Slower Perception Followed by Faster Lexical Decision in Longer Words: A Diffusion Model Analysis.

Science.gov (United States)

Oganian, Yulia; Froehlich, Eva; Schlickeiser, Ulrike; Hofmann, Markus J; Heekeren, Hauke R; Jacobs, Arthur M

2015-01-01

Effects of stimulus length on reaction times (RTs) in the lexical decision task are the topic of extensive research. While slower RTs are consistently found for longer pseudo-words, a finding coined the word length effect (WLE), some studies found no effects for words, and yet others reported faster RTs for longer words. Moreover, the WLE depends on the orthographic transparency of a language, with larger effects in more transparent orthographies. Here we investigate processes underlying the WLE in lexical decision in German-English bilinguals using a diffusion model (DM) analysis, which we compared to a linear regression approach. In the DM analysis, RT-accuracy distributions are characterized using parameters that reflect latent sub-processes, in particular evidence accumulation and decision-independent perceptual encoding, instead of typical parameters such as mean RT and accuracy. The regression approach showed a decrease in RTs with length for pseudo-words, but no length effect for words. However, DM analysis revealed that the null effect for words resulted from opposing effects of length on perceptual encoding and rate of evidence accumulation. Perceptual encoding times increased with length for words and pseudo-words, whereas the rate of evidence accumulation increased with length for real words but decreased for pseudo-words. A comparison between DM parameters in German and English suggested that orthographic transparency affects perceptual encoding, whereas effects of length on evidence accumulation are likely to reflect contextual information and the increase in available perceptual evidence with length. These opposing effects may account for the inconsistent findings on WLEs.

Longer-Term Mental and Behavioral Health Effects of the Deepwater Horizon Gulf Oil Spill

Directory of Open Access Journals (Sweden)

Tonya Cross Hansel

2015-10-01

Full Text Available Mental health issues are a significant concern after technological disasters such as the 2010 Gulf Oil Spill; however, there is limited knowledge about the long-term effects of oil spills. The study was part of a larger research effort to improve understanding of the mental and behavioral health effects of the Deepwater Horizon Gulf Oil Spill. Data were collected immediately following the spill and the same individuals were resampled again after the second anniversary (n = 314. The results show that mental health symptoms of depression, serious mental illness and posttraumatic stress have not statistically decreased, and anxiety symptoms were statistically equivalent to immediate symptoms. Results also showed that the greatest effect on anxiety is related to the extent of disruption to participants’ lives, work, family, and social engagement. This study supports lessons learned following the Exxon Valdez spill suggesting that mental health effects are long term and recovery is slow. Elevated symptoms indicate the continued need for mental health services, especially for individuals with high levels of disruption resulting in increased anxiety. Findings also suggest that the longer-term recovery trajectories following the Deepwater Horizon Gulf Oil Spill do not fall within traditional disaster recovery timelines.

Increased volume of distribution for recombinant activated factor VII and longer plasma-derived factor VII half-life may explain their long lasting prophylactic effect.

Science.gov (United States)

Mathijssen, Natascha C J; Masereeuw, Rosalinde; Holme, Pal Andre; van Kraaij, Marian G J; Laros-van Gorkom, Britta A P; Peyvandi, Flora; van Heerde, Waander L

2013-08-01

Prophylaxis with plasma-derived or recombinant activated factor VII is beneficial in severe factor VII deficiency. To understand why prophylactic treatment with both products is efficacious, we conducted a pharmacokinetic study. Ten factor VII deficient patients were treated with either recombinant activated (20 μg/kg) or plasma-derived (25 IU/kg) factor VII in a cross-over design. Pharmacokinetic parameters were analyzed through activated factor VII activity, factor VII clotting activity, and factor VII antigen levels on depicted time points. Factor VII activity half-lifes, determined by non-compartmental and one-compartmental analysis (results in brackets), were shorter for recombinant activated (1.4h; 0.7h) than for plasma-derived factor VII (6.8h; 3.2h); both recombinant activated (5.1h; 2.1h and plasma-derived factor VII (5.8h; 3.2h) resulted in longer half-lives of factor VII antigen. Activated factor VII half-lives (based on activated factor VII activity levels) were significantly higher compared to factor VII clotting activity (1.6h; 0.9h). Volumes of distribution were significantly higher for activated factor VII (236 ml/kg; 175 ml/kg, measured by activated factor VII) as compared to plasma-derived factor VII (206 ml/kg; 64 ml/kg, measured by factor FVII activity), suggesting a plasma- and extracellular fluid distribution for recombinant activated factor VII. Recombinant activated factor VII showed significantly shorter half-lifes than plasma-derived factor VII. Volumes of distribution were significantly higher for treatment with recombinant activated factor VII. The longer half-life for plasma-derived factor VII, compared to recombinant activated factor VII, and the increased volume of distribution for recombinant activated factor VII, compared to plasma-derived factor VII may further elucidate the beneficial effect of prophylactic treatment of both products. Copyright © 2013 Elsevier Ltd. All rights reserved.

Extending 3D near-cloud corrections from shorter to longer wavelengths

International Nuclear Information System (INIS)

Marshak, Alexander; Evans, K. Frank; Várnai, Tamás; Wen, Guoyong

2014-01-01

Satellite observations have shown a positive correlation between cloud amount and aerosol optical thickness (AOT) that can be explained by the humidification of aerosols near clouds, and/or by cloud contamination by sub-pixel size clouds and the cloud adjacency effect. The last effect may substantially increase reflected radiation in cloud-free columns, leading to overestimates in the retrieved AOT. For clear-sky areas near boundary layer clouds the main contribution to the enhancement of clear sky reflectance at shorter wavelengths comes from the radiation scattered into clear areas by clouds and then scattered to the sensor by air molecules. Because of the wavelength dependence of air molecule scattering, this process leads to a larger reflectance increase at shorter wavelengths, and can be corrected using a simple two-layer model [18]. However, correcting only for molecular scattering skews spectral properties of the retrieved AOT. Kassianov and Ovtchinnikov [9] proposed a technique that uses spectral reflectance ratios to retrieve AOT in the vicinity of clouds; they assumed that the cloud adjacency effect influences the spectral ratio between reflectances at two wavelengths less than it influences the reflectances themselves. This paper combines the two approaches: It assumes that the 3D correction for the shortest wavelength is known with some uncertainties, and then it estimates the 3D correction for longer wavelengths using a modified ratio method. The new approach is tested with 3D radiances simulated for 26 cumulus fields from Large-Eddy Simulations, supplemented with 40 aerosol profiles. The results showed that (i) for a variety of cumulus cloud scenes and aerosol profiles over ocean the 3D correction due to cloud adjacency effect can be extended from shorter to longer wavelengths and (ii) the 3D corrections for longer wavelengths are not very sensitive to unbiased random uncertainties in the 3D corrections at shorter wavelengths. - Highlights: �

The longer term experiences of parent training: a qualitative analysis.

Science.gov (United States)

Furlong, M; McGilloway, S

2015-09-01

Child conduct problems are a major public health priority. Group-based parenting programmes are popular in addressing such problems, but evidence for their longer-term effectiveness is limited. Moreover, process evaluations are rare and little is understood about the key facilitative and inhibitive factors associated with maintaining outcomes in the longer term. This study involved the use of qualitative methods as part of a larger process evaluation to explore the longer-term experiences of parents who participated in a randomized controlled trial (RCT) of the Incredible Years Parenting Programme (IYPP) in disadvantaged settings in Ireland. A series of one-to-one in-depth interviews was conducted with parents at 12- (n = 20) and 18-month follow-up (n = 8) and analysed using constructivist grounded theory. Most parents reported positive child behaviour despite several challenges, but a substantial subset reported periods of relapse in positive outcomes. A relapse in child behaviour was linked to relinquishing skills in stressful times, the negative influence of an unsupportive environment, and the perceived ineffectiveness of parenting skills. Resilience in implementing skills despite adversity, and the utilization of available social supports, were associated with the maintenance of positive outcomes. Strengthening resilience and social support capacities may be important factors in maintaining positive longer-term outcomes. Those who design, research and deliver parenting programmes might consider the possibility of including a relapse-prevention module and/or the provision of post-intervention supports for more vulnerable families. © 2014 John Wiley & Sons Ltd.

Impact on environmental qualification from a longer fuel cycle

International Nuclear Information System (INIS)

Sanwarwalla, M.H.; Akhtar, S.; Drankhan, D.A.

1996-01-01

There is a general trend in the nuclear industry towards longer fuel cycles because of the economic benefits. The economic benefits for increasing the fuel cycle from eighteen to twenty four months is estimated by the industry to be about $5.05 million per unit year based on a two week mid-cycle maintenance outage. Equipment with a unique characteristic may require maintenance and/or inspection more frequently than can be accommodated in a longer cycle. The maintenance and surveillance (M ampersand S) requirements for these equipment need to be reviewed to accommodate a longer cycle and avoid any unplanned outage. ComEd's LaSalle Station is considering a move to a longer fuel cycle. A study was done to determine the impact of a longer fuel cycle on their current environmental qualification (EQ) program, and the feasibility of implementing changes to their program to accommodate a longer fuel cycle. This paper discusses (1) the impact, if any, the longer fuel cycle will have on the maintenance and surveillance requirements of the 50.49 or environmentally qualified equipment at LaSalle Station, (2) the various techniques, i.e., partial testing, performance based monitoring etc., employed to extend the existing maintenance and surveillance requirements, and (3) the estimated economic savings, if any, from the extended M ampersand S interval

Working Longer in Good Health

NARCIS (Netherlands)

F.R.M. Leijten (Fenna)

2015-01-01

markdownabstractAbstract Due to an ageing society, an increasing retirement age, and high prevalence of chronic health problems among older persons, it is important to understand how older employees [with health problems] can work for longer and productively, often this is termed ‘sustainable

Enhanced performance of hybrid solar cells using longer arms of quantum cadmium selenide tetrapods

KAUST Repository

Lee, Kyu-Sung

2011-12-01

We demonstrate that enhanced device performance of hybrid solar cells based on tetrapod (TP)-shaped cadmium selenide (CdSe) nanoparticles and conjugated polymer of poly (3-hexylthiophene) (P3HT) can be obtained by using longer armed tetrapods which aids in better spatial connectivity, thus decreasing charge hopping events which lead to better charge transport. Longer tetrapods with 10 nm arm length lead to improved power conversion efficiency of 1.12% compared to 0.80% of device having 5 nm short-armed tetrapods:P3HT photoactive blends.

Enhanced performance of hybrid solar cells using longer arms of quantum cadmium selenide tetrapods

KAUST Repository

Lee, Kyu-Sung; Kim, Inho; Gullapalli, Sravani; Wong, Michael S.; Jabbour, Ghassan E.

2011-01-01

We demonstrate that enhanced device performance of hybrid solar cells based on tetrapod (TP)-shaped cadmium selenide (CdSe) nanoparticles and conjugated polymer of poly (3-hexylthiophene) (P3HT) can be obtained by using longer armed tetrapods which aids in better spatial connectivity, thus decreasing charge hopping events which lead to better charge transport. Longer tetrapods with 10 nm arm length lead to improved power conversion efficiency of 1.12% compared to 0.80% of device having 5 nm short-armed tetrapods:P3HT photoactive blends.

Inpatient cognitive behaviour therapy for adolescents with anorexia nervosa: immediate and longer-term effects

Directory of Open Access Journals (Sweden)

Riccardo eDalle Grave

2014-02-01

Full Text Available Introduction: Inpatient treatment for anorexia nervosa is often successful in restoring body weight, but a high percentage of patients relapse following discharge. The aim of the present study was to establish the immediate and longer-term effects of a novel inpatient program for adolescents that was designed to produce enduring change. Method: Twenty-seven consecutive patients with severe anorexia nervosa were admitted to a 20-week inpatient treatment program based upon enhanced cognitive behaviour therapy (CBT-E. The patients were assessed before and after hospitalization, and six and 12 months later. Results: Twenty-six patients (96% completed the program. In these patients there was a substantial improvement in weight, eating disorder features and general psychopathology that was well maintained at 12-month follow-up. Conclusions: These findings suggest that inpatient CBT-E is a promising approach to the treatment of adolescents with severe anorexia nervosa.

Comparative antinociceptive and sedative effects of epidural romifidine and detomidine in buffalo (Bubalus bubalis).

Science.gov (United States)

Marzok, M A; El-Khodery, S A

2017-07-01

In this study, comparative antinociceptive and sedative effects of epidural administration of romifidine and detomidine in buffalo were evaluated. Eighteen healthy adult buffalo, allocated randomly in three groups (two experimental and one control; n=6) received either 50 μg/kg of romifidine or detomidine diluted in sterile saline (0.9 per cent) to a final volume of 20 ml, or an equivalent volume of sterile saline epidurally. Antinociception, sedation and ataxia parameters were recorded immediately after drug administration. Epidural romifidine and detomidine produced mild to deep sedation and complete antinociception of the perineum, inguinal area and flank, and extended distally to the coronary band of the hindlimbs and cranially to the chest area. Times to onset of antinociception and sedation were significantly shorter with romifidine than with detomidine. The antinociceptive and sedative effects were significantly longer with romifidine than with detomidine. Romifidine or detomidine could be used to provide a reliable, long-lasting and cost-effective method for achieving epidural anaesthesia for standing surgical procedures in buffalo. Romifidine induces a longer antinociceptive effect and a more rapid onset than detomidine. Consequently, epidural romifidine may offer better therapeutic benefits in the management of acute postoperative pain. British Veterinary Association.

Effects of shorter versus longer storage time of transfused red blood cells in adult ICU patients

DEFF Research Database (Denmark)

Rygård, Sofie L; Jonsson, Andreas B; Madsen, Martin B

2018-01-01

on the effects of shorter versus longer storage time of transfused RBCs on outcomes in ICU patients. METHODS: We conducted a systematic review with meta-analyses and trial sequential analyses (TSA) of randomised clinical trials including adult ICU patients transfused with fresher versus older or standard issue...... blood. RESULTS: We included seven trials with a total of 18,283 randomised ICU patients; two trials of 7504 patients were judged to have low risk of bias. We observed no effects of fresher versus older blood on death (relative risk 1.04, 95% confidence interval (CI) 0.97-1.11; 7349 patients; TSA......-adjusted CI 0.93-1.15), adverse events (1.26, 0.76-2.09; 7332 patients; TSA-adjusted CI 0.16-9.87) or post-transfusion infections (1.07, 0.96-1.20; 7332 patients; TSA-adjusted CI 0.90-1.27). The results were unchanged by including trials with high risk of bias. TSA confirmed the results and the required...

Costs and longer-term savings of parenting programmes for the prevention of persistent conduct disorder: a modelling study

Directory of Open Access Journals (Sweden)

Beecham Jennifer

2011-10-01

Full Text Available Abstract Background Conduct disorders are the most common psychiatric disorders in children and may persist into adulthood in about 50% of cases. The costs to society are high and impact many public sector agencies. Parenting programmes have been shown to positively affect child behaviour, but little is known about their potential long-term cost-effectiveness. We therefore estimate the costs of and longer-term savings from evidence-based parenting programmes for the prevention of persistent conduct disorder. Methods A decision-analytic Markov model compares two scenarios: 1 a 5-year old with clinical conduct disorder receives an evidence-based parenting programme; 2 the same 5-year old does not receive the programme. Cost-savings analysis is performed by comparing the probability that conduct disorder persists over time in each scenario, adopting both a public sector and a societal perspective. If the intervention is successful in reducing persistent conduct disorder, cost savings may arise from reduced use of health services, education support, social care, voluntary agencies and from crimes averted. Results Results strongly suggest that parenting programmes reduce the chance that conduct disorder persists into adulthood and are cost-saving to the public sector within 5-8 years under base case conditions. Total savings to society over 25 years are estimated at £16,435 per family, which compares with an intervention cost in the range of £952-£2,078 (2008/09 prices. Conclusions Effective implementation of evidence-based parenting programmes is likely to yield cost savings to the public sector and society. More research is needed to address evidence gaps regarding the current level of provision, longer-term effectiveness and questions of implementation, engagement and equity.

Plantar pressures are higher in cases with diabetic foot ulcers compared to controls despite a longer stance phase duration.

Science.gov (United States)

Fernando, Malindu E; Crowther, Robert G; Lazzarini, Peter A; Sangla, Kunwarjit S; Wearing, Scott; Buttner, Petra; Golledge, Jonathan

2016-09-15

Current international guidelines advocate achieving at least a 30 % reduction in maximum plantar pressure to reduce the risk of foot ulcers in people with diabetes. However, whether plantar pressures differ in cases with foot ulcers to controls without ulcers is not clear. The aim of this study was to assess if plantar pressures were higher in patients with active plantar diabetic foot ulcers (cases) compared to patients with diabetes without a foot ulcer history (diabetes controls) and people without diabetes or a foot ulcer history (healthy controls). Twenty-one cases with diabetic foot ulcers, 69 diabetes controls and 56 healthy controls were recruited for this case-control study. Plantar pressures at ten sites on both feet and stance phase duration were measured using a pre-established protocol. Primary outcomes were mean peak plantar pressure, pressure-time integral and stance phase duration. Non-parametric analyses were used with Holm's correction to correct for multiple testing. Binary logistic regression models were used to adjust outcomes for age, sex and body mass index. Median differences with 95 % confidence intervals and Cohen's d values (standardised mean difference) were reported for all significant outcomes. The majority of ulcers were located on the plantar surface of the hallux and toes. When adjusted for age, sex and body mass index, the mean peak plantar pressure and pressure-time integral of toes and the mid-foot were significantly higher in cases compared to diabetes and healthy controls (p diabetic foot ulcers despite having a longer stance phase duration which would be expected to lower plantar pressure. Whether plantar pressure changes can predict ulcer healing should be the focus of future research. These results highlight the importance of offloading feet during active ulceration in addition to before ulceration.

Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births

Directory of Open Access Journals (Sweden)

S. J. Kroese

2017-01-01

Full Text Available Objective. To investigate the effect of hydroxychloroquine (HCQ in pregnant women with systemic lupus erythematosus (SLE. Methods. In SLE pregnancies of a single Dutch center (2000–2015, lupus activity and flares before and during pregnancy and postpartum were assessed using the SLE Disease Activity Index (SLEDAI/SLEPDAI (SLEDAI adjusted for pregnancy. The association between HCQ use and pregnancy outcomes (early spontaneous abortion, fetal death, and preterm and term live birth was analyzed using generalized estimating equations (GEE accounting for the occurrence of multiple pregnancies per patient. Analyses were adjusted for antiphospholipid antibody (aPL status. Results. 110 pregnancies (63 mostly Caucasian patients were included, of which, in 30, HCQ was used; overall occurrence of flares was low (non-HCQ group: 5 mild (6.4% and 2 severe (2.6%; HCQ group: 2 mild (6.7% and no severe flares. The HCQ group showed a trend towards lower dosage of prednisone (OR 0.2 (95% CI 0.0–1.4; p=0.10. Pregnancy outcomes were comparable between groups. Among preterm live births, pregnancy duration was significantly longer in HCQ users (2.4 weeks (95% CI 1.0–3.8; p≤0.001. Conclusion. HCQ use was associated with longer pregnancy duration in the vulnerable preterm birth population, underscoring the beneficial effect of HCQ use during pregnancy.

A randomised controlled trial comparing the effect of adjuvant ...

African Journals Online (AJOL)

Results: The duration of effective analgesia was longer in the midazolam group ... There was no significant difference (P 0.4047). ... events, peripheral vasoconstriction, and metabolic acido- .... determined and recorded every hour. ..... scriptions of chronic pain syndromes and definitions of ... Long-term intrathecal adminis-.

Longer-term effects of ADAS use on speed and headway control in drivers diagnosed with Parkinson's disease.

Science.gov (United States)

Dotzauer, Mandy; Caljouw, Simone R; De Waard, Dick; Brouwer, Wiebo H

2015-01-01

An advanced driver assistance system (ADAS) provided information about speed limits, speed, speeding, and following distance. Information was presented to the participants by means of a head-up display. Effects of the information on speed and headway control were studied in a longer-term driving simulator study including 12 repeated measures spread out over 4 weeks. Nine healthy older drivers between the ages of 65 and 82 years and 9 drivers between the ages of 68 and 82 years diagnosed with Parkinson's disease (PD) participated in the study. Within the 4 weeks, groups completed 12 consecutive sessions (10 with ADAS and 2 without ADAS) in a driving simulator. Results indicate an effect of ADAS use on performance. Removing ADAS after short-term exposure led to deterioration of performance in all speed measures in the group of drivers diagnosed with PD. These results suggest that provision of traffic information was utilized by drivers diagnosed with PD in order to control their speed.

Mammographic breast density in recent and longer-standing ethiopian immigrants to israel.

Science.gov (United States)

Sklair-Levy, Miri; Segev, Anat; Sella, Tamar; Calderon-Margalit, Ronit; Zippel, Douglas

2018-04-23

High breast density is associated with an increased risk of breast cancer development. Little is known concerning ethnic variations in breast density and its relevant contributing factors. We aimed to study breast density among Ethiopian immigrants to Israel in comparison with Israeli-born women and to determine any effect on breast density of the length of residency in the immigrant population. Mammographic breast density using the BI-RADS system was estimated and compared between 77 women of Ethiopian origin who live in Israel and 177 Israeli-born controls. Logistic regression analysis was performed to estimate the odds ratios (OR) for high density (BI-RADS score ≥ 3) vs low density (BI-RADS score density compared with Israeli-born women. Adjustments for various cofounders did not affect the results. Time since immigration to Israel seemed to modify the relationship, with a stronger association for women who immigrated within 2 years prior to mammography (OR:0.07, 95% CI: 0.03-0.17) as opposed to women with a longer residency stay in Israel (OR:0.23, 95% CI:0.10-0.50). Adjustments of various confounders did not alter these findings. Breast density in Ethiopian immigrants to Israel is significantly lower than that of Israeli-born controls. Our study suggests a positive association between time since immigration and breast density. Future studies are required to define the possible effects of dietary change on mammographic density following immigration. © 2018 Wiley Periodicals, Inc.

Do longer consultations improve the management of psychological problems in general practice? A systematic literature review

Directory of Open Access Journals (Sweden)

Hutton Catherine

2007-05-01

Full Text Available Abstract Background Psychological problems present a huge burden of illness in our community and GPs are the main providers of care. There is evidence that longer consultations in general practice are associated with improved quality of care; but this needs to be balanced against the fact that doctor time is a limited resource and longer consultations may lead to reduced access to health care. The aim of this research was to conduct a systematic literature review to determine whether management of psychological problems in general practice is associated with an increased consultation length and to explore whether longer consultations are associated with better health outcomes for patients with psychological problems. Methods A search was conducted on Medline (Ovid databases up to7 June 2006. The following search terms, were used: general practice or primary health care (free text or family practice (MeSH AND consultation length or duration (free text or time factors (MeSH AND depression or psychological problems or depressed (free text. A similar search was done in Web of Science, Pubmed, Google Scholar, and Cochrane Library and no other papers were found. Studies were included if they contained data comparing consultation length and management or detection of psychological problems in a general practice or primary health care setting. The studies were read and categories developed to enable systematic data extraction and synthesis. Results 29 papers met the inclusion criteria. Consultations with a recorded diagnosis of a psychological problem were reported to be longer than those with no recorded psychological diagnosis. It is not clear if this is related to the extra time or the consultation style. GPs reported that time pressure is a major barrier to treating depression. There was some evidence that increased consultation length is associated with more accurate diagnosis of psychological problems. Conclusion Further research is needed to

[Diabetic neuropathy: therapeutic nihilism is no longer acceptable].

Science.gov (United States)

Haslbeck, Manfred

2007-05-21

The repeatedly expressed doubts about the value of an effective therapy for diabetic neuropathies are no longer acceptable. Today a number of excellent longitudinal and cross-sectional studies, i.e. DCCT, Steno 2, DCCT/EDIC, European Diabetes Prospective Complications Study, are available. The attending physician should make every effort to diagnose diabetic neuropathies as soon as possible with all their multivarious manifestations. Treatment must be promptly, aggressively and multifactorially as described in evidence-based guidelines. In principle, the same risk factors apply to neuropathy in type 1 and type 2 diabetes as for macro-angiopathy and microangiopathy. Therapy focuses on establishing near-normal diabetes and blood pressure control, lipid management, intensive patient education, avoidance of exogenous noxae such as alcohol and nicotine and if necessary, an effective therapy of neuropathic pain. The objective of all diagnostic and preventive efforts must be always to avoid the development of the diabetic neuropathic foot syndrome, which is the most important end stage of somatic and autonomic diabetic neuropathy.

Older Korean adults have lower physical function despite longer exercise times compared to their Japanese counterparts: A Japan-Korea comparative study.

Science.gov (United States)

Jung, Songee; Okubo, Yoshiro; Osuka, Yosuke; Seino, Satoshi; Park, Joonsung; Nho, Hosung; Tanaka, Kiyoji

2018-04-01

We aimed to compare the level of physical function (PF) and habitual exercise between older Japanese and Korean adults. A comparative study was carried out on 1069 community-dwelling older Japanese and Korean adults (mean age 73.9 ± 5.2 years). The participants were asked to complete a self-reported questionnaire regarding habitual exercise and covariates. PF age, a composite measure of PF, was derived from the 12 items, using principal component analysis. PF age and habitual exercise were compared between the Japanese and Korean adults, using analysis of covariance (ancova) and multivariable logistic regression analysis adjusted for all covariates using propensity scores. ancova showed that PF age in older Japanese adults was significantly younger than in their Korean counterparts. Older Japanese adults exercised significantly less frequently than their Korean counterparts. Furthermore, older Japanese adults practiced significantly less walking, mountain climbing and bicycling, but more calisthenics, resistance training, ball games and dances than their Korean counterparts. We found that older Korean adults had lower PF (3.7 years older in PF age) than their Japanese counterparts. Although the overall frequency and amount of habitual exercise in older Korean adults were higher than those in their Japanese counterparts, particular types of exercise might have contributed to the higher PF levels among older Japanese adults. Thus, older Korean adults might need to engage more in habitual exercises that are specifically effective in maintaining PF. Geriatr Gerontol Int 2018; 18: 576-583. © 2017 Japan Geriatrics Society.

Diminish electrostatic in piezoresponse force microscopy through longer or ultra-stiff tips

Science.gov (United States)

Gomez, A.; Puig, T.; Obradors, X.

2018-05-01

Piezoresponse Force Microscopy is a powerful but delicate nanoscale technique that measures the electromechanical response resulting from the application of a highly localized electric field. Though mechanical response is normally due to piezoelectricity, other physical phenomena, especially electrostatic interaction, can contribute to the signal read. We address this problematic through the use of longer ultra-stiff probes providing state of the art sensitivity, with the lowest electrostatic interaction and avoiding working in high frequency regime. In order to find this solution we develop a theoretical description addressing the effects of electrostatic contributions in the total cantilever vibration and its quantification for different setups. The theory is subsequently tested in a Periodically Poled Lithium Niobate (PPLN) crystal, a sample with well-defined 0° and 180° domains, using different commercial available conductive tips. We employ the theoretical description to compare the electrostatic contribution effects into the total phase recorded. Through experimental data our description is corroborated for each of the tested commercially available probes. We propose that a larger probe length can be a solution to avoid electrostatic forces, so the cantilever-sample electrostatic interaction is reduced. Our proposed solution has great implications into avoiding artifacts while studying soft biological samples, multiferroic oxides, and thin film ferroelectric materials.

Immediate and Longer-Term Stressors and the Mental Health of Hurricane Ike Survivors

OpenAIRE

Lowe, Sarah R.; Tracy, Melissa; Cerdá, Magdalena; Norris, Fran H.; Galea, Sandro

2013-01-01

Previous research has documented that individuals exposed to more stressors during disasters and their immediate aftermath (immediate stressors) are at risk of experiencing longer-term postdisaster stressors. Longer-term stressors, in turn, have been found to play a key role in shaping postdisaster psychological functioning. Few studies have simultaneously explored the links from immediate to longer-term stressors, and from longer-term stressors to psychological functioning,...

Karyotypic changes through dysploidy persist longer over evolutionary time than polyploid changes.

Directory of Open Access Journals (Sweden)

Marcial Escudero

Full Text Available Chromosome evolution has been demonstrated to have profound effects on diversification rates and speciation in angiosperms. While polyploidy has predated some major radiations in plants, it has also been related to decreased diversification rates. There has been comparatively little attention to the evolutionary role of gains and losses of single chromosomes, which may or not entail changes in the DNA content (then called aneuploidy or dysploidy, respectively. In this study we investigate the role of chromosome number transitions and of possible associated genome size changes in angiosperm evolution. We model the tempo and mode of chromosome number evolution and its possible correlation with patterns of cladogenesis in 15 angiosperm clades. Inferred polyploid transitions are distributed more frequently towards recent times than single chromosome gains and losses. This is likely because the latter events do not entail changes in DNA content and are probably due to fission or fusion events (dysploidy, as revealed by an analysis of the relationship between genome size and chromosome number. Our results support the general pattern that recently originated polyploids fail to persist, and suggest that dysploidy may have comparatively longer-term persistence than polyploidy. Changes in chromosome number associated with dysploidy were typically observed across the phylogenies based on a chi-square analysis, consistent with these changes being neutral with respect to diversification.

Hyaluronic Acid Injections in Medicare Knee Osteoarthritis Patients Are Associated With Longer Time to Knee Arthroplasty.

Science.gov (United States)

Ong, Kevin L; Anderson, Allen F; Niazi, Faizan; Fierlinger, Anke L; Kurtz, Steven M; Altman, Roy D

2016-08-01

Few nonoperative treatment options for knee osteoarthritis (OA) are available, but there is ongoing debate about the effectiveness of intra-articular (IA) hyaluronic acid (HA) injections. We investigated whether the formulation of IA HA, or its combined use with IA corticosteroid (CS), may be contributing to some of the reported variation in clinical outcomes. The 5% Part B Medicare data (2005-2012) were used to identify knee OA patients who underwent knee arthroplasty (KA). The time from diagnosis of OA to KA was compared between patients with (HA) and without (no HA) IA HA use, using quantile regression with propensity score adjustment. These were further stratified by type of IA HA. Patient factors associated with time to KA were also assessed using Cox regression. The "HA" cohort was associated with a longer time to KA of 8.7 months (95% confidence interval: 8.3-9.1 months; P injection use. Patients with both IA HA and IA CS had an additional 6.3 months (95% confidence interval: 5.5-7.0 months; P < .001) to KA over those with only IA HA. In a large cohort of elderly patients undergoing KA, there was a significant longer time from diagnosis of OA to KA in those receiving IA HA. It is unclear if the extended time may lead to less KA utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

A longer stay for the kissing disease: epidemiology of bacterial tonsillitis and infectious mononucleosis over a 20-year period.

Science.gov (United States)

Lennon, P; Saunders, J; Fenton, J E

2013-02-01

Anecdotally, infectious mononucleosis is considered a more severe infection than bacterial tonsillitis, requiring a longer hospital stay. However, there is little in the literature comparing the epidemiology of the two conditions. This study aimed to compare the epidemiology of bacterial tonsillitis and infectious mononucleosis, in particular any differences in the length of in-patient stay. The hospital in-patient enquiry system was used to analyse patients admitted with bacterial tonsillitis and infectious mononucleosis between 1990 and 2009 inclusive. There was a total of 3435 cases over the 20 years: 3064 with bacterial tonsillitis and 371 with infectious mononucleosis. The mean length of stay was 3.22 days for bacterial tonsillitis and 4.37 days for infectious mononucleosis. The median length of stay for each condition was compared using the Mann-Whitney U non-parametric test, and a significant difference detected (p mononucleosis have a significantly longer stay in hospital than those with bacterial tonsillitis.

An approach for longer lifetime MCFCs

Energy Technology Data Exchange (ETDEWEB)

Matsumoto, Masaru; Tatsumi, Masahiko; Hayano, Takuro [MCFC Research Association, Tokyo (Japan)] [and others

1996-12-31

For entering into commercialization of MCFC power plants in the beginning of the 21st century, we will devote to research for increasing lifetime as long as 40,000 hours with cell performance decay rate of 0.25 %/1000hrs as the target in FY 1999. This paper will discuss on our approach for longer lifetime MCFCs through electrolyte-loss management and NiO precipitation management as well as micro-structural control of electrodes and matrix plates. Cell voltage decay rate will be estimated by simulation through series of experiments on accelerated conditions.

Simplifying anemia management in hemodialysis patients: ESAs administered at longer dosing intervals can enhance opportunities to provide patient-focused care.

Science.gov (United States)

Schiller, Brigitte; Besarab, Anatole

2011-08-01

To review issues and challenges in caring for hemodialysis patients with anemia of chronic kidney disease, specifically focusing on the effects of longer erythropoiesis-stimulating agent (ESA) dosing intervals on processes of care. PubMed searches were performed limited to the last 10 years to February 2011, focusing on articles in English that were 'clinical trials,' assessed processes of care, measured associations of hemoglobin (Hb) with outcomes, and explored/analyzed extended dosing intervals of ESAs in hemodialysis patients and recommendations for increasing the quality of care of these patients. Some limitations included the fact that a meta-analysis was not conducted; many studies were associative and therefore unable to prove causality; and none of the clinical trials directly compared the impact of more frequent or less frequent ESA dosing strategies on patient care and outcomes. Progress over the past several decades has been substantial; however, unmet needs remain and there is room for improvement in efficiencies of care. Many patients fail to meet Hb targets, and nephrology professionals' time is consumed with preparing, administering, and monitoring therapy. Direct interaction between patients and care providers has been lost as attention has shifted to 'cost-effective' (not necessarily patient-centered) ways to deliver care. Use of ESAs at longer dosage intervals represents one opportunity to improve efficiency of care. Newer ESAs have been developed for less frequent dosing. Once-monthly dosing decreases time spent administering/monitoring therapy and allows nephrology professionals to provide comprehensive renal care, wherein the patient rather than task-oriented processes becomes the primary focus. A fragmented, uncoordinated care-delivery model heightens the urgency to systematically address issues related to delivery of care and improve efficiencies in anemia management as part of the patient-centered approach. ESAs designed for administration

Longer wait times affect future use of VHA primary care.

Science.gov (United States)

Wong, Edwin S; Liu, Chuan-Fen; Hernandez, Susan E; Augustine, Matthew R; Nelson, Karin; Fihn, Stephan D; Hebert, Paul L

2017-07-29

Improving access to the Veterans Health Administration (VHA) is a high priority, particularly given statutory mandates of the Veterans Access, Choice and Accountability Act. This study examined whether patient-reported wait times for VHA appointments were associated with future reliance on VHA primary care services. This observational study examined 13,595 VHA patients dually enrolled in fee-for-service Medicare. Data sources included VHA administrative data, Medicare claims and the Survey of Healthcare Experiences of Patients (SHEP). Primary care use was defined as the number of face-to-face visits from VHA and Medicare in the 12 months following SHEP completion. VHA reliance was defined as the number of VHA visits divided by total visits (VHA+Medicare). Wait times were derived from SHEP responses measuring the usual number of days to a VHA appointment with patients' primary care provider for those seeking immediate care. We defined appointment wait times categorically: 0 days, 1day, 2-3 days, 4-7 days and >7 days. We used fractional logistic regression to examine the relationship between wait times and reliance. Mean VHA reliance was 88.1% (95% CI = 86.7% to 89.5%) for patients reporting 0day waits. Compared with these patients, reliance over the subsequent year was 1.4 (p = 0.041), 2.8 (p = 0.001) and 1.6 (p = 0.014) percentage points lower for patients waiting 2-3 days, 4-7 days and >7 days, respectively. Patients reporting longer usual wait times for immediate VHA care exhibited lower future reliance on VHA primary care. Longer wait times may reduce care continuity and impact cost shifting across two federal health programs. Copyright © 2017. Published by Elsevier Inc.

Living healthier for longer: Comparative effects of three heart-healthy behaviors on life expectancy with and without cardiovascular disease

NARCIS (Netherlands)

W.J. Nusselder (Wilma); O.H. Franco (Oscar); A. Peeters (Anna); J.P. Mackenbach (Johan)

2009-01-01

textabstractBackground. Non-smoking, having a normal weight and increased levels of physical activity are perhaps the three key factors for preventing cardiovascular disease (CVD). However, the relative effects of these factors on healthy longevity have not been well described. We aimed to calculate

Immediate and Longer-Term Stressors and the Mental Health of Hurricane Ike Survivors

Science.gov (United States)

Lowe, Sarah R.; Tracy, Melissa; Cerdá, Magdalena; Norris, Fran H.; Galea, Sandro

2014-01-01

Previous research has documented that individuals exposed to more stressors during disasters and their immediate aftermath (immediate stressors) are at risk of experiencing longer-term postdisaster stressors. Longer-term stressors, in turn, have been found to play a key role in shaping postdisaster psychological functioning. Few studies have simultaneously explored the links from immediate to longer-term stressors, and from longer-term stressors to psychological functioning, however. Additionally, studies have inadequately explored whether postdisaster psychological symptoms influence longer-term stressors. In the current study, we aimed to fill these gaps. Participants (N = 448) were from population-based study of Hurricane Ike survivors and completed assessments 2–5 months (Wave 1), 5–9 months (Wave 2) and 14–18 months (Wave 3) postdisaster. Through path analysis, we found that immediate stressors, assessed at Wave 1, were positively associated with Wave 2 and Wave 3 stressors, which in turn were positively associated with Wave 2 and Wave 3 posttraumatic stress and depressive symptoms. Wave 2 posttraumatic stress symptoms were positively associated with Wave 3 stressors, and Wave 1 depressive symptoms were positively associated with Wave 2 stressors. The findings suggest that policies and interventions can reduce the impact of disasters on mental health by preventing and alleviating both immediate and longer-term postdisaster stressors. PMID:24343752

Attention Deficit Hyperactivity Disorder (ADHD among longer-term prison inmates is a prevalent, persistent and disabling disorder

Directory of Open Access Journals (Sweden)

Hirvikoski Tatja

2010-12-01

Full Text Available Abstract Background ADHD is a common and disabling disorder, with an increased risk for coexisting disorders, substance abuse and delinquency. In the present study, we aimed at exploring ADHD and criminality. We estimated the prevalence of ADHD among longer-term prison inmates, described symptoms and cognitive functioning, and compared findings with ADHD among psychiatric outpatients and healthy controls. Methods At Norrtälje Prison, we approached 315 male inmates for screening of childhood ADHD by the Wender Utah Rating Scale (WURS-25 and for present ADHD by the Adult ADHD Self-Report Screener (ASRS-Screener. The response rate was 62%. Further, we assessed 34 inmates for ADHD and coexisting disorders. Finally, we compared findings with 20 adult males with ADHD, assessed at a psychiatric outpatient clinic and 18 healthy controls. Results The estimated prevalence of adult ADHD among longer-term inmates was 40%. Only 2 out of 30 prison inmates confirmed with ADHD had received a diagnosis of ADHD during childhood, despite most needed health services and educational support. All subjects reported lifetime substance use disorder (SUD where amphetamine was the most common drug. Mood and anxiety disorders were present among half of subjects; autism spectrum disorder (ASD among one fourth and psychopathy among one tenth. Personality disorders were common; almost all inmates presented conduct disorder (CD before antisocial personality disorder (APD. Prison inmates reported more ADHD symptoms during both childhood and adulthood, compared with ADHD psychiatric outpatients. Further, analysis of executive functions after controlling for IQ showed both ADHD groups performed poorer than controls on working memory tests. Besides, on a continuous performance test, the ADHD prison group displayed poorer results compared with both other groups. Conclusions This study suggested ADHD to be present among 40% of adult male longer-term prison inmates. Further, ADHD

Testing, Modeling, and Monitoring to Enable Simpler, Cheaper, Longer-lived Surface Caps

International Nuclear Information System (INIS)

Piet, S. J.; Breckenridge, R. P.; Burns, D. E.

2003-01-01

Society has and will continue to generate hazardous wastes whose risks must be managed. For exceptionally toxic, long-lived, and feared waste, the solution is deep burial, e.g., deep geological disposal at Yucca Mtn. For some waste, recycle or destruction/treatment is possible. The alternative for other wastes is storage at or near the ground level (in someone's back yard); most of these storage sites include a surface barrier (cap) to prevent downward water migration. Some of the hazards will persist indefinitely. As society and regulators have demanded additional proof that caps are robust against more threats and for longer time periods, the caps have become increasingly complex and expensive. As in other industries, increased complexity will eventually increase the difficulty in estimating performance, in monitoring system/component performance, and in repairing or upgrading barriers as risks are managed. An approach leading to simpler, less expensive, longer-lived, more manageable caps is needed. Our project, which started in April 2002, aims to catalyze a Barrier Improvement Cycle (iterative learning and application) and thus enable Remediation System Performance Management (doing the right maintenance neither too early nor too late). The knowledge gained and the capabilities built will help verify the adequacy of past remedial decisions, improve barrier management, and enable improved solutions for future decisions. We believe it will be possible to develop simpler, longer-lived, less expensive caps that are easier to monitor, manage, and repair. The project is planned to: (a) improve the knowledge of degradation mechanisms in times shorter than service life; (b) improve modeling of barrier degradation dynamics; (c) develop sensor systems to identify early degradation; and (d) provide a better basis for developing and testing of new barrier systems. This project combines selected exploratory studies (benchtop and field scale), coupled effects accelerated

Comparative data on effects of leading pretreatments and enzyme loadings and formulations on sugar

Energy Technology Data Exchange (ETDEWEB)

Wyman, Charles [Univ. of California, Riverside, CA (United States); Balan, Venkatech [Michigan State Univ., East Lansing, MI (United States); Dale, Bruce E. [Michigan State Univ., East Lansing, MI (United States); Elander, Richard [National Renewable Energy Lab. (NREL), Golden, CO (United States); Falls, Matthew [Texas A & M Univ., College Station, TX (United States); Hames, Bonnie [Ceres Corporation, Thousand Oaks, CA (United States); Holtzapple, Mark [Texas A & M Univ., College Station, TX (United States); Ladisch, Michael R. [Purdue Univ., West Lafayette, IN (United States); Lee, Y. Y. [Auburn Univ., AL (United States); Mosier, Nathan [Purdue Univ., West Lafayette, IN (United States); Pallapolu, Venkata R. [Auburn Univ., AL (United States); Shi, Jian [Univ. of California, Riverside, CA (United States); Warner, Ryan E. [Genencor, Palo Alto, CA (United States)

2011-06-16

Dilute sulfuric acid (DA), sulfur dioxide (SO2), liquid hot water (LHW), soaking in aqueous ammonia (SAA), ammonia fiber expansion (AFEX), and lime pretreatments were applied to Alamo, Dacotah, and Shawnee switchgrass. Application of the same analytical methods and material balance approaches facil-itated meaningful comparisons of glucose and xylose yields from combined pretreatment and enzymatic hydrolysis. Use of a common supply of cellulase, beta-glucosidase, and xylanase also eased comparisons. All pretreatments enhanced sugar recovery from pretreatment and subsequent enzymatic hydrolysis substantially compared to untreated switchgrass. Adding beta-glucosidase was effective early in enzy-matic hydrolysis while cellobiose levels were high but had limited effect on longer term yields at the enzyme loadings applied. Adding xylanase improved yields most for higher pH pretreatments where more xylan was left in the solids. Harvest time had more impact on performance than switchgrass variety, and microscopy showed changes in different features could impact performance by different pretreatments.

How diking affects the longer-term structure and evolution of divergent plate boundaries

KAUST Repository

Trippanera, Daniele

2015-04-01

Recurrent diking episodes along divergent plate boundaries, as at Dabbahu (2005, Afar) or at Bardarbunga (2014, Iceland) , highlight the possibility to have m-wide opening in a short time (days to weeks). This suggests a prominent role of magma enhancing transient plate separations. However, the role of diking on a longer term (> 102 years) and its influence on the structure and the evolution of a divergent plate boundary is still poorly investigated. Here we use field surveys along the oceanic Icelandic and continental Ethiopian plate boundaries, along five eruptive fissures and four rift segments. Field observations have also been integrated with analogue and numerical models of dike emplacement to better understand the effect of dike emplacement at depth and at the surface. Our results show that the dike-fed eruptive fissures are systematically associated with graben structures formed by inward dipping normal faults having throws up to 10 m and commonly propagating downward. Moreover, rift segments (i.e. mature rift zones), despite any asymmetry and repetition, are characterized by the same features as the eruptive fissures, the only difference lying in the larger size (higher fault throws, up to 40 m, and wider deformation zones). Analogue and numerical models of dike intrusion confirm that all the structural features observed along the rift segments may be dike-induced; these features include downward propagating normal faults bordering graben structures, contraction at the base of the hanging walls of the faults and upward propagating faults. Simple calculations based on the deeper structure of the eroded rift segments in eastern and western Iceland also suggest that all the fault slip in the active rift segments may result from diking. These results suggest that the overall deformation pattern of eruptive fissures and rift segments may be explained only by dike emplacement. In a magmatic rift, the regional tectonic stress may rarely be high enough to be

Heat transfer system safety: Comparing the effectiveness of batch venting and a light-ends removal kit (LERK

Directory of Open Access Journals (Sweden)

Christopher Ian Wright

2014-11-01

Full Text Available Heat transfer fluids (HTF should be analysed at least once per year to determine the extent of thermal degradation. Under normal operating conditions, mineral-based HTFs will thermally degrade and the bonds between hydrocarbons break to form shorter-chain hydrocarbons known as “light-ends”. These light-ends accumulate in a HTF system and present a future potential fire risk. Light-ends can be removed from a HTF system via a batch vent or installation of a temporary or permanently installed light-ends removal kit (LERK. Data was collected prior to and following batch venting or installation of a LERK. The main study parameter was closed flash temperature as open flash temperature and fire point did not change considerably. Analysis showed that both methods increased closed flash temperature in excess of 130 °C three months after the intervention, so both methods were deemed effective. Data showed that the percentage change achieved with the LERK, compared to batch venting, was 2-fold higher at three months and 10-fold higher at 6 months. The duration of effect was longer with the LERK with closed flash temperature being stable and consistently above 130 °C for 50 months after being permanently installed. This case highlights the effectiveness of a permanently fitted LERK which is effective for the longer-term control of closed flash temperature. However, mobile LERKs could be an option for manufacturers looking to manage closed flash temperature on a shorter-term basis or as an alternative to batch venting.

Women live longer than men even during severe famines and epidemics

DEFF Research Database (Denmark)

Zarulli, Virginia; Barthold Jones, Julia A; Oksuzyan, Anna

2018-01-01

Women in almost all modern populations live longer than men. Research to date provides evidence for both biological and social factors influencing this gender gap. Conditions when both men and women experience extremely high levels of mortality risk are unexplored sources of information. We...... investigate the survival of both sexes in seven populations under extreme conditions from famines, epidemics, and slavery. Women survived better than men: In all populations, they had lower mortality across almost all ages, and, with the exception of one slave population, they lived longer on average than men...

Atomic weights: no longer constants of nature

Science.gov (United States)

Coplen, Tyler B.; Holden, Norman E.

2011-01-01

Many of us were taught that the standard atomic weights we found in the back of our chemistry textbooks or on the Periodic Table of the Chemical Elements hanging on the wall of our chemistry classroom are constants of nature. This was common knowledge for more than a century and a half, but not anymore. The following text explains how advances in chemical instrumentation and isotopic analysis have changed the way we view atomic weights and why they are no longer constants of nature

Processing of semen by density gradient centrifugation selects spermatozoa with longer telomeres for assisted reproduction techniques.

Science.gov (United States)

Yang, Qingling; Zhang, Nan; Zhao, Feifei; Zhao, Wanli; Dai, Shanjun; Liu, Jinhao; Bukhari, Ihtisham; Xin, Hang; Niu, Wenbing; Sun, Yingpu

2015-07-01

The ends of eukaryotic chromosomes contain specialized chromatin structures called telomeres, the length of which plays a key role in early human embryonic development. Although the effect of sperm preparation techniques on major sperm characteristics, such as concentration, motility and morphology have been previously documented, the possible status of telomere length and its relation with sperm preparation techniques is not well-known for humans. The aim of this study was to investigate the role of density gradient centrifugation in the selection of spermatozoa with longer telomeres for use in assisted reproduction techniques in 105 samples before and after sperm processing. After density gradient centrifugation, the average telomere length of the sperm was significantly longer (6.51 ± 2.54 versus 5.16 ± 2.29, P average motile sperm rate was significantly higher (77.9 ± 11.8 versus 44.6 ± 11.2, P average DNA fragmentation rate was significantly lower (11.1 ± 5.9 versus 25.9 ± 12.9, P sperm count (rs = 0.58; P sperm with longer telomeres. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

The bleeding time may be longer in children than in adults.

Science.gov (United States)

Sanders, J M; Holtkamp, C A; Buchanan, G R

1990-01-01

The bleeding time, the most frequently performed test reflecting in vivo platelet function, is the duration of blood flow from a standardized incision on the volar surface of the forearm. Normal values have been determined in adult subjects, but with the exception of neonates, data on the range of bleeding time values in pediatric patients are unavailable. Standard hematology textbooks imply that bleeding time values in children are similar to those of adults. We have reviewed our 9 years of experience with 137 children (mean age 6.5 years) who were referred for diagnostic evaluation of a bleeding disorder but whose history and physical examination were felt by us to be inconsistent with an abnormality of hemostasis. Bleeding time values in these individuals (mean 6.0 min, 95th percentile 9.0 min) were compared with those of 85 normal adult volunteers (mean 4.4 min, 95th percentile 6.5 min). The Simplate-I disposable device and vertical (perpendicular to elbow crease) incision direction were used in both groups. This difference between the pediatric and adult bleeding time values is statistically significant (p less than 0.0001). Neither age nor sex had a significant effect on the pediatric bleeding time measurements. We conclude that the bleeding time, when performed as described, is longer in children than in adults and that pediatric standards for bleeding time should be used in order to avoid a spurious diagnosis of a primary hemostatic disorder in some normal children.

Revisiting Academic Capitalism in Canada: No Longer the Exception

Science.gov (United States)

Metcalfe, Amy Scott

2010-01-01

In "Academic Capitalism: Politics, Policies, and the Entrepreneurial University" (1997), Slaughter and Leslie found that Canada showed signs of resisting academic capitalism. Changes in postsecondary education funding policies and the emergence of new commercialization initiatives are evidence that Canada is certainly no longer, and…

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

Science.gov (United States)

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

2018-01-01

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

Economic impact of longer battery life of cardiac resynchronization therapy defibrillators in Sweden

Directory of Open Access Journals (Sweden)

Gadler F

2016-10-01

Full Text Available Fredrik Gadler,1 Yao Ding,2 Nathalie Verin,3 Martin Bergius,4 Jeffrey D Miller,5 Gregory M Lenhart,5 Mason W Russell5 1Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; 2Truven Health Analytics, an IBM Company, Bethesda, MD, USA; 3Boston Scientific Corporation, Hemel Hempstead, Hertfordshire, UK; 4Boston Scientific Nordic AB, Helsingborg, Sweden; 5Truven Health Analytics, an IBM Company, Cambridge, MA, USA Objective: The objective of this study was to quantify the impact that longer battery life of cardiac resynchronization therapy defibrillator (CRT-D devices has on reducing the number of device replacements and associated costs of these replacements from a Swedish health care system perspective.Methods: An economic model based on real-world published data was developed to estimate cost savings and avoided device replacements for CRT-Ds with longer battery life compared with devices with industry-standard battery life expectancy. Base-case comparisons were performed among CRT-Ds of three manufacturers – Boston Scientific Corporation, St. Jude Medical, and Medtronic – over a 6-year time horizon, as per the available clinical data. As a sensitivity analysis, we evaluated CRT-Ds as well as single-chamber implantable cardioverter defibrillator (ICD-VR and dual-chamber implantable cardioverter defibrillator (ICD-DR devices over a longer 10-year period. All costs were in 2015 Swedish Krona (SEK discounted at 3% per annum.Results: Base-case analysis results show that up to 603 replacements and up to SEK 60.4 million cumulative-associated costs could be avoided over 6 years by using devices with extended ­battery life. The pattern of savings over time suggests that savings are modest initially but increase rapidly beginning in the third year of follow-up with each year’s cumulative savings two to three times the previous year. Evaluating CRT-D, ICD-VR, and ICD-DR devices together over a longer 10-year period, the

Short and longer duration effects of protective gloves on hand performance capabilities and subjective assessments in a screw-driving task.

Science.gov (United States)

Dianat, Iman; Haslegrave, Christine M; Stedmon, Alex W

2010-12-01

The study investigated short and longer duration effects of gloves on hand performance capabilities (muscle activity, dexterity, touch sensitivity, finger pinch and forearm torque strength) and subjective assessments of discomfort and ease of manipulation when performing a light assembly task. The independent variables were hand condition with four levels (wearing cotton, nylon or nitrile gloves as well as barehanded) and point of time within the 2 h duration of the task (with measurements taken at 0, 30, 60, 90 and 120 min). Participants worked with a screwdriver to fit two components together using screws. Wearing gloves significantly increased the muscle activity, pinch strength and discomfort but reduced the dexterity and touch sensitivity. There was also a significant effect of task time on the muscle activity, dexterity, forearm torque strength and touch sensitivity, which indicates that the duration of the task should be an important consideration in glove evaluation studies and in the selection of work gloves. STATEMENT OF RELEVANCE: It is important to evaluate the effects of gloves on hand performance capabilities in a working context so that job demands can be taken into account and the most appropriate type of glove be chosen for each task. This study gives recommendations regarding the evaluation and use of gloves for screw-driving tasks.

Telomere length is longer in women with late maternal age

DEFF Research Database (Denmark)

Fagan, Erin; Sun, Fangui; Bae, Harold

2017-01-01

OBJECTIVE:: Maternal age at birth of last child has been associated with maternal longevity. The aim of this study was to determine whether older women with a history of late maternal age at last childbirth had a longer leukocyte telomere length than those with maternal age at last childbirth of 29...... died, but were at least 70 years old, were studied. Logistic regression models using generalized estimating equations were used to determine the association between tertiles of telomere length and maternal age at last childbirth, adjusting for covariates. RESULTS:: Age at birth of the last child...... in the first tertile. CONCLUSIONS:: These findings show an association between longer leukocyte telomere length and a later maternal age at birth of last child, suggesting that extended maternal age at last childbirth may be a marker for longevity....

Resolving prokaryotic taxonomy without rRNA: longer oligonucleotide word lengths improve genome and metagenome taxonomic classification.

Science.gov (United States)

Alsop, Eric B; Raymond, Jason

2013-01-01

Oligonucleotide signatures, especially tetranucleotide signatures, have been used as method for homology binning by exploiting an organism's inherent biases towards the use of specific oligonucleotide words. Tetranucleotide signatures have been especially useful in environmental metagenomics samples as many of these samples contain organisms from poorly classified phyla which cannot be easily identified using traditional homology methods, including NCBI BLAST. This study examines oligonucleotide signatures across 1,424 completed genomes from across the tree of life, substantially expanding upon previous work. A comprehensive analysis of mononucleotide through nonanucleotide word lengths suggests that longer word lengths substantially improve the classification of DNA fragments across a range of sizes of relevance to high throughput sequencing. We find that, at present, heptanucleotide signatures represent an optimal balance between prediction accuracy and computational time for resolving taxonomy using both genomic and metagenomic fragments. We directly compare the ability of tetranucleotide and heptanucleotide world lengths (tetranucleotide signatures are the current standard for oligonucleotide word usage analyses) for taxonomic binning of metagenome reads. We present evidence that heptanucleotide word lengths consistently provide more taxonomic resolving power, particularly in distinguishing between closely related organisms that are often present in metagenomic samples. This implies that longer oligonucleotide word lengths should replace tetranucleotide signatures for most analyses. Finally, we show that the application of longer word lengths to metagenomic datasets leads to more accurate taxonomic binning of DNA scaffolds and have the potential to substantially improve taxonomic assignment and assembly of metagenomic data.

Resolving prokaryotic taxonomy without rRNA: longer oligonucleotide word lengths improve genome and metagenome taxonomic classification.

Directory of Open Access Journals (Sweden)

Eric B Alsop

Full Text Available Oligonucleotide signatures, especially tetranucleotide signatures, have been used as method for homology binning by exploiting an organism's inherent biases towards the use of specific oligonucleotide words. Tetranucleotide signatures have been especially useful in environmental metagenomics samples as many of these samples contain organisms from poorly classified phyla which cannot be easily identified using traditional homology methods, including NCBI BLAST. This study examines oligonucleotide signatures across 1,424 completed genomes from across the tree of life, substantially expanding upon previous work. A comprehensive analysis of mononucleotide through nonanucleotide word lengths suggests that longer word lengths substantially improve the classification of DNA fragments across a range of sizes of relevance to high throughput sequencing. We find that, at present, heptanucleotide signatures represent an optimal balance between prediction accuracy and computational time for resolving taxonomy using both genomic and metagenomic fragments. We directly compare the ability of tetranucleotide and heptanucleotide world lengths (tetranucleotide signatures are the current standard for oligonucleotide word usage analyses for taxonomic binning of metagenome reads. We present evidence that heptanucleotide word lengths consistently provide more taxonomic resolving power, particularly in distinguishing between closely related organisms that are often present in metagenomic samples. This implies that longer oligonucleotide word lengths should replace tetranucleotide signatures for most analyses. Finally, we show that the application of longer word lengths to metagenomic datasets leads to more accurate taxonomic binning of DNA scaffolds and have the potential to substantially improve taxonomic assignment and assembly of metagenomic data.

Comparing headphone and speaker effects on simulated driving.

Science.gov (United States)

Nelson, T M; Nilsson, T H

1990-12-01

Twelve persons drove for three hours in an automobile simulator while listening to music at sound level 63dB over stereo headphones during one session and from a dashboard speaker during another session. They were required to steer a mountain highway, maintain a certain indicated speed, shift gears, and respond to occasional hazards. Steering and speed control were dependent on visual cues. The need to shift and the hazards were indicated by sound and vibration effects. With the headphones, the driver's average reaction time for the most complex task presented--shifting gears--was about one-third second longer than with the speaker. The use of headphones did not delay the development of subjective fatigue.

Cost-effectiveness of longer-term versus shorter-term provision of antibiotics in patients with persistent symptoms attributed to Lyme disease

NARCIS (Netherlands)

Berende, A.; Nieuwenhuis, L.; Hofstede, H.J.M. ter; Vos, F.J.; Vogelaar, M.L.; Tromp, M.A.; Middendorp, H. van; Donders, A.R.T.; Evers, A.W.M.; Kullberg, B.J.; Adang, E.M.M.

2018-01-01

BACKGROUND: The treatment of persistent symptoms attributed to Lyme disease remains controversial. Recently, the PLEASE study did not demonstrate any additional clinical benefit of longer-term versus shorter-term antibiotic treatment. However, the economic impact of the antibiotic strategies has not

LONGER-TERM EFFECTIVENESS OF CBT IN TREATMENT OF COMORBID AUD/MDD ADOLESCENTS.

Science.gov (United States)

Cornelius, Jack R; Douaihy, Antoine B; Kirisci, Levent; Daley, Dennis C

2013-01-01

Cognitive Behavioral Therapy (CBT) is a commonly used therapy among persons with major depressive disorder (MDD) and also among those with alcohol use disorders (AUD). However, less is known regarding the efficacy of CBT for treating persons with co-occurring disorders involving both MDD and an AUD. Studies assessing the efficacy of CBT in adolescent populations with co-occurring disorders are particularly sparse, especially studies designed to assess the potential longer-term efficacy of an acute phase trial of CBT therapy in that youthful comorbid population. We recently conducted a first acute phase treatment study involving comorbid AUD/MDD adolescents, which involved the medication fluoxetine as well as manualized CBT therapy. The results of that acute phase study suggested efficacy for CBT therapy but not for fluoxetine for treating the depressive symptoms and the excessive alcohol use of study subjects (Cornelius et al., 2009). The current chapter provides an assessment of the long-term efficacy of CBT for treating comorbid AUD/MDD adolescents, based on results from our own long-term (four-year) follow-up study, which was conducted following the completion of our recent acute phase treatment study. The results of the study suggest long-term efficacy for acute phase CBT/MET therapy for treating both the depressive symptoms and the excessive alcohol use of comorbid AUD/MDD adolescents, but demonstrate no evidence of long-term efficacy for fluoxetine for treating either the depressive symptoms or the excessive alcohol use of that population.

The economic efficiency of allowing longer combination vehicles in Texas.

Science.gov (United States)

2011-08-01

This paper shows the economic efficiency of allowing longer combination vehicles in Texas. First, an : overview of the truck size and weight policies is explained, with an emphasis on those that affect : Texas. Next, LCV operations in other countries...

Interference Cancellation Using Replica Signal for HTRCI-MIMO/OFDM in Time-Variant Large Delay Spread Longer Than Guard Interval

Directory of Open Access Journals (Sweden)

Yuta Ida

2012-01-01

Full Text Available Orthogonal frequency division multiplexing (OFDM and multiple-input multiple-output (MIMO are generally known as the effective techniques for high data rate services. In MIMO/OFDM systems, the channel estimation (CE is very important to obtain an accurate channel state information (CSI. However, since the orthogonal pilot-based CE requires the large number of pilot symbols, the total transmission rate is degraded. To mitigate this problem, a high time resolution carrier interferometry (HTRCI for MIMO/OFDM has been proposed. In wireless communication systems, if the maximum delay spread is longer than the guard interval (GI, the system performance is significantly degraded due to the intersymbol interference (ISI and intercarrier interference (ICI. However, the conventional HTRCI-MIMO/OFDM does not consider the case with the time-variant large delay spread longer than the GI. In this paper, we propose the ISI and ICI compensation methods for a HTRCI-MIMO/OFDM in the time-variant large delay spread longer than the GI.

Education and Training: Is There Any Longer a Useful Distinction?

Science.gov (United States)

Hager, Paul; Laurent, John

1990-01-01

Although education and training were distinct concepts when Taylorism dominated the workplace, it is no longer appropriate to separate them. Today's highly competitive environment requires the education of a flexible, multiskilled workforce, not training for narrowly defined employment tasks. (SK)

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

Science.gov (United States)

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

2018-03-21

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

Issues of using Longer Heavier Vehicles on Roads

Science.gov (United States)

Matuszkova, R.; Heczko, M.; Cepil, J.; Radimsky, M.

2018-03-01

Many logistics companies aim to save on freight costs. Recently, not only on Czech roads and on motorways, longer and heavier vehicles that exceed dimensions’ limits appeared. For these vehicles, it is necessary to apply for a special permit, which is, however, much more liberal than the permit for oversized and overweight load transport. This paper informs about checking routes of these vehicles by swept path analysis and finding locations on roads that can generate both safety risks and traffic fluency problems.

Higher dietary lycopene intake is associated with longer cardiac event-free survival in patients with heart failure.

Science.gov (United States)

Biddle, Martha; Moser, Debra; Song, Eun Kyeung; Heo, Seongkum; Payne-Emerson, Heather; Dunbar, Sandra B; Pressler, Susan; Lennie, Terry

2013-08-01

The antioxidant lycopene may be beneficial for patients with heart failure (HF). Processed tomato products are a major source of lycopene, although they are also high in sodium. Increased sodium intake may counter the positive antioxidant effect of lycopene. This was a prospective study of 212 patients with HF. Dietary intake of lycopene and sodium was obtained from weighted 4-day food diaries. Patients were grouped by the median split of lycopene of 2471 µg/day and stratified by daily sodium levels above and below 3 g/day. Patients were followed for 1 year to collect survival and hospitalization data. Cox proportional hazards modeling was used to compare cardiac event-free survival between lycopene groups within each stratum of sodium intake. Higher lycopene intake was associated with longer cardiac event-free survival compared with lower lycopene intake (p = 0.003). The worst cardiac event-free survival was observed in the low lycopene intake group regardless of sodium intake (> 3 g/day HR = 3.01; p = 0.027 and ≤ 3 g/day HR= 3.34; p = 0.023). These findings suggest that increased lycopene intake has the potential to improve cardiac event-free survival in patients with HF independent of sodium intake.

Working longer in good health [Langer doorwerken in goede gezondheid

NARCIS (Netherlands)

Leijten, F.R.M

2015-01-01

Due to an ageing society, an increasing retirement age, and high prevalence of chronic health problems among older persons, it is important to understand how older employees [with health problems] can work for longer and productively, often this is termed ‘sustainable employability’. This context

Longer-term bosentan therapy improves functional capacity in Eisenmenger syndrome : Results of the BREATHE-5 open-label extension study

NARCIS (Netherlands)

Gatzoulis, Michael A.; Beghetti, Maurice; Galie, Nazzareno; Granton, John; Berger, Rolf M. F.; Lauer, Andrea; Chiossi, Eleonora; Landzberg, Michael

2008-01-01

BACKGROUND: Bosentan, an oral endothelin ET(A)/ET(B) receptor antagonist, improves hemodynamics and exercise capacity in patients with Eisenmenger syndrome but longer-term effects are unknown. This study investigated the efficacy and safety of bosentan up to 40 weeks in these patients. METHODS:

Who stays, who drops out? Biosocial predictors of longer-term adherence in participants attending an exercise referral scheme in the UK

Directory of Open Access Journals (Sweden)

Tobi Patrick

2012-05-01

Full Text Available Abstract Background Exercise referral schemes are one of the most popular forms of physical activity intervention in primary care in the UK and present an opportunity to better understand the factors related to exercise adherence. But standard schemes tend to be delivered over a short period and so provide information about the factors associated with short-term adherence. This retrospective register-based study of a longer-duration scheme allowed investigation of longer-term adherence. Methods Social, physiological and anthropometric data were extracted from records of a cohort of ERS participants who had enrolled between 01 January and 31 December 2007 (n = 701. Characteristics of adherers and non-adherers were compared and potential predictors of longer-term adherence examined using binomial logistic regression. Results Significant adjusted odds ratios predicting longer-term adherence were found for age and medical condition. For every 10 year increase in age, the odds of people continuing exercise increased by 21.8% (OR = 1.02; CI = 1.00 to 1.04; p = 0.03. Participants referred with orthopaedic (OR = 0.25; CI = 0.07-0.94; p = 0.04, cardiovascular (OR = 0.18; CI = 0.05-0.70; p = 0.01 and other (OR = 0.20; CI = 0.04-0.93; p = 0.04 problems had significantly lower odds of adhering than those with metabolic conditions. Conclusion Improved understanding of the factors that influence adherence to exercise referral schemes will enable providers develop better referral guidance and tailor schemes to better meet participants’ needs. Longer-term schemes offer the opportunity to understand participants’ likelihood of maintaining adherence to exercise.

Inter-birth interval in zebras is longer following the birth of male foals than after female foals

Science.gov (United States)

Barnier, Florian; Grange, Sophie; Ganswindt, Andre; Ncube, Hlengisizwe; Duncan, Patrick

2012-07-01

Mammalian reproductive rates vary among individuals for physiological and environmental reasons. This study aims to determine reproductive rates from an individually monitored population of wild Plains zebras Equus quagga, and to assess the sources of variability in inter-birth intervals. The animals were monitored, where possible, every six months from 2004 to 2011. Thirty nine intervals corresponding to 65 births in 26 mares were identified, using direct observations and faecal steroid monitoring. Mean foaling rate of the population is 0.74 foal/year, and comparable with the literature. There was no significant effect of mother's age, nor of the season of previous birth on the length of inter-birth intervals. Inter-birth interval was significantly longer when the first foal was a male. This finding indicates that additional costs of having a son may delay future reproduction and thus reduce the total number of offspring a mare can have during her lifetime. Individually-based data provide critical information on the determinants of reproductive rates, and are therefore a key to understanding the causes of variations in life-history traits.

Can longer forest harvest intervals increase summer streamflow for salmon recovery?

Science.gov (United States)

The Mashel Streamflow Modeling Project in the Mashel River Basin, Washington, is using a watershed-scale ecohydrological model to assess whether longer forest harvest intervals can remediate summer low flow conditions that have contributed to sharply reduced runs of spawning Chin...

LPI Thresholds in Longer Scale Length Plasmas Driven by the Nike Laser*

Science.gov (United States)

Weaver, J.; Oh, J.; Phillips, L.; Afeyan, B.; Seely, J.; Kehne, D.; Brown, C.; Obenschain, S.; Serlin, V.; Schmitt, A. J.; Feldman, U.; Holland, G.; Lehmberg, R. H.; McLean, E.; Manka, C.

2010-11-01

The Krypton-Fluoride (KrF) laser is an attractive driver for inertial confinement fusion due to its short wavelength (248nm), large bandwidth (1-3 THz), and beam smoothing by induced spatial incoherence. Experiments with the Nike KrF laser have demonstrated intensity thresholds for laser plasma instabilities (LPI) higher than reported for other high power lasers operating at longer wavelengths (>=351 nm). The previous Nike experiments used short pulses (350 ps FWHM) and small spots (<260 μm FWHM) that created short density scale length plasmas (Ln˜50-70 μm) from planar CH targets and demonstrated the onset of two-plasmon decay (2φp) at laser intensities ˜2x10^15 W/cm^2. This talk will present an overview of the current campaign that uses longer pulses (0.5-4.0 ns) to achieve greater density scale lengths (Ln˜100-200 μm). X-rays, emission near ^1/2φo and ^3/2φo harmonics, and reflected laser light have been monitored for onset of 2φp. The longer density scale lengths will allow better comparison to results from other laser facilities. *Work supported by DoE/NNSA and ONR.

Kenya; Ex Post Assessment of Longer-Term Program Engagement

OpenAIRE

International Monetary Fund

2008-01-01

This paper discusses key findings of the Ex Post Assessment (EPA) of Longer-Term Program Engagement paper for Kenya. This EPA focuses on 1993–2007, when Kenya was engaged in four successive IMF arrangements. Macroeconomic policy design was broadly appropriate, and implementation was generally sound. Growth slowed in the 1990s, but picked up after the 2002 elections, reflecting buoyant global conditions, structural reforms, and a surge of private capital inflows. Monetary policies were complic...

Do women spend longer on wait lists for coronary bypass surgery? Analysis of a population-based registry in British Columbia, Canada

Directory of Open Access Journals (Sweden)

Kuramoto Lisa

2007-08-01

Full Text Available Abstract Background Studies have shown patients who are delayed for surgical cardiac revascularization are faced with increased risks of symptom deterioration and death. This could explain the observation that operative mortality among persons undergoing coronary artery bypass surgery (CABG is higher among women than men. However, in jurisdictions that employ priority wait lists to manage access to elective cardiac surgery, there is little information on whether women wait longer than men for CABG. It is therefore difficult to ascertain whether higher operative mortality among women is due to biological differences or to delayed access to elective CABG. Methods Using records from a population-based registry, we compared the wait-list time between women and men in British Columbia (BC between 1990 and 2000. We compared the number of weeks from registration to surgery for equal proportions of women and men, after adjusting for priority, comorbidity and age. Results In BC in the 1990s, 9,167 patients aged 40 years and over were registered on wait lists for CABG and spent a total of 136,071 person-weeks waiting. At the time of registration for CABG, women were more likely to have a comorbid condition than men. We found little evidence to suggest that women waited longer than men for CABG after registration, after adjusting for comorbidity and age, either overall or within three priority groups. Conclusion Our findings support the hypothesis that higher operative mortality during elective CABG operations observed among women is not due to longer delays for the procedure.

Longer-term Stream Nitrogen Dynamics after Wildfire and Salvage Harvesting: Implications for Management Concepts based on Trajectories of Post-disturbance Watershed Recovery.

Science.gov (United States)

Silins, U.; Emelko, M. B.; Bladon, K. D.; Stone, M.; Williams, C.; Martens, A. M.; Wagner, M. J.

2015-12-01

Biogeochemical processes reflecting interaction of vegetation and hydrology govern long-term export of nutrients such as nitrogen, phosphorus, and carbon over successional time scales. While management concepts of watershed "recovery" from disturbance back towards pre-disturbance conditions are often considered over much shorter timescales, few studies have directly explored watershed biogeochemical responses to disturbance long enough to directly document the longer-term trajectory of responses to severe land disturbance on nitrogen export. The objectives of this study were to document both the initial magnitude and patterns of longer-term recovery of stream nitrogen after the 2003 Lost Creek wildfire over nine years in front ranges of the Rocky Mountains in south-west Alberta, Canada. The study was conducted in seven instrumented catchments (4-14 km2), including burned, burned and salvage logged, and unburned (reference) conditions since 2004. Total nitrogen (TN) and nitrate (NO3-) concentrations and area-normalized yields were greater and more variable in burned and post-fire salvage logged catchments when compared with unburned catchments. Large initial increases in stream TN and NO3- production 1-3 years after both wildfire and post-fire salvage logging declined strongly to levels similar to, or below that of unburned watersheds 4-6 years after the fire, and continued to decline (although more slowly) 7-9 years after the wildfire. Post-fire salvage logging produced lower impacts on TN and NO3- in streams and these effects declined even more rapidly compared to the effects of wildfire alone. These changes closely corresponded to the early trajectory of establishment and rapid juvenile growth of post-fire regenerating forest vegetation in both catchment groups. While the concept of hydrologic recovery from disturbance is both a practical and meaningful concept for integrated landscape management for protection of forest water resources, the benchmark for

Is Patient Support Program Participation Associated with Longer Persistence and Improved Adherence Among New Users of Adalimumab? A Retrospective Cohort Study.

Science.gov (United States)

Srulovici, Einav; Garg, Vishvas; Ghilai, Adi; Feldman, Becca; Hoshen, Moshe; Balicer, Ran D; Skup, Martha; Leventer-Roberts, Maya

2018-05-10

Adalimumab (ADA) is a medication used in the treatment of several autoimmune diseases. Despite the beneficial effects of ADA, its adherence and persistence rates are low. Patients treated with ADA from Clalit Health Services (CHS) can enroll in AbbVie's patient support program (PSP), which aims to improve ADA adherence and persistence. Therefore, we examine whether PSP participation is associated with a longer persistence and/or an improved adherence to ADA. A real-world retrospective cohort study of all new ADA users from CHS, comparing those enrolled in the offered PSP to those not enrolled. The data regarding PSP users can be tracked using CHS's data warehouse. The index date was defined as the date of the patients' first purchase of ADA occurring between August 1, 2012 and December 31, 2014. The follow-up data were collected at 12, 24, and 36 months. Persistence was assessed using survival analyses of time until discontinuation, and adherence was assessed using medication possession ratio (MPR). There were 1520 patients in the study, 755 (49.7%) of whom were PSP users. PSP users were 54.3% female vs. 51.9% among non-PSP users (p = 0.355) and they were significantly younger than non-PSP users (mean age 42.3 vs. 45.0 years, p = 0.002) The PSP and non-PSP users' persistence was 673 and 574 days, respectively (p users were more likely than the non-PSP users to be persistently taking medication at the 12-month follow-up (57.5% vs. 45.6%, p users compared to the non-PSP users (94.1% vs. 92.9%, p = 0.026). The AbbVie PSP provided to CHS patients was associated with a longer persistence among new users of ADA. It was also associated with significantly higher adherence rate within the first 12 months. AbbVie Inc.

Comparing the effects of different in vitro maturation media on IVM outcomes of MI oocytes

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Farzaneh Fesahat

2017-09-01

Conclusion: While the immature oocytes rescued from stimulated cycles based on specific conditions of patients can be useful for an alternative IVM intervention, it seems that different commercial culture media and longer incubation time has no beneficial effects on maturation, fertilization and embryo development on oocytes at MI stage.

Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression.

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Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H

2017-10-27

The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.

Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression

Science.gov (United States)

Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H.

2017-01-01

The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work. PMID:29076997

Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression

Directory of Open Access Journals (Sweden)

Patrik Grahn

2017-10-01

Full Text Available The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.

Women live longer than men even during severe famines and epidemics

DEFF Research Database (Denmark)

Zarulli, Virginia; Barthold Jones, Julia A; Oksuzyan, Anna

2018-01-01

Women in almost all modern populations live longer than men. Research to date provides evidence for both biological and social factors influencing this gender gap. Conditions when both men and women experience extremely high levels of mortality risk are unexplored sources of information. We inves...

Excessive Daytime Sleepiness is Associated with Longer Culprit Lesion and Adverse Outcomes in Patients with Coronary Artery Disease

Science.gov (United States)

Lee, Chi-Hang; Ng, Wai-Yee; Hau, William; Ho, Hee-Hwa; Tai, Bee-Choo; Chan, Mark Y.; Richards, A. Mark; Tan, Huay-Cheem

2013-01-01

Study Objectives: We assessed whether excessive daytime sleepiness was associated with coronary plaque phenotype and subsequent adverse cardiovascular events. Methods: Prospective cohort study. Intravascular ultrasound (IVUS) examination of the culprit coronary stenosis was performed. The Epworth Sleepiness Scale (ESS) questionnaire was administered, and the patients were divided into 2 groups—(1) sleepier and (2) less sleepy—based on the ESS score. Adverse cardiovascular outcomes were defined as cardiac death, myocardial infarction, stroke, unplanned revascularization, or heart failure admission. Results: One hundred seventeen patients undergoing urgent or non-urgent coronary angiography were recruited. Compared with the less sleepy group (ESS ≤ 10, n = 87), the sleepier group (ESS > 10, n = 30) had higher serum levels of total cholesterol and of low-density-lipoprotein cholesterols (p 10 was associated with longer culprit lesions and future adverse cardiovascular events. Citation: Lee CH; Ng WY; Hau W; Ho HH; Tai BC; Chan MY; Richards AM; Tan HC. Excessive daytime sleepiness is associated with longer culprit lesion and adverse outcomes in patients with coronary artery disease. J Clin Sleep Med 2013;9(12):1267-1272. PMID:24340288

A comparative study of behavioural, physical and mental health status between term-limited and tenure-tracking employees in a population of Japanese male researchers.

Science.gov (United States)

Nakao, M; Yano, E

2006-04-01

Traditional lifelong employment systems have been changing rapidly in Japan. The aim of this study was to assess the health impacts of term-limited employment systems that have recently been introduced into Japanese academic institutes. Cross-sectional. A total of 514 male researchers (275 term limited and 239 tenure track) were compared in terms of behavioural, physical and mental status at annual health examinations. At these examinations, working hours and health-related lifestyles were examined using a self-completed questionnaire. Clinical structured interviews of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were used to detect major depression. The term-limited researchers tended to work longer hours (Pbreakfast less regularly (P0.05) between the two groups, fatigue was more prevalent (P=0.027) in the term-limited researchers than in the tenure-track researchers, adjusting for the effects of age. Compared with colleagues working in the same laboratories, the term-limited researchers worked longer hours, irrespective of fatigue, whereas only the fatigued tenure-track researchers worked longer hours. In the total sample, the fatigued researchers tended to belong to laboratories where their colleagues, on average, worked longer hours, compared with the non-fatigued researchers. These results imply that the term-limited researchers suffered more from fatigue, due to longer working hours, than their colleagues, and that organized, rather than personal, interventions with respect to the working environment may be effective in reducing overload in such workplaces.

Sexual intimacy in couples is associated with longer telomere length.

Science.gov (United States)

Cabeza de Baca, Tomás; Epel, Elissa S; Robles, Theodore F; Coccia, Michael; Gilbert, Amanda; Puterman, Eli; Prather, Aric A

2017-07-01

High-quality relationships have been shown to be beneficial for physical and mental health. This study examined overall relationship satisfaction and perceived stress as well as daily reports of partner support, partner conflict, and physical intimacy obtained over the course of one week in a sample of 129 high and low stress mothers. Telomere length was examined in whole blood, as well as the two cell subpopulations: peripheral blood mononuclear cells (PBMCs) and granulocytes. Telomerase activity was measured in PBMCs. Analyses revealed no statistically significant associations of telomere length with current relationship satisfaction, daily support or conflict, or perceived stress. In contrast, women who reported any sexual intimacy during the course of the week had significantly longer telomeres measured in whole blood and PBMCs, but not in granulocytes. These relationships held covarying for age, body mass index, perceived stress, the relationship indices, and caregiver status. Sexual intimacy was not significantly related to PBMC telomerase activity. These data provide preliminary data that sexual intimacy is associated with longer telomere length. Future studies investigating these associations are warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of longer Nd:LGGG crystal for high power laser application

Science.gov (United States)

Yin, Yanru; Tian, Hanlin; Zhang, Jian; Mu, Wenxiang; Zhang, Baitao; Jia, Zhitai; He, Jingliang; Tao, Xutang

2017-11-01

In order to further improve the Nd3+:(LuxGd1-x)3Ga5O12 (Nd:LGGG) crystal performance in high power laser field, a long Nd:LGGG crystal with dimensions of Φ 23 × 112 mm3 has been grown successfully by the Czochralski (Cz) method for laser rod fabrication. Compared with the normal size LGGG crystals (like 30-50 mm in length), we overcame several difficulties in the growth of longer ones, including crystal cracking by a large longitudinal temperature gradient, spiral growth by a small radial temperature gradient, and growth instability and even constitutional super cooling by Ga2O3 volatilizing continuously. The doping concentrations of Nd3+ and Lu3+ in the as-grown crystal and the crystal optical quality have been measured. The performance of diode-side-pumped Nd:LGGG rod laser has been preliminarily tested for the first time, simply by replacing the Nd:YAG crystal rod inside a commercial laser module. Under an incident pump power of 160 W, the maximum continuous wave output power of 38 W has been obtained, corresponding to an optical-optical conversion efficiency of 23.8% and a slope efficiency of 40.8%, respectively.

Sexual selection on receptor organ traits: younger females attract males with longer antennae

Science.gov (United States)

Johnson, Tamara L.; Symonds, Matthew R. E.; Elgar, Mark A.

2017-06-01

Sexual selection theory predicts that female choice may favour the evolution of elaborate male signals. Darwin also suggested that sexual selection can favour elaborate receiver structures in order to better detect sexual signals, an idea that has been largely ignored. We evaluated this unorthodox perspective by documenting the antennal lengths of male Uraba lugens Walker (Lepidoptera: Nolidae) moths that were attracted to experimentally manipulated emissions of female sex pheromone. Either one or two females were placed in field traps for the duration of their adult lives in order to create differences in the quantity of pheromone emissions from the traps. The mean antennal length of males attracted to field traps baited with a single female was longer than that of males attracted to traps baited with two females, a pattern consistent with Darwin's prediction assuming the latter emits higher pheromone concentrations. Furthermore, younger females attracted males with longer antennae, which may reflect age-specific changes in pheromone emission. These field experiments provide the first direct evidence of an unappreciated role for sexual selection in the evolution of sexual dimorphism in moth antennae and raise the intriguing possibility that females select males with longer antennae through strategic emission of pheromones.

Fetal size in the second trimester is associated with the duration of pregnancy, small fetuses having longer pregnancies

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Rasmussen Svein

2008-07-01

Full Text Available Abstract Background Conventionally, the pregnancy duration is accepted to be 280–282 days. Fetuses determined by ultrasound biometry to be small in early pregnancy, have an increased risk of premature birth. We speculate that the higher rate of preterm delivery in such small fetuses represents a pathological outcome not applicable to physiological pregnancies. Here we test the hypothesis that in low-risk pregnancies fetal growth (expressed by fetal size in the second trimester is itself a determinant for pregnancy duration with the slower growing fetuses having a longer pregnancy. Methods We analysed duration of gestation data for 541 women who had a spontaneous delivery having previously been recruited to a cross-sectional study of 650 low-risk pregnancies. All had a regular menses and a known date of their last menstrual period (LMP. Subjects were examined using ultrasound to determine fetal head circumference (HC, abdominal circumference (AC and femur length (FL at 10–24 weeks of gestation. Length of the pregnancy was calculated from LMP, and birth weights were noted. The effect of fetal size at 10–24 weeks of gestation on pregnancy duration was assessed also when adjusting for the difference between LMP and ultrasound based fetal age. Results Small fetuses (z-score -2.5 at second trimester ultrasound scan had lower birth weights (p Conclusion Fetal size in the second trimester is a determinant of birth weight and pregnancy duration, small fetuses having lower birth weights and longer pregnancies (up to 13 days compared with large fetuses. Our results support a concept of individually assigned pregnancy duration according to growth rates rather than imposing a standard of 280–282 days on all pregnancies.

Short sleep duration and longer daytime napping are associated with non-alcoholic fatty liver disease in Chinese adults.

Science.gov (United States)

Peng, Kui; Lin, Lin; Wang, Zhengyi; Ding, Lin; Huang, Ya; Wang, Po; Xu, Yu; Lu, Jieli; Xu, Min; Bi, Yufang; Wang, Weiqing; Chen, Yuhong; Ning, Guang

2017-09-01

Epidemiologic studies have reported conflicting results on the relationship between short sleep duration and non-alcoholic fatty liver disease (NAFLD). There are no previous studies investigating the effect of daytime napping on NAFLD. In the present study we examined the associations between NAFLD and both nightly sleep duration and daytime napping in a middle-aged and elderly Chinese population. This cross-sectional community-based population study was performed on 8559 individuals aged ≥40 years. Sleep duration and the duration of daytime napping were self-reported using a standardized questionnaire; NAFLD was diagnosed by ultrasonography. In this study sample, the overall prevalence of NAFLD was 30.4%. There was an inverse association between sleep duration and the risk of prevalent NAFLD. In multivariate analysis, the odds ratios (ORs) and 95% confidence intervals (CIs) of prevalent NAFLD for decreasing sleep duration categories (≥9, 8.1-9, 7.1-8, 6.1-7, and ≤6.1 h) were 1.00 (reference), 1.38 (1.13-1.70), 1.32 (1.08-1.61), 1.29 (1.04-1.60), and 1.66 (1.28-2.15), respectively (P trend  = 0.0073). Compared with participants without a daytime napping habit, nap takers with a longer nap duration (>0.5 h) had an increased risk of prevalent NAFLD (OR 1.22; 95% CI 1.06-1.41). The associations of sleep duration and daytime napping duration with NAFLD were generally consistent across different categories of age and obesity, metabolic syndrome, and insulin resistance status. Short sleep duration and longer daytime napping were associated with an increased risk of prevalent NAFLD in a middle-aged and elderly Chinese population. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Object Categorization in Finer Levels Relies More on Higher Spatial Frequencies and Takes Longer.

Science.gov (United States)

Ashtiani, Matin N; Kheradpisheh, Saeed R; Masquelier, Timothée; Ganjtabesh, Mohammad

2017-01-01

The human visual system contains a hierarchical sequence of modules that take part in visual perception at different levels of abstraction, i.e., superordinate, basic, and subordinate levels. One important question is to identify the "entry" level at which the visual representation is commenced in the process of object recognition. For a long time, it was believed that the basic level had a temporal advantage over two others. This claim has been challenged recently. Here we used a series of psychophysics experiments, based on a rapid presentation paradigm, as well as two computational models, with bandpass filtered images of five object classes to study the processing order of the categorization levels. In these experiments, we investigated the type of visual information required for categorizing objects in each level by varying the spatial frequency bands of the input image. The results of our psychophysics experiments and computational models are consistent. They indicate that the different spatial frequency information had different effects on object categorization in each level. In the absence of high frequency information, subordinate and basic level categorization are performed less accurately, while the superordinate level is performed well. This means that low frequency information is sufficient for superordinate level, but not for the basic and subordinate levels. These finer levels rely more on high frequency information, which appears to take longer to be processed, leading to longer reaction times. Finally, to avoid the ceiling effect, we evaluated the robustness of the results by adding different amounts of noise to the input images and repeating the experiments. As expected, the categorization accuracy decreased and the reaction time increased significantly, but the trends were the same. This shows that our results are not due to a ceiling effect. The compatibility between our psychophysical and computational results suggests that the temporal

Can You Lengthen Your Life? Researchers Explore How To Stay Healthy Longer

Science.gov (United States)

... a longer, healthier life. “There’s no question that smoking is a hard habit to break. But data suggest that from the moment you stop smoking, there are health benefits. So it’s worthwhile making ...

Maternal effects on male weaponry: female dung beetles produce major sons with longer horns when they perceive higher population density

Directory of Open Access Journals (Sweden)

Buzatto Bruno A

2012-07-01

Full Text Available Abstract Background Maternal effects are environmental influences on the phenotype of one individual that are due to the expression of genes in its mother, and are expected to evolve whenever females are better capable of assessing the environmental conditions that their offspring will experience than the offspring themselves. In the dung beetle Onthophagus taurus, conditional male dimorphism is associated with alternative reproductive tactics: majors fight and guard females whereas minors sneak copulations. Furthermore, variation in dung beetle population density has different fitness consequences for each male morph, and theory predicts that higher population density might select for a higher frequency of minors and/or greater expenditure on weaponry in majors. Because adult dung beetles provide offspring with all the nutritional resources for their development, maternal effects strongly influence male phenotype. Results Here we tested whether female O. taurus are capable of perceiving population density, and responding by changing the phenotype of their offspring. We found that mothers who were reared with other conspecifics in their pre-mating period produced major offspring that had longer horns across a wider range of body sizes than the major offspring of females that were reared in isolation in their pre-mating period. Moreover, our results indicate that this maternal effect on male weaponry does not operate through the amount of dung provided by females to their offspring, but is rather transmitted through egg or brood mass composition. Finally, although theory predicts that females experiencing higher density might produce more minor males, we found no support for this, rather the best fitting models were equivocal as to whether fewer or the same proportions of minors were produced. Conclusions Our study describes a new type of maternal effect in dung beetles, which probably allows females to respond to population density adaptively

Comparability Effects of Mandatory IFRS Adoption

OpenAIRE

Stefano Cascino; Joachim Gassen

2012-01-01

The mandatory adoption of IFRS by many countries worldwide fuels the expectation that financial accounting information might become more comparable across countries. This expectation is opposed to an alternative view that stresses the importance of incentives in shaping accounting information. We provide early evidence on this debate by investigating the effects of mandatory IFRS adoption on the comparability of financial accounting information around the world. Using two comparability proxie...

Using quality scores and longer reads improves accuracy of Solexa read mapping

Directory of Open Access Journals (Sweden)

Xuan Zhenyu

2008-02-01

Full Text Available Abstract Background Second-generation sequencing has the potential to revolutionize genomics and impact all areas of biomedical science. New technologies will make re-sequencing widely available for such applications as identifying genome variations or interrogating the oligonucleotide content of a large sample (e.g. ChIP-sequencing. The increase in speed, sensitivity and availability of sequencing technology brings demand for advances in computational technology to perform associated analysis tasks. The Solexa/Illumina 1G sequencer can produce tens of millions of reads, ranging in length from ~25–50 nt, in a single experiment. Accurately mapping the reads back to a reference genome is a critical task in almost all applications. Two sources of information that are often ignored when mapping reads from the Solexa technology are the 3' ends of longer reads, which contain a much higher frequency of sequencing errors, and the base-call quality scores. Results To investigate whether these sources of information can be used to improve accuracy when mapping reads, we developed the RMAP tool, which can map reads having a wide range of lengths and allows base-call quality scores to determine which positions in each read are more important when mapping. We applied RMAP to analyze data re-sequenced from two human BAC regions for varying read lengths, and varying criteria for use of quality scores. RMAP is freely available for downloading at http://rulai.cshl.edu/rmap/. Conclusion Our results indicate that significant gains in Solexa read mapping performance can be achieved by considering the information in 3' ends of longer reads, and appropriately using the base-call quality scores. The RMAP tool we have developed will enable researchers to effectively exploit this information in targeted re-sequencing projects.

Is Longer Unemployment Rewarded with Longer Job Tenure?

DEFF Research Database (Denmark)

Kohara, Miki; Sasaki, Masaru; Machikita, Tomohiro

security offices: one includes information about the circumstances of job seekers receiving unemployment insurance, and the other includes information about job seekers applying for jobs. We first show a negative relationship between unemployment duration and the subsequent job duration. Restricting...... the sample to job seekers who changed search behaviors in the final 59 days before expiration of unemployment insurance, we secondly show an even greater negative effect of unemployment duration on the following job duration. The importance lies not only in the duration of unemployment. If job seekers keep...

Longer Sleep Duration and Midday Napping Are Associated with a Higher Risk of CHD Incidence in Middle-Aged and Older Chinese: the Dongfeng-Tongji Cohort Study.

Science.gov (United States)

Yang, Liangle; Yang, Handong; He, Meian; Pan, An; Li, Xiulou; Min, Xinwen; Zhang, Ce; Xu, Chengwei; Zhu, Xiaoyan; Yuan, Jing; Wei, Sheng; Miao, Xiaoping; Hu, Frank B; Wu, Tangchun; Zhang, Xiaomin

2016-03-01

To analyze the independent and combined relations of sleep duration and midday napping with coronary heart diseases (CHD) incidence along with the underlying changes of cardiovascular disease (CVD) risk factors among Chinese adults. We included 19,370 individuals aged 62.8 years at baseline from September 2008 to June 2010, and they were followed until October 2013. Cox proportional hazards models and general linear models were used for multivariate longitudinal analyses. Compared with sleeping 7- napping > 90 min compared with 1-30 min. When sleep duration and midday napping were combined, individuals having sleep duration ≥ 10 h and midday napping > 90 min were at a greater risk of CHD than those with sleeping 7- napping 1-30 min: the HR was 1.67 (95% CI = 1.04 to 2.66; P for trend = 0.017). In addition, longer sleep duration ≥ 10 h was significantly associated with increases in triglycerides and waist circumference, and a reduction in HDL-cholesterol; while longer midday napping > 90 min was related to increased waist circumference. Both longer sleep duration and midday napping were independently and jointly associated with a higher risk of CHD incidence, and altered lipid profile and waist circumference may partially explain the relationships. © 2016 Associated Professional Sleep Societies, LLC.

Antepartum depression severity is increased during seasonally longer nights: relationship to melatonin and cortisol timing and quantity.

Science.gov (United States)

Meliska, Charles J; Martínez, Luis F; López, Ana M; Sorenson, Diane L; Nowakowski, Sara; Kripke, Daniel F; Elliott, Jeffrey; Parry, Barbara L

2013-11-01

Current research suggests that mood varies from season to season in some individuals, in conjunction with light-modulated alterations in chronobiologic indices such as melatonin and cortisol. The primary aim of this study was to evaluate the effects of seasonal variations in darkness on mood in depressed antepartum women, and to determine the relationship of seasonal mood variations to contemporaneous blood melatonin and cortisol measures; a secondary aim was to evaluate the influence of seasonal factors on measures of melancholic versus atypical depressive symptoms. We obtained measures of mood and overnight concentrations of plasma melatonin and serum cortisol in 19 depressed patients (DP) and 12 healthy control (HC) antepartum women, during on-going seasonal variations in daylight/darkness, in a cross-sectional design. Analyses of variance showed that in DP, but not HC, Hamilton Depression Rating Scale (HRSD) scores were significantly higher in women tested during seasonally longer versus shorter nights. This exacerbation of depressive symptoms occurred when the dim light melatonin onset, the melatonin synthesis offset, and the time of maximum cortisol secretion (acrophase) were phase-advanced (temporally shifted earlier), and melatonin quantity was reduced, in DP but not HC. Serum cortisol increased across gestational weeks in both the HC and DP groups, which did not differ significantly in cortisol concentration. Nevertheless, serum cortisol concentration correlated positively with HRSD score in DP but not HC; notably, HC showed neither significant mood changes nor altered melatonin and cortisol timing or quantity in association with seasonal variations. These findings suggest that depression severity during pregnancy may become elevated in association with seasonally related phase advances in melatonin and cortisol timing and reduced melatonin quantity that occur in DP, but not HC. Thus, women who experience antepartum depression may be more susceptible than

Against all odds: genocidal trauma is associated with longer life-expectancy of the survivors.

Directory of Open Access Journals (Sweden)

Abraham Sagi-Schwartz

Full Text Available Does surviving genocidal experiences, like the Holocaust, lead to shorter life-expectancy? Such an effect is conceivable given that most survivors not only suffered psychosocial trauma but also malnutrition, restriction in hygienic and sanitary facilities, and lack of preventive medical and health services, with potentially damaging effects for later health and life-expectancy. We explored whether genocidal survivors have a higher risk to die younger than comparisons without such background. This is the first population-based retrospective cohort study of the Holocaust, based on the entire population of immigrants from Poland to Israel (N = 55,220, 4-20 years old when the World War II started (1939, immigrating to Israel either between 1945 and 1950 (Holocaust group or before 1939 (comparison group; not exposed to the Holocaust. Hazard of death - a long-term outcome of surviving genocidal trauma - was derived from the population-wide official data base of the National Insurance Institute of Israel. Cox regression yielded a significant hazard ratio (HR = 0.935, CI (95% = 0.910-0.960, suggesting that the risk of death was reduced by 6.5 months for Holocaust survivors compared to non-Holocaust comparisons. The lower hazard was most substantial in males who were aged 10-15 (HR = 0.900, CI (95% = 0.842-0.962, i.e., reduced by 10 months or 16-20 years at the onset of the Holocaust (HR = 0.820, CI (95% = 0.782-0.859, i.e., reduced by18 months. We found that against all odds genocidal survivors were likely to live longer. We suggest two explanations: Differential mortality during the Holocaust and "Posttraumatic Growth" associated with protective factors in Holocaust survivors or in their environment after World War II.

Associations between longer habitual day napping and non-alcoholic fatty liver disease in an elderly Chinese population.

Directory of Open Access Journals (Sweden)

Hua Qu

Full Text Available Both longer habitual day napping and Non-Alcoholic Fatty Liver Disease (NAFLD are associated with diabetes and inflammation, but the association between day napping and NAFLD remains unexplored.To investigate the association between the duration of habitual day napping and NAFLD in an elderly Chinese population and to gain insight into the role of inflammatory cytokines in this association.We conducted a series of cross-sectional studies of the community population in Chongqing, China, from 2011 to 2012.Among 6998 participants aged 40 to 75 years, 6438 eligible participants were included in the first study and analyzed to observe the association between day napping duration and NAFLD. In a separate study, 80 non-nappers and 90 nappers were selected to identify the role of inflammatory cytokines in this association. Logistic regression models were used to examine the odds ratios (ORs of day nap duration with NAFLD.Day nappers had a significantly higher prevalence of NAFLD (P1 h of day napping compared with individuals who did not take day naps (all P0.05.Longer day napping duration is associated with a higher prevalence of NAFLD, and inflammatory cytokines may be an essential link between day napping and NAFLD.

What drives the comparability effect of mandatory IFRS adoption?

OpenAIRE

Stefano Cascino; Joachim Gassen

2015-01-01

We investigate the effects of mandatory IFRS adoption on the comparability of financial accounting information. Using two comparability proxies based on De Franco et al. [2011] and a comparability proxy based on the degree of information transfer, our results suggest that the overall comparability effect of mandatory IFRS adoption is marginal. We hypothesize that firm-level heterogeneity in IFRS compliance explains the limited comparability effect. To test this conjecture, we first hand-colle...

Contesting Citizenship: Comparative Analyses

DEFF Research Database (Denmark)

Siim, Birte; Squires, Judith

2007-01-01

importance of particularized experiences and multiple ineequality agendas). These developments shape the way citizenship is both practiced and analysed. Mapping neat citizenship modles onto distinct nation-states and evaluating these in relation to formal equality is no longer an adequate approach....... Comparative citizenship analyses need to be considered in relation to multipleinequalities and their intersections and to multiple governance and trans-national organisinf. This, in turn, suggests that comparative citizenship analysis needs to consider new spaces in which struggles for equal citizenship occur...

Female entrepreneurs in trouble: do their bad loans last longer?

OpenAIRE

Juri Marcucci; Paolo Emilio Mistrulli

2013-01-01

We investigate the duration of bad loans for a unique data set of sole proprietorships in Italy, finding that bad loans for female firms last longer. However, this result is mainly due to the fact that loans granted to female firms are less frequently written off than those to male ones, suggesting that for banks female firms might be more creditworthy than male firms. These findings are robust to censoring, alternative specifications of the distribution of bad loan duration and other bank-sp...

Women live longer than men even during severe famines and epidemics

Science.gov (United States)

Zarulli, Virginia; Barthold Jones, Julia A.; Oksuzyan, Anna; Lindahl-Jacobsen, Rune; Christensen, Kaare; Vaupel, James W.

2018-01-01

Women in almost all modern populations live longer than men. Research to date provides evidence for both biological and social factors influencing this gender gap. Conditions when both men and women experience extremely high levels of mortality risk are unexplored sources of information. We investigate the survival of both sexes in seven populations under extreme conditions from famines, epidemics, and slavery. Women survived better than men: In all populations, they had lower mortality across almost all ages, and, with the exception of one slave population, they lived longer on average than men. Gender differences in infant mortality contributed the most to the gender gap in life expectancy, indicating that newborn girls were able to survive extreme mortality hazards better than newborn boys. Our results confirm the ubiquity of a female survival advantage even when mortality is extraordinarily high. The hypothesis that the survival advantage of women has fundamental biological underpinnings is supported by the fact that under very harsh conditions females survive better than males even at infant ages when behavioral and social differences may be minimal or favor males. Our findings also indicate that the female advantage differs across environments and is modulated by social factors. PMID:29311321

Science 101: Why Does It Take Longer to Boil Potatoes at High Altitudes?

Science.gov (United States)

Robertson, Bill

2017-01-01

Why Does It Take Longer to Boil Potatoes at High Altitudes? This column provides background science information for elementary teachers. This month's issue looks at why water boils at different temperatures at different altitudes.

Early discharge with tube feeding at home for preterm infants is associated with longer duration of breast feeding.

Science.gov (United States)

Meerlo-Habing, Z E; Kosters-Boes, E A; Klip, H; Brand, P L P

2009-07-01

Mothers of preterm infants are more likely to discontinue breast feeding early than mothers of term infants. We evaluated the effect of early discharge with tube feeding of preterm infants under close supervision by paediatric nurse specialists on the duration of breast feeding. Case-control study. Medium/high-care neonatal unit of a large district general hospital. Preterm infants (paediatric nurse specialists or regular follow-up of preterm infants discharged with oral feeding. Duration of breast feeding assessed by telephone interview 6 months after birth. There were 50 preterm infants in the early discharge group and 78 in the control group. Mothers in the early discharge group continued to breast feed longer than mothers in the control group (log rank test, p = 0.028). Four months after discharge, 63% of preterm infants in the control group were fed formula compared to 36% in the early discharge group (95% CI for difference 9% to 43%, p = 0.04). The relative risk of breast feeding cessation 6 months after birth in the early discharge group compared to the control group was 0.63 (95% CI 0.41 to 0.96). After adjustment for smoking, gestational age and birth weight, this relative risk was 0.67 (95% CI 0.43 to 1.05). Close supervision and follow-up by paediatric nurse specialists of preterm infants discharged early with tube feeding appears to increase duration of breast feeding. A randomised controlled trial to confirm these findings is warranted.

Nuclear power plant life management and longer-term operation

International Nuclear Information System (INIS)

2006-01-01

This book, prepared by NEA member country experts, contains data and analyses relevant to nuclear power plant life management and the plants' extended, longer-term operation (LTO). It addresses technical, economic and environmental aspects and provides insights into the benefits and challenges of plant life management and LTO. It will be of interest to policy makers and senior managers in the nuclear power sector and governmental bodies involved in nuclear power programme design and management. The data and information on current trends in nuclear power plant life management will be useful to researchers and analysts working in the field of nuclear energy system assessment. (authors)

Comparative effectiveness of generic versus brand-name antiepileptic medications.

Science.gov (United States)

Gagne, Joshua J; Kesselheim, Aaron S; Choudhry, Niteesh K; Polinski, Jennifer M; Hutchins, David; Matlin, Olga S; Brennan, Troyen A; Avorn, Jerry; Shrank, William H

2015-11-01

The objective of this study was to compare treatment persistence and rates of seizure-related events in patients who initiate antiepileptic drug (AED) therapy with a generic versus a brand-name product. We used linked electronic medical and pharmacy claims data to identify Medicare beneficiaries who initiated one of five AEDs (clonazepam, gabapentin, oxcarbazepine, phenytoin, zonisamide). We matched initiators of generic versus brand-name versions of these drugs using a propensity score that accounted for demographic, clinical, and health service utilization variables. We used a Cox proportional hazards model to compare rates of seizure-related emergency room (ER) visit or hospitalization (primary outcome) and ER visit for bone fracture or head injury (secondary outcome) between the matched generic and brand-name initiators. We also compared treatment persistence, measured as time to first 14-day treatment gap, between generic and brand-name initiators. We identified 19,760 AED initiators who met study eligibility criteria; 18,306 (93%) initiated a generic AED. In the matched cohort, we observed 47 seizure-related hospitalizations and ER visits among brand-name initiators and 31 events among generic initiators, corresponding to a hazard ratio of 0.53 (95% confidence interval, 0.30 to 0.96). Similar results were observed for the secondary clinical endpoint and across sensitivity analyses. Mean time to first treatment gap was 124.2 days (standard deviation [sd], 125.8) for brand-name initiators and 137.9 (sd, 148.6) for generic initiators. Patients who initiated generic AEDs had fewer adverse seizure-related clinical outcomes and longer continuous treatment periods before experiencing a gap than those who initiated brand-name versions. Copyright © 2015 Elsevier Inc. All rights reserved.

Longer-term impact of cardiology e-consults.

Science.gov (United States)

Wasfy, Jason H; Rao, Sandhya K; Kalwani, Neil; Chittle, Melissa D; Richardson, Calvin A; Gallen, Kathleen M; Isselbacher, Eric M; Kimball, Alexandra B; Ferris, Timothy G

2016-03-01

Cardiac e-consults may be an effective way to deliver value-oriented outpatient cardiology care in an accountable care organization. Initial results of cardiac e-consults have demonstrated high satisfaction among both patients and referring providers, no known adverse events, and low rates of diagnostic testing. Nevertheless, differences between e-consults and traditional consults, effects of e-consults on traditional consult volume, and whether patients seek traditional consults after e-consults are unknown. We established a cardiac e-consult program on January 13, 2014. We then conducted detailed medical record reviews of all patients with e-consults to detect any adverse clinical events and detect subsequent traditional visits to cardiologists. We also performed 2 comparisons. First, we compared age, gender, and referral reason for e-consults vs traditional consults. Second, we compared changes in volume of referrals to cardiology vs other medical specialties that did not have e-consults. From January 13 to December 31, 2014, 1,642 traditional referrals and 165 e-consults were requested. The proportion of e-consults of all evaluations requested over that period was 9.1%. Gender balance was similar among traditional consults and e-consults (44.8% male for e-consults vs 45.0% for traditional consults, P = .981). E-consult patients were younger than traditional consult patients (55.3 vs 60.4 years, P cardiology visit during the follow-up period. E-consults are an effective and safe mechanism to enhance value in outpatient cardiology care, with low rates of bounceback to traditional consults. E-consults can account for nearly one-tenth of total outpatient consultation volume at 1 year within an accountable care organization and are associated with a reduction in traditional referrals to cardiologists. Copyright © 2015 Elsevier Inc. All rights reserved.

Associations between longer habitual day napping and non-alcoholic fatty liver disease in an elderly Chinese population.

Science.gov (United States)

Qu, Hua; Wang, Hang; Deng, Min; Wei, Huili; Deng, Huacong

2014-01-01

Both longer habitual day napping and Non-Alcoholic Fatty Liver Disease (NAFLD) are associated with diabetes and inflammation, but the association between day napping and NAFLD remains unexplored. To investigate the association between the duration of habitual day napping and NAFLD in an elderly Chinese population and to gain insight into the role of inflammatory cytokines in this association. We conducted a series of cross-sectional studies of the community population in Chongqing, China, from 2011 to 2012. Among 6998 participants aged 40 to 75 years, 6438 eligible participants were included in the first study and analyzed to observe the association between day napping duration and NAFLD. In a separate study, 80 non-nappers and 90 nappers were selected to identify the role of inflammatory cytokines in this association. Logistic regression models were used to examine the odds ratios (ORs) of day nap duration with NAFLD. Day nappers had a significantly higher prevalence of NAFLD (Pnapping duration was associated in a dose-dependent manner with NAFLD (P trend 1 h of day napping compared with individuals who did not take day naps (all Pnapping duration and NAFLD disappeared (all P>0.05). Longer day napping duration is associated with a higher prevalence of NAFLD, and inflammatory cytokines may be an essential link between day napping and NAFLD.

Women who prefer longer penises are more likely to have vaginal orgasms (but not clitoral orgasms): implications for an evolutionary theory of vaginal orgasm.

Science.gov (United States)

Costa, Rui Miguel; Miller, Geoffrey F; Brody, Stuart

2012-12-01

Research indicates that (i) women's orgasm during penile-vaginal intercourse (PVI) is influenced by fitness-related male partner characteristics, (ii) penis size is important for many women, and (iii) preference for a longer penis is associated with greater vaginal orgasm consistency (triggered by PVI without concurrent clitoral masturbation). To test the hypothesis that vaginal orgasm frequency is associated with women's reporting that a longer than average penis is more likely to provoke their PVI orgasm. Three hundred twenty-three women reported in an online survey their past month frequency of various sexual behaviors (including PVI, vaginal orgasm, and clitoral orgasm), the effects of a longer than average penis on likelihood of orgasm from PVI, and the importance they attributed to PVI and to noncoital sex. Univariate analyses of covariance with dependent variables being frequencies of various sexual behaviors and types of orgasm and with independent variable being women reporting vs. not reporting that a longer than average penis is important for their orgasm from PVI. Likelihood of orgasm with a longer penis was related to greater vaginal orgasm frequency but unrelated to frequencies of other sexual behaviors, including clitoral orgasm. In binary logistic regression, likelihood of orgasm with a longer penis was related to greater importance attributed to PVI and lesser importance attributed to noncoital sex. Women who prefer deeper penile-vaginal stimulation are more likely to have vaginal orgasm, consistent with vaginal orgasm evolving as part of a female mate choice system favoring somewhat larger than average penises. Future research could extend the findings by overcoming limitations related to more precise measurement of penis length (to the pubis and pressed close to the pubic bone) and girth, and large representative samples. Future experimental research might assess to what extent different penis sizes influence women's satisfaction and likelihood

Women live longer than men even during severe famines and epidemics.

Science.gov (United States)

Zarulli, Virginia; Barthold Jones, Julia A; Oksuzyan, Anna; Lindahl-Jacobsen, Rune; Christensen, Kaare; Vaupel, James W

2018-01-23

Women in almost all modern populations live longer than men. Research to date provides evidence for both biological and social factors influencing this gender gap. Conditions when both men and women experience extremely high levels of mortality risk are unexplored sources of information. We investigate the survival of both sexes in seven populations under extreme conditions from famines, epidemics, and slavery. Women survived better than men: In all populations, they had lower mortality across almost all ages, and, with the exception of one slave population, they lived longer on average than men. Gender differences in infant mortality contributed the most to the gender gap in life expectancy, indicating that newborn girls were able to survive extreme mortality hazards better than newborn boys. Our results confirm the ubiquity of a female survival advantage even when mortality is extraordinarily high. The hypothesis that the survival advantage of women has fundamental biological underpinnings is supported by the fact that under very harsh conditions females survive better than males even at infant ages when behavioral and social differences may be minimal or favor males. Our findings also indicate that the female advantage differs across environments and is modulated by social factors. Copyright © 2018 the Author(s). Published by PNAS.

More hours, more jobs? The employment effects of longer working hours

OpenAIRE

Martyn Andrews; Hans-Dieter Gerner; Thorsten Schank; Richard Upward

2015-01-01

Increases in standard hours of work have been a contentious policy issue in Germany. Whilst this might directly lead to a substitution of workers by hours, there may also be a positive employment effect due to reduced costs. Moreover, the response of firms may differ between firms that offer overtime and those that do not. For a panel of German plants (2001–2006) drawn from the IAB Establishment Panel, we are the first to analyse the effect of increased standard hours on employment. Using dif...

Hypothyroidism During Tyrosine Kinase Inhibitor Therapy Is Associated with Longer Survival in Patients with Advanced Nonthyroidal Cancers.

Science.gov (United States)

Lechner, Melissa G; Vyas, Chirag M; Hamnvik, Ole-Petter R; Alexander, Erik K; Larsen, P Reed; Choueiri, Toni K; Angell, Trevor E

2018-04-01

Tyrosine kinase inhibitor (TKI)-induced thyroid dysfunction is recognized as a common adverse effect of treatment, but the importance of incident hypothyroidism during TKI therapy remains unclear. This study analyzed the prognostic significance of hypothyroidism during TKI therapy in cancer patients. This was a retrospective cohort study of adult patients with advanced nonthyroidal cancer treated with TKI and available thyroid function testing at three affiliated academic hospitals from 2000 to 2017. Patients with preexisting thyroid disease were excluded. Demographic, clinical, and cancer treatment data were collected. Thyroid status with TKI treatment was determined from thyroid function testing and initiation of thyroid medication, and classified as euthyroid (thyrotropin [TSH] normal), subclinical hypothyroidism (SCH; TSH 5-10 mIU/L, or higher TSH if free thyroxine normal), or overt hypothyroidism (OH; TSH >10 mIU/L, low free thyroxine, or requiring replacement). Multivariate models were used to evaluate the effect of TKI-related hypothyroidism on overall survival (OS). Of 1120 initial patients, 538 remained after exclusion criteria. SCH occurred in 72 (13%) and OH in 144 (27%) patients with TKI therapy. Patients with hypothyroidism had significantly longer OS, with median OS in euthyroid patients of 685 days [confidence interval (CI) 523-851] compared to 1005 days [CI 634-1528] in SCH and 1643 days [CI 1215-1991] in OH patients (p hypothyroid patients (SCH and OH) with TSH >5 and hypothyroidism in cancer patients treated with TKI is associated with significantly improved OS, should not necessitate TKI dose reduction or discontinuation, and may provide independent prognostic information.

Economic comparisons of haul road construction versus forwarding versus longer skid distances

Science.gov (United States)

Michael D. Erickson; Curt C. Hassler; Chris B. LeDoux

1992-01-01

There currently exists no set of basic guidelines for Appalachian loggers to use in the decision making process for selecting the best way to harvest a tract of timber. Specifically, guidelines are needed for deciding between the alternatives of constructing truck haul roads to access an area or other alternatives such as skidding or forwarding timber longer distances...

Comparative effects of ionizing radiation on cycle time and mitotic duration. A time-lapse cinematography study

International Nuclear Information System (INIS)

D'Hooghe, M.C.; Hemon, D.; Valleron, A.J.; Malaise, E.P.

1980-01-01

The effects of 60 Co γ rays on the length of the intermitotic period, the duration of mitosis, and the division probability of EMT6 cells have been studied in vitro using time-lapse cinematography. Irradiation increases the duration of the mitosis and of the cycle in comparable proportions: both parameters are practically doubled by a dose of 10 Gy. When daughters of irradiated cells die, the mitotic delay and lengthening of mitosis of their mother cells are longer than average. Mitotic delay and lengthening of mitosis depend on the age of cells at the moment of irradiation. The mitotic delay increases progressively when cells are irradiated during the first 8 h of their cycle (i.e., before the transition point), whereas mitosis is slightly prolonged. On the other hand, when the cells are irradiated after this transition point the mitotic delay decreases markedly, whereas the lengthening of mitosis increases sharply. These results tend to indicate that two different mechanisms are responsible for mitotic delay and prolongation of mitosis observed after irradiation

Comparative effects of ionizing radiation on cycle time and mitotic duration. A time-lapse cinematography study

Energy Technology Data Exchange (ETDEWEB)

D' Hooghe, M.C. (Institut de Recherches sur le Cancer, Lille, France); Hemon, D.; Valleron, A.J.; Malaise, E.P.

1980-03-01

The effects of /sup 60/Co ..gamma.. rays on the length of the intermitotic period, the duration of mitosis, and the division probability of EMT6 cells have been studied in vitro using time-lapse cinematography. Irradiation increases the duration of the mitosis and of the cycle in comparable proportions: both parameters are practically doubled by a dose of 10 Gy. When daughters of irradiated cells die, the mitotic delay and lengthening of mitosis of their mother cells are longer than average. Mitotic delay and lengthening of mitosis depend on the age of cells at the moment of irradiation. The mitotic delay increases progressively when cells are irradiated during the first 8 h of their cycle (i.e., before the transition point), whereas mitosis is slightly prolonged. On the other hand, when the cells are irradiated after this transition point the mitotic delay decreases markedly, whereas the lengthening of mitosis increases sharply. These results tend to indicate that two different mechanisms are responsible for mitotic delay and prolongation of mitosis observed after irradiation.

Comparative evaluation of organic formulations of Pseudomonas ...

African Journals Online (AJOL)

Jane

2011-07-20

Jul 20, 2011 ... on the basis of comparative longer shelf life of the biocontrol bacteria. Storage condition of 4°C was ..... Islam and Toyota (2004) reported higher ..... better competitive advantage over other rhizosphere microflora (Loper et al., ...

A longer climate memory carried by soil freeze–thaw processes in Siberia

International Nuclear Information System (INIS)

Matsumura, Shinji; Yamazaki, Koji

2012-01-01

The climate memory of a land surface generally persists for only a few months, but analysis of surface meteorological data revealed a longer-term climate memory carried by soil freeze–thaw processes in Siberia. Surface temperature variability during the snowmelt season corresponds reasonably well with that in the summer of the following year, when most stations show a secondary autocorrelation peak. The surface temperature memory is thought to be stored as variations in the amount of snowmelt water held in the soil, and through soil freezing, which emerges as latent heat variations in the near-surface atmosphere during soil thawing approximately one year later. The ground conditions are dry in the longer-term climate memory regions, such as eastern Siberia, where less snow cover (higher surface air temperature) in spring results in less snowmelt water or lower soil moisture in the summer. Consequently, through soil freezing, it will require less latent heat to thaw in the summer of the following year, resulting in higher surface air temperature. In addition to soil moisture and snow cover, soil freeze–thaw processes can also act as agents of climate memory in the near-surface atmosphere. (letter)

OCT evaluation of directional atherectomy compared to balloon angioplasty

International Nuclear Information System (INIS)

Marmagkiolis, Konstantinos; Lendel, Vasili; Cilingiroglu, Mehmet

2015-01-01

Directional atherectomy (DA) is one of the most commonly used modalities for the treatment of obstructive femoropopliteal peripheral arterial disease (PAD), especially in patients with large and calcified atherosclerotic plaques. The effect of directional atherectomy to the vascular wall compared to balloon angioplasty by optical coherence tomography (OCT) has not been previously described. We present the first case of OCT after directional atherectomy with SilverHawk followed by angiosculpt balloon angioplasty. - Highlights: • Directional atherectomy avoids the vascular mechanical damage caused by angioplasty balloons and the exposure of stent struts or the potential of stent fracture with stents. • OCT can accurately assess the effect of endovacular interventions to the vessel wall. • Although angiographic results after directional atherectomy are acceptable, OCT use demonstrated suboptimal improvement of the MLA requiring additional balloon angioplasty. • Longer studies are needed to define whether the improved OCT results with angioplasty compared to DA may offer better clinical outcomes.

OCT evaluation of directional atherectomy compared to balloon angioplasty

Energy Technology Data Exchange (ETDEWEB)

Marmagkiolis, Konstantinos [Citizens Memorial Hospital Heart and Vascular Institute, Bolivar, MO (United States); Lendel, Vasili [Arkansas Heart Hospital, Peripheral Vascular Institute, Little Rock, AR (United States); Cilingiroglu, Mehmet, E-mail: mcilingiroglu@yahoo.com [Arkansas Heart Hospital, Peripheral Vascular Institute, Little Rock, AR (United States); Koc University, School of Medicine, Istanbul (Turkey)

2015-09-15

Directional atherectomy (DA) is one of the most commonly used modalities for the treatment of obstructive femoropopliteal peripheral arterial disease (PAD), especially in patients with large and calcified atherosclerotic plaques. The effect of directional atherectomy to the vascular wall compared to balloon angioplasty by optical coherence tomography (OCT) has not been previously described. We present the first case of OCT after directional atherectomy with SilverHawk followed by angiosculpt balloon angioplasty. - Highlights: • Directional atherectomy avoids the vascular mechanical damage caused by angioplasty balloons and the exposure of stent struts or the potential of stent fracture with stents. • OCT can accurately assess the effect of endovacular interventions to the vessel wall. • Although angiographic results after directional atherectomy are acceptable, OCT use demonstrated suboptimal improvement of the MLA requiring additional balloon angioplasty. • Longer studies are needed to define whether the improved OCT results with angioplasty compared to DA may offer better clinical outcomes.

Important Questions of Comparative Studies in Asian Countries

Science.gov (United States)

Pazyura, Natalia

2015-01-01

The issue of the "identity" of comparative education as a field of study or a discipline has been discussed for decades. Yet a kind of systematic structure that provides the basic principles for a coherent exposition of the field remains open. "Comparative education" is no longer conceived as an imaginary field's coherence but,…

Avalanching Systems with Longer Range Connectivity: Occurrence of a Crossover Phenomenon and Multifractal Finite Size Scaling

Directory of Open Access Journals (Sweden)

Simone Benella

2017-07-01

Full Text Available Many out-of-equilibrium systems respond to external driving with nonlinear and self-similar dynamics. This near scale-invariant behavior of relaxation events has been modeled through sand pile cellular automata. However, a common feature of these models is the assumption of a local connectivity, while in many real systems, we have evidence for longer range connectivity and a complex topology of the interacting structures. Here, we investigate the role that longer range connectivity might play in near scale-invariant systems, by analyzing the results of a sand pile cellular automaton model on a Newman–Watts network. The analysis clearly indicates the occurrence of a crossover phenomenon in the statistics of the relaxation events as a function of the percentage of longer range links and the breaking of the simple Finite Size Scaling (FSS. The more complex nature of the dynamics in the presence of long-range connectivity is investigated in terms of multi-scaling features and analyzed by the Rank-Ordered Multifractal Analysis (ROMA.

Effectiveness and cost-effectiveness of an in-home respite care program in supporting informal caregivers of people with dementia: design of a comparative study.

Science.gov (United States)

Vandepitte, Sophie; Van Den Noortgate, Nele; Putman, Koen; Verhaeghe, Sofie; Annemans, Lieven

2016-12-02

Frequent hospitalization and permanent nursing home placement not only affect the well-being of persons with dementia, but also place great financial strain on society. Therefore, it is important to create effective strategies to support informal caregivers so that they can continue to perform their demanding role. Preliminary qualitative evidence suggests that community-based respite services can actually be important for caregivers, and that the level of evidence should be further established in terms of effectiveness. Therefore, a comparative study to assess the effectiveness and cost-effectiveness of an in-home respite care program will be initiated. This manuscript described a quasi-experimental study to assess (cost)-effectiveness of an in-home respite care program to support informal caregivers of persons with dementia. 124 informal caregivers and persons with dementia will be included in the intervention group and will receive an in-home respite care program by an organization called Baluchon Alzheimer. 248 dyads will be included in the control group and will receive standard dementia care. The primary outcome is caregiver burden. Secondary outcomes are: quality of life of caregivers, frequency of behavioral problems of persons with dementia and the reactions of caregivers to those problems, intention to institutionalize the care-recipient, time to nursing home placement, resource use of the care-recipient, and willingness to pay for in-home respite care. When the trial demonstrates a difference in outcomes between both groups, within-trial and modeled cost-effectiveness analyses will be conducted in a separate economic evaluation plan to evaluate possible cost-effectiveness of the in-home respite care program compared to the control group receiving standard dementia care. Finally, the model based cost-effectiveness analyses will allow to extrapolate effects over a longer time horizon than the duration of the trial. This study will have great added value

Danish travel activities: do we travel more and longer – and to what extent?

DEFF Research Database (Denmark)

Knudsen, Mette Aagaard

Two separate Danish National travel surveys are analysed to outline the amount and extent of national and international travelling during the latest 15-20 years; the national travel survey (TU) describes mainly national daily travel activities, whereas the holiday and business travel survey...... describes national and international travel activities including overnight stay(s). When sampling only respondents with trips above 100 kilometres, they only accounts for around 2% of all daily travel activities, however, this share appears to increase and suggest in general that we do travel longer....... But due to this limited share of trips, the overall impacts of longer distance travelling vanish when considering all daily travel activities. Especially as about 95% of all daily travel destinations range less than 50 kilometres away and in total induce an average trip length of 20 kilometres. If focus...

44 CFR 65.14 - Remapping of areas for which local flood protection systems no longer provide base flood protection.

Science.gov (United States)

2010-10-01

... local flood protection systems no longer provide base flood protection. 65.14 Section 65.14 Emergency... § 65.14 Remapping of areas for which local flood protection systems no longer provide base flood... process of restoring a flood protection system that was: (i) Constructed using Federal funds; (ii...

Retrospective Comparative Study of the Effects of Dendritic Cell Vaccine and Cytokine-Induced Killer Cell Immunotherapy with that of Chemotherapy Alone and in Combination for Colorectal Cancer

Directory of Open Access Journals (Sweden)

Jingxiu Niu

2014-01-01

Full Text Available Purpose. This retrospective study determined the delayed-type hypersensitivity (DTH skin test and safety of dendritic cell (DC vaccine and cytokine-induced killer (CIK cell immunotherapy and the survival compared to chemotherapy in 239 colorectal cancer (CRC patients. Methods. DTH and safety of the immunotherapy were recorded. The overall survival (OS and disease free survival curves were compared according to the immunotherapy and/or chemotherapy received with Kaplan-Meier estimates. Results. Of the 70 patients who received immunotherapy, 62.86% had a positive DTH skin test, 38.57% developed fever, 47.14% developed insomnia, 38.57% developed anorexia, 4.29% developed joint soreness, and 11.43% developed skin rash. For 204 resectable CRC patients, median survival time (MST (198.00 days was significantly longer in patients with immunotherapy plus chemotherapy than with chemotherapy alone (106.00 days (P=0.02. For 35 patients with unresectable or postsurgery relapsed CRC and who were confirmed to be dead, no statistical difference was observed in the MST between the patients treated with immunotherapy and with chemotherapy (P=0.41. MST in the patients treated with chemotherapy plus immunotherapy was 154 days longer than that of patients treated with chemotherapy alone (P=0.41. Conclusions. DC vaccination and CIK immunotherapy did not cause severe adverse effects, induce immune response against CRC, and prolong OS.

Longer combination vehicles : an estimation of their benefits and public perception of their use.

Science.gov (United States)

2012-03-01

Longer Combination Vehicles (LCVs) are able to carry more freight than conventional single trailer trucks. As a result, these trucks can increase : efficiencies and benefits for freight movements as less fuel and less labor is used per ton of cargo. ...

Resistant Hypertension after Hypertensive Intracerebral Hemorrhage Is Associated with More Medical Interventions and Longer Hospital Stays without Affecting Outcome

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Daojun Hong

2017-05-01

Full Text Available BackgroundHypertension (HTN is the most common cause of spontaneous intracerebral hemorrhage (ICH. The aim of this study is to investigate the role of resistant HTN in patients with ICH.Methods and resultsWe conducted a retrospective study of all consecutive ICH admissions at our medical center from November 2013 to October 2015. The clinical features of patients with resistant HTN (requiring four or more antihypertensive agents to keep systolic blood pressure <140 mm Hg were compared with those with responsive HTN (requiring three or fewer agents. Of the 152 patients with hypertensive ICH, 48 (31.6% had resistant HTN. Resistant HTN was independently associated with higher body mass index and proteinuria. Compared to the responsive group, patients with resistant HTN had higher initial blood pressures and greater requirement for ventilator support, hematoma evacuation, hypertonic saline therapy, and nicardipine infusion. Resistant HTN increases length of stay (LOS in the intensive care unit (ICU (4.2 vs 2.1 days; p = 0.007 and in the hospital (11.5 vs 7.0 days; p = 0.003. Multivariate regression analysis showed that the rate of systolic blood pressure >140 mm Hg and duration of nicardipine infusion were independently associated with LOS in the ICU. There was no significant difference in hematoma expansion and functional outcome at hospital discharge between the two groups.ConclusionResistant HTN in patients with ICH is associated with more medical interventions and longer LOS without effecting outcome at hospital discharge.

On the Road to Development of an in Vitro Permeation Test (IVPT) Model to Compare Heat Effects on Transdermal Delivery Systems: Exploratory Studies with Nicotine and Fentanyl.

Science.gov (United States)

Shin, Soo Hyeon; Ghosh, Priyanka; Newman, Bryan; Hammell, Dana C; Raney, Sam G; Hassan, Hazem E; Stinchcomb, Audra L

2017-09-01

At elevated temperatures, the rate of drug release and skin permeation from transdermal delivery systems (TDS) may be higher than at a normal skin temperature. The aim of this study was to compare the effect of heat on the transdermal delivery of two model drugs, nicotine and fentanyl, from matrix-type TDSs with different formulations, using in vitro permeation tests (IVPT). IVPT experiments using pig skin were performed on two nicotine and three fentanyl TDSs. Both continuous and transient heat exposures were investigated by applying heat either for the maximum recommended TDS wear duration or for short duration. Continuous heat exposure for the two nicotine TDSs resulted in different effects, showing a prolonged heat effect for one product but not the other. The J max enhancement ratio due to the continuous heat effect was comparable between the two nicotine TDS, but significantly different (p drug from the skin depot after TDS removal differently for two drugs, with fentanyl exhibiting a longer heat effect. This exploratory work suggests that an IVPT study may be able to discriminate differences in transdermal drug delivery when different TDS are exposed to elevated temperatures. However, the clinical significance of IVPT heat effects studies should be further explored by conducting in vivo clinical studies with similar study designs.

Comparing effectiveness of regional and circular intervention zones in case of a foot-and-mouth disease outbreak

DEFF Research Database (Denmark)

Christiansen, Lasse Engbo; Dickey, Bradley F; Carpenter, Tim E

In case of a foot-and-mouth disease (FMD) or other exotic disease outbreak, surveillance zones and infected areas are conventionally created as circles with their centroids at the known infected premises. Given the availability of geographic information systems (GIS), it is no longer difficult...... model originally applied to a 3-county area in California and the available information about the state’s livestock demographics to compare these two control strategies. The comparisons included the simulated duration of outbreaks, number of herds and animals affected, and manpower issues...

Possibilities for application of comparative advertising and its effects

Directory of Open Access Journals (Sweden)

Starčević Slađana

2006-01-01

Full Text Available In recent years, it has been evident that one form of competitive advertising gained in its importance - comparative advertising. Although its extensive use has probably been inspired by the belief that the perception of relative superiority of a brand compared to competition could be encouraged in that way, research evidence suggested mixed conclusions about its effectiveness. The paper summarizes the results of previous studies in this area, and in particular those which point out the factors that can influence effectiveness of comparative advertising. Additionally,, the paper summarizes the opinions of some authors about the long-term influence of this form of advertising on brand, and gives the recommendations for its more effective use. .

Advanced pulse oximeter signal processing technology compared to simple averaging. I. Effect on frequency of alarms in the operating room.

Science.gov (United States)

Rheineck-Leyssius, A T; Kalkman, C J

1999-05-01

To determine the effect of a new signal processing technique (Oxismart, Nellcor, Inc., Pleasanton, CA) on the incidence of false pulse oximeter alarms in the operating room (OR). Prospective observational study. Nonuniversity hospital. 53 ASA physical status I, II, and III consecutive patients undergoing general anesthesia with tracheal intubation. In the OR we compared the number of alarms produced by a recently developed third generation pulse oximeter (Nellcor Symphony N-3000) with Oxismart signal processing technique and a conventional pulse oximeter (Criticare 504). Three pulse oximeters were used simultaneously in each patient: a Nellcor pulse oximeter, a Criticare with the signal averaging time set at 3 seconds (Criticareaverage3s) and a similar unit with the signal averaging time set at 21 seconds (Criticareaverage21s). For each pulse oximeter, the number of false (artifact) alarms was counted. One false alarm was produced by the Nellcor (duration 55 sec) and one false alarm by the Criticareaverage21s monitor (5 sec). The incidence of false alarms was higher in Criticareaverage3s. In eight patients, Criticareaverage3s produced 20 false alarms (p signal processing compared with the Criticare monitor with the longer averaging time of 21 seconds.

Reasons for and factors associated with issuing sickness certificates for longer periods than necessary: results from a nationwide survey of physicians

Science.gov (United States)

2013-01-01

Background Physicians’ work with sickness certifications is an understudied field. Physicians’ experience of sickness certifying for longer periods than necessary has been previous reported. However, the extent and frequency of such sickness certification is largely unknown. The aims of this study were: a) to explore the frequency of sickness certifying for longer periods than necessary among physicians working in different clinical settings; b) to examine main reasons for issuing sickness certificates for longer periods than necessary; and c) to examine factors associated with unnecessary issued sickness certificates. Methods In 2008, all physicians living and working in Sweden (a total of 36,898) were sent an invitation to participate in a questionnaire study concerning their sick-listing practices. A total of 22,349 (60.6%) returned the questionnaire. In the current study, physicians reporting handling sickness certification consultations at least weekly were included in the analyses, a total of 12,348. Results The proportion of physicians reporting issuing sickness certificates for longer periods than actually necessary varied greatly between different types of clinics, with the highest frequency among those working at: occupational medicine, orthopedic, primary health care, and psychiatry clinics; and lowest among those working in: eye, dermatology, ear/nose/throat, oncology, surgery, and infection clinics. Logistic analyses showed that sickness certifying for longer periods than necessary due to limitations in the health care system was particularly common among physicians working at occupational medicine, orthopedic, and primary health care clinics. Sickness certifying for longer periods than necessary due to patient-related factors was much more common among physicians working at psychiatric clinics. In addition to differences between clinics, frequency of sickness certificates issued for longer periods than necessary varied by age, physicians�

Targeted treatment trials for tuberous sclerosis and autism: no longer a dream

OpenAIRE

Sahin, Mustafa

2012-01-01

Genetic disorders that present with a high incidence of autism spectrum disorders (ASD) offer tremendous potential both for elucidating the underlying neurobiology of ASD and identifying therapeutic drugs and/or drug targets. As a result, clinical trials for genetic disorders associated with ASD are no longer a hope for the future but rather an exciting reality whose time has come. Tuberous sclerosis complex (TSC) is one such genetic disorder that presents with ASD, epilepsy, and intellectual...

Longer breastfeeding is an independent protective factor against development of type 1 diabetes mellitus in childhood.

Science.gov (United States)

Sadauskaite-Kuehne, Vaiva; Ludvigsson, Johnny; Padaiga, Zilvinas; Jasinskiene, Edita; Samuelsson, Ulf

2004-01-01

Early weaning diet, early introduction of breast milk substitution and cow's milk have been shown to increase the risk of type 1 diabetes later in life. It is also shown that older maternal age, maternal education, preeclampsia, prematurity, neonatal illness and neonatal icterus caused by blood group incompatibility, infections and stress might be risk factors for type 1 diabetes. We aimed to determine whether early nutrition is an independent risk factor for diabetes despite other life events. Data from 517 children (268 boys and 249 girls) in south-east of Sweden and 286 children (133 boys and 153 girls) in Lithuania in the age group of 0 to 15 years with newly diagnosed type 1 diabetes mellitus were included into analysis. Three age- and sex-matched healthy controls were randomly selected. Response rate in control families in Sweden was 72.9% and in Lithuania 94.8%. Information was collected via questionnaires. Exclusive breastfeeding longer than five months (odds ratio 0.54, 95% confidence interval 0.36-0.81) and total breastfeeding longer than 7 (0.56, 0.38-0.84) or 9 months (0.61, 0.38-0.84), breastfeeding substitution that started later than the third month (0.57, 0.33-0.98) among Swedish children 5 to 9 years old and later than the seventh month (0.24, 0.07-0.84) among all Swedish children is protective against diabetes when adjusted for all other above-listed risk factors. In Lithuania, exclusive breastfeeding longer than two months in the age group of 5 to 9 years is protective (0.58, 0.34-0.99) when adjusted for other factors. Longer exclusive and total breastfeeding appears as an independent protective factor against type 1 diabetes. Copyright 2004 John Wiley & Sons, Ltd.

Dissemination of English Culture in Chinua Achebe’s No Longer at Ease

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Bahman Zarrinjooee

2016-08-01

Full Text Available This paper deals with Chinua Achebe’s (1930-2013 No Longer at Ease (1960 which depicts the dissemination of English culture in Nigeria and its effects on the life and identity of Obi Okonkwo, the Western educated male protagonist. The focus of this paper is on the dissemination of English culture and submission of Nigerian culture in order to represent the inferiority of Nigerians. Edward Said’s (1935-2003 attempts regarding Orientalism and Frantz Fanon’s (1925-1961 issues relating inferiority of the indigenous people caused by colonization are used in this paper. The colonisers affect the life, mind, culture, and identity of the colonized through various ways such as education, religion, and language. Such effects cause some cultural transformation and changes in language of the colonized people. Moreover, the colonizer through stereotyping the colonized people assumes them as other. Indeed, the colonizer imposes his/her superiority on the natives who try to assimilate themselves with the colonizer. Achebe in his novel shows how this effort causes some binary relation among the characters. The novel shows the difference between two cultures, and Achebe puts emphasis on the superiority of English culture and depicts how colonialism and Western orientalism produce stereotyped images of Nigerians and Obi as corrupt. Consequently, such features have great impressions on the mind of Nigerians, which results in inferiority complex. Such characteristic invites the Nigerians to follow European’s value and forget their own culture, which is resulted in the rejection of native values. Keywords: Binary Relation, Colonization, Cultural Transformation, Cultural Dissemination, Orientalism, Stereotyping

Spatial and temporal variations in landscape evolution: historic and longer-term sediment flux through global catchments

Science.gov (United States)

Covault, Jacob A.; Craddock, William H.; Romans, Brian W.; Fildani, Andrea; Gosai, Mayur

2013-01-01

Sediment generation and transport through terrestrial catchments influence soil distribution, geochemical cycling of particulate and dissolved loads, and the character of the stratigraphic record of Earth history. To assess the spatiotemporal variation in landscape evolution, we compare global compilations of stream gauge–derived () and cosmogenic radionuclide (CRN)–derived (predominantly 10Be; ) denudation of catchments (mm/yr) and sediment load of rivers (Mt/yr). Stream gauges measure suspended sediment loads of rivers during several to tens of years, whereas CRNs provide catchment-integrated denudation rates at 102–105-yr time scales. Stream gauge–derived and CRN-derived sediment loads in close proximity to one another (temporary storage of sediment in flood plains can provide stream gauge–based sediment loads and denudation rates that are applicable over longer periods than the durations of gauge measurements. The buffering capacity of catchments also has implications for interpreting the stratigraphic record; delayed sediment transfer might complicate the stratigraphic record of external forcings and catchment modification.

Aging, Economic Insecurity, and Employment: Which Measures Would Encourage Older Workers to Stay Longer in the Labour Market?

Directory of Open Access Journals (Sweden)

Diane-Gabrielle Tremblay

2010-01-01

Full Text Available In the present context of aging populations, the question of how to support older workers who want to stay in employment longer is of particular importance, especially from a social justice perspective with regards to income. The challenges faced by organizations and governments are unprecedented. Interesting conclusions can be drawn from our research with regard to these challenges. First of all, the perception of retirement appears more or less unchanged over the years and remains very positive. Consequently, one of the barriers to the employment of older workers may be the image of retirement itself, since it is still perceived as a gift or a right. Secondly, our results confirm that forcing people to stay longer in the labour market is a largely unpopular measure. Consequently, if public retirement plans offer limited income, governments and organizations should adopt a more voluntary approach to encourage older workers to stay in employment longer for a better income. Our results highlight the importance of the sector and type of job in the measures or incentives that could encourage older workers to stay in employment longer. Consequently, governments and organizations will probably have to adopt a contingent approach; i.e., all incentives do not necessarily fit all jobs or all sectors and social justice would require this be taken into account. We identified three sets of measures that could encourage older workers to stay in employment longer, and thus have access to better economic security: the reduction of working time, the flexibility of working time, and the individualization of retirement options and working time. The progressive reduction of their working time appears most interesting to our respondents. These measures appear to favour social justice in terms of income and right to employment at the end of active careers.  

Aging, Economic Insecurity, and Employment: Which Measures Would Encourage Older Workers to Stay Longer in the Labour Market?

Directory of Open Access Journals (Sweden)

Émilie Genin

2009-12-01

Full Text Available In the present context of aging populations, the question of how to support older workers who want to stay in employment longer is of particular importance, especially from a social justice perspective with regards to income. The challenges faced by organizations and governments are unprecedented. Interesting conclusions can be drawn from our research with regard to these challenges. First of all, the perception of retirement appears more or less unchanged over the years and remains very positive. Consequently, one of the barriers to the employment of older workers may be the image of retirement itself, since it is still perceived as a gift or a right. Secondly, our results confirm that forcing people to stay longer in the labour market is a largely unpopular measure. Consequently, if public retirement plans offer limited income, governments and organizations should adopt a more voluntary approach to encourage older workers to stay in employment longer for a better income. Our results highlight the importance of the sector and type of job in the measures or incentives that could encourage older workers to stay in employment longer. Consequently, governments and organizations will probably have to adopt a contingent approach; i.e., all incentives do not necessarily fit all jobs or all sectors and social justice would require this be taken into account. We identified three sets of measures that could encourage older workers to stay in employment longer, and thus have access to better economic security: the reduction of working time, the flexibility of working time, and the individualization of retirement options and working time. The progressive reduction of their working time appears most interesting to our respondents. These measures appear to favour social justice in terms of income and right to employment at the end of active careers.  

The Consumer Reports Effectiveness Score: What Did Consumers Report?

Science.gov (United States)

Nielsen, Stevan Lars; Smart, David W.; Isakson, Richard L.; Worthen, Vaughn E.; Gregersen, Ann T.; Lambert, Michael J.

2004-01-01

From readers' ratings of satisfaction, problem resolution, and perceived emotional change during treatment, Consumer Reports magazine (CR, 1995) concluded both that psychotherapy is effective and that longer, more intensive therapy is more effective. The authors compared prospectively gathered 45-Item Outcome Questionnaire scores (OQ-45; M. J.…

Are translations longer than source texts? A corpus-based study of explicitation

OpenAIRE

Frankenberg-Garcia, A

2009-01-01

Explicitation is the process of rendering information which is only implicit in the source text explicit in the target text, and is believed to be one of the universals of translation (Blum-Kulka 1986, Olohan and Baker 2000, Øverås 1998, Séguinot 1988, Vanderauwera 1985). The present study uses corpus technology to attempt to shed some light on the complex relationship between translation, text length and explicitation. An awareness of what makes translations longer (or shorter) and more expl...

Cost-effectiveness of newborn screening for cystic fibrosis determined with real-life data

NARCIS (Netherlands)

van der Ploeg, C. P B; van den Akker-van Marle, M. E.; Vernooij-van Langen, A. M M; Elvers, L. H.; Gille, J. J P; Verkerk, P. H.; Dankert-Roelse, J. E.; Dankert-Roelse, J. E.; Vernooij-van Langen, A. M M; Loeber, J. G.; Elvers, L. H.; Triepels, R. H.; Gille, J. J P; Van der Ploeg, C. P B; van der Pal, S. M.; Dompeling, E.; Pals, G.; van den Akker van Marle, M. E.; Gulmans, V. A M; Oey-Spauwen, M. J W; Wijnands, Y. H H M; Castricum, L. M.; Arets, H. G M; van der Ent, C. K.; Tiddens, H. A W M; de Rijke, Y. B.; Yntema, J. B.

2015-01-01

Background: Previous cost-effectiveness studies using data from the literature showed that newborn screening for cystic fibrosis (NBSCF) is a good economic option with positive health effects and longer survival. Methods: We used primary data to compare cost-effectiveness of four screening

Comparing effects of Winter Universiade (2011) and European ...

African Journals Online (AJOL)

Comparing effects of Winter Universiade (2011) and European Youth Olympic Festival (2011) ... The participating group was composed of 878 local spectators who watched the games. ... Sample group views on both positive and negative effects of these two events have high averages. ... AJOL African Journals Online.

Novel thermal annealing methodology for permanent tuning polymer optical fiber Bragg gratings to longer wavelengths.

Science.gov (United States)

Pospori, A; Marques, C A F; Sagias, G; Lamela-Rivera, H; Webb, D J

2018-01-22

The Bragg wavelength of a polymer optical fiber Bragg grating can be permanently shifted by utilizing the thermal annealing method. In all the reported fiber annealing cases, the authors were able to tune the Bragg wavelength only to shorter wavelengths, since the polymer fiber shrinks in length during the annealing process. This article demonstrates a novel thermal annealing methodology for permanently tuning polymer optical fiber Bragg gratings to any desirable spectral position, including longer wavelengths. Stretching the polymer optical fiber during the annealing process, the period of Bragg grating, which is directly related with the Bragg wavelength, can become permanently longer. The methodology presented in this article can be used to multiplex polymer optical fiber Bragg gratings at any desirable spectral position utilizing only one phase-mask for their photo-inscription, reducing thus their fabrication cost in an industrial setting.

Comparative effectiveness of early-line nab-paclitaxel vs. paclitaxel in patients with metastatic breast cancer: a US community-based real-world analysis

Directory of Open Access Journals (Sweden)

Mahtani RL

2018-02-01

Full Text Available Reshma L Mahtani,1 Monika Parisi,2 Stefan Glück,3 Quanhong Ni,2 Siyeon Park,4 Corey Pelletier,2 Claudio Faria,2 Fadi Braiteh5,6 1Division of Hematology/Oncology, University of Miami, Miami, FL, 2Health Economics and Outcomes Research, Celgene Corporation, Summit, NJ, 3Global Medical Affairs, Celgene Corporation, Summit, NJ, 4School of Pharmacy, The Ohio State University, Columbus, OH, 5Department of Hematology/Oncology, University of Nevada School of Medicine, Las Vegas, NV, 6Department of Hematology/Oncology, Comprehensive Cancer Centers of Nevada, Las Vegas, NV, USA Background: Real-world analyses of treatments for patients with metastatic breast cancer are limited. We evaluated the comparative effectiveness of nab-paclitaxel vs. paclitaxel in patients with metastatic breast cancer using data from an electronic medical record database from community practices across the USA.Methods: We performed a retrospective cohort study using fully de-identified data from an independent US electronic medical record platform of patients with metastatic breast cancer initiating single-agent nab-paclitaxel or paclitaxel as a first- or second-line treatment from December 1, 2010 to October 6, 2014. The clinical efficacy objectives were time to treatment discontinuation (TTD and time to next treatment (TTNT. Subgroup analyses were performed in patients with 2 types of metastatic breast cancer as follows: 1 hormone receptor-positive and human epidermal growth factor receptor 2 negative, and 2 triple-negative disease. Results: This analysis included 925 patients. Patients receiving nab-paclitaxel vs. paclitaxel had significantly longer TTD (median 4.2 vs. 2.8 months, P<0.0001 and TTNT (median 6.0 vs. 4.2 months, P<0.0001; similar outcomes were observed for patients with hormone receptor-positive/human epidermal growth factor receptor 2 negative disease. Compared with paclitaxel, nab-paclitaxel was associated with significantly longer TTD in patients with triple

Prospective study comparing laparoscopic and open adenomectomy: Surgical and functional results.

Science.gov (United States)

Garcia-Segui, A; Angulo, J C

Open adenomectomy (OA) is the surgery of choice for large volume benign prostatic hyperplasia, and laparoscopic adenomectomy (LA) represents a minimally invasive alternative. We present a long-term, prospective study comparing both techniques. The study consecutively included 199 patients with benign prostatic hyperplasia and prostate volumes>80g who were followed for more than 12 months. The patients underwent OA (n=97) or LA (n=102). We recorded and compared demographic and perioperative data, functional results and complications using a descriptive statistical analysis. The mean age was 69.2±7.7 years (range 42-87), and the mean prostate volume (measured by TRUS) was 112.1±32.7mL (range 78-260). There were no baseline differences among the groups in terms of age, ASA scale, prostate volume, PSA levels, Qmax, IPSS, QoL or treatments prior to the surgery. The surgical time (P<.0001) and catheter time (P<.0002) were longer in the LA group. Operative bleeding (P<.0001), transfusion rate (P=.0015) and mean stay (P<.0001) were significantly lower in the LA group. The LA group had a lower rate of complications (P=.04), but there were no significant differences between the groups in terms of major complications (Clavien score≥3) (P=.13) or in the rate of late complications (at one year) (P=.66). There were also no differences between the groups in the functional postoperative results: IPSS (P=.17), QoL (P=.3) and Qmax (P=.17). LA is a reasonable, safe and effective alternative that results in less bleeding, fewer transfusions, shorter hospital stays and lower morbidity than OA. LA has similar functional results to OA, at the expense of longer surgical times and longer catheter times. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Analgesic effect of intra-articular magnesium sulphate compared with bupivacaine after knee arthroscopic menisectomy

Directory of Open Access Journals (Sweden)

Yasser A. Radwan

2013-07-01

Full Text Available This work aimed to evaluate the analgesic efficacy of intra-articular injection of magnesium sulphate (4% compared with equivalent volume of bupivacaine (0.5% after outpatient knee arthroscopic meniscectomy. Forty patients were randomly assigned to two groups. Group M (n = 20 received intra-articular magnesium sulphate 4%, group B (n = 20 received bupivacaine (0.5%. Analgesic effect was evaluated by analgesic duration, and by measuring pain intensity at 1, 2, 4, 6, 12, 24 h both at rest and on knee movement to 90°. The primary outcome variable was pain intensity on the VAS at 1, 2, 4, 6, 12, 24 h post arthroscopy at rest and on movement (flexion of knee to 90°, although the magnesium group had lower time weighted averages (TWAs at rest and on movement, these TWAs were not statistically significant. The median duration of postoperative analgesia was significantly longer in the patients treated with magnesium sulphate (528 min than in the bupivacaine group (317 min (p < 0.0001, with less number of patients needing supplementary analgesia in magnesium group (8/20 than those of the bupivacaine group (16/20 (p < 0.022. Also analgesic consumption was significantly lower in the magnesium sulphate group (p < 0.002. We concluded that the use of magnesium sulphate is rational and effective in reducing pain, and is more physiological and shortens convalescence after outpatient arthroscopic meniscectomy, however our hypotheses that analgesic efficacy of intra-articular isotonic magnesium sulphate would be superior to intra-articular local anaesthetic cannot be supported with this study.

Analysing accessibility effects in a continuous treatment framework: the case of Copenhagen metro

DEFF Research Database (Denmark)

Pons Rotger, Gabriel Angel; Nielsen, Thomas Alexander Sick

increases the probability of long commutes (> 4 km) - and decreases the probability of short commutes (men and women...... it is mainly women that are affected by the accessibility gain and commute longer distances in responses to proximity to the metro. Comparing older and younger commuters it is mainly the older commuters that respond to the increased accessibility offered by metro access – by commuting longer distances....... Comparing income groups a considerably stronger response to the increased accessibility is seen in the highest earning and presumably most skilled group. Comparing commuting responses to metro access grouped by the past commuting behavior of the responspondents indicate a positive effect of proximity...

Comparative effectiveness of oral drug therapies for lower urinary tract symptoms due to benign prostatic hyperplasia: a systematic review and network meta-analysis.

Directory of Open Access Journals (Sweden)

Xinghuan Wang

Full Text Available Lower urinary tract symptoms (LUTS due to benign prostatic hyperplasia (BPH are common in elder men and a number of drugs alone or combined are clinically used for this disorder. But available studies investigating the comparative effects of different drug therapies are limited. This study was aimed to compare the efficacy of different drug therapies for LUTS/BPH with network meta-analysis.An electronic search of PubMed, Cochrane Library and Embase was performed to identify randomized controlled trials (RCTs comparing different drug therapies for LUTS/BPH within 24 weeks. Comparative effects were calculated using Aggregate Data Drug Information System. Consistency models of network meta-analysis were created and cumulative probability was used to rank different therapies.A total 66 RCTs covering seven different therapies with 29384 participants were included. We found that α-blockers (ABs plus phosphodiesterase 5 inhibitors (PDE5-Is ranked highest in the test of IPSS total score, storage subscore and voiding subscore. The combination therapy of ABs plus 5α-reductase inhibitors was the best for increasing maximum urinary flow rate (Qmax with a mean difference (MD of 1.98 (95% CI, 1.12 to 2.86 as compared to placebo. ABs plus muscarinic receptor antagonists (MRAs ranked secondly on the reduction of IPSS storage subscore, although monotherapies including MRAs showed no effect on this aspect. Additionally, PDE5-Is alone showed great effectiveness for LUTS/BPH except Qmax.Based on our novel findings, combination therapy, especially ABs plus PDE5-Is, is recommended for short-term treatment for LUTS/BPH. There was also evidence that PDE5-Is used alone was efficacious except on Qmax. Additionally, it should be cautious when using MRAs. However, further clinical studies are required for longer duration which considers more treatment outcomes such as disease progression, as well as basic research investigating mechanisms involving PDE5-Is and other

Comparative Antioxidant, Antiproliferative and Apoptotic Effects of ...

African Journals Online (AJOL)

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

Genetically predicted longer telomere length is associated with increased risk of B-cell lymphoma subtypes

NARCIS (Netherlands)

Machiela, Mitchell J; Lan, Qing; Slager, Susan L; Vermeulen, Roel C H; Teras, Lauren R; Camp, Nicola J; Cerhan, James R; Spinelli, John J; Wang, Sophia S; Nieters, Alexandra; Vijai, Joseph; Yeager, Meredith; Wang, Zhaoming; Ghesquières, Hervé; McKay, James; Conde, Lucia; de Bakker, Paul I W; Cox, David G; Burdett, Laurie; Monnereau, Alain; Flowers, Christopher R; De Roos, Anneclaire J; Brooks-Wilson, Angela R; Giles, Graham G; Melbye, Mads; Gu, Jian; Jackson, Rebecca D; Kane, Eleanor; Purdue, Mark P; Vajdic, Claire M; Albanes, Demetrius; Kelly, Rachel S; Zucca, Mariagrazia; Bertrand, Kimberly A; Zeleniuch-Jacquotte, Anne; Lawrence, Charles; Hutchinson, Amy; Zhi, Degui; Habermann, Thomas M; Link, Brian K; Novak, Anne J; Dogan, Ahmet; Asmann, Yan W; Liebow, Mark; Thompson, Carrie A; Ansell, Stephen M; Witzig, Thomas E; Tilly, Hervé; Haioun, Corinne; Molina, Thierry J; Hjalgrim, Henrik; Glimelius, Bengt; Adami, Hans-Olov; Roos, Göran; Bracci, Paige M; Riby, Jacques; Smith, Martyn T; Holly, Elizabeth A; Cozen, Wendy; Hartge, Patricia; Morton, Lindsay M; Severson, Richard K; Tinker, Lesley F; North, Kari E; Becker, Nikolaus; Benavente, Yolanda; Boffetta, Paolo; Brennan, Paul; Foretova, Lenka; Maynadie, Marc; Staines, Anthony; Lightfoot, Tracy; Crouch, Simon; Smith, Alex; Roman, Eve; Diver, W Ryan; Offit, Kenneth; Zelenetz, Andrew; Klein, Robert J; Villano, Danylo J; Zheng, Tongzhang; Zhang, Yawei; Holford, Theodore R; Turner, Jenny; Southey, Melissa C; Clavel, Jacqueline; Virtamo, Jarmo; Weinstein, Stephanie; Riboli, Elio; Vineis, Paolo; Kaaks, Rudolph; Boeing, Heiner; Tjønneland, Anne; Angelucci, Emanuele; Di Lollo, Simonetta; Rais, Marco; De Vivo, Immaculata; Giovannucci, Edward; Kraft, Peter; Huang, Jinyan; Ma, Baoshan; Ye, Yuanqing; Chiu, Brian C H; Liang, Liming; Park, Ju-Hyun; Chung, Charles C; Weisenburger, Dennis D; Fraumeni, Joseph F; Salles, Gilles; Glenn, Martha; Cannon-Albright, Lisa; Curtin, Karen; Wu, Xifeng; Smedby, Karin E; de Sanjose, Silvia; Skibola, Christine F; Berndt, Sonja I; Birmann, Brenda M; Chanock, Stephen J; Rothman, Nathaniel

2016-01-01

Evidence from a small number of studies suggests that longer telomere length measured in peripheral leukocytes is associated with an increased risk of non-Hodgkin lymphoma (NHL). However, these studies may be biased by reverse causation, confounded by unmeasured environmental exposures and might

124Iodine: A Longer-Life Positron Emitter Isotope—New Opportunities in Molecular Imaging

Directory of Open Access Journals (Sweden)

Giuseppe Lucio Cascini

2014-01-01

Full Text Available 124Iodine (124I with its 4.2 d half-life is particularly attractive for in vivo detection and quantification of longer-term biological and physiological processes; the long half-life of 124I is especially suited for prolonged time in vivo studies of high molecular weight compounds uptake. Numerous small molecules and larger compounds like proteins and antibodies have been successfully labeled with 124I. Advances in radionuclide production allow the effective availability of sufficient quantities of 124I on small biomedical cyclotrons for molecular imaging purposes. Radioiodination chemistry with 124I relies on well-established radioiodine labeling methods, which consists mainly in nucleophilic and electrophilic substitution reactions. The physical characteristics of 124I permit taking advantages of the higher PET image quality. The availability of new molecules that may be targeted with 124I represents one of the more interesting reasons for the attention in nuclear medicine. We aim to discuss all iodine radioisotopes application focusing on 124I, which seems to be the most promising for its half-life, radiation emissions, and stability, allowing several applications in oncological and nononcological fields.

The role of romantic attraction and conflict resolution in predicting shorter and longer relationship maintenance among adolescents.

Science.gov (United States)

Appel, Israel; Shulman, Shmuel

2015-04-01

This study examined the role of romantic attraction and conflict resolution patterns in shorter and longer relationship maintenance among adolescent couples. Data were used from 55 couples aged 15-18 years. Partners completed the Romantic Attraction scale and were observed negotiating a disagreement. Three and 6 months later, they were asked to report whether they were still together. Findings indicated that partners' romantic attraction and the tendency to minimize disagreements during interaction predicted shorter relationship maintenance. In contrast, longer relationship maintenance was predicted by partners' capability to resolve conflicts constructively in a positive atmosphere. Findings are embedded and discussed within Fisher's (2004) evolutionary theory of love.

Preliminary Competencies for Comparative Effectiveness Research

OpenAIRE

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

2012-01-01

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

Comparative effectiveness of malaria preventive measures on ...

African Journals Online (AJOL)

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

COMPARATIVE EFFECTIVENESS RESEARCH AND ITS APPLICATION TO NURSING EDUCATION

Directory of Open Access Journals (Sweden)

Claire Su-Yeon Park

2016-07-01

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

Clinical outcomes and cost effectiveness of accelerated diagnostic protocol in a chest pain center compared with routine care of patients with chest pain.

Science.gov (United States)

Asher, Elad; Reuveni, Haim; Shlomo, Nir; Gerber, Yariv; Beigel, Roy; Narodetski, Michael; Eldar, Michael; Or, Jacob; Hod, Hanoch; Shamiss, Arie; Matetzky, Shlomi

2015-01-01

The aim of this study was to compare in patients presenting with acute chest pain the clinical outcomes and cost-effectiveness of an accelerated diagnostic protocol utilizing contemporary technology in a chest pain unit versus routine care in an internal medicine department. Hospital and 90-day course were prospectively studied in 585 consecutive low-moderate risk acute chest pain patients, of whom 304 were investigated in a designated chest pain center using a pre-specified accelerated diagnostic protocol, while 281 underwent routine care in an internal medicine ward. Hospitalization was longer in the routine care compared with the accelerated diagnostic protocol group (pdiagnostic protocol patients (98%) vs. 57 (20%) routine care patients underwent non-invasive testing, (pdiagnostic imaging testing was performed in 125 (44%) and 26 (9%) patients in the routine care and accelerated diagnostic protocol patients, respectively (pdiagnostic protocol patients compared with those receiving routine care was associated with a lower incidence of readmissions for chest pain [8 (3%) vs. 24 (9%), pdiagnostic protocol remained a predictor of lower acute coronary syndromes and readmissions after propensity score analysis [OR = 0.28 (CI 95% 0.14-0.59)]. Cost per patient was similar in both groups [($2510 vs. $2703 for the accelerated diagnostic protocol and routine care group, respectively, (p = 0.9)]. An accelerated diagnostic protocol is clinically superior and as cost effective as routine in acute chest pain patients, and may save time and resources.

Exploratory randomised controlled clinical study to evaluate the comparative efficacy of two occluding toothpastes - a 5% calcium sodium phosphosilicate toothpaste and an 8% arginine/calcium carbonate toothpaste - for the longer-term relief of dentine hypersensitivity.

Science.gov (United States)

Hall, Claire; Mason, Stephen; Cooke, Jonathan

2017-05-01

To compare the longer-term clinical efficacy of two occlusion-technology toothpastes - a 5% calcium sodium phosphosilicate (CSPS) toothpaste and a commercially available 8% arginine/calcium carbonate toothpaste - in relieving dentine hypersensitivity (DH). Efficacy was also compared with that of a regular fluoride toothpaste control. This was an exploratory, randomised, examiner-blind, parallel-group, 11-week, controlled study in healthy adults with self-reported and clinically diagnosed DH. After an acclimatisation period, subjects were randomised to one of three study treatments with which they brushed their teeth twice daily. Sensitivity was assessed at baseline and after 1, 2, 4, 6 and 11 weeks treatment in response to evaporative (air) and tactile stimuli (measured by the Schiff Sensitivity Scale/visual analogue scale and tactile threshold, respectively). A total of 135 subjects were randomised to treatment. The two occlusion-technology toothpastes performed similarly over the 11-week treatment period. All study treatments showed statistically significant reductions from baseline in DH at all timepoints for all measures (pcarbonate anti-sensitivity toothpaste provided similar benefits. Improvements in DH continued throughout the 11-week study. Dentine hypersensitivity (DH) is a common and painful condition. Twice-daily use of a 5% calcium sodium phosphosilicate toothpaste reduces DH within 1-2 weeks of initiating use. Ongoing, twice daily use of the sensitivity toothpastes evaluated in this study was associated with continued, clinically significant improvements in DH. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The effect of corticosteroid versus platelet-rich plasma injection therapies for the management of lateral epicondylitis: A systematic review

Directory of Open Access Journals (Sweden)

Ben-Nafa Walid

2018-01-01

Conclusion: Corticosteroid injections provide rapid therapeutic effect in the short-term with recurrence of symptoms afterwards, compared to the relatively slower but longer-term effect of platelet-rich plasma.

Instrumental variable methods in comparative safety and effectiveness research.

Science.gov (United States)

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

2010-06-01

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

Instrumental variable methods in comparative safety and effectiveness research†

Science.gov (United States)

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

2010-01-01

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

Studies on irradiated BNFL culture medium for decontamination and longer storage

International Nuclear Information System (INIS)

Singh, Antaryami; Malodia, P.; Jain, S.K.; Ram Gopal

2001-01-01

The feasibility of gamma radiation for microbial decontamination and shelf-life extension of culture medium was studied. Changes in total viable count, coliform count and fungal count on exposure to 5, 10, 15, 20 and 25 kGy of gamma radiation were examined. The total viable counts were reduced on irradiation. Complete destruction of bacterial and fungal contamination was observed at 20 kGy. Studies were conducted to examine the changes in microbial contamination of the medium during storage. There was no post irradiation proliferation of microorganisms. Also, no significant change in the efficiency of the irradiated culture medium was observed. Thus, irradiation is extremely useful for longer storage and quality-assurance. (author)

Attention training normalises combat-related post-traumatic stress disorder effects on emotional Stroop performance using lexically matched word lists.

Science.gov (United States)

Khanna, Maya M; Badura-Brack, Amy S; McDermott, Timothy J; Shepherd, Alex; Heinrichs-Graham, Elizabeth; Pine, Daniel S; Bar-Haim, Yair; Wilson, Tony W

2015-08-26

We examined two groups of combat veterans, one with post-traumatic stress disorder (PTSD) (n = 27) and another without PTSD (n = 16), using an emotional Stroop task (EST) with word lists matched across a series of lexical variables (e.g. length, frequency, neighbourhood size, etc.). Participants with PTSD exhibited a strong EST effect (longer colour-naming latencies for combat-relevant words as compared to neutral words). Veterans without PTSD produced no such effect, t  .37. Participants with PTSD then completed eight sessions of attention training (Attention Control Training or Attention Bias Modification Training) with a dot-probe task utilising threatening and neutral faces. After training, participants-especially those undergoing Attention Control Training-no longer produced longer colour-naming latencies for combat-related words as compared to other words, indicating normalised attention allocation processes after treatment.

Long-Term Therapeutic Effects of Mesenchymal Stem Cells Compared to Dexamethasone on Recurrent Experimental Autoimmune Uveitis of Rats

Science.gov (United States)

Zhang, Lingjun; Zheng, Hui; Shao, Hui; Nian, Hong; Zhang, Yan; Bai, Lingling; Su, Chang; Liu, Xun; Dong, Lijie; Li, Xiaorong; Zhang, Xiaomin

2014-01-01

Purpose. We tested the long-term effects of different regimens of mesenchymal stem cell (MSC) administration in a recurrent experimental autoimmune uveitis (rEAU) model in rats, and compared the efficacy of MSC to that of dexamethasone (DEX). Methods. One or two courses of MSC treatments were applied to R16-specific T cell–induced rEAU rats before or after disease onsets. The DEX injections were given for 7 or 50 days continuously after disease onsets. Clinical appearances were observed until the 50th day after transfer. On the 10th day, T cells from control and MSC groups were analyzed by flow cytometry. Supernatants from the proliferation assay and aqueous humor were collected for cytokine detection. Functions of T cells and APCs in spleens also were studied by lymphocyte proliferation assays. Results. One course of MSC therapy, administered after disease onset, led to a lasting therapeutic effect, with a decreased incidence, reduced mean clinical score, and reduced retinal impairment after 50 days of observation, while multiple courses of treatment did not improve the therapeutic benefit. Although DEX and MSCs equally reduced the severity of the first episode of rEAU, the effect of DEX was shorter lasting, and DEX therapy failed to control the disease even with long periods of treatment. The MSCs significantly decreased T helper 1 (Th1) and Th17 responses, suppressed the function of antigen-presenting cells, and upregulated T regulatory cells. Conclusions. These results suggested that MSCs might be new corticosteroid spring agents, while providing fewer side effects and longer lasting suppressive effects for recurrent uveitis. PMID:25125599

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

Science.gov (United States)

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

2018-01-01

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

Obesity Is Associated With More Complications and Longer Hospital Stays After Orthopaedic Trauma.

Science.gov (United States)

Childs, Benjamin R; Nahm, Nickolas J; Dolenc, Andrea J; Vallier, Heather A

2015-11-01

The objective of this study was to characterize relationships between obesity and initial hospital stay, including complications, in patients with multiple system trauma and surgically treated fractures. Prospective, observational. Level 1 trauma center. Three hundred seventy-six patients with an Injury Severity Score greater than 16 and mechanically unstable high-energy fractures of the femur, pelvic ring, acetabulum, or spine requiring stabilization. Data for obese (body mass index ≥ 30) versus nonobese patients included presence of pneumonia, deep vein thrombosis, pulmonary embolism, infection, organ failure, and mortality. Days in ICU and hospital, days on ventilator, transfusions, and surgical details were documented. Complications occurred more often in obese patients (38.0% vs. 28.4%, P = 0.03), with more acute renal failure (5.70% vs. 1.38%, P = 0.02) and infection (11.4% vs. 5.50%, P = 0.04). Days in ICU and mechanical ventilation times were longer for obese patients (7.06 vs. 5.25 days, P = 0.05 and 4.92 vs. 2.90 days, P = 0.007, respectively). Mean total hospital stay was also longer for obese patients (12.3 vs. 9.79 days, P = 0.009). No significant differences in rates of mortality, multiple organ failure, or pulmonary complications were noted. Medically stable obese patients were almost twice as likely to experience delayed fracture fixation due to preference of the surgeon and were more likely to experience delay overall (26.0% vs. 16.1%; P = 0.02). Mean time from injury to fixation was 34.9 hours in obese patients versus 23.7 hours in nonobese patients (P = 0.03). Obesity was noted among 42% of our trauma patients. In obese patients, complications occurred more often and hospital and ICU stays were significantly longer. These increases are likely to be associated with greater hospital costs. Surgeon decision to delay procedures in medically stable obese patients may have contributed to these findings; definitive fixation was more likely to be

Comparative Analysis of the Effects of Organization Development ...

African Journals Online (AJOL)

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

Comparative Effectiveness of Different Types of Cervical Laminoplasty

OpenAIRE

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

2013-01-01

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

Patch size effects on plant species decline in an experimentally fragmented landscape.

Science.gov (United States)

Collins, Cathy D; Holt, Robert D; Foster, Bryan L

2009-09-01

Understanding local and global extinction is a fundamental objective of both basic and applied ecology. Island biogeography theory (IBT) and succession theory provide frameworks for understanding extinction in changing landscapes. We explore the relative contribution of fragment size vs. succession on species' declines by examining distributions of abundances for 18 plant species declining over time in an experimentally fragmented landscape in northeast Kansas, U.S.A. If patch size effects dominate, early-successional species should persist longer on large patches, but if successional processes dominate, the reverse should hold, because in our system woody plant colonization is accelerated on large patches. To compare the patterns in abundance among patch sizes, we characterize joint shifts in local abundance and occupancy with a new metric: rank occupancy-abundance profiles (ROAPs). As succession progressed, statistically significant patch size effects emerged for 11 of 18 species. More early-successional species persisted longer on large patches, despite the fact that woody encroachment (succession) progressed faster in these patches. Clonal perennial species persisted longer on large patches compared to small patches. All species that persisted longer on small patches were annuals that recruit from the seed bank each year. The degree to which species declined in occupancy vs. abundance varied dramatically among species: some species declined first in occupancy, others remained widespread or even expanded their distribution, even as they declined in local abundance. Consequently, species exhibited various types of rarity as succession progressed. Understanding the effect of fragmentation on extinction trajectories requires a species-by-species approach encompassing both occupancy and local abundance. We propose that ROAPs provide a useful tool for comparing the distribution of local abundances among landscape types, years, and species.

Self-selection contributes significantly to the lower adiposity offaster, longer-distanced, male and female walkers

Energy Technology Data Exchange (ETDEWEB)

Williams, Paul T.

2006-01-06

Although cross-sectional studies show active individuals areleaner than their sedentary counterparts, it remains to be determined towhat extent this is due to initially leaner men and women choosing toexercise longer and more intensely (self-selection bias). In this reportwalking volume (weekly distance) and intensity (speed) were compared tocurrent BMI (BMIcurrent) and BMI at the start of walking (BMIstarting) in20,353 women and 5,174 men who had walked regularly for exercise for 7.2and 10.6 years,respectively. The relationships of BMIcurrent andBMIstarting with distance and intensity were nonlinear (convex). Onaverage, BMIstarting explained>70 percent of the association betweenBMIcurrent and intensity, and 40 percent and 17 percent of theassociation between BMIcurrent and distance in women and men,respectively. Although the declines in BMIcurrent with distance andintensity were greater among fatter than leaner individuals, the portionsattributable to BMIstarting remained relatively constant regardless offatness. Thus self-selection bias accounts for most of the decline in BMIwith walking intensity and smaller albeit significant proportions of thedecline with distance. This demonstration of self-selection is germane toother cross-sectional comparisons in epidemiological research, givenself-selection is unlikely to be limited to weight or peculiar tophysical activity.

Specific imaging characteristic of solitary necrotic nodule of the liver: Marked peripheral rim-like enhancement with internal hypointensity on longer delayed MRI

Energy Technology Data Exchange (ETDEWEB)

Fang, Jiayang; Yu, Dexin; Ma, Xiangxing; Xiang, Ying; Guo, Lijuan [Qilu Hospital of Shandong University, Department of Radiology, Ji' nan City, Shandong (China); Ma, Xiaoyuan [Qilu Hospital of Shandong University, Department of Orthopaedics, Ji' nan City (China)

2017-09-15

To obtain specific imaging findings of solitary necrotic nodule of the liver (SNNL) using longer delayed contrast-enhanced MRI and compare them with those of three mimic hepatic diseases. Sixteen patients with SNNL underwent plain and contrast-enhanced triphasic CT and multiphasic MRI with delayed time prolonged to 2 h after contrast bolus injection. Twenty-three patients with mimic lesions including seven with eight HCCs, five with five iCCs and 11 with metastatic lesions served as the control group. Those patients also received plain and multiphasic contrast-enhanced MRI. Imaging features of lesions such as peripheral wash-out time were evaluated. Among the 16 SNNLs, with a prolonged delayed MRI time, the enhancement degree of tumour periphery increased gradually. When it was up to 1 h, all lesions represented moderate/marked peripheral enhancement with internal hypointensity. However, the peripheral wash-out in seven HCCs (87.5%) and all metastatic lesions except three appeared at 10 or 15 min, one iCC (20%) at 30 min and the other lesions at 1 h. Longer MRI with a delayed time of 1-2 h may be useful in diagnosis SNNL, revealing the specific imaging characteristic of SNNL as pronounced peripheral enhancement with internal hypointensity. (orig.)

Obese motorcycle riders have a different injury pattern and longer hospital length of stay than the normal-weight patients.

Science.gov (United States)

Liu, Hang-Tsung; Rau, Cheng-Shyuan; Wu, Shao-Chun; Chen, Yi-Chun; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2016-04-14

The adverse effects of obesity on the physical health have been extensively studied in the general population, but not in motorcycle riders (includes both drivers and pillions). The aim of this study was to compare injury patterns, injury severities, mortality rates, and in-hospital or intensive care unit (ICU) length of stay (LOS) between obese and normal-weight patients who were hospitalized for the treatment of trauma following motorcycle accidents in a level I trauma center. Detailed data of 466 obese adult patients with a body mass index (BMI) ≥30 kg/m(2) and 2701 normal-weight patients (25 > BMI ≥18.5 kg/m(2)) who had sustained motorcycle accident-related injuries were retrieved from the Trauma Registry System between January 1, 2009 and December 31, 2013. We used the Pearson's chi-squared test, Fisher's exact test, and independent Student's t-test to analyze differences between the two groups. Compared to normal-weight motorcycle riders, more obese riders were men and drivers as opposed to pillions. In addition, fewer obese motorcycle riders showed alcohol intoxication. Analyses of the patients' Abbreviated Injury Scale (AIS) scores revealed that obese motorcycle riders presented with a higher rate of injury to the thorax, but a lower rate of injury to the face than normal-weight patients. In addition, obese motorcycle riders had a 2.7-fold greater incidence of humeral, 1.9-fold greater incidence of pelvic, and 1.5-fold greater incidence of rib fractures. In contrast, normal-weight motorcycle riders sustained a significantly higher rate of maxillary and clavicle fractures. Obese motorcycle riders had a significant longer in-hospital LOS than normal-weight motorcycle riders did (10.6 days vs. 9.5 days, respectively; p = 0.044), with an increase in in-hospital LOS of 0.82 days associated with every 10-unit increase in BMI. No statistically significant differences in Injury Severity Score (ISS), New Injury Severity Score (NISS), Trauma

Parent's Relative Perceived Work Flexibility Compared to Their Partner Is Associated With Emotional Exhaustion.

Science.gov (United States)

Leineweber, Constanze; Falkenberg, Helena; Albrecht, Sophie C

2018-01-01

A number of studies have found that control over work conditions and hours is positively related to mental health. Still, potential positive and negative effects of work flexibility remain to be fully explored. On the one hand, higher work flexibility might provide better opportunities for recovery. On the other hand, especially mothers may use flexibility to meet household and family demands. Here, we investigated the association between parent's work flexibility, rated relative to their partner, and emotional exhaustion in interaction with gender. Additionally, gender differences in time use were investigated. Cross-sectional analyses based on responses of employed parents to the 2012 wave of the Swedish Longitudinal Occupational Survey of Health (SLOSH) were conducted ( N = 2,911). Generalized linear models with gamma distribution and a log-link function were used to investigate associations between relative work-flexibility (lower, equal, or higher as compared to partner), gender, and emotional exhaustion. After control for potential confounders, we found that having lower work flexibility than the partner was associated with higher levels of emotional exhaustion as compared to those with higher relative work flexibility. Also, being a mother was associated with higher levels of emotional exhaustion, independent of possible confounders. An interaction effect between low relative work flexibility and gender was found in relation to emotional exhaustion. Regarding time use, clear differences between mothers' and fathers' were found. However, few indications were found that relative work flexibility influenced time use. Mothers spent more time on household chores as compared to fathers, while fathers reported longer working hours. Fathers spent more time on relaxation compared with mothers. To conclude, our results indicate that lower relative work flexibility is detrimental for mental health both for mothers and fathers. However, while gender seems to have a

Parent's Relative Perceived Work Flexibility Compared to Their Partner Is Associated With Emotional Exhaustion

Directory of Open Access Journals (Sweden)

Constanze Leineweber

2018-05-01

Full Text Available A number of studies have found that control over work conditions and hours is positively related to mental health. Still, potential positive and negative effects of work flexibility remain to be fully explored. On the one hand, higher work flexibility might provide better opportunities for recovery. On the other hand, especially mothers may use flexibility to meet household and family demands. Here, we investigated the association between parent's work flexibility, rated relative to their partner, and emotional exhaustion in interaction with gender. Additionally, gender differences in time use were investigated. Cross-sectional analyses based on responses of employed parents to the 2012 wave of the Swedish Longitudinal Occupational Survey of Health (SLOSH were conducted (N = 2,911. Generalized linear models with gamma distribution and a log-link function were used to investigate associations between relative work-flexibility (lower, equal, or higher as compared to partner, gender, and emotional exhaustion. After control for potential confounders, we found that having lower work flexibility than the partner was associated with higher levels of emotional exhaustion as compared to those with higher relative work flexibility. Also, being a mother was associated with higher levels of emotional exhaustion, independent of possible confounders. An interaction effect between low relative work flexibility and gender was found in relation to emotional exhaustion. Regarding time use, clear differences between mothers' and fathers' were found. However, few indications were found that relative work flexibility influenced time use. Mothers spent more time on household chores as compared to fathers, while fathers reported longer working hours. Fathers spent more time on relaxation compared with mothers. To conclude, our results indicate that lower relative work flexibility is detrimental for mental health both for mothers and fathers. However, while gender

Comparative Antioxidant, Antiproliferative and Apoptotic Effects of ...

African Journals Online (AJOL)

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

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

African Journals Online (AJOL)

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

177Lu-immunotherapy of experimental peritoneal carcinomatosis shows comparable effectiveness to 213Bi-immunotherapy, but causes toxicity not observed with 213Bi

International Nuclear Information System (INIS)

Seidl, Christof; Zoeckler, Christine; Beck, Roswitha; Senekowitsch-Schmidtke, Reingard; Quintanilla-Martinez, Leticia; Bruchertseifer, Frank

2011-01-01

213 Bi-d9MAb-immunoconjugates targeting gastric cancer cells have effectively cured peritoneal carcinomatosis in a nude mouse model following intraperitoneal injection. Because the β-emitter 177 Lu has proven to be beneficial in targeted therapy, 177 Lu-d9MAb was investigated in this study in order to compare its therapeutic efficacy and toxicity with those of 213 Bi-d9MAb. Nude mice were inoculated intraperitoneally with HSC45-M2 gastric cancer cells expressing d9-E-cadherin and were treated intraperitoneally 1 or 8 days later with different activities of specific 177 Lu-d9MAb immunoconjugates targeting d9-E-cadherin or with nonspecific 177 Lu-d8MAb. Therapeutic efficacy was evaluated by monitoring survival for up to 250 days. For evaluation of toxicity, both biodistribution of 177 Lu-d9MAb and blood cell counts were determined at different time points and organs were examined histopathologically. Treatment with 177 Lu-immunoconjugates (1.85, 7.4, 14.8 MBq) significantly prolonged survival. As expected, treatment on day 1 after tumour cell inoculation was more effective than treatment on day 8, and specific 177 Lu-d9MAb conjugates were superior to nonspecific 177 Lu-d8MAb. Treatment with 7.4 MBq of 177 Lu-d9MAb was most successful, with 90% of the animals surviving longer than 250 days. However, treatment with therapeutically effective activities of 177 Lu-d9MAb was not free of toxic side effects. In some animals lymphoblastic lymphoma, proliferative glomerulonephritis and hepatocarcinoma were seen but were not observed after treatment with 213 Bi-d9MAb at comparable therapeutic efficacy. The therapeutic efficacy of 177 Lu-d9MAb conjugates in peritoneal carcinomatosis is impaired by toxic side effects. Because previous therapy with 213 Bi-d9MAb revealed comparable therapeutic efficacy without toxicity it should be preferred for the treatment of peritoneal carcinomatosis. (orig.)

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

Science.gov (United States)

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

2016-01-13

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

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

Science.gov (United States)

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

2008-10-01

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

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

Science.gov (United States)

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

2013-06-01

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

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

DEFF Research Database (Denmark)

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

2016-01-01

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

A feasibility study on the longer cycle operation of Yonggwang nuclear power plants 3 and 4 NSSS design

Energy Technology Data Exchange (ETDEWEB)

Ha, Young Joon; Choi, Hae Yoon; Chang, Young Woo [Korea Atomic Energy Research Inst., Daeduk (Korea, Republic of)] [and others

1996-06-01

A feasible study on the NSSS design safety assessment is performed for a longer cycle operation of Yonggang units 3 and 4. The analysis of the drift errors increased and setting point changed for safety related instrument channels due to the longer refueling interval was done to assess the impact on the operational safety performance and availability of the plant if the refueling interval was extended. In the result of LOCA analysis, even though the Peak Cladding Temperature (PCT) is slightly increased due to Pin/Box ratio decrease, the PCT has enough margin and, therefore, it was proven to be acceptable. From the perspective of return-to-power and the pre-trip fuel performance during the transient operation, an impact on the results of an SLB accident analysis were assessed. The overall trend of the longer refueling operation of 18 months is similar to the standard refuel operation of 12 months. The possibility of the return to power during SLB accident condition was estimated, the detailed analysis of the reactor core using the 3-dimensional model methodology is required to confirm the fuel integrity. 11 refs.(Author) .new.

Longer reaction time of the fibularis longus muscle and reduced postural control in basketball players with functional ankle instability: A pilot study.

Science.gov (United States)

Méndez-Rebolledo, Guillermo; Guzmán-Muñoz, Eduardo; Gatica-Rojas, Valeska; Zbinden-Foncea, Hermann

2015-08-01

Motor control evaluation in subjects with functional ankle instability is questionable when both ankles of the same subject are compared (affected vs non-affected). To compare the postural control and reaction time of ankle muscles among: basketball players with FAI (instability group), basketball players without FAI (non-instability group) and healthy non-basketball-playing participants (control group). Case-control study. Laboratory. Instability (n = 10), non-instability (n = 10), and control groups (n = 11). Centre of pressure variables (area, velocity and sway) were measured with a force platform. Reaction time of ankle muscles was measured via electromyography. A one-way ANOVA demonstrated that there were significant differences between the instability and non-instability groups in the fibularis longus (p postural control and longer reaction time of the fibularis and tibialis anterior muscles. Copyright © 2014 Elsevier Ltd. All rights reserved.

COMPARATIVE STUDY OF NALBUPHINE VS. PENTAZOCINE FOR POSTOPERATIVE ANALGESIA

Directory of Open Access Journals (Sweden)

Naresh Ganpatrao Tirpude

2016-10-01

Full Text Available BACKGROUND To provide postoperative pain relief is a prime duty of health care providers. Failure to relieve pain is morally and ethically unacceptable. Post-operative pain may results in adverse effects such as: a Physiological Changes: Reduced pulmonary functions, e.g. vital capacity, tidal volume, functional residual capacity; sympathetic stimulation; reduced the physical activity of patients; thereby increasing the risk of venous thrombosis. b Psychological disturbances: Anger, Resentment, Depression, Adversarial Relationship with Doctors, Insomnia. Aim of this study was 1. To investigate whether “Postoperative analgesia with Nalbuphine is longer than Pentazocine”. 2. To investigate whether “Side effects/complications are less with Nalbuphine as compared to Pentazocine”. MATERIALS AND METHODS It was a prospective randomized double blind observational study. Eighty patients of hydrocoele & inguinal hernia were operated under spinal anaesthesia of age group 20-70 years, ASA grade I & II & patients with controlled co-morbid conditions. In postoperative period, Group N- Inj. Nalbuphine (0.3 mg/kg IM or Group P- Inj. Pentazocine (0.5 mg/kg IM was administered to provide postoperative pain relief & to know the duration of pain relief & its side effects. RESULTS On statistical analysis, demographic data i.e. age, sex had no influence on outcome of study. Mean VAS score in group N was highly significant (p-value in Inj. Pentazocine group. 2. Side Effects - Incidence of sedation was more in Nalbuphine group as compared to Pentazocine group. Nausea & Vomiting were more so in Pentazocine group as compared to Nalbuphine group. Limitation of the present study was that sample size was very small.

Effectiveness of resistance exercise compared to aerobic exercise without insulin therapy in patients with type 2 diabetes mellitus: a meta-analysis.

Science.gov (United States)

Nery, Cybelle; Moraes, Silvia Regina Arruda De; Novaes, Karyne Albino; Bezerra, Márcio Almeida; Silveira, Patrícia Verçoza De Castro; Lemos, Andrea

Physical exercise has been used to mitigate the metabolic effects of diabetes mellitus. To evaluate the effect of resistance exercise when compared to aerobic exercise without insulin therapy on metabolic and clinical outcomes in patients with type 2 diabetes mellitus. Papers were searched on the databases MEDLINE/PubMed, CINAHL, SPORTDiscus, LILACS, and SCIELO, without language or date of publication limits. Clinical trials that compared resistance exercise to aerobic exercise in adults with type 2 diabetes mellitus who did not use insulin therapy were included. The quality of evidence and risk of bias were assessed using the GRADE system and the Cochrane Risk of Bias tool, respectively. Meta-analysis was also used, whenever possible. Two reviewers extracted the data independently. Eight eligible articles were included in this study, with a total of 336 individuals, with a mean age of 48-58 years. The protocols of aerobic and resistance exercise varied in duration from eight to 22 weeks, 30-60min/day, three to five times/week. Overall the available evidence came from a very low quality of evidence and there was an increase in Maximal oxygen consumption (mean difference: -2.86; 95% CI: -3.90 to -1.81; random effect) for the resistance exercise and no difference was found in Glycated hemoglobin, Body mass index, High-density lipoprotein cholesterol, Low-density lipoprotein cholesterol, triglycerides, and total cholesterol. Resistance exercise appears to be more effective in promoting an increase in Maximal oxygen consumption in protocols longer than 12 weeks and there is no difference in the control of glycemic and lipid levels between the two types of exercise. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Working Longer Makes Students Stronger?

DEFF Research Database (Denmark)

Jensen, Vibeke Myrup

Abstract: Despite much discussion on the role of education policy on school and student performance, we know little about the effects of school spending at the margin on student cognitive achievement beyond the effects of class size. Thus this paper examines the effects of annual ninth grade...... classroom hours in literacy and maths on ninth grade (aged 16) student performance in writing and maths, respectively. Using population data for Denmark in 2003-2006, I exploit unique policy-induced variation in classroom hours.On average, the reform changed classroom hours by 2.2-3.3% in literacy and maths...

Smelling themselves: Dogs investigate their own odours longer when modified in an "olfactory mirror" test.

Science.gov (United States)

Horowitz, Alexandra

2017-10-01

While domestic dogs, Canis familiaris, have been found to be skillful at social cognitive tasks and even some meta-cognitive tasks, they have not passed the test of mirror self-recognition (MSR). Acknowledging the motivational and sensory challenges that might hinder performance, even before the question of self-recognition is broached, this study creates and enacts a novel design extrapolated from the species' natural behaviour. Given dogs' use of olfactory signals in communication, this experiment presents dogs with various canisters for approach and investigation. Each holds an odorous stimulus: in the critical test, either an "olfactory mirror" of the subject - the dog's own urine - or one in which the odour stimulus is modified. By looking at subjects' investigation times of each canister, it is shown that dogs distinguish between the olfactory "image" of themselves when modified: investigating their own odour for longer when it had an additional odour accompanying it than when it did not. Such behaviour implies a recognition of the odour as being of or from "themselves." The ecological validity of this odour presentation is examined by presenting to the subjects odours of other known or unknown dogs: dogs spend longer investigating the odour of other dogs than their own odour. Finally, in a second experiment, subjects spent longer with the modified stimulus than with the modified odour by itself, indicating that novelty alone does not explain the dogs' behavior. This study translates the MSR study for a species whose primary sensory modality is olfaction, and finds both that natural sniffing behaviour can be replicated in the lab and that dogs show more investigative interest in their own odours when modified. Copyright © 2017 Elsevier B.V. All rights reserved.

Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

Energy Technology Data Exchange (ETDEWEB)

Kim, Hayeon, E-mail: kimh2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Smith, Kenneth J. [Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (United States)

2015-03-01

Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

International Nuclear Information System (INIS)

Kim, Hayeon; Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful; Smith, Kenneth J.

2015-01-01

Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

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

Science.gov (United States)

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

2018-02-28

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

Changing Zaire to Congo: the fate of no-longer relevant mnemonic information.

Science.gov (United States)

Eriksson, Johan; Stiernstedt, Mikael; Öhlund, Maria; Nyberg, Lars

2014-11-01

In an ever-changing world there is constant pressure on revising long-term memory, such when people or countries change name. What happens to the old, pre-existing information? One possibility is that old associations gradually are weakened and eventually lost. Alternatively, old and no longer relevant information may still be an integral part of memory traces. To test the hypothesis that old mnemonic information still becomes activated when people correctly retrieve new, currently relevant information, brain activity was measured with fMRI while participants performed a cued-retrieval task. Paired associates (symbol-sound and symbol-face pairs) were first learned during two days. Half of the associations were then updated during the next two days, followed by fMRI scanning on day 5 and also 18 months later. As expected, retrieval reactivated sensory cortex related to the most recently learned association (visual cortex for symbol-face pairs, auditory cortex for symbol-sound pairs). Critically, retrieval also reactivated sensory cortex related to the no-longer relevant associate. Eighteen months later, only non-updated symbol-face associations were intact. Intriguingly, a subset of the updated associations was now treated as though the original association had taken over, in that memory performance was significantly worse than chance and that activity in sensory cortex for the original but not the updated associate correlated (negatively) with performance. Moreover, the degree of "residual" reactivation during day 5 inversely predicted memory performance 18 months later. Thus, updating of long-term memory involves adding new information to already existing networks, in which old information can stay resilient for a long time. Copyright © 2014. Published by Elsevier Inc.

Josephson comparator switching time

Energy Technology Data Exchange (ETDEWEB)

Herr, Quentin P; Miller, Donald L; Przybysz, John X [Northrop Grumman, Baltimore, MD (United States)

2006-05-15

Comparator performance can be characterized in terms of both sensitivity and decision time. Delta-sigma analogue-to-digital converters are tolerant of sensitivity errors but require short decision time due to feedback. We have analysed the Josephson comparator using the numerical solution of the Fokker-Planck equation, which describes the time evolution of the ensemble probability distribution. At balance, the result is essentially independent of temperature in the range 5-20 K. There is a very small probability, 1 x 10{sup -14}, that the decision time will be longer than seven single-flux-quantum pulse widths, defined as Phi{sub 0}/(I{sub c}R{sub n}). For junctions with a critical current density of 4.5 kA, this decision time is only 20 ps. Decision time error probability decreases rapidly with lengthening time interval, at a rate of two orders of magnitude per pulse width. We conclude that Josephson comparator performance is quite favourable for analogue-to-digital converter applications.

20 CFR 416.986 - Why and when we will find that you are no longer entitled to benefits based on statutory blindness.

Science.gov (United States)

2010-04-01

... longer entitled to benefits based on statutory blindness. 416.986 Section 416.986 Employees' Benefits... Disability and Blindness Blindness § 416.986 Why and when we will find that you are no longer entitled to benefits based on statutory blindness. (a) If your vision does not meet the definition of blindness. If you...

Why does picture naming take longer than word reading? The contribution of articulatory processes.

Science.gov (United States)

Riès, Stéphanie; Legou, Thierry; Burle, Borís; Alario, F-Xavier; Malfait, Nicole

2012-10-01

Since the 19th century, it has been known that response latencies are longer for naming pictures than for reading words aloud. While several interpretations have been proposed, a common general assumption is that this difference stems from cognitive word-selection processes and not from articulatory processes. Here we show that, contrary to this widely accepted view, articulatory processes are also affected by the task performed. To demonstrate this, we used a procedure that to our knowledge had never been used in research on language processing: response-latency fractionating. Along with vocal onsets, we recorded the electromyographic (EMG) activity of facial muscles while participants named pictures or read words aloud. On the basis of these measures, we were able to fractionate the verbal response latencies into two types of time intervals: premotor times (from stimulus presentation to EMG onset), mostly reflecting cognitive processes, and motor times (from EMG onset to vocal onset), related to motor execution processes. We showed that premotor and motor times are both longer in picture naming than in reading, although than in reading, although articulation is already initiated in the latter measure. Future studies based on this new approach should bring valuable clues for a better understanding of the relation between the cognitive and motor processes involved in speech production.

Is the Rise in the Prevalence of Renal Replacement Therapy at Older Ages the Price for Living Longer?

Directory of Open Access Journals (Sweden)

Frederik Peters

2018-05-01

Full Text Available BackgroundRenal replacement therapy (RRT is one of the most expensive in renal medicine. Cross-sectional studies suggest that life expectancy increases in the general population are associated with a higher burden of RRT. This study tests this hypothesis in a prospective setting among people aged 75+ living in Western Europe.MethodsWe gathered sex-specific data for 11 Western European countries in 2005–2014. RRT prevalence on country level was extracted from the ERA-EDTA registry, while data on population size and life expectancy for the 75+ age group came from the Eurostat database. GDP per capita was extracted from the OECD database. To measure the association between RRT prevalence and life expectancy, we performed Poisson regression models separately for each country and for all countries combined. To adjust for confounding, GDP per capita as well as time and country-fixed effects were included.ResultsOur analysis revealed that living longer coincides with rising RRT prevalence at ages 75+ in Western Europe between 2005 and 2014. On average, a 1-year increase in life expectancy was associated with a roughly 20% increase in RRT prevalence [(95% CI 21–23% in men and 19–22% in women]. However, after adjustments for confounding were made, the association became insignificant among women and became weaker among men, falling to a level of 11% [(95% CI 6–17%].ConclusionLiving longer was not necessarily associated with a higher burden of RRT in Western European countries.

Comparing robotic, laparoscopic and open cystectomy: a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Thomas Fonseka

2015-03-01

Full Text Available Objective: To conduct a systematic review and meta-analysis comparing outcomes between Open Radical Cystectomy (ORC, Laparoscopic Radical Cystectomy (LRC and Robot-assisted Radical Cystectomy (RARC. RARC is to be compared to LRC and ORC and LRC compared to ORC. Material and methods: A systematic review of the literature was conducted, collating studies comparing RARC, LRC and ORC. Surgical and oncological outcome data were extracted and a meta-analysis was performed. Results: Twenty-four studies were selected with total of 2,104 cases analyzed. RARC had a longer operative time (OPT compared to LRC with no statistical difference between length of stay (LOS and estimated blood loss (EBL. RARC had a significantly shorter LOS, reduced EBL, lower complication rate and longer OPT compared to ORC. There were no significant differences regarding lymph node yield (LNY and positive surgical margins (PSM. LRC had a reduced EBL, shorter LOS and increased OPT compared to ORC. There was no significant difference regarding LNY. Conclusion: RARC is comparable to LRC with better surgical results than ORC. LRC has better surgical outcomes than ORC. With the unique technological features of the robotic surgical system and increasing trend of intra-corporeal reconstruction it is likely that RARC will become the surgical option of choice.

Comparing the Effectiveness of Online Sunrise/Sunset Calculators

Science.gov (United States)

Phlips, Alan; Wilson, Teresa; Chizek Frouard, Malynda; Bartlett, Jennifer Lynn

2018-01-01

The USNO is responsible for providing information through its website on various types of natural phenomena, including times of sunrise and sunset for any given day and location. Alternative websites were explored to see what options are available in case the USNO can no longer support this on-line tool in the future. Websites with sunrise/sunset calculators were examined to see what algorithm they cited, if any. A large percentage of the websites took their calculations from three main sources (USNO, Meeus, and Schlyter). For ease of comparison, one website with an Application Programming Interface (API) for each algorithm was used to generate sunrise/sunset times for 2 dates per year for 24 years at latitudes from the equator to each pole along the prime meridian. Additionally, dates on which only one phenomenon was expected (first and last day of polar day and night) were tested to examine how each algorithm would perform for these extreme edge cases. At mid-latitudes, all of the algorithms agreed within 1 minute of each other but their predictions began to diverge as they approached the poles. Close to the poles, all three differed by more than a minute. While the algorithms diverged well before reaching the poles, Schlyter did so at much lower latitudes compared to the other two. In the edge cases, Schlyter and Meeus did not correctly document the missing sunrise/sunsets. Until a set of arctic or antarctic observations of sunrise and sunset times can be analyzed, we cannot ascertain which algorithm is the most accurate. However, the USNO algorithm handled cases of continuous day and night better than the others. There currently seems to be no better alternative to provide robust sunrise/set times than the USNO Complete Sun and Moon Data for One Day (http://aa.usno.navy.mil/data/docs/RS_OneDay.php).

Comparative effectiveness research: Challenges for medical journals

Directory of Open Access Journals (Sweden)

Tovey David

2010-04-01

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

Comparing sensitivity of ecotoxicological effect endpoints between laboratory and field

DEFF Research Database (Denmark)

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

2002-01-01

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

76 FR 2732 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer...

Science.gov (United States)

2011-01-14

...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer Period for Commission.... Introduction On June 18, 2010, The NASDAQ Stock Market LLC (``Nasdaq'' or the ``Exchange'') filed with the... change. The Commission may extend the period for issuing an order approving or disapproving the proposed...

Effectiveness of home-based cupping massage compared to progressive muscle relaxation in patients with chronic neck pain--a randomized controlled trial.

Science.gov (United States)

Lauche, Romy; Materdey, Svitlana; Cramer, Holger; Haller, Heidemarie; Stange, Rainer; Dobos, Gustav; Rampp, Thomas

2013-01-01

Chronic neck pain is a major public health problem with very few evidence-based complementary treatment options. This study aimed to test the efficacy of 12 weeks of a partner-delivered home-based cupping massage, compared to the same period of progressive muscle relaxation in patients with chronic non-specific neck pain. Patients were randomly assigned to self-directed cupping massage or progressive muscle relaxation. They were trained and asked to undertake the assigned treatment twice weekly for 12 weeks. Primary outcome measure was the current neck pain intensity (0-100 mm visual analog scale; VAS) after 12 weeks. Secondary outcome measures included pain on motion, affective pain perception, functional disability, psychological distress, wellbeing, health-related quality of life, pressure pain thresholds and adverse events. Sixty one patients (54.1±12.7 years; 73.8%female) were randomized to cupping massage (n = 30) or progressive muscle relaxation (n = 31). After treatment, both groups showed significantly less pain compared to baseline however without significant group differences. Significant effects in favor of cupping massage were only found for wellbeing and pressure pain thresholds. In conclusion, cupping massage is no more effective than progressive muscle relaxation in reducing chronic non-specific neck pain. Both therapies can be easily used at home and can reduce pain to a minimal clinically relevant extent. Cupping massage may however be better than PMR in improving well-being and decreasing pressure pain sensitivity but more studies with larger samples and longer follow-up periods are needed to confirm these results. ClinicalTrials.gov NCT01500330.

Comparative Characterization of Multiscale Carbon Fiber Composite with Long and Short MWCNTs at Higher Weight Fractions

Directory of Open Access Journals (Sweden)

Michael Zimmer

2012-01-01

Full Text Available There are documented advantages to using carbon nanotubes (CNTs in composites for various property enhancements. However, to date, only limited studies have been conducted on using of longer CNTs over 1 mm in length. This study used long multiwalled carbon nanotubes (LMWCNTs and their longer extended networks to test multiple properties in thermal conductivity, electrical conductivity, mechanical strength, and modulus and then compared these properties to those of shorter multi-walled carbon nanotubes (SMWCNTs. For carbon fiber-reinforced composites, the longer graphite paths from LMWCNTs in the matrix were expected to improve all properties. The longer networks were expected to allow for more undisturbed phonon transportation to improve thermal conductivity. This in turn relates to improved electrical conductivity and better mechanical properties. However, results have shown that the LMWCNTs do not improve or decrease thermal conductivity, whereas the shorter MWCNTs provide mixed results. LMWCNTs did show improvements in electrical, mechanical, and physical properties, but compared to shorter MWCNTs, the results in other certain properties varied. This perplexing outcome resides in the functioning of the networks made by both the LMWCNTs and shorter MWCNTs.

The Effect of Minimum Wages on Youth Employment in Canada: A Panel Study.

Science.gov (United States)

Yuen, Terence

2003-01-01

Canadian panel data 1988-90 were used to compare estimates of minimum-wage effects based on a low-wage/high-worker sample and a low-wage-only sample. Minimum-wage effect for the latter is nearly zero. Different results for low-wage subgroups suggest a significant effect for those with longer low-wage histories. (Contains 26 references.) (SK)

Comparing Effectiveness of Undergraduate Course Delivery: A Student Perspective

Science.gov (United States)

Koenig, Robert J.

2009-01-01

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

Square Helmholtz coil with homogeneous field for magnetic measurement of longer HTS tapes

Energy Technology Data Exchange (ETDEWEB)

Alamgir, A.K.M. [Applied Superconductivity Research Center, Department of Physics, Building Li Zhai, Room 209, Tsinghua University, Beijing 100084 (China)]. E-mail: alam643@hotmail.com; Fang, J. [Applied Superconductivity Research Center, Department of Physics, Building Li Zhai, Room 209, Tsinghua University, Beijing 100084 (China); Gu, C. [Applied Superconductivity Research Center, Department of Physics, Building Li Zhai, Room 209, Tsinghua University, Beijing 100084 (China); Han, Z. [Applied Superconductivity Research Center, Department of Physics, Building Li Zhai, Room 209, Tsinghua University, Beijing 100084 (China)

2005-08-01

Magnetic ac loss measurement of HTS tapes and films at various magnetic field orientations becomes a crucial issue from the view point of measurement precision. In principle, due to tiny loss component and anisotropic properties, longer HTS sample subjected to very good homogeneous field could facilitate the accuracy of this kind of measurement. We investigated field profile of Helmholtz coils with square winding as a magnetizer for HTS tape and films. It is found that square winding exhibits better field-homogeneity than that of conventional circular winding with the similar coil dimensions for ideal condition. Being apart from ideal condition, we investigated field profile of square Helmholtz coil with various combinations of coil parameters and made a conclusion for the best combination based on the field homogeneity and field intensity. The design also provides noise reduction facilities by allowing compact and identical pick up-compensation coil arrangement. In addition, we optimized the final design of Helmholtz coil to compensate the influence of difficulties in square winding on the field distribution. Finally, as small as 0.5% field variation was estimated for 50 mm long sample to be magnetized under a proper combination of fabrication parameters. Investigation of field homogeneity, noise effect and a practical design of square Helmholtz coil as a pick-up coil based magnetizer will be reported.

Square Helmholtz coil with homogeneous field for magnetic measurement of longer HTS tapes

International Nuclear Information System (INIS)

Alamgir, A.K.M.; Fang, J.; Gu, C.; Han, Z.

2005-01-01

Magnetic ac loss measurement of HTS tapes and films at various magnetic field orientations becomes a crucial issue from the view point of measurement precision. In principle, due to tiny loss component and anisotropic properties, longer HTS sample subjected to very good homogeneous field could facilitate the accuracy of this kind of measurement. We investigated field profile of Helmholtz coils with square winding as a magnetizer for HTS tape and films. It is found that square winding exhibits better field-homogeneity than that of conventional circular winding with the similar coil dimensions for ideal condition. Being apart from ideal condition, we investigated field profile of square Helmholtz coil with various combinations of coil parameters and made a conclusion for the best combination based on the field homogeneity and field intensity. The design also provides noise reduction facilities by allowing compact and identical pick up-compensation coil arrangement. In addition, we optimized the final design of Helmholtz coil to compensate the influence of difficulties in square winding on the field distribution. Finally, as small as 0.5% field variation was estimated for 50 mm long sample to be magnetized under a proper combination of fabrication parameters. Investigation of field homogeneity, noise effect and a practical design of square Helmholtz coil as a pick-up coil based magnetizer will be reported

77 FR 68873 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer...

Science.gov (United States)

2012-11-16

... ``Benchmark Orders'' Under NASDAQ Rule 4751(f) November 9, 2012. On May 1, 2012, The NASDAQ Stock Market LLC...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of Longer Period for Commission... proposed rule change to establish various ``Benchmark Orders'' under NASDAQ Rule 4751(f). The proposed rule...

Comparative analysis of intraluminal radiation stent in treatment of advanced esophageal carcinoma

International Nuclear Information System (INIS)

Guo Jinhe; Teng Gaojun; Zhu Guangyu; He Shicheng; Fang Wen; Deng Gang; Li Guozhao

2007-01-01

Objective: To compare the clinical effectiveness of intraluminal radiation stent with that of common covered stent to palliate dysphagia in advanced esophageal cancer. Methods: Fifty three cases were randomly assigned to the experimental group (Group A, n=27) and the control group (Group B, n26). Radiation stents were placed in Group A and common covered stents were placed in Group B. A randomized trial was performed to compare the two groups with respect to complications, relief of dysphagia, and overall survival period. Results: The placement of stents were successful in all the 53 patients. In Group A, no leakage of radiation source was observed through ECT examination, and no displacement of radiation seeds was found through radiography. The follow-up CT showed reduced lesion size compared to presurgical lesion. Three of the 5 patients who underwent uncovered radiation stent placement showed complete necrosis and inflammatory hyperblastosis in tumor tissue adjacent to radiation particles at 2 months follow-up. The lumen of the stents were smooth and had no overgrowth of tumor tissue. Granulation hyperplasia was found at both ends of the stents, prominent at the proximal ends, The incidence of stent- related complications had no significant difference between group A and group B (test, P>0.05). Dysphasia resolved significantly after stent placement in both groups. The improvement of dysphasia was more significant in Group A than in Group B after 2 months of stent placement (1.37±0.56 in group A, 1.82±0.50 in group B,P=0.004). The median survival period was longer in Group A than in Group B (7 months vs 4 months ). The mean survival period was also longer in Group A than in Group B (8.3 months vs 3.5 months). There was a statistically significant difference in the survival period between the two groups (P<0.01). Conclusion: Intraluminal radiation esophageal stent can not only palliate dysphagia but also restrain tumor growth. Palliation period of dysphagia and

Comparative Clinical Study on the Effectiveness of Homeopathic ...

African Journals Online (AJOL)

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

A comparative study between responses of isolated bovine and equine digital arteries to vasoactive mediators.

Science.gov (United States)

Zizzadoro, C; Caruso, M; Punzi, S; Crescenzo, G; Zongoli, F; Belloli, C

2018-02-01

Hemodynamic perturbations, partly resulting from abnormal vasoconstriction of digital vessels, have been implicated in the pathogenesis of bovine and equine laminitis. This study compared the responsiveness of isolated bovine (BDA) and equine (EDA) digital arteries to pharmacological agents that stimulate receptor systems involved in the regulation of normal vessel tone. The role of the endothelium and the short- and longer-term effects of an experimentally induced endothelial damage were also evaluated. Species-related differences were found in the vessel reactivity to all of the receptor agonists tested. In intact BDA, as compared to intact EDA, norepinephrine was a more effective vasoconstrictor, 5-hydroxytryptamine a more effective but less potent vasoconstrictor, isoproterenol a less effective vasodilator and carbamylcholine a less potent vasodilator. In BDA, but not in EDA, the contractile responses to norepinephrine and 5-hydroxytryptamine were enhanced immediately after endothelium removal. However, the contractile reactivity of denuded BDA returned to basal values following overnight incubation. The differences suggest species specificity for the pathophysiology of digital vasomotor tone and function in horses and cattle. © 2017 John Wiley & Sons Ltd.

Chemical toxicity of uranium hexafluoride compared to acute effects of radiation

International Nuclear Information System (INIS)

McGuire, S.A.

1991-02-01

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

Chemical toxicity of uranium hexafluoride compared to acute effects of radiation

Energy Technology Data Exchange (ETDEWEB)

McGuire, S.A.

1991-02-01

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

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

Science.gov (United States)

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

2013-03-01

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

Comparative effects of pulmonary and parenteral Δ⁹-tetrahydrocannabinol exposure on extinction of opiate-induced conditioned aversion in rats.

Science.gov (United States)

Manwell, Laurie A; Mallet, Paul E

2015-05-01

Evidence suggesting that the endogenous cannabinoid (eCB) system can be manipulated to facilitate or impair extinction of learned behaviours has important consequences for opiate withdrawal and abstinence. We demonstrated that the fatty acid amide hydrolase (FAAH) inhibitor URB597, which increases eCB levels, facilitates extinction of a naloxone-precipitated morphine withdrawal-induced conditioned place aversion (CPA). The potential of the exogenous CB1 ligand, Δ(9)-tetrahydrocannabinol (Δ(9)-THC), to facilitate extinction of this CPA was tested. Effects of both pulmonary and parenteral Δ(9)-THC exposure were evaluated using comparable doses previously determined. Rats trained to associate a naloxone-precipitated morphine withdrawal with a floor cue were administered Δ(9)-THC-pulmonary (1, 5, 10 mg vapour inhalation) or parenteral (0.5, 1.0, 1.5 mg/kg intraperitoneal injection)-prior to each of 20 to 28 extinction/testing trials. Vapourized Δ(9)-THC facilitated extinction of the CPA in a dose- and time-dependent manner: 5 and 10 mg facilitated extinction compared to vehicle and 1 mg Δ(9)-THC. Injected Δ(9)-THC significantly impaired extinction only for the 1.0-mg/kg dose: it prolonged the CPA fourfold longer than the vehicle and 0.5- and 1.5-mg/kg doses. These data suggest that both dose and route of Δ(9)-THC administration have important consequences for its pharmacokinetic and behavioural effects; specifically, pulmonary exposure at higher doses facilitates, whereas pulmonary and parenteral exposure at lower doses impairs, rates of extinction learning for CPA. Pulmonary-administered Δ(9)-THC may prove beneficial for potentiation of extinction learning for aversive memories, such as those supporting drug-craving/seeking in opiate withdrawal syndrome, and other causes of conditioned aversions, such as illness and stress.

Changes in Nutritional and Functional Status in Longer Stay Patients Admitted to a Geriatric Evaluation and Management Unit.

Science.gov (United States)

Whitley, A; Skliros, E; Graven, C; McIntosh, R; Lasry, C; Newsome, C; Bowie, A

2017-01-01

Malnutrition and functional decline are common in older inpatients admitted to subacute care settings. However the association between changes in nutritional status and relevant functional outcomes remains under-researched. This study examined changes in nutritional status, function and mobility in patients admitted to a Geriatric Evaluation and Management (GEM) unit who had a length of stay (LOS) longer than 21 days. A prospective, observational study. Two GEM units at St Vincent's Hospital Melbourne, Australia. Patients admitted to the GEM units who stayed longer than 21 days were included in the study. Patients were assessed on admission and prior to discharge using the Subjective Global Assessment (SGA), Functional Independence Measure (FIM) motor domain and the Modified Elderly Mobility Scale (MEMS). Fifty-nine patients (Mean age 84.0 ± 7 years) met the required length of stay and were included in the study. Fifty-four per cent (n=32) were malnourished on admission (SGA B/C) and 44% (n=26) were malnourished on discharge. Twenty-two per cent (n=13) improved SGA category, 75% remained stable (n=44) and 3% deteriorated (n=2) from admission to discharge. Total Motor FIM scores significantly increased from admission to discharge in both the improved (pnutritional status groups. Subjects who improved in nutritional status had a significantly higher MEMS score at discharge (pnutritional status at the time of discharge. Improvement in nutritional status was associated with greater improvement in mobility scores. Further studies are required to investigate the effectiveness of nutrition interventions, which will inform models of care aiming to optimise nutritional, functional, and associated clinical outcomes in patients admitted to GEM units.

Working Less and Living Longer: Long-Term Trends in Working Time and Time Budgets

OpenAIRE

Ausubel, J.H.; Grubler, A.

1994-01-01

Analyses of time series data beginning in the mid-nineteenth century in the industrialized nations, especially in the United Kingdom, show that on average people are working significantly less while living longer. Although the average career length has remained around 40 years, the total lifetime hours worked shrank for an average British worker from 124,000 hours in 1856 to 69,000 in 1981. The fraction of disposable lifetime hours spent working declined from 50% to 20%. The female share of c...

Comparative Effect of Graphic Organiser and Expository teaching ...

African Journals Online (AJOL)

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

Comparative study on the pathogenic effects of Diminazine ...

African Journals Online (AJOL)

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

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

African Journals Online (AJOL)

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

Comparing two books and establishing probably efficacious treatment for low sexual desire.

Science.gov (United States)

Balzer, Alexandra M; Mintz, Laurie B

2015-04-01

Using a sample of 45 women, this study compared the effectiveness of a previously studied (Mintz, Balzer, Zhao, & Bush, 2012) bibliotherapy intervention (Mintz, 2009), a similar self-help book (Hall, 2004), and a wait-list control (WLC) group. To examine intervention effectiveness, between and within group standardized effect sizes (interpreted with Cohen's, 1988 benchmarks .20 = small, .50 = medium, .80+ = large) and their confidence limits are used. In comparison to the WLC group, both interventions yielded large between-group posttest effect sizes on a measure of sexual desire. Additionally, large between-group posttest effect sizes were found for sexual satisfaction and lubrication among those reading the Mintz book. When examining within-group pretest to posttest effect sizes, medium to large effects were found for desire, lubrication, and orgasm for both books and for satisfaction and arousal for those reading the Mintz book. When directly comparing the books, all between-group posttest effect sizes were likely obtained by chance. It is concluded that both books are equally effective in terms of the outcome of desire, but whether or not there is differential efficacy in terms of other domains of sexual functioning is equivocal. Tentative evidence is provided for the longer term effectiveness of both books in enhancing desire. Arguing for applying criteria for empirically supported treatments to self-help, results are purported to establish the Mintz book as probably efficacious and to comprise a first step in this designation for the Hall book. (c) 2015 APA, all rights reserved).

Methodological Challenges in Studies Comparing Prehospital Advanced Life Support with Basic Life Support.

Science.gov (United States)

Li, Timmy; Jones, Courtney M C; Shah, Manish N; Cushman, Jeremy T; Jusko, Todd A

2017-08-01

Determining the most appropriate level of care for patients in the prehospital setting during medical emergencies is essential. A large body of literature suggests that, compared with Basic Life Support (BLS) care, Advanced Life Support (ALS) care is not associated with increased patient survival or decreased mortality. The purpose of this special report is to synthesize the literature to identify common study design and analytic challenges in research studies that examine the effect of ALS, compared to BLS, on patient outcomes. The challenges discussed in this report include: (1) choice of outcome measure; (2) logistic regression modeling of common outcomes; (3) baseline differences between study groups (confounding); (4) inappropriate statistical adjustment; and (5) inclusion of patients who are no longer at risk for the outcome. These challenges may affect the results of studies, and thus, conclusions of studies regarding the effect of level of prehospital care on patient outcomes should require cautious interpretation. Specific alternatives for avoiding these challenges are presented. Li T , Jones CMC , Shah MN , Cushman JT , Jusko TA . Methodological challenges in studies comparing prehospital Advanced Life Support with Basic Life Support. Prehosp Disaster Med. 2017;32(4):444-450.

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

Science.gov (United States)

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

2012-03-01

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

The influence of socio-economic characteristics, land use and travel time considerations on mode choice for medium- and longer-distance trips

OpenAIRE

Limtanakool, N.; Dijst, M.J.; Schwanen, T.

2006-01-01

This paper contributes to the limited number of investigations into the influence of the spatial configuration of land use and transport systems on mode choice for medium- and longer-distance travel (defined here as home-based trips of 50 km and over) in the Netherlands. We have employed data from the 1998 Netherlands National Travel Survey to address the question as to how socioeconomic factors, land use attributes, and travel time affect mode choice for medium- and longer-distance travel, a...

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

African Journals Online (AJOL)

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

A decision model to estimate the cost-effectiveness of intensity modulated radiation therapy (IMRT) compared to three dimensional conformal radiation therapy (3DCRT) in patients receiving radiotherapy to the prostate bed

International Nuclear Information System (INIS)

Carter, Hannah E.; Martin, Andrew; Schofield, Deborah; Duchesne, Gillian; Haworth, Annette; Hornby, Colin; Sidhom, Mark; Jackson, Michael

2014-01-01

Background: Intensity modulated radiation therapy (IMRT) is a radiation therapy technology that facilitates the delivery of an improved dose distribution with less dose to surrounding critical structures. This study estimates the longer term effectiveness and cost-effectiveness of IMRT in patients post radical prostatectomy. Methods: A Markov decision model was developed to calculate the incremental quality adjusted life years (QALYs) and costs of IMRT compared with three dimensional conformal radiation therapy (3DCRT). Costs were estimated from the perspective of the Australian health care system. Results: IMRT was both more effective and less costly than 3DCRT over 20 years, with an additional 20 QALYs gained and over $1.1 million saved per 1000 patients treated. This result was robust to plausible levels of uncertainty. Conclusions: IMRT was estimated to have a modest long term advantage over 3DCRT in terms of both improved effectiveness and reduced cost. This result was reliant on clinical judgement and interpretation of the existing literature, but provides quantitative guidance on the cost effectiveness of IMRT whilst long term trial evidence is awaited

Comparison of single questions and brief questionnaire with longer validated food frequency questionnaire to assess adequate fruit and vegetable intake.

Science.gov (United States)

Cook, Amelia; Roberts, Kia; O'Leary, Fiona; Allman-Farinelli, Margaret Anne

2015-01-01

The aim of this study was to determine if a single question (SQ) for fruit and a SQ or five-item questionnaire for vegetable consumption (VFQ) could replace a longer food frequency questionnaire (FFQ) to screen for inadequate versus adequate intakes in populations. Participants (109) completed three test screeners: fruit SQ, vegetable SQ, and a five-item VFQ followed by the reference 74-item FFQ (version 2 of the Dietary Questionnaire for Epidemiological Studies [DQESv2]) including 13 fruit and 25 vegetable items. The five-item VFQ asked about intake of salad vegetables, cooked vegetables, white potatoes, legumes, and vegetable juice. The screeners were compared with the reference (DQESv2 FFQ) for sensitivity, specificity, and positive and negative predictive powers (PPV, NPV) to detect intakes of two or more servings of fruit and three or more servings of vegetables. Relative validity was examined using Bland-Altman statistics. The fruit SQ showed a PPV of 56% and an NPV of 83%. The PPV for the vegetable SQ was 30% and the NPV was 89%. For the five-item VFQ, the PPV was 39% and the NPV was 85%. Bland-Altman plots and linear regression equations showed that although the screener showed good agreement for fruit (unstandardized b1 coefficient = 0.04) for vegetable intake the difference between methods increased at higher intake levels (unstandardized b1 coefficients = -0.3 for the SQ, b1 = -0.6 for five-item VFQ). The fruit SQ and the five-item VFQ are suitable replacements for longer FFQs to detect inadequate intake and assess population mean but not individual intakes. Copyright © 2015 Elsevier Inc. All rights reserved.

Genome sequence analysis of five Canadian isolates of strawberry mottle virus reveals extensive intra-species diversity and a longer RNA2 with increased coding capacity compared to a previously characterized European isolate.

Science.gov (United States)

Bhagwat, Basdeo; Dickison, Virginia; Ding, Xinlun; Walker, Melanie; Bernardy, Michael; Bouthillier, Michel; Creelman, Alexa; DeYoung, Robyn; Li, Yinzi; Nie, Xianzhou; Wang, Aiming; Xiang, Yu; Sanfaçon, Hélène

2016-06-01

In this study, we report the genome sequence of five isolates of strawberry mottle virus (family Secoviridae, order Picornavirales) from strawberry field samples with decline symptoms collected in Eastern Canada. The Canadian isolates differed from the previously characterized European isolate 1134 in that they had a longer RNA2, resulting in a 239-amino-acid extension of the C-terminal region of the polyprotein. Sequence analysis suggests that reassortment and recombination occurred among the isolates. Phylogenetic analysis revealed that the Canadian isolates are diverse, grouping in two separate branches along with isolates from Europe and the Americas.

Longer dialysis session length is associated with better intermediate outcomes and survival among patients on in-center three times per week hemodialysis: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS).

Science.gov (United States)

Tentori, Francesca; Zhang, Jinyao; Li, Yun; Karaboyas, Angelo; Kerr, Peter; Saran, Rajiv; Bommer, Juergen; Port, Friedrich; Akiba, Takashi; Pisoni, Ronald; Robinson, Bruce

2012-11-01

Longer dialysis session length (treatment time, TT) has been associated with better survival among hemodialysis (HD) patients. The impact of TT on clinical markers that may contribute to this survival advantage is not well known. Using data from the international Dialysis Outcomes and Practice Patterns Study, we assessed the association of TT with clinical outcomes using both standard regression analyses and instrumental variable approaches. The study included 37,414 patients on in-center HD three times per week with prescribed TT from 120 to 420 min. Facility mean TT ranged from 214 min in the USA to 256 min in Australia-New Zealand. Accounting for country effects, mortality risk was lower for patients with longer TT {hazard ratio for every 30 min: all-cause mortality: 0.94 [95% confidence interval (CI): 0.92-0.97], cardiovascular mortality: 0.95 (95% CI: 0.91-0.98) and sudden death: 0.93 (95% CI: 0.88-0.98)}. Patients with longer TT had lower pre- and post-dialysis systolic blood pressure, greater intradialytic weight loss, higher hemoglobin (for the same erythropoietin dose), serum albumin and potassium and lower serum phosphorus and white blood cell counts. Similar associations were found using the instrumental variable approach, although the positive associations of TT with weight loss and potassium were lost. Favorable levels of a variety of clinical markers may contribute to the better survival of patients receiving longer TT. These findings support longer TT prescription in the setting of in-center, three times per week HD.

Patients whose GP knows complementary medicine tend to have lower costs and live longer

NARCIS (Netherlands)

Kooreman, P.; Baars, E.

2012-01-01

Background Health economists have largely ignored complementary and alternative medicine (CAM) as an area of research, although both clinical experiences and several empirical studies suggest cost-effectiveness of CAM. Objective To explore the cost-effectiveness of CAM compared with conventional

Longer duration of obesity is associated with a reduction in urinary angiotensinogen in prepubertal children.

Science.gov (United States)

Morato, Manuela; Correia-Costa, Liane; Sousa, Teresa; Cosme, Dina; Schaefer, Franz; Areias, José Carlos; Guerra, António; Afonso, Alberto Caldas; Barros, Henrique; Azevedo, Ana; Albino-Teixeira, António

2017-08-01

We aimed to study the impact of obesity on urinary excretion of angiotensinogen (U-AGT) in prepubertal children, focusing on the duration of obesity and gender. Also, we aimed to evaluate whether plasma angiotensinogen (P-AGT) and hydrogen peroxide (H 2 O 2 ) play a role in the putative association. Cross-sectional evaluation of 305 children aged 8-9 years (160 normal weight, 86 overweight, and 59 obese). Anthropometric measurements and 24-h ambulatory blood pressure monitoring were performed. Angiotensinogen (AGT) was determined by a commercial enzyme-linked immunosorbent assay (ELISA) kit and H 2 O 2 by a microplate fluorometric assay. U-AGT and P-AGT levels were similar across body mass index (BMI) groups and between sexes. However, boys who were overweight/obese since the age of 4 years presented lower levels of U-AGT compared with those of normal weight at the same age. In children who were overweight/obese since the age of 4, urinary H 2 O 2 decreased with P-AGT. A higher duration of obesity was associated with decreased U-AGT in boys, thus reflecting decreased intrarenal activity of the renin-angiotensin system. Also, children with a longer duration of obesity showed an inverse association between urinary H 2 O 2 and P-AGT. Future studies should address whether these results reflect an early compensatory mechanism to limit obesity-triggered renal dysfunction.

Cost analysis of the Hemodialysis Reliable Outflow (HeRO) Graft compared to the tunneled dialysis catheter.

Science.gov (United States)

Al Shakarchi, Julien; Inston, Nicholas; Jones, Robert G; Maclaine, Grant; Hollinworth, David

2016-04-01

In end-stage renal disease patients with central venous obstruction, who have limited vascular access options, the Hemodialysis Reliable Outflow (HeRO) Graft is a new alternative with a lower incidence of complications and longer effective device life compared to tunneled dialysis catheters (TDCs). We undertook an economic analysis of introducing the HeRO Graft in the UK. A 1-year cost-consequence decision analytic model was developed comparing management with the HeRO Graft to TDCs from the perspective of the National Health Service in England. The model comprises four 3-month cycles during which the vascular access option either remains functional for hemodialysis or fails, patients can experience access-related infection and device thrombosis, and they can also accrue associated costs. Clinical input data were sourced from published studies and unit cost data from National Health Service 2014-15 Reference Costs. In the base case, a 100-patient cohort managed with the HeRO Graft experienced 6 fewer failed devices, 53 fewer access-related infections, and 67 fewer device thromboses compared to patients managed with TDCs. Although the initial device and placement costs for the HeRO Graft are greater than those for TDCs, savings from the lower incidence of device complications and longer effective device patency reduces these costs. Overall net annual costs are £2600 for each HeRO Graft-managed patient compared to TDC-managed patients. If the National Health Service were to reimburse hemodialysis at a uniform rate regardless of the type of vascular access, net 1-year savings of £1200 per patient are estimated for individuals managed with the HeRO Graft. The base case results showed a marginal net positive cost associated with vascular access with the HeRO Graft compared with TDCs for the incremental clinical benefit of reductions in patency failures, device-related thrombosis, and access-related infection events in a patient population with limited options for

Temporal event structure and timing in schizophrenia: preserved binding in a longer "now".

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Martin, Brice; Giersch, Anne; Huron, Caroline; van Wassenhove, Virginie

2013-01-01

Patients with schizophrenia experience a loss of temporal continuity or subjective fragmentation along the temporal dimension. Here, we develop the hypothesis that impaired temporal awareness results from a perturbed structuring of events in time-i.e., canonical neural dynamics. To address this, 26 patients and their matched controls took part in two psychophysical studies using desynchronized audiovisual speech. Two tasks were used and compared: first, an identification task testing for multisensory binding impairments in which participants reported what they heard while looking at a speaker's face; in a second task, we tested the perceived simultaneity of the same audiovisual speech stimuli. In both tasks, we used McGurk fusion and combination that are classic ecologically valid multisensory illusions. First, and contrary to previous reports, our results show that patients do not significantly differ from controls in their rate of illusory reports. Second, the illusory reports of patients in the identification task were more sensitive to audiovisual speech desynchronies than those of controls. Third, and surprisingly, patients considered audiovisual speech to be synchronized for longer delays than controls. As such, the temporal tolerance profile observed in a temporal judgement task was less of a predictor for sensory binding in schizophrenia than for that obtained in controls. We interpret our results as an impairment of temporal event structuring in schizophrenia which does not specifically affect sensory binding operations but rather, the explicit access to timing information associated here with audiovisual speech processing. Our findings are discussed in the context of curent neurophysiological frameworks for the binding and the structuring of sensory events in time. Copyright © 2012 Elsevier Ltd. All rights reserved.

A comparative study of spherical and flat-Earth geopotential modeling at satellite elevations

Science.gov (United States)

Parrott, M. H.; Hinze, W. J.; Braile, L. W.; Vonfrese, R. R. B.

1985-01-01

Flat-Earth modeling is a desirable alternative to the complex spherical-Earth modeling process. These methods were compared using 2 1/2 dimensional flat-earth and spherical modeling to compute gravity and scalar magnetic anomalies along profiles perpendicular to the strike of variably dimensioned rectangular prisms at altitudes of 150, 300, and 450 km. Comparison was achieved with percent error computations (spherical-flat/spherical) at critical anomaly points. At the peak gravity anomaly value, errors are less than + or - 5% for all prisms. At 1/2 and 1/10 of the peak, errors are generally less than 10% and 40% respectively, increasing to these values with longer and wider prisms at higher altitudes. For magnetics, the errors at critical anomaly points are less than -10% for all prisms, attaining these magnitudes with longer and wider prisms at higher altitudes. In general, in both gravity and magnetic modeling, errors increase greatly for prisms wider than 500 km, although gravity modeling is more sensitive than magnetic modeling to spherical-Earth effects. Preliminary modeling of both satellite gravity and magnetic anomalies using flat-Earth assumptions is justified considering the errors caused by uncertainties in isolating anomalies.

Effectiveness of Home-Based Cupping Massage Compared to Progressive Muscle Relaxation in Patients with Chronic Neck Pain—A Randomized Controlled Trial

Science.gov (United States)

Lauche, Romy; Materdey, Svitlana; Cramer, Holger; Haller, Heidemarie; Stange, Rainer; Dobos, Gustav; Rampp, Thomas

2013-01-01

Chronic neck pain is a major public health problem with very few evidence-based complementary treatment options. This study aimed to test the efficacy of 12 weeks of a partner-delivered home-based cupping massage, compared to the same period of progressive muscle relaxation in patients with chronic non-specific neck pain. Patients were randomly assigned to self-directed cupping massage or progressive muscle relaxation. They were trained and asked to undertake the assigned treatment twice weekly for 12 weeks. Primary outcome measure was the current neck pain intensity (0–100 mm visual analog scale; VAS) after 12 weeks. Secondary outcome measures included pain on motion, affective pain perception, functional disability, psychological distress, wellbeing, health-related quality of life, pressure pain thresholds and adverse events. Sixty one patients (54.1±12.7 years; 73.8%female) were randomized to cupping massage (n = 30) or progressive muscle relaxation (n = 31). After treatment, both groups showed significantly less pain compared to baseline however without significant group differences. Significant effects in favor of cupping massage were only found for wellbeing and pressure pain thresholds. In conclusion, cupping massage is no more effective than progressive muscle relaxation in reducing chronic non-specific neck pain. Both therapies can be easily used at home and can reduce pain to a minimal clinically relevant extent. Cupping massage may however be better than PMR in improving well-being and decreasing pressure pain sensitivity but more studies with larger samples and longer follow-up periods are needed to confirm these results. Trial Registration ClinicalTrials.gov NCT01500330 PMID:23762355

77 FR 39314 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of a Longer...

Science.gov (United States)

2012-07-02

...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Designation of a Longer Period for Commission Action on Proposed Rule Change To Establish ``Benchmark Orders'' Under NASDAQ Rule 4751(f) June 26, 2012. On May 1, 2012, The NASDAQ Stock Market LLC (``NASDAQ'' or ``Exchange'') filed with the...

Targeted treatment trials for tuberous sclerosis and autism: no longer a dream.

Science.gov (United States)

Sahin, Mustafa

2012-10-01

Genetic disorders that present with a high incidence of autism spectrum disorders (ASD) offer tremendous potential both for elucidating the underlying neurobiology of ASD and identifying therapeutic drugs and/or drug targets. As a result, clinical trials for genetic disorders associated with ASD are no longer a hope for the future but rather an exciting reality whose time has come. Tuberous sclerosis complex (TSC) is one such genetic disorder that presents with ASD, epilepsy, and intellectual disability. Cell culture and mouse model experiments have identified the mTOR pathway as a therapeutic target in this disease. This review summarizes the advantages of using TSC as model of ASD and the recent advances in the translational and clinical treatment trials in TSC. Copyright © 2012 Elsevier Ltd. All rights reserved.

Workflows and the Role of Images for Virtual 3d Reconstruction of no Longer Extant Historic Objects

Science.gov (United States)

Münster, S.

2013-07-01

3D reconstruction technologies have gained importance as tools for the research and visualization of no longer extant historic objects during the last decade. Within such reconstruction processes, visual media assumes several important roles: as the most important sources especially for a reconstruction of no longer extant objects, as a tool for communication and cooperation within the production process, as well as for a communication and visualization of results. While there are many discourses about theoretical issues of depiction as sources and as visualization outcomes of such projects, there is no systematic research about the importance of depiction during a 3D reconstruction process and based on empirical findings. Moreover, from a methodological perspective, it would be necessary to understand which role visual media plays during the production process and how it is affected by disciplinary boundaries and challenges specific to historic topics. Research includes an analysis of published work and case studies investigating reconstruction projects. This study uses methods taken from social sciences to gain a grounded view of how production processes would take place in practice and which functions and roles images would play within them. For the investigation of these topics, a content analysis of 452 conference proceedings and journal articles related to 3D reconstruction modeling in the field of humanities has been completed. Most of the projects described in those publications dealt with data acquisition and model building for existing objects. Only a small number of projects focused on structures that no longer or never existed physically. Especially that type of project seems to be interesting for a study of the importance of pictures as sources and as tools for interdisciplinary cooperation during the production process. In the course of the examination the authors of this paper applied a qualitative content analysis for a sample of 26 previously

Longer Lasting Bridge Deck Overlays

Science.gov (United States)

2018-04-01

The objective of this report is to determine the most effective method for bridge deck overlay construction and repair by assessing current practices; examining new products and technologies; and reviewing NCHRP (National Cooperative Highway Research...

Comparative effects of short- and long-term feeding of safflower oil and perilla oil on lipid metabolism in rats.

Science.gov (United States)

Ihara, M; Umekawa, H; Takahashi, T; Furuichi, Y

1998-10-01

Diets high in linoleic acid (20% safflower oil contained 77.3% linoleic acid, SO-diet) and alpha-linolenic acid (20% perilla oil contained 58.4% alpha-linolenic acid, PO-diet) were fed to rats for 3, 7, 20, and 50 days, and effects of the diets on lipid metabolism were compared. Levels of serum total cholesterol and phospholipids in the rats fed the PO-diet were markedly lower than those fed the SO-diet after the seventh day. In serum and hepatic phosphatidylcholine and phosphatidylethanolamine, the proportion of n-3 fatty acids showed a greater increase in the PO group than in the SO group in the respective feeding-term. At the third and seventh days after the commencement of feeding the experimental diets, expressions of hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase mRNA were significantly higher in the SO group than those in the PO group, although the difference was not observed in the longer term. There were no significant differences in the LDL receptor mRNA levels between the two groups through the experimental term, except 3-days feeding. These results indicate that alpha-linolenic acid has a more potent serum cholesterol-lowering ability than linoleic acid both in short and long feeding-terms.

[Comparing effectivity of VAC therapy for treatment of infections following arthroplasty or soft-tissue surgery].

Science.gov (United States)

Schmal, H; Oberst, M; Hansen, S; Six-Merker, J; Südkamp, N P; Izadpanah, K

2013-08-01

Although vacuum-assisted wound closure (VAC) has been developed into a standard technique in septic surgery, reliable data about the efficacy of the treatment are still lacking. Postoperative infections after arthroplasty or soft-tissue surgery were identified using a prospective database for complications (Critical Incidence Reporting System) which was retrospectively supplemented with items for evaluation of VAC therapy. Eradication success of infection was analysed considering epidemiological parameters, course of treatment, and characteristics of causing bacterial strains. Furthermore, serological C-reactive protein (CRP) concentrations were evaluated for diagnostic and prognostic reliability. 92 patients with an average age of 60 ± 4 years were included in the study. Patients with soft tissue infections (STI, n = 53) were statistically significant younger compared to patients with infections following arthroplasty (AI, n = 39) (53 ± 6 vs. 70 ± 4 years; p infected endoprostheses were longer treated on intensive care units (6.1 ± 8.4 vs. 3.5 ± 6.5 days; p infection was with 81 % statistically significant higher in the STI group compared to 38 % in the AI group (p infections in the AI group were associated with a better healing success when compared to chronic infections (p infections (p infection, the probability for eradication of infection was impaired (p infection was reached. CRP values were higher in the AI group and associated with the prognosis (p VAC therapy is higher after soft-tissue infections compared to infections following arthroplasty. Accordingly, mortality is higher in this group. Chronic courses have worse chances for healing in both groups. For serological CRP values a prognostic relevance could be shown. Georg Thieme Verlag KG Stuttgart · New York.

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

Directory of Open Access Journals (Sweden)

A. V. Pavlysh

2013-01-01

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

Effects of age on cognitive control during semantic categorization.

Science.gov (United States)

Mudar, Raksha A; Chiang, Hsueh-Sheng; Maguire, Mandy J; Spence, Jeffrey S; Eroh, Justin; Kraut, Michael A; Hart, John

2015-01-01

We used event-related potentials (ERPs) to study age effects of perceptual (basic-level) vs. perceptual-semantic (superordinate-level) categorization on cognitive control using the go/nogo paradigm. Twenty-two younger (11 M; 21 ± 2.2 years) and 22 older adults (9 M; 63 ± 5.8 years) completed two visual go/nogo tasks. In the single-car task (SiC) (basic), go/nogo responses were made based on single exemplars of a car (go) and a dog (nogo). In the object animal task (ObA) (superordinate), responses were based on multiple exemplars of objects (go) and animals (nogo). Each task consisted of 200 trials: 160 (80%) 'go' trials that required a response through button pressing and 40 (20%) 'nogo' trials that required inhibition/withholding of a response. ERP data revealed significantly reduced nogo-N2 and nogo-P3 amplitudes in older compared to younger adults, whereas go-N2 and go-P3 amplitudes were comparable in both groups during both categorization tasks. Although the effects of categorization levels on behavioral data and P3 measures were similar in both groups with longer response times, lower accuracy scores, longer P3 latencies, and lower P3 amplitudes in ObA compared to SiC, N2 latency revealed age group differences moderated by the task. Older adults had longer N2 latency for ObA compared to SiC, in contrast, younger adults showed no N2 latency difference between SiC and ObA. Overall, these findings suggest that age differentially affects neural processing related to cognitive control during semantic categorization. Furthermore, in older adults, unlike in younger adults, levels of categorization modulate neural processing related to cognitive control even at the early stages (N2). Published by Elsevier B.V.

Comparative Antitussive Effects of Medicinal Plants and Their Constituents.

Science.gov (United States)

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

2018-01-15

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

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

Science.gov (United States)

Cooke, Lynn Prince; Baxter, Janeen

2010-01-01

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

Comparative effectiveness of non-print media and live CME

Directory of Open Access Journals (Sweden)

Kuldeep Singh

2015-01-01

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

Comparative effectiveness research and medical informatics.

Science.gov (United States)

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

2010-12-01

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

Quality of care and its determinants in longer term mental health facilities across Europe; a cross-sectional analysis

NARCIS (Netherlands)

Killaspy, Helen; Cardoso, Graca; White, Sarah; Wright, Christine; Caldas de Almeida, Jose Miguel; Turton, Penny; Taylor, Tatiana L.; Schuetzwohl, Matthias; Schuster, Mirjam; Cervilla, Jorge A.; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Adamowski, Tomasz; Ploumpidis, Dimitris; Gonidakis, Fragiskos; King, Michael

2016-01-01

Background: The Quality Indicator for Rehabilitative Care (QuIRC) is an international, standardised quality tool for the evaluation of mental health facilities that provide longer term care. Completed by the service manager, it comprises 145 items that assess seven domains of care: living

Tetranectin positive expression in tumour tissue leads to longer survival in Danish women with ovarian cancer. Results from the 'Malova' ovarian cancer study

DEFF Research Database (Denmark)

Heeran, Mel C; Rask, Lene; Høgdall, Claus K

2015-01-01

of the disease. Using tissue arrays we analysed the expression levels in tissues from 166 women with borderline ovarian tumours (BOTs) and 592 women with ovarian cancer (OC). A panel of three antibodies was used for immunohistochemistry: a polyclonal and two monoclonal antibodies. Serum TN was measured using...... found to imply longer OS (p Kaplan-Meier survival analysis performed on all OC cases showed a significantly longer OS (p = 0...

Pharmacokinetics and Pharmacodynamics of Lisdexamfetamine Compared with D-Amphetamine in Healthy Subjects

Directory of Open Access Journals (Sweden)

Patrick C. Dolder

2017-09-01

Full Text Available Rationale: Lisdexamfetamine is a prodrug of D-amphetamine used for the treatment of attention-deficit/hyperactivity disorder (ADHD. Lisdexamfetamine is thought to have a prolonged pharmacokinetic profile compared with oral D-amphetamine, possibly associated with lower drug liking and a lower risk of oral misuse. However, differences in the pharmacokinetics and pharmacodynamics of lisdexamfetamine and D-amphetamine have not been directly compared.Methods: Equimolar doses of D-amphetamine (40 mg and lisdexamfetamine (100 mg, and placebo were administered in 24 healthy subjects in a randomized, double-blind, placebo-controlled, cross-over study. Plasma concentrations of amphetamine, subjective effects, and vital signs were repeatedly assessed. The pharmacokinetic parameters were determined using compartmental modeling.Results: The increase in plasma concentrations of amphetamine had a 0.6 ± 0.6 h (mean ± SD longer lag time and reached peak levels 1.1 ± 1.5 h later after lisdexamfetamine administration compared with D-amphetamine administration, but no differences in maximal concentrations or total exposure (AUC were found between the two treatments. Consistent with the pharmacokinetics, the subjective and cardiovascular stimulant effects of lisdexamfetamine also occurred later compared with D-amphetamine. However, no differences in peak ratings of potentially abuse-related subjective drug effects (e.g., drug liking, drug high, stimulation, happy, well-being, and self-confidence were observed after lisdexamfetamine administration compared with D-amphetamine administration. Lisdexamfetamine and D-amphetamine also produced similar peak increases in mean arterial blood pressure, heart rate, body temperature, pupil size, and adverse effects.Conclusion: The pharmacokinetics and pharmacodynamics of lisdexamfetamine are similar to D-amphetamine administered 1h later. Lisdexamfetamine is likely associated with a similar risk of oral abuse as D

The policy debate over public investment in comparative effectiveness research.

Science.gov (United States)

Rich, Eugene C

2009-06-01

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

Practitioner perspectives on strategies to promote longer-term benefits of acupuncture or counselling for depression: a qualitative study.

Directory of Open Access Journals (Sweden)

Hugh MacPherson

Full Text Available Non-pharmacological interventions for depression may help patients manage their condition. Evidence from a recent large-scale trial (ACUDep suggests that acupuncture and counselling can provide longer-term benefits for many patients with depression. This paper describes the strategies practitioners reported using to promote longer-term benefits for their patients.A qualitative sub-study of practitioners (acupuncturists and counsellors embedded in a randomised controlled trial. Using topic guides, data was collected from telephone interviews and a focus group, altogether involving 19 counsellors and 17 acupuncturists. Data were audio recorded, transcribed verbatim and analysed using thematic content analysis.For longer-term impact, both acupuncturists and counsellors encouraged insight into root causes of depression on an individual basis and saw small incremental changes as precursors to sustained benefit. Acupuncturists stressed the importance of addressing concurrent physical symptoms, for example helping patients relax or sleep better in order to be more receptive to change, and highlighted the importance of Chinese medicine theory-based lifestyle change for lasting benefit. Counsellors more often highlighted the importance of the therapeutic relationship, emphasising the need for careful "pacing" such that the process and tools employed were tailored and timed for each individual, depending on the "readiness" to change. Our data is limited to acupuncture practitioners using the principles of traditional Chinese medicine, and counsellors using a humanistic, non-directive and person-centred approach.Long-term change appears to be an important focus within the practices of both acupuncturists and counsellors. To achieve this, practitioners stressed the need for an individualised approach with a focus on root causes.

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

Science.gov (United States)

Osso, Diane; Kanani, Nehal

2013-02-01

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

42 CFR 60.59 - Records and Federal access after a school is no longer a HEAL school.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Records and Federal access after a school is no longer a HEAL school. 60.59 Section 60.59 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS HEALTH EDUCATION ASSISTANCE LOAN PROGRAM The School § 60.59 Records and Federal...

Infliximab effects compared to conventional therapy in the management of retinal vasculitis in Behçet disease.

Science.gov (United States)

Tabbara, Khalid F; Al-Hemidan, Amal I

2008-12-01

To assess the outcome of retinal vasculitis in patients with Behçet disease treated with infliximab compared to treatment with conventional therapy. Nonrandomized, retrospective comparative clinical study. Patients with Behçet disease with all four major criteria were included in this study. Patients had recurrent episodes of uveitis and retinal vasculitis. Thirty-three patients (Group 1) were treated with oral prednisone, cyclosporine, and azathioprine or methotrexate for a minimum period of three months. Ten patients (Group 2) who failed to respond to conventional therapy were given infliximab at a dose of 5 mg/kg in a single intravenous infusion on day 1 and every two weeks for a total of six doses. Patients were given the same treatment during each subsequent relapse. The main outcome measures were the number of relapses, visual outcome, and ocular complications. The mean follow-up period was 36 months in Group 1 and 30 months in Group 2. The mean number of relapses was significantly reduced and the duration of remission was longer in the infliximab therapy group compared to conventional therapy group (P < .0001). The visual acuity at 24 months follow-up was significantly better in patients treated with infliximab (Group 2) when compared to conventional therapy (Group 1) (P = .0059). Patients with Behçet disease had significant decrease in inflammation, improvement of visual acuity, and reduced ocular complications following infliximab when compared to conventional therapy. The number of relapses was less in the infliximab treatment group than the conventional therapy group.

Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression

NARCIS (Netherlands)

Murrough, James W.; Perez, Andrew M.; Pillemer, Sarah; Stern, Jessica; Parides, Michael K.; aan het Rot, Marije; Collins, Katherine A.; Mathew, Sanjay J.; Charney, Dennis S.; Iosifescu, Dan V.

2013-01-01

Background: Ketamine is reported to have rapid antidepressant effects; however, there is limited understanding of the time-course of ketamine effects beyond a single infusion. A previous report including 10 participants with treatment-resistant major depression (TRD) found that six ketamine

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

African Journals Online (AJOL)

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

Working (longer than) 9 to 5: are there cardiometabolic health risks for young Australian workers who report longer than 38-h working weeks?

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Reynolds, Amy C; Bucks, Romola S; Paterson, Jessica L; Ferguson, Sally A; Mori, Trevor A; McArdle, Nigel; Straker, Leon; Beilin, Lawrence J; Eastwood, Peter R

2018-05-01

The average Australian working week in middle-aged and older workers exceeds government recommendations. Long working weeks are associated with poor health outcomes; however, the relationship between long working weeks and health in young Australian workers is unknown. Data were drawn from the 22-year follow-up of the Western Australian Pregnancy Cohort (Raine) Study in Perth, Western Australia. Information was available from 873 young adults about working hours per week, shift work and sleep duration. Blood samples provided measures of cardiometabolic risk (CMR) factors. Almost one-third (32.8%) of young workers reported > 38 h working weeks. This was commonly reported in mining and construction industries for males; health and social assistance, mining and retail trade industries for females. CMR factors including increased waist circumference, higher fasting plasma glucose and reduced HDL cholesterol were associated with > 38 h working weeks. These relationships were not moderated by gender or by BMI for glucose and HDL cholesterol. Total sleep time was significantly lower in both male and female workers reporting > 38 h working weeks, but did not mediate the relationships seen with CMR factors. These findings point to early associations between > 38 h working weeks and CMR risk, and highlight the potential benefit of making young employees aware of the health associations with working arrangements to reduce the longer-term relationships seen with working hours and poor cardiometabolic health in population studies.

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

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

2012-05-01

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

Needle Decompression in Appalachia Do Obese Patients Need Longer Needles?

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Carter, Thomas Edward

2013-11-01

Full Text Available Introduction: Needle decompression of a tension pneumothorax can be a lifesaving procedure. It requires an adequate needle length to reach the chest wall to rapidly remove air. With adult obesity exceeding one third of the United States population in 2010, we sought to evaluate the proper catheter length that may result in a successful needle decompression procedure. Advance Trauma Life Support (ATLS currently recommends a 51 millimeter (mm needle, while the needles stocked in our emergency department are 46 mm. Given the obesity rates of our patient population, we hypothesize these needles would not have a tolerable success rate of 90%. Methods: We retrospectively reviewed 91 patient records that had computed tomography of the chest and measured the chest wall depth at the second intercostal space bilaterally. Results: We found that 46 mm needles would only be successful in 52.7% of our patient population, yet the ATLS recommended length of 51 mm has a success rate of 64.8%. Therefore, using a 64 mm needle would be successful in 79% percent of our patient population. Conclusion: Use of longer length needles for needle thoracostomy is essential given the extent of the nation’s adult obesity population. [West J Emerg Med. 2013;14(6:650-652.

Delayed hippocampal neuronal death in young gerbil following transient global cerebral ischemia is related to higher and longer-term expression of p63 in the ischemic hippocampus

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Eun Joo Bae

2015-01-01

Full Text Available The tumor suppressor p63 is one of p53 family members and plays a vital role as a regulator of neuronal apoptosis in the development of the nervous system. However, the role of p63 in mature neuronal death has not been addressed yet. In this study, we first compared ischemia-induced effects on p63 expression in the hippocampal regions (CA1- 3 between the young and adult gerbils subjected to 5 minutes of transient global cerebral ischemia. Neuronal death in the hippocampal CA1 region of young gerbils was significantly slow compared with that in the adult gerbils after transient global cerebral ischemia. p63 immunoreactivity in the hippocampal CA1 pyramidal neurons in the sham-operated young group was significantly low compared with that in the sham-operated adult group. p63 immunoreactivity was apparently changed in ischemic hippocampal CA1 pyramidal neurons in both ischemia-operated young and adult groups. In the ischemia-operated adult groups, p63 immunoreactivity in the hippocampal CA1 pyramidal neurons was significantly decreased at 4 days post-ischemia; however, p63 immunoreactivity in the ischemia-operated young group was significantly higher than that in the ischemia-operated adult group. At 7 days post-ischemia, p63 immunoreactivity was decreased in the hippocampal CA1 pyramidal neurons in both ischemia-operated young and adult groups. Change patterns of p63 level in the hippocampal CA1 region of adult and young gerbils after ischemic damage were similar to those observed in the immunohistochemical results. These findings indicate that higher and longer-term expression of p63 in the hippocampal CA1 region of the young gerbils after ischemia/reperfusion may be related to more delayed neuronal death compared to that in the adults.

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

African Journals Online (AJOL)

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

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

African Journals Online (AJOL)

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

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

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

2017-01-01

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

Poststroke Trajectories: The Process of Recovery Over the Longer Term Following Stroke.

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Hawkins, Rebecca J; Jowett, Adam; Godfrey, Mary; Mellish, Kirste; Young, John; Farrin, Amanda; Holloway, Ivana; Hewison, Jenny; Forster, Anne

2017-01-01

We adopted a grounded theory approach to explore the process of recovery experienced by stroke survivors over the longer term who were living in the community in the United Kingdom, and the interacting factors that are understood to have shaped their recovery trajectories. We used a combination of qualitative methods. From the accounts of 22 purposively sampled stroke survivors, four different recovery trajectories were evident: (a) meaningful recovery, (b) cycles of recovery and decline, (c) ongoing disruption, (d) gradual, ongoing decline. Building on the concept of the illness trajectory, our findings demonstrate how multiple, interacting factors shape the process and meaning of recovery over time. Such factors included conception of recovery and meanings given to the changing self, the meanings and consequences of health and illness experiences across the life course, loss, sense of agency, and enacting relationships. Awareness of the process of recovery will help professionals better support stroke survivors.

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

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Schwartz, Carolyn E; Patrick, Donald L

2014-07-01

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

Mechanistic Evaluation of Motion in Redox-Driven Rotaxanes Reveals Longer Linkers Hasten Forward Escape's and Hinder Backward Translations

DEFF Research Database (Denmark)

Andersen, S. S.; Share, A. I.; Poulsen, B. L.

2014-01-01

temperatures to provide activation enthalpies (Delta H-double dagger) and entropies (Delta S-double dagger). Longer glycol linkers led to modest increases in the forward escape (t(1/2) = 60 to 69 s); though not because of a diffusive walk. The reduced rate of motion backward depended on folded structures...

[Study on relationship of dose-effect and time-effect of APA microencapsulated bovine chromaffin cells on pain treatment].

Science.gov (United States)

Hui, Jianfeng; Li, Tao; Du, Zhi; Song, Jichang

2011-12-01

This study was to investigate the relationship of dose-effect and time-effect of Alginate-Polylysine-Alginate (APA) microencapsulated bovine chromaffin cells on the treatment of pain model rats. Using a rat model of painful peripheral neuropathy, the antinociceptive effects of APA microencapsulated bovine cells transplanted into the subarachnoid space was evaluated by cold allodynia test and hot hyperalgesia test. Compared with control group, the withdrawal difference with cell number 50 thousands groups, 100 thousands groups and 200 thousands groups was reduced (P APA microencapsulated bovine chromaffin cells which were transplanted to treat pain model rats, and the effective antinociception remained longer than 12 weeks.

Comparative effectiveness of different types of cervical laminoplasty.

Science.gov (United States)

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

2013-10-01

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

Comparative effectiveness of ceramic-on-ceramic implants in stemmed hip replacement: a multinational study of six national and regional registries.

Science.gov (United States)

Sedrakyan, Art; Graves, Stephen; Bordini, Barbara; Pons, Miquel; Havelin, Leif; Mehle, Susan; Paxton, Elizabeth; Barber, Thomas; Cafri, Guy

2014-12-17

ratio] = 0.73, 95% CI [confidence interval] = 0.60 to 0.88, p = 0.001). Use of smaller-head-size ceramic-on-ceramic bearings was associated with a higher risk of failure compared with metal-on-HXLPE bearings (HR = 1.36, 95% CI = 1.09 to 1.68, p = 0.006). Use of large-head-size ceramic-on-ceramic bearings was associated with a small protective effect relative to metal-on-HXLPE bearings (not subdivided by head size) in years zero to two, but this difference dissipated over the longer term. Our multinational study based on a harmonized, distributed network showed that use of ceramic-on-ceramic implants with a smaller head size in total hip arthroplasty without cement was associated with a higher risk of revision compared with metal-on-HXLPE and >28-mm ceramic-on-ceramic implants. These findings warrant careful reflection by regulatory and clinical communities and wide dissemination to patients for informed decision-making regarding such surgery. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Comparative effectiveness of everolimus-based therapy versus endocrine monotherapy among postmenopausal women with HR+/HER2- metastatic breast cancer: a retrospective chart review in community oncology practices in the US.

Science.gov (United States)

Xie, Jipan; Hao, Yanni; Li, Nanxin; Lin, Peggy L; Ohashi, Erika; Koo, Valerie; Signorovitch, James E; Wu, Eric Q; Yardley, Denise A

2015-06-01

Everolimus-based therapy and endocrine monotherapy are used among postmenopausal women with hormone receptor-positive human epidermal growth factor receptor-2 negative (HR+/HER2-) metastatic breast cancer (mBC) whose disease progressed or recurred on a non-steroidal aromatase inhibitor (NSAI). However, limited evidence exists regarding the real-world comparative effectiveness of these agents. This retrospective chart review examined postmenopausal HR+/HER2- mBC patients in community-based oncology practices who received everolimus-based therapy or endocrine monotherapy (index therapy) as any line of therapy for mBC between 1 July 2012 and 15 April 2013 after NSAI failure. Time on treatment (TOT), progression-free survival (PFS), and time to chemotherapy (TTC) from index therapy initiation were compared using Kaplan-Meier analyses and Cox proportional hazards models adjusting for baseline characteristics. A total of 243 and 270 patients received everolimus-based therapy or endocrine monotherapy in a quota-based sample. Patients treated with everolimus-based therapy had a higher proportion of visceral metastases, high tumor burden, and use of prior chemotherapies for mBC. After adjusting for baseline characteristics, everolimus-based therapy was associated with significantly longer TOT (HR = 0.67, 95% CI: 0.51-0.87) and PFS (HR = 0.75, 95% CI: 0.57-0.98) than endocrine monotherapy. No significant difference was found between everolimus-based therapy and endocrine monotherapy in TTC (HR = 0.81, 95% CI: 0.52-1.27). Results stratified by line of therapy were generally consistent with the overall results. Limitations include recall and information bias with potentially absent or erroneous chart data, unobserved factors due to non-randomization, inability to measure outcome assessments paired with measuring outcomes prior to exposures, and potential patient selection bias associated with chart review. Among a nationwide sample of postmenopausal HR+/HER2- m

Hypotensive effects of resistance exercise with continuous and intermittent blood flow restriction

Directory of Open Access Journals (Sweden)

Gabriel Rodrigues Neto

Full Text Available Abstract The aim of this study was to compare the acute effects of low-intensity (LI resistance exercise (RE with continuous blood flow restriction (CBFR and intermittent blood flow restriction (IBFR on systolic blood pressure (SBP, diastolic blood pressure (DBP, and mean arterial pressure (MAP. After a one-repetition maximum test, 10 normotensive recreationally trained men performed three experimental protocols. In the three RE protocols, increases in SBP, DBP, and MAP were observed immediately after exercise, but the effect sizes (ESs were greater for the LI + CBFR and high-intensity protocols. There were hypotensive effects on SBP, DBP, and MAP in all three protocols; however, the effects on MAP lasted longer for the LI + IBFR and LI + CBFR protocols. These long-lasting hypotensive effects on DBP and MAP occurred in all three protocols. Thus, we conclude that the post exercise hypotensive effects on SBP, DBP, and MAP appear to occur in all three RE protocols, with the effect on SBP being longer in the LI + IBFR and LI + CBFR protocols.

Longer epilepsy duration and multiple lobe involvement predict worse seizure outcomes for patients with refractory temporal lobe epilepsy associated with neurocysticercosis

Directory of Open Access Journals (Sweden)

Lucas Crociati Meguins

2015-12-01

Full Text Available ABSTRACT Objective To investigate the surgical outcomes of temporal lobe epilepsy associated with hippocampal sclerosis (TLE-HS and neurocysticercosis (NCC. Methods A retrospective investigation of patients with TLE-HS was conducted in a tertiary center. Results Seventy-nine (62.2%, 37 (29.1%, 6 (4.7%, and 5 (3.9% patients were Engel class I, II, III, and IV, respectively. Fifty-two (71.2% patients with epilepsy durations ≤ 10 years prior to surgery were seizure-free 1 year after the operation compared to 27 (50.0% patients with epilepsy durations > 10 years (p = 0.0121. Forty-three (72.9% patients with three or fewer lobes affected by NCC were seizure-free one year after the operation, and 36 (52.9% patients with more than three involved lobes were seizure-free after surgery (p = 0.0163. Conclusions Longer epilepsy durations and multiple lobe involvement predicted worse seizure outcomes in TLE-HS plus NCC patients.

Simulating changes to emergency care resources to compare system effectiveness.

Science.gov (United States)

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

2013-08-01

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

Comparative analysis of the effectiveness of measures to protect the public from radiation following the Kyshtym accident

International Nuclear Information System (INIS)

Romanov, G.N.; Buldakov, L.A.; Shvedov, V.L.

1991-01-01

The formation of the Eastern Urals radioactive trail meant it was necessary to take a series of urgent and planned measures to protect the public from radiation. The urgent protective measures included evacuation in the first 7-10 days of 1 100 people from the four villages nearest to the plant, since their external irradiation dose might have exceeded 100 rem in the first month. This evacuation, which later proved to be resettlement, prevented 91% of the potential 30-year dose. Parallel to this, the population was subjected to a number of hygiene measures, and dosimetric monitoring was introduced. Given that 90 Sr played the leading radiological role, a 90 Sr contamination limit of 2 Ci/km 2 was introduced for the area, and higher levels required implementation of longer-term measures to protect the populace from radiation. Such longer-term measures included monitoring radioactive contamination of produce and agricultural products, their rejection and replacement by non-contaminated produce, restricting public access, banning economic activity, and decontamination of rural populated areas/arable land. Rejection and replacement of produce came late, were difficult to implement and had little effect on reducing 90 Sr intake via food. For this reason, the longer-term measures included subsequent, additional resettlement of 9 600 people from a further 19 villages some 250-670 days after the accident. This measure prevented 20-38% of the potential 30-year dose, and from a modern radiological point of view was not wholly justified. Protection of the non-evacuated population exposed to contamination below 2 Ci 90 Sr per km 2 mainly involved reducing the 90 Sr concentration in the milk of cows belonging to the rural populace, this being achieved by banning the use of natural pastures and hay meadows. This measure reduced by a factor of 2 the 90 Sr intake into humans. Agricultural production was restored in areas with contamination levels ranging from 2 to 100 Ci 90 Sr per

Value-based medicine, comparative effectiveness, and cost-effectiveness analysis of topical cyclosporine for the treatment of dry eye syndrome.

Science.gov (United States)

Brown, Melissa M; Brown, Gary C; Brown, Heidi C; Peet, Jonathan; Roth, Zachary

2009-02-01

To assess the comparative effectiveness and cost-effectiveness (cost-utility) of a 0.05% emulsion of topical cyclosporine (Restasis; Allergan Inc, Irvine, California) for the treatment of moderate to severe dry eye syndrome that is unresponsive to conventional therapy. Data from 2 multicenter, randomized, clinical trials and Food and Drug Administration files for topical cyclosporine, 0.05%, emulsion were used in Center for Value-Based Medicine analyses. Analyses included value-based medicine as a comparative effectiveness analysis and average cost-utility analysis using societal and third-party insurer cost perspectives. Outcome measures of comparative effectiveness were quality-adjusted life-year (QALY) gain and percentage of improvement in quality of life, and for cost-effectiveness were cost-utility ratio (CUR) using dollars per QALY. Topical cyclosporine, 0.05%, confers a value gain (comparative effectiveness) of 0.0319 QALY per year compared with topical lubricant therapy, a 4.3% improvement in quality of life for the average patient with moderate to severe dry eye syndrome that is unresponsive to conventional lubricant therapy. The societal perspective incremental CUR for cyclosporine over vehicle therapy is $34,953 per QALY and the societal perspective average CUR is $11,199 per QALY. The third-party-insurer incremental CUR is $37,179 per QALY, while the third-party-insurer perspective average CUR is $34,343 per QALY. Topical cyclosporine emulsion, 0.05%, confers considerable patient value and is a cost-effective therapy for moderate to severe dry eye syndrome that is unresponsive to conventional therapy.

On the Nonsymmetric Longer Queue Model: Joint Distribution, Asymptotic Properties, and Heavy Traffic Limits

Directory of Open Access Journals (Sweden)

Charles Knessl

2013-01-01

Full Text Available We consider two parallel queues, each with independent Poisson arrival rates, that are tended by a single server. The exponential server devotes all of its capacity to the longer of the queues. If both queues are of equal length, the server devotes ν of its capacity to the first queue and the remaining 1−ν to the second. We obtain exact integral representations for the joint probability distribution of the number of customers in this two-node network. Then we evaluate this distribution in various asymptotic limits, such as large numbers of customers in either/both of the queues, light traffic where arrivals are infrequent, and heavy traffic where the system is nearly unstable.

Improving performance management for delivering appropriate care for patients no longer needing acute hospital care.

Science.gov (United States)

Penney, Christine; Henry, Effie

2008-01-01

The public, providers and policy-makers are interested in a service continuum where care is provided in the appropriate place. Alternate level of care is used to define patients who no longer need acute care but remain in an acute care bed. Our aims were to determine how subacute care and convalescent care should be defined in British Columbia (BC); how these care levels should be aligned with existing legislation to provide more consistent service standards to patients and what reporting requirements were needed for system planning and performance management. A literature review was conducted to understand the international trends in performance management, care delivery models and change management. A Canada-wide survey was carried out to determine the directions of other provinces on the defined issues and a BC survey provided a current state analysis of programming within the five regional health authorities (HAs). A provincial policy framework for subacute and convalescent care has been developed to begin to address the concerns raised and provide a base for performance measurement. The policy has been approved and disseminated to BC HAs for implementation. An implementation plan has been developed and implementation activities have been integrated into the work of existing provincial committees. Evaluation will occur through performance measurement. The benefits anticipated include: clear policy guidance for programme development; improved comparability of performance information for system monitoring, planning and integrity of the national acute care Discharge Abstracting Database; improved efficiency in acute care bed use; and improved equity of access, insurability and quality for patients requiring subacute and convalescent care. While a national reporting system exists for acute care in Canada, this project raises questions about the implications for this system, given the shifting definition of acute care as other care levels emerge. Questions are also

Optional part-time and longer GP training modules in GP practices associated with more trainees becoming GPs - a cohort study in Switzerland.

Science.gov (United States)

Studerus, Lara; Ahrens, Regina; Häuptle, Christian; Goeldlin, Adrian; Streit, Sven

2018-01-05

these modules effectively encourage the interests of those already inclined towards the GP specialty. Longer GP training modules and more opportunities for part-time training may attract and retain more interested trainees, and possibly increase the number of practicing GPs.

Out of Unemployment? A Comparative Analysis of the Risks and Opportunities Longer-Term Unemployed Immigrant Youth Face when Entering the Labour Market

Science.gov (United States)

Malmberg-Heimonen, Ira; Julkunen, Ilse

2006-01-01

Because of high unemployment rates among youth in Europe, comparative research has focused on identification of those risks and opportunities associated with the integration process from unemployment to work. The integration process of immigrant youth, however, received much less attention, despite their initially higher risk of unemployment than…

Neon soft x-ray emission studies from the UNU-ICTP plasma focus operated with longer than optimal anode length

International Nuclear Information System (INIS)

Mohammadi, M A; Verma, R; Sobhanian, S; Wong, C S; Lee, S; Springham, S V; Tan, T L; Lee, P; Rawat, R S

2007-01-01

The UNU-ICTP plasma focus with a significantly longer than conventional anode can still be a reasonably good neon soft x-ray (SXR) source. The highest average neon SXR yield of 3.3 J was achieved at 3 mbar. The time difference between the two first peaks of the voltage probe signal at the radial collapse phase was found to be inversely related to the SXR yield, i.e. the smaller the time difference, the higher the yield and vice versa. The estimation of average current sheath speeds using the shadowgraphic method coupled with laser and focus peak timing signals showed that the average axial rundown speed is similar to the one obtained for the optimal anode length but the average radial compression speed is decreased significantly. The range of pressure for a good neon SXR yield, however, has become much narrower, making efficient plasma focus operation a very sensitive function of the filling gas pressure for longer than the optimal anode length

Determinants of longer job tenure among home care aides: what makes some stay on the job while others leave?

Science.gov (United States)

Butler, Sandra S; Brennan-Ing, Mark; Wardamasky, Sara; Ashley, Alison

2014-03-01

An inadequate supply of direct care workers and a high turnover rate in the workforce has resulted in a "care gap" in our long-term care system. As people are increasingly choosing community-based care, retention of home care workers is particularly important. The mixed-method study described herein explored determinants of longer job tenure for home care aides (n = 261). Study participants were followed for 18 months, completing two mail surveys and one telephone interview each. Predictors of longer job tenure included older age, living rurally, lower physical function, higher wages, a greater sense of autonomy on the job, and less frequent feelings of personal accomplishment. Thematic analysis of telephone interviews revealed long-term stayers to be less concerned about low wages and inconsistent hours than those who left their jobs within a year; both groups of workers reported high levels of job satisfaction. Policy implications of study findings are discussed.

Effects of chemesthetic stimuli mixtures with barium on swallowing apnea duration.

Science.gov (United States)

Todd, J Tee; Butler, Susan G; Plonk, Drew P; Grace-Martin, Karen; Pelletier, Cathy A

2012-10-01

This study tested the hypotheses that swallowing apnea duration (SAD) will increase given barium versus water, chemesthetic stimuli (i.e., water barium, age (older > younger), and genetic taste differences (supertasters > nontasters). Prospective group design. University Medical Center. Eighty healthy women were identified as nontasters and supertasters, equally comprising two age groups: 18 to 35 years and 60+ years. The KayPentax Swallowing Signals Lab was used to acquire SAD via nasal cannula during individually randomized swallows of 5 mL barium, 2.7% w/v citric acid with barium, carbonation with barium, and 50:50 diluted ethanol with barium. Data were analyzed using path analysis, with the mediator of chemesthetic perception, adjusted for repeated measures. Significant main effects of age (P = .012) and chemesthetic stimuli (P = .014) were found, as well as a significant interaction between chemesthetic stimuli and age (P = .028). Older women had a significantly longer SAD than younger women. Post hoc analyses revealed that barium mixed with ethanol elicited a significantly longer SAD than other bolus conditions, regardless of age group. There were no significant differences in SAD between barium and water conditions, and no significant effect of chemesthetic perception (P > .05). Ethanol added to barium elicited longer SAD compared to plain barium, but not the other chemesthetic conditions. Older women had a longer SAD than younger women in all conditions. These findings may influence design of future studies examining effects of various stimuli on SAD. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Comparing fixed effects and covariance structure estimators for panel data

DEFF Research Database (Denmark)

Ejrnæs, Mette; Holm, Anders

2006-01-01

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

A comparative study of contractility of the heart ventricle in some ectothermic vertebrates

Directory of Open Access Journals (Sweden)

Sergey Kharin

2009-07-01

Full Text Available The purpose of this study was to analyze contractility of the heart ventricle in selected reptilian and amphibian species having the same ventricular excitation pattern. Systolic time intervals and indices of contractility of the heart ventricle were measured in anaesthetized frogs, snakes, and tortoises by use of polycardiography. The electromechanical delay was significantly shorter in tortoises compared with the other two species. The isovolumetric contraction time in frogs was approximately twofold longer than in reptiles. The pre-ejection period was the longest in frogs and the shortest in tortoises, whereas snakes were intermediate. The ejection time was slightly longer in tortoises compared with the other two species. The greatest isovolumetric contraction index and the smallest myocardial tension index corresponded to the frog and tortoise heart ventricle, respectively. The intrasystolic index in tortoises was significantly greater than in frogs, whereas quite similar to that in snakes. The frog ventricle had lower contractility compared with the reptilian one. Although ventricular contractility tended to be lower in snakes compared with tortoises, this difference was not statistically significant. Possible causes for these differences are discussed. We suppose a large variety in ventricular contractility among amphibian and reptilian species having the same ventricular activation pattern. This variety may be conditioned by heart anatomy, intracardiac shunting, lifestyles, and habitats. It can only be hypothesized that on the average, ventricular contractility is higher in reptiles compared with amphibians and in chelonians compared with snakes.

Comparative analyses of longevity and senescence reveal variable survival benefits of living in zoos across mammals.

Science.gov (United States)

Tidière, Morgane; Gaillard, Jean-Michel; Berger, Vérane; Müller, Dennis W H; Bingaman Lackey, Laurie; Gimenez, Olivier; Clauss, Marcus; Lemaître, Jean-François

2016-11-07

While it is commonly believed that animals live longer in zoos than in the wild, this assumption has rarely been tested. We compared four survival metrics (longevity, baseline mortality, onset of senescence and rate of senescence) between both sexes of free-ranging and zoo populations of more than 50 mammal species. We found that mammals from zoo populations generally lived longer than their wild counterparts (84% of species). The effect was most notable in species with a faster pace of life (i.e. a short life span, high reproductive rate and high mortality in the wild) because zoos evidently offer protection against a number of relevant conditions like predation, intraspecific competition and diseases. Species with a slower pace of life (i.e. a long life span, low reproduction rate and low mortality in the wild) benefit less from captivity in terms of longevity; in such species, there is probably less potential for a reduction in mortality. These findings provide a first general explanation about the different magnitude of zoo environment benefits among mammalian species, and thereby highlight the effort that is needed to improve captive conditions for slow-living species that are particularly susceptible to extinction in the wild.

Perceived duration of emotional events: evidence for a positivity effect in older adults.

Science.gov (United States)

Nicol, Jeffrey R; Tanner, Jessica; Clarke, Kelly

2013-01-01

BACKGROUND/STUDY CONTEXT: Arousal and negative affect modulate the effect of emotion on the subjective experience of the passage of time. Given that older adults are less aroused by negative emotional stimuli, and report lower levels of negative affect, compared with younger adults, the present study examined whether the effect of emotion on time perception differed in older and younger adults. Participants performed a temporal bisection task for emotional (i.e., angry, sad, happy) and neutral facial expressions presented at varying temporal intervals. Older adults perceived the duration of both positive and threatening events longer than neutral events, whereas younger adults only perceived threatening events longer than neutral events. The results, which are partially consistent with the positivity effect of aging postulated by the socioemotional selectivity theory, are the first to show how the effect of emotion on perceived duration affects older adults, and support previous research indicating that only threatening events prolong perceived duration in younger adults.

Extension of the energy range of the experimental activation cross-sections data of longer-lived products of proton induced nuclear reactions on dysprosium up to 65MeV.

Science.gov (United States)

Tárkányi, F; Ditrói, F; Takács, S; Hermanne, A; Ignatyuk, A V

2015-04-01

Activation cross-sections data of longer-lived products of proton induced nuclear reactions on dysprosium were extended up to 65MeV by using stacked foil irradiation and gamma spectrometry experimental methods. Experimental cross-sections data for the formation of the radionuclides (159)Dy, (157)Dy, (155)Dy, (161)Tb, (160)Tb, (156)Tb, (155)Tb, (154m2)Tb, (154m1)Tb, (154g)Tb, (153)Tb, (152)Tb and (151)Tb are reported in the 36-65MeV energy range, and compared with an old dataset from 1964. The experimental data were also compared with the results of cross section calculations of the ALICE and EMPIRE nuclear model codes and of the TALYS nuclear reaction model code as listed in the latest on-line libraries TENDL 2013. Copyright © 2015. Published by Elsevier Ltd.

Practical guide to understanding Comparative Effectiveness Research (CER).

Science.gov (United States)

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

2013-12-01

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

Do Longer Intervals between Challenges Reduce the Risk of Adverse Reactions in Oral Wheat Challenges?

Directory of Open Access Journals (Sweden)

Noriyuki Yanagida

Full Text Available The use of oral food challenges (OFCs in clinics is limited because they are complicated and associated with anaphylactic symptoms. To increase their use, it is necessary to develop novel, effective, and safe methods. However, the effectiveness of different OFCs has not been compared.To investigate the effect of ingestion methods on wheat allergy symptoms and treatment during OFCs.Without changing the total challenge dose, we changed the administration method from a 5-installment dose titration every 15 min (15-min interval method to 3 installments every 30 min (30-min interval method. We retrospectively reviewed and compared the results of 65 positive 15-min interval wheat challenge tests conducted between July 2005 and February 2008 and 87 positive 30-min interval tests conducted between March 2008 and December 2009.A history of immediate symptoms was more common for the 30-min interval method; however, no difference between methods was observed in other background parameters. Switching from the 15-min to the 30-min interval method did not increase symptoms or require treatment. The rate of cardiovascular symptoms (p = 0.032, and adrenaline use (p = 0.017 was significantly lower with the 30-min interval method. The results did not change after adjusting for the effects of immediate symptom history in multivariate analysis.This study suggests that the 30-min interval method reduces the risk of adverse events, compared to the 15-min interval method.

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

International Nuclear Information System (INIS)

Kim, Kil Yoo; Kim, Tae Woon

2007-01-01

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

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

Science.gov (United States)

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

2018-02-01

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

Cost and cost effectiveness of long-lasting insecticide-treated bed nets - a model-based analysis

Directory of Open Access Journals (Sweden)

Pulkki-Brännström Anni-Maria

2012-04-01

Full Text Available Abstract Background The World Health Organization recommends that national malaria programmes universally distribute long-lasting insecticide-treated bed nets (LLINs. LLINs provide effective insecticide protection for at least three years while conventional nets must be retreated every 6-12 months. LLINs may also promise longer physical durability (lifespan, but at a higher unit price. No prospective data currently available is sufficient to calculate the comparative cost effectiveness of different net types. We thus constructed a model to explore the cost effectiveness of LLINs, asking how a longer lifespan affects the relative cost effectiveness of nets, and if, when and why LLINs might be preferred to conventional insecticide-treated nets. An innovation of our model is that we also considered the replenishment need i.e. loss of nets over time. Methods We modelled the choice of net over a 10-year period to facilitate the comparison of nets with different lifespan (and/or price and replenishment need over time. Our base case represents a large-scale programme which achieves high coverage and usage throughout the population by distributing either LLINs or conventional nets through existing health services, and retreats a large proportion of conventional nets regularly at low cost. We identified the determinants of bed net programme cost effectiveness and parameter values for usage rate, delivery and retreatment cost from the literature. One-way sensitivity analysis was conducted to explicitly compare the differential effect of changing parameters such as price, lifespan, usage and replenishment need. Results If conventional and long-lasting bed nets have the same physical lifespan (3 years, LLINs are more cost effective unless they are priced at more than USD 1.5 above the price of conventional nets. Because a longer lifespan brings delivery cost savings, each one year increase in lifespan can be accompanied by a USD 1 or more increase in price

Informing hot flash treatment decisions for breast cancer survivors: a systematic review of randomized trials comparing active interventions.

Science.gov (United States)

Johns, Claire; Seav, Susan M; Dominick, Sally A; Gorman, Jessica R; Li, Hongying; Natarajan, Loki; Mao, Jun James; Irene Su, H

2016-04-01

Patient-centered decision making about hot flash treatments often incorporates a balance of efficacy and side effects in addition to patient preference. This systematic review examines randomized controlled trials (RCTs) comparing at least two non-hormonal hot flash treatments in breast cancer survivors. In July 2015, PubMed, SCOPUS, CINAHL, Cochrane, and Web of Science databases were searched for RCTs comparing active, non-hormonal hot flash treatments in female breast cancer survivors. Thirteen trials were included after identifying 906 potential studies. Four trials were dose comparison studies of pharmacologic treatments citalopram, venlafaxine, gabapentin, and paroxetine. Hot flash reduction did not differ by tamoxifen or aromatase inhibitor use. Citalopram 10, 20, and 30 mg daily had comparable outcomes. Venlafaxine 75 mg daily improved hot flashes without additional side effects from higher dosing. Gabapentin 900 mg daily improved hot flashes more than 300 mg. Paroxetine 10 mg daily had fewer side effects than 20 mg. Among four trials comparing different pharmacologic treatments, venlafaxine alleviated hot flash symptoms faster than clonidine; participants preferred venlafaxine over gabapentin. Five trials compared pharmacologic to non-pharmacologic treatments. Acupuncture had similar efficacy to venlafaxine and gabapentin but may have longer durability after completing treatment and fewer side effects. We could not perform a pooled meta-analysis because outcomes were not reported in comparable formats. Clinical trial data on non-hormonal hot flash treatments provide comparisons of hot flash efficacy and other patient important outcomes to guide clinical management. Clinicians can use the information to help patients select hot flash interventions.

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

African Journals Online (AJOL)

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

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

African Journals Online (AJOL)

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

Longer treatment with alternative non-drug reinforcement fails to reduce resurgence of cocaine or alcohol seeking in rats.

Science.gov (United States)

Nall, Rusty W; Craig, Andrew R; Browning, Kaitlyn O; Shahan, Timothy A

2018-04-02

Provision of alternative non-drug reinforcement is among the most effective methods for treating substance use disorders. However, when alternative reinforcers become unavailable during treatment interruptions or upon cessation of treatment, relapse often occurs. Relapse following the loss of alternative reinforcement is known as resurgence. One factor that could reduce resurgence is longer duration of treatment with alternative reinforcement, but the available data are mixed. Further, the effects of length of treatment have previously only been examined with food seeking. The present experiments directly examined if duration of treatment impacted the magnitude of resurgence of cocaine or alcohol seeking in rats. First, rats were trained to self-administer cocaine (Experiment 1) or alcohol (Experiment 2) by performing a target behavior. Second, target behavior was extinguished and performing an alternative behavior produced an alternative non-drug (i.e., food) reinforcer. Finally, resurgence was assessed following removal of alternative reinforcement after either 5 or 20 sessions of treatment. Treatment duration did not differentially affect resurgence of cocaine seeking in Experiment 1 or Alcohol seeking in Experiment 2. These results suggest that extended treatment with alternative non-drug reinforcement may not decrease propensity to relapse. Further, these results may have implications for treatment of substance use disorders and for theories of resurgence. Copyright © 2017 Elsevier B.V. All rights reserved.

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

Science.gov (United States)

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

2012-01-01

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

Effects of skin-to-skin contact on autonomic pain responses in preterm infants.

Science.gov (United States)

Cong, Xiaomei; Cusson, Regina M; Walsh, Stephen; Hussain, Naveed; Ludington-Hoe, Susan M; Zhang, Di

2012-07-01

The purpose of this randomized crossover trial was to determine the effects on autonomic responses in preterm infants of longer Kangaroo Care (30 minutes, KC30) and shorter KC (15 minutes, KC15) before and throughout heel stick compared with incubator care (IC). Beat-to-beat heart rate (HR) and spectral power analysis of heart rate variability, low frequency power (LF), high frequency power (HF), and LF/HF ratio were measured in 26 infants. HR changes from Baseline to Heel Stick were significantly less in KC30 and KC15 than in IC, and more infants had HR decrease in IC than in 2 KC conditions. In IC, LF and HF significantly increased from Baseline to Heel Stick and dropped from Heel Stick to Recovery; in 2 KC conditions, no changes across study phases were found. During Heel Stick, LF and HF were significantly higher in IC than in KC30. In all 3 conditions, LF/HF ratio decreased from Baseline to Heel Stick and increased to Recovery; no differences were found between IC and two KC conditions. Both longer and shorter KC before and throughout heel stick can stabilize HR response in preterm infants, and longer KC significantly affected infants' sympathetic and parasympathetic responses during heel stick compared with incubator care. This study showed that KC has a significant effect on reducing autonomic pain responses in preterm infants. The findings support that KC is a safe and effective pain intervention in the neonatal intensive care unit. Copyright © 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.

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

Science.gov (United States)

Meltzer, David; Basu, Anirban; Conti, Rena

2010-01-01

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

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

Science.gov (United States)

Williams, Sunyna S; Frost, Sloane L

2014-11-01

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

Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies

Science.gov (United States)

Clarke, David

2017-01-01

Objective To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Design Systematic review and thematic synthesis. Method We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Results Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Conclusions Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-07-01

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

Dispersibility of lactose fines as compared to API in dry powders for inhalation.

Science.gov (United States)

Thalberg, Kyrre; Åslund, Simon; Skogevall, Marcus; Andersson, Patrik

2016-05-17

This work investigates the dispersion performance of fine lactose particles as function of processing time, and compares it to the API, using Beclomethasone Dipropionate (BDP) as model API. The total load of fine particles is kept constant in the formulations while the proportions of API and lactose fines are varied. Fine particle assessment demonstrates that the lactose fines have higher dispersibility than the API. For standard formulations, processing time has a limited effect on the Fine Particle Fraction (FPF). For formulations containing magnesium stearate (MgSt), FPF of BDP is heavily influenced by processing time, with an initial increase, followed by a decrease at longer mixing times. An equation modeling the observed behavior is presented. Surprisingly, the dispersibility of the lactose fines present in the same formulation remains unaffected by mixing time. Magnesium analysis demonstrates that MgSt is transferred to the fine particles during the mixing process, thus lubrication both BDP and lactose fines, which leads to an increased FPF. Dry particle sizing of the formulations reveals a loss of fine particles at longer mixing times. Incorporation of fine particles into the carrier surfaces is believed to be behind this, and is hence a mechanism of importance as regards the dispersion performance of dry powders for inhalation. Copyright © 2016 Elsevier B.V. All rights reserved.

Comparative toxicity of two azadirachtin-based neem pesticides to Daphnia pulex.

Science.gov (United States)

Goktepe, Ipek; Plhak, Leslie C

2002-01-01

Azadirachtin (AZA)-based pesticides (Neemix and Bioneem) demonstrated toxicity in 48-h nonrenewal toxicity assays using Daphnia pulex at levels that were comparable with several organophosphate pesticides. The median lethal concentration (LC50) values for the two neem pesticides were found to be 0.028 and 0.033 microl/ml, respectively. The LC50 value for nonformulated (95% pure) AZA was determined to be 0.382 microg AZA/ml. Neemix and Bioneem were exposed to air and northern sky daylight in a light box at 24 and 37 degrees C for 1, 3, 6, and 9 d. Standard 48-h acute toxicity tests were used to determine the effect of aging in these dry environmental conditions. Neemix and Bioneem were also fractionated into volatile and nonvolatile fractions, and the toxicity of each was tested. Compared with Neemix, Bioneem remained toxic longer when exposed to light and air at 37 degrees C, indicating that this pesticide may be less prone to environmental degradation. When fractionated, the nonvolatile fractions for both pesticides exhibited significantly lower LC50 values than the full formulations. These results suggest that, depending on the application rate and environmental fate, AZA-based pesticides may have direct adverse effects on aquatic organisms and that the toxicity and stability of formulated pesticides depend on factors other than only the AZA concentration.

Comparative Effect of Dietary Soybean Oil, Fish Oil, and Coconut Oil on Performance, Egg Quality and Some Blood Parameters in Laying Hens.

Science.gov (United States)

Dong, X F; Liu, S; Tong, J M

2018-04-14

Two hundred and sixteen 28-wk-old Hy-line laying hens were randomly distributed to three dietary treatments and fed 1of 3 diets containing 8% soybean oil, fish oil, or coconut oil from 28 to 47 wk of age to investigate comparative effect of dietary soybean oil, fish oil, and coconut oil on the performance, egg quality and blood malondialdehyde (MDA), aspartate transaminase (AST) and uric acid (UA). Hens fed fish oil showed poor performance compared with soybean oil or coconut oil, and especially egg weight throughout the trial was significantly and consistently decreased (P oil. Unexpectedly, shell reflectivity throughout the majority of the trial was consistently and significantly higher (P oil than that when fed soybean oil or coconut oil. Dietary treatments affected (P oil treatment was higher (P oil group. Albumen height, Haugh unit and yolk color were influenced by dietary treatments only at 1 or 2 time points. However, average albumen height and Haugh unit in fish oil treatment were higher (P soybean oil or coconut oil treatments and average yolk color in coconut oil treatment was higher (P soybean oil group. Serum MDA, AST and UA concentrations were increased (P oil during the majority of the first 2 mo of the trial. These data suggested that the inclusion of fish oil into feed may reduce the performance of laying hens, especially the egg weight, decrease the intensity of egg brown color and increase blood MDA, AST and UA levels compared with soybean oil or coconut oil. As a result, hens fed fish oil may lay smaller, longer and lighter-brown eggs whereas those fed coconut oil produce blunter and darker-brown eggs relative to soybean oil.

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

Directory of Open Access Journals (Sweden)

V. PALANICHAMY

2015-02-01

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

Prasugrel compared to clopidogrel in patients with acute coronary syndrome undergoing percutenaous coronary intervention: a Spanish model-based cost effectiveness analysis.

Science.gov (United States)

Davies, A; Sculpher, M; Barrett, A; Huete, T; Sacristán, J A; Dilla, T

2013-01-01

To assess the long-term cost-effectiveness of 12 months treatment of prasugrel compared to clopidogrel in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) in the Spanish health care system. A Markov state transition model was developed to estimate health outcomes, quality adjusted life years (QALYs), life years (LY), and costs over patients' lifetimes. Clinical inputs were based on an analysis of the TRITON-TIMI 38 clinical trial. Hospital readmissions captured during the trial in a sub-study of patients from eight countries (and subsequent re-hospitalisations modelled to accrue beyond the time horizon of the trial), were assigned to Spanish diagnosis-related group payment schedules to estimate hospitalisation costs. Mean total treatment costs were ?11,427 and ?10,910 for prasugrel and clopidogrel respectively. The mean cost of the study drug was ?538 higher for prasugrel vs. clopidogrel, but rehospitalisation costs at 12 months were ?79 lower for prasugrel due to reduced rates of revascularisation. Hospitalisation costs beyond 12 months were higher with prasugrel by ?55, due to longer life expectancy (+0.071 LY and +0.054 QALYs) associated with the decreased nonfatal myocardial infarction rate in the prasugrel group. The incremental cost per life year and QALY gained with prasugrel was ?7,198, and ?9,489, respectively. Considering a willingness-to-pay threshold of ?30,000/QALY gained in the Spanish setting, prasugrel represents a cost-effective option in comparison with clopidogrel among patients with ACS undergoing PCI. Copyright © 2013 SEFH. Published by AULA MEDICA. All rights reserved.

Railway train versus motor vehicle collisions: a comparative study of injury severity and patterns.

Science.gov (United States)

Kligman, M D; Knotts, F B; Buderer, N M; Kerwin, A J; Rodgers, J F

1999-11-01

This study compares the demographics, injury severity, resource use, and injury patterns of patients involved in railway train-motor vehicle (RT-MV) to motor vehicle-motor vehicle (MV-MV) collisions. Retrospective trauma registry review of 74 RT-MV and 1,931 MV-MV consecutive patients, age more than 14 years, presenting to two Level I trauma centers, January of 1991 to May of 1998. Compared with MV-MV, RT-MV had significantly more males (72% vs. 54%), higher mortality (15% vs. 7%), higher Injury Severity Score (median, 20 vs. 9), longer intensive care unit length of stay (1.7 vs. 0.04 days), and longer hospital length of stay (7.5 vs. 4 days). RT-MV patients had a higher percentage of scalp/facial lacerations; intracranial hemorrhage; hemothorax and pneumothorax; fractures of the rib/sternum, upper extremity, skull, and face; and lung, splenic, and renal injuries. After adjusting for the difference in Injury Severity Score between groups, the only remaining significant group difference was the odds of a scalp/facial laceration. RT-MV collisions are a marker for more severe injuries, but not a different pattern of injury, compared with MV-MV collisions.

Comparative studies on the mineralization of furfural urea and urea ...

African Journals Online (AJOL)

In this research, laboratory studies were conducted to evaluate the effects of furfural urea as a slow release N fertilizer in an alfisol of Nigeria Savanna in the year 2009/2010 season. Incubation studies revealed that released N through mineralizatoin and microbial activities had confirmed that the compound may stay longer ...

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

International Nuclear Information System (INIS)

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

1987-01-01

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

A comparative study of cancer patients with short and long sick-leave after primary treatment.

Science.gov (United States)

Gudbergsson, Saevar Berg; Torp, Steffen; Fløtten, Tone; Fosså, Sophie D; Nielsen, Roy; Dahl, Alv A

2011-04-01

Sick-leave after primary cancer treatment has hardly been studied. This study compares Norwegian cancer patients (CPs) with shorter (≤8 months) and longer (≥9 months) sick-leave after primary cancer treatment. Our aim was to characterize factors associated with these two types of sick-leave in order to identify possible factors for interventions by which long-term sick-leaves may be avoided. A mailed questionnaire was completed by a sample of Norwegian CPs 15 to 39 months after primary treatment of the ten most common invasive types of cancer. The groups with shorter (n=359) and longer (n=481) sick-leaves (SSL vs LSL) were compared with each other by self-reported information as to socio-demographic and cancer-related variables, health, quality of life, work ability, work situation and supportive interventions. The LSL consisted of 78% females, and 76% of them had breast or gynaecological cancer. A higher proportion of patients with low level of education, economical problems, treated with chemotherapy, hormones and multimodal treatment belonged to LSL compared to SSL. Significantly more LSL had recurrences of cancer, co-morbidity, regular use of medication, and poorer self-rated health, quality of life and work ability. Compared to SSL, more LSL reported needs for and offers of supportive care such as physiotherapy, physical activities and psychosocial support. A multivariate regression analysis showed that reduced work ability, changes in employment due to cancer, lack of support from supervisors at work, and having had combined treatment were significantly associated with being LSL. Longer sick-leave after primary cancer treatment is associated with combined cancer treatment, lack of support from supervisors and reduced overall work ability. Interventions and counselling related to the work place and reduced work ability could be of value for prevention of long-term sick-leaves.

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

Science.gov (United States)

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

2011-11-01

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

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

Science.gov (United States)

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

2016-08-17

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

Comparative effectiveness of the SNaP™ Wound Care System.

Science.gov (United States)

Hutton, David W; Sheehan, Peter

2011-04-01

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

Analytic model comparing the cost utility of TVT versus duloxetine in women with urinary stress incontinence.

Science.gov (United States)

Jacklin, Paul; Duckett, Jonathan; Renganathan, Arasee

2010-08-01

The purpose of this study was to assess cost utility of duloxetine versus tension-free vaginal tape (TVT) as a second-line treatment for urinary stress incontinence. A Markov model was used to compare the cost utility based on a 2-year follow-up period. Quality-adjusted life year (QALY) estimation was performed by assuming a disutility rate of 0.05. Under base-case assumptions, although duloxetine was a cheaper option, TVT gave a considerably higher QALY gain. When a longer follow-up period was considered, TVT had an incremental cost-effectiveness ratio (ICER) of pound 7,710 ($12,651) at 10 years. If the QALY gain from cure was 0.09, then the ICER for duloxetine and TVT would both fall within the indicative National Institute for Health and Clinical Excellence willingness to pay threshold at 2 years, but TVT would be the cost-effective option having extended dominance over duloxetine. This model suggests that TVT is a cost-effective treatment for stress incontinence.

The self-management of longer-term depression: learning from the patient, a qualitative study.

Science.gov (United States)

Chambers, Eleni; Cook, Sarah; Thake, Anna; Foster, Alexis; Shaw, Sue; Hutten, Rebecca; Parry, Glenys; Ricketts, Tom

2015-07-24

Depression is a common mental health condition now viewed as chronic or long-term. More than 50 % of people will have at least one further episode of depression after their first, and therefore it requires long-term management. However, little is known about the effectiveness of self-management in depression, in particular from the patients' perspective. This study aimed to understand how people with longer-term depression manage the condition, how services can best support self-management and whether the principles and concepts of the recovery approach would be advantageous. Semi-structured in depth interviews were carried out with 21 participants, recruited from a range of sources using maximum variation sampling. Interpretative Phenomenological Analysis was used by a diverse team comprised of service users, practitioners and academics. Four super-ordinate themes were found: experience of depression, the self, the wider environment, self-management strategies. Within these, several prominent sub-themes emerged of importance to the participants. These included how aspects of themselves such as hope, confidence and motivation could be powerful agents; and how engaging in a wide range of chosen activities could contribute to their emotional, mental, physical, social, spiritual and creative wellbeing. Services in general were not perceived to be useful in specifically facilitating self-management. Increased choice and control were needed and a greater emphasis on an individualised holistic model. Improved information was needed about how to develop strategies and locate resources, especially during the first episode of depression. These concepts echoed those of the recovery approach, which could therefore be seen as valuable in aiding the self-management of depression.

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

DEFF Research Database (Denmark)

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

2002-01-01

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

Comparing interactive videodisc training effectiveness to traditional training methods

International Nuclear Information System (INIS)

Kenworthy, N.W.

1987-01-01

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

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

African Journals Online (AJOL)

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

Effect of Upper Limb Rehabilitation Compared to No Upper Limb Rehabilitation in Lung Transplant Recipients: A Randomized Controlled Trial.

Science.gov (United States)

Fuller, Louise M; El-Ansary, Doa; Button, Brenda M; Corbett, Monique; Snell, Greg; Marasco, Silvana; Holland, Anne E

2017-10-16

To investigate the effect of a supervised upper limb (UL) program (SULP) compared to no supervised UL program (NULP) after lung transplantation (LTx). Randomized controlled trial. Physiotherapy gym. Participants (N=80; mean age, 56±11y; 37 [46%] men) were recruited after LTx. All participants underwent lower limb strength thrice weekly and endurance training. Participants randomized to SULP completed progressive UL strength training program using handheld weights and adjustable pulley equipment. Overall bodily pain was rated on the visual analog scale. Shoulder flexion and abduction muscle strength were measured on a hand held dynamometer. Health related quality of life was measured with Medical Outcomes Study 36-item Short Form health Survey and the Quick Dash. Measurements were made at baseline, 6 weeks, 12 weeks, and 6 months by blinded assessors. After 6 weeks of training, participants in the SULP (n=41) had less overall bodily pain on the visual analog scale than did participants in the NULP (n=36) (mean VAS bodily pain score, 2.1±1.3cm vs 3.8±1.7cm; P<.001) as well as greater UL strength than did participants in the NULP (mean peak force, 8.4±4.0Nm vs 6.7±2.8Nm; P=.037). At 12 weeks, participants in the SULP better quality of life related to bodily pain (76±17 vs 66±26; P=.05), but at 6 months there were no differences between the groups in any outcome measures. No serious adverse events were reported. UL rehabilitation results in short-term improvements in pain and muscle strength after LTx, but no longer-term effects were evident. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Bupivacaine compared with etidocaine for vaginal delivery.

Science.gov (United States)

Moore, D C; Bridenbaugh, P O; Bridenbaugh, L D; Thompson, G E; Balfour, R I; Lysons, D F

1975-01-01

A comparison of 0.5 percent etidocaine with 0.25 and 0.5 percent bupivacaine, using continuous (intermittent) caudal block in 60 vaginal deliveries, showed the latter two solutions to be the agents of choice. All solutions contained a final concentration of 1:2000,000 epihephrine. In 40 parturients given either 0.25 or 0.5 percent bupivacaine, all had pain relief after the initial dose, while 5 of 20 given etidocaine required a refill dose within 30 to 50 minutes for complete pain relief. The duration of action of the initial dose with both concentrations of bupivacaine was longer than that of etidocaine. The degree of motor blockade with 0.5 percent etidocaine was greater than with 0.5 percent bupivacaine, and with 0.5 percent concentrations of either etidocaine or bupivacaine was greater than with 0.25 percent bupivacaine. The duration of motor blockade of 0.5 percent etidocaine and bupivacaine was comparable. The duration of motor blockade of the 0.25 percent concentration of bupivacaine was shorter than with the 0.5 percent concentration of both etidocaine and bupivacaine; and with both bupivacaine concentrations the duration of sensory anesthesia in the extremities was longer than motor blockade; with etidocaine, the opposite occurred.

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

Science.gov (United States)

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

2014-04-01

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

Posterolateral Trajectories Favor a Longer Motor Domain in Subthalamic Nucleus Deep Brain Stimulation for Parkinson Disease.

Science.gov (United States)

Tamir, Idit; Marmor-Levin, Odeya; Eitan, Renana; Bergman, Hagai; Israel, Zvi

2017-10-01

The clinical outcome of patients with Parkinson disease (PD) who undergo subthalamic nucleus (STN) deep brain stimulation (DBS) is, in part, determined by the length of the electrode trajectory through the motor STN domain, the dorsolateral oscillatory region (DLOR). Trajectory length has been found to correlate with the stimulation-related improvement in patients' motor function (estimated by part III of the United Parkinson's Disease Rating Scale [UPDRS]). Therefore, it seems that ideally trajectories should have maximal DLOR length. We retrospectively studied the influence of various anatomic aspects of the brains of patients with PD and the geometry of trajectories planned on the length of the DLOR and STN recorded during DBS surgery. We examined 212 trajectories and 424 microelectrode recording tracks in 115 patients operated on in our center between 2010 and 2015. We found a strong correlation between the length of the recorded DLOR and STN. Trajectories that were more lateral and/or posterior in orientation had a longer STN and DLOR pass, although the DLOR/STN fraction length remained constant. The STN target was more lateral when the third ventricle was wider, and the latter correlated with older age and male gender. Trajectory angles correlate with the recorded STN and DLOR lengths, and should be altered toward a more posterolateral angle in older patients and atrophied brains to compensate for the changes in STN location and geometry. These fine adjustments should yield a longer motor domain pass, thereby improving the patient's predicted outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

News from the Library: Microsoft products no longer on sale at the Bookshop

CERN Multimedia

CERN Library

2013-01-01

As you might know, for some time the Bookshop also acted as a point of sale of Microsoft products. Please note that this is no longer the case.   The Swiss distributor of Microsoft software - DirAction AG - provides a website where CERN users can acquire copies of Microsoft software for home use. This website is available in three languages - English, French and German - and accepts payments by credit card or by money transfer from a bank account or PayPal. Should you have any problems or questions relating to this website, you can contact the DirAction Team directly at + 41 43 299 44 00 or using the contact form. Note that the CERN Service Desk will not be able to assist you as this is a service provided by DirAction rather than CERN IT. Please refer to this website for complete information on how to purchase Microsoft products. Your feedback is welcome! Please contact us by e-mail.

Comparative efficacy of oil solution and wettable powder of lambda-cyhalothrin to naturally occurring Ornithonyssus sylviarum infestation of chickens.

Science.gov (United States)

Pan, Baoliang; Liang, Daming; Zhang, Yafeng; Wang, Hailiang; Wang, Ming

2009-10-14

The Northern Fowl Mite (NFM), Ornithonyssus sylviarum, is one of the most important and common pests of poultry. Most of available pesticides applied in the NFM control are formulated as wettable powder or emulsifiable concentrate and require to be diluted with water before use. As water has very low affinity to bird feathers, a part of the diluted pesticide will fall on the ground, on the cages, on feed bins or drift in the air upon application, which becomes a source of a potential harm to administrative workers and birds. In contrast to water, an oil solution of pesticide has a higher affinity for feathers and can stay on the feather for a longer time, and maybe provide a high efficacy and be effective for a longer, persistent period against the NFM. In the present study, the efficacy of oil solution and wettable powder of lambda-cyhalothrin to NFM in breeders was compared; the results showed that while spraying lambda-cyhalothrin wettable powder on birds could effectively control NFM, painting lambda-cyhalothrin oil solution on birds gave complete control of NFM for at least 6 weeks. In the application of lambda-cyhalothrin oil solution, no containment of pesticide to cages, feed bin and no pesticide drifting in the air was observed. These results indicated that lambda-cyhalothrin oil solution has a potential to become an effective and safe formulation to control NFM in breeders.

A call for action: comparative effectiveness research in asthma

OpenAIRE

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

2010-01-01

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

PRIVATE MANUFACTURERS’ THRESHOLDS TO INVEST IN COMPARATIVE EFFECTIVENESS TRIALS

OpenAIRE

Basu, Anirban; Meltzer, David

2012-01-01

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

Protective Effect of Daikenchuto on Dextran Sulfate Sodium-Induced Colitis in Mice

Directory of Open Access Journals (Sweden)

Takaharu Matsunaga

2017-01-01

Full Text Available Aim. To investigate the effect of daikenchuto (TJ-100; DKT for ulcerative colitis (UC model mouse and assess its anti-inflammatory mechanisms. Methods. We evaluated the effects of DKT on dextran sulfate sodium- (DSS- induced experimental colitis. First, we assessed the short-term effects of DKT using two groups: 5% DSS group and 5% DSS with DKT group. Colon length; histological scores; and interleukin- (IL- 10, IL-1β, and tumor necrosis factor-α mRNA expression profiles were analyzed using real-time PCR. Second, we assessed the long-term effects of DKT, by comparing survival time between 2% DSS and 2% DSS with DKT groups. Results. After 7 days, the colon lengths of DSS + DKT group were longer than those of the DSS group (mean values: 6.11 versus 5.69 cm, p<0.05. Furthermore, compared to DSS group, the DSS + DKT group maintained significantly higher levels of serum hemoglobin (13.1 versus 10.7 g/dL, p<0.05 and exhibited significantly higher expression levels of IL-10 (p<0.05. The 2% DSS + DKT group exhibited significantly longer survival time than the 2% DSS group (70 versus 44 days, p<0.01. Conclusion. Our results indicate that DKT prevented inflammation in the colon, indicating its potential as a new therapeutic agent for UC.

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

African Journals Online (AJOL)

Arc. Usman A. Jalam

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

A randomized controlled trial to compare fentanyl-propofol and ketamine-propofol combination for procedural sedation and analgesia in laparoscopic tubal ligation

Directory of Open Access Journals (Sweden)

Ranju Singh

2013-01-01

Full Text Available Background: Procedural sedation and analgesia is widely being used for female laparoscopic sterilization using combinations of different drugs at varying doses. This study compared the combination of fentanyl and propofol, and ketamine and propofol in patients undergoing outpatient laparoscopic tubal ligation, with respect to their hemodynamic effects, postoperative recovery characteristics, duration of hospital stay, adverse effects, and patient comfort and acceptability. Settings and Design: Randomized, double blind. Methods: Patients were assigned to receive premixed injection of either fentanyl 1.5 μg/kg + propofol 2 mg/kg (Group PF, n0=50 or ketamine 0.5 mg/kg + propofol 2 mg/kg (Group PK, n=50. Hemodynamic data, peripheral oxygen saturation, and respiratory rate were recorded perioperatively. Recovery time, time to discharge, and comfort score were noted. Statistical Analysis: Chi-square (χ2 test was used for categorical data. Student′s t-test was used for quantitative variables for comparison between the two groups. For intragroup comparison, paired t-test was used. SPSS 14.0 was used for analysis. Results: Although the heart rate was comparable, blood pressures were consistently higher in group PK. Postoperative nausea and vomiting and delay in voiding were more frequent in group PK ( P<0.05. The time to reach Aldrete score ≥8 was significantly longer in group PK (11.14±3.29 min in group PF vs. 17.3±6.32 min in group PK, P<0.01. The time to discharge was significantly longer in group PK (105.8±13.07 min in group PF vs.138.18±13.20 min in group PK, P<0.01. Patient comfort and acceptability was better in group PF, P<0.01. Conclusion: As compared to ketamine-propofol, fentanyl-propofol combination is associated with faster recovery, earlier discharge, and better patient acceptability.

When Mothers Are No Longer Respected.

Science.gov (United States)

Jones, Carole

1997-01-01

A former childcare worker addresses the connection between social problems plaguing modern life and society's attitudes toward the role of women and mothering. She describes the detrimental effects on children who are placed in day care at an early age and urges that families abandon materialism and work toward improving the quality of their own…

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

Science.gov (United States)

2010-07-19

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

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

Science.gov (United States)

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

2012-08-01

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

A Reanalysis for the Seasonal and Longer-Period Cycles and the Trends in Middle Atmosphere Temperature from the HALOE

Science.gov (United States)

Remsberg, Ellis E.

2007-01-01

Previously published analyses for the seasonal and longer-period cycles in middle atmosphere temperature versus pressure (or T(p)) from the Halogen Occultation Experiment (HALOE) are extended to just over 14 years and updated to properly account for the effects of autocorrelation in its time series of zonally-averaged data. The updated seasonal terms and annual averages are provided, and they can be used to generate temperature distributions that are representative of the period 1991-2005. QBO-like terms have also been resolved and are provided, and they exhibit good consistency across the range of latitudes and pressure-altitudes. Further, exploratory analyses of the residuals from each of the 221 time series have yielded significant 11-yr solar cycle (or SC-like) and linear trend terms at a number of latitudes and levels. The amplitudes of the SC-like terms for the upper mesosphere agree reasonably with calculations of the direct solar radiative effects for T(p). Those SC amplitudes increase by about a factor of 2 from the lower to the upper mesosphere and are also larger at the middle than at the low latitudes. The diagnosed cooling trends for the subtropical latitudes are in the range, -0.5 to -1.0 K/decade, which is in good agreement with the findings from models of the radiative effects on pressure surfaces due to known increases in atmospheric CO2. The diagnosed trends are somewhat larger than predicted with models for the upper mesosphere of the northern hemisphere middle latitudes.

Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies.

Science.gov (United States)

Wray, Faye; Clarke, David

2017-10-06

To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. Systematic review and thematic synthesis. We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such

Quality of Longer Term Mental Health Facilities in Europe : Validation of the Quality Indicator for Rehabilitative Care against Service Users' Views

NARCIS (Netherlands)

Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L.; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A.; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, Jose Miguel; Cardoso, Graca; King, Michael

2012-01-01

Background: The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise

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

African Journals Online (AJOL)

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

Radiation effects, nuclear energy and comparative risks

International Nuclear Information System (INIS)

Gopinath, D.V.

2007-01-01

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

A Comparative Study of Analgesic Efficacy of Intrathecal Buprenorphine with Ultrasound-Guided Transversus Abdominis Plane Block for Postcesarean Delivery Analgesia.

Science.gov (United States)

Marappa, Prakash; Chikkapillappa, Manjunath Abloodu; Chennappa, Nagaraj Mungasuvalli; Pujari, Vinayak Seenappa

2017-01-01

Women undergoing cesarean (CS) delivery present a unique set of challenges to the anesthetist in terms of postoperative pain management. This study was conducted to compare the analgesic efficacy of intrathecal buprenorphine (ITB) with ultrasound-guided transversus abdominis plane (TAP) block in post-CS delivery pain. A prospective randomized comparative study of sixty American Society of Anesthesiologists physical status I and II pregnant patients divided into two groups of thirty each as ITB group and TAP block group after satisfying the inclusion criteria. In the present study, demographic data were comparable between both groups. The time to first analgesic request was significantly longer in ITB group (389.67 ± 90.78 min) compared to TAP group (669.17 ± 140.65 min) and was statistically significant, P consumption in the first 24 h was higher in the TAP group (3.5 g) compared to the ITB group (1.13 g) and was statistically significant, P consumption during the first 24 h. The benefits of neuraxial opiates are significant and far outweigh the side effects.

A comparative study on poly(xylitol sebacate) and poly(glycerol sebacate): mechanical properties, biodegradation and cytocompatibility

International Nuclear Information System (INIS)

Li, Yuan; Huang, Wenchao; Cook, Wayne D; Chen, Qizhi

2013-01-01

In order to develop degradable elastomers with a satisfactory combination of flexibility and enzyme-mediated degradation rate, the mechanical properties, enzymatic degradation kinetics and biocompatibility of poly(xylitol sebcate) (PXS) has been systematically investigated in comparison with poly(glycerol sebacate) (PGS). Under the same level of crosslinked density, the PXS elastomer networks have approximately twice the stretchability (elongation at break) of their PGS counterparts. This observation is attributable to the relatively longer and more orientable xylitol monomers, compared with glycerol molecules. Although xylitol monomers have two more hydroxyl groups, we, surprisingly, found that the hydrophilic side chains did not accelerate the water attack on the ester bonds of the PXS network, compared with their PGS counterpart. This observation was attributed to a steric hindrance effect, i.e. the large-sized hydroxyl groups can shield ester bonds from the attack of water molecules. In conclusion, the use of polyols of more than three –OH groups is an effective approach enhancing flexibility, whilst maintaining the degradation rate of polyester elastomers. Further development could be seen in the copolymerization of PPS with appropriate thermoplastic polyesters, such as poly(lactic acid) and polyhydroxyalkanoate. (paper)

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

International Nuclear Information System (INIS)

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

2017-01-01

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

Translating Comparative Effectiveness Research Into Practice: Effects of Interventions on Lifestyle, Medication Adherence, and Self-care for Type 2 Diabetes, Hypertension, and Obesity Among Black, Hispanic, and Asian Residents of Chicago and Houston, 2010 to 2013.

Science.gov (United States)

Rashid, Jamila R; Leath, Brenda A; Truman, Benedict I; Atkinson, Donna Durant; Gary, Lisa C; Manian, Nanmathi

In the United States, racial/ethnic minorities account for disproportionate disease and death from type 2 diabetes, hypertension, and obesity; however, interventions with measured efficacy in comparative effectiveness research are often not adopted or used widely in those communities. To assess implementation and effects of comparative effectiveness research-proven interventions translated for minority communities. Mixed-method assessment with pretest-posttest single-group evaluation design. US Department of Health and Human Services, Office of Minority Health, research contractor, and advisory board; health centers, including a federally qualified community health center in Chicago, Illinois; and public housing facilities for seniors in Houston, Texas. A total of 97 black, Hispanic, and Asian participants with any combination of health care provider-diagnosed type 2 diabetes, hypertension, or obesity. Virtual training institutes where intervention staff learned cultural competency methods of adapting effective interventions. Health educators delivered the Health Empowerment Lifestyle Program (HELP) in Chicago; community pharmacists delivered the MyRx Medication Adherence Program in Houston. Participation rates, satisfaction with interventions during January to April 2013, and pre- to postintervention changes in knowledge, diet, and clinical outcomes were analyzed through July 2013. In Chicago, 38 patients experienced statistically significant reductions in hemoglobin A1c and systolic blood pressure, increased knowledge of hypertension management, and improved dietary behaviors. In Houston, 38 subsidized housing residents had statistically nonsignificant improvements in knowledge of self-management and adherence to medication for diabetes and hypertension but high levels of participation in pharmacist home visits and group education classes. Adaptation, adoption, and implementation of HELP and MyRx demonstrated important postintervention changes among racial

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

Energy Technology Data Exchange (ETDEWEB)

Rose, K.S.B.

1993-10-01

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

Comparative effectiveness of correction strategies in connected discourse tracking.

Science.gov (United States)

Lunato, K E; Weisenberger, J M

1994-10-01

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

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

Science.gov (United States)

Nakamura, Alice; Nakamura, Masao

1989-01-01

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

All-cause mortality and cardiovascular effects associated with the DPP-IV inhibitor sitagliptin compared with metformin, a retrospective cohort study on the Danish population

DEFF Research Database (Denmark)

Scheller, N M; Mogensen, U M; Andersson, Charlotte

2014-01-01

we analysed the hazard ratio of changing treatment. RESULTS: A total of 84 756 patients were included in the analysis, 1228 (1.4%) received sitagliptin monotherapy whereas the remaining 83 528 (98.6%) patients received metformin monotherapy. Patients using metformin were younger than patients using...... sitagliptin (59.0 ± 15.2 vs. 62.5 ± 13.1) were less often male (51.6 vs. 54.2%) and had longer treatment duration with monotherapy (1.8 ± 1.3 vs. 0.9 ± 1.1 years). Compared with patients receiving metformin, patients using sitagliptin showed no statistically significant excess risks of all-cause mortality......AIM: We performed a retrospective cohort study, investigating the clinical outcomes including mortality and cardiovascular disease of sitagliptin compared with metformin monotherapies. METHODS: All patients receiving monotherapy with the dipeptidyl peptidase-IV inhibitors (DPP-IV) inhibitor...

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

Directory of Open Access Journals (Sweden)

Rajesh Balkrishnan

2013-01-01

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

The Gaze-Cueing Effect in the United States and Japan: Influence of Cultural Differences in Cognitive Strategies on Control of Attention

OpenAIRE

Saki Takao; Yusuke Yamani; Atsunori Ariga

2018-01-01

The direction of gaze automatically and exogenously guides visual spatial attention, a phenomenon termed as the gaze-cueing effect. Although this effect arises when the duration of stimulus onset asynchrony (SOA) between a non-predictive gaze cue and the target is relatively long, no empirical research has examined the factors underlying this extended cueing effect. Two experiments compared the gaze-cueing effect at longer SOAs (700 ms) in Japanese and American participants. Cross-cultural st...

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

Science.gov (United States)

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

2017-11-01

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

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

International Nuclear Information System (INIS)

Brenner, D.J.

2012-01-01

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

A Prospective Study Comparing Ligasure and Open Hemorrhoidectomy

Directory of Open Access Journals (Sweden)

Rahimi M

2011-11-01

Full Text Available Background: Hemorrhoid is among the most common anorectal diseases and patients with high-grade disease conditions need surgical treatment. Many surgical procedures are available to treat the disease. The aim of this study was to compare the operative time and outcomes, (post-operative pain and complications of LigaSure hemorrhoidectomy with those of the open conventional method.Methods : This randomized single-blind clinical trial included 57 patients (28 in LigaSure and 29 in the open group. The primary variable was the operative time for the excision of a single hemorrhoidal packet. The other variables were post-operative pain measured by morphine doses administered to control pain, scores of visual analogue scale (VAS used to measure pain severity, pain during home stay measured by doses of oral ibuprofen and the mean daily VAS scores, early complications including bleeding and urinary retention, longer-term complications and time to return to work.Results : The demographic data were comparatively the same between the two groups. The average time to excise a single packet of hemorrhoid was significantly shorter in the LigaSure group (8.91 min vs. 17.35 min, P<0.001. Post-operative pain measurements (morphine doses and VAS scores were lower in the LigaSure group, but the differences were not statistically significant (P=0.055 and 0.077, respectively. Complications of the two procedures were also comparable. Neither of the groups returned to work in a shorter time.Conclusion: LigaSure hemorrhoidectomy seems to be a safe method and it can reduce the operative time significantly. It may also have a modest effect on post-operative pain.

Acute and long-term nutrient-led modifications of gene expression: potential role of SIRT1 as a central co-ordinator of short and longer-term programming of tissue function.

Science.gov (United States)

Holness, Mark J; Caton, Paul W; Sugden, Mary C

2010-05-01

Environmental factors can influence the acute and longer-term risks of developing diseases, including type 2 diabetes mellitus and cardiovascular disease; however, the underlying mechanism remains elusive. Increasing evidence suggests that these effects can be achieved by modification of metabolic gene expression. These include acute changes in histone methylation, acetylation, phosphorylation, and ubiquitination and longer-term DNA silencing elicited by DNA methylation. Thus, an increased risk of disease may reflect acute or chronic stable modification of genes that regulate nutrient handling, leading to altered nutrient utilization (increased lipid oxidation at the expense of glucose utilization) and/or changes in the balance between nutrient storage and energy production, thereby favoring the development of obesity. The review addresses the hypothesis that early-life epigenetic programming of gene expression could be mirrored by changes in acute function of nuclear receptors, in particular the peroxisome proliferator-activated receptors, achieved by enzymes that are more conventionally involved in regulating DNA methylation and post-transcriptional modification of histones. Emphasis is placed on the potential importance of the protein deacetylase sirtuin-1 as a central co-ordinator. Copyright 2010 Elsevier Inc. All rights reserved.

Pediatric Systemic Lupus Erythematosus: Learning From Longer Follow Up to Adulthood

Directory of Open Access Journals (Sweden)

Giorgio Costagliola

2018-05-01

Full Text Available Background: Pediatric systemic lupus erythematosus (pSLE is a rare condition, representing approximately 10% of SLE cases. The aim of this study was to identify variables to improve the diagnostic awareness and management of pSLE patients.Methods: This retrospective study included 25 patients diagnosed with pSLE and followed at the University of Pisa. We collected data about clinical profile at disease onset and during a long-term follow-up, including disease activity, organ damage development, and treatments received.Results: The mean patient age at disease onset was 14.6 ± 1.6 years, and the mean follow-up period was 14.17 ± 8.04 years. The most common initial manifestations were arthritis, malar rash, and cytopenias. The median time to diagnosis since the first symptoms was 6 months, and was significantly longer in patients with hematological onset (54 months. During follow-up, the number of patients with renal involvement showed a significant increase, from 36% at diagnosis to 72.2% after 10 years of disease evolution. Patients who developed chronic organ damage maintained a higher time-averaged disease activity during follow-up and received a significantly higher dose of corticosteroids.Conclusion: Patients with immune cytopenia represent a group deserving strict clinical follow-up for the risk of evolution to SLE. Intense surveillance of renal function, early treatment and steroid-sparing strategies should be strongly considered in the management of pSLE patients.

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

Directory of Open Access Journals (Sweden)

Juerg Schliessbach

2012-01-01

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

The Efficiency of Infants' Exploratory Play Is Related to Longer-Term Cognitive Development

Science.gov (United States)

Muentener, Paul; Herrig, Elise; Schulz, Laura

2018-01-01

In this longitudinal study we examined the stability of exploratory play in infancy and its relation to cognitive development in early childhood. We assessed infants' (N = 130, mean age at enrollment = 12.02 months, SD = 3.5 months; range: 5–19 months) exploratory play four times over 9 months. Exploratory play was indexed by infants' attention to novelty, inductive generalizations, efficiency of exploration, face preferences, and imitative learning. We assessed cognitive development at the fourth visit for the full sample, and again at age three for a subset of the sample (n = 38). The only measure that was stable over infancy was the efficiency of exploration. Additionally, infants' efficiency score predicted vocabulary size and distinguished at-risk infants recruited from early intervention sites from those not at risk. Follow-up analyses at age three provided additional evidence for the importance of the efficiency measure: more efficient exploration was correlated with higher IQ scores. These results suggest that the efficiency of infants' exploratory play can be informative about longer-term cognitive development. PMID:29904360

Cheaters Are Looked at Longer and Remembered Better than Cooperators in Social Exchange Situations

Directory of Open Access Journals (Sweden)

Dan Chiappe

2004-01-01

Full Text Available What information is most salient during social exchange? Our studies assess the relative importance of cheaters and cooperators and whether their importance is affected by amount of resources involved in the exchange. In Experiment 1, participants categorized individuals as cheaters, cooperators, or neither, and rated how important they are to remember using a 7-point scale. In Experiment 2, participants categorized individuals, and then looked at their photos. This was followed by tests of face recognition, and memory for social contract status. Experiment 1 found cheaters were rated more important to remember than cooperators and more so when a greater amount of resources was involved. Experiment 2 found cheaters were looked at longer and people had better memory for their faces and were more likely to remember their social contract status. This suggests the mind evolved to remember information most pertinent in social contract situations.

Longer time-to-pregnancy in spontaneously conceived pregnancies is associated with lower PAPP-A and free β-hCG in first trimester screening for Down syndrome

DEFF Research Database (Denmark)

Kirkegaard, I; Uldbjerg, N; Tabor, A

2014-01-01

OBJECTIVE: The aim of this study was to investigate whether subfertility, measured as longer time-to-pregnancy (TTP) in spontaneously conceived pregnancies, affects the first trimester levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotrophin (β-hCG) and......OBJECTIVE: The aim of this study was to investigate whether subfertility, measured as longer time-to-pregnancy (TTP) in spontaneously conceived pregnancies, affects the first trimester levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotrophin (β...

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

Directory of Open Access Journals (Sweden)

K Vipin Jain

2013-01-01

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

Unsupervised laparoscopic appendicectomy by surgical trainees is safe and time-effective.

Science.gov (United States)

Wong, Kenneth; Duncan, Tristram; Pearson, Andrew

2007-07-01

Open appendicectomy is the traditional standard treatment for appendicitis. Laparoscopic appendicectomy is perceived as a procedure with greater potential for complications and longer operative times. This paper examines the hypothesis that unsupervised laparoscopic appendicectomy by surgical trainees is a safe and time-effective valid alternative. Medical records, operating theatre records and histopathology reports of all patients undergoing laparoscopic and open appendicectomy over a 15-month period in two hospitals within an area health service were retrospectively reviewed. Data were analysed to compare patient features, pathology findings, operative times, complications, readmissions and mortality between laparoscopic and open groups and between unsupervised surgical trainee operators versus consultant surgeon operators. A total of 143 laparoscopic and 222 open appendicectomies were reviewed. Unsupervised trainees performed 64% of the laparoscopic appendicectomies and 55% of the open appendicectomies. There were no significant differences in complication rates, readmissions, mortality and length of stay between laparoscopic and open appendicectomy groups or between trainee and consultant surgeon operators. Conversion rates (laparoscopic to open approach) were similar for trainees and consultants. Unsupervised senior surgical trainees did not take significantly longer to perform laparoscopic appendicectomy when compared to unsupervised trainee-performed open appendicectomy. Unsupervised laparoscopic appendicectomy by surgical trainees is safe and time-effective.

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

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

2015-06-01

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

"Help seniors live better, longer: prevent brain injury": an overview of CDC's education initiative to prevent fall-related TBI among older adults.

Science.gov (United States)

Sarmiento, Kelly; Langlois, Jean A; Mitchko, Jane

2008-01-01

Falls are the leading cause of traumatic brain injury (TBI) among older adults aged 75 and older. Despite this burden, many older adults, their caregivers, and professionals are not aware of the importance of TBI as an outcome of falls among older adults. To address this important public health problem, the Centers for Disease Control and Prevention (CDC) developed the "Help Seniors Live Better, Longer: Prevent Brain Injury" initiative to help raise awareness about methods to prevent, recognize and respond to fall-related TBIs among older adults aged 75 and older. The initiative was launched in March 2008, in collaboration with 26 participating organizations, and included a multipronged outreach strategy to help blanket the country with the messages of the initiative at the national, state, and local levels. Adherence to a logical, comprehensive health-education approach has proven to be highly effective in furthering the initial goals of the project.

Comparative study between ultrasound guided TAP block and paravertebral block in upper abdominal surgeries

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Ruqaya M Elsayed Goda

2017-01-01

Conclusion: We concluded that ultrasound guided transverses abdominis plane block and thoracic paravertebral block were safe and effective anesthetic technique for upper abdominal surgery with longer and potent postoperative analgesia in thoracic paravertebral block than transverses abdominis block.

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

Science.gov (United States)

Munez, David; Orrantia, Josetxu; Rosales, Javier

2013-01-01

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

Revisiting the effect of colonial institutions on comparative economic development.

Directory of Open Access Journals (Sweden)

Valentina A Assenova

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

C14–22 n-Alkanes in Soil from the Freetown Layered Intrusion, Sierra Leone: Products of Pt Catalytic Breakdown of Natural Longer Chain n-Alkanes?

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John F. W. Bowles

2018-03-01

Full Text Available Soil above a platinum-group element (PGE-bearing horizon within the Freetown Layered Intrusion, Sierra Leone, contains anomalous concentrations of n-alkanes (CnH2n+2 in the range C14 to C22 not readily attributable to an algal or lacustrine origin. Longer chain n-alkanes (C23 to C31 in the soil were derived from the breakdown of leaf litter beneath the closed canopy humid tropical forest. Spontaneous breakdown of the longer chain n-alkanes to form C14–22 n-alkanes without biogenic or abiogenic catalysts is unlikely as the n-alkanes are stable. In the Freetown soil, the catalytic properties of the PGE (Pt in particular may lower the temperature at which oxidation of the longer chain n-alkanes can occur. Reaction between these n-alkanes and Pt species, such as Pt2+(H2O2(OH2 and Pt4+(H2O2(OH4 can bend and twist the alkanes, and significantly lower the Heat of Formation. Microbial catalysis is a possibility. Since a direct organic geochemical source of the lighter n-alkanes has not yet been identified, this paper explores the theoretical potential for abiogenic Pt species catalysis as a mechanism of breakdown of the longer n-alkanes to form C14–22 alkanes. This novel mechanism could offer additional evidence for the presence of the PGE in solution, as predicted by soil geochemistry.

Per-oral endoscopic myotomy for achalasia. Are results comparable to laparoscopic Heller myotomy?

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Kumagai, Koshi; Tsai, Jon A; Thorell, Anders; Lundell, Lars; Håkanson, Bengt

2015-05-01

Per-oral endoscopic myotomy (POEM) has recently been introduced as a minimal invasive alternative to conventional treatment for achalasia. This study aimed to clarify the feasibility and the short-term clinical efficacy of POEM as compared to laparoscopic Heller myotomy (LHM). Treatment outcomes were prospectively recorded and compared between the procedures in a nonrandomized fashion. Reduction rate (RR) in timed barium esophagogram (TBE) was calculated at 1, 2 and 5 min after barium ingestion as: RR = 1- postoperative barium height/preoperative barium height. Risk factors for treatment failure defined as the proportion of patients with RR <0.5 (1 min) and gastroesophageal reflux (GER) after POEM were analyzed. Forty-two consecutive patients who underwent POEM were compared to 41 patients who had a LHM during the immediate time period prior to the introduction of POEM. Ninety percent of the cases reported complete symptom relief after POEM. The percentage of esophageal emptying and RR in TBE improved dramatically by both procedures without significant difference. A longer operation time (odds ratio [OR] 32.80, 95%CI 2.99-359.82, p = 0.004) and younger age (OR 26.81, 95%CI 2.09-344.03, p = 0.012) were the independent predictors of treatment failure after POEM. GER was observed in seven patients where previous dilatation (OR 8.59, 95%CI 1.16-63.45, p = 0.035) and higher body mass index (OR 8.69, 95%CI 1.13-66.63, p = 0.037) were the independent predictors for symptomatic GER after POEM. POEM seems to be a safe and effective treatment option for achalasia in the short-term perspective; an effect well comparable to LHM.

Policy and programmatic considerations for introducing a longer-acting injectable contraceptive: perspectives of stakeholders from Kenya and Rwanda

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McKenna, Kevin; Arcara, Jennet; Rademacher, Kate H; Mackenzie, Caroline; Ngabo, Fidele; Munyambanza, Emmanuel; Wesson, Jennifer; Tolley, Elizabeth E

2014-01-01

ABSTRACT Background: More than 40 million women use injectable contraceptives to prevent pregnancy, and most current or previous injectable users report being satisfied with the method. However, while women may find injectables acceptable, they may not always find them accessible due to stock-outs and difficulties with returning to the clinic for reinjections. FHI 360 is spearheading efforts to develop a longer-acting injectable (LAI) contraceptive that could provide at least 6 months of protection against pregnancy. This article addresses systems-level considerations for the introduction of a new LAI. Methods: We conducted qualitative case studies in Kenya and Rwanda—two countries that have high levels of injectable use but with different service delivery contexts. Between June and September 2012, we conducted in-depth interviews with 27 service providers and 19 policy makers and program implementers focusing on 4 themes: systems-level barriers and facilitators to delivering LAI services; process for introducing an LAI; LAI distribution approaches; and potential LAI characteristics. We also obtained electronic feedback from 28 international family planning opinion leaders. Results: Respondents indicated strong interest in an LAI and thought it would appeal to existing injectable users as well as new family planning clients, both for spacing and for limiting births. Providers appreciated the potential for a lighter workload due to fewer follow-up visits, but they were concerned that fewer visits would also decrease their ability to help women manage side effects. The providers also appreciated the 1-month grace period for follow-up LAI injections; some seemed unaware of the latest international guidance that had increased the grace period from 2 weeks to 4 weeks for the currently available 3-month injectable. The majority of policy makers and program implementers were supportive of letting community health workers provide the method, but many nurses and midwives

Reading and listening in people with aphasia: effects of syntactic complexity.

Science.gov (United States)

DeDe, Gayle

2013-11-01

The purpose of this study was to compare online effects of syntactic complexity in written and spoken sentence comprehension in people with aphasia (PWA) and adults with no brain damage (NBD). The participants in Experiment 1 were NBD older and younger adults (n = 20 per group). The participants in Experiment 2 were 10 PWA. In both experiments, the participants read and listened to sentences in self-paced reading and listening tasks. The experimental materials consisted of object cleft sentences (e.g., It was the girl who the boy hugged.) and subject cleft sentences (e.g., It was the boy who hugged the girl.). The predicted effects of syntactic complexity were observed in both Experiments 1 and 2: Reading and listening times were longer for the verb in sentences with object compared to subject relative clauses. The NBD controls showed exaggerated effects of syntactic complexity in reading compared to listening. The PWA did not show different modality effects from the NBD participants. Although effects of syntactic complexity were somewhat exaggerated in reading compared with listening, both the PWA and the NBD controls showed similar effects in both modalities.

Falsification Testing of Instrumental Variables Methods for Comparative Effectiveness Research.

Science.gov (United States)

Pizer, Steven D

2016-04-01

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

Improving the Efficiency of Dye-Sensitized Solar Cells by Growing Longer ZnO Nanorods on TiO2 Photoanodes

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Bao-gai Zhai

2017-01-01

Full Text Available By increasing the temperature of hydrothermal reactions from 70 to 100°C, vertically aligned ZnO nanorods were grown on the TiO2 thin film in the photoanode of dye-sensitized solar cells (DSSCs as the blocking layer to reduce the electron back recombinations at the TiO2/electrolyte interfaces. The length effects of ZnO nanorods on the photovoltaic performances of TiO2 based DSSCs were investigated by means of scanning electron microscope, X-ray diffractometer, photoluminescence spectrophotometer, and the photocurrent-voltage measurement. Under the illumination of 100 mW/cm2, the power conversion efficiency of DSSC with ZnO nanorods decorated TiO2 thin film as its photoanode can be increased nearly fourfold from 0.27% to 1.30% as the length of ZnO nanorods increases from 300 to 1600 nm. The enhanced efficiency of DSSC with ZnO nanorods decorated TiO2 thin film as the photoanode can be attributed to the larger surface area and the lower defect density in longer ZnO nanorods, which are in favor of more dye adsorption and more efficient transport in the photoanode.

The use of 137Cs to establish longer-term soil erosion rates on footpaths in the UK.

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Rodway-Dyer, S J; Walling, D E

2010-10-01

There is increasing awareness of the damage caused to valuable and often unique sensitive habitats by people pressure as degradation causes a loss of plant species, disturbance to wildlife, on-site and off-site impacts of soil movement and loss, and visual destruction of pristine environments. This research developed a new perspective on the problem of recreational induced environmental degradation by assessing the physical aspects of soil erosion using the fallout radionuclide caesium-137 ((137)Cs). Temporal sampling problems have not successfully been overcome by traditional research methods monitoring footpath erosion and, to date, the (137)Cs technique has not been used to estimate longer-term soil erosion in regard to sensitive recreational habitats. The research was based on-sites within Dartmoor National Park (DNP) and the South West Coast Path (SWCP) in south-west England. (137)Cs inventories were reduced on the paths relative to the reference inventory (control), indicating loss of soil from the path areas. The Profile Distribution Model estimated longer-term erosion rates (ca. 40 years) based on the (137)Cs data and showed that the combined mean soil loss for all the sites on 'paths' was 1.41 kg m(-2) yr(-1) whereas the combined 'off path' soil loss was 0.79 kg m(-2) yr(-1), where natural (non-recreational) soil redistribution processes occur. Recreational pressure was shown to increase erosion in the long-term, as greater soil erosion occurred on the paths, especially where there was higher visitor pressure. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

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

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Hall, Wayne

2017-04-01

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

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

Science.gov (United States)

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

2017-05-01

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

The influence of socio-economic characteristics, land use and travel time considerations on mode choice for medium- and longer-distance trips

NARCIS (Netherlands)

Limtanakool, N.; Dijst, M.J.; Schwanen, T.

2006-01-01

This paper contributes to the limited number of investigations into the influence of the spatial configuration of land use and transport systems on mode choice for medium- and longer-distance travel (defined here as home-based trips of 50 km and over) in the Netherlands. We have employed data from

Comparative effectiveness and safety of nab-paclitaxel plus carboplatin vs gemcitabine plus carboplatin in first-line treatment of advanced squamous cell non-small cell lung cancer in a US community oncology setting

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Mudad R

2017-10-01

Full Text Available Raja Mudad,1 Manish B Patel,2 Sandra Margunato-Debay,2 David Garofalo,3 Lincy S Lal4 1University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Hollywood, FL, USA; 2Celgene Corporation, Summit, NJ, USA; 3Cardinal Health, Dallas, TX, USA; 4University of Texas School of Public Health, Houston, TX, USA Introduction: Real-world comparative effectiveness, safety, and supportive care use of nab-paclitaxel plus carboplatin vs gemcitabine plus platinum were analyzed in patients with advanced or metastatic squamous cell non-small cell lung cancer (NSCLC.Materials and methods: Patients who received ≥ 1 cycle of first-line nab-paclitaxel plus carboplatin or gemcitabine plus platinum were identified from the Navigating Cancer database. Clinical effectiveness endpoints included overall survival (OS and time to treatment discontinuation (TTD. Other endpoints included safety and utilization of supportive care. Cox proportional hazards models were used to control for potential confounding effects of baseline characteristics.Results: In total, 193 patients were included (nab-paclitaxel plus carboplatin, n = 61; gemcitabine plus platinum, n = 132. Baseline characteristics were generally similar between the cohorts. Patients receiving nab-paclitaxel plus carboplatin had a significantly longer OS than those receiving gemcitabine plus carboplatin (median, 12.8 vs 9.0 months; P = 0.03. However, the adjusted difference was not statistically significant (adjusted HR 1.55; 95% CI, 0.99–2.42; P = 0.06. nab-Paclitaxel plus carboplatin-treated patients had significantly longer TTD than gemcitabine plus carboplatin-treated patients (median, 4.3 vs 3.5 months; P = 0.03; adjusted HR 1.39; 95% CI, 1.01–1.90; P = 0.04. Grade 3 or 4 anemia and neutropenia were significantly lower in patients treated with nab-paclitaxel plus carboplatin vs gemcitabine plus carboplatin. Nausea and neuropathy (grade not specified were significantly higher in the

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

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Ouzounelli, Myrsini; Reaven, Nancy L

2015-01-01

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

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

African Journals Online (AJOL)

EB

2013-09-03

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

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

Science.gov (United States)

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

2012-07-01

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

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

Science.gov (United States)

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

2017-03-01

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

Protective Effect of Daikenchuto on Dextran Sulfate Sodium-Induced Colitis in Mice.

Science.gov (United States)

Matsunaga, Takaharu; Hashimoto, Shinichi; Yamamoto, Naoki; Kawasato, Ryo; Shirasawa, Tomohiro; Goto, Atsushi; Fujisawa, Koichi; Takami, Taro; Okamoto, Takeshi; Nishikawa, Jun; Sakaida, Isao

2017-01-01

Aim . To investigate the effect of daikenchuto (TJ-100; DKT) for ulcerative colitis (UC) model mouse and assess its anti-inflammatory mechanisms. Methods . We evaluated the effects of DKT on dextran sulfate sodium- (DSS-) induced experimental colitis. First, we assessed the short-term effects of DKT using two groups: 5% DSS group and 5% DSS with DKT group. Colon length; histological scores; and interleukin- (IL-) 10, IL-1 β , and tumor necrosis factor- α mRNA expression profiles were analyzed using real-time PCR. Second, we assessed the long-term effects of DKT, by comparing survival time between 2% DSS and 2% DSS with DKT groups. Results . After 7 days, the colon lengths of DSS + DKT group were longer than those of the DSS group (mean values: 6.11 versus 5.69 cm, p DKT group maintained significantly higher levels of serum hemoglobin (13.1 versus 10.7 g/dL, p DKT group exhibited significantly longer survival time than the 2% DSS group (70 versus 44 days, p DKT prevented inflammation in the colon, indicating its potential as a new therapeutic agent for UC.

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

Science.gov (United States)

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

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

Science.gov (United States)

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

2016-10-01

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

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

Science.gov (United States)

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

2016-01-01

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

Effect of edible coating on the aromatic attributes of roasted coffee beans.

Science.gov (United States)

Rattan, Supriya; Parande, A K; Ramalakshmi, K; Nagaraju, V D

2015-09-01

Coffee is known throughout the world for its distinct aroma and flavour which results from a number of volatile compounds present in it. It is very difficult to arrest the aromatic compounds once the roasting process is complete and it becomes even more challenging to store the beans for a longer time with the retained volatiles as these compounds are easily lost during industrialized processing such as the grinding of roasted coffee beans and storage of ground coffee. Thus, an attempt was made to minimise the loss of volatile from roasted coffee beans by coating with Carboxymethyl cellulose (CMC), Hydroxypropylmethyl cellulose (HPMC) and Whey protein concentrate. Coffee volatiles were analysed by Gas chromatography and 14 major compounds were identified and compared in this study. Results showed an increase in the relative area of major volatile compounds in coated roasted coffee beans when compared with unroasted coffee beans for consecutive two months. Moreover, effect of coating on textural properties and non-volatiles were also analysed. The results have indicated that edible coatings preserve the sensory properties of roasted coffee beans for a longer shelf life and cellulose derivatives, as an edible coating, exhibited the best protecting effect on roasted coffee beans.

Hemodynamic effects of spiral ePTFE prosthesis compared with standard arteriovenous graft in a carotid to jugular vein porcine model.

Science.gov (United States)

Jahrome, Ommid K; Hoefer, Imo; Houston, Graeme J; Stonebridge, Peter A; Blankestijn, Peter J; Moll, Frans L; de Borst, Gert J

2011-01-01

The primary patency rate of arteriovenous (AV) grafts is limited by distal venous anastomosis stenosis or occlusion due to intimal hyperplasia associated with distal graft turbulence. The normal blood flow in native arteries is spiral laminar flow. Standard vascular grafts do not produce spiral laminar flow at the distal anastomosis. Vascular grafts which induce a spiral laminar flow distally result in lower turbulence, particularly near the vessel wall. This initial study compares the hemodynamic effects of a spiral flow-inducing graft and a standard graft in a new AV carotid to jugular vein crossover graft porcine model. Four spiral flow grafts and 4 control grafts were implanted from the carotid artery to the contralateral jugular vein in 4 pigs. Two animals were terminated after 48 hours and 2 at 14 days. Graft patency was assessed by selective catheter digital angiography, and the flow pattern was assessed by intraoperative flow probe and color Doppler ultrasound (CDU) measurements. The spiral grafts were also assessed at enhanced flow rates using an external roller pump to simulate increased flow rates that may occur during dialysis using a standard dialysis needle cannulation. The method increased the flow rate through the graft by 660 ml/min. The graft distal anastomotic appearances were evaluated by explant histopathology. All grafts were patent at explantation with no complications. All anastomoses were found to be wide open and showed no significant angiographic stenosis at the distal anastomosis in both spiral and control grafts. CDU examinations showed a spiral flow pattern in the spiral graft and double helix pattern in the control graft. No gross histopathological effects were seen in either spiral or control grafts. This porcine model is robust and allows hemodynamic flow assessment up to 14 days postimplantation. The spiral flow-inducing grafts produced and maintained spiral flow at baseline and enhanced flow rates during dialysis needle

Comparing Psychodynamic Teaching, Supervision, and Psychotherapy Over Videoconferencing Technology with Chinese Students.

Science.gov (United States)

Gordon, Robert M; Wang, Xiubing; Tune, Jane

2015-12-01

How do experts compare teaching, supervision, and treatment from a psychodynamic perceptive over the Internet with in-person work? Our methodology was based on the expert opinions of 176 teachers, supervisors, and therapists in the China American Psychoanalytic Alliance (CAPA) who use videoconferencing (VCON) with Chinese students. The results from our online survey indicate: (1), The longer teachers teach, the more effective they rate teaching over VCON; (2), Teaching, supervision, and treatment were all rated in the range of "slightly less effective" than in-person, with supervision rated significantly more effective than teaching and treatment over VCON; (3), When doing psychodynamic treatment over VCON the issues of symptom reduction, exploring mental life, working on transference, relational problems, resistance, privacy issues, countertransference, are all equally rated in the range of "slightly less effective" than in-person treatment; (4), The highest significantly rated indications for treatment over VCON are: "To offer high quality treatment to underserved or remote patients" and "When patient is house-bound or travel would be impractical"; and (5), The highest significantly rated contraindication for treatment over VCON is: "Patient needs close observation due to crisis or decompensation." Overall, this survey suggests that VCON teaching, supervision, and treatment from a psychodynamic perceptive is a worthwhile option when considering its unique contribution to extending services where needed.

Family Burden and Social Support in Mental Illness: A Comparative Study in Schizophrenia and Mood Disorders

OpenAIRE

JOSY KADAVIL THOMAS

2018-01-01

The present study was an attempt to assess and compare the global functioning of individuals affected with two major mental illnesses i.e. schizophrenia and mood disorders , social support perceived by them, and family burden and social support perceived by their caregivers. The individuals affected with schizophrenia were found to be more severely ill with a longer duration of illness, and perceived less social support as compared to those with mood disorders. The caregivers’ perceived socia...

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

Science.gov (United States)

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

2015-01-01

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

Measurement of dabigatran: previously demonstrated Hemoclot® Thrombin Inhibitor assay reagent instability on Sysmex CS-2100i is no longer an issue

DEFF Research Database (Denmark)

Comuth, Willemijn; Faaborg, Louise; Henriksen, Linda Østervig

2017-01-01

hours. Since the reagent composition was unchanged, the increased stability could be due to changed logistics by the supplier, with stock and transfer closer by. Previously demonstrated HTI reagent instability is no longer an issue at our laboratory. The reliability of results of clinical studies...

A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems

NARCIS (Netherlands)

Taylor, T.L.; Killaspy, H.; Wright, C.; Turton, P.; White, S.; Kallert, T.W.; Schuster, M.; Cervilla, J.A.; Brangier, P.; Raboch, J.; Kalisova, L.; Onchev, G.; Dimitrov, H.; Mezzina, R.; Wolf, Kinou; Wiersma, D.; Visser, E.; Kiejna, A.; Piotrowski, P.; Ploumpidis, D.; Gonidakis, F.; Caldas-de-Almeida, J.; Cardoso, G.; King, M.B.

2009-01-01

Background: A proportion of people with mental health problems require longer term care in a psychiatric or social care institution. However, there are no internationally agreed quality standards for institutional care and no method to assess common care standards across countries. We aimed to

Protective effect of zinc against lethality of the irradiated mice

International Nuclear Information System (INIS)

Matsubara, J.; Inada, T.; Machida, K.

1982-01-01

The effects of adding 1000 ppm Zn in the drinking water 10 days before gamma irradiation (562 - 1000 rad) of mice were studied. The mice which had received zinc had a lower mortality rate and a longer survival time compared to the controls. The LD 50 of gamma radiation was 690 rad in the control group and 770 rad in the zinc group. Zinc added to the culture medium of human melanoma cells did not shown any change in radiosensitivity; thus the radioprotective effect of zinc appears to work at the whole body level. (U.K.)

An overview of methods for comparative effectiveness research.

Science.gov (United States)

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

2014-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2018-01-18

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

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

NARCIS (Netherlands)

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

2015-01-01

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

Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

Science.gov (United States)

Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, José Miguel; Cardoso, Graça; King, Michael

2012-01-01

The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. 1750/2495 (70%) users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning). A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care. Interventions that improve quality of care in these

Towards Comparative Leadership

DEFF Research Database (Denmark)

Jensen, Merete Storgaard

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

42 CFR 137.78 - May a Self-Governance Tribe negotiate a funding agreement for a term longer or shorter than one...

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false May a Self-Governance Tribe negotiate a funding agreement for a term longer or shorter than one year? 137.78 Section 137.78 Public Health PUBLIC HEALTH... SERVICES TRIBAL SELF-GOVERNANCE Funding General § 137.78 May a Self-Governance Tribe negotiate a funding...

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

Science.gov (United States)

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

2017-01-01

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

Challenges in comparing the acute cognitive outcomes of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) vs. electroconvulsive therapy (ECT) in major depression: A systematic review.

Science.gov (United States)

Kedzior, Karina Karolina; Schuchinsky, Maria; Gerkensmeier, Imke; Loo, Colleen

2017-08-01

The present study aimed to systematically compare the cognitive outcomes of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and electroconvulsive therapy (ECT) in head-to-head studies with major depression (MDD) patients. A systematic literature search identified six studies with 219 MDD patients that were too heterogeneous to reliably detect meaningful differences in acute cognitive outcomes after ECT vs. HF-rTMS. Cognitive effects of brain stimulation vary depending on the timeframe and methods of assessment, stimulation parameters, and maintenance treatment. Thus, acute and longer-term differences in cognitive outcomes both need to be investigated at precisely defined timeframes and with similar instruments assessing comparable functions. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

King, Molly Elizabeth

2016-01-01

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

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

Science.gov (United States)

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

2017-12-05

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

Effectiveness of sublingual nitroglycerin before puncture compared with conventional intra-arterial nitroglycerin in transradial procedures: a randomized trial

Energy Technology Data Exchange (ETDEWEB)

Turan, Burak, E-mail: drburakturan@gmail.com; Daşlı, Tolga; Erkol, Ayhan; Erden, İsmail

2015-10-15

Aim: Sublingual (SL) nitroglycerin administered before radial artery puncture can improve cannulation success and decrease the incidence of radial artery spasm (RAS) compared with intra-arterial (IA) nitroglycerin in transradial procedures. Methods: Patients undergoing diagnostic transradial angiography were randomized to IA (200 mcg) or SL (400 mcg) nitroglycerin. Primary endpoints were puncture time and puncture attempts. Secondary endpoint was the incidence of RAS. Results: Total of 101 participants (mean age 60 ± 11 years, 53% male) were randomized (51 in IA and 50 in SL groups). Puncture time (50 [36–75] vs 50 [35–90] sec), puncture attempts (1.18 ± 0.48 vs 1.20 ± 0.49), multiple punctures (13.7 vs 16.0%) and RAS (19.6 vs 24.0%) were not statistically different between IA vs SL groups respectively. A composite endpoint of all adverse events related to transradial angiography (multiple punctures, RAS, access site crossover, hypotension/bradycardia associated with nitroglycerin and radial artery occlusion) was very similar in IA vs SL groups (39 vs 40%, respectively). However puncture time was significantly longer with SL nitroglycerin in patients < 1.65 m height (47 [36–66] vs 63 [41–110] sec, p = 0.042). Multiple punctures seemed higher with SL nitroglycerin in patients with diabetes (0 vs 30%, p = 0.028) or in patients < 1.65 m height (7.4 vs 25%, p = 0.085). Likewise, RAS with SL nitroglycerin seemed more frequent in smokers compared to IA nitroglycerin (0 vs 27%, p = 0.089). Conclusions: SL nitroglycerin was not different from IA nitroglycerin in terms of efficiency and safety in overall study population. However it may be inferior to IA nitroglycerin in certain subgroups (shorter individuals, diabetics and smokers). - Highlights: • Improvement in radial artery puncture time and success with subcutaneous nitrate was reported. • Giving nitrate sublingually may have vasodilation along entire length of radial artery and may prevent RAS

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

International Nuclear Information System (INIS)

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

1986-01-01

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

COMPARATIVE EFFECTIVENESS OF DIFFERENT METHODS OF CANDIDAL DYSBACTERIOSIS THERAPY

Directory of Open Access Journals (Sweden)

S.V. Nikolaeva

2009-01-01

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

The Effectiveness of Intraocular Methotrexate in the Treatment of Posterior Uveitis in Behçet’s Disease Patients Compared to Retrobulbar Steroids Injection

Directory of Open Access Journals (Sweden)

Hossam El Din Mohamed Khalil

2016-01-01

Full Text Available Aim of Work. To evaluate the efficacy of intravitreal methotrexate (MTX compared to retrobulbar triamcinolone acetonide (TAA, in controlling posterior segment involvement and inducing remissions among Behçet’s disease (BD patients. Study Design. This is a cross-sectional nonrandomized comparative study. Patients and Methods. 31 adult BD male patients with a mean disease duration of 5.45 years who presented with bilateral posterior segment involvement were included. Each patient received intravitreal injection of 400 μg/0.1 mL (MTX for the right eye (Group A and 1 mL of retrobulbar 40 mg/mL TAA for the left eye (Group B. Results. 90% of eyes showed complete improvement of anterior chamber reaction, whereas an improvement in vitreous activity in 77% with no significant differences between both groups (p≤0.1. BCVA improved in 77.4% eyes (Group A compared to 87.1% (Group B (p≤0.4. Relapses were noted in 11 eyes (35.5%, in group A, with the mean duration of remission being 19.1 weeks ± 2.13 compared to 7.35±2.8 in 20 eyes (64.5% in group B (p≤0.1. Conclusion. No statistical differences were found between both treatment modalities; however, based on clinical observations, intravitreal MTX may ensure better control of inflammatory reaction and may encourage longer remission as compared to retrobulbar TAA in BD patients.

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

Science.gov (United States)

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

2014-11-01

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

Comparative analysis of open and robotic transversus abdominis release for ventral hernia repair.

Science.gov (United States)

Bittner, James G; Alrefai, Sameer; Vy, Michelle; Mabe, Micah; Del Prado, Paul A R; Clingempeel, Natasha L

2018-02-01

Transversus abdominis release (TAR) is a safe, effective strategy to repair complex ventral incisional hernia (VIH); however, open TAR (o-TAR) often necessitates prolonged hospitalization. Robot-assisted TAR (r-TAR) may benefit short-term outcomes and shorten convalescence. This study compares 90-day outcomes of o-TAR and r-TAR for VIH repair. A single-center, retrospective review of patients who underwent o-TAR or r-TAR for VIH from 2015 to 2016 was conducted. Patient and hernia characteristics, operative data, and 90-day outcomes were compared. The primary outcome was hospital length of stay, and secondary metrics were morbidity, surgical site events, and readmission. Overall, 102 patients were identified (76 o-TAR and 26 r-TAR). Patients were comparable regarding age, gender, body mass index, and the presence of co-morbidities. Diabetes was more common in the open group (22.3 vs. 0%, P = 0.01). Most VIH defects were midline (89.5 vs. 83%, P = 0.47) and recurrent (52.6 vs. 58.3%, P = 0.65). Hernia characteristics were similar regarding mean defect size (260 ± 209 vs. 235 ± 107 cm 2 , P = 0.55), mesh removal, and type/size mesh implanted. Average operative time was longer in the r-TAR cohort (287 ± 121 vs. 365 ± 78 min, P VIH offers the short-term benefits of low morbidity and decreased hospital length of stay compared to open TAR.

Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649

Directory of Open Access Journals (Sweden)

Franken Willemien K

2004-11-01

Full Text Available Abstract Background Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably. Methods In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study. The intensive group training protocol combines exercise therapy with principles of behavioural therapy ("graded activity" and back school. This training protocol is compared to physiotherapy care according to the recently published Low Back Pain Guidelines of the Royal Dutch College for Physiotherapy. Primary outcome measures are general improvement, pain intensity, functional status, work absenteeism and quality of life. The direct and indirect costs will be assessed using cost diaries. Patients will complete questionnaires at baseline and 6, 13, 26 and 52 weeks after randomisation. Discussion No trials are yet available that have evaluated the effect of an intensive group training protocol including behavioural principles and back school in a primary physiotherapy care setting and no data on cost-effectiveness and cost-utility are available.

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

Directory of Open Access Journals (Sweden)

Reza Yaaghubi

2018-01-01

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

Black bears with longer disuse (hibernation) periods have lower femoral osteon population density and greater mineralization and intracortical porosity.

Science.gov (United States)

Wojda, Samantha J; Weyland, David R; Gray, Sarah K; McGee-Lawrence, Meghan E; Drummer, Thomas D; Donahue, Seth W

2013-08-01

Intracortical bone remodeling is persistent throughout life, leading to age related increases in osteon population density (OPD). Intracortical porosity also increases with age in many mammals including humans, contributing to bone fragility and fracture risk. Unbalanced bone resorption and formation during disuse (e.g., physical inactivity) also increases intracortical porosity. In contrast, hibernating bears are a naturally occurring model for the prevention of both age-related and disuse osteoporoses. Intracortical bone remodeling is decreased during hibernation, but resorption and formation remain balanced. Black bears spend 0.25-7 months in hibernation annually depending on climate and food availability. We found longer hibernating bears demonstrate lower OPD and higher cortical bone mineralization than bears with shorter hibernation durations, but we surprisingly found longer hibernating bears had higher intracortical porosity. However, bears from three different latitudes showed age-related decreases in intracortical porosity, indicating that regardless of hibernation duration, black bears do not show the disuse- or age-related increases in intracortical porosity which is typical of other animals. This ability to prevent increases in intracortical porosity likely contributes to their ability to maintain bone strength during prolonged periods of physical inactivity and throughout life. Improving our understanding of the unique bone metabolism in hibernating bears will potentially increase our ability to develop treatments for age- and disuse-related osteoporoses in humans. Copyright © 2013 Wiley Periodicals, Inc.

The influence of γ-radiation on the immunological effectiveness of a brucellar protective antigen

International Nuclear Information System (INIS)

Pronin, A.V.; Dranovskaya, E.A.; Malikov, V.E.

1988-01-01

It is shown that the splenocytic response to mitogens in guinea pigs was activated 7 days following immunization thereof with with a gamma-irradiated brucellar protective agent (gamma-BPA) while nonirradiated BPA inhibited lymphocyte proliferatiuon under the effect of mitogens. Gamma-BPA as compared with BPA circulated in blood for a longer time, induced a more rapid and prolonged synthesis of antibodies and provided the development of a more intensive immunity

Improved sonothrombolysis from a modified diagnostic transducer delivering impulses containing a longer pulse duration.

Science.gov (United States)

Wu, Juefei; Xie, Feng; Kumar, Tanmay; Liu, Jinjin; Lof, John; Shi, William; Everbach, E Carr; Porter, Thomas R

2014-07-01

Although guided high-mechanical-index (MI) impulses from a diagnostic ultrasound transducer have been used in preclinical studies to dissolve coronary arterial and microvascular thrombi in the presence of intravenously infused microbubbles, it is possible that pulse durations (PDs) longer than that used for diagnostic imaging may further improve the effectiveness of this approach. By use of an established in vitro model flow system, a total of 90 occlusive porcine arterial thrombi (thrombus age: 3-4 h) within a vascular mimicking system were randomized to 10-min treatments with two different PDs (5 and 20 μs) using a Philips S5-1 transducer (1.6-MHz center frequency) at a range of MIs (from 0.2 to 1.4). All impulses were delivered in an intermittent fashion to permit microbubble replenishment within the thrombosed vessel. Diluted lipid-encapsulated microbubbles (0.5% Definity) were infused during the entire treatment period. A tissue-mimicking phantom 5 cm thick was placed between the transducer and thrombosed vessel to mimic transthoracic attenuation. Two 20-MHz passive cavitation detection systems were placed confocal to the insonified vessel to assess for inertial cavitational activity. Percentage thrombus dissolution was calculated by weighing the thrombi before and after each treatment. Percentage thrombus dissolution was significantly higher with a 20-μs PD already at the 0.2 and 0.4 MI therapeutic impulses (54 ± 12% vs. 33 ± 17% and 54 ± 22% vs. 34 ± 17%, p cavitation detection systems detected only low intensities of inertial cavitation. At higher MI settings and 20-μs PDs, percentage thrombus dissolution decreased most likely from high-intensity cavitation shielding of the thrombus. Slightly prolonging the PD on a diagnostic transducer improves the degree of sonothrombolysis that can be achieved without fibrinolytic agents at a lower mechanical index. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc

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

International Nuclear Information System (INIS)

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

1979-01-01

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

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

Science.gov (United States)

Oderda, Gary M; Balfe, Lisa M

2011-01-01

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

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

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

Association between unmet needs and quality of life in hospitalised cancer patients no longer receiving anti-cancer treatment.

Science.gov (United States)

Bužgová, R; Hajnová, E; Sikorová, L; Jarošová, D

2014-09-01

Assessing the quality of life and unmet needs of cancer patients is an integral part of palliative care. This cross-sectional study sought to determine whether there is an association between quality of life and unmet needs, anxiety and depression in cancer patients who are no longer receiving anti-cancer treatment. The sample consisted of 93 patients from the oncology department at the University Hospital in Ostrava for whom further cancer treatment had been terminated as ineffective in halting the progression of their cancer. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Patient Needs Assessment in Palliative Care (PNAP) questionnaire, and the Hospital Anxiety and Depression Scale (HADS) were used to collect data. The overall quality of life score was quite low at 46. Most unmet needs were defined in terms of physical, psychological or spiritual needs. Correlations were found between impaired quality of life and lower Karnofsky scores (r = 0.50); increased physical (r = 0.52), psychological (r = 0.44) and spiritual (r = 0.36) needs; and higher levels of anxiety (r = -0.30) and depression (r = -0.68). Effective management of patients' physical (pain, fatigue and depression), psychological and spiritual needs may improve their quality of life. © 2014 John Wiley & Sons Ltd.

[Comparative study on effects between electroacupuncture and auricular acupuncture for methamphetamine withdrawal syndrome].

Science.gov (United States)

Liang, Yan; Xu, Bo; Zhang, Xue-Chun; Zong, Lei; Chen, Yue-Lai

2014-03-01

To observe the efficacy difference of electroacupuncture and auricular acupuncture in the treatment of methamphetamine withdrawal syndrome. Ninety male patients of methamphetamine addiction were randomized into an electroacupuncture group, an auricular acupuncture group and a control group, 30 cases in each one. In the electroacupuncture group, Neiguan (PC 6), Shenmen (HT 7), Zusanli (ST 36), Sanyinjiao (SP 6), Jiaji (EX-B 2) at T5 and L2 were selected bilaterally. In the auricular acupuncture group, jiaogan (AH(6a)), shenmen (TF4), fei (CO14) and gan (CO12) were selected unilaterally. The treatment was given 3 times a week, totally 12 treatments were required. In the control group, no any intervention was applied. Separately, before treatment and after 1, 2, 3 and 4 weeks treatment, the scores of methamphetamine withdrawal syndrome, Hamilton anxiety scale and Hamilton depression scale were observed in each group. The total score of methamphetamine withdrawal syndrome, anxiety score and depression score were obviously reduced in 2, 3 and 4 weeks of treatment as compared with those before treatment in the electroacupuncture group and the auricular acupuncture group (all P electroacupuncture group and auricular acupuncture group were lower significantly than those in the control group (all P electroacupuncture group was lower significantly than that in the auricular acupuncture group in the 4th week of treatment (3.69 +/- 2.446 vs 5.73 +/- 3.169, P Electroacupuncture at the body points and auricular acupuncture play the therapeutic role in the treatment of methamphetamine withdrawal syndrome, anxiety and depression. The longer time the treatment is with electroacupuncture at the body points, the more obvious the efficacy will be on the above symptoms.

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

Science.gov (United States)

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

2012-08-01

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

Shorter Versus Longer Shift Durations to Mitigate Fatigue and Fatigue-Related Risks in Emergency Medical Services Personnel and Related Shift Workers: A Systematic Review

Science.gov (United States)

2018-01-11

Background: This study comprehensively reviewed the literature on the impact of shorter versus longer shifts on critical and important outcomes for Emergency Medical Services (EMS) personnel and related shift worker groups. Methods: Six databases (e....

Comparative effectiveness of liraglutide in the treatment of type 2 diabetes

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Rigato M

2014-03-01

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

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

Science.gov (United States)

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

2013-09-01

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

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

African Journals Online (AJOL)

EB

2013-09-03

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

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

International Nuclear Information System (INIS)

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

1984-01-01

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

A Randomized Controlled Trail Comparing the Efficacy of 0.5% Centbucridine to 2% Lignocaine as Local Anesthetics in Dental Extractions

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Samir Mansuri

2011-01-01

Full Text Available The development of local anesthesia in dentistry has marked the beginning of a new era in terms of pain control. Lignocaine is the most commonly used local anesthetic (LA agent even though it has a vasodilative effect and needs to be combined with adrenaline. Centbucridine is a non-ester, non amide group LA and has not been comprehensively studied in the dental setting and the objective was to compare it to Lignocaine. This was a randomized study comparing the onset time, duration, depth and cardiovascular parameters between Centbucridine (0.5% and Lignocaine (2%. The study was conducted in the dental outpatient department at the Government Dental College in India on patients attending for the extraction of lower molars. A total of 198 patients were included and there were no significant differences between the LAs except those who received Centbucridine reported a significantly longer duration of anesthesia compared to those who received Lignocaine. None of the patients reported any side effects. Centbucridine was well tolerated and its substantial duration of anesthesia could be attributed to its chemical compound. Centbucridine can be used for dental procedures and can confidently be used in patients who cannot tolerate Lignocaine or where adrenaline is contraindicated.

Effects of Inhalation Aromatherapy on Symptoms of Sleep Disturbance in the Elderly with Dementia

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Ai Takeda

2017-01-01

Full Text Available This study investigated the effects of inhalation aromatherapy on sleep disturbance in elderly individuals with dementia. In 19 subjects, normal sleep was observed for a 20-day control period, inhalation aromatherapy was then applied for a 20-day intervention period, and the control and intervention periods were compared. During the intervention period, essential oils were placed nightly on towels around the subjects’ pillows. The measured sleep conditions were sleep latency, total sleep time, sleep efficacy, duration of the longest sustained sleep period, wake time after sleep onset, early morning awakening, total daytime sleep, and the Neuropsychiatric Inventory. Total sleep time was significantly longer in the intervention period than in the control period (p<0.05. The duration of the longest sustained sleep period was significantly longer in the intervention period than in the control period (p<0.05. Early morning awakening in the intervention period was significantly less compared to that in the control period (p<0.05. Total daytime sleep could not be adequately measured and was omitted from the analysis. No significant differences in other sleep conditions were observed. These results indicated positive effects of inhalation aromatherapy on symptoms of sleep disturbance in elderly individuals with dementia.

Comparative Effects of Injectable and Oral Hormonal Contraceptives on Lipid Profile

OpenAIRE

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

2012-01-01

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

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

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

2014-01-01

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

Multiple sclerosis risk sharing scheme: two year results of clinical cohort study with historical comparator.

Science.gov (United States)

Boggild, Mike; Palace, Jackie; Barton, Pelham; Ben-Shlomo, Yoav; Bregenzer, Thomas; Dobson, Charles; Gray, Richard

2009-12-02

To generate evidence on the longer term cost effectiveness of disease modifying treatments in patients with relapsing-remitting multiple sclerosis. Prospective cohort study with historical comparator. Specialist multiple sclerosis clinics in 70 centres in the United Kingdom. Patients with relapsing-remitting multiple sclerosis who started treatment from May 2002 to April 2005 under the UK risk sharing scheme. Treatment with interferon beta or glatiramer acetate in accordance with guidelines of the UK Association of British Neurologists. Observed utility weighted progression in disability at two years' follow-up assessed on the expanded disability status scale (EDSS) compared with that expected by applying the progression rates in a comparator dataset, modified for patients receiving treatment by multiplying by the hazard ratio derived separately for each disease modifying treatment from the randomised trials. In the primary per protocol analysis, progression in disability was worse than that predicted and worse than that in the untreated comparator dataset ("deviation score" of 113%; excess in mean disability status scale 0.28). In sensitivity analyses, however, the deviation score varied from -72% (using raw baseline disability status scale scores, rather than applying a "no improvement" algorithm) to 156% (imputing missing data for year two from progression rates for year one). It is too early to reach any conclusion about the cost effectiveness of disease modifying treatments from this first interim analysis. Important methodological issues, including the need for additional comparator datasets, the potential bias from missing data, and the impact of the "no improvement" rule, will need to be addressed and long term follow-up of all patients is essential to secure meaningful results. Future analyses of the cohort are likely to be more informative, not least because they will be less sensitive to short term fluctuations in disability.

Photorefractive effect at 775 nm in doped lithium niobate crystals

Energy Technology Data Exchange (ETDEWEB)

Nava, G.; Minzioni, P.; Cristiani, I.; Degiorgio, V. [Department of Electrical, Computer, and Biomedical Engineering, and CNISM, University of Pavia, 27100 Pavia (Italy); Argiolas, N.; Bazzan, M.; Ciampolillo, M. V.; Pozza, G.; Sada, C. [Physics and Astronomy Departement, University of Padova, 35131 Padova (Italy)

2013-07-15

The photorefractive effect induced by 775-nm laser light on doped lithium niobate crystals is investigated by the direct observation in the far field of the transmitted-beam distortion as a function of time. Measurements performed at various Zr-doping concentrations and different light intensities show that the 775-nm light beam induces a steady-state photorefractive effect comparable to that of 532-nm light, but the observed build-up time of the photovoltaic field is longer by three-orders of magnitude. The 775-nm photorefractivity of lithium niobate crystals doped with 3 mol. % ZrO{sub 2} or with 5.5 mol. % MgO is found to be negligible.

Exposure to inorganic arsenic is associated with increased mitochondrial DNA copy number and longer telomere length in peripheral blood.

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Syeda Shegufta Ameer

2016-08-01

Full Text Available Background: Exposure to inorganic arsenic (iAs through drinking water causes cancer. Alterations in mitochondrial DNA copy number (mtDNAcn and telomere length in blood have been associated with cancer risk. We elucidated if arsenic exposure alters mtDNAcn and telomere length in individuals with different arsenic metabolizing capacity.Methods: We studied two groups in the Salta province, Argentina, one in the Puna area of the Andes (N=264, 89% females and one in Chaco (N=169, 75% females. We assessed arsenic exposure as the sum of arsenic metabolites [iAs, methylarsonic acid (MMA, dimethylarsinic acid (DMA] in urine (U-As using high-performance liquid chromatography coupled with hydride generation and inductively coupled plasma mass spectrometry. Efficiency of arsenic metabolism was expressed as percentage of urinary metabolites. MtDNAcn and telomere length were determined in blood by real-time PCR. Results: Median U-As was 196 (5 - 95 percentile: 21 - 537 µg/L in Andes and 80 (5 - 95 percentile: 15 - 1637 µg/L in Chaco. The latter study group had less-efficient metabolism, with higher %iAs and %MMA in urine compared with the Andean group. U-As was significantly associated with increased mtDNAcn (log2 transformed to improve linearity in Chaco (β=0.027 per 100 µg/L, p=0.0085; adjusted for age and sex, but not in Andes (β=0.025, p=0.24. U-As was also associated with longer telomere length in Chaco (β=0.016, p=0.0066 and Andes (β=0.0075, p=0.029. In both populations, individuals with above median %iAs showed significantly higher mtDNAcn and telomere length compared with individuals with below median %iAs. Conclusions: Arsenic was associated with increased mtDNAcn and telomere length, particularly in individuals with less-efficient arsenic metabolism, a group who may have increased risk for arsenic-related cancer.

Greater healthcare utilization and costs among Black persons compared to White persons with aphasia in the North Carolina stroke belt.

Science.gov (United States)

Ellis, Charles; Hardy, Rose Y; Lindrooth, Richard C

2017-05-15

To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs. Hospital fixed effects were included to yield within-hospital estimates of disparities. GLM models demonstrated that Blacks with aphasia experienced 1.9days longer lengths of stay compared to Whites with aphasia after controlling for demographic characteristics, 1.4days controlling for stroke/illness severity, 1.2days controlling for observed hospital characteristics, and ~1 extra day controlling for unobserved hospital characteristics. Similarly, Blacks accrued ~$2047 greater total costs compared to Whites after controlling for demographic characteristics, $1659 controlling for stroke/illness severity, $1338 controlling for observed hospital characteristics, and ~$1311 greater total costs after controlling for unobserved hospital characteristics. In the acute hospital setting, Blacks with aphasia utilize greater hospital services during longer hospitalizations and at substantially higher costs in the state of NC. A substantial portion of the adjusted difference was related to the hospital treating the patient. However, even after controlling for the hospital, the differences remained clinically and statistically significant. Copyright © 2017 Elsevier B.V. All rights reserved.

Cost-Effectiveness of Dolutegravir in HIV-1 Treatment-Experienced (TE Patients in France.

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Gilles Pialoux

Full Text Available To evaluate the cost-effectiveness of a new generation integrase inhibitor (INI, dolutegravir (DTG, in France, in treatment-experienced (TE and INI-naïve HIV-infected adults with at least two classes resistance compared to raltegravir (RAL, by adapting previously published Anti-Retroviral Analysis by Monte Carlo Individual Simulation (ARAMIS model.ARAMIS is a microsimulation Markov model with a lifetime time horizon and a monthly cycle length. Health states are defined as with or without opportunistic infection and death. In the initial cohort, efficacy and safety data were derived from a phase III study comparing DTG to RAL. Antiretroviral treatment algorithms, accounting for patient history, were based on French guidelines and experts opinion. Costs are mainly including treatment costs, routine HIV and opportunistic infection care, and death. Utilities depend on CD4+ cell count and the occurrence of opportunistic infections.The ARAMIS model indicates in the TE population that DTG compared to RAL over a life time is associated with 0.35 additional quality-adjusted life years (QALY; 10.75 versus 10.41 and additional costs of €7,266 (€390,001 versus €382,735. DTG increased costs are mainly related to a 9.1-month increase in life expectancy for DTG compared with RAL, and consequently a longer time spent on ART. The incremental cost-effectiveness ratio (ICER for DTG compared with RAL is €21,048 per QALY gained. About 83% and 14% of total lifetime costs are associated with antiretroviral therapy and routine HIV care respectively. Univariate deterministic sensitivity analyses demonstrate the robustness of the model.DTG is cost-effective in the management of TE INI naive patients in France, from a collective perspective. These results could be explained by the superior efficacy of DTG in this population and its higher genetic barrier to resistance compared to RAL. These data need to be confirmed with longer-term real life data.

Sedation with nitrous oxide compared with no sedation during catheterization for urologic imaging in children

International Nuclear Information System (INIS)

Zier, Judith L.; Kvam, Kathryn A.; Kurachek, Stephen C.; Finkelstein, Marsha

2007-01-01

Various strategies to mitigate children's distress during voiding cystourethrography (VCUG) have been described. Sedation with nitrous oxide is comparable to that with oral midazolam for VCUG, but a side-by-side comparison of nitrous oxide sedation and routine care is lacking. The effects of sedation/analgesia using 70% nitrous oxide and routine care for VCUG and radionuclide cystography (RNC) were compared. A sample of 204 children 4-18 years of age scheduled for VCUG or RNC with sedation or routine care were enrolled in this prospective study. Nitrous oxide/oxygen (70%/30%) was administered during urethral catheterization to children in the sedated group. The outcomes recorded included observed distress using the Brief Behavioral Distress Score, self-reported pain, and time in department. The study included 204 patients (99 nonsedated, 105 sedated) with a median age of 6.3 years (range 4.0-15.2 years). Distress and pain scores were greater in nonsedated than in sedated patients (P < 0.001). Time in department was longer in the sedated group (90 min vs. 30 min); however, time from entry to catheterization in a non-imaging area accounted for most of the difference. There was no difference in radiologic imaging time. Sedation with nitrous oxide is effective in reducing distress and pain during catheterization for VCUG or RNC in children. (orig.)

Comparative evaluation of combined irradiation and hyperthermia versus irradiation alone

International Nuclear Information System (INIS)

Sawas-Dimopoulou, C.; Iordanou, I.; Uzunoglu, N.; Dardoufas, K.; Kouloulias, V.; Maris, T.; Kotaridis, S.

1994-01-01

Controvesy remains as to the treatment schedule producing better results in combined hyperthermia and X-ray therapy. Our experience concerning combined therapy of the solid tumour Walker carcinoma is reported. Male Wistar rats were submitted to treatment on the ninth day after transplantation of the tumour. Two groups of rats received either a therapeutic X-ray dose of 800 cGy by a 6-MeV linear accelerator (Mevatron, Siemens) or treatment by 432 MHz of microwaves with continuous control of tumour tissue temperature to 44±1 C for 45 min. Another group of rats was submitted to a combined treatment, with X-ray therapy preceding hyperthermia by 24 h. The last group of animals constituted the control rats. Greater tumour regression and longer survival times were obtained with the combined treatment. The gain factor for survival time was equal to 1.85 after combined treatment compared with 1.30 after X-ray therapy and 1.05 after hyperthermia. In conclusion, the results suggest that in the above schedule of combined treatment, hyperthermia applied to a solid tumour 24 h after a single dose of X-rays enhances the beneficial effect of therapy. (orig.)

Effects of Aircraft Noise and Sonic Booms on Domestic Animals and Wildlife: Bibliographic Abstracts

Science.gov (United States)

1988-06-01

However, noise-exposed mice experienceda longer time interval between litters and lower weight gain of young, compared to the controls. Busnel, R.G., and...effects of sounds of varying intensities. Poult. Sci. 37:776-779. Broiler chickens were exposed to recorded airfield noise and aircraft flyovers from the...pen of broilers is more likely to occur from an isolated low-level flyover than from continuous noise resulting from close proximity to an airfield

Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

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Helen Killaspy

Full Text Available BACKGROUND: The Quality Indicator for Rehabilitative Care (QuIRC is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. METHOD: At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. RESULTS: 1750/2495 (70% users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning. A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. CONCLUSIONS: Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care

Long-term effects of psychotherapy on moderate depression: a comparative study of narrative therapy and cognitive-behavioral therapy.

Science.gov (United States)

Lopes, Rodrigo T; Gonçalves, Miguel M; Fassnacht, Daniel B; Machado, Paulo P P; Sousa, Inês

2014-01-01

In a previous clinical controlled trial (Lopes et al., 2014), narrative therapy (NT) showed promising results in ameliorating depressive symptoms with comparable outcomes to cognitive-behavioral therapy (CBT) when patients completed treatment. This paper aims to assess depressive symptoms and interpersonal problems in this clinical sample at follow-up. Using the Beck Depression Inventory-II and Outcome Questionnaire-45.2 Interpersonal Relations Scale, naturalistic prospective follow-up assessment was conducted at 21 and 31 months after the last treatment session. At follow-up, patients kept improving in terms of depressive symptoms and interpersonal problems. The odds that a patient maintained recovery from depressive symptoms at follow-up were five times higher than the odds that a patient maintained recovery from interpersonal problems. In the same way, the odds of a patient never recovering from interpersonal problems were five times higher than the odds of never recovering from depressive symptoms. The study did not control for the natural course of depression or treatment continuation. For depressed patients with greater interpersonal disabilities, longer treatment plans and alternative continuation treatments should be considered. Copyright © 2014 Elsevier B.V. All rights reserved.

The effects of the arm swing on biomechanical and physiological aspects of roller ski skating.

Science.gov (United States)

Hegge, Ann Magdalen; Ettema, Gertjan; de Koning, Jos J; Rognstad, Asgeir Bakken; Hoset, Martin; Sandbakk, Øyvind

2014-08-01

This study analyzed the biomechanical and physiological effects of the arm swing in roller ski skating, and compared leg-skating (i.e. ski skating without poles) using a pronounced arm swing (SWING) with leg-skating using locked arms (LOCKED). Sixteen elite male cross-country skiers performed submaximal stages at 10, 15 and 20kmh(-1) on a 2% inclined treadmill in the two techniques. SWING demonstrated higher peak push-off forces and a higher force impulse at all speeds, but a longer cycle length only at the highest speed (all Pskating increases the ski forces and aerobic energy cost at low and moderate speeds, whereas the greater forces at high speed lead to a longer cycle length and smaller anaerobic contribution. Copyright © 2014 Elsevier B.V. All rights reserved.

Data sources for heart failure comparative effectiveness research.

Science.gov (United States)

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

2013-01-01

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

Do benefits accrue from longer rotations for students in Rural Clinical Schools?

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Denz-Penhey, Harriet; Shannon, Susan; Murdoch, Campbell J; Newbury, Jonathon W

2005-01-01

areas of need. Clinical benefits: contributions to the clinical team: students in their clinical years want to feel useful and to be allowed to become contributors to the medical care, even as they are learning. A longer rotation allows them to become known to their teachers who are then able to easily assess the type of contribution that is appropriate for their students to undertake. Students then become full participating members of the healthcare team, rather than observing learners. Social benefits: all students with a home base actively participated in a wide range of community activities outside their role as medical students. Those students undertaking short rotations without a home base seldom connected in the same way to any rural community. Evaluation from these two RCS has shown that short rotations are likely to be less optimal than longer rotations for meeting the broader goals of the RCS to build future workforce capacity. Our results suggest that one opportunity to acculturate students into the rural lifestyle is lost when students' placements are insufficiently long for them to put down roots in their community, and to understand how to 'live' there more broadly. Good rural experiences and teaching and learning opportunities are not sufficient in themselves. Students' emotional attachment to rural living comes from experience related to time and the connection to local people that comes as a result of time spent in the community. Students on short rotations do not make that local connection.

The Effect of Culture Type on the Length of Persian Proverbs Compared to their English Equivalents

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Amir Mohammadian

2017-05-01

Full Text Available The interrelation of culture and language is to the extent that many classifications of culture are based on linguistic factors. In this article, high and low context cultures division is assessed on English and Persian as they belong to different cultural types. Forty Persian proverbs are contrasted with their equivalents in English to investigate whether there is a difference in the number of word forms used in each. In order to avoid linguistic differences which are effective in enumerating word forms, the second lines in linguistic glosses provided for Persian proverbs including a one to one correspondence of each word in English are used to count word forms. Results show that 70 percent of the Persian proverbs in the data are longer than their English counterparts. This shows that relative length of proverbs can be a distinguishing factor reflecting cultural types. The results not only confirm the applicability of this cultural division in the field of proverbs, but also a matter of tendency rather than a dichotomy in belonging to a high or low context culture is proposed. At the end, there are suggestions for further relevant investigations.

Designing questionnaires: healthcare survey to compare two different response scales

Science.gov (United States)

2014-01-01

Background A widely discussed design issue in patient satisfaction questionnaires is the optimal length and labelling of the answering scale. The aim of the present study was to compare intra-individually the answers on two response scales to five general questions evaluating patients’ perception of hospital care. Methods Between November 2011 and January 2012, all in-hospital patients at a Swiss University Hospital received a patient satisfaction questionnaire on an adjectival scale with three to four labelled categories (LS) and five redundant questions displayed on an 11-point end-anchored numeric scale (NS). The scales were compared concerning ceiling effect, internal consistency (Cronbach’s alpha), individual item answers (Spearman’s rank correlation), and concerning overall satisfaction by calculating an overall percentage score (sum of all answers related to the maximum possible sum). Results The response rate was 41% (2957/7158), of which 2400 (81%) completely filled out all questions. Baseline characteristics of the responders and non-responders were similar. Floor and ceiling effect were high on both response scales, but more pronounced on the LS than on the NS. Cronbach’s alpha was higher on the NS than on the LS. There was a strong individual item correlation between both answering scales in questions regarding the intent to return, quality of treatment and the judgement whether the patient was treated with respect and dignity, but a lower correlation concerning satisfactory information transfer by physicians or nurses, where only three categories were available in the LS. The overall percentage score showed a comparable distribution, but with a wider spread of lower satisfaction in the NS. Conclusions Since the longer scale did not substantially reduce the ceiling effect, the type of questions rather than the type of answering scale could be addressed with a focus on specific questions about concrete situations instead of general questions

Cost-Effectiveness of Percutaneous Closure of the Left Atrial Appendage in Atrial Fibrillation Based on Results from PROTECT AF vs. PREVAIL

Science.gov (United States)

Freeman, James V.; Hutton, David W.; Barnes, Geoffrey D.; Zhu, Ruo P.; Owens, Douglas K.; Garber, Alan M.; Go, Alan S.; Hlatky, Mark A.; Heidenreich, Paul A.; Wang, Paul J.; Al-Ahmad, Amin; Turakhia, Mintu P.

2016-01-01

Background Randomized trials of left atrial appendage (LAA) closure with the Watchman device have shown varying results, and its cost-effectiveness compared to anticoagulation has not been evaluated using all available contemporary trial data. Methods and Results We used a Markov decision model to estimate lifetime quality-adjusted survival, costs, and cost-effectiveness of LAA closure with Watchman, compared directly with warfarin and indirectly with dabigatran, using data from the long-term (mean 3.8 year) follow-up of PROTECT AF and PREVAIL randomized trials. Using data from PROTECT AF, the incremental cost-effectiveness ratios (ICER) compared to warfarin and dabigatran were $20,486 and $23,422 per quality adjusted life year (QALY), respectively. Using data from PREVAIL, LAA closure was dominated by warfarin and dabigatran, meaning that it was less effective (8.44, 8.54, and 8.59 QALYs, respectively) and more costly. At a willingness-to-pay-threshold of $50,000 per QALY, LAA closure was cost-effective 90% and 9% of the time under PROTECT AF and PREVAIL assumptions, respectively. These results were sensitive to the rates of ischemic stroke and intracranial hemorrhage for LAA closure and medical anticoagulation. Conclusions Using data from the PROTECT AF trial, LAA closure with the Watchman device was cost-effective; using PREVAIL trial data, Watchman was more costly and less effective than warfarin and dabigatran. PROTECT AF enrolled more patients and has substantially longer follow-up time, allowing greater statistical certainty with the cost-effectiveness results. However, longer term trial results and post-marketing surveillance of major adverse events will be vital to determining the value of the Watchman in clinical practice. PMID:27307517

Is My Exercise Partner Similar Enough? Partner Characteristics as a Moderator of the Köhler Effect in Exergames.

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Forlenza, Samuel T; Kerr, Norbert L; Irwin, Brandon C; Feltz, Deborah L

2012-12-01

Recent research has shown the Köhler motivation gain effect (working at a task with a more capable partner where one's performance is indispensable to the group) leads to greater effort in partnered exercise videogame play. The purpose of this article was to examine potential moderators of the Köhler effect by exploring dissimilarities in one's partner's appearance, namely, having an older partner (compared with a same-age partner) and having a heavier-weight partner (compared with a same-weight partner). One hundred fifty-three male and female college students completed a series of plank exercises using the "EyeToy: Kinetic™" for the PlayStation(®) 2 (Sony, Tokyo, Japan). Participants first completed the exercises individually and, after a rest, completed the same exercises with a virtually present partner. Exercise persistence, subjective effort, self-efficacy beliefs, enjoyment, and intentions to exercise were recorded and analyzed. A significant Köhler motivation gain was observed in all partner conditions (compared with individual controls) such that participants with a partner held the plank exercises longer (P<0.001) and reported higher subjective effort (P<0.01). These results were unmoderated by partner's age and weight, with one exception: Males tended to persist longer when paired with an obese partner (P=0.08). These results suggest that differences in age and weight do not attenuate the Köhler effect in exergames and may even strengthen it.

Are Sex Effects on Ethical Decision-Making Fake or Real? A Meta-Analysis on the Contaminating Role of Social Desirability Response Bias.

Science.gov (United States)

Yang, Jianfeng; Ming, Xiaodong; Wang, Zhen; Adams, Susan M

2017-02-01

A meta-analysis of 143 studies was conducted to explore how the social desirability response bias may influence sex effects on ratings on measures of ethical decision-making. Women rated themselves as more ethical than did men; however, this sex effect on ethical decision-making was no longer significant when social desirability response bias was controlled. The indirect questioning approach was compared with the direct measurement approach for effectiveness in controlling social desirability response bias. The indirect questioning approach was found to be more effective.

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-04-29

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

Small Proteins Can No Longer Be Ignored

Science.gov (United States)

Storz, Gisela; Wolf, Yuri I.; Ramamurthi, Kumaran S.

2014-01-01

Small proteins, here defined as proteins of 50 amino acids or less in the absence of processing, have traditionally been overlooked due to challenges in their annotation and biochemical detection. In the past several years however, increasing numbers of small proteins have been identified either through the realization that mutations in “intergenic” regions actually are within unannotated small protein genes, or through the discovery that some small, regulatory RNAs (sRNAs) encode small proteins. These insights together with comparative sequence analysis indicate that tens if not hundreds of small proteins are synthesized in a given organism. This review will summarize what has been learned about the functions of several of these bacterial small proteins, most of which act at the membrane, illustrating the astonishing range of processes in which the small proteins act and pointing to several general conclusions. Important questions for future studies of these overlooked proteins also will be discussed. PMID:24606146

Health Effects of Non-Ionizing Radiation on Human

International Nuclear Information System (INIS)

Zubaidah-Alatas; Yanti Lusiyanti

2001-01-01

Increases of development and use of equipment that procedures non-ionizing radiant energy such as laser, radar, microwave ovens, power lines and hand phones, bring about public concern about the possible health effects owing to the non-ionizing radiation exposure. Non ionizing electromagnetic radiation compared to ionizing radiation, has longer wavelength, lower frequency, and lower photon energy in its interaction with body tissues. The term on non-ionizing radiation refers to the groups of electromagnetic radiations with energies less than about 10 eV corresponding to wavelengths in the ultraviolet, visible, infra red microwave and radiofrequency spectral regions. This paper describes the current state of knowledge about types of non-ionizing radiation and the health effects at molecular and cellular levels as well as its effects on human health. (author)

Venous thromboembolism management in Northeast Melbourne: how does it compare to international guidelines and data?

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Lim, Hui Y; Chua, Chong C; Tacey, Mark; Sleeman, Matthew; Donnan, Geoffrey; Nandurkar, Harshal; Ho, Prahlad

2017-09-01

Venous thromboembolism (VTE) is a major cause of morbidity and mortality with significant heterogeneity in its management, both within our local practice and in international guidelines. To provide a holistic evaluation of 'real-world' Australian experience in the warfarin era, including how we compare to international guidelines. Retrospective evaluation of VTE from July 2011 to December 2012 at two major hospitals in Melbourne, Australia. These results were compared to recommendations in the international guidelines. A total of 752 episodes involving 742 patients was identified. Contrary to international guidelines, an unwarranted heritable thrombophilia screen was performed in 22.0% of patients, amounting to a cost of AU$29 000. The duration of anticoagulation was longer compared to international recommendations, although the overall recurrence (3.2/100 person-years) and clinically significant bleeding rates (2.4/100 person-years) were comparable to 'real-world' data. Unprovoked VTE (hazard ratio 2.06; P = 0.01) was a risk factor for recurrence, and there was no difference in recurrence between major VTE (proximal deep vein thrombosis (DVT) and/or pulmonary embolism) and isolated distal DVT (3.02 vs 3.94/100 person-years; P = 0.25). Fourteen patients were subsequently diagnosed with malignancy, and patients with recurrent VTE had increased risk of prospective cancer diagnosis (relative risk 6.68; P management strategies, including excessive thrombophilia screening and longer duration of anticoagulation. This audit highlights the need for national VTE guidelines, as well as prospective auditing of VTE management, in the direct oral anticoagulant era for future comparison. © 2017 Royal Australasian College of Physicians.

Antidepressants: Can They Lose Effectiveness?

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... t seem to be having the same effect. Can antidepressants lose effectiveness? Answers from Daniel K. Hall- ... some people and not in others. There also can be other reasons an antidepressant is no longer ...

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

African Journals Online (AJOL)

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

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

Science.gov (United States)

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

2017-02-01

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

Expected returns from a tax on nuclear fuel elements in the context of longer service lives of German nuclear power plants

International Nuclear Information System (INIS)

Kondziella, Hendrik; Bruckner, Thomas

2010-01-01

To what extent will the fuel element tax introduced by the German government in combination with the longer service life of nuclear power stations reduce the profits of public utilities? A qualitative assessment suggests that the tax will not equal the full profits. Using an electricity market model, various scenarios can be calculated for an eight-year prolongation of the residual service life of existing nuclear power plants. (orig.)

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

Science.gov (United States)

Salinas-Escudero, Guillermo; Vargas-Valencia, Juan; García-García, Erika Gabriela; Munciño-Ortega, Emilio; Galindo-Suárez, Rosa María

2013-01-01

to conduct cost-effectiveness analysis of etanercept compared with other biologic therapies in the treatment of moderate or severe rheumatoid arthritis in patients with previous unresponse to immune selective anti-inflammatory derivatives failure. a pharmacoeconomic model based on decision analysis to assess the clinical outcome after giving etanercept, infliximab, adalimumab or tocilizumab to treat moderate or severe rheumatoid arthritis was employed. Effectiveness of medications was assessed with improvement rates of 20 % or 70 % of the parameters established by the American College of Rheumatology (ACR 20 and ACR 70). the model showed that etanercept had the most effective therapeutic response rate: 79.7 % for ACR 20 and 31.4 % for ACR 70, compared with the response to other treatments. Also, etanercept had the lowest cost ($149,629.10 per patient) and had the most cost-effective average ($187,740.40 for clinical success for ACR 20 and $476,525.80 for clinical success for ACR 70) than the other biologic therapies. we demonstrated that treatment with etanercept is more effective and less expensive compared to the other drugs, thus making it more efficient therapeutic option both in terms of means and incremental cost-effectiveness ratios for the treatment of rheumatoid arthritis.

Comparative chloroplast genomics: Analyses including new sequencesfrom the angiosperms Nuphar advena and Ranunculus macranthus

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Raubeso, Linda A.; Peery, Rhiannon; Chumley, Timothy W.; Dziubek,Chris; Fourcade, H. Matthew; Boore, Jeffrey L.; Jansen, Robert K.

2007-03-01

The number of completely sequenced plastid genomes available is growing rapidly. This new array of sequences presents new opportunities to perform comparative analyses. In comparative studies, it is most useful to compare across wide phylogenetic spans and, within angiosperms, to include representatives from basally diverging lineages such as the new genomes reported here: Nuphar advena (from a basal-most lineage) and Ranunculus macranthus (from the basal group of eudicots). We report these two new plastid genome sequences and make comparisons (within angiosperms, seed plants, or all photosynthetic lineages) to evaluate features such as the status of ycf15 and ycf68 as protein coding genes, the distribution of simple sequence repeats (SSRs) and longer dispersed repeats (SDR), and patterns of nucleotide composition.

Consensus of recommendations guiding comparative effectiveness research methods.

Science.gov (United States)

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

2016-12-01

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

Comparative study between ultrasound guided tap block and paravertebral block in upper abdominal surgeries. Randomized controlled trial

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Ruqaya M. Elsayed

2017-01-01

Conclusion: We concluded that ultrasound guided transversus abdominis plane block and thoracic paravertebral block were safe and effective anesthetic technique for upper abdominal surgery with longer and potent postoperative analgesia in thoracic paravertebral block than transversus abdominis block.

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

Science.gov (United States)

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

2010-05-01

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

Intellectual maturity and longevity: late-blooming composers and writers live longer than child prodigies.

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Hafkamp, Maurits P J; Slaets, Joris P J; van Bodegom, David

2017-05-30

Life history theory links human physical and sexual development to longevity. However, there have been no studies on the association of intellectual development with longevity. This observational study investigates the relationship between the onset of intellectual maturity and lifespan through the life histories of composers and creative writers, whose intellectual development can be gauged through their compositions and writings. In these groups we model the relationship between the age at first creative work, and age at death using multilevel regression, adjusting for sex, date of birth, and nationality. Historical biographical records on 1110 musical composers and 1182 creative writers, born in the period 1400 AD through 1915 AD, were obtained from the Oxford Companion to Music and the Oxford Companion to English Literature. Composers and creative writers lived, respectively 0.16 ( p = 0.02) and 0.18 ( p < 0.01) years longer for each later year of age at first work. When completion of the first creative work is interpreted as a proxy for the onset of intellectual maturity in composers and creative writers, our findings indicate that a later onset of intellectual maturity is associated with higher longevity.

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

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Myrna Candelaria-Hernández

2017-06-01

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

Systematic review and meta-analysis of randomized controlled trials for the management of limited vertical height in the posterior region: short implants (5 to 8 mm) vs longer implants (> 8 mm) in vertically augmented sites.

Science.gov (United States)

Lee, Sung-Ah; Lee, Chun-Teh; Fu, Martin M; Elmisalati, Waiel; Chuang, Sung-Kiang

2014-01-01

The aim of this study was to undertake a systematic review with meta-analysis on randomized controlled trials (RCTs) to compare the rates of survival, success, and complications of short implants to those of longer implants in the posterior regions. Electronic literature searches were conducted through the MEDLINE (PubMed) and EMBASE databases to locate all relevant articles published between January 1, 1990, and April 30, 2013. Eligible studies were selected based on inclusion criteria, and quality assessments were conducted. After data extraction, meta-analyses were performed. In total, 539 dental implants (265 short implants [length 5 to 8 mm] and 274 control implants [length > 8 mm]) from four RCTs were included. The fixed prostheses of multiple short and control implants were all splinted. The mean follow-up period was 2.1 years. The 1-year and 5-year cumulative survival rates (CSR) were 98.7% (95% confidence interval [CI], 97.8% to 99.5%) and 93.6% (95% CI, 89.8% to 97.5%), respectively, for the short implant group and 98.0% (95% CI, 96.9% to 99.1%) and 90.3% (95% CI, 85.2% to 95.4%), respectively, for the control implant group. The CSRs of the two groups did not demonstrate a statistically significant difference. There were also no statistically significant differences in success rates, failure rates, or complications between the two groups. Placement of short dental implants could be a predictable alternative to longer implants to reduce surgical complications and patient morbidity in situations where vertical augmentation procedures are needed. However, only four studies with potential risk of bias were selected in this meta-analysis. Within the limitations of this meta-analysis, these results should be confirmed with robust methodology and RCTs with longer follow-up duration.

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

Directory of Open Access Journals (Sweden)

Ingunn Fride Tvete

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

Epidermal Growth Factor Receptor Mutation Is Associated With Longer Local Control After Definitive Chemoradiotherapy in Patients With Stage III Nonsquamous Non–Small-Cell Lung Cancer

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Yagishita, Shigehiro; Horinouchi, Hidehito; Katsui Taniyama, Tomoko; Nakamichi, Shinji; Kitazono, Satoru; Mizugaki, Hidenori; Kanda, Shintaro; Fujiwara, Yutaka; Nokihara, Hiroshi; Yamamoto, Noboru; Sumi, Minako; Shiraishi, Kouya; Kohno, Takashi; Furuta, Koh; Tsuta, Koji; Tamura, Tomohide

2015-01-01

Purpose: To determine the frequency and clinical significance of epidermal growth factor receptor (EGFR) mutations in patients with potentially curable stage III non–small-cell lung cancer (NSCLC) who are eligible for definitive chemoradiotherapy (CRT). Patients and Methods: Between January 2001 and December 2010, we analyzed the EGFR mutational status in consecutive NSCLC patients who were treated by CRT. The response rate, relapse-free survival, 2-year relapse-free rate, initial relapse sites, and overall survival of the patients were investigated. Results: A total of 528 patients received CRT at our hospital during the study period. Of these, 274 were diagnosed as having nonsquamous NSCLC. Sufficient specimens for mutational analyses could be obtained from 198 of these patients. The proportion of patients with EGFR activating mutations was 17%. In addition to the well-known characteristics of patients carrying EGFR mutations (female, adenocarcinoma, and never/light smoker), the proportion of cases with smaller primary lesions (T1/2) was found to be higher in patients with EGFR mutations than in those with wild-type EGFR. Patients with EGFR mutations showed similar response rate, relapse-free survival, and 2-year relapse-free rates as compared to patients with wild-type EGFR. Local relapses as the site of initial relapse occurred significantly less frequently in patients with EGFR mutation (4% vs 21%; P=.045). Patients with EGFR mutations showed longer local control (adjusted hazard ratio 0.49; P=.043). After disease progression, a majority of the patients with EGFR mutations received EGFR tyrosine kinase inhibitors (62%), and these patients showed longer postprogression survival than those with wild-type EGFR. Conclusions: Our study is the first to show radiosensitive biology of EGFR-mutated tumors in definitive CRT with curative intent. This finding could serve as a credible baseline estimate of EGFR-mutated population in stage III nonsquamous NSCLC

Epidermal Growth Factor Receptor Mutation Is Associated With Longer Local Control After Definitive Chemoradiotherapy in Patients With Stage III Nonsquamous Non–Small-Cell Lung Cancer

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Yagishita, Shigehiro [Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo (Japan); Horinouchi, Hidehito, E-mail: hhorinou@ncc.go.jp [Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo (Japan); Katsui Taniyama, Tomoko; Nakamichi, Shinji; Kitazono, Satoru; Mizugaki, Hidenori; Kanda, Shintaro; Fujiwara, Yutaka; Nokihara, Hiroshi; Yamamoto, Noboru [Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo (Japan); Sumi, Minako [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Shiraishi, Kouya; Kohno, Takashi [Division of Genome Biology, National Cancer Center Research Institute, Tokyo (Japan); Furuta, Koh [Department of Clinical Laboratories, National Cancer Center Hospital, Tokyo (Japan); Tsuta, Koji [Department of Pathology, National Cancer Center Hospital, Tokyo (Japan); Tamura, Tomohide [Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo (Japan)

2015-01-01

Purpose: To determine the frequency and clinical significance of epidermal growth factor receptor (EGFR) mutations in patients with potentially curable stage III non–small-cell lung cancer (NSCLC) who are eligible for definitive chemoradiotherapy (CRT). Patients and Methods: Between January 2001 and December 2010, we analyzed the EGFR mutational status in consecutive NSCLC patients who were treated by CRT. The response rate, relapse-free survival, 2-year relapse-free rate, initial relapse sites, and overall survival of the patients were investigated. Results: A total of 528 patients received CRT at our hospital during the study period. Of these, 274 were diagnosed as having nonsquamous NSCLC. Sufficient specimens for mutational analyses could be obtained from 198 of these patients. The proportion of patients with EGFR activating mutations was 17%. In addition to the well-known characteristics of patients carrying EGFR mutations (female, adenocarcinoma, and never/light smoker), the proportion of cases with smaller primary lesions (T1/2) was found to be higher in patients with EGFR mutations than in those with wild-type EGFR. Patients with EGFR mutations showed similar response rate, relapse-free survival, and 2-year relapse-free rates as compared to patients with wild-type EGFR. Local relapses as the site of initial relapse occurred significantly less frequently in patients with EGFR mutation (4% vs 21%; P=.045). Patients with EGFR mutations showed longer local control (adjusted hazard ratio 0.49; P=.043). After disease progression, a majority of the patients with EGFR mutations received EGFR tyrosine kinase inhibitors (62%), and these patients showed longer postprogression survival than those with wild-type EGFR. Conclusions: Our study is the first to show radiosensitive biology of EGFR-mutated tumors in definitive CRT with curative intent. This finding could serve as a credible baseline estimate of EGFR-mutated population in stage III nonsquamous NSCLC.

Prey aggregation is an effective olfactory predator avoidance strategy

Directory of Open Access Journals (Sweden)

Asa Johannesen

2014-05-01

Full Text Available Predator–prey interactions have a major effect on species abundance and diversity, and aggregation is a well-known anti-predator behaviour. For immobile prey, the effectiveness of aggregation depends on two conditions: (a the inability of the predator to consume all prey in a group and (b detection of a single large group not being proportionally easier than that of several small groups. How prey aggregation influences predation rates when visual cues are restricted, such as in turbid water, has not been thoroughly investigated. We carried out foraging (predation experiments using a fish predator and (dead chironomid larvae as prey in both laboratory and field settings. In the laboratory, a reduction in visual cue availability (in turbid water led to a delay in the location of aggregated prey compared to when visual cues were available. Aggregated prey suffered high mortality once discovered, leading to better survival of dispersed prey in the longer term. We attribute this to the inability of the dead prey to take evasive action. In the field (where prey were placed in feeding stations that allowed transmission of olfactory but not visual cues, aggregated (large groups and semi-dispersed prey survived for longer than dispersed prey—including long term survival. Together, our results indicate that similar to systems where predators hunt using vision, aggregation is an effective anti-predator behaviour for prey avoiding olfactory predators.