9+δ cathode material (Ca349), special

  18. Current Hormonal Contraceptive Use Predicts Female Extra-Pair and Dyadic Sexual Behavior: Evidence Based on Czech National Survey Data

    Directory of Open Access Journals (Sweden)

    Kateřina Klapilová

    2014-01-01

    Full Text Available Data from 1155 Czech women (493 using oral contraception, 662 non-users, obtained from the Czech National Survey of Sexual Behavior, were used to investigate evolutionary-based hypotheses concerning the predictive value of current oral contraceptive (OC use on extra-pair and dyadic (in-pair sexual behavior of coupled women. Specifically, the aim was to determine whether current OC use was associated with lower extra-pair and higher in-pair sexual interest and behavior, because OC use suppresses cyclical shifts in mating psychology that occur in normally cycling women. Zero-inflated Poisson (ZIP regression and negative binomial models were used to test associations between OC use and these sexual measures, controlling for other relevant predictors (e.g., age, parity, in-pair sexual satisfaction, relationship length. The overall incidence of having had an extra-pair partner or one-night stand in the previous year was not related to current OC use (the majority of the sample had not. However, among the women who had engaged in extra-pair sexual behavior, OC users had fewer one-night stands than non-users, and tended to have fewer partners, than non-users. OC users also had more frequent dyadic intercourse than non-users, potentially indicating higher commitment to their current relationship. These results suggest that suppression of fertility through OC use may alter important aspects of female sexual behavior, with potential implications for relationship functioning and stability.

  19. Current evidence of methotrexate efficacy in childhood chronic uveitis: a systematic review and meta-analysis approach.

    Science.gov (United States)

    Simonini, Gabriele; Paudyal, Priyamvada; Jones, Gareth T; Cimaz, Rolando; Macfarlane, Gary J

    2013-05-01

    To summarize evidence regarding the effectiveness of MTX in the treatment of childhood autoimmune chronic uveitis (ACU). A systematic search of articles between January 1990 and June 2011 was conducted using EMBASE, Ovid MEDLINE, Evidence-Based Medicine Reviews-ACP Journal Club, the Cochrane Library and EBM Reviews. Studies investigating the efficacy of MTX as a single immunosuppressant medication in the treatment of ACU refractory to therapy with topical treatment and/or systemic treatment in children (≤16 years) were eligible for inclusion. The primary outcome measure was the improvement of intraocular inflammation, expressed as Tyndall, as defined by the Standardization of Uveitis Nomenclature working group criteria. The effect measure for each study was the proportion of people classified as responders. We determined a combined estimate of the proportion of children in the eligible studies responding to MTX. The initial search identified 246 articles of which 52 were potentially eligible. Nine eligible articles, all retrospective chart reviews, remained in the analysis. The number of children in studies ranged from 3 to 25, and the dose of MTX varied from 7.5 to 30 mg/m2. Altogether, 95 of 135 children responded to MTX. The pooled analysis suggested that MTX has a favourable effect in the improvement of intraocular inflammation: the proportion of responding subjects was 0.73 (95% CI 0.66, 0.81). Although randomized controlled trials are needed, the available evidence supports the use of MTX in the treatment of childhood ACU: approximately three-quarters of patients on MTX can expect improvement in intraocular inflammation.

  20. The development of scientific reasoning in medical education: a psychological perspective.

    Science.gov (United States)

    Barz, Daniela Luminita; Achimaş-Cadariu, Andrei

    2016-01-01

    Scientific reasoning has been studied from a variety of theoretical perspectives, which have tried to identify the underlying mechanisms responsible for the development of this particular cognitive process. Scientific reasoning has been defined as a problem-solving process that involves critical thinking in relation to content, procedural, and epistemic knowledge. The development of scientific reasoning in medical education was influenced by current paradigmatic trends, it could be traced along educational curriculum and followed cognitive processes. The purpose of the present review is to discuss the role of scientific reasoning in medical education and outline educational methods for its development. Current evidence suggests that medical education should foster a new ways of development of scientific reasoning, which include exploration of the complexity of scientific inquiry, and also take into consideration the heterogeneity of clinical cases found in practice.

  1. Working conditions and health among employees at information technology--enabled services: a review of current evidence.

    Science.gov (United States)

    Kesavachandran, C; Rastogi, S K; Das, Mohan; Khan, Asif M

    2006-07-01

    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.

  2. Robotic-Assisted Procedures in Pediatric Surgery: A Critical Appraisal of the Current Best Evidence in Comparison to Conventional Minimally Invasive Surgery.

    Science.gov (United States)

    Friedmacher, Florian; Till, Holger

    2015-11-01

    In recent years, the use of robotic-assisted surgery (RAS) has expanded within pediatric surgery. Although increasing numbers of pediatric RAS case-series have been published, the level of evidence remains unclear, with authors mainly focusing on the comparison with open surgery rather than the corresponding laparoscopic approach. The aim of this study was to critically appraise the published literature comparing pediatric RAS with conventional minimally invasive surgery (MIS) in order to evaluate the current best level of evidence. A systematic literature-based search for studies comparing pediatric RAS with corresponding MIS procedures was performed using multiple electronic databases and sources. The level of evidence was determined using the Oxford Centre for Evidence-based Medicine (OCEBM) criteria. A total of 20 studies met defined inclusion criteria, reporting on five different procedures: fundoplication (n=8), pyeloplasty (n=8), nephrectomy (n=2), gastric banding (n=1), and sleeve gastrectomy (n=1). Included publications comprised 5 systematic reviews and 15 cohort/case-control studies (OCEBM Level 3 and 4, respectively). No studies of OCEBM Level 1 or 2 were identified. Limited evidence indicated reduced operative time (pyeloplasty) and shorter hospital stay (fundoplication) for pediatric RAS, whereas disadvantages were longer operative time (fundoplication, nephrectomy, gastric banding, and sleeve gastrectomy) and higher total costs (fundoplication and sleeve gastrectomy). There were no differences reported for complications, success rates, or short-term outcomes between pediatric RAS and conventional MIS in these procedures. Inconsistency was found in study design and follow-up with large clinical heterogeneity. The best available evidence for pediatric RAS is currently OCEBM Level 3, relating only to fundoplication and pyeloplasty. Therefore, higher-quality studies and comparative data for other RAS procedures in pediatric surgery are required.

  3. Probiotics as a novel treatment for non-alcoholic Fatty liver disease; a systematic review on the current evidences.

    Science.gov (United States)

    Kelishadi, Roya; Farajian, Sanam; Mirlohi, Maryam

    2013-04-01

    Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease, with 5-10% of liver having extra fat. Increase in its prevalence in all age groups is linked with obesity and Type II diabetes. The treatment of NAFLD remains controversial. A growing body of evidence suggests a relation between overgrowth of gut microbiota with NAFLD and non-alcoholic steatohepatitis (NASH). The objective of this review is to provide an overview on experimental and clinical studies assessing all positive and negative effects of probiotics. We made a critical appraisal on various types of documents published from 1999 to March 2012 in journals, electronic books, seminars, and symposium contexts including Medline, PubMed, and Cochrane Central Register of Controlled Trials databases. We used the key words: "non-alcoholic fatty liver disease, probiotics, non-alcoholic steatohepatitis, liver disease, and fatty liver". Probiotics, as biological factors, control the gut microbiota and result in its progression. It is in this sense that they are suggestive of a new and a natural way of promoting liver function. Correspondingly, limited evidence suggests that probiotics could be considered as a new way of treatment for NAFLD. Various experimental studies and clinical trials revealed promising effects of probiotics in improving NAFLD; however given the limited experience in this field, generalization of probiotics as treatment of NAFLD needs substantiation through more trials with a larger sample sizes and with longer-term follow up.

  4. No evidence for enhancements to visual working memory with transcranial direct current stimulation to prefrontal or posterior parietal cortices.

    Science.gov (United States)

    Robison, Matthew K; McGuirk, William P; Unsworth, Nash

    2017-08-01

    The present study examined the relative contributions of the prefrontal cortex (PFC) and posterior parietal cortex (PPC) to visual working memory. Evidence from a number of different techniques has led to the theory that the PFC controls access to working memory (i.e., filtering), determining which information is encoded and maintained for later use whereas the parietal cortex determines how much information is held at 1 given time, regardless of relevance (i.e., capacity; McNab & Klingberg, 2008; Vogel, McCollough, & Machizawa, 2005). To test this theory, we delivered transcranial DC stimulation (tDCS) to the right PFC and right PPC and measured visual working memory capacity and filtering abilities both during and immediately following stimulation. We observed no evidence that tDCS to either the PFC or PPC significantly improved visual working memory. Although the present results did not allow us to make firm theoretical conclusions about the roles of the PFC and PPC in working memory, the results add to the growing body of literature surrounding tDCS and its associated behavioral and neurophysiological effects. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Runout distance and dynamic pressure of pyroclastic density currents: Evidence from 18 May 1980 blast surge of Mount St. Helens

    Science.gov (United States)

    Gardner, J. E.; Andrews, B. J.

    2016-12-01

    Pyroclastic density currents (flows and surges) are one of the most deadly hazards associated with volcanic eruptions. Understanding what controls how far such currents will travel, and how their dynamic pressure evolves, could help mitigate their hazards. The distance a ground hugging, pyroclastic density current travels is partly limited by when it reverses buoyancy and lifts off into the atmosphere. The 1980 blast surge of Mount St. Helens offers an example of a current seen to lift off. Before lofting, it had traveled up to 20 km and leveled more than 600 km3 of thick forest (the blowdown zone). The outer edge of the devastated area - where burned trees that were left standing (the singe zone) - is where the surge is thought to have lifted off. We recently examined deposits in the outer parts of the blowdown and in the singe zone at 32 sites. The important finding is that the laterally moving surge travelled into the singe zone, and hence the change in tree damage does not mark the run out distance of the ground hugging surge. Eyewitness accounts and impacts on trees and vehicles reveal that the surge consisted of a fast, dilute "overcurrent" and a slower "undercurrent", where most of the mass (and heat) was retained. Reasonable estimates for flow density and velocity show that dynamic pressure of the surge (i.e., its ability to topple trees) peaked near the base of the overcurrent. We propose that when the overcurrent began to lift off, the height of peak dynamic pressure rose above the trees and stopped toppling them. The slower undercurrent continued forward, burning trees but it lacked the dynamic pressure needed to topple them. Grain-size variations argue that it slowed from 30 m/s when it entered the singe zone to 3 m/s at the far end. Buoyancy reversal and liftoff are thus not preserved in the deposits where the surge lofted upwards.

  6. Paralympic sports medicine--current evidence in winter sport: considerations in the development of equipment standards for paralympic athletes.

    Science.gov (United States)

    Burkett, Brendan

    2012-01-01

    To highlight and discuss the considerations for the future development of equipment standards for Winter Paralympic sports. Literature searches were performed (in English) during May 2011 using the key words "technology, winter sport, Olympic, and Paralympic" in the computerized databases PubMed, PsycINFO, Science Direct, and Google Scholar. In addition, personal scientific observations were made at several Winter Paralympic Games. The retrieved articles were screened and assessed for relevance to the biological, biomechanical, and sport medicine aspects of equipment. There are 3 key areas in which technology has influenced sports performance in Paralympic winter sports, namely, specialized prostheses, crutch skis or outriggers (in lieu of poles), and sport-specific wheelchairs (such as the sit-ski). From a sport medicine perspective, a crucial factor not considered in the standard laboratory test of mechanical efficiency is the influence of the human-equipment connection, such as the stump-to-prosthesis interface or the required human-to-wheelchair control. This connectivity is critical to the effective operation of the assistive device. When assessing the efficiency of this equipment, the not-so-obvious, holistic, compensatory factors need to be considered. Assistive equipment is fundamental for a person with a disability to participate and compete in winter sport activities. Although there have been improvements in the mechanical function of some assistive devices, the key issue is matching the residual function of the person with the assistive equipment. Equitable access to this technology will also ensure that the fundamental spirit of fair play that underpins the Paralympic Games is maintained.

  7. Transfusão de plaquetas: do empirismo ao embasamento científico Platelet transfusion: from empiricism to scientific evidence

    Directory of Open Access Journals (Sweden)

    Aline A. Ferreira

    2010-01-01

    Full Text Available Despite major advances in Brazilian blood transfusion therapy with a growing number of scientific publications, an increased number of repeat donors and a decline in serological ineligibility, a lack of conformity in the application of pre-transfusion tests that may compromise transfusion safety is still observed at transfusion agencies in the fringes of the blood transfusion therapy system. Additionally, although high rates of platelet transfusion refractoriness and significant rates of alloimmunization have been demonstrated in the international literature, few Brazilian centers have been concerned with the study of platelet alloimmunization and even fewer centers have evaluated the efficacy of platelet concentrate transfusion. As more than one million Brazilians, including many repeat blood donors, are listed in the National Bone Marrow Donor Registry (Redome, why not grant transfusion therapy services access to the HLA typing of these blood and marrow donors after obtaining their consent? And why not make use of the Redome data to evaluate the HLA compatibility of donors for alloimmunized patients who are candidates for bone marrow transfusion and who have already been typed? These measures, together with the identification of ABO and HPA antigens, will permit a complete assessment of platelet immunology, will guarantee the transfusion safety of this blood component, and will put Brazil at the same level as the so-called developed countries in terms of transfusion medicine.

  8. A New Proposal for the Pathogenic Mechanism of Non-Coeliac/Non-Allergic Gluten/Wheat Sensitivity: Piecing Together the Puzzle of Recent Scientific Evidence

    Directory of Open Access Journals (Sweden)

    Valentina Leccioli

    2017-11-01

    Full Text Available Non-coeliac/non-allergic gluten/wheat sensitivity (NCG/WS is a gluten-related disorder, the pathogenesis of which remains unclear. Recently, the involvement of an increased intestinal permeability has been recognized in the onset of this clinical condition. However, mechanisms through which it takes place are still unclear. In this review, we attempt to uncover these mechanisms by providing, for the first time, an integrated vision of recent scientific literature, resulting in a new hypothesis about the pathogenic mechanisms involved in NCG/WS. According to this, the root cause of NCG/WS is a particular dysbiotic profile characterized by decreased butyrate-producing-Firmicutes and/or Bifidobacteria, leading to low levels of intestinal butyrate. Beyond a critical threshold of the latter, a chain reaction of events and vicious circles occurs, involving other protagonists such as microbial lipopolysaccharide (LPS, intestinal alkaline phosphatase (IAP and wheat α-amylase trypsin inhibitors (ATIs. NCG/WS is likely to be a multi-factor-onset disorder, probably transient and preventable, related to quality and balance of the diet, and not to the presence of gluten in itself. If future studies confirm our proposal, this would have important implications both for the definition of the disease, as well as for the prevention and therapeutic-nutritional management of individuals with NCG/WS.

  9. Evidence on acne therapy

    Directory of Open Access Journals (Sweden)

    Caroline Sousa Costa

    Full Text Available Among the current treatments available for acne vulgaris, many widely practiced options lack support from studies at the best level of scientific evidence. The aim of this narrative review was to present the very latest information on topical and systemic treatments for acne vulgaris. Information from systematic reviews and well-designed clinical trials, obtained through a systematic search of the major medical databases, is emphasized. There are important issues regarding the clinical management of acne that still lack consistent grounding in scientific evidence. Among these are the optimum dose and duration of treatment with oral antibiotics that can be given without inducing bacterial resistance, and the safety of oral isotretinoin.

  10. Cardiovascular Consequences of Childhood Secondhand Tobacco Smoke Exposure: Prevailing Evidence, Burden, and Racial and Socioeconomic Disparities: A Scientific Statement From the American Heart Association.

    Science.gov (United States)

    Raghuveer, Geetha; White, David A; Hayman, Laura L; Woo, Jessica G; Villafane, Juan; Celermajer, David; Ward, Kenneth D; de Ferranti, Sarah D; Zachariah, Justin

    2016-10-18

    Although public health programs have led to a substantial decrease in the prevalence of tobacco smoking, the adverse health effects of tobacco smoke exposure are by no means a thing of the past. In the United States, 4 of 10 school-aged children and 1 of 3 adolescents are involuntarily exposed to secondhand tobacco smoke (SHS), with children of minority ethnic backgrounds and those living in low-socioeconomic-status households being disproportionately affected (68% and 43%, respectively). Children are particularly vulnerable, with little control over home and social environment, and lack the understanding, agency, and ability to avoid SHS exposure on their own volition; they also have physiological or behavioral characteristics that render them especially susceptible to effects of SHS. Side-stream smoke (the smoke emanating from the burning end of the cigarette), a major component of SHS, contains a higher concentration of some toxins than mainstream smoke (inhaled by the smoker directly), making SHS potentially as dangerous as or even more dangerous than direct smoking. Compelling animal and human evidence shows that SHS exposure during childhood is detrimental to arterial function and structure, resulting in premature atherosclerosis and its cardiovascular consequences. Childhood SHS exposure is also related to impaired cardiac autonomic function and changes in heart rate variability. In addition, childhood SHS exposure is associated with clustering of cardiometabolic risk factors such as obesity, dyslipidemia, and insulin resistance. Individualized interventions to reduce childhood exposure to SHS are shown to be at least modestly effective, as are broader-based policy initiatives such as community smoking bans and increased taxation. The purpose of this statement is to summarize the available evidence on the cardiovascular health consequences of childhood SHS exposure; this will support ongoing efforts to further reduce and eliminate SHS exposure in this

  11. Pressure ulcer research : current and future perspectives

    NARCIS (Netherlands)

    Bader, D.L.; Bouten, C.V.C.; Colin, D.; Oomens, C.W.J.

    2005-01-01

    This book provides an up-to-date scientific account of all aspects related to pressure ulcers and pressure ulcer research, as well as evidence-based knowledge of pressure ulcer aetiology. Further, it describes current and future tools for evaluating patients at risk. It comprises 20 chapters by

  12. Nonspecific non-acute low back pain and psychological interventions: A review of evidence and current strategies

    Directory of Open Access Journals (Sweden)

    Gourav Banerjee

    2015-01-01

    Full Text Available Nonspecific persistent and chronic low back pain (LBP is one of the world′s most significant burdens. Its management continues to be challenging despite advancements in medical diagnostics and therapeutics. The purpose of this narrative review is to update evidence-based, multidisciplinary assessment and treatment strategies for nonspecific non-acute LBP with special emphasis on the growing influence of psychological principles in physiotherapists′ (PT practice. An electronic literature search was performed to identify relevant clinical practice guidelines, from which an overarching summary was synthesized. All guidelines were consistent in their recommendations for the assessment of psychosocial factors and psychology-based interventions. In discussion, we underlined psychological processes and psychology-based strategies that are clinically relevant to, and within the professional competency and scope of PT practice.

  13. The potential for military diets to reduce depression, suicide, and impulsive aggression: a review of current evidence for omega-3 and omega-6 fatty acids.

    Science.gov (United States)

    Hibbeln, Joseph R; Gow, Rachel V

    2014-11-01

    The current burden of psychological distress and illness poses as a significant barrier to optimal force efficacy. Here we assess nutrients in military diets, specifically highly unsaturated essential fatty acids, in the reduction of risk or treatment of psychiatric distress. Moderate to strong evidence from several meta-analyses of prospective cohort trials indicate that Mediterranean diet patterns reduce risk of clinical depressions. Specific nutrients and foods of biological interest in relation to mental health outcomes are then discussed and evaluated. Moderate evidence indicates that when fish consumption decreases and simultaneously omega-6 increases, the risk of clinical depressive symptoms are elevated. One meta-analysis examining tissue compositions provides moderate to strong evidence that higher levels of omega-3 highly unsaturated fatty acids (HUFAs) (eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid) are associated with decreased risk of clinical depressions. Other meta-analytic reviews of randomized placebo-controlled trials provide moderate to strong evidence of significantly improving clinically depressive symptoms when the formulation given was >50% in eicosapentaenoic acid. Finally, a meta-analysis of omega-3 HUFAs provides modest evidence of clinical efficacy for attention-deficit hyperactivity disorder. This article recommends that a rebalancing of the essential fatty acid composition of U.S. military diets, achieve tissue compositions of HUFAs consistent with traditional Mediterranean diets, may help reduce military psychiatric distress and simultaneously increase force efficacy substantially. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  14. Evidence for Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    Science.gov (United States)

    Barnason, Susan; White-Williams, Connie; Rossi, Laura P; Centeno, Mae; Crabbe, Deborah L; Lee, Kyoung Suk; McCabe, Nancy; Nauser, Julie; Schulz, Paula; Stamp, Kelly; Wood, Kathryn

    2017-06-01

    The burden of cardiovascular disease as a chronic illness increasingly requires patients to assume more responsibility for their self-management. Patient education is believed to be an essential component of cardiovascular care; however, there is limited evidence about specific therapeutic patient education approaches used and the impact on patient self-management outcomes. An integrative review of the literature was conducted to critically analyze published research studies of therapeutic patient education for self-management in selected cardiovascular conditions. There was variability in methodological approaches across settings and disease conditions. The most effective interventions were tailored to individual patient needs, used multiple components to improve self-management outcomes, and often used multidisciplinary approaches. This synthesis of evidence expands the base of knowledge related to the development of patient self-management skills and provides direction for more rigorous research. Recommendations are provided to guide the implementation of therapeutic patient education in clinical practice and the design of comprehensive self-management interventions to improve outcomes for cardiovascular patients. © 2017 American Heart Association, Inc.

  15. Effects of Scaffolds and Scientific Reasoning Ability on Web-Based Scientific Inquiry

    Science.gov (United States)

    Wu, Hui-Ling; Weng, Hsiao-Lan; She, Hsiao-Ching

    2016-01-01

    This study examined how background knowledge, scientific reasoning ability, and various scaffolding forms influenced students' science knowledge and scientific inquiry achievements. The students participated in an online scientific inquiry program involving such activities as generating scientific questions and drawing evidence-based conclusions,…

  16. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association.

    Science.gov (United States)

    Fox, Caroline S; Golden, Sherita Hill; Anderson, Cheryl; Bray, George A; Burke, Lora E; de Boer, Ian H; Deedwania, Prakash; Eckel, Robert H; Ershow, Abby G; Fradkin, Judith; Inzucchi, Silvio E; Kosiborod, Mikhail; Nelson, Robert G; Patel, Mahesh J; Pignone, Michael; Quinn, Laurie; Schauer, Philip R; Selvin, Elizabeth; Vafiadis, Dorothea K

    2015-08-25

    Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus. © 2015 American Heart Association, Inc.

  17. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association

    Science.gov (United States)

    Golden, Sherita Hill; Anderson, Cheryl; Bray, George A.; Burke, Lora E.; de Boer, Ian H.; Deedwania, Prakash; Eckel, Robert H.; Ershow, Abby G.; Fradkin, Judith; Inzucchi, Silvio E.; Kosiborod, Mikhail; Nelson, Robert G.; Patel, Mahesh J.; Pignone, Michael; Quinn, Laurie; Schauer, Philip R.; Selvin, Elizabeth; Vafiadis, Dorothea K.

    2015-01-01

    Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The purpose of this scientific statement is to review the current literature and key clinical trials pertaining to blood pressure and blood glucose control, cholesterol management, aspirin therapy, and lifestyle modification. We present a synthesis of the recent literature, new guidelines, and clinical targets, including screening for kidney and subclinical cardiovascular disease for the contemporary management of patients with type 2 diabetes mellitus. PMID:26246459

  18. Implicit normativity in scientific advice

    DEFF Research Database (Denmark)

    Folker, Anna Paldam; Andersen, Hanne; Sandøe, Peter

    2008-01-01

    This paper focuses on implicit normative considerations underlying scientific advice-those normative questions, decisions, or issues that scientific advisers and the general public are not fully aware of but that nevertheless have implications for the character of the advice given. Using...... nutritional science as an example, we identify three such implicit normative issues. The first concerns the aim of scientific advice: whether it is about avoiding harm or promoting good. The second concerns the intended beneficiaries of the advice: whether advice should be framed to benefit the society...... as a whole or with special concern for the most vulnerable members of the population. The third consideration involves scientific advisers' attempts to balance the strengths of the scientific evidence with the expected consequences of scientific advice. We hope to promote more explicit discussion...

  19. Evidence for a role of transporter-mediated currents in the depletion of brain serotonin induced by serotonin transporter substrates.

    Science.gov (United States)

    Baumann, Michael H; Bulling, Simon; Benaderet, Tova S; Saha, Kusumika; Ayestas, Mario A; Partilla, John S; Ali, Syed F; Stockner, Thomas; Rothman, Richard B; Sandtner, Walter; Sitte, Harald H

    2014-05-01

    Serotonin (5-HT) transporter (SERT) substrates like fenfluramine and 3,4-methylenedioxymethamphetamine cause long-term depletion of brain 5-HT, while certain other substrates do not. The 5-HT deficits produced by SERT substrates are dependent upon transporter proteins, but the exact mechanisms responsible are unclear. Here, we compared the pharmacology of several SERT substrates: fenfluramine, d-fenfluramine, 1-(m-chlorophenyl)piperazine (mCPP) and 1-(m-trifluoromethylphenyl)piperainze (TFMPP), to establish relationships between acute drug mechanisms and the propensity for long-term 5-HT depletions. In vivo microdialysis was carried out in rat nucleus accumbens to examine acute 5-HT release and long-term depletion in the same subjects. In vitro assays were performed to measure efflux of [(3)H]5-HT in rat brain synaptosomes and transporter-mediated ionic currents in SERT-expressing Xenopus oocytes. When administered repeatedly to rats (6 mg/kg, i.p., four doses), all drugs produce large sustained elevations in extracellular 5-HT (>5-fold) with minimal effects on dopamine. Importantly, 2 weeks after dosing, only rats exposed to fenfluramine and d-fenfluramine display depletion of brain 5-HT. All test drugs evoke fluoxetine-sensitive efflux of [(3)H]5-HT from synaptosomes, but d-fenfluramine and its bioactive metabolite d-norfenfluramine induce significantly greater SERT-mediated currents than phenylpiperazines. Our data confirm that drug-induced 5-HT release probably does not mediate 5-HT depletion. However, the magnitude of transporter-mediated inward current may be a critical factor in the cascade of events leading to 5-HT deficits. This hypothesis warrants further study, especially given the growing popularity of designer drugs that target SERT.

  20. E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys.

    Science.gov (United States)

    Zhu, Shu-Hong; Zhuang, Yue-Lin; Wong, Shiushing; Cummins, Sharon E; Tedeschi, Gary J

    2017-07-26

    Objective  To examine whether the increase in use of electronic cigarettes in the USA, which became noticeable around 2010 and increased dramatically by 2014, was associated with a change in overall smoking cessation rate at the population level. Design  Population surveys with nationally representative samples. Setting  Five of the US Current Population Survey-Tobacco Use Supplement (CPS-TUS) in 2001-02, 2003, 2006-07, 2010-11, and 2014-15. Participants  Data on e-cigarette use were obtained from the total sample of the 2014-15 CPS-TUS (n=161 054). Smoking cessation rates were obtained from those who reported smoking cigarettes 12 months before the survey (n=23 270). Rates from 2014-15 CPS-TUS were then compared with those from 2010-11 CPS-TUS (n=27 280) and those from three other previous surveys. Main outcome measures  Rate of attempt to quit cigarette smoking and the rate of successfully quitting smoking, defined as having quit smoking for at least three months. Results  Of 161 054 respondents to the 2014-15 survey, 22 548 were current smokers and 2136 recent quitters. Among them, 38.2% of current smokers and 49.3% of recent quitters had tried e-cigarettes, and 11.5% and 19.0% used them currently (every day or some days). E-cigarette users were more likely than non-users to attempt to quit smoking, 65.1% v 40.1% (change=25.0%, 95% confidence interval 23.2% to 26.9%), and more likely to succeed in quitting, 8.2% v 4.8% (3.5%, 2.5% to 4.5%). The overall population cessation rate for 2014-15 was significantly higher than that for 2010-11, 5.6% v 4.5% (1.1%, 0.6% to 1.5%), and higher than those for all other survey years (range 4.3-4.5%). Conclusion  The substantial increase in e-cigarette use among US adult smokers was associated with a statistically significant increase in the smoking cessation rate at the population level. These findings need to be weighed carefully in regulatory policy making regarding e-cigarettes and in planning tobacco

  1. Evidence for non-conservative current-induced forces in the breaking of Au and Pt atomic chains

    OpenAIRE

    Sabater, Carlos; Untiedt, Carlos; van Ruitenbeek, Jan M

    2015-01-01

    This experimental work aims at probing current-induced forces at the atomic scale. Specifically it addresses predictions in recent work regarding the appearance of run-away modes as a result of a combined effect of the non-conservative wind force and a ‘Berry force’. The systems we consider here are atomic chains of Au and Pt atoms, for which we investigate the distribution of break down voltage values. We observe two distinct modes of breaking for Au atomic chains. The breaking at high volta...

  2. Evidence for non-conservative current-induced forces in the breaking of Au and Pt atomic chains.

    Science.gov (United States)

    Sabater, Carlos; Untiedt, Carlos; van Ruitenbeek, Jan M

    2015-01-01

    This experimental work aims at probing current-induced forces at the atomic scale. Specifically it addresses predictions in recent work regarding the appearance of run-away modes as a result of a combined effect of the non-conservative wind force and a 'Berry force'. The systems we consider here are atomic chains of Au and Pt atoms, for which we investigate the distribution of break down voltage values. We observe two distinct modes of breaking for Au atomic chains. The breaking at high voltage appears to behave as expected for regular break down by thermal excitation due to Joule heating. However, there is a low-voltage breaking mode that has characteristics expected for the mechanism of current-induced forces. Although a full comparison would require more detailed information on the individual atomic configurations, the systems we consider are very similar to those considered in recent model calculations and the comparison between experiment and theory is very encouraging for the interpretation we propose.

  3. Evidence for non-conservative current-induced forces in the breaking of Au and Pt atomic chains

    Directory of Open Access Journals (Sweden)

    Carlos Sabater

    2015-12-01

    Full Text Available This experimental work aims at probing current-induced forces at the atomic scale. Specifically it addresses predictions in recent work regarding the appearance of run-away modes as a result of a combined effect of the non-conservative wind force and a ‘Berry force’. The systems we consider here are atomic chains of Au and Pt atoms, for which we investigate the distribution of break down voltage values. We observe two distinct modes of breaking for Au atomic chains. The breaking at high voltage appears to behave as expected for regular break down by thermal excitation due to Joule heating. However, there is a low-voltage breaking mode that has characteristics expected for the mechanism of current-induced forces. Although a full comparison would require more detailed information on the individual atomic configurations, the systems we consider are very similar to those considered in recent model calculations and the comparison between experiment and theory is very encouraging for the interpretation we propose.

  4. Variations of the Antarctic Circumpolar Current (ACC) in the Kerguelen Sector during the Last Deglaciation : sedimentological and geochemical evidences

    Science.gov (United States)

    Bout-Roumazeilles, V.; Beny, F.; Mazaud, A.; Michel, E.; Crosta, X.; Davies, G. R.; Bory, A. J. M.

    2017-12-01

    High-resolution sedimentological and geochemical records were obtained from two sediment cores recovered by the French R/V Marion Dufresne during the INDIEN-SUD-ACC cruises near the sub-Antarctic Kerguelen Islands (49°S). This area is ideal to record past oceanic and atmospheric changes in the Southern Ocean because they are currently located in the northern branch of the Antarctic Circumpolar Current and under the direct influence of Southern Hemisphere Westerly wind belt. This study focuses on the last termination, with specific emphasis on the impact of severe climatic events (Heinrich Stadial 1, Antarctic Cold Reversal, Younger Dryas) onto the ocean-atmospheric exchange. Results indicates that most of the sediment is derived from the Kerguelen Plateau, characterized by high smectite content. Periodically, a minor contribution of Antarctica is noticeable. In particular, illite variations suggest fast and short northward incursions of Antarctic Bottom Water, probably formed in the Prydz Bay during the last glaciation. Grainsize repartition combined to magnetic parameters show a southward migration of the ACC and the fronts associated from the beginning of the deglaciation, which is consistent with Southern Hemisphere climate variations. On the opposite, it highlights an asynchronous decrease of the ACC strength, with a large drop during the Antarctic Cold Reversal when atmospheric CO2 increase was slowed down. Thus, at least in the studied area, the ACC strength and the Antarctic Climate were not synchronous during the last deglaciation.

  5. An updated systematic review of the evolution of ALPPS and evaluation of its advantages and disadvantages in accordance with current evidence.

    Science.gov (United States)

    Cai, Yu-Long; Song, Pei-Pei; Tang, Wei; Cheng, Nan-Sheng

    2016-06-01

    The main obstacle to achieving an R0 resection after a major hepatectomy is inability to preserve an adequate future liver remnant (FLR) to avoid postoperative liver failure (PLF). Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel technique for resecting tumors that were previously considered unresectable, and this technique results in a vast increase in the volume of the FLR in a short period of time. However, this technique continues to provoke heated debate because of its high mortality and morbidity.The evolution of ALPPS and its advantages and disadvantages have been systematically reviewed and evaluated in accordance with current evidence. Electronic databases (PubMed and Medline) were searched for potentially relevant articles from January 2007 to January 2016.ALPPS has evolved into various modified forms. Some of these modified techniques have reduced the difficulty of the procedure and enhanced its safety. Current evidence indicates that the advantages of ALPPS are rapid hypertrophy of the FLR, the feasibility of the procedure, and a higher rate of R0 resection in comparison to other techniques. However, ALPPS is associated with worse major complications, more deaths, and early tumor recurrence.Hepatobiliary surgeons should carefully consider whether to perform ALPPS. Some modified forms of ALPPS have reduced the mortality and morbidity of the procedure, but they cannot be recommended over the original procedure currently. Portal vein embolization (PVE) is still the procedure of choice for patients with a tumor-free FLR, and ALPPS could be used as a salvage procedure when PVE fails. More persuasive evidence needs to be assembled to determine whether ALPPS or two-stage hepatectomy (TSH) is better for patients with a tumor involving the FLR. Evidence with regard to long-term oncological outcomes is still limited. More meticulous comparative studies and studies of the 5-year survival rate of ALPPS could ultimately

  6. Current evidence on the health-beneficial effects of berry fruits in the prevention and treatment of metabolic syndrome.

    Science.gov (United States)

    Kowalska, Katarzyna; Olejnik, Anna

    2016-11-01

    Berries belong to the best dietary sources of bioactive compounds, which exert a synergistic and cumulative effect on promotion of human health and prevention of diseases. The present review presents the most recent findings of animal and human studies regarding the health benefits of berries in terms of prevention and treatment of obesity, hypertension, type 2 diabetes, dyslipidemia, and nonalcoholic fatty liver disease. In the last years, there was a growing number of evidence from human epidemiological and interventional studies, which emphasized the role of berries in the management of metabolic diseases. Based on the results from recent clinical trials, it can be established that a berry diet rich in antioxidants and bioactive phytochemicals has beneficial effects on hepatic function, increase of insulin sensitivity and high-density lipoprotein-cholesterol, decrease of serum glucose and low-density lipoprotein-cholesterol, and finally is inversely associated with the incidence of type 2 diabetes. Numerous recent studies have shown that berries provide great benefits in preventing or mitigating metabolic disorders. The results of this review indicate that regular long-term consumption of different berries could potentially delay the progression of metabolic syndrome and comorbidities.

  7. Dietary antioxidants for chronic periodontitis prevention and its treatment: a review on current evidences from animal and human studies

    Directory of Open Access Journals (Sweden)

    Alfonso Varela-López

    2015-09-01

    Full Text Available Objectives: Given the relationship between chronic periodontitis and high levels of oxidative stress, this review aims to clarify what role can played the dietary intake of different antioxidants in maintaining a healthy periodontium and in reducing chronic periodontitis risk, as well as possible use of dietary therapies based on them for this disease treatment. Methods: The database of the National Library of Medicine, Washington, DC (MEDLINE PubMed was used and all the studies in animals and humans are on the subject of interest in English writing online available from inception of the database until May 2015 were collected. Results: Antioxidants analyzed in this regard include vitamin C, vitamin A, carotenoids and some polyphenols, and coenzyme Q; as well as minerals iron, copper and zinc that are constituents of antioxidant enzymes. Still, there is a paucity of studies with few human studies, mostly observational. Among the various antioxidants, vitamin E and polyphenols seem to have more evidence for its beneficial effect, but in general the studies are insufficient to rule out or establish what antioxidants are useful and which are not. Conclusions: Overall, the data presented indicate that dietary antioxidants are beneficial for periodontal health, at least under certain circumstances. However more studies are needed to establish the relationship between chronic periodontitis and each specific antioxidant and to design useful dietary interventions for this disease management.

  8. Evidence for a Higher Number of Species of Odontotermes (Isoptera) than Currently Known from Peninsular Malaysia from Mitochondrial DNA Phylogenies