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Sample records for plato trial ticagrelor

  1. Misrepresentation of vital status follow-up: challenging the integrity of the PLATO trial and the claimed mortality benefit of ticagrelor versus clopidogrel.

    Science.gov (United States)

    DiNicolantonio, James J; Tomek, Ales

    2013-10-30

    Ticagrelor, a novel, reversible, and oral P2Y12 receptor antagonist, was claimed to reduce all-cause mortality compared to clopidogrel in the PLATO trial. We sought to ascertain vital status follow-up for clopidogrel and ticagrelor to determine if any discrepancy existed by reviewing data from the FDA Complete Response Review. The FDA Complete Response Review indicated misrepresentation of vital status follow-up by the sponsor's presenter at the Cardiovascular and Renal Drugs Advisory Committee. Instead of five patients with missing vital status follow-up, the FDA primary efficacy reviewer indicated that there was a minimum of 106 patients. Additionally and more concerning was the fact that significantly more patients on ticagrelor (3.1%, n = 289 patients) had incomplete vital status follow-up versus clopidogrel (2.6%, n = 242 patients, p = 0.04 for the difference). The Advisory Committee that voted in favor to approve ticagrelor was given misrepresented data, which may have affected the approval of ticagrelor. The fact that significantly more patients on ticagrelor had incomplete vital status follow-up versus clopidogrel challenges the claimed mortality benefit of ticagrelor and the approval of the PLATO trial. © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Cardiovascular events in acute coronary syndrome patients with peripheral arterial disease treated with ticagrelor compared to clopidogrel: Data from the PLATO trials

    DEFF Research Database (Denmark)

    Patel, Manesh R.; Becker, Richard C.; Wojdyla, Daniel M.;

    Abstract 14299: Cardiovascular Events in Acute Coronary Syndrome Patients With Peripheral Arterial Disease Treated With Ticagrelor Compared to Clopidogrel: Data From the PLATO Trial Manesh R Patel1; Richard C Becker1; Daniel M Wojdyla2; Håkan Emanuelsson3; William Hiatt4; Jay Horrow5; Steen Husted6...

  3. Ticagrelor

    Directory of Open Access Journals (Sweden)

    Gianluca Airoldi

    2013-03-01

    Full Text Available Antiplatelet drugs are the cornerstone of treatment for patients with acute coronary syndromes (ACS who undergo percutaneous coronary intervention. Clopidogrel and aspirin improve long-term clinical outcomes in these patients and have become a standard of care. However, many patients still experience ischemic/thrombotic events, and it appears that insufficient response to both aspirin and clopidogrel contribute to this failure. Clopidogrel is a prodrug that is metabolized in the liver to its active form. It inhibits platelet aggregation induced by adenosine diphosphate (ADP by irreversibly binding to the ADP purinergic receptor (P2Y12 on the platelet surface. Prasugrel, a novel thienopyridine, exhibits more potent antiplatelet effects with lower interpatient variability and more rapid onsetof activity. All thienopyridines, however, have pharmacological limitations, which have fueled the search for more effective non-thienopyridine P2Y12 inhibitors. Promising results have been reported with ticagrelor, the first oral P2Y12 receptor antagonist with reversible effects. Ticagrelor does not require metabolic activation. In vivo one active metabolite is formed whose potency and pharmacokinetic properties are very similar to those of the parent compound, but it probably plays a minor role in ticagrelor’s antiplatelet effects. Ticagrelor offers more rapid and more pronounced platelet inhibition than other antiplatelet agents. Furthermore, the reversibility of its effects may allow shorter periods of suspension of antiplatelet treatment prior to surgery, reducing the risk of perioperative thrombotic and hemorrhagic events. Preliminary results show a trend toward protection from coronary events and no increased risk for major bleeding compared with clopidogrel. Further investigation is needed, however, to determine the optimal dosage for minimizing bleeding risks and to evaluate its impact on outcomes in various subsets of ACS patients.

  4. Angiographic outcomes in the PLATO Trial (Platelet Inhibition and Patient Outcomes)

    National Research Council Canada - National Science Library

    Kunadian, Vijay; James, Stefan K; Wojdyla, Daniel M; Zorkun, Cafer; Wu, Jinhui; Storey, Robert F; Steg, Ph Gabriel; Katus, Hugo; Emanuelsson, Hakan; Horrow, Jay; Maya, Juan; Wallentin, Lars; Harrington, Robert A; Gibson, C Michael

    2013-01-01

    The PLATO (Platelet Inhibition and Patient Outcomes) angiographic substudy sought to compare the efficacy of ticagrelor versus clopidogrel with respect to angiographic outcomes before and after PCI in the setting of acute coronary syndrome...

  5. Ticagrelor Associated Heart Block: The Need for Close and Continued Monitoring

    Directory of Open Access Journals (Sweden)

    Munish Sharma

    2017-01-01

    Full Text Available Ticagrelor is an antiplatelet agent prescribed to prevent the development of adverse cardiac events after acute coronary syndrome (ACS. According to the PLATO trial, ticagrelor is associated with ventricular pauses in the first week of treatment; however, these episodes were felt to be asymptomatic and nonfatal to the patient. We present a case of ticagrelor related second-degree type II heart block causing severe dizziness and diaphoresis that resolved after discontinuation of the medication.

  6. ST-elevation acute coronary syndromes in the Platelet Inhibition and Patient Outcomes (PLATO) trial

    DEFF Research Database (Denmark)

    Armstrong, Paul W; Siha, Hany; Fu, Yuling;

    2012-01-01

    Ticagrelor, when compared with clopidogrel, reduced the 12-month risk of vascular death/myocardial infarction and stroke in patients with ST-elevation acute coronary syndromes intended to undergo primary percutaneous coronary intervention in the PLATelet inhibition and patient Outcomes (PLATO) tr...

  7. Risk for Major Bleeding in Patients Receiving Ticagrelor Compared With Aspirin After Transient Ischemic Attack or Acute Ischemic Stroke in the SOCRATES Study (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes).

    Science.gov (United States)

    Easton, J Donald; Aunes, Maria; Albers, Gregory W; Amarenco, Pierre; Bokelund-Singh, Sara; Denison, Hans; Evans, Scott R; Held, Peter; Jahreskog, Marianne; Jonasson, Jenny; Minematsu, Kazuo; Molina, Carlos A; Wang, Yongjun; Wong, K S Lawrence; Johnston, S Claiborne

    2017-09-05

    Patients with minor acute ischemic stroke or transient ischemic attack are at high risk for subsequent stroke, and more potent antiplatelet therapy in the acute setting is needed. However, the potential benefit of more intense antiplatelet therapy must be assessed in relation to the risk for major bleeding. The SOCRATES trial (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes) was the first trial with ticagrelor in patients with acute ischemic stroke or transient ischemic attack in which the efficacy and safety of ticagrelor were compared with those of aspirin. The main safety objective was assessment of PLATO (Platelet Inhibition and Patient Outcomes)-defined major bleeds on treatment, with special focus on intracranial hemorrhage (ICrH). An independent adjudication committee blinded to study treatment classified bleeds according to the PLATO, TIMI (Thrombolysis in Myocardial Infarction), and GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) definitions. The definitions of ICrH and major bleeding excluded cerebral microbleeds and asymptomatic hemorrhagic transformations of cerebral infarctions so that the definitions better discriminated important events in the acute stroke population. A total of 13 130 of 13 199 randomized patients received at least 1 dose of study drug and were included in the safety analysis set. PLATO major bleeds occurred in 31 patients (0.5%) on ticagrelor and 38 patients (0.6%) on aspirin (hazard ratio, 0.83; 95% confidence interval, 0.52-1.34). The most common locations of major bleeds were intracranial and gastrointestinal. ICrH was reported in 12 patients (0.2%) on ticagrelor and 18 patients (0.3%) on aspirin. Thirteen of all 30 ICrHs (4 on ticagrelor and 9 on aspirin) were hemorrhagic strokes, and 4 (2 in each group) were symptomatic hemorrhagic transformations of brain infarctions. The ICrHs were spontaneous in 6 and 13, traumatic in 3 and 3, and procedural in 3 and 2

  8. Ticagrelor: A new antiplatelet drug for acute coronary syndromes

    Directory of Open Access Journals (Sweden)

    Tirtha V Patel

    2013-01-01

    Full Text Available Coronary heart disease and acute coronary syndrome (ACS are a significant cause of morbidity and mortality all over the world. Antiplatelet agents play an essential role in the treatment of acute coronary syndrome (ACS, usually with aspirin and a thienopyridine. Currently, clopidogrel, a second generation thienopyridine, is the main drug of choice, and the combination of aspirin and clopidogrel is administered orally for the treatment of ACS. Clopidogrel, the most commonly used thienopyridine, is limited by a high degree of interpatient variability and inconsistent inhibition of platelets. Ticagrelor, a new, oral, direct-acting P2Y12 receptor antagonist, produces a more profound and consistent antiplatelet effect than clopidogrel. The U.S. Food and Drug Administration approved Ticagrelor on July 20, 2011. Furthermore, ticagrelor has at least one active metabolite, which has pharmacokinetics that are very similar to the parent compound. Therefore, ticagrelor has a more rapid onset and more pronounced platelet inhibition than other antiplatelet agents. The safety and efficacy of ticagrelor compared with clopidogrel, in an ACS patient, has been recently evaluated by the PLATelet inhibition and patient Outcomes (PLATO trial. Clinical studies of patients with both ST-elevation and non-ST-elevation ACS have shown that ticagrelor, when compared with clopidogrel, reduces the rates of vascular death and myocardial infarction. The clinical data currently available indicate that ticagrelor is a promising option for the treatment of patients with ACS and may be of particular use in those at high risk for ischemic events or in those unresponsive to clopidogrel.

  9. Ticagrelor in Acute Stroke or Transient Ischemic Attack in Asian Patients: From the SOCRATES Trial (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes).

    Science.gov (United States)

    Wang, Yongjun; Minematsu, Kazuo; Wong, Ka Sing Lawrence; Amarenco, Pierre; Albers, Gregory W; Denison, Hans; Easton, J Donald; Evans, Scott R; Held, Peter; Jonasson, Jenny; Molina, Carlos A; Johnston, S Claiborne

    2017-01-01

    In the SOCRATES trial (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes), ticagrelor was not superior to aspirin. Because of differences in patient demographics and stroke disease pattern in Asia, outcomes of ticagrelor versus aspirin were assessed among Asian patients in a prespecified exploratory analysis. Baseline demographics, treatment effects, and safety of ticagrelor and aspirin were assessed among Asian patients. Differences in outcomes between groups were assessed using Cox proportional hazard model. A total of 3858 (29.2%) SOCRATES participants were recruited in Asia. Among the Asian patients, the primary end point event occurred in 186 (9.6%) of the 1933 patients treated with ticagrelor, versus 224 (11.6%) of the 1925 patients treated with aspirin (hazard ratio, 0.81; 95% confidence interval, 0.67-0.99). The exploratory P value for treatment-by-region interaction was 0.27. The primary end point event rate in the Asian subgroup was numerically higher than that in the non-Asian group (10.6% versus 5.7%; nominal Pacute stroke or transient ischemic attacks, there was a trend toward a lower hazard ratio in reducing risk of the primary end point of stroke, myocardial infarction, or death in the ticagrelor group. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01994720. © 2016 American Heart Association, Inc.

  10. Chewed ticagrelor tablets provide faster platelet inhibition compared to integral tablets: The inhibition of platelet aggregation after administration of three different ticagrelor formulations (IPAAD-Tica) study, a randomised controlled trial.

    Science.gov (United States)

    Venetsanos, Dimitrios; Sederholm Lawesson, Sofia; Swahn, Eva; Alfredsson, Joakim

    2017-01-01

    To provide pharmacodynamic data of crushed and chewed ticagrelor tablets, in comparison with standard integral tablets. Ninety nine patients with stable angina were randomly assigned, in a 3:1:1 fashion, to one of the following 180mg ticagrelor loading dose (LD) formulations: A) Integral B) Crushed or C) Chewed tablets. Platelet reactivity (PR) was assessed with VerifyNow before, 20 and 60min after LD. High residual platelet reactivity (HRPR) was defined as >208 P2Y12 reaction units (PRU). There was no significant difference in PRU values at baseline. PRU 20min after LD were 237 (182-295), 112 (53-238) and 84 (29-129) and 60min after LD, 56 (15-150), 51 (18-85) and 9 (7-34) in integral, crushed and chewed ticagrelor LD, respectively (pintegral tablets at 20 and 60min. Crushed ticagrelor LD resulted in significantly lower PRU values compared to integral tablets at 20min whereas no difference was observed at 60min. At 20min, no patients had HRPR with chewed ticagrelor compared to 68% with integral and 30% with crushed ticagrelor LD (pintegral tablets. We also show that administration of chewed tablets is feasible and provides faster inhibition than either crushed or integral tablets. European Clinical Trial Database (EudraCT number 2014-002227-96). Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Cost-effectiveness analysis of ticagrelor compared to clopidogrel for the treatment of patients with acute coronary syndrome in Colombia.

    Science.gov (United States)

    Mejía, Aurelio; Senior, Juan Manuel; Ceballos, Mateo; Atehortúa, Sara; Toro, Juan Manuel; Saldarriaga, Clara; Mejía, María Elena; Ramírez, Carolina

    2015-01-01

    Acute coronary syndrome is one of the most frequent medical emergencies in developing countries. To determine, from the perspective of the Colombian health system, the cost-effectiveness of ticagrelor compared to clopidogrel for the treatment of patients with acute coronary syndrome. We conducted a cost-effectiveness analysis from the perspective of the Colombian health system comparing ticagrelor and clopidogrel for the treatment of patients with acute coronary syndrome. To estimate the expected costs and outcomes, a Markov model was constructed in which patients could remain stable without experiencing new cardiovascular events, suffer from a new event, or die. For the baseline case, a 10-year time horizon and a discount ratio of 3% for costs and benefits were adopted. The transition probabilities were extracted from the PLATO (Platelet Inhibition and Patient Outcomes) clinical trial. Vital statistics were drawn from the Departmento Administrativo Nacional de Estadística (DANE) and additional information from Colombian patients included in the Access registry. To identify and measure resource use, a standard case was built by consulting guidelines and protocols. Unit costs were obtained from Colombian rate lists. A probabilistic sensitivity analysis was conducted in which costs were represented by a triangular distribution, and the effectiveness through a beta distribution. In the base case, the additional cost per quality-adjusted life-year gained with ticagrelor was COP$ 28,411,503. The results were sensitive to changes in the time horizon and the unit cost of clopidogrel. For a willingness-to-pay equivalent to three times the Colombian per capita gross domestic product, the probability of ticagrelor being cost-effective was 75%. Ticagrelor is a cost-effective strategy for the treatment of patients with acute coronary syndrome in Colombia.

  12. Plato's Embryology.

    Science.gov (United States)

    Wilberding, James

    2015-01-01

    Embryology was a subject that inspired great cross-disciplinary discussion in antiquity, and Plato's Timaeus made an important contribution to this discussion, though Plato's precise views have remained a matter of controversy, especially regarding three key questions pertaining to the generation and nature of the seed: whether there is a female seed; what the nature of seed is; and whether the seed contains a preformed human being. In this paper I argue that Plato's positions on these three issues can be adequately determined, even if some other aspects of his theory cannot. In particular, it is argued that (i) Plato subscribes to the encephalo-myelogenic theory of seed, though he places particular emphasis on the soul being the true seed; (ii) Plato is a two-seed theorist, yet the female seed appears to make no contribution to reproduction; and (iii) Plato cannot be an advocate of preformationism.

  13. Lost in follow-up rates in TRACER, ATLAS ACS 2, TRITON and TRA 2P trials: challenging PLATO mortality rates.

    Science.gov (United States)

    DiNicolantonio, James J; Can, Mehmet Mustafa; Serebruany, Victor L

    2013-04-15

    Extreme rates of vascular and all-cause mortality especially in the clopidogrel arm of the Platelet Inhibition and Patient Outcomes (PLATO) non-USA cohort raise concerns of data integrity, and call for independent verification of vital records in the national death registries. Four recent acute coronary syndrome (ACS) trials: Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER), Anti-Xa therapy to lower cardiovascular events in addition to standard therapy in subjects with acute coronary syndrome (ATLAS-ACS 2), Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel (TRITON), and the Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2P), provide a valuable opportunity to match lost in follow-up (LIFU) with mortality rates among similar ACS studies. To compare the LIFU from PLATO, TRACER, ATLAS-ACS 2, TRITON-TIMI 38 and TRA 2P trials. The disturbingly high (8.9%-14.7%) LIFU in PLATO was no match to LIFU in TRACER (0.1%), ATLAS ACS 2 (0.3%), TRITON (0.1%) and TRA 2P (0.1%). In fact, such an astronomical (49-147 fold higher) PLATO LIFU rate should result in less mortality compared to the other ACS trials since no event can be reported or adjudicated if the patient has been lost. Adjusting LIFU rate revealed that vascular (5.55%) and all cause (6.05%) mortality in PLATO was even more disparate than in TRACER (3.2% and 4.9%), ATLAS-ACS 2 (4.1% and 4.5%), TRITON-TIMI 38 (2.4% and 3.2%) and TRA 2P (3.0% and 5.3%) control arms, respectfully. Moreover, the incomplete CV follow-up in the ATLAS ACS 2 trial was later revealed to be around 12%, which lead to the rejection of rivaroxaban for the treatment of ACS. PLATO's LIFU rate was just as high, if not higher, than seen in ATLAS ACS 2. The chance to die in PLATO far exceeds the mortality risks observed in the clopidogrel arms of four recent ACS trials, which becomes especially evident after

  14. Long-term use of ticagrelor in patients with prior heart attack: ticagrelor plus aspirin versus aspirin monotherapy.

    Science.gov (United States)

    Amico, Frank; Schlesinger, Alex; Mazzoni, Jennifer

    2016-01-01

    Review of: Bonaca MP, Bhatt DL, Cohen M, et al. Long-term use of ticagrelor in patients with prior myocardial infarction. N Engl J Med. 2015;372:1791-1800. This Practice Pearl reviews the recent study Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared With Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54). It challenges the current standard of care of 12 months of dual antiplatelet followed by aspirin indefinitely. The study demonstrated that patients who received ticagrelor, either the 60 mg or 90 mg twice daily plus aspirin, showed a decreased risk of cardiovascular death, myocardial infarction, or stroke. The PEGASUS-TIMI 54 trial also proved that the benefit of ticagrelor was seen early and continued to accrue over time, with a median of 33 months of follow-up, meaning that the benefit persists over time. It is important to note that both doses of the ticagrelor were associated with higher incidence of bleeding, but the rates of fatal bleeding did not show any difference between the ticagrelor or placebo.

  15. Filsafat Ketuhanan Menurut Plato

    Directory of Open Access Journals (Sweden)

    Ivan Th.J Weismann

    2005-06-01

    Full Text Available Plato adalah filsuf pertama yang menulis secara filosofis dan secara sistematik teologis mengenai konsep Ketuhanan sehingga dapatlah dikatakan bahwa ia adalah peletqk dasar bagi ilmu teologia dan memberikan pengaruh besar bagi perkembanganfilsafat Barat khususnya tentangkonsep Ketuhanan. Pemikiran Plato tentang Ketuhanan adalah upayanya untuk mereformasi konsep Ketuhanan yang terdapat pada masyarakat Yunani kuno. Tulisan ini berupaya menganalisis dan memahami Ketuhanan menurut Plato agar pembaca masa kini dapat mengerti lebih dalam lagi tentong konsep Ketuhanan yang dipahami masyarakat Yunani kuno dan khususnya menurut Plato, dan juga dapat dijadikan sebagai bahan perbandingan bagifilsafat Ketuhanan pada masa kini. Filsafat Ketuhanan menurut Plato ini penulis jelaskan dengan memperhatikandimensi metafisika, epistemologi, dan etika.

  16. Long-term use of ticagrelor in patients with prior myocardial infarction.

    Science.gov (United States)

    Bonaca, Marc P; Bhatt, Deepak L; Cohen, Marc; Steg, Philippe Gabriel; Storey, Robert F; Jensen, Eva C; Magnani, Giulia; Bansilal, Sameer; Fish, M Polly; Im, Kyungah; Bengtsson, Olof; Oude Ophuis, Ton; Budaj, Andrzej; Theroux, Pierre; Ruda, Mikhail; Hamm, Christian; Goto, Shinya; Spinar, Jindrich; Nicolau, José Carlos; Kiss, Robert G; Murphy, Sabina A; Wiviott, Stephen D; Held, Peter; Braunwald, Eugene; Sabatine, Marc S

    2015-05-07

    The potential benefit of dual antiplatelet therapy beyond 1 year after a myocardial infarction has not been established. We investigated the efficacy and safety of ticagrelor, a P2Y12 receptor antagonist with established efficacy after an acute coronary syndrome, in this context. We randomly assigned, in a double-blind 1:1:1 fashion, 21,162 patients who had had a myocardial infarction 1 to 3 years earlier to ticagrelor at a dose of 90 mg twice daily, ticagrelor at a dose of 60 mg twice daily, or placebo. All the patients were to receive low-dose aspirin and were followed for a median of 33 months. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The primary safety end point was Thrombolysis in Myocardial Infarction (TIMI) major bleeding. The two ticagrelor doses each reduced, as compared with placebo, the rate of the primary efficacy end point, with Kaplan-Meier rates at 3 years of 7.85% in the group that received 90 mg of ticagrelor twice daily, 7.77% in the group that received 60 mg of ticagrelor twice daily, and 9.04% in the placebo group (hazard ratio for 90 mg of ticagrelor vs. placebo, 0.85; 95% confidence interval [CI], 0.75 to 0.96; P=0.008; hazard ratio for 60 mg of ticagrelor vs. placebo, 0.84; 95% CI, 0.74 to 0.95; P=0.004). Rates of TIMI major bleeding were higher with ticagrelor (2.60% with 90 mg and 2.30% with 60 mg) than with placebo (1.06%) (P<0.001 for each dose vs. placebo); the rates of intracranial hemorrhage or fatal bleeding in the three groups were 0.63%, 0.71%, and 0.60%, respectively. In patients with a myocardial infarction more than 1 year previously, treatment with ticagrelor significantly reduced the risk of cardiovascular death, myocardial infarction, or stroke and increased the risk of major bleeding. (Funded by AstraZeneca; PEGASUS-TIMI 54 ClinicalTrials.gov number, NCT01225562.).

  17. [Plato psychiatrist, Foucault platonic].

    Science.gov (United States)

    Mathov, Nicolás

    2016-05-01

    This work explores the links between the concepts of "soul", "law" and "word" in Plato's work, in order to highlight the importance and the centrality of the philosophical-therapeutic dimension in the Greek philosopher's thought. In that way, this work pretends to show that "contemporary" problems usually discussed within "Human Sciences" in general, and Psychiatry in particular, should confront their knowledge with Plato's work, mainly due to the profound influence his ideas have had in our Greco-Christian culture. In that sense, and with that objective, this work also explores Michel Foucault's lucid and controversial interpretation of Plato.

  18. Evaluating the Risk–Benefit Profile of the Direct-Acting P2Y12 Inhibitor Ticagrelor in Acute Coronary Syndromes

    DEFF Research Database (Denmark)

    Husted, Steen

    2011-01-01

    from any cause and stent thrombosis reductions achieved nominal statistical significance. Ticagrelor showed benefit over clopidogrel in almost all patient subgroups, including patients who had previously received clopidogrel, patients with both planned invasive or noninvasive treatment, patients...... with ST-segment elevation MI (STEMI) referred for primary percutaneous coronary intervention, patients with non-STEMI, and patients who underwent bypass surgery. Hence, the PLATO population reflected specifically those patients who would ordinarily receive thienopyridine-based antiplatelet therapy...

  19. Occurrence, causes, and outcome after switching from ticagrelor to clopidogrel in a real-life scenario: data from a prospective registry.

    Science.gov (United States)

    Biscaglia, Simone; Campo, Gianluca; Pavasini, Rita; Tebaldi, Matteo; Tumscitz, Carlo; Ferrari, Roberto

    2016-07-01

    In randomized clinical trials, ticagrelor has been substituted in roughly one-third of the patients during follow-up. To date, there are no studies addressing safety and modalities of switching from ticagrelor to clopidogrel. The aim of our study is to describe the occurrence, causes, and outcome of the switch from ticagrelor to clopidogrel in a real-life scenario. From June 2013 to March 2015, 586 patients were treated with ticagrelor in our centre. Overall, 101 (17%) patients were switched to clopidogrel through a standardized protocol, and they were followed-up for 12 months. Ischemic and bleeding events were prospectively recorded. The switch from ticagrelor to clopidogrel occurred mostly after discharge (69 ± 40 days), and the most frequent cause was the need of oral anticoagulation treatment, followed by bleeding events. Patients requiring ticagrelor discontinuation were older, more frequently female, with lower body mass index and creatinine clearance if compared to the "non-switched" group. In the 10 days after the switch, we did not observe ischemic adverse events. No definite/probable stent thrombosis was recorded. Before the switch, there was a significant higher occurrence of BARC bleedings in the "switched" group, particularly BARC 1 and 2. Our data confirm that the switch from ticagrelor to clopidogrel is common, and it occurs for several reasons. Our analysis did not demonstrate a significant increase in adverse cardiovascular events in the days following the switch from ticagrelor to clopidogrel, although larger studies are needed to validate our findings.

  20. Long-term cost-effectiveness of ticagrelor versus clopidogrel in acute coronary syndrome in Spain

    Directory of Open Access Journals (Sweden)

    E. Molina-Cuadrado

    2014-07-01

    Full Text Available Objective: To assess the cost-effectiveness relationship of Ticagrelor versus Clopidogrel for the management of acute coronary syndrome in Spain. Methods: The data from the PLATO study were used for the calculation of the events rate and health-related quality of life for Ticagrelor and Clopidogrel for the first 12 months, whereas the costs were obtained from Spanish sources. Quality of lifeadjusted survival and costs were estimated according to the fact that the patients did not suffer any thrombotic event (myocardial infarction or ictus or this one was not fatal. The lifetime cots, life years gained, and the quality of life-adjusted survival were estimated for both treatment arms. Incremental costeffectiveness ratios were assessed through the perspective of the Spanish healthcare system for 2013, by using a macro-costs strategy based on published literature and the survival tables for the Spanish population. Results: Treatment with Ticagrelor was associated to an incremental cost of 1,228 per year, an increase in 0.1652 life years gained, and 0.1365 years adjusted by quality of life, as compared to Clopidogrel. The cost for one quality of life-adjusted life year was 8,997 and the cost per one gained life year of 7,435 . The sensitivity analysis showed consistent results. Conclusions: Treatment of acute coronary syndrome for 12 months with Ticagrelor was associated with a cost per 1 life year of quality of life-adjusted cost below the cost-effectiveness limits generally accepted in Spain.

  1. PLATO IV Accountancy Index.

    Science.gov (United States)

    Pondy, Dorothy, Comp.

    The catalog was compiled to assist instructors in planning community college and university curricula using the 48 computer-assisted accountancy lessons available on PLATO IV (Programmed Logic for Automatic Teaching Operation) for first semester accounting courses. It contains information on lesson access, lists of acceptable abbreviations for…

  2. Control Data's Education Offering: "Plato Would Have Enjoyed PLATO"

    Science.gov (United States)

    Datamation, 1976

    1976-01-01

    Programmed Learning and Teaching Operation (PLATO) distributes instructional materials in the form of text, numbers, animated drawings and other graphics for individualized, self-paced learning. (Author)

  3. From Pericles to Plato

    DEFF Research Database (Denmark)

    Larsen, Øjvind

    2012-01-01

    Plato is normally taken as one of the founders of Western political philosophy, not at least with his Republic. Here, he constructs a hierarchy of forms of governments, beginning with aristocracy at the top as a critical standard for the other forms of governments, and proceeding through timocrac......’ funeral oration is used to show that Pericles presented a democratic political philosophy that can serve as a counterpoint to Plato’s political philosophy in the Republic....

  4. Peers on Socrates and Plato

    Science.gov (United States)

    Mackenzie, Jim

    2014-01-01

    There is more to be said about two of the topics Chris Peers addresses in his article "Freud, Plato and Irigaray: A morpho-logic of teaching and learning" (2012, Educational Philosophy and Theory, 44, 760-774), namely the Socratic method of teaching and Plato's stance with regard to women and feminism. My purpose in this article is…

  5. PLATO Sitcom Dialogs for Russian.

    Science.gov (United States)

    Dawson, Clayton; Provenzano, Nolen

    1981-01-01

    Situation comedy (sitcom) dialogs that are included in PLATO lessons for first year Russian students are described. These comprehension exercises make use of both the touch panel and the audio capabilities of PLATO. The sitcom dialogs were written by a native speaker of Russian and are based on the vocabulary in the textbook plus a small number of…

  6. Peers on Socrates and Plato

    Science.gov (United States)

    Mackenzie, Jim

    2014-01-01

    There is more to be said about two of the topics Chris Peers addresses in his article "Freud, Plato and Irigaray: A morpho-logic of teaching and learning" (2012, Educational Philosophy and Theory, 44, 760-774), namely the Socratic method of teaching and Plato's stance with regard to women and feminism. My purpose in this article is…

  7. Ticagrelor reduces neutrophil recruitment and lung damage in abdominal sepsis.

    Science.gov (United States)

    Rahman, Milladur; Gustafsson, David; Wang, Yongzhi; Thorlacius, Henrik; Braun, Oscar Ö

    2014-01-01

    Abstract Platelets play an important role in abdominal sepsis and P2Y12 receptor antagonists have been reported to exert anti-inflammatory effects. Herein, we assessed the impact of platelet inhibition with the P2Y12 receptor antagonist ticagrelor on pulmonary neutrophil recruitment and tissue damage in a model of abdominal sepsis. Wild-type C57BL/6 mice were subjected to cecal ligation and puncture (CLP). Animals were treated with ticagrelor (100 mg/kg) or vehicle prior to CLP induction. Edema formation and bronchoalveolar neutrophils as well as lung damage were quantified. Flow cytometry was used to determine expression of platelet-neutrophil aggregates, neutrophil activation and CD40L expression on platelets. CLP-induced pulmonary infiltration of neutrophils at 24 hours was reduced by 50% in ticagrelor-treated animals. Moreover, ticagrelor abolished CLP-provoked lung edema and decreased lung damage score by 41%. Notably, ticagrelor completely inhibited formation of platelet-neutrophil aggregates and markedly reduced thrombocytopenia in CLP animals. In addition, ticagrelor reduced platelet shedding of CD40L in septic mice. Our data indicate that ticagrelor can reduce CLP-induced pulmonary neutrophil recruitment and lung damage suggesting a potential role for platelet antagonists, such as ticagrelor, in the management of patients with abdominal sepsis.

  8. Structural and functional characterization of a specific antidote for ticagrelor.

    Science.gov (United States)

    Buchanan, Andrew; Newton, Philip; Pehrsson, Susanne; Inghardt, Tord; Antonsson, Thomas; Svensson, Peder; Sjögren, Tove; Öster, Linda; Janefeldt, Annika; Sandinge, Ann-Sofie; Keyes, Feenagh; Austin, Mark; Spooner, Jennifer; Gennemark, Peter; Penney, Mark; Howells, Garnet; Vaughan, Tristan; Nylander, Sven

    2015-05-28

    Ticagrelor is a direct-acting reversibly binding P2Y12 antagonist and is widely used as an antiplatelet therapy for the prevention of cardiovascular events in acute coronary syndrome patients. However, antiplatelet therapy can be associated with an increased risk of bleeding. Here, we present data on the identification and the in vitro and in vivo pharmacology of an antigen-binding fragment (Fab) antidote for ticagrelor. The Fab has a 20 pM affinity for ticagrelor, which is 100 times stronger than ticagrelor's affinity for its target, P2Y12. Despite ticagrelor's structural similarities to adenosine, the Fab is highly specific and does not bind to adenosine, adenosine triphosphate, adenosine 5'-diphosphate, or structurally related drugs. The antidote concentration-dependently neutralized the free fraction of ticagrelor and reversed its antiplatelet activity both in vitro in human platelet-rich plasma and in vivo in mice. Lastly, the antidote proved effective in normalizing ticagrelor-dependent bleeding in a mouse model of acute surgery. This specific antidote for ticagrelor may prove valuable as an agent for patients who require emergency procedures.

  9. In-stent thrombosis when switching ticagrelor to clopidogrel after percutaneous coronary intervention.

    Science.gov (United States)

    Brice, Aaron E; Hernandez, Gabriel A; Sanchez, Mariluz; Haynick, Marshall; Mendoza, Cesar E

    2017-05-01

    Dual antiplatelet therapy with aspirin and a P2Y12 receptor blocker has been proven to reduce subsequent cardiovascular events and in-stent thrombosis in patients undergoing percutaneous coronary intervention. Newer P2Y12 antagonists with faster onset and greater inhibition of platelet activity have improved cardiovascular outcomes but have created uncertainty with the appropriate dosing when switching between agents. Currently, there are no evidence-based guidelines to aid clinicians when switching between P2Y12 receptor blockers. Here we describe two patients that developed in-stent thrombosis when switching from ticagrelor to clopidogrel using a 300 mg clopidogrel loading dose. Both patients presented with ST elevation myocardial infarction and underwent stent placement but then developed in-stent thrombosis 48 hours after switching from ticagrelor to clopidogrel. These cases illustrate the severe consequences of suboptimal platelet inhibition and the need for prospective trials thoroughly powered to assess clinical outcomes in order to determine the most appropriate strategy when switching from ticagrelor to clopidogrel.

  10. Phusis and Nomos in Plato

    Directory of Open Access Journals (Sweden)

    Zahra Nouri Sanghdehi

    2017-07-01

    Full Text Available One of the greatest problems in Plato that appears in different forms in his works is the relation of nomos and phusis. This thesis has been in fifth century B.C as the contradiction of phusis and nomos among big thinkers. In this essay, we tried to investigate the relation of phusis and nomos in Plato’s thoughts according to current theories of the contradiction of these in dialogues Gorgias, Republic and Protagoras. Plato tries to minimize consequences of belief to contradiction of phusis and nomos in social and political life by assertion large scale relation between phusis and nomos. Plato depicts the ultimate solution of this problem in Law. There he accounts nomos as raised from phusis that is sub sovereignty of divine. Indeed union of phusis and gods in Plato’s thought is sanction for the identity of phusis and nomos.

  11. What is Plato? Inference and Allusion in Plato's "Sophist."

    Science.gov (United States)

    Quandahl, Ellen

    1989-01-01

    Discusses inference and allusion in the dialogue in Plato's Sophist. Examines the sense in which a locution is used, distinguishing among senses of the verb to be, and sets the ball rolling for the development of logic and the whole metaphysics of categories of being. (RAE)

  12. Prevention of Stroke with Ticagrelor in Patients with Prior Myocardial Infarction: Insights from PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54).

    Science.gov (United States)

    Bonaca, Marc P; Goto, Shinya; Bhatt, Deepak L; Steg, P Gabriel; Storey, Robert F; Cohen, Marc; Goodrich, Erica; Mauri, Laura; Ophuis, Ton Oude; Ruda, Mikhail; Špinar, Jindřich; Seung, Ki-Bae; Hu, Dayi; Dalby, Anthony J; Jensen, Eva; Held, Peter; Morrow, David A; Braunwald, Eugene; Sabatine, Marc S

    2016-09-20

    In the PEGASUS-TIMI 54 trial (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54), ticagrelor reduced the risk of major adverse cardiovascular events when added to low-dose aspirin in stable patients with prior myocardial infarction, resulting in the approval of ticagrelor 60 mg twice daily for long-term secondary prevention. We investigated the incidence of stroke, outcomes after stroke, and the efficacy of ticagrelor focusing on the approved 60 mg twice daily dose for reducing stroke in this population. Patients were followed for a median of 33 months. Stroke events were adjudicated by a central committee. Data from similar trials were combined using meta-analysis. Of 14 112 patients randomly assigned to placebo or ticagrelor 60 mg, 213 experienced a stroke; 85% of these strokes were ischemic. A total of 18% of strokes were fatal and another 15% led to either moderate or severe disability at 30 days. Ticagrelor significantly reduced the risk of stroke (hazard ratio, 0.75; 95% confidence interval, 0.57-0.98; P=0.034), driven by a reduction in ischemic stroke (hazard ratio, 0.76; 95% confidence interval, 0.56-1.02). Hemorrhagic stroke occurred in 9 patients on placebo and 8 patients on ticagrelor. A meta-analysis across 4 placebo-controlled trials of more intensive antiplatelet therapy in 44 816 patients with coronary disease confirmed a marked reduction in ischemic stroke (hazard ratio, 0.66; 95% confidence interval, 0.54-0.81; P=0.0001). High-risk patients with prior myocardial infarction are at risk for stroke, approximately one-third of which are fatal or lead to moderate-to-severe disability. The addition of ticagrelor 60 mg twice daily significantly reduced this risk without an excess of hemorrhagic stroke but with more major bleeding. In high-risk patients with coronary disease, more intensive antiplatelet therapy should be

  13. Ticagrelor: An investigational oral antiplatelet treatment for reduction of major adverse cardiac events in patients with acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Eitan Abergel

    2010-10-01

    Full Text Available Eitan Abergel, Eugenia NikolskyHeart Institute, Rambam Health Care Campus and Technion-Israel Institute of Technology, Haifa, IsraelAbstract: Acute coronary syndromes (ACS are the leading cause of mortality and one of the main reasons for hospital admissions in the developed nations. Due to high rates of mortality and reinfarction, ACS represent a major public health concern. Platelets play a central role in atherothrombosis, the main pathologic substrate in ACS. Sufficient inhibition of platelet aggregation is therefore one of the key targets in the treatment of ACS. Blockade of the P2Y12 subtype of adenosine diphosphate (ADP receptor on platelet cell membranes has been established as a key mechanism of platelet inhibition. Clopidogrel, an ADP receptor antagonist and a second-generation thienopyridine, has been demonstrated to be of clinical benefit in patients with ACS when added to aspirin. A delayed onset of action due to two-step conversion to the active metabolite, irreversible binding to P2Y12 receptors, and broad interindividual variability in levels of platelet response are the main limitations of clopidogrel. Prasugrel, a novel third-generation thienopyridine, provides faster and stronger inhibition of platelet aggregation than clopigodrel. However, like the active metabolite of clopidogrel, prasugrel binds irreversibly to the P2Y12 ADP receptor site, causing inhibition of platelet aggregation for the life of the platelet. Although in a randomized, double-blind trial prasugrel demonstrated superiority for multiple cardiovascular endpoints compared with standard-dose clopidogrel, it was also associated with an increased bleeding risk, including fatal bleeding. This review discusses the optimal antiplatelet regimens for management of patients with ACS, with special focus on ticagrelor, the first oral agent in a new chemical class of nonthienopyridine antiplatelet agents termed cyclopentyl-triazolo-pyrimidines. Faster and greater platelet

  14. Ticagrelor en el síndrome coronario agudo: Explicando lo inexplicable

    Directory of Open Access Journals (Sweden)

    Juan Martín Criniti

    2014-06-01

    Full Text Available En el estudio PLATO se evaluó la utilidad del agregado de ticagrelor, en lugar de clopidogrel, a aspirina en pacientes con síndrome coronario agudo, mostrando resultados sorprendentemente positivos que llevaron a que la droga sea aceptada por las agencias regulatorias y las sociedades especializadas de todo el mundo. Sin embargo, el análisis crítico de los informes presentados por el patrocinador reveló la existencia de distintos aspectos difíciles de explicar y que ponen en tela de juicio la veracidad de sus resultados. La pérdida de seguimiento no explicada, la tasa de mortalidad y los beneficios excesivos no comparables con estudios previos, y la inconsistencia de hallazgos de acuerdo al país, al ente adjudicador de eventos y al comité de monitoreo, son algunos de los puntos más controvertidos. La mayoría de las críticas a este artículo se basan en información que no se desprende del texto del estudio publicado. Esto supone un desafío al análisis crítico de la literatura y genera dudas sobre hasta qué punto el conflicto de interés económico influenció el desarrollo del estudio y la comunicación de sus resultados y, probablemente, la aceptación de la droga para su uso comercial.

  15. The Method of Hypothesis in Plato's Philosophy

    Directory of Open Access Journals (Sweden)

    Malihe Aboie Mehrizi

    2016-09-01

    Full Text Available The article deals with the examination of method of hypothesis in Plato's philosophy. This method, respectively, will be examined in three dialogues of Meno, Phaedon and Republic in which it is explicitly indicated. It will be shown the process of change of Plato’s attitude towards the position and usage of the method of hypothesis in his realm of philosophy. In Meno, considering the geometry, Plato attempts to introduce a method that can be used in the realm of philosophy. But, ultimately in Republic, Plato’s special attention to the method and its importance in the philosophical investigations, leads him to revise it. Here, finally Plato introduces the particular method of philosophy, i.e., the dialectic

  16. Plato's Anti-Kohlbergian Program for Moral Education

    Science.gov (United States)

    Jonas, Mark E.

    2016-01-01

    Following Lawrence Kohlberg it has been commonplace to regard Plato's moral theory as "intellectualist", where Plato supposedly believes that becoming virtuous requires nothing other than "philosophical knowledge or intuition of the ideal form of the good". This is a radical misunderstanding of Plato's educational programme,…

  17. THEORY OF LOVE IN PLATO'S PHILOSOPHY

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    ZOHREH MOZAFARI

    2015-01-01

    Full Text Available The article presents a philosophical analysis of the phenomenon of Plato’s love. It is noted that a large number of works are devoted to the philosophy of Plato’s love, but not all aspects of his philosophy are studied, for example the problems of erotosophy of Plato. Phenomenon of love interested philosophers since ancient times. The first attempts to explain the phenomenon of love appeared in ancient times. These attempts were made by ancient philosophers Socrates, Plato and Aristotle. Platonism is a multifaceted teaching; identification of all possibilities of Plato’s erotic philosophy which can supplement other fields of philosophy is important and topical. 

  18. Critical appraisal of ticagrelor in the management of acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Nawarskas JJ

    2011-12-01

    Full Text Available James J Nawarskas, Stanley S SnowdenUniversity of New Mexico College of Pharmacy, Albuquerque, NM, USAAbstract: Ticagrelor is a novel P2Y12 receptor antagonist which, like clopidogrel and prasugrel, functions by blocking adenosine diphosphate-mediated platelet aggregation. However, unlike the aforementioned agents, the binding of ticagrelor to this receptor is reversible. Ticagrelor is also believed to mediate some of its beneficial effects by augmenting the effects of adenosine, which is another unique pharmacologic property of this drug. In terms of antiplatelet effect, ticagrelor is more potent than clopidogrel and produces a faster and stronger inhibition of platelet aggregation. This may also be an advantage of ticagrelor over prasugrel, but this has not been adequately studied. Due to the reversible nature of the binding of ticagrelor to the platelet receptor, ticagrelor has a relatively fast offset of effect, with platelet aggregation approaching pretreatment levels about 3 days after discontinuation of therapy. This has advantages in patients requiring invasive procedures, but also makes medication adherence very important in order to be able to maintain an effective antiplatelet effect. Ticagrelor has been shown to be clinically superior to clopidogrel when given to patients with an acute coronary syndrome, resulting in significantly lower rates of myocardial infarction and vascular death. However, ticagrelor is indicated to be administered with aspirin, and the clinical benefits of ticagrelor may be less when daily dosages of aspirin exceed 100 mg. As expected, bleeding is the most common adverse effect with ticagrelor, although it occurs at rates comparable with those seen for clopidogrel with the exception of noncoronary artery bypass graft-related major bleeding and fatal intracranial bleeds, the latter of which occurs only rarely. Dyspnea is another common adverse effect with ticagrelor, although this is usually not severe and

  19. Quoting Plato in Porphyrius' Cuestiones homericas

    Directory of Open Access Journals (Sweden)

    Lucía Rodríguez‑Noriega Guillén

    2016-08-01

    Full Text Available This paper studies the quotations of Plato in Porphyry’s Homeric Questions,including their typology (literal quotation, allusion, paraphrase, etc., their beingor not direct citations, their function in the work, and their possible parallels inother authors.

  20. Plato's problem an introduction to mathematical platonism

    CERN Document Server

    Panza, M

    2013-01-01

    What is mathematics about? And how can we have access to the reality it is supposed to describe? The book tells the story of this problem, first raised by Plato, through the views of Aristotle, Proclus, Kant, Frege, Gödel, Benacerraf, up to the most recent debate on mathematical platonism.

  1. The PLATO 2.0 mission

    NARCIS (Netherlands)

    Rauer, H.; et al., [Unknown; Hekker, S.

    2014-01-01

    PLATO 2.0 has recently been selected for ESA’s M3 launch opportunity (2022/24). Providing accurate key planet parameters (radius, mass, density and age) in statistical numbers, it addresses fundamental questions such as: How do planetary systems form and evolve? Are there other systems with planets

  2. Results of the 1975 Delaware PLATO Project.

    Science.gov (United States)

    Hofstetter, Fred T.

    During the Spring semester of 1975, the University of Delaware initiated a PLATO project with the dual purpose of demonstrating how a computer system might function in a university and of evaluating what part such a system might play in the future of the university and its supporting community. The demonstration phase of the project, which…

  3. Socrates, Plato, "Eros" and Liberal Education

    Science.gov (United States)

    McPherran, Mark L.

    2010-01-01

    This paper focuses on the educational method--the "elenchos"--of Plato's Socrates, arguing, against some prominent interpretations, that it is love, both "eros" and "philia", that is the key that links Socrates' philosophy with his education. This analysis, of course, raises some difficult questions regarding the relationship between teacher and…

  4. Plato's Protagoras: Professional Models, Ethical Concerns.

    Science.gov (United States)

    Gregory, Marshall W.

    1983-01-01

    In Plato's model his clear criticism of Protagorean careerism and his negotiation with Socratic radicalism shows he is a centrist cultivating criticism and open discourse. In an age when academe seems to have lost a sense of its identify and function in society, its most enduring contributions are criticism and discourse. (MLW)

  5. Dual antiplatelet therapy with prasugrel or ticagrelor versus clopidogrel in interventional cardiology

    DEFF Research Database (Denmark)

    Clemmensen, Peter; Dridi, Nadia Paarup; Holmvang, Lene

    2013-01-01

    For several years, clopidogrel plus aspirin has been the dual antiplatelet therapy (DAPT) of choice for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) with stent implantation. More recently, prasugrel and ticagrelor have demonstrated greater effica...

  6. Myocardium-protective effect of ticagrelor combined with emergency PCI treatment of acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Yu-Jun Zhao

    2016-01-01

    Objective:To study the myocardium-protective effect of ticagrelor combined with emergency PCI treatment of acute myocardial infarction and explore the possible molecular mechanisms. Methods:A total of 84 patients with acute myocardial infarction who received emergency PCI treatment in our hospital from February 2014 to October 2015 were selected for study and randomly divided into and ticagrelor group and clopidogrel group that received different perioperative anti-platelet therapy. Degree of myocardial cell damage, cardiac pump function as well as blood perfusion and platelet aggregation function of two groups were evaluated. Results:Before as well as 10 min and 24 h after PCI, plasma CK-MB and cTnI levels as well as maximum platelet aggregation rate and P2Y12 reaction unit of ticagrelor group were significantly lower than those of clopidogrel group, and ADP-way platelet inhibition rate were higher than those of clopidogrel group; after PCI, TIMI blood flow grade, TMP myocardial perfusion grade and LVEF of ticagrelor group were significantly higher than those of clopidogrel group, LVEDD was significantly lower than that of clopidogrel group and the number of cases with no reflow/slow flow was less than that of clopidogrel group. Conclusions:The myocardium-protective effect of ticagrelor combined with emergency PCI treatment of acute myocardial infarction is better than that of clopidogrel, and ticagrelor can enhance the anti-platelet aggregation effect to exert myocardium-protective effect.

  7. What scientists can learn from Plato's Symposium

    Science.gov (United States)

    van Emmerik, Tim

    2015-04-01

    Conferences and scientific meetings are as old as science itself. The ancient Greeks where (in)famous for organizing so-called symposiums. During a symposium (from Greek, drinking together), attendees followed a program that contained both social and scientific aspects, focused around a certain topic. Whilst drinking and eating, all participants were expected to share their vision on the topic of interest by giving an oral presentation. The goal of these meetings was to arrive at a new common understanding and to come closer to the truth. Plato et al. knew very well how to organize an effective scientific conference, which should make use overthink the way we are organizing present-day conferences. Scientific meetings aim to connect researchers, share research and unravel the truth. The question is now: how do we get this done effectively? Plato knew that discussing science with strangers is difficult and he believed that talking about heavy matter could be done best when combined with social events. What if we try to go back to the times of Plato and model our conferences after the ancient symposiums? We might drop laying on couches and covering ourselves in ivy and flowers. However, a mix of social and scientific events will contribute to achieving the ultimate goal of why scientists go to conferences: to connect, to share and to unravel the truth.

  8. Ticagrelor Versus Aspirin in Acute Embolic Stroke of Undetermined Source.

    Science.gov (United States)

    Amarenco, Pierre; Albers, Gregory W; Denison, Hans; Easton, J Donald; Evans, Scott R; Held, Peter; Hill, Michael D; Jonasson, Jenny; Kasner, Scott E; Ladenvall, Per; Minematsu, Kazuo; Molina, Carlos A; Wang, Yongjun; Wong, K S Lawrence; Johnston, S Claiborne

    2017-09-01

    Ticagrelor is an effective antiplatelet therapy among patients with atherosclerotic disease and, therefore, could be more effective than aspirin in preventing recurrent stroke and cardiovascular events among patients with embolic stroke of unknown source (ESUS), which includes patients with ipsilateral stenosis <50% and aortic arch atherosclerosis. We randomized 13 199 patients with a noncardioembolic, nonsevere ischemic stroke or high-risk transient ischemic attack to ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2-90) or aspirin (300 mg on day 1 followed by 100 mg daily for days 2-90) within 24 hours of symptom onset. In all patients, investigators informed on the presence of ipsilateral stenosis ≥50%, small deep infarct <15 mm, and on cardiac source of embolism detected after enrollment or rare causes, which allowed to construct an ESUS category in all other patients with documented brain infarction. The primary end point was the time to the occurrence of stroke, myocardial infarction, or death within 90 days. ESUS was identified in 4329 (32.8%) patients. There was no treatment-by-ESUS category interaction (P=0.83). Hazard ratio in ESUS patients was 0.87 (95% confidence interval, 0.68-1.10; P=0.24). However, hazard ratio was 0.51 (95% confidence interval, 0.29-0.90; P=0.02) in ESUS patients with ipsilateral stenosis <50% or aortic arch atherosclerosis (n=961) and 0.98 (95% confidence interval, 0.76-1.27; P=0.89) in the remaining ESUS patients (n=3368; P for heterogeneity =0.04). In this post hoc, exploratory analysis, we found no treatment-by-ESUS category interaction. ESUS subgroups have heterogeneous response to treatment (Funded by AstraZeneca). URL: http://www.clinicaltrials.gov. Unique identifier: NCT01994720. © 2017 American Heart Association, Inc.

  9. From Plato to Orwell: Utopian Rhetoric in a Dystopian World.

    Science.gov (United States)

    Deatherage, Scott

    Plato's "Republic" and George Orwell's "1984" both posit visionary worlds, one where humans are virtuous and understand what Plato refers to as "the Good," and the other where citizens are pawns of a government which uses language as a form of tyranny and control. Despite these overarching differences in philosophical…

  10. A Summary of Plato Curriculum and Research Materials.

    Science.gov (United States)

    Lyman, Elisabeth R.

    PLATO (programmed Logic for Automatic Teaching Operations) is a computer-based teaching system which was developed in the Coordinated Science Laboratory at the University of Illinois to explore the possibilities of automation in individual instruction. The history of the PLATO program is summarized here, along with a list of courses which used…

  11. From Plato to Orwell: Utopian Rhetoric in a Dystopian World.

    Science.gov (United States)

    Deatherage, Scott

    Plato's "Republic" and George Orwell's "1984" both posit visionary worlds, one where humans are virtuous and understand what Plato refers to as "the Good," and the other where citizens are pawns of a government which uses language as a form of tyranny and control. Despite these overarching differences in philosophical…

  12. Plato the Pederast: Rhetoric and Cultural Procreation in the Dialogues.

    Science.gov (United States)

    Ervin, Elizabeth

    1993-01-01

    Examines Plato's Dialogues by reading them through two cultural lenses: the role of eros in classical Greece and its analogous relationship to language and rhetoric; and the educational function of eros within the ancient institution of pederasty. Shows how the cultural values of ancient Greece manifested themselves in Plato's erotic educational…

  13. Plato's Philosophy of Education and the Common Core Debate

    Science.gov (United States)

    Murphy, Madonna M.

    2015-01-01

    This paper examines Plato's Philosophy of Education asking what he would say about the current Common Core initiative which is to better help students to become college and career ready. Plato would be in favor of the common core in as much as the standards are tied to specific skills needed in various career jobs as he was a proponent of…

  14. Fourth Summative Report of the Delaware PLATO Project.

    Science.gov (United States)

    Hofstetter, Fred T.

    A brief history of the Delaware PLATO project and descriptions of new developments in facilities, applications, user services, research, evaluation, and courseware produced since the Third Summative Report (1978) are provided, as well as an overview of PLATO applications at the University of Delaware. Sample lessons, illustrations, and activity…

  15. Fifth Summative Report of the Delaware PLATO Project.

    Science.gov (United States)

    Hofstetter, Fred T.

    A brief history of the Delaware PLATO project and descriptions of the new developments in facilities, applications, user services, research, evaluation, and courseware produced since the Fourth Summative Report (1979) are provided, as well as an overview of PLATO applications at the University of Delaware. Sample lessons, illustrations, and…

  16. Third Summative Report of the Delaware PLATO Project.

    Science.gov (United States)

    Hofstetter, Fred T.

    Descriptions of new developments in the areas of facilities, applications, user services, support staff, research, evaluation, and courseware production since the Second Summative Report (1977) are provided, as well as a summative overview of PLATO applications at the University of Delaware. Through the purchase of its own PLATO system, this…

  17. Plato's ghost the modernist transformation of mathematics

    CERN Document Server

    Gray, Jeremy

    2008-01-01

    Plato's Ghost is the first book to examine the development of mathematics from 1880 to 1920 as a modernist transformation similar to those in art, literature, and music. Jeremy Gray traces the growth of mathematical modernism from its roots in problem solving and theory to its interactions with physics, philosophy, theology, psychology, and ideas about real and artificial languages. He shows how mathematics was popularized, and explains how mathematical modernism not only gave expression to the work of mathematicians and the professional image they sought to create for themselves, but how modernism also introduced deeper and ultimately unanswerable questions

  18. Pemikiran Epistemologi Barat: dari Plato Sampai Gonseth

    Directory of Open Access Journals (Sweden)

    Nunu Burhanuddin

    2015-06-01

    Full Text Available This paper riviewing the Western epistemology thought. The theme focuses on Plato to Gonseth. The Epistemology that referred in this article, is to think about "how humans acquire knowledge?". From this then appear four types of sect modern western epistemology thought, namely: sect of empiricism, rationalism sect, kantinian sect, sect of positivism. Furthermore, the social positivism sciences developed by Comte leaves serious problems associated with the loss of the role of the subject. This problem being the background of epistemology philosophy appears that by Emund Husserl developed through the phenomenology, Habermas through hermeneutics, and Ferdinand Gonseth through critical theory.

  19. The PLATO 2.0 Mission

    CERN Document Server

    Rauer, H; Aerts, C; Appourchaux, T; Benz, W; Brandeker, A; Christensen-Dalsgaard, J; Deleuil, M; Gizon, L; Güdel, M; Janot-Pacheco, E; Mas-Hesse, M; Pagano, I; Piotto, G; Pollacco, D; Santos, N C; Smith, A; -C., J; Suárez,; Szabó, R; Udry, S; Adibekyan, V; Alibert, Y; Almenara, J -M; Amaro-Seoane, P; Eiff, M Ammler-von; Antonello, E; Ball, W; Barnes, S; Baudin, F; Belkacem, K; Bergemann, M; Birch, A; Boisse, I; Bonomo, A S; Borsa, F; Brandão, I M; Brocato, E; Brun, S; Burleigh, M; Burston, R; Cabrera, J; Cassisi, S; Chaplin, W; Charpinet, S; Chiappini, C; Csizmadia, Sz; Cunha, M; Damasso, M; Davies, M B; Deeg, H J; Fialho, F de Oliveira; DÍaz, R F; Dreizler, S; Dreyer, C; Eggenberger, P; Ehrenreich, D; Eigmüller, P; Erikson, A; Farmer, R; Feltzing, S; Figueira, P; Forveille, T; Fridlund, M; García, R; Giuffrida, G; Godolt, M; da Silva, J Gomes; Goupil, M -J; Granzer, T; Grenfell, J L; Grotsch-Noels, A; Günther, E; Haswell, C A; Hatzes, A P; Hébrard, G; Hekker, S; Helled, R; Heng, K; Jenkins, J M; Khodachenko, M L; Kislyakova, K G; Kley, W; Kolb, U; Krivova, N; Kupka, F; Lammer, H; Lanza, A F; Lebreton, Y; Magrin, D; Marcos-Arenal, P; Marrese, P M; Marques, J P; Martins, J; Mathis, S; Mathur, S; Messina, S; Miglio, A; Montalban, J; Montalto, M; Monteiro, M J P F G; Moradi, H; Moravveji, E; Mordasini, C; Morel, T; Mortier, A; Nascimbeni, V; Nielsen, M B; Noack, L; Norton, A J; Ofir, A; Oshagh, M; Ouazzani, R -M; Pápics, P; Parro, V C; Petit, P; Plez, B; Poretti, E; Quirrenbach, A; Ragazzoni, R; Raimondo, G; Rainer, M; Reese, D R; Redmer, R; Reffert, S; Rojas-Ayala, B; Roxburgh, I W; Solanki, S K; Salmon, S; Santerne, A; Schneider, J; Schou, J; Schuh, S; Schunker, H; Silva-Valio, A; Silvotti, R; Skillen, I; Snellen, I; Sohl, F; Sousa, A S; Sozzetti, A; Stello, D; Strassmeier, K G; Švanda, M; Szabó, G M; Tkachenko, A; Valencia, D; van Grootel, V; Vauclair, S D; Ventura, P; Wagner, F W; Walton, N A; Weingrill, J; Werner, S C; Wheatley, P J; Zwintz, K

    2013-01-01

    PLATO 2.0 is a mission candidate for ESA's M3 launch opportunity (2022/24). It addresses fundamental questions such as: How do planetary systems form and evolve? Are there other systems with planets like ours, able to develop life? The PLATO 2.0 instrument consists of 34 small aperture telescopes providing a wide field-of-view and a large photometric magnitude range. It targets bright stars in wide fields to detect and characterize planets down to Earth-size by photometric transits, whose masses can then be determined by ground-based radial-velocity follow-up measurements. Asteroseismology will be performed for stars <=11mag to obtain highly accurate stellar parameters, including masses and ages. The combination of bright targets and asteroseismology results in high accuracy for the bulk planet parameters: 2%, 4-10% and 10% for planet radii, masses and ages, respectively. The foreseen baseline observing strategy includes two long pointings (2-3 years) to detect and bulk characterize planets reaching into t...

  20. Plato on Metaphysical Explanation: Does 'Participating' Mean Nothing?

    Directory of Open Access Journals (Sweden)

    Christine J. Thomas

    2014-12-01

    Full Text Available According to Aristotle, Plato's efforts at metaphysical explanation not only fail, they are nonsensical. In particular, Plato's appeals to Forms as metaphysically explanatory of the sensibles that participate in them is "empty talk" since "'participating' means nothing" (Met. 992a28-9. I defend Plato against Aristotle's charge by identifying a particular, substantive model of metaphysical predication as the favored model of Plato's late ontology. The model posits two basic metaphysical predication relations: self-predication and participation. In order to understand the participation relation, it is important first to understand how Plato's Forms are self-predicative paradigms. According to the favored model, Forms are self-predicative paradigms insofar as they are ideal, abstract encoders of structural essences. Sensibles participate in Forms by exemplifying the structures encoded in the Forms. Given plausible conditions on metaphysical explanation, Plato's appeals to abstract Forms as metaphysically explanatory of sensibles is a reasonable competitor for Aristotle's appeals to natural, substantial forms. At the very least, Plato's appeals to a participation relation are not empty.

  1. Technology validation of the PLATO CCD at ESA

    Science.gov (United States)

    Prod'homme, Thibaut; Verhoeve, Peter; Beaufort, Thierry; Duvet, Ludovic; Lemmel, Frederic; Smit, Hans; Blommaert, Sander; Oosterbroek, Tim; van der Luijt, Cornelis; Visser, Ivo; Heijnen, Jerko; Butler, Bart

    2016-07-01

    PLATO { PLAnetary Transits and Oscillations of stars { is the third medium-class mission to be selected in the European Space Agency (ESA) Science and Robotic Exploration Cosmic Vision programme. Due for launch in 2025, the payload makes use of a large format (8 cm x 8 cm) Charge-Coupled Devices (CCDs) the e2v CCD270 operated at 4 MHz. The manufacture of such large device in large quantity constitutes an unprecedented effort. To de-risk the PLATO CCD procurement and aid the mission definition process, ESA's Payload Technology Validation team is characterizing the electro-optical performance of a number of PLATO devices before and after proton irradiation.

  2. Stent Thrombosis Patients with Hyporesponsiveness to Clopidogrel, Prasugrel, and Ticagrelor: A Case Series Using Short Thromboelastography

    Directory of Open Access Journals (Sweden)

    Bartosz Olechowski

    2016-01-01

    Full Text Available Patients after percutaneous coronary intervention (PCI with stent implantation and functional hyporesponsiveness to P2Y12 inhibitors are at higher risk of ischaemic events, particularly stent thrombosis (ST. It is currently not routine practice to assess the functional response to these agents. However, concern over functional hyporesponsiveness to clopidogrel has led to widespread uptake of prasugrel and ticagrelor as the default P2Y12 inhibitor after stent implantation in patients with acute coronary syndrome. Here we report, for the first time, 3 cases in which patients who have had ST exhibit hyporesponsiveness to clopidogrel, prasugrel, and ticagrelor.

  3. A scientific approach to Plato's Atlantis

    Directory of Open Access Journals (Sweden)

    Massimo Rapisarda

    2015-09-01

    Full Text Available The myth of Atlantis is hard to die. This attempt to use scientific evidence to give it the final smash ends up with the doubt that it might not be totally unsubstantiated. The time of the supposed existence of Atlantis (around twelve thousand years ago was, in fact, characterized by technological revolutions, acknowledged by archaeology, and abrupt climate changes, documented by geology. In principle, it cannot therefore be ruled out that some of those dramatic events left a memory, later used by Plato as a basis for its tale. The climate changes involved the majority of the northern hemisphere, thus all the ancient civilizations (Egyptian, Mesopotamian, Indian and Chinese could have preserved reminiscence, but it is clear that the events occurring closer to Greece would have been more accessible to Plato. Among the Mediterranean sites that experienced the cataclysms of the beginning of the Holocene, a good candidate to host a primordial civilization might have been the archipelago then existing in the Strait of Sicily, a natural maritime link between Tunisia and Italy, prized by the presence of an obsidian source at Pantelleria. Eleven thousand five hundred years ago, a sudden sea level rise erased the archipelago, submerging the possible settlements, but Pantelleria obsidian ores are still there and could provide a significant clue. In fact, the potential discovery of artefacts, originating from a source now submerged by the sea level rise, would imply that the collection of the mineral took place when it was still emerged, namely at the time of Atlantis. Even if such discovery would not be sufficient to prove the existence of the mythical island, it would be enough to shake up the timeline of the human occupation in the region.

  4. Intra-Socratic Polemics: The Symposia of Plato and Xenophon

    Directory of Open Access Journals (Sweden)

    Gabriel Danzig

    2010-11-01

    Full Text Available Textual relationships between the two Symposia suggest that Xenophon wrote first, prompting Plato to write Socrates' critique of Phaedrus, to which Xenophon responded by appending his ch. 8.

  5. Rationality and Motivation: Moral Psychology in Plato's Socratic Dialogues

    OpenAIRE

    Ivars Neiders

    2011-01-01

    "Rationality and Motivation: Moral Psychology in Plato's Socratic Dialogues" Annotation The dissertation "Rationality and Motivation: Moral Psychology in Plato's Socratic Dialogues" is a philosophical study of Socratic views in moral psychology. Particular attention is paid to what the author calls (1) Doxastic competence and (2) Orectic competence. It is argued that according to Socrates these two different epistemic relations are important aspects of our self-understanding. The doxast...

  6. Relationship between ADP-induced platelet-fibrin clot strength and anti-platelet responsiveness in ticagrelor treated ACS patients

    Science.gov (United States)

    Li, Dan-Dan; Wang, Xu-Yun; Xi, Shao-Zhi; Liu, Jia; Qin, Liu-An; Jing, Jing; Yin, Tong; Chen, Yun-Dai

    2016-01-01

    Background Ticagrelor provides enhanced antiplatelet efficacy but increased risk of bleeding and dyspnea. This study aimed to display the relationship between ADP-induced platelet-fibrin clot strength (MAADP) and clinical outcomes in acute coronary syndrome (ACS) patients treated by ticagrelor. Methods Consecutive Chinese-Han patients with ACS who received maintenance dose of ticagrelor on top of aspirin were recruited. After 5-day ticagrelor maintenance treatment, MAADP measured by thrombelastography (TEG) were recorded for the evaluation of ticagrelor anti-platelet reactivity. Pre-specified cutoffs of MAADP > 47 mm for high on-treatment platelet reactivity (HTPR) and MAADP < 31 mm for low on-treatment platelet reactivity (LTPR) were applied for evaluation. The occurrences of primary ischemic cardiovascular events (including a composite of cardiac death, non-fatal myocardial infarction and stroke), the Thrombolysis in Myocardial Infarction (TIMI) defined bleeding events, and ticagrelor related dyspnea were recorded after a follow-up of three months. Results Overall, 176 ACS patients (Male: 79.55%, Age: 59.91 ± 10.54 years) under ticagrelor maintenance treatment were recruited. The value of MAADP ranged from 4.80% to 72.90% (21.27% ± 12.07% on average), with the distribution higher skewed towards the lower values. Using the pre-specific cutoffs for HTPR and LTPR, seven patients (3.98%) were identified as HTPR and 144 patients (81.82%) as LTPR. After a follow-up of three months in 172 patients, major cardiovascular events occurred in no patient, but TIMI bleeding events in 81 (47.09%) with major bleedings in three patients. All patients with major bleedings were classified as LTPR. Ticagrelor related dyspnea occurred in 31 (18.02%) patients, with 30 (21.28%) classified as LTPR and no one as HTPR (P = 0.02). Conclusions In ticagrelor treated ACS patients, MAADP measured by TEG might be valuable for the prediction of major bleeding and ticagrelor related dyspnea

  7. Potential Additive Effects of Ticagrelor, Ivabradine, and Carvedilol on Sinus Node

    Directory of Open Access Journals (Sweden)

    Luigi Di Serafino

    2014-01-01

    Full Text Available A 51-year-old male patient presented to the emergency room with an anterior ST-elevation myocardial infarction. After a loading dose of both ticagrelor and aspirin, the patient underwent primary-PCI on the left anterior descending coronary artery with stent implantation. After successful revascularization, medical therapy included beta-blockers, statins, and angiotensin II receptor antagonists. Two days later, ivabradine was also administered in order to reduce heart rate at target, but the patient developed a severe symptomatic bradycardia and sinus arrest, even requiring administration of both atropine and adrenaline. Ivabradine and ticagrelor have been then suspended and this latter changed with prasugrel. Any other similar event was not reported during the following days. This clinical case raised concerns about the safety of the combination of beta-blockers and ivabradine in patients treated with ticagrelor, particularly during the acute phase of an acute coronary syndrome. These two latter drugs, in particular, might interact with the same receptor. In fact, ivabradine directly modulates the If-channel which is also modulated by the cyclic adenosine monophosphate levels. These latter have been shown to increase after ticagrelor assumption via inhibition of adenosine uptake by erythrocytes. Further studies are warrant to better clarify the safety of this association.

  8. What Plato and Murdoch Think About Love

    Directory of Open Access Journals (Sweden)

    Shadi Shakouri

    2012-07-01

    Full Text Available There are many interpretations of love and lots of scholars write and talk on love; however, what exactly is the meaning of love? Iris Murdoch’s works are an accumulation of emotional relationships and feelings of love. Her great subject is love, both sexual and non-sexual, and her characters are the portrayal of a small group of people caught up in convoluted ties of love and hate, with Eros ruling over them (Cohen 22. Murdoch was one of the most respected British writers and philosophers of the second half of the twentieth century and, of course, the postwar period. In Murdoch’s novels, love is one of the central themes—marriage, as the institution of love, more often binds than frees. Her characters are mainly ego-centric people who struggle to love and are often overwhelmed by the factor of self-obsession, jealousy, ambition, fascination with suffering and charismatic power. They are absolutely ordinary people with a consuming demand for love, and mental and physical exile. Murdoch was inspired by Plato’s ideas in many ways. Like art, here again Plato’s idea of love is more skeptical than Murdoch’s, whereas Murdoch kept it only as a way to the Good, creation, and happiness. Murdoch and Plato saw love more as a Freudian concept, the Eros, the word that comes from the name of the first Greek god of love. Both the philosophers, Plato and Murdoch, believed that this erotic longing and desires revived by Eros can led to a new direction, a way toward virtue and truth. Her protagonist or marginalized characters are usually tackling it with either vulgarity or the heavenly, which results in creation, art or salvation. Murdoch, as a major moral philosopher, usually grasps the chances to encapsulate her moral visions in her works, and created novels that should be counted as meditations on human love and goodness. Keywords: Eros, erotic love and real artwork, moral philosopher, The Black Prince

  9. Why Did Socrates Deny That He Was a Teacher? Locating Socrates among the New Educators and the Traditional Education in Plato's "Apology of Socrates"

    Science.gov (United States)

    Mintz, Avi I.

    2014-01-01

    Plato's "Apology of Socrates" contains a spirited account of Socrates' relationship with the city of Athens and its citizens. As Socrates stands on trial for corrupting the youth, surprisingly, he does not defend the substance and the methods of his teaching. Instead, he simply denies that he is a teacher. Many scholars have…

  10. 替格瑞洛联合阿司匹林治疗急性冠状动脉综合征的临床研究%Clinical trial of ticagrelor combined with aspirin in the treatment of acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    贾珠银; 杨建敏

    2016-01-01

    目的:观察替格瑞洛联合阿司匹林治疗急性冠状动脉综合征的临床疗效及安全性。方法将84例急性冠状动脉综合征患者随机分为对照组42例和试验组42例。2组患者术前均予以口服阿司匹林150 mg和硫酸氢氯吡格雷300 mg,qd,持续用药7 d。术后,对照组予以口服阿司匹林100 mg,qd;试验组在对照组的基础上,予以口服替格瑞洛90 mg,qd。2组患者均治疗6个月。比较2组患者的临床疗效、急性心肌梗死发作次数、发作持续时间、ST段下移水平、血清肌钙蛋白T、脑钠肽、C反应蛋白、D-二聚体水平以及不良反应发生情况。结果治疗后,试验组的总有效率为95.24%(40/42例)显著高于对照组的83.33%(35/42例,P<0.05)。治疗后,试验组与对照组的急性心肌梗死发作次数分别为每周(2.02±0.23),(4.53±0.52)次;发作持续时间分别为每次(2.76±0.31),(4.14±0.43) min; ST 段下移水平分别为(0.63±0.07),(1.25±0.17) mV;血清肌钙蛋白 T 分别为(0.25±0.03),(1.54±0.18) ng・ mL-1;脑钠肽分别为(28.43±3.02),(63.52±6.73) ng・ L-1, C反应蛋白分别为(4.57±0.55),(8.94±0.94) mg ・ L-1;D -二聚体分别为(59.54±61.74),(133.53±15.73) ng・ mL-1,且试验组治疗后的上述指标均显著低于对照组( P<0.05)。2组患者不良反应均以消化系统和神经系统症状为主,试验组的不良反应发生率为7.14%显著低于对照组的16.67%( P<0.05)。结论替格瑞洛联合阿司匹林治疗急性冠状动脉综合征的临床疗效显著,且安全性较高。%Objective To evaluate the clinical efficacy of ticagrelor combined with aspirin in the treatment of acute coronary syndrome . Methods Eighty-four patients with acute coronary syndrome were ran

  11. Reversing Plato’s Anti-Democratism: Castoriadis’ “Quirky” Plato

    OpenAIRE

    Wendy C. Hamblet

    2008-01-01

    This paper considers the conflicting "loves" of Cornelius Castoriadis--his love for the ancients, and especially Plato, and for the common person of the demos. A detailed study of Castoriadis' analysis of Plato's Statesman exposes that Castoriadis attempts to resolve the paradox by rereading Plato as a radical democrat. I argue that this unorthodox reading is at best "quirky, " (a charge Castoriadis levels at Plato) at worst a groundless sophism. However, I conjecture that Castoriadis' readin...

  12. Eugenics concept: from Plato to present.

    Science.gov (United States)

    Güvercin, C H; Arda, B

    2008-01-01

    All prospective studies and purposes to improve cure and create a race that would be exempt of various diseases and disabilities are generally defined as eugenic procedures. They aim to create the "perfect" and "higher" human being by eliminating the "unhealthy" prospective persons. All of the supporting actions taken in order to enable the desired properties are called positive eugenic actions; the elimination of undesired properties are defined as negative eugenics. In addition, if such applications and approaches target the public as a whole, they are defined as macro-eugenics. On the other hand, if they only aim at individuals and/or families, they are called micro-eugenics. As generally acknowledged, Galton re-introduced eugenic proposals, but their roots stretch as far back as Plato. Eugenic thoughts and developments were widely accepted in many different countries beginning with the end of the 19th to the first half of the 20th centuries. Initially, the view of negative eugenics that included compulsory sterilizations of handicapped, diseased and "lower" classes, resulted in tens of thousands being exterminated especially in the period of Nazi Germany. In the 1930s, the type of micro positive eugenics movement found a place within the pro-natalist policies of a number of countries. However, it was unsuccessful since the policy was not able to become effective enough and totally disappeared in the 1960s. It was no longer a fashionable movement and left a deep impression on public opinion after the long years of war. However, developments in genetics and its related fields have now enabled eugenic thoughts to reappear under the spotlight and this is creating new moral dilemmas from an ethical perspective.

  13. Positure in Plato's Laws: An Introduction to Figuration on Civic Education

    Science.gov (United States)

    Hall, Joshua M.

    2016-01-01

    Purpose: The aim of the research was to determine the benefits of applying the new Figuration philosophy of dance, based in part on Plato, to civic education. Design/methodology: A close phenomenological reading of Plato's "The Laws," with a strategic focus on its account of the concept of posture. Findings: Plato considers posture to be…

  14. Plato's Cosmic Theology: A Rationale for a Polytheistic Astrology?

    Science.gov (United States)

    Henriques, André

    2015-05-01

    Plato's cosmology influenced classical astronomy and religion, but was in turn influenced by the polytheistic context of its time. Throughout his texts, including the cosmological treatise Timaeus, and the discussions on the soul in the Phaedrus, Plato (c.428-c.348 BC) established what can be generalised as Platonic cosmological thought. An understanding of the philosophical and mythical levels of Platonic thought can provide a rationale for polytheistic and astrological worldviews, pointing to some cosmological continuity, alongside major shifts, from ancient Greek religion to the astrological thought of ancient astronomers such as Claudius Ptolemy.

  15. ESA's CCD test bench for the PLATO mission

    Science.gov (United States)

    Beaufort, Thierry; Duvet, Ludovic; Bloemmaert, Sander; Lemmel, Frederic; Prod'homme, Thibaut; Verhoeve, Peter; Smit, Hans; Butler, Bart; van der Luijt, Cornelis; Heijnen, Jerko; Visser, Ivo

    2016-08-01

    PLATO { PLAnetary Transits and Oscillations of stars { is the third medium-class mission to be selected in the European Space Agency (ESA) Science and Robotic Exploration Cosmic Vision programme. Due for launch in 2025, the payload makes use of a large format (8 cm x 8 cm) Charge-Coupled Devices (CCDs), the e2v CCD270 operated at 4 MHz and at -70 C. To de-risk the PLATO CCD qualification programme initiated in 2014 and support the mission definition process, ESA's Payload Technology Validation section from the Future Missions Office has developed a dedicated test bench.

  16. Microglia is a key player in the reduction of stroke damage promoted by the new antithrombotic agent ticagrelor.

    Science.gov (United States)

    Gelosa, Paolo; Lecca, Davide; Fumagalli, Marta; Wypych, Dorota; Pignieri, Alice; Cimino, Mauro; Verderio, Claudia; Enerbäck, Malin; Nikookhesal, Elham; Tremoli, Elena; Abbracchio, Maria P; Sironi, Luigi

    2014-06-01

    The ADP-responsive P2Y12 receptor is expressed on both platelets and microglia. Clinical data show that ticagrelor, a direct-acting, reversibly binding P2Y12-receptor antagonist, reduces total cardiovascular events, including stroke. In our present study, we investigated the expression of P2Y12 receptors and the effects of ticagrelor on brain injury in Sprague-Dawley rats subjected to a permanent middle cerebral artery occlusion (MCAo). Rats were treated per os with ticagrelor 3 mg/kg or vehicle at 10 minutes, 22, and 36 hours after MCAo and killed after 48 hours. Immunofluorescence analysis showed an ischemia-related modulation of the P2Y12 receptor, which is constitutively expressed in Iba1(+) resting microglia. After MCAo, activated microglia was mainly concentrated around the lesion, with fewer cells present inside the ischemic core. Ticagrelor significantly attenuated the evolution of ischemic damage-evaluated by magnetic resonance imaging (MRI) at 2, 24, and 48 hours after MCAo-, the number of infiltrating cells expressing the microglia/monocyte marker ED-1, the cerebral expression of proinflammatory mediators (interleukin 1 (IL-1), monocyte chemoattractant protein 1 (MCP-1), nitric oxide synthase (iNOS)) and the associated neurologic impairment. In transgenic fluorescent reporter CX3CR1-green fluorescent protein (GFP) mice, 72 hours after MCAo, ticagrelor markedly reduced GFP(+) microglia and both early and late infiltrating blood-borne cells. Finally, in primary cultured microglia, ticagrelor fully inhibited ADP-induced chemotaxis (P<0.01). Our results show that ticagrelor is protective against ischemia-induced cerebral injury and this effect is mediated, at least partly, by inhibition of P2Y12-mediated microglia activation and chemotaxis.

  17. A Data Bank Experience on the PLATO System.

    Science.gov (United States)

    Schwab, Wallace; St-Denis, Richard

    1980-01-01

    Current theories on terminology and lexicography which underlie the logical components of the terminology bank set up on the PLATO system and established standards are briefly presented. The units that were essential to developing the bank are discussed. References are listed. (Author)

  18. Plato and Play: Taking Education Seriously in Ancient Greece

    Science.gov (United States)

    D'Angour, Armand

    2013-01-01

    In this article, the author outlines Plato's notions of play in ancient Greek culture and shows how the philosopher's views on play can be best appreciated against the background of shifting meanings and evaluations of play in classical Greece. Play--in various forms such as word play, ritual, and music--proved central to the development of…

  19. Stonecutter Mills, Inc., Isothermal Community College. PLATO Evaluation Series.

    Science.gov (United States)

    Sherman, Greg

    Stonecutter Mills, Inc., is a textile manufacturing company with a major production facility in Spindale, North Carolina. In the past few years, Stonecutter Mills employees have been given an opportunity to spend up to 2 hours a week on company time to participate in PLATO-supported learning at Isothermal Community College. Employees could choose…

  20. Future development of the PLATO Observatory for Antarctic science

    Science.gov (United States)

    Ashley, Michael C. B.; Bonner, Colin S.; Everett, Jon R.; Lawrence, Jon S.; Luong-Van, Daniel; McDaid, Scott; McLaren, Campbell; Storey, John W. V.

    2010-07-01

    PLATO is a self-contained robotic observatory built into two 10-foot shipping containers. It has been successfully deployed at Dome A on the Antarctic plateau since January 2008, and has accumulated over 730 days of uptime at the time of writing. PLATO provides 0.5{1kW of continuous electrical power for a year from diesel engines running on Jet-A1, supplemented during the summertime with solar panels. One of the 10-foot shipping containers houses the power system and fuel, the other provides a warm environment for instruments. Two Iridium satellite modems allow 45 MB/day of data to be transferred across the internet. Future enhancements to PLATO, currently in development, include a more modular design, using lithium iron-phosphate batteries, higher power output, and a light-weight low-power version for eld deployment from a Twin Otter aircraft. Technologies used in PLATO include a CAN (Controller Area Network) bus, high-reliability PC/104 com- puters, ultracapacitors for starting the engines, and fault-tolerant redundant design.

  1. The CGE-PLATO Electronic Laboratory Station Structure and Operation.

    Science.gov (United States)

    Neal, J. P.

    An electronic laboratory station was designed for student use in learning electronic instrumentation and measurement by means of the computer-guided experimentation (CGE) system. The station features rack-mounted electronic laboratory equipment on a laboratory table adjacent to a PLATO IV terminal. An integrated logic system behind the laboratory…

  2. Pursuing the Good, Ethics and Metaphysics in Plato s Republic

    Institute of Scientific and Technical Information of China (English)

    Douglas; Cairns; Fritz-Gregor; Herrmann; Terry; Penner

    2008-01-01

    ‘Pursuing the good’ is an old subject in both social history of ancient Greece and Greek philosophy studies. There is hardly anything new when we talk about virtue or morality in the time of Plato and Aristotle. In the area of Greek history, many books and articles on or relevant to that

  3. Eschatological narrative in Plato: between logos and myth

    Directory of Open Access Journals (Sweden)

    Francesc Casadesús Bordoy

    2016-08-01

    Full Text Available In his dialogues, Plato frequently resorted to alternate and intertwine his dialectic expositions with images and allegories, aiming to illustrate his arguments. This paper analyses in detail his use of the opposition between logos and myth tointroduce his descriptions of Hades

  4. Go Tell Alcibiades: Tragedy, Comedy, and Rhetoric in Plato's "Symposium"

    Science.gov (United States)

    Crick, Nathan; Poulakos, John

    2008-01-01

    Plato's "Symposium" is a significant but neglected part of his elaborate and complex attitude toward rhetoric. Unlike the intellectual discussion of the "Gorgias" or the unscripted conversation of the "Phaedrus," the "Symposium" stages a feast celebrating and driven by the forces of "Eros." A luxuriously stylish performance rather than a rational…

  5. The Cost of PLATO in a University Environment.

    Science.gov (United States)

    Hofstetter, Fred T.

    1983-01-01

    This analysis of the cost-effectiveness of the University of Delaware's own PLATO system discusses the initial expense of acquiring the system, decreases in unit cost as number of users increased, capital investment in hardware, expenditures and funding sources, comparisons of actual and projected costs, and benefits of individualized instruction.…

  6. Second Summative Report of the Delaware PLATO Project.

    Science.gov (United States)

    Hofstetter, Fred T.

    Begun on an experimental basis in March 1975, the ongoing PLATO project at the University of Delaware has become an established part of the University's academic program. This descriptive report is divided into three sections: (1) project history and development, including organization, utilization, instructor and author training, and projections…

  7. Dodecahedrane—The chemical transliteration of Plato's universe (A Review)

    Science.gov (United States)

    Paquette, Leo A.

    1982-07-01

    The development of chemical interest in three of Plato's five convex polyhedra is described from an historical perspective. The successful synthesis of 1,16-dimethyldodecahedrane and its structural characteristics are outlined. Finally, an account of recent work leading to the still more aesthetically appealing and ultrasymmetric parent dodecahedrane is given.

  8. Effect of Pre-Hospital Ticagrelor During the First 24 h After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction

    DEFF Research Database (Denmark)

    Montalescot, Gilles; van 't Hof, Arnoud W; Bolognese, Leonardo

    2016-01-01

    OBJECTIVES: The aim of this landmark exploratory analysis, ATLANTIC-H(24), was to evaluate the effects of pre-hospital ticagrelor during the first 24 h after primary percutaneous coronary intervention (PCI) in the ATLANTIC (Administration of Ticagrelor in the cath Lab or in the Ambulance for New ...

  9. Evaluation of crushed ticagrelor tablet doses: recovery following crushing and naso-gastric tube passage ex vivo.

    Science.gov (United States)

    Crean, Barry; Finnie, Cindy; Crosby, Anna

    2013-06-01

    Orally available ticagrelor in combination with low-dose aspirin (75-100 mg/day) is indicated for adult patients with acute coronary syndromes. However, patients with swallowing difficulties may be unable to consume the currently available 90-mg tablet. It is hypothesized that ticagrelor could be given to this patient cohort as a crushed dose administered either orally or via a naso-gastric (NG) tube. To investigate the potential use of crushed ticagrelor tablets (90- and 180-mg doses) for oral dose or NG tube administration. Ticagrelor tablets (90 or 180 mg [two 90-mg tablets]) were prepared to emulate oral and NG tube administration by similar methods. For the oral dose, ticagrelor tablets were crushed using a mortar and pestle and transferred to a dosing cup. 100 mL of water was added to the mortar, stirred, and the contents were transferred to the dosing cup and stirred to form a suspension. At this stage, where the suspension would normally be administered to a patient, it was collected for high performance liquid chromatography (HPLC) analysis. The mortar was then flushed with 100 mL of water, and the contents were again transferred to the dosing cup, stirred, and collected for HPLC analysis. For the NG dose, polyvinylchloride, polyurethane, and silicone size CH10 NG tubes were used. The tablets were crushed using a mortar and pestle, diluted with 50 mL of water, and stirred. At this stage, where the suspension would normally be administered to a patient through an NG tube using a syringe, it was collected for HPLC analysis. The mortar was then flushed with two additional 50 mL aliquots of water and the contents were passed through the NG tube. HPLC analysis examined the recoverability of ticagrelor in each of the dose suspensions and flushes and the stability of the suspension when held in a syringe for up to 2 h. One or two crushed 90-mg ticagrelor tablets, prepared for either oral or NG tube administration, delivers a mean dose of ≥97% of the original

  10. Arete and physics: The lesson of Plato's "Timaeus"

    Science.gov (United States)

    Wolfe, John R.

    Plato's Timaeus is traditionally read as a work dedicated to the sole purpose of describing the origin and nature of the cosmos, as a straightforward attempt by Plato to produce a peri phuseos treatise. In accord with this reading, the body of Timaeus' monologue is then seen as nothing more than an attempt by Plato to convey his own cosmological doctrines. I propose an alternative to the view that the Timaeus is nothing more than a textbook of Platonic physics. The Timaeus is rather squarely focused on the human being, in her moral and political dimensions, and on her relation to the natural world as a whole. Ultimately, this account of the human being is intended to provide part of the answer to the question of how society can produce good citizens and leaders, and thus serves to provide a theoretical basis for the practices of paideia. When viewed in this light many of the curious features of the Timaeus appear less strange. The various parts of the dialogue: the dramatic introduction, Critias' tale of the Ancient Athenians, and Timaeus' monologue can be seen as each contributing to an investigation of a single topic. It further allows us to understand why Plato chooses to employ Timaeus the Locrian as the principle speaker of the dialogue rather than Socrates. Finally, when read in this way, the Timaeus no longer appears as an outlier in the Platonic corpus, as a work devoted to a radically different subject matter than the rest of his writings. It can be seen as dedicated to the same issues which preoccupied Plato throughout his entire life, as about the determination of the best life and providing the tools with which to realize it.

  11. Teaching Early Mathematics with PLATO[R] Software: An Overview of the New PLATO Elementary Mathematics Curricula and How To Use Them. Technical Paper.

    Science.gov (United States)

    Quinn, Bill; Foshay, Rob; Morris, Barbara

    The "PLATO[R] Math Expeditions" and "PLATO[R] Projects for the Real World" curricula are designed to implement effective, research-based instructional practices. "Math Expeditions" is designed to give elementary grade users the mathematics skills and practice needed to solve real-life problems. Across the eight…

  12. Uric acid and high-residual platelet reactivity in patients treated with clopidogrel or ticagrelor.

    Science.gov (United States)

    Barbieri, L; Verdoia, M; Pergolini, P; Nardin, M; Rolla, R; Marino, P; Bellomo, G; Suryapranata, H; De Luca, G

    2016-04-01

    High residual platelet reactivity (HRPR) is still an important challenge, despite the advent of new potent ADP-antagonists. Therefore it is of extreme importance to identify factors that can influence platelet activation. Serum uric acid (SUA) has been largely addressed in the past as a possible risk factor for coronary artery disease, with a possible association with platelets hyperreactivity. So far no studies have assessed the role of serum uric acid on the response to dual antiplatelet therapy. Therefore, the aim of our study was to evaluate the impact of uric acid levels on platelet function in patients treated with dual antiplatelet therapy (DAPT) with clopidogrel or ticagrelor. We scheduled for platelet function assessment at 30-90 days post-discharge patients treated with DAPT (ASA + clopidogrel or ticagrelor) for an ACS or elective percutaneous coronary intervention (PCI). Platelet function was assessed by whole blood impedance aggregometry (Multiplate(®)-Roche Diagnostics AG), HRPR was considered for ASPI test >862 AU(∗)min (for ASA) and ADP test values ≥417 AU* min (for ADP-antagonists). We included a total of 493 patients (262 were on ASA and clopidogrel and 231 on ASA and ticagrelor). Patients were divided according to quartiles of serum uric acid levels measured at the time of platelet aggregation assessment (Group 1 6.9, n = 122). Patients with higher uric acid levels were older, more often smokers, with history of hypertension and previous coronary artery bypass surgery and renal failure and were more often on therapy with diuretics at admission. Patients with higher SUA had higher triglycerides and fibrinogen. Uric acid levels did not influence ASPI, COL, TRAP and ADP tests. High residual platelet reactivity (HRPR) was observed in 1.5% of patients treated with ASA, with no difference according to SUA quartiles (p = 0.60), confirmed at multivariate analysis after correction for baseline confounders (adjusted OR[95%CI] = 1.05 [0.44-2.52], p = 0

  13. THE JOURNEY OF TRUTH: FROM PLATO TO ZOLA

    Directory of Open Access Journals (Sweden)

    Ribut Basuki

    1999-01-01

    Full Text Available Western theater theory and criticism is generally considered to be set forth by the Greeks. Plato was "the first theater critic" with his negative comments about theater owing to his idealistic views about "the truth." Then came Aristotle who used a different viewpoint from that of Plato, saying that there is "truth" in theater. However, hostile criticism on theater came back in the Middle Ages, championed by Tertulian before Aristotelian theory was revived by the neo-classicists such as Scaliger and Castelvetro. Theater theory and criticism discourse was then made more alive by the romanticists who disagreed with the neo-classicists' rigid rules on theater. As the influence of science became dominant in the theater world, naturalism and realism emerged and became the mainstream of theater theory and criticism until well into the twentieth century.

  14. The necessity of dialectics according to Plato and Adorno

    DEFF Research Database (Denmark)

    Olsen, Anne-Marie Eggert

    2009-01-01

    The paper deals with the notion of philosophy as, on the one hand, an academic or scientific discipline and, on the other, something perhaps superior to the disciplines and in any case dealing with what is not a 'disciplinary' matter. Through an interpretation of Plato's concept of dialectics and...... and Adorno's understanding of philosophy as expression (Ausdruck) it is proposed that this two-fold nature of philosophy is what makes dialectics necessary....

  15. Effect of loading-dose ticagrelor on coronary blood flow, left ventricular remodeling and myocardial enzyme spectrum in patients with acute myocardial infarction after interventional therapy

    Institute of Scientific and Technical Information of China (English)

    Xiao-Rui Xie; Pu Yang

    2016-01-01

    Objective:To study the effect of loading-dose ticagrelor on coronary blood flow, left ventricular remodeling and myocardial enzyme spectrum in patients with acute myocardial infarction after interventional therapy.Methods: A total of 86 patients with acute myocardial infarction who received emergency PCI in our hospital between May 2013 and May 2016 were selected and randomly divided into two groups, ticagrelor group received perioperative ticagrelor therapy and clopidogrel group received perioperative clopidogrel therapy. After PCI, coronary blood flow reperfusion was evaluated, serum myocardial remodeling indexes and myocardial enzymes were determined, and cardiac color Doppler ultrasonography was conducted to determine the cardiac function indexes.Results:TIMI grading and TMPG grading of ticagrelor group after PCI were significantly higher than those of clopidogrel group; serum MMP9, BNP, CITP, PICP, PIIINP, CK, CK-MB, cTnI and cTnT content of ticagrelor group 24h after operation were significantly lower than those of clopidogrel group; LVEDD, LVSED and LVMI of ticagrelor group 2 weeks after operation were significantly lower than those of clopidogrel group while LVEF was significantly higher than that of clopidogrel group.Conclusion:Peri-PCI loading-dose ticagrelor can improve coronary blood perfusion and reduce ventricular remodeling and myocardial injury in patients with acute myocardial infarction.

  16. Optical and dark characterization of the PLATO CCD at ESA

    Science.gov (United States)

    Verhoeve, Peter; Prod'homme, Thibaut; Oosterbroek, Tim; Duvet, Ludovic; Beaufort, Thierry; Blommaert, Sander; Butler, Bart; Heijnen, Jerko; Lemmel, Frederic; van der Luijt, Cornelis; Smit, Hans; Visser, Ivo

    2016-07-01

    PLATO - PLAnetary Transits and Oscillations of stars - is the third medium-class mission (M3) to be selected in the European Space Agency (ESA) Science and Robotic Exploration Cosmic Vision programme. It is due for launch in 2025 with the main objective to find and study terrestrial planets in the habitable zone around solar-like stars. The payload consists of >20 cameras; with each camera comprising 4 Charge-Coupled Devices (CCDs), a large number of flight model devices procured by ESA shall ultimately be integrated on the spacecraft. The CCD270 - specially designed and manufactured by e2v for the PLATO mission - is a large format (8 cm x 8 cm) back-illuminated device operating at 4 MHz pixel rate and coming in two variants: full frame and frame transfer. In order to de-risk the PLATO CCD procurement and aid the mission definition process, ESA's Payload Technology Validation section is currently validating the PLATO CCD270. This validation consists in demonstrating that the device achieves its specified electrooptical performance in the relevant environment: operated at 4 MHz, at cold and before and after proton irradiation. As part of this validation, CCD270 devices have been characterized in the dark as well as optically with respect to performance parameters directly relevant for the photometric application of the CCDs. Dark tests comprise the measurement of gain sensitivity to bias voltages, charge injection tests, and measurement of hot and variable pixels after irradiation. In addition, the results of measurements of Quantum Efficiency for a range of angles of incidence, intra- pixel response (non-)uniformity, and response to spot illumination, before and after proton irradiation. In particular, the effect of radiation induced degradation of the charge transfer efficiency on the measured charge in a star-like spot has been studied as a function of signal level and of position on the pixel grid, Also, the effect of various levels of background light on the

  17. Spontaneous subdural hematoma and antiplatelet therapy: Does efficacy of Ticagrelor come with added risk?

    Science.gov (United States)

    Suryanarayana Sharma, Pattanagere Manjunatha; Tekkatte Jagannatha, Aniruddha; Javali, Mahendra; Hegde, Anupama Venkatasubba; Mahale, Rohan; Madhusudhan; Srinivasa, Rangasetty

    2015-12-01

    Antiplatelet therapy has established clinical benefit on cardiovascular outcome and has reduced the rates of re-infarction/in stent thrombosis following percutaneous coronary intervention in acute coronary syndromes. Major bleeding episodes can occur with antiplatelet therapy and intracranial hemorrhage (ICH) is one of the most feared complications resulting in significant morbidity and mortality. Identification of high risk groups and judicious use of antiplatelet therapy reduces the bleeding risk. Ticagrelor is a newer P2Y12 receptor antagonist with established clinical benefit. However, risks of having an ICH with these newer molecules cannot be ignored. Here, we report a case of spontaneous acute subdural hematoma developing in a patient on antiplatelet therapy with aspirin and ticagrelor. Early recognition, discontinuation of the medication and appropriate management resulted in resolution of hematoma and good clinical outcome. Authors have reviewed the antithrombotic drugs and their tendencies in causing intracranial bleeds from a neurophysicians perspective. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  18. The Philosopher's Arete or theStructure of Plato's Parmenides

    Directory of Open Access Journals (Sweden)

    Raúl Gutierrez

    1998-12-01

    Full Text Available The controversy conceming the unity of Plato's Parmenides and the meaning of its first part is stillongoing. The A. proposes a solution, pointing out its structural coincidence with the Republic's simile of the line. This leads him to confine young Socrates in the segment that corresponds to óuivoux and old Parmenides in the vór¡olc; segment. As the one who "possesses insight" of truth based on his apprehension of the One-Good. Parmenides is the actual representative of the philosopher's arete.

  19. Tibial plato leveling osteotomy / Osteotomia de nivelamento do plato da tíbia

    Directory of Open Access Journals (Sweden)

    Julia Maria Matera

    2008-08-01

    Full Text Available The tibial plateau leveling osteotomy (TPLO is a relatively new and innovative surgical treatment for the cranial cruciate ligament rupture in the canine species. The real intent of the procedure is to provide functional stability to the stifle joint by eliminating or neutralizing the cranial tibial thrust during weight bearing instead to restore the cranial cruciate ligament function. The proposal of this study is to report a review of the TPLO procedure, emphasizing procedure, surgical technique, post operative care and complications. The TPLO procedure consists in a radial osteotomy in the tibial plato and rotation of the caudal plateau in order to obtain a desired angle. After the leveling of the tibial plateau, a bone plate and screws are used to stabilize the osteotomy until bone is healed up. The complications that have been associated with the procedure include tibial tuberosity fracture and patellar tendon tendinosis. This procedure has become increasingly more popular for surgical treatment of cranial cruciate ligament injuries in large breed dog. The long term clinical results have not been completely elucidated yet. It has been showed that this technique doesn’t halt the degenerative joint disease.A osteotomia do platô da tíbia (TPLO é um tratamento relativamente novo e inovador para a ruptura do ligamento cruzado cranial (RLCC na espécie canina. Ao invés de restaurar a função do ligamento, o procedimento promove estabilidade funcional para a articulação do joelho, por eliminar ou neutralizar a força tibial cranial durante a sustentação de peso. A proposta do presente estudo é revisar a técnica de TPLO, enfatizando o procedimento, técnica cirúrgica, cuidados pós-operatórios e complicações. A técnica da TPLO consiste na realização de uma osteotomia circular do platô da tíbia com rotação de sua porção caudal até a obtenção do ângulo desejado. Após o nivelamento do platô da tíbia, placa e parafusos

  20. Reversing Plato’s Anti-Democratism: Castoriadis’ “Quirky” Plato

    Directory of Open Access Journals (Sweden)

    Hamblet, Wendy C.

    2008-12-01

    Full Text Available This paper considers the conflicting "loves" of Cornelius Castoriadis--his love for the ancients, and especially Plato, and for the common person of the demos. A detailed study of Castoriadis' analysis of Plato's Statesman exposes that Castoriadis attempts to resolve the paradox by rereading Plato as a radical democrat. I argue that this unorthodox reading is at best "quirky, " (a charge Castoriadis levels at Plato at worst a groundless sophism. However, I conjecture that Castoriadis' reading may not constitute a serious attempt to describe a Platonic politics, so much as a prescriptive reading of what otherwise might have been, given certain strands of political generosity evident elsewhere in Plato's corpus.

  1. Co-administration of cyclosporine and ticagrelor may lead to a higher exposure to cyclosporine: a case report of a 49-year old man.

    Science.gov (United States)

    van Sloten, T T; de Klaver, P A G; van den Wall Bake, A W L

    2017-09-11

    A drug interaction leading to higher exposure to cyclosporine DRUGS IMPLICATED: Cyclosporine and ticagrelor THE PATIENT: A 49-year old man with a stable renal graft, managed with cyclosporine with stable trough blood concentrations for several years, was treated with ticagrelor for unstable angina pectoris EVIDENCE THAT LINKS THE DRUG TO THE EVENT: The timeline was consistent with the appearance of an interaction, the interaction was confirmed by an increase in trough concentration of cyclosporine, and there were no alternative causes that by themselves could have caused the increase in cyclosporine exposure MANAGEMENT: Cessation of ticagrelor MECHANISM: Inhibition of CYP3A4 and P-glycoprotein by ticagrelor IMPLICATIONS FOR THERAPY: Clinicians should be aware of this potential interaction as ticagrelor is frequently prescribed in individuals using cyclosporine. Close monitoring of cyclosporine serum concentrations is warranted to avoid overdosing of cyclosporine. A pharmacokinetic study is needed to further examine the probable interaction between cyclosporine and ticagrelor. This article is protected by copyright. All rights reserved.

  2. Radiation, Thermal Gradient and Weight: a threefold dilemma for PLATO

    Science.gov (United States)

    Magrin, Demetrio; Ragazzoni, Roberto; Bruno, Giordano; Piazza, Daniele; Borsa, Francesco; Ghigo, Mauro; Mogulsky, Valery; Bergomi, Maria; Biondi, Federico; Chinellato, Simonetta; Dima, Marco; Farinato, Jacopo; Greggio, Davide; Gullieuszik, Marco; Marafatto, Luca; Viotto, Valentina; Munari, Matteo; Pagano, Isabella; Sicilia, Daniela; Basso, Stefano; Spiga, Daniele; Bandy, Timothy; Brändli, Mathias; Benz, Willy; De Roche, Thierry; Rieder, Martin; Brandeker, Alexis; Klebor, Maximilian; Schweitzer, Mario; Wieser, Matthias; Erikson, Anders; Rauer, Heike

    2016-07-01

    The project PLAnetary Transits and Oscillations of stars (PLATO) is one of the selected medium class (M class) missions in the framework of the ESA Cosmic Vision 2015-2025 program. The mean scientific goal of PLATO is the discovery and study of extrasolar planetary systems by means of planetary transits detection. The opto mechanical subsystem of the payload is made of 32 normal telescope optical units (N-TOUs) and 2 fast telescope optical units (FTOUs). The optical configuration of each TOU is an all refractive design based on six properly optimized lenses. In the current baseline, in front of each TOU a Suprasil window is foreseen. The main purposes of the entrance window are to shield the following lenses from possible damaging high energy radiation and to mitigate the thermal gradient that the first optical element will experience during the launch from ground to space environment. In contrast, the presence of the window increases the overall mass by a non-negligible quantity. We describe here the radiation and thermal analysis and their impact on the quality and risks assessment, summarizing the trade-off process with pro and cons on having or dropping the entrance window in the optical train.

  3. Manufacturing and alignment tolerance analysis through Montecarlo approach for PLATO

    Science.gov (United States)

    Magrin, Demetrio; Ragazzoni, Roberto; Bergomi, Maria; Biondi, Federico; Chinellato, Simonetta; Dima, Marco; Farinato, Jacopo; Greggio, Davide; Gullieuszik, Marco; Marafatto, Luca; Viotto, Valentina; Munari, Matteo; Pagano, Isabella; Sicilia, Daniela; Basso, Stefano; Borsa, Francesco; Ghigo, Mauro; Spiga, Daniele; Bandy, Timothy; Brändli, Mathias; Benz, Willy; Bruno, Giordano; De Roche, Thierry; Piazza, Daniele; Rieder, Martin; Brandeker, Alexis; Klebor, Maximilian; Mogulsky, Valery; Schweitzer, Mario; Wieser, Matthias; Erikson, Anders; Rauer, Heike

    2016-07-01

    The project PLAnetary Transits and Oscillations of stars (PLATO) is one of the selected medium class (M class) missions in the framework of the ESA Cosmic Vision 2015-2025 program. The main scientific goal of PLATO is the discovery and study of extrasolar planetary systems by means of planetary transits detection. According to the current baseline, the scientific payload consists of 34 all refractive telescopes having small aperture (120mm) and wide field of view (diameter greater than 37 degrees) observing over 0.5-1 micron wavelength band. The telescopes are mounted on a common optical bench and are divided in four families of eight telescopes with an overlapping line-of-sight in order to maximize the science return. Remaining two telescopes will be dedicated to support on-board star-tracking system and will be specialized on two different photometric bands for science purposes. The performance requirement, adopted as merit function during the analysis, is specified as 90% enclosed energy contained in a square having size 2 pixels over the whole field of view with a depth of focus of +/-20 micron. Given the complexity of the system, we have followed a Montecarlo analysis approach for manufacturing and alignment tolerances. We will describe here the tolerance method and the preliminary results, speculating on the assumed risks and expected performances.

  4. Love as an Object of Initiation in Plato's Philosophy

    Directory of Open Access Journals (Sweden)

    Euaggelia Maraggianou

    2007-07-01

    Full Text Available Initiation ( muvhsh was the first stage of the ancient mysteries celebrating Demeter, the earth-goddess, and her daughter Kore, soon identified with Persephone or Persephasa, a pre-Greek deity of the underworld. Next came the stage of contemplation ( ejpopteiva , at which worshippers were shown a vision of the goddess of Hades. This led them to identify themselves with her, thus reaching the highest form of happiness. The Eleusinian Mysteries were inseparably linked to the Orphic doctrine, which in its turn influenced the thought of Plato. Plato sees love as an object of initiation and as one of the greatest mysteries of human existence. Plato’s dialogues, Phaedrus and Symposium, contain expressions borrowed directly from the vocabulary of the Mysteries. Although neither Socrates in Phaedrus nor Diotima in Symposium make any explicit reference to the mystic ceremonies, it is certain that both allude to them in expounding the mysteries of spiritual life. The latter has to start at the stage of physical love in order to end up in the contemplation of Ideas. The mystery into which Socrates is initiated by Diotima is the following: there is a mystic stairway leading from the earth to the sky, from man to God. It is made visible by Love, and its steps are represented by different kinds of beauty. The ascent is a gradual one, with a long stop at each of the stages. In this way Love, disciplined by philosophy and spiritualised by increasing de-personalisation, ends up in the Intellectual, conceiving the latter with an intuitive insight. By this spiritual process, one is purified, led to the road of salvation and enabled to participate in the Divine.

  5. PLATO as it is : A legacy mission for Galactic archaeology

    Science.gov (United States)

    Miglio, A.; Chiappini, C.; Mosser, B.; Davies, G. R.; Freeman, K.; Girardi, L.; Jofré, P.; Kawata, D.; Rendle, B. M.; Valentini, M.; Casagrande, L.; Chaplin, W. J.; Gilmore, G.; Hawkins, K.; Holl, B.; Appourchaux, T.; Belkacem, K.; Bossini, D.; Brogaard, K.; Goupil, M.-J.; Montalbán, J.; Noels, A.; Anders, F.; Rodrigues, T.; Piotto, G.; Pollacco, D.; Rauer, H.; Prieto, C. Allende; Avelino, P. P.; Babusiaux, C.; Barban, C.; Barbuy, B.; Basu, S.; Baudin, F.; Benomar, O.; Bienaymé, O.; Binney, J.; Bland-Hawthorn, J.; Bressan, A.; Cacciari, C.; Campante, T. L.; Cassisi, S.; Christensen-Dalsgaard, J.; Combes, F.; Creevey, O.; Cunha, M. S.; Jong, R. S.; Laverny, P.; Degl'Innocenti, S.; Deheuvels, S.; Depagne, É.; Ridder, J.; Matteo, P. Di; Mauro, M. P. Di; Dupret, M.-A.; Eggenberger, P.; Elsworth, Y.; Famaey, B.; Feltzing, S.; García, R. A.; Gerhard, O.; Gibson, B. K.; Gizon, L.; Haywood, M.; Handberg, R.; Heiter, U.; Hekker, S.; Huber, D.; Ibata, R.; Katz, D.; Kawaler, S. D.; Kjeldsen, H.; Kurtz, D. W.; Lagarde, N.; Lebreton, Y.; Lund, M. N.; Majewski, S. R.; Marigo, P.; Martig, M.; Mathur, S.; Minchev, I.; Morel, T.; Ortolani, S.; Pinsonneault, M. H.; Plez, B.; Moroni, P. G. Prada; Pricopi, D.; Recio-Blanco, A.; Reylé, C.; Robin, A.; Roxburgh, I. W.; Salaris, M.; Santiago, B. X.; Schiavon, R.; Serenelli, A.; Sharma, S.; Aguirre, V. Silva; Soubiran, C.; Steinmetz, M.; Stello, D.; Strassmeier, K. G.; Ventura, P.; Ventura, R.; Walton, N. A.; Worley, C. C.

    2017-07-01

    Deciphering the assembly history of the Milky Way is a formidable task, which becomes possible only if one can produce high-resolution chrono-chemo-kinematical maps of the Galaxy. Data from large-scale astrometric and spectroscopic surveys will soon provide us with a well-defined view of the current chemo-kinematical structure of the Milky Way, but will only enable a blurred view on the temporal sequence that led to the present-day Galaxy. As demonstrated by the (ongoing) exploitation of data from the pioneering photometric missions CoRoT, Kepler, and K2, asteroseismology provides the way forward: solar-like oscillating giants are excellent evolutionary clocks thanks to the availability of seismic constraints on their mass and to the tight age-initial-mass relation they adhere to. In this paper we identify five key outstanding questions relating to the formation and evolution of the Milky Way that will need precise and accurate ages for large samples of stars to be addressed, and we identify the requirements in terms of number of targets and the precision on the stellar properties that are needed to tackle such questions. By quantifying the asteroseismic yields expected from PLATO for red-giant stars, we demonstrate that these requirements are within the capabilities of the current instrument design, provided that observations are sufficiently long to identify the evolutionary state and allow robust and precise determination of acoustic-mode frequencies. This will allow us to harvest data of sufficient quality to reach a 10% precision in age. This is a fundamental pre-requisite to then reach the more ambitious goal of a similar level of accuracy, which will only be possible if we have to hand a careful appraisal of systematic uncertainties on age deriving from our limited understanding of stellar physics, a goal which conveniently falls within the main aims of PLATO's core science.

  6. The Legacies of Literacy: From Plato to Freire through Harvey Graff.

    Science.gov (United States)

    Gee, James Paul

    1989-01-01

    Reviews "The Legacies of Literacy: Continuities and Contradictions in Western Culture and Society" (Harvey G. Graff). Discusses the historical role of literacy education as a tool for liberation, emphasizing the viewpoints of Plato and Freire. (FMW)

  7. Genesis 2–3 and Alcibiades's speech in Plato's Symposium : A ...

    African Journals Online (AJOL)

    Genesis 2–3 and Alcibiades's speech in Plato's Symposium : A cultural critical reading. ... interpretation can arise from the analysis of Alcibiades's speech compared to M- and LXX-Genesis ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  8. Prospects for detecting decreasing exoplanet frequency with main sequence age using PLATO

    CERN Document Server

    Veras, Dimitri; Mustill, Alexander J; Pollacco, Don

    2015-01-01

    The space mission PLATO will usher in a new era of exoplanetary science by expanding our current inventory of transiting systems and constraining host star ages, which are currently highly uncertain. This capability might allow PLATO to detect changes in planetary system architecture with time, particularly because planetary scattering due to Lagrange instability may be triggered long after the system was formed. Here, we utilize previously published instability timescale prescriptions to determine PLATO's capability to detect a trend of decreasing planet frequency with age for systems with equal-mass planets. For two-planet systems, our results demonstrate that PLATO may detect a trend for planet masses which are at least as massive as super-Earths. For systems with three or more planets, we link their initial compactness to potentially detectable frequency trends in order to aid future investigations when these populations will be better characterized.

  9. Plato's Charmides as a Political Act: Apologetics and the Promotion of Ideology

    National Research Council Canada - National Science Library

    Danzig, Gabriel

    2013-01-01

      By showing that Critias and Socrates understood the same matters differently, Plato was able to treat seriously ideas that came to be associated with the Thirty and with Socrates while shielding himself from criticism...

  10. Platerm: la banque de terminologie du systeme Platon (PLATERM: The Terminology Bank of the PLATO System).

    Science.gov (United States)

    Schwab, Wallace; St-Denis, Richard

    1980-01-01

    Describes the elements and functioning of the terminology bank of the PLATO (Programmed Loqic for Automated Teaching Operation) system. Discusses contemporary terminology and lexicography notions on which the bank is based and outlines the tasks performed through PLATERM. (MES)

  11. Platerm: la banque de terminologie du systeme Platon (PLATERM: The Terminology Bank of the PLATO System).

    Science.gov (United States)

    Schwab, Wallace; St-Denis, Richard

    1980-01-01

    Describes the elements and functioning of the terminology bank of the PLATO (Programmed Loqic for Automated Teaching Operation) system. Discusses contemporary terminology and lexicography notions on which the bank is based and outlines the tasks performed through PLATERM. (MES)

  12. The PLATO Dome A site-testing observatory: Power generation and control systems

    Science.gov (United States)

    Lawrence, J. S.; Ashley, M. C. B.; Hengst, S.; Luong-van, D. M.; Storey, J. W. V.; Yang, H.; Zhou, X.; Zhu, Z.

    2009-06-01

    The atmospheric conditions above Dome A, a currently unmanned location at the highest point on the Antarctic plateau, are uniquely suited to astronomy. For certain types of astronomy Dome A is likely to be the best location on the planet, and this has motivated the development of the Plateau Observatory (PLATO). PLATO was deployed to Dome A in early 2008. It houses a suite of purpose-built site-testing instruments designed to quantify the benefits of Dome A site for astronomy, and science instruments designed to take advantage of the observing conditions. The PLATO power generation and control system is designed to provide continuous power and heat, and a high-reliability command and communications platform for these instruments. PLATO has run and collected data throughout the winter 2008 season completely unattended. Here we present a detailed description of the power generation, power control, thermal management, instrument interface, and communications systems for PLATO, and an overview of the system performance for 2008.

  13. Gaia and WEAVE/WxES: Supporting the PLATO Exoplanet Hunter

    Science.gov (United States)

    Walton, N. A.

    2016-10-01

    This paper briefly describes the powerful linkages between the Gaia and PLATO missions and the potential for WEAVE in the study of exoplanet populations, for instance through the proposed WxES survey. Gaia successfully launched in December 2013, and over the course of its nominal five year mission will discover, via their astrometric signatures, upwards of 20 000 massive Jupiter sized long period planets at distances out to several hundred parsecs around all star types. In addition Gaia will discover up to a thousand short period hot Jupiters around M stars. PLATO, to launch in 2024, will through precision photometry, observe in detail some million host stars, and will detect, via the transit technique, planets down to Earth masses. PLATO will observe two fields of over 2 000 square degrees for 2-3 years each. At least one of these will be in the northern hemisphere. WEAVE has the potential to provide detailed chemical characterization of the host stars of the Gaia and PLATO exoplanet systems. This will enable insights into, for instance, metallicity of the host star correlations against both massive exoplanets (perhaps confirming current relationships), and lower mass exoplanets. We note how the rapid exploitation of such a potential WEAVE survey could be achieved, utilizing the WEAVE processing systems being developed at the IoA, Cambridge, coupled with efficient interfaces to both Gaia and PLATO data products, that are also being generated at the IoA.

  14. The role of the poet in Plato's ideal cities of Callipolis and Magnesia

    Directory of Open Access Journals (Sweden)

    Gerard Naddaf

    2008-01-01

    Full Text Available Plato's attitude toward the poets and poetry has always been a flashpoint of debate, controversy and notoriety, but most scholars have failed to see their central role in the ideal cities of the Republic and the Laws, that is, Callipolis and Magnesia. In this paper, I argue that in neither dialogue does Plato "exile" the poets, but, instead, believes they must, like all citizens, exercise the expertise proper to their profession, allowing them the right to become full-fledged participants in the productive class. Moreover, attention to certain details reveals that Plato harnesses both positive and negative factors in poetry to bring his ideal cities closer to a practical realization. The status of the poet and his craft in this context has rarely to my knowledge been addressed.

  15. PLATO - the next-generation AASTINO for robotic site-testing on the Antarctic plateau

    Science.gov (United States)

    Hengst, S.; Lawrence, J.; Luong-van, D.; Everett, J.; Ashley, M. C. B.; Storey, J. W. V.; Hall, S.

    2006-08-01

    A new site-testing facility, PLATO (Plateau Observatory), is under development at UNSW for deployment to remote sites on the Antarctic Plateau including Dome A. The new facility will adopt many of the features of the AASTINO (Automated Astrophysical Site Testing InterNational Observatory) facility at Dome C. PLATO will autonomously control a flexible site testing and observing instrument suite, monitored via the Iridium satellite network. A challenging aspect of PLATO is to maximise the reliability of the power source while minimising fuel consumption. We are building a low pressure, low temperature environmental chamber to simulate operation at the highest altitudes (4,100 m at Dome A). Two types of engines will be tested: a single-cylinder diesel engine and a Stirling engine.

  16. Efficient methods for solving discrete topology design problems in the PLATO-N project

    DEFF Research Database (Denmark)

    Canh, Nam Nguyen; Stolpe, Mathias

    This paper considers the general multiple load structural topology design problems in the framework of the PLATO-N project. The problems involve a large number of discrete design variables and were modeled as a non-convex mixed 0–1 program. For the class of problems considered, a global optimizat......This paper considers the general multiple load structural topology design problems in the framework of the PLATO-N project. The problems involve a large number of discrete design variables and were modeled as a non-convex mixed 0–1 program. For the class of problems considered, a global...

  17. The quest for a poetics of goodness in plato and aristotle

    OpenAIRE

    Dairo Orozco

    2012-01-01

    The paper, which compares Plato and Aristotle’s different approaches towards artistic activity, is divided into three parts. The first part discusses Plato’s Ion on mimesis and technē, as well as the role that poetry plays in the Republic. The second section offers an account of Aristotle’s idea of happiness as the end of action. Thelast section of this study deals with an attempt to reconcile Plato and Aristotle’s attitude towards mimetic art in a treatise by a Neoplatonic renaissance thinke...

  18. A Similar Comparison between the Thought of Plato and Confucius on Social Hierarchy and Elitism

    Institute of Scientific and Technical Information of China (English)

    杨馥遥

    2014-01-01

    The spring-autumn period and warring state period of Chinese thoughts coincide strikingly with the thoughts of the Hel enic Age in the west. Plato and Confucius, the two outstanding seminal thinkers have shaped the philosophy of their respective cultures through some similar means and thoughts which definitely meet at a series of significant points. The highlight of the academic thesis lies in the comparison of the general similarities be-tween Plato and Confucius especial y in terms of social hierarchy and elitism.

  19. The PLATO End-to-End CCD Simulator -- Modelling space-based ultra-high precision CCD photometry for the assessment study of the PLATO Mission

    CERN Document Server

    Zima, W; De Ridder, J; Salmon, S; Catala, C; Kjeldsen, H; Aerts, C

    2010-01-01

    The PLATO satellite mission project is a next generation ESA Cosmic Vision satellite project dedicated to the detection of exo-planets and to asteroseismology of their host-stars using ultra-high precision photometry. The main goal of the PLATO mission is to provide a full statistical analysis of exo-planetary systems around stars that are bright and close enough for detailed follow-up studies. Many aspects concerning the design trade-off of a space-based instrument and its performance can best be tackled through realistic simulations of the expected observations. The complex interplay of various noise sources in the course of the observations made such simulations an indispensable part of the assessment study of the PLATO Payload Consortium. We created an end-to-end CCD simulation software-tool, dubbed PLATOSim, which simulates photometric time-series of CCD images by including realistic models of the CCD and its electronics, the telescope optics, the stellar field, the pointing uncertainty of the satellite ...

  20. Democratic Freedom and the Concept of Freedom in Plato and Aristotle

    Directory of Open Access Journals (Sweden)

    Mogens Herman Hansen

    2010-11-01

    Full Text Available Among the several meanings of eleutheria used by Greeks in the classical period, democratic freedom is rejected by both Plato and Aristotle, who do not articulate a theory of political freedom but rather confine eleutheria to a social context.

  1. Freud, Plato and Irigaray: A Morpho-Logic of Teaching and Learning

    Science.gov (United States)

    Peers, Chris

    2012-01-01

    This article discusses two well-known texts that respectively describe learning and teaching, drawn from the work of Freud and Plato. These texts are considered in psychoanalytic terms using a methodology drawn from the philosophy of Luce Irigaray. In particular the article addresses Irigaray's approach to the analysis of speech and utterance as a…

  2. Dialectic of Eros and Myth of the Soul in Plato's Phaedrus

    DEFF Research Database (Denmark)

    Larsen, Jens Kristian

    2010-01-01

    In this paper, I question a widespread reading of a passage in the last part of the Phaedrus dealing with the science of dialectic. According to this reading, the passage announces a new method peculiar to the later Plato aiming at defining natural kinds. I show that the Phaedrus itself does not ...

  3. Evaluation of a Three Year Health Sciences PLATO IV Computer-Based Education Project.

    Science.gov (United States)

    Sorlie, William E.; Essex, Diane L.

    Significant findings of the comprehensive evaluation of a computer-based curriculum in the basic medical sciences using the PLATO IV computer system are presented. The study was conducted by the Office of Curriculum and Evaluation (OCE) of the School of Basic Medical Sciences (SBMS) at the University of Illinois, Urbana/Champaign (UC). It was…

  4. Cost of Initial Development of PLATO Instruction in Veterinary Medicine. CERL Report X-43.

    Science.gov (United States)

    Grimes, George M.

    An academic program instituting the PLATO system of computer-assisted instruction at the University of Illinois College of Veterinary Medicine is discussed. Procedures involved setting up an organization, establishing an administrative system, studying capabilities of the system, studying factors making a lesson suitable for programming, and…

  5. From Dialogos to Dialogue: The Use of the Term from Plato to the Second Century CE

    Directory of Open Access Journals (Sweden)

    Katarzyna Jazdzewska

    2014-02-01

    Full Text Available In Plato the verb διαλέγεσθαι is far more common than the noun, and both denote question-and-answer discussions; it was only in the Hellenistic period that διάλογος became a genre term, though its other meanings survived.

  6. Two examples of the relation between the contemporary science and Plato

    CERN Document Server

    Antonello, Elio

    2016-01-01

    The philosopher Plato is remembered even today by scientists, and his writings are still inspiring the scientific research. In the present short note (intended essentially for public outreach) two examples are briefly illustrated: 1) the European space project that bears his name, dedicated to the discovery of exoplanets; 2) the discussion about platonism in contemporary physics.

  7. Grades 1-8, Apache Junction Unified School District 43, Apache Junction, Arizona. PLATO Evaluation Series.

    Science.gov (United States)

    Quinn, David W.; Quinn, Nancy W.

    Apache Junction Unified School District, Arizona, has embarked on a 5-year program of instructional improvement using technology. PLATO Elementary reading and mathematics products were installed in the district's elementary and middle schools at the beginning of the 1999-2000 school year. This evaluation studied the use and preliminary student…

  8. Can Prior Knowledge Hurt Text Comprehension? An Answer Borrowed from Plato, Aristotle, and Descartes.

    Science.gov (United States)

    Friedman, Lawrence B.

    Taking a philosophical approach based on what Plato, Aristotle, and Descartes said about knowledge, this paper addresses some of the murkiness in the conceptual space surrounding the issue of whether prior knowledge does or does not facilitate text comprehension. Specifically, the paper first develops a non-exhaustive typology of cases in which…

  9. A Philosophical Investigation of the Role of Teachers: A Synthesis of Plato, Confucius, Buber, and Freire

    Science.gov (United States)

    Shim, Seung Hwan

    2008-01-01

    This study proposes the ideal role of teachers through the examination of Plato, Confucius, Buber, and Freire on the subject. Teachers not only contribute to the development of individuals and societies but also attain self-realization through teaching. As such, the role of teachers is important as a goal as well as a means. To examine such role,…

  10. Genesis 2–3 and Alcibiades's speech in Plato's Symposium: A ...

    African Journals Online (AJOL)

    2015-08-26

    Aug 26, 2015 ... Friedländer 1975:26f; Gauss 1958:111–117) is the last speech in Plato's ... leader (450–404/3 BCE), appears to be in a great state of intoxication .... command (Gn 2:18: 'You are free to eat of all the trees in the garden.

  11. Freud, Plato and Irigaray: A Morpho-Logic of Teaching and Learning

    Science.gov (United States)

    Peers, Chris

    2012-01-01

    This article discusses two well-known texts that respectively describe learning and teaching, drawn from the work of Freud and Plato. These texts are considered in psychoanalytic terms using a methodology drawn from the philosophy of Luce Irigaray. In particular the article addresses Irigaray's approach to the analysis of speech and utterance as a…

  12. From Plato to Erikson: How the War on "Bad Play" Has Impoverished Higher Education

    Science.gov (United States)

    Carnes, Mark C.

    2015-01-01

    For centuries, the titans of educational reform--Plato, Rousseau, Dewey, Piaget, Erikson, Csikszentmihalyi and others--have championed the educational benefits of play. Yet many professors and administrators are boggled by the idea of playing academic games in college. They instantly dismiss faculty initiatives like "Reacting to the…

  13. Acquired Hemophilia A May Be Associated with Ticagrelor Therapy in a 52-Year-Old Man After a Recent Percutaneous Transluminal Coronary Angioplasty.

    Science.gov (United States)

    Pasquino, Paola; Canaparo, Roberto; Capello, Tiziana; Deorsola, Barbara; Perazzolo, Laura; Marengo, Claudio; Serpe, Loredana

    2016-01-01

    We present a case report of a 52-year-old man who was hospitalized for right leg pain due to a relevant hemorrhagic effusion. He was on dual antiplatelet therapy (DAPT): acetylsalicylic acid and ticagrelor, a reversible P2Y12 receptor antagonist. Signs, symptoms, and laboratory blood tests led to the diagnosis of acquired hemophilia A (AHA). Ticagrelor therapy-associated AHA was hypothesized due to the fact that, before adding this drug, all laboratory and clinical examinations were repeatedly normal. Prednisone and cyclophosphamide treatment was started without DAPT interruption due to the high risk of stent thrombosis. After 10 days, prolonged activated partial thromboplastin time dropped from 107 to 49 seconds, the patient's factor VIII (FVIII) levels gradually normalized over the following few weeks, and FVIII inhibitor titer was negative. Recently, some reports have established a link between the development of AHA and treatment with clopidogrel, an irreversible P2Y12 receptor antagonist. However, to the best of our knowledge, this is the first time that a link between AHA and ticagrelor has been reported.

  14. Acquired Hemophilia A May Be Associated with Ticagrelor Therapy in a 52-Year-Old Man After a Recent Percutaneous Transluminal Coronary Angioplasty

    Science.gov (United States)

    Pasquino, Paola; Canaparo, Roberto; Capello, Tiziana; Deorsola, Barbara; Perazzolo, Laura; Marengo, Claudio; Serpe, Loredana

    2016-01-01

    We present a case report of a 52-year-old man who was hospitalized for right leg pain due to a relevant hemorrhagic effusion. He was on dual antiplatelet therapy (DAPT): acetylsalicylic acid and ticagrelor, a reversible P2Y12 receptor antagonist. Signs, symptoms, and laboratory blood tests led to the diagnosis of acquired hemophilia A (AHA). Ticagrelor therapy-associated AHA was hypothesized due to the fact that, before adding this drug, all laboratory and clinical examinations were repeatedly normal. Prednisone and cyclophosphamide treatment was started without DAPT interruption due to the high risk of stent thrombosis. After 10 days, prolonged activated partial thromboplastin time dropped from 107 to 49 seconds, the patient’s factor VIII (FVIII) levels gradually normalized over the following few weeks, and FVIII inhibitor titer was negative. Recently, some reports have established a link between the development of AHA and treatment with clopidogrel, an irreversible P2Y12 receptor antagonist. However, to the best of our knowledge, this is the first time that a link between AHA and ticagrelor has been reported. PMID:27660505

  15. Plato, Wilde, and Woolf: the poetics of homoerotic "intercourse" in A Room of One's Own.

    Science.gov (United States)

    Vanita, Ruth

    2010-01-01

    This article places Woolf in the context of homoerotic literary ancestry. It suggests that the overall argument in A Room of One's Own owes a debt to Wilde's 1891 pamphlet The Soul of Man under Socialism. It also examines Woolf's controversial meditation on male-female collaboration and intercourse in A Room, and suggests a homoerotic reading of this meditation, drawing on images and ideas of literary transmission and creation from Plato's Symposium.

  16. The philosopher Socrates had exophthalmos (a term coined by Plato) and probably Graves' disease.

    Science.gov (United States)

    Papapetrou, Peter D

    2015-01-01

    According to a previously published theory, Socrates was afflicted with temporal lobe epilepsy since his childhood. Plato, Xenophon, and Aristoxenus described Socrates as having exophthalmos, probably diplopia, and some symptoms compatible with hyperthyroidism. Using these data, we theorize that Socrates had Graves' disease. In order to determine a cause of his temporal lobe epilepsy, we speculate that the philosopher also had autoimmune thyroiditis and Hashimoto encephalopathy during his childhood and his epilepsy may have been a sequel to this hypothesized encephalopathy.

  17. The instrument control unit of the ESA-PLATO 2.0 mission

    Science.gov (United States)

    Focardi, M.; Pezzuto, S.; Cosentino, R.; Giusi, G.; Pancrazzi, M.; Noce, V.; Ottensamer, R.; Steller, M.; Di Giorgio, A. M.; Pace, E.; Plasson, P.; Peter, G.; Pagano, I.

    2016-07-01

    PLATO 2.0 has been selected by ESA as the third medium-class Mission (M3) of the Cosmic Vision Program. Its Payload is conceived for the discovery of new transiting exoplanets on the disk of their parent stars and for the study of planetary system formation and evolution as well as to answer fundamental questions concerning the existence of other planetary systems like our own, including the presence of potentially habitable new worlds. The PLATO Payload design is based on the adoption of four sets of short focal length telescopes having a large field of view in order to exploit a large sky coverage and to reach, at the same time, the needed photometry accuracy and signalto- noise ratio (S/N) within a few tens of seconds of exposure time. The large amount of data produced by the telescope is collected and processed by means of the Payload's Data Processing System (DPS) composed by many processing electronics units. This paper gives an overview of the PLATO 2.0 DPS, mainly focusing on the architecture and processing capabilities of its Instrument Control Unit (ICU), the electronic subsystem acting as the main interface between the Payload (P/L) and the Spacecraft (S/C).

  18. Echoes in Plato's cave : ontology of sound objects in computer music and analysis

    OpenAIRE

    Marsden, Alan

    2014-01-01

    The sonic aspects of Plato's analogy of the cave is taken as a starting point for thought experiments to investigate the objective nature of sound, and the idea of quasi-Platonic forms in music. Sounds are found to be objects in a way that sights or appearances are not, and it is only in the presence of technology that they become artificial. When recognition, control and communication about sound come into play, abstract concepts emerge, but there is no reason to give these the priority stat...

  19. Ontological Questions in Schelling’s Late Philosophy: Plato and Aristotle

    Directory of Open Access Journals (Sweden)

    Jean-François Courtine

    2010-09-01

    Full Text Available The purpose of the article is to understand the reasons and procedures employed by F. W. Schelling in his Plato and Aristotle re-appropriation, and to extract the authentically ontological thematic of it. It makes a path through the Schelling’s late writings and letters, to construct a complete view about the relation between this appropriation and the possibility of the constitution of a positive philosophy, as a particular science, in opposition to a negative philosophy, understood as metaphysics.

  20. Numbers Rule The Vexing Mathematics of Democracy, from Plato to the Present

    CERN Document Server

    Szpiro, George G

    2010-01-01

    Since the very birth of democracy in ancient Greece, the simple act of voting has given rise to mathematical paradoxes that have puzzled some of the greatest philosophers, statesmen, and mathematicians. Numbers Rule traces the epic quest by these thinkers to create a more perfect democracy and adapt to the ever-changing demands that each new generation places on our democratic institutions. In a sweeping narrative that combines history, biography, and mathematics, George Szpiro details the fascinating lives and big ideas of great minds such as Plato, Pliny the Younger, Ramon Llull, Pierre Simo

  1. Philosophy and Mathematics in the Teaching of Plato: the Development of Idea and Modernity

    Directory of Open Access Journals (Sweden)

    Mikhailova N. V.

    2014-01-01

    Full Text Available It is well known that the largest philosophers differently explain the origin of mathematics. This question was investigated in antiquity, a substantial and decisive role in this respect was played by the Platonic doctrine. Therefore, discussing this issue the problem of interaction of philosophy and mathematics in the teachings of Plato should be taken into consideration. Many mathematicians believe that abstract mathematical objects belong in a certain sense to the world of ideas and that consistency of objects and theories really describes mathematical reality, as Plato quite clearly expressed his views on math, according to which mathematical concepts objectively exist as distinct entities between the world of ideas and the world of material things. In the context of foundations of mathematics, so called “Gödel’s Platonism” is of particular interest. It is shown in the article how Platonic objectification of mathematical concepts contributes to the development of modern mathematics by revealing philosophical understanding of the nature of abstraction. To substantiate his point of view, the author draws the works of contemporary experts in the field of philosophy of mathematics.

  2. The PLATO Simulator: Modelling of High-Precision High-Cadence Space-Based Imaging

    CERN Document Server

    Marcos-Arenal, P; De Ridder, J; Aerts, C; Huygen, R; Samadi, R; Green, J; Piotto, G; Salmon, S; Catala, C; Rauer, H

    2014-01-01

    Many aspects of the design trade-off of a space-based instrument and its performance can best be tackled through simulations of the expected observations. The complex interplay of various noise sources in the course of the observations make such simulations an indispensable part of the assessment and design study of any space-based mission. We present a formalism to model and simulate photometric time series of CCD images by including models of the CCD and its electronics, the telescope optics, the stellar field, the jitter movements of the spacecraft, and all important natural noise sources. This formalism has been implemented in a versatile end-to-end simulation software tool, called PLATO Simulator, specifically designed for the PLATO space mission to be operated from L2, but easily adaptable to similar types of missions. We provide a detailed description of several noise sources and discuss their properties, in connection with the optical design, the allowable level of jitter, the quantum efficiency of th...

  3. 氯吡格雷抵抗患者应用替格瑞洛临床疗效%Clinical efficacy of ticagrelor in patients with clopidogrel resistance

    Institute of Scientific and Technical Information of China (English)

    郭云飞; 吴永健; 肖文琦; 韩萍; 宋丽萍

    2015-01-01

    目的:探讨氯吡格雷抵抗的患者更换为替格瑞洛后其抗血小板聚集效果。方法本研究入选了63例经血栓弹力图结果证实存在氯吡格雷抵抗患者。所有患者均接受经皮冠状动脉介入治疗,并被分为替格瑞洛组和氯吡格雷组。所有患者接受替格瑞洛(90 mg,2次/d)或氯吡格雷(75 mg,1次/d)治疗。治疗3天后复查血栓弹力图。评价两组患者血小板抑制率及主要不良心脏事件情况。结果对于氯吡格雷抵抗患者,更换为替格瑞洛后腺苷二磷酸(adenosine diphosphate,ADP)抑制率(36.9%)较继续应用氯吡格雷(16.7%)明显升高(P <0.01)。替格瑞洛应用是安全的,并且替格瑞洛组未出现任何严重出血事件。但是有1例服用替格瑞洛患者因严重呼吸困难而停药。经过平均8.2个月随访后未出现急性心肌梗死、心血管死亡或支架内血栓事件。结论氯吡格雷抵抗患者接受替格瑞洛后能获得理想的抗血小板效果。对于接受经皮冠状动脉介入治疗,尤其存在氯吡格雷抵抗患者而言,替格瑞洛是安全、有效并且可以信赖的药物。%ABSTRACT:Objective To observe the clinical efficacy of ticagrelor against platelet aggregation in the treatment for patients with clopidogrel resistance.Methods A total of 63 patients with clopidogrel resistance identified by thrombelastography were enrolled in this study.Each patient had received percutaneous coronary intervention(PCI). The subjects were divided into ticagrelor group and clopidogrel group,according to their response to clopidogrel. Patients with clopidogrel resistance received ticagrelor treatment (90 mg twice daily)and patients responding to clopidogrel were still treated with clopidogrel (75 mg daily).After treatment for three days,thrombelastography was carried out on them again.The platelet inhibition ratio and the major adverse cardiac event in both

  4. Dialectic and Dialogue in Plato: Refuting the Model of Socrates-as-Teacher in the Pursuit of Authentic "Paideia"

    Science.gov (United States)

    Magrini, James Michael

    2014-01-01

    Incorporating Gadamer and other thinkers from the continental tradition, this essay is a close and detailed hermeneutic, phenomenological, and ontological study of the dialectic practice of Plato's Socrates--it radicalizes and refutes the Socrates-as-teacher model that educators from scholar academic ideology embrace.

  5. Three Aspects of PLATO Use at Chanute AFB: CBE Production Techniques, Computer-Aided Management, Formative Development of CBE Lessons.

    Science.gov (United States)

    Klecka, Joseph A.

    This report describes various aspects of lesson production and use of the PLATO system at Chanute Air Force Base. The first chapter considers four major factors influencing lesson production: (1) implementation of the "lean approach," (2) the Instructional Systems Development (ISD) role in lesson production, (3) the transfer of…

  6. A Plan for the Evaluation of a Project to Develop Basic Medical Sciences Lessons on PLATO IV.

    Science.gov (United States)

    Jones, Les A.; And Others

    A project to introduce PLATO IV computer-assisted instruction (CAI) in medical sciences education for health professionals was implemented at the School of Basic Medical Sciences at the University of Illinois. This paper describes the plan for evaluation of the project. Using a student questionnaire and additional general questions, the…

  7. An Evaluation of the Teaching Effectiveness of PLATO in a First Level Biology Course. CERL Report X-32.

    Science.gov (United States)

    Arsenty, Richard P.; Kieffer, George H.

    This paper describes a study of the teaching effectiveness of computer-assisted instruction using the PLATO system at the University of Illinois in a first level biology course. College enrollment, class rank, final grade, and time study data of the control and experimental groups were obtained from master rosters. A questionnaire administered to…

  8. The Education of the Third Class in "The Republic": Plato and the "Locus Classicus" of Formative Justice

    Science.gov (United States)

    Mintz, Avi I.

    2016-01-01

    Background/Context: In one of the classics of educational philosophy, a key issue is remains unsettled. In Plato's "Republic," Socrates makes a case for the importance of a comprehensive education. Socrates is unclear, however, about whether the producer class is eligible for this comprehensive education. Purpose/Objective: Previous…

  9. Dialectic and Dialogue in Plato: Refuting the Model of Socrates-as-Teacher in the Pursuit of Authentic "Paideia"

    Science.gov (United States)

    Magrini, James Michael

    2014-01-01

    Incorporating Gadamer and other thinkers from the continental tradition, this essay is a close and detailed hermeneutic, phenomenological, and ontological study of the dialectic practice of Plato's Socrates--it radicalizes and refutes the Socrates-as-teacher model that educators from scholar academic ideology embrace.

  10. Trials

    Directory of Open Access Journals (Sweden)

    Michele Fornaro

    2010-01-01

    Full Text Available Mental Retardation (MR is a developmental disability characterized by impairments in adaptive daily life skills and difficulties in social and interpersonal functioning. Since multiple causes may contribute to MR, associated clinical pictures may vary accordingly. Nevertheless, when psychiatric disorders as Treatment Resistant Depression (TRD and/or alcohol abuse co-exist, their proper detection and management is often troublesome, essentially due to a limited vocabulary MR people could use to describe their symptoms, feelings and concerns, and the lack of reliable screening tools. Furthermore, MR people are among the most medicated subjects, with (over prescription of antidepressants and/or typical antipsychotics being the rule rather than exception. Thus, treatment resistance or even worsening of depression, constitute frequent occurrences. This report describes the case of a person with MR who failed to respond to repetitive trials of antidepressant monotherapies, finally recovering using aripiprazole to fluvoxamine augmentation upon consideration of a putative bipolar diathesis for “agitated” TRD. Although further controlled investigations are needed to assess a putative bipolar diathesis in some cases of MR associated to TRD, prudence is advised in the long-term prescription of antidepressant monotherapies in such conditions.

  11. The Theory of Argumentation within Language and its relation to Plato, Saussure and Benveniste

    Directory of Open Access Journals (Sweden)

    Cristiane Dall'Cortivo-Lebler

    2014-12-01

    Full Text Available The Theory of Argumentation within Language, developed by Oswald Ducrot, Jean-Claude Anscombre and Marion Carel, has experienced along its development different phases and forms, constantly seeking to align to what its main developer, Oswald Ducrot, called external hypotheses and internal hypotheses. This paper discusses the presence of Linguistic Theories and Philosophy in Ducrot’s work regarding concepts of Plato, Ferdinand de Saussure and Émile Benveniste, which constitute its external assumptions. The presence of these concepts culminated in the creation of different concepts that comprise the Linguistic Semantics, and gave it a specific point of view about language that emphasizes the internal relationships among language components and understands that speech is the result of a linguistic activity where an “I” speaks to a “you”.

  12. Efficient methods for solving discrete topology design problems in the PLATO-N project

    DEFF Research Database (Denmark)

    Canh, Nam Nguyen; Stolpe, Mathias

    This paper considers the general multiple load structural topology design problems in the framework of the PLATO-N project. The problems involve a large number of discrete design variables and were modeled as a non-convex mixed 0–1 program. For the class of problems considered, a global...... optimization method based on the branch-and-cut concept was developed and implemented. In the method a large number of continuous relaxations were solved. We also present an algorithm for generating cuts to strengthen the quality of the relaxations. Several heuristics were also investigated to obtain efficient...... algorithms. The branch and cut method is used to solve benchmark examples which can be used to validate other methods and heuristics....

  13. Alternative communication network designs for an operational Plato 4 CAI system

    Science.gov (United States)

    Mobley, R. E., Jr.; Eastwood, L. F., Jr.

    1975-01-01

    The cost of alternative communications networks for the dissemination of PLATO IV computer-aided instruction (CAI) was studied. Four communication techniques are compared: leased telephone lines, satellite communication, UHF TV, and low-power microwave radio. For each network design, costs per student contact hour are computed. These costs are derived as functions of student population density, a parameter which can be calculated from census data for one potential market for CAI, the public primary and secondary schools. Calculating costs in this way allows one to determine which of the four communications alternatives can serve this market least expensively for any given area in the U.S. The analysis indicates that radio distribution techniques are cost optimum over a wide range of conditions.

  14. Banishing the Poet: The Pedagogical Function of Mythology in the Dialogues of Plato

    Directory of Open Access Journals (Sweden)

    Javier Martínez

    2013-06-01

    Full Text Available This text attempts to develop a sound justification for Plato’s pedagogical use of myth in the dialogues. In particular, I seek to resolve a seeming contradiction: why Plato personally made use of myths in spite of his many statements that seem to contradict such a pedagogical approach, especially his edict that poets and myth-makers be banished from his republic for the danger their works pose to the attainment of true philosophical wisdom. An analysis of the centrality of myths to the dialogues is carried out, followed by a discussion of the place of muthos in its Ionian historical context. This establishes the basis for resolving the contradiction through the division of muthos into two distinct modes: the fantastic and the eikastic.

  15. Arete and Gender-Differentiation in Socrates/Plato and Aristotle

    Directory of Open Access Journals (Sweden)

    Thomas Robinson

    1998-12-01

    Full Text Available The article grapples with the question whether Plato believed that, in the matter of arete, the female psyche had a built-in inclination to immorality in a way that the male psyche did not, and was therefore assuch signiticantly different from the male psyche. It is argued that the evidence of the Timaeus ( and, to some lesser degree, of the Laws suggests very strongly that he did, though fortunately the political consequence she drew from this (in the Laws tum out to be positive rather than negative. Aristotle, by contrast,it is argued, while still holding to the lamentable theory of the inferiority of woman, talks of ditl'eringquanta of (one and the same arete in male and female souls, rather than a difference in their very arete.

  16. Platón y el silogismo Plato and the syllogism

    Directory of Open Access Journals (Sweden)

    Manuel Correia Machuca

    2010-03-01

    Full Text Available La cuestión de si Platón pudo ser el autor de una primera noción de deducción silogística (un método que Aristóteles hizo conocido a través de una definición y un progreso teórico en los Analíticos Primeros fue discutida en la antigüedad y, desde entonces, debatida por varios comentaristas. En este artículo, comento dos pasajes de la literatura post-aristotélica, uno atestiguado por Boecio (que se remonta a Alejandro de Afrodisia y el otro presente en Juan Filópono, en su comentario a los Analíticos Primeros. El artículo intenta mostrar que estos pasajes contienen información suficiente para favorecer a Platón como conocedor de la técnica deductiva silogística, aunque no para conferirle el desarrollo de la metodología silogística.The question of whether Plato could be the author of a first concept of syllogistic deduction (a method that Aristotle made known by means of a definition and a theoretical improvement in his Prior Analytics was known in the antiquity and from that time, the question has usually examined by several commentators. In this article, I comment on two passages of post-Aristotelian tradition; one is given by Boethius (which stems from Alexander of Aphrodisias and the other was given by Johannes Philoponus in his commentary on Prior Analytics. The article intends to show that these passages contain information that is sufficient to come to an opinion favoring Plato, although it does not imply that they are sufficient to confer him the syllogistic method.

  17. Simulation results for PLATO: a prototype hybrid X-ray photon counting detector with a low energy threshold for fusion plasma diagnostics

    Science.gov (United States)

    Habib, A.; Menouni, M.; Pangaud, P.; Fenzi, C.; Colledani, G.; Moureau, G.; Escarguel, A.; Morel, C.

    2017-01-01

    PLATO is a prototype hybrid X-ray photon counting detector that has been designed to meet the specifications for plasma diagnostics for the WEST tokamak platform (Tungsten (W) Environment in Steady-state Tokamak) in southern France, with potential perspectives for ITER. PLATO represents a customized solution that fulfills high sensitivity, low dispersion and high photon counting rate. The PLATO prototype matrix is composed of 16 × 18 pixels with a 70 μm pixel pitch. New techniques have been used in analog sensitive blocks to minimize noise coupling through supply rails and substrate, and to suppress threshold dispersion across the matrix. The PLATO ASIC is designed in CMOS 0.13 μm technology and was submitted for a fabrication run in June 2016. The chip is designed to be bump-bonded to a silicon sensor. This paper presents pixel architecture as well as simulation results while highlighting novel solutions.

  18. From Pericles to Plato – from democratic political praxis to totalitarian political philosophy

    Directory of Open Access Journals (Sweden)

    Øjvind Larsen

    2012-03-01

    Full Text Available Plato is normally taken as one of the founders of Western political philosophy, not at least with his Republic. Here, he constructs a hierarchy of forms of governments, beginning with aristocracy at the top as a critical standard for the other forms of governments, and proceeding through timocracy and oligarchy to democracy and tyranny at the bottom. Following Karl Popper, the paper argues that Plato’s is a totalitarian philosophy that emphasizes the similarities between democracy and tyranny, which it considers to be the two worst forms of government. Plato’s denigration of democracy has dominated the tradition of political philosophy until recent times. This paper, however, shows that political philosophy in fact originates in democracy, especially as developed by the sophists and that philosophy is only a form of sophism with a similar origin in ancient Greek democracy. A discussion of Pericles’ funeral oration is used to show that Pericles presented a democratic political philosophy that can serve as a counterpoint to Plato’s political philosophy in the Republic.

  19. Plato's Concept of Justice%论柏拉图的正义观

    Institute of Scientific and Technical Information of China (English)

    刘欣如

    2015-01-01

    本文以柏拉图的作品《申辩》、《斐多》、《理想国》为切入点,论述了正义是在应在的位置上做应做之事、正义的本质是灵魂的一种属性以及正义的产生,并通过作品提供的背景和对话讨论了正义之人和不义之人的区别、正义的种类、正义行为的动机、正义的各种不同状态等问题.%In this paper, the works of Plato,"defense","Phaedo","Utopia"as the starting point, discusses the justice should be done is to do things in a position to be in, the nature of justice is an attribute of the soul, and justice generation, background and dialogue and through providing discussed works of justice and the unrighteous man of distinction, just the kind of moti-vation act of justice, justice of various states and other issues.

  20. Baseline Q waves and time from symptom onset to ST-segment elevation myocardial infarction: insights from PLATO on the influence of sex.

    Science.gov (United States)

    Kholaif, Naji; Zheng, Yinggan; Jagasia, Pushpa; Himmelmann, Anders; James, Stefan K; Steg, Philippe Gabriel; Storey, Robert F; Westerhout, Cynthia M; Armstrong, Paul W

    2015-08-01

    The prognostic value of time from symptom onset to reperfusion may be enhanced by the identification of Q waves on the presenting electrocardiogram (ECG) in patients with ST-segment elevation myocardial infarction (STEMI). We evaluated whether the relative prognostic utility of these 2 metrics was altered by sex. Q waves in the distribution of the ST-segment elevation on the baseline ECG were evaluated by a blinded core laboratory in 2838 STEMI patients (2163 men and 675 women) from the PLATelet inhibition and patient Outcomes (PLATO) trial who underwent percutaneous coronary intervention (PCI) within 12 hours of symptom onset. Women were older (median 63 vs 57 years), more likely to be diabetic (24.1% vs 15.5%), hypertensive (69.2% vs 50.9%), and a higher Killip class > I (8.6% vs 5.9%), as compared with men. Whereas the Q waves frequency rose progressively over time to ECG in men, this relationship was attenuated in women (P = .057). Q waves on the baseline ECG were associated with a higher excess hazard of 1-year vascular death in men (hazard ratio [HR] 2.03; 95% confidence interval [CI], 1.13-3.72), and a similar trend existed in women (HR 1.97; 95% CI, 0.86-4.51). Women with baseline Q waves tended to have higher risk of 1-year vascular death than men as continuous time from symptom onset to PCI increased (P[interaction] = .182). These differences in the evolution of baseline Q waves and relationship between time from symptom onset and vascular death in women and men deserve recognition in future studies of STEMI. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Dosimetric evaluation of PLATO and Oncentra treatment planning systems for High Dose Rate (HDR) brachytherapy gynecological treatments

    Science.gov (United States)

    Singh, Hardev; Herman, Tania De La Fuente; Showalter, Barry; Thompson, Spencer J.; Syzek, Elizabeth J.; Herman, Terence; Ahmad, Salahuddin

    2012-10-01

    This study compares the dosimetric differences in HDR brachytherapy treatment plans calculated with Nucletron's PLATO and Oncentra MasterPlan treatment planning systems (TPS). Ten patients (1 T1b, 1 T2a, 6 T2b, 2 T4) having cervical carcinoma, median age of 43.5 years (range, 34-79 years) treated with tandem & ring applicator in our institution were selected retrospectively for this study. For both Plato and Oncentra TPS, the same orthogonal films anterior-posterior (AP) and lateral were used to manually draw the prescription and anatomical points using definitions from the Manchester system and recommendations from the ICRU report 38. Data input for PLATO was done using a digitizer and Epson Expression 10000XL scanner was used for Oncentra where the points were selected on the images in the screen. The prescription doses for these patients were 30 Gy to points right A (RA) and left A (LA) delivered in 5 fractions with Ir-192 HDR source. Two arrangements: one dwell position and two dwell positions on the tandem were used for dose calculation. The doses to the patient points right B (RB) and left B (LB), and to the organs at risk (OAR), bladder and rectum for each patient were calculated. The mean dose and the mean percentage difference in dose calculated by the two treatment planning systems were compared. Paired t-tests were used for statistical analysis. No significant differences in mean RB, LB, bladder and rectum doses were found with p-values > 0.14. The mean percent difference of doses in RB, LB, bladder and rectum are found to be less than 2.2%, 1.8%, 1.3% and 2.2%, respectively. Dose calculations based on the two different treatment planning systems were found to be consistent and the treatment plans can be made with either system in our department without any concern.

  2. Dosimetric evaluation of PLATO and Oncentra treatment planning systems for High Dose Rate (HDR) brachytherapy gynecological treatments

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Hardev; De La Fuente Herman, Tania; Showalter, Barry; Thompson, Spencer J.; Syzek, Elizabeth J.; Herman, Terence; Ahmad, Salahuddin [Department of Radiation Oncology, Peggy and Charles Stephenson Oklahoma Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104 (United States)

    2012-10-23

    This study compares the dosimetric differences in HDR brachytherapy treatment plans calculated with Nucletron's PLATO and Oncentra MasterPlan treatment planning systems (TPS). Ten patients (1 T1b, 1 T2a, 6 T2b, 2 T4) having cervical carcinoma, median age of 43.5 years (range, 34-79 years) treated with tandem and ring applicator in our institution were selected retrospectively for this study. For both Plato and Oncentra TPS, the same orthogonal films anterior-posterior (AP) and lateral were used to manually draw the prescription and anatomical points using definitions from the Manchester system and recommendations from the ICRU report 38. Data input for PLATO was done using a digitizer and Epson Expression 10000XL scanner was used for Oncentra where the points were selected on the images in the screen. The prescription doses for these patients were 30 Gy to points right A (RA) and left A (LA) delivered in 5 fractions with Ir-192 HDR source. Two arrangements: one dwell position and two dwell positions on the tandem were used for dose calculation. The doses to the patient points right B (RB) and left B (LB), and to the organs at risk (OAR), bladder and rectum for each patient were calculated. The mean dose and the mean percentage difference in dose calculated by the two treatment planning systems were compared. Paired t-tests were used for statistical analysis. No significant differences in mean RB, LB, bladder and rectum doses were found with p-values > 0.14. The mean percent difference of doses in RB, LB, bladder and rectum are found to be less than 2.2%, 1.8%, 1.3% and 2.2%, respectively. Dose calculations based on the two different treatment planning systems were found to be consistent and the treatment plans can be made with either system in our department without any concern.

  3. Ancient philosophical ideas of the soul (Plato-Aristotelian tradition and Stoicism as a source of Patristic Thought

    Directory of Open Access Journals (Sweden)

    Zaitsev Cornelius

    2014-10-01

    Full Text Available The article discusses the ancient idea of the soul that in the patristic era has been enriched by the perception of the methodology of ancient philosophy. Greek and Roman thinkers considered some properties of the soul, its immortality, revealed its “levels and strata” (Plato, Aristotle, expressed first guesses about the nature of sinful passions (the Stoics. But some aspects still remained unresolved so far. This is the issue of materiality or immateriality, of the soul, which "raised" in the Russian Empire in the 19th century (the dispute saints Theophan the Recluse and Ignatius Brianchaninov and remains relevant today.

  4. Toward a Poeticognosis: Re-reading Plato's The Republic via Wallace Stevens' "An Ordinary Evening in New Haven"

    Directory of Open Access Journals (Sweden)

    Dan Disney

    2008-01-01

    Full Text Available This article is a language-based re-reading of Plato's exile of the poets via Wallace Stevens' poem-manifesto, "An Ordinary Evening in New Haven." I examine how philosophy and poetry use language differently in order to deconstruct an origin of the speech-acts -- wonder -- that I then identify as a phenomenological difference between philosophers and poets. I contend that the thinking-into-language of philosophers is based in theoria, comprehension, and a resulting closure of wonder. I contrast this with the processes of poets, who I show to be moving thought into language via gnosis, apprehension, and a phenomenology opening onto inexhaustible wonder.

  5. Love and/in psychoanalysis: a commentary on Lacan's reading of Plato's Symposium in Seminar VIII: Transference.

    Science.gov (United States)

    Fink, Bruce

    2015-02-01

    What is love and what part does it play in psychoanalysis? Where are the analyst and the analysand situated in relation to the roles defined as those of the "lover" and the "beloved"? Jacques Lacan explores these and other questions in his soon-to-be-published Seminar VIII: Transference by providing an extensive commentary on Plato's most famous dialogue on love, the Symposium. This paper outlines some of the major points about love that grow out of Lacan's reading of the dialogue and examines their relevance to the analytic setting. Can the analyst be characterized as a sort of modern-day Socrates?

  6. ¿Solamente platos? Cerámicas de barniz rojo en el depósito ibérico del Zacatín (Granada)

    OpenAIRE

    Sánchez Moreno, Amparo; Niveau de Villedary y Mariñas, Ana María; Adroher Auroux, Andrés María

    2015-01-01

    Se presenta un conjunto homogéneo de platos de barniz rojo indígena con un perfil muy particular y sin paralelos conocidos por el momento. Dicho conjunto formaba parte del depósito ritual hallado en la granadina calle del Zacatín, una fosa junto al río Darro que se rellenó con los resultantes de un festín sagrado posiblemente en relación con el propio río. En este trabajo planteamos que estos platos fueron fabricados ex profeso para el ritual que tuvo lugar fuera de las murallas de Iliberri e...

  7. The micro-fascism of Plato's good citizen: producing (dis)order through the construction of risk.

    Science.gov (United States)

    O'Byrne, Patrick; Holmes, Dave

    2007-04-01

    The human body has come to be seen as forever susceptible to both external and internal hazards, which in many circumstances require immediate, heroic, and expensive intervention. In response to this, there has been a shift from a treatment-based healthcare model to one of prevention wherein nurses play an integral role by identifying and assessing risks for individuals, communities, and populations. This paper uses Deborah Lupton's outline of the spectrum of risk and applies the theoretical works of Foucault and Plato to demonstrate the means by which nurses maintain social order by identifying and counselling risk takers. It also utilizes the work of Deleuze and Guattari to illustrate how Plato's framework for creating social order through the creation of the good citizen can be viewed as a micro-fascist system, which has been adopted wholeheartedly by preventative health professionals. The goal of this paper is to present an alternate understanding of risk to provide nurses and other healthcare professionals with a non-traditional appreciation of certain aspects of their practice as researchers and clinicians.

  8. Negação e diferença em Platão Negation and diference in Plato

    Directory of Open Access Journals (Sweden)

    Eliane Christina de Souza

    2010-01-01

    Full Text Available Platão, ao tratar da negação no diálogo Sofista, afirma que sempre que enunciamos o que não é, não enunciamos algo contrário ao que é, mas algo diferente. A negação significa cada parte da natureza da diferença em antítese ao que é. Tal tratamento da negação resulta da necessidade de resolver alguns problemas colocados pelo eleatismo. Propõe-se indicar esses problemas e examinar o tratamento que Platão dá ao não-ser como diferença.Plato, in dealing with negation in the dialogue Sophist, says that when we say what is not, we speak not of something that is the opposite of being, but of something different. Negation means each part of the nature of the difference in antithesis to what is. This treatment of negation results from the need to solve some problems posed by eleatism. It is proposed to indicate these problems and examine the treatment that Plato gives to non-being as difference.

  9. Comparative Study of Meanings and Status of Imagination in Mathnavi and Plato’s Ideas

    Directory of Open Access Journals (Sweden)

    sh alyari

    2013-02-01

    Full Text Available Describing and explaining the nature of imagination and its function with regard to human being and ontology has always been one of the preoccupations of philosophers and thinkers. Plato is the first philosopher who considered an epistemological status for imagination and, by dividing the world into the world of reason and world of senses, he ascribed the knowledge of imagination to the world of senses. In different parts of Mathnavi, Molavi, the great Muslim-Iranian mystic, has paid much attention to imagination, its types, its status in the Knowledge of Man (both physical and metaphysical affairs and its various influences on the body, soul and mental states of any individual. Thus, the present article aims to compare the concept of imagination in the view of the two thinkers. For reaching such aim, while using a descriptive-comparative method, first, the definitions of imagination in Mathnavi and Plato’s ideas are investigated and, then, the similarities and differences of the two views are shown. The conclusion is that their ideas are similar with regard to unreality and shadowiness of the world and phenomena, the relation between imitation and imagination, deficiency and restrictions of imagination for understanding the reality, whereas their ideas are different regarding the power of imagination, its epistemological status and the meaning and influence of it.

  10. Clinical effects of high maintenance dose of clopidogrel and ticagrelor%高维持量氯吡格雷和替格瑞洛临床疗效对比研究

    Institute of Scientific and Technical Information of China (English)

    汤毅; 陈魁; 党瑜华; 姜正明; 崔健健

    2015-01-01

    Objective To investigate the antiplatelet effects of high maintenance dose of clopidogrel and ticagrelor.Methods Sixty-four patients with stable coronary artery disease were screened from our hospital as poor clopidogrel metabolizer according to CYP2C19 gene type.They were divided into two groups.Group A was treated with clopidogrel with loading dose of 300 mg at the first time and 150 mg/d for 30 days; Group B was treated with ticagrelor loading with the dose of 180 mg and 90 mg,twice one day.Platelet function was measured by aggregometry ADP induced at preloading,2 hours after loading does and 30 days after maintenance dose.All patients werefollowed-up with major adverse cardiovascular events(MACE) and bleeding events for 30 days.Results The antiplatelet effect of ticagrelor was higher than that of high maintenance dose of clopidogrel(P <0.01) ; There were two MACE events in clopidogrel groups,but none in ticagrelor groups for 30 days.Minor bleeding events in ticagrelor group was higher than that in clopidogrel group(P < 0.01).Conclusions In clopidogrel slow metabolism of antiplatelet therapy in patients with stable angina.The clinical curative effect of ticagrelor is superior to clopidogrel,but with higher minor bleeding events.%目的 探讨高维持剂量(150 mg/d)氯吡格雷与替格瑞临床疗效对比.方法 筛选郑州大学第一附属医院稳定型心绞痛氯吡格雷CYP2C19基因型慢代谢患者64例,分为两组;A组给予氯吡格雷负荷剂量300 mg,维持剂量150 mg/d,B组给予替格瑞洛负荷剂量180 mg,维持量180 mg/d,分别于给药前、给药后2h、30 d光比浊法测定两组血小板聚集率(IPA)值.随访30 d观测两组的MACE和出血事件.结果 替格瑞洛对血小板抑制作用强于高维持剂量氯吡格雷组(P<0.01),氯吡格雷组发生2例MACE事件,替格瑞洛组无发生;替格瑞洛组出血事件高于氯吡格雷组(P<0.01).结论 在氯吡格雷慢代谢稳定型心绞痛患者抗血小板治

  11. The Case against the Arts from Plato to Tolstoy and Its Implications for Why and How the Arts Should Be Taught in Schools

    Science.gov (United States)

    Tate, Nicholas

    2016-01-01

    From Plato onwards many of the great Western thinkers have explored the nature of the arts, their contribution to society and their role in education. This has often involved a discussion of the potentially negative impact of the arts. The recurring message has been that the arts can warp judgment, elevate emotion at the expense of reason,…

  12. The Effect of Ticagrelor on Platelet Aggregation Ratio in Patients with Clopidogrel Resistance%替格瑞洛在治疗氯吡格雷抵抗患者时血小板聚集率分析

    Institute of Scientific and Technical Information of China (English)

    李江; 刘文娴; 赵一楠; 任燕龙

    2014-01-01

    Objective To research the variance of the platelet aggregation ratio after using ticagrelor instead of clopi-dogrel in patients with clopidogrel resistance. Methods Adenosine diphosphate( ADP)induced platelet aggregation ratio test was run to identify patients with clopidogrel resistance in 512 patients undergoing the treatment of percutaneous coronary interven-tion( PCI)and clopidogrel 75 mg/d. 88 patients with clopidogrel resistance were given randomly clopidogrel 75 mg/d or ticagrelor (90 mg twice a day)for 7 days and took the test of the platelet aggregation ratio after the treatment. Results Aftertreatment for ti-cagrelor group compared with clopidogrel platelet aggregation rate low〔(43. 3 ± 8. 2)% vs. (56. 9 ± 5. 3)%〕,the difference was statistically significant ( P ﹤0. 05 );for the ticagrelor group, platelet aggregation rate decrease than clopidogrel group〔(16. 4 ±9. 8)% vs. (1. 1 ± 4. 1)%〕,the difference is statistically significant(P﹤0. 05);for the the ticagrelor group, platelet aggregation rate compliance rate than clopidogrel group was higher(84. 4% vs. 4. 7%),the difference was statistically significant(P﹤0. 05);for the ticagrelor group and clopidogrel group in the course of the experiment showed no major bleed-ing. Conclusion Ticagrelor,comparing the regular-dose treatment of clopidogrel,can decrease the platelet aggregation ratio in patients with clopidogrel resistance.%目的:探讨在治疗氯吡格雷抵抗患者时,将氯吡格雷更换为替格瑞洛后血小板聚集率的变化情况。方法选择正在应用氯吡格雷75 mg/d治疗的经皮冠状动脉介入治疗( PCI)术后患者512例,用比浊法测定血小板聚集率,根据血小板聚集率筛选出氯吡格雷抵抗患者88例。然后将这88例患者1:1随机分为氯吡格雷组及替格瑞洛组,氯吡格雷组继续服用氯吡格雷(75 mg/d),替格瑞洛组将氯吡格雷(75 mg/d)更换为替格瑞洛(90 mg,2次/d)。随访7d

  13. Four process-related potential new impurities in ticagrelor: Identification, isolation, characterization using HPLC, LC/ESI-MS(n), NMR and their synthesis.

    Science.gov (United States)

    Kumar, Neeraj; Devineni, Subba Rao; Gajjala, Prasad Reddy; Gupta, Dharmendra Kumar; Bhat, Sandesh; Kumar, Rajesh; Dubey, Shailendra Kumar; Kumar, Pramod

    2016-02-20

    Five process-related impurities were detected in the range of 0.08-0.22% in ticagrelor laboratory batches by HPLC and LC-MS methods. These impurities were named as TIC Imp-I, -II, -III, -IV and -V. Four of these impurities, TIC Imp-I to -IV were unknown and have not been reported previously. Based on LC-ESI/MS(n) study, the chemical structures of new impurities were presumed as (1S,2S,3S,5S)-3-(2-hydroxyethoxy)-5-(7-amino-5-(propylthio)-3H-[1,2,3]triazolo[4,5-d] pyrimidin-3-yl)cyclopentane-1,2-diol (TIC Imp-I), (1S,2S,3S,5S)-3-(7-((1R,2S)-2-(3,4-difluorophenyl)cyclopropylamino)-5-(propylsulfinyl)-3H-[1,2,3]triazolo [4,5-d]pyrimidin-3-yl)-5-(2-hydroxyethoxy)cyclopentane-1,2-diol (TIC Imp-II), (1S,2R,3S,4S)-4-(7-((1R,2S)-2-(3,4-difluorophenyl)cyclopropylamino)-5-(propylthio)-3H-[1,2,3]triazolo[4,5-d]pyrimidin-3-yl)cyclopentane-1,2,3-triol (TIC Imp-III) and (3S,5S)-3-(7-((1R,2S)-2-(3,4-difluorophenyl)cyclopropylamino)-5-(propylthio)-3H-[1,2,3]triazolo[4,5-d]pyrimidin-3-yl)-5-(2-hydroxyethoxy)cyclopentane-1,2-diol (TIC Imp-IV). The unknown impurities were isolated from enriched crude sample by column chromatography and preparative HPLC. The complete spectral analysis, MS, 1D NMR ((1)H, (13)C and DEPT), 2D NMR (HSQC and HMBC) and IR confirmed the proposed chemical structures of impurities. Identification, isolation, structural characterization, prospects for the formation of impurities and their synthesis were first reported in this paper. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. 急诊PCI术前应用替格瑞洛与替罗非班疗效观察%Observation of curative effects by ticagrelor and tirofiban before emergency PCI

    Institute of Scientific and Technical Information of China (English)

    邱炳华; 齐欣

    2015-01-01

    Objective To observe the curative effect and safety of combined ticagrelor and tirofiban before emergency percutaneous coronary intervention (PCI).Methods A total of 105 with ST-segment elevation myocardial infarction (STEMI) under emergency PCI were randomly divided into observation group (54 cases) and control group (51 cases). They all received preoperative tirofiban through intravenous drip, and the observation group received combined drug with ticagrelor, while the control group received combined drug with clopidogrel. Observation and comparison were made on electrocardiogram ST-segment elevation and drop rate before operation and after 90 min of operation, blood TIMI grad of infarction related artery(IRA) before and after PCI, and TIMI myocardial perfusion grade (TMPG) after PCI of the two groups.Results The observation group had obvious drop of ST-segment, and its culprit vessel TIMI grade and TMPG were all higher than the control group. Their difference had statistical significance (P<0.05).Conclusion Combination of ticagrelor and tirofiban before emergency PCI can remarkably improve myocardial perfusion, with good clinical effect and high safety.%目的:观察急诊经皮冠状动脉介入治疗(PCI)术前联合应用替格瑞洛与替罗非班的疗效和安全性。方法105例行急诊PCI术的急性ST段抬高型心肌梗死(STEMI)患者随机分为观察组(54例)和对照组(51例),术前均给予静脉滴注替罗非班,其中观察组联合应用替格瑞洛,对照组联合应用氯吡格雷。观察并比较两组患者术前及术后90 min心电图ST段抬高回落率, PCI治疗前后梗死相关动脉(IRA)的血流TIMI分级及PCI术后的TIMI心肌灌注分级(TMPG)。结果观察组ST段回落明显,罪犯血管TIMI分级及心肌再灌注分级均高于对照组,差异有统计学意义(P<0.05)。结论急诊PCI术前联合应用替格瑞洛与替罗非班能够显著改善心肌灌注,具有更好的临床效果且安全性较高。

  15. Republican Utopia:from Plato to Moore%共和主义乌托邦:从柏拉图到莫尔

    Institute of Scientific and Technical Information of China (English)

    徐百军

    2012-01-01

    通过对柏拉图的《理想国》和莫尔的《乌托邦》的文本分析,我们发现他们的乌托邦思想中潜藏着共和主义叙事,实质上柏拉图和莫尔都希图建构一种共和主义乌托邦,由此也可以说乌托邦思想与共和主义之间原本就存在着一种共生的却被遗忘的历史关系,因而我们试图恢复以柏拉图和莫尔为代表的乌托邦思想家在共和主义政治光谱中的理论地位也并非一种主观冲动。%Through making a text analysis of Plato's Republic and Moore's Utopia,we find that a republican narrative has been hidden in their Utopian thought.Essencially,Plato and Moore both hoped to construct a republican utopia.It also can be said that there is a symbiotic and forgotten historical relation between the utopian thought and republicanism.So it is not a subjective impulse that we try to give the theoretical status in the republican political spectrum back to the utopian thinkers whose representatives are Plato and Moore.

  16. The great Lisbon earthquake and tsunami of 1755: lessons from the recent Sumatra earthquakes and possible link to Plato's Atlantis

    Science.gov (United States)

    Gutscher, M.-A.

    2006-05-01

    Great earthquakes and tsunami can have a tremendous societal impact. The Lisbon earthquake and tsunami of 1755 caused tens of thousands of deaths in Portugal, Spain and NW Morocco. Felt as far as Hamburg and the Azores islands, its magnitude is estimated to be 8.5 9. However, because of the complex tectonics in Southern Iberia, the fault that produced the earthquake has not yet been clearly identified. Recently acquired data from the Gulf of Cadiz area (tomography, seismic profiles, high-resolution bathymetry, sampled active mud volcanoes) provide strong evidence for an active east dipping subduction zone beneath Gibraltar. Eleven out of 12 of the strongest earthquakes (M>8.5) of the past 100 years occurred along subduction zone megathrusts (including the December 2004 and March 2005 Sumatra earthquakes). Thus, it appears likely that the 1755 earthquake and tsunami were generated in a similar fashion, along the shallow east-dipping subduction fault plane. This implies that the Cadiz subduction zone is locked (like the Cascadia and Nankai/Japan subduction zones), with great earthquakes occurring over long return periods. Indeed, the regional paleoseismic record (contained in deep-water turbidites and shallow lagoon deposits) suggests great earthquakes off South West Iberia every 1500 2000 years. Tsunami deposits indicate an earlier great earthquake struck SW Iberia around 200 BC, as noted by Roman records from Cadiz. A written record of even older events may also exist. According to Plato's dialogues The Critias and The Timaeus, Atlantis was destroyed by ‘strong earthquakes and floods … in a single day and night’ at a date given as 11,600 BP. A 1 m thick turbidite deposit, containing coarse grained sediments from underwater avalanches, has been dated at 12,000 BP and may correspond to the destructive earthquake and tsunami described by Plato. The effects on a paleo-island (Spartel) in the straits of Gibraltar would have been devastating, if inhabited, and may

  17. 电话随访对口服替格瑞洛患者院外指导的作用%The Effect of Telephone Follow-up on Health Guidance for the Patients After Discharge With Oral Ticagrelor

    Institute of Scientific and Technical Information of China (English)

    罗芳; 张雪好

    2016-01-01

    Objective To investigate the significance of the telephone folow-up on health guidance for the patients after discharge with oral Ticagrelor tablets. MethodsThe patients with coronary atherosclerotic heart disease who experienced stent implantation after discharge were folowed up with telephone for health guidance,and the medication compliance and the satisfaction questionnaire survey were performed. ResultsTo compare the compliance behavior and satisfaction of the two groups of patients,there was significant difference(P<0.05). Conclusion Telephone folow-up of patients taking oral ticagrelor for health guidance can significantly improve the patient’s compliance and satisfaction after discharge.%目的:探讨电话随访对口服替格瑞洛出院患者进行院外健康指导的意义。方法选取冠心病支架植入术后服用替格瑞洛的出院患者进行电话随访,观察服药的依从性,同时进行满意度问卷调查。结果对两组患者遵医行为及满意度进行比较,差异有统计学意义(P<0.05)。结论电话随访对口服替格瑞洛的出院患者进行健康指导,可提高患者的依从性及满意度。

  18. A dialogical exploration of the grey zone of health and illness: medical science, anthropology, and Plato on alcohol consumption.

    Science.gov (United States)

    Bonner, Kieran

    2009-01-01

    This paper takes a phenomenological hermeneutic orientation to explicate and explore the notion of the grey zone of health and illness and seeks to develop the concept through an examination of the case of alcohol consumption. The grey zone is an interpretive area referring to the irremediable zone of ambiguity that haunts even the most apparently resolute discourse. This idea points to an ontological indeterminacy, in the face of which decisions have to be made with regard to the health of a person (e.g., an alcoholic), a system (e.g., the health system), or a society. The fundamental character of this notion will be developed in relation to the discourse on health and the limitations of different disciplinary practices. The case of alcohol consumption will be used to tease out the grey zone embedded in the different kinds of knowledge made available through the disciplinary traditions of medical science, with its emphasis on somatic well-being, and anthropology, with its focus on communal well-being. This tension or grey zone embedded in different knowledge outcomes will be shown to have a discursive parallel with the dialogue between the Athenian, the Spartan, and the Cretan in Plato's Laws. Making use of the dialogical approach as described by Gadamer, the Athenian's particular resolution of the tension will be explored as a case study to demonstrate the necessarily particular analysis involved in a grey zone resolution.

  19. What is good sport: Plato's view Co je to dobrý sport: Platónův pohled

    Directory of Open Access Journals (Sweden)

    Jernej Pisk

    2006-02-01

    Full Text Available One of Plato's most common questions found in his dialogues is "What is something?" By asking this question Plato usually brought his co-speakers to the recognition that in fact they do not have a full comprehension of what something is, although they have a partial comprehension of it. The awareness of one's incomplete cognition is the first step to be made on the philosophic way to truth. As in ancient times also today Plato asks us – the modern philosophers of sport – "What is sport?" or more precisely "What is good sport?" Probably the best of Plato's answers to this question can be found in the basic concepts of his philosophy regarding his hierarchical division of the state and human soul into three parts. Since sport is derived from human being also the goodness of sport can be divided into three stages. The lowest stage of sport corresponds to the first part of the soul – the appetite soul. On this stage sport is based on the gaining of material goods through prizes won at competitions. In the philosophic view, this is the lowest possible stage of goodness of sport. The second stage of sport corresponds to the second part of the soul – the emotional soul. Sport at this stage is based on the elementary ancient agon, which seeks fulfilment in the winning of honour and glory. The greatest and the most superior is the third part of the soul – the reasonable soul. According to this, also the sport corresponding to the third part of the soul is the best. For this kind of sport it is no longer necessary to compete with other contestants, since it can achieve it's fulfilment in perfect execution of movement or exercise, in which the perfect cooperation between reason (soul and body is attained. At this stage of sport it is the most important to compete and win over one's self, and this can be achieved by everyone, without regard to his/her physical abilities in comparison with others. In Plato's view, good sport is the sport directed

  20. The influence of Plato, Aristotle, and the ancient Polis on a programme for congenital cardiac surgery: the virtuous partnership.

    Science.gov (United States)

    Mavroudis, Constantine; Backer, Carl L

    2007-09-01

    The problems that exist in maintaining a partnership in paediatric cardiac surgery are considerable. They relate to fairness in allocation of time for leisure, the apportioning of cases between the partners, internal competition between them, financial considerations, and promotion of the ego. In this review, we discuss our own experiences in maintaining a partnership over a period of more than 18 years, relating such a "virtuous partnership" to the writings of Plato and Aristotle, and setting it against the tenets of the ancient Greek polis. The polis, or city state, came to prominence in ancient Greece during the golden age of Pericles, this period seeing the initial evolution of Western philosophy, as well as numerous other scientific, artistic and architectural advances. The concept of the polis was to create a natural association with its citizens that nurtured all that is best in people, at the same time defining their character. In this respect, according to Plato, the person and the polis are mirror images. Aristotle then expanded this notion to incorporate the various forms of friendship, which he pointed out last only as long as the interrelated pleasure survives. Using these principles as the point of departure, we argue that cardiac surgeons should respect moral virtue in each other. Extending this process means that we should also respect, and celebrate, our relationships with affiliated physicians, nurses, perfusionists, administrators, and all concerned in the care of children with congenitally malformed hearts. In this way, we create a virtuous partnership for congenital cardiac surgery that promotes all that was good, as engendered in the ancient Greek polis. As we extend these observations to the modern world, we discuss some of the features that have permitted us to work so well together. One of the most important is a summoning and unwritten tenet that greets us as we enter the operating room, namely "check your ego at the door". The operative

  1. Proporción y autoría. Arte mueble paleolítico. Figuras de los Omóplatos de

    Directory of Open Access Journals (Sweden)

    José Antonio Fernández Lombera

    2003-01-01

    Full Text Available El trabajo se compone de las siguientes partes : a.- Realización de calcos con una gran objetividad gráfica de las figuras grabadas en los omóplatos de El Castillo, exhumados por OBERMAIER en sus campañas de 1911/12. b.- Diseño, validación y aplicación de un método para el cálculo de la proporción de una figura, independoentemente de cuál sea, enfrentándola a un arquetipo. c.- Aplicación de tal método, una vez validado, a las figuras de los omóplatos de El Castillo. d.- Análisis de la manera de hacer de cada uno de los autores de las figuras de El Castillo ; es a lo que llamamos autoría. e.- Obtención de un conjunto de conclusiones de tipo formal, artístico y paleoetnológico

  2. La cuadratura del plato

    Directory of Open Access Journals (Sweden)

    Ángeles Mora

    2012-06-01

    Full Text Available Una de las cosas que el Jurado del X Premio de Poesía Vicente Núñez destacó de este libro fue “su exquisito tratamiento del lenguaje”. Y desde luego lo es, es exquisito su tratamiento del lenguaje pero no porque utilice un lenguaje exquisito o excelso sino porque sabe arrancarle al lenguaje de todos los días, a las palabras sencillas, toda la carga poética de emoción e iluminación que llevan dentro. Mónica Doña nos dice que en su libro ha querido huir de un lirismo que muchas veces resulta falso, hueco, y nos habla de que lo que ha querido hacer es “épica cotidiana”, sin héroes, porque por su libro, como por la vida nuestra de todos los días, lo que circulan son seres que sobreviven como pueden en un mundo adverso.

  3. La cuadratura del plato

    OpenAIRE

    Ángeles Mora

    2012-01-01

    Una de las cosas que el Jurado del X Premio de Poesía Vicente Núñez destacó de este libro fue “su exquisito tratamiento del lenguaje”. Y desde luego lo es, es exquisito su tratamiento del lenguaje pero no porque utilice un lenguaje exquisito o excelso sino porque sabe arrancarle al lenguaje de todos los días, a las palabras sencillas, toda la carga poética de emoción e iluminación que llevan dentro. Mónica Doña nos dice que en su libro ha querido huir de un lirismo que muchas veces resulta fa...

  4. The comparison of ticagrelor and clopidogrel on patients undergoing percutaneous coronary intervention with acute ST elevated myocardial infarction%替格瑞洛与氯吡格雷用于急性ST段抬高心肌梗死急诊介入治疗的疗效比较

    Institute of Scientific and Technical Information of China (English)

    毛幼林; 黄琼; 陈俭; 张宇

    2015-01-01

    Objective To compare the effects of ticagrelor and clopidogrel on patients undergoing percutane-ous coronary intervention(PCI)with acute ST elevated myocardial infarction (STEMI).Methods 120 patients with STEMI received PCI within 12h of symptom onset in our hospital were randomly divided into clopidogrel treated group (n=60)and ticagrelor treated group (n=60).Serum was collected before surgery and 36 hours after PCI for ALT, Cr,CK-MB,and MA.Cardiac ultrasound was examined,too.All patients were followed 6 months post-PCI for main adverse cardiovascular and cerebrovascular events (MACCE)and medicine side effect.Results No significantly difference was noted in baseline between the two groups.The level of CK-MB and MA in the ticagrelor treated group [CK-MB(56.5 ±8.3)U/L,MA (45.9 ±6.4)mm[and clopidogrel treated group[CK-MB(74.3 ±9.6)U/L,MA (35.6 ±7.3)mm]were significant difference (CK-MB,P=0.043;MA,P=0.038).The MACCE of patients in ticagrelor treated group were significantly lower than patients in clopidogrel treated group during post-PCI 6 months follow-up(The ratio of angina in ticagrelor group was 1.7%,while in clopidogrel group was 6.7%,P=0.042). Conclusion Ticagrelor is more effective in suppress the function of platelet,decrease MACCE in patients with STE-MI undergoing PCI.%目的:比较替格瑞洛与氯吡格雷在急性心肌梗死(STEMI)接受急诊冠脉介入治疗(PCI)患者中的疗效和安全性。方法选择在发病后12 h内行急诊PCI患者120例,随机分为氯吡格雷组和替格瑞洛组,观察并比较两组术后36 h的肝肾功能、肌酸激酶同工酶(CK-MB)、左室功能、血小板抑制率,随访6个月内主要不良心脑事件(MACCE)及药物不良反应发生率。结果替格瑞洛组术后36h 的 CK -MB 水平(56.5±8.3)U/L、血小板抑制率(45.9±6.4)mm,明显优于氯吡格雷组的(74.3±9.6)U/L 与(35.6±7.3)mm、(P=0.043、0.038),在6个

  5. Myocardium-protective effects of ticagrelor combined with emergency PCI treatment of a-cute myocardial infarction and the possible molecular mechanisms%替格瑞洛联合急诊 PCI 治疗急性心肌梗死的心肌保护效应及可能分子机制的探究

    Institute of Scientific and Technical Information of China (English)

    赵玉军

    2016-01-01

    目的::研究替格瑞洛联合急诊 PCI 治疗急性心肌梗死的心肌保护效应并探究可能的分子机制。方法:选择在我院接受急诊 PCI 治疗的急性心肌梗死患者84例进行研究,随机分为替格瑞洛组和氯吡格雷组,接受不同的围手术期抗血小板治疗。评估两组心肌细胞损伤程度、心肌泵血功能及血流灌注情况、血小板聚集功能。结果:PCI 术前及术后10 min、24 h 时,替格瑞洛组血浆 CK-MB、cTnI 含量以及血小板最大聚集率、P2Y12反应单位均显著低于氯吡格雷组,ADP 途径血小板抑制率均高于氯吡格雷组;PCI 术后,替格瑞洛组 TIMI 血流分级、TMP 心肌灌注分级以及 LVEF 均显著高于氯吡格雷组, LVEDD 显著低于氯吡格雷组,无复流/慢血流的例数少于氯吡格雷组。结论:替格瑞洛联合急诊 PCI治疗急性心肌梗死的心肌保护效应优于氯吡格雷,替格瑞洛能够通过增强抑制血小板聚集的效应来发挥心肌保护效应。%Objective:To study the myocardium-protective effect of ticagrelor combined with emergency PCI treatment of acute myocardial infarction and explore the possible molecular mechanisms.Methods:A total of 84 patients with acute myo-cardial infarction who received emergency PCI treatment in our hospital were selected for study and randomly divided into and ticagrelor group and clopidogrel group that received different perioperative anti-platelet therapy.Degree of myocardial cell dam-age,cardiac pump function as well as blood perfusion and platelet aggregation function of two groups were evaluated.Results:Before as well as 10 min and 24h after PCI,plasma CK-MB and cTnI levels as well as maximum platelet aggregation rate and P2Y12 reaction unit of ticagrelor group were significantly lower than those of clopidogrel group,and ADP-way platelet inhibi-tion rate were higher than those of clopidogrel group;after PCI,TIMI blood flow grade,TMP myocardial perfusion grade

  6. A display model for the TOU of PLATO: just a cool toy or a benchmark of opportunities?

    Science.gov (United States)

    Dima, M.; Greggio, D.; Bergomi, M.; Biondi, F.; Farinato, J.; Farisato, G.; Magrin, D.; Lessio, L.; Marafatto, L.; Munari, M.; Pagano, I.; Ragazzoni, R.; Viotto, V.; Piazza, D.

    2016-07-01

    We produced a "toy-model" of one Telescope Optical Unit of PLATO, the Medium sized mission selected by ESA to fly in 2024. This is a six lenses dioptric very wide field camera with a window in front to take care of radiation impact on the first lens whose optical glass cannot be replaced with a radiation hardened one. The main aim of this project is just to produce a "cool" model for display purposes, in which one can "explore" the details of the inside through some openings in the tube, in order to visually inspect some of the fine details of the opto-mechanics. While its didactic and advertising role is out of doubt, during its construction we realized that some interesting outcome can be of some relevance for the project itself and that some findings could be useful, in order to assess the ability of producing with the same technology some (of course of much more modest quality) optical systems. In this context, we immediately dropped the option of producing the lenses with opaque material painted with a color resembling a refractive material (like blue for instance) and decided to actually produce them with transparent plastic. Furthermore the surfaces are then finely polished in order to give them basic optical properties. Such an optical system has only very coarsely the converging properties of the original nominal design for a number of reasons: the refractive indexes are not the nominal ones, the quality of the surfaces and their nominal values are only roughly, within a few percent, the targeted one, and the way the surfaces are built up makes them prone to some diffraction effects. However, the bulk of the lens and the surface roughness will give a large magnification of the scattering effects that will be experienced, at a much lower level, on the actual flight model. We investigated through propagation of a laser beam and by digital camera the main stray light modes that this toymodel offers. In other words, the model amplifies, to a large extent, the

  7. 苏格拉底、柏拉图、亚里士多德与丑%Socrates,Plato and Aristotle's Views on Ugliness

    Institute of Scientific and Technical Information of China (English)

    区翰子; 李佳

    2014-01-01

    尽管从苏格拉底开始就萌生“丑”这个美学范畴,其在古代一直处于被忽视和非独立的地位。拟通过分析苏格拉底、柏拉图和亚里士多德三位巨匠的“丑”观,揭示“审丑”在萌芽时期的状态。%Despite its first faint showing started from Socrates , Ugliness had constantly been over-looked as a dependent aesthetic category in the ancient time .The following discussion will analyze the views of Socrates ,Plato and Aristotle on the appreciation of ugliness ,thus revealing the state of the appre-ciation of ugliness in its earlier stage .

  8. On Aesthetic Thoughts of Socrates, Plato and Aristotle%古希腊“三贤”美育思想概论

    Institute of Scientific and Technical Information of China (English)

    秦宾; 刘忠伟

    2011-01-01

    Based on analysis of aesthetic thoughts of Socrates, Plato and Aristotle, the famous philosophers in ancient Greek, this paper attempts to use their ideas for reference in guiding the cur- rent teaching practice to better aesthetic education.%通过对古希腊时期三位著名哲学家苏格拉底、柏拉图、亚里土多德美育思想的简要概括和论述,试图从他们对美育思想的主张中提取有益于符合我们现实国情的教育理念,对我们在教学实践中更好地实施美育教育提供可资借鉴的依据。

  9. Clinical observation of ticagrelor in patients with acute ST-segment elevation myocardial infarction before primary percutaneous coronary intervention%急性心肌梗死PCI术前早期应用替格瑞洛的临床观察

    Institute of Scientific and Technical Information of China (English)

    张战文; 陈晖; 王宝玉; 李凌

    2016-01-01

    Objective To observe the clinical effect of ticagrelor(ADP receptor antagonist) in patients with acute ST-segment elevation myocardial infarction(STEMI) before primary percutaneous coronary intervention(PCI).Methods Eighty patients with acute STEMI diagnosed by emergency centre were treated by primary PCI,and randomly divided into ticagrelor group and control group,with 40 cases in each group.TIMI grade flow of infarct-related artery (IRA) before and after PCI was assessed.The resolution of the sum of ST-segment elevation at 2 hours after PCI was observed.The left ventricular ejection fraction (LVEF) by Ultrasonic cardiogram 1 week after PCI was examined.The incidences of the bleeding complications and thrombocytopenia during hospitalization were recorded.The major adverse cardial events 1 month after PCI were followed-up.Results TIMI grade 0-1 flow of IRA in control group at initial angiography before PCI was significantly higher than that in ticagrelor group (85.0% vs 75.0%,P < 0.05).There were no significant differences in TIMI grade 3 flow before PCI between the two groups(17.5% vs 12.5%,P >0.05).TIMI grade 3 flow in ticagrelor group was higher than that in control group after PCI (95.0% vs 90.0%,P < 0.05).There were no significant difference in TIMI grade 0-1 flow after PCI between two groups(6.25% vs 2.5%,P >0.05).There was more frequently complete STR in ticagrelor group than that in control group (80.0% vs 65.0%,P < 0.05).LVEF in control group was lower than that in ticagrelor group (P < 0.05).Hemorrhage rate in ticagrelor group was higher,but there was no difference between the two groups (P > 0.05).The incidence of MACE in control group was higher than that in ticagrelor group,but there was no significant difference(P > 0.05).Conclusions Administration of ticagrelor before primary PCI on patients with acute STEMI can make better the myocardial reperfusion,retrieve the moribund myocardium,recover survival function

  10. The Differences between Plato and Aristotle's Educational Philosophy%柏拉图与亚里士多德教育哲学的差异

    Institute of Scientific and Technical Information of China (English)

    刘良华

    2012-01-01

    古典西方教育哲学分为两个阵营:柏拉图以苏格拉底的名义组建他的“理想国”,按照“理论理性”设计他的“政治哲学”和教育方案;柏拉图坚持“哲人王”统治、公产制和道德教育。亚里士多德虽然坚持了哲学对政治的指导,但他看到了哲学对政治的危险,按照“实践理性”的优先性开创了不同于柏拉图的“政治哲学”的“政治科学”以及相关的教育方案。亚里士多德重视轮流制、私有制和法制教育。%The classical philosophy of education is divided into two camps. Plato built his Republic in the name of Socrates and designed the political philosophy and education plan with the theoretical reason. He adhered to the rule of the “philosophy king”, the communist membership system and moral education. Aristotle realized the danger of the philosophy to the politics, although he insisted in the guidance of philosophy to politics. He created the political science and education plan with the practical reason instead of Plato's political philosophy. He valued the political rule, the private ownership, and the legal education.

  11. EVALUATION OF COST-EFFECTIVENESS OF PLATELET REACTIVITY ANALYSIS USING THE VERIFYNOW P2Y12 ASSAY IN PATIENTS AFTER ACUTE CORONARY SYNDROME

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2015-09-01

    Full Text Available Dual antiplatelet therapy, including clopidogrel and aspirin, in a significant share of patients after acute coronary syndrome (ACS is characterized by high level of platelet reactivity, which is associated with an increased incidence of cardiovascular events. Perhaps it will make reasonable the prescription of new antiplatelet drugs, particularly the combination of ticagrelor with aspirin.Aim. To assess the cost-effectiveness of VerifyNow P2Y12 platelet reactivity testing in patients after ACS.Material and methods. The analysis was performed for patients aged 55 years after ACS by modeling based on the results of the PLATO trial considering Russian epidemiological data. The time horizon of simulation was 5 years. It was assumed that the patients were receiving either generic clopidogrel or ticagrelor for 1 year, or before maintenance treatment VerifyNow P2Y12 assay had been performed, and the patients with platelet reactivity index >230 24-48 hours after ACS were receiving ticagrelor and the remaining patients - generic clopidogrel. It was expected that after 1 year the patients would discontinue treatment with clopidogrel or ticagrelor, and hereafter additional therapeutic effect of their use would be absent. The costs of antiplatelet agents in the reference case corresponded to the weighted average price of public procurement in 2013 in Russia. The costs of treatment of complications corresponded to the compulsory health insurance rates for St. Petersburg in 2014. The cost and life expectancy were discounted at 3.5% per year.Results. The platelet reactivity test and the prescription by its results of the combination of clopidogrel plus aspirin or ticagrelor plus aspirin can prevent 5 myocardial infarction and 6 deaths per 1000 patients additionally as compared with the prescription of clopidogrel plus aspirin combination to all patients. The costs for one additional year of life as compared with the combination of clopidogrel plus aspirin

  12. EVALUATION OF COST-EFFECTIVENESS OF PLATELET REACTIVITY ANALYSIS USING THE VERIFYNOW P2Y12 ASSAY IN PATIENTS AFTER ACUTE CORONARY SYNDROME

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2015-01-01

    Full Text Available Dual antiplatelet therapy, including clopidogrel and aspirin, in a significant share of patients after acute coronary syndrome (ACS is characterized by high level of platelet reactivity, which is associated with an increased incidence of cardiovascular events. Perhaps it will make reasonable the prescription of new antiplatelet drugs, particularly the combination of ticagrelor with aspirin.Aim. To assess the cost-effectiveness of VerifyNow P2Y12 platelet reactivity testing in patients after ACS.Material and methods. The analysis was performed for patients aged 55 years after ACS by modeling based on the results of the PLATO trial considering Russian epidemiological data. The time horizon of simulation was 5 years. It was assumed that the patients were receiving either generic clopidogrel or ticagrelor for 1 year, or before maintenance treatment VerifyNow P2Y12 assay had been performed, and the patients with platelet reactivity index >230 24-48 hours after ACS were receiving ticagrelor and the remaining patients - generic clopidogrel. It was expected that after 1 year the patients would discontinue treatment with clopidogrel or ticagrelor, and hereafter additional therapeutic effect of their use would be absent. The costs of antiplatelet agents in the reference case corresponded to the weighted average price of public procurement in 2013 in Russia. The costs of treatment of complications corresponded to the compulsory health insurance rates for St. Petersburg in 2014. The cost and life expectancy were discounted at 3.5% per year.Results. The platelet reactivity test and the prescription by its results of the combination of clopidogrel plus aspirin or ticagrelor plus aspirin can prevent 5 myocardial infarction and 6 deaths per 1000 patients additionally as compared with the prescription of clopidogrel plus aspirin combination to all patients. The costs for one additional year of life as compared with the combination of clopidogrel plus aspirin

  13. Design and methods of European Ambulance Acute Coronary Syndrome Angiography Trial (EUROMAX): an international randomized open-label ambulance trial of bivalirudin versus standard-of-care anticoagulation in patients with acute ST-segment-elevation myocardial infarction transferred for primary percutaneous coronary intervention.

    Science.gov (United States)

    Steg, Philippe Gabriel; van 't Hof, Arnoud; Clemmensen, Peter; Lapostolle, Frédéric; Dudek, Dariusz; Hamon, Martial; Cavallini, Claudio; Gordini, Giovanni; Huber, Kurt; Coste, Pierre; Thicoipe, Michel; Nibbe, Lutz; Steinmetz, Jacob; Ten Berg, Jurrien; Eggink, Gerrit Jan; Zeymer, Uwe; Campo dell' Orto, Marco; Kanic, Vojko; Deliargyris, Efthymios N; Day, Jonathan; Schuette, Diana; Hamm, Christian W; Goldstein, Patrick

    2013-12-01

    In patients with ST-segment elevation myocardial infarction (STEMI) triaged to primary percutaneous coronary intervention (PCI), anticoagulation often is initiated in the ambulance during transfer to a PCI site. In this prehospital setting, bivalirudin has not been compared with standard-of-care anticoagulation. In addition, it has not been tested in conjunction with the newer P2Y12 inhibitors prasugrel or ticagrelor. EUROMAX is a randomized, international, prospective, open-label ambulance trial comparing bivalirudin with standard-of-care anticoagulation with or without glycoprotein IIb/IIIa inhibitors in 2200 patients with STEMI and intended for primary percutaneous coronary intervention (PCI), presenting either via ambulance or to centers where PCI is not performed. Patients will receive either bivalirudin given as a 0.75 mg/kg bolus followed immediately by a 1.75-mg/kg per hour infusion for ≥30 minutes prior to primary PCI and continued for ≥4 hours after the end of the procedure at the reduced dose of 0.25 mg/kg per hour, or heparins at guideline-recommended doses, with or without routine or bailout glycoprotein IIb/IIIa inhibitor treatment according to local practice. The primary end point is the composite incidence of death or non-coronary-artery-bypass-graft related protocol major bleeding at 30 days by intention to treat. The EUROMAX trial will test whether bivalirudin started in the ambulance and continued for 4 hours after primary PCI improves clinical outcomes compared with guideline-recommended standard-of-care heparin-based regimens, and will also provide information on the combination of bivalirudin with prasugrel or ticagrelor. © 2013 Mosby, Inc. All rights reserved.

  14. 替格瑞洛与氯吡格雷对急性ST段抬高型心肌梗死的临床疗效对比研究%A Clinical Comparative Study Between Ticagrelor and Clopidogrel for Treating the Patients With Acute ST-segment Elevation Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    王海波; 黄宜杰; 吴强; 路雯; 刘奕

    2014-01-01

    目的:观察治疗急性冠状动脉综合征(ACS)新药替格瑞洛对急性ST段抬高型心肌梗死(STEMI)的临床疗效,并将其与氯吡格雷的疗效进行对比,以获取关于替格瑞洛在国内临床应用方面的前瞻性临床数据。  方法:接受替格瑞洛治疗的157例STEMI患者为研究组,给予替格瑞洛+阿司匹林治疗;150例氯吡格雷治疗的STEMI患者为对照组,给予氯吡格雷+阿司匹林治疗。治疗1个月、3个月、6个月时,对两组患者的主要不良心血管事件(MACE)发生率、血栓再形成发生率以及血常规等疗效相关的指标进行对比分析。  结果:研究组1、3、6个月时的MACE事件累积发生率较对照组差异无统计学意义(P>0.05);研究组患者的左心室舒张末期半径、左心室射血分数、血小板水平、ST段回落情况等指标与对照组相比,差异具有统计学意义(P  结论:替格瑞洛在改善STEMI患者的血小板水平、心功能等方面的疗效与氯吡格雷基本相近,关于其国外所报道的临床疗效优势需进一步验证。%Objective: To explore the clinical efficacy of a new drug for acute coronary syndrome (ACS), ticagrelor in treating the patients with acute ST-segment elevation myocardial infarction (STEMI), and to compare the effect between ticagrelor and clopidogrel in order to obtain the prospective information of ticagrelor in clinical practice. Methods: A total of 307 STEMI patients were divided into 2 groups, Treatment group, the patients received ticagrelor with aspirin, n=157 and Control group, the patients received clopidogrel with aspirin, n=150. With a period of treatment, the major adverse cardiac events (MACE), rate of thrombosis re-formation and routine blood test result were compared between 2 groups. Results: Treatment group presented the better LVDD, LVEF, platelet level and ST-segment recovery than those in Control group, P Conclusion: The

  15. [Budget impact analysis of antiplatelet therapy with ticagrelor and clopidogrel in patients with acute coronary syndrome after coronary artery bypass surgery].

    Science.gov (United States)

    Zyryanov, S K; Belousov, D Yu; Afanas'eva, E V; Dumchenko, E V

    Резюме Цель исследования — клинико-экономическая экспертиза целесообразности применения антитромбоцитарной терапии (АТТ) тикагрелором в комбинации с ацетилсалициловой кислотой (АСК) по сравнению с комбинацией клопидогрела и АСК у пациентов с острым коронарным синдромом (ОКС), перенесших коронарное шунтирование (КШ). Материалы и методы. Использовали анализ «влияния на бюджет». Данные по эффективности и безопасности применения АТТ брали из соответствующего анализа в подгруппах рандомизированного контролируемого исследования PLATO. Учитывали прямые медицинские затраты, обусловленные применением АТТ, затраты на терапию острого инфаркта миокарда (ОИМ), инсульта и массивных кровотечений, затраты на оказание медицинской помощи пациентам, умирающим от сердечно-сосудистых осложнений и иных причин, а также косвенные затраты — потери валового внутреннего продукта (ВВП) по причине преждевременной смерти. Полученные результаты оценивали с перспективы общества. Результаты. Анализ показал, что прямые медицинские затраты на одного пациента, перенесшего КШ, как в случае расчета, о

  16. 旧概念与新环境(一):柏拉图的“恒”%OLD CONCEPTS AND NEW SITUATIONS ( Ⅰ ): PLATO

    Institute of Scientific and Technical Information of China (English)

    梁鹤年

    2012-01-01

    "Justice" is emphasized both in Plato's worldview (Timaeus) and political view (The Republic). "Justice", as an Idea, a Form, is changeless; it governs man and the Universe; it is the combination of order and balance. In city planning, Le Corbusier comes closest to the Platonic ideal, and for which he has been severely criticized by mainstream Empiricism and Individualism. City planning cannot avoid ordering and balancing. Confucianism does not only share a lot with Platonism, but also provide additional insights.%柏拉图的《宇宙论》和《理想国》都强调“义”.“义”是一种永恒的天道与人道原则,是秩序和平衡的组合,是宇宙之法.在城市规划中,柯布西耶最得其精粹.但也因此而备受现代主流经验主义与个人主义的批判.城市规划不能离开秩序与平衡,中国孔孟之道与柏拉图思路不仅有很多吻合之处,更另创新意.

  17. STEMI急诊PCI治疗联用替格瑞洛与11b/111a受体拮抗剂不明显增加出血风险的分析%Observation on Effect of PCI Treatment Combined with Ticagrelor and 11b/111a Receptor Antagonist on Hemorrhage Risks of Patients with STEMI E-mergency

    Institute of Scientific and Technical Information of China (English)

    崔文章; 刘和平

    2016-01-01

    Objective To discuss the effect of PCI treatment combined with Ticagrelor and 11b/111a receptor antagonist on hemorrhage risks of patients with STEMI emergency. Methods 184 cases of STEMI patients admitted and treated in our hospital from January 2010 to May 2015 were selected and randomly divided into two groups with 92 cases in each, the ob-servation group were treated with PCI combined with Ticagrelor and 11b/111a receptor antagonist, the control group were treated with PCI combined with clopidogrel and 11b/111a receptor antagonist, and the hemorrhage risks were compared be-tween the two groups. Results The hemorrhage risk was 3.3% in the control group and 4.4% in the observation group, P>0.05. Conclusion PCI treatment combined with Ticagrelor and 11b/111a receptor antagonist cannot obviously increase the hemorrhage risk of STEMI patients.%目的:探讨STEMI急诊PCI治疗联用替格瑞洛与11b/111a受体拮抗剂对出血风险的影响。方法整群选取2010年1月—2015年5月该医院收治的STEMI患者184例,随机分成观察组(PCI治疗联用替格瑞洛与11b/111a受体拮抗剂)和对照组(PCI治疗联用氯吡格雷与11b/111a受体拮抗剂)各92例,比较两组患者的出血风险。结果对照组出血风险为3.3%,观察组出血风险为4.4%(P>0.05)。结论急诊PCI治疗联用替格瑞洛与11b/111a受体拮抗剂不明显增加STEMI患者的出血风险。

  18. 替格瑞洛联合比伐卢定对STEMI-PCI患者血小板抑制率、聚集率及预后的影响%Effect of ticagrelor combined with bivalirudin on platelet inhibition rate, aggregation rate, and prognosis in patients with STEMI-PCI

    Institute of Scientific and Technical Information of China (English)

    张晓霞

    2016-01-01

    目的 观察替格瑞洛联合比伐卢定对行冠状动脉介入治疗的ST段抬高心肌梗死(STEMI-PCI)患者血小板抑制率、聚集率及预后的影响.方法 以2014年2月至2015年1月本院心内科收治的80例STEMI-PCI患者为研究对象,随机数字表法均分为观察组和对照组.对照组给予替格瑞洛治疗,观察组替格瑞洛联合比伐卢定治疗,比较治疗后两组血小板抑制率、聚集率及预后.结果 治疗后,观察组血小板抑制率[(80.98±9.98)%]较对照组[(48.89±8.89)%]显著高(P<0.05);两组治疗后血小板聚集率均较治疗前显著降低,且观察组血小板聚集率[(35.69±5.01)%、(29.21±4.33)%、(24.2l±3.21)%]均较对照组显著降低(P< 0.05);观察组治疗后不良事件总发生率显著低于对照组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05).结论 替格瑞洛联合比伐卢定对STEMI-PCI患者改善血小板抑制、聚集作用均显著,对患者预后效果佳.%Objective To observe the effect of ticagrelor combined with bivalirudin on the platelet inhibition,aggregation rate,and prognosis in patients with ST segment elevation myocardial infarction and undergoing percutaneous coronary intervention (STEMI-PCI).Methods Eighty patients with STEMI-PCI admitted into our hospital from February,2014 to January,2015 were randomized into an observation group and a control group.The control group was treated with ticagrelor and the observation group ticagrelor and bivalirudin.The effects on platelet inhibition rate,aggregation rate,and prognosis were compared between these two groups after treatment.Results After treatment,the platelet inhibition rate was significantly higher in the observation group than in the control group [(80.98±9.98)% vs.(48.89±8.89)%] (P < 0.05).The platelet aggregation rates were significantly lower after than before treatment in both groups.The platelet aggregation rates in the observation group [(35.69±5

  19. Effect on Inflammatory Factors between Ticagrelor and Clopidogrel after Emergency PCI about Patients with Acute ST-segment Elevation Myocardial Infarction%替格瑞洛与氯吡格雷对急性STEMI患者急诊PCI术后炎症因子的影响

    Institute of Scientific and Technical Information of China (English)

    张阳阳; 陈魁

    2014-01-01

    To compare the effect on inflammatory factors between ticagrelor and clopidogrel after emergency PCI about patients with acute ST-segment elevation myocardial infarction (STEMI) ,we divide 176 cases of acute STEMI patients who were undergone emergency PCI into ticagrelor group (group A) 58 cases ,conventional clopidogrel group (group B) 58cases and strenghed clopidogrel group (group C) 60 patients .Inflammatory cytokines such as C-reactive protein (CRP) , interleukin-6 (IL-6) ,myeloperoxidase (MPO) and soluble CD40 (sCD40L) were measured before surgery and 12 hours ,7 days ,1 month ,3months ,6months after surgery ,compared the statistics of inflammatory factors at different time .The results showed the inflammatory factors levels of enhanced clopidogrel and ticagrelor group degrades more than conventional clopidogrel group (P 0 .05 ) , but there was no statistical significance . Thus the effect on inflammatory factors of ticagrelor is stronger than conventional clopidogrel ,but near to strenghed clopidogrel .%为比较替格瑞洛与氯吡格雷对急性 ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入术(PCI)术后炎症因子的影响,将176例急性STEMI且行急诊PCI术的患者分为替格瑞洛组(A组)58例、氯吡格雷常规组(B组)58例、氯吡格雷强化组(C组)60例,分别测定术前、术后12小时、术后7天、术后1个月、术后3个月、6个月时炎症因子C-反应蛋白(CRP)、白细胞介素-6(IL-6)、髓过氧物酶(MPO)、可溶性CD40受体(sCD40L)的含量,比较3组患者各炎症因子在不同时间点有无统计学差异。结果显示C组和A组较B组明显降低(P<0.05),有统计学意义,而A组较C组稍降低(P>0.05),但两者无统计学意义。由此可见,替格瑞洛的抗炎作用较常规剂量氯吡格雷作用明显增强,和强化剂量氯吡格雷作用相仿。

  20. The fundamental characters of soma in Plato's later dialogues: an introduction to the reanalysis of Plato's physical education theory%柏拉图后期对话篇中"身体(soma)"的原理性特征——柏拉图体育论再考的前提

    Institute of Scientific and Technical Information of China (English)

    木庭康树

    2009-01-01

    This paper aims to clarify Plato's view of soma through consideration of the fundamental characters of soma in Plato's later dialogues. Soma, which had a very large extension in classical Greek, denotes not only the hu-man body but also the elemental bodies (fire, water, air, earth), the corpse, the cosmic body, the celestial body, the animal body, etc, and there also lies such a large extension in the background of the Plato's view of the human body.According to Laws, Plato's last work, soma has three common characters: spaciality, movability and sensibil-ity, and takes on a different aspect fi'om the body in the present age. Firstly, the spaciality of soma is the likeness of Form, which is copied into chora (the place of plenum), and it is the solid, which is geometrically formed by fol-lowing Form. Secondly, the movability of soma is originally motion by others or disorderly and dotted linear mo-tion, which is necessarily caused by the accidental collision between the particles, but in connection with Soul and Reason it becomes a pseudo-autonomous and orderly circular motion. Thirdly, the sensibility of soma is pathema (accidental affection), which is based on the multiplicity in the geometrical structures of the particles. Pathema in-jutes Soul and soma when it is left to Chance and Ignorance, but in the control of Reason it contributes to the reali-zation of the good and the restoration of the order.Since soma, which has close connections to Soul, Reason and Form, is represented as such a subordinate and necessarily conditional existence in Plato's later dialogues, the hu-man body, which is also called soma, should be considered on the basis of the above mentioned fundamental char-acters.%通过考察柏拉图后期对话篇中"身体(soma)"的原理性特征,阐明柏拉图身体(soma)观."身体(soma)"是具有极其宽广外延的词汇,不仅指人的身体,还代指动物的躯体、宇宙或天体的结构、丧失生命的尸体,甚至具有构成基

  1. Clinical Trials

    Science.gov (United States)

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  2. "Ideal" and "Body Ideal": Reading Plato, Foucault, Vico and Socrates%“理想”与“身体理想”——读柏拉图、福珂、维科和苏格拉底

    Institute of Scientific and Technical Information of China (English)

    龙潜

    2012-01-01

    从柏拉图的古希腊起,身体在人认知的体系中,是意识形态的,是价值判断的,亦是意义功能的。身体不是单纯的自然物,身体不能被看为一个独立的物体,它是一种社会现象。%Since Plato' s ancient Greece body has been considered part of human cognition system, involving the value judgment and meaning function. Body is not simply natural, but social as well.

  3. CLINICAL RESEARCH OF COMBINATION USE OF TICAGRELOR AND BIVALIRUDIN TREATMENT ON NO-REFLOW PHENOMENON IN PATIENTS WITH ACUTE ST-ELEVA-TION MYOCARDIAL INFARCTION DURING PERCUTANEOUS CORONARY INTERVEN-TION%替格瑞洛联合比伐卢定对 STEMI急诊 PCI无复流临床研究

    Institute of Scientific and Technical Information of China (English)

    赵榆华; 傅宴; 雷婷; 揭英纯; 蒋溢为; 唐杏彤

    2014-01-01

    目的:探讨新型抗栓药物替格瑞洛和比伐卢定在急性ST段抬高型心肌梗死( STEMI)急诊PCI中早期联合应用对无复流现象的预防效果。方法选取2012年5月~2013年12月就诊于心内科且符合纳入、排除标准的患者67例作为研究对象。依据就诊顺序随机分为对照组(32例)和治疗组(35例)。对照组术前给予口服阿司匹林和氯吡格雷,术中给予肝素,治疗组术前给予阿司匹林替格瑞洛、术中给予比伐卢定治疗。于给药前和术后分别记录两组TIMI血流分级、校正的TIMI帧数(CTFC)以及无复流率。给药前,两组在一般情况和TIMI血流分级上均无统计学差异(p>0.05),具有可比性。结果术后,治疗组的TIMI血流分级高于对照组(p<0.05),治疗组的无复流率和CTFC较对照组低(p<0.05)。结论对STEMI患者行急诊PCI时,早期联合应用替格瑞洛和比伐卢定能较好地预防无复流现象。%Objective To explore the effects of combination use of ticagrelor and bivalirudin on no -reflow phenom-enon in patients with Acute ST-Elevation Myocardial Infarction (STEMI) during percutaneous coronary intervention (PCI). Methods A total of 67 STEMI patients who received PCI during May 2012 and December 2013 were randomly divided into control group ( aspirin 300 mg and clopidogrel 600 mg taken orally before PCI) intravenous injection of Heparin 100 u/kg and treatment group (aspirin 300 mg, ticagrelor 180 mg taken orally before PCI , intravenous injection of bivalirudin 0.75 mg/kg and intravenous drip of bivalirudin 1.75 mg/( kg· h) till completing the operation.The two group had no statistical signifi-cance in all aspects before giving drugs.Results After operation, the treatment group had a higher rank of TIMI, and lower value of TCFC and lower rate of no -reflow, all P value were less than 0.05.Conclusion Early Combination use of ti-cagrelor and bivalirudin treatment during

  4. 急性冠状动脉综合征氯吡格雷抵抗患者换用替格瑞洛后的PAR变化%The changes of platelet aggregation ratio in acute coronary syndrome patients with clopigogrel resistance following alternated by ticagrelor

    Institute of Scientific and Technical Information of China (English)

    李枚岭; 李刚

    2015-01-01

    Objective To observe the variance of the platelet aggregation ratio after using ticagrelor for instead of clopidogrel in acute coronary syndrome patients suffering from clopidogrel resistance. Methods Platelet aggregation ratio test induced by adenosine diphosphate (ADP) identified acute coronary syndrome patients with clopidogrel resistance underwent the PCI(percutaneous coronary intervention) from July 2013 to July 2014. The 57 patients with clopidogrel resistance were given 180mg ticagrelor load followed by 90mg twice daily maintenance therapy,for instead of clopidogrel 75mg once daily for 1 month,and the platelet aggregation ratio were tested. Results Platelet aggregation rate had significant difference (P<0.05) statistically after administration of ticagrelor compared with clopidogrel. Conclusion Compared with the regular-dose treatment of clopidogrel,ticagrel can effectively decrease the platelet aggregation ratio in acute coronary syndrome patients with clopidogrel resistance.%目的:探讨急性冠状动脉综合征(ACS)氯吡格雷抵抗患者换用替格瑞洛后血小板聚集率(PAR)的变化情况。方法急性冠状动脉综合征患者,经皮冠状动脉介入治疗(PCI)术后测定二磷酸腺苷(ADP)诱导血小板聚集率,根据血小板聚集率筛选出氯吡格雷抵抗患者57例,男45例,年龄(62.98±10.51)岁,体重指数(24.53±2.53) kg/m2;女12例,年龄(64.17±5.84)岁,体重指数(25.49±3.37) kg/m2。氯吡格雷抵抗患者将氯吡格雷75 mg,1次/d更换为替格瑞洛负荷量180 mg,次日开始90 mg,2次/d。随访30 d,应用替格瑞洛后7、15、30 d检测血小板聚集率。结果服用替格瑞洛后血小板聚集率明显降低,与应用氯吡格雷后血小板聚集率的差异有显著统计学意义(P<0.05),患者吸烟,是否合并高血压或糖尿病及服用降压、降糖药物,其血小板聚集率下降程度之

  5. LAS CRÍTICAS DE ARISTÓTELES A PLATÓN EN METAFÍSICA I, 9 ARISTOTLE’S CRITICISMS OF PLATO IN METAPHYSICS I, 9

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    Silvana Gabriela Di Camillo

    2011-03-01

    Full Text Available

    O recurso à exposição crítica das doutrinas anteriores é um procedimento metodológico usual em Aristóteles. Mas a característica distintiva do Livro I da Metafísica é que, ao invés de estabelecer uma nova doutrina, o exame dos predecessores serve para confirmar os próprios conceitos aristotélicos, os quais ele usa para avaliar os êxitos e os erros das doutrinas analisadas. Essa imposição de conceitos próprios lhe valeu a acusação de ter uma compreensão histórica distorcida. Com a análise detalhada das críticas da teoria platônica das Idéias na Metafísica I, 9, pretendemos mostrar: a que as críticas de manipulação e distorção das opiniões dos seus antecessores ofuscam o grau em que as suas próprias posições emergem de uma análise crítica do pensamento anterior; e b que a imposição de conceitos próprios não é uma distorção, mas uma proposta de solução para os problemas que as teorias anteriores deixaram sem solução.

    The use of critical exposition of previous doctrines is a methodological procedure usual in Aristotle. But the distinctive characteristic of Book I of the Metaphysics is that, rather than to establish a new doctrine, a review of  predecessors serves to confirm the own concepts to be used in the evaluation of the doctrines examined. This imposition of own terms has cost him the charge of distorting historical understanding. With the detailed analysis of the criticisms of Plato's theory of Ideas in Metaphysics I, 9, we intend to show a that the criticism of manipulation and distortion of his predecessors' views overshadow the degree to which Aristotle's own positions emerge from a critical review of previous thought and b that the

  6. 柏拉图的“学习即回忆”与分析性默会知识%Plato's“learning is recollection” and Tacit Knowledge

    Institute of Scientific and Technical Information of China (English)

    芮夕捷

    2015-01-01

    Abstracts:In Phaedo ,Plato tried to prove the proposition “learning is recollection” based on hu‐man perception of “equality” ,but the process of reasoning is invalid because of his'misunderstanding of logic priority as time priority .In Meno ,he attempted to illustrate the proposition through the dia‐logues between Socrates and Meno's slave .However ,the knowledge involved in the experiment is a kind of analytic tacit knowledge ,and the process in getting it essentially lies in discovering the tacit knowledge that is implied in cognitive subjects'related explicit knowledge but never appearing in his awareness ,and converting it into explicit knowledge .The experiment with Meno'little slave doesn't prove the proposition “learning is recollection” ,but the process in conversion of analytic tacit knowl‐edge to explicit knowledge has great implications for today's creative studies of organizational knowl‐edge .The tacit knowledge in analytic form has a complex structure .The realization of the conversion from analytic tacit knowledge to explicit knowledge is an important way of creation of organizational knowledge ,and requires persistent efforts on the part of cognitive subjects .%在《斐多篇》中柏拉图基于人们拥有“相等”的概念对“学习即回忆”进行了论证,但论证错误地将逻辑在先混淆成了时间在先。在《美诺篇》中柏拉图试图利用苏格拉底与美诺的僮奴的对话实验证明“学习即回忆”,然而实验所涉及的知识属分析性默会知识,它的获得过程本质上在于发现蕴涵于认知主体相关显式知识中但又不曾为其所意识的默会知识,并将其转变为显式知识。僮奴实验虽未能证明“学习即回忆”,但其中所涉及的分析性默会知识向显式知识的转变过程对当代组织知识创造研究具有借鉴意义。分析性默会知识具有较为复杂的结构,实现分析性默会知识向显式知识的转

  7. Stroke Trials Registry

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Trials Registry Clinical Trials Interventions Conditions Sponsors ... a clinical trial near you Welcome to the Stroke Trials Registry Our registry of clinical trials in ...

  8. Participating in Clinical Trials

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    Full Text Available ... Z > Participating in Clinical Trials: About Clinical Trials In This Topic About Clinical Trials Risks and Benefits ... of this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study ...

  9. The Plato statistical analysis and countermeasures of internal fixation demolition mishandling%内固定拆除物处置不当的柏拉图统计分析与对策

    Institute of Scientific and Technical Information of China (English)

    马慧仙; 章霞红; 汪怡翠; 郑剑英

    2014-01-01

    目的:通过质量管理提高内固定拆除物的处理质量,防止纠纷的发生。方法:用柏拉图方法对不良数据进行收集,用鱼骨图进行原因分析,根据原因提出对策,制定措施,进行PDCA。结果:通过柏拉图分析,使得内固定拆除物处理的进步率达到了78%,合格率达到了93%。结论:用柏拉图分析等QC手法对内固定拆除物处理质量进行改进,是一种行之有效的方法。%To improve the quality of internal fixation demolition processing by the quality management methods , thus to prevent the occurrence of disputes .[Method] The data of internal fixation demolition mishandling was collected and an-alyzed by fishbone diagram .According to the reasons ,we put forward countermeasures ,set out measures and carried out plan-do-check action cycle (PDCA) .[Result] The progress rate of internal fixation demolition handling was 78% and the qual-ified rate was 93% with Plato analysis . [Conclusion ] The Plato analysis is one of the effective methods to improve the quality of internal fixation demolition processing by the quality management methods.

  10. 高效液相色谱-质谱联用法测定人血浆中替格瑞洛及其代谢物的浓度%Simultaneous determination of ticagrelor and its active metabolitein in human plasma by HPLC-MS/MS

    Institute of Scientific and Technical Information of China (English)

    陈国耘; 程敏毓; 刘炜; 李力

    2016-01-01

    目的:建立高效液相色谱-质谱联用法同时测定人血浆中替格瑞洛及其活性代谢产物AR-C124910 XX的浓度。方法血浆样品用乙腈沉淀蛋白后,以伊曲康唑为内标,用Eclipse Plus-C18色谱柱(2.1 mm ×10 mm,3.5μm),以乙腈-10 mmol・ L-1醋酸铵溶液(均含0.15%甲酸)为流动相进行梯度洗脱,流速为0.3 mL・ min-1,柱温为30℃,进样量10μL,总分析时间为4 min,用电喷雾离子化源,正离子方式,多反应监测( MRM )扫描方式进行监测。考察其专属性、标准曲线与定量下限、精密度与准确度、提取回收率、基质效应和稳定性。结果血浆中替格瑞洛的标准曲线方程为:y =3.79×10-2 x +5.27×10-3( r=0.9976),线性范围为2~2000μg・ L-1,线性相关良好,定量下限为2μg・ L-1;AR-C124910 XX标准曲线方程为:y =4.58×10-2 x+6.15×10-3( r=0.9965),线性范围为1~1000μg・ L-1,线性相关良好,定量下限为1μg・ L-1。替格瑞洛和AR-C124910 XX低、中、高3个质量浓度的准确度在93.6%~108.7%;日内、日间的相对标准偏差( RSD )均小于15%;提取回收率在84.7%~91.3%。结论液质联用法快速、灵敏、准确,专属性强,重复性好,适用于人血浆中替格瑞洛及其活性代谢产物AR-C124910 XX的浓度测定。%Objective To establish an HPLC-MS/MS method for sim-ultaneous determination of ticagrelor and its active metabolite ( AR -C124910 XX) in human plasma.Methods The plasma samples were precipitated protein by acetonitrile , with itraconazoleas an internal stand-ard.The separation was achieved on Eclipse Plus -C18 column (2.1 mm ×10 mm, 3.5 μm) and eluted with linear gradient by mobile phase con-sisted of acetonitrile and 10 mmol・ L-1 ammonium acetate , both of which were acidified with 0.15% formicacid , at the flow rate of 0.3 m

  11. Participating in Clinical Trials

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    Full Text Available ... treatment, screening, diagnostic, prevention, and supportive care trials. Treatment Trials In treatment trials, researchers may gather information about experimental treatments, ...

  12. The Trial

    Science.gov (United States)

    Bryant, Jen

    2004-01-01

    Growing up in Flemington, New Jersey, put Jen Bryant in the heart of the lore behind the Lindbergh baby kidnapping. Family stories of the events of the day and extensive research led to "The Trial," a novel in verse. The first several parts of this novel are included here.

  13. What Are Clinical Trials?

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    ... of this page please turn Javascript on. Feature: Clinical Trials What Are Clinical Trials? Past Issues / Fall 2010 Table of Contents Clinical ... conducted all the time. The Different Phases of Clinical Trials Clinical trials related to drugs are classified into ...

  14. Participating in Clinical Trials

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    ... this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical ... to treat or cure a disease. Phases of Clinical Trials Clinical trials of drugs are usually described based ...

  15. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Usually, trial participants must show signs of the disease or condition before they can join this type of trial. Prevention Trials Click for more information In prevention trials, ...

  16. 柏拉图论“诗与哲学之争”的政治哲学思考%Thinking on the Comments on “Quarrel about Poetry and Philosophy” by Plato from the Perspective of Political Philosophy

    Institute of Scientific and Technical Information of China (English)

    梁建东

    2013-01-01

    In The Republic, Plato criticized poetry and poets, which caused the quarrel about poetry and philosophy in the history of western thoughts. The death of Socrates awaked Plato to that the politicians educat-ed by ancient Athens education, which was characterized by poetry controlling the government in Athens, re-jected truly advantageous proposals for Athens City States and caused harm to people of true wisdom. Poetry is the destruction of soul and national ruling. The quarrel about poetry and philosophy is actually the quarrel about political system and life style. Poetry which represents common people�s daily life is the patriarchal clan life that most people in city state live, and is closely identified with the political community. Philosophy represents a new life that a few people live to pursue wisdom, and it would inevitably clash with the polis political commu-nity.%  古希腊哲人柏拉图在其《理想国》中批判诗和诗人,引发了西方思想史上的“诗与哲学之争”。苏格拉底之死使柏拉图认识到,被以诗为主要内容的雅典教育培养出的政客把持着雅典政府,拒绝对城邦真正有利的提议,并对真正有智慧的人实施了伤害。诗是对灵魂与国家统治的败坏。诗与哲学之争实质上是政治制度和生活方式之争。诗代表了普通民众的日常生活,是城邦中多数人过的宗法生活,与城邦政治共同体密不可分;哲学则代表了一种新兴的生活,是少数人过的追求智慧的生活,与城邦政治共同体必然发生冲突。

  17. Clinic outcome of ticagrelor in treatment of patients with acute ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention%替格瑞洛在急性ST段抬高型心肌梗死急诊PCI中应用的疗效观察

    Institute of Scientific and Technical Information of China (English)

    郭瑞威; 杨丽霞; 齐峰; 陈长征

    2014-01-01

    目的 观察替格瑞洛在急性ST段抬高型心肌梗死急诊经皮冠脉介入治疗(PCI)患者中的应用,分析其临床疗效.方法 行急诊冠脉介入治疗的急性心肌梗死62例患者,分为氯吡格雷组和替格瑞洛组,对比两组基线资料、PCI后即刻冠脉造影评价根据心肌梗死溶栓(TIMI)血流分级,30 d心血管不良事件和出血情况.结果 氯吡格雷组和替格瑞洛组年龄、性别及高血压病史率差异无统计学意义(P>0.05).替格瑞洛组术后即可恢复TIMI 3级血流率显著高于氯吡格雷组(96.7% vs 87.5%,P<0.05),30 d再发心绞痛率低于氯吡格雷组(3.3% vs 12.5%,P<0.05);两组患者30 d内全因死亡率差异无统计学意义(P>0.05),但轻微出血发生率替格瑞洛组高于氯吡格雷组(13.3% vs3.1%,P<0.05).结论 替格瑞洛可以显著改善急性心肌梗死患者的临床症状和预后,但在国人中有增加出血风险的趋势.%Objectives To investigate clinic outcome of ticagrelor in treatment of patients with acute ST-segment elevation my ocardial infarction receiving primary percutaneous coronary intervention.Methods Sixty-two consecutive patients with ST segment elevation myocardial infarction (STEMI) receiving primary percutaneous coronary intervention (PCI) were included in this study.The clinic characteristics,thrombolysis in myocardial infarction (TIMI) refuse after PCI,clinical outcomes after 30 d of patients were compared between patients who were treated with ticagrelor (group A 30 cases) and clopidogrel (group B 32 cases).Results There was no difference in the age,proportion of women,hypertension,and diabetics (P > 0.05).TIMI 3 refuse after PCI were significantly higher in group A than group B (96.7% vs 87.5%,P < 0.05).The 30 d re-angina pectoris was lower in group A than group B (3.3% vs 12.5%,P <0.05).However,tiny bleeding of group A was higher than group B (13.3% vs 3.1%,P <0.05).Conclusions

  18. Efficacy of ticagrelor and clopidogrel in the treatment of patients with acute ST elevation myocardial infarction complicated with diabetes mellitus%替格瑞洛与氯吡格雷治疗急性STEMI合并糖尿病患者疗效观察

    Institute of Scientific and Technical Information of China (English)

    卫亚丽; 赵玉英; 丁超; 于敏

    2016-01-01

    目的:比较替格瑞洛与氯吡格雷治疗急性ST段抬高型心肌梗死(STEMI)合并糖尿病患者的临床疗效。方法采用回顾性分析的方法,选择我院2013年1月至2014年2月期间收治的行急诊经皮冠状动脉介入(PCI)且接受替格瑞洛联合阿司匹林治疗的157例急性STEMI合并糖尿病患者作为观察组;选择我院2012年1月至2013年1月期间收治的行急诊PCI术后接受氯吡格雷联合阿司匹林治疗的150例急性STEMI合并糖尿病患者作为对照组,比较两组患者治疗前后的血小板相关指标、主要不良心血管事件、心绞痛、再发心梗的累积发生率,以及治疗后不同时间段内主要安全重点事件的累积发生率。结果两组患者的临床一般资料比较差异均无统计学意义(P>0.05);治疗1周后,对照组与观察组的血小板聚集率分别为(58.23±4.21)%和(55.26±3.91)%,均较治疗前明显下降,且观察组明显低于对照组(P0.05)。结论急性STEMI合并糖尿病患者应用替格瑞洛治疗较氯吡格雷能够发挥更好的抗血小板聚集作用,且能减少术后不良心血管事件发生率,降低术后致命出血累积发生率,具有较好的治疗效果,值得临床推广应用。%Objective To compare the clinical efficacy of ticagrelor and clopidogrel in the treatment of patients with acute ST elevation myocardial infarction (STEMI) complicated with diabetes mellitus. Methods A retrospective analysis method was used. A total of 157 patients with acute STEMI complicated with diabetes mellitus who underwent emergency percutaneous coronary intervention (PCI) and received ticagrelor combined with aspirin therapy in our hospi-tal from January 2013 to February 2014 were selected as the observation group. Another 150 patients with acute STEMI complicated with diabetes mellitus who were treated with clopidogrel combined with aspirin after PCI in our hospital from January 2012 to January 2013 were

  19. Types of Treatment: Clinical Trials

    Science.gov (United States)

    ... Disease Information Treatment Types of Treatment Clinical Trials Clinical Trials Clinical Trials SHARE: Print Glossary Taking part in a clinical ... for cancer are based on previous clinical trials. Clinical Trial Service: LLS provides personalized clinical trial navigation when ...

  20. Influencia de la distancia entre la tobera y el plato deflector, en la calidad de la aspersión, de las boquillas difusoras de baja presión

    Directory of Open Access Journals (Sweden)

    Miguel Domínguez G.

    2004-01-01

    Full Text Available En el presente trabajo se muestran los resultados de evaluaciones, en el laboratorio hidráulico, de un prototipo de nueva boquilla difusora. En el estudio se evaluaron diferentes distancias entre las toberas y la superficie del deflector del Instituto de Investigaciones de Riego y Drenaje (IIRD, para un orificio con diámetro de salida de 2.5 mm y presiones de 1.0,1.5,2.0 atmósferas; el que fue comparado con el plato deflector UNIRAIN SP 4, español. Para la prueba se utilizó la norma ISO 8026-1995, se aseguró, una velocidad del viento cero. Como receptores se emplearon vasos cónicos, con superficie de 66.76 cm2, espaciados a 25 cm; las mediciones se efectuaron en los cuatro radios del área humedecida. Como resultado, se tiene que el deflector IIRD, ubicado a 20 mm de distancia de la tobera, y el español situado a 42 mm, no presentaron diferencia significativa para el 5 y 1 % de probalidad, con errores típicos de 0.14 y 0.23 respectivamente

  1. 柏拉图分析法在临床案例安全风险识别中的应用%Application of Plato analysis method in identifying the security risks of the clinical cases

    Institute of Scientific and Technical Information of China (English)

    李小金; 陈雪霞; 林少玲; 成守珍

    2016-01-01

    Objective To apply Plato analysis method to clinical cases which were reported from clinical nursing, finding out the key link of the risks which were related to the cases:the key age, the key period, the key spectrum of disease and the key projects, etc. To carry out the feedforward control of the quality of care, and ensure the quality and safety of nursing. Methods A database were set up including clinical special cases, high-risk cases, security hidden danger cases and emergency cases. The"two eight"principle of Plato analysis method was used to find out the main factors, the principal contradiction, the key hazard and the key problems of the cases, etc. The aim was to provide guidelines of risk analysis, risk prevention and risk aversion for nurses, and improve their consciousness of security hidden danger, and reduce security hidden danger cases. Results The results of 207 cases collected from 2014 to 2015 showed that the main risks involved the age groups were 41-80 years old and 21-30 years old. The major risks involved the spectrum of disease were the nervous system, cardiovascular disease, surgical anesthesia related problems, kidney disease, cancer and respiratory system. The major risks involved the time were the midnight, morning and afternoon. The major risks involved the locations were sickroom, emergency room, auxiliary inspection departments and outpatient. The major risks involved items were disease mutation, psychological problems, medication safety and instrument safety, among the disease mutation, timely discovered, rescued 13 patients with heart and breathing pause, stop 13 patients who attempted suicide. Since the Plato analysis method was applied to identify the security risks of the clinical cases, the number of falling, all kinds of pipe shed, skin problems and suicides were decreased from 6, 6, 7, 5 in 2014 to 2, 2, 2, 1 in 2015, declining trend year by year. Conclusions Applying the Plato analysis method to identify the security risks

  2. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... trial is to find out if an experimental drug, therapy, medical device, lifestyle change, or test will ... disease. Phases of Clinical Trials Clinical trials of drugs are usually described based on their phase. The ...

  3. Alternativa de protección contra la corrosión del acero AISI 310S mediante recubrimiento de aluminio bajo condiciones de platos separadores en celdas de combustible de carbonatos fundidos

    Directory of Open Access Journals (Sweden)

    R. Orozco-Cruz

    2016-01-01

    Full Text Available Introducción: La celda de combustible de carbonatos fundidos (MCFC, por sus siglas en inglés convencional opera a 650°C. Consiste de un cátodo de NiO poroso y litiado, una mezcla eutéctica de carbonato de litio (Li2CO3 y carbonato de potasio (K2CO3 fundido en una matriz electrolitica de óxido de aluminio litiado (LiAlO2 y un ánodo poroso de Ni. Los platos separadores entre cada celda presentan problemas de corrosión. Ante eso, un acero inoxidable AISI 310S con recubrimiento fue estudiado en condiciones de un plato separador en una MCFC. Método: Se utilizó un acero inoxidable AISI 310S como sustrato (muestra A, aplicándole un recubrimiento de Al con (B y sin tratamiento térmico (C. Fueron expuestos en carbonatos fundidos (62 mol% Li2CO3 -38 mol% K2CO3 a 650 °C en crisoles de alúmina. El comportamiento electroquímico fue estudiado mediante la técnica de Espectroscopía de Impedancia Electroquimica (EIS. Para el análisis de los diagramas de impedancia, se utilizó el software de simulación “Boukamp Equivalent Circuit”. La sección transversal de las muestras corroídas fue caracterizada mediante Microscopía Electrónica de Barrido (SEM, por sus siglas en inglés y los productos formados por Difracción de rayos X (XRD, por sus siglas en inglés. Resultados: Los diagramas de EIS presentan aumentos y disminuciones en los semicírculos formados a altas frecuencias indicativo de disolución de la capa externa, aumento y disminución de la resistencia de esta última así como el posible rompimiento de ella. La técnica de XRD presentó fases LiFeO2, LiCrO2, -LiAlO2 y -LiAlO2 así como fases intermetálicas para las distintas condiciones de la muestra. De la misma manera, los análisis de SEM presentaron los espesores de cada una de las capas formadas. Discusión o Conclusión: En la muestra A, se formaron capas de LiFeO2 y LiCrO2 después de 200 horas de exposición. La capa de LiCrO2 aumenta por la difusión de Li hacia el

  4. Parmenide e Platone (e Aristotele nel Contro Colote di Plutarco Parménide et Platon (et Aristote dans le Contre Colotès de Plutarque Parmenides and Plato (and Aristotle in Plutarch's Against Colotes

    Directory of Open Access Journals (Sweden)

    Mauro Bonazzi

    2013-05-01

    Full Text Available The chapters dedicated to Parmenides and Plato play a decisive role in the composition strategy of the Adversus Colotem, since this is where Plutarch most clearly defines the background dualist thesis that will help demonstrate that Platonism is superior to Epicurism. By showing Parmenides too as a dualist engaged in distinguishing between the sensible and the intelligible world, Plutarch structures a history of ancient philosophy entirely focused on Plato. These chapters also bear witness of another centre of interest, namely Aristoteles (§ 14, who, despite the criticism he aimed at the theory of ideas, is not completely refuted, but rather used as a possible ally against epicurean materialists, Plutarch’s true bête noire.Les chapitres consacrés à Parménide et Platon jouent un rôle décisif dans la stratégie de composition de l’Adversus Colotem : c’est là en effet que Plutarque définit de la manière la plus claire la thèse dualiste de fond qui va servir à démontrer la supériorité du platonisme sur l’épicurisme. En présentant Parménide lui aussi comme un dualiste occupé à distinguer entre monde sensible et monde intelligible, Plutarque articule une histoire de la philosophie antique entièrement centrée sur Platon. Les chapitres témoignent ensuite d’un autre centre d’intérêt, avec la mention d’Aristote (§ 14, lequel, malgré les critiques qu’il adresse à la théorie des idées, n’est pas complètement réfuté, mais plutôt utilisé comme un allié possible contre les matérialistes épicuriens, la véritable « bête noire » de Plutarque.I capitoli dedicati a Parmenide e Platone giocano un ruolo decisivo nella strategia compositiva dell’Adversus Colotem: è qui infatti che Plutarco delinea nel modo più chiaro la tesi dualistica di fondo che servirà a dimostrare la superiorità del platonismo sull’epicureismo. Presentando anche Parmenide come un dualista, impegnato a distinguere tra mondo

  5. Clinical Trials in Vision Research

    Science.gov (United States)

    ... Eye Health Information > Clinical Trials in Vision Research Clinical Trials in Vision Research Clinical studies depend on people ... vision research in the United States. Basics of Clinical Trials What is a clinical trial? Clinical trials are ...

  6. How Do Clinical Trials Work?

    Science.gov (United States)

    ... Studies NHLBI Trials Clinical Trial Websites How Do Clinical Trials Work? If you take part in a clinical ... protect patients and help produce reliable study results. Clinical Trial Protocol Each clinical trial has a master plan ...

  7. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... trial. Prevention Trials Click for more information In prevention trials, researchers study ways to reduce the risk of getting a disease or a specific medical problem. These trials find out if lifestyle changes, such as exercising more, getting more sleep, ...

  8. La Traditio Legis de Cristo a Pedro y Pablo en un plato de vidrio de Cástulo, Linares (Jaén = Traditio Legis of Christ to Peter and Paul in a glass bowl from Cástulo, Linares (Jaén

    Directory of Open Access Journals (Sweden)

    José Mª Blázquez

    2016-04-01

    Full Text Available En este artículo analizamos la iconografía de un plato de vidrio encontrado en Cástulo con la representación de la Tradicio legis o transmisión de la ley de Cristo a los apóstoles Pedro y Pablo.In this paper we analyze the iconography of a glass bowl found in Cástulo showing the representation of the Traditio legis, or «transmission of the law» of Christ to apostles Peter and Paul.

  9. 氯吡格雷与替格瑞洛治疗急性冠状动脉综合征合并慢性阻塞性肺病的疗效及安全性比较%Comparison on clinical effectiveness and safety of ticagrelor versus clopidogrel in patients with acute coronary syndromes and chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    周学敏; 郭莉青; 王燕庆; 柴婵娟; 吕慧; 朱国斌

    2016-01-01

    Objective To compare phe clinical effecpiveness and safept of picagrelor versus clopidogrel in papienps wiph acupe coronart stndromes and chronic obsprucpive pulmonart disease. Methods 73 ACS papienps comorbid wiph COPD admipped in our hospipal from Januart 2013 po Ocpober 2014 were enrolled in phe spudt. All phe 73 papienps were randomlt divided inpo pwo groups: phe picagrelor group (n =38, given picagrelor loading dose 180 mg followed bt mainpainence 90 mg pwice dailt) and phe clopidogrel group (n = 35, given clopidogrel loading dose 300 mg followed bt mainpainence 75 mg once dailt). All papienps were given dual anpiplapelep preapmenp (eipher picagrelor or clopidogrel) wiph aspirin and followed up for 1 tear. Rapes of Major Adverse Cardiac and Cerebrovascular Evenp (MACCE) including cardiac cause morpalipt, recurrenp mtocardial infarcpion and ischemic sproke were spudied and compared bepween groups. The safept endpoinp was pime po firsp occurrence of major bleeding. Rapes of adverce evenps were recorded including dtspnea. Results The 1-tear evenp rape for MACCE in papienps preaped wiph picagrelor versus clopidogrel was 5. 3% versus 26. 3% (P = 0. 04, HR 0. 21; 95% CI 0. 05 - 0. 91). Dtspnea occurred more frequenplt wiph picagrelor (26. 3% vs. 5. 7% ; P = 0. 04; HR 4. 61, 95% CI 1. 08 - 19. 58). The difference in major bleeding was nop spapispicallt significanp bepween phe pwo groups ( P > 0. 05) . The occurance of dtspnea was higher in phe picagrelor group (26. 3% vs. 5. 7% , P = 0. 04). Dtspnea subsided sponpaneouslt in mosp papienps. Onlt 1 papienp needed po spop picagrelor. Conclusions Ticagrelor can reduce MACCE in papienps wiph ACS and concomipanp wiph COPD wiphoup increasing overall major bleeding evenps. Ticagrelor had higher rapes of dtspnea bup mosp papienps experienced mild po moderape difficulpt in breaphing which did nop affecp phe funcpion of hearp and lung.%目的:对比分析急性冠状动脉综合征(ACS)合并慢性阻塞性肺病(COPD)

  10. 教育之"道"与"术"——柏拉图《理想国》中的教育理念解读%Principles and Techniques in Education——an Interpretation of the Educational Philosophy in The Republic by Plato

    Institute of Scientific and Technical Information of China (English)

    刘晶; 连幼平

    2011-01-01

    The Republic of Plato is well known for its broad and profound ideas, yet this paper only intends to make a preliminary analysis of the educational principles and techniques in Plato's philosophy while he was on his way of forging an ideal polis.Education is,in essence,a skill of helping turn the soul of the educated into the right direction as well as a skill of cultivating virtues on the part of the educated.The above are the principles educators shall follow in the process of education, leaving the program layout, teaching contents and methods as the specific educational techniques while carrying out the educational principles.%柏拉图的思想博大精深,本文仅对其教育思想体系中涉及的教育之"道":教育是"灵魂的转向"、教育是美德的养成;以及教育过程中所遵循的原则、内容和教学方法等教育之"术"做了初步探讨.

  11. Informed Consent (Clinical Trials)

    Science.gov (United States)

    ... Research Cancer Treatment Types of Treatment Side Effects Clinical Trials Information A to Z List of Cancer Drugs ... Staging Prognosis Treatment Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer ...

  12. Research Areas - Clinical Trials

    Science.gov (United States)

    Information about NCI programs and initiatives that sponsor, conduct, develop, or support clinical trials, including NCI’s Clinical Trial Network (NCTN) and NCI Community Oncology Research Program (NCORP) initiatives.

  13. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Institutes of Health funds much of this basic research. Screening Trials In screening trials, researchers study ways of finding a disease before symptoms occur. These methods, often called screening tests, can include imaging tests ...

  14. ClinicalTrials.gov

    Science.gov (United States)

    ... to This Site Terms and Conditions Disclaimer ClinicalTrials.gov is a registry and results database of publicly ... of human participants conducted around the world. ClinicalTrials.gov is a registry and results database of publicly ...

  15. Understanding noninferiority trials

    Directory of Open Access Journals (Sweden)

    Seokyung Hahn

    2012-11-01

    Full Text Available Noninferiority trials test whether a new experimental treatment is not unacceptably less efficacious than an active control treatment already in use. With continuous improvements in health technologies, standard care, and clinical outcomes, the incremental benefits of newly developed treatments may be only marginal over existing treatments. Sometimes assigning patients to a placebo is unethical. In such circumstances, there has been increasing emphasis on the use of noninferiority trial designs. Noninferiority trials are more complex to design, conduct, and interpret than typical superiority trials. This paper reviews the concept of noninferiority trials and discusses some important issues related to them.

  16. Mimesis and ideology - from Plato to Althusser

    Directory of Open Access Journals (Sweden)

    Dolar Mladen

    2015-01-01

    Full Text Available The moment one imitates something, it sticks, it marks the imitator, there is no innocent imitation. Imitation necessarily affects the one who imitates, for better or (usually for worse, and the making of a simple copy of something necessarily affects the original. This is perhaps the briefest way to describe Plato’s concerns about the nature of mimesis in the Republic. The purpose of this paper is to give a brief account of looking at the mysterious magic powers of mimesis and of attempts to counteract them. The topic is massive, so the paper will concentrate on a few perspectives, starting with the theatrical parable of St. Genesius, leading to Pascal and to Althusser’s theory of ideology, then scrutinizing the ways in which modernity tried to disentangle itself from mimesis (Brecht’s estrangement, Irigaray’s femininity as mimesis, Badiou’s anti-mimetic stance, Freud’s account of magic and Lacan’s account of enjoyment. What is the real of the mimetic spell which has so vastly ramified aesthetic and political consequences? The paper proposes a defense of mimesis, claiming that modernity, by relegating the traditional art to the past of mimesis and representation, thereby maintained a disavowed kernel of mimesis at its core.

  17. Plato: White and Non-white Love

    Directory of Open Access Journals (Sweden)

    Amo Sulaiman

    2009-06-01

    Full Text Available Plato’s dialogues, the Symposium, and Phaedrus, provide a reasonableexplanation of love. G. Vlastos and M. Nussbaum do not share such anopinion. The former contends that Plato’s view of love is about lovingonly a person’s beauty, but not the entire person; thus, it falls short of anappropriate explanation of love. The latter holds that a theory of love should be complete, and that Plato’s one is incomplete on the grounds that it does not account for personal love. These criticisms will be re-evaluated in light of the duality of love (the white and non-white horses—in Phaedrus as well as participants’ views in the Symposium; a re-assessment will weaken the mentioned objections. This paper contends that from the Symposium and Phaedrus, one can have a fruitful understanding of being in love, being out of love, falling inlove, loving for its own sake and being erotically in love. In order to account for these related issues of love it is important to consider Plato’s works in terms of his “official” and “unofficial” views. The former is construed as the doctrine of the lover or loving for its own sake: this is associates with Diotima’s views which are repeated by Socrates. With reference to the latter, it is possible to explain what personal love or being in love, being out of love, falling in love, and being erotically in love involve. Erotic love will be interpreted as an extension of our philosophical conception of love, related to views of love that are mentioned in the Symposium other than Socrates’ report of Diotima’s conceptions. This paper is divided into two parts: the first one will show views of love in the Symposium. That is, being in love, being out of love, falling in love and loving for its own sake will be discussed. In addition, the forementioned criticisms will be re-evaluated. In the second section, we will show that Aristophanes’ speech expresses erotic love, and then Kant’s objections will be explained and discussed.

  18. The PLATO 2.0 Mission

    Science.gov (United States)

    Godolt, Mareike; Rauer, Heike; Plato Consortium

    2015-07-01

    The CHaracterising ExOPlanet Satellite (CHEOPS) is a joint ESA-Switzerland space mission dedicated to search for exoplanet transits by means of ultra-high precision photometry. It is expected to be launch-ready at the end of 2017. CHEOPS will be the first space observatory dedicated to search for transits on bright stars already known to host planets. It will have access to more than 70% of the sky. This will provide the unique capability of determining accurate radii for planets for which the mass has already been estimated from ground-based spectroscopic surveys and for new planets discovered by the next generation ground-based transits surveys (Neptune-size and smaller). The measurement of the radius of a planet from its transit combined with the determination of its mass through radial velocity techniques gives the bulk density of the planet, which provides direct insights into the structure and/or composition of the body. In order to meet the scientific objectives, a number of requirements have been derived that drive the design of CHEOPS. For the detection of Earth and super-Earth planets orbiting G5 dwarf stars with V-band magnitudes in the range 6 V 9 mag, a photometric precision of 20 ppm in 6 hours of integration time must be reached. This time corresponds to the transit duration of a planet with a revolution period of 50 days. In the case of Neptune-size planets orbiting K-type dwarf with magnitudes as faint as V=12 mag, a photometric precision of 85 ppm in 3 hours of integration time must be reached. The CHEOPS mission payload consists of only one instrument, a space telescope of 30 cm clear aperture, which has a single CCD focal plane detector. The total required duration of the CHEOPS mission is estimated to be 3.5 years (goal: 5 years).

  19. EDUCATION FOR SALVATION: PLATO'S CONCEPTION OF THE ...

    African Journals Online (AJOL)

    which he held very dear to his own philosophy it is the teaching that the best life .... present condition of "amatheia "which means "double ignorance".9. The tragedy ... which of our desires are good and which are bad, but instead we are driven to the ... dreaming.20 Dialectic is the method or process of thought upon which is ...

  20. The GUIDO System and the PLATO Project.

    Science.gov (United States)

    Arenson, Michael A.; Hofstetter, Fred T.

    1983-01-01

    The GUIDO system offers programing in ear training and theory for kindergarten through college levels, using high-resolution graphics, touch input, and a sound synthesizer. Ear training includes intervals, melodies, chord qualities, harmonies, and rhythm. Theory covers octave designation, beat units, scales, intervals, diatonic chords,…

  1. Aristotle vs. Plato: The Balkans' Paradoxical Enlightenment

    Directory of Open Access Journals (Sweden)

    D. Michalopoulos

    2007-09-01

    Full Text Available As it occurred in West, Aristotle’s thought was in Byzantium the main organon of philosophical meditation within the frame of the Christian Faith. Nonetheless, from the ninth century on it was a revival of Platonism that took place – of Neo-Platonism at the beginning and of Platonism itself at the end. The Church, initially indifferent, became suspicious only when, at the turning of the fourteenth to the fifteenth century, the Platonism seemed to engender somewhat a latent paganism; but the Patriarchate was not then able to fight that tendency. So only after the 1453 capture of Constantinople by the Ottomans, Gennadius Scholarius managed to root out from the Greek lands Platonism and its crypto-pagan extension. Be that as it may; the main paradox of the Balkan history is that in the early seventeenth century some leading Greek scholars endorsed the materialist interpretation of Aristotle’s thought – as it was taught in the University of Padua by Cesare Cremonini; and as a corollary this materialistic philosophical system began being taught in both Constantinople and Athens. It was that very way that the Enlightenment took birth in the Balkans – and somehow became a State ideology - long before its prevalence in France. And of course all this had as a result a turn toward Physics and Chemistry with far-reaching consequences

  2. Prevenção domiciliar da dengue: avaliação preliminar de tela protetora para pratos de vasos de planta Prevención domiciliar de la dengue: evaluación preliminar de tela protectora para platos de macetas de planta Dengue prevention at the household level: preliminary evaluation of a mesh cover for flowerpot saucers

    Directory of Open Access Journals (Sweden)

    Virgínia Torres Schall

    2009-10-01

    Full Text Available Avaliou-se em laboratório a eficácia de um protótipo de capa de tela de poliéster (evidengue® destinada a vedar o acesso de fêmeas do mosquito Aedes aegypti a pratos de vasos de planta. Dois pratos de vasos com água foram envolvidos individualmente com a capa e colocados com os seus respectivos vasos em duas gaiolas entomológicas, um em cada gaiola. Numa terceira gaiola foi colocado um conjunto idêntico de prato e vasos sem a capa. Cada gaiola recebeu 20 fêmeas copuladas do mosquito, alimentadas com sangue de camundongo. Os resultados mostram que a capa foi eficaz como barreira ao acesso de fêmeas. Novos testes são necessários para se avaliar a eficácia da capa como dispositivo de prevenção da ovipostura nos pratos.Se evaluó en laboratorio la eficiencia de una cubierta de tela de polyester (evidengue® con el objetivo de vedar el acceso de hembras del mosquito Aedes aegypti a platos de macetas de planta. Fueron utilizadas tres jaulas entomológicas, dos de ellas con evidengue® y una para control. En cada jaula fueron colocados dos conjuntos de macetas de planta y platos y 20 hembras copuladas, alimentadas con sangre de ratón. Los resultados muestran que la cubierta fue eficaz como barrera al acceso de hembras. Nuevas pruebas son necesarias para evaluar la eficiencia de la cubierta como dispositivo de prevención de la oviposición en los platos.The effectiveness of a polyester mesh cover (evidengue®, aimed at preventing the access of female Aedes aegypti mosquitoes to flowerpot saucers, was evaluated in laboratory. Two saucers of flowerpot with water were individually wrapped with the cover was placed with their respective pots in two entomological cages. One identical set of flowerpot and saucer was placed in a third cage. In each cage, 20 gravid females, fed on mouse blood, were released. Results show that the cover was effective to prevent access of females. Further tests are necessary to assess cover effectiveness as a

  3. The COLOFOL trial

    DEFF Research Database (Denmark)

    Hansdotter Andersson, Pernilla; Wille-Jørgensen, Peer; Horváth-Puhó, Erzsébet

    2016-01-01

    INTRODUCTION: The COLOFOL trial, a prospective randomized multicenter trial comparing two follow-up regimes after curative surgical treatment for colorectal cancer, focuses on detection of asymptomatic recurrences. This paper aims to describe the design and recruitment procedure in the COLOFOL...... trial, comparing demographic characteristics between randomized patients and eligible patients not included in the study. MATERIALS AND METHODS: COLOFOL was designed as a pragmatic trial with wide inclusion criteria and few exclusion criteria, in order to obtain a sample reflecting the general patient...

  4. Beyond trial types.

    Science.gov (United States)

    Dyrholm, Mads; Vangkilde, Signe; Bundesen, Claus

    2015-05-01

    Conventional wisdom on psychological experiments has held that when one or more independent variables are manipulated it is essential that all other conditions are kept constant such that confounding factors can be assumed negligible (Woodworth, 1938). In practice, the latter assumption is often questionable because it is generally difficult to guarantee that all other conditions are constant between any two trials. Therefore, the most common way to check for confounding violations of this assumption is to split the experimental conditions in terms of "trial types" to simulate a reduction of unintended trial-by-trial variation. Here, we pose a method which is more general than the use of trial types: use of mathematical models treating measures of potentially confounding factors and manipulated variables as equals on the single-trial level. We show how the method can be applied with models that subsume under the generalized linear item response theory (GLIRT), which is the case for most of the well-known psychometric models (Mellenbergh, 1994). As an example, we provide a new analysis of a single-letter recognition experiment using a nested likelihood ratio test that treats manipulated and measured variables equally (i.e., in exactly the same way) on the single-trial level. The test detects a confounding interaction with time-on-task as a single-trial measure and yields a substantially better estimate of the effect size of the main manipulation compared with an analysis made in terms of trial types.

  5. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... disease or prevent a disease from returning. Supportive Care Trials In supportive care trials, researchers look for ways to make life ... groups, and various types of social interventions. Supportive care interventions are not intended to treat or cure ...

  6. Comparability of prostate trials

    DEFF Research Database (Denmark)

    Suciu, S; Sylvester, R; Iversen, P

    1993-01-01

    The present overview of advanced prostate cancer required the identification of randomized clinical trials studying the question of maximal androgen blockade versus the classic castration therapy. The heterogeneity of the trials concerned the type of castration (surgical or chemical) and the type...

  7. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Trials Insurance Coverage and Clinical Trials How to Work With Your Health Insurance Plan Federal Government Programs Patient Safety Informed Consent Children's Assent Scientific Review Ending Trials Early Deciding to Take Part ...

  8. Fundamentals of clinical trials

    CERN Document Server

    Friedman, Lawrence M; DeMets, David L; Reboussin, David M; Granger, Christopher B

    2015-01-01

    This is the fifth edition of a very successful textbook on clinical trials methodology, written by recognized leaders who have long and extensive experience in all areas of clinical trials. The three authors of the first four editions have been joined by two others who add great expertise.  Most chapters have been revised considerably from the fourth edition.  A chapter on regulatory issues has been included and the chapter on data monitoring has been split into two and expanded.  Many contemporary clinical trial examples have been added.  There is much new material on adverse events, adherence, issues in analysis, electronic data, data sharing, and international trials.  This book is intended for the clinical researcher who is interested in designing a clinical trial and developing a protocol. It is also of value to researchers and practitioners who must critically evaluate the literature of published clinical trials and assess the merits of each trial and the implications for the care and treatment of ...

  9. Comparability of prostate trials

    DEFF Research Database (Denmark)

    Suciu, S; Sylvester, R; Iversen, P;

    1993-01-01

    The present overview of advanced prostate cancer required the identification of randomized clinical trials studying the question of maximal androgen blockade versus the classic castration therapy. The heterogeneity of the trials concerned the type of castration (surgical or chemical) and the type...... of antiandrogen (flutamide, Anandron, or cyproterone acetate) added to castration. This paper reviews the different types of heterogeneity that might exist among trials that are involved in the overview: study design, randomization procedure, treatment evaluation, statistical evaluation, and data maturity...... with a larger number of patients and a longer follow-up will contribute more to the overview's results....

  10. Inept media trials of clinical trials

    Directory of Open Access Journals (Sweden)

    N V Ramamurthy

    2012-01-01

    Full Text Available The Indian media in general, with the exception of a few domain expert journalists, have failed to comprehend the complexities involved in the clinical trial process. In the run up to the deadline-based coverage of a story, a majority of them fall short in conveying the right perspective to readers, but nevertheless they have been successful in sensationalizing an event in this arena. Possibly by unintended misrepresentation, or mostly out of ignorance of the nuances involved in the clinical trials process, the media has done more harm than good, and got away with it. On the other side, the industry has been reluctant to engage with the media in a meaningful dialog for too long now. It bears not only the consequences of damage to its professional reputation following such reportage, but also the repercussions of unnecessary clampdowns by the regulators. Science journalism in India has yet to rise as a profession.

  11. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... to obtain preliminary data on whether the drug works in people who have a certain disease or condition. These trials also continue to study safety, including short-term side effects. This phase ...

  12. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... out if an experimental drug, therapy, medical device, lifestyle change, or test will help treat, find, or ... specific medical problem. These trials find out if lifestyle changes, such as exercising more, getting more sleep, ...

  13. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... a disease. A clinical trial may compare experimental products or tests to those already available or may ... Institutes of Health | U.S. Department of Health & Human Services Customer Support | Accessibility | Copyright | Privacy | Viewers and Players

  14. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    Katz, J N; Losina, E; Lohmander, L S

    2015-01-01

    To highlight methodological challenges in the design and conduct of randomized trials of surgical interventions and to propose strategies for addressing these challenges. This paper focuses on three broad areas: enrollment; intervention; and assessment including implications for analysis. For eac...

  15. ClinicalTrials.gov

    Data.gov (United States)

    U.S. Department of Health & Human Services — Provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases...

  16. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... new tests that could identify a disease in its early stages. Usually, trial participants must show signs ... often healthy people (20 to 80), to judge its safety and side effects, and to find the ...

  17. TRIAL BY PREVIEW

    National Research Council Canada - National Science Library

    Bert I. Huang

    2013-01-01

    ...—that is, the judge or the jury who will be the finder of fact at trial. Both theory and policy have focused narrowly on previewing the evidence, while barely noticing the complementary effect of previewing the audience...

  18. Polyp Prevention Trial

    Science.gov (United States)

    The primary objective of the Polyp Prevention Trial (PPT) is to determine whether a low fat, high fiber, high vegetable and fruit eating plan will decrease the recurrence of adenomatous polyps of the large bowel.

  19. Anchor Trial Launch

    Science.gov (United States)

    NCI has launched a multicenter phase III clinical trial called the ANCHOR Study -- Anal Cancer HSIL (High-grade Squamous Intraepithelial Lesion) Outcomes Research Study -- to determine if treatment of HSIL in HIV-infected individuals can prevent anal canc

  20. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... experimental drug, therapy, medical device, lifestyle change, or test will help treat, find, or prevent a disease. A clinical trial may compare experimental products or tests to those already available or may compare existing ...

  1. Falsificationism and clinical trials.

    Science.gov (United States)

    Senn, S J

    1991-11-01

    The relevance of the philosophy of Sir Karl Popper to the planning, conduct and analysis of clinical trials is examined. It is shown that blinding and randomization can only be regarded as valuable for the purpose of refuting universal hypotheses. The purpose of inclusion criteria is also examined. It is concluded that a misplaced belief in induction is responsible for many false notions regarding clinical trials.

  2. Ethics and clinical trials.

    Science.gov (United States)

    Chassany, O; Duracinský, M

    1999-01-01

    The current reference guideline about ethics in clinical trials is the Declaration of Helsinki of human rights in medical research. Three major principles are emphasised: respect of the patient to accept or not to participate in a trial, the constraints and the presumed risks must be acceptable for patients included in a study, and vulnerable subjects should not participate in studies. The investigator is responsible for obtaining a free and well-informed consent from patients before their inclusion in a study. Where possible, a new drug should always first be compared to placebo in order to prove its superiority. Else, a small-sized trial comparing a new drug versus a reference treatment can lead to an erroneous conclusion of absence of difference. Moreover, good results or improvement are obtained in at least 30% of cases with placebo, whatever the disease. The use of placebo is unethical in life-threatening diseases and when an effective proved drug exists. The use of placebo is ethical in severe diseases with no efficient drug, in some severe diseases even when an active reference treatment is available, and in all moderate and functional diseases. In order to detect flawed studies, most journals now ask for any manuscript submitted and reporting results of a randomised clinical trial to join a checklist in order to verify the quality of the trial. Finally, it remains the responsibility of the doctor to decide whether or not a protocol is ethical, to participate or not and to include patients or not.

  3. The FOCUS trial

    DEFF Research Database (Denmark)

    Glenthøj, Louise B; Fagerlund, Birgitte; Randers, Lasse

    2015-01-01

    trial enrolling 126 patients meeting the standardised criteria of being at UHR for psychosis. Patients are recruited from psychiatric in- and outpatient facilities in the Copenhagen catchment area. Patients are randomised to one of the two treatment arms: cognitive remediation plus standard treatment...... functioning, psychosis-like symptoms, negative symptomatology, and depressive symptomatology as measured with the Personal and Social Performance Scale, Brief Psychiatric Rating Scale-Expanded Version, Scale for the Assessment of Negative Symptoms, and the Montgomery-Åsberg Depression Rating Scale. DISCUSSION......: This is the first trial to evaluate the effects of neurocognitive and social cognitive remediation in UHR patients. The FOCUS trial results will provide evidence on the effect of targeted and comprehensive cognitive rehabilitation on cognition, daily living, and symptomatology as well as long-term outcome...

  4. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    Kraus, V B; Blanco, F J; Englund, M

    2015-01-01

    The objective of this work was to describe requirements for inclusion of soluble biomarkers in osteoarthritis (OA) clinical trials and progress toward OA-related biomarker qualification. The Guidelines for Biomarkers Working Group, representing experts in the field of OA biomarker research from...... of reasons but in particular, to determine whether biomarkers are useful in identifying those individuals most likely to receive clinically important benefits from an intervention; and to determine whether biomarkers are useful for identifying individuals at earlier stages of OA in order to institute...... both academia and industry, convened to discuss issues related to soluble biomarkers and to make recommendations for their use in OA clinical trials based on current knowledge and anticipated benefits. This document summarizes current guidance on use of biomarkers in OA clinical trials...

  5. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    McAlindon, T. E.; Driban, J. B.; Henrotin, Y.;

    2015-01-01

    The goal of this document is to update the original OARSI recommendations specifically for the design, conduct, and reporting of clinical trials that target symptom or structure modification among individuals with knee osteoarthritis (OA). To develop recommendations for the design, conduct...... and index knee, describing interventions, patient-reported and physical performance measures, structural outcome measures, biochemical biomarkers, and reporting recommendations. In summary, the working group identified 25 recommendations that represent the current best practices regarding clinical trials...... that target symptom or structure modification among individuals with knee OA. These updated recommendations incorporate novel technologies (e.g., magnetic resonance imaging (MRI)) and strategies to address the heterogeneity of knee OA....

  6. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    Emery, C. A.; Roos, Ewa M.; Verhagen, E.;

    2015-01-01

    The risk of post-traumatic osteoarthritis (PTOA) substantially increases following joint injury. Research efforts should focus on investigating the efficacy of preventative strategies in high quality randomized controlled trials (RCT). The objective of these OARSI RCT recommendations is to inform...

  7. Participating in Clinical Trials

    Medline Plus

    Full Text Available skip navigation Help Search home health topics A-Z Videos A-Z about us Customer Support NIH SeniorHealth Built with You in Mind Resize Text: A A A Change Contrast print sign up Share Home > Health topics A-Z > Participating in Clinical Trials: About ...

  8. Hepatitis C: Clinical Trials

    Science.gov (United States)

    ... will not know if you are taking the medicine or the placebo until the clinical trial is over. How do ... can already get by prescription ) or sugar pills ( placebos ) with the new medicine may last longer than Phases I and II ...

  9. The CYTONOX trial

    DEFF Research Database (Denmark)

    Gade, Christina; Mikus, Gerd; Christensen, Hanne Rolighed

    2016-01-01

    will be defined by using well-tested probes; midazolam, chlorzoxazone and caffeine. Each of the probes will be administered as a single dose. Subsequently, blood and urine samples will be collected at pre-specified times. CONCLUSION: The aim of the CYTONOX trial is to investigate the in vivo activity of CYP3A4...

  10. Clinical Trial Basics

    Science.gov (United States)

    ... How Am I Protected? Mark Bowden / iStock Ethical guidelines The goal of clinical research is to develop knowledge that improves human ... data and decide whether the results have medical importance. Results from clinical trials are often published in peer-reviewed scientific ...

  11. Clinical Research and Clinical Trials

    Science.gov (United States)

    ... NICHD Publications Data Sharing and Other Resources Research Clinical Trials & Clinical Research Skip sharing on social media links ... health care providers, and researchers. Find NICHD-Supported Clinical Trials Use this link to find a list of ...

  12. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Trials Information A to Z List of Cancer Drugs Complementary & Alternative Medicine (CAM) Questions to Ask about ... Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer Adjusting to ...

  13. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Unusual Cancers of Childhood Treatment Childhood Cancer Genomics Study Findings Metastatic Cancer Metastatic Cancer Research Common Cancer ... Trials Insurance Coverage and Clinical Trials How to Work With Your Health Insurance Plan Federal Government Programs ...

  14. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Trials Information A to Z List of Cancer Drugs Complementary & Alternative Medicine (CAM) Questions to Ask about ... Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer Adjusting to ...

  15. The Trial of Katherine Harrison.

    Science.gov (United States)

    Woodward, Walter W.

    2003-01-01

    Presents a lesson plan in which the teacher and students participate in a mock trial of Katherine Harrison, who was accused of witchcraft in the seventeenth century. Provides background information about the trial, as well as primary sources of the testimonies given by witnesses during the trial. (CMK)

  16. The Trial of Katherine Harrison.

    Science.gov (United States)

    Woodward, Walter W.

    2003-01-01

    Presents a lesson plan in which the teacher and students participate in a mock trial of Katherine Harrison, who was accused of witchcraft in the seventeenth century. Provides background information about the trial, as well as primary sources of the testimonies given by witnesses during the trial. (CMK)

  17. A guide to clinical trials for cancer

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000823.htm A guide to clinical trials for cancer To use ... trial and where to find one. What is a Clinical Trial for Cancer? Clinical trials for cancer ...

  18. Opioid analgesics-related pharmacokinetic drug interactions: from the perspectives of evidence based on randomized controlled trials and clinical risk management

    Science.gov (United States)

    Feng, Xiu-qin; Zhu, Ling-ling; Zhou, Quan

    2017-01-01

    Background Multimorbidity results in complex polypharmacy which may bear a risk of drug interactions. A better understanding of opioid analgesics combination therapy used for pain management could help warrant medication safety, efficacy, and economic relevance. Until now there has been no review summarizing the opioid analgesics-related pharmacokinetic drug interactions from the perspective of evidence based on randomized controlled trials (RCTs). Method A literature search was performed using PubMed, MEDLINE, and the Cochrane Library, using a PRISMA flowchart. Results Fifty-two RCTs were included for data interpretation. Forty-two RCTs (80.8%) were conducted in healthy volunteers, whereas 10 RCTs (19.2%) enrolled true patients. None of the opioid–drug/herb pairs was listed as contraindications of opioids involved in this review. Circumstances in which opioid is comedicated as a precipitant drug include morphine–P2Y12 inhibitors, morphine–gabapentin, and methadone–zidovudine. Circumstances in which opioid is comedicated as an object drug include rifampin–opioids (morphine, tramadol, oxycodone, methadone), quinidine–opioids (morphine, fentanyl, oxycodone, codeine, dihydrocodeine, methadone), antimycotics–opioids (buprenorphine, fentanyl, morphine, oxycodone, methadone, tilidine, tramadol), protease inhibitors–opioids (ritonavir, ritonavir/lopinavir–oxycodone, ritonavir–fentanyl, ritonavir–tilidine), grapefruit juice–opioids (oxycodone, fentanyl, methadone), antidepressants–opioids (paroxetine–tramadol, paroxetine–hydrocodone, paroxetine–oxycodone, escitalopram–tramadol), metoclopramide–morphine, amantadine–morphine, sumatriptan–butorphanol nasal sprays, ticlopidine–tramadol, St John’s wort–oxycodone, macrolides/ketolides–oxycodone, and levomepromazine–codeine. RCTs investigating the same combination, almost unanimously, drew consistent conclusions, except two RCTs on amantadine–intravenous morphine combination

  19. Opioid analgesics-related pharmacokinetic drug interactions: from the perspectives of evidence based on randomized controlled trials and clinical risk management.

    Science.gov (United States)

    Feng, Xiu-Qin; Zhu, Ling-Ling; Zhou, Quan

    2017-01-01

    Multimorbidity results in complex polypharmacy which may bear a risk of drug interactions. A better understanding of opioid analgesics combination therapy used for pain management could help warrant medication safety, efficacy, and economic relevance. Until now there has been no review summarizing the opioid analgesics-related pharmacokinetic drug interactions from the perspective of evidence based on randomized controlled trials (RCTs). A literature search was performed using PubMed, MEDLINE, and the Cochrane Library, using a PRISMA flowchart. Fifty-two RCTs were included for data interpretation. Forty-two RCTs (80.8%) were conducted in healthy volunteers, whereas 10 RCTs (19.2%) enrolled true patients. None of the opioid-drug/herb pairs was listed as contraindications of opioids involved in this review. Circumstances in which opioid is comedicated as a precipitant drug include morphine-P2Y12 inhibitors, morphine-gabapentin, and methadone-zidovudine. Circumstances in which opioid is comedicated as an object drug include rifampin-opioids (morphine, tramadol, oxycodone, methadone), quinidine-opioids (morphine, fentanyl, oxycodone, codeine, dihydrocodeine, methadone), antimycotics-opioids (buprenorphine, fentanyl, morphine, oxycodone, methadone, tilidine, tramadol), protease inhibitors-opioids (ritonavir, ritonavir/lopinavir-oxycodone, ritonavir-fentanyl, ritonavir-tilidine), grapefruit juice-opioids (oxycodone, fentanyl, methadone), antidepressants-opioids (paroxetine-tramadol, paroxetine-hydrocodone, paroxetine-oxycodone, escitalopram-tramadol), metoclopramide-morphine, amantadine-morphine, sumatriptan-butorphanol nasal sprays, ticlopidine-tramadol, St John's wort-oxycodone, macrolides/ketolides-oxycodone, and levomepromazine-codeine. RCTs investigating the same combination, almost unanimously, drew consistent conclusions, except two RCTs on amantadine-intravenous morphine combination where a different amantadine dose was used and two RCTs on morphine-ticagrelor

  20. SMi's Conducting Clinical Trials in Europe.

    Science.gov (United States)

    Jago, Charlotte

    2009-12-01

    The Conducting Clinical Trials in Europe meeting, held in London, included topics covering new developments in the field of clinical trials and recommendations on how to best conduct a trial. This conference report highlights selected presentations on the state of affairs of trials in Europe, conducting trials in emerging markets, strategies for improving trials, trial design options, peri-approval and pediatric trials, and the role of key players, such as physicians. Company perspectives from Pfizer Inc and Nycomed are also included.

  1. The CHANGE trial

    DEFF Research Database (Denmark)

    Speyer, Helene; Christian Brix Nørgaard, Hans; Birk, Merete

    2016-01-01

    Life expectancy in patients with schizophrenia is reduced by 20 years for men and 15 years for women compared to the general population. About 60% of the excess mortality is due to physical illnesses, with cardiovascular disease being dominant. CHANGE was a randomized, parallel-group, superiority......, multi-centre trial with blinded outcome assessment, testing the efficacy of an intervention aimed to improve cardiovascular risk profile and hereby potentially reduce mortality. A total of 428 patients with schizophrenia spectrum disorders and abdominal obesity were recruited and centrally randomized 1...... cardiorespiratory fitness, physical activity, weight, diet and smoking. In conclusion, the CHANGE trial did not support superiority of individual lifestyle coaching or care coordination compared to treatment as usual in reducing cardiovascular risk in patients with schizophrenia spectrum disorders and abdominal...

  2. Gateways to clinical trials.

    Science.gov (United States)

    Bayés, M; Rabasseda, X; Prous, J R

    2007-01-01

    Gateways to Clinical Trials are a guide to the most recent clinical trials in current literature and congresses. The data the following tables have been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issues focuses on the following selection of drugs: 4'-Thio-ara-C, 5-methyltetrahydrofolate; ABT-089, AD-237, AF-37702, alvocidib hydrochloride, apricitabine, armodafinil, atrasentan, AVE-5883, avian influenza vaccine, azimilide hydrochloride; Banoxantrone, BIBF-1120; CD34+ cells, certolizumab pegol, CHIR-258, cilansetron, CoFactor, CX-3543, cystemustine; D-003, dexloxiglumide, DMXB-anabaseine; Ecogramostim, elcometrine, elcometrine/ethinylestradiol, etravirine; Fenretinide, fingolimod hydrochloride, fospropofol disodium; Gaboxadol, gestodene, glutamine; Human insulin, hyaluronic acid; Incyclinide, indacaterol, ispronicline, istradefylline; Labradimil, lamifiban, lapatinib, L-arginine hydrochloride, liposomal cisplatin, liposome encapsulated paclitaxel, LY-517717; Manidipine hydrochloride/delapril hydrochloride, maraviroc, MBP(82-98), MD-0727, MDX-214, melanotan I, MMR vaccine; Nacystelyn, nalfurafine hydrochloride, nibentan, nilotinib, NK-105; OBI-1, oblimersen sodium, olmesartan medoxomil, olmesartan medoxomil/hydrochlorothiazide, oregovomab; Pexelizumab, PG-116800, PG-CPT, PHA-794428, prasugrel; RC-3095, rDNA insulin, RFB4(dsFv)-PE38, rhEndostatin, rhenium Re-186 etidronate, rhGM-CSF, roflumilast, romidepsin; Sarcosine, SGLU1, SGN-40, succinobucol; TAU, teduglutide, telatinib, tesofensine, tipifarnib, tirapazamine, TKA-731, tolvaptan, trabectedin; Vaccimel, vatalanib succinate, velafermin, vildagliptin, vinflunine; XP-19986; YM-155.

  3. Gateways to clinical trials.

    Science.gov (United States)

    Bayés, M; Rabasseda, X; Prous, J R

    2005-04-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity. prous.com. This issue focuses on the following selection of drugs: ABX-IL-8, Acclaim, adalimumab, AGI-1067, alagebrium chloride, alemtuzumab, Alequel, Androgel, anti-IL-12 MAb, AOD-9604, aripiprazole, atomoxetine hydrochloride; Biphasic insulin aspart, bosentan, botulinum toxin type B, bovine lactoferrin, brivudine; Cantuzumab mertansine, CB-1954, CDB-4124, CEA-TRICOM, choriogonadotropin alfa, cilansetron, CpG-10101, CpG-7909, CTL-102, CTL-102/CB-1954; DAC:GRF, darbepoetin alfa, davanat-1, decitabine, del-1 Genemedicine, dexanabinol, dextofisopam, dnaJP1, dronedarone hydrochloride, dutasteride; Ecogramostim, eletriptan, emtricitabine, EPI-hNE-4, eplerenone, eplivanserin fumarate, erlotinib hydrochloride, ertapenem sodium, escitalopram oxalate, esomeprazole magnesium, etoricoxib, ezetimibe; Falecalcitriol, fingolimod hydrochloride; Gepirone hydrochloride; HBV-ISS, HSV-2 theracine, human insulin; Imatinib mesylate, Indiplon, insulin glargine, ISAtx-247; L612 HuMAb, levodopa/carbidopa/entacapone, lidocaine/prilocaine, LL-2113AD, lucinactant, LY-156735; Meclinertant, metelimumab, morphine hydrochloride, morphine-6-glucuronide; Natalizumab, nimotuzumab, NX-1207, NYVAC-HIV C; Omalizumab, onercept, osanetant; PABA, palosuran sulfate, parathyroid hormone (human recombinant), parecoxib sodium, PBI-1402, PCK-3145, peginterferon alfa-2a, peginterferon alfa-2b, peginterferon alfa-2b/ribavirin, pemetrexed disodium, pimecrolimus, PINC, pregabalin; Ramelteon, rasagiline mesilate, rasburicase, rimonabant hydrochloride, RO-0098557, rofecoxib, rosiglitazone maleate/metformin hydrochloride; Safinamide mesilate, SHL-749, sitaxsentan sodium, sparfosic acid, SprayGel, squalamine, St. John's Wort

  4. The ONTARGET trial programme

    DEFF Research Database (Denmark)

    Unger, Thomas; Kintscher, Ulrich; Kappert, Kai;

    2009-01-01

    The ONTARGET trial programme tested the effects of the angiotensin AT1 receptor blocker (ARB), telmisartan, alone or in combination with the angiotensin converting enzyme (ACE) inhibitor, ramipril, in more than 25.000 patients at high cardiovascular risk including diabetes on a combined endpoint ....... Telmisartan thus proved to be the first and so far the only representative of the ARB class that can be used as an alternative to the "gold standard" ACE-inhibitor, ramipril, in patients at high cardiovascular risk with or without hypertension. © 2009 Bentham Science Publishers Ltd....

  5. [Critical reading of clinical trials].

    Science.gov (United States)

    Aptel, F; Cucherat, M; Blumen-Ohana, E; Denis, P

    2011-12-01

    Clinical trials are playing an increasingly crucial role in modern evidence based medicine, allowing for rigorous scientific evaluation of treatment strategies and validation of patient care. The results of clinical trials often form the rational basis from which physicians draw information used to adapt their therapeutic practices. Critical reading and analysis of trials involves the assessment of whether the available data provide enough credible evidence that the treatment will result in a clinically significant and relevant improvement. Evaluating the quality of a clinical trial is a process that draws upon sometimes complex methodological and statistical concepts, with which the reader should nonetheless be familiar in order to come to impartial conclusions regarding the raw data presented in the clinical trials. The goal of the current article is to review the methodological and statistical concepts required for the design and interpretation of clinical trials, so as to allow for a critical analysis of publications or presentations of clinical trials. The first section describes the major methodological principles of clinical trial design required for a rigorous evaluation of the treatment benefit, as well as the various pitfalls or biases that could lead to erroneous conclusions. The second section briefly describes the main statistical tests used in clinical trials, as well as certain situations that may increase the risk of false positive findings (type 1 error), such as multiple, subgroup, intermediate and non-inferiority analysis. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  6. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Phases of Clinical Trials Cancer Treatment Types of Cancer Treatment Surgery Radiation Therapy Chemotherapy Immunotherapy Targeted Therapy Hormone Therapy Stem Cell Transplant Precision ...

  7. Randomised clinical trial

    DEFF Research Database (Denmark)

    Reimer, C; Lødrup, A B; Smith, G;

    2016-01-01

    BACKGROUND: Many reflux patients remain symptomatic on a standard dose of proton pump inhibitor (PPI). Alginates decrease the number of reflux events by forming a raft on top of the stomach content and thus offer a supplemental mechanism of action to acid suppression. AIM: To assess the efficacy...... of an alginate (Gaviscon Advance, Reckitt Benckiser, Slough, UK) on reflux symptoms in patients with persistent symptoms despite once daily PPI. METHODS: This was a multicentre, randomised, placebo-controlled, 7-day double-blind trial preceded by a 7-day run-in period. Reflux symptoms were assessed using......: In patients with residual reflux symptoms despite PPI treatment, adding an alginate offers additional decrease in the burden of reflux symptoms (EudraCT/IND Number: 2011-005486-21)....

  8. Trial encoding algorithms ensemble.

    Science.gov (United States)

    Cheng, Lipin Bill; Yeh, Ren Jye

    2013-01-01

    This paper proposes trial algorithms for some basic components in cryptography and lossless bit compression. The symmetric encryption is accomplished by mixing up randomizations and scrambling with hashing of the key playing an essential role. The digital signature is adapted from the Hill cipher with the verification key matrices incorporating un-invertible parts to hide the signature matrix. The hash is a straight running summation (addition chain) of data bytes plus some randomization. One simplified version can be burst error correcting code. The lossless bit compressor is the Shannon-Fano coding that is less optimal than the later Huffman and Arithmetic coding, but can be conveniently implemented without the use of a tree structure and improvable with bytes concatenation.

  9. The CYTONOX trial

    DEFF Research Database (Denmark)

    Gade, Christina; Mikus, Gerd; Christensen, Hanne Rolighed;

    2016-01-01

    INTRODUCTION: In Denmark, it is estimated that 3-5% of children are obese. Obesity is associated with pathophysiological alterations that may lead to alterations in the pharmacokinetics of drugs. In adults, obesity was found to influence important drug-metabolising enzyme pathways. The impact......, CYP2E1 and CYP1A2 in obese and non-obese children. The results are expected to be used in the future as a basis for drug dosing recommendations in obese children. FUNDING: The study was funded by the Danish Regions' "Medicinpuljen". The funder had no role in study design, data collection and analysis...... of obesity-related alterations on drug metabolism and its consequences for drug dosing remains largely unknown in both children and adults. An altered drug metabolism may contribute significantly to therapeutic failure or toxicity. The aim of this trial is to investigate the in vivo activity of CYP3A4, CYP2E...

  10. Defendants' Rights in Criminal Trials.

    Science.gov (United States)

    Martin, Ralph C., II; Keeley, Elizabeth

    1997-01-01

    Reviews the protections afforded by the Constitution for defendants in criminal trials. These include the right to a jury trial (in cases of possible incarceration), an impartial jury, and the requirement of a unanimous verdict. Defends the use of plea bargaining as essential to an efficient criminal justice system. (MJP)

  11. LTDNA Evidence on Trial

    Science.gov (United States)

    Roberts, Paul

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materiality; and (5) legal admissibility. This generic model of expert authority, highlighting law's fundamentally normative character, applies to all modern forms of criminal adjudication, across Europe and farther afield. The section titled LTDNA Evidence in UK Criminal Trials then examines English and Northern Irish courts' attempts to get to grips with LTDNA evidence in recent cases. Better appreciating the ways in which UK courts have addressed the challenges of LTDNA evidence may offer some insights into parallel developments in other legal systems. Appellate court rulings follow a predictable judicial logic, which might usefully be studied and reflected upon by any forensic scientist or statistician seeking to operate effectively in criminal proceedings. Whilst each legal jurisdiction has its own unique blend of jurisprudence, institutions, cultures and historical traditions, there is considerable scope for comparative analysis and cross-jurisdictional borrowing and instruction. In the spirit of promoting more nuanced and sophisticated international interdisciplinary dialogue, this article examines UK judicial approaches to LTDNA evidence and begins to elucidate their underlying institutional logic. Legal argument and broader policy debates are not confined to considerations of scientific validity, contamination risks and evidential integrity, or associated judgments of legal admissibility or exclusion. They also crucially

  12. Clinical Trials | Division of Cancer Prevention

    Science.gov (United States)

    Information about actively enrolling, ongoing, and completed clinical trials of cancer prevention, early detection, and supportive care, including phase I, II, and III agent and action trials and clinical trials management. |

  13. HIV/AIDS Clinical Trials Fact Sheet

    Science.gov (United States)

    ... and effective in people. What is an HIV/AIDS clinical trial? HIV/AIDS clinical trials help researchers ... to HIV Can anyone participate in an HIV/AIDS clinical trial? It depends on the study. Some ...

  14. Frailty Intervention Trial (FIT

    Directory of Open Access Journals (Sweden)

    Lockwood Keri

    2008-10-01

    Full Text Available Abstract Background Frailty is a term commonly used to describe the condition of an older person who has chronic health problems, has lost functional abilities and is likely to deteriorate further. However, despite its common use, only a small number of studies have attempted to define the syndrome of frailty and measure its prevalence. The criteria Fried and colleagues used to define the frailty syndrome will be used in this study (i.e. weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity. Previous studies have shown that clinical outcomes for frail older people can be improved using multi-factorial interventions such as comprehensive geriatric assessment, and single interventions such as exercise programs or nutritional supplementation, but no interventions have been developed to specifically reverse the syndrome of frailty. We have developed a multidisciplinary intervention that specifically targets frailty as defined by Fried et al. We aim to establish the effects of this intervention on frailty, mobility, hospitalisation and institutionalisation in frail older people. Methods and Design A single centre randomised controlled trial comparing a multidisciplinary intervention with usual care. The intervention will target identified characteristics of frailty, functional limitations, nutritional status, falls risk, psychological issues and management of chronic health conditions. Two hundred and thirty people aged 70 and over who meet the Fried definition of frailty will be recruited from clients of the aged care service of a metropolitan hospital. Participants will be followed for a 12-month period. Discussion This research is an important step in the examination of specifically targeted frailty interventions. This project will assess whether an intervention specifically targeting frailty can be implemented, and whether it is effective when compared to usual care. If successful, the study will establish a

  15. Social media in clinical trials.

    Science.gov (United States)

    Thompson, Michael A

    2014-01-01

    Social media has potential in clinical trials for pointing out trial issues, addressing barriers, educating, and engaging multiple groups involved in cancer clinical research. Social media is being used in clinical trials to highlight issues such as poor accrual and barriers; educate potential participants and physicians about clinical trial options; and is a potential indirect or direct method to improve accrual. We are moving from a passive "push" of information to patients to a "pull" of patients requesting information. Patients and advocates are often driving an otherwise reluctant health care system into communication. Online patient communities are creating new information repositories. Potential clinical trial participants are using the Twittersphere and other sources to learn about potential clinical trial options. We are seeing more organized patient-centric and patient-engaged forums with the potential to crowd source to improve clinical trial accrual and design. This is an evolving process that will meet many individual, institutional, and regulatory obstacles as we move forward in a changed research landscape.

  16. Acute Stroke | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available n(s) being investigated Acute Stroke MedDRA Classification E.1.3Condition being s... General Information on the Trial E.1 Medical condition or disease under investigation E.1.1Medical conditio

  17. Trial analytics--a tool for clinical trial management.

    Science.gov (United States)

    Bose, Anindya; Das, Suman

    2012-01-01

    Prolonged timelines and large expenses associated with clinical trials have prompted a new focus on improving the operational efficiency of clinical trials by use of Clinical Trial Management Systems (CTMS) in order to improve managerial control in trial conduct. However, current CTMS systems are not able to meet the expectations due to various shortcomings like inability of timely reporting and trend visualization within/beyond an organization. To overcome these shortcomings of CTMS, clinical researchers can apply a business intelligence (BI) framework to create Clinical Research Intelligence (CLRI) for optimization of data collection and analytics. This paper proposes the usage of an innovative and collaborative visualization tool (CTA) as CTMS "add-on" to help overwhelm these deficiencies of traditional CTMS, with suitable examples.

  18. Designing clinical trials for amblyopia.

    Science.gov (United States)

    Holmes, Jonathan M

    2015-09-01

    Randomized clinical trial (RCT) study design leads to one of the highest levels of evidence, and is a preferred study design over cohort studies, because randomization reduces bias and maximizes the chance that even unknown confounding factors will be balanced between treatment groups. Recent randomized clinical trials and observational studies in amblyopia can be taken together to formulate an evidence-based approach to amblyopia treatment, which is presented in this review. When designing future clinical studies of amblyopia treatment, issues such as regression to the mean, sample size and trial duration must be considered, since each may impact study results and conclusions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Data fraud in clinical trials

    Science.gov (United States)

    George, Stephen L; Buyse, Marc

    2015-01-01

    Highly publicized cases of fabrication or falsification of data in clinical trials have occurred in recent years and it is likely that there are additional undetected or unreported cases. We review the available evidence on the incidence of data fraud in clinical trials, describe several prominent cases, present information on motivation and contributing factors and discuss cost-effective ways of early detection of data fraud as part of routine central statistical monitoring of data quality. Adoption of these clinical trial monitoring procedures can identify potential data fraud not detected by conventional on-site monitoring and can improve overall data quality. PMID:25729561

  20. Bayes' postulate for trinomial trials

    Science.gov (United States)

    Diniz, M. A.; Polpo, A.

    2012-10-01

    In this paper, we discuss Bayes' postulate and its interpretation. We extend the binomial trial method proposed by de Finetti [1] to trinomial trials, for which we argue that the consideration of equiprobability a priori for the possible outcomes of the trinomial trials implies that the parameter vector has Dirichlet(1,1) as prior. Based on this result, we agree with Stigler [2] in that the notion in Bayes' postulate stating "absolutely know nothing" is related to the possible outcomes of an experiment and not to "non-information" about the parameter.

  1. Registration of randomized clinical trials

    DEFF Research Database (Denmark)

    Østervig, R M; Sonne, A; Rasmussen, L S

    2015-01-01

    BACKGROUND: Registration of interventional studies is necessary according to the Declaration of Helsinki but implementation has been a challenge for many journals. Acta Anaesthesiologica Scandinavica (Acta) requires registration for studies conducted after January 1(st) 2010. We aimed to assess...... registered when it could be verified that patient enrolment was started after registration in a trial registry. RESULTS: We identified 200 RCTs. Dates for patient enrolment were not specified in 51 (25.5%). The proportion of correctly registered trials increased significantly from 17.1% (19/111) for trials...

  2. The Dynamo Clinical Trial

    Science.gov (United States)

    Ayres, Thomas R.

    2016-04-01

    The Dynamo Clinical Trial evaluates long-term stellar magnetic health through periodic X-ray examinations (by the Chandra Observatory). So far, there are only three subjects enrolled in the DTC: Alpha Centauri A (a solar-like G dwarf), Alpha Cen B (an early K dwarf, more active than the Sun), and Alpha Canis Majoris A (Procyon, a mid-F subgiant similar in activity to the Sun). Of these, Procyon is a new candidate, so it is too early to judge how it will fare. Of the other two, Alpha Cen B has responded well, with a steady magnetic heartbeat of about 8 years duration. The sickest of the bunch, Alpha Cen A, was in magnetic cardiac arrest during 2005-2010, but has begun responding to treatment in recent years, and seems to be successfully cycling again, perhaps achieving a new peak of magnetic health in the 2016 time frame. If this is the case, it has been 20 years since A's last healthful peak, significantly longer than the middle-aged Sun's 11-year magnetic heartbeat, but perhaps in line with Alpha Cen A's more senescent state (in terms of "relative evolutionary age," apparently an important driver of activity). (By the way, don't miss the exciting movie of the Alpha Cen stars' 20-year X-ray dance.)

  3. GAUSS Project Trials Results

    Science.gov (United States)

    Di Fazio, Antonella; Vernucci, Antonio; Rossini, Eugenio

    2003-07-01

    the Consortium Partners. The former ones constitute the ground and space segments, the latter ones include the advanced user terminal and the applications. The assembled system was used as test-bed during the trail campaign, to validate and prove the provided services and developed applications.The GAUSS Demonstrator includes the following components:ß The Mobile User Terminal installed on a car (van) or on a boat. An innovative multi-mode user equipment was developed, consisting of the following main components:- An integrated NAV / COM digital receive front-end (DFRE), able to de-multiplex the NAV signals (the current GNSS1 band and the simulated Galileo bands), and the COM signal in the S-UMTS band;- For COM: a transmit front-end, and a baseband & control section operating in CDMA and supporting the upper protocol layers (UMTS packet transmission standard based - for short packet); a RF subsystem, including the L→S bands conversion;- For NAV: a GNSS (GPS, EGNOS) navigation receiver, the GNSS1 System (MTB - Mediterranean Test bed, ESTB / EGNOS System Test Bed) for navigation;* The Communication capacity on the INMARSAT 3F5 Satellite* The Gateway, located in LARIO Telespazio premises* The Lario07 Station* The Service Centre* The Service Provider.The GAUSS Demonstrator reflects all the main elements of a complete user platform for service provisioning: mobility assistance, safety and transport efficient management are the core of the developed applications. Applications were developed, specifically to provide reliable and effective services to the citizens: road info-mobility and fleet management, inland waterways vessel traffic management and information, port/terminals appointment monitoring & control, dangerous goods transhipment supervision, emergency assistance.A trial campaign, run into real environments, was performed in Summer 2002. GAUSS Demonstrator performances and benefits were validated with the direct involvement of an inter-modal transport user

  4. Modelling trial-by-trial changes in the mismatch negativity.

    Directory of Open Access Journals (Sweden)

    Falk Lieder

    Full Text Available The mismatch negativity (MMN is a differential brain response to violations of learned regularities. It has been used to demonstrate that the brain learns the statistical structure of its environment and predicts future sensory inputs. However, the algorithmic nature of these computations and the underlying neurobiological implementation remain controversial. This article introduces a mathematical framework with which competing ideas about the computational quantities indexed by MMN responses can be formalized and tested against single-trial EEG data. This framework was applied to five major theories of the MMN, comparing their ability to explain trial-by-trial changes in MMN amplitude. Three of these theories (predictive coding, model adjustment, and novelty detection were formalized by linking the MMN to different manifestations of the same computational mechanism: approximate Bayesian inference according to the free-energy principle. We thereby propose a unifying view on three distinct theories of the MMN. The relative plausibility of each theory was assessed against empirical single-trial MMN amplitudes acquired from eight healthy volunteers in a roving oddball experiment. Models based on the free-energy principle provided more plausible explanations of trial-by-trial changes in MMN amplitude than models representing the two more traditional theories (change detection and adaptation. Our results suggest that the MMN reflects approximate Bayesian learning of sensory regularities, and that the MMN-generating process adjusts a probabilistic model of the environment according to prediction errors.

  5. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Contacts Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training ...

  6. National Lung Screening Trial (NLST)

    Science.gov (United States)

    The National Lung Screening Trial (NLST), a research study sponsored by the National Cancer Institute that used low-dose helical CT scans or chest X-ray to screen men and women at risk for lung cancer.

  7. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Cancer Research and Discovery Stories of Discovery R&D Resources Conducting Clinical Trials Statistical Tools and Data ... about some of NCI's major research initiatives R&D Resources Tools and data sets for researchers Research ...

  8. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Lung Cancer Lymphoma Pancreatic Cancer ... Therapy Chemotherapy Immunotherapy Targeted Therapy Hormone Therapy Stem Cell Transplant Precision Medicine Side Effects Clinical Trials Information ...

  9. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Report (RPPR) Grant Closeout Grant Resources NCI Grants Management Legal Requirements NCI Grant Policies Grants Management Contacts ...

  10. What Are Clinical Trial Phases?

    Science.gov (United States)

    ... Resources Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Report (RPPR) Grant Closeout Grant Resources NCI Grants Management Legal Requirements NCI Grant Policies Grants Management Contacts ...

  11. Frailty Intervention Trial (FIT).

    Science.gov (United States)

    Fairhall, Nicola; Aggar, Christina; Kurrle, Susan E; Sherrington, Catherine; Lord, Stephen; Lockwood, Keri; Monaghan, Noeline; Cameron, Ian D

    2008-10-13

    Frailty is a term commonly used to describe the condition of an older person who has chronic health problems, has lost functional abilities and is likely to deteriorate further. However, despite its common use, only a small number of studies have attempted to define the syndrome of frailty and measure its prevalence. The criteria Fried and colleagues used to define the frailty syndrome will be used in this study (i.e. weight loss, fatigue, decreased grip strength, slow gait speed, and low physical activity). Previous studies have shown that clinical outcomes for frail older people can be improved using multi-factorial interventions such as comprehensive geriatric assessment, and single interventions such as exercise programs or nutritional supplementation, but no interventions have been developed to specifically reverse the syndrome of frailty.We have developed a multidisciplinary intervention that specifically targets frailty as defined by Fried et al. We aim to establish the effects of this intervention on frailty, mobility, hospitalisation and institutionalisation in frail older people. A single centre randomised controlled trial comparing a multidisciplinary intervention with usual care. The intervention will target identified characteristics of frailty, functional limitations, nutritional status, falls risk, psychological issues and management of chronic health conditions. Two hundred and thirty people aged 70 and over who meet the Fried definition of frailty will be recruited from clients of the aged care service of a metropolitan hospital. Participants will be followed for a 12-month period. This research is an important step in the examination of specifically targeted frailty interventions. This project will assess whether an intervention specifically targeting frailty can be implemented, and whether it is effective when compared to usual care. If successful, the study will establish a new approach to the treatment of older people at risk of further

  12. LTDNA Evidence on Trial

    Directory of Open Access Journals (Sweden)

    Paul Roberts

    2016-10-01

    factfinders in criminal trials.

  13. Birth Control in Clinical Trials

    Science.gov (United States)

    Stewart, J.; Beyer, B. K.; Chadwick, K.; De Schaepdrijver, L.; Desai, M.; Enright, B.; Foster, W.; Hui, J. Y.; Moffat, G. J.; Tornesi, B.; Van Malderen, K.; Wiesner, L.; Chen, C. L.

    2015-01-01

    The Health and Environmental Sciences Institute (HESI) Developmental and Reproductive Toxicology Technical Committee sponsored a pharmaceutical industry survey on current industry practices for contraception use during clinical trials. The objectives of the survey were to improve our understanding of the current industry practices for contraception requirements in clinical trials, the governance processes set up to promote consistency and/or compliance with contraception requirements, and the effectiveness of current contraception practices in preventing pregnancies during clinical trials. Opportunities for improvements in current practices were also considered. The survey results from 12 pharmaceutical companies identified significant variability among companies with regard to contraception practices and governance during clinical trials. This variability was due primarily to differences in definitions, areas of scientific uncertainty or misunderstanding, and differences in company approaches to enrollment in clinical trials. The survey also revealed that few companies collected data in a manner that would allow a retrospective understanding of the reasons for failure of birth control during clinical trials. In this article, suggestions are made for topics where regulatory guidance or scientific publications could facilitate best practice. These include provisions for a pragmatic definition of women of childbearing potential, guidance on how animal data can influence the requirements for male and female birth control, evidence-based guidance on birth control and pregnancy testing regimes suitable for low- and high-risk situations, plus practical methods to ascertain the risk of drug-drug interactions with hormonal contraceptives. PMID:27042398

  14. The state of infectious diseases clinical trials: a systematic review of ClinicalTrials.gov.

    Science.gov (United States)

    Goswami, Neela D; Pfeiffer, Christopher D; Horton, John R; Chiswell, Karen; Tasneem, Asba; Tsalik, Ephraim L

    2013-01-01

    There is a paucity of clinical trials informing specific questions faced by infectious diseases (ID) specialists. The ClinicalTrials.gov registry offers an opportunity to evaluate the ID clinical trials portfolio. We examined 40,970 interventional trials registered with ClinicalTrials.gov from 2007-2010, focusing on study conditions and interventions to identify ID-related trials. Relevance to ID was manually confirmed for each programmatically identified trial, yielding 3570 ID trials and 37,400 non-ID trials for analysis. The number of ID trials was similar to the number of trials identified as belonging to cardiovascular medicine (n = 3437) or mental health (n = 3695) specialties. Slightly over half of ID trials were treatment-oriented trials (53%, vs. 77% for non-ID trials) followed by prevention (38%, vs. 8% in non-ID trials). ID trials tended to be larger than those of other specialties, with a median enrollment of 125 subjects (interquartile range [IQR], 45-400) vs. 60 (IQR, 30-160) for non-ID trials. Most ID studies are randomized (73%) but nonblinded (56%). Industry was the funding source in 51% of ID trials vs. 10% that were primarily NIH-funded. HIV-AIDS trials constitute the largest subset of ID trials (n = 815 [23%]), followed by influenza vaccine (n = 375 [11%]), and hepatitis C (n = 339 [9%]) trials. Relative to U.S. and global mortality rates, HIV-AIDS and hepatitis C virus trials are over-represented, whereas lower respiratory tract infection trials are under-represented in this large sample of ID clinical trials. This work is the first to characterize ID clinical trials registered in ClinicalTrials.gov, providing a framework to discuss prioritization, methodology, and policy.

  15. Design, analysis, and presentation of crossover trials

    Directory of Open Access Journals (Sweden)

    Guyatt Gordon H

    2009-04-01

    Full Text Available Abstract Objective Although crossover trials enjoy wide use, standards for analysis and reporting have not been established. We reviewed methodological aspects and quality of reporting in a representative sample of published crossover trials. Methods We searched MEDLINE for December 2000 and identified all randomized crossover trials. We abstracted data independently, in duplicate, on 14 design criteria, 13 analysis criteria, and 14 criteria assessing the data presentation. Results We identified 526 randomized controlled trials, of which 116 were crossover trials. Trials were drug efficacy (48%, pharmacokinetic (28%, and nonpharmacologic (30%. The median sample size was 15 (interquartile range 8–38. Most (72% trials used 2 treatments and had 2 periods (64%. Few trials reported allocation concealment (17% or sequence generation (7%. Only 20% of trials reported a sample size calculation and only 31% of these considered pairing of data in the calculation. Carry-over issues were addressed in 29% of trial's methods. Most trials reported and defended a washout period (70%. Almost all trials (93% tested for treatment effects using paired data and also presented details on by-group results (95%. Only 29% presented CIs or SE so that data could be entered into a meta-analysis. Conclusion Reports of crossover trials frequently omit important methodological issues in design, analysis, and presentation. Guidelines for the conduct and reporting of crossover trials might improve the conduct and reporting of studies using this important trial design.

  16. Clinical trials. A pending subject.

    Science.gov (United States)

    Gil-Extremera, B; Jiménez-López, P; Mediavilla-García, J D

    2017-07-31

    Clinical trials are essential tools for the progress of clinical medicine in its diagnostic and therapeutic aspects. Since the first trial in 1948, which related tobacco use with lung cancer, there have been more than 150,000 clinical trials to date in various areas (paediatrics, cardiology, oncology, endocrinology, etc.). This article highlights the importance for all physicians to participate, over the course of their professional career, in a clinical trial, due to the inherent benefits for patients, the progress of medicine and for curricular prestige. The authors have created a synthesis of their experience with clinical trials on hypertension, diabetes, dyslipidaemia and ischaemic heart disease over the course of almost 3 decades. Furthermore, a brief reference has been made to the characteristics of a phase I unit, as well as to a number of research studies currently underway. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  17. Acute Schizophrenia | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available nter, Randomized, Double-blind, Placebo-controlled Trial of Three Fixed Doses of OPC-34712 in the Treatment of Adults With Acute...2 in the Treatment of Adults With Acute Schizophrenia A.4.1Sponsor's protocol code number331-10-231 A.5.2US ... Information on the Trial E.1 Medical condition or disease under investigation E.1.1Medical condition(s) being investigated Acute...ition or disease under investigation E.1.2Version 14.1 E.1.2Level LLT E.1.2Classification code 10001064 E.1.2Term Acute

  18. Acute Schizophrenia | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available 2, and 1 mg/day) in the Treatment of Adults With Acute Schizophrenia A.3.1Title ...of the trial for lay people, in easily understood, i.e. non-technical, language Efficacy Study of OPC-34712 in Adults With Acute...e Trial E.1 Medical condition or disease under investigation E.1.1Medical condition(s) being investigated Acute...nder investigation E.1.2Version 14.0 E.1.2Level LLT E.1.2Classification code 10001064 E.1.2Term Acute schizo

  19. Clinical trials on AIDS start.

    Science.gov (United States)

    A 6-month clinical trial in the Philippines sought to determine the efficacy of coconut oil and of "monolaurin," a coconut oil byproduct, in killing HIV by breaking down its coating. This research is based on the theory that medium-chain fatty acids, like monolaurin, can have this effect on certain viruses. The trial involves 12 women and 3 men in the early stage of HIV infection. 10 patients will take different doses of monolaurin, and 5 will consume coconut oil. It is hypothesized that the regimen will lead to higher CD4 counts and a lower viral load. The trial was almost abandoned because it received only lukewarm approval from the Health Secretary.

  20. Maximizing scientific knowledge from randomized clinical trials

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Atar, Dan; Pitt, Bertram;

    2010-01-01

    Trialists have an ethical and financial responsibility to plan and conduct clinical trials in a manner that will maximize the scientific knowledge gained from the trial. However, the amount of scientific information generated by randomized clinical trials in cardiovascular medicine is highly...... variable. Generation of trial databases and/or biobanks originating in large randomized clinical trials has successfully increased the knowledge obtained from those trials. At the 10th Cardiovascular Trialist Workshop, possibilities and pitfalls in designing and accessing clinical trial databases were......, in particular with respect to collaboration with the trial sponsor and to analytic pitfalls. The advantages of creating screening databases in conjunction with a given clinical trial are described; and finally, the potential for posttrial database studies to become a platform for training young scientists...

  1. Data collection in pragmatic trials.

    Science.gov (United States)

    Meinecke, Anna-Katharina; Welsing, Paco; Kafatos, George; Burke, Des; Trelle, Sven; Kubin, Maria; Nachbaur, Gaelle; Egger, Matthias; Zuidgeest, Mira

    2017-07-14

    Pragmatic trials can improve our understanding of how treatments will perform in routine practice. In a series of eight papers, the GetReal Consortium has evaluated the challenges in designing and conducting pragmatic trials and their specific methodological, operational, regulatory, and ethical implications. The present final paper of the series discusses the operational and methodological challenges of data collection in pragmatic trials. A more pragmatic data collection needs to balance the delivery of highly accurate and complete data with minimizing the level of interference that data entry and verification induce with clinical practice. Furthermore, it should allow for the involvement of a representative sample of practices, physicians, and patients who prescribe/receive treatment in routine care. This paper discusses challenges that are related to the different methods of data collection and presents potential solutions where possible. No one-size-fits-all recommendation can be given for the collection of data in pragmatic trials, although in general the application of existing routinely used data-collection systems and processes seems to best suit the pragmatic approach. However, data access and privacy, the time points of data collection, the level of detail in the data, and the lack of a clear understanding of the data-collection process were identified as main challenges for the usage of routinely collected data in pragmatic trials. A first step should be to determine to what extent existing health care databases provide the necessary study data and can accommodate data collection and management. When more elaborate or detailed data collection or more structured follow-up is required, data collection in a pragmatic trial will have to be tailor-made, often using a hybrid approach using a dedicated electronic case report form (eCRF). In this case, the eCRF should be kept as simple as possible to reduce the burden for practitioners and minimize influence on

  2. [Reading a clinical trial report].

    Science.gov (United States)

    Bergmann, J F; Chassany, O

    2000-04-15

    To improve medical knowledge by reading clinical trial reports it is necessary to check for the respect of the methodological rules, and to analyze and criticize the results. A control group and a randomisation are always necessary. Double blind assessment, sample size calculation, intention to treat analysis, a unique primary end point are also important. The conclusions of the trial are valid only for the population included and the clinical signification of the results, depending on the control treatment, has to be evaluated. Respect of the reading rules is necessary to assess the reliability of the conclusions, in order to promote evidence-based practice.

  3. Innovations in clinical trials informatics.

    Science.gov (United States)

    Summers, Ron; Vyas, Hiten; Dudhal, Nilesh; Doherty, Neil F; Coombs, Crispin R; Hepworth, Mark

    2008-01-01

    This paper will investigate innovations in information management for use in clinical trials. The application typifies a complex, adaptive, distributed and information-rich environment for which continuous innovation is necessary. Organisational innovation is highlighted as well as the technical innovations in workflow processes and their representation as an integrated set of web services. Benefits realization uncovers further innovations in the business strand of the work undertaken. Following the description of the development of this information management system, the semantic web is postulated as a possible solution to tame the complexity related to information management issues found within clinical trials support systems.

  4. Randomized clinical trials in HEPATOLOGY

    DEFF Research Database (Denmark)

    Kjaergard, L L; Nikolova, D; Gluud, C

    1999-01-01

    . Quality was assessed by means of a validated 5-point scale and separate quality components associated with empirical evidence of bias. Only 26% of all RCTs reported sample size calculations, 52% adequate generation of the allocation sequence, 34% adequate allocation concealment and 34% double......, single-center trials, and trials with no external funding. Quality did not improve with time and was not associated with country of origin. The main conclusions are that the quality of RCTs in HEPATOLOGY needs improvement and that the probability of high quality increased with the number of centers...

  5. Acute pancreatitis | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available lot Trial of Indomethacin in Acute Pancreatitis Ensayo piloto controlado y aleatorizado con indometacina en ....1 Medical condition or disease under investigation E.1.1Medical condition(s) being investigated Acute...n criteria Patients ages 18 or above admitted to hospital with a diagnosis of Acute pancreatitis (AP) based

  6. Acute Rhinosinusitis | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available edical condition or disease under investigation E.1.1Medical condition(s) being investigated Acute Rhinosinu....2.3Trial contains a sub-study No E.3Principal inclusion criteria 1. Adult male and female outpatients aged ≥ 18 - 75 years 2. Acute

  7. CAAPM: Computer-Aided Admissible Probability Measurement on PLATO IV

    Science.gov (United States)

    1976-03-01

    late Renaissance paintings b. Byzantine mosaics c. gothic stained glass 2. Of the following, the watercolorist noted for seascapes is: a...Theodore Gericault *b. Winslow Homer c. Jacob Epstein 3. Which of the following Dutch artists is noted for his genre paint- ings? *a. Jan Steen b. Jan

  8. Plato's Child and the Limit-Points of Educational Theories.

    Science.gov (United States)

    Baker, Bernadette

    2003-01-01

    Analyzes how the figure of the child has been used to authorize a series of boundaries that have been constituted the limit points of educational theories or philosophies. Concludes that the meaning-space that the child can occupy has been important to depicting Utopian and cosmological imaginings at different historical moments. (Contains 37…

  9. "From Plato to Pareto": The Western Civilization Course Reconsidered.

    Science.gov (United States)

    Mullaney, Marie Marmo

    1986-01-01

    Discusses the importance of historical study within general education. Reviews the rise and fall of the Western Civilization course as the core of general education in the humanities. Suggests ways a revised version of this course can be restored to a central place in the curriculum. (AYC)

  10. Rekindling the Dialogue: Education According to Plato and Dewey

    Science.gov (United States)

    Van Luchene, Stephen R.

    2004-01-01

    Since passage of the No Child Left Behind Act of 2001, thinking about America's schools has been taken over by something like philosopher Rene Descartes's malignant demon of doubt. The act's exclusive focus on assessing student achievement and faculty accountability in terms that can be "proved" mathematically has cast into doubt a…

  11. Plato, Socrates, Hunt, and Rotfeld: Eigenforms of Academic Collaboration

    Directory of Open Access Journals (Sweden)

    M Louise Ripley

    2011-10-01

    Full Text Available A number of academic institutions profess to offer Interdisciplinary Studies but few truly achieve it, and not without a great deal of effort over and above the normal workload of a professor and a level of patience and perseverance not found in many university students. This paper will report on a successful academic collaboration between two very different disciplines: philosophy and business. It will examine a course taught jointly by the two disciplines in a strategy of imbrication attempted by a college of York University in Toronto, Atkinson College, housing both liberal arts and professional school.

  12. Clio's kerstening. Pedagogische literatuurkritiek van Plato tot Luther

    NARCIS (Netherlands)

    Everts, G.

    2005-01-01

    Storytelling no longer occupies a central position in school education. The question of why this element has largely disappeared in standard school education has led us to an historical inquiry into the history of European institutional education. We found that this was the first time this question

  13. The History of Linguistics in Europe from Plato to 1600.

    Science.gov (United States)

    Law, Vivien

    This book examines the history of western linguistics over a 2,000-year timespan, from its origins in ancient Greece up to the crucial moments of change in the Renaissance that lay the foundations of modern linguistics. The book explores how ideas about language over the centuries have changed to reflect changing modes of thinking. Twelve chapters…

  14. Plato, Pascal, and the Dynamics of Personal Knowledge

    Science.gov (United States)

    Otte, Michael Friedrich; Campos, Tania M. M.; Abido, Alexandre S.

    2013-01-01

    Educational practices are to be based on proven scientific knowledge, not least because the function science has to perform in human culture consists of unifying practical skills and general beliefs, the episteme and the techne (Amsterdamski, 1975, pp. 43-44). Now, modern societies first of all presuppose regular and standardized ways of…

  15. plato and the teaching of entrepreneurship studies as general ...

    African Journals Online (AJOL)

    JONATHAN

    2016-08-22

    Aug 22, 2016 ... Mgbakoigba, Journal of African Studies. Vol.6 No.1. July 2016. 1 ... The second worry is the growing global melt down and the increasing rate of ..... Entrepreneurship and management in Nigeria: The concept, philosophy and ...

  16. Plato and the Internet: Liberating Knowledge From Our Heads

    OpenAIRE

    O'Hara, Kieron

    2010-01-01

    My aim in this paper is to look at corporate knowledge engineering and see what it tells us about the philosophy of knowledge. The question I am asking is whether there is anything specific in engineering that could change our understanding of what or how we know. I am interested less in generating a theory of the relationship, rather more in raising a set of questions which I hope will stimulate a dialogue between the disciplines of knowledge and engineering. The distinguished computer scien...

  17. Clinical Trials in Your Community

    Science.gov (United States)

    The NCI Community Oncology Research Program (NCORP) is a national network of investigators, cancer care providers, academic institutions, and other organizations. NCORP conducts multi-site cancer clinical trials and studies in diverse populations in community-based healthcare systems across the United States and Puerto Rico.

  18. Glossary of Clinical Trials Terms

    Science.gov (United States)

    ... National Institutes of Health grant numbers. (See also Secondary IDs data element on ClinicalTrials.gov.) OUTCOME MEASURE A planned ... and Secondary Outcome Measure . (See also Primary and Secondary Outcome Measures data element and Outcome Measure results data element on ...

  19. The scribe of stroke trials

    NARCIS (Netherlands)

    van Gijn, J

    2003-01-01

    The responsibility for reports about drug trials in medical journals should lie with the clinicians in the steering committee, not with the industrial sponsor. Examples of undue influence of sponsors on the conduct and analysis are the choice of surrogate outcome events, changes in the protocol

  20. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Questions to Ask about Your Diagnosis Research Cancer Treatment Types of Cancer Treatment Side Effects Clinical Trials Information A to Z ... Alternative Medicine (CAM) Questions to Ask about Your Treatment Research Coping with Cancer Feelings and Cancer Adjusting ...

  1. SARCOPENIA: DESIGNING PHASE IIB TRIALS

    Science.gov (United States)

    CHUMLEA, WM.C.; CESARI, M.; EVANS, W.J.; FERRUCCI, L.; FIELDING, R.A.; PAHOR, M.; STUDENSKI, S.; VELLAS, B.

    2012-01-01

    Sarcopenia is the age-related involuntary loss of skeletal muscle mass and functionality that can lead to the development of disability, frailty and increased health care costs. The development of interventions aimed at preventing and/or treating sarcopenia is complex, requiring the adoption of assumptions and standards that are not well established scientifically or clinically. A number of investigators and clinicians (both from academia and industry) met in Rome (Italy) in 2009 to develop a consensus definition of sarcopenia. Subsequently, in Albuquerque (New Mexico, USA) in 2010, the same group met again to consider the complex issues necessary for designing Phase II clinical trials for sarcopenia. Current clinical trial data indicate that fat-free mass (FFM) parameters are responsive to physical activity/nutritional treatment modalities over short time periods, but pharmacological trials of sarcopenia have yet to show significant efficacy. In order to conduct a clinical trial within a reasonable time frame, groups that model or display accelerated aging and loss of FFM are necessary. Few studies have used acceptable designs for testing treatment effects, sample sizes or primary outcomes that could provide interpretable findings or effects across studies. Dual energy x ray absorptiometry (DXA) is the measure of choice for assessing FFM, but sufficient time is needed for changes to be detected accurately and reliably. A tool set that would allow clinical, basic and epidemiological research on sarcopenia to advance rapidly toward diagnosis and treatment phases should be those reflecting function and strength. PMID:21623466

  2. The Best Bypass Surgery Trial

    DEFF Research Database (Denmark)

    Møller, Christian H; Jensen, Birte Østergaard; Gluud, Christian

    2007-01-01

    Recent trials suggest that off-pump coronary artery bypass grafting (OPCAB) reduces the risk of mortality and morbidity compared with conventional coronary artery bypass grafting (CCAB) using cardiopulmonary bypass. Patients with a moderate- to high-risk of complications after CCAB may have addit...

  3. What Are Clinical Trial Phases?

    Medline Plus

    Full Text Available ... Questions to Ask about Your Diagnosis Research Cancer Treatment Types of Cancer Treatment Side Effects Clinical Trials Information A to Z ... Alternative Medicine (CAM) Questions to Ask about Your Treatment Research Coping with Cancer Feelings and Cancer Adjusting ...

  4. Estimación de la incertidumbre global de un procedimiento para la determinación de humedad por gravimetría en platos preparados (Raciones individuales de combate Nutritional analysis in ready meals (individual combat rations, Calculation of Uncertainty global estimated in a procedure for determination of moisture by gravimetric technique

    Directory of Open Access Journals (Sweden)

    R. Pérez Grana

    2012-06-01

    Full Text Available Objetivos: Realizar una estimación de la incertidumbre de forma global para la determinación de humedad en platos preparados por gravimetría aprovechando los datos obtenidos en el proceso de validación. Material y métodos: Se analiza, mediante un diseño anidado, un material de referencia certificado (MRC con un contenido de humedad certificado de 61,8 ±0,7 g/100g. La estimación de la incertidumbre combinada, se halla aplicando la ley de propagación de la incertidumbre. La incertidumbre expandida se obtiene aplicando un factor de cobertura K=2 (nivel de confianza del 95%. Mediante la aproximación SUMU se añade el sesgo a la incertidumbre expandida. Resultados: El límite de repetibilidad y reproductibilidad, para un nivel de confianza del 95%, es igual a 0,58 % y 1,21 %, respectivamente. Se obtienen los siguientes valores de incertidumbre: duplicados (0,12%, precisión (0,44 %, trazabilidad/ sesgo (0,39 %, incertidumbre combinada (0,60 % e incertidumbre expandida corregida (1,38 %. Conclusiones: El uso de un diseño anidado (analista, instrumento, día, replicado, permite variar los factores de una forma ordenada, entre cada serie, y estimar la precisión intermedia debida a varios factores. El cálculo de la incertidumbre de forma global supone una ventaja en cuanto a simplicidad, especialmente para laboratorios con pocos recursos humanos y materiales. La inclusión del sesgo experimental no significativo como un componente de la incertidumbre tiende a evitar la infraestimación de la incertidumbre de los resultados.Objectives: The aim of this article was to estimate the uncertainty total for the determination of moisture in ready meals by gravimetric using data obtained in the validation process. Material and methods: Samples were analyzed by gravimetric method in certified reference material (CRM (moisture certificate content: 61.8 ± 0.7 a 100 g. in nested design. The combined uncertainty was estimated by applying the law of

  5. Clinical Trials: Key to Medical Progress

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Clinical Trials: Key to Medical Progress Past Issues / Summer 2008 ... this page please turn Javascript on. Photo iStock Clinical trials are research studies that test how well new ...

  6. New Eczema Drug Promising in Early Trial

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163883.html New Eczema Drug Promising in Early Trial Nemolizumab significantly ... the appearance of moderate to severe eczema, a new, preliminary trial finds. Nemolizumab is a man-made, ...

  7. Clinical Trials.Gov: A Topical Analyses.

    Science.gov (United States)

    Anand, Vibha; Cahan, Amos; Ghosh, Soumya

    2017-01-01

    ClinicalTrials.gov was established as a web-based registry for clinical trials of human participants in 2000. Mandatory registration started in 2008. Given more than a decade of registered trials, it's important to understand the "topic" areas and their evolution over time from this resource. This information may help in identifying current knowledge gaps. We use dynamic topic model (DTM) methods to discover topics and their evolution over last 17 years. Our model suggests that there are disease or organ specific trials such as 'Cardiovascular disorders', Heart & Brain conditions', or 'Breast & Prostate cancer' as well as trials registered for general health. General health trials are less likely to be FDA regulated, but both health and pain management, as well as surgical, heart, and brain trials have upward trend in recent years while advanced cancer trials have downward trended. Our model derives unique insights from metadata associated with each topic area.

  8. Clinical trials in neurology: design, conduct, analysis

    National Research Council Canada - National Science Library

    Ravina, Bernard

    2012-01-01

    .... Clinical Trials in Neurology aims to improve the efficiency of clinical trials and the development of interventions in order to enhance the development of new treatments for neurologic diseases...

  9. Novel Antiplatelet Agent Use for Acute Coronary Syndrome in the Emergency Department: A Review

    Directory of Open Access Journals (Sweden)

    M. Curial

    2013-01-01

    Full Text Available Background. Acute Coronary Syndrome (ACS is a clinical condition encompassing ST Segment Elevation Myocardial Infarction (STEMI, Non-ST Segment Elevation Myocardial Infarction (NSTEMI, and Unstable Angina (UA and is characterized by ruptured coronary plaque, ischemic stress, and/or myocardial injury. Emergency department (ED physicians are on the front lines of ACS management. The role of new antiplatelet agents ticagrelor and prasugrel in acute ED management of ACS has not yet been defined. Objective. To critically review clinical trials using ticagrelor and prasugrel in the treatment of ACS and inform practitioners of their potential utility in treating ACS in the ED. Results. Trials on the efficacy of ticagrelor and prasugrel achieve statistical significance in decreasing composite endpoints in select patient populations. Conclusion. The use of ticagrelor and prasugrel as first line ED treatment of ACS is not well established. Current evidence supports the use of several agents with the final decision based on treatment protocols conjointly developed between cardiology and emergency medicine (EM. Further clinical trials involving head-to-head trials or comparisons of drug-based strategies are required to show superiority in reducing cardiac endpoints with regard to ED initiation of treatment.

  10. Clinical Trials Management | Division of Cancer Prevention

    Science.gov (United States)

    Information for researchers about developing, reporting, and managing NCI-funded cancer prevention clinical trials. Protocol Information Office The central clearinghouse for clinical trials management within the Division of Cancer Prevention.Read more about the Protocol Information Office. | Information for researchers about developing, reporting, and managing NCI-funded cancer prevention clinical trials.

  11. The Design of Cluster Randomized Crossover Trials

    Science.gov (United States)

    Rietbergen, Charlotte; Moerbeek, Mirjam

    2011-01-01

    The inefficiency induced by between-cluster variation in cluster randomized (CR) trials can be reduced by implementing a crossover (CO) design. In a simple CO trial, each subject receives each treatment in random order. A powerful characteristic of this design is that each subject serves as its own control. In a CR CO trial, clusters of subjects…

  12. 5 CFR 316.304 - Trial period.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Trial period. 316.304 Section 316.304... Term Employment § 316.304 Trial period. (a) The first year of service of a term employee is a trial period regardless of the method of appointment. Prior Federal civilian service is credited toward...

  13. Varied acceptance of clinical trial results.

    Science.gov (United States)

    Klimt, C R

    1989-12-01

    The subject of varied acceptance of clinical trial results is discussed in the context of review of trials with which I have been involved and my subjective evaluation of their impact on the practice of clinical medicine. My experience goes back to 1949 and a World Health Organization trial of hyperimmune gamma globulin against rabies. This was followed by a large trial of secondary prevention of poliomyelitis. I participated in the planning and initiation of the first chronic disease trial, the University Group Diabetes Program (UGDP). The latter lasted for 15 years and its ramifications continue to this day. My next trial was the Coronary Drug Project (CDP), a complex trial with more than 8,000 patients. The trials of aspirin and aspirin combined with persantine (the CDPA, AMIS, PARIS I, and PARIS II) followed. My last three trials were a trial of photocoagulation in diabetic retinopathy (DRS), a six-country trial of the antiarrhythmic drug mexiletine (IMPACT), and a study involving two diagnostic procedures for pulmonary embolism (PIOPED). When one considers, in retrospect, the plethora of trials one is struck by the uniform absence of a priori considerations of the impact on medical practice, or likely lack thereof, of possible outcomes.

  14. Maximizing scientific knowledge from randomized clinical trials

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Atar, Dan; Pitt, Bertram

    2010-01-01

    Trialists have an ethical and financial responsibility to plan and conduct clinical trials in a manner that will maximize the scientific knowledge gained from the trial. However, the amount of scientific information generated by randomized clinical trials in cardiovascular medicine is highly...

  15. Trial-to-Trial Fluctuations in Attentional State and Their Relation to Intelligence

    Science.gov (United States)

    Unsworth, Nash; McMillan, Brittany D.

    2014-01-01

    Trial-to-trial fluctuations in attentional state while performing measures of intelligence were examined in the current study. Participants performed various measures of fluid and crystallized intelligence while also providing attentional state ratings prior to each trial. It was found that pre-trial attentional state ratings strongly predicted…

  16. Acute Gout | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available E.1 Medical condition or disease under investigation E.1.1Medical condition(s) being investigated Acute Gou...t E.1.1.1Medical condition in easily understood language Acute Gout E.1.1.2Therapeutic area Diseases [C] - M...n the trial (if it is different from the expected normal treatment of that condition) Acute gout is a self l

  17. Portfolio of prospective clinical trials including brachytherapy: an analysis of the ClinicalTrials.gov database

    OpenAIRE

    Cihoric, Nikola; Tsikkinis, Alexandros; Miguelez, Cristina Gutierrez; Strnad, Vratislav; Soldatovic, Ivan; Ghadjar, Pirus; Jeremic, Branislav; Dal Pra, Alan; Aebersold, Daniel M; Lössl, Kristina

    2016-01-01

    Background To evaluate the current status of prospective interventional clinical trials that includes brachytherapy (BT) procedures. Methods The records of 175,538 (100 %) clinical trials registered at ClinicalTrials.gov were downloaded on September 2014 and a database was established. Trials using BT as an intervention were identified for further analyses. The selected trials were manually categorized according to indication(s), BT source, applied dose rate, primary sponsor type, location, p...

  18. Portfolio of prospective clinical trials including brachytherapy: an analysis of the ClinicalTrials.gov database

    OpenAIRE

    Cihoric, Nikola; Tsikkinis, Alexandros; Gutierrez Miguelez, Cristina; Strnad, Vratislav; Soldatovic, Ivan; Ghadjar, Pirus; Jeremic, Branislav; Dal Pra, Alan; Aebersold, Daniel M; Lössl, Kristina

    2016-01-01

    Background To evaluate the current status of prospective interventional clinical trials that includes brachytherapy (BT) procedures. Methods The records of 175,538 (100 %) clinical trials registered at ClinicalTrials.gov were downloaded on September 2014 and a database was established. Trials using BT as an intervention were identified for further analyses. The selected trials were manually categorized according to indication(s), BT source, applied dose rate, primary sponsor type,...

  19. Current status and perspectives of interventional clinical trials for glioblastoma - analysis of ClinicalTrials.gov.

    Science.gov (United States)

    Cihoric, Nikola; Tsikkinis, Alexandros; Minniti, Giuseppe; Lagerwaard, Frank J; Herrlinger, Ulrich; Mathier, Etienne; Soldatovic, Ivan; Jeremic, Branislav; Ghadjar, Pirus; Elicin, Olgun; Lössl, Kristina; Aebersold, Daniel M; Belka, Claus; Herrmann, Evelyn; Niyazi, Maximilian

    2017-01-03

    The records of 208.777 (100%) clinical trials registered at ClinicalTrials.gov were downloaded on the 19th of February 2016. Phase II and III trials including patients with glioblastoma were selected for further classification and analysis. Based on the disease settings, trials were classified into three groups: newly diagnosed glioblastoma, recurrent disease and trials with no differentiation according to disease setting. Furthermore, we categorized trials according to the experimental interventions, the primary sponsor, the source of financial support and trial design elements. Trends were evaluated using the autoregressive integrated moving average model. Two hundred sixteen (0.1%) trials were selected for further analysis. Academic centers (investigator initiated trials) were recorded as primary sponsors in 56.9% of trials, followed by industry 25.9%. Industry was the leading source of monetary support for the selected trials in 44.4%, followed by 25% of trials with primarily academic financial support. The number of newly initiated trials between 2005 and 2015 shows a positive trend, mainly through an increase in phase II trials, whereas phase III trials show a negative trend. The vast majority of trials evaluate forms of different systemic treatments (91.2%). In total, one hundred different molecular entities or biologicals were identified. Of those, 60% were involving drugs specifically designed for central nervous system malignancies. Trials that specifically address radiotherapy, surgery, imaging and other therapeutic or diagnostic methods appear to be rare. Current research in glioblastoma is mainly driven or sponsored by industry, academic medical oncologists and neuro-oncologists, with the majority of trials evaluating forms of systemic therapies. Few trials reach phase III. Imaging, radiation therapy and surgical procedures are underrepresented in current trials portfolios. Optimization in research portfolio for glioblastoma is needed.

  20. Accrual to Cancer Clinical Trials

    LENUS (Irish Health Repository)

    Kelly, C

    2016-07-01

    Accrual to cancer clinical trials (CCT) is imperative to safeguard continued improvement in cancer outcomes. A retrospective chart review was performed of patients (n=140) starting a new anti-cancer agent in a north Dublin cancer centre. This review was performed over a four-month period, beginning in November 2015. Only 29% (n=41) had a CCT option. The overall accrual rate to CCT was 5% (n=7), which is comparable to internationally reported figures. The main reasons for failure to recruit to CCT included the lack of a CCT option for cancer type (n=30, 23%), stage (n=25, 19%), and line of treatment (n=23, 17%). Over the last decade, the rate of accrual to CCTs has in fact doubled and the number of trials open to recruitment has tripled. Ongoing governmental and philanthropic support is necessary to continue this trend to further expand CCT patient options with a target accrual rate of 10%.

  1. The ethics of clinical trials

    Science.gov (United States)

    Nardini, Cecilia

    2014-01-01

    Over the past decades, randomised controlled trials (RCTs) have prevailed over clinical judgement, case reports, and observational studies and became the gold evidential standard in medicine. Furthermore, during the same time frame, RCTs became a crucial part of the regulatory process whereby a new therapeutic can gain access to the drug market. Today, clinical trials are large and tightly regulated enterprises that have to comply with ethical requirements while maintaining high epistemic standards, a balance that becomes increasingly difficult as the research questions become more sophisticated. In this review, the author will discuss some of the most important ethical issues surrounding RCTs, with an eye to the most recent debates and the context of oncological research in particular. PMID:24482672

  2. Medical coding in clinical trials

    Directory of Open Access Journals (Sweden)

    Deven Babre

    2010-01-01

    Full Text Available Data generated in all clinical trial are recorded on the data collection instrument Case report Form / Electronic Case Report Form by investigators located at various sites in various countries. In multicentric clinical trials since different investigator or medically qualified experts are from different sites / centers recording the medical term(s uniformly is a big challenge. Medical coders from clinical data management team process these terms and perform medical coding. Medical coding is performed to categorize the medical terms reported appropriately so that they can be analyzed/reviewed. This article describes process which is used for medical coding in clinical data management and two most commonly used medical dictionaries MedDRA and WHO-DDE in brief. It is expected to help medical coders to understand the process of medical coding in clinical data management. Few common issues which the medical coder faces while performing medical coding, are also highlighted.

  3. GPON FTTH trial: lessons learned

    Science.gov (United States)

    Weis, Erik; Hölzl, Rainer; Breuer, Dirk; Lange, Christoph

    2009-11-01

    This paper reports on a FTTH field trial with GPON (Gigabit-capable passive optical network) technology in the network of Deutsche Telekom in the region of the cities of Berlin and Potsdam. Focus of this trial was to gain practical experience regarding GPON technology, fibre installation in existing ducts with micro duct technology, fibre cabling in customer buildings and impact on operational processes. Furthermore it is reported on an initial Deutsche Telekom FTTB deployment based on GPON technology in the city of Dresden with the main targets to obtain practical deployment and operation experiences with fibre-based access networks and to provide broadband access to a part of the city formerly not servable by DSL (digital subscriber line) technology.

  4. Practical trials in medical education

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Kulasegaram, Kulamakan M; Ringsted, Charlotte

    2017-01-01

    , limitations and future directions for this kind of research. CURRENT STATE: Practical trials have the overall aim of informing decision makers. They are carried out in real-life settings and are characterised by (i) comparison of viable alternative education strategies, (ii) broad inclusion criteria regarding...... participants across several settings and (iii) multiple outcome measures with long-term follow-up to evaluate both benefits and risks. Questions posed by practical trials may be proactive in applying theory in the development of educational innovations or reactive to educational reforms and innovations. Non......CONTEXT: Concerns have been raised over the gap between education theory and practice and how research can contribute to inform decision makers on their choices and priorities. Little is known about how educational theories and research outcomes produced under optimal conditions in highly...

  5. Clinical trials and gender medicine

    Directory of Open Access Journals (Sweden)

    Mariarita Cassese

    2011-01-01

    Full Text Available Women use more medicines than men because they fall ill more often and suffer more from chronic diseases, but also because women pay more attention to their health and have more consciousness and care about themselves. Although medicines can have different effects on women and men, women still represent a small percentage in the first phases of trials (22% which are essential to verify drugs dosage, side effects, and safety. Even though women are more present in trials, studies results are not presented with a gender approach. This situation is due to educational, social, ethical and economical factors. The scientific research must increase feminine presence in clinical trials in order to be equal and correct, and all the key stakeholder should be involved in this process. We still have a long way to cover and it doesn't concern only women but also children and old people. The aim is to have a medicine not only illness-focused but patient-focused: a medicine able to take into consideration all the patient characteristics and so to produce a really personalized therapy. What above described is part of the reasons why in 2005 was founded the National Observatory for Women's Health (Osservatorio Nazionale sulla Salute della Donna, ONDa which promotes a gender health awareness and culture in Italy, at all the levels of the civil and scientific society.

  6. The DiaS trial

    DEFF Research Database (Denmark)

    Andreasson, Kate; Krogh, Jesper; Rosenbaum, Bent

    2014-01-01

    BACKGROUND: In Denmark 8,000 to 10,000 people will attempt suicide each year. The Centre of Excellence in Suicide Prevention in the Capital Region of Denmark is treating patients with suicidal behavior, and a recent survey has shown that 30% of the patients are suffering from borderline personali...... measured at week 28. Other exploratory outcomes are included such as severity of symptoms, suicide intention and ideation, depression, hopelessness, self-esteem, impulsivity, anger, and duration of respective treatments. TRIAL REGISTRATION: Clinical Trial.gov: NCT01512602....... disorder. The majority of patients (70% to 75%) with borderline personality disorder have a history of deliberate self-harm and 10% have a lifetime risk to die by suicide. The DiaS trial is comparing dialectical behavior therapy with collaborative assessment and management of suicidality......-informed supportive psychotherapy, for the risk of repetition of deliberate self-harm in patients with a recent suicide attempt and personality traits within the spectrum of borderline personality disorder. Both treatments have previously shown effects in this group of patients on suicide ideation and self...

  7. Clinical Trials in Noninfectious Uveitis

    Science.gov (United States)

    Kim, Jane S.; Knickelbein, Jared E.; Nussenblatt, Robert B.; Sen, H. Nida

    2015-01-01

    The treatment of noninfectious uveitis continues to remain a challenge for many ophthalmologists. Historically, clinical trials in uveitis have been sparse, and thus, most treatment decisions have largely been based on clinical experience and consensus guidelines. The current treatment paradigm favors initiation then tapering of corticosteroids with addition of steroid-sparing immunosuppressive agents for persistence or recurrence of disease. Unfortunately, in spite of a multitude of highly unfavorable systemic effects, corticosteroids are still regarded as the mainstay of treatment for many patients with chronic and refractory noninfectious uveitis. However, with the success of other conventional and biologic immunomodulatory agents in treating systemic inflammatory and autoimmune conditions, interest in targeted treatment strategies for uveitis has been renewed. Multiple clinical trials on steroid-sparing immunosuppressive agents, biologic agents, intraocular corticosteroid implants, and topical ophthalmic solutions have already been completed, and many more are ongoing. This review discusses the results and implications of these clinical trials investigating both alternative and novel treatment options for noninfectious uveitis. PMID:26035763

  8. Clinical trials: innovation, progress and controversy

    Directory of Open Access Journals (Sweden)

    Martin GS

    2011-08-01

    Full Text Available Greg S MartinDepartment of Pulmonary, Allergy and Critical Care, Emory University, Atlanta, Georgia, USAThe Open Access Journal of Clinical Trials began in 2009 with the goal of being an authoritative, open access source for international, peer-reviewed publications in the field of human research and clinical trials. Since then, the Open Access Journal of Clinical Trials has published approximately 30 high-quality articles on original research, innovative reviews, and critical commentaries. These articles have spanned many aspects of clinical trials wonderfully, including trial design and management; legal, ethical and regulatory issues of clinical trials; subject participation and retention in clinical trials; and data collection and data management.

  9. Bayesian adaptive methods for clinical trials

    CERN Document Server

    Berry, Scott M; Muller, Peter

    2010-01-01

    Already popular in the analysis of medical device trials, adaptive Bayesian designs are increasingly being used in drug development for a wide variety of diseases and conditions, from Alzheimer's disease and multiple sclerosis to obesity, diabetes, hepatitis C, and HIV. Written by leading pioneers of Bayesian clinical trial designs, Bayesian Adaptive Methods for Clinical Trials explores the growing role of Bayesian thinking in the rapidly changing world of clinical trial analysis. The book first summarizes the current state of clinical trial design and analysis and introduces the main ideas and potential benefits of a Bayesian alternative. It then gives an overview of basic Bayesian methodological and computational tools needed for Bayesian clinical trials. With a focus on Bayesian designs that achieve good power and Type I error, the next chapters present Bayesian tools useful in early (Phase I) and middle (Phase II) clinical trials as well as two recent Bayesian adaptive Phase II studies: the BATTLE and ISP...

  10. Data monitoring committees for pragmatic clinical trials.

    Science.gov (United States)

    Ellenberg, Susan S; Culbertson, Richard; Gillen, Daniel L; Goodman, Steven; Schrandt, Suzanne; Zirkle, Maryan

    2015-10-01

    In any clinical trial, it is essential to monitor the accumulating data to be sure that the trial continues to be safe for participants and that the trial is being conducted properly. Data monitoring committees, independent expert panels who undertake regular reviews of the data as the trial progresses, serve an important role in safeguarding the interests of research participants and ensuring trial integrity in many trials. Many pragmatic clinical trials, which aim to inform healthcare decisions by comparing alternate interventions in heterogeneous healthcare delivery settings, will warrant review by an independent data monitoring committee due to their potential impact on clinical practice. However, the very features that make a trial "pragmatic" may pose challenges in terms of which aspects of a trial to monitor and when it is appropriate for a data monitoring committee to intervene. Using the Pragmatic-Explanatory Continuum Indicator Summary tool that draws distinctions between pragmatic and explanatory clinical trials, we review characteristics of pragmatic clinical trials that may have implications for data monitoring committees and interim monitoring plans. These include broad eligibility criteria, a focus on subjective patient-centered outcomes, and in some cases a lack of standardized follow-up procedures across study sites. Additionally, protocol adherence is often purposefully not addressed in pragmatic trials in order to accurately represent the clinical practice setting and maintain practicability of implementation; there are differing viewpoints as to whether adherence should be assessed and acted upon by data monitoring committees in these trials. Some other issues not specifically related to the Pragmatic-Explanatory Continuum Indicator Summary criteria may also merit special consideration in pragmatic trials. Thresholds for early termination of a pragmatic clinical trial might be controversial. The distinguishing features of pragmatic clinical

  11. Impact of a cancer clinical trials web site on discussions about trial participation: a cluster randomized trial.

    Science.gov (United States)

    Dear, R F; Barratt, A L; Askie, L M; Butow, P N; McGeechan, K; Crossing, S; Currow, D C; Tattersall, M H N

    2012-07-01

    Cancer patients want access to reliable information about currently recruiting clinical trials. Oncologists and their patients were randomly assigned to access a consumer-friendly cancer clinical trials web site [Australian Cancer Trials (ACT), www.australiancancertrials.gov.au] or to usual care in a cluster randomized controlled trial. The primary outcome, measured from audio recordings of oncologist-patient consultations, was the proportion of patients with whom participation in any clinical trial was discussed. Analysis was by intention-to-treat accounting for clustering and stratification. Thirty medical oncologists and 493 patients were recruited. Overall, 46% of consultations in the intervention group compared with 34% in the control group contained a discussion about clinical trials (P=0.08). The mean consultation length in both groups was 29 min (P=0.69). The proportion consenting to a trial was 10% in both groups (P=0.65). Patients' knowledge about randomized trials was lower in the intervention than the control group (mean score 3.0 versus 3.3, P=0.03) but decisional conflict scores were similar (mean score 42 versus 43, P=0.83). Good communication between patients and physicians is essential. Within this context, a web site such as Australian Cancer Trials may be an important tool to encourage discussion about clinical trial participation.

  12. Clinical Trials in Peripheral Vascular Disease: Pipeline and Trial Designs: An Evaluation of the ClinicalTrials.gov Database

    Science.gov (United States)

    Subherwal, Sumeet; Patel, Manesh R.; Chiswell, Karen; Tidemann-Miller, Beth A.; Jones, W. Schuyler; Conte, Michael S.; White, Christopher J.; Bhatt, Deepak L.; Laird, John R.; Hiatt, William R.; Tasneem, Asba; Califf, Robert M.

    2014-01-01

    Background Tremendous advances have occurred in therapies for peripheral vascular disease (PVD); however, until recently it has not been possible to examine the entire clinical trial portfolio of studies for treatment of PVD (both arterial and venous disease). Methods and Results We examined interventional trials registered in ClinicalTrials.gov from October 2007 through September 2010 (n=40,970) and identified 676 (1.7%) PVD trials (n=493 arterial only, n=170 venous only, n=13 both arterial and venous). Most arterial studies investigated lower extremity peripheral artery disease and acute stroke (35% and 24%, respectively), while most venous studies examined deep vein thrombosis/pulmonary embolus prevention (42%) or venous ulceration (25%). A placebo-controlled trial design was used in 27% of the PVD trials, and 4% of the PVD trials excluded patients aged >65 years. Enrollment in at least 1 US site decreased from 51% in 2007 to 41% of trials in 2010. Compared with non-cardiology disciplines, PVD trials were more likely to be double-blinded, investigate use of devices and procedures, and have industry sponsorship and assumed funding source, and less likely to investigate drug and behavioral therapies. Geographic access to PVD clinical trials within the United States is limited to primarily large metropolitan areas. Conclusions PVD studies represent a small group of trials registered in ClinicalTrials.gov, despite the high prevalence of vascular disease in the general population. This low number, compounded by the decreasing number of PVD trials in the United States, is concerning and may limit the ability to inform current clinical practice of patients with PVD. PMID:25239436

  13. Sponsorship and design characteristics of trials registered in ClinicalTrials.gov.

    Science.gov (United States)

    Roumiantseva, Dina; Carini, Simona; Sim, Ida; Wagner, Todd H

    2013-03-01

    We examine the extent to which ClinicalTrials.gov is meeting its goal of providing oversight and transparency of clinical trials with human subjects. We analyzed the ClinicalTrials.gov database contents as of June 2011, comparing interventions, medical conditions, and trial characteristics by sponsor type. We also conducted a detailed analysis of incomplete data. Among trials with only government sponsorship (N=9252), 36% were observational and 64% interventional; in contrast, almost all (90%) industry-only sponsored trials were interventional. Industry-only sponsored interventional trials (N=30,036) were most likely to report a drug intervention (81%), followed by biologics (9%) and devices (8%). Government-only interventional trials (N=5886) were significantly more likely to test behavioral interventions (28%) and procedures (13%) than industry-only trials (pgov. Published by Elsevier Inc.

  14. Factors predicting publication of spinal cord injury trials registered on www.ClinicalTrials. gov.

    Science.gov (United States)

    DePasse, J Mason; Park, Sara; Eltorai, Adam E M; Daniels, Alan H

    2017-08-11

    Treatment options for spinal cord injuries are currently limited, but multiple clinical trials are underway for a variety of interventions, drugs, and devices. The Food and Drug Administration website www.ClinicalTrials.gov catalogues these trials and includes information on the status of the trial, date of initiation and completion, source of funding, and region. This investigation assesses the factors associated with publication and the publication rate of spinal cord injury trials. Retrospective analysis of publically available data on www.ClinicalTrials.gov. The www.ClinicalTrials.gov was queried for all trials on patients with spinal cord injury, and these trials were assessed for status, type of intervention, source of funding, and region. Multiple literature searches were performed on all completed trials to determine publication status. There were 626 studies identified concerning the treatment of patients with spinal cord injury, of which 250 (39.9%) were completed. Of these, only 119 (47.6%) were published. There was no significant difference in the rate of publication between regions (p> 0.16) or by study type (p> 0.29). However, trials that were funded by the NIH were more likely to be published than trials funded by industry (p= 0.01). The current publication rate of spinal cord injury trials is only 47.6%, though this rate is similar to the publication rate for trials in other fields. NIH-funded trials are significantly more likely to become published than industry-funded trials, which could indicate that some trials remain unpublished due to undesirable results. However, it is also likely that many trials on spinal cord injury yield negative results, as treatments are often ineffective.

  15. Making randomised trials more efficient: report of the first meeting to discuss the Trial Forge platform.

    Science.gov (United States)

    Treweek, Shaun; Altman, Doug G; Bower, Peter; Campbell, Marion; Chalmers, Iain; Cotton, Seonaidh; Craig, Peter; Crosby, David; Davidson, Peter; Devane, Declan; Duley, Lelia; Dunn, Janet; Elbourne, Diana; Farrell, Barbara; Gamble, Carrol; Gillies, Katie; Hood, Kerry; Lang, Trudie; Littleford, Roberta; Loudon, Kirsty; McDonald, Alison; McPherson, Gladys; Nelson, Annmarie; Norrie, John; Ramsay, Craig; Sandercock, Peter; Shanahan, Daniel R; Summerskill, William; Sydes, Matt; Williamson, Paula; Clarke, Mike

    2015-06-05

    Randomised trials are at the heart of evidence-based healthcare, but the methods and infrastructure for conducting these sometimes complex studies are largely evidence free. Trial Forge ( www.trialforge.org ) is an initiative that aims to increase the evidence base for trial decision making and, in doing so, to improve trial efficiency.This paper summarises a one-day workshop held in Edinburgh on 10 July 2014 to discuss Trial Forge and how to advance this initiative. We first outline the problem of inefficiency in randomised trials and go on to describe Trial Forge. We present participants' views on the processes in the life of a randomised trial that should be covered by Trial Forge.General support existed at the workshop for the Trial Forge approach to increase the evidence base for making randomised trial decisions and for improving trial efficiency. Agreed upon key processes included choosing the right research question; logistical planning for delivery, training of staff, recruitment, and retention; data management and dissemination; and close down. The process of linking to existing initiatives where possible was considered crucial. Trial Forge will not be a guideline or a checklist but a 'go to' website for research on randomised trials methods, with a linked programme of applied methodology research, coupled to an effective evidence-dissemination process. Moreover, it will support an informal network of interested trialists who meet virtually (online) and occasionally in person to build capacity and knowledge in the design and conduct of efficient randomised trials.Some of the resources invested in randomised trials are wasted because of limited evidence upon which to base many aspects of design, conduct, analysis, and reporting of clinical trials. Trial Forge will help to address this lack of evidence.

  16. Microbicide clinical trial adherence: insights for introduction

    Directory of Open Access Journals (Sweden)

    Cynthia Woodsong

    2013-04-01

    Full Text Available After two decades of microbicide clinical trials it remains uncertain if vaginally- delivered products will be clearly shown to reduce the risk of HIV infection in women and girls. Furthermore, a microbicide product with demonstrated clinical efficacy must be used correctly and consistently if it is to prevent infection. Information on adherence that can be gleaned from microbicide trials is relevant for future microbicide safety and efficacy trials, pre-licensure implementation trials, Phase IV post-marketing research, and microbicide introduction and delivery. Drawing primarily from data and experience that has emerged from the large-scale microbicide efficacy trials completed to-date, the paper identifies six broad areas of adherence lessons learned: (1 Adherence measurement in clinical trials, (2 Comprehension of use instructions/Instructions for use, (3 Unknown efficacy and its effect on adherence/Messages regarding effectiveness, (4 Partner influence on use, (5 Retention and continuation and (6 Generalizability of trial participants' adherence behavior. Each is discussed, with examples provided from microbicide trials. For each of these adherence topics, recommendations are provided for using trial findings to prepare for future microbicide safety and efficacy trials, Phase IV post-marketing research, and microbicide introduction and delivery programs.

  17. [Profile of clinical trials enrolling Brazilian children].

    Science.gov (United States)

    Vieira, Jean Mendes de Lucena; Lima, Elisangela da Costa; Land, Marcelo Gerardin Poirot; Ventura, Miriam; Coelho, Helena Lutescia Luna

    2017-06-12

    This study aimed to characterize the clinical trials with medicines enrolling Brazilian children and adolescents, registered in the databases of Clinical Trials and the Brazilian Clinical Trials Network (ReBEC) from 1994 to 2014. Only 462 clinical trials enrolled Brazilian children and adolescents. There was an increase in registrations beginning in 2003, with an important drop in 2011. Among these trials, 35.5% were hosted in Brazil. The international clinical trials were mostly conducted by North American companies. In both cases, multinational industry was the principal source of funding. The clinical trials were predominantly phase III with injectable and solid oral pharmaceutical forms of antiviral drugs. Domestic clinical trials showed wider variation in the pharmaceutical forms and higher percentage of liquid formulations, when compared to the international trials. In addition to heavy external dependence for conducting clinical trials, the study emphasized the challenge for pediatric care in Brazil, which presents epidemiological peculiarities in an environment prone to the use of unlicensed medicines for children.

  18. Gatekeepers for pragmatic clinical trials.

    Science.gov (United States)

    Whicher, Danielle M; Miller, Jennifer E; Dunham, Kelly M; Joffe, Steven

    2015-10-01

    To successfully implement a pragmatic clinical trial, investigators need access to numerous resources, including financial support, institutional infrastructure (e.g. clinics, facilities, staff), eligible patients, and patient data. Gatekeepers are people or entities who have the ability to allow or deny access to the resources required to support the conduct of clinical research. Based on this definition, gatekeepers relevant to the US clinical research enterprise include research sponsors, regulatory agencies, payers, health system and other organizational leadership, research team leadership, human research protections programs, advocacy and community groups, and clinicians. This article provides a framework to help guide gatekeepers' decision-making related to the use of resources for pragmatic clinical trials. Relevant ethical considerations for gatekeepers include (1) concern for the interests of individuals, groups, and communities affected by the gatekeepers' decisions, including protection from harm and maximization of benefits; (2) advancement of organizational mission and values; and (3) stewardship of financial, human, and other organizational resources. Separate from these ethical considerations, gatekeepers' actions will be guided by relevant federal, state, and local regulations. This framework also suggests that to further enhance the legitimacy of their decision-making, gatekeepers should adopt transparent processes that engage relevant stakeholders when feasible and appropriate. We apply this framework to the set of gatekeepers responsible for making decisions about resources necessary for pragmatic clinical trials in the United States, describing the relevance of the criteria in different situations and pointing out where conflicts among the criteria and relevant regulations may affect decision-making. Recognition of the complex set of considerations that should inform decision-making will guide gatekeepers in making justifiable choices regarding

  19. a randomized controlled clinical trial

    OpenAIRE

    2013-01-01

    In this study we aimed to evaluate the effectiveness of Iyengar yoga in chronic neck pain by means of a randomized clinical trial. 77 with chronic neck pain who scored > 40 mm on a 100-mm visual analog scale (VAS) were randomized to a nine week Iyengar yoga program with weekly 90-minute classes or to a self-care/exercise program. The primary outcome measure was change of mean pain at rest (VAS) from baseline to week ten. Secondary outcomes included pain at motion, functional disabilit...

  20. Juvenile Competency to Stand Trial.

    Science.gov (United States)

    Stepanyan, Sofia T; Sidhu, Shawn S; Bath, Eraka

    2016-01-01

    Competency to stand trial is interpreted as a protected due process right for all defendants and is defined as a defendant's fundamental knowledge and understanding of the criminal charges being filed, roles and procedures within the courtroom, and a general ability to work with the defense counsel. Questions of competency are most often raised by the judge, defense, or the prosecution, and competency evaluations are most often completed by psychiatrists or psychologists with forensic training or work experience. Mental illness, intellectual disability, developmental disorders, and developmental immaturity are the 4 main factors considered in most juvenile competency evaluations.

  1. Legislation for trial registration and data transparency

    Directory of Open Access Journals (Sweden)

    Wu Tai-Xiang

    2010-05-01

    Full Text Available Abstract Public confidence in clinical trials has been eroded by data suppression, misrepresentation and manipulation. Although various attempts have been made to achieve universal trial registration- e.g., Declaration of Helsinki, WHO clinical Trial Registry Platform (WHO ICTRP, the International Committee of Medical Journal Editors requirement- they have not succeeded, probably because they lack the enough power of enforcement. Legislation appears to be the most efficient and effective means to ensure that all researchers register their trials and disseminate their data accurately and in a timely manner. We propose that a global network be established. This could be accomplished in two steps. The first step is to legislate about trial registration and data transparency, such as USA's FDAAA Act 2007; and the second step to establish a global network to ensure uniform, international consistency in policy and enforcement of trial registration and data transparency.

  2. Some ethical implications of "adaptive" trials.

    Science.gov (United States)

    Petrini, C

    2015-01-01

    Adaptive trials are a new type of sequential trial, as yet not very widespread, in which each step can be modified on the basis of findings from the preceding step. In other words, the data accumulated during the study are used to modify the trial design. The potential of this type of trial is highly promising, especially for the development of therapies for rare diseases. The planning, conduct and management of data from adaptive trials are extremely complex processes and call for highly specialised skills. Without going into the merits of the experimental protocols, the aim of this article is to point out some ethical aspects that call for caution, as well as the need for ethics committees to be aware of the challenges posed by these trials.

  3. Legislation for trial registration and data transparency.

    Science.gov (United States)

    Bian, Zhao-Xiang; Wu, Tai-Xiang

    2010-05-26

    Public confidence in clinical trials has been eroded by data suppression, misrepresentation and manipulation. Although various attempts have been made to achieve universal trial registration- e.g., Declaration of Helsinki, WHO clinical Trial Registry Platform (WHO ICTRP), the International Committee of Medical Journal Editors requirement- they have not succeeded, probably because they lack the enough power of enforcement.Legislation appears to be the most efficient and effective means to ensure that all researchers register their trials and disseminate their data accurately and in a timely manner. We propose that a global network be established. This could be accomplished in two steps. The first step is to legislate about trial registration and data transparency, such as USA's FDAAA Act 2007; and the second step to establish a global network to ensure uniform, international consistency in policy and enforcement of trial registration and data transparency.

  4. OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of rehabilitation interventions for osteoarthritis.

    Science.gov (United States)

    Fitzgerald, G K; Hinman, R S; Zeni, J; Risberg, M A; Snyder-Mackler, L; Bennell, K L

    2015-05-01

    A Task Force of the Osteoarthritis Research Society International (OARSI) has previously published a set of guidelines for the conduct of clinical trials in osteoarthritis (OA) of the hip and knee. Limited material available on clinical trials of rehabilitation in people with OA has prompted OARSI to establish a separate Task Force to elaborate guidelines encompassing special issues relating to rehabilitation of OA. The Task Force identified three main categories of rehabilitation clinical trials. The categories included non-operative rehabilitation trials, post-operative rehabilitation trials, and trials examining the effectiveness of devices (e.g., assistive devices, bracing, physical agents, electrical stimulation, etc.) that are used in rehabilitation of people with OA. In addition, the Task Force identified two main categories of outcomes in rehabilitation clinical trials, which include outcomes related to symptoms and function, and outcomes related to disease modification. The guidelines for rehabilitation clinical trials provided in this report encompass these main categories. The report provides guidelines for conducting and reporting on randomized clinical trials. The topics include considerations for entering patients into trials, issues related to conducting trials, considerations for selecting outcome measures, and recommendations for statistical analyses and reporting of results. The focus of the report is on rehabilitation trials for hip, knee and hand OA, however, we believe the content is broad enough that it could be applied to rehabilitation trials for other regions as well.

  5. Trial publication after registration in ClinicalTrials.Gov: a cross-sectional analysis.

    Directory of Open Access Journals (Sweden)

    Joseph S Ross

    2009-09-01

    Full Text Available BACKGROUND: ClinicalTrials.gov is a publicly accessible, Internet-based registry of clinical trials managed by the US National Library of Medicine that has the potential to address selective trial publication. Our objectives were to examine completeness of registration within ClinicalTrials.gov and to determine the extent and correlates of selective publication. METHODS AND FINDINGS: We examined reporting of registration information among a cross-section of trials that had been registered at ClinicalTrials.gov after December 31, 1999 and updated as having been completed by June 8, 2007, excluding phase I trials. We then determined publication status among a random 10% subsample by searching MEDLINE using a systematic protocol, after excluding trials completed after December 31, 2005 to allow at least 2 y for publication following completion. Among the full sample of completed trials (n = 7,515, nearly 100% reported all data elements mandated by ClinicalTrials.gov, such as intervention and sponsorship. Optional data element reporting varied, with 53% reporting trial end date, 66% reporting primary outcome, and 87% reporting trial start date. Among the 10% subsample, less than half (311 of 677, 46% of trials were published, among which 96 (31% provided a citation within ClinicalTrials.gov of a publication describing trial results. Trials primarily sponsored by industry (40%, 144 of 357 were less likely to be published when compared with nonindustry/nongovernment sponsored trials (56%, 110 of 198; p<0.001, but there was no significant difference when compared with government sponsored trials (47%, 57 of 122; p = 0.22. Among trials that reported an end date, 75 of 123 (61% completed prior to 2004, 50 of 96 (52% completed during 2004, and 62 of 149 (42% completed during 2005 were published (p = 0.006. CONCLUSIONS: Reporting of optional data elements varied and publication rates among completed trials registered within ClinicalTrials.gov were low

  6. Design, Analysis, and Presentation of Crossover Trials

    OpenAIRE

    Guyatt Gordon H; Vail Andy; Wu Ping; Chan An-Wen; Mills Edward J; Altman Douglas G

    2009-01-01

    Abstract Objective Although crossover trials enjoy wide use, standards for analysis and reporting have not been established. We reviewed methodological aspects and quality of reporting in a representative sample of published crossover trials. Methods We searched MEDLINE for December 2000 and identified all randomized crossover trials. We abstracted data independently, in duplicate, on 14 design criteria, 13 analysis criteria, and 14 criteria assessing the data presentation. Results We identif...

  7. Ethics, Error, and Initial Trials of Efficacy

    OpenAIRE

    Hey, Spencer Phillips; Kimmelman, Jonathan

    2013-01-01

    Concerns about the frequency of failure in late stage drug development have prompted a series of proposals for improving the positive predictivity of trials where clinical activity is first evaluated—typically phase 2 trials. However, many proposed reforms entail ethical and social tradeoffs that might not be immediately apparent. We argue that trial reforms aimed at boosting phase 2 positive predictivity have important repercussions for human subjects, as well as the capacity of the research...

  8. Supported employment: randomised controlled trial*

    Science.gov (United States)

    Howard, Louise M.; Heslin, Margaret; Leese, Morven; McCrone, Paul; Rice, Christopher; Jarrett, Manuela; Spokes, Terry; Huxley, Peter; Thornicroft, Graham

    2010-01-01

    Background There is evidence from North American trials that supported employment using the individual placement and support (IPS) model is effective in helping individuals with severe mental illness gain competitive employment. There have been few trials in other parts of the world. Aims To investigate the effectiveness and cost-effectiveness of IPS in the UK. Method Individuals with severe mental illness in South London were randomised to IPS or local traditional vocational services (treatment as usual) (ISRCTN96677673). Results Two hundred and nineteen participants were randomised, and 90% assessed 1 year later. There were no significant differences between the treatment as usual and intervention groups in obtaining competitive employment (13% in the intervention group and 7% in controls; risk ratio 1.35, 95% CI 0.95–1.93, P = 0.15), nor in secondary outcomes. Conclusions There was no evidence that IPS was of significant benefit in achieving competitive employment for individuals in South London at 1-year follow-up, which may reflect suboptimal implementation. Implementation of IPS can be challenging in the UK context where IPS is not structurally integrated with mental health services, and economic disincentives may lead to lower levels of motivation in individuals with severe mental illness and psychiatric professionals. PMID:20435968

  9. Power analysis of trials with multilevel data

    CERN Document Server

    Moerbeek, Mirjam

    2015-01-01

    Power Analysis of Trials with Multilevel Data covers using power and sample size calculations to design trials that involve nested data structures. The book gives a thorough overview of power analysis that details terminology and notation, outlines key concepts of statistical power and power analysis, and explains why they are necessary in trial design. It guides you in performing power calculations with hierarchical data, which enables more effective trial design.The authors are leading experts in the field who recognize that power analysis has attracted attention from applied statisticians i

  10. Single-Trial Inference on Visual Attention

    DEFF Research Database (Denmark)

    Dyrholm, Mads; Kyllingsbæk, Søren; Vangkilde, Signe Allerup

    In this paper we take a step towards single-trial behavioral modeling within a Theory of Visual Attention (TVA). In selective attention tasks, such as the Partial Report paradigm, the subject is asked to ignore distractors and only report stimuli that belong to the target class. Nothing about...... Report trial. This result retrodicts a latent attentional state of the subject using the observed response from that particular trial and thus differs from other predictions made with TVA which are based on expected values of observed variables. We show an example of the result in single-trial analysis...

  11. Uncertainty and the ethics of clinical trials.

    Science.gov (United States)

    Hansson, Sven Ove

    2006-01-01

    A probabilistic explication is offered of equipoise and uncertainty in clinical trials. In order to be useful in the justification of clinical trials, equipoise has to be interpreted in terms of overlapping probability distributions of possible treatment outcomes, rather than point estimates representing expectation values. Uncertainty about treatment outcomes is shown to be a necessary but insufficient condition for the ethical defensibility of clinical trials. Additional requirements are proposed for the nature of that uncertainty. The indecisiveness of our criteria for cautious decision-making under uncertainty creates the leeway that makes clinical trials defensible.

  12. How Experimental Trial Context Affects Perceptual Categorization

    Directory of Open Access Journals (Sweden)

    Thomas J Palmeri

    2015-02-01

    Full Text Available To understand object categorization, participants are tested in experiments often quite different from how people experience object categories in the real world. Learning and knowledge of categories is measured in discrete experimental trials, those trials may or may not provide feedback, trials appear one after another, after some fixed inter-trial interval, with hundreds of trials in a row, within experimental blocks with some structure dictated by the experimental design. In the real world, outside of certain educational and vocational contexts, opportunities to learn and use categories are intermixed over time with a whole multitude of intervening experiences. It is clear from any elementary understanding of human cognition that sequential effects matter, yet this understanding is often ignored, and categorization trials are often instead treated as independent events, immune to local trial context. In this perspective, we use some of our work to illustrate some of the consequences of the fact that categorization experiments have a particular trial structure. Experimental trial context can affect performance in category learning and categorization experiments in ways that can profoundly affect theoretical conclusions.

  13. Single-Trial Inference on Visual Attention

    DEFF Research Database (Denmark)

    Dyrholm, Mads; Kyllingsbæk, Søren; Vangkilde, Signe Allerup

    2011-01-01

    In this paper we take a step towards single-trial behavioral modeling within a Theory of Visual Attention (TVA). In selective attention tasks, such as the Partial Report paradigm, the subject is asked to ignore distractors and only report stimuli that belong to the target class. Nothing about...... Report trial. This result retrodicts a latent attentional state of the subject using the observed response from that particular trial and thus differs from other predictions made with TVA which are based on expected values of observed variables. We show an example of the result in single-trial analysis...

  14. [Situation analysis for drug clinical trial institutions].

    Science.gov (United States)

    Chen, Yin-Ying; Wu, Ping; Wang, Jie

    2014-08-01

    Drug clinical trial is an important link in the chain of new drug research and development. The results of drug discovery and development directly depend on the extent of standardization of clinical trials. Therefore, improving the quality of drug clinical trials is of great importance, and drug clinical trial institutions play a crucial role in the quality management of drug clinical trials. After years of development, the overall level of drug clinical trials has advanced rapidly in China, and a large number of clinical trials of traditional Chinese medicine have also been carried out. However, there is still a big gap between our country and developed countries. Therefore, for the construction and management of Chinese drug clinical trial institutions, there is still a long way to go. This study aims to analyze the current development of drug clinical trial institutions in China and explore the existing problems from three aspects, including current situations of institutional organization and management, regional and professional distributions, and quality control. And some suggestions are put forward finally, including support of traditional Chinese medicine, introduction of drug-risk management system, and construction of information management.

  15. Terminating a long-term clinical trial.

    Science.gov (United States)

    Klimt, C R

    1981-05-01

    Long-term clinical trials often include more than one active treatment group. These may be discontinued independently if found to be ineffective or possibly harmful. Certain subgroups of patients may be discovered, in the course of a clinical trial, who do not respond satisfactorily and are, therefore, excluded during the course of a trial. Yet another kind of termination comes when we have a therapeutic breakthrough or when hope has to be abandoned for demonstrating beneficial effects for one, several, or all treatments included in a trial. Examples from the authors' experience are presented, as are successful and unsuccessful techniques in managing terminations of various types.

  16. Analysis of the first field trial

    OpenAIRE

    Mesa-Lao, Bartolomé; Carl, Michael

    2014-01-01

    In this work package, we evaluate the CASMACAT workbench in eld trials to study the use of the workbench in a real-world environment. We will also integrate the workbench into com- munity translation platforms and collect user activity data from both eld trials and volunteer translators. This Deliverable covers Tasks 6.1 and 6.2. Task 6.1: Field trials at translation agency. Three annual eld trials to evaluate the CASMACAT workbench in a real-world professional translatio...

  17. The impact of advertising patient and public involvement on trial recruitment:embedded cluster randomisedrecruitment trial

    OpenAIRE

    Hughes-Morley, Adwoa; Hann, Robert; Fraser , Claire; Meade, Oonagh; Lovell, Karina; Young, Bridget; Roberts, Christopher; Cree, Lindsey; More, Donna; O'Leary, Neil; Callaghan, Patrick; Waheed, Waquas; Bower, Peter

    2016-01-01

    BackgroundPatient and public involvement in research (PPIR) may improve trial recruitment rates, but it is unclear how. Where trials use PPIR to improve design and conduct, many do not communicate this clearly to potential participants. Better communication of PPIR might encourage patient enrolment, as trials may be perceived as more socially valid, relevant and trustworthy. We aimed to evaluate the impact on recruitment of directly advertising PPIR to potential trial participants.MethodsThis...

  18. Identification of additional trials in prospective trial registers for Cochrane systematic reviews.

    Directory of Open Access Journals (Sweden)

    Wynanda A van Enst

    Full Text Available BACKGROUND: Publication and selective outcome reporting bias are a threat to the validity of systematic reviews. Extensive searching for additional trials in prospective trial registers could reduce this problem. We have evaluated how authors of Cochrane systematic reviews currently make use of trial registers as an additional source for the identification of potentially eligible trials. METHODOLOGY/PRINCIPAL FINDINGS: We included 210 systematic Cochrane reviews of interventions published between 2008 and 2010 of which the protocol was first published in 2008. When prospective trial registers were searched we recorded the names of the register(s, the authors' motive(s and if they yielded any extra trials. In 80 reviews (38.1% the authors had searched in one or more prospective trial register(s of which 55% had searched in overlapping search portals and individual registers. Most frequently assessed were the MetaRegister (66.3% and Clinicaltrials.gov (60% which is in sharp contrast of other registers or portals like the WHO ICTRP Search Portal (20%. Reported motives to use registers were to identify ongoing trials (83.3%, to identify unpublished outcomes or trials (23.5%, to identify recently published trials (11.8%, or to identify any relevant trial (3.9%.In 28 reviews (35% the authors had selected (ongoing trials identified in trial registers as potentially eligible. DISCUSSION: Trial registers as an additional source of information are gaining acknowledgement amongst Cochrane reviewers. Nevertheless, searches seem to be inefficient as overlapping databases are frequently consulted, while the WHO ICTRP Search Portal that includes the data from all approved registers worldwide is being underused. Moreover, the emphasis is now on the identification of ongoing trials, although the prospective registers offer a broader potential. Further familiarity of registers and guidance how to search and to report will help to implement this as a common method

  19. Patient reported outcomes (PROs) in clinical trials: is 'in-trial' guidance lacking? a systematic review.

    OpenAIRE

    Kyte, DG; Draper, H; Ives, J.; Liles, C; Gheorghe, A.; Calvert, M

    2013-01-01

    BACKGROUND: Patient reported outcomes (PROs) are increasingly assessed in clinical trials, and guidelines are available to inform the design and reporting of such trials. However, researchers involved in PRO data collection report that specific guidance on 'in-trial' activity (recruitment, data collection and data inputting) and the management of 'concerning' PRO data (i.e., data which raises concern for the well-being of the trial participant) appears to be lacking. The purpose of this revie...

  20. Acute cough | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available ion E.1.1Medical condition(s) being investigated Acute cough Akuter Husten E.1.1.1Medical condition in easily understood language Acu...igation E.1.2Version 17.1 E.1.2Level LLT E.1.2Classification code 10066522 E.1.2Term Acute cough E.1.2System...igible for inclusion in this trial must fulfill all of the following criteria:1. Acute cough with symptoms l...based on medical history and physical examination7. CS score of at least 50 mm on a 100 mm VAS at V1 8. Acute...te cough Akuter Husten E.1.1.2Therapeutic area Diseases [C] - Respiratory Tract Dis

  1. Type 2 diabetes mellitus | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available .2 Objective of the trial E.2.1Main objective of the trial The purpose of this trial is to demonstrate that dextromethorphan...– IMP) before and during an OGTT- For dextromethorphan: to assess whether a dose-dependency of PD exists-To

  2. Increasing recruitment to randomised trials: a review of randomised controlled trials

    Directory of Open Access Journals (Sweden)

    Torgerson David J

    2006-07-01

    Full Text Available Abstract Background Poor recruitment to randomised controlled trials (RCTs is a widespread and important problem. With poor recruitment being such an important issue with respect to the conduct of randomised trials, a systematic review of controlled trials on recruitment methods was undertaken in order to identify strategies that are effective. Methods We searched the register of trials in Cochrane library from 1996 to end of 2004. We also searched Web of Science for 2004. Additional trials were identified from personal knowledge. Included studies had to use random allocation and participants had to be allocated to different methods of recruitment to a 'real' randomised trial. Trials that randomised participants to 'mock' trials and trials of recruitment to non-randomised studies (e.g., case control studies were excluded. Information on the study design, intervention and control, and number of patients recruited was extracted by the 2 authors. Results We identified 14 papers describing 20 different interventions. Effective interventions included: telephone reminders; questionnaire inclusion; monetary incentives; using an 'open' rather than placebo design; and making trial materials culturally sensitive. Conclusion Few trials have been undertaken to test interventions to improve trial recruitment. There is an urgent need for more RCTs of recruitment strategies.

  3. A Public Trial De Novo

    DEFF Research Database (Denmark)

    Vedel, Jane Bjørn; Gad, Christopher

    2011-01-01

    This article addresses the concept of “industrial interests” and examines its role in a topical controversy about a large research grant from a private foundation, the Novo Nordisk Foundation, to the University of Copenhagen. The authors suggest that the debate took the form of a “public trial......” where the grant and close(r) intermingling between industry and public research was prosecuted and defended. First, the authors address how the grant was framed in the media. Second, they redescribe the case by introducing new “evidence” that, because of this framing, did not reach “the court.......” The article ends with a discussion of some implications of the analysis, including that policy making, academic research, and public debates might benefit from more detailed accounts of interests and stakes....

  4. Alien wavelength modeling tool and field trial

    DEFF Research Database (Denmark)

    Sambo, N.; Sgambelluri, A.; Secondini, M.

    2015-01-01

    A modeling tool is presented for pre-FEC BER estimation of PM-QPSK alien wavelength signals. A field trial is demonstrated and used as validation of the tool's correctness. A very close correspondence between the performance of the field trial and the one predicted by the modeling tool has been...

  5. International Clinical Trials Registry Platform (ICTRP)

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    @@ Introduction The mission of the WHO Intemational Clinical Trials Registry Platform is to ensure that a complete view of research is accessible to all those involved in health care decision making.This will improve research transparency and will ultimately strengthen tha validity and value of the scientific evidence base.The registration of all interventional trials is a scientific, ethical and moral responsibility.

  6. National Lung Screening Trial Results: Fast Facts

    Science.gov (United States)

    On November 4, 2010, the NLST reported initial trial results, showing 20 percent fewer lung cancer deaths among trial participants screened with low-dose helical CT (also known as spiral CT) compared to those who got screened with chest X-rays.

  7. Blinded trials taken to the test

    DEFF Research Database (Denmark)

    Hróbjartsson, A; Forfang, E; Haahr, M T

    2007-01-01

    Blinding can reduce bias in randomized clinical trials, but blinding procedures may be unsuccessful. Our aim was to assess how often randomized clinical trials test the success of blinding, the methods involved and how often blinding is reported as being successful....

  8. The design of cluster randomized crossover trials

    NARCIS (Netherlands)

    Rietbergen, C.; Moerbeek, M.

    2011-01-01

    The inefficiency induced by between-cluster variation in cluster randomized (CR) trials can be reduced by implementing a crossover (CO) design. In a simple CO trial, each subject receives each treatment in random order. A powerful characteristic of this design is that each subject serves as its own

  9. Trial Sequential Methods for Meta-Analysis

    Science.gov (United States)

    Kulinskaya, Elena; Wood, John

    2014-01-01

    Statistical methods for sequential meta-analysis have applications also for the design of new trials. Existing methods are based on group sequential methods developed for single trials and start with the calculation of a required information size. This works satisfactorily within the framework of fixed effects meta-analysis, but conceptual…

  10. Clinical Trials and the Role of the Oncology Clinical Trials Nurse.

    Science.gov (United States)

    Ness, Elizabeth A; Royce, Cheryl

    2017-03-01

    Clinical trials are paramount to improving human health. New trial designs and informed consent issues are emerging as a result of genomic profiling and the development of molecularly targeted agents. Many groups and individuals are responsible for ensuring the protection of research participants and the quality of the data produced. The specialty role of the clinical trials nurse (CTN) is critical to clinical trials. Oncology CTNs have competencies that can help guide their practice; however, not all oncology clinical trials are supervised by a nurse. Using the process of engagement, one organization has restructured oncology CTNs under a nurse-supervised model.

  11. Why are clinical trials necessary in India?

    Directory of Open Access Journals (Sweden)

    Subramani Poongothai

    2014-01-01

    Full Text Available Clinical trials are emerging as an important activity in India as it is an essential component of the drug discovery and development program to which India is committed. The only robust way to evaluate a new medicine is by doing properly designed clinical trials. In addition to advancing science, clinical trials offer myriad benefits to the participants. The recent hue that created in India about clinical trials is probably an exaggeration of facts. However, these points to the need for ensuring proper compliance with the regulatory norms and proper training of concerned personnel in good clinical practice (GCP. This will ensure that India continues to reap the benefits of clinical trials and also become a world leader in this field.

  12. Marketing and clinical trials: a case study.

    Science.gov (United States)

    Francis, David; Roberts, Ian; Elbourne, Diana R; Shakur, Haleema; Knight, Rosemary C; Garcia, Jo; Snowdon, Claire; Entwistle, Vikki A; McDonald, Alison M; Grant, Adrian M; Campbell, Marion K

    2007-11-20

    Publicly funded clinical trials require a substantial commitment of time and money. To ensure that sufficient numbers of patients are recruited it is essential that they address important questions in a rigorous manner and are managed well, adopting effective marketing strategies. Using methods of analysis drawn from management studies, this paper presents a structured assessment framework or reference model, derived from a case analysis of the MRC's CRASH trial, of 12 factors that may affect the success of the marketing and sales activities associated with clinical trials. The case study demonstrates that trials need various categories of people to buy in - hence, to be successful, trialists must embrace marketing strategies to some extent. The performance of future clinical trials could be enhanced if trialists routinely considered these factors.

  13. Paperless clinical trials: Myth or reality?

    Science.gov (United States)

    Gupta, Sandeep K.

    2015-01-01

    There is an urgent need to expedite the time-to-market for new drugs and to make the approval process simpler. But clinical trials are a complex process and the increased complexity leads to decreased efficiency. Hence, pharmaceutical organizations want to move toward a more technology-driven clinical trial process for recording, analyzing, reporting, archiving, etc., In recent times, the progress has certainly been made in developing paperless systems that improve data capture and management. The adaptation of paperless processes may require major changes to existing procedures. But this is in the best interests of these organizations to remain competitive because a paperless clinical trial would lead to a consistent and streamlined framework. Moreover, all major regulatory authorities also advocate adoption of paperless trial. But challenges still remain toward implementation of paperless clinical trial process. PMID:26288464

  14. Ethics of clinical trials in Nigeria

    Directory of Open Access Journals (Sweden)

    Patrick I Okonta

    2014-01-01

    Full Text Available The conduct of clinical trials for the development and licensing of drugs is a very important aspect of healthcare. Drug research, development and promotion have grown to a multi-billion dollar global business. Like all areas of human endeavour involving generation and control of huge financial resources, it could be subject to deviant behaviour, sharp business practices and unethical practices. The main objective of this review is to highlight potential ethical challenges in the conduct of clinical trials in Nigeria and outline ways in which these can be avoided. Current international and national regulatory and ethical guidelines are reviewed to illustrate the requirements for ethical conduct of clinical trials. Past experiences of unethical conduct of clinical trials especially in developing countries along with the increasing globalisation of research makes it imperative that all players should be aware of the ethical challenges in clinical trials and the benchmarks for ethical conduct of clinical research in Nigeria.

  15. Paperless clinical trials: Myth or reality?

    Directory of Open Access Journals (Sweden)

    Sandeep K Gupta

    2015-01-01

    Full Text Available There is an urgent need to expedite the time-to-market for new drugs and to make the approval process simpler. But clinical trials are a complex process and the increased complexity leads to decreased efficiency. Hence, pharmaceutical organizations want to move toward a more technology-driven clinical trial process for recording, analyzing, reporting, archiving, etc., In recent times, the progress has certainly been made in developing paperless systems that improve data capture and management. The adaptation of paperless processes may require major changes to existing procedures. But this is in the best interests of these organizations to remain competitive because a paperless clinical trial would lead to a consistent and streamlined framework. Moreover, all major regulatory authorities also advocate adoption of paperless trial. But challenges still remain toward implementation of paperless clinical trial process.

  16. Paperless clinical trials: Myth or reality?

    Science.gov (United States)

    Gupta, Sandeep K

    2015-01-01

    There is an urgent need to expedite the time-to-market for new drugs and to make the approval process simpler. But clinical trials are a complex process and the increased complexity leads to decreased efficiency. Hence, pharmaceutical organizations want to move toward a more technology-driven clinical trial process for recording, analyzing, reporting, archiving, etc., In recent times, the progress has certainly been made in developing paperless systems that improve data capture and management. The adaptation of paperless processes may require major changes to existing procedures. But this is in the best interests of these organizations to remain competitive because a paperless clinical trial would lead to a consistent and streamlined framework. Moreover, all major regulatory authorities also advocate adoption of paperless trial. But challenges still remain toward implementation of paperless clinical trial process.

  17. Ethics of clinical trials in Nigeria.

    Science.gov (United States)

    Okonta, Patrick I

    2014-05-01

    The conduct of clinical trials for the development and licensing of drugs is a very important aspect of healthcare. Drug research, development and promotion have grown to a multi-billion dollar global business. Like all areas of human endeavour involving generation and control of huge financial resources, it could be subject to deviant behaviour, sharp business practices and unethical practices. The main objective of this review is to highlight potential ethical challenges in the conduct of clinical trials in Nigeria and outline ways in which these can be avoided. Current international and national regulatory and ethical guidelines are reviewed to illustrate the requirements for ethical conduct of clinical trials. Past experiences of unethical conduct of clinical trials especially in developing countries along with the increasing globalisation of research makes it imperative that all players should be aware of the ethical challenges in clinical trials and the benchmarks for ethical conduct of clinical research in Nigeria.

  18. Methodological issues in negative symptom trials.

    Science.gov (United States)

    Marder, Stephen R; Daniel, David G; Alphs, Larry; Awad, A George; Keefe, Richard S E

    2011-03-01

    Individuals from academia, the pharmaceutical industry, and the US Food and Drug Administration used a workshop format to discuss important methodological issues in the design of trials of pharmacological agents for improving negative symptoms in schizophrenia. The issues addressed included the need for a coprimary functional measure for registration trials; the characteristics of individuals who should enter negative symptom trials; the optimal duration for a proof-of-concept or registration trial; the optimal design of a study of a broad-spectrum agent that treats both positive and negative symptoms or a co-medication that is added to an antipsychotic; the relative strengths and weaknesses of available instruments for measuring negative symptoms; the definition of clinically meaningful improvement for these trials; and whether drugs can be approved for a subdomain of negative symptoms.

  19. Automated information extraction of key trial design elements from clinical trial publications.

    Science.gov (United States)

    de Bruijn, Berry; Carini, Simona; Kiritchenko, Svetlana; Martin, Joel; Sim, Ida

    2008-11-06

    Clinical trials are one of the most valuable sources of scientific evidence for improving the practice of medicine. The Trial Bank project aims to improve structured access to trial findings by including formalized trial information into a knowledge base. Manually extracting trial information from published articles is costly, but automated information extraction techniques can assist. The current study highlights a single architecture to extract a wide array of information elements from full-text publications of randomized clinical trials (RCTs). This architecture combines a text classifier with a weak regular expression matcher. We tested this two-stage architecture on 88 RCT reports from 5 leading medical journals, extracting 23 elements of key trial information such as eligibility rules, sample size, intervention, and outcome names. Results prove this to be a promising avenue to help critical appraisers, systematic reviewers, and curators quickly identify key information elements in published RCT articles.

  20. Clinical Trials: Information and Options for People with Mood Disorders

    Science.gov (United States)

    ... Releases & Announcements Public Service Announcements Partnering with DBSA Clinical Trials: Information and Options for People with Mood Disorders What are clinical trials? Clinical trials are research studies involving people, which ...

  1. Clinical Trials | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Clinical Trials Clinical Trials, A Healthier Future for All Past Issues / Fall ... in was reviewed by an IRB. Find a Clinical Trial Near You Health research takes place at hospitals, ...

  2. Biopharmaceutical industry-sponsored global clinical trials in emerging countries

    National Research Council Canada - National Science Library

    Alvarenga, Lenio Souza; Martins, Elisabeth Nogueira

    2010-01-01

    .... Proportions of sites in each country were compared among emerging countries. Multiple logistic regressions were performed to evaluate whether trial placement in Brazil could be predicted by trial location in other countries and/or by trial features...

  3. Characteristics of pediatric pulmonary hypertension trials registered on ClinicalTrials.gov.

    Science.gov (United States)

    Awerbach, Jordan D; Krasuski, Richard A; Hill, Kevin D

    2017-01-01

    The investigation of pediatric pulmonary hypertension (PH) drugs has been identified as a high priority by the United States National Institutes of Health (NIH). Studying pediatric PH is challenging due to the rare and heterogeneous nature of the disease. We sought to define the pediatric PH clinical trials landscape, to evaluate areas of trial success or failure, and to identify potential obstacles to the study of pediatric PH drugs. Interventional pediatric (ages 0-17 years) PH trials registered on ClinicalTrials.gov from June 2005 through December 2014 were analyzed. There were 45 pediatric PH trials registered during the study period. Median (IQR) projected trial enrollment was 40 (24-63), with seven trials (16%) targeting > 100 participants. Industry was the most common trial sponsor (n = 23, 50%), with only two (4.4%) NIH-sponsored trials. Phosphodiesterase inhibitors were the most frequently studied drug (n = 18, 39%). Single group study designs were used in 44% (n = 20) with an active comparator (parallel, factorial, or cross-over designs) in 25 trials, including 22 with randomization and ten that were double-blinded. Study outcomes varied markedly with inconsistent use of known surrogate and composite endpoints. One-third of trials (n = 15, 33%) were terminated, predominantly due to poor participant enrollment. Of the 17 completed trials, 11 had published results and only three efficacy trials met their primary endpoint. There are unique challenges to drug development in pediatric PH, including enrolling patients, identifying appropriate study endpoints, and conducting randomized, controlled, double-blind trials where the likelihood of meeting the study endpoint is optimized.

  4. Characteristics of clinical trials registered in ClinicalTrials.gov, 2007-2010.

    Science.gov (United States)

    Califf, Robert M; Zarin, Deborah A; Kramer, Judith M; Sherman, Rachel E; Aberle, Laura H; Tasneem, Asba

    2012-05-02

    Recent reports highlight gaps between guidelines-based treatment recommendations and evidence from clinical trials that supports those recommendations. Strengthened reporting requirements for studies registered with ClinicalTrials.gov enable a comprehensive evaluation of the national trials portfolio. To examine fundamental characteristics of interventional clinical trials registered in the ClinicalTrials.gov database. A data set comprising 96,346 clinical studies from ClinicalTrials.gov was downloaded on September 27, 2010, and entered into a relational database to analyze aggregate data. Interventional trials were identified and analyses were focused on 3 clinical specialties-cardiovascular, mental health, and oncology-that together encompass the largest number of disability-adjusted life-years lost in the United States. Characteristics of registered clinical trials as reported data elements in the trial registry; how those characteristics have changed over time; differences in characteristics as a function of clinical specialty; and factors associated with use of randomization, blinding, and data monitoring committees (DMCs). The number of registered interventional clinical trials increased from 28,881 (October 2004-September 2007) to 40,970 (October 2007-September 2010), and the number of missing data elements has generally declined. Most interventional trials registered between 2007 and 2010 were small, with 62% enrolling 100 or fewer participants. Many clinical trials were single-center (66%; 24,788/37,520) and funded by organizations other than industry or the National Institutes of Health (NIH) (47%; 17,592/37,520). Heterogeneity in the reported methods by clinical specialty; sponsor type; and the reported use of DMCs, randomization, and blinding was evident. For example, reported use of DMCs was less common in industry-sponsored vs NIH-sponsored trials (adjusted odds ratio [OR], 0.11; 95% CI, 0.09-0.14), earlier-phase vs phase 3 trials (adjusted OR, 0

  5. Disclosure of investigators' recruitment performance in multicenter clinical trials

    DEFF Research Database (Denmark)

    Dal-Ré, Rafael; Moher, David; Gluud, Christian;

    2011-01-01

    Rafael Dal-Ré and colleagues argue that the recruitment targets and performance of all site investigators in multi-centre clinical trials should be disclosed in trial registration sites before a trial starts, and when it ends.......Rafael Dal-Ré and colleagues argue that the recruitment targets and performance of all site investigators in multi-centre clinical trials should be disclosed in trial registration sites before a trial starts, and when it ends....

  6. Clinical trial registration in oral health journals.

    Science.gov (United States)

    Smaïl-Faugeron, V; Fron-Chabouis, H; Durieux, P

    2015-03-01

    Prospective registration of randomized controlled trials (RCTs) represents the best solution to reporting bias. The extent to which oral health journals have endorsed and complied with RCT registration is unknown. We identified journals publishing RCTs in dentistry, oral surgery, and medicine in the Journal Citation Reports. We classified journals into 3 groups: journals requiring or recommending trial registration, journals referring indirectly to registration, and journals providing no reference to registration. For the 5 journals with the highest 2012 impact factors in each group, we assessed whether RCTs with results published in 2013 had been registered. Of 78 journals examined, 32 (41%) required or recommended trial registration, 19 (24%) referred indirectly to registration, and 27 (35%) provided no reference to registration. We identified 317 RCTs with results published in the 15 selected journals in 2013. Overall, 73 (23%) were registered in a trial registry. Among those, 91% were registered retrospectively and 32% did not report trial registration in the published article. The proportion of trials registered was not significantly associated with editorial policies: 29% with results in journals that required or recommended registration, 15% in those that referred indirectly to registration, and 21% in those providing no reference to registration (P = 0.05). Less than one-quarter of RCTs with results published in a sample of oral health journals were registered with a public registry. Improvements are needed with respect to how journals inform and require their authors to register their trials.

  7. The Clinical Trials Transformation Initiative (CTTI

    Directory of Open Access Journals (Sweden)

    Alberto Grignolo

    2011-01-01

    Full Text Available The Clinical Trials Transformation Initiative (CTTI is a public-private partnership created in 2007 between the United States Food and Drug Administration (FDA and Duke University for the purpose of identifying practices that will increase the quality and efficiency of clinical trials. The initiative was generated from the realization that the clinical trials system in the United States has been suffering as a result of increasingly longer study start-up times, slowing enrollment of patients into trials, increasing clinical trial costs, and declining investigator interest in participating in clinical trials. Although CTTI was created to address a crisis for US clinical research, it seeks to identify practice improvements that can be applied internationally, and is therefore engaging international collaborators with international efforts that have similar objectives. CTTI's approach is to involve all sectors in the selection, conduct, and interpretation of its projects; to keep the dialogue open across sectors; to provide evidence that can influence regulatory guidance, and to attempt to create a "level playing field" when recommending change. The hope is that a broad and diverse data-driven discussion of the important issues in clinical trials will lead to meaningful change for the benefit of all concerned, and importantly for patients.

  8. Justifying clinical trials for porcine islet xenotransplantation.

    Science.gov (United States)

    Ellis, Cara E; Korbutt, Gregory S

    2015-01-01

    The development of the Edmonton Protocol encouraged a great deal of optimism that a cell-based cure for type I diabetes could be achieved. However, donor organ shortages prevent islet transplantation from being a widespread solution as the supply cannot possibly equal the demand. Porcine islet xenotransplantation has the potential to address these shortages, and recent preclinical and clinical trials show promising scientific support. Consequently, it is important to consider whether the current science meets the ethical requirements for moving toward clinical trials. Despite the potential risks and the scientific unknowns that remain to be investigated, there is optimism regarding the xenotransplantation of some types of tissue, and enough evidence has been gathered to ethically justify clinical trials for the most safe and advanced area of research, porcine islet transplantation. Researchers must make a concerted effort to maintain a positive image for xenotransplantation, as a few well-publicized failed trials could irrevocably damage public perception of xenotransplantation. Because all of society carries the burden of risk, it is important that the public be involved in the decision to proceed. As new information from preclinical and clinical trials develops, policy decisions should be frequently updated. If at any point evidence shows that islet xenotransplantation is unsafe, then clinical trials will no longer be justified and they should be halted. However, as of now, the expected benefit of an unlimited supply of islets, combined with adequate informed consent, justifies clinical trials for islet xenotransplantation.

  9. The clinically-integrated randomized trial: proposed novel method for conducting large trials at low cost

    Directory of Open Access Journals (Sweden)

    Scardino Peter T

    2009-03-01

    Full Text Available Abstract Introduction Randomized controlled trials provide the best method of determining which of two comparable treatments is preferable. Unfortunately, contemporary randomized trials have become increasingly expensive, complex and burdened by regulation, so much so that many trials are of doubtful feasibility. Discussion Here we present a proposal for a novel, streamlined approach to randomized trials: the "clinically-integrated randomized trial". The key aspect of our methodology is that the clinical experience of the patient and doctor is virtually indistinguishable whether or not the patient is randomized, primarily because outcome data are obtained from routine clinical data, or from short, web-based questionnaires. Integration of a randomized trial into routine clinical practice also implies that there should be an attempt to randomize every patient, a corollary of which is that eligibility criteria are minimized. The similar clinical experience of patients on- and off-study also entails that the marginal cost of putting an additional patient on trial is negligible. We propose examples of how the clinically-integrated randomized trial might be applied in four distinct areas of medicine: comparisons of surgical techniques, "me too" drugs, rare diseases and lifestyle interventions. Barriers to implementing clinically-integrated randomized trials are discussed. Conclusion The proposed clinically-integrated randomized trial may allow us to enlarge dramatically the number of clinical questions that can be addressed by randomization.

  10. Pragmatic design in randomized controlled trials.

    Science.gov (United States)

    Purgato, M; Barbui, C; Stroup, S; Adams, C

    2015-01-01

    At more than 10 years after the paper by Hotopf and colleagues regarding pragmatic trials in psychiatry, the field has evolved and is evolving further. There have been many developments in our understanding of what pragmatism really means, and excellent examples of truly pragmatic trials in psychiatry are currently available. Funders have helped encourage more emphasis on the need for such studies, but 'local' and trans-national regulations could help more. Consumers of the evidence should have a greater voice in generating the research agenda and, as this happens, the questions generated are more likely to be answered by a pragmatic approach to trials.

  11. Lessons Learned from Radiation Oncology Clinical Trials

    OpenAIRE

    Liu, Fei-Fei; Okunieff, Paul; Bernhard, Eric J.; Stone, Helen B.; Yoo, Stephen; Coleman, C. Norman; Vikram, Bhadrasain; Brown, Martin; Buatti, John; Guha, Chandan

    2013-01-01

    A Workshop entitled “Lessons Learned from Radiation Oncology Trials” was held on December 7–8th, 2011 in Bethesda, MD, to present and discuss some of the recently conducted Radiation Oncology clinical trials with a focus on those that failed to refute the null hypothesis. The objectives of this Workshop were to summarize and examine the questions that these trials provoked, to assess the quality and limitations of the pre-clinical data that supported the hypotheses underlying these trials, an...

  12. Analysis of the third field trial

    OpenAIRE

    Alabau, Vicent; Carl, Michael; Martínez, García, G.; González-Rubio, Jesús; Mesa-Lao, Bartolomé; Ortiz-Martínez, Daniel; Rodrigues,Sofia; Schaeffer, Moritz

    2014-01-01

    In this work package, we evaluate the CasMaCat workbench in eld trials to study the use of the workbench in a real-world environment. We have also integrated the workbench into community translation platforms and collected user activity data from both eld trials and volunteer translators interacting with the workbench. This Deliverable covers Task 6.1 and 6.2. Task 6.1: Third eld trial at a translation agency (Celer Soluciones SL in Madrid) to evaluate the CasMaCat work...

  13. Analysis of the second Field trial

    OpenAIRE

    Iglesias, Eva Marcos; Pellegrino, Massimiliano; Carl, Michael; García-Martínez, Mercedes; Mesa-Lao, Bartolomé; Underwood, Nancy

    2014-01-01

    In this work package, we evaluate the CasMaCat workbench in eld trials to study the use of the workbench in a real-world environment. We will also integrate the workbench into com- munity translation platforms and collect user activity data from both eld trials and volunteer translators. This Deliverable covers Tasks 6.1 and 6.2. Task 6.1: Three eld trials at a translation agency (Celer Soluciones SL)to evaluate the CasMaCat workbench in a real-world professional translat...

  14. Provenance trials of larch in Siberia

    Energy Technology Data Exchange (ETDEWEB)

    Milyutin, L.I. [V.N. Sukachev Inst. of Forest SB RAS, Krasnoyarsk (Russian Federation)

    1995-12-31

    Some results of provenance trials of larch in Siberia are given. These provenance trials were established in the last thirty years by efforts of V.N. Sukaczev Inst. of Forest. Provenances and species of larch were tested in some field trials distributed over Siberia between Lat. N 52 deg and 66 deg, Long. E 88 deg and 113 deg: near Krasnoyarsk, in Republic Khakasia (an altitudes of 800 and 1200 metres), in the Lower Yenisei near Turukhansk, in the west and south regions of Krasnoyarsk territory, in the Upper Lena, near Chita. 2 refs

  15. Function: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Shakuri Seyed Kazem

    2015-03-01

    Full Text Available Introduction: Prevention of pulmonary complications after coronary artery bypass graft is attended as a very important issue. The aim of this study was to evaluate the role of pulmonary rehabilitation before surgery for reducing the risk of pulmonary complications after surgery. Methods: In a randomized clinical trial, 60 patients undergoing heart surgery were randomly divided into two groups A and B. Chest physiotherapy was performed before and after surgery on group A patients however it was done on group B’s, only after surgery. Effects of preoperative pulmonary rehabilitation were compared between two groups, using spirometry and arterial blood gas (ABG. Results: Thirty nine males (65% and 21 females (35% with mean age of 8.10 ± 9.56 were analyzed.The mean differences were statistically significant for predicted forced vital capacity (FVC (CI95%:1.3 to 8.7 and Predicted Peak Flow indices (PEF (CI 95%: 1.9 to 9.4 of spirometry indicator,PCO2 index (of ABG parameter (CI 95%: 1.4 to 8.9 and mean oxygen saturation (mean Spo2 (CI 95%: 0.6 to 1.7 of ABG index in two groups. Conclusion: The performance of pulmonary rehabilitation program before surgery is recommended, as it may result in the reduction of complications of heart surgery.

  16. Recruitment to randomised trials: strategies for trial enrollment and participation study. The STEPS study.

    Science.gov (United States)

    Campbell, M K; Snowdon, C; Francis, D; Elbourne, D; McDonald, A M; Knight, R; Entwistle, V; Garcia, J; Roberts, I; Grant, A; Grant, A

    2007-11-01

    To identify factors associated with good and poor recruitment to multicentre trials. Part A: database of trials started in or after 1994 and were due to end before 2003 held by the Medical Research Council and Health Technology Assessment Programmes. Part B: interviews with people playing a wide range of roles within four trials that their funders identified as 'exemplars'. Part C: a large multicentre trial (the CRASH trial) of treatment for head injury. The study used a number of different perspectives ('multiple lenses'), and three components. Part A: an epidemiological review of a cohort of trials. Part B: case studies of trials that appeared to have particularly interesting lessons for recruitment. Part C: a single, in-depth case study to examine the feasibility of applying a business-orientated analytical framework as a reference model in future trials. In the 114 trials found in Part A, less than one-third recruited their original target within the time originally specified, and around one-third had extensions. Factors observed more often in trials that recruited successfully were: having a dedicated trial manager, being a cancer or drug trial, and having interventions only available inside the trial. The most commonly reported strategies to improve recruitment were newsletters and mailshots, but it was not possible to assess whether they were causally linked to changes in recruitment. The analyses in Part B suggested that successful trials were those addressing clinically important questions at a timely point. The investigators were held in high esteem by the interviewees, and the trials were firmly grounded in existing clinical practices, so that the trial processes were not alien to clinical collaborators, and the results could be easily applicable to future practice. The interviewees considered that the needs of patients were well served by participation in the trials. Clinical collaborators particularly appreciated clear delineation of roles, which

  17. Population activity changes during a trial-to-trial adaptation of bullfrog retinal ganglion cells.

    Science.gov (United States)

    Ding, Wei; Xiao, Lei; Jing, Wei; Zhang, Pu-Ming; Liang, Pei-Ji

    2014-07-09

    A 'trial-to-trial adaptation' of bullfrog retinal ganglion cells in response to a repetitive light stimulus was investigated in the present study. Using the multielectrode recording technique, we studied the trial-to-trial adaptive properties of ganglion cells and explored the activity of population neurons during this adaptation process. It was found that the ganglion cells adapted with different degrees: their firing rates were decreased in different extents from early-adaptation to late-adaptation stage, and this was accompanied by a decrease in cross-correlation strength. In addition, adaptation behavior was different for ON-response and OFF-response, which implied that the mechanism of the trial-to-trial adaptation might involve bipolar cells and/or their synapses with other neurons and the stronger adaptation in the ganglion cells' OFF-responses might reflect the requirement to avoid possible saturation in the OFF circuit.

  18. Narrating the Mensalão trial

    DEFF Research Database (Denmark)

    Damgaard, Mads

    2015-01-01

    Coming to a close in the last days of 2012, the trial of the so-called mensalão network was heralded as Brazil's trial of the century. Involving corruption in the top ranks of the business world and the former government, the process ended with an exceptional result in the sense that severe...... sentences were meted out to 25 of the 38 defendants, thereby breaking an established pattern of impunity for corrupt politicians in Brazilian courts. As a scandal potentially harmful for the governing party and the former president Luis “Lula” da Silva, the eyes and spotlights of the national media were...... fixed on the trial. However, the varying and contested ways in which the case was presented by media from the outbreak of the scandal in 2005 until the end of the trial bears witness to the fact that narratives concerning corruption scandals can potentially encompass a broad range of political...

  19. Blinding in randomized clinical trials: imposed impartiality

    DEFF Research Database (Denmark)

    Hróbjartsson, A; Boutron, I

    2011-01-01

    Blinding, or "masking," is a crucial method for reducing bias in randomized clinical trials. In this paper, we review important methodological aspects of blinding, emphasizing terminology, reporting, bias mechanisms, empirical evidence, and the risk of unblinding. Theoretical considerations...

  20. Monitoring clinical trials: a practical guide.

    Science.gov (United States)

    Molloy, Síle F; Henley, Patricia

    2016-12-01

    This article describes the processes and procedures involved in planning, conducting and reporting monitoring activities for large Clinical Trials of Investigational Medicinal Products (CTIMPs), focusing on those conducted in resource-limited settings. © 2016 John Wiley & Sons Ltd.

  1. the infrastructure supporting hiv vaccine clinical trials

    African Journals Online (AJOL)

    networks, namely the HIV Vaccine Trials Network (HVTN - www.hvtn.org) and the International ... These include life skills education, sanitation, potable water supply ... and data management centre, central laboratories, a community advisory ...

  2. Citicoline for ischemic stroke: ICTUS trial

    Directory of Open Access Journals (Sweden)

    Vladimir Anatolyevich Parfenov

    2012-01-01

    Full Text Available The paper gives data available in the literature on the use of citicoline in an experimental model of ischemic stroke (IS and in randomized multicenter placebo-controlled trials. It analyzes the results of the ICTUS trial in which 2298 patients with IS who received randomly citicoline or placebo for 24 hours after the onset of symptoms (I000 mg intravenously every I2 hours during the first 3 days, then orally as one 500-mg tablet every 12 hours during 6 weeks. The results of the trial confirmed the safety of citicoline used in IS, but failed to show its significant advantage over placebo in reducing the degree of disability (global improvement 90 days later. However, to pool the results of the ICTUS trial with those of other randomized multicenter placebo-controlled studies demonstrates a significant decrease in the degree of disability in IS patients treated with citicoline.

  3. Nutrition Intervention Trials in Linxian, China

    Science.gov (United States)

    Randomized controlled trials were launched in 1985 to test the effects of multiple vitamin and mineral interventions on total mortality and total and cause-specific cancer mortality in a rural Chinese population

  4. Ebola Vaccine Appears Very Effective in Trial

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_162715.html Ebola Vaccine Appears Very Effective in Trial Drug manufacturer says ... Dec. 23, 2016 (HealthDay News) -- An experimental Ebola vaccine was highly effective against the deadly virus in ...

  5. The New Math of Clinical Trials

    National Research Council Canada - National Science Library

    Jennifer Couzin

    2004-01-01

    ... altering them as they run to take into account accumulating results. Although Bayesian designs are now widely used in everything from astrophysics to ecology, they've been slower to catch on in medical research, particularly clinical trials...

  6. Smart Technology in Lung Disease Clinical Trials.

    Science.gov (United States)

    Geller, Nancy L; Kim, Dong-Yun; Tian, Xin

    2016-01-01

    This article describes the use of smart technology by investigators and patients to facilitate lung disease clinical trials and make them less costly and more efficient. By "smart technology" we include various electronic media, such as computer databases, the Internet, and mobile devices. We first describe the use of electronic health records for identifying potential subjects and then discuss electronic informed consent. We give several examples of using the Internet and mobile technology in clinical trials. Interventions have been delivered via the World Wide Web or via mobile devices, and both have been used to collect outcome data. We discuss examples of new electronic devices that recently have been introduced to collect health data. While use of smart technology in clinical trials is an exciting development, comparison with similar interventions applied in a conventional manner is still in its infancy. We discuss advantages and disadvantages of using this omnipresent, powerful tool in clinical trials, as well as directions for future research.

  7. Trials of electronet fencing to exclude coyotes

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report is on the trials of using electronet fencing to exclude coyotes for the protection of black-footed ferrets in Montana. Reintroduction of black-tailed...

  8. The PACT trial: PAtient Centered Telerehabilitation

    Directory of Open Access Journals (Sweden)

    Andreas Stefan Rothgangel

    2015-01-01

    Discussion: Several questions concerning the study design that emerged during the preparation of this trial will be discussed. This will include how these questions were addressed and arguments for the choices that were made.

  9. The unintended consequences of clinical trials regulations.

    Directory of Open Access Journals (Sweden)

    Alex D McMahon

    2009-11-01

    Full Text Available Alex McMahon and colleagues critique the International Conference on Harmonisation (ICH guidance on good clinical practice (GCP, arguing that it is having a disastrous effect on noncommerical randomized clinical trials in Europe.

  10. The unintended consequences of clinical trials regulations

    OpenAIRE

    Alex D McMahon; Conway, David I; MacDonald, Tom M; McInnes, Gordon T

    2009-01-01

    Alex McMahon and colleagues critique the International Conference on Harmonisation (ICH) guidance on good clinical practice (GCP), arguing that it is having a disastrous effect on noncommerical randomized clinical trials in Europe.

  11. Involving South Asian patients in clinical trials.

    Science.gov (United States)

    Hussain-Gambles, M; Leese, B; Atkin, K; Brown, J; Mason, S; Tovey, P

    2004-10-01

    To investigate how South Asian patients conceptualise the notion of clinical trials and to identify key processes that impact on trial participation and the extent to which communication difficulties, perceptions of risk and attitudes to authority influence these decisions. Also to identify whether 'South Asian' patients are homogeneous in these issues, and which factors differ between different South Asian subgroups and finally how professionals regard the involvement of South Asian patients and their views on strategies to increase participation. A review of the literature on minority ethnic participation in clinical trials was followed by three qualitative interview studies. Interviews were taped and transcribed (and translated if required) and subjected to framework analysis. Face-to-face interviews were conducted with 25 health professionals; 60 South Asian lay people who had not taken part in a trial and 15 South Asian trial participants. Motivations for trial participation were identified as follows: to help society, to improve own health or that of family and friends, out of obligation to the doctor and to increase scientific knowledge. Deterrents were concerns about drug side-effects, busy lifestyles, language, previous bad experiences, mistrust and feelings of not belonging to British society. There was no evidence of antipathy amongst South Asians to the concept of clinical trials and, overall, the younger respondents were more knowledgeable than the older ones. Problems are more likely to be associated with service delivery. Lack of being approached was a common response. Lay-reported factors that might affect South Asian participation in clinical trials include age, language, social class, feeling of not belonging/mistrust, culture and religion. Awareness of clinical trials varied between each group. There are more similarities than differences in attitudes towards clinical trial participation between the South Asian and the general population

  12. ORIGINAL ARTICLES Pharmacologically active: clinical trials and ...

    African Journals Online (AJOL)

    2008-01-22

    Jan 22, 2008 ... Manufacturers Association, on the basis of a survey of its members ... from this information. The US database, on the other hand, clearly identifies 172 ... workforce involved in clinical trials outside the public sector. This figure ...

  13. Minority Representation in Migraine Treatment Trials.

    Science.gov (United States)

    Robbins, Nathaniel M; Bernat, James L

    2017-03-01

    Minorities have historically been underrepresented in clinical research trials despite having comparatively poor health indicators. Recognizing the dual inequalities of increased disease burden and decreased research participation, the National Institute of Health (NIH) Revitalization Act of 1993 mandated the inclusion and reporting of women and minorities in NIH-funded research. While progress has been made in the subsequent decades, this underrepresentation of minorities in research trials persists and has been documented in multiple disciplines. However, the extent of adequate representation and reporting of minority inclusion in clinical trials for migraine remains unknown. In this systematic review and study, we review the literature examining the representation of women and minorities in migraine clinical research trials METHODS: First we searched PubMed for pertinent articles examining the inclusion of women and minorities in migraine clinical research trials. Second, we identified controlled-trials for migraine published since 2011 in major neurology, headache, and general medicine journals using the terms "migraine randomized controlled trial." We then reviewed the results manually and excluded pilot studies and those with fewer than 50 participants. We next determined (a) how frequently representation of minorities and women were reported in these major trials; (b) what factors correlated with reporting; and (c) whether women and minority inclusion comprised their ratios in the general population. We identified 128 relevant clinical trials, of which 36 met our inclusion criteria. All 36 trials (100%) reported gender frequency, and 25 of 36 (69.4%) reported ethnicity or race. Among all studies, women and Whites represented 84.2 and 82.9% of participants (mean), respectively. Studies conducted in the United States and funded by a private company were more likely to report race than studies conducted exclusively outside of the U.S. or with a public sponsor

  14. Robust inference for group sequential trials.

    Science.gov (United States)

    Ganju, Jitendra; Lin, Yunzhi; Zhou, Kefei

    2017-03-01

    For ethical reasons, group sequential trials were introduced to allow trials to stop early in the event of extreme results. Endpoints in such trials are usually mortality or irreversible morbidity. For a given endpoint, the norm is to use a single test statistic and to use that same statistic for each analysis. This approach is risky because the test statistic has to be specified before the study is unblinded, and there is loss in power if the assumptions that ensure optimality for each analysis are not met. To minimize the risk of moderate to substantial loss in power due to a suboptimal choice of a statistic, a robust method was developed for nonsequential trials. The concept is analogous to diversification of financial investments to minimize risk. The method is based on combining P values from multiple test statistics for formal inference while controlling the type I error rate at its designated value.This article evaluates the performance of 2 P value combining methods for group sequential trials. The emphasis is on time to event trials although results from less complex trials are also included. The gain or loss in power with the combination method relative to a single statistic is asymmetric in its favor. Depending on the power of each individual test, the combination method can give more power than any single test or give power that is closer to the test with the most power. The versatility of the method is that it can combine P values from different test statistics for analysis at different times. The robustness of results suggests that inference from group sequential trials can be strengthened with the use of combined tests. Copyright © 2017 John Wiley & Sons, Ltd.

  15. Gulf War Illness Inflammation Reduction Trial

    Science.gov (United States)

    2015-10-01

    1 AWARD NUMBER: W81XWH-14-1-0477 TITLE: Gulf War Illness Inflammation Reduction Trial PRINCIPAL INVESTIGATOR: Ronald R. Bach, Ph.D...5a. CONTRACT NUMBER Gulf War Illness Inflammation Reduction Trial 5b. GRANT NUMBER W81XWH-14-1-0477 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...GWI). Elevated biomarkers of inflammation were observed in our pilot observational study of GWI. Thus, chronic inflammation appears to be part of

  16. The Impact of Putting Mubarak on Trial

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    On August 3,2011,83-year-old former Egyptian President Hosni Mubarak was put on trial,lying on a hospital bed an iron cage in a Cairo courtroom. Zhang Zhongxiang,Deputy Director of the Department of the West Asian and African Studies at the Shanghai Institutes for International Studies,believes that the Mubarak trial will not only aggravate conflict among Egyptian people, but also complicate the regional tensions and

  17. Therapeutic trials for systemic sclerosis: An update

    Directory of Open Access Journals (Sweden)

    Sardana Kabir

    2008-01-01

    Full Text Available The pathogenesis of systemic sclerosis (SSc is complex, and the final story is yet to be elucidated. The clinical heterogeneity of the disease, its various autoimmune and antibody profiles, its long course and tendency for spontaneous cure makes the design of clinical trials difficult. The overwhelming need in this disease is to diagnose it early and identify those patients who will benefit most from early, aggressive treatment. We attempt to review data from recent clinical trials and the lessons derived.

  18. Phase 1 Trials in Pancreatic Cancer

    OpenAIRE

    Esther Yu; Muhammad Wasif Saif; Kathryn Huber

    2014-01-01

    Despite many clinical trials over the last two decades since the approval of gemcitabine, the survival of patients with pancreatic cancer has improved by a few only months. This disappointing reality underlines an urgent need to develop more effective drugs or better combinations. A variety of phase I trials were presented at the annual meeting of ASCO 2014 focusing on locally advanced and metastatic pancreatic cancer. We summarize four abstracts (abstracts #4116, #4123, #4026, #4138).

  19. Trial geography, pharmacogenetics, and global drug development.

    Science.gov (United States)

    Schuck, R N; Florian, J; Charlab, R; Pacanowski, M

    2015-03-01

    Drug development is increasingly global. The benefits of multiregional trials include worldwide evaluation of safety and efficacy. However, clinical practice, environmental, and genetic factors can vary across geographic regions, significantly influencing trial outcomes within a specific geographic region or the global population relative to the United States (US). Genomic technologies and research discoveries continue to advance at a remarkable pace, offering opportunities to explore intrinsic factors that could account for regional variability in drug pharmacokinetics or response.

  20. Razors versus clippers. A randomised controlled trial.

    Science.gov (United States)

    Taylor, Tracy; Tanner, Judith

    2005-12-01

    The purpose of this randomised controlled trial was to determine if patients showed a preference for preoperative hair removal with razors or clippers and to identify if one method was associated with more trauma or postoperative infections. The trial took place in a day surgery unit with patients who were having a range of surgical procedures including hernias and varicose veins. This study was sponsored by an award from the NATN/3M Clinical Fellowship.

  1. Strength of Mock-up Trial Grout

    DEFF Research Database (Denmark)

    Sørensen, Eigil V.

    The present report describes tests carried out on samples taken and cast during the execution of a mock-up trial placement of the high performance grout MASTERFLOW 9500 on January 21, 2009.......The present report describes tests carried out on samples taken and cast during the execution of a mock-up trial placement of the high performance grout MASTERFLOW 9500 on January 21, 2009....

  2. Phase 1 Trials in Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Esther Yu

    2014-07-01

    Full Text Available Despite many clinical trials over the last two decades since the approval of gemcitabine, the survival of patients with pancreatic cancer has improved by a few only months. This disappointing reality underlines an urgent need to develop more effective drugs or better combinations. A variety of phase I trials were presented at the annual meeting of ASCO 2014 focusing on locally advanced and metastatic pancreatic cancer. We summarize four abstracts (abstracts #4116, #4123, #4026, #4138.

  3. From international to zonal trials: the origins of the Nuremberg medical trial.

    Science.gov (United States)

    Weindling, P

    2000-01-01

    This article examines how plans to have a second International Military Tribunal led to the Medical Trial at Nuremberg. While the British opposed a second international trial because of their distrust of the Soviets, they supported a plan for a series of special zonal trials to be conducted by the American authorities at Nuremberg. In December 1945 the British became aware of the extent of medical war crimes committed by the Germans. Their investigation led to an eventual handover to the Americans of a group of German doctors for trial at Nuremberg. At the same time the British and French Supported an International Scientific Commission for the Investigation of Medical War Crimes.

  4. Qualitative research within trials: developing a standard operating procedure for a clinical trials unit

    Science.gov (United States)

    2013-01-01

    Background Qualitative research methods are increasingly used within clinical trials to address broader research questions than can be addressed by quantitative methods alone. These methods enable health professionals, service users, and other stakeholders to contribute their views and experiences to evaluation of healthcare treatments, interventions, or policies, and influence the design of trials. Qualitative data often contribute information that is better able to reform policy or influence design. Methods Health services researchers, including trialists, clinicians, and qualitative researchers, worked collaboratively to develop a comprehensive portfolio of standard operating procedures (SOPs) for the West Wales Organisation for Rigorous Trials in Health (WWORTH), a clinical trials unit (CTU) at Swansea University, which has recently achieved registration with the UK Clinical Research Collaboration (UKCRC). Although the UKCRC requires a total of 25 SOPs from registered CTUs, WWORTH chose to add an additional qualitative-methods SOP (QM-SOP). Results The qualitative methods SOP (QM-SOP) defines good practice in designing and implementing qualitative components of trials, while allowing flexibility of approach and method. Its basic principles are that: qualitative researchers should be contributors from the start of trials with qualitative potential; the qualitative component should have clear aims; and the main study publication should report on the qualitative component. Conclusions We recommend that CTUs consider developing a QM-SOP to enhance the conduct of quantitative trials by adding qualitative data and analysis. We judge that this improves the value of quantitative trials, and contributes to the future development of multi-method trials. PMID:23433341

  5. Clinical trial networks in orthopaedic surgery.

    Science.gov (United States)

    Rangan, A; Jefferson, L; Baker, P; Cook, L

    2014-05-01

    The aim of this study was to review the role of clinical trial networks in orthopaedic surgery. A total of two electronic databases (MEDLINE and EMBASE) were searched from inception to September 2013 with no language restrictions. Articles related to randomised controlled trials (RCTs), research networks and orthopaedic research, were identified and reviewed. The usefulness of trainee-led research collaborations is reported and our knowledge of current clinical trial infrastructure further supplements the review. Searching yielded 818 titles and abstracts, of which 12 were suitable for this review. Results are summarised and presented narratively under the following headings: 1) identifying clinically relevant research questions; 2) education and training; 3) conduct of multicentre RCTs and 4) dissemination and adoption of trial results. This review confirms growing international awareness of the important role research networks play in supporting trials in orthopaedic surgery. Multidisciplinary collaboration and adequate investment in trial infrastructure are crucial for successful delivery of RCTs. Cite this article: Bone Joint Res 2014;3:169-74. ©2014 The British Editorial Society of Bone & Joint Surgery.

  6. Randomized controlled trials - a matter of design.

    Science.gov (United States)

    Spieth, Peter Markus; Kubasch, Anne Sophie; Penzlin, Ana Isabel; Illigens, Ben Min-Woo; Barlinn, Kristian; Siepmann, Timo

    2016-01-01

    Randomized controlled trials (RCTs) are the hallmark of evidence-based medicine and form the basis for translating research data into clinical practice. This review summarizes commonly applied designs and quality indicators of RCTs to provide guidance in interpreting and critically evaluating clinical research data. It further reflects on the principle of equipoise and its practical applicability to clinical science with an emphasis on critical care and neurological research. We performed a review of educational material, review articles, methodological studies, and published clinical trials using the databases MEDLINE, PubMed, and ClinicalTrials.gov. The most relevant recommendations regarding design, conduction, and reporting of RCTs may include the following: 1) clinically relevant end points should be defined a priori, and an unbiased analysis and report of the study results should be warranted, 2) both significant and nonsignificant results should be objectively reported and published, 3) structured study design and performance as indicated in the Consolidated Standards of Reporting Trials statement should be employed as well as registration in a public trial database, 4) potential conflicts of interest and funding sources should be disclaimed in study report or publication, and 5) in the comparison of experimental treatment with standard care, preplanned interim analyses during an ongoing RCT can aid in maintaining clinical equipoise by assessing benefit, harm, or futility, thus allowing decision on continuation or termination of the trial.

  7. The International "Trial of the 20th Century": Nuremberg.

    Science.gov (United States)

    Chemerinsky, Erwin

    1999-01-01

    Considers the Nuremberg trials to be the "Trial of the Century." Highlights the series of 13 trials in which Nazi leaders, officials, judges, and others were tried, and most convicted, for war crimes. Relates that these trials had far-reaching effects in that they showed that moral obligations transcend national boundaries. (CMK)

  8. UK Dermatology Clinical Trials Network’s STOP GAP trial (a multicentre trial of prednisolone versus ciclosporin for pyoderma gangrenosum: protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Craig Fiona F

    2012-04-01

    Full Text Available Abstract Background Pyoderma gangrenosum (PG is a rare inflammatory skin disorder characterised by painful and rapidly progressing skin ulceration. PG can be extremely difficult to treat and patients often require systemic immunosuppression. Recurrent lesions of PG are common, but the relative rarity of this condition means that there is a lack of published evidence regarding its treatment. A systematic review published in 2005 found no randomised controlled trials (RCTs relating to the treatment of PG. Since this time, one small RCT has been published comparing infliximab to placebo, but none of the commonly used systemic treatments for PG have been formally assessed. The UK Dermatology Clinical Trials Network’s STOP GAP Trial has been designed to address this lack of trial evidence. Methods The objective is to assess whether oral ciclosporin is more effective than oral prednisolone for the treatment of PG. The trial design is a two-arm, observer-blind, parallel-group, randomised controlled trial comparing ciclosporin (4 mg/kg/day to prednisolone (0.75 mg/kg/day. A total of 140 participants are to be recruited over a period of 4 years, from up to 50 hospitals in the UK and Eire. Primary outcome of velocity of healing at 6 weeks is assessed blinded to treatment allocation (using digital images of the ulcers. Secondary outcomes include: (i time to healing; (ii global assessment of improvement; (iii PG inflammation assessment scale score; (iv self-reported pain; (v health-related quality of life; (vi time to recurrence; (vii treatment failures; (viii adverse reactions to study medications; and (ix cost effectiveness/utility. Patients with a clinical diagnosis of PG (excluding granulomatous PG; measurable ulceration (that is, not pustular PG; and patients aged over 18 years old who are able to give informed consent are included in the trial. Randomisation is by computer generated code using permuted blocks of randomly varying size

  9. Study of the trial subjects’ protection aspects in Phase I clinical trials and bioequivalence studies

    Directory of Open Access Journals (Sweden)

    K. O. Zupanets

    2016-03-01

    Full Text Available Protection of rights, health and well-being of persons who are taking the drug during the trial (trial subjects is one of the basic principles of clinical trials (CT management. Aim. In order to study key aspects of volunteer protection, determine factors that influence these indicators and estimate the importance of ensuring their proper implementation on the clinical site (CS three survey of 135 trial subjects were carried out to evaluate the importance of assessing the impact of factors such as the procedure of signing the informed consent (IC at the CS and testing procedures for HIV / AIDS, hepatitis and others. Assessment of the quality of life of trial subjects as indirect indicator of the quality of clinical trials that ensures the proper protection of their life was the subject of the third survey. Methods and results. The general model of the relationship between the key aspects of the trial subjects protection and the factors which are providing them during the clinical trials of drugs management was substantiated, which included the main aspects of the trial subjects’ protection, protective factors and basic CT management procedures, the impact of the above factors on the possibility of providing protection aspects depends on their implementation quality. It was found that trial subjects’ protection improvement can be achieved during the IC signing process. It is necessary to ensure a higher level of volunteers understanding of the terms that could be used in the IC form. Regarding the procedure of compulsory testing for HIV/AIDS in the course of screening, we can conclude that the majority of the trial subjects believe that this procedure is an additional factor in their health protection and do not consider it as an excessive psychological pressure on them. Conclusion. Assessing the quality of life during the bioequivalence study at the CS makes possible to reach a conclusion on general well-being and satisfaction with those

  10. Biased safety reporting in blinded randomized clinical trials: meta-analysis of angiotensin receptor blocker trials.

    Directory of Open Access Journals (Sweden)

    Nobuyoshi Takabayashi

    Full Text Available BACKGROUND: Cough is listed as an adverse drug reaction (ADR on the labels of angiotensin receptor blockers (ARB. However, a causal association with cough has also been reported for angiotensin converting enzyme inhibitors (ACEI, which have frequently been used as comparator drugs in the registration clinical trials of ARBs. This prompted us to examine the possible influence of using comparator drugs with well-known ADRs on the safety reporting of investigational drugs in blinded randomized clinical trials. METHODS AND FINDINGS: The double-blinded, randomized clinical trials with comparator drugs were identified in the Japanese dossiers for the new drug applications of ARBs. The risk ratios (RR of reporting cough and headache in ARB arms were calculated for each ARB by comparing trials using ACEIs and trials using non-ACEIs, were then combined with a meta-analysis. 23 trials with a total of 6643 patients were identified, consisting 6 trials using an ACEI comparator including 819 ARB patients and 17 trials using a non-ACEI comparator including 5824 ARB patients. The combined RR of cough reporting was significantly elevated (20.77; 95% confidence interval [CI], 7.47 to 57.76, indicating more frequent reporting of cough in clinical trials using an ACEI comparator. In contrast, the combined RR of headache, a negative control, was insignificant (1.45; 95% CI, 0.34 to 6.22. CONCLUSION: The use of comparators with well-known ADRs in blinded randomized trials produces potential bias in the reporting frequency of ADRs for investigational drugs. The selection of appropriate comparator drugs should be critical in unbiased safety assessment in double-blinded, randomized clinical trials and thus have relevance in reviewing the safety results from a regulatory point of view.

  11. An analysis of registered clinical trials in otolaryngology from 2007 to 2010: ClinicalTrials.gov.

    Science.gov (United States)

    Witsell, David L; Schulz, Kristine A; Lee, Walter T; Chiswell, Karen

    2013-11-01

    To describe the conditions studied, interventions used, study characteristics, and funding sources of otolaryngology clinical trials from the ClinicalTrials.gov database; compare this otolaryngology cohort of interventional studies to clinical visits in a health care system; and assess agreement between clinical trials and clinical activity. Database analysis. Trial registration data downloaded from ClinicalTrials.gov and administrative data from the Duke University Medical Center from October 1, 2007 to September 27, 2010. Data extraction from ClinicalTrials.gov was done using MeSH and non-MeSH disease condition terms. Studies were subcategorized to create the following groupings for descriptive analysis: ear, nose, allergy, voice, sleep, head and neck cancer, thyroid, and throat. Duke Health System visits were queried by using selected ICD-9 codes for otolaryngology and non-otolaryngology providers. Visits were grouped similarly to ClinicalTrials.gov for further analysis. Chi-square tests were used to explore differences between groups. A total of 1115 of 40,970 registered interventional trials were assigned to otolaryngology. Head and neck cancer trials predominated. Study models most frequently incorporated parallel design (54.6%), 2 study groups (46.6%), and randomization (69.1%). Phase 2 or 3 studies constituted 46.4% of the cohort. Comparison of the ClinicalTrials.gov database with administrative health system visit data by disease condition showed discordance between national research activity and clinical visit volume for patients with otolaryngology complaints. Analysis of otolaryngology-related clinical research as listed in ClinicalTrials.gov can inform patients, physicians, and policy makers about research focus areas. The relative burden of otolaryngology-associated conditions in our tertiary health system exceeds research activity within the field.

  12. Likely country of origin in publications on randomised controlled trials and controlled clinical trials during the last 60 years

    DEFF Research Database (Denmark)

    Gluud, Christian; Nikolova, Dimitrinka

    2007-01-01

    The number of publications on clinical trials is unknown as well as the countries publishing most trial reports. To try to examine these questions we performed an ecological study.......The number of publications on clinical trials is unknown as well as the countries publishing most trial reports. To try to examine these questions we performed an ecological study....

  13. Information on blinding in registered records of clinical trials

    Directory of Open Access Journals (Sweden)

    Viergever Roderik F

    2012-11-01

    Full Text Available Abstract Information on blinding is part of the data that should be provided upon registration of a trial at a clinical trials registry. Reporting of blinding is often absent or of low quality in published articles of clinical trials. This study researched the presence and quality of information on blinding in registered records of clinical trials and highlights the important role of data-recording formats at clinical trial registries in ensuring high-quality registration.

  14. Optimizing detector trials for humanitarian demining

    Science.gov (United States)

    Gaal, Mate; Baer, Sylke; Bloodworth, Thomas J.; Guelle, Dieter; Lewis, Adam M.; Mueller, Christina; Scharmach, Martina

    2004-09-01

    The performance of mine detecting instruments is embedded in the behavior of a complex system. The total reliability is always composed of the intrinsic physical detection capability of the sensor, application/environmental influences and human factors. The intrinsic capability and some application factors can be investigated in laboratory measurements. Human factors, other application factors and the overall reliability, can only be evaluated in blind field trials in which the probability of detection (PoD) and false alarm rate (FAR) are measured statistically. Both of these approaches are included in CEN Workshop Agreement CWA 14747:2003, which standardizes detector testing in Humanitarian Demining. We report here the results of a study to investigate how to optimize such testing. For efficient and statistically valid field trials, the number, types and burial depths of targets, and the number of test lanes, soil types, repetitions and operators need to be carefully chosen. Laboratory results should be used to help construct field trial protocols and also to help distinguish the different contributions to the PoD and FAR, to determine where to improve insufficient performance. In this study, four models of metal detector were tested in three field trials and in the laboratory. The repeatability of the field trials is assessed, taking into account operator training and experience. Results of the laboratory tests are compared with results of the field trials and used to construct a "modular model" of the system, as used in nondestructive testing. The conclusions are, in principle, applicable to trials of other types of sensor.

  15. Acute Lung Injury | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available rnedUK - MHRA A.2EudraCT number2010-021186-70 A.3Full title of the trial Keratinocyte growth factor in Acute...reviated title of the trial where available Keratinocyte Growth Factor in Acute L...nder investigation E.1.1Medical condition(s) being investigated Acute Lung Injury

  16. Lung-MAP Launches: First Precision Medicine Trial From National Clinical Trials Network

    Science.gov (United States)

    A unique public-private collaboration today announced the initiation of the Lung Cancer Master Protocol (Lung-MAP) trial, a multi-drug, multi-arm, biomarker-driven clinical trial for patients with advanced squamous cell lung cancer. Squamous cell carcinom

  17. The Trial of Napoleon: A Case Study for Using Mock Trials.

    Science.gov (United States)

    MacKay, Charles

    2000-01-01

    Describes a course entitled "The Trial of Napoleon Bonaparte" that focuses on a fictitious mock trial of Napoleon Bonaparte to answer the question: did Napoleon pervert or preserve the gain of the French Revolution? Discusses the strengths and weaknesses of the course. (CMK)

  18. Trial-to-trial fluctuations in attentional state and their relation to intelligence.

    Science.gov (United States)

    Unsworth, Nash; McMillan, Brittany D

    2014-05-01

    Trial-to-trial fluctuations in attentional state while performing measures of intelligence were examined in the current study. Participants performed various measures of fluid and crystallized intelligence while also providing attentional state ratings prior to each trial. It was found that pre-trial attentional state ratings strongly predicted subsequent trial performance on the fluid intelligence measures, such that when participants rated their current attentional state as highly focused on the current task, performance tended to be high compared to when participants reported their current attentional state as being low and unfocused on the current task. Furthermore, overall attentional state ratings and variability in attentional state ratings were moderately correlated with overall levels of performance on the fluid intelligence measures. However, attentional state ratings did not predict performance on the measure of crystallized intelligence. These results suggest a strong link between variation in attention state and variation in fluid intelligence as postulated by a number of recent theories.

  19. The AIDS Clinical Trials Information Service (ACTIS): a decade of providing clinical trials information.

    Science.gov (United States)

    Katz, Deborah G; Dutcher, Gale A; Toigo, Theresa A; Bates, Ruthann; Temple, Freda; Cadden, Cynthia G

    2002-01-01

    The AIDS Clinical Trials Information Service (ACTIS) is a central resource for information about federally and privately funded HIV/AIDS clinical trials. Sponsored by four components of the U.S. Department of Health and Human Services, ACTIS has been a key part of U.S. HIV/AIDS information and education services since 1989. ACTIS offers a toll-free telephone service, through which trained information specialists can provide callers with information about AIDS clinical trials in English or Spanish, and a website that provides access to clinical trials databases and a variety of educational resources. Future priorities include the development of new resources to target diverse and underserved populations. In addition, research needs to be conducted on the use of telephone services vs. Web-based information exchange to ensure the broadest possible dissemination of up-to-date information on HIV infection and clinical trials.

  20. Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: clinical trial design

    OpenAIRE

    Lammertse, D; Tuszynski, MH; Steeves, JD; Curt, A; Fawcett, JW; Rask, C; Ditunno, JF; Fehlings, MG; Guest, JD; Ellaway, PH; Kleitman, N; Blight, AR; Dobkin, BH; Grossman, R.; Katoh, H.

    2006-01-01

    The International Campaign for Cures of Spinal Cord Injury Paralysis established a panel tasked with reviewing the methodology for clinical trials for spinal cord injury (SCI), and making recommendations on the conduct of future trials. This is the fourth of four papers. Here, we examine the phases of a clinical trial program, the elements, types, and protocols for valid clinical trial design. The most rigorous and valid SCI clinical trial would be a prospective double-blind randomized contro...

  1. Using e-technologies in clinical trials.

    Science.gov (United States)

    Rosa, Carmen; Campbell, Aimee N C; Miele, Gloria M; Brunner, Meg; Winstanley, Erin L

    2015-11-01

    Clinical trials have been slow to incorporate e-technology (digital and electronic technology that utilizes mobile devices or the Internet) into the design and execution of studies. In the meantime, individuals and corporations are relying more on electronic platforms and most have incorporated such technology into their daily lives. This paper provides a general overview of the use of e-technologies in clinical trials research, specifically within the last decade, marked by rapid growth of mobile and Internet-based tools. Benefits of and challenges to the use of e-technologies in data collection, recruitment and retention, delivery of interventions, and dissemination are provided, as well as a description of the current status of regulatory oversight of e-technologies in clinical trials research. As an example of ways in which e-technologies can be used for intervention delivery, a summary of e-technologies for treatment of substance use disorders is presented. Using e-technologies to design and implement clinical trials has the potential to reach a wide audience, making trials more efficient while also reducing costs; however, researchers should be cautious when adopting these tools given the many challenges in using new technologies, as well as threats to participant privacy/confidentiality. Challenges of using e-technologies can be overcome with careful planning, useful partnerships, and forethought. The role of web- and smartphone-based applications is expanding, and the increasing use of those platforms by scientists and the public alike make them tools that cannot be ignored.

  2. Biomarkers in T cell therapy clinical trials

    Directory of Open Access Journals (Sweden)

    Kalos Michael

    2011-08-01

    Full Text Available Abstract T cell therapy represents an emerging and promising modality for the treatment of both infectious disease and cancer. Data from recent clinical trials have highlighted the potential for this therapeutic modality to effect potent anti-tumor activity. Biomarkers, operationally defined as biological parameters measured from patients that provide information about treatment impact, play a central role in the development of novel therapeutic agents. In the absence of information about primary clinical endpoints, biomarkers can provide critical insights that allow investigators to guide the clinical development of the candidate product. In the context of cell therapy trials, the definition of biomarkers can be extended to include a description of parameters of the cell product that are important for product bioactivity. This review will focus on biomarker studies as they relate to T cell therapy trials, and more specifically: i. An overview and description of categories and classes of biomarkers that are specifically relevant to T cell therapy trials, and ii. Insights into future directions and challenges for the appropriate development of biomarkers to evaluate both product bioactivity and treatment efficacy of T cell therapy trials.

  3. Quantitative Imaging in Cancer Clinical Trials.

    Science.gov (United States)

    Yankeelov, Thomas E; Mankoff, David A; Schwartz, Lawrence H; Lieberman, Frank S; Buatti, John M; Mountz, James M; Erickson, Bradley J; Fennessy, Fiona M M; Huang, Wei; Kalpathy-Cramer, Jayashree; Wahl, Richard L; Linden, Hannah M; Kinahan, Paul E; Zhao, Binsheng; Hylton, Nola M; Gillies, Robert J; Clarke, Laurence; Nordstrom, Robert; Rubin, Daniel L

    2016-01-15

    As anticancer therapies designed to target specific molecular pathways have been developed, it has become critical to develop methods to assess the response induced by such agents. Although traditional, anatomic CT, and MRI examinations are useful in many settings, increasing evidence suggests that these methods cannot answer the fundamental biologic and physiologic questions essential for assessment and, eventually, prediction of treatment response in the clinical trial setting, especially in the critical period soon after treatment is initiated. To optimally apply advances in quantitative imaging methods to trials of targeted cancer therapy, new infrastructure improvements are needed that incorporate these emerging techniques into the settings where they are most likely to have impact. In this review, we first elucidate the needs for therapeutic response assessment in the era of molecularly targeted therapy and describe how quantitative imaging can most effectively provide scientifically and clinically relevant data. We then describe the tools and methods required to apply quantitative imaging and provide concrete examples of work making these advances practically available for routine application in clinical trials. We conclude by proposing strategies to surmount barriers to wider incorporation of these quantitative imaging methods into clinical trials and, eventually, clinical practice. Our goal is to encourage and guide the oncology community to deploy standardized quantitative imaging techniques in clinical trials to further personalize care for cancer patients and to provide a more efficient path for the development of improved targeted therapies.

  4. Quality of clinical trials: A moving target

    Directory of Open Access Journals (Sweden)

    Arun Bhatt

    2011-01-01

    Full Text Available Quality of clinical trials depends on data integrity and subject protection. Globalization, outsourcing and increasing complexicity of clinical trials have made the target of achieving global quality challenging. The quality, as judged by regulatory inspections of the investigator sites, sponsors/contract research organizations and Institutional Review Board, has been of concern to the US Food and Drug Administration, as there has been hardly any change in frequency and nature of common deficiencies. To meet the regulatory expectations, the sponsors need to improve quality by developing systems with specific standards for each clinical trial process. The quality systems include: personnel roles and responsibilities, training, policies and procedures, quality assurance and auditing, document management, record retention, and reporting and corrective and preventive action. With an objective to improve quality, the FDA has planned new inspection approaches such as risk-based inspections, surveillance inspections, real-time oversight, and audit of sponsor quality systems. The FDA has partnered with Duke University for Clinical Trials Transformation Initiative, which will conduct research projects on design principles, data quality and quantity including monitoring, study start-up, and adverse event reporting. These recent initiatives will go a long way in improving quality of clinical trials.

  5. Public information about clinical trials and research.

    Science.gov (United States)

    Plétan, Yannick; Zannad, Faïez; Jaillon, Patrice

    2003-01-01

    Be it to restore the confused image of clinical research in relation to the lay public, or to develop new ways of accruing healthy volunteers or patients for clinical trials, there is a need to draft some guidance on how best to provide information on research. Although the French legal and regulatory armamentarium in this area is essentially liberal, there is currently little-justified reluctance among study sponsors to advertise publicly. A group of academic and pharmaceutical industry researchers, assembled for a workshop, together with regulators, journalists, representatives from ethics committees, social security, patient and health consumer groups and other French institutional bodies, has suggested the following series of recommendations: there is no need for additional legal or regulatory constraints; sponsors should be aware of and make use of direct public information on trials; a 'good practice charter' on public communication about clinical trials should be developed; all professionals should be involved in this communication platform; communication in the patient's immediate vicinity should be preferred (primary-care physician, local press); clinical databases and websites accessible to professionals, but also to patients and non-professionals, should be developed; genuine instruction on clinical trials for physicians and health professionals unfamiliar with such trials should be developed and disseminated; media groups should receive at least some training in the fundamentals of clinical research.

  6. Prostate cancer vaccines in clinical trials.

    Science.gov (United States)

    Lubaroff, David M

    2012-07-01

    This review presents important information about the current state of the art for vaccine immunotherapy of prostate cancer. It includes important preclinical research for each of the important prostate cancer vaccines to have reached clinical trials. To date, the only prostate cancer vaccine that has completed Phase III trials and has been approved and licensed by the US FDA is Sipuleucel-T, which immunizes patients against the prostate-associated antigen prostatic acid phosphatase. The benefits and concerns associated with the vaccine are presented. A current Phase III trial is currently underway using the vaccinia-based prostate-specific antigen vaccine Prostvac-TRICOM. Other immunotherapeutic vaccines in trials include the Ad/prostate-specific antigen vaccine Ad5-prostate-specific antigen and the DNA/prostatic acid phosphatase vaccine. A cellular vaccine, GVAX, has been in clinical trials but has not seen continuous study. This review also delves into the multiple immune regulatory elements that must be overcome in order to obtain strong antitumor-associated antigen immune responses capable of effectively destroying prostate tumor cells.

  7. Patient reported outcomes (PROs in clinical trials: is 'in-trial' guidance lacking? a systematic review.

    Directory of Open Access Journals (Sweden)

    Derek G Kyte

    Full Text Available BACKGROUND: Patient reported outcomes (PROs are increasingly assessed in clinical trials, and guidelines are available to inform the design and reporting of such trials. However, researchers involved in PRO data collection report that specific guidance on 'in-trial' activity (recruitment, data collection and data inputting and the management of 'concerning' PRO data (i.e., data which raises concern for the well-being of the trial participant appears to be lacking. The purpose of this review was to determine the extent and nature of published guidelines addressing these areas. METHODS AND FINDINGS: Systematic review of 1,362 articles identified 18 eligible papers containing 'in-trial' guidelines. Two independent authors undertook a qualitative content analysis of the selected papers. Guidelines presented in each of the articles were coded according to an a priori defined coding frame, which demonstrated reliability (pooled Kappa 0.86-0.97, and validity (<2% residual category coding. The majority of guidelines present were concerned with 'pre-trial' activities (72%, for example, outcome measure selection and study design issues, or 'post-trial' activities (16% such as data analysis, reporting and interpretation. 'In-trial' guidelines represented 9.2% of all guidance across the papers reviewed, with content primarily focused on compliance, quality control, proxy assessment and reporting of data collection. There were no guidelines surrounding the management of concerning PRO data. CONCLUSIONS: The findings highlight there are minimal in-trial guidelines in publication regarding PRO data collection and management in clinical trials. No guidance appears to exist for researchers involved with the handling of concerning PRO data. Guidelines are needed, which support researchers to manage all PRO data appropriately and which facilitate unbiased data collection.

  8. Patient information in phase I trials

    DEFF Research Database (Denmark)

    Gad, Katrine Toubro; Lassen, Ulrik; Mau-Sørensen, Morten

    2017-01-01

    influenced by the drug being tested, information procedures, physician-related factors and the patient's individual approach to decision-making. Patients have difficulties correctly repeating the purpose of a phase I trial. In several studies, the majority of the patients expressed expectations of personal......OBJECTIVE: To review what is known about cancer patients' decisions to enter a phase I trial and how they and their relatives perceive the information they receive when they are invited to participate. METHODS: This systematic review is based on the principles of "preferred reporting items...... for systematic reviews and meta-analyses" (PRISMA). A systematic search was performed in the PubMed, Embase and PsycInfo databases, supplemented by a search for unpublished literature. RESULTS: We identified 37 studies for inclusion in this review. Patients' decisions to participate in a phase I trial were...

  9. Developments in statistical evaluation of clinical trials

    CERN Document Server

    Oud, Johan; Ghidey, Wendimagegn

    2014-01-01

    This book describes various ways of approaching and interpreting the data produced by clinical trial studies, with a special emphasis on the essential role that biostatistics plays in clinical trials. Over the past few decades the role of statistics in the evaluation and interpretation of clinical data has become of paramount importance. As a result the standards of clinical study design, conduct and interpretation have undergone substantial improvement. The book includes 18 carefully reviewed chapters on recent developments in clinical trials and their statistical evaluation, with each chapter providing one or more examples involving typical data sets, enabling readers to apply the proposed procedures. The chapters employ a uniform style to enhance comparability between the approaches.

  10. [Radiotherapy phase I trials' methodology: Features].

    Science.gov (United States)

    Rivoirard, R; Vallard, A; Langrand-Escure, J; Guy, J-B; Ben Mrad, M; Yaoxiong, X; Diao, P; Méry, B; Pigne, G; Rancoule, C; Magné, N

    2016-12-01

    In clinical research, biostatistical methods allow the rigorous analysis of data collection and should be defined from the trial design to obtain the appropriate experimental approach. Thus, if the main purpose of phase I is to determine the dose to use during phase II, methodology should be finely adjusted to experimental treatment(s). Today, the methodology for chemotherapy and targeted therapy is well known. For radiotherapy and chemoradiotherapy phase I trials, the primary endpoint must reflect both effectiveness and potential treatment toxicities. Methodology should probably be complex to limit failures in the following phases. However, there are very few data about methodology design in the literature. The present study focuses on these particular trials and their characteristics. It should help to raise existing methodological patterns shortcomings in order to propose new and better-suited designs. Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  11. Perfusion Pressure Cerebral Infarct (PPCI) trial

    DEFF Research Database (Denmark)

    Vedel, Anne G.; Holmgaard, Frederik; Rasmussen, Lars Simon

    2016-01-01

    to be caused by emboli, but inadequate blood flow caused by other mechanisms may increase ischaemia in the penumbra or cause watershed infarcts. During cardiopulmonary bypass, blood pressure can be below the lower limit of cerebral autoregulation. Although much debated, the constant blood flow provided...... by the cardiopulmonary bypass system is still considered by many as appropriate to avoid cerebral ischaemia despite the low blood pressure. Methods/design: The Perfusion Pressure Cerebral Infarct trial is a single-centre superiority trial with a blinded outcome assessment. The trial is randomising 210 patients...... with coronary vessel and/or valve disease and who are undergoing cardiac surgery with the use of cardiopulmonary bypass. Patients are stratified by age and surgical procedure and are randomised 1:1 to either an increased mean arterial pressure (70–80 mmHg) or ‘usual practice’ (40–50 mmHg) during cardiopulmonary...

  12. Franz Kafka's The Trial: guilty or innocent?

    Science.gov (United States)

    Siegel, E

    1996-07-01

    Through an examination of The Trial by Kafka I attempt to show that the depiction of the Court apparatus is dynamically related to the commission of unconscious crimes of the type we encounter in our patients. To provide a context for the novel, I discuss Kafka's biography and some possible unconscious motivations. My goal is to show how the concept of a particular type of superego pressure can be used to understand the subtle irony in The Trial. Although Joseph K.'s behavior frequently involves oedipal crimes, there are many preoedipal themes that help account for his experience of the Court. I contrast this psychoanalytic understanding of K.'s guilt with that of literary critics who interpret The Trial as an allegory of guilt but who minimize the psychological dimensions.

  13. [Clinical trials: principles of the method].

    Science.gov (United States)

    Aboulker, J P

    2000-04-15

    Comparative judgement, which is seminal to any kind of science performing measurements, has been applied to clinical reasoning for many centuries. The need for systematizing the observational methods used in medicine in order to draw more reliable inferences about the effects of therapies has been active all along the 19th century. This has resulted in controlled studies which yielded important advances in clinical and therapeutic knowledge, although their designs were not fully satisfactory. Clinical trials have gained their status of "hard science", methodology allowing causal inference, by the end of the 1940s after having adopted the statistical theories developed in the 1930s by Fisher for experimental design in agronomy. A long way has been run since the first controlled randomized trial. However, half a century later, modern clinical trial remains essentially a controlled randomized prospective study using methods to limit potential biases and to establish statistical significance.

  14. [Ethical implications of clinical trials in Tunisia].

    Science.gov (United States)

    Chadly, Ali

    2004-11-01

    Clinical trials are necessary for medical advancement. They must respect legal obligations. Ethical questions related to protection of the human being's rights are yielded by these trials. Joining research to medical core is problematical in consideration of patient's consent to clinical trial. Exclusion by the Tunisian law of persons under age, pregnant or breast-feeding women from medical experimentation in the aim of protecting them against clinical research adverse events or abuses is ethically questionable since it deprives them from a possible medical progress. So why not to involve them in clinical research when there is an expected benefit, after bringing them protection as vulnerable persons like we should do for instance for the elderly, handicapped persons or prisoners. Legal creation of research ethics committees is important for the respect of experimentation rules on human beings.

  15. Control groups in recent septic shock trials

    DEFF Research Database (Denmark)

    Pettilä, Ville; Hjortrup, Peter Buhl; Jakob, Stephan M

    2016-01-01

    , and mortality outcomes, and calculated a data completeness score to provide an overall view of quality of reporting. RESULTS: A total of 24 RCTs were included (mean n = 287 patients and 71 % of eligible patients were randomized). Of the 24 studies, 14 (58 %) presented baseline data on vasopressors and 58......PURPOSE: The interpretation of septic shock trial data is profoundly affected by patients, control intervention, co-interventions and selected outcome measures. We evaluated the reporting of control groups in recent septic shock trials. METHODS: We searched for original articles presenting...... randomized clinical trials (RCTs) in adult septic shock patients from 2006 to 2016. We included RCTs focusing on septic shock patients with at least two parallel groups and at least 50 patients in the control group. We selected and evaluated data items regarding patients, control group characteristics...

  16. Registration of clinical trials: Is it really needed?

    Directory of Open Access Journals (Sweden)

    Ameer Aslam

    2013-01-01

    Full Text Available Background and Aims: Withholding findings of clinical trials for publication or presentation to the regulatory authorities is a major concern. We aimed to address the importance of clinical trial registration and whether it is needed or not. Discussion: For ethical conduct of clinical trial, registration is an important but debatable issue due to proprietary interest of the pharmaceutical industry. Over the years, investigating agencies uncovered several instances of misconduct during the clinical trial. The International committee of medical journal editors requires registration of trial methodology, but does not require registration of trial results; however, the U.S. Food and Drug Administration Amendments does require researchers to register results. Conclusion: Prospective registration of clinical trial is mandatory for more transparent research and sustaining the validity of evidence based practice and availability of reliable data. Clinical trials registration has the potential to contribute substantially to improve clinical trial transparency and reducing publication bias and selective reporting.

  17. The Hawthorne Effect: a randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    van Haselen Robbert

    2007-07-01

    Full Text Available Abstract Background The 'Hawthorne Effect' may be an important factor affecting the generalisability of clinical research to routine practice, but has been little studied. Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge, no attempt has been made to quantify them. Our aim was to compare minimal follow-up to intensive follow-up in participants in a placebo controlled trial of Ginkgo biloba for treating mild-moderate dementia. Methods Participants in a dementia trial were randomised to intensive follow-up (with comprehensive assessment visits at baseline and two, four and six months post randomisation or minimal follow-up (with an abbreviated assessment at baseline and a full assessment at six months. Our primary outcomes were cognitive functioning (ADAS-Cog and participant and carer-rated quality of life (QOL-AD. Results We recruited 176 participants, mainly through general practices. The main analysis was based on Intention to treat (ITT, with available data. In the ANCOVA model with baseline score as a co-variate, follow-up group had a significant effect on outcome at six months on the ADAS-Cog score (n = 140; mean difference = -2.018; 95%CI -3.914, -0.121; p = 0.037 favouring the intensive follow-up group, and on participant-rated quality of life score (n = 142; mean difference = -1.382; 95%CI -2.642, -0.122; p = 0.032 favouring minimal follow-up group. There was no significant difference on carer quality of life. Conclusion We found that more intensive follow-up of individuals in a placebo-controlled clinical trial of Ginkgo biloba for treating mild-moderate dementia resulted in a better outcome than minimal follow-up, as measured by their cognitive functioning. Trial registration Current controlled trials: ISRCTN45577048

  18. Lessons from randomised direct comparative trials.

    Science.gov (United States)

    Achiron, Anat; Fredrikson, Sten

    2009-02-01

    For over a decade, four immunomodulatory therapies have been available for the treatment of relapsing remitting multiple sclerosis. However, few direct comparative data were available to facilitate the choice of treatment. This choice has been influenced by the perception that interferon-beta preparations have greater efficacy than glatiramer acetate, due to apparently more rapid and robust reduction of gadolinium-enhancing lesions seen on magnetic resonance imaging in the pivotal trials of these agents. This situation has changed in the last year, with the outcomes of three randomised clinical trials comparing the efficacy and safety of glatiramer acetate with that of a high-dose interferon-beta in relapsing remitting multiple sclerosis. These are the REGARD, BEYOND and BECOME trials. In the REGARD trial, 764 patients were randomised to treatment with either interferon-beta 1a sc 44 microg or glatiramer acetate for 96 weeks; no significant difference in the time to first relapse was observed. The largest of the three comparative studies, the BEYOND trial, compared treatment with interferon-beta 1b sc 500 microg, interferon-beta 1b sc 250 microg or glatiramer acetate for two years in 2,244 patients. The hazard ratio for multiple relapses was close to unity for comparisons between all groups, indicating equivalent efficacy in all three treatment arms. Relapse rates (around 0.3 relapses/year) in all these studies were much lower than anticipated and lower than those reported a decade previously in the pivotal trials of beta-interferons and glatiramer acetate. No unexpected safety issues were identified in any of these studies. The completion of these direct comparative studies has considerably enriched the clinical evidence database by contributing large numbers of patients. This provides an invaluable contribution for helping the physician make an informed choice about treatment. The results of the direct comparative studies provide evidence that glatiramer acetate

  19. Clinical Trials and their Impact on Society

    Directory of Open Access Journals (Sweden)

    Olga Lidia Cuevas Pérez

    2016-02-01

    Full Text Available Today there are countless examples that illustrate the nature of technoscience, including biotechnology and pharmacology. The clinical trial is the appropriate methodology used by clinical pharmacology to test the efficacy and safety of a treatment or intervention in humans. It constitutes the cornerstone of research. Once the preclinical research is completed, one of the biggest challenges currently facing the Cuban Pharmaceutical and Biotechnological Industry is precisely the clinical evaluation. Therefore, this work aims to provide a reflection on the most significant aspects of clinical trials and their impact on society.

  20. Prospective Clinical Trial for Septic Arthritis

    DEFF Research Database (Denmark)

    Schmal, Hagen; Bernstein, Anke; Feucht, Matthias J;

    2016-01-01

    clinical trial and the cytokine composition of effusions (n = 76) was analyzed. Characteristics of epidemiology and disease severity were correlated with levels of cytokines with known roles in cartilage turnover and degradation. Results. Higher synovial IL-1β concentrations were associated with clinical......-2, and BMP-7. Infections with Staphylococcus species induced higher IL-1β expression but less cartilage destruction than other bacteria. Conclusion. Articular infections have bacteria-specific implications on cartilage metabolism. Collagen type II cleavage products reliably mark destruction, which...... is associated with upregulation of typical cartilage turnover cytokines. This trial is registered with DRKS00003536, MISSinG....