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Sample records for longer comparative effects

  1. Minimum Wage Effects in the Longer Run

    Science.gov (United States)

    Neumark, David; Nizalova, Olena

    2007-01-01

    Exposure to minimum wages at young ages could lead to adverse longer-run effects via decreased labor market experience and tenure, and diminished education and training, while beneficial longer-run effects could arise if minimum wages increase skill acquisition. Evidence suggests that as individuals reach their late 20s, they earn less the longer…

  2. Needle thoracostomy: Clinical effectiveness is improved using a longer angiocatheter.

    Science.gov (United States)

    Aho, Johnathon M; Thiels, Cornelius A; El Khatib, Moustafa M; Ubl, Daniel S; Laan, Danuel V; Berns, Kathleen S; Habermann, Elizabeth B; Zietlow, Scott P; Zielinski, Martin D

    2016-02-01

    Decompression of tension physiology may be lifesaving, but significant doubts remain regarding ideal needle thoracostomy (NT) catheter length in the treatment of tension physiology. We aimed to demonstrate increased clinical effectiveness of longer NT angiocatheter (8 cm) compared with current Advanced Trauma Life Support recommendations of 5-cm NT length. This is a retrospective review of all adult trauma patients from 2003 to 2013 (age > 15 years) transported to a Level I trauma center. Patients underwent NT at the second intercostal space midclavicular line, either at the scene of injury, during transport (prehospital), or during initial hospital trauma resuscitation. Before March 2011, both prehospital and hospital trauma team NT equipment routinely had a 5-cm angiocatheter available. After March 2011, prehospital providers were provided an 8-cm angiocatheter. Effectiveness was defined as documented clinical improvement in respiratory, cardiovascular, or general clinical condition. There were 91 NTs performed on 70 patients (21 bilateral placements) either in the field (prehospital, n = 41) or as part of resuscitation in the hospital (hospital, n = 29). Effectiveness of NT was 48% until March 2011 (n = 24). NT effectiveness was significantly higher in the prehospital setting than in the hospital (68.3% success rate vs. 20.7%, p < 0.01). Patients who underwent NT using 8 cm compared with 5 cm were significantly more effective (83% vs. 41%, respectively, p = 0.01). No complications of NT were identified in either group. Eight-centimeter angiocatheters are more effective at chest decompression compared with currently recommended 5 cm at the second intercostal space midclavicular line. Therapeutic study, level IV.

  3. Longer Term Impact of Cigarette Package Warnings in Australia Compared with the United Kingdom and Canada

    Science.gov (United States)

    Li, Lin; Borland, Ron; Yong, Hua; Cummings, Kenneth M.; Thrasher, James F.; Hitchman, Sara C.; Fong, Geoffrey T.; Hammond, David; Bansal-Travers, Maansi

    2015-01-01

    This study examines the effects of different cigarette package warnings in Australia, Canada and the United Kingdom up to 5 years post-implementation. The data came from the International Tobacco Control Surveys. Measures included salience of warnings, cognitive responses, forgoing cigarettes and avoiding warnings. Although salience of the UK…

  4. Short versus longer term effectiveness of an outreach program for the homeless mentally ill.

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    Bybee, D; Mowbray, C T; Cohen, E

    1994-04-01

    Presents 12-month follow-up results from an outreach/linkage intervention with persons who are homeless and mentally ill, contrasting these with results obtained at 4 months. Both sets reflect the success of the program in placing individuals in independent housing. However, longer term data provide useful information regarding client movement patterns and increased tenure in nonhomeless living arrangements beyond the termination of specialized services. Analyses of 12-month residential outcomes identified four variables as significant predictors: recruitment source, project service duration, CMH service duration, and client age. In contrast to 4-month predictors, variables reflecting baseline client functioning were no longer significantly related to outcome, suggesting that the positive effects of the intervention may take longer to achieve with some clients. Discussion focuses on the implications of these effectiveness results for future research designs and measures as well as the utility and limitations of preexperimental approaches for evaluating innovative service models when implementation and efficacy experiences are lacking.

  5. Longer Term Effects of a Tier 2 Kindergarten Vocabulary Intervention for English Learners

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    Vadasy, Patricia F.; Nelson, J. Ron; Sanders, Elizabeth A.

    2013-01-01

    This study examines the longer term effectiveness of a standard protocol, Tier 2 supplemental vocabulary intervention for kindergarten English learners, designed to develop root word vocabulary knowledge and reinforce beginning word reading skills. Participating students in the original study ("n" = 93 treatment, 92 control) received 20 weeks of…

  6. Dissecting the roles of local packing density and longer-range effects in protein sequence evolution.

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    Shahmoradi, Amir; Wilke, Claus O

    2016-06-01

    What are the structural determinants of protein sequence evolution? A number of site-specific structural characteristics have been proposed, most of which are broadly related to either the density of contacts or the solvent accessibility of individual residues. Most importantly, there has been disagreement in the literature over the relative importance of solvent accessibility and local packing density for explaining site-specific sequence variability in proteins. We show that this discussion has been confounded by the definition of local packing density. The most commonly used measures of local packing, such as contact number and the weighted contact number, represent the combined effects of local packing density and longer-range effects. As an alternative, we propose a truly local measure of packing density around a single residue, based on the Voronoi cell volume. We show that the Voronoi cell volume, when calculated relative to the geometric center of amino-acid side chains, behaves nearly identically to the relative solvent accessibility, and each individually can explain, on average, approximately 34% of the site-specific variation in evolutionary rate in a data set of 209 enzymes. An additional 10% of variation can be explained by nonlocal effects that are captured in the weighted contact number. Consequently, evolutionary variation at a site is determined by the combined effects of the immediate amino-acid neighbors of that site and effects mediated by more distant amino acids. We conclude that instead of contrasting solvent accessibility and local packing density, future research should emphasize on the relative importance of immediate contacts and longer-range effects on evolutionary variation. Proteins 2016; 84:841-854. © 2016 Wiley Periodicals, Inc.

  7. Dissecting the roles of local packing density and longer-range effects in protein sequence evolution

    CERN Document Server

    Shahmoradi, Amir

    2015-01-01

    What are the structural determinants of protein sequence evolution? A number of site-specific structural characteristics have been proposed, most of which are broadly related to either the density of contacts or the solvent accessibility of individual residues. Most importantly, there has been disagreement in the literature over the relative importance of solvent accessibility and local packing density for explaining site-specific sequence variability in proteins. We show here that this discussion has been confounded by the definition of local packing density. The most commonly used measures of local packing, such as the contact number and the weighted contact number, represent by definition the combined effects of local packing density and longer-range effects. As an alternative, we here propose a truly local measure of packing density around a single residue, based on the Voronoi cell volume. We show that the Voronoi cell volume, when calculated relative to the geometric center of amino-acid side chains, be...

  8. Effect of longer combination vehicles on the total logistic costs of truckload shippers

    Energy Technology Data Exchange (ETDEWEB)

    Middendorf, D.P.; Bronzini, M.S. [Oak Ridge National Lab., TN (United States); Jacoby, J. [Federal Highway Administration, Washington, DC (United States); Coyle, J.J. [Pennsylvania State Univ., University Park, PA (United States)

    1994-10-12

    The purpose of the research described in this paper was to examine the effects of using longer and heavier tractor-trailer combinations from the standpoint of the individual firm or shipper rather than from the viewpoint of the motor carrier. The objective was to determine the effect of longer combination vehicles (LCVS) not only on shippers freight costs but on their inventory and other logistical costs as well. A sample of companies in selected industries provided data on their principal products, traffic flows, and logistics costs in a mail survey. These data were entered into a computer program called the Freight Transportation Analyzer (FTA) which calculated the component logistics costs associated with shipping by single trailers and by two alternative types of double trailer LCVS. A major finding of the study was that, given sufficient flows of a company`s product in a traffic lane, LCVs would in most cases greatly reduce the total logistics cost of firms that currently ship in single trailer truckload quantities. Annual lane volume, lane distance, and annual lane ton-mileage appeared to be good indicators of whether or not shipping by LCVs would benefit a company, whereas product value had surprisingly little influence on the cost-effectiveness of LCVS. An even better indicator was the ratio of current annual freight costs to current annual inventory carrying costs for a firm`s single trailer truckload shipments. Given the current trend toward maintaining small inventories and shipping in small quantities, it is not clear to what extent shippers will abandon single trailer transport to take advantage of the potential reduction in total logistics cost afforded by LCVS.

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

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    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.

  10. 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.

  11. The effect of longer-term creatine supplementation on elite swimming performance after an acute creatine loading.

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    Theodorou, A S; Cooke, C B; King, R F; Hood, C; Denison, T; Wainwright, B G; Havenetidis, K

    1999-11-01

    We investigated the effect of an acute creatine loading (25 g per day for 4 days) and longer-term creatine supplementation (5 g of creatine or 5 g of placebo per day for 2 months) on the performance of 22 elite swimmers during maximal interval sessions. After the acute creatine loading, the mean of the average interval swim times for all swimmers (n = 22) improved (44.3+/-16.5 s before vs. 43.7+/-16.3 s after supplementation; Pswimmers did not respond positively to supplementation. After 2 months of longer-term creatine supplementation or placebo, neither group showed a significant change in swimming performance (38.7+/-13.5 s before vs. 38.7+/-14.1 s after for the creatine group; 48.7+/-18.0 s before vs. 48.7+/-18.1 s after for the placebo group). We conclude that, in elite swimmers, 4 days of acute creatine loading improves swimming performance significantly when assessed by maximal interval sessions. However, longer-term supplementation for 2 months (5 g of creatine per day) did not benefit significantly the creatine group compared with the placebo group.

  12. Effect of longer-term modest salt reduction on blood pressure.

    Science.gov (United States)

    He, Feng J; Li, Jiafu; Macgregor, Graham A

    2013-04-30

    A reduction in salt intake lowers blood pressure (BP) and, thereby, reduces cardiovascular risk. A recent meta-analysis by Graudal implied that salt reduction had adverse effects on hormones and lipids which might mitigate any benefit that occurs with BP reduction. However, Graudal's meta-analysis included a large number of very short-term trials with a large change in salt intake, and such studies are irrelevant to the public health recommendations for a longer-term modest reduction in salt intake. We have updated our Cochrane meta-analysis. To assess (1) the effect of a longer-term modest reduction in salt intake (i.e. of public health relevance) on BP and whether there was a dose-response relationship; (2) the effect on BP by sex and ethnic group; (3) the effect on plasma renin activity, aldosterone, noradrenaline, adrenaline, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides. We searched MEDLINE, EMBASE, Cochrane Hypertension Group Specialised Register, Cochrane Central Register of Controlled Trials, and reference list of relevant articles. We included randomised trials with a modest reduction in salt intake and duration of at least 4 weeks. Data were extracted independently by two reviewers. Random effects meta-analyses, subgroup analyses and meta-regression were performed. Thirty-four trials (3230 participants) were included. Meta-analysis showed that the mean change in urinary sodium (reduced salt vs usual salt) was -75 mmol/24-h (equivalent to a reduction of 4.4 g/d salt), the mean change in BP was -4.18 mmHg (95% CI: -5.18 to -3.18, I (2)=75%) for systolic and -2.06 mmHg (95% CI: -2.67 to -1.45, I (2)=68%) for diastolic BP. Meta-regression showed that age, ethnic group, BP status (hypertensive or normotensive) and the change in 24-h urinary sodium were all significantly associated with the fall in systolic BP, explaining 68% of the variance between studies. A 100 mmol reduction in 24 hour urinary sodium (6 g

  13. Longer Intestinal Persistence of Enterococcus faecalis Compared to Enterococcus faecium Clones in Intensive-Care-Unit Patients▿

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    Ruiz-Garbajosa, Patricia; del Campo, Rosa; Coque, Teresa M.; Asensio, Angel; Bonten, Marc; Willems, Rob; Baquero, Fernando; Cantón, Rafael

    2009-01-01

    The dynamics of intestinal colonization with enterococcal clones in intensive-care-unit (ICU) patients was evaluated. Eight patients admitted directly to the neurosurgical ICU at the Ramón y Cajal University Hospital (Madrid, Spain) from the community and with no overlapping stay during a 10-month period in 2006 were studied. Rectal swab specimens were collected on admission and daily until the patients were discharged. Clonality was determined by pulsed-field gel electrophoresis and multilocus sequence typing. Clonal colonization dynamics were estimated by using two new parameters: the clonal diversity per patient per day (CDPD) and the clonal persistence ratio (CPR). Enterococcus faecalis isolates (n = 123) and Enterococcus faecium isolates (n = 66) were resolved into 13 and 15 clones, respectively. The CDPD of E. faecalis steadily increased during admission, and E. faecalis showed a higher (P = 0.001) CPR value than E. faecium (0.86 and 0.42, respectively). E. faecium, with the exception of an ampicillin-resistant clone belonging to clonal complex 17, frequently appeared as a short-term colonizer, even though the E. faecalis clones had significantly (P = 0.03) more days under antibiotic exposure than E. faecium (77.5 and 65 days/100 colonization days, respectively). E. faecalis had a longer persistence than E. faecium, except for the CC17 ampicillin-resistant clone, and E. faecalis showed a cumulative increase in CDPD, whereas E. faecium did not. CDPD and CPR were useful for measuring the dynamics of intestinal colonization with enterococcal clones. PMID:19052172

  14. The Effect of Longer Development Times on Product Pipeline Management Performance

    Directory of Open Access Journals (Sweden)

    Paulo S. Figueiredo

    2015-07-01

    Full Text Available In the pharmaceutical industry, value is being destroyed through longer product development times. Given that patent lives are (normally fixed at 20 years, the double hit of increasing time to market is evident – higher R&D costs and less time at market before generic competitors are able to be released into the marketplace. The Policy implications are massive: A huge and permanent shift away from internal R&D towards partnerships, licensing deals and acquisitions of more innovative biotechnology companies. In this study, we build a system dynamics model of the product development pipeline for a single company operating in the pharmaceutical market. The study shows that in the presence of loss of value due to longer lead times, it is more advantageous to: (a work faster to reduce the backlog of projects; (b increase the number of projects started whenever it is possible reduce complexity in the pipeline; and also (c the optimal decision on resource allocation is independent of the loss of value due to longer lead times.

  15. Longer-term effects of selective thinning on microarthropod communities in a late-successional coniferous forest

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    Peck, R.W.; Niwa, C.G.

    2005-01-01

    Microarthropod densities within late-successional coniferous forests thinned 16-41 yr before sampling were compared with adjacent unthinned stands to identify longer term effects of thinning on this community. Soil and forest floor layers were sampled separately on eight paired sites. Within the forest floor oribatid, mesostigmatid, and to a marginal extent, prostigmatid mites, were reduced in thinned stands compared with unthinned stands. No differences were found for Collembola in the forest floor or for any mite suborder within the soil. Family level examination of mesostigmatid and prostigmatid mites revealed significant differences between stand types for both horizons. At the species level, thinning influenced numerous oribatid mites and Collembola. For oribatid mites, significant or marginally significant differences were found for seven of 15 common species in the forest floor and five of 16 common species in soil. Collembola were affected less, with differences found for one of 11 common species in the forest floor and three of 13 common species in soil. Multivariate analysis of variance and ordination indicated that forest thinning had little influence on the composition of oribatid mite and collembolan communities within either the forest floor or soil. Differences in microclimate or in the accumulation of organic matter on the forest floor were likely most responsible for the observed patterns of abundance. Considering the role that microarthropods play in nutrient cycling, determining the functional response of a wide range of taxa to thinning may be important to effective ecosystem management.

  16. When existence is not futile: The influence of mortality salience on the longer-is-better effect.

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    McCabe, Simon; Spina, Melissa R; Arndt, Jamie

    2016-09-01

    This research examines how death reminders impact the valuation of objects of various ages. Building from the existence bias, the longer-is-better effect posits that which exists is good and that which has existed for longer is better. Integrating terror management theory, it was reasoned that mortality reminders fostering a motivation to at least symbolically transcend death would lead participants to evaluate older object more positively as they signal robustness of existence. Participants were reminded of death (vs. control) and evaluated new, 20-, or 100-year-old objects. Results indicated death reminders resulted in greater valuation of older objects. Findings are discussed with implications for terror management theory, the longer-is-better effect, ageism, materialism, and consumer behaviour.

  17. Longer-duration uses of tetracyclines and penicillins in U.S. food-producing animals: Indications and microbiologic effects.

    Science.gov (United States)

    Mathers, Jeremy J; Flick, Sondra C; Cox, L Anthony

    2011-07-01

    We review and analyze regulatory categories for longer duration of use (defined as ≥ 7 day) tetracyclines (TCs) and penicillins (PNs) approved for U.S. livestock and poultry, together with scientific studies, surveillance programs and risk assessments pertaining to antimicrobial resistance. Indications listed on a government database were grouped into three broad categories according to the terminology used to describe their use: disease control (C), treatment (T) and growth improvement (G). Consistent with mostly therapeutic uses, the majority (86%) of listed indications had C and/or T terms. Several studies showed interruption of early disease stages in animals and modulation of intestinal microflora. Longer-duration exposures are consistent with bacteriostatic modes of action, where adequate exposure time as well as concentration is needed for sufficient antimicrobial activity. Other effects identified included reduced animal pathogen prevalence, toxin formation, inflammation, environmental impacts, improved animal health, reproductive measures, nutrient utilization, and others. Several animal studies have shown a limited, dose-proportionate, selective increase in resistance prevalence among commensal animal bacteria following longer-duration exposures. Pathogen surveillance programs showed overall stable or declining resistance trends among sentinel bacteria. Quantitative, microbiologically detailed resistance risk assessments indicate small probabilities of human treatment failure due to resistance under current conditions. Evaluations of longer-duration uses of TCs, PNs, and other antimicrobial classes used in food-producing animals should consider mechanisms of activity, known individual- and population-level health and waste reduction effects in addition to resistance risks.

  18. Do Longer Delays Matter? The Effect of Prolonging Delay in CTL Activation

    CERN Document Server

    Gallegos, Angela

    2010-01-01

    The activation of a specific immune response takes place in the lymphoid organs such as the spleen. We present here a simplified model of the proliferation of specific immune cells in the form of a single delay equation. We show that the system can undergo switches in stability as the delay is increased, and we interpret these results in the context of sustaining an effective immune response to a dendritic cell vaccine.

  19. Higher risk of pre-eclampsia after change of partner. An effect of longer interpregnancy intervals?

    DEFF Research Database (Denmark)

    Basso, Olga; Christensen, Kaare; Olsen, J.

    2001-01-01

    together with a sample of women with two births (26,596 women). A long interpregnancy interval was associated with a higher risk of pre-eclampsia in women with no previous pre-eclampsia when the father was the same. We estimated the risk of pre-eclampsia in second birth according to paternal change...... in different models. Although partner change was associated with an increased risk of pre-eclampsia in women with no history of pre-eclampsia, this effect disappeared after adjustment for the interpregnancy interval. We saw, however, different results when we stratified on the length of the interval. Our...

  20. SHORT AND LONGER-TERM EFFECTS OF CREATINE SUPPLEMENTATION ON EXERCISE INDUCED MUSCLE DAMAGE

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    John Rosene

    2009-03-01

    Full Text Available The purpose of this investigation was to determine if creatine supplementation assisted with reducing the amount of exercise induced muscle damage and if creatine supplementation aided in recovery from exercise induced muscle damage. Two groups of subjects (group 1 = creatine; group 2 = placebo participated in an eccentric exercise protocol following 7 and 30 days of creatine or placebo supplementation (20 g.d-1 for 7 d followed by 6g.d-1 for 23 d = 30 d. Prior to the supplementation period, measurements were obtained for maximal dynamic strength, maximal isometric force, knee range of motion, muscle soreness, and serum levels of creatine kinase (CK and lactate dehydrogenase (LDH. Following 7 days of creatine supplementation, on day 8, subjects began consuming 6 g.d-1 of creatine for 23 days. Additionally on days 8 and 31, subjects performed an eccentric exercise protocol using the knee extensors to induce muscle damage. Indirect markers of muscle damage, including maximal isometric force, knee range of motion, muscle soreness, and serum levels of CK and LDH, were collected at 12, 24, and 48 hours following each exercise bout. The results indicated that acute bouts of creatine have no effect on indirect markers of muscle damage for the acute (7 days bout. However, maximal isometric force was greater for the creatine group versus placebo for the chronic (30 days bout. This suggests that the ergogenic effect of creatine following 30 days of supplementation may have a positive impact on exercise induced muscle damage

  1. Effect of longer-term modest salt reduction on blood pressure.

    Science.gov (United States)

    He, F J; MacGregor, G A

    2004-01-01

    Many randomised trials assessing the effect of salt reduction on blood pressure show reduction in blood pressure in individuals with high blood pressure. However, there is controversy about the magnitude and the clinical significance of the fall in blood pressure in individuals with normal blood pressure. Several meta-analyses of randomised salt reduction trials have been published in the last few years. However, most of these included trials of very short duration (e.g. 5 days) and included trials with salt loading followed by salt deprivation (e.g. from 20 to 1 g/day) over only a few days. These short-term experiments are not appropriate to inform public health policy which is for a modest reduction in salt intake over a prolonged period of time. A meta-analysis by Hooper et al is an important attempt to look at whether advice to achieve a long-term salt reduction (i.e. more than 6 months) in randomised trials causes a fall in blood pressure. However, most trials included in this meta-analysis achieved a small reduction in salt intake; on average, salt intake was reduced by 2 g/day. It is, therefore, not surprising that this analysis showed a small fall in blood pressure, and that a dose-response to salt reduction was not demonstrable. To assess the effect of the currently recommended modest reduction in salt intake (WHO 2003; SACN 2003; Whelton 2002), on blood pressure in individuals with normal and elevated blood pressure. To assess whether the magnitude of the reduction in blood pressure is dependent on the magnitude of the reduction in salt intake. We searched MEDLINE, EMBASE, Cochrane library, CINAHL, and reference list of original and review articles. We included randomised trials with a modest reduction in salt intake and a duration of 4 or more weeks. Data were extracted independently by two persons. Mean effect sizes were calculated using both fixed and random effect models using Review Manager 4.2.1 software. Weighted linear regression was used to

  2. The longer-term effects of human capital enrichment programs on poverty and inequality: Oportunidades in Mexico*

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    McKee, Douglas; Todd, Petra E.

    2012-01-01

    Previous empirical research has shown that Mexico’s Oportunidades program has succeeded in increasing schooling and improving health of disadvantaged children. This paper studies the program’s potential longer-term consequences for the poverty and inequality of these children. It adapts methods developed in DiNardo, Fortin and Lemieux (1996) and incorporates existing experimental estimates of the program’s effects on human capital to analyze how Oportunidades will affect future earnings of program participants. We nonparametrically simulate earnings distributions, with and without the program, and predict that Oportunidades will increase future mean earnings but have only modest effects on poverty rates and earnings inequality. PMID:22577618

  3. The longer-term effects of human capital enrichment programs on poverty and inequality: Oportunidades in Mexico.

    Science.gov (United States)

    McKee, Douglas; Todd, Petra E

    2011-06-01

    Previous empirical research has shown that Mexico's Oportunidades program has succeeded in increasing schooling and improving health of disadvantaged children. This paper studies the program's potential longer-term consequences for the poverty and inequality of these children. It adapts methods developed in DiNardo, Fortin and Lemieux (1996) and incorporates existing experimental estimates of the program's effects on human capital to analyze how Oportunidades will affect future earnings of program participants. We nonparametrically simulate earnings distributions, with and without the program, and predict that Oportunidades will increase future mean earnings but have only modest effects on poverty rates and earnings inequality.

  4. Single-session interventions for problem gambling may be as effective as longer treatments: Results of a randomized control trial.

    Science.gov (United States)

    Toneatto, Tony

    2016-01-01

    Empirically supported treatments for problem gambling tend to be multimodal combining cognitive, behavior and motivational interventions. Since problem gamblers often prefer briefer treatments it is important that interventions adopt strategies that are optimally effective. In this study, 99 community-recruited problem gamblers (74% male, mean age: 47.5 years) were randomized to one of four treatments: six sessions of cognitive therapy, behavior therapy, and motivational therapy or a single-session intervention. The sample was followed up for 12 months post-treatment. In both the Intent-to-Treat and Completer statistical analyses, no significant group differences on key gambling variables (i.e., frequency, expenditures, severity) were found. All four treatments showed significant improvement as a result of treatment that endured throughout the follow-up period. These results, although preliminary, suggest that very brief, single-session interventions may be as effective as longer treatments.

  5. 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.

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

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    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

  7. Longer term follow-up on effects of Tailored Physical Activity or Chronic Pain Self-Management Programme on return-to-work

    DEFF Research Database (Denmark)

    Andersen, Lotte Nygaard; Juul-Kristensen, Birgit; Sørensen, Thomas Lund

    2016-01-01

    the reference group as regards return-to-work. Compared with the reference group no other benefits of TPA and CPSMP were evident regarding pain, work ability, kinesiophobia or physical capacity. CONCLUSION: After 11 months TPA, the reference group, and CPSMP show similar patterns of facilitating return-to-work......OBJECTIVE: To evaluate the longer term efficacy of the interventions Tailored Physical Activity (TPA) and Chronic Pain Self-management Program (CPSMP) against a reference group on return-to-work for sick-listed subjects with pain in the back or upper body. DESIGN: A randomized controlled trial...... to work and the co-primary end-point was the duration of the sickness absence period retrieved 11 months after the first day on sick leave. Secondary outcomes were pain level, body mass index, aerobic capacity, work ability and kinesiophobia. RESULTS: TPA and CPSMP were no more effective than...

  8. Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials.

    Science.gov (United States)

    He, Feng J; Li, Jiafu; Macgregor, Graham A

    2013-04-03

    To determine the effects of longer term modest salt reduction on blood pressure, hormones, and lipids. Systematic review and meta-analysis. Medline, Embase, Cochrane Hypertension Group Specialised Register, Cochrane Central Register of Controlled Trials, and reference list of relevant articles. Randomised trials with a modest reduction in salt intake and duration of at least four weeks. Data were extracted independently by two reviewers. Random effects meta-analyses, subgroup analyses, and meta-regression were performed. Thirty four trials (3230 participants) were included. Meta-analysis showed that the mean change in urinary sodium (reduced salt v usual salt) was -75 mmol/24 h (equivalent to a reduction of 4.4 g/day salt), and with this reduction in salt intake, the mean change in blood pressure was -4.18 mm Hg (95% confidence interval -5.18 to -3.18, I(2)=75%) for systolic blood pressure and -2.06 mm Hg (-2.67 to -1.45, I(2)=68%) for diastolic blood pressure. Meta-regression showed that age, ethnic group, blood pressure status (hypertensive or normotensive), and the change in 24 hour urinary sodium were all significantly associated with the fall in systolic blood pressure, explaining 68% of the variance between studies. A 100 mmol reduction in 24 hour urinary sodium (6 g/day salt) was associated with a fall in systolic blood pressure of 5.8 mm Hg (2.5 to 9.2, P=0.001) after adjustment for age, ethnic group, and blood pressure status. For diastolic blood pressure, age, ethnic group, blood pressure status, and the change in 24 hour urinary sodium explained 41% of the variance between studies. Meta-analysis by subgroup showed that in people with hypertension the mean effect was -5.39 mm Hg (-6.62 to -4.15, I(2)=61%) for systolic blood pressure and -2.82 mm Hg (-3.54 to -2.11, I(2)=52%) for diastolic blood pressure. In normotensive people, the figures were -2.42 mm Hg (-3.56 to -1.29, I(2)=66%) and -1.00 mm Hg (-1.85 to -0.15, I(2)=66%), respectively. Further

  9. Longer travel time to district hospital worsens neonatal outcomes: a retrospective cross-sectional study of the effect of delays in receiving emergency cesarean section in Rwanda.

    Science.gov (United States)

    Niyitegeka, Joseph; Nshimirimana, Georges; Silverstein, Allison; Odhiambo, Jackline; Lin, Yihan; Nkurunziza, Theoneste; Riviello, Robert; Rulisa, Stephen; Banguti, Paulin; Magge, Hema; Macharia, Martin; Habimana, Regis; Hedt-Gauthier, Bethany

    2017-07-25

    In low-resource settings, access to emergency cesarean section is associated with various delays leading to poor neonatal outcomes. In this study, we described the delays a mother faces when needing emergency cesarean delivery and assessed the effect of these delays on neonatal outcomes in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean section in 2015 at three district hospitals in Rwanda. Four delays were measured: duration of labor prior to hospital admission, travel time from health center to district hospital, time from admission to surgical incision, and time from decision for emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR cesarean sections started within 5 h after hospital admission and 85.2% (288 of 338) started more than 30 min after the decision for cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 min of travel time from the health center to the district hospital compared to mothers referred from health centers located on the same compound as the hospital (aOR = 5.12, p = 0.02). Neonates with cesarean deliveries starting more than 30 min after decision for cesarean section had better outcomes than those starting immediately (aOR = 0.32, p = 0.04). Longer travel time between health center and district hospital was associated with poor neonatal outcomes, highlighting a need to decrease barriers to accessing emergency maternal services. However, longer decision to incision interval posed less risk for adverse neonatal outcome. While this could indicate thorough pre-operative interventions including triage and resuscitation, this relationship should be studied prospectively in the future.

  10. 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

  11. 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 infusion

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

    NARCIS (Netherlands)

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

    2015-01-01

    Objective: 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. Methods: Effects of the information on speed and headway control were studied in a

  13. Long-lasting insecticidal nets no longer effectively kill the highly resistant Anopheles funestus of southern Mozambique.

    Science.gov (United States)

    Glunt, Katey D; Abílio, Ana Paula; Bassat, Quique; Bulo, Helder; Gilbert, Allison E; Huijben, Silvie; Manaca, Maria Nélia; Macete, Eusebio; Alonso, Pedro; Paaijmans, Krijn P

    2015-08-05

    Chemical insecticides are crucial to malaria control and elimination programmes. The frontline vector control interventions depend mainly on pyrethroids; all long-lasting insecticidal nets (LLINs) and more than 80% of indoor residual spraying (IRS) campaigns use chemicals from this class. This extensive use of pyrethroids imposes a strong selection pressure for resistance in mosquito populations, and so continuous resistance monitoring and evaluation are important. As pyrethroids have also been used for many years in the Manhiça District, an area in southern Mozambique with perennial malaria transmission, an assessment of their efficacy against the local malaria vectors was conducted. Female offspring of wild-caught Anopheles funestus s.s. females were exposed to deltamethrin, lambda-cyhalothrin and permethrin using the World Health Organization (WHO) insecticide-resistance monitoring protocols. The 3-min WHO cone bioassay was used to evaluate the effectiveness of the bed nets distributed or available for purchase in the area (Olyset, permethrin LLIN; PermaNet 2.0, deltamethrin LLIN) against An. funestus. Mosquitoes were also exposed to PermaNet 2.0 for up to 8 h in time-exposure assays. Resistance to pyrethroids in An. funestus s.s. was extremely high, much higher than reported in 2002 and 2009. No exposure killed more than 25.8% of the mosquitoes tested (average mortality, deltamethrin: 6.4%; lambda-cyhalothrin: 5.1%; permethrin: 19.1%). There was no significant difference in the mortality generated by 3-min exposure to any net (Olyset: 9.3% mortality, PermaNet 2.0: 6.0%, untreated: 2.0%; p = 0.2). Six hours of exposure were required to kill 50% of the An. funestus s.s. on PermaNet 2.0. Anopheles funestus s.s. in Manhiça is extremely resistant to pyrethroids, and this area is clearly a pyrethroid-resistance hotspot. This could severely undermine vector control in this district if no appropriate countermeasures are undertaken. The National Malaria Control

  14. Mediation of Short and Longer Term Effects of an Intervention Program to Enhance Resilience in Immigrants from Mainland China to Hong Kong

    Science.gov (United States)

    Yu, Nancy X.; Lam, T. H.; Liu, Iris K. F.; Stewart, Sunita M.

    2015-01-01

    Few clinical trials report on the active intervention components that result in outcome changes, although this is relevant to further improving efficacy and adapting effective programs to other populations. This paper presents follow-up analyses of a randomized controlled trial to enhance adaptation by increasing knowledge and personal resilience in two separate brief interventions with immigrants from Mainland China to Hong Kong (Yu et al., 2014b). The present paper extends our previous one by reporting on the longer term effect of the interventions on personal resilience, and examining whether the Resilience intervention worked as designed to enhance personal resilience. The four-session intervention targeted at self-efficacy, positive thinking, altruism, and goal setting. In this randomized controlled trial, 220 immigrants were randomly allocated to three arms: Resilience, Information (an active control arm), and Control arms. Participants completed measures of the four active components (self-efficacy, positive thinking, altruism, and goal setting) at baseline and immediately after the intervention. Personal resilience was assessed at baseline, post-intervention, and 3- and 6-month follow-ups. The results showed that the Resilience arm had greater increases in the four active components post-intervention. Changes in each of the four active components at the post-intervention assessment mediated enhanced personal resilience at the 3-month follow-up in the Resilience arm. Changes in self-efficacy and goal setting showed the largest effect size, and altruism showed the smallest. The arm effects of the Resilience intervention on enhanced personal resilience at the 6-month follow-up were mediated by increases of personal resilience post-intervention (Resilience vs. Control) and at the 3-month follow-up (Resilience vs. Information). These findings showed that these four active components were all mediators in this Resilience intervention. Our results of the effects

  15. A Meta-analysis of the effects of Exercise Training on Left Ventricular Remodeling Following Myocardial Infarction: Start early and go longer for greatest exercise benefits on remodeling

    Directory of Open Access Journals (Sweden)

    Warburton Darren

    2011-04-01

    Full Text Available Abstract Background The effects of variations in exercise training on Left ventricular (LV remodeling in patients shortly after Myocardial Infarction (MI are important but poorly understood. Methods Systematic review incorporating meta-analysis using meta-regression. Studies were identified via systematic searches of: OVID MEDLINE (1950 to 2009, Cochrane Central Register of Controlled Trials (1991 to 2009, AMED (1985 to 2009, EMBASE (1988 to 2009, PUBMED (1966 to 2009, SPORT DISCUS (1975 to 2009, SCOPUS (1950 to 2009 and WEB OF SCIENCE (1950 to 2009 using the medical subject headings: myocardial infarction, post myocardial infarction, post infarction, heart attack, ventricular remodeling, ventricular volumes, ejection fraction, left ventricular function, exercise, exercise therapy, kinesiotherapy, exercise training. Reference lists of all identified studies were also manually searched for further relevant studies. Studies selected were randomized controlled trials of exercise training interventions reporting ejection fraction (EF and/or ventricular volumes in patients following recent MI (≤ 3 months post-MI patients involving control groups. Studies were excluded if they were not randomized, did not have a 'usual-care' control (involving no exercise, evaluated a non-exercise intervention, or did not involve human subjects. Non-English studies were also excluded. Results After screening of 1029 trials, trials were identified that reported EF (12 trials, n = 647, End Systolic Volumes (ESV (9 trials, n = 475 and End Diastolic Volumes (EDV (10 trials, n = 512. Meta-regression identified that changes in EF effect size difference decreased as the time between MI and initiation of the exercise program lengthened, and increased as the duration of the program increased (Q = 25.48, df = 2, p 2 = 0.76. Greater reductions in ESV and EDV (as indicated by effect size decreases occurred with earlier initiation of exercise training and with longer training

  16. [Sauna-goers live longer!].

    Science.gov (United States)

    Flury, Gian

    2015-10-21

    Sudden cardiac death (SCD) and death from cardiovascular disease are the most frequent causes of death in the general population. A new Finnish long-term study demonstrates that regular sauna bathing significantly reduces cardiovascular mortality - the more frequent and longer the more the benefit. This new insight creates new opportunities for primary prevention of SCD and cardiovascular death.

  17. Assessment of second- and third-order ionospheric effects on regional networks: case study in China with longer CMONOC GPS coordinate time series

    Science.gov (United States)

    Deng, Liansheng; Jiang, Weiping; Li, Zhao; Chen, Hua; Wang, Kaihua; Ma, Yifang

    2017-02-01

    Higher-order ionospheric (HOI) delays are one of the principal technique-specific error sources in precise global positioning system analysis and have been proposed to become a standard part of precise GPS data processing. In this research, we apply HOI delay corrections to the Crustal Movement Observation Network of China's (CMONOC) data processing (from January 2000 to December 2013) and furnish quantitative results for the effects of HOI on CMONOC coordinate time series. The results for both a regional reference frame and global reference frame are analyzed and compared to clarify the HOI effects on the CMONOC network. We find that HOI corrections can effectively reduce the semi-annual signals in the northern and vertical components. For sites with lower semi-annual amplitudes, the average decrease in magnitude can reach 30 and 10 % for the northern and vertical components, respectively. The noise amplitudes with HOI corrections and those without HOI corrections are not significantly different. Generally, the HOI effects on CMONOC networks in a global reference frame are less obvious than the results in the regional reference frame, probably because the HOI-induced errors are smaller in comparison to the higher noise levels seen when using a global reference frame. Furthermore, we investigate the combined contributions of environmental loading and HOI effects on the CMONOC stations. The largest loading effects on the vertical displacement are found in the mid- to high-latitude areas. The weighted root mean square differences between the corrected and original weekly GPS height time series of the loading model indicate that the mass loading adequately reduced the scatter on the CMONOC height time series, whereas the results in the global reference frame showed better agreements between the GPS coordinate time series and the environmental loading. When combining the effects of environmental loading and HOI corrections, the results with the HOI corrections reduced

  18. Assessment of second- and third-order ionospheric effects on regional networks: case study in China with longer CMONOC GPS coordinate time series

    Science.gov (United States)

    Deng, Liansheng; Jiang, Weiping; Li, Zhao; Chen, Hua; Wang, Kaihua; Ma, Yifang

    2016-09-01

    Higher-order ionospheric (HOI) delays are one of the principal technique-specific error sources in precise global positioning system analysis and have been proposed to become a standard part of precise GPS data processing. In this research, we apply HOI delay corrections to the Crustal Movement Observation Network of China's (CMONOC) data processing (from January 2000 to December 2013) and furnish quantitative results for the effects of HOI on CMONOC coordinate time series. The results for both a regional reference frame and global reference frame are analyzed and compared to clarify the HOI effects on the CMONOC network. We find that HOI corrections can effectively reduce the semi-annual signals in the northern and vertical components. For sites with lower semi-annual amplitudes, the average decrease in magnitude can reach 30 and 10 % for the northern and vertical components, respectively. The noise amplitudes with HOI corrections and those without HOI corrections are not significantly different. Generally, the HOI effects on CMONOC networks in a global reference frame are less obvious than the results in the regional reference frame, probably because the HOI-induced errors are smaller in comparison to the higher noise levels seen when using a global reference frame. Furthermore, we investigate the combined contributions of environmental loading and HOI effects on the CMONOC stations. The largest loading effects on the vertical displacement are found in the mid- to high-latitude areas. The weighted root mean square differences between the corrected and original weekly GPS height time series of the loading model indicate that the mass loading adequately reduced the scatter on the CMONOC height time series, whereas the results in the global reference frame showed better agreements between the GPS coordinate time series and the environmental loading. When combining the effects of environmental loading and HOI corrections, the results with the HOI corrections reduced

  19. Comparative effectiveness in esophagogastric cancer.

    Science.gov (United States)

    Knab, Lawrence M; Belotte, Jim; Munshi, Hidayatullah G; Bentrem, David J

    2015-01-01

    Cancer of the esophagus and the gastroesophageal junction (GEJ) continues to have a dismal prognosis, with the incidence of esophageal cancer increasing in the United States. Although radical resection was initially the primary treatment for this disease process, systemic chemotherapy and radiation have been shown to play a role in prolonging survival in most patient populations. This chapter explores the evidence that guides treatment for esophageal and GEJ cancer today. Chemotherapy and radiation therapy were introduced as treatment modalities for esophageal and GEJ cancers when it became evident that surgical therapy alone provided poor long-term survival rates. A variety of treatment strategies have been explored including preoperative (neoadjuvant) and postoperative (adjuvant) chemotherapy, with and without radiation. The evidence suggests that neoadjuvant chemotherapy or chemoradiotherapy provides better outcomes compared to surgery alone for esophageal, GEJ, and gastric cancers. Studies indicate a trend towards improved survival when neoadjuvant chemoradiotherapy is compared to chemotherapy alone. When patients have undergone resection with node-positive disease without receiving neoadjuvant therapy, some form of adjuvant treatment is recommended. This chapter also explores the surgical management of esophageal, GEJ, and gastric cancers including the extent of the gastric lymph node dissection. It also includes a discussion about adherence to national guidelines in terms of gastric cancer treatment and esophageal and gastric lymph node examinations.

  20. The longer-term cognitive effects of adjunctive antiepileptic treatment with lacosamide in comparison with lamotrigine and topiramate in a naturalistic outpatient setting.

    Science.gov (United States)

    Helmstaedter, Christoph; Witt, Juri-Alexander

    2013-02-01

    In this retrospective controlled study, the impact of adjunctive lacosamide (LCM) on cognition in patients with epilepsy was evaluated and compared with that of topiramate (TPM) and lamotrigine (LTG) in a naturalistic outpatient setting. Cognition was investigated by means of objective assessment of executive functions (EpiTrack®) and verbal memory and by subjective ratings of self-perceived side effects (cognition, mood, and vegetative). Quality of life was assessed using the QOLIE-10 questionnaire. Patients underwent assessment at baseline and after a median follow-up interval of 32 weeks. Forty-four patients were treated with LCM, 11 with LTG, and 15 with TPM. Treatment arms differed with regard to the age at onset of epilepsy (LTG>TPM) and to seizure control from baseline to follow-up, which was best in patients whose seizures were treated with LTG (55% vs. 16% in patients whose seizures were treated with LCM and 13% in patients whose seizures were treated with TPM). Groups did not differ in the type of epilepsy, daily drug load or drug load change, nor in baseline seizure frequency. Repeated measures statistics controlling for epilepsy onset and seizure outcome showed deteriorated executive functions with TPM (F=7.5, p=0.001). On an individual level (reliable change indices), 53% of the patients whose seizures were treated with TPM showed losses in this domain (LCM 14%, LTG 27%) and none of the patients showed improvement (LCM 23%, LTG 27%; χ(2)=11.8, p=0.019). No differences in memory, quality of life, or mood were noted among patients in the three treatment arms. Subjective cognitive complaints increased in 5 of the 9 patients whose seizures were treated with TPM (LCM 1/9, LTG 0/9; χ(2)=11.9, p=0.025). The findings of this study demonstrate for the first time that the cognitive side effect profile of LCM is comparable to that of LTG and superior to that of TPM. This is indicated by both subjective and objective measures. Given the naturalistic setting and

  1. The effectiveness of exercise training in lowering blood pressure: a meta-analysis of randomised controlled trials of 4 weeks or longer.

    Science.gov (United States)

    Halbert, J A; Silagy, C A; Finucane, P; Withers, R T; Hamdorf, P A; Andrews, G R

    1997-10-01

    To identify the features of an optimal exercise programme in terms of type of exercise, intensity and frequency that would maximise the training induced decrease in blood pressure (BP). Trials were identified by a systematic search of Medline, Embase and Science Citation Index (SCI), previous review articles and the references of relevant trials, from 1980 until 1996, including only English language studies. The inclusion criteria were limited to randomised controlled trials of aerobic or resistance exercise training conducted over a minimum of 4 weeks where systolic and diastolic BP was measured. A total of 29 studies (1533 hypertensive and normotensive participants) were included, 26 used aerobic exercise training, two trials used resistance training and one study had both resistance and aerobic training groups. Aerobic exercise training reduced systolic BP by 4.7 mm Hg (95% CI: 4.4, 5.0) and diastolic BP by 3.1 mm Hg (95% CI: 3.0, 3.3) as compared to a non-exercising control group, however, significant heterogeneity was observed between trials in the analysis. The BP reduction seen with aerobic exercise training was independent of the intensity of exercise and the number of exercise sessions per week. The evidence for the effect of resistance exercise training was inconclusive. Aerobic exercise training had a small but clinically significant effect in reducing systolic and diastolic BP. Increasing exercise intensity above 70% VO2 max or increasing exercise frequency to more than three sessions per week did not have any additional impact on reducing BP.

  2. 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.

  3. Clinical Effects of a Longer Duration of Polymyxin B-Immobilized Fiber Column Direct Hemoperfusion Therapy for Severe Sepsis and Septic Shock.

    Science.gov (United States)

    Yamashita, Chizuru; Hara, Yoshitaka; Kuriyama, Naohide; Nakamura, Tomoyuki; Nishida, Osamu

    2015-08-01

    Polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) therapy is widely used for the treatment of severe sepsis and septic shock, and is generally performed for 2 h. Although previous studies demonstrated the efficacy of PMX-DHP therapy, it currently remains unclear whether its optimal duration is 2 h. This retrospective study analyzed 37 patients with septic shock who showed a poor clinical response to 2 h of PMX-DHP, and underwent a longer duration of this therapy. The mean duration of PMX-DHP therapy was 15.8 ± 7.9 h, and none of the patients developed adverse events, which enabled the therapy to be performed safely. The pressure catecholamine index [CAIP = catecholamine index/mean arterial pressure; catecholamine index = dopamine + dobutamine + (adrenaline + noradrenaline) × 100 μg/kg per min], as an indicator of hemodynamics, improved significantly in the survival group in the period between the start and 24 h after the end of PMX-DHP therapy (P hemodynamics and pulmonary oxygenation capacity of patients with severe sepsis/septic shock. Strict prospective studies are needed in the future.

  4. Effect of rosiglitazone and ramipril on macrovasculopathy in patients with type 2 diabetes: needs longer treatment and/or higher doses?

    Science.gov (United States)

    Rahman, Sayeeda; Ismail, Aziz Al-Shafi; Ismail, Shaiful Bhari; Naing, Nyi Nyi; Rahman, Abdul Rashid Abdul

    2010-01-01

    Introduction The aim of the study is to investigate whether standard doses of rosiglitazone (4 mg/daily) and ramipril (5 mg/daily) can reverse pre-clinical macrovasculopathy in newly diagnosed never treated type 2 diabetes (T2DM) patients. Methods In this randomized, double-blind, placebo-controlled study, 33 T2DM patients were randomized to rosiglitazone (4 mg/daily) or ramipril (5 mg/daily) or placebo for 1 year. Hemodynamic variables were measured at 3 treatment phases and pulse wave velocity (PWV) and augmentation index (AI) were measured throughout the treatment period. Result In diabetic patients, PWV (P = 0.037) and AI (P = 0.005) with ramipril and AI (P < 0.001) with rosiglitazone were significantly reduced during overall treatment period from the baseline; however, these differences were not significant in comparison to placebo. Discussion and conclusion The present study showed that treatment with standard doses of rosiglitazone and ramipril are not adequate to reverse pre-clinical vasculopathy in T2DM. The lack of benefit in newly diagnosed T2DM may be because of the relatively short-term intervention and/or the use of lower doses of rosiglitazone/ramipril. Further trials are needed for a longer period of time, possibly with higher doses, to show whether rosiglitazone/ramipril can reverse pre-clinical vasculopathy in T2DM (ClinicalTrials.gov number, NCT00489229). PMID:22291490

  5. 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 clas...

  6. 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......, with an impact on student achievement. For literacy I find no significant effects of classroom hours, but for maths I find stronger effects. One additional hour per year increases the maths score by 0.21% of a standard deviation....

  7. Is Longer Unemployment Rewarded with Longer Job Tenure?

    DEFF Research Database (Denmark)

    Kohara, Miki; Sasaki, Masaru; Machikita, Tomohiro

    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...... a high reservation wage and a low search intensity because of the benefits of unemployment insurance, and change them in response to the expiration of insurance, prolonged unemployment will result in short job duration after unemployment.......This paper examines whether or not a prolonged unemployment period can raise the quality of job matching after unemployment. We focus on job tenure as an indicator of a good quality job match after unemployment. We match two sets of Japanese administrative data compiled by the public employment...

  8. Children's Brain Development Benefits from Longer Gestation.

    Science.gov (United States)

    Davis, Elysia Poggi; Buss, Claudia; Muftuler, L Tugan; Head, Kevin; Hasso, Anton; Wing, Deborah A; Hobel, Calvin; Sandman, Curt A

    2011-01-01

    Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was to determine if the benefit for brain development conferred by increased gestational length exists on a continuum across the gestational age spectrum among healthy children with a stable neonatal course. Neurodevelopment was evaluated with structural magnetic resonance imaging in 100 healthy right-handed 6- to 10-year-old children born between 28 and 41 gestational weeks with a stable neonatal course. Data indicate that a longer gestational period confers an advantage for neurodevelopment. Longer duration of gestation was associated with region-specific increases in gray matter density. Further, the benefit of longer gestation for brain development was present even when only children born full term were considered. These findings demonstrate that even modest decreases in the duration of gestation can exert profound and lasting effects on neurodevelopment for both term and preterm infants and may contribute to long-term risk for health and disease.

  9. Testing Mediators Hypothesized to Account for the Effects of a Dissonance-Based Eating Disorder Prevention Program over Longer Term Follow-Up

    Science.gov (United States)

    Stice, Eric; Marti, C. Nathan; Rohde, Paul; Shaw, Heather

    2011-01-01

    Objective: Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method: Data were drawn from a randomized effectiveness trial in which 306 female high school students…

  10. Testing Mediators Hypothesized to Account for the Effects of a Dissonance-Based Eating Disorder Prevention Program over Longer Term Follow-Up

    Science.gov (United States)

    Stice, Eric; Marti, C. Nathan; Rohde, Paul; Shaw, Heather

    2011-01-01

    Objective: Test the hypothesis that reductions in thin-ideal internalization and body dissatisfaction mediate the effects of a dissonance-based eating disorder prevention program on reductions in eating disorder symptoms over 1-year follow-up. Method: Data were drawn from a randomized effectiveness trial in which 306 female high school students…

  11. Memory effect in balanced Josephson comparators

    Energy Technology Data Exchange (ETDEWEB)

    Ortlepp, Th., E-mail: tortlepp@cismst.de [CiS Research Institute for Micro-Sensor Systems and Photovoltaics, 14 Konrad-Zuse Street, 99099 Erfurt (Germany); Volkmann, M.H., E-mail: mvolkmann@cismst.de [CiS Research Institute for Micro-Sensor Systems and Photovoltaics, 14 Konrad-Zuse Street, 99099 Erfurt (Germany); Yamanashi, Y., E-mail: yamanasi@ynu.ac.jp [Department of Electrical and Computer Engineering, Yokohama National University, 79-5 Tokiwadai, Yokohama 240-8501 (Japan)

    2014-05-15

    Highlights: • Balanced Josephson comparator decisions depend on previous decisions at high frequencies. • The maximum effective data rate is lower than the clock frequency. • Tradeoff between maximum effective data rate and minimum comparator gray-zone. - Abstract: The performance of a balanced Josephson comparator is measured by its gray-zone and its maximum operation frequency. A typical effect at high clock frequencies is the correlation of output bits with their predecessors, the comparator develops a memory. This is undesirable, as it imposes an upper limit on the useful clock frequency at which the comparator can be operated. In this work, we describe and observe experimentally the memory effect of a Josephson comparator and study its influence on the gray zone width and the maximum effective data rate.

  12. Longer Life for Steel Structures

    Science.gov (United States)

    1990-01-01

    IC 531 is a coating manufactured and marketed by Inorganic Coatings, Inc. The coating was developed by Goddard to protect structures at Kennedy Space Center. It is a high ratio potassium silicate formula. The coating is water based, nontoxic, and nonflammable. It generates no volatile organic compounds nor hazardous chemical waste, and bonds to steel in 30 minutes. At the present time, no one can say for sure how long IC 531's effective lifetime is. Some of the original Goddard test applications of 1976 are still going strong after lengthy exposure to the Sun, salt and moisture. Says IC in company literature: 'IC 531 offers virtually permanent protection for steel. We predict it will protect structures for well beyond 25 years. If necessary, it is infinitely maintainable; if damaged, it can easily be touched up with more IC 531.'

  13. Longer Addiction Treatment Is Better, Study Confirms

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163911.html Longer Addiction Treatment Is Better, Study Confirms Success rate goes up ... 3, 2017 (HealthDay News) -- The longer patients receive treatment for addiction, the greater their chances of success, a new ...

  14. Assessments of higher-order ionospheric effects on GPS coordinate time series: A case study of CMONOC with longer time series

    Science.gov (United States)

    Jiang, Weiping; Deng, Liansheng; Zhou, Xiaohui; Ma, Yifang

    2014-05-01

    Higher-order ionospheric (HIO) corrections are proposed to become a standard part for precise GPS data analysis. For this study, we deeply investigate the impacts of the HIO corrections on the coordinate time series by implementing re-processing of the GPS data from Crustal Movement Observation Network of China (CMONOC). Nearly 13 year data are used in our three processing runs: (a) run NO, without HOI corrections, (b) run IG, both second- and third-order corrections are modeled using the International Geomagnetic Reference Field 11 (IGRF11) to model the magnetic field, (c) run ID, the same with IG but dipole magnetic model are applied. Both spectral analysis and noise analysis are adopted to investigate these effects. Results show that for CMONOC stations, HIO corrections are found to have brought an overall improvement. After the corrections are applied, the noise amplitudes decrease, with the white noise amplitudes showing a more remarkable variation. Low-latitude sites are more affected. For different coordinate components, the impacts vary. The results of an analysis of stacked periodograms show that there is a good match between the seasonal amplitudes and the HOI corrections, and the observed variations in the coordinate time series are related to HOI effects. HOI delays partially explain the seasonal amplitudes in the coordinate time series, especially for the U component. The annual amplitudes for all components are decreased for over one-half of the selected CMONOC sites. Additionally, the semi-annual amplitudes for the sites are much more strongly affected by the corrections. However, when diplole model is used, the results are not as optimistic as IGRF model. Analysis of dipole model indicate that HIO delay lead to the increase of noise amplitudes, and that HIO delays with dipole model can generate false periodic signals. When dipole model are used in modeling HIO terms, larger residual and noise are brought in rather than the effective improvements.

  15. The effects of dietary and lifestyle interventions among pregnant women who are overweight or obese on longer-term maternal and early childhood outcomes

    DEFF Research Database (Denmark)

    Dodd, Jodie M; Grivell, Rosalie M; Louise, Jennie

    2017-01-01

    on the established International Weight Management in Pregnancy (i-WIP) IPD Collaborative Network, having identified researchers who have conducted randomised dietary and lifestyle interventions among pregnant women who are overweight or obese, and where ongoing childhood follow-up of participants has been......BACKGROUND: The aim of this individual participant data meta-analysis (IPDMA) is to evaluate the effects of dietary and lifestyle interventions among pregnant women who are overweight or obese on later maternal and early childhood outcomes at ages 3-5 years. METHODS/DESIGN: We will build...... or is being undertaken. The primary maternal outcome is a diagnosis of maternal metabolic syndrome. The primary childhood outcome is BMI above 90%. We have identified 7 relevant trials, involving 5425 women who were overweight or obese during pregnancy, with approximately 3544 women and children with follow...

  16. Estudo comparativo dos fatores prognósticos entre os pacientes com maior e menor sobrevida em portadores de carcinoma broncogênico Comparative study of prognostic factors among longer and shorter survival patients with bronchogenic carcinoma

    Directory of Open Access Journals (Sweden)

    SÉRGIO JAMNIK

    2002-09-01

    Full Text Available Apesar dos avanços no tratamento, há pouca melhora na sobrevida dos pacientes com câncer do pulmão. Atualmente, é importante o conhecimento dos fatores que intervêm na sobrevida. Objetivos: Verificar possíveis diferenças de fatores prognósticos em duas populações de pacientes com câncer de pulmão, uma com pequena sobrevida (menos de seis meses e outra com maior sobrevida (acima de 24 meses. Métodos: De 1997 a 1999 foram estudados 52 pacientes com diagnóstico histopatológico de carcinoma homogênico, sendo colhidos dados demográficos, clínicos, paramétricos, hábitos tabágicos, índice de Karnofsky, estadiamento da doença e dosagem laboratorial de desidrogenase lática, fosfatase alcalina, antígeno carcinoembrionário e cálcio. Resultados: 29 pacientes tiveram sobrevida menor do que seis meses e 23, superior a 24 meses. Os três fatores mais importantes que influenciaram o tempo curto de sobrevida foram baixo índice de Karnofsky inicial, redução do apetite e alto nível sérico de DHL. Conclusão: Os três componentes do prognóstico são o estado físico atual, o estado físico prévio e o estado atual da doença.Despite the improvements seen in the treatment of lung cancer, little has improved in the survival of these patients, and a great importance is attributed to the factors that have a role to play in such survival. Purpose: To check for possible prognostic factor differences in two populations of lung cancer patients, one of them with short survival (less than six months, and the other with longer survival (more than 24 months. Methods: From 1997 to 1999, 52 patients with histopathologic diagnosis of homogenous carcinoma were studied, and demographics, clinical parameters, smoking pattern, Karnofsky's index, disease staging, and laboratory dosing of lactic dehydrogenase, alkaline phosphatase, carcinoembryonic antigen, and calcium data were surveyed. Results: 29 patients had less than six month survival, and 23

  17. Wheel Balanced Cancer Therapy for Longer Than 21 Days Can Have a Positive Effect on the Survival of Patients with Stage IV Cancer

    Directory of Open Access Journals (Sweden)

    Hyung-Joon Jeon

    2015-09-01

    Full Text Available Objectives: Correlations of the levels of the nonspecific inflammatory markers C-reactive protein (CRP and erythrocyte sedimentation rate (ESR and of the coagulation marker fibrinogen with the treatment period of wheel balanced cancer therapy were determined. Methods: Electronic charts of stage IV cancer patients hospitalized from February 1, 2008, to November 30, 2013, were reviewed retrospectively. Patients whose laboratory follow-up tests included at least two data points for at least one marker were included. Patients receiving chemotherapy or radiotherapy or having Eastern Cooperative Oncology Group (ECOG levels exceeding 2 were excluded. Correlations of the markers with the length of treatment for treatment periods ≥ 21 and ≤ 20 days were determined by gender and whether or not surgery had been performed. Results: Analyses of the CRP and the ESR revealed a higher proportion of patients with stable marker levels than with increased or decreased levels. Also, only the ESR in female and the CRP in male groups had higher proportions of patients with stable marker levels than with increased or decreased levels. The ≥ 21 day group had a higher proportion of patients with stable CRP and ESR levels than the ≤ 20 day group. Only the ESR in female and the CRP in male groups had higher proportions of patients with stable marker levels in the ≥ 21 day than in the ≤ 20 day group. In addition, only the CRP in the surgery group and the ESR in the non-surgery group had higher proportions of patients with stable marker levels in the ≥ 21 day group than in the ≤ 20 day group. Conclusion: For stage IV cancer patients at hospitals that offer Korean medicine, more than 21 days of long-term wheel balanced cancer therapy (WBCT should help maintain the CRP and the ESR levels and should have a favorable effect on the survival rate.

  18. Three-year results from a randomised controlled trial comparing prostheses supported by 5-mm long implants or by longer implants in augmented bone in posterior atrophic edentulous jaws.

    Science.gov (United States)

    Esposito, Marco; Pistilli, Roberto; Barausse, Carlo; Felice, Pietro

    2014-01-01

    implants and 1.63 mm at long implants of peri-implant marginal bone. This difference was not statistically significant (difference = 0.24 mm; 95% CI -0.01, 0.49 P = 0.059). In maxillae, patients lost on average 1.02 mm at short implants and 1.54 mm at long implants. This difference was statistically significant (difference = 0.41 mm; 95% CI 0.21, 0.60, P = 0.001). Three years after loading, 5-mm short implants achieved similar results as longer implants in augmented bone. Short implants might be a preferable choice to vertical bone augmentation, especially in mandibles, since the treatment is faster and cheaper, however there are still insufficient data on the long-term prognosis of short implants.

  19. Comparing hotels' employer brand effectiveness through social ...

    African Journals Online (AJOL)

    Comparing hotels' employer brand effectiveness through social media and websites. ... for talent in the hospitality and tourism industry and the available talent pool. ... The impact of on-line tools for companies to present themselves as a good ...

  20. The pragmatist's guide to comparative effectiveness research.

    Science.gov (United States)

    Chandra, Amitabh; Jena, Anupam B; Skinner, Jonathan S

    2011-01-01

    Following an acrimonious health care reform debate involving charges of "death panels," in 2010, Congress explicitly forbade the use of cost-effectiveness analysis in government programs of the Patient Protection and Affordable Care Act. In this context, comparative effectiveness research emerged as an alternative strategy to understand better what works in health care. Put simply, comparative effectiveness research compares the efficacy of two or more diagnostic tests, treatments, or health care delivery methods without any explicit consideration of costs. To economists, the omission of costs from an assessment might seem nonsensical, but we argue that comparative effectiveness research still holds promise. First, it sidesteps one problem facing cost-effectiveness analysis--the widespread political resistance to the idea of using prices in health care. Second, there is little or no evidence on comparative effectiveness for a vast array of treatments: for example, we don't know whether proton-beam therapy, a very expensive treatment for prostate cancer (which requires building a cyclotron and a facility the size of a football field) offers any advantage over conventional approaches. Most drug studies compare new drugs to placebos, rather than "head-to-head" with other drugs on the market, leaving a vacuum as to which drug works best. Finally, the comparative effectiveness research can prove a useful first step even in the absence of cost information if it provides key estimates of treatment effects. After all, such effects are typically expensive to determine and require years or even decades of data. Costs are much easier to measure, and can be appended at a later date as financial Armageddon draws closer.

  1. Randomized controlled multicenter study comparing short dental implants (6 mm) versus longer dental implants (11-15 mm) in combination with sinus floor elevation procedures. Part 2: clinical and radiographic outcomes at 1 year of loading.

    Science.gov (United States)

    Schincaglia, Gian Pietro; Thoma, Daniel S; Haas, Robert; Tutak, Marcin; Garcia, Abel; Taylor, Thomas D; Hämmerle, Christoph H F

    2015-11-01

    To compare, clinically and radiographically, short dental implants (6 mm) to long implants (11-15 mm) placed with sinus grafting. Participants with 5-7 mm of bone height in the posterior maxilla were randomly allocated to receive short implants (GS) or long implants with sinus grafting (GG). Implants were loaded with single crowns 6 months after placement (PR). Patients were re-evaluated 12 months after loading (FU-1). Outcome variables included: Implant survival rate (CSR), marginal bone level alteration (MBL), periodontal probing depth (PPD), bleeding on probing (BoP), plaque control record (PCR) and crown-to-implant ratios (C/I). Statistical analysis was performed using parametric tests. In 97 subjects, 132 implants were re-evaluated at FU-1. The CSR was 100%. The MBL from implant placement (IP) to (PR) was -0.22 ± 0.4 mm for GG and -0.3 ± 0.45 mm for GS (p 0.05), PPD (p = 1) and PCR (p = 0.09). BoP was higher in the GS (p = 0.04). The C/I was 0.99 ± 0.17 for GG and 1.86 ± 0.23 for GS (p < 0.001). No correlation was observed between C/I and MBL, (GG: p = 0.13; GS: p = 0.38). Both treatment modalities provided similar outcomes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Therapeutic manuka honey: no longer so alternative

    Directory of Open Access Journals (Sweden)

    Dee A Carter

    2016-04-01

    Full Text Available Medicinal honey research is undergoing a substantial renaissance. From a folklore remedy largely dismissed by mainstream medicine as alternative, we now see increased interest by scientists, clinical practitioners and the general public in the therapeutic uses of honey. There are a number of drivers of this interest: first, the rise in antibiotic resistance by many bacterial pathogens has prompted interest in developing and using novel antibacterials; second, an increasing number of reliable studies and case reports have demonstrated that certain honeys are very effective wound treatments; third, therapeutic honey commands a premium price, and the honey industry is actively promoting studies that will allow it to capitalize on this; and finally, the very complex and rather unpredictable nature of honey provides an attractive challenge for laboratory scientists. In this paper we review manuka honey research, from observational studies on its antimicrobial effects through to current experimental and mechanistic work that aims to take honey into mainstream medicine. We outline current gaps and remaining controversies in our knowledge of how honey acts, and suggest new studies that could make honey a no longer alternative alternative.

  3. 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.

  4. Comparative angioprotective effects of magnesium compounds.

    Science.gov (United States)

    Kharitonova, Maria; Iezhitsa, Igor; Zheltova, Anastasia; Ozerov, Alexander; Spasov, Alexander; Skalny, Anatoly

    2015-01-01

    Magnesium (Mg) deficiency is implicated in the development of numerous disorders of the cardiovascular system. Moreover, the data regarding the efficacy of different magnesium compounds in the correction of impaired functions due to low magnesium intake are often fragmentary and inconsistent. The aim of this study was to compare the effects of the most bioavailable Mg compounds (Mg l-aspartate, Mg N-acetyltaurate, Mg chloride, Mg sulphate and Mg oxybutyrate) on systemic inflammation and endothelial dysfunction in rats fed a low Mg diet for 74 days. A low Mg diet decreased the Mg concentration in the plasma and erythrocytes, which was accompanied by a reduced concentration of eNOs and increased levels of endothelin-1 level in the serum and impaired endothelium-dependent vasodilatation. These effects increased the concentration of proinflammatory molecules, such as VCAM-1, TNF-α, IL-6 and CRP, indicating the development of systemic inflammation and endothelial dysfunction. The increased total NO level, which estimated from the sum of the nitrate and nitrite concentrations in the serum, may also be considered to be a proinflammatory marker. Two weeks of Mg supplementation partially or fully normalised the ability of the vascular wall to effect adequate endothelium-dependent vasodilatation and reversed the levels of most endothelial dysfunction and inflammatory markers (except CRP) to the mean values of the control group. Mg sulphate had the smallest effect on the endothelin-1, TNF-α and VCAM-1 levels. Mg N-acetyltaurate was significantly more effective in restoring the level of eNOS compared to all other studied compounds, except for Mg oxybutyrate. Taken together, the present findings demonstrate that all Mg compounds equally alleviate endothelial dysfunction and inflammation caused by Mg deficiency. Mg sulphate tended to be the least effective compound.

  5. Comparative antibacterial effectiveness of seven hand antiseptics.

    Science.gov (United States)

    Myklebust, S

    1985-12-01

    Seven hand antiseptics (alcohol-, iodophor- and chlorhexidine preparations) were compared for antibacterial effectiveness using finger-print contact sampling on blood agar in duplicate series with 18 students as test persons. Bacterial samples were obtained before and after handwashing (with unmedicated liquid soap) as well as after hand disinfection. Hibiscrub was tested without prewashing. The antiseptics were rubbed into the skin and the hands left uncontaminated for 2 min before sampling. Due to results showing unexpectedly low antibacterial effectiveness of 70% (v/v) ethanol, a series of supplementary experiments with ethanol (70% (v/v) and 80% (v/v] and isopropanol (60% (v/v] were performed with 10 laboratory staff-members. These experiments confirmed the previously demonstrated weak antibacterial effect of 70% (v/v) ethanol on the normal hand flora. Alcoholic chlorhexidine solutions and Hibiscrub were the only preparations that gave significant, mean reductions (97.9-99.9% and 80.3-93.4%, respectively) in the number of colony forming units. According to the present study, these are the only test preparations that can be recommended for presurgical hand disinfection, and when hand disinfection is needed in general dental practice.

  6. PEOPLE BORN IN AUTUMN LIVE LONGER

    Institute of Scientific and Technical Information of China (English)

    张梦华

    2004-01-01

    People born in the autumn live longer an those born in the spring and are less likely to fall chronically ill when they are older,according to an Austrian scientist.Using census data for more than one million people in Austria,Denmark and Australia,scien-

  7. 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.

  8. Comparative effectiveness research: policy and politics.

    Science.gov (United States)

    Zusman, Edie E

    2012-07-01

    Comparative effectiveness research (CER) is the basis for some of the fiercest rhetoric of the current political era. While it is a relatively old and previously academic pursuit, CER may well become the foundation upon which the future of health care in the US is based. The actual impact of CER on-and uptake among-doctors, patients, hospitals, and health insurers, however, remains to be seen. Political considerations and compromises have led to the removal of key aspects of CER implementation from policy legislation to prevent alienating stakeholders critical to the success of health care reform. Health care providers, including specialists such as neurosurgeons, will need to understand both the policies and political implications of CER as its practices becomes an indelible part of the future health care landscape.

  9. To Your Health: NLM update transcript - Child mental health and longer hospitalizations

    Science.gov (United States)

    ... html To Your Health: NLM update Transcript Child mental health and longer hospitalizations : 01/03/2017 To use ... up on weekly topics. Children and teens with mental health conditions experience comparatively longer and more expensive hospital ...

  10. Worms Live Longer and Have Fun, Too

    Institute of Scientific and Technical Information of China (English)

    Maggie Fox; 单先新

    2004-01-01

    长命,是自古以来人们的一种渴望.现在看来,人类在延续人的寿命方面的努力已经闪烁成功的曙光.本文告诉我们,科学家在虫子身上的试验,已经获得成功.就现在的科研成果而言,具有实践意义的内容是:Experiments haveshown that lifetime low-calorie diets,for instance,can help mice live longer than normal.另一条却是无法实现的:...reproduction somehow shortens lifespan and that animals whose reproductive systems are shut down may live longer.

  11. Worms Live Longer and Have Fun, Too

    Institute of Scientific and Technical Information of China (English)

    Maggie; Fox; 单先新

    2004-01-01

    长命,是自古以来人们的一种渴望。现在看来,人类在延续人的寿命方面的努力已经闪烁成功的曙光。本文告诉我们,科学家在虫子身上的试验,已经获得成功。就现在的科研成果而言,具有实践意义的内容是:Experiments haveshown that lifetime low-calorie diets,for instance,can help mice live longer thannormal.另一条却是无法实现的:…reproduction somehow shortens lifespanand that animals whose reproductive systems are shut down may live longer.

  12. Ethical pitfalls in neonatal comparative effectiveness trials.

    Science.gov (United States)

    Modi, Neena

    2014-01-01

    Evidence-based medicine has been embraced wholeheartedly, and rightly so, as the best approach for reducing clinical uncertainty and ensuring that patients receive treatment and care that are efficacious (i.e. they work) and effective (i.e. they work in real life). High-quality evidence comes from high-quality clinical research. It would hence be reasonable to assume that these two would form a closely integrated partnership. Alas, this is not yet the case. So many uncertainties in medical care relate to treatments and practices already widely in use. In neonatal medicine, for example, some of us use protein-carbohydrate fortification of human milk and some of us do not, some of us stop enteral feeds during blood transfusions whereas some of us do not, some of us reach for dopamine when blood pressure falls while some of us use dobutamine. For our patients, these uncertainties represent a lottery, the throw of the dice that determines whether they receive the treatment advocated by Dr. A or Dr. B. They deserve better than this. Randomization is considered the gold standard approach to eliminating the clinician bias that very often dominates the choice of treatments. Randomization reduces the influence on outcomes of confounding by unknown factors, and ensures that every patient has a fair and equal chance of receiving the best possible treatment when this is, in fact, not known. In an ideal world, every medical uncertainty would be addressed in this way. The evaluation of treatments that are in accepted use has been termed 'comparative effectiveness research', i.e. the comparison of existing healthcare interventions to determine which works best, for whom and under which circumstances. Recently a long-standing uncertainty, the optimum saturation target for preterm babies receiving oxygen was put to the test of randomization. The accepted standard-of-care saturation range of 85-95% has been used for a considerable time and its use is intended to avoid both levels of

  13. 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.

  14. 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

  15. COMPARATIVE EFFECTS OF SCREW PRESS FOR HONEY ...

    African Journals Online (AJOL)

    2013-03-01

    Mar 1, 2013 ... substitute in cooking, baking, cereals, drinks and bev- erages. It is a preferable sweetener ... energy and therefore much used in medicine. It is used .... the performance test was carried out and compared with the traditional ...

  16. Challenges conducting comparative effectiveness research: the Clinical and Health Outcomes Initiative in Comparative Effectiveness (CHOICE experience

    Directory of Open Access Journals (Sweden)

    Friedly JL

    2014-05-01

    Full Text Available Janna L Friedly,1,4 Zoya Bauer,2,4 Bryan A Comstock,3,4 Emily DiMango,5 Assiamira Ferrara,6 Susan S Huang,7 Elliot Israel,8 Jeffrey G Jarvik,2,4 Andrew A Nierenberg,9 Michael K Ong,10 David F Penson,11 Rebecca Smith-Bindman,12 Arthur E Stillman,13 William M Vollmer,6 Stephen M Warren,14 Chunliu Zhan,15 David Chu-Wen Hsia,15 Anne Trontell15 1Department of Rehabilitation Medicine, 2Department of Radiology, 3Department of Biostatistics, 4Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, Seattle, WA, 5Columbia University Medical Center, New York, NY, 6Kaiser Foundation Research Institute, Oakland, 7Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, CA, 8Harvard Medical School, Pulmonary and Critical Care, Allergy and Immunology, Brigham and Women's Hospital, 9Massachusetts General Hospital, Boston, MA, 10Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, 11Vanderbilt University and Tennessee Valley VAHCC, Nashville, TN, 12Departments of Radiology and Biomedical Imaging, Health Policy, Epidemiology and Biostatistics, University of California, San Francisco, SF, 13Emory University, Atlanta, GA, 14Department of Plastic Surgery, Division of Clinical and Translational Research, NYU Langone Medical Center, New York, NY, 15Agency for Healthcare Research and Quality, Rockville, MD, USA Abstract: The Clinical and Health Outcomes Initiative in Comparative Effectiveness (CHOICE program, which includes 12 ongoing comparative effectiveness research (CER trials funded by the Agency for Healthcare Research and Quality under the American Recovery and Reinvestment Act of 2009, has had firsthand experience in dealing with the unique challenges of conducting CER since the trials started in the fall of 2010. This paper will explore the collective experience

  17. Comparative analysis on temperature reduction effectiveness of ...

    African Journals Online (AJOL)

    The process of urbanization causes alterations in the landscape, affects the ... Five ornamental tree species effectiveness on temperature reduction were ... Keywords: Crown, Climate change, Shading, Temperature, Urban environment ...

  18. Single molecule imaging with longer x-ray laser pulses

    CERN Document Server

    Martin, Andrew V; Caleman, Carl; Quiney, Harry M

    2015-01-01

    In serial femtosecond crystallography, x-ray laser pulses do not need to outrun all radiation damage processes because Bragg diffraction exceeds the damage-induced background scattering for longer pulses ($\\sim$ 50--100 fs). This is due to a "self-gating pulse" effect whereby damage terminates Bragg diffraction prior to the pulse completing its passage through the sample, as if that diffraction were produced by a shorter pulse of equal fluence. We show here that a similar gating effect applies to single molecule diffraction with respect to spatially uncorrelated damage processes like ionization and ion diffusion. The effect is clearly seen in calculations of the diffraction contrast, by calculating the diffraction of average structure separately to the diffraction from statistical fluctuations of the structure due to damage ("damage noise"). Our results suggest that sub-nanometer single molecule imaging with longer pulses, like those produced at currently operating facilities, should not yet be ruled out. The...

  19. Comparative nuclear effects of biomedical interest. Civil effects study

    Energy Technology Data Exchange (ETDEWEB)

    White, C.S.; Bowen, I.G.; Richmond, D.R.; Corsbie, R.L.

    1961-01-12

    Selected physical and biological data bearing upon the environmental variations created by nuclear explosions are presented in simplified form. Emphasis is placed upon the ``early`` consequences of exposure to blast, thermal radiation, and ionizing radiation to elucidate the comparative ranges of the major effects as they vary with explosive yield and as they contribute to the total hazard to man. A section containing brief definitions of the terminology employed is followed by a section that utilizes text and tabular material to set forth events that follow nuclear explosions and the varied responses of exposed physical and biological materials. Finally, selected quantitative weapons-effects data in graphic and tabular form are presented over a wide range of explosive yields to show the relative distances from Ground Zero affected by significant levels of blast overpressures, thermal fluxes, and initial and residual penetrating ionizing radiations. However, only the ``early`` rather than the ``late`` effects of the latter are considered.

  20. Open appendectomy: no longer an intern case.

    Science.gov (United States)

    Neville, Angela L; Nemceff, Dennis; Bricker, Scott D; Plurad, David; Bongard, Frederick; Putnam, Brant A

    2012-10-01

    Laparoscopy and work-hour restrictions are altering surgical training. We hypothesized interns were no longer gaining experience in open appendectomy, historically an intern index case. We retrospectively reviewed Accreditation Council for Graduate Medical Education (ACGME) case logs of postgraduate Year (PGY) 1 general surgery trainees from our academic teaching program for the last 9 years. Number of appendectomies performed (Current Procedural Terminology codes 44950, 44960, and 44970) were recorded and analyzed. The national ACGME database was similarly evaluated for resident experience during junior (PGY-1 to 4) years. Data were available for 47 residents completing internship at our institution between 2003 and 2011. Mean number of appendectomies performed per intern steadily decreased throughout the study period from 22 in 2003 to 5 in 2011 (P=0.0367). Mean percentage of cases done open decreased from 79.5 to 2.4 per cent (P=0.0001). National data found residents graduating in the year 2000 performed an average of 26.6 open appendectomies during junior years, whereas those graduating in 2011 had done only 13.7. Surgical trainees are performing fewer open appendectomies than just several years ago. Open appendectomy traditionally served as an introduction to open surgery. Because outcome differences are small between open and laparoscopic appendectomy, we propose teaching institutions consider performing open appendectomies in select patients to preserve an important educational experience.

  1. Live Longer, Work Longer: Making It Happen in the Labor Market

    Directory of Open Access Journals (Sweden)

    Milan Vodopivec

    2008-03-01

    Full Text Available An aging population and the corresponding shrinkage of the labor force will create a significant drag on economic growth and may jeopardize the economic well-being of some of the elderly. Thus working longer is an imperative – but extending working lives has proven difficult, both because workers do not want to work longer and because employers are lukewarm about employing older workers. As measures that can be taken to motivate workers to work longer, the paper proposes providing retirement incentives and attractive, flexible working arrangements. To induce employers to hire old workers, it suggests removing the obstacles imposed by restrictive labor market institutions, an increase in the human capital of workers via life-long learning, and addressing age-discrimination. Chances for extending working lives will also increase as the health of elderly workers is improved.

  2. Native Tissue Prolapse Repairs: Comparative Effectiveness Trials.

    Science.gov (United States)

    Siff, Lauren N; Barber, Matthew D

    2016-03-01

    This report reviews the success rates and complications of native tissue (nonmesh) vaginal reconstruction of pelvic organ prolapse by compartment. For apical prolapse, both uterosacral ligament suspensions and sacrospinous ligament fixations are effective and provided similar outcomes in anatomy and function with few adverse events. In the anterior compartment, traditional colporrhaphy technique is no different than ultralateral suturing. In the posterior compartment, transvaginal rectocele repair is superior to transanal repair. For uterine preservation, sacrospinous hysteropexy is not inferior to vaginal hysterectomy with uterosacral ligament suspension for treatment of apical uterovaginal prolapse. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Children’s Brain Development Benefits from Longer Gestation

    Directory of Open Access Journals (Sweden)

    Elysia Poggi Davis

    2011-02-01

    Full Text Available Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was to determine if the benefit for brain development conferred by increased gestational length exists on a continuum across the gestational age spectrum among healthy children with a stable neonatal course. Neurodevelopment was evaluated with structural magnetic resonance imaging (MRI in 100 healthy right-handed six to ten year old children born between 28 and 41 gestational weeks with a stable neonatal course. Data indicate that a longer gestational period confers an advantage for neurodevelopment. Longer duration of gestation was associated with region-specific increases in grey matter density. Further, the benefit of longer gestation for brain development was present even when only full term infants were considered. These findings demonstrate that even modest decreases in the duration of gestation can exert profound and lasting effects on neurodevelopment for both term and preterm infants and may contribute to long-term risk for health and disease.

  4. Ground Water Flow No Longer A Mystery

    Science.gov (United States)

    Lehr, Jay H.; Pettyjohn, Wayne A.

    1976-01-01

    Examined are the physical characteristics of ground water movement. Some potential pollution problems are identified. Models are used to explain mathematical and hydraulic principles of flow toward a pumping well and an effluent stream, flow around and through lenticular beds, and effects of pumping on the water table. (Author/MR)

  5. Longer opening hours, alcohol consumption and health

    OpenAIRE

    Green, Colin Peter; Hollingsworth, Bruce Philip; Navarro Paniagua, Maria

    2015-01-01

    Two related issues in public policy with respect to alcohol are how increased availability influences consumption and what effect excess consumption has on individual health outcomes. This paper examines one particular source of variation in availability, bar opening hours, and how this influences alcohol consumption, physical and mental health. We focus on the extension of opening hours in England and Wales that occurred in 2005. We demonstrate a marked increase in consumption, which appears...

  6. 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

  7. COMPARATIVE ADVERTISING EFFECTIVENESS: A CROSS-CULTURAL STUDY

    OpenAIRE

    KONSOLAKI, KALLIOPI

    2015-01-01

    The lucrative world of comparative advertising has been attractive to marketers, who seek economic types of persuasive communication. Nevertheless, research in the actual effectiveness of comparative advertising has been inconclusive, contradicting, and insufficient. The increasing importance of comparative advertising in the current competitive global environment requires immediate findings about how comparative advertising can work effectively. This study is the first study to develop an in...

  8. Scalable video compression using longer motion compensated temporal filters

    Science.gov (United States)

    Golwelkar, Abhijeet V.; Woods, John W.

    2003-06-01

    Three-dimensional (3-D) subband/wavelet coding using a motion compensated temporal filter (MCTF) is emerging as a very effective structure for highly scalable video coding. Most previous work has used two-tap Haar filters for the temporal analysis/synthesis. To make better use of the temporal redundancies, we are proposing an MCTF scheme based on longer biorthogonal filters. We show a lifting based coder capable of subpixel accurate motion compensation. If we retain the fixed size GOP structure of the Haar filter MCTFs, we need to use symmetric extensions at both ends of the GOP. This gives rise to loss of coding efficiency at the GOP boundaries resulting in significant PSNR drops there. This performance can be considerably improved by using a 'sliding window,' in place of the GOP block. We employ the 5/3 filter and its non-orthogonality causes PSNR variation, which can be reduced by employing filter-based weighting coefficients. Overall the longer filters have a higher coding gain than the Haar filters and show significant improvement in average PSNR at high bit rates. However, a doubling in the number of motion vectors to be transmitted, translates to a drop in PSNR at the lower video bit rates.

  9. 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.

  10. Comparative Job Performance Effectiveness of Teachers in Public ...

    African Journals Online (AJOL)

    Comparative Job Performance Effectiveness of Teachers in Public and Private ... management, students discipline and supervision of co-curricular activities. ... of Education should adequately fund the school system, equip the laboratories, ...

  11. 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...

  12. 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.

  13. "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…

  14. 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.

  15. Slower perception followed by faster lexical decision in longer words: a diffusion model analysis

    Directory of Open Access Journals (Sweden)

    Yulia eOganian

    2016-01-01

    Full Text Available 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 word length effects.

  16. 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.

  17. Strategic planning effectiveness comparative analysis of the Macedonian context

    Directory of Open Access Journals (Sweden)

    Bobek Šuklev

    2012-01-01

    Full Text Available Strategic planning is an important element in the organizational success and the key to effectiveness and overall competitiveness of the organizations. Strategic planning practice and effectiveness has been the subject of much academic debate in the Western context, but little empirical research and comparative analysis exists on this subject in emerging and developing countries. The aim of this study is to investigate the relationship between strategic planning and the organizational effectiveness with the examination of a wider list of strategic planning dimensions and different approaches and measures to assess the strategic planning effectiveness in the case of the Republic of Macedonia, as well as to conduct comparative analysis of the strategic planning effectiveness in different emerging and developing countries. After the initial processing of the total number of received questionnaires, 113 questionnaires proceeded to the next phase of processing, as companies were found to be strategic planners. Two regression models were performed, enclosed with necessary tests, as well as in order to achieve unidimensionality, factor analysis was performed for all stated items for each of the investigated variables. The empirical analysis conducted in Macedonian companies shows that strategic planning can generally contribute to organizational effectiveness. A significant correlation between different strategic planning dimensions and the strategic planning effectiveness was found in the relationship between the formality of strategic planning, the management participation in strategic planning and the employee participation in strategic planning. The comparative analysis conducted in this study with the purpose of comparing the case of Republic of Macedonia with the studies in the other emerging and developing counties, and indicating the probable reasons for potential differences in strategic planning effectiveness in different counties, refers to

  18. Breaking the Legend: Maxmin Fairness notion is no longer effective

    Directory of Open Access Journals (Sweden)

    Yaser Miaji

    2010-06-01

    Full Text Available In this paper we analytically propose an alternative approach to achieve better fairness in schedulingmechanisms which could provide better quality of service particularly for real time application. Our proposaloppose the allocation of the bandwidth which adopted by all previous scheduling mechanism. It rather adopt theopposition approach be proposing the notion of Maxmin-charge which fairly distribute the congestion.Furthermore, analytical proposition of novel mechanism named as Just Queueing is been demonstrated.

  19. Breaking the Legend: Maxmin Fairness notion is no longer effective

    CERN Document Server

    Miaji, Yaser; 10.5121/jgraphoc.2010.2203

    2010-01-01

    In this paper we analytically propose an alternative approach to achieve better fairness in scheduling mechanisms which could provide better quality of service particularly for real time application. Our proposal oppose the allocation of the bandwidth which adopted by all previous scheduling mechanism. It rather adopt the opposition approach be proposing the notion of Maxmin-charge which fairly distribute the congestion. Furthermore, analytical proposition of novel mechanism named as Just Queueing is been demonstrated.

  20. IUDs no longer profitable in U.S. market.

    Science.gov (United States)

    1986-01-01

    Ortho Pharmaceuticals and G.D. Searle & Company have decided to stop supplying IUDs to the US market because it is no longer profitable for them to do so. The Lippes Loop IUD, manufactured by Ortho Pharmaceuticals, and the Copper-7 and Tatum-T IUDs, manufactured by G.D. Searle, continue to have Food and Drug Administration (FDA) approval. These decisions were not related to issues of safety or effectiveness and will not affect supplies to programs in developing countries. product liability suits such as those brought against Searle are an increasingly common feature of health care product manfacturing in the US. Medical malpractice suits also are increasing dramatically. Searle spent $1.5 million successfully defending the Copper-7 in 4 recent trials initiated by women who claimed Searle's IUDs had caused such problems as pelvic inflammatory disease (FE). Although IUD use has been linked to an increased incidence of PID, the exact nature of that link remains controversial, and not every woman is at higher risk. Long before the Ortho and Searle decisions, the US Agency for International Development began the process of shifting to the Copper-T 380A, which is approved by the FDA and manufactured by Finishing Enterprises in New York but not marketed directly in the US. The primary effect of the Searle and Ortho decisions has been to shift entirely to providing Copper-T 380A IUDs.

  1. Does the Longer Application of Anodal-Transcranial Direct Current Stimulation Increase Corticomotor Excitability Further? A Pilot Study

    Directory of Open Access Journals (Sweden)

    Shapour Jaberzadeh

    2012-09-01

    Full Text Available Introduction: Anodal transcranial direct current stimulation (a-tDCS of the primary motor cortex (M1 has been shown to be effective in increasing corticomotor excitability.Methods: We investigated whether longer applications of a-tDCS coincide with greater increases in corticomotor excitability compared to shorter application of a-tDCS. Ten right-handed healthy participants received one session of a-tDCS(1mA current with shorter (10 min and longer (10+10 min stimulation durationsapplied to the left M1 of extensor carpi radialis muscle (ECR. Corticomotorexcitability following application of a-tDCS was assessed at rest with transcranial magnetic stimulation (TMS elicited motor evoked otentials (MEP and compared with baseline data for each participant.Results: MEP amplitudes were increased following 10 min of a-tDCS by 67%(p = 0.001 with a further increase (32% after the second 10 min of a-tDCS (p = 0.005. MEP amplitudes remained elevated at 15 min post stimulation compared to baseline values by 65% (p = 0.02.Discussion: The results demonstrate that longer application of a-tDCS within the recommended safety limits, increases corticomotor excitability with after effects of up to 15 minutes post stimulation.

  2. The comparative effectiveness of statin therapy in selected chronic diseases compared with the remaining population

    Directory of Open Access Journals (Sweden)

    Sheng Xia

    2012-08-01

    Full Text Available Abstract Background Total cholesterol (TC concentration is the most commonly used measure of statin efficacy in the UK. This study aimed to evaluate the effectiveness of statins in lowering TC, cardiovascular events (CV and mortality five common chronic diseases (chronic obstructive pulmonary disease (COPD, osteoarthritis (OA, rheumatoid arthritis (RA, chronic kidney disease (CKD, and diabetes mellitus (DM and to compare effectiveness with the rest of the population not recorded as having these diseases. Methods A population-based cohort study was conducted in Tayside population who had at least two TC measurements between 1993 and 2007. There were 12,140 patients with chronic diseases and 9,481 patients in the rest of the population not recorded as having these chronic diseases. The main outcomes were TC change from baseline, CV events and all-cause mortality. Results Statin-associated TC reductions varied from 15% to 28% with baseline value of between 5.1 and 5.9 mmol/L in the primary prevention (PP and from 7% to 23% with baseline value of 4.5 to 5.2 mmol/L in the secondary prevention (SP among chronic diseases patients. In the rest of the population, TC reductions with statins were 31% in PP and 28% in SP with baselines of 6.3 mmol/L and 5.3 mmol/L, respectively (test of heterogeneity with chronic disease groups: p  0.05. Conclusions The effectiveness of statins in common chronic diseases varied. With the exception of diabetes, statins tends to be less effective in patients with the chronic diseases compared with the rest of the study population. Changes in TC with statins appear not to correlate well with the changes in cardiovascular events and all-cause mortality.

  3. Comparative assessment of PV plant performance models considering climate effects

    DEFF Research Database (Denmark)

    Tina, Giuseppe; Ventura, Cristina; Sera, Dezso

    2017-01-01

    The paper investigates the effect of climate conditions on the accuracy of PV system performance models (physical and interpolation methods) which are used within a monitoring system as a reference for the power produced by a PV system to detect inefficient or faulty operating conditions....... The methodological approach is based on comparative tests of the analyzed models applied to two PV plants installed respectively in north of Denmark (Aalborg) and in the south of Italy (Agrigento). The different ambient, operating and installation conditions allow to understand how these factors impact the precision...... and effectiveness of such approaches, among these factors it is worth mentioning the different percentage of diffuse component of the yearly solar radiation on the global one. The experimental results show the effectiveness of the proposed approach. In order to have the possibility to analyze and compare...

  4. 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.

  5. Comparative cardiometabolic effects of fibrates and omega-3 fatty acids.

    Science.gov (United States)

    Han, Seung Hwan; Oh, Pyung Chun; Lim, Soo; Eckel, Robert H; Koh, Kwang Kon

    2013-09-10

    Even with the aggressive reduction of low-density lipoprotein cholesterol by statin therapy, a high residual risk of cardiovascular events remains substantially and attracts attention to the need for additional preventive therapies. Therefore, effective reductions of residual risk of cardiovascular disease have emerged as therapeutic targets. Fibrates and omega-3 fatty acids have been introduced to reduce triglycerides and to increase high-density lipoprotein cholesterol and have shown anti-atherosclerotic, vascular and metabolic effects. However, some effects are controversial and very recent randomized clinical trials report different results from the earlier ones. In this review, we address the vascular and metabolic effects and the results of recent clinical trials of fibrates and omega-3 fatty acids. We also compared their effects under modern guideline therapy regarding potential drugs to reduce a residual cardiometabolic risk of cardiovascular disease.

  6. Effects of conventional versus laparoscopic surgery in treatment of congenital bile duct dilatation: a comparative analysis

    Directory of Open Access Journals (Sweden)

    CHEN Houbin

    2015-06-01

    Full Text Available ObjectiveTo compare the clinical effects of conventional versus laparoscopic surgery in adults with congenital bile duct dilatation. MethodsA retrospective analysis was performed on the clinical data of 37 patients with congenital bile duct dilation who were treated in our hospital from February 2011 to February 2013. All the 37 cases underwent bile duct cyst resection and common hepatic duct-jejunal Roux-en-Y anastomosis; 20 of them (study group underwent laparoscopic surgery, while the other 17 cases (control group underwent open surgery. The mean operative time, mean intraoperative blood loss, mean length of hospital stay after surgery, mean time to first flatus after surgery, and postoperative complications were compared between the two groups. Comparison of continuous data between the two groups was made by t test, while comparison of categorical data was made by chi-square test. ResultsCompared with the control group, the study group had a significantly longer operative time (P<0.05 but significantly less mean intraoperative blood loss, mean length of hospital stay after surgery, and mean time to first flatus after surgery (P<0.05. The incidence of postoperative complications showed no significant difference between the two groups (P>0.05. ConclusionCompared with conventional surgery, laparoscopic bile duct cyst resection and common hepatic duct-jejunal Roux-en-Y anastomosis is less invasive and safer and leads to faster recovery in adults with congenital bile duct dilation, and it is worthy of clinical application.

  7. Can a Community's 'Well-Being' Help You Live Longer?

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_161961.html Can a Community's 'Well-Being' Help You Live Longer? Study found ... News) -- The level of "well-being" in a community -- including people's emotional health and life satisfaction -- may ...

  8. The incident user design in comparative effectiveness research.

    Science.gov (United States)

    Johnson, Eric S; Bartman, Barbara A; Briesacher, Becky A; Fleming, Neil S; Gerhard, Tobias; Kornegay, Cynthia J; Nourjah, Parivash; Sauer, Brian; Schumock, Glen T; Sedrakyan, Art; Stürmer, Til; West, Suzanne L; Schneeweiss, Sebastian

    2013-01-01

    Comparative effectiveness research includes cohort studies and registries of interventions. When investigators design such studies, how important is it to follow patients from the day they initiated treatment with the study interventions? Our article considers this question and related issues to start a dialogue on the value of the incident user design in comparative effectiveness research. By incident user design, we mean a study that sets the cohort's inception date according to patients' new use of an intervention. In contrast, most epidemiologic studies enroll patients who were currently or recently using an intervention when follow-up began. We take the incident user design as a reasonable default strategy because it reduces biases that can impact non-randomized studies, especially when investigators use healthcare databases. We review case studies where investigators have explored the consequences of designing a cohort study by restricting to incident users, but most of the discussion has been informed by expert opinion, not by systematic evidence.

  9. Comparing Effects of Different Cinematic Visualization Strategies on Viewer Comprehension

    Science.gov (United States)

    Jhala, Arnav; Young, R. Michael

    Computational storytelling systems have mainly focused on the construction and evaluation of textual discourse for communicating stories. Few intelligent camera systems have been built in 3D environments for effective visual communication of stories. The evaluation of effectiveness of these systems, if any, has focused mainly on the run-time performance of the camera placement algorithms. The purpose of this paper is to present a systematic cognitive-based evaluation methodology to compare effects of different cinematic visualization strategies on viewer comprehension of stories. In particular, an evaluation of automatically generated visualizations from Darshak, a cinematic planning system, against different hand-generated visualization strategies is presented. The methodology used in the empirical evaluation is based on QUEST, a cognitive framework for question-answering in the context of stories, that provides validated predictors for measuring story coherence in readers. Data collected from viewers, who watch the same story renedered with three different visualization strategies, is compared with QUEST's predictor metrics. Initial data analysis establishes significant effect on choice of visualization strategy on story comprehension. It further shows a significant effect of visualization strategy selected by Darshak on viewers' measured story coherence.

  10. Comparing the face inversion effect in crows and humans.

    Science.gov (United States)

    Brecht, Katharina F; Wagener, Lysann; Ostojić, Ljerka; Clayton, Nicola S; Nieder, Andreas

    2017-09-13

    Humans show impaired recognition of faces that are presented upside down, a phenomenon termed face inversion effect, which is thought to reflect the special relevance of faces for humans. Here, we investigated whether a phylogenetically distantly related avian species, the carrion crow, with similar socio-cognitive abilities to human and non-human primates, exhibits a face inversion effect. In a delayed matching-to-sample task, two crows had to differentiate profiles of crow faces as well as matched controls, presented both upright and inverted. Because crows can discriminate humans based on their faces, we also assessed the face inversion effect using human faces. Both crows performed better with crow faces than with human faces and performed worse when responding to inverted pictures in general compared to upright pictures. However, neither of the crows showed a face inversion effect. For comparative reasons, the tests were repeated with human subjects. As expected, humans showed a face-specific inversion effect. Therefore, we did not find any evidence that crows-like humans-process faces as a special visual stimulus. Instead, individual recognition in crows may be based on cues other than a conspecific's facial profile, such as their body, or on processing of local features rather than holistic processing.

  11. Disseminating Comparative Effectiveness Research Through Community-based Experiential Learning.

    Science.gov (United States)

    Hansen, Richard A; Williamson, Margaret; Stevenson, Lynn; Davis, Brandy R; Evans, R Lee

    2017-02-25

    Objectives. To launch and evaluate a comparative effectiveness research education and dissemination program as part of an introductory pharmacy practice experience (IPPE). Methods. First- through third-year PharmD students received training on comparative effectiveness research and disseminated printed educational materials to patients in the community who they were monitoring longitudinally (n=314). Students completed an assessment and initial visit documentation form at the first visit, and a follow-up assessment and documentation form at a subsequent visit. Results. Twenty-three diabetes patients, 29 acid-reflux patients, 30 osteoarthritis patients, and 50 hypertension patients received materials. Aside from the patient asking questions, which was the most common outcome (n=44), the program resulted in 38 additional actions, which included stopping, starting, or changing treatments or health behaviors, or having additional follow-up or diagnostic testing. Small but positive improvements in patient understanding, confidence, and self-efficacy were observed. Conclusions. Dissemination of comparative effectiveness research materials in an IPPE program demonstrated a positive trend in markers of informed decision-making.

  12. Disseminating Comparative Effectiveness Research Through Community-based Experiential Learning

    Science.gov (United States)

    Williamson, Margaret; Stevenson, Lynn; Davis, Brandy R.; Evans, R. Lee

    2017-01-01

    Objectives. To launch and evaluate a comparative effectiveness research education and dissemination program as part of an introductory pharmacy practice experience (IPPE). Methods. First- through third-year PharmD students received training on comparative effectiveness research and disseminated printed educational materials to patients in the community who they were monitoring longitudinally (n=314). Students completed an assessment and initial visit documentation form at the first visit, and a follow-up assessment and documentation form at a subsequent visit. Results. Twenty-three diabetes patients, 29 acid-reflux patients, 30 osteoarthritis patients, and 50 hypertension patients received materials. Aside from the patient asking questions, which was the most common outcome (n=44), the program resulted in 38 additional actions, which included stopping, starting, or changing treatments or health behaviors, or having additional follow-up or diagnostic testing. Small but positive improvements in patient understanding, confidence, and self-efficacy were observed. Conclusions. Dissemination of comparative effectiveness research materials in an IPPE program demonstrated a positive trend in markers of informed decision-making. PMID:28289299

  13. Diminish Electrostatic in Piezoresponse Force Microscopy through longer ultra-stiff tips

    CERN Document Server

    Gomez, Andres; Puig, Teresa; Obradors, Xavier

    2016-01-01

    Piezoresponse Force Microscopy is a powerful but delicate nanoscale technique that measures the mechanical 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 0deg and 180deg domains, using different commercial available conductive tips. We employ the theoretical description to compare the electrostatic contributi...

  14. Comparing methods for assessing the effectiveness of subnational REDD+ initiatives

    Science.gov (United States)

    Bos, Astrid B.; Duchelle, Amy E.; Angelsen, Arild; Avitabile, Valerio; De Sy, Veronique; Herold, Martin; Joseph, Shijo; de Sassi, Claudio; Sills, Erin O.; Sunderlin, William D.; Wunder, Sven

    2017-07-01

    The central role of forests in climate change mitigation, as recognized in the Paris agreement, makes it increasingly important to develop and test methods for monitoring and evaluating the carbon effectiveness of REDD+. Over the last decade, hundreds of subnational REDD+ initiatives have emerged, presenting an opportunity to pilot and compare different approaches to quantifying impacts on carbon emissions. This study (1) develops a Before-After-Control-Intervention (BACI) method to assess the effectiveness of these REDD+ initiatives; (2) compares the results at the meso (initiative) and micro (village) scales; and (3) compares BACI with the simpler Before-After (BA) results. Our study covers 23 subnational REDD+ initiatives in Brazil, Peru, Cameroon, Tanzania, Indonesia and Vietnam. As a proxy for deforestation, we use annual tree cover loss. We aggregate data into two periods (before and after the start of each initiative). Analysis using control areas (‘control-intervention’) suggests better REDD+ performance, although the effect is more pronounced at the micro than at the meso level. Yet, BACI requires more data than BA, and is subject to possible bias in the before period. Selection of proper control areas is vital, but at either scale is not straightforward. Low absolute deforestation numbers and peak years influence both our BA and BACI results. In principle, BACI is superior, with its potential to effectively control for confounding factors. We conclude that the more local the scale of performance assessment, the more relevant is the use of the BACI approach. For various reasons, we find overall minimal impact of REDD+ in reducing deforestation on the ground thus far. Incorporating results from micro and meso level monitoring into national reporting systems is important, since overall REDD+ impact depends on land use decisions on the ground.

  15. Comparing Scales of Environmental Effects from Gasoline and Ethanol Production

    Science.gov (United States)

    Parish, Esther S.; Kline, Keith L.; Dale, Virginia H.; Efroymson, Rebecca A.; McBride, Allen C.; Johnson, Timothy L.; Hilliard, Michael R.; Bielicki, Jeffrey M.

    2013-02-01

    Understanding the environmental effects of alternative fuel production is critical to characterizing the sustainability of energy resources to inform policy and regulatory decisions. The magnitudes of these environmental effects vary according to the intensity and scale of fuel production along each step of the supply chain. We compare the spatial extent and temporal duration of ethanol and gasoline production processes and environmental effects based on a literature review and then synthesize the scale differences on space-time diagrams. Comprehensive assessment of any fuel-production system is a moving target, and our analysis shows that decisions regarding the selection of spatial and temporal boundaries of analysis have tremendous influences on the comparisons. Effects that strongly differentiate gasoline and ethanol-supply chains in terms of scale are associated with when and where energy resources are formed and how they are extracted. Although both gasoline and ethanol production may result in negative environmental effects, this study indicates that ethanol production traced through a supply chain may impact less area and result in more easily reversed effects of a shorter duration than gasoline production.

  16. Comparing Scales of Environmental Effects from Gasoline and Ethanol Production

    Energy Technology Data Exchange (ETDEWEB)

    Parish, Esther S [ORNL; Kline, Keith L [ORNL; Dale, Virginia H [ORNL; Efroymson, Rebecca Ann [ORNL; McBride, Allen [ORNL; Johnson, Timothy L [U.S. Environmental Protection Agency, Raleigh, North Carolina; Hilliard, Michael R [ORNL; Bielicki, Dr Jeffrey M [University of Minnesota

    2013-01-01

    Understanding the environmental effects of alternative fuel production is critical to characterizing the sustainability of energy resources to inform policy and regulatory decisions. The magnitudes of these environmental effects vary according to the intensity and scale of fuel production along each step of the supply chain. We compare the scales (i.e., spatial extent and temporal duration) of ethanol and gasoline production processes and environmental effects based on a literature review, and then synthesize the scale differences on space-time diagrams. Comprehensive assessment of any fuel-production system is a moving target, and our analysis shows that decisions regarding the selection of spatial and temporal boundaries of analysis have tremendous influences on the comparisons. Effects that strongly differentiate gasoline and ethanol supply chains in terms of scale are associated with when and where energy resources are formed and how they are extracted. Although both gasoline and ethanol production may result in negative environmental effects, this study indicates that ethanol production traced through a supply chain may impact less area and result in more easily reversed effects of a shorter duration than gasoline production.

  17. Innovation in health economic modelling of service improvements for longer-term depression: demonstration in a local health community.

    Science.gov (United States)

    Tosh, Jonathan; Kearns, Ben; Brennan, Alan; Parry, Glenys; Ricketts, Thomas; Saxon, David; Kilgarriff-Foster, Alexis; Thake, Anna; Chambers, Eleni; Hutten, Rebecca

    2013-04-26

    The purpose of the analysis was to develop a health economic model to estimate the costs and health benefits of alternative National Health Service (NHS) service configurations for people with longer-term depression. Modelling methods were used to develop a conceptual and health economic model of the current configuration of services in Sheffield, England for people with longer-term depression. Data and assumptions were synthesised to estimate cost per Quality Adjusted Life Years (QALYs). Three service changes were developed and resulted in increased QALYs at increased cost. Versus current care, the incremental cost-effectiveness ratio (ICER) for a self-referral service was £11,378 per QALY. The ICER was £2,227 per QALY for the dropout reduction service and £223 per QALY for an increase in non-therapy services. These results were robust when compared to current cost-effectiveness thresholds and accounting for uncertainty. Cost-effective service improvements for longer-term depression have been identified. Also identified were limitations of the current evidence for the long term impact of services.

  18. Effect of ozone on oral cells compared with established antimicrobials.

    Science.gov (United States)

    Huth, Karin C; Jakob, Franz M; Saugel, Bernd; Cappello, Christian; Paschos, Ekaterini; Hollweck, Regina; Hickel, Reinhard; Brand, Korbinian

    2006-10-01

    Ozone has been proposed as an alternative antiseptic agent in dentistry based on reports of its antimicrobial effects in both gaseous and aqueous forms. This study investigated whether gaseous ozone (4 x 10(6) microg m(-3)) and aqueous ozone (1.25-20 microg ml(-1)) exert any cytotoxic effects on human oral epithelial (BHY) cells and gingival fibroblast (HGF-1) cells compared with established antiseptics [chlorhexidine digluconate (CHX) 2%, 0.2%; sodium hypochlorite (NaOCl) 5.25%, 2.25%; hydrogen peroxide (H(2)O(2)) 3%], over a time of 1 min, and compared with the antibiotic, metronidazole, over 24 h. Cell counts, metabolic activity, Sp-1 binding, actin levels, and apoptosis were evaluated. Ozone gas was found to have toxic effects on both cell types. Essentially no cytotoxic signs were observed for aqueous ozone. CHX (2%, 0.2%) was highly toxic to BHY cells, and slightly (2%) and non-toxic (0.2%) to HGF-1 cells. NaOCl and H(2)O(2) resulted in markedly reduced cell viability (BHY, HGF-1), whereas metronidazole displayed mild toxicity only to BHY cells. Taken together, aqueous ozone revealed the highest level of biocompatibility of the tested antiseptics.

  19. Developments in post-marketing comparative effectiveness research.

    Science.gov (United States)

    Schneeweiss, S

    2007-08-01

    Physicians and insurers need to weigh the effectiveness of new drugs against existing therapeutics in routine care to make decisions about treatment and formularies. Because Food and Drug Administration (FDA) approval of most new drugs requires demonstrating efficacy and safety against placebo, there is limited interest by manufacturers in conducting such head-to-head trials. Comparative effectiveness research seeks to provide head-to-head comparisons of treatment outcomes in routine care. Health-care utilization databases record drug use and selected health outcomes for large populations in a timely way and reflect routine care, and therefore may be the preferred data source for comparative effectiveness research. Confounding caused by selective prescribing based on indication, severity, and prognosis threatens the validity of non-randomized database studies that often have limited details on clinical information. Several recent developments may bring the field closer to acceptable validity, including approaches that exploit the concepts of proxy variables using high-dimensional propensity scores, within-patient variation of drug exposure using crossover designs, and between-provider variation in prescribing preference using instrumental variable (IV) analyses.

  20. Medication Adherence in a Comparative Effectiveness Trial for Bipolar Disorder

    Science.gov (United States)

    Sylvia, Louisa G.; Reilly-Harrington, Noreen A.; Leon, Andrew C.; Kansky, Christine I.; Calabrese, Joseph R.; Bowden, Charles L.; Ketter, Terence A.; Friedman, Edward S.; Iosifescu, Dan V.; Thase, Michael E.; Ostacher, Michael J.; Keyes, Michelle; Rabideau, Dustin; Nierenberg, Andrew A.

    2013-01-01

    Objective Psychopharmacology remains the foundation of treatment for bipolar disorder, but medication adherence in this population is low (Range = 20% to 64%). We examined medication adherence in a multi-site, comparative effectiveness study of lithium. Method The Lithium Moderate Dose Use Study (LiTMUS) was a six-month, six-site, randomized effectiveness trial of adjunctive moderate dose lithium therapy compared to optimized treatment in adult outpatients with bipolar I or II disorder (N=283). Medication adherence was measured at each study visit with the Tablet Routine Questionnaire. Results We found that 4.50% of participants reported missing at least 30% of their medications in the past week at baseline and non-adherence remained low throughout the trial (< 7%). Poor medication adherence was associated with more manic symptoms and side effects as well as lower lithium serum levels at mid- and post-treatment, but not with poor quality of life, overall severity of illness, or depressive symptoms. Conclusion Participants in LiTMUS were highly adherent with taking their medications. The lack of association with possible predictors of adherence, such as depression and quality of life, could be explained by the limited variance or other factors as well as by not using an objective measure of adherence. PMID:24117232

  1. 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

  2. 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

  3. Longer Interset Rest Periods Enhance Muscle Strength and Hypertrophy in Resistance-Trained Men.

    Science.gov (United States)

    Schoenfeld, Brad J; Pope, Zachary K; Benik, Franklin M; Hester, Garrett M; Sellers, John; Nooner, Josh L; Schnaiter, Jessica A; Bond-Williams, Katherine E; Carter, Adrian S; Ross, Corbin L; Just, Brandon L; Henselmans, Menno; Krieger, James W

    2016-07-01

    Schoenfeld, BJ, Pope, ZK, Benik, FM, Hester, GM, Sellers, J, Nooner, JL, Schnaiter, JA, Bond-Williams, KE, Carter, AS, Ross, CL, Just, BL, Henselmans, M, and Krieger, JW. Longer interset rest periods enhance muscle strength and hypertrophy in resistance-trained men. J Strength Cond Res 30(7): 1805-1812, 2016-The purpose of this study was to investigate the effects of short rest intervals normally associated with hypertrophy-type training versus long rest intervals traditionally used in strength-type training on muscular adaptations in a cohort of young, experienced lifters. Twenty-one young resistance-trained men were randomly assigned to either a group that performed a resistance training (RT) program with 1-minute rest intervals (SHORT) or a group that employed 3-minute rest intervals (LONG). All other RT variables were held constant. The study period lasted 8 weeks with subjects performing 3 total body workouts a week comprised 3 sets of 8-12 repetition maximum (RM) of 7 different exercises per session. Testing was performed prestudy and poststudy for muscle strength (1RM bench press and back squat), muscle endurance (50% 1RM bench press to failure), and muscle thickness of the elbow flexors, triceps brachii, and quadriceps femoris by ultrasound imaging. Maximal strength was significantly greater for both 1RM squat and bench press for LONG compared to SHORT. Muscle thickness was significantly greater for LONG compared to SHORT in the anterior thigh, and a trend for greater increases was noted in the triceps brachii (p = 0.06) as well. Both groups saw significant increases in local upper body muscle endurance with no significant differences noted between groups. This study provides evidence that longer rest periods promote greater increases in muscle strength and hypertrophy in young resistance-trained men.

  4. Distinguishing Selection Bias and Confounding Bias in Comparative Effectiveness Research.

    Science.gov (United States)

    Haneuse, Sebastien

    2016-04-01

    Comparative effectiveness research (CER) aims to provide patients and physicians with evidence-based guidance on treatment decisions. As researchers conduct CER they face myriad challenges. Although inadequate control of confounding is the most-often cited source of potential bias, selection bias that arises when patients are differentially excluded from analyses is a distinct phenomenon with distinct consequences: confounding bias compromises internal validity, whereas selection bias compromises external validity. Despite this distinction, however, the label "treatment-selection bias" is being used in the CER literature to denote the phenomenon of confounding bias. Motivated by an ongoing study of treatment choice for depression on weight change over time, this paper formally distinguishes selection and confounding bias in CER. By formally distinguishing selection and confounding bias, this paper clarifies important scientific, design, and analysis issues relevant to ensuring validity. First is that the 2 types of biases may arise simultaneously in any given study; even if confounding bias is completely controlled, a study may nevertheless suffer from selection bias so that the results are not generalizable to the patient population of interest. Second is that the statistical methods used to mitigate the 2 biases are themselves distinct; methods developed to control one type of bias should not be expected to address the other. Finally, the control of selection and confounding bias will often require distinct covariate information. Consequently, as researchers plan future studies of comparative effectiveness, care must be taken to ensure that all data elements relevant to both confounding and selection bias are collected.

  5. 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 ...

  6. 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…

  7. Sweet dream,sleep less,live longer

    Institute of Scientific and Technical Information of China (English)

    薛宗明

    2006-01-01

    Different from popular belief, people who sleep six to seven hours a night live longer,and those who sleep eight hours or more die younger, according to the latest study.There’s an old idea that people should sleep eight

  8. 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 perhaps never…

  9. 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…

  10. Comparative effectiveness research and health care reform in C hina

    Institute of Scientific and Technical Information of China (English)

    Yilong Wang; Yongjun Wang

    2016-01-01

    China has made significant progress in modernizing its healthcare system in the past 20 years. However, there are some issues that are difficult to solve on the current healthcare status, including the lack of medical care satisfaction in rural areas and urban areas, excessive consumption of medical resources, conflict and tension between the healthcare provider and patients, and the problems caused by the change of model of healthcare. Therefore, the State Council in-troduced the Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform in 2009 in order to provide basic, safe, effective, convenient and affordable healthcare for all residents. Despite the goals and policies set by the gov-ernment, how to implement them remains to be chal-lenging. Like evidence-based medicine, comparative effective research ( CER ) which started in the US in 2000 ’s can provide diagnosis and treatment information for patients, doctors, and health policy makers to make decisions on the effective ways of caring for both indi-vidual and population. It also may apply to the condi-tions of healthcare reform in China. And there are op-portunities and challenges of conducting CER in our country. We suggest that the government should estab-lish the national-level CER research institute, CER Leadership Committee and relevant standards, fund the CER projects, and begin CER in certain disciplines.

  11. Why is the Sun No Longer Accelerating Particles to High Energy in Solar Cycle 24?

    Science.gov (United States)

    Mewaldt, R. A.; Cohen, C. M.; Li, G.; Mason, G. M.; Smith, C. W.; von Rosenvinge, T. T.; Vourlidas, A.

    2015-12-01

    Why is the Sun No Longer Accelerating Particles to High Energy in Solar Cycle 24?Measurements by ACE, STEREO, and GOES show that the number of large Solar Energetic Particle (SEP) events in solar cycle 24 is reduced by a factor of ~2 compared to this point of solar cycle 23, while the fluences of >10 MeV/nuc ions from H to Fe are reduced by factors ranging from ~4 to ~10. Compared to solar Cycle 22 and 23, the fluence of >100 MeV protons is reduced by factors of ~7 to ~10 in the current cycle. A common element of these observations is that the observed Cycle-24 energy spectra have "breaks" that suddenly steepen 2 to 4 times lower in energy/nucleon than in Cycle 23. We investigate the origin of these cycle-to-cycle spectral differences by evaluating possible factors that control the maximum energy of CME-shock-accelerated particles in the two cycles, including seed-particle densities of suprathermal ions, the interplanetary magnetic field strength and turbulence level, and properties of the associated CMEs. The effect of these conditions will be evaluated in the context of existing SEP acceleration models by comparing SEP data with simulations and with analytic evaluations of the maximum kinetic energy to which CME shocks can accelerate solar energetic ions from H to Fe. Understanding the properties that control the maximum kinetic energy of CME-shock accelerated particles has important implications for predicting future solar activity.

  12. The comparative effectiveness of conventional and digital image libraries.

    Science.gov (United States)

    McColl, R I; Johnson, A

    2001-03-01

    Before introducing a hospital-wide image database to improve access, navigation and retrieval speed, a comparative study between a conventional slide library and a matching image database was undertaken to assess its relative benefits. Paired time trials and personal questionnaires revealed faster retrieval rates, higher image quality, and easier viewing for the pilot digital image database. Analysis of confidentiality, copyright and data protection exposed similar issues for both systems, thus concluding that the digital image database is a more effective library system. The authors suggest that in the future, medical images will be stored on large, professionally administered, centrally located file servers, allowing specialist image libraries to be tailored locally for individual users. The further integration of the database with web technology will enable cheap and efficient remote access for a wide range of users.

  13. 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.

  14. A CTSA agenda to advance methods for comparative effectiveness research.

    Science.gov (United States)

    Helfand, Mark; Tunis, Sean; Whitlock, Evelyn P; Pauker, Stephen G; Basu, Anirban; Chilingerian, Jon; Harrell, Frank E; Meltzer, David O; Montori, Victor M; Shepard, Donald S; Kent, David M

    2011-06-01

    Clinical research needs to be more useful to patients, clinicians, and other decision makers. To meet this need, more research should focus on patient-centered outcomes, compare viable alternatives, and be responsive to individual patients' preferences, needs, pathobiology, settings, and values. These features, which make comparative effectiveness research (CER) fundamentally patient-centered, challenge researchers to adopt or develop methods that improve the timeliness, relevance, and practical application of clinical studies. In this paper, we describe 10 priority areas that address 3 critical needs for research on patient-centered outcomes (PCOR): (1) developing and testing trustworthy methods to identify and prioritize important questions for research; (2) improving the design, conduct, and analysis of clinical research studies; and (3) linking the process and outcomes of actual practice to priorities for research on patient-centered outcomes. We argue that the National Institutes of Health, through its clinical and translational research program, should accelerate the development and refinement of methods for CER by linking a program of methods research to the broader portfolio of large, prospective clinical and health system studies it supports. Insights generated by this work should be of enormous value to PCORI and to the broad range of organizations that will be funding and implementing CER.

  15. Biases in Social Comparative Judgments: The Role of Nonmotivated Factors in Above-Average and Comparative-Optimism Effects

    Science.gov (United States)

    Chambers, John R.; Windschitl, Paul D.

    2004-01-01

    Biases in social comparative judgments, such as those illustrated by above-average and comparative-optimism effects, are often regarded as products of motivated reasoning (e.g., self-enhancement). These effects, however, can also be produced by information-processing limitations or aspects of judgment processes that are not necessarily biased by…

  16. The effects of variable sample biomass on comparative metagenomics.

    Science.gov (United States)

    Chafee, Meghan; Maignien, Loïs; Simmons, Sheri L

    2015-07-01

    Longitudinal studies that integrate samples with variable biomass are essential to understand microbial community dynamics across space or time. Shotgun metagenomics is widely used to investigate these communities at the functional level, but little is known about the effects of combining low and high biomass samples on downstream analysis. We investigated the interacting effects of DNA input and library amplification by polymerase chain reaction on comparative metagenomic analysis using dilutions of a single complex template from an Arabidopsis thaliana-associated microbial community. We modified the Illumina Nextera kit to generate high-quality large-insert (680 bp) paired-end libraries using a range of 50 pg to 50 ng of input DNA. Using assembly-based metagenomic analysis, we demonstrate that DNA input level has a significant impact on community structure due to overrepresentation of low-GC genomic regions following library amplification. In our system, these differences were largely superseded by variations between biological replicates, but our results advocate verifying the influence of library amplification on a case-by-case basis. Overall, this study provides recommendations for quality filtering and de-replication prior to analysis, as well as a practical framework to address the issue of low biomass or biomass heterogeneity in longitudinal metagenomic surveys.

  17. Novel Therapeutics for Diabetes: Uptake, Usage Trends, and Comparative Effectiveness.

    Science.gov (United States)

    Ahuja, Vishal; Chou, Chia-Hung

    2016-06-01

    The number of available therapies for treating type 2 diabetes has grown considerably in recent years. This growth has been fueled by availability of newer medications, whose benefits and risks have not been fully established. In this study, we review and synthesize the existing literature on the uptake, efficacy, safety, and cost-effectiveness of novel antidiabetic agents. Specifically, we focus on three drug classes that were introduced in the market recently: thiazolidinediones (TZDs), dipeptidyl peptidase-4 (DPP-4) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists. Not surprisingly, we find that the usage trends reflect the efficacy and safety profile of these novel drugs. The use of TZDs increased initially but decreased after a black-box warning was issued for rosiglitazone in 2007 that highlighted the cardiovascular risks associated with using the drug. Conversely, DPP-4 inhibitors and GLP-1 receptor agonists gained market shares due to their efficacy in glycemic control as an add-on treatment to metformin. DPP-4 inhibitors were the most commonly prescribed agents among the three novel drug classes, likely because they are relatively less expensive, have better safety profile, are administered orally, and are weight neutral. Sitagliptin was the most preferred DPP-4 inhibitor. The level of evidence on the comparative effectiveness, safety, and cost implications of using novel antidiabetic agents remains low and further studies with long-term follow-ups are needed.

  18. 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.

  19. Low expression of tissue inhibitor of metalloproteinases-1 (TIMP-1) in glioblastoma predicts longer patient survival

    DEFF Research Database (Denmark)

    Aaberg-Jessen, Charlotte; Christensen, Karina; Offenberg, Hanne Kjær

    2009-01-01

    In colorectal cancer and breast cancer a high TIMP-1 level has been shown to correlate with a shorter overall patient survival and it has been suggested that TIMP-1 is involved in tumour invasion, proliferation and apoptosis in different types of cancers. TIMP-1 is known to be expressed in gliomas...... with the lowest TIMP-1 expression had a significantly longer overall survival (HR (95% CI) = 3.2 (1.5-6.7), P = 0.004) when compared to the patients with higher TIMP-1 protein expression. In conclusion, this study showed that low TIMP-1 immunohistochemical expression predicts longer overall survival...

  20. No Longer the Outlier: Updating the Air Component Structure

    Science.gov (United States)

    2016-06-23

    4 | Air & Space Power Journal No Longer the Outlier Updating the Air Component Structure Lt Gen CQ Brown Jr., USAF Lt Col Rick Fournier, USAF...This article may be reproduced in whole or in part without permission. If it is reproduced, the Air and Space Power Journal requests a courtesy...COCOM) with a highly competent air component that is capable of con- ducting and supporting air , space , and cyberspace operations within its assigned

  1. 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.

  2. PRIVATE MANUFACTURERS’ THRESHOLDS TO INVEST IN COMPARATIVE EFFECTIVENESS TRIALS

    Science.gov (United States)

    Basu, Anirban; Meltzer, David

    2015-01-01

    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 manufacturer that compares its own product to its competitor’s in head to head trials. Our analysis shows that private incentives to invest in CER are determined by how the results of CER may affect the price and quantity of the product sold and the duration over which resulting changes in revenue would accrue given the time required to complete CER and the time from the completion of CER to the time of patent expiration. We highlight the result that private incentives may often be less than public incentives to invest in CER and may even be negative if the likelihood of adverse findings is sufficient. We find that these incentives imply a number of predictions about patterns of CER and how they will be affected by changes in public financing of CER and CER methods. For example, these incentives imply that incumbent patent holders may be less likely to invest in CER than entrants and that public investments in CER may crowd out similar private investments. In contrast, newer designs and methods for CER, such as Bayesian adaptive trials, which can reduce ex-post risk of unfavorable results and shorten the time for the production of CER, may increase the expected benefits of CER and may tend to increase private investment in CER as long as the costs of such innovative designs are not excessive. Bayesian approaches to design also naturally highlight the dynamic aspects of CER, allowing less expensive initial studies to guide decisions about future investments and thereby encouraging

  3. Private manufacturers' thresholds to invest in comparative effectiveness trials.

    Science.gov (United States)

    Basu, Anirban; Meltzer, David

    2012-10-01

    The recent rush of enthusiasm for public investment in comparative effectiveness research (CER) in the US has focussed 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 manufacturer that compares its own product to a competitor's product in head-to-head trials. Our analysis shows that private incentives to invest in CER are determined by how the results of CER may affect the price and quantity of the product sold and the duration over which resulting changes in revenue would accrue, given the time required to complete CER and the time from the completion of CER to the time of patent expiration. We highlight the result that private incentives may often be less than public incentives to invest in CER and may even be negative if the likelihood of adverse findings is sufficient. We find that these incentives imply a number of predictions about patterns of CER and how they will be affected by changes in public financing of CER and CER methods. For example, these incentives imply that incumbent patent holders may be less likely to invest in CER than entrants and that public investments in CER may crowd out similar private investments. In contrast, newer designs and methods for CER, such as Bayesian adaptive trials, which can reduce ex post risk of unfavourable results and shorten the time for the production of CER, may increase the expected benefits of CER and may tend to increase private investment in CER as long as the costs of such innovative designs are not excessive. Bayesian approaches to design also naturally highlight the dynamic aspects of CER, allowing less expensive initial studies to guide decisions about future investments and thereby encouraging greater

  4. The implications of comparative effectiveness research for academic medicine.

    Science.gov (United States)

    Rich, Eugene C; Bonham, Ann C; Kirch, Darrell G

    2011-06-01

    With growing constraints on government spending, policy makers are investing in comparative effectiveness research (CER) to attempt to bring the power of science to bear on the problems of suboptimal outcomes and high cost in the U.S. health care system. This commitment of resources to CER reflects confidence that better evidence can help clinicians and patients make better decisions, consistent with the long tradition of medical schools' and teaching hospitals' use of science to inform medical care. Thus, CER offers a great opportunity, albeit with some considerable challenges, for academic medicine to play a central role in comprehensive health care reform. Certainly, many scientists conducting CER will learn their methodological rigor in the training programs of academic health centers. Numerous new CER research teams will be needed, establishing effective partnerships far outside the walls of the traditional academic setting. And the clinicians interpreting the medical literature and applying the insights from CER to the unique problems of individual patients will need to learn this evidence-based, patient-centered care from the educators, mentors, and role models at U.S. medical and other health science schools and teaching hospitals. Achieving this will require investment in research infrastructure, adaptations of institutional culture, development of new disciplines and research methods, establishment of new collaborations, training of new faculty, and the expansion and refocusing of educational capacity. By successfully responding to this challenge, academic medicine can further strengthen its long-standing commitment to the scientific practice of medicine and the use of evidence in patient-centered, personalized care.

  5. Effective LiDAR Damage Detection: Comparing Two Detection Algorithms

    Institute of Scientific and Technical Information of China (English)

    BIAN Haitao; BAI Libin; WANG Xiaoyu; LIU Wangiu; CHEN Shenen; WANG Shengguo

    2011-01-01

    The health conditions of highway bridges is critical for sustained transportation operations. US federal government mandates that all bridges built with public funds are to be inspected visually every two years.There is a growing consensus that additional rapid and non-intrusive methods for bridge damage evaluation are needed. This paper explores the potential of applying ground-based laser scanners for bridge damage evaluation. LiDAR has the potential of providing high-density, full-field surface static imaging. Hence, it can generate volumetric quantification of concrete corrosion or steel erosion. By recording object surface topology, LiDAR can detect different damages on the bridge structure and differentiate damage types according to the surface flatness and smoothness. To determine the effectiveness of LiDAR damage detection, two damage detection algorithms are presented and compared using scans on actual bridge damages. The results demonstrate and validate LiDAR damage quantification, which can be a powerful tool for bridge condition evaluation.

  6. The politics of comparative effectiveness research: lessons from recent history.

    Science.gov (United States)

    Sorenson, Corinna; Gusmano, Michael K; Oliver, Adam

    2014-02-01

    Efforts to support and use comparative effectiveness research (CER), some more successful than others, have been promulgated at various times over the last forty years. Following a resurgence of interest in CER, recent health care reforms provided substantial support to strengthen its role in US health care. While CER has generally captured bipartisan support, detractors have raised concerns that it will be used to ration services and heighten government control over health care. Such concerns almost derailed the initiative during passage of the health care reform legislation and are still present today. Given recent investments in CER and the debates surrounding its development, the time is ripe to reflect on past efforts to introduce CER in the United States. This article examines previous initiatives, highlighting their prescribed role in US health care, the reasons for their success or failure, and the political lessons learned. Current CER initiatives have corrected for many of the pitfalls experienced by previous efforts. However, past experiences point to a number of issues that must still be addressed to ensure the long-term success and sustainability of CER, including adopting realistic aims about its impact, demonstrating the impact of Patient-Centered Outcomes Research Institute (PCORI) and communicating the benefits of CER, and maintaining strong political and stakeholder support.

  7. Cost Effectiveness Ratio: Evaluation Tool for Comparing the Effectiveness of Similar Extension Programs

    Science.gov (United States)

    Jayaratne, K. S. U.

    2015-01-01

    Extension educators have been challenged to be cost effective in their educational programming. The cost effectiveness ratio is a versatile evaluation indicator for Extension educators to compare the cost of achieving a unit of outcomes or educating a client in similar educational programs. This article describes the cost effectiveness ratio and…

  8. Comparative effectiveness of drugs for chronic obstructive pulmonary disease.

    Science.gov (United States)

    Cazzola, M; Segreti, A; Rogliani, P

    2012-12-01

    Current guidelines for the management of chronic obstructive pulmonary disease (COPD) recommend the use of inhaled long-acting bronchodilators, inhaled corticosteroids (ICSs) and their combinations for maintenance treatment of moderate to severe COPD. However, doctors still wonder if in patients with mild/moderate stable COPD it is best to start with a β-adrenoceptor agonist or an antimuscarinic agent. They also wonder if once- or twice-daily dosing is preferable, and if it is enough to develop a novel therapy that is dosed once daily rather than twice daily if the agents are both equally safe and effective. It also remains unclear whether and when a second bronchodilator with a different mechanism of action should be used in patients with stable COPD and when, in its place, an ICS must be added, and also whether long-acting antimuscarinic agent (LAMA)/long-acting β-adrenoceptor agonist (LABA) combination therapy is preferred over LAMA plus LABA/ICS. Moreover, there is no solid evidence of the best way to administer a triple combination product: should drugs be delivered concomitantly or sequentially? In any case, the growing evidence that COPD is a heterogeneous disease with characteristics that occur with different phenotypes suggests that a specific therapy may not be ultimately identified for every phenotype. Therefore, there is a clear need to move toward personalized treatment in COPD because phenotypic heterogeneity may affect treatment response and the clinical course of the disease. Unfortunately, however, there is not enough money or time to examine the impact of each treatment step or combination of treatments in each specific phenotype using randomized controlled trials. Consequently, doctors wonder if there is a role for comparative effectiveness research (CER), which can be considered a subset of patient-oriented research that examines available therapeutic options in particular patients to determine relevant health outcomes. There is a strong

  9. Comparing seed dispersal effectiveness by frugivores at the community level.

    Science.gov (United States)

    González-Castro, Aarón; Calviño-Cancela, Marĺa; Nogales, Manuel

    2015-03-01

    Seed dispersal effectiveness (SDE) is the contribution of dispersers to plant recruitment and is estimated as the product of the number of seeds dispersed (quantity) and the probability of recruitment of each dispersed seed (quality). Although SDE is a key concept in seed dispersal ecology, few studies estimate SDE and none has a community approach. Oceanic islands, with simple communities, are ideal for this purpose. In this study, we compared the SDE of the main types of dispersers (lizards and passerine birds) at the community level in a given habitat. We estimated SDE using a stochastic simulation model parameterized with empirical data on quantity and quality components measured throughout the recruitment process. Although lizards are highly frugivorous and their density was approximately 20 times higher than that of birds, lizards and birds dispersed a similar quantity of seeds. This may be due to lower intake of seeds by lizards due to their slower metabolism (approximately 20 times lower than birds). This low metabolic rate limits the importance of lizards as seed dispersers, but it is compensated by extraordinarily high lizard densities in the study area (approximately 9600 individuals/km2). High densities of lizards are typical of islands, and this helps to explain why dispersal by lizards seems mainly an island phenomenon. Birds and lizards showed functional complementarity, especially regarding seed dispersal distribution patterns. In fact, lizards dispersed more seeds in shrublands and open sites, and birds in woodlands and beneath canopies, with their joint contribution helping to maximize recruitment. Lizards provided higher SDE than birds for 7 out of 11 plant species. The disperser with a higher quantity for a given plant generally had the higher quality, and plants could be classified as bird- or lizard-dependent for dispersal. This dependence increased when considering SDE instead of dispersal quantity only. Moreover, quality was a better

  10. 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.

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

    African Journals Online (AJOL)

    between adjuvant intrathecal 2 mg midazolam as compared to intrathecal 20 micrograms fentanyl for patients undergoing ... in mental processes, respiratory depression, and other .... nificance level and power of 90%, the required sample.

  12. Comparative study on effect of blending, thermal barrier coating (LHR)

    African Journals Online (AJOL)

    But proper deployment of blending the biodiesel with diesel and adopting thermal ... almost comparable engine performance with acceptable emission norms. ... Keywords: Uppage oil, biodiesel, thermal barrier coating, low heat rejection ...

  13. randomised double blind study to compare effectiveness of honey ...

    African Journals Online (AJOL)

    2014-02-02

    Feb 2, 2014 ... efficacy over placebo (p< 0.002) however no difference was noted when compared to salbutamol ... suggesting benefit from use of natural demulcents such as honey ... was, how it affected the child's and the parents' sleep.

  14. U32: Vehicle Stability and Dynamics: Longer Combination Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Petrolino, Joseph [National Transportation Research Center (NTRC); Spezia, Tony [National Transportation Research Center (NTRC); Arant, Michael [Clemson University; Broshears, Eric [Auburn University, Auburn, Alabama; Chitwood, Caleb [Battelle; Colbert, Jameson [Auburn University, Auburn, Alabama; Hathaway, Richard [Western Michigan University; Keil, Mitch [Western Michigan University; LaClair, Tim J [ORNL; Pape, Doug [Battelle; Patterson, Jim [Hendrickson; Pittro, Collin [Battelle

    2011-01-01

    This study investigated the safety and stability of longer combination vehicles (LCVs), in particular a triple trailer combination behind a commercial tractor, which has more complicated dynamics than the more common tractor in combination with a single semitrailer. The goal was to measure and model the behavior of LCVs in simple maneuvers. Example maneuvers tested and modeled were single and double lane changes, a gradual lane change, and a constant radius curve. In addition to test track data collection and a brief highway test, two computer models of LCVs were developed. One model is based on TruckSim , a lumped parameter model widely used for single semitrailer combinations. The other model was built in Adams software, which more explicitly models the geometry of the components of the vehicle, in terms of compliant structural members. Among other results, the models were able to duplicate the experimentally measured rearward amplification behavior that is characteristic of multi-unit combination vehicles.

  15. Disproportionate longer-term opioid use among U.S. adults with mood disorders.

    Science.gov (United States)

    Halbert, Brian T; Davis, Roger B; Wee, Christina C

    2016-11-01

    Adults with mood disorders frequently use prescription opioids. The factors associated with this increased use remain unclear. We used the Medical Expenditure Panel Surveys from 2005 to 2011 to measure the association of mood disorders with new opioid use and the transition to longer-term opioid use for a variety of pain conditions before and after controlling for patient characteristics and clinical disability. We analyzed 33,450 adults with likely acute or potentially chronic pain conditions who were not using opioids at baseline. Among respondents with likely acute pain conditions, those with mood disorders initiated opioids more frequently for that pain condition compared with those without mood disorders (19.3%, vs 17.2%, P = 0.01). After initiation, they also transitioned to longer-term opioid therapy more frequently (11.7% vs 5.3%, P new opioid use for likely acute (adjusted odds ratio [aOR] 1.05 [0.92-1.20]) or potentially chronic pain (aOR 0.91 [0.80-1.03]). However, there remained a strong association between mood disorders and the transition to longer-term opioid use for likely acute (aOR 1.77 [1.15-2.72]) and potentially chronic pain (aOR 1.95 [1.42-2.68]). Targeting the transition to longer-term opioid use may help clinicians reduce potentially inappropriate opioid prescriptions in this high-risk population.

  16. Longer Life and Higher Fertility in an OLG Economy with Production

    Directory of Open Access Journals (Sweden)

    Luciano Fanti

    2013-01-01

    Full Text Available This paper investigates the effect of a change in life expectancy (i.e., longevity on fertility in a standard OLG economy. The main result is that, in contrast with other papers, an increase in the longevity rate may increase the fertility rate as well. It is shown that such a result holds when the cost of rearing children in terms of goods and services (rather than in terms of forgone wages matters. In particular, such a result depends on the relative “strength” of the capital in the technology as compared with the “strength” of the parsimony. Moreover it is shown, again in contrast with other papers, that with an unfunded social security system it is more likely that a longer life may increase the fertility. The latter result is even more likely in the presence of child subsidy policies, which are widespread in developed countries. In conclusion, we argue that in countries having a population with a high longevity, a high capital share, a large unfunded social security, and child subsidy policies (such as Italy, a further increase of longevity may increase fertility in the long run and thus partially alleviate the peril of the so-called “demographic bomb.”

  17. Longer lithium exposure is associated with better white matter integrity in older adults with bipolar disorder.

    Science.gov (United States)

    Gildengers, Ariel G; Butters, Meryl A; Aizenstein, Howard J; Marron, Megan M; Emanuel, James; Anderson, Stewart J; Weissfeld, Lisa A; Becker, James T; Lopez, Oscar L; Mulsant, Benoit H; Reynolds, Charles F

    2015-05-01

    Bipolar disorder (BD) is associated with cognitive dysfunction and structural brain abnormalities. In human and non-human studies, lithium has been related to neuroprotective and neurotrophic effects. We explored whether lithium treatment is related to better brain integrity and cognitive function in older adults with BD. We examined cognitive and neuroimaging data in 58 individuals with BD [mean (standard deviation) age = 64.5 (9.8) years] and 21 mentally healthy comparators (controls) of similar age and education. Subjects received comprehensive neurocognitive assessment and structural brain imaging, examining total gray matter volume, overall white matter integrity (fractional anisotropy), and total white matter hyperintensity burden. In comparison to controls, subjects with BD had worse overall cognitive performance, lower total gray matter volume, and lower white matter integrity. Among subjects with BD, longer duration of lithium treatment was related to higher white matter integrity after controlling for age and vascular disease burden, but not with better cognitive performance. Lithium treatment appears to be related to better brain integrity in older individuals with BD, in particular, in those who take lithium long-term. While intriguing, these findings need to be confirmed in a larger sample. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Comparative study measuring the dilatory effect of a mydriatic device (Mydriasert®) versus topical drops

    Science.gov (United States)

    Saenz-de-Viteri, Manuel; Fernández-Robredo, Patricia; de Nova, Elisa; Bonet-Farriol, Elvira; Sabater, Alfonso L.; Zarranz-Ventura, Javier; Caire, Josemaria; Sádaba, Luis M.; Salinas-Alamán, Angel; García-Layana, Alfredo

    2013-01-01

    AIM To compare the mydriatic efficacy of an ophthalmic insert (Mydriasert, MY) versus phenylephrine and tropicamide (PT) eye drops. METHODS Two controlled, prospective, randomized, single-blind studies were performed. In the first study, a total of 80 eyes from 40 outpatient-clinic patients were analyzed. PT drops were applied to the right eye, and a MY device was inserted in the left eye for 30min. Time until maximal pupil dilation for each eye was then assessed. In the second study, 80 eyes from 80 patients undergoing cataract surgery were analyzed. Pupil dilation was achieved using either PT drops three-times for one hour prior to surgery (40 patients), or a MY device was inserted one hour prior to surgery (40 patients). RESULTS In the first study, MY achieved superior mydriasis compared to PT eye drops at 90min (9.04±1.33mm vs 8.78±1.37mm, P=0.012). However MY took longer than PT drops to achieve maximal dilation, and mydriasis was inferior in eyes with MY compared to PT drops at 30min (7.21±1.73mm vs 8.22±1.43mm, P<0.001), the two groups only becoming similar by 60min (8.85±1.44mm vs 8.71±1.27mm, P=0.236). In the second study, both MY and PT achieved similar levels of mydriasis at the beginning of surgery (8.75±0.76mm with MY vs 8.77±0.63mm with PT), and also at the end of surgery (7.96±1.06mm with MY vs 8.32±0.72mm with PT), with no significant difference between groups (P=0.08). MY was well tolerated and cardiovascular effects were not influenced by dilation method. CONLUSION MY could be a safe and efficacious alternative for mydriasis. The mydriatic effect of MY is as good as conventional PT eye drops after 60min, and is superior after 90min. MY also maintains good pupil dilation during cataract surgery. PMID:24392328

  19. Liraglutide and DPP-4 inhibitors - side effects comparative clinical study.

    Science.gov (United States)

    Timofte, Luminiţa; Stratmann, Bernd; Quester, Wulf; Bojiţă, Marius Traian; Tschoepe, Diethelm

    2013-01-01

    The objective of this study was to monitor the side effects of the GLP-1 receptor agonist liraglutide in comparison to those of DPP-4 inhibitors (sitagliptin and vildagliptin), in order to determine their safety, tolerability and therapeutic efficiency. The study was carried out in the "Heart and Diabetes Center NRW" and included overweight patients with type 2 diabetes whose therapeutic regimen was switched to liraglutide or DPP-4 inhibitors. A validated questionnaire method was used to monitor the side effects during the hospitalization period, then again at 3, and 6 months after the beginning of the therapy. The therapy with liraglutide was associated with more side effects than the one with DPP-4 inhibitors. In general, side effects were declining with time, thus only few patients stopped therapy. The incretin therapy turned out to be a safe and effective therapeutic option for patients with type 2 diabetes mellitus.

  20. [Effectiveness and tolerance of tramadol in cancer pain. A comparative study with respect to buprenorphine].

    Science.gov (United States)

    Bono, A V; Cuffari, S

    1997-01-01

    Opioid analgesics represent one of the most important tools in a sequential pharmacological approach to oncological pain relief. They are recommended by the WHO when nonsteroidal anti-inflammatory drugs (NSAIDs) no longer provide adequate analgesia. However, the use of opioids is limited because of their numerous and often severe adverse effects. This aspect of opioids has motivated continuous research projects aimed at discovering drugs that can provide maximum pain relief but with improved tolerability. Tramadol is a new, centrally acting analgesic with a dual mechanism of action. It shows a selective interaction with mu receptors, which are responsible for nociception, and has weak pharmacodynamic activity on other opioid receptors. At the same time, it acts synergistically on neuroamine transmission by inhibiting synaptic noradrenaline (norepinephrine) reuptake and inducing intrasynaptic serotonin (5-hydroxytryptamine; 5-HT) release. From a pharmacokinetic standpoint, tramadol offers high bioavailability, with similar patterns after oral or parenteral administration (half-life 5 to 7 hours, time to peak plasma concentration 3.1 hours, and approximately 20% plasma protein binding). Although the efficacy of tramadol is comparable to that of other drugs with similar modes of action, the incidence of side effects such as constipation and respiratory depression is lower. The frequency of euphoria and dysphoria is negligible, resulting in little risk of abuse or dependence. It therefore seemed appropriate to further investigate the efficacy and tolerability of tramadol, defined as having only weak potency, in comparison with a widely used opioid, in oncological pain. Buprenorphine was selected as an opioid with a potency equivalent to half that of morphine, but with tolerability that is partially limited by the fact that it frequently gives rise to adverse reactions considered typical of stronger opioids. To compare the analgesic effect and tolerability of tramadol

  1. Comparative Study of the Protective Effect of Granulated Sugar and ...

    African Journals Online (AJOL)

    ADOWIE PERE

    cellular macromolecules such as DNA, lipids and proteins (Breimer 1990; Romero .... mortality but may have significant effects which can ... diet could predispose humans to cardiovascular diseases .... saturated-fat diet on apolipoprotein B and.

  2. Comparative Clinical Study on the Effectiveness of Homeopathic ...

    African Journals Online (AJOL)

    maintenance therapy for the treatment of dengue fever. Method: A total of ... intense headache, retro-ocular pain, muscular ... the febrile phase of illness or after the ... effective vaccine [2]. .... treatment of acute childhood diarrhea: results from a.

  3. Comparative Effect of Forward and Backward Stair Climbing on ...

    African Journals Online (AJOL)

    olagbegi

    Forward stair climbing (FSC) is associated with cardiovascular fitness benefits, but the .... Step benches (male = 40cm high, 28cm wide; female = ... The cardiovascular endurance index was then estimated ..... Effects of stair climbing vs run.

  4. Comparative study of effects of table sugar, laboratory grade ...

    African Journals Online (AJOL)

    cntaganda

    four weeks, plants grown on the culture medium with laboratory grade sucrose showed consistently ... characteristics to those grown in the field (ZRYD, 1988). ... electrical neutrality, and its apparent lack of inhibitory effect on the majority of.

  5. Comparing the effects of community service and imprisonment on reconviction

    DEFF Research Database (Denmark)

    Klement, Christian

    2015-01-01

    Objective This study compares reconviction rates for Danish offenders sentenced to community service and imprisonment. A large general sample of offenders (n=1602) is examined. Methods The study relies on a quasi-experimental design and uses propensity score matching as well as logistic regression...... models to analyze the data. Models are differentiated in terms of length of observation period and control variable combinations. The study stands out as compared to previous studies due to the unprecedented assortment of individual background data available. These data, obtained from community service...... eligibility assessments and registry databases, provide powerful controls over potential selection mechanisms in the multivariate analyses. Furthermore, contrary to previous studies, the current study limits itself to subjects officially assessed and deemed eligible for community service sentences. Results...

  6. Effect of pooled comparative information on judgments of quality

    Science.gov (United States)

    Baumgart, Leigh A.; Bass, Ellen J.; Voss, John D.; Lyman, Jason A.

    2015-01-01

    Quality assessment is the focus of many health care initiatives. Yet it is not well understood how the type of information used in decision support tools to enable judgments of quality based on data impacts the accuracy, consistency and reliability of judgments made by physicians. Comparative pooled information could allow physicians to judge the quality of their practice by making comparisons to other practices or other specific populations of patients. In this study, resident physicians were provided with varying types of information derived from pooled patient data sets: quality component measures at the individual and group level, a qualitative interpretation of the quality measures using percentile rank, and an aggregate composite quality score. 32 participants viewed thirty quality profiles consisting of information applicable to the practice of thirty de-identified resident physicians. Those provided with quality component measures and a qualitative interpretation of the quality measures (rankings) judged quality of care more similarly to experts and were more internally consistent compared to participants who were provided with quality component measures alone. Reliability between participants was significantly less for those who were provided with a composite quality score compared to those who were not. PMID:26949581

  7. 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.

  8. 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.

  9. Comparative Evaluation Of Reinforced Concrete, Steel And Composite Structures Under The Effect Of Static And Dynamic Loads

    Directory of Open Access Journals (Sweden)

    Zafar Mujawar

    2015-01-01

    Full Text Available Steel-concrete composite construction has gained wide acceptance all over the world as an alternative for pure steel and pure concrete construction. However this approach is a new concept for construction industry. R.C.C are no longer economical because of their increased dead load, hazardous formwork. The present study deals with comparison of reinforced concrete, steel and composite structures under the effect of static and dynamic loads. The results of this work show that composite structures are best suited for high rise buildings compared to that of steel and reinforced concrete structures. Response spectrum method is used for comparison of three structures with the help of ETABS software.

  10. Comparative technique in measurements of Ge detectors effective volumes

    Science.gov (United States)

    Demidova, E. V.; Kirpichnikov, I. V.; Vasenko, A. A.

    1999-01-01

    A simple and quick procedure was proposed for measurements of large coaxial Ge detectors effective volumes. It included a comparison of background spectra collected with several detectors without any shielding in an underground laboratory. Such measurements were performed in Homestake (USA) and Canfranc (Spain) laboratories with several 1 kg and 2 kg detectors. Monte-Carlo calculations confirmed that ratios of numbers of events in continua of the spectra should be either equal or very close to the ratios of the detectors effective volumes.

  11. Comparative effect of pesticides on brain acetylcholinesterase in tropical fish.

    Science.gov (United States)

    Assis, Caio Rodrigo Dias; Linhares, Amanda Guedes; Oliveira, Vagne Melo; França, Renata Cristina Penha; Carvalho, Elba Veronica Matoso Maciel; Bezerra, Ranilson Souza; de Carvalho, Luiz Bezerra

    2012-12-15

    Monitoring of pesticides based on acetylcholinesterase (AChE; EC 3.1.1.7) inhibition in vitro avoids interference of detoxification defenses and bioactivation of some of those compounds in non-target tissues. Moreover, environmental temperature, age and stress are able to affect specific enzyme activities when performing in vivo studies. Few comparative studies have investigated the inter-specific differences in AChE activity in fish. Screening studies allow choosing the suitable species as source of AChE to detect pesticides in a given situation. Brain AChE from the tropical fish: pirarucu (Arapaima gigas), cobia (Rachycentron canadum) and Nile tilapia (Oreochromis niloticus) were characterized and their activities were assayed in the presence of pesticides (the organophosphates: dichlorvos, diazinon, chlorpyrifos, temephos, tetraethyl pyrophosphate- TEPP and the carbamates: carbaryl and carbofuran). Inhibition parameters (IC₅₀ and Ki) for each species were found and compared with commercial AChE from electric eel (Electrophorus electricus). Optimal pH and temperature were found to be 8.0 and 35-45 °C, respectively. A. gigas AChE retained 81% of the activity after incubation at 50 °C for 30 min. The electric eel enzyme was more sensitive to the compounds (mainly carbofuran, IC₅₀ of 5 nM), excepting the one from A. gigas (IC₅₀ of 9 nM) under TEPP inhibition. These results show comparable sensitivity between purified and non-purified enzymes suggesting them as biomarkers for organophosphorus and carbamate detection in routine environmental and food monitoring programs for pesticides.

  12. Framing effects over time: comparing affective and cognitive news frames

    NARCIS (Netherlands)

    Lecheler, S.; Matthes, J.

    2012-01-01

    A growing number of scholars examine the duration of framing effects. However, duration is likely to differ from frame to frame, depending on how strong a frame is. This strength is likely to be enhanced by adding emotional components to a frame. By means of an experimental survey design (n = 111),

  13. Framing effects over time: comparing affective and cognitive news frames

    NARCIS (Netherlands)

    Lecheler, S.; Matthes, J.

    2012-01-01

    A growing number of scholars examine the duration of framing effects. However, duration is likely to differ from frame to frame, depending on how strong a frame is. This strength is likely to be enhanced by adding emotional components to a frame. By means of an experimental survey design (n = 111),

  14. A Comparative Study of the Effects of Aerobic and Resisted ...

    African Journals Online (AJOL)

    AWEPTO H

    Although a few studies have evaluated the effects of exercises on asthma control .... week and these included: heart rate (HR), systolic blood. 53 ..... exercise over a period of time is likely to cause an increase ... During this type of exercise, it is.

  15. Effectiveness of tramadol/paracetamol compared with etoricoxib as ...

    African Journals Online (AJOL)

    Choy Y. Choy

    2016-04-11

    Apr 11, 2016 ... analgesia was a rational approach to pain management, and was more effective ... nausea with tramadol/paracetamol (p-value 0.001), and dizziness with etoricoxib (p-value 0.024). .... chi-square test for nonparametric data and Student's t-test .... did not increase the risk of postoperative bleeding after day.

  16. COMPARATIVE STUDY OF EFFECTIVENESS OF DISINFECTANTS ON CANDIDA ALBICANS

    OpenAIRE

    Naga Jyothi; Venkateswarlu; Shanti Reddy; Umadevi

    2015-01-01

    A considerable proportion of the population have detectable numbers of yeast in the mouth, yet very few of those people suffer from oral Candida infection. Placement of removable dentures in the oral cavity produces profound changes of the oral environment that may have an adverse effect on the integrity of the oral tissues, which mi...

  17. Design Effects in Web Surveys : Comparing Trained and Fresh Respondents

    NARCIS (Netherlands)

    Toepoel, V.; Das, J.W.M.; van Soest, A.H.O.

    2008-01-01

    In this paper we investigate whether there are differences in design effects between trained and fresh respondents. In three experiments, we varied the number of items on a screen, the choice of response categories, and the layout of a five point rating scale. We find that trained respondents are mo

  18. 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

  19. Comparative Effectiveness of Cancer Control and Survival after Robot-Assisted versus Open Radical Prostatectomy.

    Science.gov (United States)

    Hu, Jim C; O'Malley, Padraic; Chughtai, Bilal; Isaacs, Abby; Mao, Jialin; Wright, Jason D; Hershman, Dawn; Sedrakyan, Art

    2017-01-01

    Robot-assisted surgery has been rapidly adopted in the U.S. for prostate cancer. Its adoption has been driven by market forces and patient preference, and debate continues regarding whether it offers improved outcomes to justify the higher cost relative to open surgery. We examined the comparative effectiveness of robot-assisted vs open radical prostatectomy in cancer control and survival in a nationally representative population. This population based observational cohort study of patients with prostate cancer undergoing robot-assisted radical prostatectomy and open radical prostatectomy during 2003 to 2012 used data captured in the SEER (Surveillance, Epidemiology, and End Results)-Medicare linked database. Propensity score matching and time to event analysis were used to compare all cause mortality, prostate cancer specific mortality and use of additional treatment after surgery. A total of 6,430 robot-assisted radical prostatectomies and 9,161 open radical prostatectomies performed during 2003 to 2012 were identified. The use of robot-assisted radical prostatectomy increased from 13.6% in 2003 to 2004 to 72.6% in 2011 to 2012. After a median followup of 6.5 years (IQR 5.2-7.9) robot-assisted radical prostatectomy was associated with an equivalent risk of all cause mortality (HR 0.85, 0.72-1.01) and similar cancer specific mortality (HR 0.85, 0.50-1.43) vs open radical prostatectomy. Robot-assisted radical prostatectomy was also associated with less use of additional treatment (HR 0.78, 0.70-0.86). Robot-assisted radical prostatectomy has comparable intermediate cancer control as evidenced by less use of additional postoperative cancer therapies and equivalent cancer specific and overall survival. Longer term followup is needed to assess for differences in prostate cancer specific survival, which was similar during intermediate followup. Our findings have significant quality and cost implications, and provide reassurance regarding the adoption of more

  20. 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.

  1. Comparing analgesic and hemodynamic effects of unilateral spinal levobupivacaine, levobupivacaine-fentanyl and levobupivacaine-morphine combinations for arthroscopic procedures

    Directory of Open Access Journals (Sweden)

    Özlem Özorak

    2010-09-01

    Full Text Available Objectives: Aim of the study was to compare the analgesic and hemodynamic effects of levobupivacaine, levobupivacaine-fentanyl, levobupivacaine-morphine for arthroscopic knee surgery under unilateral spinal anesthesia.Methods: A total of 44 ASA I/II patients scheduled for arthroscopy were included in the study. After prehydration patients kept in a lateral position on the nondependent side. Spinal puncture was performed at L3–4/L4–5 intervertebral space. Patients divided into three subgroups: Group L (n=14 received 0.5% levobupivacaine 1 ml+1 ml distilled water; Group LF (n=15, 25 mcg fentanyl (0.5 ml+0.5 ml distilled water; and Group LM (n=15, 0.01 mg morphine (0.5 ml+0.5 ml distilled water. Patients remained in that position for 15 minutes. Blood pressure and heart rate were recorded before and 1st, 3rd, 5th, 10th, 15th, 20th and 30th minutes after the block and every 15 minutes during the operation. Motor blockade and sensorial level, side effects, motor block regression time (MBRT, first urination time and first analgesic need (FAN were recorded.Results: Group LM had the longest MBRT, but difference with other groups did not reach to a significant level (p>0.05. Group LM had significantly longer FAN time compare with other groups (p<0.05. The first urination time was latest in Group LM (p<0.05. Motor blockade was least in Group L (p<0.05 and almost 50% patients had not motor block.Conclusion: All three groups had successful anesthesia. Morphine group added group had significantly longer analgesia without significant urinary retention and motor blockade regression time. We concluded that additional low doses of morphine will be a better choice.

  2. Comparative effectiveness of open versus minimally invasive sacroiliac joint fusion

    Directory of Open Access Journals (Sweden)

    Ledonio CGT

    2014-06-01

    Full Text Available Charles GT Ledonio,1 David W Polly Jr,1 Marc F Swiontkowski,1 John T Cummings Jr2 1Department of Orthopaedic Surgery, University of Minnesota, Twin Cities, MN, 2Community Neurosurgical Care, Indianapolis, IN, USA Background: The mainstay of sacroiliac joint disruption/degenerative sacroiliitis therapy has been nonoperative management. This nonoperative management often includes a regimen of physical therapy, chiropractic treatment, therapeutic injections, and possibly radiofrequency ablation at the discretion of the treating physician. When these clinical treatments fail, sacroiliac joint fusion has been recommended as the standard treatment. Open and minimally invasive (MIS surgical techniques are typical procedures. This study aims to compare the perioperative measures and Oswestry Disability Index (ODI outcomes associated with each of these techniques. Methods: A comparative retrospective chart review of patients with sacroiliac joint fusion and a minimum of 1 year of follow-up was performed. Perioperative measures and ODI scores were compared using the Fisher's exact test and two nonparametric tests, ie, the Mann–Whitney U test and the Wilcoxon signed-rank test. The results are presented as percent or median with range, as appropriate. Results: Forty-nine patients from two institutions underwent sacroiliac joint fusion between 2006 and 2012. Ten patients were excluded because of incomplete data, leaving 39 evaluable patients, of whom 22 underwent open and 17 underwent MIS sacroiliac joint fusion. The MIS group was significantly older (median age 66 [39–82] years than the open group (median age 51 [34–74] years. Surgical time and hospital stay were significantly shorter in the MIS group than in the open group. Preoperative ODI was significantly greater in the open group (median 64 [44–78] than in the MIS group (median 53 [14–84]. Postoperative improvement in ODI was statistically significant within and between groups, with MIS

  3. The effect of cannabis compared with alcohol on driving.

    Science.gov (United States)

    Sewell, R Andrew; Poling, James; Sofuoglu, Mehmet

    2009-01-01

    The prevalence of both alcohol and cannabis use and the high morbidity associated with motor vehicle crashes has lead to a plethora of research on the link between the two. Drunk drivers are involved in 25% of motor vehicle fatalities, and many accidents involve drivers who test positive for cannabis. Cannabis and alcohol acutely impair several driving-related skills in a dose-related fashion, but the effects of cannabis vary more between individuals than they do with alcohol because of tolerance, differences in smoking technique, and different absorptions of Delta(9)-tetrahydrocannabinol (THC), the active ingredient in marijuana. Detrimental effects of cannabis use vary in a dose-related fashion, and are more pronounced with highly automatic driving functions than with more complex tasks that require conscious control, whereas alcohol produces an opposite pattern of impairment. Because of both this and an increased awareness that they are impaired, marijuana smokers tend to compensate effectively while driving by utilizing a variety of behavioral strategies. Combining marijuana with alcohol eliminates the ability to use such strategies effectively, however, and results in impairment even at doses which would be insignificant were they of either drug alone. Epidemiological studies have been inconclusive regarding whether cannabis use causes an increased risk of accidents; in contrast, unanimity exists that alcohol use increases crash risk. Furthermore, the risk from driving under the influence of both alcohol and cannabis is greater than the risk of driving under the influence of either alone. Future research should focus on resolving contradictions posed by previous studies, and patients who smoke cannabis should be counseled to wait several hours before driving, and avoid combining the two drugs.

  4. Comparative study on the effect of zopiclone and flurazepam

    Directory of Open Access Journals (Sweden)

    *R. Najam

    2011-06-01

    Full Text Available Anxiety disorders are among most frequent mental disorders encountered by Clinicians. Untreated anxiety may result in increase health care utilization, morbidity, mortality and poorer quality of life. Individual with GAD, social phobias and panic disorder show less satisfaction with their quality of life. Basolateral amygdale has been implicated in anxiety generations. Mutations in Sk3 (calcium channel are suspected to be underlying cause of severe neurological disorder including anxiety. Therapeutic effects of benzodiazepine are usually or often sustained over months or years, with the need for increased dosage in the treatment of GAD and panic disorders. Flurazepam is a hypnotic agent useful for the treatment of insomnia characterized by frequent nocturnal awakening and other insomnia symptoms such as trouble falling or staying sleep. It acts on BZ1 and BZ2 receptor sites. The mechanism of action of zopiclone is similar to benzodiazepines, but it wines more selectively to BZ1 receptor with similar effects on locomotor activity and on dopamine and serotonin turnover. Zopiclone although molecularly different from benzodiazepines, shares an almost identical pharmacological profile as benzodiazepines including anxiolytic properties. The present study is designed to assess two drugs of different classes that act through same receptor against control for their effects on some of the behavioral activities. Results indicated that zopiclone produced reduction in anxiety more than flurazepam.

  5. Confinement Effects for Lithium Borohydride: Comparing Silica and Carbon Scaffolds.

    Science.gov (United States)

    Suwarno; Ngene, Peter; Nale, Angeloclaudio; Eggenhuisen, Tamara M; Oschatz, Martin; Embs, Jan Peter; Remhof, Arndt; de Jongh, Petra E

    2017-03-02

    LiBH4 is a promising material for hydrogen storage and as a solid-state electrolyte for Li ion batteries. Confining LiBH4 in porous scaffolds improves its hydrogen desorption kinetics, reversibility, and Li(+) conductivity, but little is known about the influence of the chemical nature of the scaffold. Here, quasielastic neutron scattering and calorimetric measurements were used to study support effects for LiBH4 confined in nanoporous silica and carbon scaffolds. Pore radii were varied from 8 Å to 20 nm, with increasing confinement effects observed with decreasing pore size. For similar pore sizes, the confinement effects were more pronounced for silica than for carbon scaffolds. The shift in the solid-solid phase transition temperature is much larger in silica than in carbon scaffolds with similar pore sizes. A LiBH4 layer near the pore walls shows profoundly different phase behavior than crystalline LiBH4. This layer thickness was 1.94 ± 0.13 nm for the silica and 1.41 ± 0.16 nm for the carbon scaffolds. Quasi-elastic neutron scattering confirmed that the fraction of LiBH4 with high hydrogen mobility is larger for the silica than for the carbon nanoscaffold. These results clearly show that in addition to the pore size the chemical nature of the scaffold also plays a significant role in determining the hydrogen mobility and interfacial layer thickness in nanoconfined metal hydrides.

  6. Comparative Effectiveness of Dental Anatomy Carving Pedagogy: A Systematic Review.

    Science.gov (United States)

    de Azevedo, Renato de A; da Rosa, Wellington Luiz de O; da Silva, Adriana F; Correa, Marcos B; Torriani, Marcos A; Lund, Rafael G

    2015-08-01

    The aim of this study was to review the effectiveness of methods used for teaching dental anatomy carving to dental students in operative dentistry as evaluated in published studies. This systematic review is described in accordance with the PRISMA statement. Two independent reviewers performed a systematic literature search of research published from January 1945 until May 2014. Seven databases were screened: MedLine (PubMed), Lilacs, IBECS, Web of Science, Scopus, SciELO, and The Cochrane Library. After removing duplicates, only studies using dental carving to assess the practical knowledge of anatomy were selected. The tabulated data were organized by title of article, names of authors, number of students assessed, assessment method, material used, groups tested, main results, and conclusions. The methodology quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. Initially, 2,258 studies were identified in all databases. Five articles met the eligibility criteria and were included in this review. According to these studies, the geometric method, teaching step-by-step along with the teacher, and adjuvant methods such as the use of tutors and teaching through digital media with DVDs proved to be effective in improving learning. There is no standard technique that is widely accepted for the teaching of dental carving, nor is there an appropriately validated method of evaluation to verify whether the teaching methods used are effective for the acquisition of skills and expertise in dental anatomy by students.

  7. Confinement Effects for Lithium Borohydride: Comparing Silica and Carbon Scaffolds

    Science.gov (United States)

    2017-01-01

    LiBH4 is a promising material for hydrogen storage and as a solid-state electrolyte for Li ion batteries. Confining LiBH4 in porous scaffolds improves its hydrogen desorption kinetics, reversibility, and Li+ conductivity, but little is known about the influence of the chemical nature of the scaffold. Here, quasielastic neutron scattering and calorimetric measurements were used to study support effects for LiBH4 confined in nanoporous silica and carbon scaffolds. Pore radii were varied from 8 Å to 20 nm, with increasing confinement effects observed with decreasing pore size. For similar pore sizes, the confinement effects were more pronounced for silica than for carbon scaffolds. The shift in the solid–solid phase transition temperature is much larger in silica than in carbon scaffolds with similar pore sizes. A LiBH4 layer near the pore walls shows profoundly different phase behavior than crystalline LiBH4. This layer thickness was 1.94 ± 0.13 nm for the silica and 1.41 ± 0.16 nm for the carbon scaffolds. Quasi-elastic neutron scattering confirmed that the fraction of LiBH4 with high hydrogen mobility is larger for the silica than for the carbon nanoscaffold. These results clearly show that in addition to the pore size the chemical nature of the scaffold also plays a significant role in determining the hydrogen mobility and interfacial layer thickness in nanoconfined metal hydrides. PMID:28286596

  8. COMPARATIVE STUDY TO EVALUATE LIPID-LOWERING EFFECT OF

    Directory of Open Access Journals (Sweden)

    Niteesh Shanbag

    2017-03-01

    Full Text Available BACKGROUND Dyslipidaemia is a widely established risk factor for coronary artery disease. As Asians differ in pattern of various lipid abnormalities than non-Asians, this study was undertaken to compare efficacy of commonly administrated drugs, atorvastatin and fenofibrate. MATERIALS AND METHODS The present study was carried out in 100 diagnosed cases of hypertriglyceridaemia divided into two groups, A and B. The mean, standard deviation, standard error of mean and t value were calculated following 12 weeks of therapy of atorvastatin 10 mg in group A and micronized fenofibrate in group B. RESULTS Our study showed that fenofibrate is more efficacious in reducing the levels of triglycerides and rising level of HDL cholesterol, while atorvastatin is more efficacious in reducing LDL cholesterol. CONCLUSION Micronized fenofibrate has more efficiency in reducing triglycerides and raising HDL. Atorvastatin is more efficacious in reducing LDL levels.

  9. The comparative effects of group prenatal care on psychosocial outcomes.

    Science.gov (United States)

    Heberlein, Emily C; Picklesimer, Amy H; Billings, Deborah L; Covington-Kolb, Sarah; Farber, Naomi; Frongillo, Edward A

    2016-04-01

    To compare the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care, we conducted a prospective cohort study of women who chose CP group (N = 124) or individual prenatal care (N = 124). Study participants completed the first survey at study recruitment (mean gestational age 12.5 weeks), with 89% completing the second survey (mean gestational age 32.7 weeks) and 84% completing the third survey (6 weeks' postpartum). Multiple linear regression models compared changes by prenatal care model in pregnancy-specific distress, prenatal planning-preparation and avoidance coping, perceived stress, affect and depressive symptoms, pregnancy-related empowerment, and postpartum maternal-infant attachment and maternal functioning. Using intention-to-treat models, group prenatal care participants demonstrated a 3.2 point greater increase (p prenatal planning-preparation coping strategies. While group participants did not demonstrate significantly greater positive outcomes in other measures, women who were at greater psychosocial risk benefitted from participation in group prenatal care. Among women reporting inadequate social support in early pregnancy, group participants demonstrated a 2.9 point greater decrease (p = 0.03) in pregnancy-specific distress in late pregnancy and 5.6 point higher mean maternal functioning scores postpartum (p = 0.03). Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 point greater increase (p prenatal planning-preparation coping strategies in late pregnancy and a 4.9 point greater decrease (p = 0.02) in postpartum depressive symptom scores. This study provides further evidence that group prenatal care positively impacts the psychosocial well-being of women with greater stress or lower personal coping resources. Large randomized studies are needed to establish conclusively the biological and psychosocial benefits of group

  10. LWIR pupil imaging and longer-term calibration stability

    Science.gov (United States)

    LeVan, Paul D.; Sakoglu, Ünal

    2016-09-01

    A previous paper described LWIR pupil imaging, and an improved understanding of the behavior of this type of sensor for which the high-sensitivity focal plane array (FPA) operated at higher flux levels includes a reversal in signal integration polarity. We have since considered a candidate methodology for efficient, long-term calibration stability that exploits the following two properties of pupil imaging: (1) a fixed pupil position on the FPA, and (2) signal levels from the scene imposed on significant but fixed LWIR background levels. These two properties serve to keep each pixel operating over a limited dynamic range that corresponds to its location in the pupil and to the signal levels generated at this location by the lower and upper calibration flux levels. Exploiting this property for which each pixel of the Pupil Imager operates over its limited dynamic range, the signal polarity reversal between low and high flux pixels, which occurs for a circular region of pixels near the upper edges of the pupil illumination profile, can be rectified to unipolar integration with a two-level non-uniformity correction (NUC). Images corrected real-time with standard non-uniformity correction (NUC) techniques, are still subject to longer-term drifts in pixel offsets between recalibrations. Long-term calibration stability might then be achieved using either a scene-based non-uniformity correction approach, or with periodic repointing for off-source background estimation and subtraction. Either approach requires dithering of the field of view, by sub-pixel amounts for the first method, or by large off-source motions outside the 0.38 milliradian FOV for the latter method. We report on the results of investigations along both these lines.

  11. Effect of orthostasis on endothelial function: a gender comparative study.

    Directory of Open Access Journals (Sweden)

    Nandu Goswami

    Full Text Available As the vascular endothelium has multiple functions, including regulation of vascular tone, it may play a role in the pathophysiology of orthostatic intolerance. We investigated the effect of orthostasis on endothelial function using EndoPAT®, a non-invasive and user-independent method, and across gender. As sex steroid hormones are known to affect endothelial function, this study examined the potential effect of these hormones on the endothelial response to orthostasis by including females at different phases of the menstrual cycle (follicular and luteal-where the hormone balance differs, and females taking an oral contraceptive. A total of 31 subjects took part in this study (11 males, 11 females having normal menstrual cycles and 9 females taking oral contraceptive. Each subject made two visits for testing; in the case of females having normal menstrual cycles the first session was conducted either 1-7 (follicular or 14-21 days (luteal after the start of menstruation, and the second session two weeks later, i.e., during the other phase, respectively. Endothelial function was assessed at baseline and following a 20-min orthostatic challenge (active standing. The EndoPAT® index increased from 1.71 ± 0.09 (mean ± SEM at baseline to 2.07 ± 0.09 following orthostasis in females (p<0.001. In males, the index increased from 1.60 ± 0.08 to 1.94 ± 0.13 following orthostasis (p<0.001. There were no significant differences, however, in the endothelial response to orthostasis between females and males, menstrual cycle phases and the usage of oral contraceptive. Our results suggest an increased vasodilatatory endothelial response following orthostasis in both females and males. The effect of gender and sex hormones on the endothelial response to orthostasis appears limited. Further studies are needed to determine the potential role of this post orthostasis endothelial response in the pathophysiology of orthostatic intolerance.

  12. Comparative analgesic and sedative effects of tramadol, tramadol-lidocaine and lidocaine for caudal epidural analgesia in donkeys (Equus asinus).

    Science.gov (United States)

    Marzok, Mohamed A; El-khodery, Sabry A

    2015-03-01

    To compare anti-nociceptive and sedative effects of tramadol, a combination of tramadol-lidocaine, and lidocaine alone for perineal analgesia in donkeys. Experimental 'blinded' randomized cross-over study. Six healthy adult donkeys. Treatments were tramadol (TR) (1.0 mg kg(-1) ), tramadol-lidocaine (TRLD) (0.5 and 0.2 mg kg(-1) respectively) and lidocaine (LD) (0.4 mg kg(-1) ) given into the epidural space. The volume of all treatments was 0.02 mL kg(-1) . Nociception was tested at the perineal region by pin prick, followed, if no reaction, by pressure from a haemostat clamp. Times to onset, degree and duration of anti-nociception of the perineal region were recorded. Response was tested immediately after drug administration and at: 2, 5, 10, 15, 30, 45, and 60 minutes post-administration and then at 30 minute intervals thereafter until a response re-occurred. Physiologic data and degree of sedation and ataxia were recorded pre-administration and at intervals for 240 minutes post-administration. Results were analyzed using anova, Kruskal-Wallis tests, and Wilks' Lambda test as relevant. Significance was taken as p < 0.05. Times (minutes, mean ± SD) to onset and duration of anti-nociception, respectively were; TR 13 ± 1.6 and 220 ± 4.6; TRLD 6 ± 0.8 and 180 ± 8.5; LD 4 ± 1.4 and 75 ± 4. Onset and duration times were significantly longer with TR than the other two treatments. TR never produced complete anti-nociception, whereas the TRLD and LD induced complete anti-nociceptive effects. Duration was significantly longer with TRLD than with LD alone. Epidural injections of TR and TRLD induced mild sedation. Epidural combination of TRLD produced an anti-nociceptive effect in the perineum, which was rapid in onset and had a longer duration of action than LD alone. An epidural single dose of TRLD combination would appear to provide an acceptable analgesic effect in the perineal region of donkeys. © 2014 Association of Veterinary

  13. 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.

  14. The REFANI-N study protocol: a cluster-randomised controlled trial of the effectiveness and cost-effectiveness of early initiation and longer duration of emergency/seasonal unconditional cash transfers for the prevention of acute malnutrition among children, 6-59 months, in Tahoua, Niger.

    Science.gov (United States)

    Sibson, Victoria L; Grijalva-Eternod, Carlos S; Bourahla, Leila; Haghparast-Bidgoli, Hassan; Morrison, Joanna; Puett, Chloe; Trenouth, Lani; Seal, Andrew

    2015-12-23

    The global burden of acute malnutrition among children remains high, and prevalence rates are highest in humanitarian contexts such as Niger. Unconditional cash transfers are increasingly used to prevent acute malnutrition in emergencies but lack a strong evidence base. In Niger, non-governmental organisations give unconditional cash transfers to the poorest households from June to September; the 'hunger gap'. However, rising admissions to feeding programmes from March/April suggest the intervention may be late. This cluster-randomised controlled trial will compare two types of unconditional cash transfer for 'very poor' households in 'vulnerable' villages defined and identified by the implementing organisation. 3,500 children (6-59 months) and 2,500 women (15-49 years) will be recruited exhaustively from households targeted for cash and from a random sample of non-recipient households in 40 villages in Tahoua district. Clusters of villages with a common cash distribution point will be assigned to either a control group which will receive the standard intervention (n = 10), or a modified intervention group (n = 10). The standard intervention is 32,500 FCFA/month for 4 months, June to September, given cash-in-hand to female representatives of 'very poor' households. The modified intervention is 21,500 FCFA/month for 5 months, April, May, July, August, September, and 22,500 FCFA in June, providing the same total amount. In both arms the recipient women attend an education session, women and children are screened and referred for acute malnutrition treatment, and the households receive nutrition supplements for children 6-23 months and pregnant and lactating women. The trial will evaluate whether the modified unconditional cash transfer leads to a reduction in acute malnutrition among children 6-59 months old compared to the standard intervention. The sample size provides power to detect a 5 percentage point difference in prevalence of acute malnutrition between trial

  15. [COMPARATIVE ANALYSIS OF ANTIBACTERIAL EFFECT OF PHYTOANTIBIOTICS AND ANTIBIOTICS].

    Science.gov (United States)

    Akhvlediani, L; Koiava, T; Lomtadze, L; Joxadze, M; Msxiladze, L; Berashvili, D; Bakuridze, A

    2016-11-01

    The objective of this study was to determine the antibacterial activity of individual medicines and containing sum of the phyto-extracts against the bacteria causing nosocomial infections in compare to antibiotics. In the investigation were involved four strains of gram-negative bacteria Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Acinetobacter spp. Each object was investigated on antibiotic resistance using Kirby-Bauer diffusion method on 22 types of antibiotics. The objects of the study were: Sanguinarine, Chelerythrine and Berberine hydrochloride (of lab quality); essential oils and aromatic waters of Eucalyptus, Salvia and Lavanda. For determination their antibacterial activity was used Raits serological dilution method with adaptation. The results show that the antibiotic resistant bacteria did not rise in non-diluted and 1:1 diluted test-tubes. In 1:5 diluted test-tubes was observed a little turbidity and growth, as for in other test-tubes - intensive growth. The investigated phyto-medicines show the higher antibacterial activity than the antibiotics.

  16. Energy policy: Comparative effects on minority population groups

    Energy Technology Data Exchange (ETDEWEB)

    Poyer, D.A.; Henderson, L.

    1995-06-01

    For a number of years, analyses of minority household energy demand have been supported by the United States Department of Energy (DOE), Office of Economic Impact and Diversity (formerly the Office of Minority Economic Impact). The intention of these analyses has been to characterize patterns of energy demand by various demographic, regional and socioeconomic groups and to develop analytical tools to assess the distributive impact of energy prices and policy on these groups. The model supports strategic objectives outlined by the Department of Energy to explicitly recognize and promote equity in state public utility commission decisions and to assess the potential impact of federal and state energy policy on demographically diverse groups as reported in the Department`s Annual Energy Outlook and the upcoming National Energy Policy Plan. The legislation mandating the Office of Economic Impact and Diversity had been premised on the assumption that patterns of energy demand for minority households are different from the population as a whole. Determining the validity of this premise and its potential economic impact on different population groups has been a major objective of these analyses. Consequently, the recripriocal impacts of energy policy on demographic groups and energy consumption and expenditure dynamics on policy formulation and strategy is a central objective of these studies. Residential energy demand research has been substantial in the past twenty years. Insightful and useful research has been done in this area. However, none of this research has addressed the potential differences in the residential energy demand structure among various population groups. Recent work does compare energy and electricity demand elasticities for non-Latino Whites, with the demand elasticities for Latinos and Blacks. This research is particularly important for examination of questions related to the economic welfare implications of national energy policy.

  17. A Comparative Study on the Therapeutic Effect of Astragaloside (

    Institute of Scientific and Technical Information of China (English)

    CHEN; Xiang-jian

    2001-01-01

    [1]Anandasabapathy S, Frishman W.H. Innovative drug treatments for viral and autoimmune myocarditis. J Clin Pharmacol 1998;38∶295-308.[2]ZHANG JN, YANG GP, SU EB, et al. The study of serum cardiac troponin I in diagnosing acute myocardial infarction. J of Chin Cardiovas Disea 1997;25(5)∶379-382.[3]ZHU BH, ZHANG JN, LIU NF, et al. The experimental study of relationship between left ventricular hypertrophy in hypertension and cardiac sarcoplasmic calcium-regulated protein. J of Chin Med 1999;79(4)∶286-288.[4]ZHANG JN, SU EB, WEI J, et al. Elevation of cardiac troponin I and its association with diagnosis and progress of viral myocarditis. Clin J Cardiol 1999;27(6)∶1-4.[5]Arai M, Matsui H, Periasamy M. Sarcoplasmic Reticulum Gene Expression in Cardiac Hypertrophy and Heart Failure. Circ Res 1994;74∶555-564.[6]LU S, ZHANG JN. The study on progress of cardiovascular pharmacological effects of Astragalus. Chin Herbs 1998;29(1)∶59-61.

  18. Comparative study of interfacial effects in photovoltaic diodes

    Energy Technology Data Exchange (ETDEWEB)

    Tavakolian, H.

    1988-01-01

    Several different type of photodiodes (NASA standard n-p, p-on-n single crystal silicon, GaAs homojunction, ITO/p-Si, Au/n-GaAs Schottky diode and CdS/CuInSe{sub 2}) have been examined. Measurements of current vs. voltage as a function of temperature and light intensity, plus capacitance vs. voltage and frequency were an attempt to identify the causes on non-ideal behavior. An automatic, computer controlled system greatly enhanced the precision of measurements and the ability to separate non-ideal effects. No dispersion in capacitance with frequency was observed in single crystal homojunction diodes and Au/n-GaAs Schottky barrier, indicating near zero interfacial states for these devices. CdS/CuInSe{sub 2} cells from ARCO Solar, Boeing and IEC all showed interfacial states with a wide range of time constants and zero bias densities at the Fermi level in the junction of 10{sup 10} to 10{sup 11} states/cm{sup 2}-eV. In reverse bias, however, the density of states, decreased by an order of magnitude. Under illumination, this number increased with increasing light intensity and saturated near 100 mW/cm{sup 2}. The CdS/CuInSe{sub 2} solar cell was modeled as a heterojunction diode with charge at the junction interface. The low open-circuit voltage and the shift to lower voltage (about 125 mV) observed in some photodiodes is explained by this model.

  19. Comparative cost-effectiveness of focal and total salvage 125I brachytherapy for recurrent prostate cancer after primary radiotherapy

    Science.gov (United States)

    Piena, Marjanne A.; Steuten, Lotte M.G.; van der Voort van Zyp, Jochem R.N.; Moerland, Marinus A.; van Vulpen, Marco

    2016-01-01

    Purpose Focal salvage (FS) iodine 125 (125I) brachytherapy could be an effective treatment for locally radiorecurrent prostate cancer (PCa). Toxicity is often reduced compared to total salvage (TS) while cancer control can be maintained, which could increase cost-effectiveness. The current study estimates the incremental cost per quality-adjusted life year (QALY) of FS compared to TS. Material and methods A decision analytic Markov model was developed, which compares costs and QALYs associated with FS and TS. A 3-year time horizon was adopted with six month cycles, with a hospital perspective on costs. Probabilities for genitourinary (GU) and gastrointestinal (GI) toxicity and their impact on health-related quality of life (SF-36) were derived from clinical studies in the University Medical Center Utrecht (UMCU). Probabilistic sensitivity analysis, using 10,000 Monte Carlo simulations, was performed to quantify the joint decision uncertainty up to the recommended maximum willingness-to-pay threshold of €80,000/QALY. Results Focal salvage dominates TS as it results in less severe toxicity and lower treatment costs. Decision uncertainty is small, with a 97-100% probability for FS to be cost-effective compared to TS (€0-€80,000/QALY). Half of the difference in costs between FS and TS was explained by higher treatment costs of TS, the other half by higher incidence of severe toxicity. One-way sensitivity analyses show that model outcomes are most sensitive to utilities and probabilities for severe toxicity. Conclusions Focal salvage 125I brachytherapy dominates TS, as it has lower treatment costs and leads to less toxicity in our center. Larger comparative studies with longer follow-up are necessary to assess the exact influence on (biochemical disease free) survival and toxicity. PMID:28115953

  20. Does telomere elongation lead to a longer lifespan if cancer is considered?

    Science.gov (United States)

    Masa, Michael; Cebrat, Stanisław; Stauffer, Dietrich

    2006-05-01

    As cell proliferation is limited due to the loss of telomere repeats in DNA of normal somatic cells during division, telomere attrition can possibly play an important role in determining the maximum life span of organisms as well as contribute to the process of biological ageing. With computer simulations of cell culture development in organisms, which consist of tissues of normal somatic cells with finite growth, we obtain an increase of life span and life expectancy for longer telomeric DNA in the zygote. By additionally considering a two-mutation model for carcinogenesis and indefinite proliferation by the activation of telomerase, we demonstrate that the risk of dying due to cancer can outweigh the positive effect of longer telomeres on the longevity.

  1. The inverse care law revisited: impact of disadvantaged location on accessing longer GP consultation times.

    Science.gov (United States)

    Furler, John S; Harris, Elizabeth; Chondros, Patty; Powell Davies, P Gawaine; Harris, Mark F; Young, Doris Y L

    2002-07-15

    To compare the rate of provision of longer consultations per head of population across practice locations categorised by socioeconomic status. Retrospective analysis of Medicare data for all consultations for all general practitioners in Australia for the 1998-99 and 1999-2000 financial years, grouped by postcode of practice location. Postcodes were categorised by the Socio-Economic Indexes for Areas, Index of Relative Socio-Economic Disadvantage score. Number of consultations and number of brief, standard, long and prolonged consultations per capita in each postcode grouping. The absolute number of long plus prolonged consultations showed no trend across postcode groups, but the rate ratio per person was significantly higher in more advantaged postcode areas. This represents an example of care provision in inverse relationship to need. Despite higher rates of chronic disease and lower rates of preventive care uptake, patients in low socioeconomic status areas receive longer GP consultations at a lower rate than patients in more advantaged areas. Possible strategies to overcome this inverse care provision include increased numbers of GPs in disadvantaged communities, removal of financial disincentives to longer consultations, and strengthening health promotion and community health services in disadvantaged areas.

  2. Longer thaw seasons increase nitrogen availability for leaching during fall in tundra soils

    Science.gov (United States)

    Treat, Claire C.; Wollheim, Wilfred M.; Varner, Ruth K.; Bowden, William B.

    2016-06-01

    Climate change has resulted in warmer soil temperatures, earlier spring thaw and later fall freeze-up, resulting in warmer soil temperatures and thawing of permafrost in tundra regions. While these changes in temperature metrics tend to lengthen the growing season for plants, light levels, especially in the fall, will continue to limit plant growth and nutrient uptake. We conducted a laboratory experiment using intact soil cores with and without vegetation from a tundra peatland to measure the effects of late freeze and early spring thaw on carbon dioxide (CO2) exchange, methane (CH4) emissions, dissolved organic carbon (DOC) and nitrogen (N) leaching from soils. We compared soil C exchange and N production with a 30 day longer seasonal thaw during a simulated annual cycle from spring thaw through freeze-up and thaw. Across all cores, fall N leaching accounted for ˜33% of total annual N loss despite significant increases in microbial biomass during this period. Nitrate ({{{{NO}}}3}-) leaching was highest during the fall (5.33 ± 1.45 mg N m-2 d-1) following plant senescence and lowest during the summer (0.43 ± 0.22 mg N m-2 d-1). In the late freeze and early thaw treatment, we found 25% higher total annual ecosystem respiration but no significant change in CH4 emissions or DOC loss due to high variability among samples. The late freeze period magnified N leaching and likely was derived from root turnover and microbial mineralization of soil organic matter coupled with little demand from plants or microbes. Large N leaching during the fall will affect N cycling in low-lying areas and streams and may alter terrestrial and aquatic ecosystem nitrogen budgets in the arctic.

  3. The effect of comparative effectiveness research on drug development innovation: a 360° value appraisal

    Directory of Open Access Journals (Sweden)

    Doyle JJ

    2011-03-01

    Full Text Available John J DoyleQuintiles, NY, USAAbstract: The drug development process is in dire need of transformation. Even after achieving regulatory approval, pharmaceutical companies are increasingly seeing their products subjected to health technology assessments (HTAs by public and private payers. The cornerstone of HTA value appraisal, and thus reimbursability, is comparative effectiveness research (CER, a ‘real-world’ comparison of a new product with the existing standard of care. Burgeoning demand for CER will fundamentally transform drug development by forcing biopharmaceutical manufacturers to view drug innovation from a holistic, 360° perspective. Specifically, drug and device developers must alter their existing approach to R&D by: adapting experimental research design methods to address multiple stakeholder demands; demonstrating real-world value through a suite of post-market observational research methods; and creating a transparent CER evaluation protocol based on standard principles. In the long-term, CER is forecast to propel innovation by focusing R&D on products that deliver real-world value to multiple customers and market stakeholders.Keywords: comparative effectiveness research, comparative effectiveness balance sheet, health technology assessment, large simple trial, moderator, observational studies, patient randomized clinical trial, registry, ‘real-world’ value

  4. Look at longer lives as a good thing, not a burden

    DEFF Research Database (Denmark)

    Vaupel, James W.; Schwentker, Björn

    2011-01-01

    People in most countries are living longer and longer. Indeed, the rise in life expectancy is seen as a major looming social and economic problem. But is it?......People in most countries are living longer and longer. Indeed, the rise in life expectancy is seen as a major looming social and economic problem. But is it?...

  5. Reference intervals data mining: no longer a probability paper method.

    Science.gov (United States)

    Katayev, Alexander; Fleming, James K; Luo, Dajie; Fisher, Arren H; Sharp, Thomas M

    2015-01-01

    To describe the application of a data-mining statistical algorithm for calculation of clinical laboratory tests reference intervals. Reference intervals for eight different analytes and different age and sex groups (a total of 11 separate reference intervals) for tests that are unlikely to be ordered during routine screening of disease-free populations were calculated using the modified algorithm for data mining of test results stored in the laboratory database and compared with published peer-reviewed studies that used direct sampling. The selection of analytes was based on the predefined criteria that include comparability of analytical methods with a statistically significant number of observations. Of the 11 calculated reference intervals, having upper and lower limits for each, 21 of 22 reference interval limits were not statistically different from the reference studies. The presented statistical algorithm is shown to be an accurate and practical tool for reference interval calculations. Copyright© by the American Society for Clinical Pathology.

  6. Short-wavelength infrared laser activates the auditory neurons: comparing the effect of 980 vs. 810 nm wavelength.

    Science.gov (United States)

    Tian, Lan; Wang, Jingxuan; Wei, Ying; Lu, Jianren; Xu, Anting; Xia, Ming

    2017-02-01

    Research on auditory neural triggering by optical stimulus has been developed as an emerging technique to elicit the auditory neural response, which may provide an alternative method to the cochlear implants. However, most previous studies have been focused on using longer-wavelength near-infrared (>1800 nm) laser. The effect comparison of different laser wavelengths in short-wavelength infrared (SWIR) range on the auditory neural stimulation has not been previously explored. In this study, the pulsed 980- and 810-nm SWIR lasers were applied as optical stimuli to irradiate the auditory neurons in the cochlea of five deafened guinea pigs and the neural response under the two laser wavelengths was compared by recording the evoked optical auditory brainstem responses (OABRs). In addition, the effect of radiant exposure, laser pulse width, and threshold with the two laser wavelengths was further investigated and compared. The one-way analysis of variance (ANOVA) was used to analyze those data. Results showed that the OABR amplitude with the 980-nm laser is higher than the amplitude with the 810-nm laser under the same radiant exposure from 10 to 102 mJ/cm(2). And the laser stimulation of 980 nm wavelength has lower threshold radiant exposure than the 810 nm wavelength at varied pulse duration in 20-500 μs range. Moreover, the 810-nm laser has a wider optimized pulse duration range than the 980-nm laser for the auditory neural stimulation.

  7. Is longer sevoflurane preconditioning neuroprotective in permanent focal cerebral ischemia?

    Institute of Scientific and Technical Information of China (English)

    Caiwei Qiu; Bo Sheng; Shurong Wang; Jin Liu

    2013-01-01

    Sevoflurane preconditioning has neuroprotective effects in the cerebral ischemia/reperfusion model. However, its influence on permanent cerebral ischemia remains unclear. In the present study, the rats were exposed to sevoflurane for 15, 30, 60, and 120 minutes, fol owed by induction of perma-nent cerebral ischemia. Results demonstrated that 30-and 60-minute sevoflurane preconditioning significantly reduced the infarct volume at 24 hours after cerebral ischemia, and 60-minute lurane preconditioning additional y reduced the number of TUNEL-and caspase-3-positive cel s in the ischemic penumbra. However, 120-minute sevoflurane preconditioning did not show evident neuroprotective effects. Moreover, 60-minute sevoflurane preconditioning significantly attenuated neurological deficits and infarct volume in rats at 4 days after cerebral ischemia. These findings in-dicated that 60-minute sevoflurane preconditioning can induce the best neuroprotective effects in rats with permanent cerebral ischemia through the inhibition of apoptosis.

  8. Randomised clinical study comparing the effectiveness and physiological effects of hypertonic and isotonic polyethylene glycol solutions for bowel cleansing

    Science.gov (United States)

    Yamano, Hiro-o; Matsushita, Hiro-o; Yoshikawa, Kenjiro; Takagi, Ryo; Harada, Eiji; Tanaka, Yoshihito; Nakaoka, Michiko; Himori, Ryogo; Yoshida, Yuko; Satou, Kentarou; Imai, Yasushi

    2016-01-01

    Objectives Bowel cleansing is necessary before colonoscopy, but is a burden to patients because of the long cleansing time and large dose volume. A low-volume (2 L) hypertonic polyethylene glycol-ascorbic acid solution (PEG-Asc) has been introduced, but its possible dehydration effects have not been quantitatively studied. We compared the efficacy and safety including the dehydration risk between hypertonic PEG-Asc and isotonic PEG regimens. Design This was an observer-blinded randomised study. Participants (n=310) were allocated to receive 1 of 3 regimens on the day of colonoscopy: PEG-Asc (1.5 L) and water (0.75 L) dosed with 1 split (PEG-Asc-S) or 4 splits (PEG-Asc-M), or PEG-electrolyte solution (PEG-ES; 2.25 L) dosed with no split. Dehydration was analysed by measuring haematocrit (Ht). Results The cleansing time using the hypertonic PEG-Asc-S (3.33±0.48 hours) was significantly longer than that with isotonic PEG-ES (3.05±0.56 hours; p<0.001). PEG-Asc-M (3.00±0.53 hours) did not have this same disadvantage. Successful cleansing was achieved in more than 94% of participants using each of the 3 regimens. The percentage changes in Ht from baseline (before dosing) to the end of dosing with PEG-Asc-S (3.53±3.32%) and PEG-Asc-M (4.11±3.07%) were significantly greater than that with PEG-ES (1.31±3.01%). Conclusions These 3 lower volume regimens were efficacious and had no serious adverse effects. Even patients cleansed with isotonic PEG-ES showed significant physiological dehydration at the end of dosing. The four-split PEG-Asc-M regimen is recommended because of its shorter cleansing time without causing serious nausea. Trial registration number UMIN000013103; Results. PMID:27547443

  9. A cost-effectiveness analysis comparing different strategies to implement noninvasive prenatal testing into a Down syndrome screening program.

    Science.gov (United States)

    Ayres, Alice C; Whitty, Jennifer A; Ellwood, David A

    2014-10-01

    Currently, noninvasive prenatal testing (NIPT) is only recommended in high-risk women following conventional Down syndrome (DS) screening, and it has not yet been included in the Australian DS screening program. To evaluate the cost-effectiveness of different strategies of NIPT for DS screening in comparison with current practice. A decision-analytic approach modelled a theoretical cohort of 300,000 singleton pregnancies. The strategies compared were the following: current practice, NIPT as a second-tier investigation, NIPT only in women >35 years, NIPT only in women >40 years and NIPT for all women. The direct costs (low and high estimates) were derived using both health system costs and patient out-of-pocket expenses. The number of DS cases detected and procedure-related losses (PRL) were compared between strategies. The incremental cost per case detected was the primary measure of cost-effectiveness. Universal NIPT costs an additional $134,636,832 compared with current practice, but detects 123 more DS cases (at an incremental cost of $1,094,608 per case) and avoids 90 PRL. NIPT for women >40 years was the most cost-effective strategy, costing an incremental $81,199 per additional DS case detected and avoiding 95 PRL. The cost of NIPT needs to decrease significantly if it is to replace current practice on a purely cost-effectiveness basis. However, it may be beneficial to use NIPT as first-line screening in selected high-risk patients. Further evaluation is needed to consider the longer-term costs and benefits of screening. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  10. Chronic Idiopathic Urticaria (CIU) is no longer idiopathic

    DEFF Research Database (Denmark)

    Maurer, M; Bindslev-Jensen, C; Gimenez-Arnau, A

    2013-01-01

    During recent years our knowledge of the aetiology and pathogenesis of urticaria has advanced considerably allowing us to better characterize urticaria subtypes. However, although the classification of urticaria has undergone some revisions during this time (1), authors still use different names...... for the same type of urticaria, which has implications for comparing study outcomes and drug licensing. Consequently, there is an urgent need for a harmonized and universally accepted nomenclature and classification of urticaria and to avoid the routine use of the outdated aetiological term, chronic idiopathic...... urticaria (CIU)....

  11. Safety of maintaining intravenous sites for longer than 48 H.

    OpenAIRE

    1981-01-01

    Two years of experience with infections in intravenous (IV) therapy were studied through cohort analysis of infection surveillance records. The overall rate of infection was low compared with other published reports, but the risk of infection was related to the duration of cannulation. IVs in place for no more than 48 h accounted for 75% of all IVs and 26% of IV-associated infections, those in place for 48 to 72 h accounted for 12.5% of IVs and 23% of IV-associated infections, and those in pl...

  12. Extending 3D Near-Cloud Corrections from Shorter to Longer Wavelengths

    Science.gov (United States)

    Marshak, Alexander; Evans, K. Frank; Varnai, Tamas; Guoyong, Wen

    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. However, correcting only for molecular scattering skews spectral properties of the retrieved AOT. Kassianov and Ovtchinnikov 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.

  13. Oxidized zirconium: a potentially longer lasting hip implant

    Energy Technology Data Exchange (ETDEWEB)

    Good, V. [Smith and Nephew Inc., Memphis, TN 38116 (United States)]. E-mail: victoria.good@smithnephew.com; Widding, K. [Smith and Nephew Inc., Memphis, TN 38116 (United States); Hunter, G. [Smith and Nephew Inc., Memphis, TN 38116 (United States); Heuer, D. [Smith and Nephew Inc., Memphis, TN 38116 (United States)

    2005-07-01

    Because younger, more active patients are receiving total hip replacements, it is necessary to develop materials, which would increase the life span of the implants and challenge their wear potential under adverse conditions. Oxidized zirconium (OxZr) is a metal with the surface transformed to ceramic by oxidation that offers low fracture risk and excellent abrasion resistance. This study compared wear of polyethylene (non-irradiated and highly crosslinked) with OxZr and CoCr heads under smooth and rough (clinically relevant) conditions. Wear was up to 15-fold less and up to 4-fold fewer particles were produced when coupled with OxZr than with CoCr, demonstrating that OxZr heads should increase clinical implant longevity.

  14. A clinical comparative study on effects of intracavernous injection of sodium nitroprusside and papaverine/phentolamine in erectile dysfunction patients

    Institute of Scientific and Technical Information of China (English)

    QiangFU; De-HongYAO; Yue-QinJIANG

    2000-01-01

    Aim: To study the effect of intracavemous sodium nitropmsside (SNP), a nitric oxide (NO) donor, on penile erection. Methods: Forty-two patients with erectile dysfunction (ED) were randomly assigned to receive SNP 300μg or the control drugs (papaverine 30mg+phentolamine 1mg) intracavemously crosswise one week apart. The penile length, circumference and hardness after the administration of the experimental and control drugs were assessed and compared statistically. Results: (1)There was no significant difference between the changes in penile length and circumference in the two occasions; (2)In 25 SNP and 28 control cases, the hardness of the penis was scored above 100 as evaluated by the Virag method (P>0.05);(3)The duration of erection in the controls was longer than that in the SNP, but there were three priapism in the controls and not a single one in the SNP; (4)there was no apparent change in the heart rate and blood pressure in both occasions; other side effects were minimal except slight local pain in a few controls. Conclusion: SNP facilitates relaxation of the penile smooth muscle and penile erection without significant side effects. SNP may be used in ED patients that experience pain and priapism with papaverine/phentolamine.(Asian J Androl 2000 Dec;2:301-303)

  15. Longer-term increased cortisol levels in young people with mental health problems.

    Science.gov (United States)

    Heinze, Kareen; Lin, Ashleigh; Reniers, Renate L E P; Wood, Stephen J

    2016-02-28

    Disturbance of hypothalamus-pituitary-adrenal axis activity is commonly reported in a range of mental disorders in blood, saliva and urine samples. This study aimed to look at longer-term cortisol levels and their association with clinical symptoms. Hair strands of 30 young people (16-25 years) presenting with mental health problems (Mage±SD=21±2.4, 26 females) and 28 healthy controls (HC, Mage±SD=20±2.9, 26 females) were analyzed for cortisol concentrations, representing the past 6 months prior to hair sampling. Clinical participants completed an assessment on psychiatric symptoms, functioning and lifestyle factors. All participants completed the Perceived Stress Scale. Hair cortisol concentrations representing the past 3 (but not 3-6) months were significantly increased in clinical participants compared to HC. Perceived stress in the past month was significantly higher in clinical participants compared to HC, but not significantly correlated with hair cortisol. Hair cortisol levels were not significantly associated with any other measures. Hair segment analyses revealed longer-term increased levels of cortisol in the past 3 months in early mental health problems. Further insight into the role of cortisol on the pathogenesis of mental illnesses requires longitudinal studies relating cortisol to psychopathology and progression of illness.

  16. Modified femoral pressuriser generates a longer lasting high pressure during cement pressurisation

    Directory of Open Access Journals (Sweden)

    Kjellson Fred

    2011-10-01

    Full Text Available Abstract Background The strength of the cement-bone interface in hip arthroplasty is strongly related to cement penetration into the bone. A modified femoral pressuriser has been investigated, designed for closer fitting into the femoral opening to generate higher and more constant cement pressure compared to a commercial (conventional design. Methods Femoral cementation was performed in 10 Sawbones® models, five using the modified pressuriser and five using a current commercial pressuriser as a control. Pressure during the cementation was recorded at the proximal and distal regions of the femoral implant. The peak pressure and the pressure-time curves were analysed by student's t-test and Two way ANOVA. Results The modified pressuriser showed significantly and substantially longer durations at higher cementation pressures and slightly, although not statistically, higher peak pressures compared to the conventional pressuriser. The modified pressuriser also produced more controlled cement leakage. Conclusion The modified pressuriser generates longer higher pressure durations in the femoral model. This design modification may enhance cement penetration into cancellous bone and could improve femoral cementation.

  17. Amputations: no longer the end of the road.

    Science.gov (United States)

    Turney, B W; Kent, S J; Walker, R T; Loftus, I M

    2001-10-01

    The aim of this prospective study was to assess the effect of an intensive in-patient rehabilitation programme upon the mobility of amputees. All major lower limb amputations between 1997 and 1999 received a pre-operative mobility assessment and, where appropriate, were referred for a vigorous rehabilitation programme. 92 lower limb amputations were performed in 87 patients (57 below knee, 33 above knee, two hip disarticulations). Overall, 63% of patients were able to ambulate independently following rehabilitation. Univariate analysis revealed that the only predictor of mobility was the level of amputation, below knee gaining better mobility than above knee (p=0.002). Lower limb amputees should participate in an aggressive in-patient physiotherapy regimen since reasonable mobility can be achieved in the majority of patients.

  18. Does living longer in good health facilitate longer working lives? The relationship between disability and working lives.

    Science.gov (United States)

    Wubulihasimu, Parida; Brouwer, Werner; van Baal, Pieter

    2015-10-01

    Improvements in life expectancy have fuelled debates about the statutory retirement age in many European countries. This article contributes to this debate by investigating how changes in disability may influence both employment outcomes and disability-free life expectancy. We used data from the European Community Household Panel to estimate the impact of disability incidence on labour supply by country using propensity score techniques. In a second step, we translated the estimated effects of disability incidence into effects on working life expectancy as well as disability-free life expectancy using multi-state life tables. Results from the matching analysis show that individuals who become disabled are more likely to leave the labour market. However, the size of the effect is much weaker than a simple descriptive analysis suggests and varies by country. A 10% decrease in disability incidence results in increases in disability-free life expectancy and working life expectancy of respectively 0.6 and 0.07 years on average. A large part of the differences in employment between disabled and non-disabled individuals is not due to a causal effect of disability on employment. Policies that reduce disability incidence increase disability-free life expectancy but have only a limited impact on working life expectancy. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  19. Coupling giant impacts and longer-term evolution models

    Science.gov (United States)

    Golabek, Gregor; Jutzi, Martin; Emsenhuber, Alexandre; Gerya, Taras; Asphaug, Erik

    2016-04-01

    The crustal dichotomy is the dominant geological feature on planet Mars. The exogenic approach to the origin of the crustal dichotomy assumes that the northern lowlands correspond to a giant impact basin formed after primordial crust formation. However these simulations only consider the impact phase without studying the long-term repercussions of such a collision. The endogenic approach, suggesting a degree-1 mantle upwelling underneath the southern highlands, relies on a high Rayleigh number and a particular viscosity profile to form a low degree convective pattern within the geological constraints for the dichotomy formation. Such vigorous convection, however, results in continuous magmatic resurfacing, destroying the initially dichotomous crustal structure in the long-term. A further option is a hybrid exogenic-endogenic approach, which proposes an impact-induced magma ocean and subsequent superplume in the southern hemisphere. However these models rely on simple scaling laws to impose the thermal effects of the collision. Here we present the first results of impact simulations performed with a SPH code serially coupled with geodynamical computations performed using the code I3VIS to improve the latter approach and test it against observations. We are exploring collisions varying the impactor velocities, impact angles and target body properties, and are gauging the sensitivity to the handoff from SPH to I3VIS. As expected, our first results indicate the formation of a transient hemispherical magma ocean in the impacted hemisphere, and the merging of the cores. We also find that impact angle and velocity have a strong effect on the post-impact temperature field and on the timescale and nature of core merger.

  20. 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.

  1. Timely bystander CPR improves outcomes despite longer EMS times.

    Science.gov (United States)

    Park, Gwan Jin; Song, Kyoung Jun; Shin, Sang Do; Lee, Kyung Won; Ahn, Ki Ok; Lee, Eui Jung; Hong, Ki Jeong; Ro, Young Sun

    2017-08-01

    This study aimed to determine the impact of bystander CPR on clinical outcomes in patients with increasing response time from collapse to EMS response. A population-based observational study was conducted in patients with witnessed out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology from 2012 to 2014. The time interval from collapse to CPR by EMS providers was categorized into quartile groups: fastest group (bystander CPR and the time interval from collapse to CPR by EMS providers. A total of 15,354 OHCAs were analyzed. Bystander CPR was performed in 8591 (56.0%). Survival to hospital discharge occurred in 1632 (10.6%) and favorable neurological outcome in 996 (6.5%). In an interaction model of bystander CPR, compared to the fastest group, adjusted odds ratios (AORs) (95% CIs) for survival to discharge were 0.89 (0.66-1.20) in the fast group, 0.76 (0.57-1.02) in the late group, and 0.52 (0.37-0.73) in the latest group. For favorable neurological outcome, AORs were 1.12 (0.77-1.62) in the fast group, 0.90 (0.62-1.30) in the late group, 0.59 (0.38-0.91) in the latest group. The survival from OHCA decreases as the ambulance response time increases. The increase in mortality and worsening neurologic outcomes appear to be mitigated in those patients who receive bystander CPR. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. When does picture naming take longer than word reading?

    Directory of Open Access Journals (Sweden)

    Andrea eValente

    2016-01-01

    Full Text Available Differences between the cognitive processes involved in word reading and picture naming are well established (e.g. visual or lexico-semantic stages. Still, it is commonly thought that retrieval of phonological forms is shared across tasks. We report a test of this second hypothesis based on the time course of electroencephalographic (EEG neural activity, reasoning that similar EEG patterns might index similar processing stages.Seventeen participants named objects and read aloud the corresponding words while their behavior and EEG activity were recorded. The latter was analyzed from stimulus onset onwards (stimulus-locked analysis and from response onset backwards (response-locked analysis, using non-parametric statistics and the spatio-temporal segmentation of ERPs.Behavioral results confirmed that reading entails shorter latencies than naming. The analysis of EEG activity within the stimulus-to-response period allowed distinguishing three phases, broadly successive. Early on, we observed identical distribution of electric field potentials (i.e. topographies albeit with large amplitude divergences between tasks. Then, we observed sustained cross-task differences in topographies accompanied by extended amplitude differences. Finally, the two tasks again revealed the same topographies, with significant cross-task delays in their onsets and offsets, and still significant amplitude differences. In the response-locked ERPs, the common topography displayed an offset closer to response articulation in word reading compared with picture naming, that is the transition between the offset of this shared map and the onset of articulation was significantly faster in word reading.The results suggest that the degree of cross-task similarity varies across time. The first phase suggests similar visual processes of variable intensity and time course across tasks, while the second phase suggests marked differences. Finally, similarities and differences within the

  3. Death and taxes: longer life, consumption, and social security.

    Science.gov (United States)

    Lee, R; Tuljapurkar, S

    1997-02-01

    We analyze in three steps the influence of the projected mortality decline on the long run finances of the Social Security System. First, on a theoretical level, mortality decline adds person years of life which are distributed across the life cycle. The interaction of this distribution with the age distribution of labor earnings minus consumption, or of taxes minus benefits, partially determines the corresponding steady state financial consequences of mortality decline. The effect of mortality decline on population growth rates also matters, but is negligible in low mortality populations. Second, examination of past mortality trends in the United States and of international trends in low mortality populations, suggests that mortality will decline faster than foreseen by the Social Security Administration's forecasts. Third, we combine the work of the first two parts in dynamic simulations to examine the implications of mortality decline and of alternative forecasts of mortality for the finances of the social security system. Also, we use stochastic population forecasts to assess the influence of uncertainty about mortality decline on uncertainty about finances; we find that uncertainty about fertility still has more important implications than uncertainty about mortality, contrary to sensitivity tests in the official forecasts.

  4. 75 FR 990 - HHS Intent To Publish Grant and Contract Solicitations for Comparative Effectiveness Research...

    Science.gov (United States)

    2010-01-07

    ...- Coordination Implementation Team, the Federal Coordinating Council for Comparative Effectiveness Research (FCC... inventory and evaluation projects and $4 million for ] salary and benefits for ARRA-related staff...

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

    National Research Council Canada - National Science Library

    Osso, Diane; Kanani, Nehal

    2013-01-01

    .... 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...

  6. 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.

  7. 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

  8. 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

  9. 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…

  10. 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…

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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…

  13. Comparative effectiveness research and the psychology of medical practice: the vicissitudes of knowledge implementation.

    Science.gov (United States)

    Kassirer, Jerome P; Wong, John B

    2010-01-01

    Comparative effectiveness research should provide much-needed information about the benefits and risks of different current treatment options in the community. Taking the perspective of medical care providers, we consider many of the psychological, social and behavioural hurdles to implementation of comparative effectiveness analyses and explain why these obstacles should not be ignored.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. The Differential Effects of Two Self-Managed Math Instruction Procedures: Cover, Copy, and Compare versus Copy, Cover, and Compare

    Science.gov (United States)

    Grafman, Joel M.; Cates, Gary L.

    2010-01-01

    This study compared the fluency and error rates produced when using the Cover, Copy, and Compare (CCC) and a modified CCC procedure (MCCC) called Copy, Cover, and Compare to complete subtraction math problems. Two second-grade classrooms consisting of 47 total students participated in the study. The following items were administered to…

  16. A comparative study of the effect of caudal dexmedetomidine versus morphine added to bupivacaine in pediatric infra-umbilical surgery

    Directory of Open Access Journals (Sweden)

    Hossam A El Shamaa

    2014-01-01

    Full Text Available Background: One of the most commonly used regional anesthetic techniques in pediatric surgeries is the caudal epidural block. Its main disadvantage remains the short duration of action. Hence, different additives have been used. Dexmedetomidine is a potent as well as highly selective α2 adrenergic receptor agonist. The aim of this randomized, double-blinded, study was to compare the duration of postoperative analgesia of caudal dexmedetomidine versus morphine in combination with bupivacaine in pediatric patients undergoing lower abdominal or perineal surgery. Patients and Methods: A total of 50 pediatric patients 1-5 years old The American Society of Anesthesiologists status I, II scheduled for lower abdominal and perineal surgeries were included in the study. The patients were enrolled into 2 equal groups: Group A patients (n = 25 received dexmedetomidine with bupivacaine while Group B patients (n = 25 received morphine with bupivacaine. Patients were placed in a supine position then inhalational general anesthesia was induced, and laryngeal mask airway (LMA was placed. Patients were then given caudal epidural analgesia. By the end of surgery reversal of muscle relaxation was done and the LMA was removed. Post-operatively, the sedation as well as pain score were observed and recorded. Results: The current study showed that minor complications were recorded in the post-anesthesia care unit; in addition, significantly longer periods of analgesia and sedation were detected in Group A. However, no significant differences in demographic data, as well as in the duration of surgery, and the time of emergence from anesthesia and patient condition during recovery were detected. Conclusion: The present study suggested that use of dexmedetomidine, during single dose injection, as an additive to the local anesthetic bupivacaine in caudal epidural analgesia prolongs the duration of post-operative analgesia following lower abdominal as well as perineal

  17. The effects of desflurane and remifentanyl anaesthesia compared to lumbar epidural analgesia combined with desflurane on recovery

    Directory of Open Access Journals (Sweden)

    Celaleddin Soyalp

    2014-12-01

    Full Text Available Objective: Our primary objective in this study is to compare the effects of the applications of desflurane and remifentanyl anaesthesia, along with lumbar epidural analgesia combined with desflurane on postoperative recovery in the cases who undergoing lower abdominal surgery. Methods: This study performed 240 patients who undergoing elective lower abdominal surgery. Patients were divided into two random groups as Group DR (desflurane + remifentanyl n=120 and Group DL (desflurane +Lumbar Epidural Analgesia n=120.The general anaesthesia in Group DR was performed through the use of desflurane and remifentanyl. Group DL was administered a general anaesthesia through a pre-operative epidural catheter insertion and an application of desflurane. Extubation, eye opening, head lift for 5 seconds, and the surgical durations of the patients as well as the postoperative side-effects were recorded. Modified Aldrete Scoring System was used to assess the recovery of the patients from anaesthesia. Results: According to the inter group comparison results between Group DR and Group DL, the duration of extubation, eye opening, head lift for 5 seconds and the average amount of elapsed time until the modified Aldrete Scoring reached 10 were found statistically and significantly shorter in Group DL than Group DR( respectively p=0.002, p<0.001, p<0.001, p<0.001.The duration of the first analgesic need was statistically and significantly longer in Group DL compared to Group DR (p<0.001. The postoperative patient satisfaction in Group DL was statistically and significantly higher than that in Group DR (p=0.010. Conclusion: The Epidural analgesia included in the general anaesthesia in lower abdominal surgery is considered by us to be the beneficial and efficient method of analgesia which leads to an earlier recovery of the patients without affecting the intraoperative hemodynamic stability and which boosts the patient satisfaction by providing a more efficient analgesia

  18. Darbepoietin-alfa has comparable erythropoietic stimulatory effects to recombinant erythropoietin whilst preserving the bone marrow microenvironment.

    Science.gov (United States)

    Dewamitta, Sita R; Russell, Megan R; Nandurkar, Harshal; Walkley, Carl R

    2013-05-01

    Erythropoiesis stimulating agents are widely used for the treatment of anemia. Recently, we reported erythroid expansion with impaired B lymphopoiesis and loss of trabecular bone in C57BL/6 mice following ten days of treatment with low-dose short acting recombinant human erythropoietin. We have assessed erythropoietin against longer-acting darbepoietin-alfa at a comparable erythroid stimulatory dosage regime. Darbepoietin-alfa and erythropoietin induced similar in vivo erythropoietic expansion. Both agents induced an expansion of the colony-forming unit-erythroid populations. However, unlike erythropoietin, darbepoietin-alfa did not impair bone marrow B lymphopoiesis. Strikingly the bone loss observed with erythropoietin was not apparent following darbepoietin-alfa treatment. This analysis demonstrates that whilst darbepoietin-alfa has similar in vivo erythropoietic potency to erythropoietin, it preserves the bone marrow microenvironment. Thus erythropoietin and darbepoietin-alfa manifest different action showing that erythropoiesis stimulating agents have differential non-erythroid effects dependent on their duration of action.

  19. A Comparative Effectiveness Study of Rescue Strategies in 1,000 Subjects With Severe Hypoxemic Respiratory Failure.

    Science.gov (United States)

    Moreno Franco, Pablo; Enders, Felicity; Wilson, Gregory; Gajic, Ognjen; Pannu, Sonal R

    2016-02-01

    Subjects with severe hypoxemic respiratory failure have shown a high mortality in previous studies. All adult ICU patients requiring mechanical ventilation from 2005 to 2010 at Mayo Clinic were screened for severe hypoxemia (Murray lung injury score of ≥ 3). Extracorporeal membrane oxygenation, prone positioning, high-frequency oscillatory ventilation (HFOV), and inhaled vasodilators were considered as rescue strategies. A propensity-based scoring was created for the indication or predilection to use each strategy. A model was created to evaluate the association of each rescue strategy with hospital mortality. Among 1,032 subjects with severe hypoxemia, 239 subjects received some form of rescue strategy (59 received a combination of therapies, and 180 received individual therapies). Inhaled vasodilators were the most common, followed by HFOV. Rescue strategies were used in younger subjects with severe oxygenation deficits. Subjects receiving rescue strategies had higher mortality and longer ICU stays. None of the strategies individually or in combination showed a significant association with hospital mortality after adjusting covariates by propensity scoring. Adjusted Odds ratios and respective 95% CI were as follows: HFOV 0.67 (0.35-1.27), extracorporeal membrane oxygenation 0.63 (0.18-1.92), prone position 1.07 (0.49-2.28), and inhaled vasodilators 1.17 (0.78-1.77). In this retrospective comparative effectiveness study, there was no association of rescue strategies with hospital mortality in subjects with severe hypoxemia. Copyright © 2016 by Daedalus Enterprises.

  20. Comparing the Cost-Effectiveness of Simulation Modalities: A Case Study of Peripheral Intravenous Catheterization Training

    Science.gov (United States)

    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…

  1. Exploratory Literature Meta-Analysis to Characterize the Relationship Between Early and Longer Term Body Weight Loss for Antiobesity Compounds.

    Science.gov (United States)

    Plock, Nele; Bax, Leon; Lee, Douglas; DeManno, Deborah; Lahu, Gezim; Pfister, Marc

    2017-01-01

    The presented analysis was performed to characterize the relationship between treatment-related early (week 4) and longer term (3-6 months) weight loss to understand the potential utility of 4-week proof-of-mechanism studies in the early decision-making process during clinical development of new antiobesity compounds. A regression-based meta-analysis was performed leveraging publically available clinical outcomes data to (1) characterize the within-trial relationship between treatment-related early and longer term body weight loss and (2) identify and quantify key covariate effects on this relationship. Data from 89 randomized clinical trials with 209 treatment arms, representing observations from 54 461 patients and 9 treatments, were available for the meta-analysis. Results indicated that (1) there is a correlation between treatment-related early and longer term body weight loss (r > 0.9), (2) baseline body weight influences the relationship between early and longer term weight loss, whereas comorbidity such as type 2 diabetes mellitus, class of drugs including GLP-1 analogues and the antiobesity compounds lorcaserin or phentermine/topiramate showed no significant effects on this relationship. The model was externally evaluated with data from the investigational compound beloranib, for which longer term weight loss could be successfully predicted based on early response data. Based on these results, the identified strong relationship between treatment-related early and longer term weight loss appears to be independent of mechanism of action. Thus, findings from this analysis can optimize design of clinical studies and facilitate development of new anti-obesity compounds. © 2016, The American College of Clinical Pharmacology.

  2. Category activation effects in judgment and behaviour: the moderating role of perceived comparability.

    Science.gov (United States)

    Aarts, Henk; Dijksterhuis, Ap

    2002-03-01

    Previous research on category activation effects demonstrates that extreme exemplar priming can lead to contrast effects as well as assimilation effects in target judgments. Two experiments extended this line of research by investigating the moderating role of perceived comparability, that is, the extent to which the exemplar and target are believed to belong to the same category and thus can be compared. In both experiments, participants judged the speed of a person displayed on a picture following priming with animals exemplifying either extreme speed ('cheetah') or extreme slowness ('turtle'). In addition, in the second experiment a behavioural measure was included. In the first experiment individual differences concerning the perceived comparability between animals and humans were assessed. In the second experiment perceived comparability was experimentally varied. Results showed that the direction of category activation effects (i.e. assimilation versus contrast) depended on the extent to which the prime and target categories were seen as comparable. Contrast effects on both judgments and behaviour emerged when the prime and the target category were perceived as comparable. However, assimilation effects on judgment and behaviour ensued when the prime and target category were not perceived as comparable.

  3. 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.

  4. Testing, Modeling, and Monitoring to Enable Simpler, Cheaper, Longer-Lived Surface Caps

    Energy Technology Data Exchange (ETDEWEB)

    Piet, Steven James; Breckenridge, Robert Paul; Burns, Douglas Edward

    2003-02-01

    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 aging

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-02-25

    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

  6. Effects of Teriparatide Compared with Risedronate on Recovery After Pertrochanteric Hip Fracture

    DEFF Research Database (Denmark)

    Aspenberg, Per; Malouf, Jorge; Tarantino, Umberto;

    2016-01-01

    BACKGROUND: Osteoporosis drugs might affect fracture-healing. We therefore studied the effects of teriparatide in comparison with risedronate on recovery after pertrochanteric hip fractures. METHODS: The study was a randomized, multicenter, active-controlled, 78-week trial comparing teriparatide ...

  7. The comparative effects of metformin and insulin on the kidney, lung ...

    African Journals Online (AJOL)

    The comparative effects of metformin and insulin on the kidney, lung and heart of ... in tests groups, there was sparing of peripheral lung tissue in metformin group. ... insulin groups having pericardial congestion and moderate myocardial fatty ...

  8. Longer brainstem auditory evoked response latencies of individuals with fragile X syndrome related to sedation.

    Science.gov (United States)

    Miezejeski, C M; Heaney, G; Belser, R; Brown, W T; Jenkins, E C; Sersen, E A

    1997-04-18

    Brainstem auditory evoked response latencies were studies in 75 males (13 with fragile X syndrome, 18 with mental retardation due to other causes, and 44 with no disability). Latency values were obtained for each ear for the positive deflections of waves I (P1), III (P3), and V (P5). Some individuals with mental retardation required sedation. Contrary to previous report, latencies obtained for individuals with fragile X did not differ from those obtained for persons without mental retardation. Persons receiving sedation, whether or not their retardation was due to fragile X, had longer latencies for wave P5 than persons who did not receive sedation. This effect of sedation may also explain the previously reported increased latencies for persons with fragile X.

  9. Longer telomere length in COPD patients with α1-antitrypsin deficiency independent of lung function.

    Directory of Open Access Journals (Sweden)

    Aabida Saferali

    Full Text Available Oxidative stress is involved in the pathogenesis of airway obstruction in α1-antitrypsin deficient patients. This may result in a shortening of telomere length, resulting in cellular senescence. To test whether telomere length differs in α1-antitrypsin deficient patients compared with controls, we measured telomere length in DNA from peripheral blood cells of 217 α1-antitrypsin deficient patients and 217 control COPD patients. We also tested for differences in telomere length between DNA from blood and DNA from lung tissue in a subset of 51 controls. We found that telomere length in the blood was significantly longer in α1-antitrypsin deficient COPD patients compared with control COPD patients (p = 1×10(-29. Telomere length was not related to lung function in α1-antitrypsin deficient patients (p = 0.3122 or in COPD controls (p = 0.1430. Although mean telomere length was significantly shorter in the blood when compared with the lungs (p = 0.0078, telomere length was correlated between the two tissue types (p = 0.0122. Our results indicate that telomere length is better preserved in α1-antitrypsin deficient COPD patients than in non-deficient patients. In addition, measurement of telomere length in the blood may be a suitable surrogate for measurement in the lung.

  10. Longer telomere length in COPD patients with α1-antitrypsin deficiency independent of lung function.

    Science.gov (United States)

    Saferali, Aabida; Lee, Jee; Sin, Don D; Rouhani, Farshid N; Brantly, Mark L; Sandford, Andrew J

    2014-01-01

    Oxidative stress is involved in the pathogenesis of airway obstruction in α1-antitrypsin deficient patients. This may result in a shortening of telomere length, resulting in cellular senescence. To test whether telomere length differs in α1-antitrypsin deficient patients compared with controls, we measured telomere length in DNA from peripheral blood cells of 217 α1-antitrypsin deficient patients and 217 control COPD patients. We also tested for differences in telomere length between DNA from blood and DNA from lung tissue in a subset of 51 controls. We found that telomere length in the blood was significantly longer in α1-antitrypsin deficient COPD patients compared with control COPD patients (p = 1×10(-29)). Telomere length was not related to lung function in α1-antitrypsin deficient patients (p = 0.3122) or in COPD controls (p = 0.1430). Although mean telomere length was significantly shorter in the blood when compared with the lungs (p = 0.0078), telomere length was correlated between the two tissue types (p = 0.0122). Our results indicate that telomere length is better preserved in α1-antitrypsin deficient COPD patients than in non-deficient patients. In addition, measurement of telomere length in the blood may be a suitable surrogate for measurement in the lung.

  11. Comparative effectiveness of three national healthcare schemes in Thailand: in-hospital medical expenses for diabetes and hypertension in 2010.

    Science.gov (United States)

    Tatsanavivat, Pyatat; Thavornpitak, Yupa; Pongchaiyakul, Chatlert

    2012-07-01

    To compare the health insurance schemes regarding treatment of diabetes (DM) and hypertension (HT). In-patient expense data for all ICD-10 DM and HT for 2010 were accessed from the National Health Security Office (UC), the Social Security office (SS) and the Civil Servants Benefit System (CSMBS). Mean hospital stay charges and mortality rates were calculated and compared across schemes and types of hospital. Thais > or = 19 years accounted for 4,863,939 admissions (12.6% DM-All; 17.9% HT-All). Average admission per case was higher for DM-All (1.66) than HT-All (1.46). CSMBS patients trended to be older than UC and SS. Most under UC were admitted to primary care (51.9% DM-All; 50.0% HT-All) vs. tertiary under CSMBS (45.5% DM-All; 48.4% HT-All). Median of stay under CSMBS was longer (1.3-2.0x) and charges higher (1.3-1.6x) than UC for all levels for both DM and HT Mortality rate under CSMBS was higher than UC in primary care for both DM and HT while respective rates were higher under UC than CSMBS for secondary (DM-All: 9.9 vs. 8.1; HT-All: 8.2 vs. 6.6) and tertiary care (DM-All:11.7 vs.8.6; HT-All: 9.8 vs. 6.8). Inequalities among three health insurance schemes for DM and HT including hospital charge, hospital stay and mortality rate according to health care settings for DM and HT were shown, effectiveness improvement is needed.

  12. Coffee Consumption Is Positively Associated with Longer Leukocyte Telomere Length in the Nurses’ Health Study12

    Science.gov (United States)

    Liu, Jason J; Crous-Bou, Marta; Giovannucci, Edward; De Vivo, Immaculata

    2016-01-01

    Background: Coffee is an important source of antioxidants, and consumption of this beverage is associated with many health conditions and a lower mortality risk. However, no study, to our knowledge, has examined whether varying coffee or caffeine consumption levels are associated with telomere length, a biomarker of aging whose shortening can be accelerated by oxidative stress. Objective: We performed a large comprehensive study on how coffee consumption is associated with telomere length. Methods: We used data from the Nurses’ Health Study (NHS), a prospective cohort study of female nurses that began in 1976. We examined the cross-sectional association between coffee consumption and telomere length in 4780 women from the NHS. Coffee consumption information was obtained from validated food-frequency questionnaires, and relative telomere length was measured in peripheral blood leukocytes by the quantitative real-time polymerase chain reaction. Unconditional logistic regression was used to obtain ORs when the telomere length outcome was dichotomized at the median. Linear regression was used for tests of trend with coffee consumption and telomere length as continuous variables. Results: Higher total coffee consumption was significantly associated with longer telomeres after potential confounding adjustment. Compared with non-coffee drinkers, multivariable ORs for those drinking 2 to <3 and ≥3 cups of coffee/d were, respectively, 1.29 (95% CI: 0.99, 1.68) and 1.36 (95% CI: 1.04, 1.78) (P-trend = 0.02). We found a significant linear association between caffeine consumption from all dietary sources and telomere length (P-trend = 0.02) after adjusting for potential confounders, but not after additionally adjusting for total coffee consumption (P-trend = 0.37). Conclusions: We found that higher coffee consumption is associated with longer telomeres among female nurses. Future studies are needed to better understand the influence of coffee consumption on telomeres

  13. Comparative Evaluation Of Reinforced Concrete, Steel And Composite Structures Under The Effect Of Static And Dynamic Loads

    OpenAIRE

    Zafar Mujawar; Prakarsh Sangave

    2015-01-01

    Steel-concrete composite construction has gained wide acceptance all over the world as an alternative for pure steel and pure concrete construction. However this approach is a new concept for construction industry. R.C.C are no longer economical because of their increased dead load, hazardous formwork. The present study deals with comparison of reinforced concrete, steel and composite structures under the effect of static and dynamic loads. The results of this work show that compo...

  14. Longer genotypically-estimated leukocyte telomere length is associated with increased adult glioma risk.

    Science.gov (United States)

    Walsh, Kyle M; Codd, Veryan; Rice, Terri; Nelson, Christopher P; Smirnov, Ivan V; McCoy, Lucie S; Hansen, Helen M; Elhauge, Edward; Ojha, Juhi; Francis, Stephen S; Madsen, Nils R; Bracci, Paige M; Pico, Alexander R; Molinaro, Annette M; Tihan, Tarik; Berger, Mitchel S; Chang, Susan M; Prados, Michael D; Jenkins, Robert B; Wiemels, Joseph L; Samani, Nilesh J; Wiencke, John K; Wrensch, Margaret R

    2015-12-15

    Telomere maintenance has emerged as an important molecular feature with impacts on adult glioma susceptibility and prognosis. Whether longer or shorter leukocyte telomere length (LTL) is associated with glioma risk remains elusive and is often confounded by the effects of age and patient treatment. We sought to determine if genotypically-estimated LTL is associated with glioma risk and if inherited single nucleotide polymorphisms (SNPs) that are associated with LTL are glioma risk factors. Using a Mendelian randomization approach, we assessed differences in genotypically-estimated relative LTL in two independent glioma case-control datasets from the UCSF Adult Glioma Study (652 patients and 3735 controls) and The Cancer Genome Atlas (478 non-overlapping patients and 2559 controls). LTL estimates were based on a weighted linear combination of subject genotype at eight SNPs, previously associated with LTL in the ENGAGE Consortium Telomere Project. Mean estimated LTL was 31bp (5.7%) longer in glioma patients than controls in discovery analyses (P = 7.82x10-8) and 27bp (5.0%) longer in glioma patients than controls in replication analyses (1.48x10-3). Glioma risk increased monotonically with each increasing septile of LTL (O.R.=1.12; P = 3.83x10-12). Four LTL-associated SNPs were significantly associated with glioma risk in pooled analyses, including those in the telomerase component genes TERC (O.R.=1.14; 95% C.I.=1.03-1.28) and TERT (O.R.=1.39; 95% C.I.=1.27-1.52), and those in the CST complex genes OBFC1 (O.R.=1.18; 95% C.I.=1.05-1.33) and CTC1 (O.R.=1.14; 95% C.I.=1.02-1.28). Future work is needed to characterize the role of the CST complex in gliomagenesis and further elucidate the complex balance between ageing, telomere length, and molecular carcinogenesis.

  15. Comparative effect of propolis of honey bee and some herbal extracts on Candida albicans.

    Science.gov (United States)

    Gavanji, Shahin; Larki, Behrouz

    2017-03-01

    To determine the effect of propolis on Candida albicans and to compare it with the effects of some other herbal extracts and antibiotics on this pathogenic fungi. The extracts of propolis, Thymus vulgaris, Caryophillium aromaticus, Echinophora platyloba, Allium cepa and Cinnamomum zeylanicum were prepared and the antifungi effects of the extracts were examined on Candida albicans ATCC10231 using disc-diffusion assay and micro-broth dilution. The minimum fungicidal concentration (MFC) and minimum inhibitory concentrations (MIC) as well as inhibition zone were evaluated and the anti fungi effects of herbal extracts were compared with amphotricin B and nystatin at the times of 24, 48 and 72 h. Data analysis was performed using t test. Obtained results showed that propolis extract with MIC90 and MFC equal to 39 and 65 μg/mL, respectively, possess the highest antifungal activity when compared with other studied extracts. The extracts of Allium cepa and Thymus vulgaris, with MFC of 169 and 137 μg/mL, respectively, showed the lowest effects on the fungi. Also nystatin and amphotricin B yielded better effects on the tested fungi compared with the effects of all studied extracts on Candida albicans. Propolis extract is effective in controlling Candida albicans. However, the issue requires further investigation on samples in animals and performing toxicological examinations.

  16. Emotion self-regulation and empathy depend upon longer stimulus exposure.

    Science.gov (United States)

    Ikezawa, Satoru; Corbera, Silvia; Wexler, Bruce E

    2014-10-01

    Observation of others in pain induces positive elevation (pain effect) in late event-related potentials (ERP). This effect is associated with top-down attention regulating processes. It has previously been shown that stimulus exposure duration can affect top-down attentional modulation of response to threat-related stimuli. We investigated the effect of exposure duration on ERP response to others in pain. Two late ERP components, P3 and late positive potentials (LPP), from 18 healthy people were measured while they viewed pictures of hands in painful or neutral situations for either 200 or 500 ms, during two task conditions (pain judgment and counting hands). P3 and LPP pain effects during the pain judgment condition were significantly greater with 500 ms than 200 ms stimulus presentation. Ours is the first study to suggest that engagement of empathy-related self-regulatory processes reflected in late potentials requires longer exposure to the pain-related stimulus. Although this is important information about the relationship between early sensory and subsequent brain processing, and about engagement of self-regulatory processes, the neural basis of this time-dependence remains unclear. It might be important to investigate the relationship between stimulus duration and empathic response in clinical populations where issues of self-regulation, empathic response and speed of information processing exist.

  17. A COMPARATIVE STUDY OF EFFECT OF 0.5% AND 0.75% ISOBARIC ROPIVACAINE IN SPINAL ANAESTHESIA IN PATIENTS UNDERGOING ELECTIVE LOWER LIMB SURGERIES

    Directory of Open Access Journals (Sweden)

    Tridip Jyoti

    2016-04-01

    Full Text Available OBJECTIVES The study was conducted to compare the differences in the onset, duration of action and complications of intrathecal isobaric ropivacaine 0.5% (Group I and intrathecal isobaric ropivacaine 0.75% (Group II in elective lower limb surgeries. METHODS We enrolled 60 patients of ASA (American Society of Anaesthesiologists Grade I-II scheduled for lower limb surgeries under spinal anaesthesia for this prospective randomized control trial. The patients were randomized to receive either 15 mg of 0.5% isobaric ropivacaine or 22.5 mg of 0.75% isobaric ropivacaine intrathecally. The time of onset of sensory and motor block, haemodynamic status, time for regression of sensory level to T10 dermatome, time of first request of analgesics and adverse effects were compared in both the groups. RESULTS The time of onset of sensory and motor block was significantly longer in Group-I than Group-II (P0.05. The onset of analgesia was faster in Group II (2.13±0.50 mins. than Group I (2.6±0.93 mins.. The time for regression of sensory level to T10 dermatome (Group-I 150±28.9 minutes and Group-II 180±32.07 were statistically longer in Group II (P<0.001. The time of first request of analgesics by the patient in Group-I was 197±31.20 minutes and in Group II was 219±31.66 minutes, which was statistically significant (P<0.001. The onset of motor block was quicker (P˂0.05 and the total duration of motor block was longer (P˂0.05 in Group II. No unexpected adverse events were registered. CONCLUSION The subarachnoid injection of glucose-free isobaric ropivacaine 0.5% and 0.75% solutions results in a variable spread of analgesia, accompanied by a good quality of motor block. Ropivacaine 0.75% produces a better quality of analgesia and longer duration of analgesia than the 0.5% solution.

  18. 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.

  19. Comparative Evaluation of Substituent Effect on the Photochromic Properties of Spiropyrans and Spirooxazines.

    Science.gov (United States)

    Balmond, Edward I; Tautges, Brandon K; Faulkner, Andrea L; Or, Victor W; Hodur, Blanka M; Shaw, Jared T; Louie, Angelique Y

    2016-10-07

    Spiropyrans and spirooxazines represent an important class of photochromic compounds with a wide variety of applications. In order to effectively utilize and design these photoswitches it is desirable to understand how the substituents affect photochromic properties, and how the different structural motifs compare under identical conditions. In this work a small library of photoswitches was synthesized in order to comparatively evaluate the effect of substituent modifications and structure on photochromism. The library was designed to modify positions that were believed to have the greatest effect on C-O bond lability and therefore the photochromic properties. Herein we report a comparative analysis of the UV and visible light responses of 30 spiropyrans, spiroindolinonaphthopyrans, and spirooxazines. The influence of gadolinium(III) binding was also investigated on the library of compounds to determine its effect on photoswitching. Both assays demonstrated different trends in substituent and structural requirements for optimal photochromism.

  20. Everolimus-Based Therapy versus Chemotherapy among Patients with HR+/HER2- Metastatic Breast Cancer: Comparative Effectiveness from a Chart Review Study.

    Science.gov (United States)

    Li, Nanxin; Hao, Yanni; Xie, Jipan; Lin, Peggy L; Koo, Valerie; Ohashi, Erika; Wu, Eric Q

    2015-01-01

    Objective. To compare the real-world effectiveness of everolimus-based therapy and chemotherapy in postmenopausal women with hormone-receptor-positive/human-epidermal-growth-factor-receptor-2-negative (HR+/HER2-) metastatic breast cancer (mBC). Methods. This retrospective chart review examined a nationwide sample of postmenopausal HR+/HER2- mBC women in community-based oncology practices. Patients received everolimus-based therapy or chemotherapy for mBC between 07/01/2012 and 04/15/2013, after failure of a non-steroidal aromatase inhibitor. Overall survival (OS), progression-free survival (PFS), and time on treatment (TOT) were compared using Kaplan-Meier analysis and Cox proportional hazards models adjusting for line of therapy and baseline characteristics. Results. 234 and 137 patients received everolimus-based therapy and chemotherapy. Patients treated with everolimus-based therapy tended to have less aggressive mBC than patients treated with chemotherapy. Multivariate-adjusted Cox models showed that everolimus-based therapy was associated with significantly longer OS [hazard ratio (HR) = 0.37, 95% confidence interval (CI): 0.22-0.63], PFS (HR = 0.70, 95% CI = 0.50-0.97), and TOT (HR = 0.34, 95% CI: 0.25-0.45) than chemotherapy. Adjusted comparative effectiveness results were generally consistent across lines of therapy. Conclusion. In this retrospective chart review of postmenopausal HR+/HER2- mBC patients, treatment with everolimus-based therapy was associated with longer OS, PFS, and TOT than chemotherapy.

  1. 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.

  2. A comparative analysis of the effects of economic policy instruments in promoting environmentally sustainable transport

    DEFF Research Database (Denmark)

    Elvik, Rune; Ramjerdi, Farideh

    2014-01-01

    This paper presents a comparative analysis of the effects of economic policy instruments in promoting environmentally sustainable transport. Promoting environmentally sustainable transport is defined as follows: (1) Reducing the volume of motorised travel; (2) Transferring travel to modes...... generating less external effects, and (3) Modifying road user behaviour in a way that will reduce external effects of transport. External effects include accidents, congestion, traffic noise and emissions to air. Four economic policy instruments are compared: (1) Prices of motor fuel; (2) Congestion charges......; (3) Toll schemes; (4) Reward systems giving incentives to reduce driving or change driver behaviour. The effects of these policy instruments are stated in terms of elasticities. All four economic policy instruments have negative elasticities, which means that they do promote environmentally...

  3. 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

    2016-01-01

    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.

  4. Does Understanding Relational Terminology Mediate Effects of Intervention on Compare Word Problems?

    OpenAIRE

    Schumacher, Robin F.; Fuchs, Lynn S.

    2012-01-01

    The purpose of this study was to assess whether understanding relational terminology (i.e., more, less, and fewer) mediates the effects of intervention on compare word problems. Second-grade classrooms (n = 31) were randomly assigned to 3 conditions: researcher-designed word-problem intervention, researcher-designed calculation intervention, or business-as-usual (teacher-designed) control. Students in word-problem intervention classrooms received instruction on the compare problem type, which...

  5. Comparative effectiveness of psychological treatments for depressive disorders in primary care: network meta-analysis

    OpenAIRE

    2015-01-01

    Background A variety of psychological interventions to treat depressive disorders have been developed and are used in primary care. In a systematic review, we compared the effectiveness of psychological treatments grouped by theoretical background, intensity of contact with the health care professional, and delivery mode for depressed patients in this setting. Methods Randomized trials comparing a psychological treatment with usual care, placebo, another psychological treatment, pharmacothera...

  6. 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

    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...... pharmacology, two exercise). From these, 54 trials were eligible (20 pharmacology, 34 exercise), with 9806 participants (5627 pharmacology, 4179 exercise). The pooled effect size of pharmacological pain interventions was 0.41 (95% CI: 0.23-0.59) and for exercise 0.46 standardized mean difference (95% CI: 0...... 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...

  7. Comparing the painlessness effects of spinal (sufentanil and epidural(bupivacaine plus lidocaine analgesic methods in labour and delivery

    Directory of Open Access Journals (Sweden)

    A. Shafiee

    2006-01-01

    Full Text Available Background and purpose: This study was designed in order to compare the effects of spinal and epidural analgesia on labour and also several maternal and fetal factors in vaginal delivery.Materials and Methods: The study was a randomized clinical trail and participatnts were 120 gravid 1 and gravid 2 women in the active phase of delivery, admitted to the labour room of Fatemieh Hospital in Hamedan in 1381-1382.Sixty patients were randomly divided into two groups of 30, analgesia was induced by single spinal sufentanil injection in one group and, bupivacaine plus lidocaine injection in the other group.Maternal vital signs and pain score were recorded (VAS at 1, 5, 15 and 30 minutes after administration of analgesia and every 30 minutes thereafter. Fetal heart rate every 15 minutes, vaginal examination every hour, urinary output every 4 hours after delivery and the incidence of headache and back pain, one week after delivery were the variables under study.Results: Both groups were matched regarding demographic, gravida and Parity factors. There was no significant difference between groups regarding pain score, (based on VAS,duration of the first and second delivery phase, the incidence of fetal distress, meconium excretion, apgar scores at 1 and 5 minutes after delivery, abnormal laboar, operative or assisted delivery. Average analgesic duration was longer in spinal analgesia than single epidural injection analgesia.Conclusion: Considering the difficulty of the technique, the need for anaestheticianHs supervision and injection repeatition in epidural analgesia, it seems that spinal analgesia is a suitable replacement which is more practical, less expensive, easy to perform and induces a desirable analgesia.

  8. 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.

  9. Comparative effectiveness research and big data: balancing potential with legal and ethical considerations.

    Science.gov (United States)

    Gray, Elizabeth Alexandra; Thorpe, Jane Hyatt

    2015-01-01

    Big data holds big potential for comparative effectiveness research. The ability to quickly synthesize and use vast amounts of health data to compare medical interventions across settings of care, patient populations, payers and time will greatly inform efforts to improve quality, reduce costs and deliver more patient-centered care. However, the use of big data raises significant legal and ethical issues that may present barriers or limitations to the full potential of big data. This paper addresses the scope of some of these legal and ethical issues and how they may be managed effectively to fully realize the potential of big data.

  10. 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.

  11. Patients with Risk Factors for Complications Do Not Require Longer Antimicrobial Therapy for Complicated Intra-Abdominal Infection.

    Science.gov (United States)

    Rattan, Rishi; Allen, Casey J; Sawyer, Robert G; Mazuski, John; Duane, Therese M; Askari, Reza; Banton, Kaysie L; Claridge, Jeffrey A; Coimbra, Raul; Cuschieri, Joseph; Dellinger, E Patchen; Evans, Heather L; Guidry, Christopher A; Miller, Preston R; O'Neill, Patrick J; Rotstein, Ori D; West, Michaela A; Popovsky, Kimberley; Namias, Nicholas

    2016-09-01

    A prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. We hypothesized that patients with specific risk factors for complications also had similar outcomes. Short-course patients with obesity, diabetes, or Acute Physiology and Chronic Health Evaluation II ≥15 from the STOP-IT trial were compared with longer duration patients. Outcomes included incidence of and days to infectious complications, mortality, and length of stay. Obese and diabetic patients had similar incidences of and days to surgical site infection, recurrent intra-abdominal infection, extra-abdominal infection, and Clostridium difficile infection. Short- and long-course patients had similar incidences of complications among patients with Acute Physiology and Chronic Health Evaluation II ≥15. However, there were fewer days to the diagnosis of surgical site infection (9.5 ± 3.4 vs 21.6 ± 6.2, P = 0.010) and extra-abdominal infection (12.4 ± 6.9 vs 21.8 ± 6.1, P = 0.029) in the short-course group. Mortality and length of stay was similar for all groups. A short course of antibiotics in complicated intra-abdominal infection with source control seems to have similar outcomes to a longer course in patients with diabetes, obesity, or increased severity of illness.

  12. White LED compared with other light sources: age-dependent photobiological effects and parameters for evaluation.

    Science.gov (United States)

    Rebec, Katja Malovrh; Klanjšek-Gunde, Marta; Bizjak, Grega; Kobav, Matej B

    2015-01-01

    Ergonomic science at work and living places should appraise human factors concerning the photobiological effects of lighting. Thorough knowledge on this subject has been gained in the past; however, few attempts have been made to propose suitable evaluation parameters. The blue light hazard and its influence on melatonin secretion in age-dependent observers is considered in this paper and parameters for its evaluation are proposed. New parameters were applied to analyse the effects of white light-emitting diode (LED) light sources and to compare them with the currently applied light sources. The photobiological effects of light sources with the same illuminance but different spectral power distribution were determined for healthy 4-76-year-old observers. The suitability of new parameters is discussed. Correlated colour temperature, the only parameter currently used to assess photobiological effects, is evaluated and compared to new parameters.

  13. Comparative effectiveness of a serious game and an e-module to support patient safety knowledge and awareness.

    Science.gov (United States)

    Dankbaar, Mary E W; Richters, Olivier; Kalkman, Cor J; Prins, Gerrie; Ten Cate, Olle T J; van Merrienboer, Jeroen J G; Schuit, Stephanie C E

    2017-02-02

    Serious games have the potential to teach complex cognitive skills in an engaging way, at relatively low costs. Their flexibility in use and scalability makes them an attractive learning tool, but more research is needed on the effectiveness of serious games compared to more traditional formats such e-modules. We investigated whether undergraduate medical students developed better knowledge and awareness and were more motivated after learning about patient-safety through a serious game than peers who studied the same topics using an e-module. Fourth-year medical students were randomly assigned to either a serious game that included video-lectures, biofeedback exercises and patient missions (n = 32) or an e-module, that included text-based lectures on the same topics (n = 34). A third group acted as a historical control-group without extra education (n = 37). After the intervention, which took place during the clinical introduction course, before the start of the first rotation, all students completed a knowledge test, a self-efficacy test and a motivation questionnaire. During the following 10-week clinical rotation they filled out weekly questionnaires on patient-safety awareness and stress. The results showed patient safety knowledge had equally improved in the game group and e-module group compared to controls, who received no extra education. Average learning-time was 3 h for the game and 1 h for the e-module-group. The serious game was evaluated as more engaging; the e-module as more easy to use. During rotations, students in the three groups reported low and similar levels of patient-safety awareness and stress. Students who had treated patients successfully during game missions experienced higher self-efficacy and less stress during their rotation than students who treated patients unsuccessfully. Video-lectures (in a game) and text-based lectures (in an e-module) can be equally effective in developing knowledge on specific topics. Although

  14. Comparing Usage and Cost- Effectiveness Analysis of English Printed and Electronic Books for University of Tehran

    OpenAIRE

    Davoud Haseli; Nader Naghshineh; fatemeh Fahimnia

    2014-01-01

    Libraries operate in a competitive environment, and this is essentially needed to prove its benefits for stockholders, and continuously evaluate and compare advantages for printed and electronic resources. In these cases, economic evaluation methods such as cost- effectiveness analysis, is one of the best methods, because of a comprehensive study of the use and cost of library sources. The purpose of this study is to discovery of use and cost- effectiveness analysis of English printed and ebo...

  15. Comparative Effect of Treadmill Exercise on Mature BDNF Production in Control versus Stroke Rats

    OpenAIRE

    Quirié, Aurore; Hervieu, Marie; Garnier, Philippe; Demougeot, Céline; Mossiat, Claude; Bertrand, Nathalie; Martin, Alain; Marie, Christine; Prigent-Tessier, Anne

    2012-01-01

    Physical exercise constitutes an innovative strategy to treat deficits associated with stroke through the promotion of BDNF-dependent neuroplasticity. However, there is no consensus on the optimal intensity/duration of exercise. In addition, whether previous stroke changes the effect of exercise on the brain is not known. Therefore, the present study compared the effects of a clinically-relevant form of exercise on cerebral BDNF levels and localization in control versus stroke rats. For this ...

  16. Comparative antibacterial effectiveness of alcohol and herbal based commercially available hand antiseptics

    OpenAIRE

    K Vipin Jain; Sequeira Peter Simon; Jithesh Jain; S Supreetha; Mathew, M.J.; C B Sudeep

    2013-01-01

    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 a...

  17. Comparing the effects of different individualized music interventions for elderly individuals with severe dementia

    OpenAIRE

    Sakamoto, Mayumi; Ando, Hiroshi; Tsutou, Akimitsu

    2013-01-01

    Background: Individuals with dementia often experience poor quality of life (QOL) due to behavioral and psychological symptoms of dementia (BPSD). Music therapy can reduce BPSD, but most studies have focused on patients with mild to moderate dementia. We hypothesized that music intervention would have beneficial effects compared with a no-music control condition, and that interactive music intervention would have stronger effects than passive music intervention. Methods: Thirty-nine individua...

  18. Comparing the Effects of CAFTA on Internal Trade of China and ASEAN Countries

    OpenAIRE

    Supriana, Tavi

    2016-01-01

    This paper compares the effects of CAFTA on internal trade of China and ASEAN Countries. ASEAN countries are analyzed individually, by developing two gravity models and using the panel data of7 samples countries and areas from 2002 to 2010. The empirical result shows that GDP, distance, exchange rate, population and policy framework of CAFTA are trade detenninant factors for China and ASEAN countries. The effects of CAFTA implementation in this study can be divided in four categories. Firstly...

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

    OpenAIRE

    Beecham Jennifer; Stevens Madeleine; Bonin Eva-Maria; Byford Sarah; Parsonage Michael

    2011-01-01

    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 c...

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

    OpenAIRE

    Bonin, Eva-Maria; Stevens, Madeleine; Beecham, Jennifer; Byford, Sarah; Parsonage, Michael

    2011-01-01

    Background\\ud \\ud 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 con...

  1. Comparing the cost-effectiveness of simulation modalities: a case study of peripheral intravenous catheterization training.

    Science.gov (United States)

    Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

    2014-05-01

    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 simulation-based programs. Medical students (n = 15 per group) practiced in one of three 2-h intravenous catheterization skills training programs: low-fidelity (virtual reality), high-fidelity (mannequin), or progressive (consisting of virtual reality, task trainer, and mannequin simulator). One week later, all performed a transfer test on a hybrid simulation (standardized patient with a task trainer). We used a net benefit regression model to identify the most cost-effective training program via paired comparisons. We also created a cost-effectiveness acceptability curve to visually represent the probability that one program is more cost-effective when compared to its comparator at various 'willingness-to-pay' values. We conducted separate analyses for implementation and total costs. The results showed that the progressive program had the highest total cost (p willingness-to-pay value, the progressive training program was generally most educationally- and cost-effective. Our analyses suggest that a progressive program that strategically combines simulation modalities provides a cost-effective solution. More generally, we have introduced how a cost-effectiveness analysis may be applied to simulation training; a method that medical educators may use to investment decisions (e.g., purchasing cost-effective and educationally sound simulators).

  2. Longer Intestinal Persistence of Enterococcus faecalis Compared to Enterococcus faecium Clones in Intensive-Care-Unit Patients

    NARCIS (Netherlands)

    Ruiz-Garbajosa, Patricia; del Campo, Rosa; Coque, Teresa M.; Asensio, Angel; Bonten, Marc; Willems, Rob; Baquero, Fernando; Canton, Rafael

    2009-01-01

    The dynamics of intestinal colonization with enterococcal clones in intensive-care-unit (ICU) patients was evaluated. Eight patients admitted directly to the neurosurgical ICU at the Ramon y Cajal University Hospital (Madrid, Spain) from the community and with no overlapping stay during a 10-month p

  3. Distinctive Hemodynamics in the Immediate Postoperative Period of Patients with a Longer Cardiac Intensive Care Stay Post-Tetralogy of Fallot Repair.

    Science.gov (United States)

    Beg, Kisha A; Haq, Anwarul; Amanullah, Muneer; Laique, Sobia N; Sadqani, Saleem; Aslam, Nadeem; Rehmat, Amina Wali; Hasan, Babar S

    2015-01-01

    After complete surgical repair the majority of tetralogy of Fallot (ToF), patients stay ≤2 days in the Cardiac Intensive Care Unit (CICU) while some may stay longer. We undertook this study to investigate the factors associated with shorter vs. longer length of stay in the CICU to help manage resources effectively. Patients who underwent ToF repair at Aga Khan University, Pakistan, between July 2006 and December 2011 were studied in a case-control design. Clinical parameters were compared between short stay group (SSG) (≤2 days) and long stay group (LSG) (>2 days). Odds ratios were calculated, and regression was performed. Ninety-eight patients (LSG 65, SSG 33) were included. Patients with lower preoperative saturation were 2.67 times more likely to be in the LSG group (P = .02). At 4 hours postoperatively, patients with a higher inotropic score (odds ratio [OR] = 3.03, confidence interval [CI] = 1.19-7.7, P = .02), higher central venous pressure (OR = 3.04, CI = 1.27-7.32, P = .013), and significant tachycardia at 4 hours (OR = 3.5, CI = 1.19-10.3. P = .02) were at risk for having a prolonged CICU stay. On multivariate analysis, significant postoperative tachycardia at 4 hours (z-score ≥3) was highly specific (sensitivity = 38.5%, specificity = 84.9%) for predicting the chances of being in the LSG. Other predictors included preop O(2) saturation ≤82.5% (sensitivity = 61.1%, specificity = 63.0%) and CVP ≥10 mm Hg at 4 hours (sensitivity = 55.4%, specificity = 71.9%). Patients who end up staying longer in the CICU have features that are distinctive in the immediate postoperative period, and this can help clinicians in identifying patients who may need more support. © 2015 Wiley Periodicals, Inc.

  4. The effects of physiotherapy for female urinary incontinence: Individual compared with group treatment

    NARCIS (Netherlands)

    Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

    2001-01-01

    OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126

  5. The effects of physiotherapy for female urinary incontinence: individual compared with group treatment

    NARCIS (Netherlands)

    Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

    2001-01-01

    OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126

  6. From participation to adoption: Comparing the effectiveness of soil conservation programs in the Peruvian Andes

    NARCIS (Netherlands)

    Posthumus, H.; Gardebroek, C.; Ruben, R.

    2010-01-01

    Many efforts are made to promote soil conservation in developing countries. This paper compares the effect of two programs promoting soil conservation in Peru on the adoption decision of households. One program applies a top-down approach with soil conservation as its core activity. The other progra

  7. COMPARATIVE STUDIES OF THE EFFECT OF POLYCYCLIC AROMATIC HYDROCARBON GEOMETRY ON THE HYDROLYSIS OF DIOL EPOXIDES

    Science.gov (United States)

    Comparative studies of the effect of polycyclic aromatic hydrocarbon geometry on the hydrolysis of diol epoxides The interaction of the diol epoxides (DEs) of both planar and non-planar PAHs with water have been examined using quantum mechanical and molecular dynamics. Th...

  8. From Participation to Adoption: Comparing the effectiveness of soil conservation programs in the Peruvian Andes

    NARCIS (Netherlands)

    Posthumus, H.; Gardebroek, C.; Ruben, R.

    2010-01-01

    Many efforts are made to promote soil conservation in developing countries. This paper compares the effect of two programs promoting soil conservation in Peru on the adoption decision of households. One program applies a top-down approach with soil conservation as its core activity. The other

  9. The Comparative Effect of Individually-Constructed vs. Collaboratively-Constructed Computer-Based Concept Maps

    Science.gov (United States)

    Kwon, So Young; Cifuentes, Lauren

    2009-01-01

    The researchers investigated the comparative effects of individually-constructed and collaboratively-constructed computer-based concept mapping on middle school science concept learning. One hundred and sixty one students completed the entire study. Using prior science performance scores to assure equivalence of student achievement across groups,…

  10. Comparative safety and effectiveness of rivaroxaban versus VKAs in patients with venous thromboembolism

    DEFF Research Database (Denmark)

    Sindet-Pedersen, Caroline; Langtved Pallisgaard, Jannik; Staerk, Laila

    2017-01-01

    The approval of rivaroxaban has changed the landscape of treatment of venous thromboembolism (VTE). Little is known about the effect of rivaroxaban compared with vitamin K antagonists (VKA), when used in the everyday clinical practice. The aim of this study was to investigate the safety and effec...

  11. Comparative Effect of Memory and Cognitive Strategies Training on EFL Intermediate Learners' Vocabulary Learning

    Science.gov (United States)

    Banisaeid, Maryam

    2013-01-01

    The present study was conducted to compare the effect of memory and cognitive strategies training on vocabulary learning of intermediate proficiency group of Iranian learners of English as a foreign language. It is to check how memory and cognitive strategies training affect word learning of EFL intermediate learners (N = 60) who were homogenized…

  12. Calculating magnetic shielding effectiveness for high-power dc comparator by magnetic circuit method

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-wei; REN Shi-yan

    2007-01-01

    Magnetic shielding is very important in the design of a high-power dc comparator. This paper addressed the application of magnetic circuit method to calculate the magnetic shielding effectiveness of high-power dc comparators when an external radial magnetic field is added. The mathematical relationship between the magnetic shielding effectiveness and the parameters of the magnetic shielding body were obtained. To verify the validity of the calculation method, we developped a procedure to measure the magnetic shielding effectiveness of the magnetic body by measuring the induction voltage of the detection winding instead of the magnetic intensity at a point in the magnetic shielding body, making the manipulation much easier. The result calculated with the magnetic circuit method turns out to be closer to the measured one compared with that calculated with a conventional algorithm proposed by Ren, suggesting that the magnetic circuit method is an applicable tool for estimating the toroidal cavity magnetic shielding effectiveness of a heavy current comparator when a radial magnetic field is added.

  13. A Study of the Comparative Effectiveness of Zoology Prerequisites at Slippery Rock State College.

    Science.gov (United States)

    Morrison, William Sechler

    This study compared the effectiveness of three sequences of prerequisite courses required before taking zoology. Sequence 1 prerequisite courses consisted of general biology and human biology; Sequence 2 consisted of general biology; and Sequence 3 required cell biology. Zoology students in the spring of 1972 were pretest and a posttest. The mean…

  14. Comparative estimate of the effectiveness of different algorithms for the radar classification of thunderstorms and showers

    Science.gov (United States)

    Linev, A. G.; Oprishko, V. S.; Popova, N. D.; Salman, Y. M.

    1975-01-01

    Several schemes for discriminating severe weather phenomena with the aid of different algorithms are examined. The schemes were tested on the same sample. A comparative estimate of the effectiveness of the different algorithms for classifying thunderstorms and showers is carried out.

  15. Comparing treatment effects after adjustment with multivariable Cox proportional hazards regression and propensity score methods

    NARCIS (Netherlands)

    Martens, Edwin P|info:eu-repo/dai/nl/088859010; de Boer, Anthonius|info:eu-repo/dai/nl/075097346; Pestman, Wiebe R; Belitser, Svetlana V; Stricker, Bruno H Ch; Klungel, Olaf H|info:eu-repo/dai/nl/181447649

    PURPOSE: To compare adjusted effects of drug treatment for hypertension on the risk of stroke from propensity score (PS) methods with a multivariable Cox proportional hazards (Cox PH) regression in an observational study with censored data. METHODS: From two prospective population-based cohort

  16. The effects of physiotherapy for female urinary incontinence: individual compared with group treatment

    NARCIS (Netherlands)

    Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

    2001-01-01

    OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126 re

  17. The effects of physiotherapy for female urinary incontinence: Individual compared with group treatment

    NARCIS (Netherlands)

    Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

    2001-01-01

    OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126 re

  18. Comparative Effectiveness of CAPA and FOCUS Online: Career Assessment Systems with Undecided College Students

    Science.gov (United States)

    Betz, Nancy E.; Borgen, Fred H.

    2009-01-01

    The present study compared the effectiveness of two online career exploration systems in increasing the career decision self-efficacy and decidedness of 960 students enrolled in a program for undecided freshmen students at a large public university. Results indicated that both systems led to significant increases in career decision self-efficacy…

  19. The Misdirection of Public Policy: Comparing and Combining Standardised Effect Sizes

    Science.gov (United States)

    Simpson, Adrian

    2017-01-01

    Increased attention on "what works" in education has led to an emphasis on developing policy from evidence based on comparing and combining a particular statistical summary of intervention studies: the standardised effect size. It is assumed that this statistical summary provides an estimate of the educational impact of interventions and…

  20. Does Understanding Relational Terminology Mediate Effects of Intervention on Compare Word Problems?

    Science.gov (United States)

    Schumacher, Robin F.; Fuchs, Lynn S.

    2012-01-01

    The purpose of this study was to assess whether understanding relational terminology (i.e., "more, less," and "fewer") mediates the effects of intervention on compare word problems. Second-grade classrooms (N = 31) were randomly assigned to one of three conditions: researcher-designed word-problem intervention, researcher-designed calculation…

  1. 75 FR 41867 - Request for Information on Development of an Inventory of Comparative Effectiveness Research

    Science.gov (United States)

    2010-07-19

    ... HUMAN SERVICES Request for Information on Development of an Inventory of Comparative Effectiveness...-based system. Comments should focus on appropriate resources and approaches for developing the CER... Information. SUMMARY: The Office of the Assistant Secretary for Planning Evaluation (ASPE) is developing...

  2. A Comparative Study on Teaching Effects of Different Innovative Methods for Curriculum System

    DEFF Research Database (Denmark)

    Luo, Lingling; Wang, Na; Zhang, Ping

    2016-01-01

    In order to test the feasibility of the curriculum system of TRIZ used in humanities and social science majors, compared with the traditional creativity developing, this study will test whether it is effective to cultivate students' creativity and to train their ability to solve problems. This st...... in Humanities and Social Science Teaching and addressed the needs to improve....

  3. COMPARATIVE STUDY ON THE PHARMACOLOGICAL EFFECTS OF NORGESTIMATE AND DPE9

    Institute of Scientific and Technical Information of China (English)

    CAOLu-Min; SIYuan-Zhen; LIYu; SHANZhen-Zhen; WUXi-Rui

    1989-01-01

    Levonorgestrel (LNG) and naproxen have been used as active constituents for progestogen-relcasing and prostaglandin synthetasc inhibitor (PGSI) -releasing IUDs.For development of new medicated IUDs, effects of norgestimate and DPE9 have been compared with those of LNG and naproxen respectively in our institute.

  4. Mississippi Communities for Healthy Living: Results of a 6-Month Nutrition Education Comparative Effectiveness Trial

    Science.gov (United States)

    Landry, Alicia S.; Thomson, Jessica L.; Huye, Holly F.; Yadrick, Kathy; Connell, Carol L.

    2017-01-01

    Background: Improving the diet of communities experiencing health inequities can be challenging given that multiple dietary components are low in quality. Mississippi Communities for Healthy Living was designed to test the comparative effectiveness of nutrition education using a single- versus multiple-message approach to improve the diet of adult…

  5. Assessing the Comparative Effectiveness of Teaching Undergraduate Intermediate Accounting in the Online Classroom Format

    Science.gov (United States)

    Rich, Anne J.; Dereshiwsky, Mary I.

    2011-01-01

    This paper presents the results of a study assessing the comparative effectiveness of teaching an undergraduate intermediate accounting course in the online classroom format. Students in a large state university were offered an opportunity to complete the first course in intermediate accounting either online or on-campus. Students were required to…

  6. Length Is Associated with Pain: Jellyfish with Painful Sting Have Longer Nematocyst Tubules than Harmless Jellyfish.

    Science.gov (United States)

    Kitatani, Ryuju; Yamada, Mayu; Kamio, Michiya; Nagai, Hiroshi

    2015-01-01

    A large number of humans are stung by jellyfish all over the world. The stings cause acute pain followed by persistent pain and local inflammation. Harmful jellyfish species typically cause strong pain, whereas harmless jellyfish cause subtle or no pain. Jellyfish sting humans by injecting a tubule, contained in the nematocyst, the stinging organ of jellyfish. The tubule penetrates into the skin leading to venom injection. The detailed morphology of the nematocyst tubule and molecular structure of the venom in the nematocyst has been reported; however, the mechanism responsible for the difference in pain that is caused by harmful and harmless jellyfish sting has not yet been explored or explained. Therefore, we hypothesized that differences in the length of the nematocyst tubule leads to different degrees of epithelial damage. The initial acute pain might be generated by penetration of the tubule, which stimulates pain receptor neurons, whilst persistent pain might be caused by injection of venom into the epithelium. To test this hypothesis we compared the lengths of discharged nematocyst tubules from harmful and harmless jellyfish species and evaluated their ability to penetrate human skin. The results showed that the harmful jellyfish species, Chrysaora pacifica, Carybdea brevipedalia, and Chironex yamaguchii, causing moderate to severe pain, have nematocyst tubules longer than 200 μm, compared with a jellyfish species that cause little or no pain, Aurelia aurita. The majority of the tubules of harmful jellyfishes, C. yamaguchii and C. brevipedalia, were sufficiently long to penetrate the human epidermis and physically stimulate the free nerve endings of Aδ pain receptor fibers around plexuses to cause acute pain and inject the venom into the human skin epithelium to cause persistent pain and inflammation.

  7. Just as good is no longer acceptable: The promise of educational design research

    NARCIS (Netherlands)

    McKenney, Susan; Reeves, Thomas

    2013-01-01

    McKenney, S., & Reeves, T. (2012, 2 April). Just as good is no longer acceptable: The promise of educational design research. Invited webinar for the EDUCAUSE Learning Initiative, Online international broadcast. http://net.educause.edu/Archives/8996.

  8. 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.

  9. Comparative Analysis and Approximations of Space -Charge Formation in Langmuir Electrodes Including Temperature Effects.

    Science.gov (United States)

    Valdeblànquez, Eder

    2001-10-01

    Eder Valdeblànquez,Universidad del Zulia,Apartado 4011-A 526,Maracaibo,Venezuela. ABSTRACT: In this paper by space charge effect in Langmuir probes are compared for different kind of symmetries; plane, cylindrical and spherical. A detailed analysis is performed here including temperature effects, and therefore kinetic theory is used instead of fluid equations as other authors. The strongly non-linear equations obtained here have been solved first by numerical analysis and later by approximations using Bessel functions. The accuracy of each approximaton is also discussed. Space Charge effects are important in plane geometries than in the case of cylindrical or spherical symmetries.

  10. Stavudine toxicity in adult longer-term ART patients in Blantyre, Malawi.

    Directory of Open Access Journals (Sweden)

    Joep J van Oosterhout

    Full Text Available BACKGROUND: Stavudine is an effective and inexpensive antiretroviral drug, but no longer recommended by WHO for first-line antiretroviral regimens in resource-limited settings due to toxicity concerns. Because of the high cost of alternative drugs, it has not been feasible to replace stavudine in most adults in the Malawi ART programme. We aimed to provide policy makers with a detailed picture of stavudine toxicities in Malawians on longer-term ART, in order to facilitate prioritization of stavudine replacement among other measures to improve the quality of ART programmes. METHODS: Prospective cohort of Malawian adults who had just completed one year of stavudine containing ART in an urban clinic, studying peripheral neuropathy, lipodystrophy, diabetes mellitus, high lactate syndromes, pancreatitis and dyslipidemia during 12 months follow up. Stavudine dosage was 30 mg irrespective of weight. Cox regression was used to determine associations with incident toxicities. RESULTS: 253 patients were enrolled, median age 36 years, 62.5% females. Prevalence rates (95%-confidence interval of toxicities after one year on stavudine were: peripheral neuropathy 21.3% (16.5-26.9, lipodystrophy 14.7% (2.4-8.1, high lactate syndromes 0.0% (0-1.4, diabetes mellitus 0.8% (0-2.8, pancreatitis 0.0% (0-1.5. Incidence rates per 100 person-years (95%-confidence interval during the second year on stavudine were: peripheral neuropathy 19.8 (14.3-26.6, lipodystrophy 11.4 (7.5-16.3, high lactate syndromes 2.1 (0.7-4.9, diabetes mellitus 0.4 (0.0-1.4, pancreatitis 0.0 (0.0-0.2. Prevalence of hypercholesterolemia and hypertriglyceridemia increased from 12.1% to 21.1% and from 29.5% to 37.6% respectively between 12 and 24 months. 5.5% stopped stavudine, 1.3% died and 4.0% defaulted during follow up. Higher age was an independent risk factor for incident peripheral neuropathy and lipodystrophy. CONCLUSION: Stavudine associated toxicities continued to accumulate during the

  11. Facial Cosmetics and Attractiveness: Comparing the Effect Sizes of Professionally-Applied Cosmetics and Identity.

    Science.gov (United States)

    Jones, Alex L; Kramer, Robin S S

    2016-01-01

    Forms of body decoration exist in all human cultures. However, in Western societies, women are more likely to engage in appearance modification, especially through the use of facial cosmetics. How effective are cosmetics at altering attractiveness? Previous research has hinted that the effect is not large, especially when compared to the variation in attractiveness observed between individuals due to differences in identity. In order to build a fuller understanding of how cosmetics and identity affect attractiveness, here we examine how professionally-applied cosmetics alter attractiveness and compare this effect with the variation in attractiveness observed between individuals. In Study 1, 33 YouTube models were rated for attractiveness before and after the application of professionally-applied cosmetics. Cosmetics explained a larger proportion of the variation in attractiveness compared with previous studies, but this effect remained smaller than variation caused by differences in attractiveness between individuals. Study 2 replicated the results of the first study with a sample of 45 supermodels, with the aim of examining the effect of cosmetics in a sample of faces with low variation in attractiveness between individuals. While the effect size of cosmetics was generally large, between-person variability due to identity remained larger. Both studies also found interactions between cosmetics and identity-more attractive models received smaller increases when cosmetics were worn. Overall, we show that professionally-applied cosmetics produce a larger effect than self-applied cosmetics, an important theoretical consideration for the field. However, the effect of individual differences in facial appearance is ultimately more important in perceptions of attractiveness.

  12. Longer-Term Postcure Measurement of Cuspal Deformation Induced by Dimensional Changes in Dental Materials

    Directory of Open Access Journals (Sweden)

    A. Falsafi

    2015-01-01

    Full Text Available Aim. This paper presents a simple, versatile in vitro methodology that enables indirect quantification of shrinkage and expansion stresses under clinically relevant conditions without the need for a dedicated instrument. Methods. For shrinkage effects, resulting cusp deformation of aluminum blocks with MOD type cavity, filled with novel filling compositions and commercial cements, has been measured using a bench-top micrometer and a Linear Variable Differential Transformer (LVDT, a displacement transducer based instrument. Results. The results demonstrated the validity of the proposed simple methodology. The technique was successfully used in longer-term measurements of shrinkage and expansion stress for several dental compositions. Conclusions. In contrast to in situ techniques where a measuring instrument is dedicated to the sample and its data collection, the proposed simple methodology allows for transfer of the samples to the environment of choice for storage and conditioning. The presented technique can be reliably used to quantify stress development of curing materials under clinically relevant (oral conditions. This enables direct examination and comparison of structural properties corresponding to the final stage of formed networks. The proposed methodology is directly applicable to the study of self-curing systems as they require mouth-type conditions (temperature and humidity to achieve their designed kinetics and reactions.

  13. Longer-Term Postcure Measurement of Cuspal Deformation Induced by Dimensional Changes in Dental Materials

    Science.gov (United States)

    Falsafi, A.; Oxman, J. D.; Tse, P.-H.; Ton, T. T.

    2015-01-01

    Aim. This paper presents a simple, versatile in vitro methodology that enables indirect quantification of shrinkage and expansion stresses under clinically relevant conditions without the need for a dedicated instrument. Methods. For shrinkage effects, resulting cusp deformation of aluminum blocks with MOD type cavity, filled with novel filling compositions and commercial cements, has been measured using a bench-top micrometer and a Linear Variable Differential Transformer (LVDT, a displacement transducer) based instrument. Results. The results demonstrated the validity of the proposed simple methodology. The technique was successfully used in longer-term measurements of shrinkage and expansion stress for several dental compositions. Conclusions. In contrast to in situ techniques where a measuring instrument is dedicated to the sample and its data collection, the proposed simple methodology allows for transfer of the samples to the environment of choice for storage and conditioning. The presented technique can be reliably used to quantify stress development of curing materials under clinically relevant (oral) conditions. This enables direct examination and comparison of structural properties corresponding to the final stage of formed networks. The proposed methodology is directly applicable to the study of self-curing systems as they require mouth-type conditions (temperature and humidity) to achieve their designed kinetics and reactions. PMID:26257783

  14. 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.

  15. 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

  16. Beyond "safe and effective": the role of the federal government in supporting and disseminating comparative-effectiveness research.

    Science.gov (United States)

    Francis, Maggie H

    2012-01-01

    Over the past century, medical advancements have resulted in tremendous health gains for Americans. Although the federal government has played a prominent role in ensuring that new treatments are safe and effective, questions about which medical treatments work best under which circumstances have largely remained unanswered. Thus, the federal government's recent major investments in comparative-effectiveness research have potential to play a significant role in helping both patients and health care providers navigate the vast array of available treatment options, as well as in improving the quality, efficiency, and delivery of health care system-wide. Yet, the controversial nature of the government's foray into comparative-effectiveness research also suggests that the path toward realizing these goals may be treacherous. This Article describes the rationales for federal support of comparative-effectiveness research and potential models for that involvement, analyzes the federal government's recent investments in the research, and concludes with predictions about the probable outcomes of these investments. While increased federal support for comparative-effectiveness research is unlikely to achieve all of the benefits anticipated by its supporters, it is a crucial step toward ensuring that Americans are able to take full advantage of the benefits of medical innovation

  17. Comparative effects of enalapril and nifedipine on renal hemodynamics in hypertensive renal allograft recipients.

    Science.gov (United States)

    Abu-Romeh, S H; el-Khatib, D; Rashid, A; Patel, M; Osman, N; Fayyad, M; Scheikhoni, A; Higazi, A S

    1992-04-01

    The comparative effects of enalapril (E) and nifedipine (N) on renal hemodynamics were assessed in twenty-two moderately hypertensive, cadaveric renal transplant patients who were maintaining stable renal function. Fourteen patients were on cyclosporin (CSA) and eight were receiving azathioprine with prednisolone (AZA). In each patient effective renal plasma flow (ERPF) was determined four times, first baseline, second with E, third as another baseline after a washout period, and fourth with N; and renal vascular resistance (RVR) was derived in each. ERPF and RVR were significantly compromised in the CSA group (202 +/- 55 ml/min and 65 +/- 18 mmHg/ml/min) compared to the AZA group (302 +/- 99 and 43 +/- 15 respectively). During E therapy, RVR further increased in the CSA group to 82 +/- 37 while it decreased in the AZA group to 31 +/- 7 (both changes were significant when compared to their respective baseline values). N, on the other hand, only significantly lowered RVR in the AZA group. Furthermore, two patients, one from each group, developed acute reversible renal failure shortly after E therapy. However, both agents were effective in lowering blood pressure to a comparable degree in both groups. In conclusion, our data showed a somewhat less favourable renal hemodynamic response to short-term enalapril therapy in hypertensive renal transplant patients maintained on CSA. However, the significance of such hemodynamic changes for long-term renal function remains uncertain.

  18. Effect of short-term school closures on the H1N1 pandemic in Japan: a comparative case study.

    Science.gov (United States)

    Uchida, M; Tsukahara, T; Kaneko, M; Washizuka, S; Kawa, S

    2012-10-01

    The 2009 worldwide influenza A/H1N1 pandemic particularly affected younger people, including schoolchildren. We assessed the effects of class/school closure during the pandemic on the spread of H1N1 infection in Japan. We prospectively monitored 2,141 schoolchildren in 57 classes at two elementary schools and two junior high schools in Japan, and evaluated the effects of class/school closures on the spread of H1N1 using descriptive epidemiological methods. The cumulative rate of H1N1 infection among these children was 40.9% (876 children). There was a total of 53 closures of 40 classes, including school closures, during the pandemic. Time-course changes in the epidemic curve showed that school closure reduced the following epidemic peak more than class closure. A Poisson regression model showed that a longer duration of closure was significantly related to decreased H1N1 occurrence after the resumption of classes. School closure more effectively inhibits subsequent epidemic outbreaks than class closure. Longer school closures are effective in reducing the spread of infection, and school closure should be implemented as early as possible.

  19. 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

  20. 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

    have been excluded. RESULTS: NSAIDs were clearly more effective in dental surgery, whereas the efficacy of NSAIDs and paracetamol seemed without substantial differences in major and orthopaedic surgery, although firm conclusions could not be made because the number of studies was limited. The addition...... of an NSAID to paracetamol may confer additional analgesic efficacy compared with paracetamol alone, and the limited data available also suggest that paracetamol may enhance analgesia when added to an NSAID, compared with NSAIDs alone. CONCLUSION: Paracetamol is a viable alternative to the NSAIDs, especially...

  1. 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.

  2. Comparative Effects of Retinoic Acid or Glycolic Acid Vehiculated in Different Topical Formulations

    Directory of Open Access Journals (Sweden)

    Patrícia Maria Berardo Gonçalves Maia Campos

    2015-01-01

    Full Text Available 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.

  3. 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.

  4. Effectiveness of behavioural graded activity compared with physiotherapy treatment in chronic neck pain: design of a randomised clinical trial [ISRCTN88733332

    Directory of Open Access Journals (Sweden)

    Vos Cees J

    2004-10-01

    Full Text Available Abstract Background Chronic neck pain is a common complaint in the Netherlands with a point prevalence of 14.3%. Patients with chronic neck pain are often referred to a physiotherapist and, although many treatments are available, it remains unclear which type of treatment is to be preferred. The objective of this article is to present the design of a randomised clinical trial, Ephysion, which examines the clinical and cost effectiveness of behavioural graded activity compared with a physiotherapy treatment for patients with chronic non-specific neck pain. Methods Eligible patients with non-specific neck pain persisting longer than 3 months will be randomly allocated to either the behavioural graded activity programme or to the physiotherapy treatment. The graded activity programme is based on an operant approach, which uses a time-contingent method to increase the patient's activity level. This treatment is compared with physiotherapy treatment using a pain-contingent method. Primary treatment outcome is the patient's global perceived effect concerning recovery from the complaint. Global perceived effect on daily functioning is also explored as primary outcome to establish the impact of treatment on daily activity. Direct and indirect costs will also be assessed. Secondary outcomes include the patient's main complaints, pain intensity, medical consumption, functional status, quality of life, and psychological variables. Recruitment of patients will take place up to the end of the year 2004 and follow-up measurement will continue until end 2005.

  5. 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.

  6. Comparative effectiveness of the nicotine lozenge and tobacco-free snuff for smokeless tobacco reduction.

    Science.gov (United States)

    Ebbert, Jon O; Severson, Herbert H; Croghan, Ivana T; Danaher, Brian G; Schroeder, Darrell R

    2013-05-01

    Long-term smokeless tobacco (ST) use is associated with cardiovascular disease and cancer, but not all ST users want to quit. Previous studies have evaluated the effectiveness of nicotine lozenges and tobacco-free snuff for reducing ST use among ST users not ready to quit, but no comparative effectiveness trials of these two products have been conducted. We conducted a multicenter, randomized clinical pilot study evaluating the comparative effectiveness of the 4-mg nicotine lozenge and tobacco-free snuff for reducing ST use and increasing tobacco abstinence among ST users with no intention of quitting in the next 30 days. Participants received 8 weeks of treatment and behavioral counseling on tobacco reduction strategies with follow-up to 26 weeks. We randomized 81 participants (40 nicotine lozenges, 41 tobacco-free snuff). No significant differences in reduction were observed between the two groups at weeks 8, 12, and 26. No significant differences were observed between groups in nicotine withdrawal or tobacco craving. However, both groups significantly reduced (psnuff both appear to be effective and comparable for reducing ST use among ST users not ready to quit in the next 30 days.

  7. [The interactive effects of comparative advertising on brand and company image change].

    Science.gov (United States)

    Hama, Y

    1991-04-01

    The purpose of the present study was: 1) to investigate the effects of two types of comparative advertising--Merit-type (emphasizing positive aspects of their own brand) and Demerit-type (pointing out negative aspects of the rival brand); and 2) to find an effective strategy against comparative advertising of a rival company. Subjects were shown advertisements, and were then asked to evaluate those advertisements (17 items), the brands and company images (3 items) for these two companies. The results are as follows: Comparative advertising, especially of the Demerit-type, was the most conspicuous type of advertising, which also had a significant negative effect on the perception of rival brands. However, this type of advertising also had a negative effect on his own advertising, the brands advertised, and the company itself. Furthermore, it was found that when a rival company uses Demerit-type advertising, it is better not to respond by the same type, but to respond by Merit-type advertising. In such a situation, positive image of his own brand and company become significantly higher.

  8. A comparative study of the effect of soft and hard cervical collars on static postural

    Directory of Open Access Journals (Sweden)

    Minoo Khalkhali Zavieh

    2013-01-01

    Full Text Available AbstractBackground and Aim: Using cervical collars is one of the treatment methods for releaving cervical pain. The effect of limb orthotics on proprioception and postural stability has been suggested. There is not sufficient studies about the effect of cervical collars on static and dynamic stability, and the effect of soft and hard collars have not been compared with one another. The objective of this study is investigating and comparing the immediate effect of soft and hard cervical collars on static postural stability in healthy young subjects. Methods & Materials: In standing position on firm surface with closed eyes, both soft and hard collars decreased the stability and there was not any significant difference among collars. In standing positions on soft surface with closed and opened eyes, using none of the soft and hard collars did not change the stability. This quasi experimental study through repeated measure method has been conducted on 65 healthy young male and female college students. Static stability was evaluated by modified Clinical Test for Sensory Interaction and Balance (CTSIB in conditions without collar and by soft and hard cervical collars and were compared between the conditions. Results: Conclusion: Our results suggest that in static conditions, without vision, both collars decrease the stability in healthy young subjects. So considering the evaluation of stability and prevention of balance disturbance during the collar prescription seems to be necessary.

  9. Systematic reviews, overviews of reviews and comparative effectiveness reviews: a discussion of approaches to knowledge synthesis.

    Science.gov (United States)

    Hartling, Lisa; Vandermeer, Ben; Fernandes, Ricardo M

    2014-06-01

    The Cochrane Collaboration has been at the forefront of developing methods for knowledge synthesis internationally. We discuss three approaches to synthesize evidence for healthcare interventions: systematic reviews (SRs), overviews of reviews and comparative effectiveness reviews. We illustrate these approaches with examples from knowledge syntheses on interventions for bronchiolitis, a common acute paediatric condition. Some of the differences among these approaches are subtle and methods are not necessarily mutually exclusive to a single review type. Systematic reviews bring together evidence from multiple studies in a rigorous fashion for a single intervention or group of interventions. Systematic reviews, as they have developed within healthcare, often focus on single or select interventions and direct pairwise comparisons; therefore, end-users may need to read several individual SRs to inform decision making. Overviews of reviews compile information from multiple SRs relevant to a single health problem. Overviews provide the end-user with a quick overview of the available evidence; however, overviews are dependent on the methods and decisions employed at the SR level. Furthermore, overviews do not often integrate evidence from different SRs quantitatively. Comparative effectiveness reviews, as we define them here, synthesize relevant evidence from individual studies to describe the relative benefits (or harms) of a range of interventions. Comparative effectiveness reviews may use statistical methods (network meta-analysis) to incorporate direct and indirect evidence; therefore, they can provide stronger inferences about the relative effectiveness (or safety) of interventions. While potentially more expensive and time-consuming to produce, a comparative effectiveness review provides a synthesis of a range of interventions for a given condition and the relative efficacy across interventions using consistent and standardized methodology. Copyright © 2014 The

  10. Comparing the effectiveness of competing tests for reducing colorectal cancer mortality: a network meta-analysis.

    Science.gov (United States)

    Elmunzer, B Joseph; Singal, Amit G; Sussman, Jeremy B; Deshpande, Amar R; Sussman, Daniel A; Conte, Marisa L; Dwamena, Ben A; Rogers, Mary A M; Schoenfeld, Philip S; Inadomi, John M; Saini, Sameer D; Waljee, Akbar K

    2015-03-01

    Comparative effectiveness data pertaining to competing colorectal cancer (CRC) screening tests do not exist but are necessary to guide clinical decision making and policy. To perform a comparative synthesis of clinical outcomes studies evaluating the effects of competing tests on CRC-related mortality. Traditional and network meta-analyses. Two reviewers identified studies evaluating the effect of guaiac-based fecal occult blood testing (gFOBT), flexible sigmoidoscopy (FS), or colonoscopy on CRC-related mortality. gFOBT, FS, colonoscopy. Traditional meta-analysis was performed to produce pooled estimates of the effect of each modality on CRC mortality. Bayesian network meta-analysis (NMA) was performed to indirectly compare the effectiveness of screening modalities. Multiple sensitivity analyses were performed. Traditional meta-analysis revealed that, compared with no intervention, colonoscopy reduced CRC-related mortality by 57% (relative risk [RR] 0.43; 95% confidence interval [CI], 0.33-0.58), whereas FS reduced CRC-related mortality by 40% (RR 0.60; 95% CI, 0.45-0.78), and gFOBT reduced CRC-related mortality by 18% (RR 0.82; 95% CI, 0.76-0.88). NMA demonstrated nonsignificant trends favoring colonoscopy over FS (RR 0.71; 95% CI, 0.45-1.11) and FS over gFOBT (RR 0.74; 95% CI, 0.51-1.09) for reducing CRC-related deaths. NMA-based simulations, however, revealed that colonoscopy has a 94% probability of being the most effective test for reducing CRC mortality and a 99% probability of being most effective when the analysis is restricted to screening studies. Randomized trials and observational studies were combined within the same analysis. Clinical outcomes studies demonstrate that gFOBT, FS, and colonoscopy are all effective in reducing CRC-related mortality. Network meta-analysis suggests that colonoscopy is the most effective test. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-04-01

    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.

  13. An Laboratory Experiment for Comparing Effectiveness of Three Types of Online Recommendations

    Institute of Scientific and Technical Information of China (English)

    SHI Lin; WANG Kanliang

    2008-01-01

    The widespread use of Internet accelerates the rapid development of business to customer electronic commerce. To reduce information overload and help their customers to make better purchase decisions, e-commerce websites are beginning to use online recommendations. This paper compares the effectiveness of three types of online recommendations, the personalized recommendation, best sellers, and consumers' reviews, which are widely used in e-commerce. This research used a laboratory experiment combined with a questionnaire. This paper also establishes an integrated model of the facts that influence recommendation effectiveness.

  14. Health effects of war stress on Norwegian World War II resistance groups: a comparative study.

    Science.gov (United States)

    Major, Ellinor F

    2003-12-01

    The main aim of this study was to investigate the extent to which adverse long-term health effects of World War II stress exposure were present in 3 groups of resistance veterans. The groups had been exposed to different types of war stressors: concentration camp incarceration, resistance participation within the illegal press, and a secret military organization. With the differences in war stressors as a basis, we assumed that those incarcerated in a concentration camp would display more adverse health effect compared to the resistance veterans. The findings point to a relationship between the severity of war stressors and postwar health in all 3 groups.

  15. Fucoidan from Macrocystis pyrifera Has Powerful Immune-Modulatory Effects Compared to Three Other Fucoidans

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    2015-02-01

    Full Text Available Fucoidan, a sulfated polysaccharide purified from brown algae, has a variety of immune-modulation effects, such as promoting activation of dendritic cells (DCs, natural killer (NK cells and T cells, and enhancing anti-viral and anti-tumor responses. However, the immune-modulatory effect of fucoidan from different seaweed extracts has not been thoroughly analyzed and compared. We analyzed fucoidans obtained from Ascophyllum nodosum (A. nodosum, Macrocystis pyrifera (M. pyrifera, Undaria pinnatifida (U. pinnatifida and Fucus vesiculosus (F. vesiculosus for their effect on the apoptosis of human neutrophils, activation of mouse NK cells, maturation of spleen DCs, proliferation and activation of T cells, and the adjuvant effect in vivo. Fucoidans from M. pyrifera and U. pinnatifida strongly delayed human neutrophil apoptosis at low concentration, whereas fucoidans from A. nodosum and F. vesiculosus delayed human neutrophil apoptosis at higher concentration. Moreover, fucoidan from M. pyrifera promoted NK cell activation and cytotoxic activity against YAC-1 cells. In addition, M. pyrifera fucoidan induced the strongest activation of spleen DCs and T cells and ovalbumin (OVA specific immune responses compared to other fucoidans. These data suggest that fucoidan from M. pyrifera can be potentially useful as a therapeutic agent for infectious diseases, cancer and an effective adjuvant for vaccine.

  16. Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review

    Science.gov (United States)

    2012-01-01

    Background Insomnia is common in primary care, can persist after co-morbid conditions are treated, and may require long-term medication treatment. A potential alternative to medications is cognitive behavioral therapy for insomnia (CBT-I). Methods In accordance with PRISMA guidelines, we systematically reviewed MEDLINE, EMBASE, the Cochrane Central Register, and PsycINFO for randomized controlled trials (RCTs) comparing CBT-I to any prescription or non-prescription medication in patients with primary or comorbid insomnia. Trials had to report quantitative sleep outcomes (e.g. sleep latency) in order to be included in the analysis. Extracted results included quantitative sleep outcomes, as well as psychological outcomes and adverse effects when available. Evidence base quality was assessed using GRADE. Results Five studies met criteria for analysis. Low to moderate grade evidence suggests CBT-I has superior effectiveness to benzodiazepine and non-benzodiazepine drugs in the long term, while very low grade evidence suggests benzodiazepines are more effective in the short term. Very low grade evidence supports use of CBT-I to improve psychological outcomes. Conclusions CBT-I is effective for treating insomnia when compared with medications, and its effects may be more durable than medications. Primary care providers should consider CBT-I as a first-line treatment option for insomnia. PMID:22631616

  17. Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review

    Directory of Open Access Journals (Sweden)

    Mitchell Matthew D

    2012-05-01

    Full Text Available Abstract Background Insomnia is common in primary care, can persist after co-morbid conditions are treated, and may require long-term medication treatment. A potential alternative to medications is cognitive behavioral therapy for insomnia (CBT-I. Methods In accordance with PRISMA guidelines, we systematically reviewed MEDLINE, EMBASE, the Cochrane Central Register, and PsycINFO for randomized controlled trials (RCTs comparing CBT-I to any prescription or non-prescription medication in patients with primary or comorbid insomnia. Trials had to report quantitative sleep outcomes (e.g. sleep latency in order to be included in the analysis. Extracted results included quantitative sleep outcomes, as well as psychological outcomes and adverse effects when available. Evidence base quality was assessed using GRADE. Results Five studies met criteria for analysis. Low to moderate grade evidence suggests CBT-I has superior effectiveness to benzodiazepine and non-benzodiazepine drugs in the long term, while very low grade evidence suggests benzodiazepines are more effective in the short term. Very low grade evidence supports use of CBT-I to improve psychological outcomes. Conclusions CBT-I is effective for treating insomnia when compared with medications, and its effects may be more durable than medications. Primary care providers should consider CBT-I as a first-line treatment option for insomnia.

  18. Effects of acute tobacco abstinence in adolescent smokers compared with nonsmokers.

    Science.gov (United States)

    Smith, Anne E; Cavallo, Dana A; Dahl, Tricia; Wu, Ran; George, Tony P; Krishnan-Sarin, Suchitra

    2008-07-01

    Abstinence effects such as nicotine withdrawal and mood changes contribute to the maintenance of cigarette smoking in adult smokers, and emerging reports on adolescent smokers suggest they may experience similar subjective effects when deprived. This study aimed to prospectively document tobacco abstinence-induced changes during the first 48 hours of abstinence in adolescent smokers compared with nonsmokers, to distinguish effects distinct from typical adolescent lability. Fifty-seven adolescent smokers and 44 adolescent nonsmokers were assessed during a 48-hour inpatient session. Characteristic nicotine withdrawal symptoms, cravings for cigarettes, and mood symptoms were measured at 13 time points following initiation of abstinence. The only abstinence-related effects observed were changes in craving for tobacco and feelings of anger. Tobacco craving increased and peaked quickly following initiation of abstinence and displayed a slight decrease toward the end of the 48-hour abstinence period, while anger symptoms peaked after a more prolonged abstinence. Overall, smokers' symptoms and cravings were positively associated with amount of daily smoking but not with reports of dependence or biological measures of extent of use. We observed that among adolescent smokers, the primary effects associated with abstinence from cigarettes are relatively minimal, and include a heightened and persistent craving to smoke and increases in anger. Although smokers had greater negative mood symptoms compared with nonsmokers, the presence and severity of most of these symptoms appear to be minimally altered by abstinence and not associated with dependency or biological indicators of amount of tobacco use.

  19. Causal inference in longitudinal comparative effectiveness studies with repeated measures of a continuous intermediate variable.

    Science.gov (United States)

    Wang, Chen-Pin; Jo, Booil; Brown, C Hendricks

    2014-09-10

    We propose a principal stratification approach to assess causal effects in nonrandomized longitudinal comparative effectiveness studies with a binary endpoint outcome and repeated measures of a continuous intermediate variable. Our method is an extension of the principal stratification approach originally proposed for the longitudinal randomized study "Prevention of Suicide in Primary Care Elderly: Collaborative Trial" to assess the treatment effect on the continuous Hamilton depression score adjusting for the heterogeneity of repeatedly measured binary compliance status. Our motivation for this work comes from a comparison of the effect of two glucose-lowering medications on a clinical cohort of patients with type 2 diabetes. Here, we consider a causal inference problem assessing how well the two medications work relative to one another on two binary endpoint outcomes: cardiovascular disease-related hospitalization and all-cause mortality. Clinically, these glucose-lowering medications can have differential effects on the intermediate outcome, glucose level over time. Ultimately, we want to compare medication effects on the endpoint outcomes among individuals in the same glucose trajectory stratum while accounting for the heterogeneity in baseline covariates (i.e., to obtain 'principal effects' on the endpoint outcomes). The proposed method involves a three-step model estimation procedure. Step 1 identifies principal strata associated with the intermediate variable using hybrid growth mixture modeling analyses. Step 2 obtains the stratum membership using the pseudoclass technique and derives propensity scores for treatment assignment. Step 3 obtains the stratum-specific treatment effect on the endpoint outcome weighted by inverse propensity probabilities derived from Step 2.

  20. Longer coronary anastomosis provides lower energy loss in coronary artery bypass grafting.

    Science.gov (United States)

    Tsukui, Hiroyuki; Shinke, Manabu; Park, Young Kwang; Yamazaki, Kenji

    2017-01-01

    Distal anastomosis technique affects graft patency and long-term outcomes in coronary artery bypass grafting, however, there is no standard for the appropriate length of distal anastomosis. The purpose of this study is to evaluate whether longer distal anastomosis provides higher quality of distal anastomosis and better hemodynamic patterns. Off pump CABG training simulator, YOUCAN (EBM Corporation, Japan), was used for distal anastomosis model. Two lengths of distal anastomosis model (10 versus 4 mm) were prepared by end-to-side anastomosis technique. After CT scan constructed three-dimensional inner shape of distal anastomosis, computational flow dynamics (CFD) was used to analyze hemodynamic patterns. The working flow was defined as Newtonian fluid with density of 1050 kg/m(3) and viscosity of 4 mPa s. The boundary condition was set to 100 mmHg at inlet, 50 ml/min at outlet, and 100 % stenosis of proximal coronary artery. Three-dimensional CT imaging showed quality of distal anastomosis in 10 mm model was more uniform without vessel wall inversion or kinking compared to 4 mm model. Anastomotic flow area was significantly larger in 10 mm model than that in 4 mm model (28.67 ± 4.91 versus 8.89 ± 3.18 mm(2), p anastomosis provided higher quality of distal anastomosis, larger anastomotic flow area, smaller anastomotic angle, and smoother graft curvatures. These factors yielded lower energy loss at distal anastomosis.

  1. Comparative effect of Citrus sinensis and carbimazole on serum T 4 , T 3 and TSH levels

    Directory of Open Access Journals (Sweden)

    Okon Uduak Uduak

    2014-01-01

    Full Text Available Background: There are previous independent reports on the anti-thyroid property of Citrus sinensis. This isoflavones and phenolic acid-rich natural agent is widely consumed as dietary supplement, thus the need to investigate its comparative effect with a standard anti-thyroid drug on T 4 , T 3 and thyroid stimulating hormone (TSH levels. Objective: To compare the effect of Citrus sinensis and carbimazole (CARB on blood levels of thyroid hormones (T 4 and T 3 and TSH. Materials and Methods: Male wistar albino rats weighing 100-150 g were employed in this research. The rats were randomly assigned to four groups of seven rats per group. Group I served as control and were administered distilled water while groups II-IV were administered with 1500 mg/kg of Citrus sinensis (fresh orange juice; FOJ, 0.1 μg/g of levothyroxine (LVT and 0.01 mg/g of CARB, respectively, per oral once daily for 28 days. The animals were sacrificed under chloroform anaesthesia and blood sample collected by cardiac puncture and processed by standard method to obtain serum. TSH, T 4 and T 3 were assayed with the serum using ARIA II automated radioimmunoassay instrument. Results: The results showed that TSH level was significantly (P < 0.05 decreased in LVT treated group compared with the FOJ group. T 4 was significantly (P < 0.05 decreased in the FOJ and CARB groups compared with the control and LVT groups. LVT significantly increased T 4 when compared with FOJ group. T 3 was significantly (P < 0.05 decreased in the CARB group compared with the control. Conclusion: These findings suggest that FOJ alters thyroid hormones metabolism to reduce their serum levels with a compensatory elevations of TSH level in a direction similar to CARB.

  2. 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

  3. Effects of sample size and intraspecific variation in phylogenetic comparative studies: a meta-analytic review.

    Science.gov (United States)

    Garamszegi, László Z; Møller, Anders P

    2010-11-01

    Comparative analyses aim to explain interspecific variation in phenotype among taxa. In this context, phylogenetic approaches are generally applied to control for similarity due to common descent, because such phylogenetic relationships can produce spurious similarity in phenotypes (known as phylogenetic inertia or bias). On the other hand, these analyses largely ignore potential biases due to within-species variation. Phylogenetic comparative studies inherently assume that species-specific means from intraspecific samples of modest sample size are biologically meaningful. However, within-species variation is often significant, because measurement errors, within- and between-individual variation, seasonal fluctuations, and differences among populations can all reduce the repeatability of a trait. Although simulations revealed that low repeatability can increase the type I error in a phylogenetic study, researchers only exercise great care in accounting for similarity in phenotype due to common phylogenetic descent, while problems posed by intraspecific variation are usually neglected. A meta-analysis of 194 comparative analyses all adjusting for similarity due to common phylogenetic descent revealed that only a few studies reported intraspecific repeatabilities, and hardly any considered or partially dealt with errors arising from intraspecific variation. This is intriguing, because the meta-analytic data suggest that the effect of heterogeneous sampling can be as important as phylogenetic bias, and thus they should be equally controlled in comparative studies. We provide recommendations about how to handle such effects of heterogeneous sampling.

  4. Effects of human population growth on the Fraser and Okanagan River systems, Canada: a comparative inquiry.

    Science.gov (United States)

    Northcote, T G

    1996-10-01

    The author compares the impact of human population growth on the Fraser and Okanagan river systems in Canada. The effects "on water, fisheries and other aquatic resources of the two basins are explored along with possibilities and suggestions for their sustainable development. The latter, despite some glimmers of hope, will not be tenable without major changes in public attitude, in government policy at all levels, and in other measures which to many may seem impossible." excerpt

  5. Training models in laparoscopy: a systematic review comparing their effectiveness in learning surgical skills.

    Science.gov (United States)

    Willaert, W; Van De Putte, D; Van Renterghem, K; Van Nieuwenhove, Y; Ceelen, W; Pattyn, P

    2013-01-01

    Surgery has traditionally been learned on patients in the operating room, which is time-consuming, can have an impact on the patient outcomes, and is of variable effectiveness. As a result, surgical training models have been developed, which are compared in this systematic review. We searched Pubmed, CENTRAL, and Science Citation index expanded for randomised clinical trials and randomised cross-over studies comparing laparoscopic training models. Studies comparing one model with no training were also included. The reference list of identified trials was searched for further relevant studies. Fifty-eight trials evaluating several training forms and involving 1591 participants were included (four studies with a low risk of bias). Training (virtual reality (VR) or video trainer (VT)) versus no training improves surgical skills in the majority of trials. Both VR and VT are as effective in most studies. VR training is superior to traditional laparoscopic training in the operating room. Outcome results for VR robotic simulations versus robot training show no clear difference in effectiveness for either model. Only one trial included human cadavers and observed better results versus VR for one out of four scores. Contrasting results are observed when robotic technology is compared with manual laparoscopy. VR training and VT training are valid teaching models. Practicing on these models similarly improves surgical skills. A combination of both methods is recommended in a surgical curriculum. VR training is superior to unstructured traditional training in the operating room. The reciprocal effectiveness of the other models to learn surgical skills has not yet been established.

  6. Comparative effect of olive oil and fish oil supplementation in combating gentamicin induced nephrotoxicity in rats

    OpenAIRE

    Rashid, Fouzia; M. Kaleem; Sheema; Bano, B.

    2005-01-01

    The present study is related to the comparative effects of fish oil and olive oil supplementation on gentamicin induced nephrotoxicity in rats. Three treatment groups (Pretrement, Co-treatment and post treatment) were chosen for the study. Nephrotoxicity in rats was induced by intraperitonial administration of gentamicin (80 mg/kg/d) for 3,5,7,10,& 12 consecutive days. The animals were sacrificed 12 hrs after last treatment in each group. The maximum nephrotoxicity was developed on 10 days tr...

  7. COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF THREE METHODS FOR PROXIMAL CARIES DIAGNOSIS – A CLINICAL STUDY.

    OpenAIRE

    Mirela Marinova-Takorova; Radostina Anastasova; Vladimir E. Panov; Spartak Yanakiev

    2014-01-01

    Aim: The aim of the presented study is to compare the effectiveness of the diagnosis with a dental microscope, laser fluorescence (DIAGNOcam) and X-ray examination in proximal caries diagnosis. Material and methods: Thirty-eight adult patients were examined. They were first examined with a dental mirror and a probe, under magnification 6.4 times. After that a diagnosis with DIAGNOcam was performed. Bitewing X-ray images were administered. The data from the three diagnostic methods was comp...

  8. Comparative Transcriptome Analysis Reveals Effects of Exogenous Hematin on Anthocyanin Biosynthesis during Strawberry Fruit Ripening

    OpenAIRE

    2016-01-01

    Anthocyanin in strawberries has a positive effect on fruit coloration. In this study, the role of exogenous hematin on anthocyanin biosynthesis was investigated. Our result showed that the white stage of strawberries treated with exogenous hematin had higher anthocyanin content, compared to the control group. Among all treatments, 5 μM of hematin was the optimal condition to promote color development. In order to explore the molecular mechanism of fruit coloring regulated by hematin, transcri...

  9. Comparative effects of balm hydro alcoholic extract and diazepam on reducing anxiety of in mice

    OpenAIRE

    2016-01-01

    Background & aim: Anxiety is a normal feeling which is experienced in threatening situations and can affect neural system. Wide spread of anxiety forces many people to permanent use of anti-stress drugs especially benzodiazepines. This study was carried out to compare the effects of balm extract and diazepam on anxiety adjustment. Methods: In this experimental study 70 female mice weighing approximately 25 to 30 g were studied in seven treatments groups including control, placebo, anxiety...

  10. COMPARATIVE EFFECTIVENESS OF AN ADJUSTABLE TRANSFEMORAL PROSTHETIC INTERFACE ACCOMMODATING VOLUME FLUCTUATION: CASE STUDY

    OpenAIRE

    Kahle, Jason T.; Klenow, Tyler D.; Highsmith, M. Jason

    2016-01-01

    The socket-limb interface is vital for functionality and provides stability and mobility for the amputee. Volume fluctuation can lead to compromised fit and function. Current socket technology does not accommodate for volume fluctuation. An adjustable interface may improve function and comfort by filling this technology gap. The purpose of this study was to compare the effectiveness of the standard of care (SOC) ischial ramus containment to an adjustable transfemoral prosthetic interface sock...

  11. Comparative analysis of surface urban heat island effect in Central Sydney

    OpenAIRE

    E Sharifi; Lehmann, Steffen

    2014-01-01

    The Urban Heat Island (UHI) effect can result in higher urban densities being significantly hotter (frequently more than 4 °C, even up to 10 °C) compared to their peri-urban surroundings. Such artificial heat stress increases the health risk of spending time outdoors and boosts the need for energy consumption, particularly for cooling during summer. Urban structure, land cover and metabolism are underlined as key contributors in city scale. Under question is which urban configurations can mak...

  12. Practice based evidence: incorporating clinical heterogeneity and patient-reported outcomes for comparative effectiveness research.

    Science.gov (United States)

    Horn, Susan D; Gassaway, Julie

    2010-06-01

    Comparative effectiveness research analyzes groups of patients and looks for associations between medical treatments and patient outcomes. To make meaningful comparisons of medical interventions, one must consider clinical heterogeneity of patient populations, intervention combinations, and outcomes. To explain how practice-based evidence (PBE) study methodology measures and controls for heterogeneity of patients, treatments, and outcomes seen in real-world clinical settings. Overview of PBE methodology. PBE study designs address comparative effectiveness by creating a comprehensive set of patient, treatment, and outcome variables, and analyzing them to identify treatments associated with better outcomes for specific types of patients. PBE studies are an alternative to randomized controlled trials, well suited to determine what works best for specific patient types, and provide clinicians with a rational basis for treatment recommendations for individual patients. They provide a holistic picture of patients, treatments, and outcomes, with no preset limits to the number of variables that can be included. Such an approach is needed for high quality comparative effectiveness research.

  13. 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.

  14. Interview: A private sector life in comparative effectiveness research. Interview with Robert W Dubois.

    Science.gov (United States)

    Dubois, Robert W

    2013-09-01

    Robert W Dubois joined the National Pharmaceutical Council (Washington, DC, USA) in October 2010 as its Chief Science Officer. In this role, he oversees the National Pharmaceutical Council's research on policy issues related to comparative effectiveness research, as well as on how health outcomes are valued. Dr Dubois has cofounded and led various healthcare research organizations in developing quality research with practical application. Throughout his career, Dr Dubois' primary interest has centered on defining 'what works' in healthcare and finding ways for that evidence to inform healthcare decision-making. He is a recognized expert in the areas of defining best practice, disease management and appropriateness of care. He has authored more than 100 peer-reviewed articles on comparative effectiveness, evidence-based medicine, the development of practice guidelines and determining the optimal use of high-cost medical services. Dr Dubois received his AB from Harvard College (MA, USA), his MD from the Johns Hopkins School of Medicine (MD, USA) and his PhD in Health Policy from the RAND Graduate School (CA, USA). In addition, he is the associate editor of the Journal of Comparative Effectiveness Research and is on the editorial board for Health Affairs.

  15. Longer treatment time and slower ultrafiltration in hemodialysis: associations with reduced mortality in the DOPPS.

    Science.gov (United States)

    Saran, R; Bragg-Gresham, J L; Levin, N W; Twardowski, Z J; Wizemann, V; Saito, A; Kimata, N; Gillespie, B W; Combe, C; Bommer, J; Akiba, T; Mapes, D L; Young, E W; Port, F K

    2006-04-01

    Longer treatment time (TT) and slower ultrafiltration rate (UFR) are considered advantageous for hemodialysis (HD) patients. The study included 22,000 HD patients from seven countries in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Logistic regression was used to study predictors of TT > 240 min and UFR > 10 ml/h/kg bodyweight. Cox regression was used for survival analyses. Statistical adjustments were made for patient demographics, comorbidities, dose of dialysis (Kt/V), and body size. Europe and Japan had significantly longer (P V increased concomitantly with TT in all three regions with the largest absolute difference observed in Japan. TT > 240 min was independently associated with significantly lower relative risk (RR) of mortality (RR = 0.81; P = 0.0005). Every 30 min longer on HD was associated with a 7% lower RR of mortality (RR = 0.93; P V and TT (P = 0.007) toward mortality reduction. UFR > 10 ml/h/kg was associated with higher odds of intradialytic hypotension (odds ratio = 1.30; P = 0.045) and a higher risk of mortality (RR = 1.09; P = 0.02). Longer TT and higher Kt/V were independently as well as synergistically associated with lower mortality. Rapid UFR during HD was also associated with higher mortality risk. These results warrant a randomized clinical trial of longer dialysis sessions in thrice-weekly HD.

  16. Comparing the Frequency Effect Between the Lexical Decision and Naming Tasks in Chinese.

    Science.gov (United States)

    Gao, Xin-Yu; Li, Meng-Feng; Chou, Tai-Li; Wu, Jei-Tun

    2016-04-01

    In psycholinguistic research, the frequency effect can be one of the indicators for eligible experimental tasks that examine the nature of lexical access. Usually, only one of those tasks is chosen to examine lexical access in a study. Using two exemplar experiments, this paper introduces an approach to include both the lexical decision task and the naming task in a study. In the first experiment, the stimuli were Chinese characters with frequency and regularity manipulated. In the second experiment, the stimuli were switched to Chinese two-character words, in which the word frequency and the regularity of the leading character were manipulated. The logic of these two exemplar experiments was to explore some important issues such as the role of phonology on recognition by comparing the frequency effect between both the tasks. The results revealed different patterns of lexical access from those reported in the alphabetic systems. The results of Experiment 1 manifested a larger frequency effect in the naming task as compared to the LDT, when the stimuli were Chinese characters. And it is noteworthy that, in Experiment 1, when the stimuli were regular Chinese characters, the frequency effect observed in the naming task was roughly equivalent to that in the LDT. However, a smaller frequency effect was shown in the naming task as compared to the LDT, when the stimuli were switched to Chinese two-character words in Experiment 2. Taking advantage of the respective demands and characteristics in both tasks, researchers can obtain a more complete and precise picture of character/word recognition.

  17. Anaerobic biodegradation of longer-chain n-alkanes coupled to methane production in oil sands tailings.

    Science.gov (United States)

    Siddique, Tariq; Penner, Tara; Semple, Kathleen; Foght, Julia M

    2011-07-01

    Extraction of bitumen from mined oil sands ores produces enormous volumes of tailings that are stored in settling basins (current inventory ≥ 840 million m(3)). Our previous studies revealed that certain hydrocarbons (short-chain n-alkanes [C(6)-C(10)] and monoaromatics [toluene, o-xylene, m-xylene]) in residual naphtha entrained in the tailings are biodegraded to CH(4) by a consortium of microorganisms. Here we show that higher molecular weight n-alkanes (C(14), C(16), and C(18)) are also degraded under methanogenic conditions in oil sands tailings, albeit after a lengthy lag (~180 d) before the onset of methanogenesis. Gas chromatographic analyses showed that the longer-chain n-alkanes each added at ~400 mg L(-1) were completely degraded by the resident microorganisms within ~440 d at ~20 °C. 16S rRNA gene sequence analysis of clone libraries implied that the predominant pathway of longer-chain n-alkane metabolism in tailings is through syntrophic oxidation of n-alkanes coupled with CO(2) reduction to CH(4). These studies demonstrating methanogenic biodegradation of longer-chain n-alkanes by microbes native to oil sands tailings may be important for effective management of tailings and greenhouse gas emissions from tailings ponds.

  18. Comparing five alternative methods of breast reconstruction surgery: a cost-effectiveness analysis.

    Science.gov (United States)

    Grover, Ritwik; Padula, William V; Van Vliet, Michael; Ridgway, Emily B

    2013-11-01

    The purpose of this study was to assess the cost-effectiveness of five standardized procedures for breast reconstruction to delineate the best reconstructive approach in postmastectomy patients in the settings of nonirradiated and irradiated chest walls. A decision tree was used to model five breast reconstruction procedures from the provider perspective to evaluate cost-effectiveness. Procedures included autologous flaps with pedicled tissue, autologous flaps with free tissue, latissimus dorsi flaps with breast implants, expanders with implant exchange, and immediate implant placement. All methods were compared with a "do-nothing" alternative. Data for model parameters were collected through a systematic review, and patient health utilities were calculated from an ad hoc survey of reconstructive surgeons. Results were measured in cost (2011 U.S. dollars) per quality-adjusted life-year. Univariate sensitivity analyses and Bayesian multivariate probabilistic sensitivity analysis were conducted. Pedicled autologous tissue and free autologous tissue reconstruction were cost-effective compared with the do-nothing alternative. Pedicled autologous tissue was the slightly more cost-effective of the two. The other procedures were not found to be cost-effective. The results were robust to a number of sensitivity analyses, although the margin between pedicled and free autologous tissue reconstruction is small and affected by some parameter values. Autologous pedicled tissue was slightly more cost-effective than free tissue reconstruction in irradiated and nonirradiated patients. Implant-based techniques were not cost-effective. This is in agreement with the growing trend at academic institutions to encourage autologous tissue reconstruction because of its natural recreation of the breast contour, suppleness, and resiliency in the setting of irradiated recipient beds.

  19. Comparing Efficacy and Side Effects of Memantine vs. Risperidone in the Treatment of Autistic Disorder.

    Science.gov (United States)

    Nikvarz, Nikvarz; Alaghband-Rad, Javad; Tehrani-Doost, Mehdi; Alimadadi, Abbas; Ghaeli, Padideh

    2017-01-01

    Introduction: This study was aimed to compare the efficacy and side effects of memantine, an antagonist of the NMDA receptor of glutamate, with risperidone given the fact that glutamate has been noted for its possible effects in the pathogenesis of autism. Risperidone, an atypical antipsychotic, has been approved by FDA for the management of irritability associated with autism. Methods: 30 children, aged 4-17 years, entered an 8-week, randomized trial. Patients were randomly assigned to receive either risperidone or memantine. Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Clinical Global Impressions - Improvement (CGI-I) and Clinical Global Impression-Severity (CGI-S) scales were used to assess behavioral symptoms of the patients. Results: Both risperidone and memantine reduced the scores of 4 subscales of ABC as well as the 10-item and the total score of CARS significantly. However, differences between the 2 drugs in the scores of each evaluating scale were not found to be significant. Relatively, larger number of patients on risperidone showed "very much improvement" when assessed by CGI-I scale when compared with those on memantine. Discussion and conclusion: The present study suggests that memantine may have beneficial effects in the treatment of many core symptoms of autism. Therefore, memantine may be considered as a potential medication in the treatment of those autistic children who do not respond or cannot tolerate side effects of risperidone.

  20. 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.

  1. Comparative effectiveness of guidelines for the management of hyperlipidemia and hypertension for type 2 diabetes patients.

    Directory of Open Access Journals (Sweden)

    Nilay D Shah

    Full Text Available BACKGROUND: Several guidelines to reduce cardiovascular risk in diabetes patients exist in North America, Europe, and Australia. Their ability to achieve this goal efficiently is unclear. METHODS AND FINDINGS: Decision analysis was used to compare the efficiency and effectiveness of international contemporary guidelines for the management of hypertension and hyperlipidemia for patients aged 40-80 with type 2 diabetes. Measures of comparative effectiveness included the expected probability of a coronary or stroke event, incremental medication costs per event, and number-needed-to-treat (NNT to prevent an event. All guidelines are equally effective, but they differ significantly in their medication costs. The range of NNT to prevent an event was small across guidelines (6.5-7.6 for males and 6.5-7.5 for females; a larger range of differences were observed for expected cost per event avoided (ranges, $117,269-$157,186 for males and $115,999-$163,775 for females. Australian and U.S. guidelines result in the highest and lowest expected costs, respectively. CONCLUSIONS: International guidelines based on the same evidence and seeking the same goal are similar in their effectiveness; however, there are large differences in expected medication costs.

  2. Comparing antifungal effects of Zatariamultiflora and Punicagranatum extract with Nystatin on Candida Albicans

    Directory of Open Access Journals (Sweden)

    F. Nouri

    2016-12-01

    Full Text Available Background: Despite all the progress that has been made in the manufacture of synthetic drugs, herbal drugs are increasingly taken into account. This is due to the growing belief that they have fewer side effects compared to synthetic ones. Objective: To compare the antifungal effects of extracts of Zatariamultiflora and Punicagranatum with Nystatin on Candida Albicans. Methods: This inviro trial accomplished in the school of dentistry of Tehran University in 2012. From the mouths of 25 patients with denture stomatitis were sampled using sterile swabs. Candida Albicans strains were isolated from samples and standard Candida Albicans PTCC 5027 were cultured too. Then extract of Zatariamultiflora and Punicagranatum to be obtained and antifungal of extract studied with disk diffusion method. Antifungal power of each of the extracts on the inhibition zone diameter was created in the medium. Data were analyzed by ANOVA and Friedman statistical tests. Findings: Results showed extracts of Zataria and pomegranate flowers have antifungal significant effects (P<0.001. Diameter of inhabitation zone was 17.66±./75 mm in Nystatin group and in the Zataria and pomegranate flowers extracts groups was lower (P<0.001. None of the negative control disc did inhibition zone in the medium. Conclusion: With due attention of Zataria and pomegranate flowers extracts exhibited antifungal effects on Candida Albincans.

  3. Comparative effectiveness research on patients with acute ischemic stroke using Markov decision processes

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    Wu Darong

    2012-03-01

    Full Text Available Abstract Background Several methodological issues with non-randomized comparative clinical studies have been raised, one of which is whether the methods used can adequately identify uncertainties that evolve dynamically with time in real-world systems. The objective of this study is to compare the effectiveness of different combinations of Traditional Chinese Medicine (TCM treatments and combinations of TCM and Western medicine interventions in patients with acute ischemic stroke (AIS by using Markov decision process (MDP theory. MDP theory appears to be a promising new method for use in comparative effectiveness research. Methods The electronic health records (EHR of patients with AIS hospitalized at the 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine between May 2005 and July 2008 were collected. Each record was portioned into two "state-action-reward" stages divided by three time points: the first, third, and last day of hospital stay. We used the well-developed optimality technique in MDP theory with the finite horizon criterion to make the dynamic comparison of different treatment combinations. Results A total of 1504 records with a primary diagnosis of AIS were identified. Only states with more than 10 (including 10 patients' information were included, which gave 960 records to be enrolled in the MDP model. Optimal combinations were obtained for 30 types of patient condition. Conclusion MDP theory makes it possible to dynamically compare the effectiveness of different combinations of treatments. However, the optimal interventions obtained by the MDP theory here require further validation in clinical practice. Further exploratory studies with MDP theory in other areas in which complex interventions are common would be worthwhile.

  4. Field study comparing the effect of hydraulic mixing on septic tank performance and sludge accumulation.

    Science.gov (United States)

    Almomani, Fares

    2016-01-01

    This study investigates the effect of hydraulic mixing on anaerobic digestion and sludge accumulation in a septic tank. The performance of a septic tank equipped with a hydraulic mixer was compared with that of a similar standard septic tank over a period of 10 months. The study was conducted in two phases: Phase-I--from May to November 2013 (6 months); Phase-II--from January to May 2014 (4 months). Hydraulic mixing effectively reduced the effluent biological oxygen demand (BOD) and total suspended solids, and reduced the sludge accumulation rate in the septic tank. The BOD removal efficiencies during Phase-II were 65% and 75% in the standard septic tank and a septic tank equipped with hydraulic mixer (Smart Digester™), respectively. The effect of hydraulic mixing reduced the rate of sludge accumulation from 0.64 cm/day to 0.27 cm/day, and increased the pump-out interval by a factor of 3.

  5. On the mental representation of negative numbers: context-dependent SNARC effects with comparative judgments.

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    Shaki, Samuel; Petrusic, William M

    2005-10-01

    In one condition, positive and negative number pairs were compared in separate blocks of trials. In another condition, the positive and the negative number pairs were intermixed. In the intermixed condition, comparisons involving negative numbers were faster with the left hand than with the right, and comparisons were faster with the right hand than with the left hand with the positive numbers; that is, a spatial numerical association of response codes (SNARC) effect was obtained, in which the mental number line was extended leftward with the negative numbers. On the other hand, in the blocked condition, a reverse SNARC effect was obtained with the negative numbers; that is, negative number pairs have the same underlying spatial representation as the positive numbers in this context. Nongraded semantic congruity effects, obtained in both the blocked and the intermixed conditions, are consistent with the idea that magnitude information is extracted prior to the generation of discrete semantic codes.

  6. Facial cosmetics have little effect on attractiveness judgments compared with identity.

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    Jones, Alex L; Kramer, S S

    2015-01-01

    The vast majority of women in modern societies use facial cosmetics, which modify facial cues to attractiveness. However, the size of this increase remains unclear--how much more attractive are individuals after an application of cosmetics? Here, we utilised a 'new statistics' approach, calculating the effect size of cosmetics on attractiveness using a within-subjects design, and compared this with the effect size due to identity--that is, the inherent differences in attractiveness between people. Women were photographed with and without cosmetics, and these images were rated for attractiveness by a second group of participants. The proportion of variance in attractiveness explained by identity was much greater than the variance within models due to cosmetics. This result was unchanged after statistically controlling for the perceived amount of cosmetics that each model used. Although cosmetics increase attractiveness, the effect is small, and the benefits of cosmetics may be inflated in everyday thinking.

  7. Genre Matters: A Comparative Study on the Entertainment Effects of 3D in Cinematic Contexts

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    Ji, Qihao; Lee, Young Sun

    2014-09-01

    Built upon prior comparative studies of 3D and 2D films, the current project investigates the effects of 2D and 3D on viewers' perception of enjoyment, narrative engagement, presence, involvement, and flow across three movie genres (Action/fantasy vs. Drama vs. Documentary). Through a 2 by 3 mixed factorial design, participants (n = 102) were separated into two viewing conditions (2D and 3D) and watched three 15-min film segments. Result suggested both visual production methods are equally efficient in terms of eliciting people's enjoyment, narrative engagement, involvement, flow and presence, no effects of visual production method was found. In addition, through examining the genre effects in both 3D and 2D conditions, we found that 3D works better for action movies than documentaries in terms of eliciting viewers' perception of enjoyment and presence, similarly, it improves views' narrative engagement for documentaries than dramas substantially. Implications and limitations are discussed in detail.

  8. Effect of Tool Shoulder and Pin Probe Profiles on Friction Stirred Aluminum Welds - a Comparative Study

    Institute of Scientific and Technical Information of China (English)

    H. K. Mohanty; M. M. Mahapatra; P. Kumar; P. Biswas; N. R. Mandal

    2012-01-01

    In marine application,marine grade steel is generally used for haul and superstructures.However,aluminum has also become a good choice due to its lightweight qualities,while rusting of aluminum is minimal compared to steel.In this paper a study on friction stir welding of aluminum alloys was presented.The present investigation deals with the effects of different friction stir welding tool geometries on mechanical strength and the microstructure properties of aluminum alloy welds.Three distinct tool geometries with different types of shoulder and tool probe profiles were used in the investigation according to the design matrix.The effects of each tool shoulder and probe geometry on the weld was evaluated.It was also observed that the friction stir weld tool geometry has a significant effect on the weldment reinforcement,microhardness,and weld strength.

  9. Comparative effectiveness of intravenous immunoglobulin from different manufacturing processes on Kawasaki disease

    Institute of Scientific and Technical Information of China (English)

    Ming-Chih Lin[

    2014-01-01

    Background: The comparative effectiveness of intravenous immunoglobulin (IVIG) for Kawasaki disease was regarded as inconclusive in the international guidelines. However, several new evidences have been published in recent years. Data sources: A literature search of PubMed was conducted using key words of "Kawasaki disease or mucocutaneous lymph node syndrome" and "immunoglobulin" in combination. Only original articles published after 2004 were selected. A total of 813 papers were found in PubMed. These papers were screened manually by their titles and abstracts. Results: Patients treated with IVIG prepared by betapropiolactonation might have worse outcome (a higher non-responsive rate in one report and a higher rate of coronary aneurysm in two reports). Storage of IVIG in acidic solution might be correlated with a higher rate of coronary aneurysm (two reports). Conclusions: Different processes of preparation and conditions of preservation of IVIG may have profound effects on its clinical effectiveness. Randomized controlled studies are needed to further elucidate this issue.

  10. Comparative effectiveness of intravenous immunoglobulin from different manufacturing processes on Kawasaki disease.

    Science.gov (United States)

    Lin, Ming-Chih

    2014-05-01

    The comparative effectiveness of intravenous immunoglobulin (IVIG) for Kawasaki disease was regarded as inconclusive in the international guidelines. However, several new evidences have been published in recent years. A literature search of PubMed was conducted using key words of "Kawasaki disease or mucocutaneous lymph node syndrome" and "immunoglobulin" in combination. Only original articles published after 2004 were selected. A total of 813 papers were found in PubMed. These papers were screened manually by their titles and abstracts. Patients treated with IVIG prepared by betapropiolactonation might have worse outcome (a higher non-responsive rate in one report and a higher rate of coronary aneurysm in two reports). Storage of IVIG in acidic solution might be correlated with a higher rate of coronary aneurysm (two reports). Different processes of preparation and conditions of preservation of IVIG may have profound effects on its clinical effectiveness. Randomized controlled studies are needed to further elucidate this issue.

  11. Comparative Research of Residents’ Effect Perception and Participation Capacity and Willingness on Pro-poor Tourism

    Institute of Scientific and Technical Information of China (English)

    Guoqing; HUANG; Hong; SHU

    2014-01-01

    In this article,comparative research on residents’ effect perception,participation capacity and willingness on Pro-poor Tourism( PPT) is given based on the questionnaire carried out in Wulong County and Fengjie County in Three Gorges Area,Chongqing,China. Some technologies,such as SPSS 13. 0,ANOVA and T-test are applied to analyze the data and results show Wulong residents’ perception behavior is better than that of Fengjie residents. Moreover,the residents with different demographic characteristics have different participation behavior.Finally,multiple regression analysis is applied to identify the key factors influencing residents’ perception behavior,that is participation willingness and positive economic effect perception,positive social and cultural effect perception and participation capacity.

  12. Comparative effectiveness of combined digital mammography and tomosynthesis screening for women with dense breasts.

    Science.gov (United States)

    Lee, Christoph I; Cevik, Mucahit; Alagoz, Oguzhan; Sprague, Brian L; Tosteson, Anna N A; Miglioretti, Diana L; Kerlikowske, Karla; Stout, Natasha K; Jarvik, Jeffrey G; Ramsey, Scott D; Lehman, Constance D

    2015-03-01

    To evaluate the effectiveness of combined biennial digital mammography and tomosynthesis screening, compared with biennial digital mammography screening alone, among women with dense breasts. An established, discrete-event breast cancer simulation model was used to estimate the comparative clinical effectiveness and cost-effectiveness of biennial screening with both digital mammography and tomosynthesis versus digital mammography alone among U.S. women aged 50-74 years with dense breasts from a federal payer perspective and a lifetime horizon. Input values were estimated for test performance, costs, and health state utilities from the National Cancer Institute Breast Cancer Surveillance Consortium, Medicare reimbursement rates, and medical literature. Sensitivity analyses were performed to determine the implications of varying key model parameters, including combined screening sensitivity and specificity, transient utility decrement of diagnostic work-up, and additional cost of tomosynthesis. For the base-case analysis, the incremental cost per quality-adjusted life year gained by adding tomosynthesis to digital mammography screening was $53 893. An additional 0.5 deaths were averted and 405 false-positive findings avoided per 1000 women after 12 rounds of screening. Combined screening remained cost-effective (less than $100 000 per quality-adjusted life year gained) over a wide range of incremental improvements in test performance. Overall, cost-effectiveness was most sensitive to the additional cost of tomosynthesis. Biennial combined digital mammography and tomosynthesis screening for U.S. women aged 50-74 years with dense breasts is likely to be cost-effective if priced appropriately (up to $226 for combined examinations vs $139 for digital mammography alone) and if reported interpretive performance metrics of improved specificity with tomosynthesis are met in routine practice.

  13. Comparative efficiency research (COMER): meta-analysis of cost-effectiveness studies.

    Science.gov (United States)

    Crespo, Carlos; Monleon, Antonio; Díaz, Walter; Ríos, Martín

    2014-12-22

    The aim of this study was to create a new meta-analysis method for cost-effectiveness studies using comparative efficiency research (COMER). We built a new score named total incremental net benefit (TINB), with inverse variance weighting of incremental net benefits (INB). This permits determination of whether an alternative is cost-effective, given a specific threshold (TINB > 0 test). Before validation of the model, the structure of dependence between costs and quality-adjusted life years (QoL) was analysed using copula distributions. The goodness-of-fit of a Spanish prospective observational study (n = 498) was analysed using the Independent, Gaussian, T, Gumbel, Clayton, Frank and Placket copulas. Validation was carried out by simulating a copula distribution with log-normal distribution for costs and gamma distribution for disutilities. Hypothetical cohorts were created by varying the sample size (n: 15-500) and assuming three scenarios (1-cost-effective; 2-non-cost-effective; 3-dominant). The COMER result was compared to the theoretical result according to the incremental cost-effectiveness ratio (ICER) and the INB, assuming a margin of error of 2,000 and 500 monetary units, respectively. The Frank copula with positive dependence (-0.4279) showed a goodness-of-fit sufficient to represent costs and QoL (p-values 0.524 and 0.808). The theoretical INB was within the 95% confidence interval of the TINB, based on 15 individuals with a probability > 80% for scenarios 1 and 2, and > 90% for scenario 3. The TINB > 0 test with 15 individuals showed p-values of 0.0105 (SD: 0.0411) for scenario 1, 0.613 (SD: 0.265) for scenario 2 and < 0.0001 for scenario 3. COMER is a valid tool for combining cost-effectiveness studies and may be of use to health decision makers.

  14. The Effectiveness of Fissure Sealant Therapy Placed by Professional Complementary to Dentistry Compared with Dentists

    Directory of Open Access Journals (Sweden)

    F Nilchian

    2005-10-01

    , NHS EED, CENTRAL, NHS CRD (National Health System Centre for Review and Dissemination. In addition, a hand search of references has been done after searching relating articles in mentioned databases. Results: The conclusion of the Galloway review (2003 shows that the studies available were not only poor, but also old. They searched from the 1960s, with more coming from the 1970s than from other decades and few of these studies come from the UK. It also recommended that there is a need for rigorous British studies to improve the evidence about effectiveness and cost-effectiveness of PCDs. In updated search for effectiveness of work by PCDs in carrying out fissure sealants, only one of the studies compare the caries preventive effect of fissure sealant placed by PCDs but in the USA and in a single private practice. Folke et al concluded that assistants showed increased risk of failure in occlusal sealants compared with the Hygienists, whereas dentists did not differ significantly from the dental hygienists in one private practice. Conclusion: It can be seen from present review that, some new research has been published after Galloway review, which could answer some of the questions regarding quality of work by PCDs. In this regard further researches need to demonstrate the preventive effectiveness of fissure sealant placed by PCDs in the community services in the UK and compare them with the dentists’ work.

  15. Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study

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    Nasir Nur-Azida

    2010-06-01

    Full Text Available Abstract Background The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. Methods In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml. Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro to see the effectiveness of those dressings by zone of inhibition assays. Results Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Conclusions Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care

  16. Cost-effectiveness of cardiotocography plus ST analysis of the fetal electrocardiogram compared with cardiotocography only.

    Science.gov (United States)

    Vijgen, Sylvia M C; Westerhuis, Michelle E M H; Opmeer, Brent C; Visser, Gerard H A; Moons, Karl G M; Porath, Martina M; Oei, Guid S; Van Geijn, Herman P; Bolte, Antoinette C; Willekes, Christine; Nijhuis, Jan G; Van Beek, Erik; Graziosi, Giuseppe C M; Schuitemaker, Nico W E; Van Lith, Jan M M; Van Den Akker, Eline S A; Drogtrop, Addy P; Van Dessel, Hendrikus J H M; Rijnders, Robbert J P; Oosterbaan, Herman P; Mol, Ben Willem J; Kwee, Anneke

    2011-07-01

    To assess the cost-effectiveness of addition of ST analysis of the fetal electrocardiogram (ECG; STAN) to cardiotocography (CTG) for fetal surveillance during labor compared with CTG only. Cost-effectiveness analysis based on a randomized clinical trial on ST analysis of the fetal ECG. Obstetric departments of three academic and six general hospitals in The Netherlands. Population. Laboring women with a singleton high-risk pregnancy, a fetus in cephalic presentation, a gestational age >36 weeks and an indication for internal electronic fetal monitoring. A trial-based cost-effectiveness analysis was performed from a health-care provider perspective. Primary health outcome was the incidence of metabolic acidosis measured in the umbilical artery. Direct medical costs were estimated from start of labor to childbirth. Cost-effectiveness was expressed as costs to prevent one case of metabolic acidosis. The incidence of metabolic acidosis was 0.7% in the ST-analysis group and 1.0% in the CTG-only group (relative risk 0.70; 95% confidence interval 0.38-1.28). Per delivery, the mean costs per patient of CTG plus ST analysis (n= 2 827) were €1,345 vs. €1,316 for CTG only (n= 2 840), with a mean difference of €29 (95% confidence interval -€9 to €77) until childbirth. The incremental costs of ST analysis to prevent one case of metabolic acidosis were €9 667. The additional costs of monitoring by ST analysis of the fetal ECG are very limited when compared with monitoring by CTG only and very low compared with the total costs of delivery. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Comparing Cost-Effectiveness of HIV Testing Strategies: Targeted and Routine Testing in Washington, DC.

    Directory of Open Access Journals (Sweden)

    Amanda D Castel

    Full Text Available Routine HIV testing is an essential approach to identifying undiagnosed infections, linking people to care and treatment, and preventing new infections. In Washington, DC, where HIV prevalence is 2.4%, a combination of routine and targeted testing approaches has been implemented since 2006.We sought to evaluate the cost effectiveness of the District of Columbia (DC Department of Health's routine and targeted HIV testing implementation strategies. We collected HIV testing data from 3 types of DC Department of Health-funded testing sites (clinics, hospitals, and community-based organizations; collected testing and labor costs; and calculated effectiveness measures including cost per new diagnosis and cost per averted transmission.Compared to routine testing, targeted testing resulted in higher positivity rates (1.33% vs. 0.44%. Routine testing averted 34.30 transmissions per year compared to targeted testing at 17.78. The cost per new diagnosis was lower for targeted testing ($2,467 vs. $7,753 per new diagnosis as was the cost per transmission averted ($33,160 vs. $104,205. When stratified by testing site, both testing approaches were most cost effective in averting new transmissions when conducted by community based organizations ($25,037 routine; $33,123 targeted compared to hospitals or clinics.While routine testing identified more newly diagnosed infections and averted more infections than targeted testing, targeted testing is more cost effective per diagnosis and per transmission averted overall. Given the high HIV prevalence in DC, the DC Department of Health's implementation strategy should continue to encourage routine testing implementation with emphasis on a combined testing strategy among community-based organizations.

  18. Effect of feeding whole compared with cell-free colostrum on calf immune status: Vaccination response.

    Science.gov (United States)

    Langel, S N; Wark, W A; Garst, S N; James, R E; McGilliard, M L; Petersson-Wolfe, C S; Kanevsky-Mullarky, I

    2016-05-01

    Vaccination contributes to improved herd health and production. Boosting immune development at a young age may have long-term effects by enhancing vaccine immune response and efficacy. In the bovine, colostrum is the sole source of maternal immunity, having a substantial effect on health status in the neonate. To date, colostral antibody concentration is used to evaluate colostrum quality. However, colostrum also contains proteins and cells, which may affect immune development and future responses to vaccines. To determine the effect of maternal colostral cells on immune development, 37 female Holstein and Jersey dairy calves were bottle-fed 4 quarts total of whole colostrum (WC) or cell-free colostrum (CFC) at birth. Calves were vaccinated with 2 series of multivalent vaccines. Series A consisted of vaccines given between 1 and 4mo of life. Series B consisted of vaccines given between 5 and 10mo of life. Calf peripheral blood samples were obtained before each vaccination series and monthly for 3mo after each vaccination series. Cellular blood parameters were determined by flow cytometry. Quantitative real-time PCR was used to determine cytokine gene expression in peripheral blood mononuclear cells before vaccination series B and once a month for 2mo after vaccination series B. Calves fed CFC had fewer numbers of B cells in mo 2 after vaccination series A when compared with WC-fed calves. Calves fed CFC had decreased gene expression levels of IL-2 in mo 1 and numbers of CD4(+)CD62L(+)CD45RO(-) and CD4(+)CD62L(+)CD45RO(+) T cells in mo 0 and 1 after vaccination series B as compared with WC-fed calves. Our findings indicate a greater response to vaccines up to 6 to 10mo post-WC feeding when compared with CFC. These data suggest that adoptive transfer of maternal colostral cells at birth has a long-term effect on development of the neonatal immune system.

  19. The Effectiveness of Acupuncture Compared to Loratadine in Patients Allergic to House Dust Mites

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    Bettina Hauswald

    2014-01-01

    Full Text Available Background. The aim of this work was to evaluate the clinical effectiveness of acupuncture and its impact on the immune system in comparison to loratadine in the treatment of persistent allergic rhinitis caused by house dust mites. Methods. In this study, 24 patients suffering from persistent allergic rhinitis induced by house dust mites were treated either with acupuncture (n=15 or with loratadine (n=9. The evaluation of the data was based on the subjective and the objective rhinoconjunctivitis symptom scores, specific and total IgE, and interleukins (IL-4, IL-10, and IFN-γ as markers for the activity of Th1 or Th2 cells. Results. The treatments with acupuncture as well as with loratadine were considered effective in the patients’ subjective assessment, whereby the effect of the acupuncture tended to be assessed as more persistent after the end of treatment. A change in the specific or the total IgE was not detectable in either group. The interleukin profile showed the tendency of an increasing IL-10 value in the acupuncture group. The results of the study show that the effectiveness of acupuncture is comparable to that of loratadine. Conclusion. Acupuncture is a clinically effective form of therapy in the treatment of patients suffering from persistent allergic rhinitis. The results indicate the probability of an immunomodulatory effect.

  20. Effects of persistent insecticides on beneficial soil arthropod in conventional fields compared to organic fields, puducherry.

    Science.gov (United States)

    Anbarashan, Padmavathy; Gopalswamy, Poyyamoli

    2013-07-15

    The usage of synthetic fertilizers/insecticides in conventional farming has dramatically increased over the past decades. The aim of the study was to compare the effects of bio-pesticides and insecticides/pesticides on selected beneficial non targeted arthropods. Orders Collembola, Arachinida/Opiliones, Oribatida and Coleoptera were the main groups of arthropods found in the organic fields and Coleoptera, Oribatida, Gamasida and Collembola in conventional fields. Pesticides/insecticides had a significant effect on non-targeted arthropods order- Collembola, Arachinida/Opiliones, Hymenoptera and Thysonoptera were suppressed after pesticides/insecticides spraying. Bio-insecticides in organic fields had a non-significant effect on non targeted species and they started to increase in abundance after 7 days of spraying, whereas insecticide treatment in conventional fields had a significant long-term effect on non targeted arthropods and short term effect on pests/insects, it started to increase after 21 days of the spraying. These results indicate that insecticide treatment kept non targeted arthropods at low abundance. In conclusion, organic farming does not significantly affected the beneficial-non targeted arthropods biodiversity, whereas preventive insecticide application in conventional fields had significant negative effects on beneficial non targeted arthropods. Therefore, conventional farmers should restrict insecticide applications, unless pest densities reach the thresholds and more desirably can switch to organic farming practices.

  1. Inhibitory Effect of Curcumin on Candida-albicans compared with Nystatin: an in-vitro Study

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    Neda Babaii

    2016-10-01

    Full Text Available Introduction: Curcumin is the active ingredient in the traditional herbal remedy and dietary spice turmeric (Curcuma longa. Curcumin has a surprisingly wide range of beneficial properties, including anti-inflammatory, antioxidant, chemopreventive and chemotherapeutic activity. on basis of recent studies; it has antifungal and antibacterial effects. The aim of this study was in-vitro evaluation of antifungal effect of curcumin on candida albicans and comparing it with nystatin. Methods: after preparing curcumin powder, 3 laboratory methods were used to evaluate antifungal effect. The first method was cell count technique, used to evaluate the amount of candida albicans after time, in different concentrations of curcumin in Dimethyl sulfoxide (DMSO. The second was cup bioassay, in which inhibitory a zone of curcumin in DMSO was evaluated in sabouraud culture plates; and in third method, inhibitory zones of dried disks; which contained curcumin in DMSO were evaluated. Results: the result of all three methods showed that curcumin has antifungal effect and this effect increases in more concentrations. Conclusion: curcumin has apparent and dose dependent antifungal effect on candida albicans.

  2. Comparative Investigation of Protective Effects of Metyrosine and Metoprolol Against Ketamine Cardiotoxicity in Rats.

    Science.gov (United States)

    Ahiskalioglu, Ali; Ince, Ilker; Aksoy, Mehmet; Ahiskalioglu, Elif Oral; Comez, Mehmet; Dostbil, Aysenur; Celik, Mine; Alp, Hamit Hakan; Coskun, Resit; Taghizadehghalehjoughi, Ali; Suleyman, Bahadir

    2015-10-01

    This study investigated the effect of metyrosine against ketamine-induced cardiotoxicity in rats and compared the results with the effect of metoprolol. In this study, rats were divided into groups A, B and C. In group A, we investigated the effects of a single dose of metyrosine (150 mg/kg) and metoprolol (20 mg/kg) on single dose ketamine (60 mg/kg)-induced cardiotoxicity. In group B, we investigated the effect of metyrosine and metoprolol, which were given together with ketamine for 30 days. In group C, we investigated the effect of metyrosine and metoprolol given 15 days before ketamine and 30 days together with ketamine on ketamine cardiotoxicity. By the end of this process, we evaluated the effects of the levels of oxidant-antioxidant parameters such as MDA, MPO, 8-OHGua, tGSH, and SOD in addition to CK-MB and TP I on cardiotoxicity in rat heart tissue. The experimental results show that metyrosine prevented ketamine cardiotoxicity in groups A, B and C and metoprolol prevented it in only group C.

  3. Longer leukocyte telomere length in Costa Rica's Nicoya Peninsula: a population-based study.

    Science.gov (United States)

    Rehkopf, David H; Dow, William H; Rosero-Bixby, Luis; Lin, Jue; Epel, Elissa S; Blackburn, Elizabeth H

    2013-11-01

    Studies in humans suggest that leukocyte telomere length may act as a marker of biological aging. We investigated whether individuals in the Nicoya region of Costa Rica, known for exceptional longevity, had longer telomere length than those in other parts of the country. After controlling for age, age squared, rurality, rainy season and gender, the mean leukocyte telomere length in Nicoya was substantially longer (81 base pairs, ptelomere length that characterizes this unique region does not appear to be explainable by traditional behavioral and biological risk factors. More detailed examination of mean leukocyte telomere length by age shows that the regional telomere length difference declines at older ages.

  4. Endoscopic treatments for Barrett's esophagus: a systematic review of safety and effectiveness compared to esophagectomy

    Directory of Open Access Journals (Sweden)

    Lau Darren

    2010-09-01

    Full Text Available Abstract Background Recently, several new endoscopic treatments have been used to treat patients with Barrett's esophagus with high grade dysplasia. This systematic review aimed to determine the safety and effectiveness of these treatments compared with esophagectomy. Methods A comprehensive literature search was undertaken to identify studies of endoscopic treatments for Barrett's esophagus or early stage esophageal cancer. Information from the selected studies was extracted by two independent reviewers. Study quality was assessed and information was tabulated to identify trends or patterns. Results were pooled across studies for each outcome. Safety (occurrence of adverse events and effectiveness (complete eradication of dysplasia were compared across different treatments. Results The 101 studies that met the selection criteria included 8 endoscopic techniques and esophagectomy; only 12 were comparative studies. The quality of evidence was generally low. Methods and outcomes were inconsistently reported. Protocols, outcomes measured, follow-up times and numbers of treatment sessions varied, making it difficult to calculate pooled estimates. The surgical mortality rate was 1.2%, compared to 0.04% in 2831 patients treated endoscopically (1 death. Adverse events were more severe and frequent with esophagectomy, and included anastomotic leaks (9.4%, wound infections (4.1% and pulmonary complications (4.1%. Four patients (0.1% treated endoscopically experienced bleeding requiring transfusions. The stricture rate with esophagectomy (5.3% was lower than with porfimer sodium photodynamic therapy (18.5%, but higher than aminolevulinic acid (ALA 60 mg/kg PDT (1.4%. Dysphagia and odynophagia varied in frequency across modalities, with the highest rates reported for multipolar electrocoagulation (MPEC. Photosensitivity, an adverse event that occurs only with photodynamic therapy, was experienced by 26.4% of patients who received porfimer sodium. Some

  5. Effects of kinesio tape compared with non-elastic tape on hand grip strength.

    Science.gov (United States)

    Kim, Ji Young; Kim, Seong Yeol

    2016-05-01

    [Purpose] Many assumptions have been made about taping and several studies have considered tape application methods; however, the true effect of taping on muscle strength remains unclear. Most previous studies compared application techniques using Kinesio tape (KT), but studies that compared muscle strength using non-elastic tape (NT) are limited. Moreover, no studies have applied KT and NT in the same way to assess grip strength in normal subjects. The purpose of this study was to evaluate the immediate effect of application of two tapes with different elastic properties on maximal grip strength in healthy adults. [Subjects and Methods] Twenty healthy adults were divided into two groups (KT and NT). Maximal grip strength was measured with a dynamometer. Forearm extensor muscles of the dominant hand were then taped and subjects were immediately asked to perform hand grip movement with maximum strength in the same standardized manner. [Results] In the KT group, maximal grip strength was significantly increased compared to the initial value; however, in the NT group, there was no significant difference in maximal grip strength. [Conclusion] This study suggests that only Kinesio tape can increase maximal grip strength immediately after application on the extensor region of the forearm.

  6. Antimicrobial and cytotoxic effects of phosphoric acid solution compared to other root canal irrigants

    Directory of Open Access Journals (Sweden)

    Maíra PRADO

    2015-04-01

    Full Text Available Phosphoric acid has been suggested as an irrigant due to its effectiveness in removing the smear layer. Objectives : The purpose of this study was to compare the antimicrobial and cytotoxic effects of a 37% phosphoric acid solution to other irrigants commonly used in endodontics. Material and Methods : The substances 37% phosphoric acid, 17% EDTA, 10% citric acid, 2% chlorhexidine (solution and gel, and 5.25% NaOCl were evaluated. The antimicrobial activity was tested against Candida albicans, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Actinomyces meyeri, Parvimonas micra, Porphyromonas gingivalis, and Prevotella nigrescens according to the agar diffusion method. The cytotoxicity of the irrigants was determined by using the MTT assay. Results : Phosphoric acid presented higher antimicrobial activity compared to the other tested irrigants. With regard to the cell viability, this solution showed results similar to those with 5.25% NaOCl and 2% chlorhexidine (gel and solution, whereas 17% EDTA and 10% citric acid showed higher cell viability compared to other irrigants. Conclusion : Phosphoric acid demonstrated higher antimicrobial activity and cytotoxicity similar to that of 5.25% NaOCl and 2% chlorhexidine (gel and solution.

  7. Comparative effects of three beta blockers (atenolol, metoprolol, and propranolol) on survival after acute myocardial infarction.

    Science.gov (United States)

    Gottlieb, S S; McCarter, R J

    2001-04-01

    The beneficial impact of beta blockade after an acute myocardial infarction (AMI) is clear, but beta-adrenergic blockers differ in multiple characteristics, including lipophilicity and selectivity. The impact of these factors on the effects of beta blockade is unknown. We therefore compared the effects of different beta blockers on mortality after AMI. Charts of 201,752 patients with AMI were abstracted by the Cooperative Cardiovascular Project, a quality assurance program sponsored by the Health Care Financing Administration. Of the 69,338 patients prescribed beta blockers, we compared mortality of patients receiving different beta-adrenergic blockers using the Cox proportional-hazards model accounting for multiple factors that might influence survival. The mortality rates of the 2 selective agents, metoprolol and atenolol, were virtually identical (13.5% and 13.4% 2-year mortality, respectively). Compared with metoprolol, patients discharged on propranolol had a slightly increased mortality (15.9% 2-year mortality), which may be related to undetected differences at baseline. Survival with all of the drugs was superior to the 23.9% 2-year mortality seen in patients not receiving beta blockers. Beta blockade overall was associated with a 40% improvement in survival. Although the use of beta blockade after AMI has major prognostic importance, the present study suggests that the specific beta blocker chosen will have little influence on mortality.

  8. Antimicrobial and cytotoxic effects of phosphoric acid solution compared to other root canal irrigants.

    Science.gov (United States)

    Prado, Maíra; Silva, Emmanuel João Nogueira Leal da; Duque, Thais Mageste; Zaia, Alexandre Augusto; Ferraz, Caio Cezar Randi; Almeida, José Flávio Affonso de; Gomes, Brenda Paula Figueiredo de Almeida

    2015-01-01

    Phosphoric acid has been suggested as an irrigant due to its effectiveness in removing the smear layer. The purpose of this study was to compare the antimicrobial and cytotoxic effects of a 37% phosphoric acid solution to other irrigants commonly used in endodontics. The substances 37% phosphoric acid, 17% EDTA, 10% citric acid, 2% chlorhexidine (solution and gel), and 5.25% NaOCl were evaluated. The antimicrobial activity was tested against Candida albicans, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Actinomyces meyeri, Parvimonas micra, Porphyromonas gingivalis, and Prevotella nigrescens according to the agar diffusion method. The cytotoxicity of the irrigants was determined by using the MTT assay. Phosphoric acid presented higher antimicrobial activity compared to the other tested irrigants. With regard to the cell viability, this solution showed results similar to those with 5.25% NaOCl and 2% chlorhexidine (gel and solution), whereas 17% EDTA and 10% citric acid showed higher cell viability compared to other irrigants. Phosphoric acid demonstrated higher antimicrobial activity and cytotoxicity similar to that of 5.25% NaOCl and 2% chlorhexidine (gel and solution).

  9. Effects of kinesio tape compared with non-elastic tape on hand grip strength

    Science.gov (United States)

    Kim, Ji Young; Kim, Seong Yeol

    2016-01-01

    [Purpose] Many assumptions have been made about taping and several studies have considered tape application methods; however, the true effect of taping on muscle strength remains unclear. Most previous studies compared application techniques using Kinesio tape (KT), but studies that compared muscle strength using non-elastic tape (NT) are limited. Moreover, no studies have applied KT and NT in the same way to assess grip strength in normal subjects. The purpose of this study was to evaluate the immediate effect of application of two tapes with different elastic properties on maximal grip strength in healthy adults. [Subjects and Methods] Twenty healthy adults were divided into two groups (KT and NT). Maximal grip strength was measured with a dynamometer. Forearm extensor muscles of the dominant hand were then taped and subjects were immediately asked to perform hand grip movement with maximum strength in the same standardized manner. [Results] In the KT group, maximal grip strength was significantly increased compared to the initial value; however, in the NT group, there was no significant difference in maximal grip strength. [Conclusion] This study suggests that only Kinesio tape can increase maximal grip strength immediately after application on the extensor region of the forearm. PMID:27313372

  10. Diabetes mellitus and hypertension have comparable adverse effects on health-related quality of life

    Directory of Open Access Journals (Sweden)

    Metelko Željko

    2010-01-01

    Full Text Available Abstract Background We aimed to assess health-related quality of life (HRQoL among people with diabetes or hypertension, estimate the effect of cardiovascular comorbidities on HRQoL as well as compare HRQoL in these groups with that of healthy individuals. Methods A total of 9,070 respondents aged 18 years and over were assessed for HRQoL. Data were obtained from the Croatian Adult Health Survey. Respondents were divided into five groups according to their medical history: participants with hypertension (RR, hypertension and cardiovascular comorbidities (RR+, diabetes mellitus (DM, diabetes and cardiovascular comorbidities (DM+ and participants free of these conditions (healthy individuals, HI. HRQoL was assessed on 8 dimensions of the SF-36 questionnaire. Results Participants with diabetes and those with hypertension reported comparably limited (p > 0.05 HRQoL in all dimensions of SF-36, compared with healthy individuals (p 0.05 than participants without such comorbidities (p Conclusion Diabetes and hypertension seem to comparably impair HRQoL. Cardiovascular comorbidities further reduce HRQoL in participants with both chronic conditions. Future research of interventions aimed at improving these participants' HRQoL is needed.

  11. COMPARATIVE EFFECTIVENESS OF AN ADJUSTABLE TRANSFEMORAL PROSTHETIC INTERFACE ACCOMMODATING VOLUME FLUCTUATION: CASE STUDY.

    Science.gov (United States)

    Kahle, Jason T; Klenow, Tyler D; Highsmith, M Jason

    2016-09-01

    The socket-limb interface is vital for functionality and provides stability and mobility for the amputee. Volume fluctuation can lead to compromised fit and function. Current socket technology does not accommodate for volume fluctuation. An adjustable interface may improve function and comfort by filling this technology gap. The purpose of this study was to compare the effectiveness of the standard of care (SOC) ischial ramus containment to an adjustable transfemoral prosthetic interface socket in the accommodation of volume fluctuation. A prospective experimental case study using repeated measures of subjective and performance outcome measures between socket conditions was employed. In the baseline volume condition, the adjustable socket improved subjective and performance measures 19% to 37% over SOC, whereas the two-minute walk test demonstrated equivalence. In the volume loss condition, the adjustable socket improved all subjective and performance measures 22% to 93%. All aggregated data improved 16% to 50% compared with the SOC. In simulated volume gain, the SOC socket failed, while the subject was able to complete the protocol using the adjustable socket. In this case study, the SOC socket was inferior to the comparative adjustable transfemoral amputation interface in subjective and performance outcomes. There is a lack of clinical trials and evidence comparing socket functional outcomes related to volume fluctuation.

  12. COMPARATIVE EFFECTIVENESS OF AN ADJUSTABLE TRANSFEMORAL PROSTHETIC INTERFACE ACCOMMODATING VOLUME FLUCTUATION: CASE STUDY

    Science.gov (United States)

    Kahle, Jason T.; Klenow, Tyler D.; Highsmith, M. Jason

    2016-01-01

    The socket-limb interface is vital for functionality and provides stability and mobility for the amputee. Volume fluctuation can lead to compromised fit and function. Current socket technology does not accommodate for volume fluctuation. An adjustable interface may improve function and comfort by filling this technology gap. The purpose of this study was to compare the effectiveness of the standard of care (SOC) ischial ramus containment to an adjustable transfemoral prosthetic interface socket in the accommodation of volume fluctuation. A prospective experimental case study using repeated measures of subjective and performance outcome measures between socket conditions was employed. In the baseline volume condition, the adjustable socket improved subjective and performance measures 19% to 37% over SOC, whereas the two-minute walk test demonstrated equivalence. In the volume loss condition, the adjustable socket improved all subjective and performance measures 22% to 93%. All aggregated data improved 16% to 50% compared with the SOC. In simulated volume gain, the SOC socket failed, while the subject was able to complete the protocol using the adjustable socket. In this case study, the SOC socket was inferior to the comparative adjustable transfemoral amputation interface in subjective and performance outcomes. There is a lack of clinical trials and evidence comparing socket functional outcomes related to volume fluctuation. PMID:28066526

  13. Longer length of first stay in intermittent residential programmes is associated with larger weight loss at 1 and 2 years.

    Science.gov (United States)

    Martins, Catia; Strommen, Magnus; Kulseng, Bård

    2013-01-01

    To determine if length of first stay impacts on weight loss and cardiovascular fitness, at 1 and 2 years in severely obese patients enrolled in intermittent residential programs. In a retrospective follow-up study, we assessed weight loss and changes in cardiovascular fitness (VO₂ peak) at 1 and 2 years in 179 severely obese adults who participated in two intermittent residential programmes. Both programmes consisted of five stays at the Røros Rehabilitation Centre over a 2-year period, but programme A consisted of a much longer first stay compared with programme B (8 vs. 2 weeks). Of 179 participants (BMI 44 ± 6 kg/m²), 162 completed 1-year and 117 2-year evaluation. Programme A led to significantly larger weight reduction (-20.7 ± 10.8 vs. -13.5 ± 8.1 kg and -16.0 ± 12.7 vs. -7.9 ± 11.2 kg, p < 0.0001) and improvement in VO₂ peak (7.8 vs. 3.6 ml/kg/min (p < 0.0001) and 5.6 vs. 2.5 ml/kg/min (p < 0.01)) at both 1 and 2 years, compared with programme B. Intention-to-treat analysis showed similar results. A residential intermittent programme with a longer initial stay is associated with better weight loss and improvement in cardiovascular fitness at both 1 and 2 years. A longer follow-up is needed to clearly establish the sustainability of these programmes. Copyright © 2013 S. Karger GmbH, Freiburg

  14. Assessing the comparative effectiveness of newly marketed medications: methodological challenges and implications for drug development.

    Science.gov (United States)

    Schneeweiss, S; Gagne, J J; Glynn, R J; Ruhl, M; Rassen, J A

    2011-12-01

    Comparative-effectiveness research (CER) aims to produce actionable evidence regarding the effectiveness and safety of medical products and interventions as they are used outside of controlled research settings. Although CER evidence regarding medications is particularly needed shortly after market approval, key methodological challenges include (i) potential bias due to channeling of patients to the newly marketed medication because of various patient-, physician-, and system-related factors; (ii) rapid changes in the characteristics of the user population during the early phase of marketing; and (iii) lack of timely data and the often small number of users in the first few months of marketing. We propose a mix of approaches to generate comparative-effectiveness data in the early marketing period, including sequential cohort monitoring with secondary health-care data and propensity score (PS) balancing, as well as extended follow-up of phase III and phase IV trials, indirect comparisons of placebo-controlled trials, and modeling and simulation of virtual trials.

  15. Comparing the Effect of Different Bleaching Regims of Carbamide Peroxide on Microhardness of Z250 Composite

    Directory of Open Access Journals (Sweden)

    B Esmaeili

    2015-11-01

    Full Text Available Introduction: Bleaching products with oxidizing mechanism can exert side effects on the restorative materials existing in the oral cavity. Since bleaching agents are applied in different concentrations, the present study aimed to compare the effect of different bleaching regims of carbamide peroxide on microhardness of Z250 microhybride composite. Methods: In this in vitro study , 32 specimens of micro hybride composite (Z250 were made which were randomly divided into 4 subgroups (n=8: G1: bleached with10% carbamide peroxide 4 hours a day for 2 weeks G2: bleached with 16%carbamide peroxide 3 hours a day for 2 weeks G3: bleached with 22%carbamide peroxide 1hour a day for 2 weeks G4: the control subgroup stored in distilled water at 37◦c for 2 weeks. Microhardness of specimens was measured before and after bleaching using Vickers hardness testing machine. Moreover, the study data were analyzed statistically applying Anova and t-test (&alpha= 0.05. Results: This study findings revealed that using bleaching agent significantly decreased the  microhardness of composite resin in the bleaching groups compared to the control group, though the concentration of carbamide peroxide produced no significant effect on the microhardness value. (p>0.13 Conclusion: Bleaching therapy can cause a reduction in microhardness of Z250 composite and different concentrations of carbamide peroxide can reduce microhardness of Z250 to the same value.

  16. Comparing the effects of Calendula officinalis and clotrimazole on vaginal Candidiasis: A randomized controlled trial.

    Science.gov (United States)

    Saffari, Elnaz; Mohammad-Alizadeh-Charandabi, Sakineh; Adibpour, Mohammad; Mirghafourvand, Mojgan; Javadzadeh, Yousef

    2016-11-23

    This triple-blind trial examined the effects of Calendula officinalis vaginal cream on the treatment of vaginal Candidiasis (primary outcome) and sexual function (secondary outcome). Married women aged 18-45 years with vaginal Candidiasis (n = 150) were recruited from April to October 2014 and randomized into Calendula and clotrimazole groups, using 5-g vaginal cream every night for seven nights. Clinical and laboratory assessments were conducted at 10-15 and 30-35 days after intervention and the female sexual function index was assessed at 30-35 days. Six women were lost to follow-up. The frequency of testing negative for Candidiasis in the Calendula group was significantly lower at the first (49% vs. 74%; odds ratio (OR) 0.32; 95% confidence interval (CI) 0.16-0.67) but higher at the second (77% vs. 34%; OR 3.1; 95% CI 1.5-6.2) follow-up compared to the clotrimazole group. The frequency of most signs and symptoms were almost equal in the two groups at the first follow-up, but were significantly lower in the Calendula group at the second follow-up. Sexual function had almost equal significant improvement in both groups. Calendula vaginal cream appears to have been effective in the treatment of vaginal Candidiasis and to have a delayed but greater long-term effect compared to clotrimazole.

  17. Antibacterial Effect of Essential Vegetal Extracts on Staphylococcus aureus Compared to Antibiotics

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    Nicodim Iosif FIT

    2009-11-01

    Full Text Available This study is aiming to evaluate the antimicrobial activity of ten essential vegetal extracts on strains of Staphylococcus aureus isolated from animal lesions. The comparative effect of some antibiotics on these strains isolated from animals was also tested and estimated. The extracts were represented by Albies alba, Aloe barbadensis, Calendula officinalis, Cocos nucifera, Eucalyptus globulus, Hypericum perforatum, Lavandula angustifolia, Satureja hortensis, Mentha piperita, Pinus silvestris essential oils, in three amounts (30 μl, 3 μl and 0,3 μl and comparatively eight antibiotics frequently utilized in staphylococci infections treatment in animals were used. Animal origin S. aureus strains were identified using API staph tests (BioMerieux, France. The tests were realized by diffusion method using Muller Hilton agar while the antibacterial effect was interpreted depending on the inhibition area diameter. The obtained results revealed that Satureja hortensis and Albies alba extracts inhibit the develop of the most staphylococci tested strains. The highest inhibition areas were observed for the amounts of 30 μl and 3 μl essential extract. Most of the staphylococci strains were resistant to antibiotics, the most efficient being Ceftiofur and Methicillin. The results are suggesting that savory and fir has antibacterial effect on S. aureus similar to the best antibiotics proving to be an alternative as natural antibiotics utilization in infectious diseases.

  18. Firm insoles effectively reduce hemolysis in runners during long distance running - a comparative study.

    Science.gov (United States)

    Janakiraman, Kamal; Shenoy, Shweta; Sandhu, Jaspal Singh

    2011-06-09

    Shock absorbing insoles are effective in reducing the magnitude and rate of loading of peak impact forces generated at foot strike during running, whereas the foot impact force during running has been considered to be an important cause of intravascular hemolysis in long distance runners. Objective of this study was to evaluate the intravascular hemolysis during running and compare the effect of two different types of insoles (Soft and Firm) on hemolysis. Twenty male long and middle distance runners volunteered to participate in this study. We selected two insoles (Soft and Firm) according to their hardness level (SHORE 'A' scale). Participants were randomly assigned to the soft insole (group 1) and firm insole (group 2) group with ten athletes in each group. Each athlete completed one hour of running at the calculated target heart rate (60-70%). Venous blood samples were collected before and immediately after running. We measured unconjucated bilirubin (mg/dl), lactate dehydrogenase (μ/ml), hemoglobin (g/l) and serum ferritin (ng/ml) as indicators of hemolysis. Our study revealed a significant increase in the mean values of unconjucated bilirubin (P running with soft insoles indicating the occurrence of hemolysis in this group of athletes. Graphical analysis revealed an inverse relationship between hardness of insoles and hemolysis for the observed values. Our results indicate that intravascular hemolysis occurs in athletes during long distance running and we conclude that addition of firm insoles effectively reduces the amount of hemolysis in runners compared to soft insoles.

  19. Firm insoles effectively reduce hemolysis in runners during long distance running - a comparative study

    Directory of Open Access Journals (Sweden)

    Janakiraman Kamal

    2011-06-01

    Full Text Available Abstract Background Shock absorbing insoles are effective in reducing the magnitude and rate of loading of peak impact forces generated at foot strike during running, whereas the foot impact force during running has been considered to be an important cause of intravascular hemolysis in long distance runners. Objective of this study was to evaluate the intravascular hemolysis during running and compare the effect of two different types of insoles (Soft and Firm on hemolysis. Methods Twenty male long and middle distance runners volunteered to participate in this study. We selected two insoles (Soft and Firm according to their hardness level (SHORE 'A' scale. Participants were randomly assigned to the soft insole (group 1 and firm insole (group 2 group with ten athletes in each group. Each athlete completed one hour of running at the calculated target heart rate (60-70%. Venous blood samples were collected before and immediately after running. We measured unconjucated bilirubin (mg/dl, lactate dehydrogenase (μ/ml, hemoglobin (g/l and serum ferritin (ng/ml as indicators of hemolysis. Results Our study revealed a significant increase in the mean values of unconjucated bilirubin (P Conclusion Our results indicate that intravascular hemolysis occurs in athletes during long distance running and we conclude that addition of firm insoles effectively reduces the amount of hemolysis in runners compared to soft insoles.

  20. Integrating economic evaluation methods into clinical and translational science award consortium comparative effectiveness educational goals.

    Science.gov (United States)

    Iribarne, Alexander; Easterwood, Rachel; Russo, Mark J; Wang, Y Claire

    2011-06-01

    With the ongoing debate over health care reform in the United States, public health and policy makers have paid growing attention to the need for comparative effectiveness research (CER). Recent allocation of federal funds for CER represents a significant move toward increased evidence-based practice and better-informed allocation of constrained health care resources; however, there is also heated debate on how, or whether, CER may contribute to controlling national health care expenditures. Economic evaluation, in the form of cost-effectiveness or cost-benefit analysis, is often an aspect of CER studies, yet there are no recommendations or guidelines for providing clinical investigators with the necessary skills to collect, analyze, and interpret economic data from clinical trials or observational studies. With an emphasis on multidisciplinary research, the Clinical and Translational Science Award (CTSA) consortium and institutional CTSA sites serve as an important resource for training researchers to engage in CER. In this article, the authors discuss the potential role of CTSA sites in integrating economic evaluation methods into their comparative effectiveness education goals, using the Columbia University Medical Center CTSA as an example. By allowing current and future generations of clinical investigators to become fully engaged not only in CER but also in the economic evaluations that result from such analyses, CTSA sites can help develop the necessary foundation for advancing research to guide clinical decision making and efficient use of limited resources.

  1. A comparative study of the effect of clonidine and tramadol on post-spinal anaesthesia shivering

    Directory of Open Access Journals (Sweden)

    Usha Shukla

    2011-01-01

    Full Text Available The aim of this study was to evaluate the efficacy, potency and side effects of clonidine as compared to tramadol in post-spinal anaesthesia shivering. In this prospective double-blind randomized controlled clinical trial, 80 American Society of Anaesthesiologists grade-l (ASAI patients aged between 18 and 45 years scheduled for various surgical procedures under spinal anaesthesia, who developed shivering were selected.The patients were divided into two groups: Group C (n=40 comprised of patients who received clonidine 0.5mg/kg intravenously (IV and group patients who received tramadol 0.5 mg/kg IV. Grade of shivering, disappearance of shivering, haemodynamics and side effects were observed at scheduled intervals. Disappearance of shivering was significantly earlier in group C (2.54±0.76 than in group T (5.01±1.02 (P=.0000001. Response rate to treatment in group C was higher (97.5% than in group T (92.5%, but the difference was not significant. Nausea, vomiting and dizziness were found to be higher in group T (P=0.001, 0.005, 0.001, respectively, while the patients in group C were comparatively more sedated (sedation level, 2; group C, 25%. We conclude that clonidine gives better thermodynamics than tramadol, with fewer side effects.

  2. Relations and effects of transformational leadership: a comparative analysis with traditional leadership styles.

    Science.gov (United States)

    Molero, Fernando; Cuadrado, Isabel; Navas, Marisol; Morales, J Francisco

    2007-11-01

    This study has two main goals: (a) to compare the relationship between transformational leadership and other important leadership styles (i.e., democratic versus autocratic or relations- and task-oriented leadership) and (b) to compare the effects of transformational leadership and the other styles on some important organizational outcomes such as employees' satisfaction and performance. For this purpose, a sample of 147 participants, working in 35 various work-teams, was used. Results show high correlations between transformational leadership, relations-oriented, democratic, and task-oriented leadership. On the other hand, according to the literature, transformational leadership, especially high levels, significantly increases the percentage of variance accounted for by other leadership styles in relevant organizational outcome variables (subordinates' performance, satisfaction and extra effort).

  3. Comparative effects of dietary corn, fish and Krill oils on intestinal glycosylation.

    Science.gov (United States)

    Ruggiero-Lopez, D; Servetto, C; Lopez, E; Lenoir, D; Alallon, W; Biol, M C; Louisot, P; Martin, A

    1994-08-01

    Antarctic Krill is considered as a valuable protein resource for animal and human nutrition. Due to the high content of long chain polyunsaturated fatty acids of the n-3 family, Krill consumption could be also interesting in cardiovascular diseases. In the search for the demonstration of the absence of toxicity of Krill, we studied the effect of Krill oil, as compared to fish and corn oil, on the rat intestinal fucosylation process at weaning, a very sensitive model of the influence of nutritional factors. Krill oil containing diets were very well tolerated as compared to other currently used oils and induced only slight modification in fucose and mannose proportions in intestinal glycoprotein sugars. These modifications were not reflected in the enzymatic activities involved in the fucosylation pathway. These results confirm the harmlessness of Krill derived products and their possible use in human nutrition.

  4. COMPARING THE EFFECTS OF VARIOUS WHOLE-BODY VIBRATION ACCELERATIONS ON COUNTER-MOVEMENT JUMP PERFORMANCE

    Directory of Open Access Journals (Sweden)

    David M. Bazett-Jones

    2008-03-01

    Full Text Available While it seems that whole body vibration (WBV might be an effective modality to enhance physical performance, the proper prescription of WBV for performance enhancement remains unknown. The purpose of this study was to compare the immediate effect of various WBV accelerations on counter movement jump (CMJ height, the duration of any effect, and differences between men and women. Forty-four participants (33 men, 11 women participated in no less than four CMJ familiarization sessions and completed all vibration sessions. Participants performed a pre-test (three maximal CMJs, followed randomly by one of five WBV accelerations; 1g (no-WBV control, 2.16g, 2.80g, 4.87g, and 5.83g. Participants performed three maximal CMJs immediately, five, and 10 minutes following each 45 sec WBV session. The mean of the three performances was used and calculated as a percentage of the pre-vibration mean value. A Repeated Measures Analysis of Variance (ANOVA; acceleration x time x gender model was used to analyze the data. The two-way interactions of acceleration-gender (p = 0.033 and time-gender (p = 0.050 were significant. Women performed significantly better following the 2.80g (p = 0.0064 and 5.83g (p = 0. 0125 WBV sessions compared to the 1g (control session. Men, however, did not experience performance enhancing effects following any of the vibration sessions. While significant differences did not occur between time in either gender, the effects of the 45 sec WBV session in women were transient, lasting approximately five minutes. During the prescription of WBV, gender should be considered given that the results of this study seem to indicate that men and women respond differently to WBV. The results of this study suggest that WBV might be a useful modality as applied during the pre-competition warm-up

  5. Comparative effectiveness of topical drugs in dermatologic priority diseases: geometry of randomized trial networks.

    Science.gov (United States)

    Maruani, Annabel; Samimi, Mahtab; Lorette, Gérard; le Cleach, Laurence

    2015-01-01

    Among the 100 initial priority topics for comparative effectiveness research, three concern topical drugs in the following dermatologic diseases: psoriasis, chronic lower-extremity wounds (CLEWs), and acne vulgaris (AV). Our objective was to explore the geometry of the corresponding networks of randomized controlled trials (RCTs). We performed a review of RCTs on topical drugs in psoriasis, CLEWs, and AV. We searched MEDLINE, Embase, and CENTRAL for published trials from 2007 to 2012 and ClinicalTrials.gov for unpublished trials registered since 2011. RCTs comparing at least one topical treatment with any active or inactive comparator, regardless of RCT design and outcomes, were eligible. We produced network graphs (each node representing a treatment and links between nodes representing trials) and tested for co-occurrence (preference or avoidance of specific comparisons). We included 60 RCTs on psoriasis (14,255 patients) and 19 registered RCTs, 50 of CLEWs (5,916 patients) and 7 registered RCTs, and 90 of AV (22,984 patients) and 21 registered RCTs. Head-to-head comparisons were made in 78%, 32%, and 57% of published RCTs of these conditions, respectively. The co-occurrence test suggested that no specific head-to-head comparison was significantly preferred or avoided (P-value=0.53, 0.20, and 0.57, respectively). This study has limitations, the main being that the search period was restricted to 5 years. In conclusion, more comparative effectiveness trials are needed for CLEWs, for which head-to-head comparisons are fewer than those for psoriasis and AV.

  6. Effects of iloprost on bleomycin-induced pulmonary fibrosis in rats compared with methyl-prednisolone.

    Science.gov (United States)

    Aytemur, Z A; Hacievliyagil, S S; Iraz, M; Samdanci, E; Ozerol, E; Kuku, I; Nurkabulov, Z; Yildiz, K

    2012-01-01

    Prostacyclin (PGI2) has been shown to inhibit the expression of pro-inflammatory and pro-fibrotic mediators in pulmonary fibrosis. In this study, we aimed to test the preventive effects of intraperitoneally administered iloprost, a stable PGI2 analog, on bleomycin-induced pulmonary fibrosis in rats and to compare the effects of iloprost with the effects of methyl-prednisolone, a traditional therapy. Rats were randomly allocated into four groups: 1. Saline alone (n=6); 2. Bleomycin+placebo (n=7); 3. Bleomycin+methyl-prednisolone (n=7); 4. Bleomycin+iloprost (n=7). Fibrotic changes in the lungs were demonstrated by analyzing the cellular composition of bronchoalveolar lavage fluid, histological evaluation and lung hydroxyproline content. Fibrosis was made in the lungs of rats by bleomycin experimentally. Fibrosis scores in the methyl-prednisolone and the iloprost groups were significantly lower than in the placebo group (piloprost group was significantly lower than the score of the methyl-prednisolone group. The hydroxyproline content was significantly less in the methyl-prednisolone and the iloprost groups (pIloprost has protective effect on the pulmonary fibrosis induced by bleomycin and it may be more effective in decreasing fibrotic changes than methyl-prednisolone. Copyright © 2011 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  7. Comparative study of the antitumor effect of natural monoterpenes: relationship to cell cycle analysis

    Directory of Open Access Journals (Sweden)

    Abdeslam Jaafari

    2012-06-01

    Full Text Available Monoterpenes have been identified as responsible of important therapeutic effects of plant-extracts. In this work, we try to compare the cytotoxic effect of six monoterpenes (carvacrol, thymol, carveol, carvone, eugenol and isopulegol as well as their molecular mechanisms. The in vitro antitumor activity of the tested products, evaluated against five tumor cell lines, show that the carvacrol is the most cytotoxic monoterpene. The investigation of an eventual synergistic effect of the six natural monoterpenes with two anticancer drugs revealed that there is a significant synergy between them (p<5%. On the other hand, the effect of the tested products on cell cycle progression was examined by flow cytometry after DNA staining in order to investigate the molecular mechanism of their cytotoxic activity. The results revealed that carvacrol and carveol stopped the cell cycle progression in S phase; however, thymol and isopulegol stopped it in G0/G1 phase. Regarding carvone and eugenol, no effect on cell cycle was observed.

  8. Periastron Advance in Spinning Black Hole Binaries: Comparing Effective-One-Body and Numerical Relativity

    CERN Document Server

    Hinderer, Tanja; Mroué, Abdul H; Hemberger, Daniel A; Lovelace, Geoffrey; Pfeiffer, Harald P

    2013-01-01

    We compute the periastron advance using the effective-one-body formalism for binary black holes moving on quasi-circular orbits and having spins collinear with the orbital angular momentum. We compare the predictions with the periastron advance recently computed in accurate numerical-relativity simulations and find remarkable agreement for a wide range of spins and mass ratios. These results do not use any numerical-relativity calibration of the effective-one-body model, and stem from two key ingredients in the effective-one-body Hamiltonian: (i) the mapping of the two-body dynamics of spinning particles onto the dynamics of an effective spinning particle in a (deformed) Kerr spacetime, fully symmetrized with respect to the two-body masses and spins, and (ii) the resummation, in the test-particle limit, of all post-Newtonian (PN) corrections linear in the spin of the particle. In fact, even when only the leading spin PN corrections are included in the effective-one-body spinning Hamiltonian but all the test-p...

  9. Comparing the level of bystander effect in a couple of tumor and normal cell lines.

    Science.gov (United States)

    Soleymanifard, Shokouhozaman; Bahreyni, Mohammad T Toossi

    2012-04-01

    Radiation-induced bystander effect refers to radiation responses which occur in non-irradiated cells. The purpose of this study was to compare the level of bystander effect in a couple of tumor and normal cell lines (QU-DB and MRC5). To induce bystander effect, cells were irradiated with 0.5, 2, and 4 Gy of (60)Co gamma rays and their media were transferred to non-irradiated (bystander) cells of the same type. Cells containing micronuclei were counted in bystander subgroups, non-irradiated, and 0.5 Gy irradiated cells. Frequencies of cells containing micronuclei in QU-DB bystander subgroups were higher than in bystander subgroups of MRC5 cells (P bystander cells, a dose-dependent increase in the number of micronucleated cells was observed as the dose increased, but at all doses the number of micronucleated cells in MRC5 bystander cells was constant. It is concluded that QU-DB cells are more susceptible than MRC5 cells to be affected by bystander effect, and in the two cell lines there is a positive correlation between DNA damages induced directly and those induced due to bystander effect.

  10. Comparative Study on Prediction Effects of Short Fatigue Crack Propagation Rate by Two Different Calculation Methods

    Science.gov (United States)

    Yang, Bing; Liao, Zhen; Qin, Yahang; Wu, Yayun; Liang, Sai; Xiao, Shoune; Yang, Guangwu; Zhu, Tao

    2017-05-01

    To describe the complicated nonlinear process of the fatigue short crack evolution behavior, especially the change of the crack propagation rate, two different calculation methods are applied. The dominant effective short fatigue crack propagation rates are calculated based on the replica fatigue short crack test with nine smooth funnel-shaped specimens and the observation of the replica films according to the effective short fatigue cracks principle. Due to the fast decay and the nonlinear approximation ability of wavelet analysis, the self-learning ability of neural network, and the macroscopic searching and global optimization of genetic algorithm, the genetic wavelet neural network can reflect the implicit complex nonlinear relationship when considering multi-influencing factors synthetically. The effective short fatigue cracks and the dominant effective short fatigue crack are simulated and compared by the Genetic Wavelet Neural Network. The simulation results show that Genetic Wavelet Neural Network is a rational and available method for studying the evolution behavior of fatigue short crack propagation rate. Meanwhile, a traditional data fitting method for a short crack growth model is also utilized for fitting the test data. It is reasonable and applicable for predicting the growth rate. Finally, the reason for the difference between the prediction effects by these two methods is interpreted.

  11. EFFECT OF COGNITIVE BEHAVIOR THERAPY AS COMPARED TO MYOFASCIAL RELEASE TECHNIQUE IN FIBROMYALGIA SYNDROME

    Directory of Open Access Journals (Sweden)

    Kaur kusumpreet

    2013-10-01

    Full Text Available Background and introduction:Fibromyalgia or fibromyalgic syndrome is a common form of non-articularrheumatism characterized by variety of non-specific symptoms including diffuse widespread musculoskeletalaching associated with fatigue, morning stiffness and sleep disturbances (Bennett, 1997. The current study willcompare the beneficial effects of Cognitive behavior therapy (CBT and Myofascial release (MFR along withconventional treatment. This study tries to find out new effective method for reducing the problemsof pain,anxiety and sleep disturbance in fibromyalgia.Method:24 subjects selected according to the inclusion andexclusion criteria were randomly divided in to three groups: Conventional group, Myofascial releasealong withconventional treatment and Cognitive behavior therapy along with conventional treatment. Pre and post readingsat 0 day, 7thday and 14thday were recorded for Fibromyalgia Impact Questionnaire (FIQ, Epworth SleepinessScale (ESS and State Trait Anxiety Inventory (STAI.Results:After two week protocol it was found that all threetreatment approaches were effective in reducing the problem of pain, anxiety and sleep disturbance to someextent. However on comparing three treatment approaches , CBT is the most effective in reducing theaboveparameters. (p<0.05Conclusion:Cognitive behavior therapy is more effective than Myofascial release tehniquesin reducing fibromyalgia symptoms.

  12. The joint flanker effect and the joint Simon effect: On the comparability of processes underlying joint compatibility effects.

    Science.gov (United States)

    Dittrich, Kerstin; Bossert, Marie-Luise; Rothe-Wulf, Annelie; Klauer, Karl Christoph

    2017-09-01

    Previous studies observed compatibility effects in different interference paradigms such as the Simon and flanker task even when the task was distributed across two co-actors. In both Simon and flanker tasks, performance is improved in compatible trials relative to incompatible trials if one actor works on the task alone as well as if two co-actors share the task. These findings have been taken to indicate that actors automatically co-represent their co-actor's task. However, recent research on the joint Simon and joint flanker effect suggests alternative non-social interpretations. To which degree both joint effects are driven by the same underlying processes is the question of the present study, and it was scrutinized by manipulating the visibility of the co-actor. While the joint Simon effect was not affected by the visibility of the co-actor, the joint flanker effect was reduced when participants did not see their co-actors but knew where the co-actors were seated. These findings provide further evidence for a spatial interpretation of the joint Simon effect. In contrast to recent claims, however, we propose a new explanation of the joint flanker effect that attributes the effect to an impairment in the focusing of spatial attention contingent on the visibility of the co-actor.

  13. Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial.

    Science.gov (United States)

    Wang, Chenchen; Schmid, Christopher H; Iversen, Maura D; Harvey, William F; Fielding, Roger A; Driban, Jeffrey B; Price, Lori Lyn; Wong, John B; Reid, Kieran F; Rones, Ramel; McAlindon, Timothy

    2016-07-19

    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. To compare Tai Chi with standard physical therapy for patients with knee osteoarthritis. Randomized, 52-week, single-blind comparative effectiveness trial. (ClinicalTrials.gov: NCT01258985). An urban tertiary care academic hospital. 204 participants with symptomatic knee osteoarthritis (mean age, 60 years; 70% women; 53% white). Tai Chi (2 times per week for 12 weeks) or standard physical therapy (2 times per week for 6 weeks, followed by 6 weeks of monitored home exercise). The primary outcome was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at 12 weeks. Secondary outcomes included physical function, depression, medication use, and quality of life. At 12 weeks, the WOMAC score was substantially reduced in both groups (Tai Chi, 167 points [95% CI, 145 to 190 points]; physical therapy, 143 points [CI, 119 to 167 points]). The between-group difference was not significant (24 points [CI, -10 to 58 points]). Both groups also showed similar clinically significant improvement in most secondary outcomes, and the benefits were maintained up to 52 weeks. Of note, the Tai Chi group had significantly greater improvements in depression and the physical component of quality of life. The benefit of Tai Chi was consistent across instructors. No serious adverse events occurred. Patients were aware of their treatment group assignment, and the generalizability of the findings to other settings remains undetermined. Tai Chi produced beneficial effects similar to those of a standard course of physical therapy in the treatment of knee osteoarthritis. National Center for Complementary and Integrative Health of the National Institutes of Health.

  14. The Comparative effects of synthetic choline and herbal choline on hepatic lipid metabolism in broilers

    Directory of Open Access Journals (Sweden)

    G.R.Gangane1

    Full Text Available An experiment of 0-42 days in day old 150 Vencobb broiler chickens was conducted to determine comparative effects of synthetic choline and herbal sources of choline on hepatic lipid metabolism in broilers. Birds were randomly distributed into three groups (T0- T2, one untreated control and two treatments. Chicks in Group T0 were given feed without any additional source choline chloride. Chicks of Group T1 were fed with feed mixed with herbal product (Repchol supplied by Ayurvet Ltd., Baddi, India @ 500gm/tonne of feed and T2 was given combination of synthetic choline chloride@1kg/tonne (60% and biotin @ 150 mg/ton of feed. To study the effect of inclusion of herbal sources of choline and synthetic choline on hepatic lipid metabolism, serum triglycerides and cholesterol were estimated on day 21st and 42nd of experimental study. Gross pathological changes in liver were recorded on representative birds per group at the end of the study. It was recorded that inclusion of either synthetic choline or herbal source of choline exerted a hypocholesterolemic effect and also decreased the level of triglycerides as compared to untreated control thus minimizing the incidence of fatty liver, however the two treatment do not differ significantly. Gross pathological study also revealed no significant changes in the architecture of liver as compared to control. It can be concluded that the herbal supplements can successfully replace their synthetic analogues from broiler ration. [Veterinary World 2010; 3(7.000: 318-320

  15. Comparative effectiveness research in radiation oncology: stereotactic radiosurgery, hypofractionation, and brachytherapy.

    Science.gov (United States)

    Aneja, Sanjay; Yu, James B

    2014-01-01

    Radiation oncology encompasses a diverse spectrum of treatment modalities, including stereotactic radiosurgery, hypofractionated radiotherapy, and brachytherapy. Though all these modalities generally aim to do the same thing-treat cancer with therapeutic doses of radiation while relatively sparing normal tissue from excessive toxicity, the general radiobiology and physics underlying each modality are distinct enough that their equivalence is not a given. Given the continued innovation in radiation oncology, the comparative effectiveness of these modalities is important to review. Given the broad scope of radiation oncology, this article focuses on the 3 most common sites requiring radiation treatment: breast, prostate, and lung cancer.

  16. The policies and politics of creating a comparative clinical effectiveness research center.

    Science.gov (United States)

    Wilensky, Gail R

    2009-01-01

    As part of the early efforts of the Obama administration to begin health care reform, $1.1 billion for comparative effectiveness research was included in the stimulus bill. Although this amount can be considered as an initial down payment, difficult issues such as where to place an ongoing effort, the role of such research in informing clinical decision making or reducing health care spending, and the governance to ensure full involvement by stakeholders have not yet been resolved. Legislation proposed over the past two years offers some insights into the options available going forward.

  17. Cold Nuclear Matter effects on J/psi production at RHIC: comparing shadowing models

    Energy Technology Data Exchange (ETDEWEB)

    Ferreiro, E.G.; /Santiago de Compostela U.; Fleuret, F.; /Ecole Polytechnique; Lansberg, J.P.; /SLAC; Rakotozafindrabe, A.; /SPhN, DAPNIA, Saclay

    2009-06-19

    We present a wide study on the comparison of different shadowing models and their influence on J/{psi} production. We have taken into account the possibility of different partonic processes for the c{bar c}-pair production. We notice that the effect of shadowing corrections on J/{psi} production clearly depends on the partonic process considered. Our results are compared to the available data on dAu collisions at RHIC energies. We try different break up cross section for each of the studied shadowing models.

  18. Comparative effect of glucagon and isoproterenol on hepatic glycogenolysis and glycolysis in isolated perfused liver

    OpenAIRE

    Vardanega-Peicher Márcia; Galletto Ricardo; Pagliarini e Silva Sarah; Bazotte Roberto Barbosa

    2003-01-01

    The effect of glucagon and isoproterenol (beta-adrenergic agonist) on hepatic glycogenolysis and glycolysis in isolated perfused liver was compared. The levels of isoproterenol and glucagon which promoted the maximal activation of glycogenolysis were 20 muM and 1nM respectively. However, glucagon (1 nM) not only increased glycogenolysis but also inhibited glycolysis. Because adenosine-3'-5'-cyclic monophosphate (cAMP) is a common second messenger to glucagon and isoproterenol, the level of cA...

  19. The effective atomic numbers of some biomolecules calculated by two methods: A comparative study

    DEFF Research Database (Denmark)

    Manohara, S.R.; Hanagodimath, S.M.; Gerward, Leif

    2009-01-01

    The effective atomic numbers Z(eff) of some fatty acids and amino acids have been calculated by two numerical methods, a direct method and an interpolation method, in the energy range of 1 keV-20 MeV. The notion of Z(eff) is given a new meaning by using a modern database of photon interaction cross...... constant and equal to the mean atomic number of the material. Wherever possible, the calculated values of Z(eff) are compared with experimental data....

  20. Cost-effective cloud computing: a case study using the comparative genomics tool, roundup.

    Science.gov (United States)

    Kudtarkar, Parul; Deluca, Todd F; Fusaro, Vincent A; Tonellato, Peter J; Wall, Dennis P

    2010-12-22

    Comparative genomics resources, such as ortholog detection tools and repositories are rapidly increasing in scale and complexity. Cloud computing is an emerging technological paradigm that enables researchers to dynamically build a dedicated virtual cluster and may represent a valuable alternative for large computational tools in bioinformatics. In the present manuscript, we optimize the computation of a large-scale comparative genomics resource-Roundup-using cloud computing, describe the proper operating principles required to achieve computational efficiency on the cloud, and detail important procedures for improving cost-effectiveness to ensure maximal computation at minimal costs. Utilizing the comparative genomics tool, Roundup, as a case study, we computed orthologs among 902 fully sequenced genomes on Amazon's Elastic Compute Cloud. For managing the ortholog processes, we designed a strategy to deploy the web service, Elastic MapReduce, and maximize the use of the cloud while simultaneously minimizing costs. Specifically, we created a model to estimate cloud runtime based on the size and complexity of the genomes being compared that determines in advance the optimal order of the jobs to be submitted. We computed orthologous relationships for 245,323 genome-to-genome comparisons on Amazon's computing cloud, a computation that required just over 200 hours and cost $8,000 USD, at least 40% less than expected under a strategy in which genome comparisons were submitted to the cloud randomly with respect to runtime. Our cost savings projections were based on a model that not only demonstrates the optimal strategy for deploying RSD to the cloud, but also finds the optimal cluster size to minimize waste and maximize usage. Our cost-reduction model is readily adaptable for other comparative genomics tools and potentially of significant benefit to labs seeking to take advantage of the cloud as an alternative to local computing infrastructure.

  1. Comparative effect of diclofenac sodium and dexamethasone on incisional wound healing in dogs

    Directory of Open Access Journals (Sweden)

    Adamu Abdul Abubakar

    2012-11-01

    Full Text Available The study was carried out to compare and evaluate the effect of diclofenac sodium, a non-steroidal anti-inflammatory drug (NSAID and dexamethasone, a steroidal, anti-inflammatory drug on incisional wound healing in dogs. Fifteen (15 clinically healthy, mixed sex, intact Nigerian local dogs free of dermatological lesion with mean age of 14.97±3.7 months (Mean ± SD and mean body weight of 10.73± 2.6kg (Mean ± SD were used for the study. The dogs were randomly divided into three treatment groups: A, B and C comprising of five dogs per group. A caudal mid-ventral laparotomy skin incision was made to create surgical wounds. Immediately after anesthetic recovery, 7.5% diclofenac sodium injection intramuscularly at standard clinical therapeutic dose rate of 2.5mg kg-1 was administered to group A for three day, 2.5% dexamethasone injection intramuscularly at standard clinical therapeutic dose rate of 0.25mg kg-1 was administered to the group B for three days. Group C were not treated with any anti-inflammatory medication. Subjectively, diclofenac sodium group shows shorter healing interval compare to dexamethasone group (P. Objective histological evaluation at day 7 and 14 revealed low inflammatory density in group B compared to A and C, fibroblast, collagen fibers, and surface keratinization was higher in group A at day 7 and 14 post surgery compared to B and C suggestive of faster healing in diclofenac sodium group compare to dexamethasone group. There was statistical significant different (P among the groups. It is concluded that diclofenac sodium when used as an anti inflammatory agent post operative does not interfere with surgical wound healing.

  2. Longer duration of asthma is significantly associated with increased RV/TLC ratio.

    Science.gov (United States)

    Tiwari, Anupama; Rahman, Kazi; Abejie, Belayneh; Jain, Vipul V; Vempilly, Jose Joseph

    2017-03-01

    Although FEV1/FVC ratio has been shown to be negatively associated with longer duration of asthma; an association between RV/TLC ratio and longer duration of asthma has not been explored. Patients with established asthma for more than a year and met inclusion and exclusion criteria were recruited. Data obtained by questionnaire after informed consent was obtained, Pulmonary function tests and laboratory results were collected through chart review. Correlation and multiple linear regressions were used to analyze the data. Among the 93 subjects, 61 were women. The mean age of patients was 58 ± 15 years, and the mean duration of asthma was 21 ± 18 years. The ethnic composition included: Caucasians 64%, Hispanics 28% and other groups 8%. The FEV1/FVC ratio was not significantly associated with duration of asthma (R2 = 0.15, p = 0.05). However, the RV/TLC ratio was significantly associated with duration of asthma (R2 = 0.46, p TLC ratio may be a better indicator than FEV1/FVC ratio to detect airway obstruction related to longer duration of asthma. Lung volume measurements should be done in addition to spirometry to detect changes related to airway obstruction in patients with longer duration of asthma. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. 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 mis

  4. Longer growing seasons do not increase net carbon uptake in Northeastern Siberian tundra

    NARCIS (Netherlands)

    Parmentier, F.J.W.; Molen, van der M.K.; Huissteden, van J.; Karsanaev, S.; Kononov, A.V.; Suzdalov, D.; Maximov, T.C.; Dolman, A.J.

    2011-01-01

    With global warming, snowmelt is occurring earlier and growing seasons are becoming longer around the Arctic. It has been suggested that this would lead to more uptake of carbon due to a lengthening of the period in which plants photosynthesize. To investigate this suggestion, 8 consecutive years of

  5. 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...

  6. The Future Is More than Just Tomorrow: Higher Education, the Economy and the Longer Term

    Science.gov (United States)

    Crossick, Geoffrey

    2010-01-01

    In this commentary the author reflects on longer-term issues facing higher education in the context of recession and crisis in public finance. The views expressed are written from a personal perspective with the aim of stimulating and encouraging a wider and ongoing debate around the themes presented. The author draws upon the findings of three…

  7. Buspirone, gepirone, ipsapirone, and zalospirone have distinct effects on the differential-reinforcement-of-low-rate 72-s schedule when compared with 5-HTP and diazepam.

    Science.gov (United States)

    Richards, J B; Sabol, K E; Hand, T H; Jolly, D C; Marek, G J; Seiden, L S

    1994-02-01

    The effects of four serotonin (5-HT)-1A compounds (buspirone, gepirone, ipsapirone and zalospirone) were compared with 5-hydroxytryptophan (5-HTP) [a 5-HT precursor with antidepressant (AD) efficacy], and diazepam (a benzodiazepine anxiolytic), on a differential-reinforcement-of-low-rate 72-s (DRL 72-s) schedule. Past research has shown that AD and anxiolytic compounds each have distinct effects on the DRL 72-s interresponse time (IRT) distribution profile. In the present paper, the profile of the IRT distribution was quantitatively characterized by three metrics: burst ratio, peak location and peak area. 5-HTP shifted the IRT distribution peak toward longer IRT durations, increased reinforcement rate and decreased response rate. The profile of the IRT distribution was not disrupted by 5-HTP. Diazepam disrupted the IRT distribution and increased bursting. In general, the arylpiperazine, 5-HT1A compounds increased reinforcement rate, decreased response rate and disrupted the profile of the IRT distribution. The effects of the four arylpiperazine 5-HT1A compounds on the IRT distribution profile were different from the AD profile of 5-HTP and the benzodiazepine anxiolytic profile of diazepam. Disruption of the IRT distribution by buspirone, gepirone, ipsapirone and zalospirone may result from decreased 5-HT transmission mediated by the presynaptic, somatodendritic 5-HT1A receptor.

  8. Comparing and Counting Logs in Direct and Effective Methods of Resummation

    CERN Document Server

    Almeida, Leandro G; Lee, Christopher; Sterman, George; Sung, Ilmo; Walsh, Jonathan R

    2014-01-01

    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 in a form that resums a larger number of terms than normally written, and endow direct 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 how certain existing formulas for resummed differential distributions in momentum space are susceptible to being evaluated in such a way that their accuracy does not match the corresponding accuracy of the integrated distribution (cumulant) or of the Laplace transform computed using the same method...

  9. Thermo-Kinetic Investigation of Comparative Ligand Effect on Cysteine Iron Redox Reaction

    Directory of Open Access Journals (Sweden)

    Masood Ahmad Rizvi

    2015-03-01

    Full Text Available Transition metal ions in their free state bring unwanted biological oxidations generating oxidative stress. The ligand modulated redox potential can be indispensable in prevention of such oxidative stress by blocking the redundant bio-redox reactions. In this study we investigated the comparative ligand effect on the thermo-kinetic aspects of biologically important cysteine iron (III redox reaction using spectrophotometric and potentiometric methods. The results were corroborated with the complexation effect on redox potential of iron(III-iron(II redox couple. The selected ligands were found to increase the rate of cysteine iron (III redox reaction in proportion to their stability of iron (II complex (EDTA < terpy < bipy < phen. A kinetic profile and the catalytic role of copper (II ions by means of redox shuttle mechanism for the cysteine iron (III redox reaction in presence of 1,10-phenanthroline (phen ligand is also reported.

  10. Comparative effects of gamma irradiation and phosphine fumigation on the quality of white ginseng

    Science.gov (United States)

    Kwon, J.-H. J.-H.; Byun, M.-W. M.-W.; Kim, K.-S. K.-S.; Kang, I.-J. I.-J.

    2000-03-01

    The hygienic, physicochemical, and organoleptic qualities of white ginseng were monitored during 6 months under accelerated conditions (40°C, 90% r.h.) by observing its microbial populations, disinfestation, and some quality attributes following either gamma irradiation at 2.5-10 kGy or commercial phosphine (PH 3) fumigation. In a comparative study, both treatments were found to be effective for disinfecting the stored samples. Phosphine showed no appreciable decontaminating effects on microorganisms contaminated including coliforms, while 5 kGy irradiation was sufficient to control all microorganisms related to the quality of the packed samples. Irradiation at 5 kGy caused negligible changes in physicochemical attributes of the samples, such as ginsenosides, amino acids, fatty acids, and organoleptic properties, whereas phosphine fumigation was found detrimental to sensory flavor ( Pphosphine-, and 2.5-5 kGy-treated samples. Accordingly, irradiation at phosphine fumigation for white ginseng.

  11. Markedly blunted metabolic effects of fructose in healthy young female subjects compared with male subjects.

    Science.gov (United States)

    Couchepin, Caroline; Lê, Kim-Anne; Bortolotti, Murielle; da Encarnaçao, Joana Amarante; Oboni, Jean-Baptiste; Tran, Christel; Schneiter, Philippe; Tappy, Luc

    2008-06-01

    To compare the metabolic effects of fructose in healthy male and female subjects. Fasting metabolic profile and hepatic insulin sensitivity were assessed by means of a hyperglycemic clamp in 16 healthy young male and female subjects after a 6-day fructose overfeeding. Fructose overfeeding increased fasting triglyceride concentrations by 71 vs. 16% in male vs. female subjects, respectively (P glucose production was increased by 12%, alanine aminotransferase concentration was increased by 38%, and fasting insulin concentrations were increased by 14% after fructose overfeeding in male subjects (all P fructose in male but not in female subjects. Short-term fructose overfeeding produces hypertriglyceridemia and hepatic insulin resistance in men, but these effects are markedly blunted in healthy young women.

  12. Comparative effectiveness of indacaterol/glycopyrronium in the treatment of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Cazzola, Mario; Rogliani, Paola

    2017-08-25

    Indacaterol/glycopyrronium has been the first long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA) fixed dose combination to be approved as a maintenance treatment in chronic obstructive pulmonary disease patients. Comparative effectiveness studies indicate that it is constantly superior to a LAMA or a LABA alone or even a LABA/inhaled corticosteroid combination, regardless of the drugs used. However, definitive data documenting the benefit of indacaterol/glycopyrronium fixed dose combination over these consolidated therapies are still absent in real-world, although the results of pivotal randomized controlled trials show that this is the case. Therefore, in addition to the large body of evidence already available supporting the use of indacaterol/glycopyrronium, pragmatic observational studies or ad hoc designed trials should be planned to collect data that could confirm the high effectiveness of indacaterol/glycopyrronium even in the real-life clinical practice.

  13. Practice-Based Knowledge Discovery for Comparative Effectiveness Research: An Organizing Framework.

    Science.gov (United States)

    Lucero, Robert J; Bakken, Suzanne

    2013-03-01

    Electronic health information systems can increase the ability of health-care organizations to investigate the effects of clinical interventions. The authors present an organizing framework that integrates outcomes and informatics research paradigms to guide knowledge discovery in electronic clinical databases. They illustrate its application using the example of hospital acquired pressure ulcers (HAPU). The Knowledge Discovery through Informatics for Comparative Effectiveness Research (KDI-CER) framework was conceived as a heuristic to conceptualize study designs and address potential methodological limitations imposed by using a single research perspective. Advances in informatics research can play a complementary role in advancing the field of outcomes research including CER. The KDI-CER framework can be used to facilitate knowledge discovery from routinely collected electronic clinical data.

  14. Comparative study of neuroprotective effect of tricyclics vs. trazodone on animal model of depressive disorder.

    Science.gov (United States)

    Marinescu, Ileana P; Predescu, Anca; Udriştoiu, T; Marinescu, D

    2012-01-01

    The neurobiological model of depressive disorder may be correlated with the animal model on rat, hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, the increase of cortisol level being specific to the model of depression in women. The neurobiological model of depression in women presents vulnerabilities for some cerebral structures (hippocampus, frontal cortex, cerebral amygdala). A decrease of frontal cortex and hippocampus volumes are recognized in depressive disorder in women, depending on duration of disease and antidepressant therapy. Neurobiological vulnerability may be pronounced through cholinergic blockade. The purpose of the study was to highlight the cytoarchitectural changes in the frontal cortex and hippocampus by comparing two antidepressant substances: amitriptyline with a strong anticholinergic effect and trazodone, without anticholinergic effect. The superior neuroprotective qualities of trazodone for the frontal cortex, hippocampus and dentate gyrus are revealed. The particular neurobiological vulnerability of depression in women requires a differentiated therapeutic approach, avoiding the use of antidepressants with anticholinergic action.

  15. Comparative effects of dimethoate and deltamethrin on reproductive system in male mice.

    Science.gov (United States)

    Abdallah, F Ben; Slima, A Ben; Dammak, I; Keskes-Ammar, L; Mallek, Z

    2010-06-01

    The effects of dimethoate (5, 15 and 28 mg kg(-1) day(-1)), deltamethrin (5 mg kg(-1) day(-1)) and their mixture (5 mg kg(-1) day(-1)) on male reproduction in mice were studied. The insecticides were given orally by gavage to male mice for 21 days. At the end of the treatment period, body, testes and epididymides weights and sperm parameters were determined. Alone mixture treatment has significantly decreased body weights. Dimethoate at 28 mg kg(-1) day(-1), deltamethrin at 5 mg kg(-1) day(-1) and their mixture at 5 mg kg(-1) day(-1) were associated with a significantly decreased sperm count, motility and viability and significantly increased percent morphologically abnormal spermatozoa compared with the controls. This study demonstrated the adverse effects of dimethoate at high dose, deltamethrin and their combining at 5 mg kg(-1) day(-1) on reproductive system and sperm parameters in male mice.

  16. Stakeholder engagement in comparative effectiveness research: how will we measure success?

    Science.gov (United States)

    Lavallee, Danielle C; Williams, Carla J; Tambor, Ellen S; Deverka, Patricia A

    2012-09-01

    Stakeholder engagement in comparative effectiveness research continues to gain national attention. While various methods are used to gather stakeholder expertise and form recommendations, evaluation of the stakeholder experience is often missing. The lack of evaluation prohibits assessing how effective and meaningful engagement practices are for enhancing research efforts and limits the ability to identify areas for future improvement. We propose that an evaluation plan of engagement processes be developed before stakeholder involvement begins and be required as part of a request for proposal or research grant where stakeholder input is being sought. Furthermore, we recommend the inclusion of six meta-criteria that represent normative goals of multiple studies: respect, trust, legitimacy, fairness, competence and accountability. To aid in the development of future evaluations, we have developed definitions for and matched specific examples of measuring each meta-criterion to serve a guide for others in the field.

  17. Comparative assessment of the effectiveness of modern neuroprotectors in conditions of experimental chronic cerebral ischemia

    Directory of Open Access Journals (Sweden)

    A. V. Demchenko

    2015-04-01

    Full Text Available Modern pharmacological influence on the pathological changes in cerebral ischemia is actual task of the modern neurology. Aim. To make a comparative assessment of the effectiveness of modern neuroprotectors in conditions of experimental chronic cerebral ischemia. Methods and results. Experimental study of the neuroprotective effects of the citicoline, cortexin and tiocetam on the cognitive functions on the model of the chronic cerebral ischemia was conducted on 75 white rats. Biochemical, immunoassay, pharmacological, statistical methods were used. Conclusion. Obtained results showed citicoline, cortexin and tiocetam ability to positively influence on the molecular-biochemical changes in the brain cortex with ischemia. This resulted in the glutathione-dependent enzymes activity increase, recover of the thiol-disulfide system balance, nitrotyrosine concentration decrease, improvement of the cognitive function in the experimental animals.

  18. Comparing the clinical effectiveness of different new-born hearing screening strategies. A decision analysis

    Directory of Open Access Journals (Sweden)

    Schnell-Inderst Petra

    2005-01-01

    Full Text Available Abstract Background Children with congenital hearing impairment benefit from early detection and treatment. At present, no model exists which explicitly quantifies the effectiveness of universal newborn hearing screening (UNHS versus other programme alternatives in terms of early diagnosis. It has yet to be considered whether early diagnosis (within the first few months of hearing impairment is of importance with regard to the further development of the child compared with effects resulting from a later diagnosis. The objective was to systematically compare two screening strategies for the early detection of new-born hearing disorders, UNHS and risk factor screening, with no systematic screening regarding their influence on early diagnosis. Methods Design: Clinical effectiveness analysis using a Markov Model. Data Sources: Systematic literature review, empirical data survey, and expert opinion. Target Population: All newborn babies. Time scale: 6, 12 and 120 months. Perspective: Health care system. Compared Strategies: UNHS, Risk factor screening (RS, no systematic screening (NS. Outcome Measures: Quality weighted detected child months (QCM. Results UNHS detected 644 QCM up until the age of 6 months (72,2%. RS detected 393 child months (44,1% and no systematic screening 152 child months (17,0%. UNHS detected 74,3% and 86,7% weighted child months at 12 and 120 months, RS 48,4% and 73,3%, NS 23,7% and 60,6%. At the age of 6 months UNHS identified approximately 75% of all children born with hearing impairment, RS 50% and NS 25%. At the time of screening UNHS marked 10% of screened healthy children for further testing (false positives, RS 2%. UNHS demonstrated higher effectiveness even under a wide range of relevant parameters. The model was insensitive to test parameters within the assumed range but results varied along the prevalence of hearing impairment. Conclusion We have shown that UNHS is able to detect hearing impairment at an earlier age

  19. The Metabolic and Performance Effects of Caffeine Compared to Coffee during Endurance Exercise

    Science.gov (United States)

    Hodgson, Adrian B.; Randell, Rebecca K.; Jeukendrup, Asker E.

    2013-01-01

    There is consistent evidence supporting the ergogenic effects of caffeine for endurance based exercise. However, whether caffeine ingested through coffee has the same effects is still subject to debate. The primary aim of the study was to investigate the performance enhancing effects of caffeine and coffee using a time trial performance test, while also investigating the metabolic effects of caffeine and coffee. In a single-blind, crossover, randomised counter-balanced study design, eight trained male cyclists/triathletes (Mean±SD: Age 41±7y, Height 1.80±0.04 m, Weight 78.9±4.1 kg, VO2 max 58±3 ml•kg−1•min−1) completed 30 min of steady-state (SS) cycling at approximately 55% VO2max followed by a 45 min energy based target time trial (TT). One hour prior to exercise each athlete consumed drinks consisting of caffeine (5 mg CAF/kg BW), instant coffee (5 mg CAF/kg BW), instant decaffeinated coffee or placebo. The set workloads produced similar relative exercise intensities during the SS for all drinks, with no observed difference in carbohydrate or fat oxidation. Performance times during the TT were significantly faster (∼5.0%) for both caffeine and coffee when compared to placebo and decaf (38.35±1.53, 38.27±1.80, 40.23±1.98, 40.31±1.22 min respectively, pcaffeine and coffee. Average power for caffeine and coffee during the TT was significantly greater when compared to placebo and decaf (294±21 W, 291±22 W, 277±14 W, 276±23 W respectively, pcaffeine (5 mg/kg/BW) and coffee (5 mg/kg/BW) consumed 1 h prior to exercise can improve endurance exercise performance. PMID:23573201

  20. Cord blood T cells mediate enhanced antitumor effects compared with adult peripheral blood T cells.

    Science.gov (United States)

    Hiwarkar, Prashant; Qasim, Waseem; Ricciardelli, Ida; Gilmour, Kimberly; Quezada, Sergio; Saudemont, Aurore; Amrolia, Persis; Veys, Paul

    2015-12-24

    Unrelated cord blood transplantation (CBT) without in vivo T-cell depletion is increasingly used to treat high-risk hematologic malignancies. Following T-replete CBT, naïve CB T cells undergo rapid peripheral expansion with memory-effector differentiation. Emerging data suggest that unrelated CBT, particularly in the context of HLA mismatch and a T-replete graft, may reduce leukemic relapse. To study the role of CB T cells in mediating graft-versus-tumor responses and dissect the underlying immune mechanisms for this, we compared the ability of HLA-mismatched CB and adult peripheral blood (PB) T cells to eliminate Epstein-Barr virus (EBV)-driven human B-cell lymphoma in a xenogeneic NOD/SCID/IL2rg(null) mouse model. CB T cells mediated enhanced tumor rejection compared with equal numbers of PB T cells, leading to improved survival in the CB group (P cells that were autologous vs allogeneic to the lymphoma demonstrated that this antitumor effect was mediated by alloreactive rather than EBV-specific T cells. Analysis of tumor-infiltrating lymphocytes demonstrated that CB T cells mediated this enhanced antitumor effect by rapid infiltration of the tumor with CCR7(+)CD8(+) T cells and prompt induction of cytotoxic CD8(+) and CD4(+) T-helper (Th1) T cells in the tumor microenvironment. In contrast, in the PB group, this antilymphoma effect is impaired because of delayed tumoral infiltration of PB T cells and a relative bias toward suppressive Th2 and T-regulatory cells. Our data suggest that, despite being naturally programmed toward tolerance, reconstituting T cells after unrelated T-replete CBT may provide superior Tc1-Th1 antitumor effects against high-risk hematologic malignancies.

  1. Comparative and Mixture Effect of Cynodon Dactylon, ElectroMagnetic Field and Insulin on Diabetic Mouse

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    Mohammad Hossein Asghari

    2012-12-01

    Full Text Available Objective: New investigations are in progress to find some alternative treatments for diabetes mellitus. Herbs are some of the interesting medications in this regard. Cynodon dactylon (C.d is a potential plant to be considered as a new medication. On the other hand, the effect of the Electromagnetic Field (EMF on bio organisms is becoming clearer. In this study, the effect of C.d, EMF and insulin have been investigated on the diabetic mouse. Material and Methods: Diabetes was induced by a combination of ketamine (60 mg/Kg and xylazine (10 mg/Kg which induces a sustained hyperglycemia. Mice were divided into 12 groups: 1 control, 2 normal saline, 3 and 4 50mg/Kg C.d, 5 and 6 100 mg/Kg C.d, 7 insulin, 8 insulin and C.d, 9 EMF (110 KHz, 700±20 mG, 10 insulin and EMF, 11 EMF plus C.d and 12 insulin plus C.d and EMF. Blood glucose level was measured after 5 and 60 minutes in C.d administrated groups, and 5 minutes in the other groups by a glucometer set. The data were analyzed by ANOVA and different means were compared by Tukey and Bonferroni tests (p<0.05. Results: According to results, both dosages of C.d had significant lowering effect on blood glucose level. The first dose was more effective than the second, and its impact was just like insulin. The 6th, 9th and 10th groups were significant, also . However, they did not show a higher effect than insulin or C.d. The application of EMF had a significant effect compared to the second group, but it did not reduce the glucose level to the normal range. The effect of the 8th group was very impressive and the mean glucose levels in this group were lower than the control group. Conclusion: Considering the data, C.d is a good alternative medication for diabetes mellitus.

  2. Telerehabilitation after total knee replacement in Italy: cost-effectiveness and cost-utility analysis of a mixed telerehabilitation-standard rehabilitation programme compared with usual care

    Science.gov (United States)

    Fusco, Francesco; Turchetti, Giuseppe

    2016-01-01

    Objectives To assess cost-effectiveness and cost utility of telerehabilitation (TR) versus standard rehabilitation (SR) after total knee replacement (TKR). Design Markov decision modelling of cost-effectiveness and cost-utility analysis based on patient-level and secondary data sources employing Italian National Health Service (NHS; Ita-NHS) and Society perspectives. Setting Primary care units (PCUs) in Italy. Participants Patients discharged after TKR. Interventions Mixed SR-TR service (10 face-to-face sessions and 10 telesessions) versus SR (20 face-to-face sessions) Primary and secondary outcome measures The incremental cost per additional knee flexion range of motion (ROM) and per QALY gained by SR-TR compared with SR. Second, we considered the probability of being cost-effective and the probability of being more effective and less expensive. Results TR appears to be the cost-effective in the base case and in all of the considered scenarios, but is no longer more effective and less expensive if transportation costs are excluded. Comparing SR-TR with SR, the incremental cost-effectiveness ratio (ICER) adopting the Ita-NHS perspective for the base case was −€117/ROM gained. The cost-effectiveness probability for SR-TR was 0.98 (ceiling ratio: €50/ROM), while the joint probability of being more effective and less expensive was 0.87. Assuming that TR would increase health-related quality of life (HRQOL) utilities by 2.5%, the ICER adopting Ita-NHS perspective is −€960/QALY (cost-effectiveness probability: 1; ceiling ratio: €30 000/QALY). All the performed sensitivity analyses did not change the conclusions, but if transportation costs were excluded, the probability for SR-TR of being more clinically effective and less expensive reduced to 0.56. Conclusions The analysis suggested SR-TR to be cost-effective, even less expensive and more effective if the PCUs provide ambulance transportations. However, the uncertainty related to TR costs, HRQOL and long

  3. The cost effectiveness of lung transplantation compared with that of heart and liver transplantation in the Netherlands

    NARCIS (Netherlands)

    Ouwens, JP; van Enckevort, PJ; TenVergert, EM; Bonsel, GJ; van der Bij, W; Haagsma, EB; Rutten, FFH; Slooff, MJH; Koeter, GH

    This study was performed to assess the main reasons for the unfavorable cost effectiveness of lung transplantation compared with that of heart and liver transplantation. Costs, effects, and cost-effectiveness ratios of Dutch lung, heart, and liver transplantation programs were compared. The data are

  4. 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...... to identify relevant zonal or area boundaries. However, it is not clear if from a disease control standpoint this is the optimal strategy. An alternative approach is to define regions using ZIP codes, counties, states, major roads, or natural barriers. We used an updated version of an epidemic simulation...... 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...

  5. Patient satisfaction and side effects in primary care: An observational study comparing homeopathy and conventional medicine

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    Thurneysen André

    2008-09-01

    Full Text Available Abstract Background This study is part of a nationwide evaluation of complementary medicine in Switzerland (Programme Evaluation of Complementary Medicine PEK and was funded by the Swiss Federal Office of Public Health. The main objective of this study is to investigate patient satisfaction and perception of side effects in homeopathy compared with conventional care in a primary care setting. Methods We examined data from two cross-sectional studies conducted in 2002–2003. The first study was a physician questionnaire assessing structural characteristics of practices. The second study was conducted on four given days during a 12-month period in 2002/2003 using a physician and patient questionnaire at consultation and a patient questionnaire mailed to the patient one month later (including Europep questionnaire. The participating physicians were all trained and licensed in conventional medicine. An additional qualification was required for medical doctors providing homeopathy (membership in the Swiss association of homeopathic physicians SVHA. Results A total of 6778 adult patients received the questionnaire and 3126 responded (46.1%. Statistically significant differences were found with respect to health status (higher percentage of chronic and severe conditions in the homeopathic group, perception of side effects (higher percentage of reported side effects in the conventional group and patient satisfaction (higher percentage of satisfied patients in the homeopathic group. Conclusion Overall patient satisfaction was significantly higher in homeopathic than in conventional care. Homeopathic treatments were perceived as a low-risk therapy with two to three times fewer side effects than conventional care

  6. Effects of mental workload and caffeine on catecholamines and blood pressure compared to performance variations.

    Science.gov (United States)

    Papadelis, Christos; Kourtidou-Papadeli, Chrysoula; Vlachogiannis, Emmanouil; Skepastianos, Petros; Bamidis, Panayiotis; Maglaveras, Nikos; Pappas, Kostantinos

    2003-02-01

    Caffeine is characterised as a central nervous system stimulant, also affecting metabolic and cardiovascular functions. A number of studies have demonstrated an effect of caffeine on the excretion of catecholamines and their metabolites. Urinary epinephrine and norepinephrine have been shown to increase after caffeine administration. Similar trends were observed in our study in adrenaline (ADR) and noradrenaline (NORADR) levels and additionally a dose dependent effect of caffeine. The effect of caffeine on cognitive performance, blood pressure, and catecholamines was tested under resting conditions and under mental workload. Each subject performed the test after oral administration of 1 cup and then 3 cups of coffee. Root mean square error (RMSE) for the tracking task was continuously monitored. Blood pressure was also recorded before and after each stage of the experiment. Catecholamines were collected and measured for three different conditions as: at rest, after mental stress alone, after one dose of caffeine under stress, and after triple dose of caffeine under stress. Comparison of the performance of each stage with the resting conditions revealed statistically significant differences between group of smokers/coffee drinkers compared with the other two groups of non-coffee drinkers/non-smokers and non-smokers/coffee drinkers. There was no statistically significant difference between the last two groups. There was an increase of urine adrenaline with 1 cup of coffee and statistically significant increase of urine noradrenaline. Both catecholamines were significantly increased with triple dose of caffeine. Mental workload increased catecholamines. There was a dose dependent effect of caffeine on catecholamines.

  7. Comparative effectiveness of group and individual prenatal care on gestational weight gain.

    Science.gov (United States)

    Tanner-Smith, Emily E; Steinka-Fry, Katarzyna T; Gesell, Sabina B

    2014-09-01

    This study examined differences in gestational weight gain for women in CenteringPregnancy (CP) group prenatal care versus individually delivered prenatal care. We conducted a retrospective chart review and used propensity scores to form a matched sample of 393 women (76 % African-American, 13 % Latina, 11 % White; average age 22 years) receiving prenatal care at a community health center in the South. Women were matched on a wide range of demographic and medical background characteristics. Compared to the matched group of women receiving standard individual prenatal care, CP participants were less likely to have excessive gestational weight gain, regardless of their pre-pregnancy weight (b = -.99, 95 % CI [-1.92, -.06], RRR = .37). CP reduced the risk of excessive weight gain during pregnancy to 54 % of what it would have been in the standard model of prenatal care (NNT = 5). The beneficial effect of CP was largest for women who were overweight or obese prior to their pregnancy. Effects did not vary by gestational age at delivery. Post-hoc analyses provided no evidence of adverse effects on newborn birth weight outcomes. Group prenatal care had statistically and clinically significant beneficial effects on reducing excessive gestational weight gain relative to traditional individual prenatal care.

  8. A preliminary evaluation of comparative effectiveness of riluzole in therapeutic regimen for irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Surya Prakash Mishra; Sunit Kumar Shukla; Bajrang Lal Pandey

    2014-01-01

    Objective: To develop agents that are specifically effective in controlling the key disturbance of visceral hyperalgesia besides abating of associated multiple symptoms, and evaluate comparative effectiveness for IBS symptom relief for standard regimen (antispasmodic and probiotic) and add-on amitriptyine or riluzole regimens following two weeks administration.Methods:groups were studied. First group received standard treatment (mebeverine 200 mg twice daily and probiotic 200 mg twice daily). Second group received add-on amitriptyline 25 mg before bedtime, while the third group got add-on riluzole 50 mg twice daily. Overall gastrointestinal symptom rating scale improving symptoms and hospital anxiety depression scale improving associated psychological morbidity were employed as measures at induction and at two-week follow-up period. Individual symptom scores were also examined to define the outcome profiles.Results:108 patients with visceral hypersensitivity accompanying IBS, divided into three rating scale score, not the other two regimens. Pain relief was seen with both riluzole and amitriptyline regimens significantly superior to standard treatment regimen, but riluzole effect appeared specific and independent anxiolytic effect. Amitriptyline caused relief in diarrhea and did not benefit in constipation point to non-specific remedial role in IBS. Riluzole regimen resulted in significant reduction of overall gastrointestinal symptom Conclusions: Riluzole specifically relieves visceral hypersensitivity and is proved to be superior to current treatments in IBS patients. It appears a lead remedy based on glutamate transporter mechanisms in visceral hypersensititvity.

  9. Comparative study of antitumor effects of bromelain and papain in human cholangiocarcinoma cell lines.

    Science.gov (United States)

    Müller, Alena; Barat, Samarpita; Chen, Xi; Bui, Khac Cuong; Bozko, Przemyslaw; Malek, Nisar P; Plentz, Ruben R

    2016-05-01

    Cholangiocarcinoma (CC) worldwide is the most common biliary malignancy with poor prognostic value and new systemic treatments are desirable. Plant extracts like bromelain and papain, which are cysteine proteases from the fruit pineapple and papaya, are known to have antitumor activities. Therefore, in this study for the first time we investigated the anticancer effect of bromelain and papain in intra- and extrahepatic human CC cell lines. The effect of bromelain and papain on human CC cell growth, migration, invasion and epithelial plasticity was analyzed using cell proliferation, wound healing, invasion and apoptosis assay, as well as western blotting. Bromelain and papain lead to a decrease in the proliferation, invasion and migration of CC cells. Both plant extracts inhibited NFκB/AMPK signalling as well as their downstream signalling proteins such as p-AKT, p-ERK, p-Stat3. Additionally, MMP9 and other epithelial-mesenchymal-transition markers were partially found to be downregulated. Apoptosis was induced after bromelain and papain treatment. Interestingly, bromelain showed an overall more effective inhibition of CC as compared to papain. siRNA mediated silencing of NFκB on CC cells indicated that bromelain and papain have cytotoxic effects on human CC cell lines and bromelain and partially papain in comparison impair tumor growth by NFκB/AMPK signalling. Especially bromelain can evolve as promising, potential therapeutic option that might open new insights for the treatment of human CC.

  10. Personality, effective goal-striving, and enhanced well-being: comparing 10 candidate personality strengths.

    Science.gov (United States)

    Sheldon, Kennon M; Jose, Paul E; Kashdan, Todd B; Jarden, Aaron

    2015-04-01

    In a three-wave, year-long, large-sample dataset (N = 755), 10 candidate "personality strengths" (Grit, Gratitude, Curiosity, Savoring, Control Beliefs, Meaning in Life-Presence, Strengths Use, and Engagement, Pleasure, and Meaning-Based Orientations Toward Happiness) were compared as predictors of 6-month increases in goal attainment, and as moderators of goal attainment effects upon boosted subjective well-being (SWB). Seeking internal replication, we tested our models twice, both during T1-T2 and during T2-T3. We also examined whether any Personality × Attainment moderator effects upon change in SWB at T2 still persisted at T3. Grit was the only candidate strength that predicted increased goal attainment from T1 to T2 and from T2 to T3, and Curiosity was the only candidate strength that moderated attainment effects on well-being from T1 to T2 and from T2 to T3. T2 Goal attainment effects on SWB were best sustained at T3 when Meaning Orientation increased from T1 to T2. Implications for identifying keystone constructs in personality (and positive) psychology are discussed.

  11. [Comparative effects of terbutaline sulphate and ipratropium bromide on the respiratory system (author's transl)].

    Science.gov (United States)

    Villate Navarro, J I; Sobradillo Peña, V; Atxotequi Iaraoligoitia, V; Salaverri Nalda, A; Orive Martínez, C

    1980-04-10

    Bronchodilator action of two pharmacologically different drugs have been compared. Ipratropium bromide (Sch 1000) is a synthetic atropine derivative and terbutaline sulphate is a beta-stimulating agent. Twelve asthmatic patients and eight patients with chronic bronquitis received terbutaline 0.50 mg. and ipratropium 0.04 mg by aerosol inhalation. Both drugs were given at random on a consecutive-day schedule. All patients were clinically stable before treatment (basal FEV/VC less than 60 percent). Total lung capacity (TLC) forced expiratory volume (FEV), SRaw, and V'/V curves before and at 15, 60, 120, and 240 minutes after the produce administration were registered. Presence of side-effects was also checked. An intensive bronchodilator action was observed either after inhalation of ipratropium bromide or terbutaline, but statistical studies showed no significant differences between both drugs in relation to intensity and duration of their actions. Sch 1000 caused similar bronchodilator effects in all cases; a more intense effect in patients with chronic bronchitis could not be noticed. Evaluation of V'/V curve, and especially its relation to a same pulmonary volume, pointed out that both drugs act upon small respiratory airways. Advance side-effects were not present.

  12. COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF THREE METHODS FOR PROXIMAL CARIES DIAGNOSIS – A CLINICAL STUDY.

    Directory of Open Access Journals (Sweden)

    Mirela Marinova-Takorova

    2014-06-01

    Full Text Available Aim: The aim of the presented study is to compare the effectiveness of the diagnosis with a dental microscope, laser fluorescence (DIAGNOcam and X-ray examination in proximal caries diagnosis. Material and methods: Thirty-eight adult patients were examined. They were first examined with a dental mirror and a probe, under magnification 6.4 times. After that a diagnosis with DIAGNOcam was performed. Bitewing X-ray images were administered. The data from the three diagnostic methods was compared using SPSS 16 package of Windows. The lesions that were diagnosed as involving dentin were then excavated which served as a confirmation of the diagnosis. Results: The results of the study showed that dentinal lesions were detected with a high degree of correlation with all three diagnostic methods. The visual examination seriously underestimated lesions involving only enamel. In these cases there was a good correlation between laser fluorescence and X-ray data. Conclusions: Based on the conducted study we could conclude that the diagnosis of proximal caries with DIAGNOcam is equivalent to X-ray, both being more accurate in cases with early lesions, compared to visual diagnosis.

  13. Compared performance of penetrometers and effect of soil water content on penetration resistance measurements

    Directory of Open Access Journals (Sweden)

    Edison Aparecido Mome Filho

    2014-06-01

    Full Text Available Modern agriculture techniques have a great impact on crops and soil quality, especially by the increased machinery traffic and weight. Several devices have been developed for determining soil properties in the field, aimed at managing compacted areas. Penetrometry is a widely used technique; however, there are several types of penetrometers, which have different action modes that can affect the soil resistance measurement. The objective of this study was to compare the functionality of two penetrometry methods (manual and automated mode in the field identification of compacted, highly mechanized sugarcane areas, considering the influence of soil water volumetric content (θ on soil penetration resistance (PR. Three sugarcane fields on a Rhodic Eutrudrox were chosen, under a sequence of harvest systems: one manual harvest (1ManH, one mechanized harvest (1MH and three mechanized harvests (3MH. The different degrees of mechanization were associated to cumulative compaction processes. An electronic penetrometer was used on PR measurements, so that the rod was introduced into the soil by hand (Manual and by an electromechanical motor (Auto. The θ was measured in the field with a soil moisture sensor. Results showed an effect of θ on PR measurements and that regression models must be used to correct data before comparing harvesting systems. The rod introduction modes resulted in different mean PR values, where the "Manual" overestimated PR compared to the "Auto" mode at low θ.

  14. Effect of blonanserin on cognitive and social function in acute phase Japanese schizophrenia compared with risperidone.

    Science.gov (United States)

    Hori, Hikaru; Yamada, Kenji; Kamada, Dan; Shibata, Yuka; Katsuki, Asuka; Yoshimura, Reiji; Nakamura, Jun

    2014-01-01

    This study aims to determine the effectiveness of blonanserin (BNS) on the cognitive and social functions of patients with schizophrenia compared with risperidone (RIS) during acute-phase (8-week) treatment. A total of 39 schizophrenia inpatients were included in this study. The subjects received either BNS (N=20) or RIS (N=19), and the clinical responses were evaluated periodically. The concomitant use of mood stabilizers was not allowed. Efficacy was assessed with the Positive and Negative Syndrome Scale for schizophrenia. Cognition was assessed using the Brief Assessment of Cognition in Schizophrenia, Japanese-language version. Social function was assessed using the Life Assessment Scale for the Mentally Ill. For both groups, each assessment exhibited a decrease in the mean change from baseline on the Positive and Negative Syndrome Scale. The depression subscale was significantly improved in the BNS group compared with the RIS group at 8 weeks after administration. BNS improved verbal fluency and executive function (cognitive function) and daily living and work skills (social function). Compared with the RIS group, BNS was observed to improve daily living. BNS may improve psychotic symptoms, cognitive function, and daily living in patients with acute-phase schizophrenia. BNS may be superior to RIS in the improvement of daily living.

  15. 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

  16. Effects of Pooling Samples on the Performance of Classification Algorithms: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Kanthida Kusonmano

    2012-01-01

    Full Text Available A pooling design can be used as a powerful strategy to compensate for limited amounts of samples or high biological variation. In this paper, we perform a comparative study to model and quantify the effects of virtual pooling on the performance of the widely applied classifiers, support vector machines (SVMs, random forest (RF, k-nearest neighbors (k-NN, penalized logistic regression (PLR, and prediction analysis for microarrays (PAMs. We evaluate a variety of experimental designs using mock omics datasets with varying levels of pool sizes and considering effects from feature selection. Our results show that feature selection significantly improves classifier performance for non-pooled and pooled data. All investigated classifiers yield lower misclassification rates with smaller pool sizes. RF mainly outperforms other investigated algorithms, while accuracy levels are comparable among all the remaining ones. Guidelines are derived to identify an optimal pooling scheme for obtaining adequate predictive power and, hence, to motivate a study design that meets best experimental objectives and budgetary conditions, including time constraints.

  17. Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

    Directory of Open Access Journals (Sweden)

    Saeed Imani

    2015-11-01

    Full Text Available  Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT compared to the usual opioid dependence treatment (TAU.Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS were randomly assigned into experimental (Mindfulness-Based Group Therapy and control groups (the Usual Treatment.The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program.  Methods:The Five Factor Mindfulness Questionnaire (FFMQ and the Addiction Sevier Index (ASI were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. Results:The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. Conclusion:The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

  18. Comparative Antifungal Effect of Lactic Acid Bacteria Strains on Penicillium digitatum

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    Adrian Matei

    2015-11-01

    Full Text Available Lactic acid bacteria (LAB are natural alternative to chemical preservatives for fruits. The aim of the research was to select LAB strains with high antifungal activity against Penicillium digitatum for the biopreservation of fruits. The antifungal activity of eight lactic acid bacteria strains has been evaluated against Penicilliuum digitatum isolated from orange, by overlay assay method and by optical microscope examination. The reversion of inhibition zone after 96 h was recorded as a fungistatic effect while those with inhibition zone for at least 7 days were recorded as fungicidal. The antifungal effect of efficient LAB strains was assessed by comparing inhibition of fungal biofilm formation in liquid media. The strains Lpl, Lpa, LAB 13, LAB 15, LAB 43 and LAB 58 presented intense antifungal activity with clear inhibition zones diameter over 20 mm. The microscopy evidenced atypical hyphae and delaying of conidial chain formation. The strains Lpa, LAB 13, LAB 15 fully inhibited the mycelia growth, strains LAB 43 and LAB 58 partly with delaying of biofilm formation on the surface of culture medium. The results of comparative antifungal activity of LAB strains evidenced the highest inhibition of fungal biofilm formation and structural damages of hyphae and spores caused by the strains Lpa, LAB 13 and LAB 15. These strains could be efficient biocontrol agents of Penicillium digitatum in fruits.

  19. Comparing the effects of nebivolol and dexpanthenol on wound healing: an experimental study.

    Science.gov (United States)

    Ulger, Burak V; Kapan, Murat; Uslukaya, Omer; Bozdag, Zubeyir; Turkoglu, Ahmet; Alabalık, Ulas; Onder, Akın

    2016-06-01

    Wound healing is a dynamic, interactive process that is initiated in response to injury. A number of investigations and clinical studies have been performed to determine new approaches for the improvement of wound healing. The aim of this study was to compare the effects of dexpanthenol, a molecule that is widely used for improving wound healing, and nebivolol, a molecule that increases nitric oxide release, on wound healing. A total of 30 rats were divided into three equal groups (n = 10). A linear 2 cm incision was made in the rats' skin. No treatment was administered in the first (control) group. Dexpanthenol cream was administered to the rats in the second group and 5% nebivolol cream was administered to the rats in the third group. The wound areas of all of the rats were measured on certain days. On the 21(st) day, all wounds were excised and histologically evaluated. The wound healing rates of the dexpanthenol and nebivolol groups were higher than those of the control group (P wound healing rates of the dexpanthenol and nebivolol groups were not significantly different. Nebivolol and dexpanthenol have comparable effects on wound healing.

  20. Comparative effects of ohmic, induction cooker, and electric stove heating on soymilk trypsin inhibitor inactivation.

    Science.gov (United States)

    Lu, Lu; Zhao, Luping; Zhang, Caimeng; Kong, Xiangzhen; Hua, Yufei; Chen, Yeming

    2015-03-01

    During thermal treatment of soymilk, a rapid incorporation of Kunitz trypsin inhibitor (KTI) into protein aggregates by covalent (disulfide bond, SS) and/or noncovalent interactions with other proteins is responsible for its fast inactivation of trypsin inhibitor activity (TIA). In contrast, the slow cleavage of a single Bowman-Birk inhibitor (BBI) peptide bond is responsible for its slow inactivation of TIA and chymotrypsin inhibitor activity (CIA). In this study, the effects of Ohmic heating (220 V, 50 Hz) on soymilk TIA and CIA inactivation were examined and compared to induction cooker and electric stove heating with similar thermal histories. It was found that: (1) TIA and CIA inactivation was slower from 0 to 3 min, and faster after 3 min as compared to induction cooker and electric stove. (2) The thiol (SH) loss rate was slower from 0 to 3 min, and similar to induction cooker and electric stove after 3 min. (3) Ohmic heating slightly increased protein aggregate formation. (4) In addition to the cleavage of one BBI peptide bond, an additional reaction might occur to enhance BBI inactivation. (5) Ohmic heating was more energy-efficient for TIA and CIA inactivation. (6) TIA and CIA inactivation was accelerated with increasing electric voltage (110, 165, and 220 V) of Ohmic heating. It is likely that the enhanced inactivation of TIA by Ohmic heating is due to its combined electrochemical and thermal effects.

  1. Comparative study of effectiveness of oral acyclovir with oral erythromycin in the treatment of Pityriasis rosea.

    Science.gov (United States)

    Amatya, A; Rajouria, E A; Karn, D K

    2012-01-01

    Pityriasis rosea is an acute, self-limiting disease, probably infective in origin, affecting mainly children and young adults, characterized by distinctive skin eruptions and minimal constitutional symptoms. Both oral Erythromycin and oral Acyclovir have been used in its management. To compare the effectiveness of oral Erythromycin and oral Acyclovir in the treatment of Pityriasis rosea. Forty two patients with clinical diagnosis of Pityriasis rosea were enrolled. They were randomized into two groups. One group was given high-dose oral Acyclovir and another group oral Erythromycin in standard dose. The participants were evaluated one, two, four, six and eight weeks and six months after commencement of the study. Forty two patients including 26 males and 16 females completed the study. After 8th week, all patients showed complete response in both the groups. The response to oral Acyclovir compared with that to oral Erythromycin was better and was statistically significant in 1st, 2nd, 4th and 6th weeks. Although it is a self-limiting disease which resolves within three weeks to three months, this study reveals that both oral Acyclovir and oral Erythromycin are helpful in decreasing the severity and duration of Pityriasis rosea. Moreover, the study also indicates that oral Acyclovir is more effective than oral Erythromycin in reducing the severity and duration of Pityriasis rosea.

  2. Comparative effectiveness of chewing stick and toothbrush: A randomized clinical trial

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    Aeeza S Malik

    2014-01-01

    Full Text Available Background: With the increasing rate of oral diseases, the global necessity of effective and economical products for its prevention and treatment has intensified. Aim: This study was to compare the effectiveness of two oral hygiene aids: Chewing stick and manual toothbrush, for plaque removal and gingival health after one month of a randomized clinical trial. Materials and Methods: Dental students (age 18-22 years of a public sector dental hospital were recruited. Sample size was determined using the American Dental Association guidelines. Participants were randomized into two interventional groups and provided with either chewing sticks or toothbrushes. Pre- and post-intervention examinations were executed by two blind and calibrated examiners using plaque and gingival dental indices. Statistical analysis included descriptive statistics, paired t-test, and two sample independent t-tests. Results: Fifty subjects were recruited with mean age 20 ± 0.66 years (80% were females and 20% were males. Except for the mean plaque scores of toothbrush users (which increased at post-intervention examination, all other scores showed reduction. In contrast to the final mean gingival scores, a significant difference (P = < 0.0001 in the final mean plaque score was observed for the two respective interventional groups. Conclusion: Chewing stick has revealed parallel and at times greater mechanical and chemical cleansing of oral tissues as compared to a toothbrush.

  3. Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activity.

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    Ommerborn, Michelle A; Schneider, Christine; Giraki, Maria; Schäfer, Ralf; Handschel, Jörg; Franz, Matthias; Raab, Wolfgang H-M

    2007-02-01

    The impact of an occlusal splint (OS) compared with cognitive-behavioral treatment (CBT) on the management of sleep bruxism (SB) has been poorly investigated. The aim of this study was to evaluate the efficacy of an OS with CBT in SB patients. Following a randomized assignment, the OS group consisted of 29, and the CBT group of 28, SB patients. The CBT comprised problem-solving, progressive muscle relaxation, nocturnal biofeedback, and training of recreation and enjoyment. The treatment took place over a period of 12 wk, and the OS group received an OS over the same time period. Both groups were examined pretreatment, post-treatment, and at 6 months of follow-up for SB activity, self-assessment of SB activity and associated symptoms, psychological impairment, and individual stress-coping strategies. The analyses demonstrated a significant reduction in SB activity, self-assessment of SB activity, and psychological impairment, as well as an increase of positive stress-coping strategies in both groups. However, the effects were small and no group-specific differences were seen in any dependent variable. This is an initial attempt to compare CBT and OS in SB patients, and the data collected substantiate the need for further controlled evaluations, using a three-group randomized design with repeated measures to verify treatment effects.

  4. Comparative effects of contraction and angiotensin II on growth of adult feline cardiocytes in primary culture

    Science.gov (United States)

    Wada, H.; Zile, M. R.; Ivester, C. T.; Cooper, G. 4th; McDermott, P. J.

    1996-01-01

    The purposes of this study were 1) to determine whether angiotensin II causes growth of adult feline cardiocytes in long-term culture, 2) to compare the growth effects of angiotensin II with those resulting from electrically stimulated contraction, and 3) to determine whether the anabolic effects of contraction are exerted via the angiotensin type 1 receptor. Adult feline cardiocytes were cultured on laminin-coated trays in a serum-free medium. Cardiocytes were either electrically stimulated to contract (1 Hz, 5-ms pulse duration, alternating polarity) or were nonstimulated and quiescent. Quiescent cells were studied as controls and after treatment with angiotensin II (10(-8) M), losartan (10(-6) M; an angiotensin type 1-receptor antagonist), or angiotensin II plus losartan. Contracting cells were studied in the presence and absence of angiotensin II or losartan. In quiescent cardiocytes, angiotensin II treatment on day 7 significantly increased protein synthesis rates by 22% and protein content per cell by 17%. The effects of angiotensin II were completely blocked by losartan. Electrically stimulated contraction on days 4 and 7 in culture significantly increased protein synthesis rate by 18 and 38% and protein content per cell by 19 and 46%, respectively. Angiotensin II treatment did not further increase protein synthesis rate or protein content in contracting cardiocytes. Furthermore, losartan did not block the anabolic effects of contraction on protein synthesis rates or protein content. In conclusion, angiotensin II can exert a modest anabolic effect on adult feline cardiocytes in culture. In contracting feline cardiocytes, angiotensin II has no effect on growth. Growth caused by electrically stimulated contraction occurs more rapidly and is greater in magnitude than that caused by angiotensin II. Growth of contracting adult feline cardiocytes is not dependent on activation of the angiotensin receptor.

  5. Comparing the effects of aerobic exercise and Foeniculum vulgare on pre-menstrual syndrome

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    Hassan Pazoki

    2016-03-01

    Full Text Available Introduction: Premenstrual syndrome (PMS has been identified by a number of psychological and physical symptoms which occur cyclically in the luteal phase of the menstrual cycle. The present study has been carried out to compare the effects of regular exercise and Foeniculum vulgare extract (fennel together and separately on PMS in high school girls. Materials and methods: In this randomized clinical trial 48 students aged 16–18 years were selected by filling the daily record of severity of problem questionnaire (DRSP-Q. The participants were divided into four equal groups: the first group received fennel, the second group had aerobic exercise, the third group received fennel along with exercise and the last group was control group without fennel and exercise. Participants filled DRSP-Q three times: the first menstrual cycle before the intervention, the first menstrual cycle after four weeks and finally the first menstrual cycle after eight weeks of intervention. Results: After 8 weeks of intervention the severity of PMS symptoms reduced significantly in experimental groups (fennel, exercise and fennel + exercise compared to control group (P < 0.05. Meanwhile, there were not any significant differences in age, body mass index, age at menarche, age at dysmenorrhea onset and duration of menstruation among the four groups. Discussions: The result of this study indicated that fennels and exercise could reduce the severity of premenstrual syndrome. In addition, fennel extract and exercise together seem to be more effective on symptoms of anxiety and depression compared with using them alone.

  6. Comparative effectiveness of primary tumor resection in patients with stage IV colon cancer.

    Science.gov (United States)

    Alawadi, Zeinab; Phatak, Uma R; Hu, Chung-Yuan; Bailey, Christina E; You, Y Nancy; Kao, Lillian S; Massarweh, Nader N; Feig, Barry W; Rodriguez-Bigas, Miguel A; Skibber, John M; Chang, George J

    2017-04-01

    Although the safety of combination chemotherapy without primary tumor resection (PTR) in patients with stage IV colon cancer has been established, questions remain regarding a potential survival benefit with PTR. The objective of this study was to compare mortality rates in patients who had colon cancer with unresectable metastases who did and did not undergo PTR. An observational cohort study was conducted among patients with unresectable metastatic colon cancer identified from the National Cancer Data Base (2003-2005). Multivariate Cox regression analyses with and without propensity score weighting (PSW) were performed to compare survival outcomes. Instrumental variable analysis, using the annual hospital-level PTR rate as the instrument, was used to account for treatment selection bias. To account for survivor treatment bias, in situations in which patients might die soon after diagnosis from different reasons, a landmark method was used. In the total cohort, 8641 of 15,154 patients (57%) underwent PTR, and 73.8% of those procedures (4972 of 6735) were at landmark. PTR was associated with a significant reduction in mortality using Cox regression (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.44-0.47) or PSW (HR, 0.46; 95% CI, 0. 44-0.49). However, instrumental variable analysis revealed a much smaller effect (relative mortality rate, 0.91; 95% CI, 0.87-0.96). Although a smaller benefit was observed with the landmark method using Cox regression (HR, 0.6; 95% CI, 0.55-0.64) and PSW (HR, 0.59; 95% CI, 0.54-0.64), instrumental variable analysis revealed no survival benefit (relative mortality rate, 0.97; 95% CI, 0.87-1.06). Among patients with unresectable metastatic colon cancer, after adjustment for confounder effects, PTR was not associated with improved survival compared with systemic chemotherapy; therefore, routine noncurative PTR is not recommended. Cancer 2017;123:1124-1133. © 2016 American Cancer Society. © 2016 American Cancer Society.

  7. 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

  8. Comparative effect of treadmill exercise on mature BDNF production in control versus stroke rats.

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    Aurore Quirié

    Full Text Available Physical exercise constitutes an innovative strategy to treat deficits associated with stroke through the promotion of BDNF-dependent neuroplasticity. However, there is no consensus on the optimal intensity/duration of exercise. In addition, whether previous stroke changes the effect of exercise on the brain is not known. Therefore, the present study compared the effects of a clinically-relevant form of exercise on cerebral BDNF levels and localization in control versus stroke rats. For this purpose, treadmill exercise (0.3 m/s, 30 min/day, for 7 consecutive days was started in rats with a cortical ischemic stroke after complete maturation of the lesion or in control rats. Sedentary rats were run in parallel. Mature and proBDNF levels were measured on the day following the last boot of exercise using Western blotting analysis. Total BDNF levels were simultaneously measured using ELISA tests. As compared to the striatum and the hippocampus, the cortex was the most responsive region to exercise. In this region, exercise resulted in a comparable increase in the production of mature BDNF in intact and stroke rats but increased proBDNF levels only in intact rats. Importantly, levels of mature BDNF and synaptophysin were strongly correlated. These changes in BDNF metabolism coincided with the appearance of intense BDNF labeling in the endothelium of cortical vessels. Notably, ELISA tests failed to detect changes in BDNF forms. Our results suggest that control beings can be used to find conditions of exercise that will result in increased mBDNF levels in stroke beings. They also suggest cerebral endothelium as a potential source of BDNF after exercise and highlight the importance to specifically measure the mature form of BDNF to assess BDNF-dependent plasticity in relation with exercise.

  9. Mutagenic and cytotoxic effects of exhaust particulate matter of biodiesel compared to fossil diesel fuel.

    Science.gov (United States)

    Bünger, J; Krahl, J; Franke, H U; Munack, A; Hallier, E

    1998-07-08

    The mutagenic and cytotoxic effects of diesel engine exhaust (DEE) from a modern passenger car using rapeseed oil methyl esters (RME, biodiesel) as fuel were directly compared to DEE of diesel fuel (DF) derived from petroleum. Combustion particulate matter was collected on glass fiber filters coated with polytetrafluoroethylene (PTFE) from an exhaust dilution tunnel using three different engine test cycles on a chassis dynamometer. Filters were extracted with dichloromethane in a soxhlet apparatus for 12 h. The mutagenicity of the extracts was tested in the Salmonella typhimurium/mammalian microsome plate-incorporation assay using strains TA97a, TA98, TA100, and TA102. The toxicity to the established cell line L929 (mouse lung fibroblasts) was investigated in the neutral red assay. In the tester strains TA98 and TA100 a significant increase of mutations resulted for the particle extracts of both fuels, but for DF the revertants were significantly higher compared to RME. The highest levels of revertants were observed in tests including a cold start phase. This was probably due to incomplete combustion in the cold engine and a lower conversion rate of the cold catalytic converter. Testing with activated liver S9 fraction induced a slightly lower increase of revertants in most experiments. TA97a and TA102 showed no significant enhancement of spontaneous mutations. In the FTP-75 test cycle RME extracts showed slightly higher toxic effects to the L929 cells than DF, whereas in the other tests no significant differences were observable. These results indicate a higher mutagenic potency of DEE of DF compared to RME. This is probably due to the lower content of polycyclic aromatic compounds (PAC) in RME exhaust, although the emitted masses of RME were higher in most test procedures applied in this study.

  10. Comparative performance of high-fidelity training models for flexible ureteroscopy: Are all models effective?

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    Shashikant Mishra

    2011-01-01

    Full Text Available Objective: We performed a comparative study of high-fidelity training models for flexible ureteroscopy (URS. Our objective was to determine whether high-fidelity non-virtual reality (VR models are as effective as the VR model in teaching flexible URS skills. Materials and Methods: Twenty-one trained urologists without clinical experience of flexible URS underwent dry lab simulation practice. After a warm-up period of 2 h, tasks were performed on a high-fidelity non-VR (Uro-scopic Trainer TM ; Endo-Urologie-Modell TM and a high-fidelity VR model (URO Mentor TM . The participants were divided equally into three batches with rotation on each of the three stations for 30 min. Performance of the trainees was evaluated by an expert ureteroscopist using pass rating and global rating score (GRS. The participants rated a face validity questionnaire at the end of each session. Results: The GRS improved statistically at evaluation performed after second rotation (P<0.001 for batches 1, 2 and 3. Pass ratings also improved significantly for all training models when the third and first rotations were compared (P<0.05. The batch that was trained on the VR-based model had more improvement on pass ratings on second rotation but could not achieve statistical significance. Most of the realistic domains were higher for a VR model as compared with the non-VR model, except the realism of the flexible endoscope. Conclusions: All the models used for training flexible URS were effective in increasing the GRS and pass ratings irrespective of the VR status.

  11. A Comparative Effectiveness Meta-Analysis of Drugs for the Prophylaxis of Migraine Headache.

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    Jeffrey L Jackson

    Full Text Available To compare the effectiveness and side effects of migraine prophylactic medications.We performed a network meta-analysis. Data were extracted independently in duplicate and quality was assessed using both the JADAD and Cochrane Risk of Bias instruments. Data were pooled and network meta-analysis performed using random effects models.PUBMED, EMBASE, Cochrane Trial Registry, bibliography of retrieved articles through 18 May 2014.We included randomized controlled trials of adults with migraine headaches of at least 4 weeks in duration.Placebo controlled trials included alpha blockers (n = 9, angiotensin converting enzyme inhibitors (n = 3, angiotensin receptor blockers (n = 3, anticonvulsants (n = 32, beta-blockers (n = 39, calcium channel blockers (n = 12, flunarizine (n = 7, serotonin reuptake inhibitors (n = 6, serotonin norepinephrine reuptake inhibitors (n = 1 serotonin agonists (n = 9 and tricyclic antidepressants (n = 11. In addition there were 53 trials comparing different drugs. Drugs with at least 3 trials that were more effective than placebo for episodic migraines included amitriptyline (SMD: -1.2, 95% CI: -1.7 to -0.82, -flunarizine (-1.1 headaches/month (ha/month, 95% CI: -1.6 to -0.67, fluoxetine (SMD: -0.57, 95% CI: -0.97 to -0.17, metoprolol (-0.94 ha/month, 95% CI: -1.4 to -0.46, pizotifen (-0.43 ha/month, 95% CI: -0.6 to -0.21, propranolol (-1.3 ha/month, 95% CI: -2.0 to -0.62, topiramate (-1.1 ha/month, 95% CI: -1.9 to -0.73 and valproate (-1.5 ha/month, 95% CI: -2.1 to -0.8. Several effective drugs with less than 3 trials included: 3 ace inhibitors (enalapril, lisinopril, captopril, two angiotensin receptor blockers (candesartan, telmisartan, two anticonvulsants (lamotrigine, levetiracetam, and several beta-blockers (atenolol, bisoprolol, timolol. Network meta-analysis found amitriptyline to be better than several other medications including candesartan, fluoxetine, propranolol, topiramate and valproate and no different than

  12. Comparative Analysis of the Immunogenicity and Protective Effects of Inactivated EV71 Vaccines in Mice

    Science.gov (United States)

    Mao, Qunying; Dong, Chenghong; Li, Xiuling; Gao, Qiang; Guo, Zengbing; Yao, Xin; Wang, Yiping; Gao, Fan; Li, Fengxiang; Xu, Miao; Yin, Weidong; Li, Qihan; Shen, Xinliang; Liang, Zhenglun; Wang, Junzhi

    2012-01-01

    Background Enterovirus 71 (EV71) is the major causative agent of hand, foot, and mouth disease (HFMD). Three inactivated EV71 whole-virus vaccines of different strains developed by different manufacturers in mainland China have recently entered clinical trials. Although several studies on these vaccines have been published, a study directly comparing the immunogenicity and protective effects among them has not been carried out, which makes evaluating their relative effectiveness difficult. Thus, properly comparing newly developed vaccines has become a priority, especially in China. Methods and Findings This comparative immunogenicity study was carried out on vaccine strains (both live and inactivated), final container products (FCPs) without adjuvant, and corresponding FCPs containing adjuvant (FCP-As) produced by three manufacturers. These vaccines were evaluated by neutralizing antibody (NAb) responses induced by the same or different dosages at one or multiple time points post-immunization. The protective efficacy of the three vaccines was also determined in one-day-old ICR mice born to immunized female mice. Survival rates were observed in these suckling mice after challenge with 20 LD50 of EV71/048M3C2. Three FCP-As, in a dose of 200 U, generated nearly 100% NAb positivity rates and similar geometric mean titers (GMTs), especially at 14–21 days post-inoculation. However, the dynamic NAb responses were different among three vaccine strains or three FCPs. The FCP-As at the lowest dose used in clinical trials (162 U) showed good protective effects in suckling mice against lethal challenge (90–100% survival), while the ED50 of NAb responses and protective effects varied among three FCP-As. Conclusions These studies establish a standard method for measuring the immunogenicity of EV71 vaccines in mice. The data generated from our mouse model study indicated a clear dose-response relationship, which is important for vaccine quality control and assessment

  13. Comparative analysis of the immunogenicity and protective effects of inactivated EV71 vaccines in mice.

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    Qunying Mao

    Full Text Available BACKGROUND: Enterovirus 71 (EV71 is the major causative agent of hand, foot, and mouth disease (HFMD. Three inactivated EV71 whole-virus vaccines of different strains developed by different manufacturers in mainland China have recently entered clinical trials. Although several studies on these vaccines have been published, a study directly comparing the immunogenicity and protective effects among them has not been carried out, which makes evaluating their relative effectiveness difficult. Thus, properly comparing newly developed vaccines has become a priority, especially in China. METHODS AND FINDINGS: This comparative immunogenicity study was carried out on vaccine strains (both live and inactivated, final container products (FCPs without adjuvant, and corresponding FCPs containing adjuvant (FCP-As produced by three manufacturers. These vaccines were evaluated by neutralizing antibody (NAb responses induced by the same or different dosages at one or multiple time points post-immunization. The protective efficacy of the three vaccines was also determined in one-day-old ICR mice born to immunized female mice. Survival rates were observed in these suckling mice after challenge with 20 LD(50 of EV71/048M3C2. Three FCP-As, in a dose of 200 U, generated nearly 100% NAb positivity rates and similar geometric mean titers (GMTs, especially at 14-21 days post-inoculation. However, the dynamic NAb responses were different among three vaccine strains or three FCPs. The FCP-As at the lowest dose used in clinical trials (162 U showed good protective effects in suckling mice against lethal challenge (90-100% survival, while the ED(50 of NAb responses and protective effects varied among three FCP-As. CONCLUSIONS: These studies establish a standard method for measuring the immunogenicity of EV71 vaccines in mice. The data generated from our mouse model study indicated a clear dose-response relationship, which is important for vaccine quality control and

  14. Timothy pollen. Longer follow-up, but still no proven advantage.

    Science.gov (United States)

    2010-12-01

    For patients with persistent hay fever despite allergen avoidance and symptomatic treatment, data available in 2007 did not favour sublingual desensitisation over subcutaneous desensitisation.There are still no comparative trials of sublingual versus subcutaneous desensitisation. A systematic review in a total of 410 children and adolescents, published in 2008, confirmed the lack of efficacy of sublingual lyophilisates of timothy grass pollen extract. A placebo-controlled double-blind trial was subsequently published, including 253 children aged 5 to 16 years, who were monitored during one pollen season. Preventive treatment with timothy grass pollen extract for about 5 to 9 months was associated with an average of 9 extra days without the need for symptomatic treatment during the pollen season, compared to placebo therapy. In children, the main adverse effect was itchy mouth (32% versus 2% with placebo). One child had to stop treatment due to an adverse effect that worsened from day to day. In adults who continue to suffer from hay fever despite symptomatic treatment, a summary of follow-up data from the randomised placebo-controlled trial of timothy grass pollen extract included in the initial assessment report has been published. However, it is too vague to assess the benefit in terms of the number of days without symptomatic treatment during pollen season (it was only 4 additional days after the first year of treatment). Most adverse effects observed in adults were local reactions. Data on possible severe adverse effects are scarce. In practice, the preventive effects of sublingual timothy grass pollen extract are very modest in both adults and children.There are no trials comparing this treatment with subcutaneous desensitisation. Adverse effects are frequent and mainly local reactions.

  15. The Effect of Neoadjuvant Chemotherapy Compared to Adjuvant Chemotherapy in Healing after Nipple-Sparing Mastectomy.

    Science.gov (United States)

    Frey, Jordan D; Choi, Mihye; Karp, Nolan S

    2017-01-01

    Nipple-sparing mastectomy is the latest advancement in the treatment of breast cancer. The authors aimed to investigate the effects of neoadjuvant and adjuvant chemotherapy in nipple-sparing mastectomy. Patients undergoing nipple-sparing mastectomy from 2006 to June of 2015 were identified. Results were stratified by presence of neoadjuvant or adjuvant chemotherapy. A total of 840 nipple-sparing mastectomies were performed. Twenty-eight were in those who received neoadjuvant chemotherapy and 93 were in patients receiving adjuvant chemotherapy. Patients receiving both neoadjuvant and adjuvant chemotherapy were included in the neoadjuvant group. Nipple-sparing mastectomies that received neoadjuvant (with or without adjuvant) chemotherapy were compared to those in patients who received adjuvant chemotherapy. Those with neoadjuvant (with or without adjuvant) chemotherapy were more likely to have explantation (p = 0.0239) and complete nipple-areola complex necrosis (p = 0.0021). Those with neoadjuvant (with or without adjuvant) chemotherapy were more likely to have implant explantation (p = 0.0015) and complete nipple-areola complex necrosis (p = 0.0004) compared to those with no chemotherapy. Compared to nipple-sparing mastectomies in patients with no chemotherapy, those with adjuvant chemotherapy were more likely to have a hematoma (p = 0.0021). Those that received both neoadjuvant and adjuvant chemotherapy were more likely to have complete nipple-areola complex necrosis compared with both the neoadjuvant chemotherapy-only and adjuvant chemotherapy-only groups (p < 0.0001). Nipple-sparing mastectomy is safe to perform in the setting of neoadjuvant and adjuvant chemotherapy. As a whole, neoadjuvant (with or without adjuvant) chemotherapy increases risk of complications. Therapeutic, III.

  16. Bipolar mixed features - Results from the comparative effectiveness for bipolar disorder (Bipolar CHOICE) study.

    Science.gov (United States)

    Tohen, Mauricio; Gold, Alexandra K; Sylvia, Louisa G; Montana, Rebecca E; McElroy, Susan L; Thase, Michael E; Rabideau, Dustin J; Nierenberg, Andrew A; Reilly-Harrington, Noreen A; Friedman, Edward S; Shelton, Richard C; Bowden, Charles L; Singh, Vivek; Deckersbach, Thilo; Ketter, Terence A; Calabrese, Joseph R; Bobo, William V; McInnis, Melvin G

    2017-08-01

    DSM-5 changed the criteria from DSM-IV for mixed features in mood disorder episodes to include non-overlapping symptoms of depression and hypomania/mania. It is unknown if, by changing these criteria, the same group would qualify for mixed features. We assessed how those meeting DSM-5 criteria for mixed features compare to those meeting DSM-IV criteria. We analyzed data from 482 adult bipolar patients in Bipolar CHOICE, a randomized comparative effectiveness trial. Bipolar diagnoses were confirmed through the MINI International Neuropsychiatric Interview (MINI). Presence and severity of mood symptoms were collected with the Bipolar Inventory of Symptoms Scale (BISS) and linked to DSM-5 and DSM-IV mixed features criteria. Baseline demographics and clinical variables were compared between mood episode groups using ANOVA for continuous variables and chi-square tests for categorical variables. At baseline, the frequency of DSM-IV mixed episodes diagnoses obtained with the MINI was 17% and with the BISS was 20%. Using DSM-5 criteria, 9% of participants met criteria for hypomania/mania with mixed features and 12% met criteria for a depressive episode with mixed features. Symptom severity was also associated with increased mixed features with a high rate of mixed features in patients with mania/hypomania (63.8%) relative to those with depression (8.0%). Data on mixed features were collected at baseline only and thus do not reflect potential patterns in mixed features within this sample across the study duration. The DSM-5 narrower, non-overlapping definition of mixed episodes resulted in fewer patients who met mixed criteria compared to DSM-IV. Copyright © 2017. Published by Elsevier B.V.

  17. Comparative effectiveness of tocilizumab with either methotrexate or leflunomide in the treatment of rheumatoid arthritis.

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    Javier Narváez

    Full Text Available In agreement with EULAR recommendations, a DMARD in combination with a biotherapy is the reference treatment because of the superior long-term clinical and radiographic outcomes. Methotrexate (MTX is the cornerstone of combination therapy but is in some cases contra-indicated or poorly tolerated. This observational study aimed to compare the effectiveness and safety of TCZ in combination with either MTX or leflunomide (LEF in the treatment of patients with active rheumatoid arthritis (RA and an inadequate response to one or more DMARDs and/or biological agents in a real-world setting.We performed an ambispective review of 91 patients with active RA who were routinely treated with TCZ plus MTX or LEF. A comparative study between the two combinations of treatment was performed at 6 months of follow-up considering 3 outcomes: improvement of RA disease activity, evolution of functional disability, and tolerability and side effect profile.Of the 91 patients, 62 received TCZ with MTX and 29 received TCZ with LEF. Eighty-one patients were followed for 6 months, and the remaining 10 patients discontinued treatment due to serious adverse events. At baseline, there were no significant differences between the groups in terms of the main clinical and laboratory data or in the number of previous DMARDs and biological agents used. At 6 months, there were no significant differences between the combinations in terms of disease activity and functional disability. Serious adverse events occurred in 11% and 10% of the patients treated in combination with MTX and LEF, respectively.Our preliminary data support the argument that LEF is an effective and safe (equivalent alternative to MTX for combination treatment with TCZ.

  18. Comparative effect of thymus vulgaris and ibuprofen on primary dysmenorrhea: A triple-blind clinical study.

    Science.gov (United States)

    Salmalian, Hajar; Saghebi, Roshanak; Moghadamnia, Ali Akbar; Bijani, Ali; Faramarzi, Mahbobeh; Nasiri Amiri, Fatemeh; Bakouei, Fatemeh; Behmanesh, Fereshte; Bekhradi, Reza

    2014-01-01

    Dysmenorrhea is one of the most common medical problems in gynecology causing several problems in the personal and social life of women. This study was conducted to compare the effect of thymus vulgaris and ibuprofen on the treatment of primary dysmenorrhea Methods: This clinical study was conducted on 84 students of Babol University of Medical Sciences with primary dysmenorrhea. The students were randomly assigned to three groups receiving thymus vulgaris, ibuprofen and placebo. In all three groups, with the beginning of pain, 200 mg capsules and 25 drops of essential oil were given every 6 hours for two consecutive cycles. Pain intensity used the visual scale before and one hour after each dose for 48 hour after starting medication. The data were collected and analyzed. This study was registered in the Iranian Registry of Clinical Trial (www.irct.ir) with registration number ID: IRCT201101245683N1 RESULTS: The mean age of participants was 20.5±1.8 years. Both thymus vulgaris and ibuprofen were effective to reduce the pain severity of dysmenorrhea. Before treatment, the mean pain intensity in thymus vulgaris, ibuprofen and placebo groups were 6.57±2.02, 5.30±2.23 and 6.18±1.78, respectively and after treatment decreased to 1.21±1.06, 1.48±1.62 and 3.54±2.26, respectively. Reduction of pain severity was not statistically significant between the two medications, however it was significant for each drug compared with placebo (pthymus vulgaris as well as ibuprofen can be effective in reducing the severity of pain and spasm in primary dysmenorrhea.

  19. Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia

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    Hajheydari Zohreh

    2009-01-01

    Full Text Available Background: Finasteride, a type P-selective 5a-reductase inhibitor, as a causative agent of decreasing dihydroxy testestrone (DHT level, is effective in the treatment of male androgenic alopecia. Aim: We compared the local and oral finasteride in the treatment of androgenic alopecia. Method: This is a double blind, randomized clinical trial study of 45 male patients, who were referred with alopecia to the private clinics and departments in Boo-Ali Sina Hospital, in Sari. Patients with male androgenic alopecia were selected according to the history and physical examinations. The patients were randomly divided into two: topical finasteride (A and oral finasteride (B groups. Topical finasteride group (A received a topical gel of 1% finasteride and placebo tablets, while the oral finasteride group (B received finasteride tablets (1 mg and gel base (without drug as placebo for 6 months. The patients were followed by clinical observation and recording of side effects prior to the treatment and at the end of first week, and then by a monthly follow-up. The size of bald area, total hair count, and terminal hair were studied. Data were analyzed by descriptive and Chi-square statistical test. Results: The mean duration of hair loss was 18.8±23.10 months. Each month the terminal hair, size of bald area and hair count between the two groups were compared. There were no significant differences between the two groups as a viewpoint of hair thickness, hair counts and the size of bald area. Serial measurements indicated a significant increase in hair counts and terminal hair counts between the two groups. Conclusions: The results of this study showed that the therapeutic effects of both finasteride gel and finasteride tablet were relatively similar to each other.

  20. A comparative study of the modeled effects of atrazine on aquatic plant communities in midwestern streams.

    Science.gov (United States)

    Nair, Shyam K; Bartell, Steven M; Brain, Richard A

    2015-11-01

    Potential effects of atrazine on the nontarget aquatic plants characteristic of lower-order streams in the Midwestern United States were previously assessed using the Comprehensive Aquatic System Model (CASMATZ ). Another similar bioenergetics-based, mechanistic model, AQUATOX, was examined in the present study, with 3 objectives: 1) to develop an AQUATOX model simulation similar to the CASMATZ model reference simulation in describing temporal patterns of biomass production by modeled plant populations, 2) to examine the implications of the different approaches used by the models in deriving plant community-based levels of concern (LOCs) for atrazine, and 3) to determine the feasibility of implementing alternative ecological models to assess ecological impacts of atrazine on lower-order Midwestern streams. The results of the present comparative modeling study demonstrated that a similar reference simulation to that from the CASMATZ model could be developed using the AQUATOX model. It was also determined that development of LOCs and identification of streams with exposures in excess of the LOCs were feasible with the AQUATOX model. Compared with the CASMATZ model results, however, the AQUATOX model consistently produced higher estimates of LOCs and generated non-monotonic variations of atrazine effects with increasing exposures. The results of the present study suggest an opportunity for harmonizing the treatments of toxicity and toxicity parameter estimation in the CASMATZ and the AQUATOX models. Both models appear useful in characterizing the potential impacts of atrazine on nontarget aquatic plant populations in lower-order Midwestern streams. The present model comparison also suggests that, with appropriate parameterization, these process-based models can be used to assess the potential effects of other xenobiotics on stream ecosystems.

  1. Comparing effects of transmitters within and among populations: application to swimming performance of juvenile Chinook salmon

    Science.gov (United States)

    Perry, Russell W.; Plumb, John M.; Fielding, Scott D.; Adams, Noah S.; Rondorf, Dennis W.

    2013-01-01

    The sensitivity of fish to a transmitter depends on factors such as environmental conditions, fish morphology, life stage, rearing history, and tag design. However, synthesizing general trends across studies is difficult because each study focuses on a particular performance measure, species, life stage, and transmitter model. These differences motivated us to develop simple metrics that allow effects of transmitters to be compared among different species, populations, or studies. First, we describe how multiple regression analysis can be used to quantify the effect of tag burden (transmitter mass relative to fish mass) on measures of physiological performance. Next, we illustrate how the slope and intercept parameters can be used to calculate two summary statistics: θ, which estimates the tag burden threshold above which the performance of tagged fish begins to decline relative to untagged fish; and k, which measures the percentage change in performance per percentage point increase in tag burden. When θ = 0, k provides a single measure of the tag's effect that can be compared among species, populations, or studies. We apply this analysis to two different experiments that measure the critical swimming speed (U crit) of tagged juvenile Chinook Salmon Oncorhynchus tshawytscha. In both experiments, U crit declined as tag burden increased, but we found no significant threshold in swimming performance. Estimates of θ ranged from −0.6% to 2.1% among six unique treatment groups, indicating that swimming performance began to decline at a relatively low tag burden. Estimates of k revealed that U crit of tagged fish declined by −2.68% to −4.86% for each 1% increase in tag burden. Both θ and k varied with the tag's antenna configuration, tag implantation method, and posttagging recovery time. Our analytical approach can be used to gain insights across populations to better understand factors affecting the ability of fish to carry a transmitter.

  2. 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

    2017-07-05

    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.

  3. Autonomic, neuroendocrine, and immunological effects of ayahuasca: a comparative study with d-amphetamine.

    Science.gov (United States)

    Dos Santos, Rafael G; Valle, Marta; Bouso, José Carlos; Nomdedéu, Josep F; Rodríguez-Espinosa, José; McIlhenny, Ethan H; Barker, Steven A; Barbanoj, Manel J; Riba, Jordi

    2011-12-01

    Ayahuasca is an Amazonian psychotropic plant tea combining the 5-HT2A agonist N,N-dimethyltryptamine (DMT) and monoamine oxidase-inhibiting β-carboline alkaloids that render DMT orally active. The tea, obtained from Banisteriopsis caapi and Psychotria viridis, has traditionally been used for religious, ritual, and medicinal purposes by the indigenous peoples of the region. More recently, the syncretistic religious use of ayahuasca has expanded to the United States and Europe. Here we conducted a double-blind randomized crossover clinical trial to investigate the physiological impact of ayahuasca in terms of autonomic, neuroendocrine, and immunomodulatory effects. An oral dose of encapsulated freeze-dried ayahuasca (1.0 mg DMT/kg body weight) was compared versus a placebo and versus a positive control (20 mg d-amphetamine) in a group of 10 healthy volunteers. Ayahuasca led to measurable DMT plasma levels and distinct subjective and neurophysiological effects that were absent after amphetamine. Both drugs increased pupillary diameter, with ayahuasca showing milder effects. Prolactin levels were significantly increased by ayahuasca but not by amphetamine, and cortisol was increased by both, with ayahuasca leading to the higher peak values. Ayahuasca and amphetamine induced similar time-dependent modifications in lymphocyte subpopulations. Percent CD4 and CD3 were decreased, whereas natural killer cells were increased. Maximum changes occurred around 2 hours, returning to baseline levels at 24 hours. In conclusion, ayahuasca displayed moderate sympathomimetic effects, significant neuroendocrine stimulation, and a time-dependent modulatory effect on cell-mediated immunity. Future studies on the health impact of long-term ayahuasca consumption should consider the assessment of immunological status in regular users.

  4. Greater physiological and behavioral effects of interrupted stress pattern compared to daily restraint stress in rats.

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    Wei Zhang

    Full Text Available Repeated stress can trigger a range of psychiatric disorders, including anxiety. The propensity to develop abnormal behaviors after repeated stress is related to the severity, frequency and number of stressors. However, the pattern of stress exposure may contribute to the impact of stress. In addition, the anxiogenic nature of repeated stress exposure can be moderated by the degree of coping that occurs, and can be reflected in homotypic habituation to the repeated stress. However, expectations are not clear when a pattern of stress presentation is utilized that diminishes habituation. The purpose of these experiments is to test whether interrupted stress exposure decreases homotypic habituation and leads to greater effects on anxiety-like behavior in adult male rats. We found that repeated interrupted restraint stress resulted in less overall homotypic habituation compared to repeated daily restraint stress. This was demonstrated by greater production of fecal boli and greater corticosterone response to restraint. Furthermore, interrupted restraint stress resulted in a lower body weight and greater adrenal gland weight than daily restraint stress, and greater anxiety-like behavior in the elevated plus maze. Control experiments demonstrated that these effects of the interrupted pattern could not be explained by differences in the total number of stress exposures, differences in the total number of days that the stress periods encompased, nor could it be explained as a result of only the stress exposures after an interruption from stress. These experiments demonstrate that the pattern of stress exposure is a significant determinant of the effects of repeated stress, and that interrupted stress exposure that decreases habituation can have larger effects than a greater number of daily stress exposures. Differences in the pattern of stress exposure are therefore an important factor to consider when predicting the severity of the effects of repeated

  5. [Comparative study on curative effects of stroke treated with acupuncture by NIRS].

    Science.gov (United States)

    Li, Hong; Hou, Zhong-wei; Bai, Yu-lan; Gu, Shi-zhe

    2011-11-01

    To compare the intracephalic imaging differences of stroke treated with combined therapy of scalp and body acupuncture and body acupuncture only, in order to apply the image basis for the differences of clinical curative effects. Twenty cases of stroke were randomized into a body acupuncture group (group A) and a scalp and body acupuncture group (group B), ten cases in each group respectively. In group A, body acupuncture was applied simply, and different acupoints were selected according to the symptoms: Shousanli (LI 10), Jianliao (TE 14), Huantiao (GB 30) and Jiaji (EX-B 2) etc. were selected for hemiplegia, Fengchi (GB 20), Xiaguan (ST 7) and Quanliao (SI 18) etc. were for facial paralysis, Fengfu (GV 16) and Lianquan (CV 23) etc. were for aphasia. In group B, combined therapy were applied, the body acupoints selection was same as above; for scalp acupoints, corresponding motor area, sensory area and foot motor sensory area were selected. Instant changes of local cerebral blood flow before and after treatment were examined and evaluated by NIRS and the curative effects of both groups were evaluated. The total therapeutic effective rate was 90.0% (9/10) and the basically cured rate was 30.0% (3/10) in group A; and 100.0% (10/10) and 50.0% (5/10) respectively in group B, indicating that the clinical curative effect in group B was superior to that in group A at 20, 30 min of acupuncture treatment (P acupuncture treatment (all P Acupuncture can significantly increase blood flow and oxygen saturation in brain cortex, and the effect with combined therapy of scalp and body acupuncture is superior to that with body acupuncture.

  6. COMPARATIVE EFFECTS OF NITRAZEPAM AND ACTH ON THE TREATMENT OF INFANTILE SPASM

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    MM. Taghdir

    2007-08-01

    Full Text Available ObjectiveInfantile spasms (IS or West syndrome is a convulsive disease characterizedby brief, symmetric axial muscle contractions (neck, trunk, and/or extremities.The therapy universally recognized as most effective in the treatment of IS,is treatment with the adrenocorticotropic hormone (ACTH or oral corticosteroids.This therapy however has important side effects. Many studies have soughtto find alternative therapies with fewer side effects. Nitrazepam, it has beenproven, can be as effective as ACTH in controlling infantile spasms. The aimof this study was to evaluate and compare the efficacy of Nitrazepam andACTH on the treatment of infantile spasms.Materials & MethodsThis randomized controlled clinical trial, enrolled sixty patients with newlydiagnosed and previously untreated IS; diagnosis was made based on thecriteria of The International Classification of Epilepsies of the InternationalLeague Against Epilepsy (ILAE. Prior to treatment, all patients underwentElectro encephalo graphs (EEGs and CT scans. Patients were randomized toreceive 0.5-1 mg/kg Nitrazpam (NZP in three daily doses or 40 IU DepotACTH in a single morning dose. Complete cessation of spasms was consideredto be as optimal response.ResultsOf the sixty patients studied, 24 (40% were girls and 36(60% were boys. Allpatients in the both groups were matched for age and sex.There were nodifferences between the both groups regarding age and sex (non-significant.Following treatments, at the end of the 6-week duration therapy, optimalresponse (Cessation of spasms was obtained in 19 (63% patients of NZPgroup and 9 (30% patients of ACTH group, (P0.05.ConclusionThis study supports the belief that NZP offers an effective and possibly safertherapy than ACTH, for the management of IS and that the therapeuticresponse, if imminent, can be detected within 4-6 weeks of treatment. Cliniciansshould consider using NZP as a first-line therapy for IS.

  7. Impact of vaccine herd-protection effects in cost-effectiveness analyses of childhood vaccinations. A quantitative comparative analysis

    Science.gov (United States)

    Maldonado, Yvonne; Ioannidis, John P. A.; Contopoulos-Ioannidis, Despina

    2017-01-01

    Background Inclusion of vaccine herd-protection effects in cost-effectiveness analyses (CEAs) can impact the CEAs-conclusions. However, empirical epidemiologic data on the size of herd-protection effects from original studies are limited. Methods We performed a quantitative comparative analysis of the impact of herd-protection effects in CEAs for four childhood vaccinations (pneumococcal, meningococcal, rotavirus and influenza). We considered CEAs reporting incremental-cost-effectiveness-ratios (ICERs) (per quality-adjusted-life-years [QALY] gained; per life-years [LY] gained or per disability-adjusted-life-years [DALY] avoided), both with and without herd protection, while keeping all other model parameters stable. We calculated the size of the ICER-differences without vs with-herd-protection and estimated how often inclusion of herd-protection led to crossing of the cost-effectiveness threshold (of an assumed societal-willingness-to-pay) of $50,000 for more-developed countries or X3GDP/capita (WHO-threshold) for less-developed countries. Results We identified 35 CEA studies (20 pneumococcal, 4 meningococcal, 8 rotavirus and 3 influenza vaccines) with 99 ICER-analyses (55 per-QALY, 27 per-LY and 17 per-DALY). The median ICER-absolute differences per QALY, LY and DALY (without minus with herd-protection) were $15,620 (IQR: $877 to $48,376); $54,871 (IQR: $787 to $115,026) and $49 (IQR: $15 to $1,636) respectively. When the target-vaccination strategy was not cost-saving without herd-protection, inclusion of herd-protection always resulted in more favorable results. In CEAs that had ICERs above the cost-effectiveness threshold without herd-protection, inclusion of herd-protection led to crossing of that threshold in 45% of the cases. This impacted only CEAs for more developed countries, as all but one CEAs for less developed countries had ICERs below the WHO-cost-effectiveness threshold even without herd-protection. In several analyses, recommendation for the

  8. Comparative Effects of Two Gingerol-Containing Zingiber officinale Extracts on Experimental Rheumatoid Arthritis1

    Science.gov (United States)

    Funk, Janet L.; Frye, Jennifer B.; Oyarzo, Janice N.; Timmermann, Barbara N.

    2009-01-01

    Ginger (Zingiber officinale) supplements are being promoted for arthritis treatment in western societies based on ginger’s traditional use as an anti-inflammatory in Chinese and Ayurvedic medicine. However, scientific evidence of ginger’s antiarthritic effects is sparse, and its bioactive joint-protective components have not been identified. Therefore, the ability of a well-characterized crude ginger extract to inhibit joint swelling in an animal model of rheumatoid arthritis, streptococcal cell wall (SCW)-induced arthritis, was compared to that of a fraction containing only gingerols and their derivatives. Both extracts were efficacious in preventing joint inflammation. However, the crude dichloromethane extract, which also contained essential oils and more polar compounds, was more efficacious (when normalized to gingerol content) in preventing both joint inflammation and destruction. In conclusion, these data document a very significant joint-protective effect of these ginger samples, and suggest that non-gingerol components are bioactive and can enhance the antiarthritic effects of the more widely studied gingerols. PMID:19216559

  9. Analgesic effect of intra-articular tramadol compared with morphine after arthroscopic knee surgery.

    Science.gov (United States)

    Akinci, Seda B; Saricaoğlu, Fatma; Atay, Ozgur Ahmet; Doral, Mahmut Nedim; Kanbak, Meral

    2005-09-01

    The aim of the study was to compare the analgesic effect of 5 mg intra-articular (IA) morphine with 50 mg IA tramadol. Prospective double-blind randomized trial. Seventy-five patients having elective arthroscopic surgery of the knee were randomized to receive IA tramadol 50 mg (tramadol group), IA morphine 5 mg (morphine group), or IA normal saline (control group), in equivalent volumes (20 mL). The tourniquet was released 10 minutes after analgesic administration. Verbal pain rating score between 0 and 10 (VRS), supplemental analgesic requirements, and incidence of side effects were recorded postoperatively. Results are given as (median [5-95 percentiles]). The control group had a significantly shorter time to first analgesic request (25 min [15-55]) than morphine group, (34 min [15-158], P tramadol group, (33 min [17-728], P tramadol group (VRS 0 [0-9], P = .002). These treatment benefits were especially prominent in the patients who had meniscectomy or in the subgroup of patients with more than 6 months of preoperative pain. There was no statistical difference between the tramadol and morphine groups in the time to first analgesia, postoperative pain scores after arrival at the postanesthesia care unit, consumption of rescue analgesic, or side effects. We conclude that 50 mg IA tramadol provides analgesia equivalent to 5 mg IA morphine. Level II, randomized controlled trial that shows no significant difference and lacks narrow confidence intervals.

  10. Comparative effects of gamma irradiation and phosphine fumigation on the quality of white ginseng

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    Kwon, J.-H.Joong-Ho; Byun, M.-W.Myung-Woo; Kim, K.-S.Kang-Soo; Kang, I.-J.Il-Jun

    2000-03-01

    The hygienic, physicochemical, and organoleptic qualities of white ginseng were monitored during 6 months under accelerated conditions (40 deg. C, 90% r.h.) by observing its microbial populations, disinfestation, and some quality attributes following either gamma irradiation at 2.5-10 kGy or commercial phosphine (PH{sub 3}) fumigation. In a comparative study, both treatments were found to be effective for disinfecting the stored samples. Phosphine showed no appreciable decontaminating effects on microorganisms contaminated including coliforms, while 5 kGy irradiation was sufficient to control all microorganisms related to the quality of the packed samples. Irradiation at 5 kGy caused negligible changes in physicochemical attributes of the samples, such as ginsenosides, amino acids, fatty acids, and organoleptic properties, whereas phosphine fumigation was found detrimental to sensory flavor (P<0.01). Quality deterioration occurred in the commercially-packed samples was in the following order: the control, 10 kGy-, phosphine-, and 2.5-5 kGy-treated samples. Accordingly, irradiation at <5 kGy was found to be an effective alternative to phosphine fumigation for white ginseng. (author)

  11. Building a Strategic Framework for Comparative Effectiveness Research in Complementary and Integrative Medicine

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    Claudia M. Witt

    2012-01-01

    Full Text Available The increasing burden of chronic diseases presents not only challenges to the knowledge and expertise of the professional medical community, but also highlights the need to improve the quality and relevance of clinical research in this domain. Many patients now turn to complementary and integrative medicine (CIM to treat their chronic illnesses; however, there is very little evidence to guide their decision-making in usual care. The following research recommendations were derived from a CIM Stakeholder Symposium on Comparative Effectiveness Research (CER: (1 CER studies should be made a priority in this field; (2 stakeholders should be engaged at every stage of the research; (3 CER study designs should highlight effectiveness over efficacy; (4 research questions should be well defined to enable the selection of an appropriate CER study design; (5 the CIM community should cultivate widely shared understandings, discourse, tools, and technologies to support the use and validity of CER methods; (6 Effectiveness Guidance Documents on methodological standards should be developed to shape future CER studies. CER is an emerging field and its development and impact must be reflected in future research strategies within CIM. This stakeholder symposium was a first step in providing systematic guidance for future CER in this field.

  12. Building a Strategic Framework for Comparative Effectiveness Research in Complementary and Integrative Medicine

    Science.gov (United States)

    Witt, Claudia M.; Chesney, Margaret; Gliklich, Richard; Green, Lawrence; Lewith, George; Luce, Bryan; McCaffrey, Anne; Rafferty Withers, Shelly; Sox, Harold C.; Tunis, Sean; Berman, Brian M.

    2012-01-01

    The increasing burden of chronic diseases presents not only challenges to the knowledge and expertise of the professional medical community, but also highlights the need to improve the quality and relevance of clinical research in this domain. Many patients now turn to complementary and integrative medicine (CIM) to treat their chronic illnesses; however, there is very little evidence to guide their decision-making in usual care. The following research recommendations were derived from a CIM Stakeholder Symposium on Comparative Effectiveness Research (CER): (1) CER studies should be made a priority in this field; (2) stakeholders should be engaged at every stage of the research; (3) CER study designs should highlight effectiveness over efficacy; (4) research questions should be well defined to enable the selection of an appropriate CER study design; (5) the CIM community should cultivate widely shared understandings, discourse, tools, and technologies to support the use and validity of CER methods; (6) Effectiveness Guidance Documents on methodological standards should be developed to shape future CER studies. CER is an emerging field and its development and impact must be reflected in future research strategies within CIM. This stakeholder symposium was a first step in providing systematic guidance for future CER in this field. PMID:23346206

  13. [Comparative study on effect of acupuncture and lidocaine block for lumbar myofascial pain syndrome].

    Science.gov (United States)

    Jiang, Gui-Mei; Lin, Mou-De; Wang, Lu-Ying

    2013-03-01

    To observe the clinical efficacy of acupuncture at Jiaji (EX-B 2) points mainly for lumbar myofascial pain syndrome (MPS). Sixty-six cases of MPS were randomized into an acupuncture group and a lidocaine group, 33 cases in each group. The acupuncture group was treated with acupuncture at Jiaji (EX-B 2) points combined with needling local myofascial trigger points (MTrP), and the lidocaine group was treated with local block at trigger points with lidocaine injection. The treatment was given once every 2 days. After three and five times of the treatment, the simplified McGill scale, Oswestry disability index (ODI) and pressure-pain threshold were assessed to compare the therapeutic effects between the two groups. After treatment, the scores of simplified McGill and ODI of two groups were obviously reduced while the score of pressure-pain threshold was obviously increased (all P 0.05). Acupuncture at Jiaji (EX-B 2) points combined with needling MTrP is an effective and safe therapy for lumbar MPS, the therapeutic effect is equal to lidocaine block.

  14. Comparative anti-inflammatory effects of anti-arthritic herbal medicines and ibuprofen.

    Science.gov (United States)

    Kang, Joshua J; Samad, Mohammed A; Kim, Kye S; Bae, Soochan

    2014-09-01

    Non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, are widely used over-the-counter drugs to treat arthritis, but they are often associated with side effects. Herbal medicines have been used to treat various diseases such as arthritis, but the scientific profiles are not well understood. In this study, we examined, in comparison with ibuprofen, the inhibitory effects on various inflammatory markers of the most commonly used herbal medicines to treat arthritis, boswellia (Boswellia sapindales), licorice (Glycyrrhiza glabra), guggul (Commiphora wightii), and neem (Azadirachta indica). To elicit inflammatory response, we exposed mouse myoblast C2C12 cells to lipopolysaccharide (LPS). Tumor necrosis factor-alpha (TNF-α) and monocyte chemotactic protein-1 (MCP-1), which are cytokines activated during an inflammatory response, were determined. The optimal non-toxic concentration was determined by exposing different concentrations of drugs (from 0.01 to 10 mg/mL). Cell death measurement revealed that the drug concentrations lower than 0.05 mg/mL were non-toxic concentrations for each drug, and these doses were used for the main experiments. We found that neem and licorice showed robust anti-inflammatory responses compared with ibuprofen. However, boswellia and guggul did not demonstrate significant anti-inflammatory responses. We concluded that neem and licorice are more effective than ibuprofen in suppressing LPS-induced inflammation in C2C12 cells.

  15. Comparative effectiveness of monomolecular surface film on Aedes aegypti (L. and Anopheles minimus (Theobald (Diptera: Culicidae

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    Chutipong Sukkanon

    2016-11-01

    Full Text Available Silicone-based surfactants have become of interest for mosquito control in Thailand. When this non-ionic surfactant is applied in mosquito habitats, a monomolecular film (MMF forms on the water surface and disrupts the ability of larvae and pupae to breathe. In this study, a laboratory bioassay was conducted to determine the mosquito control potential of MMF against Aedes aegypti (L. and Anopheles minimus (Theobald, and to compare its efficacy with other larvicides consisting of temephos (an organophosphate, Bacillus thuringiensis israelensis (Bti and pyriproxyfen (an insect growth regulator. It was determined that the percentage mortality of Ae. aegypti and An. minimus treated with MMF at a recommended dosage of 1 mL/m2 was significantly greater in pupae (99.2% and 100%, respectively than old stage larvae (L3–L4, age 46 d; 70.8% and 97.5%, respectively and young stage larvae (L1–L2, age 1–2 d; 8.3% and 58.0%, respectively. Small larvae and prolonged stage transformations indicated MMF growth inhibition activity. MMF also displayed oviposition deterrence behavior and caused female mosquitoes to drown during egg laying. In comparison, temephos and Bti were highly effective in larval control while pyriproxyfen and MMF provided excellent control effects against the pupal stage. Based on the results, MMF showed promise as an alternative larvicide for mosquito control in Thailand. Further studies on the environmental effects of MMF are needed.

  16. Comparative effect of telmisartan vs lisinopril on blood pressure in patients of metabolic syndrome.

    Science.gov (United States)

    Gore, Pradip N; Badar, Vandana A; Hardas, Mrunalini M; Bansode, Varsha J

    2015-01-01

    The present study was planned to focus on comparative effects of telmisartan vs lisinopril on blood pressure in patients of metabolic syndrome The study was carried out on 62 patients of metabolic syndrome from Dec 2010 to Oct 2012 in OPD of Institute. There were two groups, A and B. Group A- Telmisartan (31 patients) and Group B- Lisinopril (31 patients) receiving Telmisartan 40 mg and lisinopril 5 mg orally once a day respectively for 12 weeks. The diagnosis of essential hypertension was made by the physician based on two measurements of blood pressure on two different occasions using auscultatory method and was done at initial stage and repeated after 6 weeks and 12 weeks of treatment in Group A and Group B patients. Our study found that telmisartan or lisinopril treatment for 12 weeks leads to statistically significant (ptelmisartan and lisinopril treatment failed to show any statistically significant effect. Treatment of metabolic patients with telmisartan or lisinopril for the management of hypertension reduced both Systolic blood pressure (SBP) as well as Diastolic blood pressure (DBP) statistically significantly during 12 weeks treatment. However, telmisartan and lisinopril treatment were found effective.

  17. [A comparative analysis of effectiveness, tolerance and cost of second generation antidepressants in France].

    Science.gov (United States)

    Fond, Guillaume

    2015-03-01

    While French authorities point to the need for rational prescribing, especially concerning psychotropic drugs, few data on the prescription of second-generation antidepressants (SGA) are synthesized for clinicians' use. Our objective is to carry out a comparative analysis of effectiveness and tolerability / acceptability of SGA. Considering the benefit/risk ratio and the cost (generic), the first-line treatment for a major depressive episode may be currently sertraline (50 mg / d). It may however have more digestive side effects than other SSRIs (due to the serotonin action), which calls for caution while increasing doses. Fluoxetine seems relevant in treatment of negative symptoms of schizophrenia (20mg / d) and in bulimia (60mg / d). Fluvoxamine seems relevant in the case of sexual side effects with a previous SSRI, in treatment of anxiety disorders (it's affinity for sigma receptors may confer a specific action) and in psychotic depression. Mirtazapine may be a treatment of interest when a fast remission of depressive symptoms (especially insomnia) is warranted but