WorldWideScience

Sample records for preliminary controlled clinical

  1. Clinical and Radiographic Evaluation of Immediate Loaded Dental Implants With Local Application of Melatonin: A Preliminary Randomized Controlled Clinical Trial.

    Science.gov (United States)

    El-Gammal, Mona Y; Salem, Ahmed S; Anees, Mohamed M; Tawfik, Mohamed A

    2016-04-01

    Immediate loading of dental implants in situations where low bone density exist, such as the posterior maxillary region, became possible recently after the introduction of biomimetic agents. This 1-year preliminary clinical trial was carried out to clinically and radiographically evaluate immediate-loaded 1-piece implants with local application of melatonin in the osteotomy site as a biomimetic material. 14 patients with missing maxillary premolars were randomized to receive 14 implants of 1-piece type that were subjected to immediate loading after 2 weeks of initial placement. Group I included 7 implants with acid-etched surface while group II included 7 implants with acid-etched surface combined with local application of melatonin gel at the osteotomy site. Patients were recalled for follow up at 1, 3, 6, and 12 months after loading. All implants were considered successful after 12 months of follow-up. Significant difference (P implant loading when considering the implant stability. At 1 and 3 months there were significant differences in the marginal bone level between the 2 groups. These results suggest that the local application of melatonin at the osteotomy site is associated with good stability and minimal bone resorption. However, more studies for longer follow-up periods are required to confirm the effect of melatonin hormone on osseointegration of dental implants.

  2. Aromatherapy Massage on the Abdomen for Alleviating Menstrual Pain in High School Girls: A Preliminary Controlled Clinical Study

    Directory of Open Access Journals (Sweden)

    Myung-Haeng Hur

    2012-01-01

    Full Text Available This study investigated the alleviating effects of aromatherapy massage and acetaminophen on menstrual pain in Korean high school girls. Subjects were divided into two groups: the aromatherapy massage (treatment group (=32 and the acetaminophen (control group (=23. Aromatherapy massage was performed on subjects in the treatment group. The abdomen was massaged once using clary sage, marjoram, cinnamon, ginger, and geranium in a base of almond oil. The level of menstrual pain was assessed using a visual analogue scale at baseline and twenty-four hours afterward. The reduction of menstrual pain was significantly higher in the aromatherapy group than in the acetaminophen group. Using multiple regression, aromatherapy massage was found to be more highly associated with reduction in the level of menstrual pain than acetaminophen. These finding suggest that aromatherapy massage may be an effective treatment for menstrual pain in high school girls. However, it could not be verified whether the positive effects derived from the aromatherapy, the massage, or both. Further rigorous studies should be conducted using more objective measures.

  3. Metabolic Control with Insulin Pump Therapy: Preliminary Experience

    Directory of Open Access Journals (Sweden)

    Shang-Ren Hsu

    2008-07-01

    Conclusion: Our preliminary experience demonstrated the effectiveness of insulin pump therapy for both type 1 and type 2 diabetic patients. The reduction in their HbA1C values was both statistically and clinically significant. This treatment should be considered for patients poorly controlled by subcutaneous insulin injection therapy.

  4. Preliminary clinical results with the ISL laser

    Science.gov (United States)

    Hoppeler, Thomas; Gloor, Balder

    1992-08-01

    The ISL laser (Intelligent Surgical Lasers, Inc.), a Nd:YLF picosecond pulse laser, is currently being used under investigational device exemption to perform microsurgery of the anterior segment of the eye. At different study sites procedures for cataract fragmentation and iridotomy, as well as for posterior capsulotomy after cataract surgery, are under evaluation. Other potential applications include: sclerostomy ab interno, the cutting of membranes in the anterior and posterior segment of the eye; corneal incisions; and corneal intrastromal effects. We discuss various clinically relevant aspects of the use of this picosecond laser. An overview of different computer controlled laser patterns is given.

  5. Immediate Effect of Postural Insoles on Gait Performance of Children with Cerebral Palsy: Preliminary Randomized Controlled Double-blind Clinical Trial.

    Science.gov (United States)

    Neto, Hugo Pasini; Grecco, Luanda André Collange; Duarte, Natália Almeida Carvalho; Christovão, Thaluanna Calil Lourenço; Franco de Oliveira, Luis Vicente; Dumont, Arislander Jonathan Lopes; Galli, Manuela; Oliveira, Claudia Santos

    2014-07-01

    [Purpose] Improved gait efficiency is one of the goals of therapy for children with cerebral palsy (CP). Postural insoles can allow more efficient gait by improving biomechanical alignment. The aim of the present study was to assess the effect of postural insoles on gait performance of children with CP classified as levels I or II of the Gross Motor Function Classification System (GMFCS). [Subjects and Methods] the study was a randomized controlled double-blind clinical trial. After meeting the legal aspects and the eligibility criteria, 10 children between four and 12 years old were randomly divided into a two groups: a control group (n=5), and an experimental group (n=5). Children in the control group used a placebo insoles, and children in the experimental group used postural insoles. Evaluation consisted of three-dimensional gait analysis under three conditions: barefoot, shoes without insoles and shoes with postural insoles or shoes with placebo insoles. [Results] Regarding the immediate effects of insole use, significant improvements in gait velocity and cadence were observed in the experimental group in comparison to the control group. [Conclusion] The use of postural insoles led to improvements in gait velocity and cadence of the children with cerebral palsy classified as levels I or II of the GMFCS.

  6. Supervisory control of remote manipulation: A preliminary evaluation

    Science.gov (United States)

    Starr, G. P.

    1981-01-01

    A system for supervisory control is described, and preliminary results are presented. Supervisory control, where control is traded between man and computer, offers benefits in the control of a remote manipulator. The system has the potential to accomplish sophisticated tasks. It is indicated that supervisory control yields lower task completion times and is preferred over manual control.

  7. Emotion understanding in clinically anxious children: A preliminary investigation.

    OpenAIRE

    Bender, Patrick K; Francisco ePons; Harris, Paul L.; Barbara H. Esbjørn; Reinholdt-Dunne, Marie L.

    2015-01-01

    Children’s understanding of the nature, origins and consequences of emotions has been intensively investigated over the last 30–40 years. However, few empirical studies have looked at the relation between emotion understanding and anxiety in children and their results are mixed. The aim of the present study was to perform a preliminary investigation of the relationships between emotion understanding, anxiety, emotion dysregulation, and attachment security in clinically anxious children. A sam...

  8. Preliminary Clinical Evaluation: The What, Where, How Approach to Scoring

    OpenAIRE

    Wright, C.; Akimoto, T.

    2016-01-01

    The SCoR is driving for preliminary clinical evaluation (PCE) however; currently there is no method of quantification to assess quality. FRCR has an approach to quantify comments in the rapid reporting examination (CR2B).The aim of this project was to develop a robust scoring system that enables comprehensive image evaluation regardless of profession. An image test bank was administered using RadBench with equal prevalence of normal /abnormal. A random sample of attempts was selected to pilot...

  9. Photodynamic therapy of port wine stain: preliminary clinical studies

    Science.gov (United States)

    Nelson, J. Stuart

    1993-07-01

    The broad, long term objective of this work is the development of Photodynamic Therapy (PDT) for application in the clinical management of patients with port wine stain (PWS). PDT involves the use of an exogenous drug which is concentrated in a targeted tissue. When irradiated at wavelengths specifically absorbed by the drug, selective destruction of the targeted tissue, without the production of heat, occurs. The results of this preliminary study demonstrate in human PWS patients that a photosensitizer, such as PHOTOFRINR, activated by red light at the appropriate therapeutic wavelength, can cause destruction of subsurface blood vessels in the skin with a high degree of specificity, and further study appears warranted.

  10. [Controlling in clinical management].

    Science.gov (United States)

    Bähr, K; Ellinger, K

    1999-02-01

    Managers of industrial enterprises strive continually to improve the efficiency of production, distribution and service for their customers in order to be able to compete on the market. In socially orientated non-profit-organisations this is not universe practice. Relating to section 17 Abs. 1 KHG and section 13 BPfIV of German social legislation hospital charges are refunded only, if the hospital is working efficiently and economically. Controlling is a tool to achieve these goals. Controlling coordinates the flow of information for planning and evaluation. Strategic and operative controlling are closely interrelated: Strategic controlling is directed towards new and promising activities, operative controlling supports decision--making--including future-oriented aspects-by providing and condensing information. Controlling is definitely not intended to dictate or "command" any action. Its object is to serve as an instrument or tool supporting result-oriented planning, regulating and evaluation.

  11. Emotion understanding in clinically anxious children: A preliminary investigation

    Directory of Open Access Journals (Sweden)

    Patrick K. Bender

    2015-12-01

    Full Text Available Children’s understanding of the nature, origins and consequences of emotions has been intensively investigated over the last 30-40 years. However, few empirical studies have looked at the relation between emotion understanding and anxiety in children and their results are mixed. The aim of the present study was to perform a preliminary investigation of the relationships between emotion understanding, anxiety, emotion dysregulation, and attachment security in clinically anxious children. A sample of 16 clinically anxious children (age 8-12, 8 girls/boys was assessed for emotion understanding (Test of Emotion Comprehension, anxiety (Screening for Child Anxiety Related Emotional Disorders-Revised and Anxiety Disorder Interview Schedule, emotion dysregulation (Difficulties in Emotion Regulation Scale and attachment security (Security Scale. Children who reported more overall anxiety also reported greater difficulties in regulating their emotions, and were less securely attached to their parents. The results also showed that more specific symptoms of anxiety (i.e., OCD and PTSD correlated not only with emotion dysregulation and attachment insecurity but also with emotion understanding. Finally, there were interrelations among emotion understanding, attachment security, and emotion dysregulation. The present results provide the first comprehensive evidence for a socio-emotional framework and its relevance to childhood anxiety.

  12. Emotion Understanding in Clinically Anxious Children: A Preliminary Investigation.

    Science.gov (United States)

    Bender, Patrick K; Pons, Francisco; Harris, Paul L; Esbjørn, Barbara H; Reinholdt-Dunne, Marie L

    2015-01-01

    Children's understanding of the nature, origins and consequences of emotions has been intensively investigated over the last 30-40 years. However, few empirical studies have looked at the relation between emotion understanding and anxiety in children and their results are mixed. The aim of the present study was to perform a preliminary investigation of the relationships between emotion understanding, anxiety, emotion dysregulation, and attachment security in clinically anxious children. A sample of 16 clinically anxious children (age 8-12, eight girls/boys) was assessed for emotion understanding (Test of Emotion Comprehension), anxiety (Screening for Child Anxiety Related Emotional Disorders-Revised and Anxiety Disorder Interview Schedule), emotion dysregulation (Difficulties in Emotion Regulation Scale) and attachment security (Security Scale). Children who reported more overall anxiety also reported greater difficulties in regulating their emotions, and were less securely attached to their parents. The results also showed that more specific symptoms of anxiety (i.e., OCD and PTSD) correlated not only with emotion dysregulation and attachment insecurity but also with emotion understanding. Finally, there were interrelations among emotion understanding, attachment security, and emotion dysregulation. The present results provide the first comprehensive evidence for a socio-emotional framework and its relevance to childhood anxiety.

  13. Preliminary clinical investigations of a new noninvasive venous pulse oximeter

    Science.gov (United States)

    Chan, Daniel; Smith, Peter R.; Caine, Michael P.; Spyt, Tomasz; Boehm, Maria; Machin, David

    2003-10-01

    For decades, the monitoring of mixed venous oxygen saturation, SvO2 has been performed invasively using fibre-optic catheters. This procedure is not without risk as complications may arise from catheterisation. The group has devised a new non-invasive venous oximetry method which involves inducing regular modulations of the venous blood volume and associated measurement of those modulations using optical means. A clinical investigation was conducted in Glenfield Hospital, UK to evaluate the sensitivity of the new technique to haemodynamic changes such as Cardiac Output (CO) in intraoperative and postoperative cardiac patients. Preliminary trials on patients recovering from cardiac surgery yielded an average correlation of r = 0.72 between CO at different Intra Aortic Balloon Pump (IABP) augmentation levels and SvO2 measured by the new venous oximeter. In intraoperative patients undergoing off-pump cardiac surgery, SvO2 recorded by the new technique responded to unplanned events such as a cardiac arrest. CONCLUSION: The new venous oximetry technique is a promising technique which responds to haemodynamic changes such as CO and with further development might offer an alternative means of monitoring SvO2 non-invasively.

  14. Preliminary design of the Space Station internal thermal control system

    Science.gov (United States)

    Herrin, Mark T.; Patterson, David W.; Turner, Larry D.

    1987-01-01

    The baseline preliminary design configuration of the Internal Thermal Control system (ITCS) of the U.S. Space Station pressurized elements (i.e., the Habitation and U.S. Laboratory modules, pressurized logistics carrier, and resources nodes) is defined. The ITCS is composed of both active and passive components. The subsystems which comprise the ITCS are identified and their functional descriptions are provided. The significant trades and analyses, which were performed during Phase B (i.e., the preliminary design phase) that resulted in the design described herein, are discussed. The ITCS interfaces with the station's central Heat Rejection and Transport System (HRTS), other systems, and externally attached pressurized payloads are described. Requirements on the ITCS with regard to redundancy and experiment support are also addressed.

  15. 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

  16. [Placebo control and clinical trial of Chinese medicine].

    Science.gov (United States)

    Wu, Jing

    2010-10-01

    World Health Organization aims to develop safe, effective and practical traditional medicine. Traditional Chinese medicine (TCM) and other complementary and alternative medicine are being recognized in the whole world nowadays. However, the definite effect of Chinese medicine is still in need of scientific research proof. Placebo control is of equal importance to active control and blank control in clinical trial of TCM. This article briefly reviewed the importance of placebo control and commented on its present situation in clinical trial of TCM. This article also brought up the preliminary proposals of placebo application in TCM clinical trial. We should emphasize scientific placebo preparation and good design of placebo-controlled trial, which are directed by International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use. A good clinical trial project will avoid unnecessary wastes and provide safe and effective treatment for people.

  17. CUSUM control charts based on likelihood ratio for preliminary analysis

    Institute of Scientific and Technical Information of China (English)

    Yi DAI; Zhao-jun WANG; Chang-liang ZOU

    2007-01-01

    To detect and estimate a shift in either the mean and the deviation or both for the preliminary analysis, the statistical process control (SPC) tool, the control chart based on the likelihood ratio test (LRT), is the most popular method.Sullivan and woodall pointed out the test statistic lrt (n1, n2) is approximately distributed as x2 (2) as the sample size n, n1 and n2 are very large, and the value of n1 = 2, 3,..., n- 2 and that of n2 = n- n1.So it is inevitable that n1 or n2 is not large. In this paper the limit distribution of lrt(n1, n2) for fixed n1 or n2 is figured out, and the exactly analytic formulae for evaluating the expectation and the variance of the limit distribution are also obtained.In addition, the properties of the standardized likelihood ratio statistic slr(n1,n) are discussed in this paper. Although slr(n1, n) contains the most important information, slr(i, n)(i ≠ n1) also contains lots of information. The cumulative sum (CUSUM) control chart can obtain more information in this condition. So we propose two CUSUM control charts based on the likelihood ratio statistics for the preliminary analysis on the individual observations. One focuses on detecting the shifts in location in the historical data and the other is more general in detecting a shift in either the location and the scale or both.Moreover, the simulated results show that the proposed two control charts are, respectively, superior to their competitors not only in the detection of the sustained shifts but also in the detection of some other out-of-control situations considered in this paper.

  18. CUSUM control charts based on likelihood ratio for preliminary analysis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To detect and estimate a shift in either the mean and the deviation or both for the preliminary analysis, the statistical process control (SPC) tool, the control chart based on the likelihood ratio test (LRT), is the most popular method. Sullivan and woodall pointed out the test statistic lrt(n1, n2) is approximately distributed as x2(2) as the sample size n,n1 and n2 are very large, and the value of n1 = 2,3,..., n - 2 and that of n2 = n - n1. So it is inevitable that n1 or n2 is not large. In this paper the limit distribution of lrt(n1, n2) for fixed n1 or n2 is figured out, and the exactly analytic formulae for evaluating the expectation and the variance of the limit distribution are also obtained. In addition, the properties of the standardized likelihood ratio statistic slr(n1, n) are discussed in this paper. Although slr(n1, n) contains the most important information, slr(i, n)(i≠n1) also contains lots of information. The cumulative sum (CUSUM) control chart can obtain more information in this condition. So we propose two CUSUM control charts based on the likelihood ratio statistics for the preliminary analysis on the individual observations. One focuses on detecting the shifts in location in the historical data and the other is more general in detecting a shift in either the location and the scale or both. Moreover, the simulated results show that the proposed two control charts are, respectively, superior to their competitors not only in the detection of the sustained shifts but also in the detection of some other out-of-control situations considered in this paper.

  19. Prevention of postoperative tooth sensitivity: a preliminary clinical trial.

    Science.gov (United States)

    Sobral, M A P; Garone-Netto, N; Luz, M A A C; Santos, A P

    2005-09-01

    The purpose of this study was to evaluate clinically the effects of pre-treatments with a 35% hydroxyethyl metacrylate/5% glutaraldehyde dentine desensitizer (Gluma Desensitizer) and a 2% chlorexidine-based cavity disinfectant (Cav-Clean) on postoperative sensitivity. Three premolar teeth with no pain symptoms were selected from each one of 17 patients, totalling 51 teeth, for which Class II restoration using a composite was indicated. Each one of the three premolar teeth of the same patient was submitted to a different treatment. After acid etching, only a dental adhesive was applied to the first tooth, which served as the control. Gluma Desensitizer dentinal desensitizer was applied to the second premolar tooth prior to applying the dental adhesive. Cav-Clean cavity disinfectant was used on the third premolar tooth before applying the dental adhesive. Only one tooth was restored per session, and all premolar teeth were restored with a condensable composite, according to current restoration technique guidelines. Sensitivity to different stimuli (cold, heat, sweet and dental floss) was assessed on Day 1, Day 4 and Day 7 by questionnaire following restorative procedures. The results of this clinical research showed that, as far as the investigated stimuli and postoperative course are concerned, there was no statistically significant difference in the three different treatments (P>0.05). Postoperative sensitivity resulting from Class II restorations using composite resin cannot be completely eliminated with the prior use of a dentinal desensitizer or a cavity disinfectant. In day-to-day clinical treatment, postoperative sensitivity may possibly be related to the technique employed.

  20. Preliminary Cost Estimates of Pollution Control Technologies for Geothermal Developments

    Energy Technology Data Exchange (ETDEWEB)

    Sung, R.; Houser, G.; Richard, G.; Cotter, J.; Weller, P.; Pulaski, E.

    1979-10-01

    This is the first report from the EPA estimating the cost of technology for mitigating pollution that might arise from geothermal power systems. The Environmental Protection Agency (EPA) has taken an initial step towards the establishment of regulatory standards for the geothermal industry by preparing a document entitled Pollution Control Guidance for Geothermal Energy Development. This report supports that document by providing pollution control cost information. The objective of this report is to provide preliminary cost estimates for air and water pollution treatment and disposal technologies applicable for geothermal energy conversion systems. Cost estimates include both annualized capital investment and operation and maintenance (O&M) costs for various levels of environmental requirements. [DJE-2005

  1. Voltage-Controlled Sapphire Oscillator: Design, Development, and Preliminary Performance

    Science.gov (United States)

    Wang, R. T.; Dick, G. J.; Tjoelker, R. L.

    2007-08-01

    We present the design for a new short-term frequency standard, the voltage-controlled sapphire oscillator, as a practical and lower-cost alternative to a cryogenic sapphire oscillator operating at liquid helium temperatures. Performance goals are a frequency stability of 1 x 10^-14 (1 second equal to or less than tau equal to or less than 100 seconds), more than 2 years of continuous operation, and practical operability. Key elements include the sapphire resonator, low-power and long-life cryocooler, frequency compensation method, and cryo-Pound design. We report the design verification, experimental results, and test results of the cryocooler environmental sensitivity, as well as a preliminary stability measurement.

  2. Greenridge Multi-Pollutant Control Project Preliminary Public Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Connell, Daniel P

    2009-01-12

    the commercial readiness of an emissions control system that is specifically designed to meet the environmental compliance requirements of these smaller coal-fired EGUs. The multi-pollutant control system is being installed and tested on the AES Greenidge Unit 4 (Boiler 6) by a team including CONSOL Energy Inc. as prime contractor, AES Greenidge LLC as host site owner, and Babcock Power Environmental Inc. as engineering, procurement, and construction contractor. All funding for the project is being provided by the U.S. Department of Energy, through its National Energy Technology Laboratory, and by AES Greenidge. AES Greenidge Unit 4 is a 107 MW{sub e} (net), 1950s vintage, tangentially-fired, reheat unit that is representative of many of the 440 smaller coal-fired units identified above. Following design and construction, the multi-pollutant control system will be demonstrated over an approximately 20-month period while the unit fires 2-4% sulfur eastern U.S. bituminous coal and co-fires up to 10% biomass. This Preliminary Public Design Report is the first in a series of two reports describing the design of the multi-pollutant control facility that is being demonstrated at AES Greenidge. Its purpose is to consolidate for public use all available nonproprietary design information on the Greenidge Multi-Pollutant Control Project. As such, the report includes a discussion of the process concept, design objectives, design considerations, and uncertainties associated with the multi-pollutant control system and also summarizes the design of major process components and balance of plant considerations for the AES Greenidge Unit 4 installation. The Final Public Design Report, the second report in the series, will update this Preliminary Public Design Report to reflect the final, as-built design of the facility and to incorporate data on capital costs and projected operating costs.

  3. Preliminary Examination of the Interpersonal Psychological Theory of Suicide in an Adolescent Clinical Sample.

    Science.gov (United States)

    Horton, Sarah E; Hughes, Jennifer L; King, Jessica D; Kennard, Betsy D; Westers, Nicholas J; Mayes, Taryn L; Stewart, Sunita M

    2016-08-01

    This study offers a preliminary examination of the Interpersonal-Psychological Theory of Suicide (IPTS; Joiner 2005) in an adolescent clinical sample. The IPTS offers a nuanced framework that has many conceptual and practical merits. Although this theory has a growing base of evidence among adults, it has yet to be tested in adolescents using direct measures of its central constructs. Participants were 147 adolescents (76.2 % girls) on an inpatient psychiatric unit, who completed measures of key IPTS constructs of thwarted belongingness, perceived burdensomeness, acquired capability for suicide, as well as depression severity, hopelessness, and severity of suicidal symptoms. Our findings were largely consistent with hypotheses derived from the IPTS: perceived burdensomeness, and at a marginal level, thwarted belongingness, were independently associated with current suicidal ideation. The thwarted belongingness by perceived burdensomeness interaction marginally distinguished between adolescents with passive and active suicidal ideation. Acquired capability for suicide was associated with recent suicidal intent. Examination of all three IPTS constructs simultaneously revealed main effects of each construct (with a marginal effect of thwarted belongingness), and interaction effects for thwarted belongingness by perceived burdensomeness, and thwarted belongingness by perceived burdensomeness by acquired capability for suicide in association with suicidal symptom severity. Sex, age, depression severity, and hopelessness were controlled in all analyses. This study offers strong, albeit preliminary, support of the IPTS in a clinical adolescent sample. Assessment of IPTS constructs may be useful in determining persistent risk for suicide attempt. Prospective tests of the theory, and extensions to intervention and prevention should be considered in future IPTS research.

  4. In situ photoimmunotherapy for melanoma: preliminary clinical results

    Science.gov (United States)

    Naylor, Mark F.; Nordquist, Robert E.; Teauge, T. Kent; Perry, Lisa A.; Chen, Wei R.

    2006-02-01

    Although melanoma accounts for only 4% of skin cancer cases, it causes 79% of all skin cancer deaths. Patients with metastatic melanoma have a poor prognosis, and long term survival is only about 5% [1, 2]. Conventional therapies such as surgery and radiation therapy usually do not cure stage III or stage IV melanoma, while traditional chemotherapy is primarily palliative. Over the last decade we have been developing new methods for treating solid tumors like melanoma, first in animal models and now in humans. We present here preliminary results from a new technique that utilizes a combination of laser stimulation and drug therapy to stimulate brisk immunological responses in cases of advanced melanoma with cutaneous metastases. A high-power, near-infrared diode laser (805 nm) is used to kill tumors in situ and a topical toll-like receptor agonist (imiquimod cream, 5%) is used to intensify the resulting immunological response. This is essentially an in situ, tumor vaccine approach to treating solid tumors.

  5. Clinical classification of chronic prostatitis: a preliminary investigation

    Institute of Scientific and Technical Information of China (English)

    Wei-DongHUANG; PeiLIU; Wen-JieHUANG

    2000-01-01

    Aim: To propose a practical clinical classification for the chronic prostatitis (CP). Methods: The clinical features and the findings in the expressed prostatic secretion (EPS) in 804 cases of CP patients were retrospectively analyzed. Results: Four types of CP were identified based on the clinical manifestations and the amounts of white blood cells (WBC) and lecithin in EPS. They were the latent type (85 cases; 10.6%), the common type (423 cases;52.6%), the persisting type (104 cases; 12.9%), and the active type (192 cases, 23.9%). The therapeutic efficacy for these 4 subtypes were 40.4%, 76.8%, 30.8% and 37%, respectively; a statistical difference was noticed between the common type and the persisting type (P<0.01). Conclusion: The method of classification proposed by the authors may help clinicians in the diagnosis and predicting the prognosis of CP. (Asian J Androl 2000 Dec;2:311-313)

  6. A preliminary clinical evaluation of external snehan and asanas in the patients of sciatica

    Science.gov (United States)

    Singh, Akhilesh K; Singh, Om P

    2013-01-01

    Lower back pain radiating to either on one leg or both legs along the course of sciatic nerve is a common ailment in the clinical practice, this type of peculiar symptomatology is termed as "Sciatica" in modern medicine. The medical treatment is unsatisfactory for both the patient and the neurosurgeons, as the surgical treatment has its own hazards and the cost of the surgical procedure and medical treatment is prohibitory to most of the Indian patients. Hence, most of the patients present themselves to the practitioners of Indian medicines like Ayurveda and yoga. This study was designed to evaluate the preliminary clinical effects of Bahya Snehan and Asanas in the patients of sciatica. This was a prospective randomized active control trial. A total of 60 participants showing classical symptoms of Sciatica between 18 and 65 years of age were randomly assigned to receive Ayurvedic or Yogic measure. One group received Snehan (external) with Bhujang and Shalabh Asana while another group received Bhujang and Salabh Asana only. Both groups practiced supervised intervention for 4 weeks. The signs and symptoms like Katishool (pain), tenderness, Stambha (rigidity), difficulty in walking, pain on bending forward were graded and interpreted at the end of the trail Significant improvement was observed in both groups before and after external Snehan with Bhujang and Shalabh Asana and in another group Bhujang and Salabh Asana only. Conclusions: Both groups, one with Snehan with asanas and the second with asanas only showed significant improvement in the patients of sciatica (Gridhrasi). PMID:23439799

  7. A preliminary clinical evaluation of external snehan and asanas in the patients of sciatica

    Directory of Open Access Journals (Sweden)

    Akhilesh K Singh

    2013-01-01

    Full Text Available Lower back pain radiating to either on one leg or both legs along the course of sciatic nerve is a common ailment in the clinical practice, this type of peculiar symptomatology is termed as "Sciatica" in modern medicine. The medical treatment is unsatisfactory for both the patient and the neurosurgeons, as the surgical treatment has its own hazards and the cost of the surgical procedure and medical treatment is prohibitory to most of the Indian patients. Hence, most of the patients present themselves to the practitioners of Indian medicines like Ayurveda and yoga. This study was designed to evaluate the preliminary clinical effects of Bahya Snehan and Asanas in the patients of sciatica. This was a prospective randomized active control trial. A total of 60 participants showing classical symptoms of Sciatica between 18 and 65 years of age were randomly assigned to receive Ayurvedic or Yogic measure. One group received Snehan (external with Bhujang and Shalabh Asana while another group received Bhujang and Salabh Asana only. Both groups practiced supervised intervention for 4 weeks. The signs and symptoms like Katishool (pain, tenderness, Stambha (rigidity, difficulty in walking, pain on bending forward were graded and interpreted at the end of the trail Significant improvement was observed in both groups before and after external Snehan with Bhujang and Shalabh Asana and in another group Bhujang and Salabh Asana only. Conclusions: Both groups, one with Snehan with asanas and the second with asanas only showed significant improvement in the patients of sciatica (Gridhrasi.

  8. Bio-Contamination Control for Spacesuit Garments - A Preliminary Study

    Science.gov (United States)

    Rhodes, Richard; Korona, Adam; Orndoff, Evelyn; Ott, Mark; Poritz, Darwin

    2010-01-01

    This paper outlines a preliminary study to review, test, and improve upon the current state of spacesuit bio-contamination control. The study includes an evaluation of current and advanced suit materials, ground and on-orbit cleaning methods, and microbial test and analysis methods. The first aspect of this study was to identify potential anti-microbial textiles and cleaning agents, and to review current microbial test methods. The anti-microbial cleaning agent and textile market survey included a review of current commercial-off-the-shelf (COTS) products that could potentially be used as future space flight hardware. This review included replacements for any of the softgood layers that may become contaminated during an extravehicular activity (EVA), including the pressure bladder, liquid cooling garment, and ancillary comfort undergarment. After a series of COTS anti-microbial textiles and clean ing agents were identified, a series of four tests were conducted: (1) a stacked configuration test that was conducted in order to review how bio-contamination would propagate through the various suit layers, (2) a individual materials test that evaluated how well each softgood layer either promoted or repressed growth, (3) a cleaning agent test that evaluated the efficacy on each of the baseline bladders, and (4) an evaluation of various COTS anti-microbial textiles. All antimicrobial COTS materials tested appeared to control bacteria colony forming unit (CFU) growth better than the Thermal Comfort Undergarment (TCU) and ACES Liquid Cooling Garment (LCG)/EMU Liquid Cooling Ventilation Garment (LCVG) materials currently in use. However, a comparison of fungi CFU growth in COTS to current suit materials appeared to vary per material. All cleaning agents tested in this study appeared to inhibit the level of bacteria and fungi growth to acceptable levels for short duration tests. While several trends can be obtained from the current analysis, a series of test improvements are

  9. Safety, immunogenicity, and preliminary clinical efficacy of a vaccine against extraintestinal pathogenic Escherichia coli in women with a history of recurrent urinary tract infection: a randomised, single-blind, placebo-controlled phase 1b trial.

    Science.gov (United States)

    Huttner, Angela; Hatz, Christoph; van den Dobbelsteen, Germie; Abbanat, Darren; Hornacek, Alena; Frölich, Rahel; Dreyer, Anita M; Martin, Patricia; Davies, Todd; Fae, Kellen; van den Nieuwenhof, Ingrid; Thoelen, Stefan; de Vallière, Serge; Kuhn, Anette; Bernasconi, Enos; Viereck, Volker; Kavvadias, Tilemachos; Kling, Kerstin; Ryu, Gloria; Hülder, Tanja; Gröger, Sabine; Scheiner, David; Alaimo, Cristina; Harbarth, Stephan; Poolman, Jan; Fonck, Veronica Gambillara

    2017-05-01

    Escherichia coli infections are increasing worldwide in community and hospital settings. The E coli O-antigen is a promising vaccine target. We aimed to assess the safety and immunogenicity of a bioconjugate vaccine containing the O-antigens of four E coli serotypes (ExPEC4V). In this multicentre phase 1b, first-in-human, single-blind, placebo-controlled trial, we randomly assigned (1:1) healthy adult women with a history of recurrent urinary tract infection (UTI) to receive a single injection of either intramuscular ExPEC4V or placebo. The primary outcome was the incidence of adverse events among vaccine and placebo recipients throughout the study. Secondary outcomes included immunogenicity and antibody functionality, and the incidence of UTIs caused by E coli vaccine serotypes in each group. This study is registered with ClinicalTrials.gov, number NCT02289794. Between Jan 20, 2014, and Aug 27, 2014, 93 women received target-dose ExPEC4V and 95 received placebo. The vaccine was well tolerated: no vaccine-related serious adverse events occurred. Overall, 56 (60%) target-dose vaccines and 47 (49%) placebo recipients experienced at least one adverse event that was possibly, probably, or certainly related to injection. Vaccination induced significant IgG responses for all serotypes: at day 30 compared with baseline, O1A titres were 4·6 times higher, O2 titres were 9·4 times higher, O6A titres were 4·9 times higher, and O25B titres were 5·9 times higher (overall pcoli was noted in the vaccine compared with the placebo group (0·149 mean episodes vs 0·146 mean episodes; p=0·522). In post-hoc exploratory analyses of UTIs with higher bacterial counts (≥10(5) colony-forming units per mL), the number of vaccine serotype UTIs did not differ significantly between groups (0·046 mean episodes in the vaccine group vs 0·110 mean episodes in the placebo group; p=0·074). However, significantly fewer UTIs caused by E coli of any serotype were noted in the vaccine group

  10. Preliminary Clinical Study of Intra-vas Device

    Institute of Scientific and Technical Information of China (English)

    吴伟雄; 袁石锦; 陈振文; 谷翊群; 李世勤

    1994-01-01

    Fifty-one volunteers with implanted intravas device (IVD ) in comparison with 40 volunteers undergone no-scalpel vasectomy have been recruited for 1 to 3 years clinical follow-up study, The results demonstrate that efficacy rates of contraception in both the IVD group and the vasectomy group are 100%, Sixteen out of thirty - one volunteers (51.6% ) in the IVD group were found to have glucosidase activity in their seminal plasma 1 to 3 years after the operation. Only 12 subjects in the IVD

  11. [Clinical diagnosis and standardized evaluation of borderline personality: preliminary report].

    Science.gov (United States)

    Chaine, F; Guelfi, J D; Monier, C; Brun, A; Seunevel, F

    1995-01-01

    A sample of 36 patients considered by French clinicians as suffering from a borderline personality disorder was evaluated using the International Personality Disorder Examination, the Diagnostic Interview for Borderline-Revised, and the Minnesota Multiphasic Personality Inventory. First, global descriptive analysis of the sample elicited the socio-demographic and standard clinical characteristics of the borderline individuals. After diagnostic evaluation, the sample appeared to be quite homogeneous with 25 of the 36 patients evaluated (69.5%) being defined as borderline by two of the three diagnostic systems: ICD 10, DSM III-R and Gunderson (15/36 = 41.5% of patients were defined as borderline by all three systems). It is the types of BL personality co-diagnoses which differentiated the BL subjects in the sample from those classically described in the international literature, since the most frequent personalities were the Dependent and Avoiding ones, not the Antisocial, Histrionic, Narcissistic or Schizotypic personalities of the DSM III-R. ICD 10 elicited the same significant prevalence of Anxious and Dependent personalities. Lastly, the patients diagnosed as borderline both by clinicians and by all diagnostic systems (forming the sample "core") were compared with the rest of the sample with regard to socio-demographic, clinical and diagnostic characteristics. A few hypotheses are proposed on the type of variables that may permit to discriminate between these two types of patients.

  12. Preliminary clinical pharmacological investigations of tylosin and tiamulin in chickens.

    Science.gov (United States)

    Ziv, G

    1980-10-15

    The minimal inhibitory concentrations (MIC) of tiamulin and tylosin for mycoplasma, Gram-positive, and Gram-negative micro-organisms isolated from chickens were determinated by the agar dilution method. Median MIC values for tiamulin against Mycoplasma gallisepticum (0.05 microgram/ml) and Mycoplasma synoviae (0.10 microgram/ml) were 2 to 4 times lower than the corresponding values for tylosin. Tiamulin was also slightly more effective in vitro in inhibiting Escherichia coli, Pasteurella multocida, and beta-haemolytic streptococci than was tylosin. Groups of chicken were offered tiamulin medicated drinking water at rates of 125 and 250 mg/litre for 48 hours. Average serum tiamulin concentrations were 0.38 and 0.78 microgram/ml, respectively. When tylosin tartrate was added to the drinking water at 500 and 700 mg/litre, average serum drug levels were 0.12 and 0.17 microgram/ml, respectively. Tiamulin was 45% bound in chicken serum, as against 30% serum protein binding for tylosin. Correlations were made between free (non protein bound) serum drug levels and the MIC values of the two drugs. Such comparisons suggest that when tiamulin is given in the drinking water at rates of 125 to 250 mg/litre, better antimycoplasmal activity is to be expected in vivo than by giving tylosin tartrate in the drinking water at 500 to 700 mg/litre. Based on these data, no clinical efficacy of these dose rates can be expected in flocks infected by gram-negative micro-organisms such as E. coli or P. multocida. The tylosin tartrate rate of 500 to 700 mg/litre, may be clinical ineffective the treatment of Staphylococcus aureus infections.

  13. Preliminary control system design and analysis for the Space Station Furnace Facility thermal control system

    Science.gov (United States)

    Jackson, M. E.

    1995-01-01

    This report presents the Space Station Furnace Facility (SSFF) thermal control system (TCS) preliminary control system design and analysis. The SSFF provides the necessary core systems to operate various materials processing furnaces. The TCS is defined as one of the core systems, and its function is to collect excess heat from furnaces and to provide precise cold temperature control of components and of certain furnace zones. Physical interconnection of parallel thermal control subsystems through a common pump implies the description of the TCS by coupled nonlinear differential equations in pressure and flow. This report formulates the system equations and develops the controllers that cause the interconnected subsystems to satisfy flow rate tracking requirements. Extensive digital simulation results are presented to show the flow rate tracking performance.

  14. The Preliminary Clinical Observation of Array Multifocal lntraocular Lens Implantation

    Institute of Scientific and Technical Information of China (English)

    Zhende Lin; Bo Feng; Yizhi Liu; Bing Cheng

    2001-01-01

    Purpose: To evaluate the clinical effects of implantation of Array multifocal intraocular lenses. Methods: Thirty-one cases (37 eyes) of cataract patients, including 15 males( 19 eyes)and 16 females( 18 eyes), were involved in this study. All patients underwent standard phacoemulsification with Array multifocal intraocular lens implantation. The complications during operation, postoperative distant visual acuity, near visual acuity,corneal curvature and visual symptoms were observed. Results: the mean value of best postoperative visual acuity was recorded as follows:uncorrected distant visual acuity was 0.8, the best-corrected distant visual acuity was 0.9, uncorrected near visual acuity was 0.5, near visual acuity with distant-corrected was 0.6, the best-corrected near visual acuity wss 0.9. The astigmatism of cornea was less than 1.5 D pre-operatively and post-operatively. One patient complained of glare. Conclusion: Array multifocal intraocular lens can provide good distant and near visual acuity. With observation of more cases and follow-up of longer time, we can draw a further conclusion. Eye Science 2001; 17: 57 ~ 60.

  15. Feasibility and preliminary effectiveness of ice therapy in patients with an acute tear in the gastrocnemius muscle: A pilot randomized controlled trial

    NARCIS (Netherlands)

    Prins, J.C.M.; Stubbe, J.H.; Meeteren, N.L.U. van; Scheffers, F.A.; Dongen, M.C.J.M. van

    2011-01-01

    Objective: To investigate the feasibility of a randomized controlled trial and the preliminary effectiveness of ice therapy in the acute phase of a gastrocnemius tear for the quality of functional recovery. Design: A pilot version of an intended prospective randomized controlled clinical trial was

  16. Biofeedback treatment for Tourette syndrome: a preliminary randomized controlled trial.

    Science.gov (United States)

    Nagai, Yoko; Cavanna, Andrea E; Critchley, Hugo D; Stern, Jeremy J; Robertson, Mary M; Joyce, Eileen M

    2014-03-01

    To study the clinical effectiveness of biofeedback treatment in reducing tics in patients with Tourette syndrome. Despite advances in the pharmacologic treatment of patients with Tourette syndrome, many remain troubled by their tics, which may be resistant to multiple medications at tolerable doses. Electrodermal biofeedback is a noninvasive biobehavioral intervention that can be useful in managing neuropsychiatric and neurologic conditions. We conducted a randomized controlled trial of electrodermal biofeedback training in 21 patients with Tourette syndrome. After training the patients for 3 sessions a week over 4 weeks, we observed a significant reduction in tic frequency and improved indices of subjective well-being in both the active-biofeedback and sham-feedback (control) groups, but there was no difference between the groups in these measurements. Furthermore, the active-treatment group did not demonstrably learn to reduce their sympathetic electrodermal tone using biofeedback. Our findings indicate that this form of biofeedback training was unable to produce a clinical effect greater than placebo. The main confounding factor appeared to be the 30-minute duration of the training sessions, which made it difficult for patients to sustain a reduction in sympathetic tone when their tics themselves were generating competing phasic electrodermal arousal responses. Despite a negative finding in this study, electrodermal biofeedback training may have a role in managing tics if optimal training schedules can be identified.

  17. PVA-Sago starch hydrogel and the preliminary clinical animal study of the hydrogel

    Energy Technology Data Exchange (ETDEWEB)

    Hashim, Kamaruddin; Mohd Dahlan, Khairul Zaman [Malaysian Institute for Nuclear Technology Research, Bangi, Kajang (Malaysia); Halim, Ahmad Sukari; Md Nor, Mohd Tarmizi [Sciences University of Malaysia, School of Medical Sciences, Kerian, Kelantan (Malaysia); Yoshii, Fumio [Japan Atomic Energy Research Inst., Takasaki, Gunma (Japan). Takasaki Radiation Chemistry Research Establishment

    2002-03-01

    Sago starch granule dissolves in hot water to form physically crosslink semi-gel structure. Polyvinyl alcohol (PVA) in aqueous solution is chemically crosslink and form hydrogel after expose to gamma or electron beam irradiation. Combination of sago starch and PVA give tremendous improvement on strength and elasticity of the gel. Adding additive such as carboxymethyl cellulose enhance the swelling or absorption property of the gel. These properties of hydrogel are important for wound dressing application. The preliminary clinical animal study on the PVA Sago hydrogel dressing shows promising results of healing process in comparison with the conventional dressing using vaseline impregnated gauze acting as control dressing. This re-confirmed by biopsy tests on the wound tissue taking during the healing process. The tests show the increasing amount of fibroblast and endothelial cells on both wounds using hydrogel and jalonet during the healing process. Also, the rate of epitheliazation is almost completed for both wounds after 10 days of dressing and the lymphocytes cell increase tremendously for the first 14 days with hydrogel dressing. (author)

  18. Clinical utility of color-form naming in Alzheimer's disease: preliminary evidence

    DEFF Research Database (Denmark)

    Nielsen, Niels Peter; Wiig, Elisabeth H; Warkentin, Siegbert

    2004-01-01

    Performances on Alzheimer's Quick Test color-form naming and Mini-Mental State Examination were compared for 38 adults with Alzheimer's disease and 38 age- and sex-matched normal controls. Group means differed significantly and indicated longer naming times by adults with Alzheimer's disease...... associated with Alzheimer's disease, are preliminary given the relatively small sample....

  19. Breast ultrasound tomography with two parallel transducer arrays: preliminary clinical results

    Science.gov (United States)

    Huang, Lianjie; Shin, Junseob; Chen, Ting; Lin, Youzuo; Intrator, Miranda; Hanson, Kenneth; Epstein, Katherine; Sandoval, Daniel; Williamson, Michael

    2015-03-01

    Ultrasound tomography has great potential to provide quantitative estimations of physical properties of breast tumors for accurate characterization of breast cancer. We design and manufacture a new synthetic-aperture breast ultrasound tomography system with two parallel transducer arrays. The distance of these two transducer arrays is adjustable for scanning breasts with different sizes. The ultrasound transducer arrays are translated vertically to scan the entire breast slice by slice and acquires ultrasound transmission and reflection data for whole-breast ultrasound imaging and tomographic reconstructions. We use the system to acquire patient data at the University of New Mexico Hospital for clinical studies. We present some preliminary imaging results of in vivo patient ultrasound data. Our preliminary clinical imaging results show promising of our breast ultrasound tomography system with two parallel transducer arrays for breast cancer imaging and characterization.

  20. Preliminary results of transcutaneous vagus nerve stimulation for chronic subjective tinnitus:A controlled clinical study%经皮迷走神经刺激术治疗慢性耳鸣的初步研究

    Institute of Scientific and Technical Information of China (English)

    曾祥丽; 招柏明; 张姝琪; 黎志成; 岑锦添; 顾晶; 袁涛; 李水颜

    2016-01-01

    Objective To report the efficacy and safety of transcutaneous vagus nerve stimulation (T-VNS) for treat-ment of chronic subjective tinnitus. Methods Chronic subjective tinnitus patients whose THI score was≥38 points, and with a tinnitus history of ≥6 months, were randomly divided into a T-VNS and a control groups. For patients in the T-VNS group, in addition to routine treatments, T-VNS was added using a G6805-type I cupping therapy apparatus, while only routine treatment were provided to patients in the control group. Treatment efficacy was evaluated with the Tinnitus Handicap Inventory (THI), Pittsburgh Sleep Quality Index (PSQI) and Depression and Anxiety-Stress Scale-21 (DASS-21) administered before and after treatment. Results Tinnitus symptoms improved more in the T-VNS group than in the control group during the 10 days of T-VNS treatment (p<0.05), with significantly improved PSQI scores, al-though there was a mild rebound of the scores at 3 months follow-up. DASS-21 scores showed decreased anxiety in the T-VNS group during VNS therapy, but no change in the control group. THI scores showed no significant difference be-tween the T-VNS and control groups either during treatment or at 3 months follow-up, although within the T-VNS group, THI scores reduced after T-VNS therapy (with no statistically significant difference) and at 3 months follow-up (statistically significant). Conclusion T-VNS may improve anxiety and sleep quality in patients who suffer from chron-ic subjective tinnitus. The primary study showed that this therapy was safe, with only transient cough or ear tingling dur-ing treatment in a minority of patients, while partially improving tinnitus distress over the 10-days treatment. Stimula-tion parameters and treatment course remain to be further investigated.%目的:探讨经皮外耳道迷走神经刺激术对慢性主观性耳鸣的治疗效果、安全性及可行性。方法选取THI评分≥38分,病史6≥个月的慢性主观性耳

  1. 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...

  2. A preliminary study of intravenous surfactants in paraplegic dogs: polymer therapy in canine clinical SCI.

    Science.gov (United States)

    Laverty, Peter H; Leskovar, Alenka; Breur, Gert J; Coates, Joan R; Bergman, Robert L; Widmer, William R; Toombs, James P; Shapiro, Scott; Borgens, Richard B

    2004-12-01

    Hydrophilic polymers, both surfactants and triblock polymers, are known to seal defects in cell membranes. In previous experiments using laboratory animals, we have exploited this capability using polyethylene glycol (PEG) to repair spinal axons after severe, standardized spinal cord injury (SCI) in guinea pigs. Similar studies were conducted using a related co-polymer Poloxamer 188 (P 188). Here we carried out initial investigations of an intravenous application of PEG or P 188 (3500 Daltons, 30% w/w in saline; 2 mL/kg I.V. and 2 mL/kg body weight or 300 mL P 188 per kg, respectively) to neurologically complete cases of paraplegia in dogs. Our aim was to first determine if this is a clinically safe procedure in cases of severe naturally occurring SCI in dogs. Secondarily, we wanted to obtain preliminary evidence if this therapy could be of clinical benefit when compared to a larger number of similar, but historical, control cases. Strict entry criteria permitted recruitment of only neurologically complete paraplegic dogs into this study. Animals were treated by a combination of conventional and experimental techniques within approximately 72 h of admission for spinal trauma secondary to acute, explosive disk herniation. Outcome measures consisted of measurements of voluntary ambulation, deep and superficial pain perception, conscious proprioception in hindlimbs, and evoked potentials (somatosensory evoked potentials [SSEP]). We determined that polymer injection is a safe adjunct to the conventional management of severe neurological injury in dogs. We did not observe any unacceptable clinical response to polymer injection; there were no deaths, nor any other problem arising from, or associated with, the procedures. Outcome measures over the 6-8-week trial were improved by polymer injection when compared to historical cases. This recovery was unexpectedly rapid compared to these comparator groups. The results of this pilot trial provides evidence consistent with the

  3. The Relationship of Clinical, Cognitive and Social Measures in Schizophrenia: A Preliminary Finding Combining Measures in Probands and Relatives

    Science.gov (United States)

    Huepe, David; Riveros, Rodrigo; Manes, Facundo; Couto, Blas; Hurtado, Esteban; Cetkovich, Marcelo; Escobar, Maria; Vergara, Viviana; Parrao, Teresa; Ibañez, Agustin

    2012-01-01

    This study examines performance of schizophrenia patients, unaffected relatives and controls in social cognition, cognitive and psychiatric scales looking for possible markers of vulnerability in schizophrenia. Performance of schizophrenia patients from multiplex families, first-degree relatives, and matched controls was compared and, subsequently, discriminant analysis method was used for identifying the best predictors for group membership. By using Multigroup Discriminant Analyses on the three groups, the best predictors were PANSS, Premorbid Adjustment Scale, Faux Pas test, and a face/emotion categorizing task. This model obtained 82% correct global classification, suggesting that the combination of psychiatric scales and neuropsychological/social cognition tesks are the best approach for characterizing this disease. Although preliminary, our results suggest that social cognition tasks are robust markers of schizophrenia family impairments, and that combining clinical, social and neuropsychological measures is the best approach to asses patients and relatives vulnerability. PMID:22425724

  4. The Relationship of Clinical, Cognitive and Social Measures in Schizophrenia: A Preliminary Finding Combining Measures in Probands and Relatives

    Directory of Open Access Journals (Sweden)

    David Huepe

    2012-01-01

    Full Text Available This study examines performance of schizophrenia patients, unaffected relatives and controls in social cognition, cognitive and psychiatric scales looking for possible markers of vulnerability in schizophrenia. Performance of schizophrenia patients from multiplex families, first-degree relatives, and matched controls was compared and, subsequently, discriminant analysis method was used for identifying the best predictors for group membership. By using Multigroup Discriminant Analyses on the three groups, the best predictors were PANSS, Premorbid Adjustment Scale, Faux Pas test, and a face/emotion categorizing task. This model obtained 82% correct global classification, suggesting that the combination of psychiatric scales and neuropsychological/social cognition tesks are the best approach for characterizing this disease. Although preliminary, our results suggest that social cognition tasks are robust markers of schizophrenia family impairments, and that combining clinical, social and neuropsychological measures is the best approach to asses patients and relatives vulnerability.

  5. Mindfulness Therapy for Maladaptive Interpersonal Dependency: A Preliminary Randomized Controlled Trial.

    Science.gov (United States)

    McClintock, Andrew S; Anderson, Timothy; Cranston, Saryn

    2015-11-01

    Existing treatments for maladaptive interpersonal dependency and dependent personality disorder do not meet basic scientific standards for effectiveness. The present investigation tested the efficacy of a mindfulness-based approach: mindfulness therapy for maladaptive interpersonal dependency (MT-MID). Forty-eight participants who reported consistently high levels of maladaptive dependency (i.e., scored higher than 1 standard deviation above the mean on the Interpersonal Dependency Inventory at two separate assessments) were randomized to either 5 sessions of MT-MID or a minimal contact control. Five self-reported outcomes (mindfulness, maladaptive interpersonal dependency, helplessness, fears of negative evaluation, and excessive reassurance seeking) were assessed at pretreatment, posttreatment, and a 4-week follow-up. Intent-to-treat analyses indicated that MT-MID yielded greater improvements than the control on all 5 outcomes at posttreatment (median d=1.61) and follow-up (median d=1.51). Participants assigned to MT-MID were more likely than control participants to meet criteria for clinically significant change at posttreatment (56.5% vs. 0%) and follow-up (42.9% vs. 0%). There was also evidence that increases in mindfulness mediated the dependency-related improvements. These results provide preliminary support for the efficacy of a mindfulness-based approach for treating the symptoms of maladaptive dependency.

  6. Preliminary clinical nursing leadership competency model: a qualitative study from Thailand.

    Science.gov (United States)

    Supamanee, Treeyaphan; Krairiksh, Marisa; Singhakhumfu, Laddawan; Turale, Sue

    2011-12-01

    This qualitative study explored the clinical nursing leadership competency perspectives of Thai nurses working in a university hospital. To collect data, in-depth interviews were undertaken with 23 nurse administrators, and focus groups were used with 31 registered nurses. Data were analyzed using content analysis, and theory development was guided by the Iceberg model. Nurses' clinical leadership competencies emerged, comprising hidden characteristics and surface characteristics. The hidden characteristics composed three elements: motive (respect from the nursing and healthcare team and being secure in life), self-concept (representing positive attitudes and values), and traits (personal qualities necessary for leadership). The surface characteristics comprised specific knowledge of nurse leaders about clinical leadership, management and nursing informatics, and clinical skills, such as coordination, effective communication, problem solving, and clinical decision-making. The study findings help nursing to gain greater knowledge of the essence of clinical nursing leadership competencies, a matter critical for theory development in leadership. This study's results later led to the instigation of a training program for registered nurse leaders at the study site, and the formation of a preliminary clinical nursing leadership competency model.

  7. Virtual reality therapy versus cognitive behavior therapy for social phobia: a preliminary controlled study.

    Science.gov (United States)

    Klinger, E; Bouchard, S; Légeron, P; Roy, S; Lauer, F; Chemin, I; Nugues, P

    2005-02-01

    Social phobia is one of the most frequent mental disorders and is accessible to two forms of scientifically validated treatments: anti-depressant drugs and cognitive behavior therapies (CBT). In this last case, graded exposure to feared social situations is one of the fundamental therapeutic ingredients. Virtual reality technologies are an interesting alternative to the standard exposure in social phobia, especially since studies have shown its usefulness for the fear of public speaking. This paper reports a preliminary study in which a virtual reality therapy (VRT), based on exposure to virtual environments, was used to treat social phobia. The sample consisted of 36 participants diagnosed with social phobia assigned to either VRT or a group-CBT (control condition). The virtual environments used in the treatment recreate four situations dealing with social anxiety: performance, intimacy, scrutiny, and assertiveness. With the help of the therapist, the patient learns adapted cognitions and behaviors in order to reduce anxiety in the corresponding real situations. Both treatments lasted 12 weeks, and sessions were delivered according to a treatment manual. Results showed statistically and clinically significant improvement in both conditions. The effect-sizes comparing the efficacy of VRT to the control traditional group-CBT revealed that the differences between the two treatments are trivial.

  8. Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

    Directory of Open Access Journals (Sweden)

    Sandini Giulio

    2009-12-01

    Full Text Available Abstract Background In the last two decades robot training in neuromotor rehabilitation was mainly focused on shoulder-elbow movements. Few devices were designed and clinically tested for training coordinated movements of the wrist, which are crucial for achieving even the basic level of motor competence that is necessary for carrying out ADLs (activities of daily life. Moreover, most systems of robot therapy use point-to-point reaching movements which tend to emphasize the pathological tendency of stroke patients to break down goal-directed movements into a number of jerky sub-movements. For this reason we designed a wrist robot with a range of motion comparable to that of normal subjects and implemented a self-adapting training protocol for tracking smoothly moving targets in order to facilitate the emergence of smoothness in the motor control patterns and maximize the recovery of the normal RoM (range of motion of the different DoFs (degrees of Freedom. Methods The IIT-wrist robot is a 3 DoFs light exoskeleton device, with direct-drive of each DoF and a human-like range of motion for Flexion/Extension (FE, Abduction/Adduction (AA and Pronation/Supination (PS. Subjects were asked to track a variable-frequency oscillating target using only one wrist DoF at time, in such a way to carry out a progressive splinting therapy. The RoM of each DoF was angularly scanned in a staircase-like fashion, from the "easier" to the "more difficult" angular position. An Adaptive Controller evaluated online performance parameters and modulated both the assistance and the difficulty of the task in order to facilitate smoother and more precise motor command patterns. Results Three stroke subjects volunteered to participate in a preliminary test session aimed at verify the acceptability of the device and the feasibility of the designed protocol. All of them were able to perform the required task. The wrist active RoM of motion was evaluated for each patient at the

  9. Clinical assessment, neuroimaging and immunomarkers in Chagas disease study (CLINICS: rationale, study design and preliminary findings

    Directory of Open Access Journals (Sweden)

    Jamary Oliveira-Filho

    Full Text Available ABSTRACT Chagas disease (CD is an important cause of cardiomyopathy and stroke in Brazil. Brain infarcts and atrophy seem to occur independently of cardiomyopathy severity and cognitive impairment is understudied. Objective: Compare the prevalence of brain magnetic resonance imaging abnormalities between patients with or without CD; determine if inflammatory biomarkers are increased in CD; and determine the efficacy of aspirin in reducing the rate of microembolization in these patients. Methods: 500 consecutive patients with heart failure will undergo a structured cognitive evaluation, biomarker collection and search for microembolic signals on transcranial Doppler. The first 90 patients are described, evaluated with cognitive tests and brain magnetic resonance imaging to measure N-acetyl aspartate (NAA, choline (Cho, myo-inositol (MI and creatine (Cr. Results: Mean age was 55±11 years, 51% female, 38 (42% with CD. Mean NAA/Cr ratio was lower in patients with CD as compared to other cardiomyopathies. Long-term memory and clock-drawing test were also significantly worse in CD patients. In the multivariable analysis correcting for ejection fraction, age, sex and educational level, reduced NAA/Cr (p=0.006 and cognitive dysfunction (long-term memory, p=0.023; clock-drawing test, p=0.015 remained associated with CD. Conclusion: In this preliminary sample, CD was associated with cognitive impairment and decreased NAA/Cr independently of cardiac function or educational level.

  10. Preliminary Design of Control Network for HT-7U Tokamak Cryogenic System

    Institute of Scientific and Technical Information of China (English)

    Jin Yibin(金毅彬); Zhuang Ming(庄明); Bai Hongyu(白宏宇)

    2003-01-01

    In the course of the cryoplant modernization, a control network will be set up in order to facilitate the control, the supervision, the centralized data acquisition and the alarm handling of the cryogenic system for HT-7U tokamak. The paper introduces the preliminary design of control network based on the Controller Link Network for HT-7U tokamak cryogenic system. The multi-layer structure mentioned in the paper is the mainstream of automatic control.The control philosophy, the structure of the network and the components for control are also presented.

  11. Clinical and neuroimaging correlates of antiphospholipid antibodies in multiple sclerosis: a preliminary study

    Directory of Open Access Journals (Sweden)

    Gonzalez-Toledo Eduardo

    2007-10-01

    Full Text Available Abstract Background The presence of antiphospholipid antibodies (APLA in multiple sclerosis (MS patients has been reported frequently but no clear relationship between APLA and the clinical and neuroimaging features of MS have heretofore been shown. We assessed the clinical and neuroimaging features of MS patients with plasma APLA. Methods A consecutive cohort of 24 subjects with relapsing-remitting (RR MS were studied of whom 7 were in remission (Rem and 17 in exacerbation (Exc. All subjects were examined and underwent MRI of brain. Patients' plasma was tested by standard ELISA for the presence of both IgM and IgG antibodies using a panel of 6 targets: cardiolipin (CL, β2 glycoprotein I (β2GPI, Factor VII/VIIa (FVIIa, phosphatidylcholine (PC, phosphatidylserine (PS and phosphatidylethanolamine (PE. Results In exacerbation up to 80% of MS subjects had elevated titers of IgM antibodies directed against the above antigens. However, in remission, less than half of MS patients had elevated titers of IgM antibodies against one or more of the above antigens. This difference was significant, p Conclusion The findings of this preliminary study show that increased APLA IgM is associated with exacerbations of MS. Currently, the significance of this association in pathogenesis of MS remains unknown. However, systematic longitudinal studies to measure APLA in larger cohorts of patients with relapsing-remitting MS, particularly before and after treatment with immunomodulatory agents, are needed to confirm these preliminary findings.

  12. Preliminary Single-Center Canadian Experience of Human Normothermic Ex Vivo Liver Perfusion: Results of a Clinical Trial.

    Science.gov (United States)

    Bral, M; Gala-Lopez, B; Bigam, D; Kneteman, N; Malcolm, A; Livingstone, S; Andres, A; Emamaullee, J; Russell, L; Coussios, C; West, L J; Friend, P J; Shapiro, A M J

    2017-04-01

    After extensive experimentation, outcomes of a first clinical normothermic machine perfusion (NMP) liver trial in the United Kingdom demonstrated feasibility and clear safety, with improved liver function compared with standard static cold storage (SCS). We present a preliminary single-center North American experience using identical NMP technology. Ten donor liver grafts were procured, four (40%) from donation after circulatory death (DCD), of which nine were transplanted. One liver did not proceed because of a technical failure with portal cannulation and was discarded. Transplanted NMP grafts were matched 1:3 with transplanted SCS livers. Median NMP was 11.5 h (range 3.3-22.5 h) with one DCD liver perfused for 22.5 h. All transplanted livers functioned, and serum transaminases, bilirubin, international normalized ratio, and lactate levels corrected in NMP recipients similarly to controls. Graft survival at 30 days (primary outcome) was not statistically different between groups on an intent-to-treat basis (p = 0.25). Intensive care and hospital stays were significantly more prolonged in the NMP group. This preliminary experience demonstrates feasibility as well as potential technical risks of NMP in a North American setting and highlights a need for larger, randomized studies. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  13. Clobazam: uncontrolled and standard controlled clinical trials.

    Science.gov (United States)

    Ban, T A; Amin, M M

    1979-01-01

    1 In an uncontrolled clinical trial, carried out in 11 psychiatric patients with the clinical diagnoses of anxiety neurosis and depressive neurosis, clobazam, a new benzodiazepine preparation, in the dosage range 10-60 mg daily produced statistically significant improvement in the total and both factor scores of the Hamilton Anxiety Scale (HAM-A). The lowest mean total HAM-A scores occurred with a mean clobazam dosage of 48 mg daily. 2 Results of the uncontrolled clinical trial were further substantiated in a standard-controlled clinical study in which no statistically significant difference between the therapeutic effectiveness of clobazam and diazepam could be revealed. The lowest mean total HAM-A scores occurred with a mean clobazam dosage of 49 mg daily. There was a lower incidence of adverse effects reported in patients receiving clobazam than in those taking the control drug (diazepam).

  14. Preliminary statistical assessment towards characterization of biobotic control.

    Science.gov (United States)

    Latif, Tahmid; Meng Yang; Lobaton, Edgar; Bozkurt, Alper

    2016-08-01

    Biobotic research involving neurostimulation of instrumented insects to control their locomotion is finding potential as an alternative solution towards development of centimeter-scale distributed swarm robotics. To improve the reliability of biobotic agents, their control mechanism needs to be precisely characterized. To achieve this goal, this paper presents our initial efforts for statistical assessment of the angular response of roach biobots to the applied bioelectrical stimulus. Subsequent findings can help to understand the effect of each stimulation parameter individually or collectively and eventually reach reliable and consistent biobotic control suitable for real life scenarios.

  15. Nonattendance at a hospital-based otolaryngology clinic: a preliminary analysis within a universal healthcare system.

    Science.gov (United States)

    Zirkle, Molly S; McNelles, Laurie R

    2011-08-01

    Missed appointments at specialty clinics generate concerns for physicians and clinic administrators. Appointment nonattendance obstructs the provision of timely medical interventions and the maximization of systemic efficiencies. Yet, empiric study of factors associated with missed appointments at adult specialty clinics has received little attention in North America. We conducted a preliminary study of otolaryngology clinic nonattendance in the context of a universal healthcare system environment in Canada. Our data were based on the schedule of 1,512 new patient appointments at a hospital-based clinic from May 1 through Sept. 30, 2008. Gathered information included the employment status of the attending physician (i.e., full-time vs. part-time), the patient's sex and age, the day of the week and the time of the appointment, and the attendance status. We found that the rate of nonattendance was 24.4% (n = 369). Nonattendance rates varied significantly according to physician employment status (more common for part-time physicians), patient sex (women) and age (younger adults), and the day of the appointment (Wednesdays), but not according to the time of day. Our findings suggest that there are predictable patient and systemic factors that influence nonattendance at medical appointments. Awareness of these factors can have implications for the delivery of healthcare services within a universal healthcare context.

  16. Preliminary study on three pathogens with potential biological control in Barnyard grass (Echinochloa crus galli)

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@ More than 10 species of pathogenic fungi were isolated from the naturally infected leaves of barnyard grass (Echinochloa crus-galli) in paddy. After preliminary bioassaying, it was found that the Alternaria alternata (Fr.) keissler(AA), Exserohilum monoceras (EM),and "99-10" were three potential agents for biological control of barnyard grass.

  17. Preliminary evaluation of an experimental clinical chemistry analyzer developed for space medicine.

    Science.gov (United States)

    Wu, A H; Gornet, T G; Schenkel, O; Smith-Cronin, L; Graham, G A; Tonnesen, A S; McKinley, B A

    1993-01-01

    An experimental clinical chemistry analyzer system was designed and built to demonstrate the feasibility of clinical chemistry as part of a medical-care system at NASA's planned space station Freedom. We report the performance of the experimental analyzer, called a medical development unit (MDU), for selected analytes in a laboratory setting in preparation for a preliminary clinical trial at patients' bedsides in an intensive-care unit. Within-run CVs ranged from 0.7% for sodium to 7.1% for phosphorus; day-to-day CVs ranged from 1.0% for chloride to 23.4% for calcium. Correlation of patients' blood sample analyses compared well with those by Ektachem E700 and other high-volume central laboratory analyzers (r ranged from 0.933 for creatine kinase MB isoenzyme to 0.997 for potassium), except for hemoglobin (r = 0.901) and calcium (r = 0.823). Although several CVs obtained in this study exceeded theoretical desired precision limits based on biological variations, performance was adequate for clinical laboratory diagnosis. We examined the effect of potentially interfering concentrations of hemoglobin, bilirubin, and lipids: the only effect was negative interference with calcium analyses by high concentrations of bilirubin. We also examined the effects of preanalytical variables and the performance of experimental sample-transfer cups designed to retain sample and reference liquid in microgravity. Continued development of the MDU system is recommended, especially automation of sample processing.

  18. Selection of Sperm Based on Hypo-Osmotic Swelling May Improve ICSI Outcome: A Preliminary Prospective Clinical Trial

    Directory of Open Access Journals (Sweden)

    Nasim Charehjooy

    2014-03-01

    Full Text Available Background: The intra-cytoplasmic sperm injection (ICSI technique selects sperm according to morphology and motility. However, these parameters cannot predict the chromatin integrity of sperm. Considering the detrimental effects of DNA-damaged sperm on reproductive outcomes, novel sperm selection procedures have been proposed to circumvent the possibility of inseminating DNA-damaged sperm. It has been shown that different potential hypo-osmotic swelling test (HOST patterns possess the potential to differentiate between sperm that have intact or damaged chromatin. Therefore, for the first time, this preliminary study evaluates the role of HOST as a sperm selection procedure in a clinical setting. Materials and Methods: In this preliminary prospective clinical trial study, we divided infertile couples diagnosed with male infertility into two groups. In the treatment group (n=39, half of the oocytes were inseminated by sperm selected following density gradient centrifugation (DGC group. The remaining oocytes from the treatment group were inseminated by sperm chosen according to HOST pattern (c, d or e following DGC processing (HOST group. In the control group (n=63, all oocytes were inseminated by sperm chosen after DGC. Results: There was a significantly higher percentage of embryos that had good quality, implantation, and chemical pregnancy rates in the HOST group compared to the DGC group (p≤0.05. Conclusion: This study has shown that selecting sperm according to membrane functionality (HOST pattern rather morphology and viability may open a new window in our approach for determining the appropriate sperm for ICSI, particularly in individuals with severe male infertility (Registration Number: IRCT201307087223N2.

  19. Preliminary Screening of Potential Control Products against Drosophila suzukii

    Directory of Open Access Journals (Sweden)

    Andrew G. S. Cuthbertson

    2014-06-01

    Full Text Available The first recording of Drosophila suzukii in the UK occurred in the south of England during August 2012. Since then sticky traps have continued to record the presence of individuals. Several products (both chemical and biological were investigated for their efficacy against different life-stages of the pest. Both direct and indirect exposure to control products was assessed. Spinosad, chlorantraniliprole and the experimental product, TA2674, showed excellent potential as control agents when used as either a pre- or post-dipping treatment for blueberries with mortalities of 100%, 93% and 98% mortality, respectively, being achieved following pre-treatment. Direct spray application of all products tested had limited impact upon adult flies. Highest mortality (68% was achieved following direct application of TA2674. Entomopathogenic agents (nematodes and fungi tested appeared to reduce fly population development (ranges of 34–44% mortality obtained but would seem unable to eradicate outbreaks. The potential of the tested products to control D. suzukii is discussed.

  20. QUALITY CONTROL PARAMETERS OF BRIHAT DASHAMULA TAILA: A PRELIMINARY STUDY

    Directory of Open Access Journals (Sweden)

    Sharma Vinay

    2011-05-01

    Full Text Available Standard analytical parameters of a number of Ayurvedic oils have been described in API. Brihat Dashamula Taila is one of the most commonly used oil by Ayurvedic Physicians. But there no standard analytical parameters are available in any authentic texts. Therefore this study aimed to set the quality control parameters with SOP of Brihat Dashamula Taila and found values like Refractive index (1.47 at 400C, specific gravity (0.923 at 250C Acid value (1.2, Iodine value (92.6 and Saponification value (86.34 may be considered as standard.

  1. N-Acetyl Cysteine May Support Dopamine Neurons in Parkinson's Disease: Preliminary Clinical and Cell Line Data.

    Directory of Open Access Journals (Sweden)

    Daniel A Monti

    Full Text Available The purpose of this study was to assess the biological and clinical effects of n-acetyl-cysteine (NAC in Parkinson's disease (PD.The overarching goal of this pilot study was to generate additional data about potentially protective properties of NAC in PD, using an in vitro and in vivo approach. In preparation for the clinical study we performed a cell tissue culture study with human embryonic stem cell (hESC-derived midbrain dopamine (mDA neurons that were treated with rotenone as a model for PD. The primary outcome in the cell tissue cultures was the number of cells that survived the insult with the neurotoxin rotenone. In the clinical study, patients continued their standard of care and were randomized to receive either daily NAC or were a waitlist control. Patients were evaluated before and after 3 months of receiving the NAC with DaTscan to measure dopamine transporter (DAT binding and the Unified Parkinson's Disease Rating Scale (UPDRS to measure clinical symptoms.The cell line study showed that NAC exposure resulted in significantly more mDA neurons surviving after exposure to rotenone compared to no NAC, consistent with the protective effects of NAC previously observed. The clinical study showed significantly increased DAT binding in the caudate and putamen (mean increase ranging from 4.4% to 7.8%; p<0.05 for all values in the PD group treated with NAC, and no measurable changes in the control group. UPDRS scores were also significantly improved in the NAC group (mean improvement of 12.9%, p = 0.01.The results of this preliminary study demonstrate for the first time a potential direct effect of NAC on the dopamine system in PD patients, and this observation may be associated with positive clinical effects. A large-scale clinical trial to test the therapeutic efficacy of NAC in this population and to better elucidate the mechanism of action is warranted.ClinicalTrials.gov NCT02445651.

  2. Celiac Patients: A Randomized, Controlled Clinical Study

    Directory of Open Access Journals (Sweden)

    Giuseppe Mazzarella

    2012-01-01

    Full Text Available A lifelong gluten-free diet (GFD is mandatory for celiac disease (CD but has poor compliance, justifying novel strategies. We found that wheat flour transamidation inhibited IFN-γ secretion by intestinal T cells from CD patients. Herein, the primary endpoint was to evaluate the ability of transamidated gluten to maintain GFD CD patients in clinical remission. Secondary endpoints were efficacy in prevention of the inflammatory response and safety at the kidney level, where reaction products are metabolized. In a randomized single blinded, controlled 90-day trial, 47 GFD CD patients received 3.7 g/day of gluten from nontransamidated (12 or transamidated (35 flour. On day 15, 75% and 37% of patients in the control and experimental groups, respectively, showed clinical relapse (=0.04 whereas intestinal permeability was mainly altered in the control group (50% versus 20%, =0.06. On day 90, 0 controls and 14 patients in the experimental group completed the challenge with no variation of antitransglutaminase IgA (=0.63, Marsh-Oberhuber grading (=0.08, or intestinal IFN-γ mRNA (>0.05. Creatinine clearance did not vary after 90 days of treatment (=0.46. In conclusion, transamidated gluten reduced the number of clinical relapses in challenged patients with no changes of baseline values for serological/mucosal CD markers and an unaltered kidney function.

  3. Preliminary Experimental Results for Indirect Vector-Control of Induction Motor Drives with Forced Dynamics

    Directory of Open Access Journals (Sweden)

    Jan Vittek

    2003-01-01

    Full Text Available The contribution presents an extension of indirect vector control of electric drives employing induction motors to 'Forced Dynamic Control'. This method of control offers an accurate realisation of dynamic response profiles, which can be selected by the user. The developed system can be integrated into a drive with a shaft position encoder or a shaft sensoriess drive, in which only the stator currents are measured. The applied stator voltages are determined by a computed inverter switching algorithm. Simulation results and preliminary experimental results for indirect vector control of an idle running induction motor indicate good agreement with the theoretical predictions.

  4. 21 CFR 862.3280 - Clinical toxicology control material.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Clinical toxicology control material. 862.3280... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3280 Clinical toxicology control material. (a) Identification. A clinical toxicology...

  5. Preliminary Seafloor Controlled Source EM Results From APPLE

    Science.gov (United States)

    Behrens, J. P.; MacGregor, L.; Constable, S.; Everett, M.

    2001-12-01

    Certain events in the life cycle of oceanic lithosphere are dominantly two-dimensional. These include formation of crust at axial spreading centers and deformation at the lithosphere - asthenosphere boundary. These processes may result in an electrically anisotropic oceanic lithosphere by creating conductive pathways in preferred orientations. Controlled Source Electromagnetic (CSEM) soundings and Magnetotelluric (MT) soundings were made during the Anisotropy and Physics of the Pacific Lithosphere Experiment (APPLE), carried out in February/March 2001 approximately 600 km west of San Diego, California. Twenty seafloor electromagnetic field sensors were deployed: 4 long-wire CSEM recorders with 200 m electrode offsets, 6 high-frequency MT/CSEM recorders with two orthogonal 10 m offset electrodes and two orthogonal induction coil magnetometers, and 10 low-frequency MT recorders with a three-component fluxgate magnetometer and two orthogonal 10 m electric dipoles, 5 of which also recorded CSEM data. Every instrument was recovered, with data, during this primary cruise and a follow-up recovery cruise for the long-period instruments in August 2001. The deep-towed EM transmitter (DASI) was a 100 m horizontal electric dipole, which was towed in a 30 km radius circle around a central core of recorders. A radial tow was also performed. DASI transmitted a 4 Hz square wave throughout the CSEM phase of the experiment. Initial processing of the CSEM data reveals evidence of crustal anisotropy. In particular, transmitted electromagnetic energy is attenuated more strongly when propagating from west to east than from north to south. The difference in attenuation is about a factor of two, at a range of 30 km and a frequency of 4Hz. This confirms earlier results from the PEGASUS experiment, which proposed that oceanic lower crust and upper mantle with east-west trending lineaments of increased conductivity will exhibit greater attenuation of electric fields in the east

  6. Diagnosis of breast cancer using elastic-scattering spectroscopy: preliminary clinical results

    Science.gov (United States)

    Bigio, Irving J.; Brown, Stephen G.; Briggs, Gavin M.; Kelley, Christine; Lakhani, Sunil; Pickard, David; Ripley, Paul M.; Rose, Ian; Saunders, Christobel

    2000-04-01

    We report on the first stages of a clinical study designed to test elastic-scattering spectroscopy, medicated by fiberoptic probes, for three specific clinical applications in breast-tissue diagnosis: (1) a transdermal-needle (interstitial) measurement for instant diagnosis with minimal invasiveness similar to fine-needle aspiration but with sensitivity to a larger tissue volume, (2) a hand-held diagnostic probe for use in assessing tumor/resection margins during open surgery, and (3) use of the same probe for real-time assessment of the `sentinel' node during surgery to determine the presence or absence of tumor (metastatic). Preliminary results from in vivo measurements on 31 women are encouraging. Optical spectra were measured on 72 histology sites in breast tissue, and 54 histology sites in sentinel nodes. Two different artificial intelligence methods of spectral classification were studied. Artificial neural networks yielded sensitivities of 69% and 58%, and specificities of 85% and 93%, for breast tissue and sentinel nodes, respectively. Hierarchical cluster analysis yielded sensitivities of 67% and 91%, and specificities of 79% and 77%, for breast tissue and sentinel nodes, respectively. These values are expected to improve as the data sets continue to grow and more sophisticated data preprocessing is employed. The study will enroll up to 400 patients over the next two years.

  7. An Algorithm for Glaucoma Screening in Clinical Settings and Its Preliminary Performance Profile

    Directory of Open Access Journals (Sweden)

    S-Farzad Mohammadi

    2013-01-01

    Full Text Available Purpose: To devise and evaluate a screening algorithm for glaucoma in clinical settings. Methods: Screening included examination of the optic disc for vertical cupping (≥0.4 and asymmetry (≥0.15, Goldmann applanation tonometry (≥21 mmHg, adjusted or unadjusted for central corneal thickness, and automated perimetry. In the diagnostic step, retinal nerve fiber layer imaging was performed using scanning laser polarimetry. Performance of the screening protocol was assessed in an eye hospital-based program in which 124 non-physician personnel aged 40 years or above were examined. A single ophthalmologist carried out the examinations and in equivocal cases, a glaucoma subspecialist′s opinion was sought. Results: Glaucoma was diagnosed in six cases (prevalence 4.8%; 95% confidence interval, 0.01-0.09 of whom five were new. The likelihood of making a definite diagnosis of glaucoma for those who were screened positively was 8.5 times higher than the estimated baseline risk for the reference population; the positive predictive value of the screening protocol was 30%. Screening excluded 80% of the initial population. Conclusion: Application of a formal screening protocol (such as our algorithm or its equivalent in clinical settings can be helpful in detecting new cases of glaucoma. Preliminary performance assessment of the algorithm showed its applicability and effectiveness in detecting glaucoma among subjects without any visual complaint.

  8. Brief narrative exposure therapy for posttraumatic stress in Iraqi refugees: a preliminary randomized clinical trial.

    Science.gov (United States)

    Hijazi, Alaa M; Lumley, Mark A; Ziadni, Maisa S; Haddad, Luay; Rapport, Lisa J; Arnetz, Bengt B

    2014-06-01

    Many Iraqi refugees suffer from posttraumatic stress. Efficient, culturally sensitive interventions are needed, and so we adapted narrative exposure therapy into a brief version (brief NET) and tested its effects in a sample of traumatized Iraqi refugees. Iraqi refugees in the United States reporting elevated posttraumatic stress (N = 63) were randomized to brief NET or waitlist control conditions in a 2:1 ratio; brief NET was 3 sessions, conducted individually, in Arabic. Positive indicators (posttraumatic growth and well-being) and symptoms (posttraumatic stress, depressive, and somatic) were assessed at baseline and 2- and 4-month follow-up. Treatment participation (95.1% completion) and study retention (98.4% provided follow-up data) were very high. Significant condition by time interactions showed that those receiving brief NET had greater posttraumatic growth (d = 0.83) and well-being (d = 0.54) through 4 months than controls. Brief NET reduced symptoms of posttraumatic stress (d = -0.48) and depression (d = -0.46) more, but only at 2 months; symptoms of controls also decreased from 2 to 4 months, eliminating condition differences at 4 months. Three sessions of brief NET increased growth and well-being and led to symptom reduction in highly traumatized Iraqi refugees. This preliminary study suggests that brief NET is both acceptable and potentially efficacious in traumatized Iraqi refugees.

  9. The impact of recovery-oriented day clinic treatment on internalized stigma: preliminary report.

    Science.gov (United States)

    Sibitz, Ingrid; Provaznikova, Katarina; Lipp, Madeleine; Lakeman, Richard; Amering, Michaela

    2013-10-30

    Internalized stigma is a complicating feature in the treatment of schizophrenia spectrum disorders and considerably hinders the recovery process. The empowerment and recovery-oriented program of our day clinic might contribute to a reduction in internalized stigma. The aim of the study was to explore the influence of this day clinic program on internalized stigma and other subjectively important outcome measures such as quality of life and psychopathology. Data from two groups of patients had been collected twice, at baseline and after 5 weeks. The experimental group attended the day clinic treatment (N=40) and the control group waited for the day clinic treatment (N=40). The following significant differences between the two groups were found: Patients in day clinic treatment showed a reduction in internalized stigma while the control group showed a minimal increase (Cohen's d=0.446). The experimental group as compared with the control group also showed a greater improvement in the quality of life domain psychological health (Cohen's d=0.6) and in overall psychopathology (Cohen's d=0.452). Interestingly, changes in internalized stigma and psychological quality of life were not associated with changes in psychopathology. Results are encouraging but have to be confirmed in a randomized design. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Preliminary Design and Analysis of the ARES Atmospheric Flight Vehicle Thermal Control System

    Science.gov (United States)

    Gasbarre, J. F.; Dillman, R. A.

    2003-01-01

    The Aerial Regional-scale Environmental Survey (ARES) is a proposed 2007 Mars Scout Mission that will be the first mission to deploy an atmospheric flight vehicle (AFV) on another planet. This paper will describe the preliminary design and analysis of the AFV thermal control system for its flight through the Martian atmosphere and also present other analyses broadening the scope of that design to include other phases of the ARES mission. Initial analyses are discussed and results of trade studies are presented which detail the design process for AFV thermal control. Finally, results of the most recent AFV thermal analysis are shown and the plans for future work are discussed.

  11. Self-assessed efficacy of a clinical musculoskeletal anatomy workshop: A preliminary survey.

    Science.gov (United States)

    Saavedra, Miguel Ángel; Navarro-Zarza, José E; Alvarez-Nemegyei, José; Canoso, Juan J; Kalish, Robert A; Villaseñor-Ovies, Pablo; Hernández-Díaz, Cristina

    2015-01-01

    To survey the efficacy of a practical workshop on clinical musculoskeletal anatomy held in five American countries. A self-assessment competence questionnaire sent to participants 1-3 months after the workshop. Results were compared to the results of a practical, instructor-assessed, pre-workshop test. The response rate of participants was 76.4%. The overall, self-assessed competence score for anatomical items that had been included in the pre-test was 76.9 (scale 0-100) as compared to an overall score of 48.1 in the practical, pre-workshop test (p<0.001). For items that were addressed in the workshop, but not included in the pre-test, self-assessed competence was rated at 62.9. Differences in anatomical knowledge between individuals from different countries and professional groups noted in the practical pre-test were no longer present in the post-test self-assessment. From this preliminary data and supporting evidence from the literature we believe that our anatomy workshop provides an effective didactic tool for increasing competence in musculoskeletal anatomy. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  12. Software tools and preliminary design of a control system for the 40m OAN radiotelescope

    Science.gov (United States)

    de Vicente, P.; Bolaño, R.

    2004-07-01

    The Observatorio Astronómico Nacional (OAN) is building a 40m radiotelescope in its facilities in Yebes (Spain) which will be delivered by April 2004. The servosystem will be controlled by an ACU (Antenna Control Unit), a real time computer running VxWorks which will be commanded from a remote computer (RCC) or from a local computer (LCC) which will act as console. We present the tools we have chosen to develop and use the control system for the RCC and the criteria followed for the choices we made. We also present a preliminary design of the control system on which we are currently working. The RCC will run a server which communicates with the ACU using sockets and with the clients, receivers and backends using OmniOrb, a free implementation of CORBA. Clients running Python will allow the users to control the antenna from any host connected to a LAN or a secure Internet connection.

  13. PET/MRI: a novel hybrid imaging technique. Major clinical indications and preliminary experience in Brazil.

    Science.gov (United States)

    Vitor, Taise; Martins, Karine Minaif; Ionescu, Tudor Mihai; Cunha, Marcelo Livorsi da; Baroni, Ronaldo Hueb; Garcia, Marcio Ricardo Taveira; Wagner, Jairo; Campos, Guilherme de Carvalho; Nogueira, Solange Amorim; Guerra, Elaine Gonçalves; Amaro, Edson

    2017-01-01

    In recent years, medical imaging with hybrid techniques has widely accepted and employed in clinical routine. PET/MRI offers significant advantages, including excellent contrast and resolution and reduced ionizing radiation, as compared to well-established PET/CT. Therefore, PET/MRI is a promising modality for oncologic imaging of some regions, such as brain, head and neck, liver and pelvis. This article set out to analyze clinical conditions that could benefit from PET/MRI imaging based on our caseload. The potential of PET/MRI to become the imaging modality of choice for assessment of neurologic and oncologic conditions associated with soft tissues is highlighted. Clinical aspects of PET/MRI and its application to clinical cases are illustrated with examples extracted from the authors' preliminary experience. RESUMO Nos últimos anos, imagens médicas com tecnologias híbridas tornaram-se amplamente aceitas e utilizadas na prática clínica. O PET/RM possui vantagens importantes, incluindo excelentes contrastes e resolução, e menor radiação ionizante, em comparação ao PET/TC. Por isto, é uma modalidade promissora para exames de imagem de pacientes oncológicos, para avaliar o cérebro, cabeça e pescoço, o fígado e a pelve. O objetivo deste artigo foi analisar as situações clínicas que se beneficiariam de exames de PET/RM a partir de uma casuística. Destacamos o potencial desta técnica se tornar o método de imagem de escolha para doenças neurológicas e oncológicas que envolvam partes moles. Os aspectos clínicos de PET/RM e sua aplicação aos casos clínicos são ilustrados com exemplos da experiência inicial dos autores.

  14. Use of cross-linked carboxymethyl cellulose for soft-tissue augmentation: preliminary clinical studies

    Directory of Open Access Journals (Sweden)

    Mauro Leonardis

    2010-11-01

    Full Text Available Mauro Leonardis1, Andrea Palange2, Rodrigo FV Dornelles3, Felipe Hund41Department of Plastic Surgery, Salvator Mundi International Hospital, Roma, Italy; 2Department of Aesthetic Medicine, Fisiobios, Roma, Italy; 3Department of Plastic Surgery, Núcleo de Plástica Avançada, São Paulo, SP, Brazil; 4Department of Plastic Surgery, Consultorio de Cirurgia Plastica, Criciuma, SC, BrazilPurpose: The continual search for new products for soft-tissue augmentation has in recent years led to the introduction of long lasting alternatives to hyaluronic acids and collagen that are composed of other polymers able to improve clinical persistence over time. This is the first report in which sodium carboxymethyl cellulose (CMC has been chemically treated by the cross-linking process and thus used as a hydrogel for soft-tissue augmentation through injection with thin needles. The study evaluates, from a clinical point of view, the behavior of cross-linked carboxymethyl cellulose hydrogel used in the aesthetic field and its side effects so as to check the safety and performance of the polymer following intradermal injections.Patients and methods: This work shows the preliminary results of an ongoing clinical study conducted between 2006 and 2009, performed on 84 healthy volunteers (62 females, 22 males aged between 18 and 72 years, for the treatment of 168 nasolabial folds, 45 perioral wrinkles, and 39 lip volume.Results: Study results show an excellent correction of facial defects. Tolerance and aesthetic quality of the correction obtained indicate considerable safety features and absence of side effects. From a clinical point of view, hydrogel is gradually absorbed into the injection site without migration issues.Conclusion: Cross-linked CMC hydrogel proves to be an ideal agent for soft tissue augmentation with regard to safety and ease of application. It did not cause infection, extrusion, migration, or adverse reactions in the patients who have been

  15. Acceptance and Commitment Therapy for Depression: A Preliminary Randomized Clinical Trial for Unemployed on Long-Term Sick Leave

    Science.gov (United States)

    Folke, Fredrik; Parling, Thomas; Melin, Lennart

    2012-01-01

    This preliminary study investigated the feasibility of a brief Acceptance and Commitment Therapy (ACT) in a Swedish sample of unemployed individuals on long-term sick leave due to depression. Participants were randomized to a nonstandardized control condition (N = 16) or to the ACT condition (N = 18) consisting of 1 individual and 5 group…

  16. Acceptance and Commitment Therapy for Depression: A Preliminary Randomized Clinical Trial for Unemployed on Long-Term Sick Leave

    Science.gov (United States)

    Folke, Fredrik; Parling, Thomas; Melin, Lennart

    2012-01-01

    This preliminary study investigated the feasibility of a brief Acceptance and Commitment Therapy (ACT) in a Swedish sample of unemployed individuals on long-term sick leave due to depression. Participants were randomized to a nonstandardized control condition (N = 16) or to the ACT condition (N = 18) consisting of 1 individual and 5 group…

  17. Intraprostatic injection of alcohol gel for the treatment of benign prostatic hyperplasia: preliminary clinical results.

    Science.gov (United States)

    Larson, Benjamin T; Netto, Nelson; Huidobro, Christian; de Lima, Marcelo Lopez; Matheus, Wagner; Acevedo, Cristian; Larson, Thayne R

    2006-09-06

    Benign prostatic hyperplasia (BPH) is one of the most common diseases ailing older men. Office-based procedures offer the advantage of being more effective than medications, while limiting the adverse effects, cost, and recovery of surgery. This study presents preliminary data on a new procedure that utilizes intraprostatic alcohol gel injection to ablate prostatic tissue. The purpose of this study is to evaluate the feasibility of using this gel as a treatment for BPH. A total of 65 patients with lower urinary tract symptoms (LUTS) due to BPH were treated with intraprostatic injections of alcohol gel. The gel is composed of 97% denatured alcohol and a patented polymer to cause viscosity. Three different methods of injection were utilized: transrectal (TR) injections (8), transurethral (TU) injections (36), and transperineal (TP) injections guided by biplaned ultrasound (21). Each method provided easy access to the center of the prostate, where a volume of gel, approximately 20-30% of the prostatic volume, was injected. Follow-up was based on changes in peak urinary flow (Qmax), IPSS scores, quality of life scores (QoL), adverse effects, and failures. Data are available at 3 and 12 months. The procedure was well tolerated with only local or no anesthesia in the TR and TP groups; the TU group received spinal anesthesia. All groups showed statistically significant (p gel injected was 8.05 ml, representing 21.56% of the prostatic volume. Qmax increased from a baseline mean of 8.50 to 12.01 ml/s at 3 months, and to 11.29 ml/s at 12 months. IPSS scores improved from a baseline mean of 21.12 to 10.00 at 3 months, and to 11.84 at 12 months. QoL scores were only available for 55 patients. QoL scores improved from a baseline of 3.93 to 1.98 at 3 months, and to 2.18 at 12 months. No extraprostatic injury or adverse effects were reported due to treatment. This preliminary study presents significant results showing that intraprostatic injection of alcohol gel could be an

  18. Impaired motor unit control in paretic muscle post stroke assessed using surface electromyography: a preliminary report.

    Science.gov (United States)

    Hu, Xiaogang; Suresh, Aneesha K; Li, Xiaoyan; Rymer, William Zev; Suresh, Nina L

    2012-01-01

    The objective of this preliminary study was to examine the possible contribution of disordered control of motor unit (MU) recruitment and firing patterns in muscle weakness post-stroke. A novel surface EMG (sEMG) recording and decomposition system was used to record sEMG signals and extract single MU activities from the first dorsal interosseous muscle (FDI) of two hemiparetic stroke survivors. To characterize MU reorganization, an estimate of the motor unit action potential (MUAP) amplitude was derived using spike triggered averaging of the sEMG signal. The MUs suitable for further analysis were selected using a set of statistical tests that assessed the variability of the morphological characteristics of the MUAPs. Our preliminary results suggest a disrupted orderly recruitment based on MUAP size, a compressed recruitment range, and reduced firing rates evident in the paretic muscle compared with the contralateral muscle of one subject with moderate impairment. In contrast, the MU organization was largely similar bilaterally for the subject with minor impairment. The preliminary results suggest that MU organizational changes with respect to recruitment and rate modulation can contribute to muscle weakness post-stroke. The contrasting results of the two subjects indicate that the degree of MU reorganization may be associated with the degree of the functional impairment, which reveals the differential diagnostic capability of the sEMG decomposition system.

  19. Advanced and controlled drug delivery systems in clinical disease management

    NARCIS (Netherlands)

    Brouwers, JRBJ

    1996-01-01

    Advanced and controlled drug delivery systems are important for clinical disease management. In this review the most important new systems which have reached clinical application are highlighted. Microbiologically controlled drug delivery is important for gastrointestinal diseases like ulcerative co

  20. A preliminary investigation of the use of throttles for emergency flight control

    Science.gov (United States)

    Burcham, F. W., Jr.; Fullerton, C. Gordon; Gilyard, Glenn B.; Wolf, Thomas D.; Stewart, James F.

    1991-01-01

    A preliminary investigation was conducted regarding the use of throttles for emergency flight control of a multiengine aircraft. Several airplanes including a light twin-engine piston-powered airplane, jet transports, and a high performance fighter were studied during flight and piloted simulations. Simulation studies used the B-720, B-727, MD-11, and F-15 aircraft. Flight studies used the Lear 24, Piper PA-30, and F-15 airplanes. Based on simulator and flight results, all the airplanes exhibited some control capability with throttles. With piloted simulators, landings using manual throttles-only control were extremely difficult. An augmented control system was developed that converts conventional pilot stick inputs into appropriate throttle commands. With the augmented system, the B-720 and F-15 simulations were evaluated and could be landed successfully. Flight and simulation data were compared for the F-15 airplane.

  1. A new extra-abdominal channel alternative to the mitrofanoff principle: experimental and preliminary clinical experience

    Directory of Open Access Journals (Sweden)

    Antonio Macedo Jr.

    2009-04-01

    Full Text Available INTRODUCTION: The appendix is the gold-standard channel for the Mitrofanoff principle in pediatric urology, but the search for alternatives is justified considering it may not be available or preferably used for colonic stomas (Malone antegrade continence enema. The aim of this study is to report on technical feasibility of a new approach for creating catheterizable channels in a rabbit model and to present our preliminary clinical experience. MATERIAL AND METHODS: We configured a tube from two rectangular skin flaps 1x4 cm opposite each other in the middle line of the lower inferior abdomen. The channel was anastomosed to the bladder dome with embedding sutures to create a valvular mechanism. The experimental study consisted of 12 rabbits, divided in 4 groups according to the sacrifice schedule at 2, 4, 8 and 12 weeks. At 30th postoperative day, an urodynamic evaluation was performed to record continence of the stoma. A histological analysis of the specimens stained with hematoxylin-eosin, Masson trichrome and Picrosirius red was also done in group 2 (sacrifice at 4 weeks postoperatively. We used this method in 3 patients with congenital non-neurogenic bladder disease presenting with massive residual volumes without compliance deficits. RESULT: The technique proved feasible in all animals, 9 of 12 could be easily catheterized and underwent urodynamic study. No stoma leakage was observed in 7 animals at high bladder pressures (> 50 cm H20 and only 2 animals had some leakage at 40 cm H20. Urodynamics performed through the stoma showed urethral leakage at 20 cm H20, therefore demonstrating the efficacy of the valvular mechanism. Histological analysis confirmed good integration between the tube and the bladder. Mean follow-up of the clinical series (3 patients was 7.2 months. Two patients remained continent up to 4 hours, whereas 1 patient had some leakage after 2 hours. CONCLUSION: We were able to confirm feasibility of a new extra

  2. Controlled outcome studies of child clinical hypnosis.

    Science.gov (United States)

    Adinolfi, Barbara; Gava, Nicoletta

    2013-09-01

    Background Hypnosis is defined as "as an interaction in which the hypnotist uses suggested scenarios ("suggestions") to encourage a person's focus of attention to shift towards inner experiences". Aim of the work The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues. Results Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children. Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress. Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children. Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema Conclusions Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations. Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem.

  3. Clinical Preliminary Study on Biodegradable Subcuta neous Contraceptive Implant-CaproF

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    CaproF is a biodegradable subcutaneous contraceptive implant of releasing lev onorgestrel (LNG), which is expected to provide an effective contraception for 2 years. This study was undertaken to assess the one-year preliminary clinical results of using CaproF in 19 subjects. All subjects (n = 19) completed the 1-year study, and the contraceptive effectiveness and follow up rate were both 100%. The incidence of side effects was low. The major side effects were menstrual disorder, but bleeding patterns tended to be improved and restored to be the same as pre-implantation ones with time. There were no significant increase in weight (P> 0. 05) and no changes in blood pres sure. In the 3d, 6th and 12th months after using CaproF, the cervical mucus became scanty and viscous without fern-like crystals. The amount of menstrual blood loss de creased from 49. 38 ml of pre-implantation to 33. 23 ml of the 12th month of using the implant (P<0.05). Hemoglobin concentrations showed no changes, but serum ferritin concentrations were slightly increased. No changes in liver function, kidney function, glucose tolerance test and lipoprotein levels were found. Determinations of sex hor mones (FSH, LH, E2 and progesterone) levels, ultrasonography of ovary, and en dometrial biopsy in observed group (n = 9) showed that all had normal ovulation before insertion. But ovulation was suppressed and endometrium development was inhibited after insertion. All basal body temperatures were single-phase patterns during the 1- year follow-up. This study suggested that CaproF is an effective, safe and acceptable long-acting contraceptive method. It is likely to reach its contraceptive effectiveness through suppressing ovulation, inhibiting endometrium development and influencing cervical musus characteristics.

  4. Clinical Preliminary Study on Biodegradable Subcuta-neous Contraceptive Implant-CaproF

    Institute of Scientific and Technical Information of China (English)

    刘春海; 钱丽娟

    2000-01-01

    CaproF is a biodegradable subcutaneous contraceptive implant of releasing lev-onorgestrel (LNG), which is expected to provide an effective contraception for 2 years. This study was undertaken to assess the one-year preliminary clinical results of using CaproF in 19 subjects. All subjects (n = 19) completed the 1-year study, and the contraceptive effectiveness and follow up rate were both 100%. The incidence of side effects was low. The major side effects were menstrual disorder, but bleeding patterns tended to be improved and restored to be the same as pre-implantation ones with time.There were no significant increase in weight (P> 0. 05) and no changes in blood pres-sure. In the 3rd, 6th and 12th months after using CaproF, the cervical mucus became scanty and viscous without fern-like crystals. The amount of menstrual blood loss de-creased from 49. 38 ml of pre-implantation to 33. 23 ml of the 12th month of using the implant (P< 0. 05). Hemoglobin concentrations showed no changes, but serum ferritin concentrations were slightly increased. No changes in liver function, kidney function,glucose tolerance test and lipoprotein levels zoere found. Determinations of sex hor-mones (FSH , LH , E2 and progesterone) levels, ultrasonography of ovary, and en-dometrial biopsy in observed group (n = 9) shorted that all had normal ovulation before insertion. But ovulation was suppressed and endometrium development was inhibited after insertion. All basal body temperatures were single-phase patterns during the 1-year follow-up. This study suggested that CaproF is an effective, safe and acceptable long-acting contraceptive method. It is likely to reach its contraceptive effectiveness through suppressing ovulation, inhibiting endometrium development and influencing cervical mucus characteristics.

  5. [Oral candidiasis: clinical features and control].

    Science.gov (United States)

    Yamamoto, Tetsuya

    2010-10-01

    Candidiasis is the most commonly encountered fungal infection, and oral candidiasis is often observed as a local opportunistic infection. Oral candidiasis is clinically divided into three types: acute forms, chronic forms, and Candida-associated lesions. Candida adhesion and multiplication are largely regulated by the local and systemic factors of the host. The local factors include impairment of the oral mucosal integrity, which is usually impaired by hyposalivation, anticancer drugs/radiation for head and neck cancers, denture wearing, a decrease in the oral bacterial population, and poor oral hygiene. Among Candida species, oral candidiasis is mostly caused by Candida albicans (C. albicans), C. glabrata, or C. tropicalis. Oral Candida induces a variety of symptoms, such as oral mucosal inflammation manifesting as an uncomfortable feeling, pain, erythema, erosion, taste abnormalities, and hyperplasia of the oral mucosa. Candida overgrowth in the oral cavity may disseminate to distant organs. Therefore, in order to avoid the sequelae of systemic candidiasis, oral candidiasis should be rapidly controlled. Oral candidiasis is usually treated by the local application of antifungal drugs. However, oral candidiasis occasionally escapes the control of such local treatment due to the development of multi-drug resistant Candida strains and species or due to the suppression of salivation or cellular immune activity. When drug-resistant strains are suspected as the pathogens and when the host is generally compromised, the oral administration of combinations of antifungal drugs, enhancement of cellular immune activity, and improvement of the nutritional condition are recommended.

  6. Efficacy of fentanyl transdermal patch in pain control after lower third molar surgery: A preliminary study

    Science.gov (United States)

    Vasovic, Miroslav; Andric, Miroslav; Todorovic, Ljubomir; Kokovic, Vladimir

    2016-01-01

    Background Surgical removal of impacted lower third molars is a common oral surgical procedure, generally followed by moderate to severe postoperative pain. Transdermal drug delivery as a concept offers interesting possibilities for postoperative pain control. The aim of this study was to evaluate the efficacy of transdermal system with fentanyl in relieving pain following impacted lower third molar surgery. Material and Methods Seventeen patients with bilateral impacted lower third molars were included in this preliminary study. For postoperative pain control, patients randomly received a fentanyl patch plus placebo tablet after the first operation and regular (placebo) patch and an analgesic, after the second operation. Analgesia was evaluated during first 24 hours postoperatively according to patients’ reports about time of first pain appearance and additional analgesic consumption. Pain severity was rated using a 10 cm long visual analogue scale (VAS). Results Intensity of postoperative pain and postoperative analgesic consumption were significantly lower after the Fentanyl Transdermal System (FTS) was applied (p<0.05). Duration of postoperative analgesia was significantly higher with FTS when compared to control treatment (p<0.05). Conclusions Based on the results of this preliminary study, transdermal system with fentanyl significantly reduced postoperative pain after third molar surgery. Key words:Analgesia, fentanyl, transdermal administration, third molar surgery, acute pain, postoperative care. PMID:27475691

  7. Effects of an aquatic exercise program on inhibitory control in children with ADHD: a preliminary study.

    Science.gov (United States)

    Chang, Yu-Kai; Hung, Chiao-Ling; Huang, Chung-Ju; Hatfield, Bradley D; Hung, Tsung-Min

    2014-05-01

    The purpose of this preliminary study was to examine whether an aquatic exercise intervention that involves both aerobic and coordinative exercises influences restraint inhibition in children with ADHD. Thirty participants were assigned to either an aquatic exercise or a wait-list control group. Participants were assessed by Go/Nogo Task and motor ability prior to and after an 8-week exercise intervention (twice per week, 90 min per session) or a control intervention. Significant improvements in accuracy associated with the Nogo stimulus and the coordination of motor skills were observed over time in the exercise group compared with the control group. Only main effects of group were found for reaction time and accuracy associated with the Go stimulus. These findings suggest that an exercise program that involves both quantitative and qualitative exercise characteristics facilitates the restraint inhibition component of behavioral inhibition in children with ADHD.

  8. Preliminary clinical outcomes of percutaneous kyphoplasty with Sky-bone expander

    Institute of Scientific and Technical Information of China (English)

    ZHENG Zhao-min; KUANG Guan-ming; DONG Zhi-yong; K.M.C. Cheung; William W. Lu; LI Fo-bao

    2007-01-01

    Background Percutaneous kyphoplasty (PKP) using balloon expander has been proved to be effective in the treatment of painful vertebral compression fractures. Recently, Sky-bone expander, an alternative bone expander for PKP has been developed. The purpose of this study was to show our preliminary clinical outcomes of PKP with Sky-bone expander.Methods PKP with Sky-bone expander was performed in 25 patients (30 vertebrae). The operation time, bleeding volume, cement volume injected were recorded. The pain and functional activities of the patients before and after the operation were compared using Wilcoxon signed-rank test. The cement distribution in the vertebrae, vertebral height restoration, and kyphosis correction after the procedure were evaluated by radiography. The pre- and post-operative absolute values of the vertebral height and kyphotic angle were compared by paired-sample t test. All the patients were followed up by telephone or clinic consulting after being discharged from our hospital.Results The procedure was performed successfully in all the patients. Bipedicular injection was used in 2 of the patients, and unipedicular injection was made in the others. The operation time ranged from 25 to 120 minutes (45 minutes per vertebra on average). The average bleeding volume was about 20 ml. Polymethylmethacrylate1.5 - 5.0 ml (mean, (3.15±0.78) ml) was injected through each pedicle into all the patients except one, who received calcium sulphate 3.5 ml instead. The patients were followed up for 12-15 months (13.5 months on average). The mean visual analogue scale (VAS) score, Oswestry Disability Index, anterior, midline, and posterior vertebral height, and kyphotic angle of the patients were improved significantly at the end of the follow-up compared with those before the operation.(2.5±1.3, 35.1%, (20.94±6.15) mm, (20.26±4.59) mm, (26.72±3.49) mm, and 8.2 degrees vs. 8.5±1.9, 61.2%, (19.11±6.72) mm, (15.88±5.73) mm, (25.78±3.67) mm, and 17.3 degrees

  9. Comparative Evaluation of Clinical and Radiographic Success of Formocresol, Propolis, Turmeric Gel, and Calcium Hydroxide on Pulpotomized Primary Molars: A Preliminary Study

    Science.gov (United States)

    Hugar, Shivayogi M; Hugar, Shweta S; Gokhale, Niraj; Assudani, Harsha

    2017-01-01

    Aims Despite various advents in technology, the present era marks a shift to phytotherapeutics and alternative modalities to conventional endodontic treatments. Newer endodontic modalities have been developed inculcating the ancient system of medicine. The present study was done to compare and evaluate the clinical pulp response and radiographic signs after pulpotomy in four groups of primary molar teeth treated with formocresol (control), propolis extract, turmeric gel, and calcium hydroxide respectively. Materials and methods Following ethical clearance, 90 primary molar teeth in 45 pediatric patients, aged between 4 and 9 years, were selected for pulpotomy. These were then randomly divided by split-mouth technique into two groups as experimental (propolis extract/turmeric gel/calcium hydroxide) and control (formocresol) groups. The patients were followed up for 6 months for clinical and radiographic signs and symptoms to evaluate the success of treatment. Results A comparable clinical and radiographic success rate was seen with all experimental groups as compared to the control (formocresol) group. Conclusion With concerns about the safety of formocresol appearing in the dental and medical literature for more than 20 years, the materials used in this study can be considered as promising alternatives for formocresol in pediatric endodontic treatment. How to cite this article Hugar SM, Kukreja P, Hugar SS, Gokhale N, Assudani H. Comparative Evaluation of Clinical and Radiographic Success of Formocresol, Propolis, Turmeric Gel, and Calcium Hydroxide on Pulpotomized Primary Molars: A Preliminary Study. Int J Clin Pediatr Dent 2017;10(1):18-23.

  10. Comparative Evaluation of Clinical and Radiographic Success of Formocresol, Propolis, Turmeric Gel, and Calcium Hydroxide on Pulpotomized Primary Molars: A Preliminary Study.

    Science.gov (United States)

    Hugar, Shivayogi M; Kukreja, Pratibha; Hugar, Shweta S; Gokhale, Niraj; Assudani, Harsha

    2017-01-01

    Despite various advents in technology, the present era marks a shift to phytotherapeutics and alternative modalities to conventional endodontic treatments. Newer endodontic modalities have been developed inculcating the ancient system of medicine. The present study was done to compare and evaluate the clinical pulp response and radiographic signs after pulpotomy in four groups of primary molar teeth treated with formocresol (control), propolis extract, turmeric gel, and calcium hydroxide respectively. Following ethical clearance, 90 primary molar teeth in 45 pediatric patients, aged between 4 and 9 years, were selected for pulpotomy. These were then randomly divided by split-mouth technique into two groups as experimental (propolis extract/turmeric gel/calcium hydroxide) and control (formocresol) groups. The patients were followed up for 6 months for clinical and radiographic signs and symptoms to evaluate the success of treatment. A comparable clinical and radiographic success rate was seen with all experimental groups as compared to the control (formocresol) group. With concerns about the safety of formocresol appearing in the dental and medical literature for more than 20 years, the materials used in this study can be considered as promising alternatives for formocresol in pediatric endodontic treatment. Hugar SM, Kukreja P, Hugar SS, Gokhale N, Assudani H. Comparative Evaluation of Clinical and Radiographic Success of Formocresol, Propolis, Turmeric Gel, and Calcium Hydroxide on Pulpotomized Primary Molars: A Preliminary Study. Int J Clin Pediatr Dent 2017;10(1):18-23.

  11. Ossiculoplasty in Missing Malleus and Stapes Patients : Experimental and Preliminary Clinical Results With a New Malleus Replacement Prosthesis With the Otology-Neurotology Database

    NARCIS (Netherlands)

    Vincent, Robert; Bittermann, Arnold J. N.; Wenzel, Gentiana; Oates, John; Sperling, Neil; Lenarz, Thomas; Grolman, Wilko

    2013-01-01

    Objective: To present the preliminary results of new malleus replacement prosthesis combined with a total ossicular prosthesis in middle ear reconstruction in patients missing the malleus and stapes. Study Design: Prospective experimental and nonrandomized clinical study. Setting: Tertiary referral

  12. Preliminary Drop Time Analysis of a Control Rod Using CFD Code

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Myoung Hwan; Park, Jin Seok; Lee, Won Jae [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Park, Jun Hong [SEST Co., Seoul (Korea, Republic of)

    2010-05-15

    A control rod drive mechanism (CRDM) is a reactor regulating system, which can insert and withdraw a control rod containing a neutron absorbing material to control the reactivity of the reactor core. The latch type CRDM for the SMART (System-integrated Modular Advanced ReacTor) is going to be used. The drop time of the control rod in the design stage is one of important parameters for a safety analysis of the reactor. When the control rod is falling down into the core, it is retarded by various forces acting on it such as fluid resistance buoyancy and mechanical friction caused by contacting the inner surface of the guide thimble, etc.. However, complicated coupling of the various forces makes it difficult to predict the drop behavior. This paper describes the development of the 3D CFD analysis model using a FLUENT code. The single control rod of the Westinghouse 17x17 type optimized fuel assembly (W-OFA) was considered for the verification of the CFD model. A preliminary drop time analysis for the SMART with the simulated control rod was performed

  13. Fractionating the role of executive control in control over worry: a preliminary investigation.

    Science.gov (United States)

    Hallion, Lauren S; Ruscio, Ayelet Meron; Jha, Amishi P

    2014-03-01

    Uncontrollable anxious thought characterizes a number of emotional disorders. Little is known, however, about the cognitive mechanisms that underlie the ability to control these thoughts. The present study investigated the extent to which two well-characterized executive control processes--working memory and inhibition--are engaged when an individual attempts to control worry. Participants completed a concurrent assessment of these processes while attempting to control personally-relevant worried and neutral thoughts. To examine the specificity of these effects to attempts to control worry, versus a residual "depletion" effect of having previously engaged in worry, a subset of participants completed the assessment without instructions to control their worried or neutral thoughts. Attempts to control worry engaged working memory and inhibition to a greater extent than did attempts to control neutral thought. This increased engagement was not explained solely by anxious affect, nor was it significantly associated with trait worry. Engagement did not differ by group, suggesting that executive control depletion by worry cannot be dismissed as an alternative explanation of these findings. These results highlight working memory and inhibition as potentially valuable constructs for deepening our understanding of the nature and treatment of worry and its control.

  14. A preliminary analysis of microRNA as potential clinical biomarker for schizophrenia.

    Science.gov (United States)

    Sun, Xin-yang; Zhang, Jin; Niu, Wei; Guo, Wei; Song, Hong-tao; Li, Heng-yu; Fan, Hui-min; Zhao, Lin; Zhong, Ai-fang; Dai, Yun-hua; Guo, Zhong-min; Zhang, Li-yi; Lu, Jim; Zhang, Qiao-li

    2015-04-01

    MicroRNAs (miRNA, miR) have been implicated as promising blood-based biomarkers for schizophrenia patients. This study aimed to clinically validate miRNA as potential schizophrenia biomarkers. Plasma levels of 10 miRNAs were analyzed using qPCR in a cohort of 61 schizophrenia patients and 62 normal controls, as well as 25 patients particularly selected for a six-week antipsychotic treatment course. Positive And Negative Syndrome Scale (PANSS), Global Assessment Scale (GAS) and Clinical Global Impression (CGI) were administered to assess the clinical symptoms. The results demonstrated that a panel of miRNAs consisting of miR-30e, miR-181b, miR-34a, miR-346 and miR-7 had significantly increased expression levels with significant combined diagnostic value (AUC:0.713; sensitivity:35.5%; specificity:90.2%). In response to pharmacological treatment, expression levels of miR-132, miR-181b, miR-432 and miR-30e were significantly decreased. In addition, the improvement of clinical symptomatology was significantly correlated with the changes of miR-132, miR-181b, miR-212 and miR-30e expression levels. Furthermore, the decreases of plasma levels of miR-132 and miR-432 were significantly greater in high-effect subgroup than those in low-effect subgroup after six-week treatment course. We conclude that miR-30e, miR-181b, miR-34a, miR-346 and miR-7 combined as a panel are potentially useful non-invasive biomarkers for schizophrenia diagnosis. Markers miR-132, miR-181b, miR-30e and miR-432 are potential indicators for symptomatology improvements, treatment responses and prognosis for schizophrenia patients.

  15. Preliminary Validation of a New Clinical Tool for Identifying Problem Video Game Playing

    Science.gov (United States)

    King, Daniel Luke; Delfabbro, Paul H.; Zajac, Ian T.

    2011-01-01

    Research has estimated that between 6 to 13% of individuals who play video games do so excessively. However, the methods and definitions used to identify "problem" video game players often vary considerably. This research presents preliminary validation data for a new measure of problematic video game play called the Problem Video Game Playing…

  16. Translation of the Manchester Clinical Supervision Scale (MCSS) into Danish and a preliminary psychometric validation

    DEFF Research Database (Denmark)

    Buus, Niels; Gonge, Henrik

    2013-01-01

    for the translation of the MCSS from English into Danish and to present a preliminary psychometric validation of the Danish version of the scale. Methods included a formal translation/back-translation procedure and statistical analyses. The sample consisted of MCSS scores from 139 Danish mental health nursing staff...

  17. Preliminary Validation of a New Clinical Tool for Identifying Problem Video Game Playing

    Science.gov (United States)

    King, Daniel Luke; Delfabbro, Paul H.; Zajac, Ian T.

    2011-01-01

    Research has estimated that between 6 to 13% of individuals who play video games do so excessively. However, the methods and definitions used to identify "problem" video game players often vary considerably. This research presents preliminary validation data for a new measure of problematic video game play called the Problem Video Game…

  18. Integration einer OSCE in das zahnmedizinische Physikum [Integration of an Objective Structured Clinical Examination (OSCE into the Dental Preliminary Exams

    Directory of Open Access Journals (Sweden)

    Ratzmann, Anja

    2012-02-01

    Full Text Available [english] Introduction: In the pre-clinical phase of the study of dentistry at the University of Greifswald, the course “Early Patient Contact (EPC” is conducted within the framework of Community Medicine/Dentistry. The course is based on three pillars: the patient visiting program, special problem-oriented seminars, and communication training for doctors. The essential goal consists of providing students with real patient contact right at the beginning of their study of dentistry, thus making the study of dentistry patient-based very early on. Students are trained in taking comprehensive anamneses and recording clinical findings.Methods: Within the framework of the dental preliminary exams, the course is evaluated using an OSCE on a standardized patient. Furthermore, the added value of an additional training unit (conducting anamnesis and clinical examination in preparation for the OSCE was evaluated. The exam results of a group without training (control group were compared with those of a group with training (intervention group.Results: The intervention group performed significantly better than the control on the following items: the total number of points achieved on the OSCE early patient contact, and in the most important points of the anamnesis and clinical examination. In addition, the intervention group tended to score higher in terms of the item “oral health status”.Conclusion: The present study showed a positive effect of an additional training unit on students’ performance in the OSCE. Taking the limitations of the study and the results of a literature review into account, we recommend conducting such training as preparation for the OSCE.[german] Einleitung: An der Universität Greifswald wird im vorklinischen Abschnitt des Studienganges der Zahnmedizin im Rahmen der Community Medicine/Dentistry der Kurs „Der Frühe Patientenkontakt (FPK“ durchgeführt. Der Kurs basiert auf drei Prinzipien: dem Patientenbesuchsprogramm

  19. Blood pressure changes in African American patients receiving chiropractic care in a teaching clinic: a preliminary study.

    Science.gov (United States)

    McMasters, Kim L; Wang, Joe; York, Jennifer; Hart, John; Neely, Cheneir; Delain, Rochelle J

    2013-06-01

    The purpose of this preliminary study was to determine if a course of chiropractic care would change blood pressure measurements in African American patients and to determine if a study was feasible in a chiropractic teaching clinic. Twenty-four African American patients received chiropractic care in a chiropractic teaching clinic over a study period that spanned 23 visits for each patient. Inclusion criteria consisted of patients having a diagnosis of prehypertension (120-139/80-89) or hypertension stage 1 (140-159/90-99). The mean values of 3 baseline blood pressure readings were compared with the mean values of blood pressure readings taken on visits 21, 22, and 23. For the entire sample, reductions for both systolic and diastolic blood pressures were not statistically significant (P > .07). When 4 patients having body mass index values that were considered as outliers were excluded, a statistically significant decrease in diastolic blood pressure was observed (P = .004). By group, a statistically significant reduction occurred in the hypertension stage 1 group for systolic and diastolic blood pressures. This study showed that research of this nature may be feasible in chiropractic teaching clinics. The preliminary findings of this study showed that, for a subgroup of African American patients receiving chiropractic care, blood pressure decreased for (a) hypertension stage 1 patients and (b) the sample when those with excessive body mass index were excluded.

  20. Malaria mosquito control using edible fish in western Kenya: preliminary findings of a controlled study

    Directory of Open Access Journals (Sweden)

    Omlin Francois X

    2007-08-01

    Full Text Available Abstract Background Biological control methods are once again being given much research focus for malaria vector control. This is largely due to the emerging threat of strong resistance to pesticides. Larvivorous fish have been used for over 100 years in mosquito control and many species have proved effective. In the western Kenyan highlands the larvivorous fish Oreochromis niloticus L. (Perciformes: Cichlidae (formerly Tilapia nilotica is commonly farmed and eaten but has not been previously tested in the field for malaria mosquito control. Methods This fish was introduced into abandoned fishponds at an altitude of 1,880 m and the effect measured over six months on the numbers of mosquito immatures. For comparison an untreated control pond was used. During this time, all ponds were regularly cleared of emergent vegetation and fish re-stocking was not needed. Significant autocorrelation was removed from the time series data, and t-tests were used to investigate within a pond and within a mosquito type any differences before and after the introduction of O. niloticus. Mulla's formula was also used on the raw data to calculate the percentage reduction of the mosquito larvae. Results After O. niloticus introduction, mosquito densities immediately dropped in the treated ponds but increased in the control pond. This increase was apparently due to climatic factors. Mulla's formula was applied which corrects for that natural tendency to increase. The results showed that after 15 weeks the fish caused a more than 94% reduction in both Anopheles gambiae s.l. and Anopheles funestus (Diptera: Culicidae in the treated ponds, and more than 75% reduction in culicine mosquitoes. There was a highly significantly reduction in A. gambiae s.l. numbers when compared to pre-treatment levels. Conclusion This study reports the first field trial data on O. niloticus for malaria mosquito control and shows that this species, already a popular food fish in western Kenya

  1. Cetuximab in the treatment of head and neck cancer: preliminary results outside clinical trials

    Directory of Open Access Journals (Sweden)

    Didier Dequanter

    2010-06-01

    not to provide the most benefit for patients with oropharyngeal cancers but will in patients with T4 tumors. However, the median duration of local control was less as described in the clinical trials.Keywords: head and neck cancer, epidermal growth factor receptor antagonist, radiotherapy, clinical trials

  2. A Randomized, Controlled Clinical Trial Comparing Efficacy, Safety ...

    African Journals Online (AJOL)

    A Randomized, Controlled Clinical Trial Comparing Efficacy, Safety and Cost Effectiveness of ... Log in or Register to get access to full text downloads. ... Pharmacological control of pain is the mainstay of management of osteoarthritis.

  3. Disrupted Tactile Acuity in People With Achilles Tendinopathy: A Preliminary Case-Control Investigation.

    Science.gov (United States)

    Debenham, James; Butler, Prue; Mallows, Adrian; Wand, Benedict M

    2016-12-01

    Study Design Controlled laboratory study, preliminary case-control design. Background The mechanisms that contribute to Achilles tendinopathy remain poorly understood. The disparity between pain experience and peripheral pathology demonstrated in patients with Achilles tendinopathy suggests that changes in central nervous system function may be involved. Objectives To investigate whether lower-limb tactile acuity is impaired in people with nonacute Achilles tendinopathy. Methods Thirteen consecutive participants with nonacute midportion Achilles tendinopathy and 13 healthy controls were enrolled. Two-point discrimination thresholds over the affected Achilles tendon, unaffected tendon, and tendon of healthy controls were evaluated. Independent and dependent t tests were used to compare group means. Results Two-point discrimination distance over the affected limb in participants with Achilles tendinopathy was significantly increased when compared to the unaffected limb (mean difference, 11.7 mm; 95% confidence interval [CI]: 1.9, 21.5; P = .02) and to healthy controls (mean difference, 13.1 mm; 95% CI: 1.6, 24.6; P = .03). There was no significant difference between the healthy controls and the unaffected side in people with Achilles tendinopathy (mean difference, 1.4 mm; 95% CI: -7.9, 5.1; P = .66). Conclusion These data provide the first evidence of reduced 2-point discrimination over the affected tendon in patients with Achilles tendinopathy. Further research is needed to determine the cause for the change in tactile acuity. J Orthop Sports Phys Ther 2016;46(12):1061-1064. Epub 30 Oct 2016. doi:10.2519/jospt.2016.6514.

  4. Clinical Research Methodology 3: Randomized Controlled Trials.

    Science.gov (United States)

    Sessler, Daniel I; Imrey, Peter B

    2015-10-01

    Randomized assignment of treatment excludes reverse causation and selection bias and, in sufficiently large studies, effectively prevents confounding. Well-implemented blinding prevents measurement bias. Studies that include these protections are called randomized, blinded clinical trials and, when conducted with sufficient numbers of patients, provide the most valid results. Although conceptually straightforward, design of clinical trials requires thoughtful trade-offs among competing approaches-all of which influence the number of patients required, enrollment time, internal and external validity, ability to evaluate interactions among treatments, and cost.

  5. Diffusion-weighted imaging in assessing renal pathology of chronic kidney disease: A preliminary clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Li, Qinghai; Li, Jinning; Zhang, Lan; Chen, Ying; Zhang, Minming [Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009 (China); Yan, Fuhua, E-mail: zemylife@163.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025 (China)

    2014-05-15

    Objective: To investigate the clinical potential of diffusion-weighted imaging (DWI) in assessing renal pathology of chronic kidney disease (CKD). Methods: Seventy-one CKD patients and twelve healthy volunteers were examined using DWI with prospective acquisition correction. Renal biopsy specimens from the CKD patients were scored based on the severity of renal pathology and to confirm pathology type. CKD patients were divided into three groups according to pathology scores: mild, moderate, or severe. The association between renal apparent diffusion coefficient (ADC) values and pathology scores was investigated using Pearson's correlation and single factor analysis of variance. Multiple linear regression analysis was performed to explore associations between renal ADC values and pathology score, glomerular filtration rate, serum creatinine, and age. The Kruskal–Wallis H test was conducted to compare ADC values and pathology type. Results: Renal ADC values correlated negatively with pathology scores (r = −0.633, P < 0.001). The ADC values among the four groups (mild, moderate, severe impairment, and controls) were significantly different (F = 19.512, P < 0.001). However, when patients were stratified by pathology type, no significant differences were found in ADC values among these groups (χ{sup 2} = 9.929, P = 0.270). Further multiple linear regression analysis showed that only the pathology score and ADC values were related (t = −4.586, P = 0.000). Conclusions: DWI has clinical potential in assessing the severity of renal pathology in CKD and shows promise as a non-invasive and effective technique to guide therapy and follow-up.

  6. Preliminary Analysis of Aircraft Loss of Control Accidents: Worst Case Precursor Combinations and Temporal Sequencing

    Science.gov (United States)

    Belcastro, Christine M.; Groff, Loren; Newman, Richard L.; Foster, John V.; Crider, Dennis H.; Klyde, David H.; Huston, A. McCall

    2014-01-01

    Aircraft loss of control (LOC) is a leading cause of fatal accidents across all transport airplane and operational classes, and can result from a wide spectrum of hazards, often occurring in combination. Technologies developed for LOC prevention and recovery must therefore be effective under a wide variety of conditions and uncertainties, including multiple hazards, and their validation must provide a means of assessing system effectiveness and coverage of these hazards. This requires the definition of a comprehensive set of LOC test scenarios based on accident and incident data as well as future risks. This paper defines a comprehensive set of accidents and incidents over a recent 15 year period, and presents preliminary analysis results to identify worst-case combinations of causal and contributing factors (i.e., accident precursors) and how they sequence in time. Such analyses can provide insight in developing effective solutions for LOC, and form the basis for developing test scenarios that can be used in evaluating them. Preliminary findings based on the results of this paper indicate that system failures or malfunctions, crew actions or inactions, vehicle impairment conditions, and vehicle upsets contributed the most to accidents and fatalities, followed by inclement weather or atmospheric disturbances and poor visibility. Follow-on research will include finalizing the analysis through a team consensus process, defining future risks, and developing a comprehensive set of test scenarios with correlation to the accidents, incidents, and future risks. Since enhanced engineering simulations are required for batch and piloted evaluations under realistic LOC precursor conditions, these test scenarios can also serve as a high-level requirement for defining the engineering simulation enhancements needed for generating them.

  7. Group Cognitive Behavioural Therapy and Group Recreational Activity for Adults with Autism Spectrum Disorders: A Preliminary Randomized Controlled Trial

    Science.gov (United States)

    Hesselmark, Eva; Plenty, Stephanie; Bejerot, Susanne

    2014-01-01

    Although adults with autism spectrum disorder are an increasingly identified patient population, few treatment options are available. This "preliminary" randomized controlled open trial with a parallel design developed two group interventions for adults with autism spectrum disorders and intelligence within the normal range: cognitive…

  8. Group Cognitive Behavioural Therapy and Group Recreational Activity for Adults with Autism Spectrum Disorders: A Preliminary Randomized Controlled Trial

    Science.gov (United States)

    Hesselmark, Eva; Plenty, Stephanie; Bejerot, Susanne

    2014-01-01

    Although adults with autism spectrum disorder are an increasingly identified patient population, few treatment options are available. This "preliminary" randomized controlled open trial with a parallel design developed two group interventions for adults with autism spectrum disorders and intelligence within the normal range: cognitive…

  9. Secure Microprocessor-Controlled Prosthetic Leg for Elderly Amputees: Preliminary Results

    Directory of Open Access Journals (Sweden)

    S. Krut

    2011-01-01

    Full Text Available We introduce a new prosthetic leg design, adapted to elderly trans-femoral amputees. Technical progress in prosthesis design mainly concerns active individuals. An important number of elderly amputees are not very mobile, tire easily, present reduced muscle strength, and have difficulties managing their balance. Therefore, the needs and characteristics of this specific population are very different from those of younger ones and the prosthetic solutions are not adapted. Our artificial knee has been designed to fulfill the specific requirements of this population in terms of capabilities, transfer assistance, security, intuitiveness, simplicity of use, and types of physical activity to be performed. We particularly focused our efforts on ensuring safe and secure stand-to-sit transfers. We developed an approach to control the different states of the prosthetic joint (blocked, free, resistant, associated with different physical activities. Amputee posture and motion are observed through a single multi-axis force sensor embedded in the prosthesis. The patient behaves naturally, while the controller analyses his movements in order to detect his intention to sit down. The detection algorithm is based on a reference pattern, calibrated individually, to which the sensor data are compared, and submitted to a set of tests allowing the discrimination of the intention to sit down from other activities. Preliminary validation of the system has been performed in order to verify the applicability of the prosthesis to different tasks: walking, standing, sitting down, standing up, picking up an object from a chair, slope and stair climbing.

  10. Fractionated stereotactic radiation therapy for intracranial benign tumor : preliminary results of clinical application

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Yong; Ahn, Yong Chan; Huh, Seung Jae [Samsung Medical Center, Syungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)] (and others)

    1998-06-01

    With the development of stereotactic immobilization systems capable of reliable serial repositioning, fractionated stereotactic radiation therapy(FSRT) offers the potential for an improved treatment outcome by excellent dose delivery, and dose distribution characteristics with the favorable radio-biological properties of fractionated irradiation. We describe our initial experience using FSRT for the treatment of intracranial benign tumor. Between August 1995 and December 1996, 15 patients(7 males and 8 females aged 6-70 years) were treated with FSRT. The patients had the following diagnosis : pituitary adenoma(10) including one patient who previously had received radiotherapy, craniopharyngioma(2), acoustic neurinoma(1), meningioma(2). Using the Gill-Thomas-Cos-man relocatable head frame and multiple non-coplanar therapy, the daily dose of 2Gy was irradiated at 90% to 100% isodose surface of the isocenter. The collimator sizes ranged from 26mm to 70mm. In all patients except one follow-up lost, disease was well-controlled. Acute complication was negligible and no patient experienced cranial nerve neuropathies and radiation necrosis. In overall patient setup with scalp measurements, reproducibility was found to have mean of 1.1{+-}0.6mm from the baseline reading. Relocatable stereotactic system for FSRT is highly reproducible and comfortable. Although the follow-up period was relatively short, FSRT is considered to be a safe an effective radiation technique as the treatment of intracranial tumor. But the fractionation schedule(fraction size, overall treatment time and total dose) still remains to be solved by further clinical trials.

  11. Preliminary Design of the Guidance, Navigation, and Control System of the Altair Lunar Lander

    Science.gov (United States)

    Lee, Allan Y.; Ely, Todd; Sostaric, Ronald; Strahan, Alan; Riedel, Joseph E.; Ingham, Mitch; Wincentsen, James; Sarani, Siamak

    2010-01-01

    Guidance, Navigation, and Control (GN&C) is the measurement and control of spacecraft position, velocity, and attitude in support of mission objectives. This paper provides an overview of a preliminary design of the GN&C system of the Lunar Lander Altair. Key functions performed by the GN&C system in various mission phases will first be described. A set of placeholder GN&C sensors that is needed to support these functions is next described. To meet Crew safety requirements, there must be high degrees of redundancy in the selected sensor configuration. Two sets of thrusters, one on the Ascent Module (AM) and the other on the Descent Module (DM), will be used by the GN&C system. The DM thrusters will be used, among other purposes, to perform course correction burns during the Trans-lunar Coast. The AM thrusters will be used, among other purposes, to perform precise angular and translational controls of the ascent module in order to dock the ascent module with Orion. Navigation is the process of measurement and control of the spacecraft's "state" (both the position and velocity vectors of the spacecraft). Tracking data from the Earth-Based Ground System (tracking antennas) as well as data from onboard optical sensors will be used to estimate the vehicle state. A driving navigation requirement is to land Altair on the Moon with a landing accuracy that is better than 1 km (radial 95%). Preliminary performance of the Altair GN&C design, relative to this and other navigation requirements, will be given. Guidance is the onboard process that uses the estimated state vector, crew inputs, and pre-computed reference trajectories to guide both the rotational and the translational motions of the spacecraft during powered flight phases. Design objectives of reference trajectories for various mission phases vary. For example, the reference trajectory for the descent "approach" phase (the last 3-4 minutes before touchdown) will sacrifice fuel utilization efficiency in order to

  12. Preliminary Design of the Guidance, Navigation, and Control System of the Altair Lunar Lander

    Science.gov (United States)

    Lee, Allan Y.; Ely, Todd; Sostaric, Ronald; Strahan, Alan; Riedel, Joseph E.; Ingham, Mitch; Wincentsen, James; Sarani, Siamak

    2010-01-01

    Guidance, Navigation, and Control (GN&C) is the measurement and control of spacecraft position, velocity, and attitude in support of mission objectives. This paper provides an overview of a preliminary design of the GN&C system of the Lunar Lander Altair. Key functions performed by the GN&C system in various mission phases will first be described. A set of placeholder GN&C sensors that is needed to support these functions is next described. To meet Crew safety requirements, there must be high degrees of redundancy in the selected sensor configuration. Two sets of thrusters, one on the Ascent Module (AM) and the other on the Descent Module (DM), will be used by the GN&C system. The DM thrusters will be used, among other purposes, to perform course correction burns during the Trans-lunar Coast. The AM thrusters will be used, among other purposes, to perform precise angular and translational controls of the ascent module in order to dock the ascent module with Orion. Navigation is the process of measurement and control of the spacecraft's "state" (both the position and velocity vectors of the spacecraft). Tracking data from the Earth-Based Ground System (tracking antennas) as well as data from onboard optical sensors will be used to estimate the vehicle state. A driving navigation requirement is to land Altair on the Moon with a landing accuracy that is better than 1 km (radial 95%). Preliminary performance of the Altair GN&C design, relative to this and other navigation requirements, will be given. Guidance is the onboard process that uses the estimated state vector, crew inputs, and pre-computed reference trajectories to guide both the rotational and the translational motions of the spacecraft during powered flight phases. Design objectives of reference trajectories for various mission phases vary. For example, the reference trajectory for the descent "approach" phase (the last 3-4 minutes before touchdown) will sacrifice fuel utilization efficiency in order to

  13. Clinical evaluation of children testing positive in screening tests for attention-deficit/hyperactivity disorder: A preliminary report

    Directory of Open Access Journals (Sweden)

    Maria Skounti

    2009-06-01

    Full Text Available Background and Objectives: Screening tests are of great diagnostic value in attention-deficit/hyperactivity disorder (ADHD, however final diagnosis relies on a clinical examination by an expert. The objective of the present study was to clinically evaluate children who had been screened positive for ADHD through both a parent and a teacher questionnaire. Methods: Parent interview and child behavior checklist and clinical assessment were used to confirm the preliminary diagnosis in 42 children aged 8 years, who have been screened positive for ADHD out of 1,708 children, in a large, two-setting screening study conducted in Crete, Greece. Results: The diagnosis of ADHD was confirmed for 31 children (74%. In the remaining 11 children, ADHD manifestations were attributed to other primary disorders. None of the 42 children was classified as lacking symptoms suggesting ADHD. Among the 31 children with confirmed ADHD, only 2 had been diagnosed prior to the screening test. Conclusions: Although clinical evaluation is the golden standard for diagnosis of ADHD, two-setting screening questionnaires by parent and teacher are useful tools in identifying children who need further investigation and intervention.

  14. Digital data acquisition and preliminary instrumentation study for the F-16 laminar flow control vehicle

    Science.gov (United States)

    Ostowari, Cyrus

    1992-01-01

    Preliminary studies have shown that maintenance of laminar flow through active boundary-layer control is viable. Current research activity at NASA Langley and NASA Dryden is utilizing the F-16XL-1 research vehicle fitted with a laminar-flow suction glove that is connected to a vacuum manifold in order to create and control laminar flow at supersonic flight speeds. This experimental program has been designed to establish the feasibility of obtaining laminar flow at supersonic speeds with highly swept wing and to provide data for computational fluid dynamics (CFD) code calibration. Flight experiments conducted as supersonic speeds have indicated that it is possible to achieve laminar flow under controlled suction at flight Mach numbers greater than 1. Currently this glove is fitted with a series of pressure belts and flush mounted hot film sensors for the purpose of determining the pressure distributions and the extent of laminar flow region past the stagnation point. The present mode of data acquisition relies on out-dated on board multi-channel FM analogue tape recorder system. At the end of each flight, the analogue data is digitized through a long laborious process and then analyzed. It is proposed to replace this outdated system with an on board state-of-the-art digital data acquisition system capable of a through put rate of up to 1 MegaHertz. The purpose of this study was three-fold: (1) to develop a simple algorithm for acquiring data via 2 analogue-to-digital convertor boards simultaneously (total of 32 channels); (2) to interface hot-film/wire anemometry instrumentation with a PCAT type computer; and (3) to characterize the frequency response of a flush mounted film sensor. A brief description of each of the above tasks along with recommendations are given.

  15. Drug interactions in controlled clinical trials.

    Science.gov (United States)

    Gershon, S

    1982-12-01

    As much information as possible should be obtained in clinical trials to assess possible interactions between test drugs and concomitant medications prescribed for other medical indications. Side effect profiles were compared in patients taking buspirone, mean = 20 mg/day; diazepam, 20 mg/day; clorazepate, 23 mg/day; and placebo, with or without concomitant medications. Approximately 1,000 anxious patients were included in the analysis; 700 received buspirone. The use of a variety of common medications did not affect the side effect profile in the buspirone, clorazepate, and placebo groups, but did increase the incidence of side effects in the diazepam group. The increased incidence of sedation noted with diazepam and clorazepate, however, was not due to concomitant medication.

  16. Bed bugs: clinical relevance and control options.

    Science.gov (United States)

    Doggett, Stephen L; Dwyer, Dominic E; Peñas, Pablo F; Russell, Richard C

    2012-01-01

    Since the late 1990s, bed bugs of the species Cimex lectularius and Cimex hemipterus have undergone a worldwide resurgence. These bed bugs are blood-sucking insects that readily bite humans. Cutaneous reactions may occur and can start out as small macular lesions that can develop into distinctive wheals of around 5 cm in diameter, which are accompanied by intense itching. Occasionally, bullous eruptions may result. If bed bugs are numerous, the patient can present with widespread urticaria or eythematous rashes. Often, bites occur in lines along the limbs. Over 40 pathogens have been detected in bed bugs, but there is no definitive evidence that they transmit any disease-causing organisms to humans. Anemia may result when bed bugs are numerous, and their allergens can trigger asthmatic reactions. The misuse of chemicals and other technologies for controlling bed bugs has the potential to have a deleterious impact on human health, while the insect itself can be the cause of significant psychological trauma. The control of bed bugs is challenging and should encompass a multidisciplinary approach utilizing nonchemical means of control and the judicious use of insecticides. For accommodation providers, risk management procedures should be implemented to reduce the potential of bed bug infestations.

  17. A preliminary study of the effect of eliminating requirements on clinical performance.

    Science.gov (United States)

    Dodge, W W; Dale, R A; Hendricson, W D

    1993-09-01

    This study determined the effect of a clinical program driven by patient needs upon students' productivity, attitudes, and academic performance. A group of eight senior students, whose academic and clinical performance profile replicated that of the rest of the class, were chosen to participate in a year-long non-requirement clinic. The students were expected to attend all clinic sessions, and treat their assigned patients. Their performance was compared to that of classmates in the regular requirement-driven curriculum. The non-requirement group had significantly higher academic achievement and significantly outproduced their classmates. Non-requirement students had no state board failures, versus 17 percent in the regular curriculum, and reported significantly lower stress. This study suggests that predoctoral clinical programs can maintain quality and productivity in the absence of unit requirements.

  18. Control Region-mtDNA heterogeneity of Kalimantan false gharial (Tomistoma schiegelii population: a preliminary study

    Directory of Open Access Journals (Sweden)

    Hellen Hellen

    2003-06-01

    Full Text Available The preliminary genetic study on Kalimantan false gharial from the wild was reported. Eleven tail scutes were collected fromeleven individuals that originally consisting of two individuals from Kapuas River, one individual from Sentarum Lake, Jelai River,Mapam River, Perian Lake, and Lamandau River, two individuals from Barito River and three individuals from Mahakam River. PCRamplifying and sequencing 451 nucleotides in average that can be aligned at the same length of control region mitochondrial DNA.Among 11 individuals found eight polymorphic sites that consisted four haplotypes (A, B, C, and D respectively, which is haplotypeA is dominant. Based on phylogenetic tree that constructed by Tamura-Nei parameter, false gharial population in Kalimantan can bedivided into two population groups; there were Central-Eastern Kalimantan population group and Western Kalimantan populationgroup. Based on the hypothesis of landmasses separating between central-eastern Kalimantan and western Kalimantan that known asSchwaner Mountains, the genetic distance D = 1.53% was expected to be equal to 20 million years.

  19. Preliminary clinical results: an analyzing tool for 2D optical imaging in detection of active inflammation in rheumatoid arthritis

    Science.gov (United States)

    Adi Aizudin Bin Radin Nasirudin, Radin; Meier, Reinhard; Ahari, Carmen; Sievert, Matti; Fiebich, Martin; Rummeny, Ernst J.; No"l, Peter B.

    2011-03-01

    Optical imaging (OI) is a relatively new method in detecting active inflammation of hand joints of patients suffering from rheumatoid arthritis (RA). With the high number of people affected by this disease especially in western countries, the availability of OI as an early diagnostic imaging method is clinically highly relevant. In this paper, we present a newly in-house developed OI analyzing tool and a clinical evaluation study. Our analyzing tool extends the capability of existing OI tools. We include many features in the tool, such as region-based image analysis, hyper perfusion curve analysis, and multi-modality image fusion to aid clinicians in localizing and determining the intensity of inflammation in joints. Additionally, image data management options, such as the full integration of PACS/RIS, are included. In our clinical study we demonstrate how OI facilitates the detection of active inflammation in rheumatoid arthritis. The preliminary clinical results indicate a sensitivity of 43.5%, a specificity of 80.3%, an accuracy of 65.7%, a positive predictive value of 76.6%, and a negative predictive value of 64.9% in relation to clinical results from MRI. The accuracy of inflammation detection serves as evidence to the potential of OI as a useful imaging modality for early detection of active inflammation in patients with rheumatoid arthritis. With our in-house developed tool we extend the usefulness of OI imaging in the clinical arena. Overall, we show that OI is a fast, inexpensive, non-invasive and nonionizing yet highly sensitive and accurate imaging modality.-

  20. Factors controlling short-term soil microbial response after laboratory heating. Preliminary results

    Science.gov (United States)

    Jiménez-Compán, Elizabeth; Jiménez-Morillo, Nicasio; Jordán, Antonio; Bárcenas-Moreno, Gema

    2015-04-01

    Soil microbial response after fire is controlled by numerous variables which conclude with a mosaic of results depending on organic carbon alterations or pH fire-induced changes. This fact has complicated the studies focused on post-fire microbial response, compiling high variability of opposite result in the bibliography. Soil laboratory heating cannot emulate a real wildfire effect on soil but lead us the possibility to control several variables and it is a valid tool to clarify the relative weight of different factors controlling microbial response after soil heating. In this preliminary study different heated treatments were applied to unaltered forest soil samples, obtaining 4 different heating treatments to simulate a range of fire intensities: unaltered-control (UH), and soil heated at 300, 450 and 500 °C. In order to isolate possible nutrient availability or pH heating-induced changes, different culture media were prepared using soil:water extract from each heating treatments and adding different supplements to obtain the total of 11 different culture media: unheated soil without supplements (UH-N-), unheated soil with nutrient supplement (UH-N+), soil heated at 300 °C without supplements (300-N-), soil heated at 300 °C with nutrient supplement (300-N+), soil heated at 300 °C with nutrient supplement and pH-buffered (300-N+pH); soil heated at 450 °C without supplements (450-N-), soil heated at 450 °C with nutrient supplement (450-N+), soil heated at 450 °C with nutrient supplement and pH-buffered (450-N+); soil heated at 500 °C without supplements (500-N-), soil heated at 500 °C with nutrient supplement (500-N+), soil heated at 500 °C with nutrient supplement and pH-buffered (500-N+). Each media was inoculated with different dilutions of a microbial suspension from the original unaltered soil, and the abundance of viable and cultivable microorganisms were measured by plate count method. In addition, the analysis of heating-induced soil organic

  1. From asthma severity to control: a shift in clinical practice

    DEFF Research Database (Denmark)

    Pedersen, Søren

    2009-01-01

    Variability is a characteristic feature of asthma, and the aim of asthma management is to eliminate or minimise disease variability. Controlled asthma shows little or no variability, and is achievable and sustainable in the majority of patients. New international guidelines recommend control...... involves the control of several outcomes. Its assessment should include components relevant to achievement of best possible clinical control and reduction of future risk of adverse outcomes. Focusing on a single or a few outcomes can lead to incorrect control assessment and increased risk of under......-treatment. Several validated asthma control assessment tools have been developed to facilitate correct assessment of the level of control in clinical practice. It is hoped that focusing on control will reduce the frequency of sub-optimal treatment in the primary care setting. Further validation of the best way...

  2. MR elastography of the liver at 3.0 T in diagnosing liver fibrosis grades; preliminary clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimitsu, Kengo; Mitsufuji, Toshimichi; Shinagawa, Yoshinobu; Fujimitsu, Ritsuko; Morita, Ayako; Urakawa, Hiroshi; Takano, Koichi [Fukuoka University, Department of Radiology, Fukuoka (Japan); Hayashi, Hiroyuki [Fukuoka University, Department of Pathology, Faculty of Medicine, Fukuoka (Japan)

    2016-03-15

    To clarify the usefulness of 3.0-T MR elastography (MRE) in diagnosing the histological grades of liver fibrosis using preliminary clinical data. Between November 2012 and March 2014, MRE was applied to all patients who underwent liver MR study at a 3.0-T clinical unit. Among them, those who had pathological evaluation of liver tissue within 3 months from MR examinations were retrospectively recruited, and the liver stiffness measured by MRE was correlated with histological results. Institutional review board approved this study, waiving informed consent. There were 70 patients who met the inclusion criteria. Liver stiffness showed significant correlation with the pathological grades of liver fibrosis (rho = 0.89, p < 0.0001, Spearman's rank correlation). Areas under the receiver operating characteristic curve were 0.93, 0.95, 0.99 and 0.95 for fibrosis score greater than or equal to F1, F2, F3 and F4, with cut-off values of 3.13, 3.85, 4.28 and 5.38 kPa, respectively. Multivariate analysis suggested that grades of necroinflammation also affected liver stiffness, but to a significantly lesser degree as compared to fibrosis. 3.0-T clinical MRE was suggested to be sufficiently useful in assessing the grades of liver fibrosis. (orig.)

  3. Safety and feasibility of transcranial direct current stimulation in pediatric hemiparesis: randomized controlled preliminary study.

    Science.gov (United States)

    Gillick, Bernadette T; Feyma, Tim; Menk, Jeremiah; Usset, Michelle; Vaith, Amy; Wood, Teddi Jean; Worthington, Rebecca; Krach, Linda E

    2015-03-01

    Transcranial direct current stimulation (tDCS) is a form of noninvasive brain stimulation that has shown improved adult stroke outcomes. Applying tDCS in children with congenital hemiparesis has not yet been explored. The primary objective of this study was to explore the safety and feasibility of single-session tDCS through an adverse events profile and symptom assessment within a double-blind, randomized placebo-controlled preliminary study in children with congenital hemiparesis. A secondary objective was to assess the stability of hand and cognitive function. A double-blind, randomized placebo-controlled pretest/posttest/follow-up study was conducted. The study was conducted in a university pediatric research laboratory. Thirteen children, ages 7 to 18 years, with congenital hemiparesis participated. Adverse events/safety assessment and hand function were measured. Participants were randomly assigned to either an intervention group or a control group, with safety and functional assessments at pretest, at posttest on the same day, and at a 1-week follow-up session. An intervention of 10 minutes of 0.7 mA tDCS was applied to bilateral primary motor cortices. The tDCS intervention was considered safe if there was no individual decline of 25% or group decline of 2 standard deviations for motor evoked potentials (MEPs) and behavioral data and no report of adverse events. No major adverse events were found, including no seizures. Two participants did not complete the study due to lack of MEP and discomfort. For the 11 participants who completed the study, group differences in MEPs and behavioral data did not exceed 2 standard deviations in those who received the tDCS (n=5) and those in the control group (n=6). The study was completed without the need for stopping per medical monitor and biostatisticial analysis. A limitation of the study was the small sample size, with data available for 11 participants. Based on the results of this study, tDCS appears to be safe

  4. Clinical effects of an avocado-soybean unsaponifiable extract on arthralgia and osteoarthritis of the temporomandibular joint: preliminary study.

    Science.gov (United States)

    Catunda, I S; Vasconcelos, B C do E; Andrade, E S de S; Costa, D F N

    2016-08-01

    The aim of the present preliminary study was to investigate the effectiveness of an avocado-soybean unsaponifiable extract (ASU) in patients with arthralgia and osteoarthritis of the temporomandibular joint (TMJ). A randomized, double-blind, placebo-controlled trial was carried out. Fourteen women diagnosed with arthralgia and osteoarthritis of the TMJ using the Research Diagnostic Criteria for Temporomandibular Disorders were included in the statistical analysis. The women were allocated randomly to two groups: ASU group and placebo group. Pain was measured using a visual analogue scale and pressure algometer. Mandibular function was evaluated through measurement of mandibular movements. Quality of life was measured using the Oral Health Impact Profile (OHIP-14). The medication (ASU capsules or placebo capsules) was used for 4 months and the total follow-up was 6 months. Those taking the ASU extract had a decrease in pain symptoms and an improvement in quality of life. Moreover, a significant reduction in the use of rescue medication was found in the ASU group compared to the placebo group. This preliminary study provides strong evidence of the effectiveness of an avocado-soybean unsaponifiable extract in patients with degenerative joint diseases and arthralgia in the TMJ. Further studies with larger samples should be performed.

  5. Survey of integrative lumbar spinal stenosis treatment in Korean medicine doctors: preliminary data for clinical practice guidelines.

    Science.gov (United States)

    Lee, Yoon Jae; Shin, Joon-Shik; Lee, Jinho; Kim, Me-Riong; Ahn, Yong-Jun; Shin, Ye-Sle; Park, Ki Byung; Shin, Byung-Cheul; Lee, Myeong Soo; Kim, Joo-Hee; Cho, Jae-Heung; Ha, In-Hyuk

    2017-08-29

    Considering that large variations exist amongst practitioners in lumbar disorder management and the significant costs that lumbar disorders incur, determining clinical practice patterns to provide preliminary data for standardization should be given higher priority. Lumbar spinal stenosis (LSS) is commonly treated using integrative non-surgical methods by Korean medicine doctors (KMDs) in Korea, and this is the first study to assess current Korean medicine practice trends for LSS. A survey on KMD diagnosis, treatment, prognosis and decision-making in LSS treatment was developed in a 3-step procedure of preliminary drafting, revision based on extramural expert opinion, and final editing. The survey was conducted at the internal conference of a spine-specialty Korean medicine hospital on January 25th, 2015. The response rate was high at 79.19% (n = 118/149). Participants replied that they treated 7.3 ± 6.8 LSS patients/day using a multimodal treatment method consisting of acupuncture, pharmacopuncture, herbal medicine, Chuna manipulation, and electroacupuncture. Acupuncture mainly used Ashi points and MSAT, and pharmacopuncture mainly Shinbaro solution. The most frequently prescribed herbal medicine was Chungpa-jun, and the most commonly applied Chuna techniques were sidelying lumbar extension dysfunction correction technique, and prone lumbosacral joint distraction method. Radiological findings were mainly referred to for diagnosis, and clinical symptoms, age, radiological findings, and medical history were regarded to be important for prognosis. Participants replied that 7.8 ± 3.3 weeks were required for 50% reduction in pain, and 16.1 ± 7.7 weeks for 80% reduction. These results suggest that KMDs in Korea combine a conventional approach to LSS and a Korean medicine approach to low back pain for integration of empirical- and evidence-based diagnosis and treatment. The findings may contribute in bridging the divide between evidence and clinical practice

  6. Pre-operative diclofenac HPβCD for pain control of needle biopsy in musculoskeletal neoplasm: preliminary results.

    Science.gov (United States)

    D'Arienzo, Antonio; Beltrami, Giovanni; Mancini, Daniele; Scoccianti, Guido; Cuomo, Pierluigi; Muratori, Francesco; Matera, Davide; Ippolito, Massimiliano; Mondanelli, Nicola; Frenos, Filippo; Totti, Francesca; Capanna, Rodolfo

    2015-01-01

    Needle biopsy is the main standard method used for diagnosis of musculoskeletal tumors of the limbs and superficial trunk. Pain control during this procedure is through the use of Local Anaestetic (L.A.). In order to achieve a complete pain control in our cases, recently we started using diclofenac HPβCD 50 mg via s.c. preoperativly. We present the clinical results of a non-randomized study of two eterogeneous groups of patients: "Experimental" Group (1): diclofenac HPβCD 50 mg via s.c. one hour before surgical procedure, local anesthesia and ev. diclofenac HPβCD 50 mg via s.c. 12 hours postoperative; "Conventional" Group (2): local anesthesia and ev. postoperative tramadol 100 mg via oral for pain control. In October 2014, at the Department of Orthopedic Oncology and Reconstructive Surgery of Florence, 37 musculoskeletal biopsies for a bone or a soft tissue lesion were performed. Exclusion criteria for this study were: known allergies to lidocaine, diclofenac, tramadol; known gastric or duodenal ulcers; known gastrointestinal bleed or perforation; refusal of the patients to collaborate. For one or more of these reasons, 6 patients were excluded from this study. In the Group 1, 10 patients (59%) referred no pain during the surgical procedure (8/14 biopsies on soft tissue and 2/3 on bone). In 5 cases (29%) no exacerbation of previous chronic pain, and in 2 cases (12%) a progression of local pain after biopsy (average 1 points higher in the VAS). In Group 2, only 6 patients (42%) did not have any pain during the procedure, 4 (29%) no exacerbation of previous chronic pain and 4 (29%) a progression of local pain (average 2 points higher in the VAS). Despite similar results in both Groups, Group 1 seemed to have a mild better control of perioperative pain. The use of diclofenac HPβCD 50 mg preoperative seems to be a rational approach for minimizing perioperative pain and the preliminary data of our study seem encouraging. Obviously many bias are present in this

  7. Nimotuzumab combined with radiotherapy for esophageal cancer: preliminary study of a Phase II clinical trial

    Directory of Open Access Journals (Sweden)

    Liang J

    2013-11-01

    Full Text Available Jun Liang,1 Mingyan E,2 Gang Wu,3 Lujun Zhao,4 Xia Li,5 Xia Xiu,6 Ning Li,1 Bo Chen,1 Zhouguang Hui,1 Jima Lv,1 Hui Fang,1 Yu Tang,1 Nan Bi,1 Wenqing Wang,1 Yirui Zhai,1 Tao Li,1 Dongfu Chen,1 Shuangmei Zou,7 Ning Lu,7 Rolando Perez-Rodríguez,8 Junqi Zheng,9 Luhua Wang11Department of Radiotherapy, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China; 2Department of Radiotherapy, Cancer Hospital of Harbin Medical University, Harbin, People's Republic of China; 3Department of Radiotherapy, Tongji Cancer Center Hospital, Wuhan, People's Republic of China; 4Department of Radiotherapy, Cancer Hospital of Tianjin Medical University, Tianjin, People's Republic of China; 5Department of Radiotherapy, LiaoNing Province Cancer Hospital, Shenyang, People's Republic of China; 6Department of Radiotherapy, Beijing Hospital, Beijing, People's Republic of China; 7Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China; 8Center of Molecular Immunology, Havana, Cuba; 9School of Medicine, Tongji University, Shanghai, People's Republic of ChinaObjective: To determine the safety and therapeutic effects of nimotuzumab (h-R3 combined with radiotherapy in esophageal cancer.Methods: This Phase II clinical trial involved 42 patients with stage II (inoperable or refused surgery to stage IV (supraclavicular lymph node metastasis only esophageal cancers treated between November 2008 and July 2010. All patients had squamous cell carcinomas, and all received three-dimensional conformal radiotherapy and 200 mg nimotuzumab per week during radiotherapy.Results: There were 9, 25, and 8 patients with stage II, III and IV disease, respectively. All except two patients received 50–70 Gy radiation; 37 patients (88.1% received more than five nimotuzumab doses. Grade III toxicities (21.4% of all adverse events included esophagitis and gastrointestinal, dermatological and hematological

  8. Mapping clinically useful terminology to a controlled medical vocabulary.

    Science.gov (United States)

    Barrows, R. C.; Cimino, J. J.; Clayton, P. D.

    1994-01-01

    We have mapped clinically used diagnostic terms from a legacy ambulatory care system to the separate controlled vocabulary of our central clinical information system. The methodology combines elements of lexical and morphologic text matching techniques, followed by manual physician review. Results of the automated matching algorithm before and after partial manual review are presented. The results of this effort will permit the migration of coded clinical data from one system to another. Output from the system after the term review process will be fed back to the target vocabulary via automated and semi-automated means to improve its clinical utility. PMID:7949922

  9. Preliminary study of trace element emissions and control during coal combustion

    Institute of Scientific and Technical Information of China (English)

    ZHANG Junying; ZHAO Yongchun; DING Feng; ZENG Hancai; ZHENG Chuguang

    2007-01-01

    Hazardous trace element emissions have caused serious harm to human health in China.Several typical high-toxic trace element coals were collected from different districts and were used to investigate the emission characteristics of toxic trace elements (As,Se,Cr,Hg) and to explore preliminary control methods.Coal combustion tests were conducted in several bench-scale furnaces including drop tube furnace (DTF),circulating fluidized bed (CFB) combustion furnace,and fixed-bed combustion furnace.Calcium oxide was used to control the emission of arsenic and selenium.The granular activated carbons (AC) and activatedcarbon fibers (ACF) were used to remove mercury in the flue gas from coal combustion.The chemical composition and trace element contents of ash and particulate matter (PM)were determined by X-ray fluorescence (XRF) spectrometry and inductively coupled plasma-atomic emission spectrometry (ICP-AES),respectively.The speciation and concentration of mercury were investigated using the Ontario-Hydro method.X-ray diffraction spectrometry (XRD) was used to determine the mineral composition of production during combustion experiments.With the addition of a calciumbased sorbent,arsenic concentration in PM1 sharply decreased from 0.25-0.11 mg/m3.In fixed-bed combustion of coal,the retention rates of selenium volatiles were between 11.6% and 50.7% using lime.In the circulating fluidized-bed combustion of coal,the content of selenium in ash from the chimney was reduced to one-fourth of its original value and that in leaching water from the chimney decreased by two orders of magnitude using lime.Calcium-based sorbent is an effective additive to control the emission of As and Se during coal combustion.The emission of chromium is influenced by the occurrence mode of Cr in coal.Chromium emission in PM2.5 during coal combustion is 55.5 and 34.7 μg/m3 for Shenbei coal and mixed Pingdingshan coal,respectively.The adsorptive capacity of granular activated carbon for Hg0 is

  10. Choosing a control intervention for a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Djulbegovic Benjamin

    2003-04-01

    Full Text Available Abstract Background Randomised controlled clinical trials are performed to resolve uncertainty concerning comparator interventions. Appropriate acknowledgment of uncertainty enables the concurrent achievement of two goals : the acquisition of valuable scientific knowledge and an optimum treatment choice for the patient-participant. The ethical recruitment of patients requires the presence of clinical equipoise. This involves the appropriate choice of a control intervention, particularly when unapproved drugs or innovative interventions are being evaluated. Discussion We argue that the choice of a control intervention should be supported by a systematic review of the relevant literature and, where necessary, solicitation of the informed beliefs of clinical experts through formal surveys and publication of the proposed trial's protocol. Summary When clinical equipoise is present, physicians may confidently propose trial enrollment to their eligible patients as an act of therapeutic beneficence.

  11. MR coronary angiography with breath-hold targeted volumes: preliminary clinical results

    NARCIS (Netherlands)

    R.J.M. van Geuns (Robert Jan); P.A. Wielopolski (Piotr); H.G. de Bruin (Hein); B.J.W.M. Rensing (Benno); M. Hulshoff (Maarten); P.M.A. van Ooijen (Peter); P.J. de Feyter (Pim); M. Oudkerk (Matthijs)

    2000-01-01

    textabstractPURPOSE: To assess the clinical value of a magnetic resonance (MR) coronary angiography strategy involving a small targeted volume to image one coronary segment in a single breath hold for the detection of greater than 50% stenosis. MATERIALS AND METHODS:

  12. MR coronary angiography with breath-hold targeted volumes : Preliminary clinical results

    NARCIS (Netherlands)

    van Geuns, R J; Wielopolski, P A; de Bruin, Hein G.; Rensing, B J; Hulshoff, Marc; van Ooijen, P M; de Feyter, P J; Oudkerk, M

    2000-01-01

    PURPOSE: To assess the clinical value of a magnetic resonance (MR) coronary angiography strategy involving a small targeted volume to image one coronary segment in a single breath hold for the detection of greater than 50% stenosis. MATERIALS AND METHODS: Thirty-eight patients referred for elective

  13. Preliminary comparison of the Essie and PubMed search engines for answering clinical questions using MD on Tap, a PDA-based program for accessing biomedical literature.

    Science.gov (United States)

    Sutton, Victoria R; Hauser, Susan E

    2005-01-01

    MD on Tap, a PDA application that searches and retrieves biomedical literature, is specifically designed for use by mobile healthcare professionals. With the goal of improving the usability of the application, a preliminary comparison was made of two search engines (PubMed and Essie) to determine which provided most efficient path to the desired clinically-relevant information.

  14. A dual-modality photoacoustic and ultrasound imaging system for noninvasive sentinel lymph node detection: preliminary clinical results

    Science.gov (United States)

    Erpelding, Todd N.; Garcia-Uribe, Alejandro; Krumholz, Arie; Ke, Haixin; Maslov, Konstantin; Appleton, Catherine; Margenthaler, Julie; Wang, Lihong V.

    2014-03-01

    Sentinel lymph node biopsy (SLNB) has emerged as an accurate, less invasive alternative to axillary lymph node dissection, and it has rapidly become the standard of care for patients with clinically node-negative breast cancer. The sentinel lymph node (SLN) hypothesis states that the pathological status of the axilla can be accurately predicted by determining the status of the first (i.e., sentinel) lymph nodes that drain from the primary tumor. Physicians use radio-labeled sulfur colloid and/or methylene blue dye to identify the SLN, which is most likely to contain metastatic cancer cells. However, the surgical procedure causes morbidity and associated expenses. To overcome these limitations, we developed a dual-modality photoacoustic and ultrasound imaging system to noninvasively detect SLNs based on the accumulation of methylene blue dye. Ultimately, we aim to guide percutaneous needle biopsies and provide a minimally invasive method for axillary staging of breast cancer. The system consists of a tunable dye laser pumped by a Nd:YAG laser, a commercial ultrasound imaging system (Philips iU22), and a multichannel data acquisition system which displays co-registered photoacoustic and ultrasound images in real-time. Our clinical results demonstrate that real-time photoacoustic imaging can provide sensitive and specific detection of methylene blue dye in vivo. While preliminary studies have shown that in vivo detection of SLNs by using co-registered photoacoustic and ultrasound imaging is feasible, further investigation is needed to demonstrate robust SLN detection.

  15. Preliminary report on management of neonatal jaundice in maternity clinics of São Paulo city, Brazil

    Directory of Open Access Journals (Sweden)

    Fernando Bastos

    2007-03-01

    Full Text Available Objective: The treatment of neonatal hyperbilirubinemia remains aproblem because it can lead to sequelae in both children and adults. Theobjective of this study was to evaluate how neonatal jaundice is treatedin maternity hospitals in the city of São Paulo. Methods: Prospective andtransversal study on maternity hospitals in the city of São Paulo, Brazil. Aquestionnaire was applied to doctors working at neonatal wards withinmaternity hospitals in the city of São Paulo, divided into public (n = 6 andprivate maternity clinics (n = 18. The results obtained from the differentitems of the questionnaire were then compared. Statistical analysis wasperformed using the Student’s t test, chi-square test and Mann-Whitneytest when appropriate, and a p value < 0.005 was considered significant.Results: There were no significant differences between the two typesof maternity hospitals in relation to the treatment method for neonataljaundice. However, among private maternities there were some that didnot have written guidelines (5/17 and those that performed exchangetransfusion (3/18. Teaching was significantly more present amongpublic (100% than private maternity hospitals (17.6%. The mean serumbilirubin levels to initiate treatment did not show significant differencesbetween the two types of maternities. Some clinical practices in use bymaternity hospitals are not evidence based. Conclusions: The presentdata were considered preliminary and showed that further research inthe area is required and if our findings are confirmed, indicate the needfor continuous medical education on the part of health professionals incharge of newborns.

  16. Design, Implementation, Use, and Preliminary Evaluation of SEBASTIAN, a Standards-Based Web Service for Clinical Decision Support

    Science.gov (United States)

    Kawamoto, Kensaku; Lobach, David F.

    2005-01-01

    Despite their demonstrated ability to improve care quality, clinical decision support systems are not widely used. In part, this limited use is due to the difficulty of sharing medical knowledge in a machine-executable format. To address this problem, we developed a decision support Web service known as SEBASTIAN. In SEBASTIAN, individual knowledge modules define the data requirements for assessing a patient, the conclusions that can be drawn using that data, and instructions on how to generate those conclusions. Using standards-based XML messages transmitted over HTTP, client decision support applications provide patient data to SEBASTIAN and receive patient-specific assessments and recommendations. SEBASTIAN has been used to implement four distinct decision support systems; an architectural overview is provided for one of these systems. Preliminary assessments indicate that SEBASTIAN fulfills all original design objectives, including the re-use of executable medical knowledge across diverse applications and care settings, the straightforward authoring of knowledge modules, and use of the framework to implement decision support applications with significant clinical utility. PMID:16779066

  17. The clinical significance of brain microbleeds in patients with Alzheimer′s disease: Preliminary study

    Directory of Open Access Journals (Sweden)

    Jae-Hyeok Heo

    2016-01-01

    Full Text Available Background: Microbleeds (MBs are observed frequently in Alzheimer′s disease (AD and suggested to play a crucial role in the pathophysiology, but their clinical significance remains unclear. Materials and Methods: The study recruited 100 patients with AD who were diagnosed at the memory clinic in Seoul Medical Center in 2014. For each patient, baseline characteristics, neuropsychological tests, cerebrovascular risk factors, medial temporal lobe atrophy (MTLA, and severity of small vessel disease (SVD according to the existence of MBs were evaluated. Results: The prevalence of MBs in patients with AD was 33%. The percentage of male gender, the severity of SVD and MTLA were significantly increased in MB(+ group. The MB(+ group showed more severe MTLA and SVD than MB(− group. Conclusions: These results suggested that MBs might reflect the burden of amyloid and ischemic vascular pathology.

  18. Preliminary evaluation of a new clinical algorithm to interpret blood cultures growing coagulase-negative staphylococci.

    Science.gov (United States)

    Schnell, David; Lécuyer, Hervé; Geeraerts, Thomas; Dumenil, Anne-Sylvie; Bille, Emmanuelle; Mercier, Frédéric J; Benhamou, Dan; Zahar, Jean-Ralph

    2013-07-01

    Evaluating the clinical significance of blood cultures positive for coagulase-negative staphylococci (CoNS) is of critical importance since these microorganisms represent both the first contaminants of blood cultures and one of the leading causes of bloodstream infection (BSI). This prospective 2-centre study aimed to compare a previously reported algorithm to a clinical algorithm based on our experience. We identified 84 patients with CoNS-positive blood cultures. Twenty-seven (32%) were considered to have BSI according to our study algorithm. Thirty-seven (44%) patients were considered to have CoNS BSI according to the previously reported algorithm. The 2 algorithms isolated patients with similar rates of recurrences and hospital mortality. Our algorithm seemed to result in less diagnoses of CoNS BSI without harmful consequences compared to the previously reported algorithm. The impact on patient outcome and the inappropriate use of antibiotics deserves further investigation.

  19. A preliminary clinical evaluation of external snehan and asanas in the patients of sciatica

    OpenAIRE

    Singh, Akhilesh K.; Singh, Om P.

    2013-01-01

    Lower back pain radiating to either on one leg or both legs along the course of sciatic nerve is a common ailment in the clinical practice, this type of peculiar symptomatology is termed as "Sciatica" in modern medicine. The medical treatment is unsatisfactory for both the patient and the neurosurgeons, as the surgical treatment has its own hazards and the cost of the surgical procedure and medical treatment is prohibitory to most of the Indian patients. Hence, most of the patients present th...

  20. Frequency, Clinical Correlates, and Ratings of Behavioral Changes in Primary Brain Tumor Patients: A Preliminary Investigation

    OpenAIRE

    Simpson, Grahame K.; Eng-Siew eKoh; Diane eWhiting; Wright, Kylie M.; Teresa eSimpson; Rochelle eFirth; Lauren eGillett; Kathryn eYounan

    2015-01-01

    Purpose Few studies have addressed the specific behavioral changes associated with primary brain tumor (PBT). This paper will report on the frequency and demographic/clinical correlates of such behaviors, and the reliability of rating such behaviors among people with PBT, family informants, and clinicians. The association of behavioral changes and patient functional status will also be discussed. Methods A total of 57 patients with 37 family informants were recruited from two large...

  1. Clinical features of Crohn disease concomitant with ankylosing spondylitis: A preliminary single-center study.

    Science.gov (United States)

    Liu, Song; Ding, Jie; Wang, Meng; Zhou, Wanqing; Feng, Min; Guan, Wenxian

    2016-07-01

    Extraintestinal manifestations (EIMs) cause increased morbidity and decreased quality of life in Crohn disease (CD). Ankylosing spondylitis (AS) belongs to EIMs. Very little is known on the clinical features of CD concomitant with AS. This study is to investigate the clinical features of CD patients with AS.We retrospectively collected all CD patients with AS in our hospital, and established a comparison group (CD without AS) with age, sex, and duration of Crohn disease matched. Clinical information was retrieved for comparison.Eight CD + AS patients were identified from 195 CD patients. Sixteen CD patients were randomly selected into comparison group. All CD + AS patients were male, HLA-B27 (+), and rheumatoid factor (-) with an average age of 40.8 ± 4.52 years. Significant correlation between disease activity of CD and AS was revealed (r = 0.857, P = 0.011). Significant correlation between disease activity of CD and functional limitation associated with AS was identified (r = 0.881, P Crohn disease activity index (CDAI), Bath AS disease activity index, and Bath AS functional index(BASFI) scores (r = 0.73-0.93, P Disease activity of CD correlates with disease activity of AS and functional limitation caused by AS. CRP, ESR, and Alb/Glo may serve as biomarkers for disease activity and functional limitation in CD patients concomitant with AS, although future studies are expected.

  2. A Preliminary Clinical Laboratory Investigation of Endemic Spiking Mortality Syndrome of Broiler Chickens in Nepal

    Directory of Open Access Journals (Sweden)

    Tika Ram Neupane

    Full Text Available During the period of March-April-May 2008 first time a sudden and unexpected jump in mortality in Broiler of 8 to 16 days of age was reported from broiler farms from Chitwan and Kathmandu valley in Nepal.Affected birds become recumbent, depressed and often go into a star-gazing spasm. Those signs included, huddling of the birds, trembling, blindness, loud chirping, litter eating, ataxia, comatose, birds dead with breast down and feet and legs straight out behind birds. Death within two to six hours after the onset of the symptoms Postmortem Lesions found with this syndrome include hemorrhages in the liver with necrosis of liver cells, regressed thymus, regression of the bursa of Fabricius, dehydration with the accumulation of kidney urates, fluid in the crop, fluid in the lower gut and watery contents of the ceca.Yellow elastic shanks swollen joints. Molted appearance of brain. . The mortality lasted for three to five days, after which, the mortality patterns return to a relatively normal level. When treated with liquid toxin binders like toxol,toxolivum,livertonic like hepatocare,naturaliv, immunomodulaters like immunocare,promin,pentasol and antibiotics there was check in mortality but the body weight recovery was not satisfactory only half as in comparison of in other illness. During this period laboratory culture of total 298 tissue specimen from dead bird was conducted which revealed growth of fungus spp like Aspergillus and Penicillium in 182 specimen while mixed E.coli and Staphylococcus were recovered in 68 specimen 24 specimen revealed the growth of Salmonella spp of bacteria and 24 samples were turn out to be negative while the attempt to isolate the Avian encephalomyelitis virus as it might be the cause suspected also turnout negative. On the basis of all laboratory findings and response to the treatment attempted finding of this preliminary investigation work is suggestive that the above syndrome indicates that mycosis emerging as

  3. Hyperacuity test to evaluate vision through dense cataracts: research preliminary to a clinical study in India

    Science.gov (United States)

    Enoch, Jay M.; Giraldez, Maria J.; Huang, Doahua; Hirose, Hiroshi; Knowles, Richard A.; Namperumalsamy, P.; LaBree, Lauri; Azen, Stanley P.

    1995-03-01

    Using high luminance point-of-light stimuli, Vernier judgments can be made in the presence of markedly degraded retinal imagery. Without coaching, observers perform center-of-gravity assessments of relative locations of degraded point images. We seek to defined, presurgery, individuals who will derive the most benefit from advanced cataract removal (a form of triage), and to determine which of two cataractous eyes has the better postsurgical visual prognosis. There are incredible and growing backlogs of patients with severe cataracts (and other dense media opacities) in the developing world, and generally, limited resources are available for provision of health care. Postcataract surgical failure rates for good visual function are often high, and only one eye is operated on in over 95% of indigent patients treated. Prior to initiating advanced studies in the developing world, at Berkeley we conducted preliminary research on Vernier acuity test techniques on normal adult subjects. We sought to determine the number of repeat trials necessary; to compare a two-point and a three-point Vernier display; to determine the shape of the measured response function at large gap separations between test points (required when testing advanced cataract patients); to assess the effect(s) of a broad range of uncorrected refractive errors on outcomes; and to consider means to minimize refraction-based errors. From these and prior data and analyses, we defined a protocol for use in the developing world. Using a newly designed and rugged precision instrument, these tests were repeated on an advanced cataract population at Aravind Eye Hospital in Madurai, India. Although we had much prior experience in India, the initial protocol required major revision on site. Necessary changes in test methods and analytical approaches were made, and next stages in this program were planned. And a new and simple gap `visual acuity' (gap `VA') test was added to the protocol, which greatly facilitated

  4. [A comparative study on efficacy of glucocorticoids, mineralocorticoids and vasoactive drugs on reversing hearing loss in patients suffering idiopathic sensorineural cochlear hypoacusis. A preliminary clinical trial].

    Science.gov (United States)

    Campos-Bañales, Eugenia María; López-Campos, Daniel; de Serdio-Arias, José Luis; Esteban-Rodriguez, J; García-Sáinz, Mar; Muñoz-Cortés, Álvaro; López-Aguado, Daniel

    2015-01-01

    Sensory neural hearing loss (SNHL) is a disorder characterised by an important deterioration of the auditory function. Re-establishing normal ion homeostasis of the endolymph could be related to hearing recovery and it might be mediated by mineralocorticoids. The main purpose of this preliminary, randomized controlled clinical trial was assessing the recovery of idiopathic sensory neural cochlear hearing loss (SNHL) by comparing the efficacy of 2 types of steroids versus vasodilators. The 3-month intervention involved 70 patients, allocated into 4 different groups: a control with no medication, consisting of 14 patients (8 men and 6 women); a vasodilator group of 21 patients (11 men and 10 women); a glucocorticoid group with 16 patients (10 men and 6 women); and a mineralocorticoid therapy group, consisting of 19 patients (11 men and 8 women). The level of hearing loss and its topography were estimated using Liminal Tone Audiometry (LTA) and Auditory Brainstem Response (ABR). Our research found overall greater efficacy of mineralocorticoids versus glucocorticoids and vasodilators. There was better response in women than in men and it was higher from the left ear, regardless of patient gender. The hearing gain was significantly superior in the mineralocorticoid group, followed by the glucocorticoid group. However, the responses to vasodilators were lesser and of low statistical significance. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  5. Preliminary Clinical Observation on Treatment of Chronic Rhinitis with Rhinitis Spray

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To investigate the clinical effect of Rhinitis Spray (RS) in treating chronic rhinitis. Methods: Eighty patients with chronic rhinitis were divided into three groups, and treated with RS, ephedrine and normal saline respectively. Results: The short-term effective rate in the three groups was 89.3%, 66.7% and 8.0% respectively. RS was effective in alleviating symptoms, increasing IgG level in nasal discharge, improving ventilation of nasal cavity and transfer function of cilia of nasal mucosa obviously. Conclusion: The therapeutic effect of RS in treating chronic rhinitis is good.

  6. Preliminary Clinical Observation on Treatment of Chronic Simple and Hypertrophic Rhinitis with Rhinitis Spray

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the clinical effect of Rhinitis Spray (RS) in treating chronic simple and hypertrophic rhinitis. Methods: Eighty patients with chronic rhinitis were divided into three groups and treated with RS, ephedrine and normal saline respectively. Results: The short-term effective rate in the three groups was 89.3%, 66.7% and 8.0% respectively. RS was effective in alleviating symptoms, increasing IgG level in nasal discharge, improving ventilatory function of nasal cavity and transfer function of nasal muosa cilia obviously. Conclusion: The therapeutic effect of RS in treating chronic rhinitis is satisfactory.

  7. Anticoagulation control in atrial fibrillation patients present to outpatient clinic of cardiology versus anticoagulant clinics

    Institute of Scientific and Technical Information of China (English)

    DU Xin; MA Chang-sheng; LIU Xiao-hui; DONG Jian-zeng; WANG Jun-nan; CHENG Xiao-jing

    2005-01-01

    @@ Nonvalvular atrial fibrillation (NVAF) is the most common sustained cardiac arrhythmia in clinical practice, which if untreated results in a doubling of cardiovascular morbidity and mortality. AF is an independent predictor of stroke, with an annual risk 5 to 6 times higher than patients in sinus rhythm.1 During recent years, several randomised clinical trials conducted by investigators around the world involving 13 843 participants with NVAF have demonstrated convincingly the value of warfarin therapies for stroke prevention in high risk patients.2-8 However, the dose response of warfarin is complex and its activity is easily altered by concurrent medications, food interactions, alcohol and illnesses. Adherence to medical advice and routine monitoring of the international normalized ratio (INR) is important, because low anticoagulant intensity predisposes the patients to thromboembolic complications and high intensity to haemorrhage. Studies suggested that anticoagulant clinics could improve the quality of anticoagulation control,9 and anticoagulant clinics are common in western countries. However, in China, most AF patients taking warfarin usually attend the outpatient clinic of cardiology, while the quality of anticoagulation control is never investigated. We therefore assessed anticoagulation control in the outpatient clinic of cardiology, and the quality of anticoagulation control since the establishment of anticoagulant clinics.

  8. Physical exercise as a supplement to outpatient treatment of alcohol use disorders – design and preliminary results of a randomized controlled trial

    DEFF Research Database (Denmark)

    Sari, Sengül; Bilberg, Randi Marie; Roessler, Kirsten Kaya

    . The aim of this study is to investigate the effect of physical exercise on alcohol intake, cardio-respiratory fitness and socio-psychological outcomes. Methods and design The study is a randomized controlled trial with three arms: (A) Standard treatment alone, (B) Standard treatment and physical exercise...... the study and inform about the first preliminary results. Perspectives If this study detects a positive relationship between exercise as a supplement to alcohol treatment and patients’ alcohol intake, quality of life, fitness, well-being, anxiety, depression and interpersonal problems......Background and aim Alcohol use disorder is a widespread problem in Denmark and has severe impacts on health and quality of life of each individual. The clinical treatment of alcohol use disorder involves evidence-based knowledge on medical treatment, physical training, and psychological management...

  9. Glass fiber reinforcement in repaired acrylic resin removable dentures: preliminary results of a clinical study.

    Science.gov (United States)

    Vallittu, P K

    1997-01-01

    The clinical usefulness of continuous E-glass partial fiber reinforcement of acrylic resin removable dentures was evaluated an average 13 months after the insertion of the fibers. Twelve removable complete dentures and ten removable partial dentures with a history of recurrent fracture were selected for this study. The partial fiber reinforcement was incorporated into the denture at the time of repair. One complete denture and one removable partial denture fractured in the region of reinforcement during the examination period. These fractures were most likely caused by faulty placement of the fiber reinforcement in the denture in the dental laboratory. In six dentures, new fractures occurred in regions without partial fiber reinforcement. The results revealed the importance of both the correct positioning of the partial fiber reinforcement in the denture and the use of accurate laboratory techniques.

  10. Focal choroidal excavation: a preliminary interpretation based on clinic and review

    Institute of Scientific and Technical Information of China (English)

    Guang-Hui; Liu; Bing; Lin; Xin-Quan; Sun; Zi-Fang; He; Ji-Rong; Li; Rong; Zhou; Xiao-Ling; Liu

    2015-01-01

    AIM: To describe the clinical and imaging characteristics associated with focal choroidal excavation(FCE), analyze the possible complication, and interpret its probable etiopathogenesis.METHODS: Retrospective descriptive case series of 37 eyes of 32 patients with FCE. Findings of spectral-domain optical coherence tomography(SD-OCT),fluorescein angiography, indocyanine green angiography,and clinical features were analyzed. RESULTS: All patients were Chinese. Five patients(15.6%) were bilaterally involved. Patients’ ages ranged from 7 to 66 y. Refractive error ranged between +2.0 D and 11.0 D. Mean best-corrected visual acuity was 0.6(range, 0.1 to 1.2). Fundus examinations exhibited mild-moderate localized pigmentary disturbances in the corresponding area of 17 eyes. Fluorescein angiography performed in 18 patients showed varying degrees of hyperfluorescence and hypofluorescence related to a range of retinal pigment epithelium(RPE) alterations.Indocyanine green angiography performed in 7 patients showed hypofluorescence at the excavation. SD-OCT demonstrated choroidal excavation in all 37 eyes.Twenty-nine eyes showed a single lesion of FCE, and three eyes showed 2-3 separated lesions. Fifteen eyes showed separation between the photoreceptor tips andRPE consistent with nonconforming FCE. Central serous chorioretinopathy(CSC, n =1) and choroidal neovascularization(CNV, n =1) developed during follow-up.CONCLUSION: FCE could be interpreted as congenital focal choroidal dysplasia involving the RPE,choriocapillaris, and photoreceptor associated with the faulty anatomy. The abnormal anatomy of FCE was similar to anatomy at risk of CSC and CNV.

  11. A preliminary randomized clinical trial comparing diode laser and scalpel periosteal incision during implant surgery: impact on postoperative morbidity and implant survival.

    Science.gov (United States)

    Shahnaz, Aysan; Jamali, Raika; Mohammadi, Farnush; Khorsand, Afshin; Moslemi, Neda; Fekrazad, Reza

    2017-08-31

    The aim of this preliminary randomized clinical trial was to compare: (1) post-operative morbidity after application of laser or scalpel incision for flap advancement during implant surgery and bone grafting and (2) implant survival rate following flap advancement with laser or scalpel incision after 6 months of loading. Eighteen patients who were scheduled for dental implant placement and simultaneous bone grafting were randomly assigned to test or control groups. Diode laser (810 nm, 2 W, pulse interval 200 μs; pulse length 100 μs, 400-μm initiated fiber tip), or scalpel (control) was used to sever the periosteum to create a tension-free flap. Visual analogue scale (VAS) pain score, rate of nonsteroid anti-inflammatory drug (NSAID) consumption, intensity of swelling, and ecchymosis were measured for the six postsurgical days. Six months after loading, implant survival was assessed. VAS pain score (during the first four postoperative days), rate of NSAID consumption (during the first three postoperative days), and intensity of swelling (during the first five postoperative days) were significantly lower in the test group compared to the control group (All P values < 0.05). One patient in the control group experienced ecchymosis. All implants were successful in function. Application of laser for performing periosteal releasing incision reduced the incidence and severity of postoperative morbidity of the patients undergone implant surgery in conjunction with bone augmentation procedure. We did not find any detrimental effect of laser incision on the implant survival within 6 months of loading.

  12. The clinical evaluation of Pterocarpus santalinus Linn. Ointment on lower extremity wounds--a preliminary report.

    Science.gov (United States)

    Biswas, Tuhin Kanti; Maity, Lakshmi Narayan; Mukherjee, Biswapati

    2004-12-01

    Pterocarpus santalinus is described in the Ayurveda for its wide spectrum of medicinal properties including wound healing. Previously the authors reported animal studies that demonstrated that an ointment made from the bark of this tree was effective without any toxic effects. They used the same ointment in 6 cases of lower extremity wounds. Healing was observed in all wounds. The study was not controlled, the findings are presented here as case studies. Further studies are planned to develop a wound healing ointment from a locally available and inexpensive plant.

  13. Preliminary clinical and radiographic results of large ceramic heads on highly cross-linked polyethylene.

    Science.gov (United States)

    Meftah, Morteza; Ebrahimpour, Prouskeh Bruce; He, Chuan; Ranawat, Amar S; Ranawat, Chitranjan S

    2011-06-14

    Data are limited regarding large ceramic femoral heads with highly cross-linked polyethylene. We hypothesized that large ceramic head articulation with highly cross-linked polyethylene is safe with a low wear rate, comparable to metal-on-highly cross-linked polyethylene.The study group comprised 63 patients (72 hips) who had undergone total hip replacement (THR) with ceramic-on-highly cross-linked polyethylene between April 2006 and March 2007 with a minimum 2-year follow-up. Postoperative Western Ontario and Mc-Master Universities Arthritis Index (WOMAC) and Hospital for Special Surgery (HSS) scores were used for clinical assessment. Six-week and 2-year radiographs were analyzed by 2 independent observers using Roman 1.70 software. Twenty-six patients (29 hips) had 32-mm and 37 patients (43 hips) had 36-mm Biolox delta ceramic femoral heads (Ceramtec, Plochingen, Germany). Mean patient age was 60.9 ± 8.9 years, and mean follow-up was 2.9 ± 0.5 years. Mean postoperative WOMAC and HSS hip scores were 30.4 and 36.6, respectively. Mean wear at 1 and 2 years postoperatively was 0.06 ± 0.28 and 0.006 ± 0.12 mm/yr for all hips, respectively. Mean wear at 1 and 2 years postoperatively for the 32-mm femoral head was 0.063 ± 0.278 and 0.007 ± 0.126 mm/yr, respectively, and for the 36-mm femoral head was 0.057 ± 0.292 and 0.006 ± 0.118 mm/yr, respectively. No patient had any clinical complications, such as reoperation, infection, fractures, or radiographic evidence of osteolysis or loosening. The early results of THR with large ceramic heads demonstrate high safety and efficacy. Our data with 2-year follow-up show low wear rates, similar to published data for metal-on-highly cross-linked polyethylene.

  14. Preliminary analysis of a clinical trial for threedimensional conformal radiation therapy after conservative surgery

    Institute of Scientific and Technical Information of China (English)

    Hui Yao; Jinlan Gong; Li Li; Yun Wang; Xiaofeng Wu; Kezhu Hou

    2012-01-01

    Objective: The aim of this study was to evaluate the efficacy, complications and cosmetic results of three-dimensional conformal radiation therapy for early breast cancer after conservative surgery. Methods: Among 80 patients, 44 were treated by modified radical mastectomy followed by adjuvant radiotherapy (modified radical mastectomy, MMT), 36 were treated with breast conservative surgery with adjuvant irradiation [breast-conservation therapy (BCT)]. Tangential fields were used to deliver 6 MV X-ray beams to a total dose of 50 Gy. Another 16 Gy was added to the tumor bed with 6-9 MeV electron beams for BCT. Results: In MMT group, the local control, metastasis-free and death were 41, 41 and 1 respectively; in BCT group, the local control, metastasis-free and death were 35, 35 and 0. The difference of the above two indicators between the two groups showeed no statistical insignificance (P > 0. 05). In MMT group, 32 patients suffer radiation dermatitis above 2-level, 12 patients suffer radiation pneumonia, and 10 patients suffer edema of illness-side upper extremity; in BCT group, the above indicators were only 6, 2 and 1 respectively. Three months, six months and one year after radiation therapy, 90%, 92% and 95% patients were assessed as excellence in fine cosmetic state in BCT group. Conclusion: The effects of threedimensional conformal radiation therapy after conservative surgery are the same as that of modified radical mastectomy, while the former has better cosmetic results and lower radiation therapy induced complications.

  15. Cortisol and cortisone ratio in urine: LC-MS/MS method validation and preliminary clinical application.

    Science.gov (United States)

    Antonelli, Giorgia; Artusi, Carlo; Marinova, Mariela; Brugnolo, Laura; Zaninotto, Martina; Scaroni, Carla; Gatti, Rosalba; Mantero, Franco; Plebani, Mario

    2014-02-01

    The determination of urinary cortisol/cortisone ratio is of clinical utility in cases of Cushing's syndrome, apparent mineralocorticoid excess, and also provides information on 11β-hydroxysteroid dehydrogenase (11β-HSD) type 2 activity. It is therefore of utmost importance to ensure accurate cortisol and cortisone measurement and establish appropriate reference ranges. After the isotopic dilution of urine, sample cleanups were obtained with on-line solid-phase extraction and cortisol and cortisone, separated using a Zorbax Eclipse XDB-C18 HPLC analytical column, were analyzed by tandem mass spectrometry with an electrospray ionization source in positive ion mode operation. The method was linear, with concentrations of up to 625 and 1125 nmol/L and lower limit of quantitation (LLOQ) of 5 and 6 nmol/L, for cortisol and cortisone, respectively. Within-run and between-run coefficients of variation were cortisone, respectively. No ion suppression was observed. The non-parametric reference range for the cortisol/cortisone ratio was 0.14-1.09. A simple and sensitive liquid chromatography tandem mass spectrometry method was developed and validated for the measurement of cortisol and cortisone in urine. Our findings indicate that the proposed analytical method is suitable for routine purposes and useful in many pathological conditions.

  16. The opinion of post graduate students on objective structured clinical examination in Anaesthesiology: A preliminary report

    Directory of Open Access Journals (Sweden)

    Parul Jindal

    2016-01-01

    Full Text Available Background and Aims: The scenario in medical education is changing with objective structured clinical examination (OSCE being introduced as an assessment tool. Its successful implementation in anaesthesiology postgraduate evaluation process is still limited. We decided to to evaluate the effectiveness of OSCE and compare it to conventional examinations as formative assessment tools in anaesthesiology. Methods: We conducted a cross-sectional comparative study in defined population of anaesthesiology postgraduate students to evaluate the effectiveness of OSCE as compared to conventional examination as formative assessment tool in anaesthesiology. Thirty-five students appeared for the conventional examination on the 1st day and viva voce on the 2nd day and OSCE on the last day. At the conclusion of the assessment, all the students were asked to respond to the perception evaluation questionnaire. We analysed the perception of OSCE among the students. Results: Results showed a positive perception of the objective structured physical examination (OSCE as well as structured 9 (25.7%, fair 19 (54.2% and unbiased 13 (37.1% with more standardised scoring 9 (25.7%. The students perceived OSCE to be less stressful than other examination. Thirty-one (88.5% students agreed that OSCE is easier to pass than conventional method and 29 (82.5% commented that the degree of emotional stress is less in OSCE than traditional methods. Conclusion: OSCE is better evaluation tool when compared to conventional examination.

  17. Factors associated with medical student test anxiety in objective structured clinical examinations: a preliminary study

    Science.gov (United States)

    2016-01-01

    Objectives To investigate attributes of medical students associated with their test anxiety on Objective Structured Clinical Examinations (OSCEs). Methods A cross-sectional study using a self-administered questionnaire was conducted of all Year 3 and 4 students at a private medical school in South Korea in 2014. This 53-item questionnaire consisted of factors pertaining to test anxiety on the OSCE identified from a review of relevant literature, which included students’ motivational beliefs and achievement emotions, perceived values of the OSCE, and attitude and orientation towards patients. Participants’ test anxiety levels were measured using the Korean Achievement Emotions Questionnaire. Participants rated their responses using a five-point Likert-type scale. Univariate analysis was performed to examine relationships between the variables. Results A total of 94 students completed the questionnaire (a 93% response rate). No differences in the participants’ test anxiety scores were observed across genders, entry-levels, or years in medical school. Participants’ test anxiety on the OSCE showed moderate association with their class-related achievement emotions (i.e., anxiety and boredom), where r = 0.46 and 0.32, p OSCE (r = -0.21, p OSCE. These findings have implications for developing effective educational interventions for helping students cope with such a stress by enhancing our understanding of the various factors that influence their test anxiety in OSCEs. PMID:28035056

  18. Clinical implications and applications of the twinkling sign in ureteral calculus: a preliminary study.

    Science.gov (United States)

    Sharma, Gyanendra; Sharma, Anshu

    2013-06-01

    Twinkling is an artifact seen on color Doppler ultrasound as a rapidly changing mixture of red and blue behind a stationary echogenic structure. We studied the presence or absence of this artifact in ureteral calculi detected on ultrasound and correlated it with clinical parameters. We evaluated 284 ureteral calculi seen on color Doppler ultrasound. The twinkling artifact was graded as 0 to 2 and correlated with the presence or absence of pain, symptom duration, degree of hydronephrosis and passage of a Glidewire® guidewire across the ureteral calculus during ureterorenoscopy. The presence or absence of twinkling was not associated with the degree of hydronephrosis. Twinkling was absent in 92% of patients with significant pain and grade 2 twinkling was seen in 69.5% without significant pain. Twinkling was dominantly absent in patients with a recent colic episode, while 77% who presented 2 to 15 days after a colic episode had grade 2 twinkling. The guidewire was difficult to pass in cases with absent twinkling compared to those with grade 2 twinkling, in which the guidewire and ureteral catheter crossed the calculus easily. Absent twinkling is associated with significant pain, a recent colic episode and difficult guidewire passage across the calculus. These findings suggest that absent twinkling implies significant obstruction, while its presence indicates no significant obstruction. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  19. Reconstruction of intraoral defects with superior labial artery musculo-mucosal flap: a preliminary clinical study.

    Science.gov (United States)

    Güven, Erdem; Uğurlu, Alper Mete; Başaran, Karaca; Basat, Salih Onur; Yiğit, Bariş; Hafiz, Günter; Kuvat, Samet Vasfi

    2010-01-01

    In this article, we present the use of the superior labial artery musculo-mucosal (SLAMM) flap for intraoral reconstruction. The study included five patients (2 females, 3 males; mean age 36 years; range 11 to 56 years) who consulted at our clinic between October 2008 and January 2010. Five oral defects were reconstructed with the SLAMM flap. Three patients underwent reconstruction with SLAMM flap following oncologic resection. The other two patients had traumatic defects in the oral cavity which necessitated flap application. First, the distal end of the flap was incised and the superior labial artery was identified after dissection. After ligation of the artery, the mucosa, submucosa and the cuff of orbicularis oris muscle were elevated. The dissection was extended laterally and anteriorly, depending on the necessary flap size. None of the patients had partial or total flap necrosis. During the follow-up period, contracture developed in only one patient. Successful reconstruction was observed in all patients. The superior labial artery musculo-mucosal flap is a simple and feasible technique which can be used for reconstruction of intraoral defects.

  20. Factors associated with medical student test anxiety in objective structured clinical examinations: a preliminary study.

    Science.gov (United States)

    Kim, Kyong-Jee

    2016-12-29

    To investigate attributes of medical students associated with their test anxiety on Objective Structured Clinical Examinations (OSCEs). A cross-sectional study using a self-administered questionnaire was conducted of all Year 3 and 4 students at a private medical school in South Korea in 2014. This 53-item questionnaire consisted of factors pertaining to test anxiety on the OSCE identified from a review of relevant literature, which included students' motivational beliefs and achievement emotions, perceived values of the OSCE, and attitude and orientation towards patients. Participants' test anxiety levels were measured using the Korean Achievement Emotions Questionnaire. Participants rated their responses using a five-point Likert-type scale. Univariate analysis was performed to examine relationships between the variables. A total of 94 students completed the questionnaire (a 93% response rate). No differences in the participants' test anxiety scores were observed across genders, entry-levels, or years in medical school. Participants' test anxiety on the OSCE showed moderate association with their class-related achievement emotions (i.e., anxiety and boredom), where r = 0.46 and 0.32, p anxiety on the OSCE. These findings have implications for developing effective educational interventions for helping students cope with such a stress by enhancing our understanding of the various factors that influence their test anxiety in OSCEs.

  1. Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

    Institute of Scientific and Technical Information of China (English)

    LI Yong-dong; HAN Xin-wei; WU Gang; LI Ming-hua

    2007-01-01

    Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula (BSF). Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types (A and B) of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7(87.5%) of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple,safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. (J Intervent Radiol, 2007, 16: 253-257)[ Key words ] Fistula, pulmonary; Bronchialpleural fistula; Stents and prostheses; Computed tomography

  2. [The design of plantar pressure distribution monitoring system and preliminary clinical application].

    Science.gov (United States)

    Zhu, Xianfeng; Zhao, Zilei; Xu, Donghao; Xu, Dongming

    2014-04-01

    Plantar pressure distribution can reflect the force of several key points on foot while standing and walking. A comprehensive understanding of the plantar pressure distribution makes great sense in the following aspects: the understanding of the normal foot biomechanics and function, clinical diagnosis, measurement of disease extent, postoperative efficacy evaluation, and rehabilitation research. A simple plantar pressure measurement device was designed in this study. This paper uses FlexiForce flexible sensor to pickup plantar pressure signal and USB A/D board to do data acquisition. The data are transferred into a laptop and processed by a VB-based software which can display, remember and replay the data. We chose patients with hallux valgus and normal people to measure the pressure distribution and make contrast analysis of plantar pressure with this device. It can be concluded that people with hallux valgus have higher pressure on the second metatarsophalangeal joint and the distribution move outward. The plantar pressure of patients postoperative could be greatly improved compared to the preoperative. The function of this device has been confirmed.

  3. [Preliminary study on clinical application of robotic sacral hysteropexy in treatment of uterine prolapse].

    Science.gov (United States)

    Li, Xiuli; Zhou, Ning; Yang, Yizhuo; Liu, Zhongyu; Yao, Yuanqing

    2014-06-01

    To study the clinical efficacy of robotic sacral hysteropexy in treatment of uterine prolapse. From January 2012 to December 2013, 3 patients undergoing robotic sacral hysteropexy in treatment of uterine prolapse in General Hospital of People's Liberation Army were studied retrospectively. Operation time, blood loss and postoperative recovery exhaust time and pelvic organ prolapse quantification (POP-Q) staging were evaluated. Three patients were treated by robotic sacral hysteropexy successfully. The mean operation time was 221 minutes (210-240 minutes), mean blood loss was 45 ml. One case with II degree perineal laceration patients simultaneously perineal repair, neither intra-nor post-operative complications occurred. The mean postoperative recovery exhaust time was 16 hours. At three months of follow-up, all 3 patients got satisfaction. Although one patient at the first six months of postoperation had leakage of urine when coughing, instruct exercise pelvic floor muscle function and acupuncture one month their symptoms disappear. Robotic sacral hysteropexy pave the way for an effective option in the management of uterine prolapse.

  4. A Structured Clinical Interview for Kleptomania (SCI-K): preliminary validity and reliability testing.

    Science.gov (United States)

    Grant, Jon E; Kim, Suck Won; McCabe, James S

    2006-06-01

    Kleptomania presents difficulties in diagnosis for clinicians. This study aimed to develop and test a DSM-IV-based diagnostic instrument for kleptomania. To assess for current kleptomania the Structured Clinical Interview for Kleptomania (SCI-K) was administered to 112 consecutive subjects requesting psychiatric outpatient treatment for a variety of disorders. Reliability and validity were determined. Classification accuracy was examined using the longitudinal course of illness. The SCI-K demonstrated excellent test-retest (Phi coefficient = 0.956 (95% CI = 0.937, 0.970)) and inter-rater reliability (phi coefficient = 0.718 (95% CI = 0.506, 0.848)) in the diagnosis of kleptomania. Concurrent validity was observed with a self-report measure using DSM-IV kleptomania criteria (phi coefficient = 0.769 (95% CI = 0.653, 0.850)). Discriminant validity was observed with a measure of depression (point biserial coefficient = -0.020 (95% CI = -0.205, 0.166)). The SCI-K demonstrated both high sensitivity and specificity based on longitudinal assessment. The SCI-K demonstrated excellent reliability and validity in diagnosing kleptomania in subjects presenting with various psychiatric problems. These findings require replication in larger groups, including non-psychiatric populations, to examine their generalizability. Copyright (c) 2006 John Wiley & Sons, Ltd.

  5. Clinical utility of the Multiple Errands Test in schizophrenia: A preliminary assessment.

    Science.gov (United States)

    Bulzacka, Ewa; Delourme, Gwenaëlle; Hutin, Valérie; Burban, Nathalie; Méary, Alexandre; Lajnef, Mohamed; Leboyer, Marion; Schürhoff, Franck

    2016-06-30

    Schizophrenia (SZ) is a chronic, severe disease, which results in misperception of reality, major social withdrawal, and cognitive disturbances. One type of cognitive disturbance, known as executive dysfunction, is widely considered as a primary determinant of functional outcome. However, classic neuropsychological measures of executive functioning (EF) poorly represent patients' functional outcome, and thus seem inappropriate for evaluating the real-world functional impact of diseases such as SZ. We hypothesized that the Multiple Errands Test (MET), an ecological assessment of executive function would show greater ability to measure everyday adaptive functioning SZ, compared to conventional EF assessment methods. 100 clinically stable SZ patients were administered the MET, Wisconsin Card Sorting Test - 64 and a paper version of MET. Correlation analyses were performed between each EF measure and functional outcome, as measured by the Social Autonomy Scale (SAS). After adjusting for age, education, IQ and illness duration, SAS was significantly predicted by MET global score. No other EF measure correlated with SAS. Results from this study suggest that MET offers a valuable prediction of daily life functional outcome in this large sample of SZ patients. Therefore, it could be used as a complementary measure to improve the identification of executive dysfunctions prior to psychosocial interventions.

  6. Preliminary Clinical Studies Using A Self Scanning Lineak Diode Array To Obtain 1024 X 1024 Digital Radiographs

    Science.gov (United States)

    Sashin, Donald; Slasky, B. Simon; Sternglass, Ernest J.; Bron, Klaus M.; Herron, John M.; Kennedy, William H.; Boyer, Joseph W.; Girdany, Bertram R.; Simpson, Raymond W.; Horton, Joseph A.

    1984-08-01

    A digital radiography system using self scanning linear diode arrays is being developed for improved diagnosis at reduced radiation dose. Our technique is based on the use of solid state sensors with 1024 diodes per inch and with very high dynamic range. The slit geometry of our method results in image improvement and dose reduction by efficiently rejecting scattered x-rays in the patient. In our present configuration the images have a field of view of six inches by six inches or 6 inches by 12 inches and are digitized to 1024 x 1024 pixels with 12 bits. This digital system differs from the conventional digital radiography in that no image intensifier TV fluoroscopy chain is required. Preliminary clinical studies have demonstrated the high detail of our system at low radiation levels. In dog studies the system has clearly visualized very small coronary arteries following aortic root injection of contrast material. Even with intravenous injections some of the coronary arteries could be seen.

  7. Control of clinical paratuberculosis in New Zealand pastoral livestock.

    Science.gov (United States)

    Gautam, M; Ridler, A; Wilson, P R; Heuer, C

    2017-09-17

    This review summarises current control measures for clinical paratuberculosis (Johne's disease; JD) in New Zealand pastoral livestock. Most New Zealand sheep, deer, beef and dairy cattle herds and flocks are infected by Mycobacterium avium ssp. paratuberculosis (Map). Dairy cattle and deer are mostly infected with bovine (Type II), and sheep and beef cattle with ovine (Type I) strains. Control in all industries is voluntary. While control in sheep and beef cattle is ad hoc, the dairy and deer industries have developed resources to assist development of farm-specific programmes. The primary target for all livestock is reduction of the incidence rate of clinical disease rather than bacterial eradication per se. For dairy farms, a nationally instituted JD-specific programme provides guidelines for risk management, monitoring and testing clinically suspect animals. While there is no formal programme for sheep farms, for those with annual prevalences of clinical disease >2%, especially fine wool breeds, vaccination may be a cost effective control option. The deer industry proactively monitors infection by a national abattoir surveillance programme and farmers with an apparent high disease incidence are encouraged to engage with a national network of trained consultants for management and control advice. Evaluation of the biological and economic effectiveness of control in all industries remains to be undertaken. Nevertheless, opportunities exist for farmers who perceive significant JD problems in their herds/flocks to participate in systematic best-practice activities that are likely to reduce the number of clinical infections with Map on their farms and therefore the overall prevalence of JD in New Zealand's farming industries.

  8. Safety and preliminary immunogenicity of Cuban pneumococcal conjugate vaccine candidate in healthy children: a randomized phase I clinical trial.

    Science.gov (United States)

    Dotres, Carlos P; Puga, Rinaldo; Ricardo, Yariset; Broño, Carmen R; Paredes, Beatriz; Echemendía, Vladimir; Rosell, Sandra; González, Nadezhda; García-Rivera, Dagmar; Valdés, Yury; Goldblatt, David; Vérez-Bencomo, Vicente

    2014-09-15

    A new heptavalent conjugate vaccine (PCV7-TT) is under development in Cuba. PCV7-TT contains 2 μg of serotypes 1, 5, 14, 18C, 19F, 23F and 4 μg of 6B, each one conjugated to tetanus toxoid (TT). This vaccine was designed with the serotypes that cause most invasive pneumococcal diseases (IPD) worldwide. In the present study, we investigated the safety and explored the immunogenicity of PCV7-TT during a controlled, randomized and double blind clinical trial phase I in 4-5-year-old children. PCV7-TT was well tolerated and as safe as Synflorix used as control vaccine. Following a single-dose vaccination, all individual serotypes included in PCV7-TT induced statistically significant increase of IgG GMC and OPA GMT. These are the first clinical results of PCV7-TT in children and they pave the way toward next clinical trials in children and infants. This clinical trial was published in the Cuban Public Register of Clinical Trials with code RPCEC00000173.

  9. Use of thermographic imaging in clinical diagnosis of small animal: preliminary notes

    Directory of Open Access Journals (Sweden)

    Veronica Redaelli

    2014-06-01

    Full Text Available INTRODUCTION. The authors, after a description of the physics of infrared thermographic technique (IRT, analyze the reading of images and the main applications in the veterinary field, compared to the existing literature on the subject and to their experimental researches. IRT lends itself to countless applications in biology, thanks to its characteristics of versatility, lack of invasiveness and high sensitivity. Probably the major limitation to its application in the animal lies in the ease of use and in its extreme sensitivity. MATERIALS AND METHODS. From September 2009 to October 2010, the experimental investigation with the thermo camera took into consideration 110 animals (92 dogs and 18 cats, without any selection criteria. All patients were brought to the Faculty of Veterinary Medicine in Milan University by the owner, to be examined by a specialist, or to undergo one of the following diagnostic procedures: X-rays, computed tomography, or ultrasound examinations; finally some patients were brought in for surgical procedures. With the consent of the owner, 1 to 10 thermographic images were recorded from each clinical case. Results. In this first experimental investigation, thermography has shown a high sensitivity (100%, but a low specificity (44%. This figure excludes the use of thermal imaging technology to replace other imaging techniques such as radiography, computed tomography and magnetic resonance imaging. Furthermore, it does not show any ability to recognize the etiology of the disease, but only the thermal alteration, and this is restricting its use. However, this experimental study has demonstrated that thermography can be used in veterinary medicine, and specifically in dogs and cats. It is hoped that in the field of targeted diseases this technique will become an important tool for diagnostic purposes by using working protocols validated and repeatable.

  10. Adaptive clutter rejection for 3D color Doppler imaging: preliminary clinical study.

    Science.gov (United States)

    Yoo, Yang Mo; Sikdar, Siddhartha; Karadayi, Kerem; Kolokythas, Orpheus; Kim, Yongmin

    2008-08-01

    In three-dimensional (3D) ultrasound color Doppler imaging (CDI), effective rejection of flash artifacts caused by tissue motion (clutter) is important for improving sensitivity in visualizing blood flow in vessels. Since clutter characteristics can vary significantly during volume acquisition, a clutter rejection technique that can adapt to the underlying clutter conditions is desirable for 3D CDI. We have previously developed an adaptive clutter rejection (ACR) method, in which an optimum filter is dynamically selected from a set of predesigned clutter filters based on the measured clutter characteristics. In this article, we evaluated the ACR method with 3D in vivo data acquired from 37 kidney transplant patients clinically indicated for a duplex ultrasound examination. We compared ACR against a conventional clutter rejection method, down-mixing (DM), using a commonly-used flow signal-to-clutter ratio (SCR) and a new metric called fractional residual clutter area (FRCA). The ACR method was more effective in removing the flash artifacts while providing higher sensitivity in detecting blood flow in the arcuate arteries and veins in the parenchyma of transplanted kidneys. ACR provided 3.4 dB improvement in SCR over the DM method (11.4 +/- 1.6 dB versus 8.0 +/- 2.0 dB, p < 0.001) and had lower average FRCA values compared with the DM method (0.006 +/- 0.003 versus 0.036 +/- 0.022, p < 0.001) for all study subjects. These results indicate that the new ACR method is useful for removing nonstationary tissue motion while improving the image quality for visualizing 3D vascular structure in 3D CDI.

  11. Preliminary Data from an Advanced Dementia Consult Service: Integrating Research, Education, and Clinical Expertise

    Science.gov (United States)

    Catic, Angela G.; Mitchell, Susan L.

    2013-01-01

    Hospitalized patients with advanced dementia often receive care that is of limited clinical benefit and inconsistent with preferences. We designed an Advanced Dementia Consult Service and conducted a pre and post pilot study to evaluate it in a Boston hospital. Consults were conducted by geriatricians and palliative care nurse practitioner. They consisted of structured consultation, counseling and provision of an information booklet to the family, and post-discharge follow-up with the family and primary care providers. Patients > 65 admitted with advanced dementia were identified and consults were solicited using pop-ups programmed into the computerized provider order entry (POE) system. In the initial 3-month period, patients received usual care (N=24). In the subsequent 3-month period, consults were provided to patients for whom it was requested (N=5). Data were obtained from the electronic medical record and proxies interviews (admission, 1-month post-discharge). The patients’ mean age in the combined sample (N=29) was 85.4, 58.6% were from nursing homes, and 86.2% of their proxies stated comfort was the goal of care. Nonetheless, their hospitalizations were characterized by high rates of intravenous antibiotics (86.2%), > 5 venipunctures (44.8%), and radiological exams (96.6%). Acknowledging the small sample size, there were trends towards better outcomes in the intervention group including: higher proxy knowledge of the disease, greater communication between proxies and providers, more advance care planning, lower re-hospitalization rates, and fewer feeding tube insertions after discharge. Targeted consultation for advanced dementia is feasible and may promote greater engagement of proxies and goal-directed care for patients after discharge. PMID:24219202

  12. Preliminary Clinical Observation of Arteriovenous Sheathotomy for Treatment of Branch Retinal Vein Occlusion

    Institute of Scientific and Technical Information of China (English)

    Lin Lu; Yonghao Li; Changxian Yi; Mei Li; Xiulan Lu; Jinglin Zhang

    2003-01-01

    Purpose: To document the anatomic and functional improvement of six patients withbranch retinal vein occlusion (BRVO) following successful arteriovenous adventitialsheathotomy (AAS).Methods: Retrospective study of 6 patients (6 eyes) with BRVO treated with AAS. Allpatients were not eligible for laser photocoagulation and had both macular edema andintraretinal hemorrhage. The visual acuity was in the range of 0.4 to 0.02. All patientsunderwent pars plana vitrectomy and AAS. The clinical improvement was determined byfundus photograph, fluorescein angiography (FAG), optical coherence tomography(OCT) and multifocal electroretinography (ERG). All patients were followedpostoperatively for an average of 20 months ranging from 12 to 24 months.Results: Sheathotomy and decompression of the arteriole/venule (A/V) crossing wereachieved in all 6 patients. 5 patients have improved their best-corrected visual acuity 4lines or more. The best one could reach to 1.0. One month after the operation, fundusphotograph and FAG demonstrated the resolution of intraretinal hemorrhage, reduction ofnon-perfusion area and apparent resolution of retinal venous dilation and tortuosity. OCTconfirmed remarkable reduction of retinal thickness. The microcysts at the foveadiminished. Multifocal ERG showed the recovery of the central peak at the macular andthe peripheral response density. However, capillary nonperfusion area andmicroaneurysm were found out by FAG in four patients at the points distal to thesheathotomy three months after the operation.Conclusions: Anatomic and functional improvement of retina can be achieved in patientswith BRV0 through AAS. However, the capillary nonperfusion and microaneurysm mayfollow this surgical procedure in some cases that need further treatment with laserphotocoagulation. The better visual improvement may be expected in the patients withearlier surgical intervention.

  13. Veterinary clinical research database for homeopathy: placebo-controlled trials.

    Science.gov (United States)

    Clausen, J; Albrecht, H; Mathie, R T

    2013-04-01

    Veterinary homeopathy has led a somewhat shadowy existence since its first introduction. Only in the last three decades has the number of clinical trials increased considerably. This literature is generally not well perceived, which may be partly a consequence of the diffuse and somewhat inaccessible nature of some of the relevant research publications. The Veterinary Clinical Research Database for Homeopathy (VetCR) was launched in 2006 to provide information on existing clinical research in veterinary homeopathy and to facilitate the preparation of systematic reviews. The aim of the present report is to provide an overview of this first database on clinical research in veterinary homeopathy, with a special focus on its content of placebo controlled clinical trials and summarising what is known about placebo effects in animals. In April 2012, the VetCR database contained 302 data records. Among these, 203 controlled trials were identified: 146 randomised and 57 non-randomised. In 97 of those 203 trials, the homeopathic medical intervention was compared to placebo. A program of formal systematic reviews of peer-reviewed randomised controlled trials in veterinary homeopathy is now underway; detailed findings from the program's data extraction and appraisal approach, including the assessment of trial quality (risk of bias), will be reported in due course. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Sodium alginate as an ideal submucosal injection material for endoscopic submucosal resection: preliminary experimental and clinical study.

    Science.gov (United States)

    Akagi, Tomonori; Yasuda, Kazuhiro; Tajima, Masaaki; Suzuki, Kosuke; Inomata, Masafumi; Shiraishi, Norio; Sato, Yuhki; Kitano, Seigo

    2011-11-01

    Sodium alginate is used clinically in the treatment of peptic ulcer disease. Because of its viscosity, sodium alginate could possibly become a new submucosal injection material for use in endoscopic resection. We evaluated the feasibility of endoscopic submucosal dissection (ESD) using sodium alginate. The lesion-lifting properties of sodium alginate were examined in porcine stomachs and were compared with those of normal saline solution and sodium hyaluronate solution. After confirming the proper concentration of sodium alginate, ESD using sodium alginate was performed in 11 patients with gastric mucosal cancer or adenoma. The lesion-lifting properties of sodium alginate and clinical outcomes were assessed. The thickness of the submucosal elevation created by 3% sodium alginate in porcine stomach was equivalent to that of sodium hyaluronate. ESD using sodium alginate was completed successfully in all patients without adverse effects except in 1 patient in whom transient shrinkage of the gastric wall disappeared spontaneously after approximately 30 minutes. The mean tumor size was 15.3 mm. En bloc resection and a negative resection margin were obtained in all. Histopathologic examination revealed that all tumors were confined to the mucosal layer except for 1 that was confined to the submucosal layer without lymphovascular invasion, and there were no adverse effects such as tissue damage. No patient required additional treatment, and none showed recurrence during a median follow-up period of 28 months. Small sample size. This preliminary study suggests that sodium alginate might be a novel, safe submucosal injection material for use in endoscopic resection. Further investigation of the properties of sodium alginate is warranted. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  15. An assistive controller for a lower-limb exoskeleton for rehabilitation after stroke, and preliminary assessment thereof.

    Science.gov (United States)

    Murray, Spencer A; Ha, Kevin H; Goldfarb, Michael

    2014-01-01

    This paper describes a novel controller, intended for use in a lower-limb exoskeleton, to aid gait rehabilitation in patients with hemiparesis after stroke. The controller makes use of gravity compensation, feedforward movement assistance, and reinforcement of isometric joint torques to achieve assistance without dictating the spatiotemporal nature of joint movement. The patient is allowed to self-select walking speed and is able to make trajectory adaptations to maintain balance without interference from the controller. The governing equations and the finite state machine which comprise the system are described herein. The control architecture was implemented in a lower-limb exoskeleton and a preliminary experimental assessment was conducted in which a patient with hemiparesis resulting from stroke walked with assistance from the exoskeleton. The patient exhibited improvements in fast gait speed, step length asymmetry, and stride length in each session, as measured before and after exoskeleton training, presumably as a result of using the exoskeleton.

  16. Dynamic pelvic floor MR imaging at 3 T in patients with clinical signs of urinary incontinence-preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Morakkabati-Spitz, Nuschin; Willinek, Winfried A.; Traeber, Frank; Jaeger, Ursula; Schild, Hans H. [University of Bonn, Department of Radiology, Bonn (Germany); Gieseke, Juergen [University of Bonn, Department of Radiology, Bonn (Germany); Philips Medical Systems, Best (Netherlands); Bastian, Patrick J. [University of Munich, Department of Urology, Munich (Germany); Schmitz, Bettina; Mueller, Stefan C. [University of Bonn, Department of Urology, Bonn (Germany)

    2008-11-15

    To prospectively evaluate feasibility, image quality and diagnostic accuracy of dynamic MR imaging the pelvic floor at 3.0 T in patients with urinary incontinence and to compare these results with those of MRI performed at 1.5 T. Ten patients with the diagnosis of urinary incontinence (clinical symptoms, clinical examination, pelvic ultrasound) were examined with a dynamic balanced FFE (B-FFE) sequence at 1.5 T and 3.0 T on the same day in a randomized order. Spatial (1.5 x 1.5 x 8 mm) and temporal (0.44 s) resolution at 3.0 T were comparable to the 1.5-T B-FFE sequence. Two radiologists assessed visual signal to noise (three-point scale), artefact level (five-point scale) and final MR diagnoses with regard to pelvic floor weakness (independent analysis). The diagnoses obtained at 1.5-T field strength and the results of the clinical tests served as standard of reference. In addition, ROI-based quantitative measurements were performed to assess different tissue contrasts at both field strengths. Data were analyzed for statistical differences by using the Wilcoxon's matched pairs test and the marginal homogeneity test. Visual signal to noise was rated higher at 3.0 T for all ten studies by both radiologists. With regard to artefact level, there was no statistically significant difference between the studies obtained at 3.0 T as compared to the corresponding 1.5-T studies (marginal homogeneity test: p = 0.18 for reviewer 1 and 0.41 for reviewer 2). Mean artefact level was rated minor to moderate by both reviewers for both field strengths (excellent interobserver agreement with Kendall-W value of 0.973). Except for a higher tissue contrast between fat and urethra at 1.5 T, there were no statistically significant differences between tissue contrast at 1.5 T as compared to 3.0 T (Wilcoxon's test). Final MR diagnoses regarding pelvic floor weakness did not differ between 3.0-T and 1.5-T field strength and correlated well with the results of the clinical tests

  17. Franklin, Lavoisier, and Mesmer: origin of the controlled clinical trial.

    Science.gov (United States)

    Herr, Harry W

    2005-01-01

    In 1784, a Royal Commission headed by Benjamin Franklin and Antoine Lavoisier designed a series of ingenious experiments to debunk France's greatest medical rogue, Anton Mesmer, and his bizarre healing of illnesses based on his bogus theory of animal magnetism. Using intentional subject ignorance and sham interventions to investigate mesmerism, Franklin's commission provided a model for the controlled clinical trial.

  18. Amalgam and ART restorations in children: a controlled clinical trial

    NARCIS (Netherlands)

    Amorim, R.G. de; Leal, S.C.; Mulder, J.; Creugers, N.H.J.; Frencken, J.E.F.M.

    2014-01-01

    OBJECTIVES: The aims of this study were to compare 2-year cumulative survival rates of amalgam and atraumatic restorative treatment (ART) restorations in primary molars and to investigate the determinants of the survival rate of restorations. MATERIALS AND METHODS: A controlled clinical trial using

  19. 3D–2D registration in mobile radiographs: algorithm development and preliminary clinical evaluation.

    Science.gov (United States)

    Otake, Yoshito; Wang, Adam S; Uneri, Ali; Kleinszig, Gerhard; Vogt, Sebastian; Aygun, Nafi; Lo, Sheng-fu L; Wolinsky, Jean-Paul; Gokaslan, Ziya L; Siewerdsen, Jeffrey H

    2015-03-07

    An image-based 3D-2D registration method is presented using radiographs acquired in the uncalibrated, unconstrained geometry of mobile radiography. The approach extends a previous method for six degree-of-freedom (DOF) registration in C-arm fluoroscopy (namely 'LevelCheck') to solve the 9-DOF estimate of geometry in which the position of the source and detector are unconstrained. The method was implemented using a gradient correlation similarity metric and stochastic derivative-free optimization on a GPU. Development and evaluation were conducted in three steps. First, simulation studies were performed that involved a CT scan of an anthropomorphic body phantom and 1000 randomly generated digitally reconstructed radiographs in posterior-anterior and lateral views. A median projection distance error (PDE) of 0.007 mm was achieved with 9-DOF registration compared to 0.767 mm for 6-DOF. Second, cadaver studies were conducted using mobile radiographs acquired in three anatomical regions (thorax, abdomen and pelvis) and three levels of source-detector distance (~800, ~1000 and ~1200 mm). The 9-DOF method achieved a median PDE of 0.49 mm (compared to 2.53 mm for the 6-DOF method) and demonstrated robustness in the unconstrained imaging geometry. Finally, a retrospective clinical study was conducted with intraoperative radiographs of the spine exhibiting real anatomical deformation and image content mismatch (e.g. interventional devices in the radiograph that were not in the CT), demonstrating a PDE = 1.1 mm for the 9-DOF approach. Average computation time was 48.5 s, involving 687 701 function evaluations on average, compared to 18.2 s for the 6-DOF method. Despite the greater computational load, the 9-DOF method may offer a valuable tool for target localization (e.g. decision support in level counting) as well as safety and quality assurance checks at the conclusion of a procedure (e.g. overlay of planning data on the radiograph for verification of the surgical product

  20. 3D-2D registration in mobile radiographs: algorithm development and preliminary clinical evaluation

    Science.gov (United States)

    Otake, Yoshito; Wang, Adam S.; Uneri, Ali; Kleinszig, Gerhard; Vogt, Sebastian; Aygun, Nafi; Lo, Sheng-fu L.; Wolinsky, Jean-Paul; Gokaslan, Ziya L.; Siewerdsen, Jeffrey H.

    2015-03-01

    An image-based 3D-2D registration method is presented using radiographs acquired in the uncalibrated, unconstrained geometry of mobile radiography. The approach extends a previous method for six degree-of-freedom (DOF) registration in C-arm fluoroscopy (namely ‘LevelCheck’) to solve the 9-DOF estimate of geometry in which the position of the source and detector are unconstrained. The method was implemented using a gradient correlation similarity metric and stochastic derivative-free optimization on a GPU. Development and evaluation were conducted in three steps. First, simulation studies were performed that involved a CT scan of an anthropomorphic body phantom and 1000 randomly generated digitally reconstructed radiographs in posterior-anterior and lateral views. A median projection distance error (PDE) of 0.007 mm was achieved with 9-DOF registration compared to 0.767 mm for 6-DOF. Second, cadaver studies were conducted using mobile radiographs acquired in three anatomical regions (thorax, abdomen and pelvis) and three levels of source-detector distance (~800, ~1000 and ~1200 mm). The 9-DOF method achieved a median PDE of 0.49 mm (compared to 2.53 mm for the 6-DOF method) and demonstrated robustness in the unconstrained imaging geometry. Finally, a retrospective clinical study was conducted with intraoperative radiographs of the spine exhibiting real anatomical deformation and image content mismatch (e.g. interventional devices in the radiograph that were not in the CT), demonstrating a PDE = 1.1 mm for the 9-DOF approach. Average computation time was 48.5 s, involving 687 701 function evaluations on average, compared to 18.2 s for the 6-DOF method. Despite the greater computational load, the 9-DOF method may offer a valuable tool for target localization (e.g. decision support in level counting) as well as safety and quality assurance checks at the conclusion of a procedure (e.g. overlay of planning data on the radiograph for verification of

  1. Simultaneous PET/MR head–neck cancer imaging: Preliminary clinical experience and multiparametric evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Covello, M., E-mail: echoplanare@gmail.com [IRCCS SDN, Via E. Gianturco, 111-113 – 80143, Naples (Italy); Cavaliere, C.; Aiello, M.; Cianelli, M.S. [IRCCS SDN, Via E. Gianturco, 111-113 – 80143, Naples (Italy); Mesolella, M.; Iorio, B. [Department of Otorhinolaryngoiatry, Federico II University, Naples (Italy); Rossi, A.; Nicolai, E. [IRCCS SDN, Via E. Gianturco, 111-113 – 80143, Naples (Italy)

    2015-07-15

    Highlights: • Simultaneous PET/MRI is a suitable tool for head/neck T-staging. • No significant differences have been found for PET measures get by both PET/CT and PET/MRI. • SUV 2D and 3D measures in HN lesion offer comparable estimations. • Multiparametric evaluation allows a complete characterization of HN lesions. - Abstract: Purpose: To evaluate the role of simultaneous hybrid PET/MR imaging and to correlate metabolic PET data with morpho-functional parameters derived by MRI in patients with head–neck cancer. Methods: Forty-four patients, with histologically confirmed head and neck malignancy (22 primary tumors and 22 follow-up) were studied. Patients initially received a clinical exam and endoscopy with direct biopsy. Next patients underwent whole body PET/CT followed by PET/MR of the head/neck region. PET and MRI studies were separately evaluated by two blinded groups (both included one radiologist and one nuclear physician) in order to define the presence or absence of lesions/recurrences. Regions of interest (ROIs) analysis was conducted on the primary lesion at the level of maximum size on metabolic (SUV and MTV), diffusion (ADC) and perfusion (K{sup trans}, V{sub e}, k{sub ep} and iAUC) parameters. Results: PET/MR examinations were successfully performed on all 44 patients. Agreement between the two blinded groups was found in anatomic allocation of lesions by PET/MR (Primary tumors: Cohen's kappa 0.93; Follow-up: Cohen's kappa 0.89). There was a significant correlation between CT-SUV measures and MR (e.g., CT-SUV VOI vs. MR-SUV VOI: ρ = 0.97, p < 0.001 for the entire sample). There was also significant positive correlations between the ROI area, SUV measures, and the metabolic parameters (SUV and MTV) obtained during both PET/CT and PET/MR. A significant negative correlation was observed between ADC and K{sup trans} values in the primary tumors. In addition, a significant negative correlation existed between MR SUV and ADC in

  2. 遥控推注机器臂辅助下椎体成形术对避免术者放射线暴露的临床评价%Preliminary clinical evaluation of a remote controlled injection manipulator system in preventing radiation exposure to the operator during vertebroplasty

    Institute of Scientific and Technical Information of China (English)

    阎峻; 杨志平; 郑燕平; 李昕; 李振峰; 杨强; 李建民

    2014-01-01

    目的:引入一种新型的可远程操作的骨水泥推注机器臂,初步评价在其辅助下的椎体成形术治疗脊柱转移瘤的临床应用价值。方法对2012年7至2013年6月,我科收治的20例脊柱转移瘤患者的30个病变椎体行椎体成形术,其中手动组10例(16个椎体),行传统椎体成形术;机器臂推注(RCIM)组10例(14个椎体),在可遥控操作的骨水泥推注机器臂辅助下完成。RCIM组整个骨水泥推注过程中,通过术中X线透视全程监控,术者远离手术野,在屏蔽保护下完成遥控操作,从而免受放射线照射。手术前后采用视觉模拟评分(visualanaloguescale,VAS)评价所有患者疼痛程度,同时利用放射线测量仪测量患者和术者放射线暴露剂量。结果手动组术前、术后VAS评分分别为8.3±1.0和4.6±0.9,改善明显,差异有统计学意义(P=0.000);RCIM组术前、术后VAS评分分别为7.6±1.1和4.1±0.8,改善明显,差异有统计学意义(P=0.000)。术前、术后VAS评分,组间差异无统计学意义(P>0.05)。手动组和RCIM组患者放射线暴露剂量分别为(32.4±12.1)uSv和(35.1±11.7)uSv,差异无统计学意义(P>0.05);而两组术者在术中的放射线暴露剂量分别为(28.9±15.2)uSv和(0.29±0.014)uSv,手动组放射线暴露量显著高于RCIM组,差异有统计学意义(P<0.05)。结论与传统椎体成形术的操作不同,机器臂辅助下的椎体成形术使术者在进行骨水泥推注时,完全免受放射线的伤害;与此同时,通过术中X线透视全程监控,理论上亦相对增加了骨水泥推注过程的安全性。%Objective To preliminarily assess the clinical application value of a novel remote controlled injection manipulator ( RCIM ) system in preventing radiation exposure to the operator during vertebroplasty for the patients with spinal metastases. Methods From June 2012 to July 2013, 20 patients ( 30 vertebral bodies

  3. Optical guidance for stereotactic brain tumor biopsy procedures: preliminary clinical evaluation (Conference Presentation)

    Science.gov (United States)

    Haj-Hosseini, Neda; Richter, Johan; Milos, Peter; Hallbeck, Martin; Wârdell, Karin

    2017-02-01

    In the routine of stereotactic biopsy on suspected tumors located deep in the brain or patients with multiple lesions, tissue samples are harvested to determine the type of malignancy. Biopsies are taken from pre-calculated positions based on the preoperative radiologic images susceptible to brain shift. In such cases the biopsy procedure may need to be repeated leading to a longer operation time. To provide guidance for targeting diagnostic tumor tissue and to avoid vessel rupture on the insertion path of the tumor, an application specific fiber optic probe was developed. The setup incorporated spectroscopy for 5-aminolevulinic acid induced protopophyrin IX (PpIX) fluorescence in the tumor and laser Doppler for measuring microvascular blood flow which recorded backscattered light (TLI) at 780 nm and blood perfusion. The recorded signals were compared to the histopathologic diagnosis of the tissue samples (n=16) and to the preoperative radiologic images. All together 146 fluorescence and 276 laser Doppler signals were recorded along 5 trajectories in 4 patients. On all occasions strong PpIX fluorescence peaks were visible during real-time guidance. Comparing the gliotic tumor marginal zone with the tumor, the PpIX (51 vs. 528 a.u., [0-1790], p 0.05) and blood perfusion (8.3 vs. 17 a.u., [0-254], p > 0.05) were not significantly different. In conclusion, the optical guidance probe made real-time tumor detection and vessel tracking possible during the stereotactic biopsy procedures. Moreover, the fluorescence and blood perfusion in the tumor could be studied at controlled positions in the brain and the tumor.

  4. Preliminary clinical findings on NEUMUNE as a potential treatment for acute radiation syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Stickney, Dwight R; Groothuis, Jessie R; Ahlem, Clarence; Kennedy, Mike; Miller, Barry S; Onizuka-Handa, Nanette; Schlangen, Karen M; Destiche, Daniel; Reading, Chris; Garsd, Armando; Frincke, James M [Harbor Biosciences, 9171 Towne Centre Drive, Suite 180, San Diego, CA 92122 (United States)

    2010-12-01

    5-androstenediol (5-AED) has been advanced as a possible countermeasure for treating the haematological component of acute radiation syndrome (ARS). It has been used in animal models to stimulate both innate and adaptive immunity and treat infection and radiation-induced immune suppression. We here report on the safety, tolerability and haematologic activity of 5-AED in four double-blinded, randomized, placebo-controlled studies on healthy adults including elderly subjects. A 5-AED injectable suspension formulation (NEUMUNE) or placebo was administered intramuscularly as either a single injection, or once daily for five consecutive days at doses of 50, 100, 200 or 400 mg. Subjects (n = 129) were randomized to receive NEUMUNE (n = 95) or the placebo (n = 34). NEUMUNE was generally well-tolerated; the most frequent adverse events were local injection site reactions (n = 104, 81%) that were transient, dose-volume dependent, mild to moderate in severity, and that resolved over the course of the study. Blood chemistries revealed a transient increase (up to 28%) in creatine phosphokinase and C-reactive protein levels consistent with intramuscular injection and injection site irritation. The blood concentration profile of 5-AED is consistent with a depot formulation that increases in disproportionate increments following each dose. NEUMUNE significantly increased circulating neutrophils (p < 0.001) and platelets (p < 0.001) in the peripheral blood of adult and elderly subjects. A dose-response relationship was identified. Findings suggest that parenteral administration of 5-AED in aqueous suspension may be a safe and effective means to stimulate innate immunity and alleviate neutropenia and thrombocytopenia associated with ARS.

  5. Clinical audit of posterior three-unit fixed-movable resin-bonded fixed partial dentures - A retrospective, preliminary clinical investigation.

    Science.gov (United States)

    Botelho, Michael G; Dyson, John E; Mui, Thomas H F; Lam, Walter Y H

    2017-02-01

    Two-unit cantilevered resin-bonded fixed partial dentures (RBFPDs) have higher retention rates over longer span fixed-fixed RBFPDs. It has been hypothesized that interabutment stresses associated with fixed-fixed designs cause prosthesis debonds therefore for the replacement of molar-sized and longer spans, non-rigid connectors have been used to allow independent movement between two abutment teeth. This preliminary study evaluates the clinical longevity and subjects' satisfaction of three-unit fixed-movable (FM3) RBFPDs provided at a dental teaching hospital. Subjects who had received FM3 RBFPD(s) in the posterior region were clinically reviewed for complications. History of any debonds and subjects' satisfaction to the prosthesis was recorded. Time-to-debond (retention rate) and time-to-loss (survival rate) of these prostheses were presented in life tables. Ninety-eight prostheses in 84 subjects were examined. Their mean service life was 31.8 months (SD 11.5, range 3-67 months). Twenty-two prostheses had a history of debond, resulting in a retention proportion of 77.6%; seventeen of these were rebonded and still present at the time of review. One prosthesis was lost after extraction of a periodontally-involved abutment tooth, giving a survival proportion of 93.9%. High subject satisfaction and no adverse outcome were reported. Three-unit fixed-movable RBFPDs have a shorter success than two-unit cantilevered RBFPDs. However, non-rigid connectors allow the possibility of rebonding giving satisfactory short-term survival rate. Further research is needed to investigate their long-term efficacy. Three-unit fixed-movable RBFPDs incorporating non-rigid connectors may be a feasible option for replacement of molar-size pontic in the posterior region. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Oats in the Diet of Children with Celiac Disease: Preliminary Results of a Double-Blind, Randomized, Placebo-Controlled Multicenter Italian Study

    Science.gov (United States)

    Gatti, Simona; Caporelli, Nicole; Galeazzi, Tiziana; Francavilla, Ruggiero; Barbato, Maria; Roggero, Paola; Malamisura, Basilio; Iacono, Giuseppe; Budelli, Andrea; Gesuita, Rosaria; Catassi, Carlo; Lionetti, Elena

    2013-01-01

    A gluten-free diet (GFD) is currently the only available treatment for patients with celiac disease (CD). Several clinical trials have demonstrated that most celiac patients can tolerate a medium-high quantity of oats without any negative clinical effects; however, the inclusion of oats in GFD is still a matter of debate. In this study, Italian children with CD were enrolled in a 15-month, randomized, double-blind, placebo-controlled multicenter trial. Participants were randomized in two groups following either A-B treatment (6 months of diet “A”, 3 months of standard GFD, 6 months of diet “B”), or B-A treatment (6 months of diet “B”, 3 months of standard GFD, 6 months of diet “A”). A and B diets included gluten-free (GF) products (flour, pasta, biscuits, cakes and crisp toasts) with either purified oats or placebo. Clinical data (Gastrointestinal Symptoms Rate Scale [GSRS] score) and intestinal permeability tests (IPT), were measured through the study period. Although the study is still blinded, no significant differences were found in GSRS score or the urinary lactulose/mannitol (L/M) ratio between the two groups after 6 months of treatment. These preliminary results suggest that the addition of non-contaminated oats from selected varieties in the treatment of children with CD does not determine changes in intestinal permeability and gastrointestinal symptoms. PMID:24264227

  7. Oats in the diet of children with celiac disease: preliminary results of a double-blind, randomized, placebo-controlled multicenter Italian study.

    Science.gov (United States)

    Gatti, Simona; Caporelli, Nicole; Galeazzi, Tiziana; Francavilla, Ruggiero; Barbato, Maria; Roggero, Paola; Malamisura, Basilio; Iacono, Giuseppe; Budelli, Andrea; Gesuita, Rosaria; Catassi, Carlo; Lionetti, Elena

    2013-11-20

    A gluten-free diet (GFD) is currently the only available treatment for patients with celiac disease (CD). Several clinical trials have demonstrated that most celiac patients can tolerate a medium-high quantity of oats without any negative clinical effects; however, the inclusion of oats in GFD is still a matter of debate. In this study, Italian children with CD were enrolled in a 15-month, randomized, double-blind, placebo-controlled multicenter trial. Participants were randomized in two groups following either A-B treatment (6 months of diet "A", 3 months of standard GFD, 6 months of diet "B"), or B-A treatment (6 months of diet "B", 3 months of standard GFD, 6 months of diet "A"). A and B diets included gluten-free (GF) products (flour, pasta, biscuits, cakes and crisp toasts) with either purified oats or placebo. Clinical data (Gastrointestinal Symptoms Rate Scale [GSRS] score) and intestinal permeability tests (IPT), were measured through the study period. Although the study is still blinded, no significant differences were found in GSRS score or the urinary lactulose/mannitol (L/M) ratio between the two groups after 6 months of treatment. These preliminary results suggest that the addition of non-contaminated oats from selected varieties in the treatment of children with CD does not determine changes in intestinal permeability and gastrointestinal symptoms.

  8. Oats in the Diet of Children with Celiac Disease: Preliminary Results of a Double-Blind, Randomized, Placebo-Controlled Multicenter Italian Study

    Directory of Open Access Journals (Sweden)

    Simona Gatti

    2013-11-01

    Full Text Available A gluten-free diet (GFD is currently the only available treatment for patients with celiac disease (CD. Several clinical trials have demonstrated that most celiac patients can tolerate a medium-high quantity of oats without any negative clinical effects; however, the inclusion of oats in GFD is still a matter of debate. In this study, Italian children with CD were enrolled in a 15-month, randomized, double-blind, placebo-controlled multicenter trial. Participants were randomized in two groups following either A-B treatment (6 months of diet “A”, 3 months of standard GFD, 6 months of diet “B”, or B-A treatment (6 months of diet “B”, 3 months of standard GFD, 6 months of diet “A”. A and B diets included gluten-free (GF products (flour, pasta, biscuits, cakes and crisp toasts with either purified oats or placebo. Clinical data (Gastrointestinal Symptoms Rate Scale [GSRS] score and intestinal permeability tests (IPT, were measured through the study period. Although the study is still blinded, no significant differences were found in GSRS score or the urinary lactulose/mannitol (L/M ratio between the two groups after 6 months of treatment. These preliminary results suggest that the addition of non-contaminated oats from selected varieties in the treatment of children with CD does not determine changes in intestinal permeability and gastrointestinal symptoms.

  9. A mindfulness-based intervention to control weight after bariatric surgery: Preliminary results from a randomized controlled pilot trial.

    Science.gov (United States)

    Chacko, Sara A; Yeh, Gloria Y; Davis, Roger B; Wee, Christina C

    2016-10-01

    This study aimed to develop and test a novel mindfulness-based intervention (MBI) designed to control weight after bariatric surgery. Randomized, controlled pilot trial. Beth Israel Deaconess Medical Center, Boston, MA, USA. Bariatric patients 1-5 years post-surgery (n=18) were randomized to receive a 10-week MBI or a standard intervention. Primary outcomes were feasibility and acceptability of the MBI. Secondary outcomes included changes in weight, eating behaviors, psychosocial outcomes, and metabolic and inflammatory biomarkers. Qualitative exit interviews were conducted post-intervention. Major themes were coded and extracted. Attendance was excellent (6 of 9 patients attended ≥7 of 10 classes). Patients reported high satisfaction and overall benefit of the MBI. The intervention was effective in reducing emotional eating at 6 months (-4.9±13.7 in mindfulness vs. 6.2±28.4 in standard, p for between-group difference=0.03) but not weight. We also observed a significant increase in HbA1C (0.34±0.38 vs. -0.06±0.31, p=0.03). Objective measures suggested trends of an increase in perceived stress and symptoms of depression, although patients reported reduced stress reactivity, improved eating behaviors, and a desire for continued mindfulness-based support in qualitative interviews. This novel mindfulness-based approach is highly acceptable to bariatric patients post-surgery and may be effective for reducing emotional eating, although it did not improve weight or glycemic control in the short term. Longer-term studies of mindfulness-based approaches may be warranted in this population. ClinicalTrials.gov identifier NCT02603601. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. The Asthma Control Questionnaire as a clinical trial endpoint

    DEFF Research Database (Denmark)

    Barnes, P J; Casale, T B; Dahl, Ronald;

    2014-01-01

    The goal of asthma treatment is to control the disease according to guidelines issued by bodies such as the Global Initiative for Asthma. Effective control is dependent upon evaluation of symptoms, initiation of appropriate treatment and minimization of the progressive adverse effects...... of the disease and its therapies. Although individual outcome measures have been shown to correlate with asthma control, composite endpoints are preferred to enable more accurate and robust monitoring of the health of the individual patient. A number of validated instruments are utilized to capture...... these component endpoints; however, there is no consensus on the optimal instrument for use in clinical trials. The Asthma Control Questionnaire (ACQ) has been shown to be a valid, reliable instrument that allows accurate and reproducible assessment of asthma control that compares favourably with other commonly...

  11. Clinical applications of biomedical microdevices for controlled drug delivery.

    Science.gov (United States)

    Gurman, Pablo; Miranda, Oscar R; Clayton, Kevin; Rosen, Yitzhak; Elman, Noel M

    2015-01-01

    Miniaturization of devices to micrometer and nanometer scales, combined with the use of biocompatible and functional materials, has created new opportunities for the implementation of drug delivery systems. Advances in biomedical microdevices for controlled drug delivery platforms promise a new generation of capabilities for the treatment of acute conditions and chronic illnesses, which require high adherence to treatment, in which temporal control over the pharmacokinetic profiles is critical. In addition, clinical conditions that require a combination of drugs with specific pharmacodynamic profiles and local delivery will benefit from drug delivery microdevices. This review provides a summary of various clinical applications for state-of-the-art controlled drug delivery microdevices, including cancer, endocrine and ocular disorders, and acute conditions such as hemorrhagic shock. Regulatory considerations for clinical translation of drug delivery microdevices are also discussed. Drug delivery microdevices promise a remarkable gain in clinical outcomes and a substantial social impact. A review of articles covering the field of microdevices for drug delivery was performed between January 1, 1990, and January 1, 2014, using PubMed as a search engine.

  12. Evaluation of the mental health benefits of yoga in a secondary school: a preliminary randomized controlled trial.

    Science.gov (United States)

    Khalsa, Sat Bir S; Hickey-Schultz, Lynn; Cohen, Deborah; Steiner, Naomi; Cope, Stephen

    2012-01-01

    The goal of this study was to evaluate potential mental health benefits of yoga for adolescents in secondary school. Students were randomly assigned to either regular physical education classes or to 11 weeks of yoga sessions based upon the Yoga Ed program over a single semester. Students completed baseline and end-program self-report measures of mood, anxiety, perceived stress, resilience, and other mental health variables. Independent evaluation of individual outcome measures revealed that yoga participants showed statistically significant differences over time relative to controls on measures of anger control and fatigue/inertia. Most outcome measures exhibited a pattern of worsening in the control group over time, whereas changes in the yoga group over time were either minimal or showed slight improvements. These preliminary results suggest that implementation of yoga is acceptable and feasible in a secondary school setting and has the potential of playing a protective or preventive role in maintaining mental health.

  13. 乳腺专用PET临床初步应用%The preliminary clinical application of MAMMI dedicated breast PET

    Institute of Scientific and Technical Information of China (English)

    鲍晓; 姚之丰; 张勇平; 章英剑; 胡四龙; 程竞仪; 杨忠毅; 刘帅; 刘芮; 孙艺斐; 王思阳; 刘畅

    2015-01-01

    Objective:To evaluate the preliminary clinical application value of MAMMI dedicated breast PET.Methods:A total of 76 patients with positive breast lesions on whole-body18F-lfuorodeoxyglucose (18F-FDG) PET/CT or suspicious occult breast cancer voluntarily underwent MAMMI PET in prone position after whole-body18F-FDG PET/CT. The maximal standardized uptake values (SUVmax) were compared according to lesion size, ultrasound grading and molecular subtype of breast cancer. Results:MAMMI PET visualized 63 lesions in 48 patients with speciifc pathologic diagnosis. The smallest lesion was 0.3 cm indiameter. Malignant lesions were classiifed into 3 groups based on diameter as follows: grade 1, 1 cm or smaller; grade 2, 1 to 2 cm; and grad 3, larger than 2 cm. The mean values of SUVmax of them were 4.58 ±2.01, 7.51 ±3.10 and 11.27±5.29, respectively, and there were signiifcant differences in SUVmax through pairwise comparison (P2 cm时,SUVmax平均值分别为4.58±2.01、7.51±3.10和11.27±5.29,两两比较差异均有统计学意义(P<0.01或P<0.05);乳腺影像报告和数据系统(BI-RADS)4级与5级之间SUVmax差异也有统计学意义(P<0.05);各分子亚型之间SUVmax差异无统计学意义。结论:乳腺专用PET对探测乳腺小病灶、多中心、多原发病灶具有很好的临床应用价值。

  14. Blood pressure changes in African American patients receiving chiropractic care in a teaching clinic: a preliminary study

    National Research Council Canada - National Science Library

    McMasters, Kim L; Wang, Joe; York, Jennifer; Hart, John; Neely, Cheneir; Delain, Rochelle J

    2013-01-01

    The purpose of this preliminary study was to determine if a course of chiropractic care would change blood pressure measurements in African American patients and to determine if a study was feasible...

  15. Clinical efficacy of low level laser therapy in reducing pain and swelling after periapical surgery. A preliminary report.

    Directory of Open Access Journals (Sweden)

    Lilia Escalante-Macías

    2015-06-01

    Full Text Available ABSTRACT The objective of this study was to evaluate the efficacy of the low level laser therapy (LLLT in postoperative pain and swelling associated with periapical surgery. A double-blind, randomized, controlled clinical trial was carried out in 2 groups of 10 patients each, undergoing periapical surgery. The experimental group was treated with an intraoral application of an 810 nm-GaAsAl-laser, having an output power of 100 mW, with overlapping movements over the wound. In the control group, the same procedure was carried out, without therapeutic laser activation. Postoperative pain, swelling, and rescue medication were registered. The experimental group exhibited a decrease in pain intensity after periapical surgery compared with control group (p

  16. Human-FES cooperative control for wrist movement: a preliminary study

    Directory of Open Access Journals (Sweden)

    Kai Gui

    2016-07-01

    Full Text Available Functional electrical stimulation (FES sometimes applies to patients with partial paralysis, so human voluntary control and FES control both exist. Our study aims to build a cooperative controller to achieve human-FES cooperation. This cooperative controller is formed by a classical FES controller and an impedance controller. The FES controller consists of a back propagation (BP neural network-based feedforward controller and a PID-based feedback controller. The function of impedance controller is to convert volitional force/torque, which is estimated from a three-stage filter based on EMG, into additional angle. The additional angle can reduce the FES intensity in our cooperative controller, comparing to that in classical FES controller. Some assessment experiments are designed to test the performance of the cooperative controller.

  17. Nutritional screening: control of clinical undernutrition with analytical parameters

    OpenAIRE

    José Ignacio de Ulíbarri Pérez; Guillermo Fernández; Francisco Rodríguez Salvanés; Ana María Díaz López

    2014-01-01

    Objective: To update the system for nutritional screening. The high prevalence of nutritional unstability that causes the Clinical Undernutrition (CU), especially within the hospitals and assisted residencies, makes it necessary to use screening tools for the constant control of undernutrition to combat it during its development. CU is not so much due to a nutritional deficiency but to the illness and its treatments. However, the screening systems currently used are aimed at detecting an alre...

  18. Water quality-based real time control of integrated urban drainage: a preliminary study from Copenhagen, Denmark

    DEFF Research Database (Denmark)

    Vezzaro, Luca; Lund Christensen, Margit; Thirsing, Carsten

    2013-01-01

    in the Lynetten catchment (Copenhagen, Denmark). Two different strategies were simulated, considering: (i) water quality at the wastewater treatment plant (WWTP) inlet and (ii) pollution discharge to the bathing areas. These strategies were included in the Dynamic Overflow Risk Assessment (DORA) RTC strategy......Global Real Time Control (RTC) of urban drainage systems is increasingly seen as cost-effective solution for responding to increasing performance demands. This study investigated the potential for including water-quality based RTC into the global control strategy which is under implementation...... period, no significant changes were observed. These preliminary results require further analysis by including detailed water quality measurements and simulations. Nevertheless, the potential for including water-quality RTC in global RTC schemes was unveiled, providing a further option to urban water...

  19. Effect of Intravenous Iron Supplementation on Acute Mountain Sickness: A Preliminary Randomized Controlled Study.

    Science.gov (United States)

    Ren, Xuewen; Zhang, Qiuying; Wang, Hao; Man, Chunyan; Hong, Heng; Chen, Li; Li, Tanshi; Ye, Ping

    2015-07-15

    The aim of this study was to assess the role of intravenous iron supplementation in the prevention of AMS. This was a randomized, double-blinded, placebo-controlled study. Forty-one (n=41) healthy Chinese low-altitude inhabitants living in Beijing, China (altitude of about 50 meters) were randomly assigned into intravenous iron supplementation (ISS group; n=21) and placebo (CON group; n=20) groups. Participants in the ISS group received iron sucrose supplement (200 mg) before flying to Lhasa, China (altitude of 4300 meters). Acute mountain sickness (AMS) severity was assessed with the Lake Louise scoring (LLS) system within 5 days after landing on the plateau (at high altitude). Routine check-ups, clinical biochemistry, and blood tests were performed before departure and 24 h after arrival. A total of 38 participants completed the study (ISS group: n=19; CON group: n=19). The rate of subjects with AMS (LLS>3) was lower in the ISS group compared with the CON group, but no significant differences were obtained (P>0.05). There were no differences in patients' baseline characteristics. The physiological indices were similar in both groups except for serum iron concentrations (19.44±10.02 vs. 85.10±26.78 μmol/L) and transferrin saturation rates (28.20±12.14 vs. 68.34±33.12%), which were significantly higher in the ISS group (Piron supplementation has no significant protective effect on AMS in healthy Chinese low-altitude inhabitants.

  20. The concept of control of COPD in clinical practice

    Directory of Open Access Journals (Sweden)

    Soler-Cataluña JJ

    2014-12-01

    Full Text Available Juan José Soler-Cataluña,1,2 Bernardino Alcázar-Navarrete,3 Marc Miravitlles2,4 1Pneumology Department, Hospital Arnau de Vilanova, Valencia, Spain; 2CIBER de Enfermedades Respiratorias (CIBERES, 3Respiratory Department, Hospital de Alta Resolucion, Granada, Spain; 4Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain Abstract: Treatment of chronic obstructive pulmonary disease (COPD requires a personalized approach according to the clinical characteristics of the patients, the level of severity, and the response to the different therapies. Furthermore, patients with the same level of severity measured by the degree of airflow obstruction or even with multidimensional indices may have very different symptoms and limitations for daily activities. The concept of control has been extensively developed in asthma but has not been defined in COPD. Here, we propose a definition of COPD control based on the concepts of impact and stability. Impact is a cross-sectional concept that can be measured by questionnaires such as the COPD Assessment Test or the Clinical COPD Questionnaire. Alternatively, impact can be assessed by the degree of dyspnea, the use of rescue medication, the level of physical activity, and sputum color. Stability is a longitudinal concept that requires the absence of exacerbations and deterioration in the aforementioned variables or in the COPD Assessment Test or Clinical COPD Questionnaire scores. Control is defined by low impact (adjusted for severity and stability. The concept of control in COPD can be useful in the decision making regarding an increase or decrease in medication in the stable state. Keywords: COPD, control, CAT, CCQ, exacerbations, prognosis

  1. Clinical trials of antihypertensives: Nature of control and design

    Directory of Open Access Journals (Sweden)

    Bhaswat S Chakraborty

    2011-01-01

    Full Text Available This paper reviews the critical issues in the control and design of antihypertension (anti-HT clinical trials. The international guidelines and current clinical and biostatistical practices were reviewed for relevant clinical, design, end-point assessments and regulatory issues. The results are grouped mainly into ethical, protocol and assessment issues. Ethical issues arise as placebo-controlled trials (PCTs for HT-lowering agents in patients with moderate to severe HT are undertaken. Patients with organ damage due to HT should not be included in long-term PCT. Active-control trials, however, are suitable for all randomized subsets of patients, including men and women, and different ethnic and age groups. Severity subgroups must be studied separately with consideration to specific study design. Mortality and morbidity outcome studies are not required in anti-HT trials except when significant mortality and cardiovascular morbidity are suspected. Generally, changes in both systolic and diastolic blood pressures (BP at the end of the dosing interval from the baseline are compared between the active and the control arms as the primary endpoint of anti-HT effect. Onset of the anti-HT effect can be studied as the secondary endpoint. For maintenance of efficacy, long-term studies of ≥6 months need to be undertaken. Error-free measurement of BP is a serious issue as spontaneous changes in BP are large and active drug effect on diastolic BP is often small. Placebo-controlled short-term studies (of ~12 weeks for dose-response and titration are very useful. Safety studies must be very vigilant on hypotension, orthostatic hypotension and effects on heart. In dose-response studies, at least three doses in addition to placebo should be used to well characterize the benefits and side-effects.

  2. An Adaptive Neuromuscular Controller for Assistive Lower-Limb Exoskeletons: A Preliminary Study on Subjects with Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Amy R. Wu

    2017-06-01

    Full Text Available Versatility is important for a wearable exoskeleton controller to be responsive to both the user and the environment. These characteristics are especially important for subjects with spinal cord injury (SCI, where active recruitment of their own neuromuscular system could promote motor recovery. Here we demonstrate the capability of a novel, biologically-inspired neuromuscular controller (NMC which uses dynamical models of lower limb muscles to assist the gait of SCI subjects. Advantages of this controller include robustness, modularity, and adaptability. The controller requires very few inputs (i.e., joint angles, stance, and swing detection, can be decomposed into relevant control modules (e.g., only knee or hip control, and can generate walking at different speeds and terrains in simulation. We performed a preliminary evaluation of this controller on a lower-limb knee and hip robotic gait trainer with seven subjects (N = 7, four with complete paraplegia, two incomplete, one healthy to determine if the NMC could enable normal-like walking. During the experiment, SCI subjects walked with body weight support on a treadmill and could use the handrails. With controller assistance, subjects were able to walk at fast walking speeds for ambulatory SCI subjects—from 0.6 to 1.4 m/s. Measured joint angles and NMC-provided joint torques agreed reasonably well with kinematics and biological joint torques of a healthy subject in shod walking. Some differences were found between the torques, such as the lack of knee flexion near mid-stance, but joint angle trajectories did not seem greatly affected. The NMC also adjusted its torque output to provide more joint work at faster speeds and thus greater joint angles and step length. We also found that the optimal speed-step length curve observed in healthy humans emerged for most of the subjects, albeit with relatively longer step length at faster speeds. Therefore, with very few sensors and no predefined

  3. Development of a current-controlled defibrillator for clinical tests.

    Science.gov (United States)

    Fischer, M; Schönegg, M; Schöchlin, J; Bolz, A

    2002-01-01

    The work presented here is only a part of the development for a new current-controlled defibrillator. In the diploma thesis "Development and construction of a current-controlled defibrillator for clinical tests" the most important part was the control and safety of the defibrillator. To ensure a safe circuit design, a risk-analysis and a Failure Mode and Effects Analysis (FMEA) were necessary. Another major part was the programming of a microcontroller in embedded C and a programmable logic device in Very High Speed Integrated Circuit Description Language (VHDL). The circuit had to be constructed, and the defibrillator was optically decoupled from the laptop for safety reasons. The waveform-data can be transmitted to the microcontroller from the laptop, and the logged data is then transmitted back.

  4. Clinical randomized controlled trial of chemomechanical caries removal (Carisolv).

    Science.gov (United States)

    Lozano-Chourio, M A; Zambrano, O; González, H; Quero, M

    2006-05-01

    The purpose of this study was to compare the chemomechanical caries-removal system (Carisolv) with high-speed excavation in cavitated occlusal caries of primary molars. Design and setting. The study was a randomized controlled, clinical trial in which the two techniques were compared in each subject. Participants were chosen from public schools, in Maracaibo County, Zulia State, Venezuela. The sample consisted of 80 primary molars selected from 40 children (mean age 7.7+/-0.7 years). Each patient had at least two contralateral primary molars with cavitated occlusal caries and approximately equal-size access to lesions. The outcome variables were: clinically complete caries removal, size of the opening of the cavity, volume of carious tissue removed, pain during caries removal, anaesthesia requested by the patient, caries-removal time, and behaviour and preference of patients. All treated molars were clinically caries free whichever caries-removal procedure was used. When Carisolv' was used the final cavity entrance sizes were smaller (Premoved was less (Premoval was three times longer (7.51+/-1.83 min, Premoval of occlusal dentinal caries in cavitated primary molars; it is more conservative of dental tissue and appeared to be more comfortable for most patients, although the clinical time spent is longer than when using high-speed excavation.

  5. Preliminary results from multicenter clinical trials for detection of cervical squamous intraepithelial lesions using a novel full-field evoked-tissue-flourescence-based imaging instrument

    Science.gov (United States)

    Dattamajumdar, Anupam K.; Wells, D.; Parnell, Julie R.; Ganguly, Dipankur; Wright, Thomas C., Jr.

    2001-10-01

    We report preliminary results from a multi-center trial of evaluating the performance of a novel, full-field multi-spectral tissue fluorescence imaging system (CerviscanTM) designed to detect cervical squamous intraepithelial lesions. Spectral data from multiple regions of 48 patients enrolled from clinical performance sites in the US and Canada are included in this preliminary analysis. This includes 30 women used for the training set and 18 used for the testing set. In the testing set, 37/43 SIL and 70/80 NonSIL regions were correctly identified for a sensitivity of 86% and specificity of 87.5%. CerviscanTM locates cervical precancerous lesions with high sensitivity and specificity and has the potential to permit 'see and treat' patient management.

  6. Phase I: controls preliminary design report for Brayton Isotope Power System (BIPS)

    Energy Technology Data Exchange (ETDEWEB)

    1976-08-20

    Background analyses of three control systems capable of controlling the speed, output voltage, and start rate of Brayton Isotope Power Systems (BIPS) are presented. Conclusions of all functions considered are summarized. (TFD)

  7. Control of anxiety through music in a head and neckoutpatient clinic: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Mariana Alves Firmeza

    Full Text Available Abstract OBJECTIVE Evaluating the effectiveness of a musical intervention in reducing anxiety and vital parameters in people suffering from head and neck cancer. METHOD A randomized controlled clinical trial, performed in a head and neck outpatient clinic with 40 participants, subdivided into two groups (intervention and control.The classicalmusic“Spring” from The Four Seasons by Vivaldi was used as an intervention.The State-Trait Anxiety Inventory (STAI was used as the data collectioninstrument,along with an inventory of socio-demographic and clinical data. Student'st-test was used to verify intragroup and intergroup statistical significance. RESULTS Participants presented a statistically significant reduction in levels of perceived anxiety (t= 12.68; p<0.001,as well as blood pressure levels (t = 4.56; p<0.001; pulse (t = 6.15; p<0.001 and respiratory rate (t = 5.10; p<0.001. CONCLUSION Music has proven to be an effective non-pharmacological therapeutic resource in managinganxiety in an outpatient setting for people with cancer, as well as in reducing blood pressure, pulse and respiratory rate. Brazilian Registry of Clinical Trials: RBR-7W4YJJ

  8. Clinical and microbiological effects of commercially available dentifrice containing amine fluoride: A randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    A R Pradeep

    2012-01-01

    Full Text Available Background: The inability of the normal adult population to perform adequate tooth brushing has led to the search for chemotherapeutic agents in order to improve plaque control. This 6 month, single center, randomized controlled clinical trial was conducted to assess the clinical and microbiological effects of a dentifrice containing only amine fluoride (AF as the active ingredient on gingivitis. Materials and Methods: Ninety subjects diagnosed with chronic generalized gingivitis were selected and randomly divided in three groups: Group 1 - placebo toothpaste, Group 2 - AF containing toothpaste, and Group 3 - triclosan containing toothpaste with polymer and fluoride. Clinical evaluation was undertaken using the gingival index of Loe and Silness and the plaque index and microbiological counts were assessed at baseline, 6 weeks, 12 weeks, and 24 weeks. A subjective evaluation was also undertaken by a questionnaire. Results: AF containing toothpaste showed significant improvement in gingival and plaque index scores as well as microbiologic counts compared with placebo dentifrice. These improvements were comparable to triclosan containing toothpaste. Conclusions: AF containing toothpaste may be a useful formulation for chemical plaque control agent and improvement in plaque and gingival status and add to the list of various therapeutic agents used for maintenance of gingival health.

  9. Clinical and microbiological effects of commercially available dentifrice containing amine fluoride: A randomized controlled clinical trial.

    Science.gov (United States)

    Pradeep, A R; Agarwal, Esha; Bajaj, Pavan; Naik, Savitha B; Kumari, Minal; Guruprasad, C N

    2012-07-01

    The inability of the normal adult population to perform adequate tooth brushing has led to the search for chemotherapeutic agents in order to improve plaque control. This 6 month, single center, randomized controlled clinical trial was conducted to assess the clinical and microbiological effects of a dentifrice containing only amine fluoride (AF) as the active ingredient on gingivitis. NINETY SUBJECTS DIAGNOSED WITH CHRONIC GENERALIZED GINGIVITIS WERE SELECTED AND RANDOMLY DIVIDED IN THREE GROUPS: Group 1 - placebo toothpaste, Group 2 - AF containing toothpaste, and Group 3 - triclosan containing toothpaste with polymer and fluoride. Clinical evaluation was undertaken using the gingival index of Loe and Silness and the plaque index and microbiological counts were assessed at baseline, 6 weeks, 12 weeks, and 24 weeks. A subjective evaluation was also undertaken by a questionnaire. AF containing toothpaste showed significant improvement in gingival and plaque index scores as well as microbiologic counts compared with placebo dentifrice. These improvements were comparable to triclosan containing toothpaste. AF containing toothpaste may be a useful formulation for chemical plaque control agent and improvement in plaque and gingival status and add to the list of various therapeutic agents used for maintenance of gingival health.

  10. Preliminary open-label clinical evaluation of the soothing and reepithelialization properties of a novel topical formulation for rosacea

    Directory of Open Access Journals (Sweden)

    Sparavigna A

    2014-10-01

    Full Text Available Adele Sparavigna, Beatrice Tenconi, Ileana De Ponti Derming Srl, Monza, Italy Background: Rosacea is a common, incurable skin barrier disorder characterized by relapses and remissions. Purpose: To evaluate the efficacy of Farmaka Rosacea Cream (FRC, a novel topical formulation for rosacea. Methods: This single-center, open-label pilot study comprised a single-dose substudy in 20 healthy subjects and a long-term, repeat-dose substudy in 22 subjects with rosacea. The 2-hour, controlled, single-dose substudy assessed the soothing and reepithelialization properties of FRC after stripping-induced erythema based on the erythema index, transepidermal water loss, skin hydration, and clinical assessments of erythema. In the long-term substudy, subjects applied FRC twice daily for 8 weeks. Clinical assessments included vascular and pigmentary homogeneity and erythema and hemoglobin indices. Subjects completed questionnaires to assess FRC efficacy and cosmetic acceptability. Results: Greater reductions were seen in FRC-treated areas compared with untreated areas for the erythema index (-16% versus -8%; P<0.001 and mean transepidermal water loss (-35.8% versus -10.1%; P<0.001 30 minutes after stripping. Significant improvements over untreated areas were maintained 2 hours after stripping. Skin hydration and clinical erythema assessments also indicated that FRC soothed rosacea symptoms and promoted skin reepithelialization. Erythema and hemoglobin indices were significantly reduced from baseline after 4 and 8 weeks of treatment. Clinically assessed parameters were significantly improved following FRC application. Subjects assessed FRC positively. Conclusion: Improvement of rosacea symptoms was noted with FRC application. The main film-forming ingredients of FRC (trehalose, cholesterol, ceramide, and fatty acids, combined with other soothing and calming ingredients and ultraviolet filters, could explain its efficacy. Keywords: rosacea, erythema, skin

  11. RANDOMIZED CONTROLLED CLINICAL TRIALS IN ORTHOPEDICS: DIFFICULTIES AND LIMITATIONS

    Science.gov (United States)

    Malavolta, Eduardo Angeli; Demange, Marco Kawamura; Gobbi, Riccardo Gomes; Imamura, Marta; Fregni, Felipe

    2015-01-01

    Randomized controlled clinical trials (RCTs) are considered to be the gold standard for evidence-based medicine nowadays, and are important for directing medical practice through consistent scientific observations. Steps such as patient selection, randomization and blinding are fundamental for conducting a RCT, but some additional difficulties are presented in trials that involve surgical procedures, as is common in orthopedics. The aim of this article was to highlight and discuss some difficulties and possible limitations on RCTs within the field of surgery. PMID:27027037

  12. Vitamin E neuroprotection against cisplatin ototoxicity: Preliminary results from a randomized, placebo-controlled trial.

    Science.gov (United States)

    Villani, Veronica; Zucchella, Chiara; Cristalli, Giovanni; Galiè, Edvina; Bianco, Francesco; Giannarelli, Diana; Carpano, Silvia; Spriano, Giuseppe; Pace, Andrea

    2016-04-01

    Few studies have investigated the effect of vitamin E in reducing the cisplatin (CDDP)-induced ototoxicity. This study evaluated vitamin E supplementation as a protecting agent against CDDP-induced ototoxicity. Patients who started CDDP were randomly assigned to receive vitamin E supplementation at 400 mg per day (group 1) or placebo (group 2). Audiograms and evoked brainstem responses were obtained at baseline, and after 1, 2, and 3 months. Twenty-three patients affected by solid malignancies were enrolled (13 in group 1 and 10 in group 2). At 1 month, a significant hearing loss in group 2 at both 2000 HZ (right ear: p = .05; left ear: p = .04) and 8000 HZ (right ear: p = .04; left ear: p = .03) was detected when compared to baseline values. Audiograms did not show significant changes. At 1 month, evoked brainstem responses remained unchanged in both arms without significant differences between groups. These preliminary findings confirm the neuroprotective properties of vitamin E against the CDDP-induced ototoxicity. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2118-E2121, 2016. © 2016 Wiley Periodicals, Inc.

  13. Control of the parameters of attention in basketball at the stage of preliminary basic preparation

    Directory of Open Access Journals (Sweden)

    Olena Mitova

    2015-10-01

    Full Text Available Purpose: to determine the parameters of attention of basketball players aged 13–14 years old before and after the exercises of various kinds. Material and Methods: the study involved 3 teams of basketball players aged 13–14 years old from training groups. The total number of investigated people is 50. The study was carried out on the basis of Sports Children and Youth Olympic school № 5 in Dnepropetrovsk. We used the methods of theoretical analysis and synthesis of the literature, the method of analysis of documentary materials, pedagogical supervision, psychological testing, pulsometry, methods of mathematical statistics.The following techniques were used to determine the parameters of attention: «Mixed up line», proofreading test with Landoldt rings, proofreading test with letters. Results: during our research there was defined the predominantly low level of attention of basketball players at the stage of preliminary basic preparation. It was found out the specific nature of the load influences the decrease of the parameters in a greater degree, especially concentration, switching, and stability decline, the number of errors increases. Conclusions: on the basis of studies arises the necessity to improve monitoring systems in the Sports Children and Youth schools with usage of tests to determine the components of psychological readiness

  14. Thirty Meter Telescope (TMT) Narrow Field Infrared Adaptive Optics System (NFIRAOS) real-time controller preliminary architecture

    Science.gov (United States)

    Kerley, Dan; Smith, Malcolm; Dunn, Jennifer; Herriot, Glen; Véran, Jean-Pierre; Boyer, Corinne; Ellerbroek, Brent; Gilles, Luc; Wang, Lianqi

    2016-08-01

    The Narrow Field Infrared Adaptive Optics System (NFIRAOS) is the first light Adaptive Optics (AO) system for the Thirty Meter Telescope (TMT). A critical component of NFIRAOS is the Real-Time Controller (RTC) subsystem which provides real-time wavefront correction by processing wavefront information to compute Deformable Mirror (DM) and Tip/Tilt Stage (TTS) commands. The National Research Council of Canada - Herzberg (NRC-H), in conjunction with TMT, has developed a preliminary design for the NFIRAOS RTC. The preliminary architecture for the RTC is comprised of several Linux-based servers. These servers are assigned various roles including: the High-Order Processing (HOP) servers, the Wavefront Corrector Controller (WCC) server, the Telemetry Engineering Display (TED) server, the Persistent Telemetry Storage (PTS) server, and additional testing and spare servers. There are up to six HOP servers that accept high-order wavefront pixels, and perform parallelized pixel processing and wavefront reconstruction to produce wavefront corrector error vectors. The WCC server performs low-order mode processing, and synchronizes and aggregates the high-order wavefront corrector error vectors from the HOP servers to generate wavefront corrector commands. The Telemetry Engineering Display (TED) server is the RTC interface to TMT and other subsystems. The TED server receives all external commands and dispatches them to the rest of the RTC servers and is responsible for aggregating several offloading and telemetry values that are reported to other subsystems within NFIRAOS and TMT. The TED server also provides the engineering GUIs and real-time displays. The Persistent Telemetry Storage (PTS) server contains fault tolerant data storage that receives and stores telemetry data, including data for Point-Spread Function Reconstruction (PSFR).

  15. A Preliminary Study on Natural Matrix Materials for Controlled Release Nitrogen Fertilizers

    Institute of Scientific and Technical Information of China (English)

    DU Chang-Wen; ZHOU Jian-Min; WANG Huo-Yan; LI Shou-Tian

    2004-01-01

    A controlled release N fertilizer was developed by the carrier method using natural polysaccharides (PS)and urea. The results showed that mixing of PS and urea led to significant control of urea release. When a cross-linker (boric acid or glutaraldehyde) was added, a better control effect was observed. During a 30 min leaching time the nitrogen release rate from the controlled release fertilizer was nearly constant, which was significantly different from normal urea. One of the controlled release mechanisms was related to space resistance from a large molecular structure. Infrared (IR) analysis indicated that interaction of PS with urea was through a hydrogen bond or a covalent bond. These bonds created an α-helix or high molecular network fertilizer carrier system, which was another reason for a controlled nutrient release. Pot experiment showed that nitrogen use efficiency could increase significantly with a carrier fertilizer.

  16. Confounding Effect in Clinical Research of Otolaryngology and Its Control.

    Science.gov (United States)

    Yu, Yong-qiang; Huang, Dong-yan; Armijo Olivo, Susan; Yang, Huai-an; Bambanini, Yagesh; Sonnenberg, Lyn; Clark, Brenda; Constantinescu, Gabriela; Qian Yu, Jason; Zhang, Ming

    2015-06-01

    Confounding effect is a critical issue in clinical research of otolaryngology because it can distort the research's conclusion. In this review, we introduce the definition of confounding effect, the methods of verifying and controlling the effect. Confounding effect can be prevented by research's design, and adjusted by data analysis. Clinicians would be aware and cautious about confounding effect in their research. They would be able to set up a research's design in which appropriate methods have been applied to prevent this effect.They would know how to adjust confounding effect after data collection. It is important to remember that sometimes it is impossible to eliminate confounding effect completely, and statistical method is not a master key. Solid research knowledge and critical thinking of our brain are the most important in controlling confounding effect.

  17. Confounding Effect in Clinical Research of Otolaryngology and Its Control

    Institute of Scientific and Technical Information of China (English)

    Yong-qiang Yu; Ming Zhang; Dong-yan Huang; Susan Armijo Olivo; Huai-an Yang; Yagesh Bambanini; Lyn Sonnenberg; renda Clark; Gabriela Constantinescu; Jason Qian Yu

    2015-01-01

    Confounding effect is a critical issue in clinical research of otolaryngology because it can distort the research’s conclusion. In this review, we introduce the definition of confounding effect, the methods of verifying and controlling the effect. Confounding effect can be prevented by research’s design, and adjusted by data analysis. Clinicians would be aware and cautious about confounding effect in their research. They would be able to set up a research’s design in which appropriate methods have been applied to prevent this effect. They would know how to adjust confounding effect after data collection. It is important to remember that sometimes it is impossible to eliminate confounding effect completely, and statistical method is not a master key. Solid research knowledge and critical thinking of our brain are the most important in controlling confounding effect.

  18. Non-surgical periodontal treatment of peri-implant diseases with the adjunctive use of diode laser: preliminary clinical study.

    Science.gov (United States)

    Lerario, Francesco; Roncati, Marisa; Gariffo, Annalisa; Attorresi, Enrica; Lucchese, Alessandra; Galanakis, Alexandros; Palaia, Gaspare; Romeo, Umberto

    2016-01-01

    Peri-implant diseases present in two forms: peri-implant mucositis and peri-implantitis. The prevalence of peri-implant complications is significantly rising. The aim of this study was to compare conventional treatment of inflamed peri-implant tissues with conventional treatment together with diode laser application. Twenty-seven patients (age 36 to 67, 15 women and 12 men, 12 smokers and 15 non-smokers) requiring treatment for mucositis or peri-implantitis were taken into account for this preliminary study. Plaque index (PI), pocket depth (PD), and bleeding on probing (BoP) were recorded at baseline evaluation. Patients in control group (CG) received conventional non-surgical periodontal treatment. Patients in test group received conventional non-surgical periodontal treatment together with diode laser application (810 nm, 30 s, 1 W, 50 Hz, t on = 100 ms, t off = 100 ms, energy density = 24.87 J/cm(2)). Paired t test was used to evaluate the difference in repeated measurements of considered indexes at T 0 and T 1 (1 year) in both groups. A total of 606 sites were taken into account in the test group (TG) and 144 in the CG. PD mean variation in the TG was 2.66 mm ± 1.07, while mean PD variation in the CG was 0.94 ± 1.13 mm. Paired t testing of the variation in PD in CG and TG revealed a statistically significant difference between the two groups (p < 0.0001). A reduction of pathological sites from 89 % (T 0) to 14.35 % (T 1) was achieved in the TG, while reduction obtained in the CG was from 75.69 % (T 0) to 50 % (T 1); BoP scores at time T 1 had fallen below 5 % in the TG and decreased to 59.7 %, in the CG. Within the limitations of this study, diode laser seems to be an additional valuable tool for peri-implant disease treatment.

  19. Preliminary input to the space shuttle reaction control subsystem failure detection and identification software requirements (uncontrolled)

    Science.gov (United States)

    Bergmann, E.

    1976-01-01

    The current baseline method and software implementation of the space shuttle reaction control subsystem failure detection and identification (RCS FDI) system is presented. This algorithm is recommended for conclusion in the redundancy management (RM) module of the space shuttle guidance, navigation, and control system. Supporting software is presented, and recommended for inclusion in the system management (SM) and display and control (D&C) systems. RCS FDI uses data from sensors in the jets, in the manifold isolation valves, and in the RCS fuel and oxidizer storage tanks. A list of jet failures and fuel imbalance warnings is generated for use by the jet selection algorithm of the on-orbit and entry flight control systems, and to inform the crew and ground controllers of RCS failure status. Manifold isolation valve close commands are generated in the event of failed on or leaking jets to prevent loss of large quantities of RCS fuel.

  20. Oral azithromycin in extended dosage schedule for chronic, subclinical Chlamydia pneumoniae infection causing coronary artery disease: a probable cure in sight? Results of a controlled preliminary trial

    Directory of Open Access Journals (Sweden)

    Dogra J

    2012-06-01

    Full Text Available Jaideep DograPoly Clinic, Central Government Health Scheme, Jaipur, Rajasthan, IndiaPurpose: Two mega trials have raised the question as to whether the hypothesis that infection plays a role in atherosclerosis is still relevant. This controlled preliminary trial investigated an extended dose of azithromycin in the treatment of Chlamydia pneumoniae infection causing coronary artery disease (CAD.Patients and methods: Forty patients with documentary evidence of CAD were screened for immunoglobulin G titers against C. pneumoniae and grouped into either the study group (patients with positive titer, n = 32 or control group (patients with negative titer, n = 8. Cases who met inclusion criteria could not have had coronary artery bypass graft surgery or percutaneous coronary intervention in the preceding 6 months. Informed consent was obtained from every patient. Baseline blood samples were analyzed for red blood cell indices, serum creatinine, and liver function tests, and repeated every 2 months. A primary event was defined as the first occurrence of death by any cause, recurrent myocardial infarction, coronary revascularization procedure, or hospitalization for angina. Patients in the study group received 500 mg of oral azithromycin once daily for 5 days, which was then repeated after a gap of 10 days (total of 24 courses in the 1-year trial period. The control group did not have azithromycin added to their standard CAD treatment.Results: In the study group, 30 patients completed the trial. Two patients had to undergo percutaneous coronary intervention in the initial first quarter of the 1-year trial period. In the control group, one patient died during the trial, one had to undergo coronary artery bypass graft surgery, and one had percutaneous coronary intervention.Conclusion: The patients tolerated the therapy well and there was a positive correlation between azithromycin and secondary prevention of CAD.Keywords: azithromycin, Chlamydia pneumoniae

  1. Clinical value of digital image analysis in the diagnosis of urinary bladder cancer, particularly in aggressive tumors: a preliminary report.

    Science.gov (United States)

    Borkowski, T; Monika Dulewicz, A; Borkowski, A; Piętka, D; Radziszewski, P

    2016-06-01

    The aim of the project was to evaluate the clinical value of a computer analysis of cytological specimen images obtained from urine and bladder washing samples. Three sample types (voided urine, catheterized urine and bladder washing) from 59 patients with primary or recurrent tumor were analyzed. All patients underwent cystoscopy and biopsy or resection. The histological results were compared with the results of the image analyzing computer system of collected urine samples. The consistency between the computer diagnosis and the clinical or histological diagnosis both in the presence and absence of cancer was as follows: 77% for voided urine samples, 72.5% for catheterized urine samples and 78% for bladder washing samples. The specificity of the method at the standard pathology level was 71%, and the sensitivity was 83%. The positive and negative predictive values (PPV and NPV) were 87.5% and 63% respectively. The sensitivity for G3 or CIS or T2 or T3 tumors reached nearly 100%. Computer analysis of urine provided correct diagnoses in cancer and control patients with the sensitivity of 83% and specificity of 71% and gave excellent results in aggressive tumors such as T2, T3, G3 and in CIS.

  2. Sexual Arousal and Self-Control: Results from a Preliminary Experimental Test of the Stability of Self-Control

    Science.gov (United States)

    Bouffard, Jeffrey; Kunzi, Tasha

    2012-01-01

    A central proposition of Gottfredson and Hirschi's (1990) General Theory of Crime is the relative stability of low self-control, however research on "self-control strength" suggests that it may vary across contexts. The current study examines these differing conceptions by randomly assigning participants to one of two sexual arousal conditions or…

  3. Myopia Control with Bifocal Contact Lenses: A Randomized Clinical Trial.

    Science.gov (United States)

    Aller, Thomas A; Liu, Maria; Wildsoet, Christine F

    2016-04-01

    Most studies have reported only minimal reductions in myopia progression with bifocal or progressive multifocal spectacles, although somewhat larger, although mostly still clinically insignificant, effects have been reported in children with nearpoint esophoria and/or accommodative dysfunctions. The CONTROL study was a 1-year, prospective, randomized, clinical trial of bifocal contact lenses for control of myopia in children with eso fixation disparities at near. Eighty-six myopic subjects, aged 8 to 18 years, were enrolled in the study after passing the screening examination. Of these, 79 completed lens assignment and 78 completed the study. The mean refractive error of these 79 subjects was -2.69 ± 1.40D (SD), and all had progressed by -0.50D or more since their last examination. All subjects also had eso fixation disparity at near. Subjects were randomly assigned to wear either Vistakon Acuvue 2 (single-vision soft contact lenses [SVSCLs]) or Vistakon Acuvue Bifocal (bifocal soft contact lenses [BFSCLs]). Bifocal adds were selected to neutralize the associated phoria. Treatment outcomes included cycloplegic autorefraction and axial length, assessed in terms of changes after 6 and 12 months of treatment from pretreatment baseline values. The BFSCLs significantly slowed myopia progression, with statistically significant differences between the treatment groups after 6 months. After 12 months of treatment, the SVSCL group had progressed by -0.79 ± 0.43D compared with -0.22 ± 0.34D for the BFSCL group (cycloplegic objective spherical equivalent, average of two eyes). Corresponding axial length changes were 0.24 ± 0.17 mm and 0.05 ± 0.14 mm, respectively. All of these differences were found to be statistically significant (unpaired t-tests, p 70%) compared with most published results with multifocal spectacles. Further studies are warranted to identify the critical factors and mechanisms underlying this myopia control effect.

  4. Nutritional screening: control of clinical undernutrition with analytical parameters

    Directory of Open Access Journals (Sweden)

    José Ignacio de Ulíbarri Pérez

    2014-04-01

    Full Text Available Objective: To update the system for nutritional screening. The high prevalence of nutritional unstability that causes the Clinical Undernutrition (CU, especially within the hospitals and assisted residencies, makes it necessary to use screening tools for the constant control of undernutrition to combat it during its development. CU is not so much due to a nutritional deficiency but to the illness and its treatments. However, the screening systems currently used are aimed at detecting an already established undernutrition rather than at detecting any nutritional risk that may be present. The metabolic changes of the nutritional status that have a trophopathic effect, can be easily and automatically detected in plasma, which allows to make the necessary changes in treatments that might be too aggressive, as well as to apply nutritional support according to each case. The manual screening systems can detect those somatic changes typical of undernutrition only after many days or weeks, which might be too late. Plasma albumin is a very reliable parameter for nutritional control. A lowered amount of it, due to whatever reason, is a clear sign of a possible deficit as well as of a nutritional risk suffered by the cell way before the somatic signs of undernutrition will become apparent. A fast detection of nutritional risk, anticipating undernutrition, offers prognostic abilities, which makes screening tools based on analytic parameters the most useful, ergonomic, reliable and efficient system for nutritional screening and prognosis in the clinical practice. Conclusion: It is necessary to update some concepts, to leave behind old myths and to choose modern screening systems that have proven to be efficient. This is the only way achieving the dream of controlling CU among ill and vulnerable patients.

  5. Preliminary Retrospective Analysis of Daily Tomotherapy Output Constancy Checks Using Statistical Process Control.

    Directory of Open Access Journals (Sweden)

    Emilio Mezzenga

    Full Text Available The purpose of this study was to retrospectively evaluate the results from a Helical TomoTherapy Hi-Art treatment system relating to quality controls based on daily static and dynamic output checks using statistical process control methods. Individual value X-charts, exponentially weighted moving average charts, and process capability and acceptability indices were used to monitor the treatment system performance. Daily output values measured from January 2014 to January 2015 were considered. The results obtained showed that, although the process was in control, there was an out-of-control situation in the principal maintenance intervention for the treatment system. In particular, process capability indices showed a decreasing percentage of points in control which was, however, acceptable according to AAPM TG148 guidelines. Our findings underline the importance of restricting the acceptable range of daily output checks and suggest a future line of investigation for a detailed process control of daily output checks for the Helical TomoTherapy Hi-Art treatment system.

  6. A DDC-based capacity controller of a direct expansion (DX) air conditioning (A/C) unit for simultaneous indoor air temperature and humidity control - Pt. 1: Control algorithms and preliminary controllability tests

    Energy Technology Data Exchange (ETDEWEB)

    Li, Zheng [Institute of Air Conditioning, China Academy of Building Research, Beijing 100013 (China); Deng, Shiming [Department of Building Services Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR (China)

    2007-01-15

    For residential buildings located in the subtropics, direct expansion (DX) air conditioning (A/C) units are commonly used. Most DX A/C units are currently equipped with single-speed compressors and supply fans, relying on on-off cycling compressors as a low-cost approach to maintain only indoor air dry-bulb temperature, resulting in either space overcooling or an uncontrolled equilibrium indoor relative humidity (RH) level. With the rapid development of A/C industry, the use of variable-speed compressor and supply fan has become more and more prevalent and practical. This paper, the first part of a two-part series, reports on the development of a novel direct digital control (DDC)-based capacity controller for a DX A/C unit having variable-speed compressor and supply fan to simultaneously control indoor air temperature and RH in a conditioned space served by the DX A/C unit. The controller is the first of its kind as a composite parameter, sensible heat ratio (SHR), is used as a controlled parameter. The core element of the capacity controller, a numerical calculation algorithm (NCA) is firstly presented. This is followed by reporting the results of preliminary controllability tests of the DDC-based capacity controller, which suggested that the controller developed could achieve a reasonable control accuracy, but with room for improvement with respect to control sensitivity. Part II of the two-part series reports on the further development of the controller to improve its control sensitivity, and the results of associated controllability tests. (author)

  7. Effect of the probiotic Lactobacilli reuteri (Prodentis in the management of periodontal disease: a preliminary randomized clinical trial

    Directory of Open Access Journals (Sweden)

    M.R. Vivekananda

    2010-11-01

    Full Text Available Objectives: The aim of this study was to evaluate the effects of Lactobacilli reuteri (Prodentis alone and in combination with scaling and root planing (SRP in a double blind, randomized, placebo-controlled clinical trial of volunteers with chronic periodontitis. Methods: Thirty, otherwise systemically healthy, chronic periodontitis patients (19 males and 11 females, aged between 34 and 50 years were included. The study period was 42 days. ‘Split-mouth’ design was used for the SRP, which was performed on day 0; two quadrants (either right or left were treated with SRP whereas the remaining two quadrants were left untreated. The participants received a toothbrush, toothpaste, and brushing instructions. L. reuteri Prodentis lozenges (1×108 CFU DSM17938 + 1×108 CFU ATCC PTA 5289 or the corresponding placebo lozenges were taken twice daily from day 21 to day 42. Statistical analysis was done for comparisons of clinical parameters (Plaque Index (PI, Gingival Index (GI, Gingival Bleeding Index (GBI, probing pocket depth (PPD, clinical attachment level (CAL and microbiological levels of the pathogens Aggregibacter actinomycetemcomitans (Aa, Porphyromonas gingivalis (Pg, and Prevotella intermedia (Pi. All p-values less than 0.05 were considered significant. Assessments were made on day 0 before SRP treatment, on day 21 before administration of the lozenges, and on day 42. Results: At day 42, the PI, GI, and GBI were significantly reduced by all treatment modalities. When ranked, the amount of PI, GI and GBI reduction by the different treatments was SRP + Prodentis > Prodentis > SRP + placebo > placebo; all differences were statistically significant. For PPD and CAL, the best result was obtained with the SRP + Prodentis treatment. PPD was reduced from 5.08±0.75 to 3.78±0.61 mm (p<0.001 and CAL from 3.93±0.93 to 2.85±0.74 mm (p<0.001. Prodentis, either alone or following SRP, reduced Aa, Pi, and Pg by 1 log10 unit

  8. Spot Scanning Proton Therapy for Malignancies of the Base of Skull: Treatment Planning, Acute Toxicities, and Preliminary Clinical Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Grosshans, David R., E-mail: dgrossha@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhu, X. Ronald; Melancon, Adam [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Allen, Pamela K. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Poenisch, Falk; Palmer, Matthew [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); McAleer, Mary Frances; McGovern, Susan L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gillin, Michael [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); DeMonte, Franco [Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chang, Eric L. [Department of Radiation Oncology, University of Southern California Keck School of Medicine, Los Angeles, California (United States); Brown, Paul D.; Mahajan, Anita [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2014-11-01

    Purpose: To describe treatment planning techniques and early clinical outcomes in patients treated with spot scanning proton therapy for chordoma or chondrosarcoma of the skull base. Methods and Materials: From June 2010 through August 2011, 15 patients were treated with spot scanning proton therapy for chordoma (n=10) or chondrosarcoma (n=5) at a single institution. Toxicity was prospectively evaluated and scored weekly and at all follow-up visits according to Common Terminology Criteria for Adverse Events, version 3.0. Treatment planning techniques and dosimetric data were recorded and compared with those of passive scattering plans created with clinically applicable dose constraints. Results: Ten patients were treated with single-field-optimized scanning beam plans and 5 with multifield-optimized intensity modulated proton therapy. All but 2 patients received a simultaneous integrated boost as well. The mean prescribed radiation doses were 69.8 Gy (relative biological effectiveness [RBE]; range, 68-70 Gy [RBE]) for chordoma and 68.4 Gy (RBE) (range, 66-70) for chondrosarcoma. In comparison with passive scattering plans, spot scanning plans demonstrated improved high-dose conformality and sparing of temporal lobes and brainstem. Clinically, the most common acute toxicities included fatigue (grade 2 for 2 patients, grade 1 for 8 patients) and nausea (grade 2 for 2 patients, grade 1 for 6 patients). No toxicities of grades 3 to 5 were recorded. At a median follow-up time of 27 months (range, 13-42 months), 1 patient had experienced local recurrence and a second developed distant metastatic disease. Two patients had magnetic resonance imaging-documented temporal lobe changes, and a third patient developed facial numbness. No other subacute or late effects were recorded. Conclusions: In comparison to passive scattering, treatment plans for spot scanning proton therapy displayed improved high-dose conformality. Clinically, the treatment was well tolerated, and

  9. Asthma control limitations in selected primary health care clinics

    Directory of Open Access Journals (Sweden)

    Jan J. Gerber

    2009-04-01

    Full Text Available Primary health care services worldwide are currently experiencing many quality-related problems. Efforts to improve these services appear to be sporadic and unsatisfactory. Investigations have revealed (Sharma & Sharma 2007 that one of the main causes for this state of affairs can be identif ed as neglected or inadequate documentation of patient/case history. The health care provider (HCP should be equipped to improve the quality of health care and to take the lead in assuaging the predicament.

    The present study was undertaken to assess the correlation between asthma control and patient-related case history notes as recorded via the HCP. The data were obtained retrospectively from the patient notes of all asthmatic patients (including children and pregnant women who attended six selected clinics in the North West Province of South Africa (Dr Kenneth Kaunda Municipal District.

    The analysis of the data collected from the patient clinic books confirmed the suspicion of poor quality of documentation, although the documentation in certain categories rendered some positive results. When compared to the GINA® guidelines, none of the patients had been controlled properly and only a small number (18.4% had been controlled partly (GINA 2008. Asthma control may be enhanced when a standard template is developed for completion by the HCP. It is envisaged that this will ensure that vital information regarding asthma control is documented in order to contribute to satisfactory chronic disease control.

    Opsomming

    Primêre gesondheidsorgdienste wêreldwyd ondervind tans menige gehaltediens-verwante probleme, terwyl pogings om dit te verbeter sporadies en onbevredigend voorkom. Navorsing toon (Sharma & Sharma, 2007 dat een van die hoofoorsake hiervan die onvoldoende dokumentasie van die pasiënt of die geval se geskiedenis of nalating om te dokumenteer, is. Die gesondheidsorgverskaffer (GSV moet toegerus word om die gehalte

  10. Preliminary findings of cortical thickness abnormalities in blast injured service members and their relationship to clinical findings.

    Science.gov (United States)

    Tate, D F; York, G E; Reid, M W; Cooper, D B; Jones, L; Robin, D A; Kennedy, J E; Lewis, J

    2014-03-01

    Though cortical abnormalities have been demonstrated in moderate and severe traumatic brain injured (TBI) patients, there have been no studies examining cortical changes following blast related mild TBI (mTBI). The purpose of this study was to determine the effects and functional relevance of blast mTBI on cortical thickness in a small cohort of carefully screened blast injured US Service Members (SM). Twelve SM with mTBI acquired through blast injury were compared to 11 demographically matched control SM without TBI. Both mTBI and control participants were active duty and had completed a combat deployment. Subjects underwent MRI examination and the T1 weighted anatomic images were processed using the FreeSurfer suite of tools. Cortical thickness maps were compared between groups and examined for relationships with time since injury (TSI). Utilizing a large database of functional imaging results (BrainMap), significant regions of interest (ROI) were used to determine the behavioral profiles most consistently associated with the specific ROI. In addition, clinical variables were examined as part of post-hoc analysis of functional relevance. Group comparisons controlling for age demonstrated several significant clusters of cortical thinning for the blast injured SM. After multiple comparisons correction (False Discovery Rate (FDR)), two left hemisphere clusters remained significant (left superior temporal (STG) and frontal (SFG) gyri). No clusters were significantly correlated with TSI after FDR correction. Behavioral analysis for the STG and SFG clusters demonstrated three significant behavioral/cognitive sub-domains, each associated with audition and language. Blast injured SMs demonstrated distinct areas of cortical thinning in the STG and SFG. These areas have been previously shown to be associated with audition and language. Post-hoc analyses of clinical records demonstrated significant abnormal audiology reports for the blast injured SM suggesting that the

  11. Electrorheological clutch for robotics applications: validation of mathematical model and preliminary control study

    Science.gov (United States)

    Tan, Kim P.; Stanway, Roger; Johnson, Andrew R.; Bullough, William A.; Tozer, Richard C.

    2001-08-01

    There is much current interest in the development of smart fluid clutches for use in the design of high speed machinery. In this paper, the authors employ an ER clutch mechanism in a robotic application. This clutch mechanism consists of twin ER clutches which are driven in opposite directions by two electric motors. By controlling the electric field applied to each clutch, it is possible to control the angular displacement of a robot arm. Before considering control, an established mathematical model is validated. The purpose of this model validation is to help design a control strategy for accurate positioning of the robot arm. Through the use of a Simulink program and a digital controller, both the simulated and experimental angular displacements are compared and shown to be in close agreement. Finally, the displacement response of the ER- driven and DC servo-actuatored robot arm are compared and conclusions are drawn as to the suitability of the ER clutch mechanism as a robotic actuator.

  12. Effects of Adjunct Low-Dose Vitamin D on Relapsing-Remitting Multiple Sclerosis Progression: Preliminary Findings of a Randomized Placebo-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Vahid Shaygannejad

    2012-01-01

    Full Text Available The aim of this preliminary study was to evaluate the effect of low-dose oral vitamin D in combination with current disease-modifying therapy on the prevention of progression of relapsing-remitting multiple sclerosis (RRMS. A phase II double-blind placebo-controlled randomized clinical trial conducted between October 2007 and October 2008 included 50 patients with confirmed RRMS aged 25 to 57 years and normal serum 25-hydroxyvitamin D. They were randomly allocated to receive 12 months of treatment with either escalating calcitriol doses up to 0.5 μg/day or placebo combined with disease-modifying therapy. Response to treatment was assessed at eight-week intervals. In both groups, the mean relapse rate decreased significantly (P<0.001. In the 25 patients treated with placebo, the mean (SD Expanded Disability Status Scale (EDSS increased from 1.70 (1.21 at baseline to 1.94 (1.41 at the end of study period (P<0.01. Average EDSS and relapse rate at the end of trial did not differ between groups. Adding low-dose vitamin D to routine disease-modifying therapy had no significant effect on the EDSS score or relapse rate. A larger phase III multicenter study of vitamin D in RRMS is warranted to more assess the efficacy of this intervention.

  13. Preliminary investigation of the effect of air-pollution-control residue from waste incineration on the properties of cement paste and mortar

    DEFF Research Database (Denmark)

    Geiker, Mette Rica; Kjeldsen, Ane Mette; Galluci, Emmanuel

    2006-01-01

    For preliminary assessment of the engineering properties of concrete with air-pollution-control residue from waste incineration (APC) the possible reactivity of APC and the effect of APC on cement hydration were investigated by isothermal calorimetry, chemical shrinkage (pychnometry), thermal...

  14. Preliminary study of S-CO{sub 2} cycle control logic for part load operation

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Yoonhan; Lee, Jeong Ik [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2016-05-15

    The benefits of S-CO{sub 2} cycle are relatively high efficiency under the mild turbine inlet temperature region, simple layout configuration and small foot-print. In addition, the safety of the SFR system can be inherently enhanced as the violent sodium-water reaction can be substituted with the mild sodium-CO{sub 2} reaction. 75MWe S-CO{sub 2} recompression cycle with radial type turbomachineries and PCHE was designed. Under various part load conditions (30-100% thermal load), off-design performance of the designed system was assessed, and different control logics were first tested. It was identified that the inventory control strategy is the most efficient logic for the part load operation. In the system operation, the compressor surge condition is seriously considered and controlled to avoid the system damage.

  15. Acupressure therapy for morning sickness. A controlled clinical trial.

    Science.gov (United States)

    Hyde, E

    1989-01-01

    A prospective, controlled clinical trial examined the efficacy of acupressure therapy for morning sickness, using a two group, random assignment, crossover design. Subjects in Group 1 (N = 8) used acupressure wristbands for five days, followed by five days without therapy. Subjects in Group 2 (N = 8) had no therapy for five days, followed by five days use of wristbands. The Multiple Affect Adjective Checklist and Sickness Impact Profile were used, and extent of nausea was assessed at baseline, day five, and day ten. Use of acupressure wristbands relieved morning sickness for 12 of 16 subjects (chi 2 = 5.31 with Yates' correction factor, df = 1, p less than .025). Acupressure therapy resulted in statistically significant (p less than .05) reductions in anxiety, depression, behavioral dysfunction, and nausea. Limitations of the study and suggestions for future research are presented.

  16. Clinical spectrum of impulse control disorders in Parkinson's disease.

    Science.gov (United States)

    Weintraub, Daniel; David, Anthony S; Evans, Andrew H; Grant, Jon E; Stacy, Mark

    2015-02-01

    Impulse control disorders (ICDs), including compulsive gambling, buying, sexual behavior, and eating, are a serious and increasingly recognized psychiatric complication in Parkinson's disease (PD). Other impulsive-compulsive behaviors (ICBs) have been described in PD, including punding (stereotyped, repetitive, purposeless behaviors) and dopamine dysregulation syndrome (DDS; compulsive PD medication overuse). ICDs have been most closely related to the use of dopamine agonists (DAs), perhaps more so at higher doses; in contrast, DDS is primarily associated with shorter-acting, higher-potency dopaminergic medications, such as apomorphine and levodopa. Possible risk factors for ICDs include male sex, younger age and younger age at PD onset, a pre-PD history of ICDs, and a personal or family history of substance abuse, bipolar disorder, or gambling problems. Given the paucity of treatment options and potentially serious consequences, it is critical for PD patients to be monitored closely for development of ICDs as part of routine clinical care.

  17. Quality assurance and quality control in clinical cytogenetics.

    Science.gov (United States)

    Mikhail, Fady M; Watson, Michael S

    2014-07-14

    The goal of any clinical laboratory should be to provide patients with the most accurate test results possible. This is accomplished through various overlapping programs that continuously monitor and optimize all aspects of a test, including decisions by the laboratory to offer a test, the decision of providers to request the test, the testing itself, and the reporting of results to the referral source and patient. The levels at which test performance and accuracy can be optimized are encompassed under quality control (QC) and quality assurance (QA). The monitoring of QC and QA problems allows for the integration of these parameters into a total quality management program. This unit reviews QC and QA guidelines, in addition to discussing how to establish a quality assurance program.

  18. Quality control of parasitology stool examination in Tabriz clinical laboratories

    Directory of Open Access Journals (Sweden)

    shahram Khademvatan

    2011-06-01

    Full Text Available The purpose of quality control program was to make doctors and laboratory personnel trust in laboratory results and consequently increasing confidence in laboratory achievements. The quality assurance means raising the level of quality in all tests that lead to raising the level of work efficiency and laboratories including minimum expense for society and minimum time for lab personnel. This study aimed to assess and determine the accuracy and precision of results in Tabriz medical diagnostic laboratories. Materials and Methods: In this retrospective study, 790 stool samples were selected randomly and tested by standard methods.Student t- test, SPSS software and sensitivity and accuracy formulas were used for data analysis. Results: The sensitivity was 62%, 22% and 8% with 95% confidence intervals for worm's eggs, protozoan cysts and trophozoite detection respectively. Conclusion: To elevate quality assurance in clinical diagnostic laboratory, monitoring and check of the laboratories by standard methods continually should be done.

  19. Preliminary Marine Safety Risk Assessment, Brandon Road Lock and Dam Invasive Species Control Measures

    Science.gov (United States)

    2016-12-01

    highlights individual standing at deck-edge without life jacket ...the open deck, wear a life jacket . Generally, these provisions intend to minimize the chance of falls into the water, either while a vessel crosses...standing at deck-edge without life jacket ). 6 CONCLUSIONS Of the different, potential invasive species control measures, and fully acknowledging

  20. A telerehabilitation program improves postural control in multiple sclerosis patients: a Spanish preliminary study.

    Science.gov (United States)

    Ortiz-Gutiérrez, Rosa; Cano-de-la-Cuerda, Roberto; Galán-del-Río, Fernando; Alguacil-Diego, Isabel María; Palacios-Ceña, Domingo; Miangolarra-Page, Juan Carlos

    2013-10-31

    Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session).The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test) was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available.

  1. A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study

    Directory of Open Access Journals (Sweden)

    Rosa Ortiz-Gutiérrez

    2013-10-01

    Full Text Available Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25 received physiotherapy treatment twice a week (40 min per session. Experimental group (n = 25 received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session.The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available.

  2. A Preliminary Investigation of Stimulus Control Training for Worry: Effects on Anxiety and Insomnia

    Science.gov (United States)

    McGowan, Sarah Kate; Behar, Evelyn

    2013-01-01

    For individuals with generalized anxiety disorder, worry becomes associated with numerous aspects of life (e.g., time of day, specific stimuli, environmental cues) and is thus under poor discriminative stimulus control (SC). In addition, excessive worry is associated with anxiety, depressed mood, and sleep difficulties. This investigation sought…

  3. Preliminary Analysis of an Oscillating Surge Wave Energy Converter with Controlled Geometry: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Tom, Nathan; Lawson, Michael; Yu, Yi-Hsiang; Wright, Alan

    2015-09-09

    The aim of this paper is to present a novel wave energy converter device concept that is being developed at the National Renewable Energy Laboratory. The proposed concept combines an oscillating surge wave energy converter with active control surfaces. These active control surfaces allow for the device geometry to be altered, which leads to changes in the hydrodynamic properties. The device geometry will be controlled on a sea state time scale and combined with wave-to-wave power-take-off control to maximize power capture, increase capacity factor, and reduce design loads. The paper begins with a traditional linear frequency domain analysis of the device performance. Performance sensitivity to foil pitch angle, the number of activated foils, and foil cross section geometry is presented to illustrate the current design decisions; however, it is understood from previous studies that modeling of current oscillating wave energy converter designs requires the consideration of nonlinear hydrodynamics and viscous drag forces. In response, a nonlinear model is presented that highlights the shortcomings of the linear frequency domain analysis and increases the precision in predicted performance.

  4. Effectiveness of Mindfulness-Based Stress Reduction Bibliotherapy: A Preliminary Randomized Controlled Trial.

    Science.gov (United States)

    Hazlett-Stevens, Holly; Oren, Yelena

    2017-06-01

    This randomized controlled investigation examined the effectiveness of a self-help bibliotherapy format of the evidence-based mindfulness-based stress reduction (MBSR) intervention. College students seeking stress reduction were randomly assigned to a 10-week MBSR bibliotherapy intervention group (n = 47) or a no-treatment control group (n = 45). Self-report measures were collected at baseline and postintervention. A total of 25 bibliotherapy and 43 control group participants provided final data following the intervention period. Compared to the control group, bibliotherapy participants reported increased mindfulness following the intervention. Significant decreases on measures of depression, anxiety, stress, perceived stress, and anxiety sensitivity also were reported postintervention as well as increased quality of life in physical health, psychological, and environmental domains. No statistically significant group effects were found for social relationships quality of life domain, worry, and experiential avoidance measures. This MBSR workbook may provide an acceptable and effective alternative for motivated individuals seeking to reduce stress, at least for a select group of individuals who are willing and able to sustain participation in the intervention. © 2016 Wiley Periodicals, Inc.

  5. Feasibility of controlling prosthetic hand using sonomyography signal in real time: preliminary study.

    Science.gov (United States)

    Shi, Jun; Chang, Qian; Zheng, Yong-Ping

    2010-01-01

    The morphological changes of muscle can be accurately detected by sonography, a process we have termed sonomyography (SMG). This article investigates the feasibility of using muscle thickness deformation SMG as a new signal source to control a prosthetic hand in real time. Thickness deformation SMG of the extensor muscle was measured by a block-matching algorithm during wrist extension-flexion; the amplitude of the deformation was used to control the prosthetic hand. We compared various fast-search algorithms to select the best one for real-time prosthetic control. The two-dimensional logarithmic search (TDL) algorithm, with and without streaming single-instruction multiple-data extensions, showed excellent execution efficiency, with an overall mean correlation coefficient of about 0.99, a mean standard root-mean-square error prosthetic hand, allowing for proprioception of muscle tension, and that the SMG provides good control of the prosthetic hand, allowing it to proportionally open and close with a fast-search algorithm.

  6. Control of Relative Air Humidity as a Potential Means to Improve Hygiene on Surfaces: A Preliminary Approach with Listeria monocytogenes.

    Science.gov (United States)

    Zoz, Fiona; Iaconelli, Cyril; Lang, Emilie; Iddir, Hayet; Guyot, Stéphane; Grandvalet, Cosette; Gervais, Patrick; Beney, Laurent

    2016-01-01

    Relative air humidity fluctuations could potentially affect the development and persistence of pathogenic microorganisms in their environments. This study aimed to characterize the impact of relative air humidity (RH) variations on the survival of Listeria monocytogenes, a bacterium persisting on food processing plant surfaces. To assess conditions leading to the lowest survival rate, four strains of L. monocytogenes (EGDe, CCL500, CCL128, and LO28) were exposed to different RH conditions (75%, 68%, 43% and 11%) with different drying kinetics and then rehydrated either progressively or instantaneously. The main factors that affected the survival of L. monocytogenes were RH level and rehydration kinetics. Lowest survival rates between 1% and 0.001% were obtained after 3 hours of treatment under optimal conditions (68% RH and instantaneous rehydration). The survival rate was decreased under 0.001% after prolonged exposure (16h) of cells under optimal conditions. Application of two successive dehydration and rehydration cycles led to an additional decrease in survival rate. This preliminary study, performed in model conditions with L. monocytogenes, showed that controlled ambient RH fluctuations could offer new possibilities to control foodborne pathogens in food processing environments and improve food safety.

  7. A new concept and preliminary study of variable hypersonic inlet with fixed geometry based on shockwave control

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The inlet plays a significant role in the hypersonic airbreathing propulsion. A fixed-geometry inlet is troubled by low air-capture ratio and large additional drag while operating below the design Mach number. Whereas a variable-geometry inlet can maximize performance, but adds weight and complexity to the propulsion system. Based on a fluidic shock shape control technique, this paper proposes a new concept of variable hypersonic inlet with fixed geometry, gives the realization scheme, and conducts a preliminary validation. The results show that the control of the external shock system and the effective throat area can be achieved by the self-provided high pressure fluid of the inlet. For an inlet with an operating Mach-number region of 4 to 6, the shock-on-lip condition can be maintained from Mach 5 to Mach 6 with the maximum expense of 1.8% secondary flow ratio, resulting in 20% extra captured mass flow and 8% less forebody drag at low Mach numbers compared with conventional fixed-geometry inlets. Thus, the performance enhancement by using the proposed variable inlet can substantially benefit the acceleration process of hypersonic vehicles at low Mach numbers.

  8. Preliminary assessment of Tongue Drive System in medium term usage for computer access and wheelchair control.

    Science.gov (United States)

    Yousefi, Behnaz; Huo, Xueliang; Ghovanloo, Maysam

    2011-01-01

    Tongue Drive System (TDS) is a wireless, wearable assistive technology that enables individuals with severe motor impairments access computers, drive wheelchairs, and control their environments using tongue motion. In this paper, we have evaluated the TDS performance as a computer input device using ISO9241-9 standard tasks for pointing and selecting, based on the well known Fitts' Law, and as a powered wheelchair controller through an obstacle course navigation task. Nine able-bodied subjects who already had tongue piercing participated in this trial over 5 sessions during 5 weeks, allowing us to study the TDS learning process and its current limiting factors. Subjects worn tongue rings made of titanium in the form of a barbell with a small rare earth magnetic tracer hermetically sealed inside the upper ball. Comparing the results between 1(st) and 5(th) sessions showed that subjects' performance improved in all the measures through 5 sessions, demonstrating the effects of learning.

  9. A Yoga Intervention for Posttraumatic Stress: A Preliminary Randomized Control Trial.

    Science.gov (United States)

    Jindani, Farah; Turner, Nigel; Khalsa, Sat Bir S

    2015-01-01

    Yoga may be effective in the reduction of PTSD symptomology. The purpose of this study was to evaluate the impact of a Kundalini Yoga (KY) treatment on PTSD symptoms and overall wellbeing. To supplement the current field of inquiry, a pilot randomized control trial (RCT) was conducted comparing an 8-session KY intervention with a waitlist control group. 80 individuals with current PTSD symptoms participated. Both groups demonstrated changes in PTSD symptomology but yoga participants showed greater changes in measures of sleep, positive affect, perceived stress, anxiety, stress, and resilience. Between-groups effect sizes were small to moderate (0.09-0.25). KY may be an adjunctive or alternative intervention for PTSD. Findings indicate the need for further yoga research to better understand the mechanism of yoga in relation to mental and physical health, gender and ethnic comparisons, and short- and long-term yoga practice for psychiatric conditions.

  10. A preliminary investigation on the application of robotics to missile fire control

    Science.gov (United States)

    McIngvale, P. H.; Sherrill, A. D.; Herring, J. W.

    1983-11-01

    This report explores the possible applications of artificial intelligence and robotics to Army fire control problems. A candidate robotics system is presented and its development is detailed. The system is a ground Remote Target Acquisition/Designation System which would be developed in stages and would make use of technology existing in HELLFIRE, FOG-M, and other related systems. It is intended to evolve from a relatively simple surveillance and designation system to an essentially autonomous fire control system. It has the advantages of removing the soldier to a less hazardous position, allowing the operator(s) to oversee the operation of many robotic forward observers, and allowing the acquisition and designation of many robotic forward observers, and allowing the acquisition and designation of targets over a wide area. In the latter evolutionary stages, the system should be equipped with weapons and be autonomous or semi-autonomous.

  11. Evaluation of an additive efficacy in broiler litter microbial level control in field: preliminary results

    Directory of Open Access Journals (Sweden)

    Matteo Pennacchi

    2010-01-01

    Full Text Available The present study was conducted to evaluate in field the efficacy of an additive (SOP® C POULTRY, as an agent for the control of micro-organisms in broiler litter. The Total aerobic Microbial Count (TMC, Staphylococcus species (spp., Coliforms, and Salmonella spp. in broiler litter samples of both the Houses, 2 (H2 and 3 (H3, were determined, and also at the end of each cycle the mortality rate was recorded. The results showed significant reduction of all the microbial counts: P= 0.0078 (CMT, 0,0021 (Staphylococcus spp. and 0.0541 (Coliforms, and mortality (P= 0.00106 in treated litter samples H2 and the control H3.

  12. A Yoga Intervention for Posttraumatic Stress: A Preliminary Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Farah Jindani

    2015-01-01

    Full Text Available Yoga may be effective in the reduction of PTSD symptomology. The purpose of this study was to evaluate the impact of a Kundalini Yoga (KY treatment on PTSD symptoms and overall wellbeing. To supplement the current field of inquiry, a pilot randomized control trial (RCT was conducted comparing an 8-session KY intervention with a waitlist control group. 80 individuals with current PTSD symptoms participated. Both groups demonstrated changes in PTSD symptomology but yoga participants showed greater changes in measures of sleep, positive affect, perceived stress, anxiety, stress, and resilience. Between-groups effect sizes were small to moderate (0.09–0.25. KY may be an adjunctive or alternative intervention for PTSD. Findings indicate the need for further yoga research to better understand the mechanism of yoga in relation to mental and physical health, gender and ethnic comparisons, and short- and long-term yoga practice for psychiatric conditions.

  13. Production control in the steel industry with energy conservation considerations: a preliminary evaluation. [GASP

    Energy Technology Data Exchange (ETDEWEB)

    Takamoto, H.; Williams, T.J.

    1979-06-01

    The work here consists mainly of three tasks; the first is to construct the basic production model for the raw-material preparation and the iron-making area which had been ignored in the earlier work, but is vital to the energy problem. The second is to construct the energy utilization and energy generation models over all the steel production units involved in the plant. The third is to develop the hierarchy structure to control the energy management function.

  14. HIGH EFFICIENCY STRUCTURAL FLOWTHROUGH ROTOR WITH ACTIVE FLAP CONTROL: VOLUME ONE: PRELIMINARY DESIGN REPORT

    Energy Technology Data Exchange (ETDEWEB)

    Zuteck, Michael D. [Zimitar, Inc.; Jackson, Kevin L. [Zimitar, Inc.; Santos, Richard A. [Zimitar, Inc.; Chow, Ray [Zimitar, Inc.; Nordenholz, Thomas R. [The California Maritime Academy; Wamble, John Lee [Zimitar, Inc.

    2015-05-16

    The Zimitar one-piece rotor primary structure is integrated, so balanced thrust and gravity loads flow through the hub region without transferring out of its composite material. Large inner rotor geometry is used since there is no need to neck down to a blade root region and pitch bearing. Rotor control is provided by a highly redundant, five flap system on each blade, sized so that easily handled standard electric linear actuators are sufficient.

  15. Nuclear Hardness Evaluation Procedures for the Preliminary Assessment of the FLEETSATCOM Attitude and Velocity Control Subsystem.

    Science.gov (United States)

    1979-12-01

    attitude and velocity control subsystem of the FLSATCOM satellite to various nuclear weapon effects. DD1473 E ITION OF INOV 6 IS OBSOLETE...thermomechanical damage and material degradation. These procedures are presented in Section 3. 3) the so-called top-level screen of the AVCS assessment which ETI...bays with cat-a-lac paint, a low Z material , to minimize cavity field coupling. 44 0 use of terminal protection, mostly in the form of zener diodes or

  16. The Verbal Clock Test: preliminary validation of a brief, vision- and motor-free measure of executive function in a clinical sample.

    Science.gov (United States)

    Cercy, Steven P

    2012-01-01

    Assessment of executive functions is frequently time-consuming, and although some brief measures exist they are subject to problems associated with limited education, culture of origin, impairments of motor or visual systems, and tolerability. Preliminary validation of a newly developed measure, the Verbal Clock Test (VCT), was conducted in a clinical sample of 294 patients who underwent neuropsychological evaluation. The evidence supports the interpretation of VCT scores as demonstrating construct validity, criterion-related validity, and sound internal consistency. Performance does not vary substantially with gender or mood, and variability associated with age, education, and ethnicity is modest. Confounding effects of motor and visual impairments are eliminated. Initial data suggest the VCT represents a reasonable method of assessing abstract reasoning and concept formation when clinical circumstances limit the use of currently available measures.

  17. Endodontic surgery using 2 different magnification devices: preliminary results of a randomized controlled study.

    Science.gov (United States)

    Taschieri, Silvio; Del Fabbro, Massimo; Testori, Tiziano; Francetti, Luca; Weinstein, Roberto

    2006-02-01

    The introduction of microsurgical instruments and magnification devices has brought advantages in root-end management and the application of root-end filling materials. The main purpose of this prospective clinical study was to monitor the outcome of ultrasonic root-end preparation using magnification loupes or an endoscope. Tooth location and the presence of post restoration were also examined as potentially affecting the outcome. Teeth treated surgically showed a periradicular lesion of strictly endodontic origin. A total of 59 patients were included in the study, according to specific selection criteria. Following the reflection of a full mucoperiosteal tissue flap, residual soft tissues were curetted, root ends were resected, and root-end cavities were prepared ultrasonically with a zirconium nitrate tip, and zinc oxide EBA-reinforced cement root-end fillings were placed. Thirty-two root-end management procedures were performed using magnification loupes and 39 using an endoscope. All cases followed for a period of 1 year were classified into 3 groups (success, uncertain healing, and failure) according to radiographic and clinical criteria. Of the 71 teeth evaluated at 1-year follow-up, 67 teeth (92.95%) successfully healed, 3 teeth had uncertain healing, and 2 failed. In the group using endoscopy, 94.9% of successful healing was achieved, while for the other group, 90.6% was recorded. We found no statistically significant differences in treatment results related to the arch (P = .20), post restoration (P = .21), or type of magnification device (P = .08). In the present study, adherence to a strict endodontic surgical protocol and the use of modern surgical endodontic procedures, together with visual magnifications, resulted in an overall high success rate.

  18. Neuropsychology, Social Cognition and Global Functioning Among Bipolar, Schizophrenic Patients and Healthy Controls: Preliminary Data

    Directory of Open Access Journals (Sweden)

    Elisabetta eCaletti

    2013-10-01

    Full Text Available This study aimed to determine the extent of impairment in social and non-social cognitive domains in an ecological context comparing bipolar (BD, schizophrenic patients (SKZ and healthy controls (HC. The sample was enrolled at the Department of Psychiatry of Policlinico Hospital, University of Milan, it includes stabilized schizophrenic patients (n = 30, euthymic bipolar patients (n = 18 and healthy controls (n = 18. Patients and controls completed psychiatric assessment rating scales, the Brief Assessment of Cognition in Schizophrenia (BACS and the Executive and Social Cognition Battery (ESCB that contains both ecological tests of executive function and social cognition, in order to better detect cognitive deficits in patients with normal results in standard executive batteries. The three groups differed significantly for gender and substance abuse, however the differences did not influence the results. Bipolar patients showed less impairment on cognitive performance compared to schizophrenic patients, even in ecological tests that mimic real life scenarios. In particular, BD performed better than SKZ in verbal memory (p

  19. Blood pressure and heart rate during ovariohysterectomy in pyometra and control dogs: a preliminary investigation.

    Science.gov (United States)

    Höglund, Odd Viking; Lövebrant, Johanna; Olsson, Ulf; Höglund, Katja

    2016-11-17

    Surgery causes a stress response, a physiologic response to trauma. The intraoperative surgical stress response in dogs diagnosed with pyometra has not previously been described. The aim of this study was to investigate the intraoperative surgical stress response, assessed by blood pressure and heart rate measurements, in dogs diagnosed with pyometra and healthy controls. All dogs were premedicated with acepromazine and methadone, anaesthesia was induced with propofol and maintained with isoflurane, where after the dogs were subjected to ovariohysterectomy. Eight dogs diagnosed with pyometra and eight healthy controls were used. Systolic blood pressure and heart rate were measured to assess the surgical stress response. Additionally propofol dosage at induction of anaesthesia and the end-tidal isoflurane concentration were investigated. The surgery was split into four phases. Phase 0 was the period 10 min before the skin incision, phase 1 was skin incision and opening of abdomen, phase 2 was manipulation of uterine horns, lifting of the ovary with stretching of the mesovarium, ligation and transection of mesovarium and phase 3 was ligation and transection of cervix, removal of organs and closing of the abdomen. Dosage of propofol at induction of anaesthesia was 3.6 ± 1 mg/kg in dogs with pyometra and 4.1 ± 1 in healthy controls (P = 0.37). In both groups, systolic blood pressure increased between phase 1 and 2, from 87 ± 15 to 114 ± 19 mmHg in dogs with pyometra, and from 88 ± 18 to 106 ± 20 mmHg in healthy controls, (both P blood pressure did not differ significantly between groups in any of the phases. Heart rate and end-tidal concentration of isoflurane did not differ significantly between phases or between groups. The increased blood pressure at removal of ovaries during ovariohysterectomy suggests a pronounced noxious stimulus at this part of the procedure. In principle, the study parameters and response to surgery did not differ

  20. Active Video Game Exercise Training Improves the Clinical Control of Asthma in Children: Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Evelim L F D Gomes

    Full Text Available The aim of the present study was to determine whether aerobic exercise involving an active video game system improved asthma control, airway inflammation and exercise capacity in children with moderate to severe asthma.A randomized, controlled, single-blinded clinical trial was carried out. Thirty-six children with moderate to severe asthma were randomly allocated to either a video game group (VGG; N = 20 or a treadmill group (TG; n = 16. Both groups completed an eight-week supervised program with two weekly 40-minute sessions. Pre-training and post-training evaluations involved the Asthma Control Questionnaire, exhaled nitric oxide levels (FeNO, maximum exercise testing (Bruce protocol and lung function.No differences between the VGG and TG were found at the baseline. Improvements occurred in both groups with regard to asthma control and exercise capacity. Moreover, a significant reduction in FeNO was found in the VGG (p < 0.05. Although the mean energy expenditure at rest and during exercise training was similar for both groups, the maximum energy expenditure was higher in the VGG.The present findings strongly suggest that aerobic training promoted by an active video game had a positive impact on children with asthma in terms of clinical control, improvement in their exercise capacity and a reduction in pulmonary inflammation.Clinicaltrials.gov NCT01438294.

  1. Preliminary clinical prediction rule for identifying patients with ankylosing spondylitis who are likely to respond to an exercise program: a pilot study.

    Science.gov (United States)

    Alonso-Blanco, Cristina; Fernández-de-las-Peñas, César; Cleland, Joshua A

    2009-06-01

    The aim of this study was to develop a preliminary clinical prediction rule to identify the potential predictors for identifying patients presenting with ankylosing spondylitis who are likely to respond to a specific exercise program. Consecutive patients with ankylosing spondylitis underwent a standardized examination and then received eight physical therapy sessions during a 2-mo period, which included an exercise program based on the treatment of the shortened muscle chains, following the guideline described by the global posture re-education method. Patients were classified as having experienced a successful outcome at 1 mo after discharge based on a 20% reduction on Bath Ankylosing Spondylitis Functional Index and self-report perceived recovery. Potential predictor variables were entered into a stepwise logistic regression model to determine the most accurate set of variables for identifying treatment success. Data from 35 patients were included, of which 16 (46%) experienced a successful outcome. A clinical prediction rule with three variables (physical role >37, bodily pain >27, and Bath Ankylosing Spondylitis Disease Activity Index >31) was identified. The most accurate predictor of success was if the patient exhibited two of the three variables, and the positive likelihood ratio was 11.2 (95% confidence interval, 1.7-76.0) and the posttest probability of success increased to 91%. The accuracy of prediction declined if either 1/3 (+likelihood ratio = 7.7; 95% confidence interval, 0.52-113.5) or 3/3 (+likelihood ratio = 2.6, 95% confidence interval, 1.6-4.0) variables were present. The present preliminary clinical prediction rule provides the potential to identify patients with ankylosing spondylitis who are likely to experience short-term follow-up success with a specific exercise program. Future studies are necessary to validate the clinical prediction rule.

  2. Feasibility, safety, and preliminary efficacy of Low Amplitude Seizure Therapy (LAP-ST): A proof of concept clinical trial in man.

    Science.gov (United States)

    Youssef, Nagy A; Sidhom, Emad

    2017-11-01

    Current pulse amplitude used in clinical ECT may be higher than needed. Reducing pulse amplitude may improve focality of the electric field and thus cognitive adverse effects. Here we examine the feasibility, safety, and whether Low Pulse Amplitude Seizure Therapy (LAP-ST, 0.5-0.6A) minimizes cognitive adverse effects while retaining efficacy. Patients with treatment-resistant primary mood (depressive episodes) or psychotic disorders who were clinically indicated to undergo ECT were offered to be enrolled in an open-label study. The study consisted of a full acute course of LAP-ST under standard anesthesia and muscle relaxation. The primary outcome was feasibility of seizure induction. Clinical outcome measures were: time to reorientation (TRO), Mini Mental State Examination, Montgomery Aberg Depression Scale, and Brief Psychiatric Rating Scale, and Clinical Global Impression Scale. Twenty-two patients consented for enrollment in the study. LAP-ST was feasible, and all patients had seizures in the first session. Participants had a quick orientation with median TRO of 4.5min. Treatment was efficacious for both depressive and psychotic symptoms. Relatively small sample size, non-blinded, and no randomization was performed in this initial proof of concept study. This first human preliminary data of a full course of focal LAP-ST demonstrates that seizure induction is feasible. These results, although preliminary, suggest that the LAP-ST compared to the standard ECT techniques may result in less cognitive side effects, but comparable efficacy. Larger studies are needed to replicate these findings. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Socio-demographic and clinical characteristics of pregnant and puerperal crack-cocaine using women: preliminary data

    Directory of Open Access Journals (Sweden)

    MARIA LUCRÉCIA SCHERER ZAVASCHI

    2014-01-01

    Full Text Available Background The literature provides several studies on the effects of cocaine when exposed to the fetus. However, the majority of these data comes from animal models. Objective The objective of this study is to present socio-demographic and clinical data in crack-cocaine using pregnant women and their babies, as compared to non-users. Methods Cross-sectional study, comprised by 56 dyads of crack-cocaine using mothers-babies and 89 control dyads. In addition to the socio-demographic data and the babies’ information, data collection was based on ABIPEMI for socioeconomic level, WAIS for IQ, MINI for psychopathology and ASSIST for drug use. Results Most crack users, in comparison to non-users, did not have a partner (10.52% vs 4.4%, P = 0.001 and presented lower IQ (78.15, +/-8.07 vs 84.27 +/- 9.87; P = 0.002. The prevalence of antisocial personality disorder and suicide risk in users was higher than in non-users (24.44% vs none, P < 0.001; 28.26% vs 10.46% P = 0.01. Most of the users did not participate in prenatal care (75%. The babies that the crack-cocaine using mothers gave birth to weighed significantly less than the controls (2.858 g vs 3.240 g, P = 0.002. Discussion Users had a higher degree of psychopathology and lower attendance in prenatal care. There was an overlap of adverse factors, both for exposed mothers and babies. The sum of these vulnerabilities could result in significant harm to the developing infant.

  4. A preliminary investigation of the Environmental Control and Life Support Subsystem (EC/LSS) for the space construction base manufacturing modules

    Science.gov (United States)

    Wells, H. B.

    1977-01-01

    The preliminary data of the environmental control and life support subsystem for a space construction base manufacturing module was reported. A space processing module, which is capable of performing production biological experiments, was chosen as a baseline configuration. The primary assemblies and components considered for use were humidity and temperature control, ventilation fan, cabin fan, water separator, condensate storage, overboard dumping, distribution system, contaminant monitoring, cabin sensors, and fire and smoke detection.

  5. Preliminary Report: Controller Prototyping and Validation for Photo-Voltaic Comfort Cooling

    DEFF Research Database (Denmark)

    Agesen, Mads Kronborg; Skou, Arne Joachim; Pedersen, Keld Lotzfeldt

    2016-01-01

    Large office buildings - typically with glass fronts - often suffer from a high cooling demand during summertime. Typically, this requires a large amount of additional electricity for the cooling system. One straightforward alternative is to store cooling energy using electricity generated by sol......, the possibility of providing improved comfort through intelligent supervisory control is studied. The system is comprised of a grid coupled photovoltaic system, a heat pump, an ice bank and a cooling coil to interface the existing ventilation system in the office building....

  6. Age-related differences in control of a visuomotor coordination task: a preliminary study

    OpenAIRE

    2016-01-01

    [Purpose] The purpose of the current study was to examine age-related differences in control of a perception-action coordination skill. We adapted a visuomotor tracking experiment requiring various coordination patterns between a limb’s motion and an external signal. [Subjects and Methods] A total of 12 subjects (6 elderly and 6 young) voluntarily participated in the study. The experimental session consisted of 3 trials for 3 different relative phase patterns: 0°, 90°, and 180°, defined by th...

  7. Preliminary Design of Muses Control System Based on RT-Corba and Java

    CERN Document Server

    Tanabé, T; Ohnishi, J; Takano, M; Katayama, T; Tanabe, Toshiya; Masuoka, Toshikatsu; Ohnishi, Jun-ichi; Takano, Motonobu; Katayama, Takeshi

    2001-01-01

    Common Object Request Broker Architecture (CORBA) based control system has been utilized for the first phase of RIKEN-RI Beam Factory (RIBF) [1] at the developing stage. Software sharing with Jozef Stefan Institute (JSI) in Slovenia via CORBA/JavaBeans has been successfully demonstrated. Accelerator Beans (Abeans) [2] components developed in JDK1.2.2 have been ported to RIKEN's CORBA server. The second phase of the RIBF project is named "Multi-Use Experimental Storage rings" (MUSES) project, which includes an accumulator cooler ring (ACR) and collider rings. Due to the much larger number of controlled objects and more stringent timing requirement than the first-phase project, we contemplate using recently established real-time (RT) CORBA specification [3]. Summary of our efforts to test RT-CORBA with the existing JaveBeans components and other related subjects are described in this paper. [1] http://ribfweb1.riken.go.jp/ [2] http://kgb.ijs.si/KGB/ [3] http://www.omg.org/

  8. OLIVE PASTE CONSISTENCY AS A CONTROL PARAMETER FOR OIL EXTRACTION: A PRELIMINARY APPROACH

    Directory of Open Access Journals (Sweden)

    Piernicola Masella

    2008-09-01

    Full Text Available Malaxation is a critical step of olive oil extraction process as it can largely affect the extraction yield along with product quality. At present, malaxation control is based upon accumulated empirical results and the experience of the operators. There are evidences that this method rarely point out the olive-paste state suitable for oil extraction. The paper reports the results of a laboratory investigation aimed to verify the feasibility of using the olive paste consistency variation during malaxation as a parameter representing the right state for oil extraction. Olive pastes consistency evaluation was performed with a rotational rheometer. Oil extraction yield was evaluated by means of an extractability index (EI determined by laboratory centrifugation of the paste. The effect of different malaxation time and pastes humidity was investigated. Both malaxation time and humidity increments involve significant decrements of paste consistency and a simultaneous increase of EI. A good linear correlation among paste consistency and EI has been found, i.e. a large proportion of EI variance, about 90%, can be explained in terms of paste consistency variation during malaxation. The availability of a measurable parameter representing the paste state suitable for oil extraction could allow to implement a “closed-loop” control system for extraction yield maximization.

  9. A preliminary investigation of the effect of force variation for myoelectric control of hand prosthesis.

    Science.gov (United States)

    Al-Timemy, Ali H; Bugmann, Guido; Escudero, Javier; Outram, Nicholas

    2013-01-01

    The myoelectric control of prostheses has been an important area of research for the past 40 years. Significant advances have been achieved with Pattern Recognition (PR) systems regarding the number of movements to be classified with high accuracy. However, practical robustness still needs further research. This paper focuses on investigating the effect of the change in force levels by transradial amputee persons on the performance of PR systems. Two below-elbow amputee persons participated in the study. Three levels of forces (low, medium, and high) were recorded for different hand grips with the help of visual feedback from the Electromyography (EMG) signals. Results showed that changing the force level degraded the performance of the myoelectric control system by up to 60% with 12 EMG channels for 4 hand grips and a rest position. We investigated different EMG feature sets in combination with a Linear Discriminant Analysis (LDA) classifier. The performance was slightly better with Time Domain (TD) features compared to Auto Regression (AR) coefficients and Root Mean Square (RMS) features. Finally, the error of the classification was considerably reduced to approximately 17% when the PR system was trained with all force levels.

  10. Preliminary results from a four-working space, double-acting piston, Stirling engine controls model

    Science.gov (United States)

    Daniele, C. J.; Lorenzo, C. F.

    1980-01-01

    A four working space, double acting piston, Stirling engine simulation is being developed for controls studies. The development method is to construct two simulations, one for detailed fluid behavior, and a second model with simple fluid behaviour but containing the four working space aspects and engine inertias, validate these models separately, then upgrade the four working space model by incorporating the detailed fluid behaviour model for all four working spaces. The single working space (SWS) model contains the detailed fluid dynamics. It has seven control volumes in which continuity, energy, and pressure loss effects are simulated. Comparison of the SWS model with experimental data shows reasonable agreement in net power versus speed characteristics for various mean pressure levels in the working space. The four working space (FWS) model was built to observe the behaviour of the whole engine. The drive dynamics and vehicle inertia effects are simulated. To reduce calculation time, only three volumes are used in each working space and the gas temperature are fixed (no energy equation). Comparison of the FWS model predicted power with experimental data shows reasonable agreement. Since all four working spaces are simulated, the unique capabilities of the model are exercised to look at working fluid supply transients, short circuit transients, and piston ring leakage effects.

  11. Predictors of high score patient-reported barriers to controlling cancer pain: a preliminary report.

    Science.gov (United States)

    Kwon, Jung Hye; Oh, Sung Yong; Chisholm, Gary; Lee, Jung-Ae; Lee, Jae Jin; Park, Keon Woo; Nam, Seung-Hyun; Song, Hun Ho; Lee, Keehyun; Zang, Dae Young; Kim, Ho Young; Choi, Dae Ro; Kim, Hyo Jung; Kim, Jung Han; Jung, Joo Young; Jang, Geundoo; Kim, Hyeong Su; Won, Ji Yun; Bruera, Eduardo

    2013-04-01

    Pain is one of the most common and devastating symptoms in cancer patients, and misunderstandings on the patient's part can cause major obstacles in pain management. We evaluated factors associated with patient's high barrier score to managing cancer-associated pain by having 201 patients complete the Korean Barriers Questionnaire II, the Brief Pain Inventory--Korean, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and the Korean Beck Depression Inventory. The Pain Management Index (PMI) was also assessed. The patients were from nine oncology clinics in university hospitals and a veterans' hospital in South Korea. The median pain score (0-10 scale) was 4, with a median percentage of pain improvement during the last 24 h of 70 %. A total of 150 patients (75 %) received strong opioids, and 177 (88 %) achieved adequate analgesia (positive PMI). Mean scores ± SD for the Barriers Questionnaire II ranged from 1.5 ± 1 to 2.8 ± 1.1, with the harmful effects subscale the highest. In the multiple regression model, depression was significantly associated with total barrier score to pain management (p Management of cancer pain should include screening for depression, and management of depression could reduce patient-reported barriers to pain management.

  12. Effective local control of vertebral metastases by simultaneous integrated boost radiotherapy. Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Lubgan, Dorota; Ziegaus, Anke; Semrau, Sabine; Lambrecht, Ulrike; Lettmaier, Sebastian; Fietkau, Rainer [Erlangen University Hospital, Department of Radiation Oncology, Erlangen (Germany)

    2014-11-14

    The primary endpoint was to improve local tumour control of patients with metastatic spinal tumours by stereotactic body radiotherapy (SBRT) and dose escalation by simultaneous, integrated boost (PTV-boost). We used a whole vertebral body (PTV-elective) contouring approach. Secondary endpoints were severity of acute and chronic adverse effects and overall survival. In all, 33 patients with metastases of the vertebral column were treated at Erlangen University Hospital. SBRT was given in 12 or 10 fractions. The metastatic lesion (PTV-boost) received 3.6 Gy (range 3.0-4.51 Gy) per fraction for a total of 42.0 Gy (24.36-48.0 Gy) and the whole vertebra (PTV-elective) received 2.85 Gy (range 1.8-3.6 Gy) per fraction for a total of 32.39 Gy (range 21.60-38.0 Gy). Patients were followed up every 3 months. Local control rate of all patients was 93 % at 12 and 24 months. The overall survival rate was 54 % at 12 months, 38 % at 24 months and 18 % at 36 months. No radiation myelopathy occurred. The most frequently observed adverse events in 3 cases was oesophagitis grade 2. SBRT with simultaneous, integrated boost was associated with excellent local control of 93 % after 24 months. This result shows the possibility of delivering escalated doses to the target while still keeping the incidence of side effects low. This study forms the basis for a future randomised controlled trial comparing conventional radiotherapy (10 fractions of 3 Gy) with hypofractionated dose intensified SBRT (12 fractions of 3 Gy + integrated boost 12 fractions of 4 Gy) for improvement of local tumour control and pain. (orig.) [German] Das primaere Ziel der Studie war die Verbesserung der lokalen Tumorkontrolle von Patienten mit Wirbelkoerpermetastasen mittels stereotaktischer Radiotherapie (SBRT) mit Dosiseskalation durch einen simultan integrierten Boost (PTV-Boost). Dabei wurde der ganze Wirbelkoerper konturiert (PTV-Elektive). Zu den sekundaeren Endpunkten der Studie gehoerten der Schweregrad von

  13. Examination of motor unit control properties in stroke survivors using surface EMG decomposition: a preliminary report.

    Science.gov (United States)

    Suresh, Nina; Li, Xiaoyan; Zhou, Ping; Rymer, William Zev

    2011-01-01

    The objective of this pilot study was to examine alterations in motor unit (MU) control properties, (i.e. MU recruitment and firing rate) after stroke utilizing a recently developed high-yield surface electromyogram (EMG) decomposition technique. Two stroke subjects participated in this study. A sensor array was used to record surface EMG signals from the first dorsal interosseous (FDI) muscle during voluntary isometric contraction at varying force levels. The recording was performed in both paretic and contralateral muscles using a matched force protocol. Single motor unit activity was extracted using the surface EMG decomposition software from Delsys Inc. The results from the two stroke subjects indicate a reduction in the mean motor unit firing rate and a compression of motor unit recruitment range in paretic muscle as compared with the contralateral muscles. These findings provide further evidence of spinal motoneuron involvement after a hemispheric brain lesion, and help us to understand the complex origins of stroke induced muscle weakness.

  14. Preliminary study on hazards and critical control points of kokoro, a Nigerian indigenous fermented maize snack.

    Science.gov (United States)

    Oranusi, S; Dahunsi, S O

    2015-01-01

    The microbial and proximate composition of an indigenous snack from fermented maize was investigated. Critical control points of milling the raw materials, fermentation pH, processing temperature and time intervals during holdings in processing and storage were evaluated with a view to optimizing the product. The mean total aerobic plate count (TAPC) log10 values for samples of the finished products range from 2.07 ± 0.50 to 4.36 ± 0.10 cfu/g. Mean fungi count log10 was 2.00 ± 0.00 to 3.50 ± 0.50 while mean coliform count 1.04 ± 0.10 log10 cfu/g was detected in one of the sales outlets investigated. Bacterial and fungal species were isolated belonging to the genera Aspergillus, Rhizopus, Penicillium, Fusarium, Cephalosporium, Alternaria, Bacillus, Klebsiella, Staphylococcus, Lactobacillus, Pseudomonas, Proteus and Enterobacter. The moisture content of the samples ranged from 3.41 to 6.75%; fat content was 19.68 to 32.59%; fiber content was 1.84 to 2.78% while protein ranged from 6.76 to 9.23%. The ash and carbohydrate contents ranged from 1.97 to 2.31% and 49.21 to 61.96%, respectively. Based on the specifications by International Commission for Microbiological Specification for Foods (ICMSF), the TAPC counts of the finished products remained at low levels. However, presence of coliforms could prejudice the hygienic quality of these types of products hence, the need for quality control.

  15. [Development of external quality control protocol for CyberKnife beams dosimetry: preliminary tests multicentre].

    Science.gov (United States)

    Guinement, L; Marchesi, V; Veres, A; Lacornerie, T; Buchheit, I; Peiffert, D

    2013-01-01

    To develop an external quality control procedure for CyberKnife(®) beams. This work conducted in Nancy, has included a test protocol initially drawn by the medical physicist of Nancy and Lille in collaboration with Equal-Estro Laboratory. A head and neck anthropomorphic phantom and a water-equivalent homogeneous cubic plastic test-object, so-called "MiniCube", have been used. Powder and solid thermoluminescent dosimeters as well as radiochromic films have been used to perform absolute and relative dose studies, respectively. The comparison between doses calculated by Multiplan treatment planning system and measured doses have been studied in absolute dose. The dose distributions measured with films and treatment planning system calculations have been compared via the gamma function, configured with different tolerance criteria. This work allowed, via solid thermoluminescent dosimeter measurements, verifying the beam reliability with a reproducibility of 1.7 %. The absolute dose measured in the phantom irradiated by the seven participating centres has shown an error inferior to the standard tolerance limits (± 5 %), for most of participating centres. The relative dose measurements performed at Nancy and by the Equal-Estro laboratory allowed defining the most adequate parameters for gamma index (5 %/2mm--with at least 95 % of pixels satisfying acceptability criteria: γsoftware. This work allowed defining a dosimetric external quality control for CyberKnife(®) systems, based on a reproducible irradiation plan through measurements performed with thermoluminescent dosimeters and radiochromic films. This protocol should be validated by a new series of measurement and taking into account the lessons of this work. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  16. Are fluoride releasing dental materials clinically effective on caries control?

    Science.gov (United States)

    Cury, Jaime Aparecido; de Oliveira, Branca Heloisa; dos Santos, Ana Paula Pires; Tenuta, Livia Maria Andaló

    2016-03-01

    (1) To describe caries lesions development and the role of fluoride in controlling disease progression; (2) to evaluate whether the use of fluoride-releasing pit and fissure sealants, bonding orthodontic agents and restorative materials, in comparison to a non-fluoride releasing material, reduces caries incidence in children or adults, and (3) to discuss how the anti-caries properties of these materials have been evaluated in vitro and in situ. The search was performed on the Cochrane Database of Systematic Reviews and on Medline via Pubmed. Caries is a biofilm-sugar dependent disease and as such it provokes progressive destruction of mineral structure of any dental surface - intact, sealed or restored - where biofilm remains accumulated and is regularly exposed to sugar. The mechanism of action of fluoride released from dental materials on caries is similar to that of fluoride found in dentifrices or other vehicles of fluoride delivery. Fluoride-releasing materials are unable to interfere with the formation of biofilm on dental surfaces adjacent to them or to inhibit acid production by dental biofilms. However, the fluoride released slows down the progression of caries lesions in tooth surfaces adjacent to dental materials. This effect has been clearly shown by in vitro and in situ studies but not in randomized clinical trials. The anti-caries effect of fluoride releasing materials is still not based on clinical evidence, and, in addition, it can be overwhelmed by fluoride delivered from dentifrices. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  17. Method to control depth error when ablating human dentin with numerically controlled picosecond laser: a preliminary study.

    Science.gov (United States)

    Sun, Yuchun; Yuan, Fusong; Lv, Peijun; Wang, Dangxiao; Wang, Lei; Wang, Yong

    2015-07-01

    A three-axis numerically controlled picosecond laser was used to ablate dentin to investigate the quantitative relationships among the number of additive pulse layers in two-dimensional scans starting from the focal plane, step size along the normal of the focal plane (focal plane normal), and ablation depth error. A method to control the ablation depth error, suitable to control stepping along the focal plane normal, was preliminarily established. Twenty-four freshly removed mandibular first molars were cut transversely along the long axis of the crown and prepared as 48 tooth sample slices with approximately flat surfaces. Forty-two slices were used in the first section. The picosecond laser was 1,064 nm in wavelength, 3 W in power, and 10 kHz in repetition frequency. For a varying number (n = 5-70) of focal plane additive pulse layers (14 groups, three repetitions each), two-dimensional scanning and ablation were performed on the dentin regions of the tooth sample slices, which were fixed on the focal plane. The ablation depth, d, was measured, and the quantitative function between n and d was established. Six slices were used in the second section. The function was used to calculate and set the timing of stepwise increments, and the single-step size along the focal plane normal was d micrometer after ablation of n layers (n = 5-50; 10 groups, six repetitions each). Each sample underwent three-dimensional scanning and ablation to produce 2 × 2-mm square cavities. The difference, e, between the measured cavity depth and theoretical value was calculated, along with the difference, e 1, between the measured average ablation depth of a single-step along the focal plane normal and theoretical value. Values of n and d corresponding to the minimum values of e and e 1, respectively, were obtained. In two-dimensional ablation, d was largest (720.61 μm) when n = 65 and smallest when n = 5 (45.00 μm). Linear regression yielded the quantitative

  18. Preliminary description of aging cats and dogs presented to a New Zealand first-opinion veterinary clinic at end-of-life.

    Science.gov (United States)

    Gates, M C; Hinds, H J; Dale, A

    2017-08-09

    AIMS To conduct a preliminary investigation into the chronic disease conditions and clinical signs present in aging New Zealand companion animals at end-of-life and to describe the timing, circumstances, and manner of death. METHODS The medical records database of a first-opinion, companion animal, veterinary practice in Auckland, New Zealand was searched to identify all canine and feline patients ≥7 years of age that were subjected to euthanasia or cremated in the period between July 2012-June 2014. The free-text medical notes were analysed for information on the circumstances surrounding the death, previous diagnoses of chronic disease conditions, and the presence of clinical signs associated with decreased quality-of-life at the time of euthanasia. RESULTS The median age at death was 15 (max 22) years for the 130 cats and 12 (max 17) years for the 68 dogs in the study sample. Euthanasia at the clinic was carried out for 119/130 (91%) cats and 62/68 (91%) dogs, with the remainder recorded as having an unassisted death. The frequency of deaths was highest during December for both cats and dogs. Cost was mentioned as an issue in the medical records for 39/181 (21.6%) patients that were subjected to euthanasia. At the time of euthanasia, 92/119 (77.3%) cats and 43/62 (69.4%) dogs were recorded as having >1 clinical sign associated with a decreased quality-of-life. Inappetence and non-specific decline were the two most commonly recorded clinical signs for both dogs and cats. Cardiovascular disease (44/130, 34%), renal failure (40/130, 31%), and malignant neoplasia (36/130, 28%) were the most common chronic disease conditions recorded for cats. Degenerative joint disease (22/68, 32%), malignant neoplasia (14/68, 21%), and cardiovascular disease (8/68, 12%) were the most common chronic disease conditions recorded for dogs. CONCLUSIONS AND CLINICAL RELEVANCE These preliminary findings highlight that aging companion animals in New Zealand frequently have chronic

  19. Habit reversal training and educational group treatments for children with tourette syndrome: A preliminary randomised controlled trial.

    Science.gov (United States)

    Yates, Rachel; Edwards, Katie; King, John; Luzon, Olga; Evangeli, Michael; Stark, Daniel; McFarlane, Fiona; Heyman, Isobel; İnce, Başak; Kodric, Jana; Murphy, Tara

    2016-05-01

    Quality of life of children with Tourette Syndrome (TS) is impacted greatly by its symptoms and their social consequences. Habit Reversal Training (HRT) is effective but has not, until now, been empirically evaluated in groups. This randomised controlled trial evaluated feasibility and preliminary efficacy of eight HRT group sessions compared to eight Education group sessions. Thirty-three children aged 9-13 years with TS or Chronic Tic Disorder took part. Outcomes evaluated were tic severity and quality of life (QoL). Tic severity improvements were found in both groups. Motor tic severity (Yale Global Tic Severity Scale) showed greatest improvements in the HRT group. Both groups showed a strong tendency toward improvements in patient reported QoL. In conclusion, group-based treatments for TS are feasible and exposure to other children with tics did not increase tic expression. HRT led to greater reductions in tic severity than Education. Implications, such as cost-effectiveness of treatment delivery, are discussed.

  20. A preliminary investigation of the environmental Control and Life Support Subsystems (EC/LSS) for animal and plant experiment payloads

    Science.gov (United States)

    Wells, H. B.

    1972-01-01

    A preliminary study of the environmental control and life support subsystems (EC/LSS) necessary for an earth orbital spacecraft to conduct biological experiments is presented. The primary spacecraft models available for conducting these biological experiments are the space shuttle and modular space station. The experiments would be housed in a separate module that would be contained in either the shuttle payload bay or attached to the modular space station. This module would be manned only for experiment-related tasks, and would contain a separate EC/LSS for the crew and animals. Metabolic data were tabulated on various animals that are considered useful for a typical experiment program. The minimum payload for the 30-day space shuttle module was found to require about the equivalent of a one-man EC/LSS; however, the selected two-man shuttle assemblies will give a growth and contingency factor of about 50 percent. The maximum payloads for the space station mission will require at least a seven-man EC/LSS for the laboratory colony and a nine-man EC/LSS for the centrifuge colony. There is practically no room for growth or contingencies in these areas.

  1. Preliminary safety analysis of the B-C Cribs Controlled Area. [Hanford Reservation

    Energy Technology Data Exchange (ETDEWEB)

    Maxfield, H.L.

    1974-07-31

    Approximately 2,000 acres of land in the center of the Hanford Reservation is contaminated with an estimated 14 Ci of /sup 137/Cs and 81 Ci of /sup 90/Sr associated with animal wastes. Approximately half of this activity is located on (or within) 2.5 centimeters of the ground surface. The source of the contamination was the B-C Cribs and trenches which were used as liquid radioactive waste disposal sites during the 1950's. The mechanism for movement of radionuclides from the disposal site to the ground surface is believed to have been burrowing by an animal (probably a badger) followed by use of the exposed material as a salt lick by rabbits and other animals. When the radioactivity was discovered, the burrow was sealed, the contaminated site was classed as a radiation zone, and surveillance initiated. The contamination site has not been a significant hazard to employees at the plant or to the public. The Atlantic Richfield Hanford Company maintained control over the surface contamination by isolation, zoning, and by continued surveillance. Methods of handling the contaminated area have been considered. Discussions of these alternatives and applicable safety analysis information are included in this document.

  2. Preliminary observation on the effect of baking soda volume on controlling odour from discarded organic waste.

    Science.gov (United States)

    Qamaruz-Zaman, N; Kun, Y; Rosli, R-N

    2015-01-01

    Food wastes with high moisture and organic matter content are likely to emit odours as a result of the decomposition process. The management of odour from decomposing wastes is needed to sustain the interest of residents and local councils in the source separation of kitchen wastes. This study investigated the potential of baking soda (at 50 g, 75 g and 100g per kg food waste) to control odour from seven days stored food waste. It was found that 50 g of baking soda, spread at the bottom of 8l food wastes bin, can reduce the odour by about 70%. A higher amount (above 100g) is not advised as a pH higher than 9.0 may be induced leading to the volatilization of odorous ammonia. This research finding is expected to benefit the waste management sector, food processing industries as well as the local authorities where malodour from waste storage is a pressing issue. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Preliminary Study on Controlling Black Fungi Dwelling on Stone Monuments by Using a Microwave Heating System

    Directory of Open Access Journals (Sweden)

    Oana-Adriana CUZMAN

    2013-06-01

    Full Text Available Microcolonial black fungi have their natural ecological niche on rocks and walls of hypogean environments, playing an important role in the deterioration of materials and aesthetical alteration of monumental stones and mortars. Three black fungi (Sarcinomyces sp., Pithomyces sp. and Scolecobasidium sp. have been isolated from cultural assets of historical interest. These fungal strains have been used to test the microwave heating method as a new control methodology for eradicating the fungal biological growth on cultural stone artifacts. This methodology is based on a 2.45 GHz microwave electromagnetic radiation, generated by a new apparatus with an appropriate applicator. The first results showed the best dose of 65°C for three minutes, for all the investigated fungal strains. This methodology is very promising because is safety for the operator and the environment, and can be easily applied on site. The use of this method to kill biodeteriogens can avoid the application of chemicals formulates potentially dangerous for substrates and environment.

  4. User attitudes in analyzing digital slides in a quality control test bed: a preliminary study.

    Science.gov (United States)

    Della Mea, Vincenzo; Demichelis, Francesca; Viel, Federico; Dalla Palma, Paolo; Beltrami, Carlo Alberto

    2006-05-01

    The pathologist examines suitably stained glass slides through a bright field microscope in order to render histopathological or cytological diagnosis by looking at tissues and cells. Glass slides serve as a permanent record of the patient disease. Over the course of a patient's treatment slides may need to be reviewed at other institutions before treatment can commence. Due to their fragile nature a transportable permanent digital facsimile of the glass slide would be ideal. A digital slide is a set of digital images representing the whole slide normally used by the pathologist, or a significant part of it; it is usually made by a large amount of images, up to thousands, which makes its management difficult. The present paper provides a description of the requirements needed to reproduce glass slides and of the available technological equipment, then the features of the two systems we implemented on different hardware are described, together with those of the digital slide viewer. The viewer was evaluated in two experimental test phases, during which user behaviour and diagnostic reports were measured. Digital slides used in the two experiments were acquired with either system. Possible applications of digital slides are then discussed, including undergraduate and professional education, quality control, and image analysis on full samples as well as on tissue microarrays.

  5. Preliminary Results On The Use Of Clay To Control Pyrodinium Bloom - A Mitigation Strategy

    Directory of Open Access Journals (Sweden)

    Larry Padilla

    2006-06-01

    Full Text Available The frequent and expanded occurrence of Pyrodinium bahamense var compressum blooms in thePhilippines since 1983 has prompted the need to find mechanisms to control the harmful effects of thesetoxic dinoflagellates. A promising method now being explored is the use of powdered clay mineralswhich when added to the growth media is capable of flocculating with the algal cells. In this study, theefficiency of ball clay, brown bentonite, and Malampaya Sound sediments to remove Pyrodinium cellsin seawater was tested. The addition of 1 g/L of suspended ball clay to 50 mL of cultured Pyrodiniumcells (~1.037 x106 cells/L removed 99.56% of the algal cells after 2.5 hours. Prolonging the exposuretime to 5 and 24 hours showed no significant increase in flocculation. Brown bentonite and MalampayaSound sediments showed low to moderate removal efficiency not exceeding 70% and 50%, respectively.The effect of ball clay addition on seawater chemistry showed no change in ammonia concentration butnitrate decreased after 5 and 24 hours of clay addition. Results for nitrite and phosphate were howevermore variable.

  6. Parenchymal texture measures weighted by breast anatomy: preliminary optimization in a case-control study

    Science.gov (United States)

    Gastounioti, Aimilia; Keller, Brad M.; Hsieh, Meng-Kang; Conant, Emily F.; Kontos, Despina

    2016-03-01

    Growing evidence suggests that quantitative descriptors of the parenchymal texture patterns hold a valuable role in assessing an individual woman's risk for breast cancer. In this work, we assess the hypothesis that breast cancer risk factors are not uniformly expressed in the breast parenchymal tissue and, therefore, breast-anatomy-weighted parenchymal texture descriptors, where different breasts ROIs have non uniform contributions, may enhance breast cancer risk assessment. To this end, we introduce an automated breast-anatomy-driven methodology which generates a breast atlas, which is then used to produce a weight map that reinforces the contributions of the central and upper-outer breast areas. We incorporate this methodology to our previously validated lattice-based strategy for parenchymal texture analysis. In the framework of a pilot case-control study, including digital mammograms from 424 women, our proposed breast-anatomy-weighted texture descriptors are optimized and evaluated against non weighted texture features, using regression analysis with leave-one-out cross validation. The classification performance is assessed in terms of the area under the curve (AUC) of the receiver operating characteristic. The collective discriminatory capacity of the weighted texture features was maximized (AUC=0.87) when the central breast area was considered more important than the upperouter area, with significant performance improvement (DeLong's test, p-valuepersonalized recommendations regarding women's cancer risk evaluation.

  7. Age-related differences in control of a visuomotor coordination task: a preliminary study.

    Science.gov (United States)

    Ryu, Young Uk; Lee, Kyu-Ho; Lee, Hocheol; Park, Jungsik

    2016-04-01

    [Purpose] The purpose of the current study was to examine age-related differences in control of a perception-action coordination skill. We adapted a visuomotor tracking experiment requiring various coordination patterns between a limb's motion and an external signal. [Subjects and Methods] A total of 12 subjects (6 elderly and 6 young) voluntarily participated in the study. The experimental session consisted of 3 trials for 3 different relative phase patterns: 0°, 90°, and 180°, defined by the relationship between the online visual feedback of the joystick motion and the white dot signal. [Results] The 0° and 180° tracking patterns were stable compared with the 90° tracking pattern for both age groups. The present results also showed that the elderly subjects were less stable than were young subjects for all tracking patterns. [Conclusion] The intrinsic coordination dynamics predicted by the Haken-Kelso-Bunz (HKB) mathematical model did not change with age, whereas utilization of visual feedback information declined overall. Further research is needed regarding methods for increasing utilization of visual feedback information from the perspective of rehabilitation.

  8. Preliminary observation on the effect of baking soda volume on controlling odour from discarded organic waste

    Energy Technology Data Exchange (ETDEWEB)

    Qamaruz-Zaman, N., E-mail: cenastaein@usm.my; Kun, Y.; Rosli, R.-N.

    2015-01-15

    Highlights: • Approximately 50 g baking soda reduced odour concentration by 70%. • Reducing volatile acid concentration reduces odour concentration. • Ammonia has less effect on odour concentration. - Abstract: Food wastes with high moisture and organic matter content are likely to emit odours as a result of the decomposition process. The management of odour from decomposing wastes is needed to sustain the interest of residents and local councils in the source separation of kitchen wastes. This study investigated the potential of baking soda (at 50 g, 75 g and 100 g per kg food waste) to control odour from seven days stored food waste. It was found that 50 g of baking soda, spread at the bottom of 8 l food wastes bin, can reduce the odour by about 70%. A higher amount (above 100 g) is not advised as a pH higher than 9.0 may be induced leading to the volatilization of odorous ammonia. This research finding is expected to benefit the waste management sector, food processing industries as well as the local authorities where malodour from waste storage is a pressing issue.

  9. Randomized clinical trial of implant-supported ceramic-ceramic and metal-ceramic fixed dental prostheses: preliminary results.

    Science.gov (United States)

    Esquivel-Upshaw, Josephine F; Clark, Arthur E; Shuster, Jonathan J; Anusavice, Kenneth J

    2014-02-01

    The aim of this study was to determine the survival rates over time of implant-supported ceramic-ceramic and metal-ceramic prostheses as a function of core-veneer thickness ratio, gingival connector embrasure design, and connector height. An IRB-approved, randomized, controlled clinical trial was conducted as a single-blind pilot study involving 55 patients missing three teeth in either one or two posterior areas. These patients (34 women; 21 men; age range 52-75 years) were recruited for the study to receive a three-unit implant-supported fixed dental prosthesis (FDP). Two implants were placed for each of the 72 FDPs in the study. The implants (Osseospeed, Astra Tech), which were made of titanium, were grit blasted. A gold-shaded, custom-milled titanium abutment (Atlantis, Astra Tech), was secured to each implant body. Each of the 72 FDPs in 55 patients were randomly assigned based on one of the following options: (1) A. ceramic-ceramic (Yttria-stabilized zirconia core, pressable fluorapatite glass-ceramic, IPS e.max ZirCAD, and ZirPress, Ivoclar Vivadent) B. metal-ceramic (palladium-based noble alloy, Capricorn, Ivoclar Vivadent, with press-on leucite-reinforced glass-ceramic veneer, IPS InLine POM, Ivoclar Vivadent); (2) occlusal veneer thickness (0.5, 1.0, and 1.5 mm); (3) curvature of gingival embrasure (0.25, 0.5, and 0.75 mm diameter); and (4) connector height (3, 4, and 5 mm). FDPs were fabricated and cemented with dual-cure resin cement (RelyX, Universal Cement, 3M ESPE). Patients were recalled at 6 months, 1 year, and 2 years. FDPs were examined for cracks, fracture, and general surface quality. Recall exams of 72 prostheses revealed 10 chipping fractures. No fractures occurred within the connector or embrasure areas. Two-sided Fisher's exact tests showed no significant correlation between fractures and type of material system (p = 0.51), veneer thickness (p = 0.75), radius of curvature of gingival embrasure (p = 0.68), and connector height (p = 0

  10. Randomized Clinical Trial of Implant-Supported Ceramic-Ceramic and Metal-Ceramic Fixed Dental Prostheses: Preliminary Results

    Science.gov (United States)

    Esquivel-Upshaw, Josephine F.; Clark, Arthur E.; Shuster, Jonathan J.; Anusavice, Kenneth J.

    2013-01-01

    Purpose The aim of this study was to determine the survival rates over time of implant-supported ceramic-ceramic and metal-ceramic prostheses as a function of core-veneer thickness ratio, gingival connector embrasure design, and connector height. Materials and Methods An IRB-approved, randomized, controlled clinical trial was conducted as a single-blind pilot study involving 55 patients missing three teeth in either one or two posterior areas. These patients (34 women; 21 men; age range 52–75 years) were recruited for the study to receive a 3-unit implant-supported fixed dental prosthesis (FDP). Two implants were placed for each of the 72 FDPs in the study. The implants (Osseospeed, Astra Tech), which were made of titanium, were grit blasted. A gold-shaded, custom-milled titanium abutment (Atlantis, Astra Tech), was secured to each implant body. Each of the 72 FDPs in 55 patients were randomly assigned based on one of the following options: (1) A. Material: ceramic-ceramic (Yttria-stabilized zirconia core, pressable fluorapatite glass-ceramic, IPS e.max ZirCAD and ZirPress, Ivoclar Vivadent) B. metal-ceramic (palladium-based noble alloy, Capricorn, Ivoclar Vivadent, with press-on leucite-reinforced glass-ceramic veneer, IPS InLine POM, Ivoclar Vivadent); (2) occlusal veneer thickness (0.5, 1.0, and 1.5 mm); (3) curvature of gingival embrasure (0.25, 0.5, and 0.75 mm diameter); and (4) connector height (3, 4, and 5 mm). FDPs were fabricated and cemented with dual-cure resin cement (RelyX, Universal Cement, 3M ESPE). Patients were recalled at 6 months, 1 year, and 2 years. FDPs were examined for cracks, fracture, and general surface quality. Results Recall exams of 72 prostheses revealed 10 chipping fractures. No fractures occurred within the connector or embrasure areas. Two-sided Fisher’s exact tests showed no significant correlation between fractures and type of material system (p = 0.51), veneer thickness (p = 0.75), radius of curvature of gingival embrasure

  11. Soft tissue cell adhesion to titanium abutments after different cleaning procedures: preliminary results of a randomized clinical trial.

    Science.gov (United States)

    Canullo, L; Penarrocha-Oltra, D; Marchionni, S; Bagán, L; Peñarrocha-Diago, M-A; Micarelli, C

    2014-03-01

    A randomized controlled trial was performed to assess soft tissue cell adhesion to implant titanium abutments subjected to different cleaning procedures and test if plasma cleaning can enhance cell adhesion at an early healing time. Eighteen patients with osseointegrated and submerged implants were included. Before re-opening, 18 abutments were divided in 3 groups corresponding to different clinical conditions with different cleaning processes: no treatment (G1), laboratory customization and cleaning by steam (G2), cleaning by plasma of Argon (G3). Abutments were removed after 1 week and scanning electron microscopy was used to analyze cell adhesion to the abutment surface quantitatively (percentage of area occupied by cells) and qualitatively (aspect of adhered cells and presence of contaminants). Mean percentages of area occupied by cells were 17.6 ± 22.7%, 16.5 ± 12.9% and 46.3 ± 27.9% for G1, G2 and G3 respectively. Differences were statistically significant between G1 and G3 (p=0.030), close to significance between G2 and G3 (p=0.056), and non-significant between G1 and G2 (p=0.530). The proportion of samples presenting adhered cells was homogeneous among the 3 groups (p-valor = 1.000). In all cases cells presented a flattened aspect; in 2 cases cells were less efficiently adhered and in 1 case cells presented filipodia. Three cases showed contamination with cocobacteria. Within the limits of the present study, plasma of Argon may enhance cell adhesion to titanium abutments, even at the early stage of soft tissue healing. Further studies with greater samples are necessary to confirm these findings.

  12. CONTROL CLINICAL EVALUATION OF KULATTHADI YOGA AS ASHMARIBHEDAN IN MUTRASHMARI

    Directory of Open Access Journals (Sweden)

    Jangle Vidya Muralidhar

    2012-10-01

    Full Text Available Urolithiasis, a presence of calculi single or multiple in renal or urinary tracks is a clinical entity which has been universally accepted as problematic condition regarding its treatment in all systems of medical science. There is no known drug therapy at present which dissolves or fragments the calculi by changing lithogenic potential of particular person. Urinary calculi disease has been described in detail under the heading of Ashmari in Ayurvedic texts. Ashmari is one of the few surgical conditions which have been given very prominent place in Ayurveda by Acharya Sushruta and Various herbs like Kulattha (Dolicos Biflorus, Gokshura (Tribulus Terrestris, Apamarga (Achyranthes Aspera, Pashanbheda (Berginia Lingulata and Varuna (Crataeva Nurvela etc. and herbomineral compounds are described which are effective against urolithiasis by dissolving calculi thus facilitating their expulsion. This study was aimed to evaluate Ashmaribhedana property of “Kulatthadi yoga” in Mutrashmari to make an effective, long lasting, cost effective, authentic alternative & easily available conservative management of Mutrashmari. After observation, it was found that Kulatthadi Yoga is effective in Kapha-Vataja Mutrashmari & control group shows significant result in Mutrashmari.

  13. [Review of controled clinical trials of behavioral treatment for obesity].

    Science.gov (United States)

    Márquez-Ibáñez, B; Armendáriz-Anguiano, A L; Bacardí-Gascón, M; Jiménez-Cruz, A

    2008-01-01

    The increased prevalence of obesity has been associated to an increment in chronic-degenerative diseases. The behavioral conduct therapies (BCT) have been used to help subjects develop a series of skills to reach a healthy weight. We conducted a review of the literature of BCT from controlled clinical trials registered at PubMed from January 2000 to november 2006. We found five long-term (> or = 12 months) studies and analyzed each study. The percent of weight loss at the end of follow up ranged from 3% to 9% of the initial weight; the percent of retention fluctuated from 92% at three months to 55% at 24 months. There were no similar reported studies conducted in Latino or Hispanic population. These results suggest that the change in loss of weight with BCT are modest at the end of the follow up period and that most of the studies report low adherence to treatment. It is recommended that public and private funds are needed to implement effective and safe multicentric long term randomized studies on different cultural populations, including most Latin-American countries.

  14. Control of odontogenic pain by diclofenac and meloxicam mucoadhesive patches: A randomized, double-blinded, placebo-controlled, preliminary study

    Directory of Open Access Journals (Sweden)

    Pratik R Pipalia

    2016-01-01

    Full Text Available Aims and Objectives: To evaluate and compare the efficacy of diclofenac and meloxicam as mucoadhesive patches in dental pain management. Materials and Method: This study was conducted among 45 adult patients of either sex, who were diagnosed with dental pain and were attending the outpatient department. Written informed consent was obtained from all the patients. A 1 × 1 cm2 mucoadhesive patch of any one (diclofenac, meloxicam or placebo was applied on the attached gingival region of the tooth with pain. Pain was recorded using a ten point visual analog scale (VAS score at every 5 min for 30 min. Pain was measured and compared before and after the application of the patch. Results: The results showed that patients with diclofenac patch gained mean pain reduction from 6 ± 1.54 mm to 2.60 ± 1.32 mm after 30 min (P 0.05. The maximum pain reduction was seen with meloxicam patch. Conclusion: Transmucosal mucoadhesive analgesic patches are a better alternative to oral analgesics to control dental pain. Hence, routine use of mucoadhesive analgesic patch for dental pain reduction is recommended in day to day practice.

  15. Preliminary Experimental Examination Of Controls On Methane Expulsion During Melting Of Natural Gas Hydrate Systems

    Science.gov (United States)

    Kneafsey, T. J.; Flemings, P. B.; Bryant, S. L.; You, K.; Polito, P. J.

    2013-12-01

    Global climate change will cause warming of the oceans and land. This will affect the occurrence, behavior, and location of subseafloor and subterranean methane hydrate deposits. We suggest that in many natural systems local salinity, elevated by hydrate formation or freshened by hydrate dissociation, may control gas transport through the hydrate stability zone. We are performing experiments and modeling the experiments to explore this behavior for different warming scenarios. Initially, we are exploring hydrate association/dissociation in saline systems with constant water mass. We compare experiments run with saline (3.5 wt. %) water vs. distilled water in a sand mixture at an initial water saturation of ~0.5. We increase the pore fluid (methane) pressure to 1050 psig. We then stepwise cool the sample into the hydrate stability field (~3 degrees C), allowing methane gas to enter as hydrate forms. We measure resistivity and the mass of methane consumed. We are currently running these experiments and we predict our results from equilibrium thermodynamics. In the fresh water case, the modeled final hydrate saturation is 63% and all water is consumed. In the saline case, the modeled final hydrate saturation is 47%, the salinity is 12.4 wt. %, and final water saturation is 13%. The fresh water system is water-limited: all the water is converted to hydrate. In the saline system, pore water salinity is elevated and salt is excluded from the hydrate structure during hydrate formation until the salinity drives the system to three phase equilibrium (liquid, gas, hydrate) and no further hydrate forms. In our laboratory we can impose temperature gradients within the column, and we will use this to investigate equilibrium conditions in large samples subjected to temperature gradients and changing temperature. In these tests, we will quantify the hydrate saturation and salinity over our meter-long sample using spatially distributed temperature sensors, spatially distributed

  16. Biomass accumulation in hydroponically grown sweetpotato in a controlled environment: a preliminary study

    Science.gov (United States)

    Hill, J.; Douglas, D.; David, P.; Mortley, D.; Trotman, A.; Bonsi, C.

    1996-01-01

    In the development of a plant growth model, the assumptions made and the general equations representing an understanding of plant growth are gradually refined as more information is acquired through experimentation. One such experiment that contributed to sweetpotato model development consisted of measuring biomass accumulation of sweetpotato grown in hydroponic culture in a plant growth chamber. Plants were started from fifteen centimeter long 'TU-82-155' sweetpotato vine cuttings spaced 25 cm apart in each of 18 rectangular growing channels (0.15 by 0.15 by 1.2m) in a system designed to use the nutrient film technique (NFT). Each channel contained four plants. The 3.5m by 5.2m plant growth chamber environmental parameters included an 18h photoperiod, 500 micromoles m-2 s-1 of photosynthetic photon flux (PPF), and a diurnal light/dark temperature of 28 degrees C/22 degrees C. The relative humidity was 80 +/- 5% and the CO2 partial pressure was ambient (350 ppm). The nutrient solution contained in 30L reservoirs was a modified half Hoagland's solution with a 1:2.4 N:K ratio and a pH of 6.2. Solution replenishment occurred when the electrical conductivity (EC) level dropped below 1050. Plants were harvested at 15 days after planting (DAP) and weekly thereafter until day 134. By 57 DAP, stems and fibrous roots had acquired 90% of their total dry biomass, while leaves had reached 84% of their maximum dry biomass. Beginning at 64 DAP dry biomass accumulation in the storage roots dominated the increase in dry biomass for the plants. Dry weight of storage roots at 120 DAP was 165 g/plant or 1.1 kg/m2. Resulting growth curves were consistent with the physiological processes occurring in the plant. Results from this study will be incorporated in a plant growth model for use in conjunction with controlled life support systems for long-term manned space missions.

  17. A Preliminary Core Domain Set for Clinical Trials of Shoulder Disorders: A Report from the OMERACT 2016 Shoulder Core Outcome Set Special Interest Group.

    Science.gov (United States)

    Buchbinder, Rachelle; Page, Matthew J; Huang, Hsiaomin; Verhagen, Arianne P; Beaton, Dorcas; Kopkow, Christian; Lenza, Mario; Jain, Nitin B; Richards, Bethan; Richards, Pamela; Voshaar, Marieke; van der Windt, Danielle; Gagnier, Joel J

    2017-01-15

    The Outcome Measures in Rheumatology (OMERACT) Shoulder Core Outcome Set Special Interest Group (SIG) was established to develop a core outcome set (COS) for clinical trials of shoulder disorders. In preparation for OMERACT 2016, we systematically examined all outcome domains and measurement instruments reported in 409 randomized trials of interventions for shoulder disorders published between 1954 and 2015. Informed by these data, we conducted an international Delphi consensus study including shoulder trial experts, clinicians, and patients to identify key domains that should be included in a shoulder disorder COS. Findings were discussed at a stakeholder premeeting of OMERACT. At OMERACT 2016, we sought consensus on a preliminary core domain set and input into next steps. There were 13 and 15 participants at the premeeting and the OMERACT 2016 SIG meeting, respectively (9 attended both meetings). Consensus was reached on a preliminary core domain set consisting of an inner core of 4 domains: pain, physical function/activity, global perceived effect, and adverse events including death. A middle core consisted of 3 domains: emotional well-being, sleep, and participation (recreation and work). An outer core of research required to inform the final COS was also formulated. Our next steps are to (1) analyze whether participation (recreation and work) should be in the inner core, (2) conduct a third Delphi round to finalize definitions and wording of domains and reach final endorsement for the domains, and (3) determine which instruments fulfill the OMERACT criteria for measuring each domain.

  18. Preliminary Evaluation of Clinical and Angiographic Outcomes with Biodegradable Polymer Coated Sirolimus-Eluting Stent in De Novo Coronary Artery Disease: Results of the MANIPAL-FLEX Study

    Directory of Open Access Journals (Sweden)

    Ranjan Shetty

    2016-01-01

    Full Text Available Objective. The objective of the MANIPAL-FLEX study was to evaluate the feasibility, preliminary safety, and efficacy of the Supraflex sirolimus-eluting stent (SES implantation, in de novo coronary artery disease, using clinical and quantitative coronary angiography (QCA follow-ups. Methods. This was a prospective, nonrandomized, multicenter, single-arm study that enrolled 189 patients with de novo coronary artery disease who were treated with the Supraflex SES. Of 189 patients enrolled, the first 61 consecutive patients who consented to a 9-month follow-up evaluation by QCA, irrespective of presence of symptoms, were to be followed up with angiography at 9 months. The primary endpoint of the study was target lesion failure (TLF, including cardiac death, myocardial infarction, and target lesion revascularization during 12-month follow-up after the index procedure. Results. The mean age of the study population was 58±11 years, with 51.3% (97/189 of hypertensive patients. Total of 66 lesions, analyzed by offline QCA, showed good scaffolding of the target vessel with in-stent late lumen loss at 9 months of 0.18±0.23 mm. The observed TLF at 30-day, 6-month, and 12-month follow-up were 2 (1.1%, 6 (3.2%, and 10 (5.3%, respectively. Conclusion. This study provides preliminary evidence for the feasibility, safety, and efficacy of the Supraflex sirolimus-eluting stent.

  19. Evaluation of the Military Functional Assessment Program: Preliminary Assessment of the Construct Validity Using an Archived Database of Clinical Data

    Science.gov (United States)

    2013-08-01

    Status (Rbans): Clinical Utility in a Traumatic Brain Injury Sample. Clinical Neuropsychology. 1-14. Moses , J. A. 2004. Test review-Comprehensive...traumatic brain injury (mTBI) have persistent symptoms and/or functional limitations (Iverson, Zasler, & Lange, 2006; Ruff, Camenzuli, & Mueller...diagnoses and symptoms. Diagnosis/symptom Frequency Traumatic brain injury 54 mild TBI 7 penetrating TBI 2 unknown

  20. Clinical evaluation of target controlled infusion system for sufentanil administration

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan; ZHANG Li-ping; WU Xin-min; JIANG Jian-yu; DUAN Jing-li; HU Yong-fang; LI Min; LIU Wei; SHENG Xiao-yan; NI Cheng; XU Mao; GUO Xiang-yang

    2009-01-01

    Background Sufentanil target controlled infusion (TCI) provides stable analgesia, better hemodynamic control than a bolus injection of intravenous anesthetics, anticipated recovery and improved quality of anesthesia during perioperative period. This study evaluated the accuracy and feasibility of TCI system for sufentanil at high concentrations in Chinese surgical patients.Methods Twelve low risk adult patients undergoing elective surgery under general anesthesia were included in this study. Sufentanil was administered with a specific TCI system incorporating the population pharmacokinetic data of sufentanil previously reported, using a target effect-site concentration of sufentanil 4 or 6 ng/ml. Sufentanil TCI duration was 30 minutes. Frequent arterial blood samples were taken during and up to 24 hours after sufentanil TCI for determination of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry. The changes of circulatory system function during the precedure, recovery profile and adverse effects were recorded.Measured plasma sufentanil concentrations were compared with the values predicted by the TCI system. The bias (median performance error, MDPE), procision (median absolute performance error, MDAPE) and wobble (variability of performance error) of the sufentanil TCI system were determined.Results All patients had stable cardiovascular variables during induction and maintenance of anesthesia. Time to eye opening and extubation were (5.6±1.7) minutes when TCI set to 4 ng/ml and (7.2±9.3) minutes when set to 6 ng/ml.There was no episode of agitation, muscle rigidity or intraoperative awareness. The bias (MDPE), precision (MDAPE)and wobble of the sufentanil TCI system were -3.7%, 18.9% and 19.6% respectively during TCI, and the MDPE, MDAPE and wobble were -29.1%, 31.7% and 15.0% respectively after TCI (up to 8 hours).Conclusions The TCI system programmed for sufentanil at 4 or 6 ng/ml was considered acceptable for

  1. Feasibility of Applying the Extended ICF Core Set for Stroke to Clinical Settings in Rehabilitation: A Preliminary Study

    Science.gov (United States)

    Han, Kyu Yong; Kim, Hyo Jong

    2015-01-01

    Objective To evaluate the potential feasibility of application of the extended International Classification of Functioning, Disability and Health (ICF) Core Set for stroke. Methods We retrospectively reviewed the medical records of 40 stroke outpatients (>6 months after onset) admitted to the Department of Rehabilitation Medicine for comprehensive rehabilitation. Clinical information of the patients were respectively evaluated to link to the 166 second-level categories of the extended ICF Core Set for stroke. Results Clinical information could be linked to 111 different ICF categories, 58 categories of the body functions component, eight categories of the body structures component, 38 categories of the activities and participation component, and seven categories of the environmental factors component. Conclusion The body functions component might be feasible for application of the extended ICF Core Set for stroke to clinical settings. The activities and participation component and environmental factors component may not be directly applied to clinical settings without additional evaluation tools including interview and questionnaire. PMID:25750873

  2. Design, Implementation, Use, and Preliminary Evaluation of an UMLS-Enabled Terminology Web Service for Clinical Decision Support

    Science.gov (United States)

    Kawamoto, Kensaku; Lobach, David F.

    2006-01-01

    To facilitate the provision of clinical decision support (CDS), the Unified Medical Language System (UMLS) was leveraged to implement a terminology Web service. Supported functions include inter-vocabulary translation and the identification of concepts subsumed by a parent concept. Currently, the service is being used to aid the specification of clinical concepts within CDS knowledge modules. Insights gained from this process are discussed, including the limitations of using the UMLS to fulfill CDS terminology needs. PMID:17238598

  3. The effectiveness of ENAR® for the treatment of chronic neck pain in Australian adults: a preliminary single-blind, randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Pollard Henry

    2007-07-01

    Full Text Available Abstract Background Current evidence on electrotherapies for the management of chronic neck pain is either lacking or conflicting. New therapeutic devices being introduced to the market should be investigated for their effectiveness and efficacy. The ENAR® (Electro Neuro Adaptive Regulator therapy device combines Western biofeedback with Eastern energy medicine. Methods A small, preliminary randomised and controlled single-blinded trial was conducted on 24 participants (ten males, 14 females between the ages of 18 to 50 years (median age of 40.5 Consent was obtained and participants were randomly allocated to one of three groups – ENAR, Transcutaneous Electrical Nerve Stimulation (TENS, or control therapy – to test the hypothesis that ENAR therapy would result in superior pain reduction/disability and improvements in neck function compared with TENS or control intervention. The treatment regimen included twelve 15-minute treatment sessions over a six week period, followed by two assessment periods. Visual Analogue Scale (VAS pain scores, Neck Disability Index (NDI scores, Patient Specific Functional Scale (PSFS scores and Short Form 36v1 (SF-36 quality of life scores reported by participants were collected at each of the assessments points throughout the trial (0, 6, 12, 18 and 24 weeks. Results Eligible participants (n = 30 were recruited and attended clinic visits for 6 months from the time of randomisation. Final trial sample (n = 24 comprised 9 within the ENAR group, 7 within the TENS group and 8 within the control group. With an overall study power of 0.92, the ENAR group showed a decrease in mean pain score from measurement at time zero (5.0 ± 0.79 95%CI to the first follow-up measurement at six weeks (1.4 ± 0.83 95%CI. Improvement was maintained until week 24 (1.75 ± 0.9 95%CI. The TENS and control groups showed consistent pain levels throughout the trial (3.4 ± 0.96 95%CI and 4.1 ± 0.9 95%CI respectively. Wald analysis for pain

  4. A Single-Session Preliminary Evaluation of an Affordable BCI-Controlled Arm Exoskeleton and Motor-Proprioception Platform.

    Science.gov (United States)

    Elnady, Ahmed Mohamed; Zhang, Xin; Xiao, Zhen Gang; Yong, Xinyi; Randhawa, Bubblepreet Kaur; Boyd, Lara; Menon, Carlo

    2015-01-01

    Traditional, hospital-based stroke rehabilitation can be labor-intensive and expensive. Furthermore, outcomes from rehabilitation are inconsistent across individuals and recovery is hard to predict. Given these uncertainties, numerous technological approaches have been tested in an effort to improve rehabilitation outcomes and reduce the cost of stroke rehabilitation. These techniques include brain-computer interface (BCI), robotic exoskeletons, functional electrical stimulation (FES), and proprioceptive feedback. However, to the best of our knowledge, no studies have combined all these approaches into a rehabilitation platform that facilitates goal-directed motor movements. Therefore, in this paper, we combined all these technologies to test the feasibility of using a BCI-driven exoskeleton with FES (robotic training device) to facilitate motor task completion among individuals with stroke. The robotic training device operated to assist a pre-defined goal-directed motor task. Because it is hard to predict who can utilize this type of technology, we considered whether the ability to adapt skilled movements with proprioceptive feedback would predict who could learn to control a BCI-driven robotic device. To accomplish this aim, we developed a motor task that requires proprioception for completion to assess motor-proprioception ability. Next, we tested the feasibility of robotic training system in individuals with chronic stroke (n = 9) and found that the training device was well tolerated by all the participants. Ability on the motor-proprioception task did not predict the time to completion of the BCI-driven task. Both participants who could accurately target (n = 6) and those who could not (n = 3), were able to learn to control the BCI device, with each BCI trial lasting on average 2.47 min. Our results showed that the participants' ability to use proprioception to control motor output did not affect their ability to use the BCI-driven exoskeleton

  5. A Single-Session Preliminary Evaluation of an Affordable BCI-Controlled Arm Exoskeleton and Motor-Proprioception Platform

    Science.gov (United States)

    Elnady, Ahmed Mohamed; Zhang, Xin; Xiao, Zhen Gang; Yong, Xinyi; Randhawa, Bubblepreet Kaur; Boyd, Lara; Menon, Carlo

    2015-01-01

    Traditional, hospital-based stroke rehabilitation can be labor-intensive and expensive. Furthermore, outcomes from rehabilitation are inconsistent across individuals and recovery is hard to predict. Given these uncertainties, numerous technological approaches have been tested in an effort to improve rehabilitation outcomes and reduce the cost of stroke rehabilitation. These techniques include brain–computer interface (BCI), robotic exoskeletons, functional electrical stimulation (FES), and proprioceptive feedback. However, to the best of our knowledge, no studies have combined all these approaches into a rehabilitation platform that facilitates goal-directed motor movements. Therefore, in this paper, we combined all these technologies to test the feasibility of using a BCI-driven exoskeleton with FES (robotic training device) to facilitate motor task completion among individuals with stroke. The robotic training device operated to assist a pre-defined goal-directed motor task. Because it is hard to predict who can utilize this type of technology, we considered whether the ability to adapt skilled movements with proprioceptive feedback would predict who could learn to control a BCI-driven robotic device. To accomplish this aim, we developed a motor task that requires proprioception for completion to assess motor-proprioception ability. Next, we tested the feasibility of robotic training system in individuals with chronic stroke (n = 9) and found that the training device was well tolerated by all the participants. Ability on the motor-proprioception task did not predict the time to completion of the BCI-driven task. Both participants who could accurately target (n = 6) and those who could not (n = 3), were able to learn to control the BCI device, with each BCI trial lasting on average 2.47 min. Our results showed that the participants’ ability to use proprioception to control motor output did not affect their ability to use the BCI

  6. Preliminary performance of a vertical-attitude takeoff and landing, supersonic cruise aircraft concept having thrust vectoring integrated into the flight control system

    Science.gov (United States)

    Robins, A. W.; Beissner, F. L., Jr.; Domack, C. S.; Swanson, E. E.

    1985-01-01

    A performance study was made of a vertical attitude takeoff and landing (VATOL), supersonic cruise aircraft concept having thrust vectoring integrated into the flight control system. Those characteristics considered were aerodynamics, weight, balance, and performance. Preliminary results indicate that high levels of supersonic aerodynamic performance can be achieved. Further, with the assumption of an advanced (1985 technology readiness) low bypass ratio turbofan engine and advanced structures, excellent mission performance capability is indicated.

  7. Physical activities of Patients with adolescent idiopathic scoliosis (AIS): preliminary longitudinal case–control study historical evaluation of possible risk factors

    OpenAIRE

    McMaster, Marianne E; Lee, Amanda Jane; Burwell, R Geoffrey

    2015-01-01

    To our knowledge there are no publications that have evaluated physical activities in relation to the etiopathogenesis of adolescent idiopathic scoliosis (AIS) other than sports scolioses. In a preliminary longitudinal case–control study, mother and child were questioned and the children examined by one observer. The aim of the study was to examine possible risk factors for AIS. Two study groups were assessed for physical activities: 79 children diagnosed as having progressive AIS at one spin...

  8. A novel nonpharmacological intervention - breathing-controlled electrical stimulation for neuropathic pain management after spinal cord injury - a preliminary study.

    Science.gov (United States)

    Li, Shengai; Davis, Matthew; Frontera, Joel E; Li, Sheng

    2016-01-01

    The objective of this study was to examine the effectiveness of a novel nonpharmacological intervention - breathing-controlled electrical stimulation (BreEStim) - for neuropathic pain management in spinal cord injury (SCI) patients. There were two experiments: 1) to compare the effectiveness between BreEStim and conventional electrical stimulation (EStim) in Experiment (Exp) 1 and 2) to examine the dose-response effect of BreEStim in Exp 2. In Exp 1, 13 SCI subjects (6 males and 7 females, history of SCI: 58.2 months, from 7 to 150 months, impairments ranging from C4 AIS B to L1 AIS B) received both BreEStim and EStim in a randomized order with at least 3 days apart. A total of 120 electrical stimuli to the median nerve transcutaneously were triggered by voluntary inhalation during BreEStim or were randomly delivered during EStim. In Exp 2, a subset of 7 subjects received BreEStim120 and 240 stimuli randomly on two different days with 7 days apart (BreEStim120 vs BreEStim240). The primary outcome variable was the visual analog scale (VAS) score. In Exp 1, both BreEStim and EStim showed significant analgesic effects. Reduction in VAS score was significantly greater after BreEStim (2.6±0.3) than after EStim (0.8±0.3) (P<0.001). The duration of analgesic effect was significantly longer after BreEStim (14.2±6 hours) than after EStim (1.9±1 hours) (P=0.04). In Exp 2, BreEStim120 and BreEStim240 had similar degree and duration of analgesic effects. The findings from this preliminary study suggest that BreEStim is an effective alternative nonpharmacological treatment for chronic neuropathic pain in patients suffering from SCI.

  9. The role of psychology in a pediatric outpatient cardiology setting: preliminary results from a new clinical program.

    Science.gov (United States)

    Brosig, Cheryl; Yang, Kai; Hoffmann, Raymond G; Dasgupta, Mahua; Mussatto, Kathleen

    2014-12-01

    The aim of this study was to provide a descriptive analysis of a new clinical program integrating psychology services within a pediatric outpatient cardiology clinic. Patients with congenital heart disease (CHD) (n = 79) were referred for psychological services by their pediatric cardiologist. Parents completed the child behavior checklist, and the pediatric quality of life inventory generic core scales (PedsQL parent report). Teachers completed the teacher report form. Reasons for referral included: emotional problems (29%); attention problems (25%); learning problems (22%); behavior problems (16%); and developmental delay (8%). Parents and teachers reported higher rates of behavior problems and lower quality of life scores than the general population. Psychological evaluation suggested that incorporating a psychologist within a pediatric cardiology clinic may be beneficial for children with CHD in order to optimize their psychosocial functioning. Practice implications for implementing psychology services within a pediatric outpatient cardiology program are discussed.

  10. Preliminary Scaling and controls Analysis of an FHR-HTSE System Idaho National Laboratory Summer 2013 Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Shannon Bragg-Sitton; Piyush Sabharwall; Rohit Upadhya

    2014-01-01

    For new nuclear reactor system designs to be approved by regulatory agencies like the Nuclear Regulatory Commission (NRC), the details of system operation must be validated with respect to standards of safety, control, and output. A scaled experiment that replicates certain properties of the system can be used to validate compliance with regulatory standards, while avoiding the prohibitive cost and labor required to develop a fully functional prototype system; therefore, designing such an experiment is of special interest to current efforts to develop hybrid energy systems (HES) that integrate small modular reactors (SMRs), renewable energy systems, and industrial process applications such as hydrogen production and desalination. In addition, a scaled experiment can be an economical method of analyzing the interconnections between HES components and understanding the time constants associated between inter-component energy and information flows. This report discusses the results of a preliminary scaling analysis done for the primary loop of a 300 MWth Fluoride-Salt-Cooled High Temperature Reactor (FHR) that is coupled with a High-Temperature Steam Electrolysis system (HTSE), as well as the basic control logic that governs the primary components and the necessary hardware to achieve optimal functionality. The scaled facility will be a 1 MWth system that uses Dowtherm A as the simulant fluid for Flibe (the coolant of choice for the primary loop of molten salt reactors), and can validate the heat transfer and steady-state operational requirements of the 300 MWth prototype. The scaled facility matches the Prandtl and Reynolds numbers associated with steady-state operation of the FHR-HTSE’s primary loop without having to deal with very high temperatures, flow rates, or power inputs. This will allow the facility to run experiments that analyze various thermophysical and fluid-dynamic properties that characterize reactor operation, such as pressure drops, radial

  11. Preliminary Scaling and controls Analysis of an FHR-HTSE System Idaho National Laboratory Summer 2013 Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Shannon Bragg-Sitton; Piyush Sabharwall; Rohit Upadhya

    2013-08-01

    For new nuclear reactor system designs to be approved by regulatory agencies like the Nuclear Regulatory Commission (NRC), the details of system operation must be validated with respect to standards of safety, control, and output. A scaled experiment that replicates certain properties of the system can be used to validate compliance with regulatory standards, while avoiding the prohibitive cost and labor required to develop a fully functional prototype system; therefore, designing such an experiment is of special interest to current efforts to develop hybrid energy systems (HES) that integrate small modular reactors (SMRs), renewable energy systems, and industrial process applications such as hydrogen production and desalination. In addition, a scaled experiment can be an economical method of analyzing the interconnections between HES components and understanding the time constants associated between inter-component energy and information flows. This report discusses the results of a preliminary scaling analysis done for the primary loop of a 300 MWth Fluoride-Salt-Cooled High Temperature Reactor (FHR) that is coupled with a High-Temperature Steam Electrolysis system (HTSE), as well as the basic control logic that governs the primary components and the necessary hardware to achieve optimal functionality. The scaled facility will be a 1 MWth system that uses Dowtherm A as the simulant fluid for Flibe (the coolant of choice for the primary loop of molten salt reactors), and can validate the heat transfer and steady-state operational requirements of the 300 MWth prototype. The scaled facility matches the Prandtl and Reynolds numbers associated with steady-state operation of the FHR-HTSE’s primary loop without having to deal with very high temperatures, flow rates, or power inputs. This will allow the facility to run experiments that analyze various thermophysical and fluid-dynamic properties that characterize reactor operation, such as pressure drops, radial

  12. Metabolic deterioration of the sedentary control group in clinical trials

    National Research Council Canada - National Science Library

    Mahesh J. Patel; Cris A. Slentz; William E. Kraus

    2011-01-01

    Randomized clinical trials of exercise training regimens in sedentary individuals have provided a mechanistic understanding of the long-term health benefits and consequences of physical activity and inactivity...

  13. Prevalence and clinical correlations of BRCA1/BRCA2 unclassified variant carriers among unselected primary ovarian cancer cases - preliminary report

    NARCIS (Netherlands)

    Majdak, EJ; De Bock, GH; Brozek, [No Value; Perkowska, M; Ochman, K; Debniak, J; Milczek, T; Cornelisse, CJ; Jassem, J; Emerich, J; Limon, J; Devilee, P; Brozek, I.

    The objective of this study was to determine the prevalence of BRCA1 and BRCA2 gene mutations in unselected ovarian cancer patients, and to analyse clinical and pathological features of ovarian cancer unclassified variant mutation carriers in comparison with BRCA1 pathogenic mutation carriers and

  14. The Use of the Bayley Scales of Infant and Toddler Development III with Clinical Populations: A Preliminary Exploration

    Science.gov (United States)

    Milne, Susan; McDonald, Jenny; Comino, Elizabeth J.

    2012-01-01

    In response to concerns that the Bayley Scales of Infant and Toddler Development III (BSIDIII) underestimate delay in clinical populations, this study explores developmental quotient scores as an alternative to composite scores for these children. One hundred and twenty-two children aged [less than or equal to] 42 months, referred for diagnosis of…

  15. The Use of the Bayley Scales of Infant and Toddler Development III with Clinical Populations: A Preliminary Exploration

    Science.gov (United States)

    Milne, Susan; McDonald, Jenny; Comino, Elizabeth J.

    2012-01-01

    In response to concerns that the Bayley Scales of Infant and Toddler Development III (BSIDIII) underestimate delay in clinical populations, this study explores developmental quotient scores as an alternative to composite scores for these children. One hundred and twenty-two children aged [less than or equal to] 42 months, referred for diagnosis of…

  16. TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS - CLINICAL AND RADIOGRAPHIC CHARACTERISTICS 30 YEARS AFTER NONSURGICAL TREATMENT - A PRELIMINARY-REPORT

    NARCIS (Netherlands)

    DELEEUW, R; BOERING, G; STEGENGA, B; DEBONT, LGM

    1993-01-01

    Thirty years after being treated nonsurgically for osteoarthrosis and internal derangement, 14 women and seven men were re-examined clinically and radiographically. The results of this examination were compared with those recorded before and after treatment 30 years ago, and with those of a matched

  17. Prevalence and clinical correlations of BRCA1/BRCA2 unclassified variant carriers among unselected primary ovarian cancer cases - preliminary report

    NARCIS (Netherlands)

    Majdak, EJ; De Bock, GH; Brozek, [No Value; Perkowska, M; Ochman, K; Debniak, J; Milczek, T; Cornelisse, CJ; Jassem, J; Emerich, J; Limon, J; Devilee, P; Brozek, I.

    2005-01-01

    The objective of this study was to determine the prevalence of BRCA1 and BRCA2 gene mutations in unselected ovarian cancer patients, and to analyse clinical and pathological features of ovarian cancer unclassified variant mutation carriers in comparison with BRCA1 pathogenic mutation carriers and sp

  18. Implementation of fast macromolecular proton fraction mapping on 1.5 and 3 Tesla clinical MRI scanners: preliminary experience

    Science.gov (United States)

    Yarnykh, V.; Korostyshevskaya, A.

    2017-08-01

    Macromolecular proton fraction (MPF) is a biophysical parameter describing the amount of macromolecular protons involved into magnetization exchange with water protons in tissues. MPF represents a significant interest as a magnetic resonance imaging (MRI) biomarker of myelin for clinical applications. A recent fast MPF mapping method enabled clinical translation of MPF measurements due to time-efficient acquisition based on the single-point constrained fit algorithm. However, previous MPF mapping applications utilized only 3 Tesla MRI scanners and modified pulse sequences, which are not commonly available. This study aimed to test the feasibility of MPF mapping implementation on a 1.5 Tesla clinical scanner using standard manufacturer’s sequences and compare the performance of this method between 1.5 and 3 Tesla scanners. MPF mapping was implemented on 1.5 and 3 Tesla MRI units of one manufacturer with either optimized custom-written or standard product pulse sequences. Whole-brain three-dimensional MPF maps obtained from a single volunteer were compared between field strengths and implementation options. MPF maps demonstrated similar quality at both field strengths. MPF values in segmented brain tissues and specific anatomic regions appeared in close agreement. This experiment demonstrates the feasibility of fast MPF mapping using standard sequences on 1.5 T and 3 T clinical scanners.

  19. Fluoxetine for poststroke depression A randomized placebo controlled clinical trial

    Institute of Scientific and Technical Information of China (English)

    Yan Kong; Wanli Dong; Chunfeng Liu

    2007-01-01

    BACKGROUND: Studies have demonstrated that poststroke depression(PSD) may be related with the disequilibrium between noradrenaline and 5-hydroxytryptamine (5-HT) caused by cerebral injury. The injured regions involve noradrenergic and 5-hydroxytryptaminergic neurons as well as conduction pathway.The levels of noradrenaline and 5-HT would be decreased.OBJECTIVE: To observe the effect of fluoxetine on preventing against PSD and recovery of neurologic function, and analyze the relationship of fluoxetine and the 5-HT level.DESIGN: A randomized controlled clinical trial.SETTING: Department of Neurology, First Hospital Affiliated to Soochow University.PARTICIPANTS: Ninety consecutive patients, 47 female and 43 male, were recruited who admitted to hospital for recent stroke in the Department of Neurology, First Affiliated Hospital of Soochow University between September 2003 and February 2005. Subjects were aged (64±7) years, ranging from 47 to 79 years old. They all met the diagnosis criteria of various cerebrovascular diseases formulated in the 4th National Cerebrovascular Disease Conference and confirmed as stroke by skull CT or MRI; The time from onset to tentative administration was less than 7 days; The patients had clear consciousness, without obvious language disorder. They were randomized into treatment group (n =48) and placebo group (n =42).METHODS: ①All the patients were given routine treatment according to treatment guideline of cerebrovascular disease after admission. Patients in the treatment group and placebo group received 20 mg/d fluoxetine and placebo (component: vitamin C) for 8 weeks, respectively. ② Neurologic deficit was assessed according to 24-item Hamilton Rating Scale for Depression (HAMD) and Activity of Daily Living Scale (ADL) before and at 2,4 and 8 weeks after test, separately; Meanwhile, the levels of platelet 5-HT and plasma 5-HT were determined. Grading criteria of HAMD intergral depression: non-depression < 8 points

  20. Analytical and Preliminary Simulation Study of a Pilot's Ability to Control the Terminal Phase of a Rendezvous with Simple Optical Devices and a Timer

    Science.gov (United States)

    Lineberry, Edgar C., Jr.; Brissenden, Roy F.; Kurbjun, Max C.

    1961-01-01

    One method of controlling the terminal phase of a space rendezvous between two vehicles is first to correct the flight path of the controlled vehicle so that a constant line of sight is established between the vehicles. This correction is accomplished by thrusting normal to the sight line in a direction to arrest the angular motion of this line. Once this collision course has been established, the second step is to control the closure rate for a safe approach along the line of sight. Adequate control of this maneuver requires range and closure-rate information. A combined analytical and preliminary simulation study was conducted to determine the ability of a human pilot to control the rendezvous by this method using visual sightings made during the initial collision-course control to obtain the range and closure rate. The analytical phase of the study reviewed the geometric relations between the vehicles and formed the basis for techniques to transform the angular sightings into range and closure rate. A preliminary simulation was then made to investigate the accuracy of these techniques. The simulation consisted of an analog computer, an oscilloscope to represent the view a pilot would have-with a stabilized sight, and a timer. Results indicate that pilots, using an optical sight and a timer, can successfully arrest the angular motion of the line of sight between two rendezvous vehicles and obtain relative range and closure rate with sufficient accuracy to perform the final braking maneuver successfully.

  1. The relationship between self-control, job satisfaction and life satisfaction in Chinese employees: A preliminary study.

    Science.gov (United States)

    Dou, Kai; Nie, Yan-Gang; Wang, Yu-Jie; Liu, Yao-Zhong

    2016-01-01

    Previous studies have demonstrated that self-control is positively related to life satisfaction, but this association in Chinese employees and its underlying mechanism are less commonly investigated. In this preliminary study the relationships between self-control and life satisfaction and the mediating effect of job satisfaction were tested. Participants were 482 full-time employees (188 male, 294 female) from different cities in China. They answered self-report questionnaires online that assessed self-control, job satisfaction, and life satisfaction. Path analyses were conducted and bootstrap technique was used to judge the significance of the mediation. Self-control was positively related to both job and life satisfaction. More importantly, job satisfaction significantly mediated the association between self-control and life satisfaction. Furthermore, there was no significant difference in the size of the mediating effect between intrinsic and extrinsic job satisfaction. Results of this preliminary study provide further evidence of the positive association between self-control and life satisfaction. Job satisfaction is found to mediate this relationship.

  2. Preliminary investigation of the effect of air-pollution-control residue from waste incineration on the properties of cement paste and mortar

    DEFF Research Database (Denmark)

    Geiker, Mette Rica; Kjeldsen, Ane Mette; Galluci, Emmanuel

    2006-01-01

    For preliminary assessment of the engineering properties of concrete with air-pollution-control residue from waste incineration (APC) the possible reactivity of APC and the effect of APC on cement hydration were investigated by isothermal calorimetry, chemical shrinkage (pychnometry), thermal...... metals (approx. 3%) the preliminary studies were performed on untreated samples to evaluate the possible application of the least expensive materials and processes. Pastes and mortars of low alkali sulphate resistant Portland cement with 0%, 10%, and 20% APC substitution were prepared. Mixes with 10......% and 20% APC showed a major retarding effect of APC on the development of hydration. The APC was found to be pozzolanic. Chemical shrinkage measurements indicated early expansive reactions of pastes with the APC including evolution of air. Crack formation was observed in mortars with APC, and strength...

  3. The Relationship of Clinical, Cognitive and Social Measures in Schizophrenia: A Preliminary Finding Combining Measures in Probands and Relatives

    OpenAIRE

    David Huepe; Rodrigo Riveros; Facundo Manes; Blas Couto; Esteban Hurtado; Marcelo Cetkovich; Maria Escobar; Viviana Vergara; Teresa Parrao; Agustin Ibañez

    2012-01-01

    This study examines performance of schizophrenia patients, unaffected relatives and controls in social cognition, cognitive and psychiatric scales looking for possible markers of vulnerability in schizophrenia. Performance of schizophrenia patients from multiplex families, first-degree relatives, and matched controls was compared and, subsequently, discriminant analysis method was used for identifying the best predictors for group membership. By using Multigroup Discriminant Analyses on the t...

  4. Clinical evaluation of an antiinflammatory and antioxidant diet effect in 30 dogs affected by chronic otitis externa: preliminary results.

    Science.gov (United States)

    Di Cerbo, Alessandro; Centenaro, Sara; Beribè, Francesca; Laus, Fulvio; Cerquetella, Matteo; Spaterna, Andrea; Guidetti, Gianandrea; Canello, Sergio; Terrazzano, Giuseppe

    2016-03-01

    The aim of this evaluation study was to assess the possible role of a specific nutraceutical diet in relieving main clinical symptoms of chronic bilateral otitis externa (occlusion of ear canal, erythema, discharge quantity, and odor) in 30 adult dogs. Thirty dogs of different breeds (mean age ± SEM; 6.03 ± 0.15 years and mean weight ± SEM; 32.01 ± 1.17 Kg; 53.3% males, 46.6% females) with evident chronic clinical otitis symptoms were equally divided and randomly assigned to receive either the nutraceutical diet (ND group) or a standard diet (SD group) over a period of 90 days. In all cases a topical pharmacological treatment was given. The nutraceutical diet, also endowed with anti-inflammatory and antioxidant activities, significantly decreased the mean score intensity of all symptoms after 90 days of intervention (P otitis externa-related symptoms. This study opens new insights into otitis externa clinical management providing evidence of efficacy of a combined therapy with drugs and a specific nutraceutical diet.

  5. Comparison between Clinical Aspects and Salivary Microbial Profile of Children with and without Early Childhood Caries: A Preliminary Study.

    Science.gov (United States)

    Neves, A B; Lobo, L A; Pinto, K C; Pires, E S; Requejo, Mep; Maia, L C; Antonio, A G

    2015-01-01

    To compare the clinical aspects and microbial profile of children with and without early childhood caries (ECC). 14 patients (7 without caries and 7 with ECC) were submitted to anamnesis, clinical exam and saliva collection for microbiological analyses. Counts of Streptococcus mutans, Lactobacillus spp. Candida spp., and total microorganisms were performed by culture methods. Microbial diversity was characterized by PCR-DGGE. Demographic/clinical data and salivary microbial counts were compared between groups. Habits of hygiene and breastfeeding presented no association with ECC. Use of pacifiers was associated with absence of caries (p=0.035). Counts of total microorganisms and Candida spp. did not differ between the groups. The ECC group presented larger quantity of S. mutans (p=0.026) and Lactobacillus spp. (p=0.002). There was no correlation between microorganisms and breastfeeding and pacifier use. The dmf-t of ECC Group was 10.5 ± 1.9 and the modified dmf-t was 11.3 ± 3.6. The DGGE demonstrated difference in the pattern of bands between the groups. Pacifiers usage was associated with the absence of ECC and microorganism number was higher in the caries group. The PCR-DGGE revealed a characteristic microbial diversity in the ECC Group, being an excellent tool for observing the dynamics of the salivary microbial community in these patients.

  6. Ultrasound-guided Interdigital Neuroma Injections: Short-term Clinical Outcomes after a Single Percutaneous Injection—Preliminary Results

    Science.gov (United States)

    Adler, Ronald S.; Ciavarra, Gina A.; Pavlov, Helene

    2006-01-01

    Purpose To describe the procedure of ultrasound-guided Morton’s neuroma and recurrent stump neuroma injections and early clinical outcomes after a single injection. Materials and Methods Retrospective review of 44 percutaneous ultrasound-guided neuroma injections in 24 patients who had completed clinical outcomes questionnaires. A 10-point pain scale [scale of 1 (no pain) to 10 (severe pain)] in a 7-day pain log format was distributed to patients at the time percutaneous neuroma injection was performed. Results Neuromas were clearly visualized with sonography as hypoechoic nodules and were distinguishable from other causes of forefoot pain, such as metatarsophalangeal joint synovitis and intermetatarsal bursae. The sizes of the neuromas injected ranged between 4 and 19 mm. Postinjection, all neuromas displayed increased echogenicity and/or the appearance of fluid surrounding it, confirming localization of the therapeutic mixture. We arbitrarily subdivided the pain ratings into symptomatic (greater than 4) and asymptomatic (less than or equal to 4) for statistical analysis. Average pain level pre injection was 5.2 and average pain level was 3.7 at 7 days post single injection, with 62% of the initially symptomatic patients asymptomatic on day 7 (p neuromas injected once were asymptomatic on day 7. Conclusion Ultrasound can be used to accurately target Morton’s neuromas and, therefore, appropriately direct therapeutic interventions, with good short-term clinical results. PMID:18751769

  7. A Preliminary Randomized Controlled Trial of Multifaceted Educational Intervention for Mild Cognitive Impairment Among Elderly Malays in Kuala Lumpur

    Directory of Open Access Journals (Sweden)

    Sa’ida Munira Johari

    2014-06-01

    Conclusion: A 12-month educational intervention on nutritional, lifestyle, and cognitive exercise significantly improved nutritional status, knowledge, and attitude score. The study lacked power to demonstrate a statistically significant positive effect on cognitive functioning; thus, the preliminary findings should be confirmed in a larger trial.

  8. A randomized controlled trial of Minnesota day clinic treatment of alcoholics

    DEFF Research Database (Denmark)

    Grønbaek, Morten; Nielsen, Bent

    2007-01-01

    AIM: To compare the Minnesota day clinic treatment with the traditional public psychosocial treatment. DESIGN: Randomized controlled trial. SETTING: Public out-patient alcohol clinic and privately funded Minnesota day clinic in Denmark. PARTICIPANTS: A total of 148 individuals with alcohol...

  9. Clinical evaluation of a novel herbal dental cream in plaque formation: a double-blind, randomized, controlled clinical trial

    OpenAIRE

    amrutesh, sunita; Malini, J; Tandur, Prakash S; Pralhad S. Patki

    2010-01-01

    Background The aim of this study was to evaluate the efficacy and safety of herbal dental cream in comparison to fluoride dental cream. Objectives Clinical evaluation of a novel herbal dental cream in plaque formation: a double-blind, randomized, controlled clinical trial. Methods One hundred and two patients with established dental plaque were randomly assigned to either herbal dental group or fluoride dental group for six weeks in a double-blind design. Improvement in plaque index, oral hyg...

  10. Clinical and socio-demographic predictors for virologic failure in rural Southern Africa: preliminary findings from CART-1

    Science.gov (United States)

    Daniel Labhardt, Niklaus; Bader, Joëlle; Ramoeletsi, Mojakisane; Kamele, Mashaete; Ismael Lejone, Thabo; Cheleboi, Molisana; Motlatsi, Mokete M.; Ehmer, Jochen; Faturyiele, Olatunbosun; Puga, Daniel; Klimkait, Thomas

    2014-01-01

    Introduction In 2013, the World Health Organization (WHO) recommended scaling up of routine viral load (VL) monitoring for patients on antiretroviral therapy (ART) in resource-limited settings [1]. During the transition phase from no VL-testing at all to routine VL-monitoring, targeted VL for groups at particular risk of virologic failure (VF) may be an option [2]. We present socio-demographic and clinical risk factors for VF in a cohort in rural Lesotho with no access to VL prior to the study. Materials and Methods Data derive from a cross-sectional study providing multi-disease screening as well as VL testing to adult patients (≥16 years old) on first-line ART ≥6 months [3]. VF was defined as VL≥1000 copies/mL. Assessed potential predictors of VF were: (1) socio-demographic (sex, age, wealth-quintile, education, employment status, disclosure of HIV status to environment, travel-time to facility); (2) treatment history (history of treatment interruption >2 days, previous drug substitution within first-line ART, time on ART, ART-base and -backbone); (3) adherence (pill count) and (4) clinical (clinical or immunological failure as defined by WHO guidelines [1], presence of papular pruritic eruption (PPE)). All variables with association to VF in univariate analysis were included in a multivariate logistic regression reporting adjusted Odds ratios (aOR). Results Data from 1,488 patients were analyzed. Overall VF-prevalence was 6.9% (95% CI 5.7–8.3). In univariate analysis, the following were associated with VF: age <30, lower wealth-quintile, no primary education, history of treatment interruption, nevirapine-base, zidovudine-backbone, history of drug substitution, travel-time to clinic ≥2 hours, disclosure of HIV status to <5 persons, clinical failure, presence of PPE and immunological failure. In multivariate analysis, 6 out of the above 12 variables were independent predictors: age <30 years (aOR: 2.4; 95% CI 1.1–5.3, p=0.029), history of treatment

  11. Robot-Assisted Surgery for Mandibular Angle Split Osteotomy Using Augmented Reality: Preliminary Results on Clinical Animal Experiment.

    Science.gov (United States)

    Zhou, Chaozheng; Zhu, Ming; Shi, Yunyong; Lin, Li; Chai, Gang; Zhang, Yan; Xie, Le

    2017-07-19

    Mandibular angle split osteotomy (MASO) is a procedure widely used for prominent mandibular angles. However, conventional mandibular plastic surgery is invasive and high risk. It may induce postoperative neurosensory disturbance of the inferior alveolar nerve, fractures and infection due to the complexity of the anatomical structure and the narrow surgical field of view. The success rate of MASO surgery usually depends on the clinical experience and skills of the surgeon. To evaluate the performance of inexperienced plastic surgeons conducting this surgery, a self-developed and constructed robot system based on augmented reality is used. This robot system provides for sufficient accuracy and safety within the clinical environment. To evaluate the accuracy and safety of MASO surgery, an animal study using this robot was performed in the clinical room, and the results were then evaluated. Four osteotomy planes were successfully performed on two dogs; that is, twenty tunnels (each dog drilled on bilaterally) were drilled in the dogs' mandible bones. Errors at entrance and target points were 1.04 ± 0.19 and 1.22 ± 0.24 mm, respectively. The angular error between the planned and drilled tunnels was 6.69° ± 1.05°. None of the dogs experienced severe complications. Therefore, this technique can be regarded as a useful approach for training inexperienced plastic surgeons on the various aspects of plastic surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  12. The relationship between clinical outcomes and medication adherence in difficult-to-control asthma.

    Science.gov (United States)

    Murphy, Anna C; Proeschal, Amandine; Brightling, Christopher E; Wardlaw, Andrew J; Pavord, Ian; Bradding, Peter; Green, Ruth H

    2012-08-01

    Medication non-adherence and the clinical implications in difficult-to-control asthma were audited. Prescription issue data from 115 patients identified sub-optimal adherence (asthma (p=0.008). The majority of patients with difficult-to-control asthma are non-adherent with their asthma medication. Non-adherence is correlated with poor clinical outcomes.

  13. Hyperthermic intraperitoneal chemotherapy with mitomycin C and 5-fluorouracil in patients at high risk of peritoneal metastasis from colorectal cancer: A preliminary clinical study.

    Science.gov (United States)

    Shimizu, Tomoharu; Murata, Satoshi; Sonoda, Hiromichi; Mekata, Eiji; Ohta, Hiroyuki; Takebayashi, Katsushi; Miyake, Tohru; Tani, Tohru

    2014-05-01

    Although hyperthermic intraperitoneal chemotherapy (HIPEC) has been extensively used to treat patients with peritoneal metastases (PM) from colorectal cancer (CRC), a standard protocol has not yet been established. The aim of this preliminary clinical study was to confirm in vitro the efficacy of mitomycin C combined with 5-fluorouracil (MMC-5FU) under hyperthermic conditions in CRC and investigate the pharmacokinetics and feasibility of HIPEC with MMC-5FU for patients at high risk of PM from CRC. To simulate HIPEC in vitro, we used the collagen gel droplet-embedded culture drug sensitivity test with the HCT166 colorectal cell line to assess the antitumor efficacy of MMC and 5FU as single-agent and combination treatments following incubation with HCT116 cells for 30 min at either 37 or 42°C. In addition, five patients at high risk of PM from CRC underwent surgical tumor resection followed by HIPEC with MMC-5FU. Our results demonstrated that the combined administration of MMC-5FU suppressed tumor cell proliferation more efficiently compared to either agent used alone. In addition, hyperthermia at 42°C significantly enhanced drug sensitivity. During the clinical application of HIPEC with MMC-5FU, no grade 4 hematological toxicities or surgical adverse events were recorded. In addition, there was no evidence of peritoneal recurrence during a median observational period of 38 months. Of note, two patients with positive intraoperative peritoneal cytology at the first surgery developed no peritoneal recurrence and exhibited negative peritoneal cytology at the second surgery. In conclusion, HIPEC using MMC-5FU was shown to be a feasible therapeutic option, with an acceptable toxicity profile, for patients at high risk of PM from CRC. Therefore, HIPEC with MMC-5FU may be a promising novel therapeutic option for such patients, which merits further verification of its safety and efficacy in large-scale clinical trials.

  14. Curriculum time compared to clinical procedures in amalgam and composite posterior restorations in U.S. dental schools: a preliminary study.

    Science.gov (United States)

    Rey, Rosalia; Nimmo, Susan; Childs, Gail S; Behar-Horenstein, Linda S

    2015-03-01

    Dental clinicians have an expanding range of biomaterial choices for restoring tooth structure. Scientific developments in cariology, advances in dental biomaterials, and patients' esthetic concerns have led to a reduction in amalgam restorations and an increase in composite restorations. The aim of this study was to compare teaching time with students' clinical procedures in amalgam and composite posterior restorations in dental schools across the United States. Academic deans in 60 schools were invited to complete a survey that asked for the amount of instructional time for amalgam and composite posterior restorations and the number of clinical restorations performed by their Classes of 2009, 2010, and 2011. Of these 60, 12 returned surveys with complete data, for a 20% response rate. Responses from these schools showed little change in lecture and preclinical laboratory instruction from 2009 to 2011. There was a slight increase in two-surface restorations for both amalgam and composites; however, the total number of reported composite and amalgam restorations remained the same. Of 204,864 restorations reported, 53% were composite, and 47% were amalgam. There were twice as many multisurface large or complex amalgam restorations as composites. One-surface composite restorations exceeded amalgams. Among the participating schools, there was little to no change between curriculum time and clinical procedures. Findings from this preliminary study reflect a modest increase in two-surface resin-based restorations placed by dental students from 2009 to 2011 and little change in curricular time devoted to teaching amalgam restorations. The total number of posterior composite restorations placed by students in these schools was slightly higher than amalgams.

  15. American College of Rheumatology/European League against Rheumatism Preliminary Definition of Remission in Rheumatoid Arthritis for Clinical Trials

    Science.gov (United States)

    Felson, David T.; Smolen, Josef S.; Wells, George; Zhang, Bin; van Tuyl, Lilian H. D.; Funovits, Julia; Aletaha, Daniel; Allaart, Renée; Bathon, Joan; Bombardieri, Stefano; Brooks, Peter; Brown, Andrew; Matucci-Cerinic, Marco; Choi, Hyon; Combe, Bernard; de Wit, Maarten; Dougados, Maxime; Emery, Paul; Furst, Dan; Gomez-Reino, Juan; Hawker , Gillian; Keystone, Edward; Khanna, Dinesh; Kirwan, John; Kvien, Tore; Landewé, Robert; Listing, Joachim; Michaud, Kaleb; Mola, Emilio Martin; Montie, Pam; Pincus, Ted; Richards, Pam; Siegel, Jeff; Simon, Lee; Sokka, Tuulikki; Strand, Vibeke; Tugwell, Peter; Tyndall, Alan; van der Heijde, Desirée; Verstappen, Suzan; White, Barbara; Wolfe, Fred; Zink, Angela; Boers, Maarten

    2010-01-01

    Background With remission in rheumatoid arthritis (RA) an increasingly attainable goal, there is no widely used definition of remission that is stringent but achievable and could be applied uniformly as an outcome in clinical trials. Methods A committee consisting of members of the American College of Rheumatology, the European League Against Rheumatism and the Outcome Measures in Rheumatology Initiative (OMERACT) met to guide the process and review prespecified analyses from clinical trials of patients with RA. The committee requested a stringent definition (little, if any, active disease) and decided to use core set measures to define remission including at least joint counts and an acute phase reactant. Members were surveyed to select the level of each core set measure consistent with remission. Candidate definitions of remission were tested including those that constituted a number of individual measures in remission (Boolean approach) as well as definitions using disease activity indexes. To select a definition of remission, trial data were analyzed to examine the added contribution of patient reported outcomes and the ability of candidate measures to predict later good x-ray and functional outcomes. Results Survey results for the definition of remission pointed to indexes at published thresholds and to a count of core set measures with each measure scored as 1 or less (e.g. tender and swollen joint counts, CRP and global assessments on 0-10 scale). Analyses suggested the need to include a patient reported measure. Examination of 2 year follow-up data suggested that many candidate definitions performed comparably in terms of predicting later good x-ray and functional outcomes, although DAS28 based measures of remission did not predict good radiographic outcomes as well as did the other candidate definitions. Given these and other considerations, we propose that a patient be defined as in remission based on one of two definitions : 1: When their scores on the

  16. Development of a Clinical Data Warehouse for Hospital Infection Control

    Science.gov (United States)

    Wisniewski, Mary F.; Kieszkowski, Piotr; Zagorski, Brandon M.; Trick, William E.; Sommers, Michael; Weinstein, Robert A.

    2003-01-01

    Existing data stored in a hospital's transactional servers have enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to support research and quality improvement projects are evolving challenges for hospital systems. The authors report development of a clinical data warehouse that they created by importing data from the information systems of three affiliated public hospitals. They describe their methodology; difficulties encountered; responses from administrators, computer specialists, and clinicians; and the steps taken to capture and store patient-level data. The authors provide examples of their use of the clinical data warehouse to monitor antimicrobial resistance, to measure antimicrobial use, to detect hospital-acquired bloodstream infections, to measure the cost of infections, and to detect antimicrobial prescribing errors. In addition, they estimate the amount of time and money saved and the increased precision achieved through the practical application of the data warehouse. PMID:12807807

  17. Development of a clinical data warehouse for hospital infection control.

    Science.gov (United States)

    Wisniewski, Mary F; Kieszkowski, Piotr; Zagorski, Brandon M; Trick, William E; Sommers, Michael; Weinstein, Robert A

    2003-01-01

    Existing data stored in a hospital's transactional servers have enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to support research and quality improvement projects are evolving challenges for hospital systems. The authors report development of a clinical data warehouse that they created by importing data from the information systems of three affiliated public hospitals. They describe their methodology; difficulties encountered; responses from administrators, computer specialists, and clinicians; and the steps taken to capture and store patient-level data. The authors provide examples of their use of the clinical data warehouse to monitor antimicrobial resistance, to measure antimicrobial use, to detect hospital-acquired bloodstream infections, to measure the cost of infections, and to detect antimicrobial prescribing errors. In addition, they estimate the amount of time and money saved and the increased precision achieved through the practical application of the data warehouse.

  18. Case of asymmetrical arthrogryposis. A clinical study and a preliminary report on the value of CT-scanning

    Energy Technology Data Exchange (ETDEWEB)

    Hageman, G.; Vette, J.K.; Willemse, J. (University Hospital, Utrecht (Netherlands))

    1983-01-01

    Following the introduction of the conception that arthrogryposis is a symptom and not a clinical entity, a case of the very rare asymmetric form of neurogenic arthrogryposis is presented. The asymmetry of congenital contractures and weakness is associated with hemihypotrophy. The value of muscular CT-scanning prior to muscle biopsy is demonstrated. Muscular CT-scanning shows the extension of adipose tissue, which has replaced damaged muscles and therby indicates the exact site for muscle biopsy. Since orthopaedic treatment in arthrogryposis can be unrewarding due to severe muscular degeneration, preoperative scanning may provide additional important information on muscular function and thus be of benefit for surgery. The advantage of muscular CT-scanning in other forms of arthrogryposis requires further determination. The differential diagnosis with Werdnig-Hoffmann disease is discussed.

  19. Benefits of Group Singing for People with Eating Disorders: Preliminary Findings from a Non-Clinical Study

    Directory of Open Access Journals (Sweden)

    Metaxia Pavlakou

    2009-01-01

    Full Text Available The purpose of this study is to examine the possible benefits of participation in group singing for people with eating disorders in a non-clinical context. The creation of a group singing workshop for women that exhibited disordered eating provided the opportunity to explore the participants’ experiences as perceived by them. A qualitative approach utilizing a semi-structured interview was employed to explore in depth the women’s perceptions regarding the group singing workshop. A thematic analysis of the data identified four main categories concerning the benefits of group singing for the population under study. The theoretical model of Sears (1968 of the processes in music therapy and its application on anorexic clients (Parente 1989 informed the discussion of the empirical findings.

  20. [A preliminary clinical study on endoscopic measurement of lesion area with the method of digital image processing technology].

    Science.gov (United States)

    Zhang, Lei; Wang, Zhihua; Fu, Zhongqian; Fang, Pengcheng; Ling, Kai; Xu, Jianming; Kong, Derun; Xu, Zhangwei

    2013-10-01

    It is of great importance to measure the lesion area in scientific research and clinical practice. The present study aims to solve barrel distortion and measure lesion area with the technology of computer visualization. With the ultimate purpose to obtain the precise lesion area, the study, based on the original endoscopy system and digital image processing technology, dealt with the correction of barrel distortion by lens adjustment, calculated the gastric ulcer area with the aid of Qt database and finally developed an image processing software--Endoscope Assistant (EAS). The results showed that the EAS was accurate in vitro. It was employed to measure the gastric ulcer area of 45 patients and the results were compared with the traditional formula method. It could be well concluded that this technology is safe, accurate and economical for measuring gastric ulcer area.

  1. Clinical experience with fortnightly buprenorphine/naloxone versus buprenorphine in Italy: preliminary observational data in an office-based setting.

    Science.gov (United States)

    Amato, Patrizia

    2010-01-01

    Buprenorphine/naloxone is a new option for the management of opioid dependence. It has a reduced potential for abuse or misuse compared with methadone and buprenorphine alone, and has a long half-life allowing less frequent dosing. Buprenorphine/naloxone appears to be well suited for the management of opioid dependence in an office-based setting. The aim of this study was to evaluate the efficacy and safety of a buprenorphine/naloxone combination treatment in an office-based setting. Therefore, we evaluated the effect on misuse/diversion, quality of care, quality of life and service delivery. Seventy-eight patients were switched to buprenorphine/naloxone from either methadone or buprenorphine alone; the median duration of previous buprenorphine or methadone treatment was 10 years. Patients received buprenorphine/naloxone and were evaluated throughout a 1-year follow-up period. Treatment was self-administered by the patients every 2 weeks and the mean buprenorphine dosage at 1 year was 8 mg/day. Comparisons were made before and after the switch for patients who switched from buprenorphine alone to buprenorphine/naloxone. Switching to buprenorphine/naloxone was not associated with clinically relevant problems in 50% of patients studied. Buprenorphine/naloxone provided satisfactory coverage of withdrawal symptoms in 78.1% of patients, and 50% of patients were satisfied with buprenorphine/naloxone therapy. Seventy-eight per cent of patients reported improved psychosocial functioning. The majority of patients (approximately 85%) were negative for opioids during toxicological testing. A significantly higher proportion of treatment recipients were highly satisfied during buprenorphine/naloxone administration (p buprenorphine given before the switch). Other outcomes were similar during buprenorphine and buprenorphine/naloxone administration. Fortnightly self-administration of buprenorphine/naloxone appeared to be cost saving for the clinic. Buprenorphine/naloxone is an

  2. Combination therapy with mitoxantrone and plasma exchange in aggressive relapsing remitting multiple sclerosis: A preliminary clinical study

    Directory of Open Access Journals (Sweden)

    Nasim Tabrizi

    2012-01-01

    Full Text Available Background: The efficacy of mitoxantrone induction therapy in rapidly worsening multiple sclerosis (MS is well established. Plasma exchange is also applied as an adjuvant in exacerbations of relapsing MS. The aim of this study was to compare the efficacy of combination therapy with mitoxantrone and plasma exchange versus mitoxantrone alone in patients with aggressive MS. Materials and Methods: Forty patients with aggressive relapsing remitting MS were randomly put into two groups. The first group underwent monthly plasma exchange for three successive months, followed by 12 mg/m 2 mitoxantrone at the end of each course and two more doses of 6 mg/m 2 mitoxantrone in 3-month intervals. The second group received the same doses of mitoxantrone only without plasma exchange. At the end of 8 months treatment course, clinical reassessment and neuroimaging was performed and treatment was continued with interferon-β. Results: At the end of induction therapy, Expanded Disability Status Scale score was significantly improved in both groups (P < 0.001. Number of demyelinating and gadolinium-enhancing plaques in brain magnetic resonance imaging (MRI was prominently reduced in group 2 (P ≤ 0.05, but the changes were not statistically significant in group 1, except for juxtacortical plaques. Conclusion: Administration of mitoxantrone as an induction therapy in patients of aggressive relapsing remitting MS results in significant improvement of their clinical state and MRI activity. However, combination of plasma exchange with mitoxantrone gives no more benefits than mitoxantrone alone and sometimes worsens the situation possibly by reduction of mitoxantrone efficacy as a result of plasma exchange.

  3. Association between dynamic features of breast DCE-MR imaging and clinical response of neoadjuvant chemotherapy: a preliminary analysis

    Science.gov (United States)

    Huang, Lijuan; Fan, Ming; Li, Lihua; Zhang, Juan; Shao, Guoliang; Zheng, Bin

    2016-03-01

    Neoadjuvant chemotherapy (NACT) is being used increasingly in the management of patients with breast cancer for systemically reducing the size of primary tumor before surgery in order to improve survival. The clinical response of patients to NACT is correlated with reduced or abolished of their primary tumor, which is important for treatment in the next stage. Recently, the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is used for evaluation of the response of patients to NACT. To measure this correlation, we extracted the dynamic features from the DCE- MRI and performed association analysis between these features and the clinical response to NACT. In this study, 59 patients are screened before NATC, of which 47 are complete or partial response, and 12 are no response. We segmented the breast areas depicted on each MR image by a computer-aided diagnosis (CAD) scheme, registered images acquired from the sequential MR image scan series, and calculated eighteen features extracted from DCE-MRI. We performed SVM with the 18 features for classification between patients of response and no response. Furthermore, 6 of the 18 features are selected to refine the classification by using Genetic Algorithm. The accuracy, sensitivity and specificity are 87%, 95.74% and 50%, respectively. The calculated area under a receiver operating characteristic (ROC) curve is 0.79+/-0.04. This study indicates that the features of DCE-MRI of breast cancer are associated with the response of NACT. Therefore, our method could be helpful for evaluation of NACT in treatment of breast cancer.

  4. Effect of concussion on clinically measured reaction time in nine NCAA Division I collegiate athletes: a preliminary study

    Science.gov (United States)

    Eckner, James T.; Kutcher, Jeffrey S.; Richardson, James K

    2013-01-01

    Objectives To evaluate the effect of concussion on clinically-measured reaction time (RTclin) with comparison to a computerized reaction time measure (RTcomp). Design Prospective, repeated measures observational study. Setting Athletic training clinic at an NCAA Division I university. Participants Data are reported for 9 collegiate athletes with acute concussion who were part of a larger cohort of 209 athletes recruited from the university’s football, women’s soccer, and wrestling teams prior to the start of their respective athletic seasons. Methods Baseline RTclin and RTcomp were measured during pre-participation physical examinations. RTclin measured the time required to catch a suspended vertical shaft by hand closure after its release by the examiner. RTcomp was derived from the simple reaction time component of the CogState-Sport computerized neurocognitive test battery. Athletes who subsequently sustained a physician-diagnosed concussion underwent repeat RTclin and RTcomp testing within 72 hours of injury. A Wilcoxon signed rank test was used to compare baseline and after-injury reaction times. Main Outcome Measurements After-injury changes in RTclin and RTcomp calculated with respect to each athlete’s own pre-season baseline value. Results After-injury RTclin was prolonged in 8 of the 9 concussed athletes, while RTcomp was prolonged in 5 of the 9 concussed athletes. Mean RTclin increased from 193 ± 21 ms to 219 ± 31 ms (p = 0.050), and mean RTcomp increased from 247 ± 75 to 462 ± 120 ms (p = 0.214). Conclusions We conclude that RTclin appears to be sensitive to the known prolongation of reaction time following concussion, and compares favorably to an accepted computerized reaction time measure. This study supports the potential utility of RTclin as part of a multi-faceted concussion assessment battery. PMID:21402367

  5. NeuroControl: system identification approach for clinical benefit.

    Directory of Open Access Journals (Sweden)

    Carel G.M. Meskers

    2015-09-01

    Full Text Available Progress in diagnosis and treatment of movement disorders after neurological diseases like stroke, cerebral palsy, dystonia and at old age requires understanding of the altered capacity to adequately respond to physical obstacles in the environment. With posture and movement disorders, the control of muscles is hampered, resulting in aberrant force generation and improper impedance regulation. Understanding of this improper regulation not only requires the understanding of the role of the neural controller, but also attention for the 1 the interaction between the neural controller and the plant, comprising the biomechanical properties of the skeleton including the viscoelastic properties of the contractile (muscle and non-contractile (connective tissues: neuromechanics and 2 the closed loop nature of neural controller and biomechanical system in which cause and effect interact and are hence difficult to separate. Properties of the neural controller and the biomechanical system need to be addressed synchronously by the combination of haptic robotics, (closed loop system identification, and neuro-mechanical modelling. In this paper, we argue that assessment of neuromechanics in response to well defined environmental conditions and tasks may provide for key parameters to understand posture and movement disorders in neurological diseases and as biomarkers to increase accuracy of prediction models for functional outcome and effects of intervention.

  6. Comparison of prone versus supine 18F-FDG-PET of locally advanced breast cancer: Phantom and preliminary clinical studies

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Jason M.; Rani, Sudheer D.; Li, Xia; Whisenant, Jennifer G.; Abramson, Richard G. [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 and Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee 37232 (United States); Arlinghaus, Lori R. [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 (United States); Lee, Tzu-Cheng [Department of Bioengineering, University of Washington, Seattle, Washington 98195 (United States); MacDonald, Lawrence R.; Partridge, Savannah C. [Department of Radiology, University of Washington, Seattle, Washington 98195 (United States); Kang, Hakmook [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 and Department of Biostatistics, Vanderbilt University, Nashville, Tennessee 37232 (United States); Linden, Hannah M. [Department of Medical Oncology, University of Washington, Seattle, Washington 98195 (United States); Kinahan, Paul E. [Department of Radiology, University of Washington, Seattle, Washington 98195 (United States); Department of Bioengineering, University of Washington, Seattle, Washington 98195 (United States); Department of Physics, University of Washington, Seattle, Washington 98195 (United States); Department of Electrical Engineering, University of Washington, Seattle, Washington 98195 (United States); Yankeelov, Thomas E., E-mail: thomas.yankeelov@vanderbilt.edu [Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Physics, Vanderbilt University, Nashville, Tennessee 37232 (United States); Department of Cancer Biology, Vanderbilt University, Nashville, Tennessee 37232 (United States)

    2015-07-15

    Purpose: Previous studies have demonstrated how imaging of the breast with patients lying prone using a supportive positioning device markedly facilitates longitudinal and/or multimodal image registration. In this contribution, the authors’ primary objective was to determine if there are differences in the standardized uptake value (SUV) derived from [{sup 18}F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in breast tumors imaged in the standard supine position and in the prone position using a specialized positioning device. Methods: A custom positioning device was constructed to allow for breast scanning in the prone position. Rigid and nonrigid phantom studies evaluated differences in prone and supine PET. Clinical studies comprised 18F-FDG-PET of 34 patients with locally advanced breast cancer imaged in the prone position (with the custom support) followed by imaging in the supine position (without the support). Mean and maximum values (SUV{sub peak} and SUV{sub max}, respectively) were obtained from tumor regions-of-interest for both positions. Prone and supine SUV were linearly corrected to account for the differences in 18F-FDG uptake time. Correlation, Bland–Altman, and nonparametric analyses were performed on uptake time-corrected and uncorrected data. Results: SUV from the rigid PET breast phantom imaged in the prone position with the support device was 1.9% lower than without the support device. In the nonrigid PET breast phantom, prone SUV with the support device was 5.0% lower than supine SUV without the support device. In patients, the median (range) difference in uptake time between prone and supine scans was 16.4 min (13.4–30.9 min), which was significantly—but not completely—reduced by the linear correction method. SUV{sub peak} and SUV{sub max} from prone versus supine scans were highly correlated, with concordance correlation coefficients of 0.91 and 0.90, respectively. Prone SUV{sub peak} and SUV{sub max} were

  7. Clinical requirements for closed-loop control systems.

    Science.gov (United States)

    Clarke, William L; Renard, Eric

    2012-03-01

    Closed-loop (CL) therapy systems should be safe, efficacious, and easily manageable for type 1 diabetes mellitus patient use. For the first two clinical requirements, noninferiority and superiority criteria must be determined based on current conventional and intensive therapy outcomes. Current frequencies of hypoglycemia and diabetic ketoacidosis are reviewed and safety expectations for CL therapy systems are proposed. Glycosylated hemoglobin levels lower than current American Diabetes Association recommendations for different age groups are proposed as superiority criteria. Measures of glycemic variability are described and the recording of blood glucose levels as percentages within, above, and below a target range are suggested as reasonable alternatives to sophisticated statistical analyses. It is also suggested that Diabetes Quality of Life and Fear of Hypoglycemia surveys should be used to track psychobehavioral outcomes. Manageability requirements for safe and effective clinical management of CL systems are worth being underscored. The weakest part of the infusion system remains the catheter, which is exposed to variable and under-delivery incidents. Detection methods are needed to warn both the system and the patient about altered insulin delivery, including internal pressure and flow alarms. Glucose monitor sensor accuracy is another requirement; it includes the definition of conditions that lead to capillary glucose measurement, eventually followed by sensor recalibration or replacement. The crucial clinical requirement will be a thorough definition of the situations when the patient needs to move from CL to manual management of insulin delivery, or inversely can switch back to CL after a requested interruption. Instructions about these actions will constitute a major part of the education process of the patients before using CL systems and contribute to the manageability of these systems.

  8. Preliminary clinical trial in percutaneous nephrolithotomy using a real-time navigation system for percutaneous kidney access

    Science.gov (United States)

    Rodrigues, Pedro L.; Moreira, António H. J.; Rodrigues, Nuno F.; Pinho, A. C. M.; Fonseca, Jaime C.; Lima, Estevão.; Vilaça, João. L.

    2014-03-01

    Background: Precise needle puncture of renal calyces is a challenging and essential step for successful percutaneous nephrolithotomy. This work tests and evaluates, through a clinical trial, a real-time navigation system to plan and guide percutaneous kidney puncture. Methods: A novel system, entitled i3DPuncture, was developed to aid surgeons in establishing the desired puncture site and the best virtual puncture trajectory, by gathering and processing data from a tracked needle with optical passive markers. In order to navigate and superimpose the needle to a preoperative volume, the patient, 3D image data and tracker system were previously registered intraoperatively using seven points that were strategically chosen based on rigid bone structures and nearby kidney area. In addition, relevant anatomical structures for surgical navigation were automatically segmented using a multi-organ segmentation algorithm that clusters volumes based on statistical properties and minimum description length criterion. For each cluster, a rendering transfer function enhanced the visualization of different organs and surrounding tissues. Results: One puncture attempt was sufficient to achieve a successful kidney puncture. The puncture took 265 seconds, and 32 seconds were necessary to plan the puncture trajectory. The virtual puncture path was followed correctively until the needle tip reached the desired kidney calyceal. Conclusions: This new solution provided spatial information regarding the needle inside the body and the possibility to visualize surrounding organs. It may offer a promising and innovative solution for percutaneous punctures.

  9. A preliminary survey on the religious profile of Brazilian psychiatrists and their approach to patients’ religiosity in clinical practice

    Science.gov (United States)

    Gonçalves, Juliane P.B.; Leão, Frederico C.; Peres, Mario F.P.; Vallada, Homero

    2016-01-01

    Background Although there is evidence of a relationship between religion/spirituality and mental health, it remains unclear how Brazilian psychiatrists deal with the religion/spirituality of their patients. Aims To explore whether Brazilian psychiatrists enquire about religion/spirituality in their practice and whether their own beliefs influence their work. Method Four hundred and eighty-four Brazilian psychiatrists completed a cross-sectional survey on religion/spirituality and clinical practice. Results Most psychiatrists had a religious affiliation (67.4%) but more than half of the 484 participants (55.5%) did not usually enquire about patients’ religion/spirituality. The most common reasons for not assessing patients’ religion/spirituality were ‘being afraid of exceeding the role of a doctor’ (30.2%) and ‘lack of training’ (22.3%). Conclusions Very religious/spiritual psychiatrists were the most likely to ask about their patients’ religion/spirituality. Training in how to deal with a patient’s religiosity might help psychiatrists to develop better patient rapport and may contribute to the patient’s quicker recovery. Declaration of interest None Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:27847592

  10. A text-based data mining and toxicity prediction modeling system for a clinical decision support in radiation oncology: A preliminary study

    Science.gov (United States)

    Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Chang, Kyung Hwan; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie

    2017-08-01

    The aim of this study is an integrated research for text-based data mining and toxicity prediction modeling system for clinical decision support system based on big data in radiation oncology as a preliminary research. The structured and unstructured data were prepared by treatment plans and the unstructured data were extracted by dose-volume data image pattern recognition of prostate cancer for research articles crawling through the internet. We modeled an artificial neural network to build a predictor model system for toxicity prediction of organs at risk. We used a text-based data mining approach to build the artificial neural network model for bladder and rectum complication predictions. The pattern recognition method was used to mine the unstructured toxicity data for dose-volume at the detection accuracy of 97.9%. The confusion matrix and training model of the neural network were achieved with 50 modeled plans (n = 50) for validation. The toxicity level was analyzed and the risk factors for 25% bladder, 50% bladder, 20% rectum, and 50% rectum were calculated by the artificial neural network algorithm. As a result, 32 plans could cause complication but 18 plans were designed as non-complication among 50 modeled plans. We integrated data mining and a toxicity modeling method for toxicity prediction using prostate cancer cases. It is shown that a preprocessing analysis using text-based data mining and prediction modeling can be expanded to personalized patient treatment decision support based on big data.

  11. Turbo STIR magnetic resonance imaging as a whole-body screening tool for metastases in patients with breast carcinoma: preliminary clinical experience.

    Science.gov (United States)

    Walker, R; Kessar, P; Blanchard, R; Dimasi, M; Harper, K; DeCarvalho, V; Yucel, E K; Patriquin, L; Eustace, S

    2000-04-01

    This study was undertaken to assess the utility of whole-body turbo short tau inversion recovery (STIR) magnetic resonance imaging (MRI) to detect metastases to liver, brain, and bone as a single examination in women with breast cancer. Seventeen patients with biopsy-proven breast cancer and suspected metastatic disease attending over a 12-month period referred for both conventional imaging and whole-body MRI were included in the study. Three patients were found to be free of metastases at both conventional and MR imaging. Appendicular or axial skeletal metastases were identified in 11 of 17 patients, with correlation between findings at whole-body MRI and scintigraphy in 15 of the 17 patients. Five patients had evidence of hepatic metastases on whole-body MRI, of which metastases were identified in only three patients at CT despite contrast enhancement. Four patients had brain abnormalities (metastases in three patients, meningioma in one patient) detected on both whole-body and dedicated brain MRI. Preliminary clinical experience suggests that turbo STIR whole-body MRI may represent a convenient and cost-effective method of total body screening for metastases in patients with breast carcinoma.

  12. Evaluation of the multiaxial system of ICD-10 (preliminary praft): correlations between multiaxial assessment and clinical judgements of aetiology, treatment indication and prognosis.

    Science.gov (United States)

    Michels, R; Siebel, U; Freyberger, H J; Schönell, H; Dilling, H

    2001-01-01

    Forty-five raters in 7 German centres took part in a multicentric field trial of the multiaxial system of ICD-10, delivering a total of 488 multiaxial assessments of 12 written case summaries. In addition to the multi-axial ratings (including main and subsidiary psychiatry diagnoses, level of social dysfunctioning and psychosocial stressors), assessments were made by the raters of the aetiology, treatment indications and prognosis of the main psychiatric disorder. There were significant correlations between these judgements and the measures of the multiaxial ratings: 62% of the cases diagnosed as endogenous were assessed as having a high level of social dysfunctioning (the proportion for all cases being 50.4%) and 63.4% as having a low number of stressors (vs. 52.8% in all cases). In contrast, cases diagnosed as reactive were assessed as having a lower level of social dysfunctioning and more social stressors. Cases whose prognosis was poor showed a higher rate of comorbidity and a high level of social dysfunctioning. The results demonstrate that the multiaxial approach reflects factors important to the process of clinical treatment and decision making and delivers preliminary evidence of this system's treatment and prognostic validity.

  13. The innovative viscoelastic CP ESP cervical disk prosthesis with six degrees of freedom: biomechanical concepts, development program and preliminary clinical experience.

    Science.gov (United States)

    Lazennec, Jean-Yves; Aaron, Alain; Ricart, Olivier; Rakover, Jean Patrick

    2016-01-01

    The viscoelastic cervical disk prosthesis ESP is an innovative one-piece deformable but cohesive interbody spacer. It is an evolution of the LP ESP lumbar disk implanted since 2006. CP ESP provides six full degrees of freedom about the three axes including shock absorbtion. The prosthesis geometry allows limited rotation and translation with resistance to motion (elastic return property) aimed at avoiding overload of the posterior facets. The rotation center can vary freely during motion. The concept of the ESP prosthesis is fundamentally different from that of the devices currently used in the cervical spine. The originality of the concept of the ESP® prosthesis led to innovative and intense testing to validate the adhesion of the viscoelastic component of the disk on the titanium endplates and to assess the mechanical properties of the PCU cushion. The preliminary clinical and radiological results with 2-year follow-up are encouraging for pain, function and kinematic behavior (range of motion and evolution of the mean centers of rotation). In this series, we did not observe device-related specific complications, misalignment, instability or ossifications. Additional studies and longer patient follow-up are needed to assess long-term reliability of this innovative implant.

  14. Computer-controlled stimulator for clinical cardiac studies

    NARCIS (Netherlands)

    Heethaar, R.M.; Poelgeest, R. van; Meijler, F.L.; Woudstra, E.S.; Zouw, C. van de

    A computer-controlled stimulator is described to generate the complex stimulation patterns required for a detailed analysis of ventricular myocardial function and the responses of the conduction system to applied stimuli, Pulse interval, height and width can be generated on a beat-to-beat basis.

  15. Computer-controlled stimulator for clinical cardiac studies

    NARCIS (Netherlands)

    Heethaar, R.M.; Poelgeest, R. van; Meijler, F.L.; Woudstra, E.S.; Zouw, C. van de

    1977-01-01

    A computer-controlled stimulator is described to generate the complex stimulation patterns required for a detailed analysis of ventricular myocardial function and the responses of the conduction system to applied stimuli, Pulse interval, height and width can be generated on a beat-to-beat basis. For

  16. A randomised controlled trial on the efficacy of a multidisciplinary health care team on morbidity and mortality of elderly patients attending the Emergency Department. Study design and preliminary results

    Directory of Open Access Journals (Sweden)

    Rosario Santolaya-Perrín

    2016-12-01

    Full Text Available Objective: To estimate the prevalence of potentially inadequate drug prescriptions in elderly patients who attend the Emergency Department. Design: A multicentre randomized clinical trial. Patients over 65 years of age attending the Emergency Department are randomized to the control arm or the intervention arm. In the intervention arm, the pharmacist will review the chronic medication of patients and identify any potentially inadequate prescriptions, according to the STOPP-START criteria. The cases are discussed with the Emergency Specialist and, if considered adequate, a recommendation to modify the treatment is sent to the Primary Care Physician. The control arm will receive the standard of care, not including a systematic review of the adequacy to the STOPP-START criteria. This article presents preliminary outcomes regarding the prevalence of potentially inadequate prescriptions. Outcomes: Four hospitals participated in the study, and 665 patients were included (342 in the control arm and 305 in the intervention arm. The mean age in the control arm was 78.2 years vs. 78.99 in the intervention arm. The total number of medications received by patients at the time of inclusion was 3 275. Of these, 9.3% (CI 95%: 8.3-10.4 were considered potentially inadequate prescriptions according to the STOPP criteria. On the other hand, 81.1% (CI 95%: 76.8-85.4 of the patients evaluated presented potentially inadequate prescriptions. Conclusion: This study has detected a high prevalence of potentially inadequate prescriptions in elderly patients attending the Emergency Department

  17. Ultrasensitive detection of pepsinogen I and pepsinogen II by a time-resolved fluoroimmunoassay and its preliminary clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Huang Biao [Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu Province 214063 (China) and Southern Yangzi University, Wuxi, Jiangsu Province 214036 (China)]. E-mail: huangbiao78@hotmail.com; Xiao Hualong [Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu Province 214063 (China); Zhang Xiangrui [Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu Province 214063 (China); Zhu, Lan [Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu Province 214063 (China); Liu Haiyan [Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu Province 214063 (China); Jin Jian [Southern Yangzi University, Wuxi, Jiangsu Province 214036 (China)

    2006-06-30

    .8 {+-} 7.4 for the PG I/PG II ratio. The normal ranges of Serum PG I levels for healthy volunteers were 58.2-266.6 {mu}g L{sup -1}, and those of serum PG II levels were less than 25.3 {mu}g L{sup -1}. The availability of a highly sensitive, reliable, and convenient PG-TRFIA method for quantifying PG will allow investigations into the possible diagnostic value of this analysis in various clinical conditions, including gastric carcinoma, duodenal ulcer, gastric ulcer and gastritis. The sensitivity and reproducibility of the assay were satisfactory for clinical applications.

  18. Preliminary clinical application of dopamine transporter imaging with technetium-99m TRODAT-1 and SPECT on the early and differential diagnosis of Parkinson's Disease

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The aim of the study was to demonstrate the degeneration of the dopaninergic nigrostriatal pathway in Parkinson's disease(PD) and Essential Tremor (ET) by using the cocaine derivative 99mTc-TRODAT-1 SPECT and correlate the findings to the clinical severities (Hoehn and Yahr scale, H/Y). 28 patients with idiopathic Parkinson's disease, 10 patients with Essential Trenor and 19 healthy volunteers were investigated. The acquisition were performed 3 h postinjection of 99mTc-TRODAT-1, ROIs were drawn over the images of striatum and cerebellum, and ratios of striatum to cerebellar(ST/CB) were calculated. Ratios differed significantly between PD and controls, but ratios didn't show significant difference between ET patients and controls. A significant correlation didn't exist between ratios and clinical severities. Hemiparkinson's patients revealed significantly diminished 99mTc-TRODAT-1 binding not only clinically affected but unaffected side. Our findings indicated that 99mTc-TRODAT-1 SPECT is not only a reliable method to discriminate between PD and controls but also a useful tool for differential diagnosis in clinically unclear cases such as ET resembling PD.

  19. Efficacy of metronidazole versus placebo in pain control after hemorrhoidectomy: results of a controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Sergio Solorio-López

    2015-11-01

    Full Text Available Introduction: Hemorrhoidal disease occurs in 50% of people aged > 40 years and is the most common reason for anorectal surgery. Pain is the main complication. Multiple topical and systemic drugs have been investigated for pain control, but there is no ideal treatment. Metronidazole has been shown to decrease postoperative pain but is not used widely. Objective: To evaluate the effect of oral metronidazole versus placebo and to assess postoperative pain following hemorrhoidectomy. Material and methods: Controlled clinical trial in adult patients who underwent elective hemorrhoidectomy for grade III/IV hemorrhoids. Patients were assigned to receive metronidazole (500 mg q8 h orally; study group, SG or placebo (control group, CG for 7 days after surgery. Pain was assessed using a visual analog scale after surgery. Analgesic administration (time and use of analgesics and resumption of daily life activities were also assessed. Results: Forty-four patients were included, 22 in each group. Postoperative pain differed significantly between the SG and CG at 6 h (3.86 ± 0.56, 6.64 ± 1.49, 12 h (5.59 ± 1.33, 8.82 ± 0.79, 24 h (6.86 ± 1.49, 9.73 ± 0.45, day 4 (5.32 ± 2.10, 9.50 ± 0.59, day 7 (3.14 ± 1.03, 7.36 ± 1.39, and day 14 (2.14 ± 0.46, 5.45 ± 1.29. The first analgesia dose was required at 21.27 ± 5.47 h in the CG and 7.09 ± 2.36 h in the SG (p < 0.05, the time of analgesic use was 6.86 ± 1.61 days in the CG and 13.09 ± 2.48 days in the SG (p < 0.05, and resumption of daily activities occurred at 7.59 ± 1.56 days in the CG and 14.73 ± 3.76 days in the SG (p < 0.05. Conclusion: Oral administration of metronidazole is effective in pain management after hemorrhoidectomy.

  20. Clinical Effects of Subgingivally Delivered Spirulina Gel in Chronic Periodontitis Cases: A Placebo Controlled Clinical Trial

    Science.gov (United States)

    Mahendra, Jaideep; Mahendra, Little; Muthu, Jananni; John, Libby; Romanos, Georgios E.

    2013-01-01

    Aims and Objectives: The aim of this study was to assess the clinical effects of Spirulina in-situ gel as an adjunct to Scaling And Root Planning (SRP) in the treatment of chronic periodontitis subjects. Material and Methods: 64 sites were selected with probing pocket depth of ≥5mm and they were divided into 2 groups; 33 sites were treated with SRP along with spirulina gel (Group A) and 31 sites were treated with SRP alone (Group B). Clinical parameters were recorded at baseline before SRP and at 120th day after the treatment therapy. The parameters included Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL). Results: Both the groups showed significant improvement in the parameters. However, Group A (SRP along with spirulina) showed statistically significant decrease in mean probing pocket depth and gain in the clinical attachment level after 120 days as compared to Group B SRP alone. Conclusion: Locally delivered spirulina gel, along with scaling and root planning, has been shown to cause a beneficial impact. The efficacy of the product as a local drug delivery system in the non-surgical treatment of periodontitis without any side effects has been proved. Spirulina appears to be promising. It exerts strong anti-inflammatory effects which are closely connected with its antioxidative activity. This study can have a significant impact on the treatment procedures of periodontitis, with the use of blue green algae in the future. PMID:24298522

  1. Impact of comorbidity on three month follow-up outcome of children with ADHD in a child guidance clinic: Preliminary report

    Directory of Open Access Journals (Sweden)

    Rangan Srinivasaraghavan

    2013-01-01

    Full Text Available Context: Attention deficit hyperactivity disorder (ADHD is one of the common neurodevelopmental disorders. Aims: Study objective is to report impact of comorbidities on short-term outcome in children with ADHD followed in a child guidance clinic. Settings and Design: This was done in a child guidance clinic run jointly by the pediatric and psychiatry department at a tertiary teaching hospital. This is a 3 month prospective follow-up study to assess the outcome in ADHD children. Materials and Methods: Children attending pediatric department with behavioral problems or poor scholastic performance were screened for ADHD and further confirmation of diagnosis was done by semistructured interview of the child and parent. Children functional assessment and ADHD symptom profile was compared at baseline and at follow-up. We screened for and excluded those showing autistic spectrum disorder and having worse than mild mental retardation. Baseline variables were compared between improved and not improved subgroups and impact of these variables on outcome at 3-month follow-up was analyzed. Statistical Analysis: Descriptive statistics. Results: Of the 25 children completing the study, at the end of 3 months, 15 improved (not fulfilling criteria for ADHD and 10 did not improve. Applying Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS for diagnosis of psychiatric comorbidities, six had associated psychiatric comorbidities. This was significantly higher in those who did not improve. Conclusions: Presence of comorbidities at baseline was found to affect outcome at 3 month assessment in this preliminary study. Future studies with larger sample and longer follow-up are needed for finding the predictors of outcome in ADHD children in developing nations.

  2. Preliminary study on field buses for the control system of the high voltage of the ATLAS hadronic calorimeter; Etude preliminaire d`un reseau de terrain pour le systeme de controle des hautes tensions du calorimetre hadronique d`Atlas

    Energy Technology Data Exchange (ETDEWEB)

    Drevet, F.; Chadelas, R.; Montarou, G.

    1996-12-31

    We present here after a preliminary study on field buses for the control system of the high voltage of the photomultipliers of the TILECAL calorimeter. After some generalities, different commercial buses are reviewed (CAN, ARCET, WorldFIP, Profibus and LonWorks). The Profibus and LonWorks solution are more extensively studies as a possible solution for the high voltage system of the TILE hadronic calorimeter. (authors).

  3. Clinical features and preliminary studies of virological correlates of neurocognitive impairment among HIV-infected individuals in Nigeria.

    Science.gov (United States)

    Royal, Walter; Cherner, Mariana; Carr, Jean; Habib, Abdulrazaq G; Akomolafe, Abimbola; Abimiku, Alashl'e; Charurat, Manhattan; Farley, John; Oluyemisi, Akinwande; Mamadu, Ibrahim; Johnson, Joyce; Ellis, Ronald; McCutchan, J Allen; McCutchen, J Allen; Grant, Igor; Blattner, William A

    2012-06-01

    In Nigeria, the incidence and prevalence of human immunodeficiency virus (HIV)-related neurocognitive impairment (NCI) are unknown and there currently exists little information related to the viral correlates rates of NCI. Therefore, studies were performed to examine the potential utility of applying an established neuropsychological (NP) screening battery and detailed NP testing to detect NCI and correlations with functional impairment and the presence of specific viral signatures among infected subjects. A total of 60 HIV-1 seropositive antiretroviral-naive individuals and 56 seronegative control subjects were administered the International HIV Dementia Scale (IHDS) and assessed for functional impairment using the Karnofsky performance status scale. Fifteen HIV-infected patients and 11 controls were also administered a detailed NP battery. Blood samples from eight infected subjects, three with evidence of NCI, were obtained for molecular analysis of HIV-1 strain. Unadjusted scores on the IHDS showed that, using a recommended total score cutoff of 10, 28.8% of the HIV-1 seropositive and 16.0% of seropositive individuals scored abnormally. Results from testing using the full NP battery showed that, overall, the HIV seropositive group performed worse than the seronegative group, with effect sizes spanning from small (0.25 on the trail making test A) to large (0.82 on action fluency), and an average effect size across the battery of 0.45, which approaches that which has been recorded in other international settings. Sequencing of partial pol amplicons from viral isolates revealed that two of three patients with NCI were infected with subtype G virus and 1 with the circulating recombinant form (CRF)02_AG; all four individuals without NCI were infected with CRF_02AG. These studies demonstrate the utility of the IHDS in identifying cognitive impairment among HIV infected individuals in Nigeria. Future studies aimed at examining the burden of NCI among the population of

  4. Slow cortical potential Neurofeedback and self-management training in outpatient care for children with ADHD: study protocol and first preliminary results of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hanna eChristiansen

    2014-11-01

    Full Text Available Background: Treatment for children with attention deficit/hyperactivity disorder (ADHD today is predominantly pharmacological. While it is the most common treatment, it might not always be the most appropriate one. Moreover, long term effects remain unclear. Behavior therapy and non-pharmacological treatments such as neurofeedback (NF are promising alternatives, though there are no routine outpatient care/effectiveness studies yet that have included children with medication or changes in medication.Methods/design: This paper presents the protocol of a randomized controlled trial to compare the effectiveness of a Slow Cortical Potential (SCP NF protocol with self-management (SM in a high frequent outpatient care setting. Both groups (NF/SM receive a total of 30 high frequent therapy sessions. Additionally, 6 sessions are reserved for comorbid problems. The primary outcome measure is the reduction of ADHD core symptoms according to parent and teacher ratings.Preliminary Results: Untill now 58 children were included in the study (48 males, with a mean age of 8.42 (1.34 years, and a mean IQ of 110 (13.37. Conners-3 parent and teacher ratings were used to estimate core symptom change. Since the study is still ongoing, and children are in different study stages, pre-post and follow-up results are not yet available for all children included. Preliminary results suggest overall good pre-post effects, though. For parent and teacher ratings an ANOVA with repeated measures yielded overall satisfying pre-post effects (η2 .175 to .513. Differences between groups (NF vs. SM could not yet be established (p = .81.Discussion: This is the first randomized controlled trial to test the effectiveness of a NF protocol in a high frequent outpatient care setting that does not exclude children on or with changes in medication. First preliminary results show positive effects. The rationale for the trial, the design, and the strengths and limitations of the study are

  5. Improving the outcome of fractional CO2 laser resurfacing using a probiotic skin cream: Preliminary clinical evaluation.

    Science.gov (United States)

    Zoccali, Giovanni; Cinque, Benedetta; La Torre, Cristina; Lombardi, Francesca; Palumbo, Paola; Romano, Lucia; Mattei, Antonella; Orsini, Gino; Cifone, Maria Grazia; Giuliani, Maurizio

    2016-11-01

    As known, fractional CO2 resurfacing treatments are more effective than non-ablative ones against aging signs, but post-operative redness and swelling prolong the overall downtime requiring up to steroid administration in order to reduce these local systems. In the last years, an increasing interest has been focused on the possible use of probiotics for treating inflammatory and allergic conditions suggesting that they can exert profound beneficial effects on skin homeostasis. In this work, the Authors report their experience on fractional CO2 laser resurfacing and provide the results of a new post-operative topical treatment with an experimental cream containing probiotic-derived active principles potentially able to modulate the inflammatory reaction associated to laser-treatment. The cream containing DermaACB (CERABEST™) was administered post-operatively to 42 consecutive patients who were treated with fractional CO2 laser. All patients adopted the cream twice a day for 2 weeks. Grades were given according to outcome scale. The efficacy of the cream containing DermaACB was evaluated comparing the rate of post-operative signs vanishing with a control group of 20 patients topically treated with an antibiotic cream and a hyaluronic acid based cream. Results registered with the experimental treatment were good in 22 patients, moderate in 17, and poor in 3 cases. Patients using the study cream took an average time of 14.3 days for erythema resolution and 9.3 days for swelling vanishing. The post-operative administration of the cream containing DermaACB induces a quicker reduction of post-operative erythema and swelling when compared to a standard treatment.

  6. [Clinical research XI. From the clinical judgment to the case and controls design].

    Science.gov (United States)

    Talavera, Juan O; Rivas-Ruiz, Rodolfo

    2012-01-01

    The case-control design like the historical cohort carries a number of potential biases as a consequence of the reconstruction of events once the outcome has occurred, and as a consequence of the bias generated by the selection of the control group. This design is characterized by a number of cases (cases), for which we identify a comparison group (controls). It begins at the outcome in direction to the probable cause; therefore, it requires reconstructing events in the opposite direction as it occurs in the phenomenon of causality. However, we must always keep in mind the architectural design, and consider in each section--baseline, maneuver and outcome--characteristics that allow us to demonstrate the effect of the maneuver, avoiding improper assembly, susceptibility, performance and detection bias. The transfer bias can only be controlled with the provision of a defined population, whether it is a population based case-control study or a case-control study nested in a cohort. When a defined population is not possible, this design is only recommended in rare diseases.

  7. Attitudes toward Placebo-Controlled Clinical Trials of Patients with Schizophrenia in Japan.

    Directory of Open Access Journals (Sweden)

    Norio Sugawara

    Full Text Available Although the use of placebo in clinical trials of schizophrenia patients is controversial because of medical and ethical concerns, placebo-controlled clinical trials are commonly used in the licensing of new drugs.The objective of this study was to assess the attitudes toward placebo-controlled clinical trials among patients with schizophrenia in Japan.Using a cross-sectional design, we recruited patients (n = 251 aged 47.7±13.2 (mean±SD with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who were admitted to six psychiatric hospitals from December 2013 to March 2014. We employed a 14-item questionnaire specifically developed to survey patients' attitudes toward placebo-controlled clinical trials.The results indicated that 33% of the patients would be willing to participate in a placebo-controlled clinical trial. Expectations for improvement of disease, a guarantee of hospital treatment continuation, and encouragement by family or friends were associated with the willingness to participate in such trials, whereas a belief of additional time required for medical examinations was associated with non-participation.Fewer than half of the respondents stated that they would be willing to participate in placebo-controlled clinical trials. Therefore, interpreting the results from placebo-controlled clinical trials could be negatively affected by selection bias.

  8. Phytothermotherapy in osteoarthritis: a randomized controlled clinical trial.

    Science.gov (United States)

    Fioravanti, Antonella; Bellisai, Barbara; Iacoponi, Francesca; Manica, Patrizia; Galeazzi, Mauro

    2011-05-01

    The aim of this study was to assess the efficacy of adding a cycle of phytothermotherapy (a traditional treatment with fermenting grass used in Trentino-Alto Adige, Italy) to the usual drug treatment, in patients with primary symptomatic osteoarthritis (OA) of the knee, hip, or lumbar spine. In this randomized, single-blind, controlled trial, 218 outpatients were enrolled; 109 patients were treated with a cycle of phytothermotherapy at the thermal resort of Garniga Terme (Trento, Italy) for 10 days; the other 109 patients continued regular outpatient care. Patients were assessed at baseline, after 2 weeks, and after 3 months from the beginning of the study and were evaluated using a visual analogue scale (VAS) for spontaneous pain, a Health Assessment Questionnaire, the Lequesne index for hip and knee osteoarthritis, and the Rolland Morris Questionnaire for lumbar spine OA and symptomatic drug consumption. In patients treated with phytothermotherapy, a significant improvement of VAS and a reduction of nonsteroidal anti-inflammatory drug consumption at the end of treatment and 3 months later were observed. In the control group, no significant differences were noted. The analyses performed separately for each subgroup for OA localization showed that the best results were evident in lumbar spine OA. Concerning tolerability, in the group treated with phytothermotherapy 10% of patients presented side-effects due to treatment, but these were of low intensity and did not interrupt the therapy. In conclusion, the results show beneficial effects of a cycle of phytothermotherapy in patients with OA of the hip, knee, or lumbar spine. Phytothermotherapy may therefore be a useful aid alongside the usual pharmacologic and physiokinesic therapies, or may be used as a valid alternative for patients who do not tolerate pharmacologic treatments.

  9. Preliminary clinical application of dopamine transporter imaging with technetium—99m TRODAT—1 and SPECT on the early and differential diagnosis of Parkinson‘s Disease

    Institute of Scientific and Technical Information of China (English)

    WANGFeng; LIUZeng-Li; 等

    2002-01-01

    The aim of the study was to demonstrate the degeneration of the dopaminergic nigrostriatal pathway in Parkinson's disease(PD)and Essential Tremor(ET) by using the cocaine derivative 99m Tc-TRODAT-1 SPECT and correlate the findings to the clinical severities(Hoehn and Yahr scale,H/Y).28 patients with idiopathic Parkinson's disease,10 patients with Essential Tremor and 19 healthy volunteers were investigated.The acquisition were performed 3h postinjection of 99mTc-TRODAT-1,ROIs were drawn over the images of striatum and cerebellum,and ratios of striatum to cerebellar(ST/CB) were calculated.Ratios differed significantly between PD and controls,but ratios didn't show significant difference between ET patients and controls.A significant correlation didn't exist between ratios and clincal severities.Hemiparkinson's patients revealed significantly diminished 99mTc-TRODAT-1 binding not only clinically affected but unaffected side.Our findings indicated that 99mTc-TRODAT-1 SPECT is not only a reliable method to discriminate between PD and controls but also a useful tool for differential diagnosis in clinically unclear cases such as ET resembling PD.

  10. Model-based control of mechanical ventilation: design and clinical validation.

    Science.gov (United States)

    Martinoni, E P; Pfister, Ch A; Stadler, K S; Schumacher, P M; Leibundgut, D; Bouillon, T; Böhlen, T; Zbinden, A M

    2004-06-01

    We developed a model-based control system using end-tidal carbon dioxide fraction (FE'(CO(2))) to adjust a ventilator during clinical anaesthesia. We studied 16 ASA I-II patients (mean age 38 (range 20-59) yr; weight 67 (54-87) kg) during i.v. anaesthesia for elective surgery. After periods of normal ventilation the patients were either hyper- or hypoventilated to assess precision and dynamic behaviour of the control system. These data were compared with a previous group where a fuzzy-logic controller had been used. Responses to different clinical events (invalid carbon dioxide measurement, limb tourniquet release, tube cuff leak, exhaustion of carbon dioxide absorbent, simulation of pulmonary embolism) were also noted. The model-based controller correctly maintained the setpoint. No significant difference was found for the static performance between the two controllers. The dynamic response of the model-based controller was more rapid (Pfuzzy-logic and model-based control, respectively, and after a 1 vol% decrease was 355 (127) s and 177 (36) s, respectively. The new model-based controller had a consistent response to clinical artefacts. A model-based FE'(CO(2)) controller can be used in a clinical setting. It reacts appropriately to artefacts, and has a better dynamic response to setpoint changes than a previously described fuzzy-logic controller.

  11. Ankylosing spondylitis confers substantially increased risk of clinical spine fractures : a nationwide case-control study

    NARCIS (Netherlands)

    Prieto-Alhambra, D; Muñoz-Ortego, J; De Vries, F; Vosse, D; Arden, N K; Bowness, P; Cooper, C; Diez-Perez, A; Vestergaard, P

    2015-01-01

    UNLABELLED: Ankylosing spondylitis (AS) leads to osteopenia/osteoporosis and spine rigidity. We conducted a case-control study and found that AS-affected patients have a 5-fold and 50 % increased risk of clinical spine and all clinical fractures, respectively. Excess risk of both is highest in the f

  12. An official American Thoracic Society/European Respiratory Society statement: asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice.

    Science.gov (United States)

    Reddel, Helen K; Taylor, D Robin; Bateman, Eric D; Boulet, Louis-Philippe; Boushey, Homer A; Busse, William W; Casale, Thomas B; Chanez, Pascal; Enright, Paul L; Gibson, Peter G; de Jongste, Johan C; Kerstjens, Huib A M; Lazarus, Stephen C; Levy, Mark L; O'Byrne, Paul M; Partridge, Martyn R; Pavord, Ian D; Sears, Malcolm R; Sterk, Peter J; Stoloff, Stuart W; Sullivan, Sean D; Szefler, Stanley J; Thomas, Mike D; Wenzel, Sally E

    2009-07-01

    The assessment of asthma control is pivotal to the evaluation of treatment response in individuals and in clinical trials. Previously, asthma control, severity, and exacerbations were defined and assessed in many different ways. The Task Force was established to provide recommendations about standardization of outcomes relating to asthma control, severity, and exacerbations in clinical trials and clinical practice, for adults and children aged 6 years or older. A narrative literature review was conducted to evaluate the measurement properties and strengths/weaknesses of outcome measures relevant to asthma control and exacerbations. The review focused on diary variables, physiologic measurements, composite scores, biomarkers, quality of life questionnaires, and indirect measures. The Task Force developed new definitions for asthma control, severity, and exacerbations, based on current treatment principles and clinical and research relevance. In view of current knowledge about the multiple domains of asthma and asthma control, no single outcome measure can adequately assess asthma control. Its assessment in clinical trials and in clinical practice should include components relevant to both of the goals of asthma treatment, namely achievement of best possible clinical control and reduction of future risk of adverse outcomes. Recommendations are provided for the assessment of asthma control in clinical trials and clinical practice, both at baseline and in the assessment of treatment response. The Task Force recommendations provide a basis for a multicomponent assessment of asthma by clinicians, researchers, and other relevant groups in the design, conduct, and evaluation of clinical trials, and in clinical practice.

  13. Complement analysis 2016: Clinical indications, laboratory diagnostics and quality control.

    Science.gov (United States)

    Prohászka, Zoltán; Nilsson, Bo; Frazer-Abel, Ashley; Kirschfink, Michael

    2016-11-01

    In recent years, complement analysis of body fluids and biopsies, going far beyond C3 and C4, has significantly enhanced our understanding of the disease process. Such expanded complement analysis allows for a more precise differential diagnosis and for critical monitoring of complement-targeted therapy. These changes are a result of the growing understanding of the involvement of complement in a diverse set of disorders. To appreciate the importance of proper complement analysis, it is important to understand the role it plays in disease. Historically, it was the absence of complement as manifested in severe infection that was noted. Since then complement has been connected to a variety of inflammatory disorders, such as autoimmune diseases and hereditary angioedema. While the role of complement in the rejection of renal grafts has been known longer, the significant impact of complement. In certain nephropathies has now led to the reclassification of some rare kidney diseases and an increased role for complement analysis in diagnosis. Even more unexpected is that complement has also been implicated in neural, ophtalmological and dermatological disorders. With this level of involvement in some varied and impactful health issues proper complement testing is clearly important; however, analysis of the complement system varies widely among laboratories. Except for a few proteins, such as C3 and C4, there are neither well-characterized standard preparations nor calibrated assays available. This is especially true for the inter-laboratory variation of tests which assess classical, alternative, or lectin pathway function. In addition, there is a need for the standardization of the measurement of complement activation products that are so critical in determining whether clinically relevant complement activation has occurred in vivo. Finally, autoantibodies to complement proteins (e.g. anti-C1q), C3 and C4 convertases (C3 and C4 nephritic factor) or to regulatory proteins

  14. Preliminary Planning and Process Control of Railway Engineering Project%浅谈铁路工程项目前期策划及过程控制

    Institute of Scientific and Technical Information of China (English)

    刘佰川

    2016-01-01

    在铁路项目建设的整个周期,如何能保持或达到策划测算的经济目标,如何实施项目全过程控制,使项目施工全过程在预定的轨道上运行,项目的前期策划及过程控制就显得尤为重要。%In the whole cycle of railway construction projects, how to maintain or achieve the economic targets and implement the project whole process control to make the whole process of the project construction in the scheduled track running, the preliminary planning and process control of the project are particularly important.

  15. Contribution of family social support to the metabolic control of people with diabetes mellitus: A randomized controlled clinical trial.

    Science.gov (United States)

    Gomes, Lilian Cristiane; Coelho, Anna Claudia Martins; Gomides, Danielle Dos Santos; Foss-Freitas, Maria Cristina; Foss, Milton César; Pace, Ana Emilia

    2017-08-01

    This randomized controlled clinical trial aimed to evaluate the contribution of family social support to the clinical/metabolic control of people with type 2 diabetes mellitus. Diabetes mellitus is a chronic disease that requires continuous care in order for individuals to reach glycemic control, the primordial goal of treatment. Family social support is essential to the development of care skills and their maintenance. However, there are few studies that investigate the contribution of family social support to diabetes control. The study was developed between June 2011 and May 2013, and included 164 people who were randomized using simple randomization. The intervention group differed from the control group in that it included a family caregiver, who was recognized by the patient as a source of social support. The educational interventions received by people with diabetes mellitus were used as the basis of the education provided through telephone calls to patients' family members and caregivers, and their purpose was to encourage dialogue between the patients and their relatives about the topics related to diabetes. Regarding the clinical impact, the results showed that there was a greater reduction in blood pressure and glycated hemoglobin in the intervention group than in the control group, showing a positive effect on the control of the disease. Families should be incorporated into the care of people with diabetes mellitus and especially in health care programs, in particular those that can promote different forms of social support to strengthen the bond between family members. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. A preliminary randomized double blind placebo-controlled trial of intravenous immunoglobulin for Japanese encephalitis in Nepal.

    Directory of Open Access Journals (Sweden)

    Ajit Rayamajhi

    Full Text Available Japanese encephalitis (JE virus (JEV is a mosquito-borne flavivirus found across Asia that is closely related to West Nile virus. There is no known antiviral treatment for any flavivirus. Results from in vitro studies and animal models suggest intravenous immunoglobulin (IVIG containing virus-specific neutralizing antibody may be effective in improving outcome in viral encephalitis. IVIG's anti-inflammatory properties may also be beneficial.We performed a pilot feasibility randomized double-blind placebo-controlled trial of IVIG containing anti-JEV neutralizing antibody (ImmunoRel, 400mg/kg/day for 5 days in children with suspected JE at two sites in Nepal; we also examined the effect on serum neutralizing antibody titre and cytokine profiles. 22 children were recruited, 13 of whom had confirmed JE; 11 received IVIG and 11 placebo, with no protocol violations. One child (IVIG group died during treatment and two (placebo subsequently following hospital discharge. Overall, there was no difference in outcome between treatment groups at discharge or follow up. Passive transfer of anti-JEV antibody was seen in JEV negative children. JEV positive children treated with IVIG had JEV-specific neutralizing antibody titres approximately 16 times higher than those treated with placebo (p=0.2, which was more than could be explained by passive transfer alone. IL-4 and IL-6 were higher in the IVIG group.A trial of IVIG for JE in Nepal is feasible. IVIG may augment the development of neutralizing antibodies in JEV positive patients. IVIG appears an appealing option for JE treatment that warrants further study.ClinicalTrials.gov NCT01856205.

  17. Functional MRI in human motor control studies and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Toma, Keiichiro [Kyoto Univ. (Japan). Graduate School of Medicine; Nakai, Toshiharu [Inst. of Biomedical Research and Innovation, Kobe (Japan)

    2002-07-01

    Functional magnetic resonance imaging (fMRI) has been a useful tool for the noninvasive mapping of brain function associated with various motor and cognitive tasks. Because fMRI is based on the blood oxygenation level dependent (BOLD) effect, it does not directly record neural activity. With the fMRI technique, distinguishing BOLD signals creased by cortical projection neurons from those created by intracortical neurons appears to be difficult. Two major experimental designs are used in fMRI studies: block designs and event-related designs. Block-designed fMRI presupposes the steady state of regional cerebral blood flow and has been applied to examinations of brain activation caused by tasks requiring sustained or repetitive movements. By contrast, the more recently developed event-related fMRI with time resolution of a few seconds allows the mapping of brain activation associated with a single movement according to the transient aspects of the hemodynamic response. Increasing evidence suggests that multiple motor areas are engaged in a networked manner to execute various motor acts. In order to understand functional brain maps, it is important that one understands sequential and parallel organizations of anatomical connections between multiple motor areas. In fMRI studies of complex motor tasks, elementary parameters such as movement length, force, velocity, acceleration and frequency should be controlled, because inconsistency in those parameters may alter the extent and intensity of motor cortical activation, confounding interpretation of the findings obtained. In addition to initiation of movements, termination of movements plays an important role in the successful achievement of complex movements. Brain areas exclusively related to the termination of movements have been, for the first time, uncovered with an event-related fMRI technique. We propose the application of fMRI to the elucidation of the pathophysiology of movement disorders, particularly dystonia

  18. Two-year survival analysis of twisted wire fixed retainer versus spiral wire and fiber-reinforced composite retainers: a preliminary explorative single-blind randomized clinical trial

    Science.gov (United States)

    Sobouti, Farhad; Rakhshan, Vahid; Saravi, Mahdi Gholamrezaei; Zamanian, Ali

    2016-01-01

    Objective Traditional retainers (both metal and fiber-reinforced composite [FRC]) have limitations, and a retainer made from more flexible ligature wires might be advantageous. We aimed to compare an experimental design with two traditional retainers. Methods In this prospective preliminary clinical trial, 150 post-treatment patients were enrolled and randomly divided into three groups of 50 patients each to receive mandibular canine-to-canine retainers made of FRC, flexible spiral wire (FSW), and twisted wire (TW). The patients were monitored monthly. The time at which the first signs of breakage/debonding were detected was recorded. The success rates of the retainers were compared using chi-squared, Kaplan-Meier, and Cox proportional-hazard regression analyses (α = 0.05). Results In total, 42 patients in the FRC group, 41 in the FSW group, and 45 in the TW group completed the study. The 2-year failure rates were 35.7% in the FRC group, 26.8% in the FSW group, and 17.8% in the TW group. These rates differed insignificantly (chi-squared p = 0.167). According to the Kaplan-Meier analysis, failure occurred at 19.95 months in the FRC group, 21.37 months in the FSW group, and 22.36 months in the TW group. The differences between the survival rates in the three groups were not significant (Cox regression p = 0.146). Conclusions Although the failure rate of the experimental retainer was two times lower than that of the FRC retainer, the difference was not statistically significant. The experimental TW retainer was successful, and larger studies are warranted to verify these results. PMID:27019825

  19. Effect of nonsurgical periodontal treatment on clinical response and glycemic control in type 2 diabetic patients with periodontitis: Controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Ajitha Kanduluru

    2014-01-01

    Full Text Available Background: Type 2 diabetes mellitus (type 2 DM and chronic periodontitis are common chronic diseases in adults in the world population. Once periodontal disease is established, the chronic nature of this infection may contribute to worsening of diabetic status leading to more severe diabetes-related complications. It has been proposed that the relation of periodontitis and diabetes is bidirectional. Objectives: The objective was to compare the clinical response and glycemic control in type 2 DM patients with periodontitis, before and after the nonsurgical periodontal treatment with controls. Materials and Methods: A total 70 type 2 DM patients with chronic generalized moderate periodontitis was divided into 2 groups. Treatment group (35 received one stage full mouth scaling and root planning plus oral hygiene instructions; the control group (35 received only oral hygiene instructions. At baseline, 1 st month and 3 rd month, the clinical periodontal parameters (plaque index [PI], gingival index [GI], pocket depth [PD], clinical attachment loss [CAL], gingival recession [GR], and bleeding on probing [BOP] and glycemic parameters (fasting blood sugar [FBS], and postprandial blood sugar [PPBS] were recorded, whereas the glycated hemoglobin (HbA1c was recorded only at baseline and 3rd month. The collected data were subjected to statistical analysis. Results: When comparing the mean scores of clinical parameters for both the groups, there was a significant difference in all clinical parameters, that is, mean PI, GI, BOP, PD, CAL scores except mean GR, whereas for the glycemic parameters, there was a significant difference in mean FBS; PPBS values and no significant difference in mean percentage of HbA1c for treatment group at 3 rd month follow-up. Conclusion: Findings of the present study showed that nonsurgical periodontal treatment resulted in lower glycemic levels and the reduction of clinical parameters of periodontal infection, confirming the

  20. Nutritional screening; control of clinical undernutrition with analytical parameters.

    Science.gov (United States)

    de Ulíbarri Pérez, José Ignacio; Fernández, Guillermo; Rodríguez Salvanés, Francisco; Díaz López, Ana María

    2014-01-13

    Objetivo: Actualizar el cribado nutricional. La alta prevalencia del desequilibrio nutricional que genera la Desnutrición Clínica (DC), especialmente en hospitales y residencias asistidas, obliga al uso de herramientas de cribado y a controlar su evolución para combatirla sobre la marcha. La DC deriva menos de la carencia nutricional que de los efectos de la enfermedad y sus tratamientos, pero los actuales sistemas de cribado buscan más la desnutrición ya establecida que el riesgo nutricional existente. Las alteraciones metabólicas del equilibrio nutricional que constituyen la trofopatía se pueden captar en el plasma sin demoras, automáticamente, permitiendo rectificar actitudes terapéuticas demasiado agresivas o complementarlas con el adecuado soporte nutricional. Con los sistemas manuales de cribado, solo pasados días o semanas se evidenciarán, tardíamente, los cambios somáticos expresivos de esa desnutrición. La concentración de la albúmina plasmática es un parámetro muy valioso en el control nutricional. Su disminución, cualquiera que sea la causa, expresa un posible déficit pero también el riesgo nutricional a que se ve sometida la célula, antes de que la desnutrición se manifieste somáticamente. La precocidad de la detección del riesgo nutricional, anticipándose a la desnutrición y su gran capacidad pronóstica hacen de las herramientas basadas en parámetros analíticos, el procedimiento más útil, ergonómico, seguro y eficiente para el cribado y pronóstico nutricional en el entorno clínico. Conclusión: es hora de actualizar conceptos, deshacer mitos y optar por sistemas modernos de cribado eficientes, única manera de alcanzar el sueño de controlar la DC en nuestras poblaciones enfermas y frágiles.

  1. A pragmatic guide on how physicians can take over financial control of their clinical practice.

    Science.gov (United States)

    Jacobs, Volker R; Fischer, Thorsten

    2012-01-01

    Control of clinical cost is becoming increasingly important in health care worldwide. Physicians should accept the limitation of resources and take responsibility to improve their clinical cost-reimbursement ratio. To achieve this, they will need basic education in clinic management to control and adjust costs and reimbursement, without impacting professional quality of care. Rational use of diagnostics and therapy should be implemented and frequently verified. Physicians are the only professionals that are able to integrate economics with health care. This is in the best interest of patients and will improve a physician's position, influence, and professional freedom levels within our hospitals.

  2. DC Brushless Motor Control Design and Preliminary Testing for Independent 4-Wheel Drive Rev-11 Robotic Platform

    Directory of Open Access Journals (Sweden)

    Roni Permana Saputra

    2012-03-01

    Full Text Available This paper discusses the design of control system for brushless DC motor using microcontroller ATMega 16 that will be applied to an independent 4-wheel drive Mobile Robot LIPI version 2 (REV-11. The control system consists of two parts which are brushless DC motor control module and supervisory control module that coordinates the desired command to the motor control module. To control the REV-11 platform, supervisory control transmit the reference data of speed and direction of motor to control the speed and direction of each actuator on the platform REV-11. From the test results it is concluded that the designed control system work properly to coordinate and control the speed and direction of motion of the actuator motor REV-11 platform. 

  3. Are Randomized Controlled Trials the (G)old Standard? From Clinical Intelligence to Prescriptive Analytics.

    Science.gov (United States)

    Van Poucke, Sven; Thomeer, Michiel; Heath, John; Vukicevic, Milan

    2016-07-06

    Despite the accelerating pace of scientific discovery, the current clinical research enterprise does not sufficiently address pressing clinical questions. Given the constraints on clinical trials, for a majority of clinical questions, the only relevant data available to aid in decision making are based on observation and experience. Our purpose here is 3-fold. First, we describe the classic context of medical research guided by Poppers' scientific epistemology of "falsificationism." Second, we discuss challenges and shortcomings of randomized controlled trials and present the potential of observational studies based on big data. Third, we cover several obstacles related to the use of observational (retrospective) data in clinical studies. We conclude that randomized controlled trials are not at risk for extinction, but innovations in statistics, machine learning, and big data analytics may generate a completely new ecosystem for exploration and validation.

  4. 作物控效肥效果初步评价%Preliminary Evaluation on Effect of Crops Controlled-Release Fertilizers

    Institute of Scientific and Technical Information of China (English)

    任仕伟; 罗微

    2012-01-01

    采用水浸泡法对5种包膜控效肥(不包括对照)试样的养分溶出率进行了比较测定,测得各种肥料的初期溶出率、微分溶出率分别为,自行研制控效CAF1:1.14、1.78;CAF4:1.59、1.84;CAF5:1.37、1.76;国外肥料FB:1.01、1.24;FZ:1.24、1.27,自行研制的肥料的初期溶出率平均值为1.37,微分溶出率为1.79;国外肥料为1.13、1.25,自行研制的肥料的初期溶出率与微分溶出率分别高于国外肥料,但都达到了国际标准(初期溶出率小于15%、微分溶出率在0.25%~2.5%之间)。同时用土壤淋溶法对自制的2种控效肥和1种进口肥进行了N溶出量的测定,结果表明:控效肥土壤淋溶出量与对照比较为显著,6d内CAF1、CAF5溶出N总量分别为对照的33.3%、36.1%,同时将两种方法所得出的结果进行了综合分析,对控效效果作出初步评价,为作物合理施肥提供参考。%Five kinds of controlled-release fertilizers (except for the CK),coated by organic polymer,were used in this study.The soluble properties of fertilizers were tested and compared in water.The preliminary solubility and differential solubility,are respectively:CAF1:1.14,1.78; CAF4:1.59,1.84; CAF5:1.37,1.76; FB:1.01,1.24; FZ:1.24,1.27.Among the five kinds of controlled-release fertilizers,CAF1,CAF4 and CAF5 were prepared by ourselves,while FB and FZ were imported fertilizers.The average of preliminary solubility of CAF1,CAF4 and CAF5 is 1.37,differential solubility is 1.79.However,the average of preliminary solubility is 1.25.Compared with the latter,the preliminary solubility of the former exceeds 0.26,and the differential solubility exceeds 0.54,but they all reach the international standards——-the preliminary solubility less than 15%,differential solubility is 0.25% to 2.5%.Meanwhile,we determinated the quantity of N release of CAF1,CAF5 and FB by soil dissolution rate method.The total quantity of N release in six days of CAF1 was

  5. Theory of Mind in Schizophrenia: Associations With Clinical and Cognitive Insight Controlling for Levels of Psychopathology.

    Science.gov (United States)

    Popolo, Raffaele; Dimaggio, Giancarlo; Luther, Lauren; Vinci, Giancarlo; Salvatore, Giampaolo; Lysaker, Paul H

    2016-03-01

    Poor insight in schizophrenia is a risk factor for both poor outcomes and treatment adherence. Accordingly, interest in identifying causes of poor insight has increased. This study explored whether theory of mind (ToM) impairments are linked to poor clinical and cognitive insight independent of psychopathology. Participants with schizophrenia (n = 37) and control subjects (n = 40) completed assessments of ToM with the Hinting Task and the Brüne Picture Sequencing Task, clinical insight and psychopathology with the Positive and Negative Syndrome Scale, and cognitive insight with the Beck Cognitive Insight Scale. Results indicated that the schizophrenia group had greater impairments in ToM relative to control subjects. In the schizophrenia group, the Hinting Task performance was related to both cognitive and clinical insight, with only the relationship with cognitive insight persisting after controlling for psychopathology. Picture Sequencing Task performance was related to cognitive insight only. Future research directions and clinical implications are discussed.

  6. Clinical Evidence of Effects of Lactobacillus plantarum HY7714 on Skin Aging: A Randomized, Double Blind, Placebo-Controlled Study.

    Science.gov (United States)

    Lee, Dong Eun; Huh, Chul-Sung; Ra, Jehyeon; Choi, Il-Dong; Jeong, Ji-Woong; Kim, Sung-Hwan; Ryu, Ja Hyun; Seo, Young Kyoung; Koh, Jae Sook; Lee, Jung-Hee; Sim, Jae-Hun; Ahn, Young-Tae

    2015-12-28

    The beneficial effects of probiotics are now widely reported, although there are only a few studies on their anti-aging effects. We have found that Lactobacillus plantarum HY7714 (HY7714) improves skin hydration and has anti-photoaging effects, and in the present study, we have further evaluated the anti-aging effect of HY7714 via a randomized, double blind, placebo-controlled clinical trial. The trial included 110 volunteers aged 41 and 59 years who have dry skin and wrinkles. Participants took 1 × 10(10) CFU/day of HY7714 (probiotic group) or a placebo (placebo group) for 12 weeks. Skin hydration, wrinkles, skin gloss, and skin elasticity were measured every 4 weeks during the study period. There were significant increases in the skin water content in the face (p < 0.01) and hands (p < 0.05) at week 12 in the probiotic group. Transepidermal water loss decreased significantly in both groups at weeks 4, 8, and 12 (p < 0.001 compared with baseline), and was suppressed to a greater extent in the face and forearm in the probiotic group at week 12. Volunteers in the probiotic group had a significant reduction in wrinkle depth at week 12, and skin gloss was also significantly improved by week 12. Finally, skin elasticity in the probiotic group improved by 13.17% (p < 0.05 vs. controls) after 4 weeks and by 21.73% (p < 0.01 vs. controls) after 12 weeks. These findings are preliminary confirmation of the anti-aging benefit to the skin of L. plantarum HY7714 as a nutricosmetic agent.

  7. Effects of doxycycline on clinical, microbiological and immunological parameters in well-controlled diabetes type-2 patients with periodontal disease: a randomized, controlled clinical trial.

    Science.gov (United States)

    Tsalikis, Lazaros; Sakellari, Dimitra; Dagalis, Panagiotis; Boura, Panagiota; Konstantinidis, Antonios

    2014-10-01

    To evaluate the clinical, microbiological and immunological effects of systemic doxycycline as an adjunct to scaling and root planing (SRP) in chronic periodontitis patients with well-controlled type 2 diabetes. Sixty-six patients compliant to oral hygiene (Hygiene Index periodontal disease or levels of MMP-8 between the two groups. Adjunctive systemic doxycycline does not seem to significantly enhance the effects of SRP in well-controlled diabetes type 2 patients. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Individualized Quality Control Plan (IQCP): Is It Value-Added for Clinical Microbiology?

    Science.gov (United States)

    Sharp, Susan E; Miller, Melissa B; Hindler, Janet

    2015-12-01

    The Center for Medicaid and Medicare Services (CMS) recently published their Individualized Quality Control Plan (IQCP [https://www.cms.gov/regulations-and-guidance/legislation/CLIA/Individualized_Quality_Control_Plan_IQCP.html]), which will be the only option for quality control (QC) starting in January 2016 if laboratories choose not to perform Clinical Laboratory Improvement Act (CLIA) [U.S. Statutes at Large 81(1967):533] default QC. Laboratories will no longer be able to use "equivalent QC" (EQC) or the Clinical and Laboratory Standards Institute (CLSI) standards alone for quality control of their microbiology systems. The implementation of IQCP in clinical microbiology laboratories will most certainly be an added burden, the benefits of which are currently unknown.

  9. International Conference on Harmonisation; choice of control group and related issues in clinical trials; availability. Notice.

    Science.gov (United States)

    2001-05-14

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "E10 Choice of Control Group and Related Issues in Clinical Trials." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance sets forth general principles that are relevant to all controlled trials and are especially pertinent to the major clinical trials intended to demonstrate drug (including biological drug) efficacy. The guidance describes the principal types of control groups and discusses their appropriateness in particular situations. The guidance is intended to assist sponsors and investigators in the choice of control groups for clinical trials.

  10. An open pilot study of zonisamide augmentation in major depressive patients not responding to a low dose trial with duloxetine: preliminary results on tolerability and clinical effects

    Directory of Open Access Journals (Sweden)

    Benvenuti Marzia

    2011-09-01

    Full Text Available Abstract Background Despite multiple antidepressant options, major depressive disorder (MDD still faces high non-response rates, eventually requiring anticonvulsant augmentation strategies too. The aim of this study was to explore such a potential role for zonisamide. Methods A total of 40 MDD outpatients diagnosed using the Diagnostic and Statistical Manual for Mental Disorders, fourth edition criteria entered a 24 week open trial receiving duloxetine 60 mg/day for the first 12 weeks and subsequently (weeks 12 to 24 augmentation with zonisamide 75 mg/day if they did not respond to the initial monotherapy. Efficacy and tolerability were assessed using the Hamilton Scales for Anxiety and Depression (a 12 week score ≥50% vs baseline defined 'non-response', the Arizona Sexual Experience Scale, the Patient Rated Inventory of Side Effects and the Young Mania Rating Scale. Results At week 12, 15 patients out of 39 (38.5% were responders, and 1 had dropped out; remarkably, 14 patients out of 24 (58.3% had achieved response by week 24. Poor concentration and general malaise were associated with non-response both at week 12 and 24 (P = 0.001, while loss of libido and reduced energy were prominent among final timepoint non-responders. Patients receiving zonisamide also experienced weight reduction (2.09 ± 12.14 kg; P = 0.001 independently of the outcome. Conclusions Although only a preliminary study due to strong methodological limitations, and thus requiring confirmation by further controlled investigations, the current results indicate zonisamide may be a potential augmentation option for some depressed patients receiving low doses of duloxetine.

  11. Informed Conditioning on Clinical Covariates Increases Power in Case-Control Association Studies

    OpenAIRE

    Zaitlen, Noah; Lindstroem, Sara; Pasaniuc, Bogdan; Cornelis, Marilyn; Genovese, Giulio; Pollack, Samuela; Barton, Anne; Bickeboeller, Heike; Donald W. Bowden; Eyre, Steve; Barry I Freedman; Friedman, David J.; Field, John K.; Groop, Leif; Haugen, Aage

    2012-01-01

    Genetic case-control association studies often include data on clinical covariates, such as body mass index (BMI), smoking status, or age, that may modify the underlying genetic risk of case or control samples. For example, in type 2 diabetes, odds ratios for established variants estimated from low-BMI cases are larger than those estimated from high-BMI cases. An unanswered question is how to use this information to maximize statistical power in case-control studies that ascertain individuals...

  12. Stereotactic body radiation therapy for abdominal targets using volumetric intensity modulated arc therapy with RapidArc: Feasibility and clinical preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Scorsetti, Marta; Bignardi, Mario; Alongi, Filippo; Mancosu, Pietro; Navarria, Piera; Castiglioni, Simona; Pentimalli, Sara; Tozzi, Angelo (IRCCS Istituto Clinico Humanitas, Rozzano (Italy)), e-mail: pietro.mancosu@humanitas.it; Fogliata, Antonella; Cozzi, Luca (Oncology Inst. of Southern Switzerland, Bellinzona (Switzerland))

    2011-05-15

    Purpose. To report early clinical experience in stereotactic body radiation therapy (SBRT) delivered using volumetric intensity modulated arc therapy with RapidArc (RA) in patients with primary or metastatic tumours at abdominal sites. Material and methods. Thirty-seven consecutive patients were treated using RA. Of these, 16 had primary or metastatic liver tumours, nine had pancreatic cancer and 12 a nodal metastasis in the retro-peritoneum. Dose prescription varied from 45 to 75 Gy to the Clinical Target Volume in 3 to 6 fractions. The median follow-up was 12 months (6-22). Early local control and toxicity were investigated and reported. Results. Planning objectives on target volumes and organs at risk were met in most cases. Delivery time ranged from 2.8 +- 0.3 to 9.2 +- 2.4 minutes and pre-treatment plan verification resulted in a Gamma Agreement Index from 95.3 +- 3.8 to 98.3 +- 1.7%. At the time of analysis, local control (freedom from progression) at six months, was assessable in 24 of 37 patients and was achieved in 19 patients with a crude rate of 79.2%. Seven patients experienced treatment-related toxicity. Three patients experienced a mild and transient G1 enteritis and two showed a transient G1 liver damage. Two had late toxicity: one developed chronic enteritis causing G1 diarrhoea and G1 abdominal pain and one suffered at three months a G3 gastric bleeding. No patients experienced G4 acute toxicity. Conclusions. SBRT for abdominal targets delivered by means of RA resulted to be feasible with good early clinical results in terms of local control rate and acute toxicity profile. RA allowed to achieve required target coverage as well as to keep within normal tissue dose/volume constraints

  13. The Declaration of Helsinki and clinical trials: a focus on placebo-controlled trials in schizophrenia.

    Science.gov (United States)

    Carpenter, William T; Appelbaum, Paul S; Levine, Robert J

    2003-02-01

    The authors' goal was to consider ethical approaches to placebo-controlled clinical trials in the light of the evolving Declaration of Helsinki, with special attention to applications to research on schizophrenia. They review the Helsinki position on placebos, including the 2002 Clarification, exploring the potential negative effects of banning placebos in studies involving conditions for which at least partially effective treatments exist. The Clarification is examined as an approach to this issue that, in contrast to earlier formulations, better acknowledges the complexity of clinical research and the need for protocol-specific determinations. Placebo controls in schizophrenia studies are used to illustrate issues relevant to all clinical research on therapeutic interventions. The Helsinki Clarification provides a basis for operationalizing criteria for review of placebo use in clinical trials. Six criteria are proposed for judging the ethical acceptability of placebo controls, including the likelihood that the intervention being tested will have clinically significant advantages over existing treatments, the presence of compelling reasons for placebo use, subject selection that minimizes the possibility of serious adverse consequences, and a risk-versus-benefit analysis that favors the advantages from placebo use over the risks to subjects. The Helsinki Clarification constitutes an important advance in international approaches to placebo use, requiring protocol-by-protocol judgments on complex issues of clinical research ethics. When operationalized, it provides review boards with a useful methodology for reaching determinations on the appropriateness of placebo controls in particular studies.

  14. PET/MRI: a novel hybrid imaging technique: major clinical indications and preliminary experience in Brazil; PET/RM: um novo metodo de imagem hibrida: principais indicacoes clinicas e experiencia preliminar no Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Vitor, Taise; Martins, Karine Minaif; Ionescu, Tudor Mihai and others, E-mail: taisevitor@gmail.com [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil)

    2017-04-01

    In recent years, medical imaging with hybrid techniques has widely accepted and employed in clinical routine. PET/MRI offers significant advantages, including excellent contrast and resolution and reduced ionizing radiation, as compared to well-established PET/ CT. Therefore, PET/MRI is a promising modality for oncologic imaging of some regions, such as brain, head and neck, liver and pelvis. This article set out to analyze clinical conditions that could benefit from PET/MRI imaging based on our caseload. The potential of PET/MRI to become the imaging modality of choice for assessment of neurologic and oncologic conditions associated with soft tissues is highlighted. Clinical aspects of PET/MRI and its application to clinical cases are illustrated with examples extracted from the authors' preliminary experience. (author)

  15. Clinical nurse preceptor teaching competencies: relationship to locus of control and self-directed learning.

    Science.gov (United States)

    Chen, Ya-Lin; Hsu, Li-Ling; Hsieh, Suh-Ing

    2012-06-01

    An effective preceptor is a vital component of a strong learning experience for learners. Many clinical preceptors provide on-site supervision and clinical teaching but lack the skills necessary to be effective teachers. Few studies have examined the factors related to teaching competence among clinical nurse preceptors. This article is a report of a study that examined (a) the differences in teaching competence by preceptor background, (b) the influence of locus of control on self-evaluated teaching competence, (c) the association between self-directed learning and self-evaluated teaching competence, and (d) the predictors of self-evaluated teaching competence among clinical nurse preceptors. This descriptive and correlational study used a cross-sectional survey of a convenience sample of 243 clinical nurse preceptors from a medical center in northern Taiwan. Of these, 242 completed questionnaires for an effective response rate of 99.6%. The self-evaluated Teaching Competencies Scale, Internal-External Scale, and Self-Directed Learning Instrument were used to assess teaching competencies and related factors among clinical nurse preceptors. Descriptive statistics, one-way ANOVA, Mann-Whitney test, and multivariate linear regression were used to analyze data. Clinical nurse preceptors averaged 4.03 in teaching competence, indicating a moderately above average score. Higher teaching competence was associated with older age, being married, >10-year work experience, not assigned by unit manager, and good internal locus of control. Self-directed learning significantly correlated with teaching competence (r = .62). Internal locus of control and self-directed learning were significant independent predictors of teaching competence after adjusting for age, marital status, total years as a clinical nurse preceptor, and willingness to be a clinical nurse preceptor. Together, these accounted for 33.6% of teaching competence variance. Nurse managers should recognize all factors

  16. Atypical Antipsychotics in the Treatment of Acute Bipolar Depression with Mixed Features: A Systematic Review and Exploratory Meta-Analysis of Placebo-Controlled Clinical Trials

    Directory of Open Access Journals (Sweden)

    Michele Fornaro

    2016-02-01

    Full Text Available Evidence supporting the use of second generation antipsychotics (SGAs in the treatment of acute depression with mixed features (MFs associated with bipolar disorder (BD is scarce and equivocal. Therefore, we conducted a systematic review and preliminary meta-analysis investigating SGAs in the treatment of acute BD depression with MFs. Two authors independently searched major electronic databases from 1990 until September 2015 for randomized (placebo- controlled trials (RCTs or open-label clinical trials investigating the efficacy of SGAs in the treatment of acute bipolar depression with MFs. A random-effect meta-analysis calculating the standardized mean difference (SMD between SGA and placebo for the mean baseline to endpoint change in depression as well as manic symptoms score was computed based on 95% confidence intervals (CI. Six RCTs and one open-label placebo-controlled studies (including post-hoc reports representing 1023 patients were included. Participants received either ziprasidone, olanzapine, lurasidone, quetiapine or asenapine for an average of 6.5 weeks across the included studies. Meta-analysis with Duval and Tweedie adjustment for publication bias demonstrated that SGA resulted in significant improvements of (hypo-manic symptoms of bipolar mixed depression as assessed by the means of the total scores of the Young Mania Rating Scale (YMRS (SMD −0.74, 95% CI −1.20 to −0.28, n SGA = 907, control = 652. Meta-analysis demonstrated that participants in receipt of SGA (n = 979 experienced a large improvement in the Montgomery–Åsberg Depression Rating Scale (MADRS scores (SMD −1.08, 95% CI −1.35 to −0.81, p < 0.001 vs. placebo (n = 678. Publication and measurement biases and relative paucity of studies. Overall, SGAs appear to offer favorable improvements in MADRS and YMRS scores vs. placebo. Nevertheless, given the preliminary nature of the present report, additional original studies are required to allow more reliable

  17. Atypical Antipsychotics in the Treatment of Acute Bipolar Depression with Mixed Features: A Systematic Review and Exploratory Meta-Analysis of Placebo-Controlled Clinical Trials

    Science.gov (United States)

    Fornaro, Michele; Stubbs, Brendon; De Berardis, Domenico; Perna, Giampaolo; Valchera, Alessandro; Veronese, Nicola; Solmi, Marco; Ganança, Licínia

    2016-01-01

    Evidence supporting the use of second generation antipsychotics (SGAs) in the treatment of acute depression with mixed features (MFs) associated with bipolar disorder (BD) is scarce and equivocal. Therefore, we conducted a systematic review and preliminary meta-analysis investigating SGAs in the treatment of acute BD depression with MFs. Two authors independently searched major electronic databases from 1990 until September 2015 for randomized (placebo-) controlled trials (RCTs) or open-label clinical trials investigating the efficacy of SGAs in the treatment of acute bipolar depression with MFs. A random-effect meta-analysis calculating the standardized mean difference (SMD) between SGA and placebo for the mean baseline to endpoint change in depression as well as manic symptoms score was computed based on 95% confidence intervals (CI). Six RCTs and one open-label placebo-controlled studies (including post-hoc reports) representing 1023 patients were included. Participants received either ziprasidone, olanzapine, lurasidone, quetiapine or asenapine for an average of 6.5 weeks across the included studies. Meta-analysis with Duval and Tweedie adjustment for publication bias demonstrated that SGA resulted in significant improvements of (hypo-)manic symptoms of bipolar mixed depression as assessed by the means of the total scores of the Young Mania Rating Scale (YMRS) (SMD −0.74, 95% CI −1.20 to −0.28, n SGA = 907, control = 652). Meta-analysis demonstrated that participants in receipt of SGA (n = 979) experienced a large improvement in the Montgomery–Åsberg Depression Rating Scale (MADRS) scores (SMD −1.08, 95% CI −1.35 to −0.81, p < 0.001) vs. placebo (n = 678). Publication and measurement biases and relative paucity of studies. Overall, SGAs appear to offer favorable improvements in MADRS and YMRS scores vs. placebo. Nevertheless, given the preliminary nature of the present report, additional original studies are required to allow more reliable and

  18. Regional brain activation supporting cognitive control in the context of reward is associated with treated adolescents’ marijuana problem severity at follow-up: A preliminary study

    Directory of Open Access Journals (Sweden)

    Tammy Chung

    2015-12-01

    Full Text Available This preliminary study examined the extent to which regional brain activation during a reward cue antisaccade (AS task was associated with 6-month treatment outcome in adolescent substance users. Antisaccade performance provides a sensitive measure of executive function and cognitive control, and generally improves with reward cues. We hypothesized that when preparing to execute an AS, greater activation in regions associated with cognitive and oculomotor control supporting AS, particularly during reward cue trials, would be associated with lower substance use severity at 6-month follow-up. Adolescents (n = 14, ages 14–18 recruited from community-based outpatient treatment completed an fMRI reward cue AS task (reward and neutral conditions, and provided follow-up data. Results indicated that AS errors decreased in reward, compared to neutral, trials. AS behavioral performance, however, was not associated with treatment outcome. As hypothesized, activation in regions of interest (ROIs associated with cognitive (e.g., ventrolateral prefrontal cortex and oculomotor control (e.g., supplementary eye field during reward trials were inversely correlated with marijuana problem severity at 6-months. ROI activation during neutral trials was not associated with outcomes. Results support the role of motivational (reward cue factors to enhance cognitive control processes, and suggest a potential brain-based correlate of youth treatment outcome.

  19. Evaluation of the preliminary effectiveness of hand massage therapy on postoperative pain of adults in the intensive care unit after cardiac surgery: a pilot randomized controlled trial.

    Science.gov (United States)

    Boitor, Mădălina; Martorella, Géraldine; Arbour, Caroline; Michaud, Cécile; Gélinas, Céline

    2015-06-01

    Although many intensive care unit patients experience significant pain, very few studies explored massage to maximize their pain relief. This study aimed to evaluate the preliminary effects of hand massage on pain after cardiac surgery in the adult intensive care unit. A pilot randomized controlled trial was used for this study. The study was conducted in a Canadian medical-surgical intensive care unit. Forty adults who were admitted to the intensive care unit after undergoing elective cardiac surgery in the previous 24 hours participated in the study. They were randomly assigned to the experimental (n = 21) or control (n = 19) group. The experimental group received a 15-minute hand massage, and the control group received a 15-minute hand-holding without massage. In both groups the intervention was followed by a 30-minute rest period. The interventions were offered on 2-3 occasions within 24 hours after surgery. Pain, muscle tension, and vital signs were assessed. Pain intensity and behavioral scores were decreased for the experimental group. Although hand massage decreased muscle tension, fluctuations in vital signs were not significant. This study supports potential benefits of hand massage for intensive care unit postoperative pain management. Although larger randomized controlled trials are necessary, this low-cost nonpharmacologic intervention can be safely administered.

  20. Participants' perception of pharmaceutical clinical research: a cross-sectional controlled study

    Directory of Open Access Journals (Sweden)

    González-Saldivar G

    2016-04-01

    Full Text Available Gerardo González-Saldivar,1 René Rodríguez-Gutiérrez,2 José Luis Viramontes-Madrid,3 Alejandro Salcido-Montenegro,2 Kevin Erick Gabriel Carlos-Reyna,2 Andrés Marcelo Treviño-Alvarez,2 Neri Alejandro Álvarez-Villalobos,4 José Gerardo González-González2 1Ophthalmology Department, 2Endocrinology Division, Hospital Universitario “Dr. José E. González”, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, 3Instituto Nacional de Salud Pública, Cuernavaca, Morelos, 4Medical Statistics Department, Hospital Universitario “Dr. José E. González”, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico Background: There is scarce scientific information assessing participants’ perception of pharmaceutical research in developed and developing countries concerning the risks, safety, and purpose of clinical trials.Methods: To assess the perception that 604 trial participants (cases and 604 nonparticipants (controls of pharmaceutical clinical trials have about pharmaceutical clinical research, we surveyed participants with one of four chronic diseases from 12 research sites throughout Mexico.Results: Participation in clinical trials positively influences the perception of pharmaceutical clinical research. More cases (65.4% than controls (50.7% perceived that the main purpose of pharmaceutical research is to cure more diseases and to do so more effectively. In addition, more cases considered that there are significant benefits when participating in a research study, such as excellent medical care and extra free services, with this being the most important motivation to participate for both groups (cases 52%, controls 54.5%. We also found a sense of trust in their physicians to deal with adverse events, and the perception that clinical research is a benefit to their health, rather than a risk. More controls believed that clinical trial participants’ health is put at risk

  1. Preliminary Clinical Experience of trans-1-Amino-3-(18F-fluorocyclobutanecarboxylic Acid (anti-(18F-FACBC PET/CT Imaging in Prostate Cancer Patients

    Directory of Open Access Journals (Sweden)

    Kalevi Kairemo

    2014-01-01

    Full Text Available Background. In this retrospective analysis we assessed the role of [18F]-FACBC-PET/CT in the prostatic cancer staging. Procedure. 30 first [18F]-FACBC-PET/CT images of 26 patients (68.1 ± 5.8 years were analyzed. PET/CT findings were compared with PSA concentrations, with PSA doubling times (PDT, and with correlative imaging. Results. On 16 [18F]-FACBC (53.3% scans, 58 metabolically active lesions were found. 12 (20.7% lesions corresponding to the local relapse were found in prostate/prostate bed and seminal vesicles, 9 (15.5% lesions were located in regional lymph nodes, 10 (17.2% were located in distal lymph nodes, and 26 (44.8% metabolically active lesions were found in the skeleton. In one case, focal uptake was found in the brain, confirmed further on MRI as meningioma. The mean S-PSA level in patients with positive [18F]-FACBC findings was 9.5 ± 16.9 μg/L (0.54–69 μg/L and in patients with negative [18F]-FACBC findings was 1.96 ± 1.87 μg/L (0.11–5.9 μg/L, but the difference was not statistically significant. However, the PSA doubling time (PDT in patients with positive findings was significantly shorter than PDT in patients with negative findings: 3.25 ± 2.09 months (0.3–6 months versus 31.2 ± 22.02 months (8–84 months, P<0.0001. There was a strong positive correlation between PSA value and number of metabolically active lesions (R=0.74 and a negative correlation between PDT and number of metabolically active lesions (R=-0.56. There was a weak negative correlation between PDT and SUVmax⁡ (R=-0.30. Conclusion. According to our preliminary clinical experience, [18F]-FACBC-PET may play a role in in vivo restaging of an active prostate cancer, especially in patients with a short S-PSA doubling time.

  2. A randomised, controlled clinical study on total hip arthroplasty using 4 different bearings

    DEFF Research Database (Denmark)

    Borgwardt, Arne; Zerahn, Bo; Fabricius, Sandra D

    2017-01-01

    PURPOSE: To compare 4 different bearings in total hip arthroplasty (THA) in a randomised controlled clinical study on clinical performance. METHODS: 393 patients with osteoarthritis of the hip or avascular necrosis were included and allocated to 1 of the head-and-cup couples zirconia-on-polyethyl......PURPOSE: To compare 4 different bearings in total hip arthroplasty (THA) in a randomised controlled clinical study on clinical performance. METHODS: 393 patients with osteoarthritis of the hip or avascular necrosis were included and allocated to 1 of the head-and-cup couples zirconia...... cumulated prosthesis survival percentages and 95% confidence interval after 10 years were: group A 84.6 (75.8-93.4); group B 95.0 (89.5-100); group C 93.2 (86.7-99.7); group D 66.1 (54.5-77.7). The patients' physical function was significantly improved and remained equally good in all 4 groups, however...

  3. Effect of nonsurgical periodontal therapy and strict plaque control on preterm/low birth weight: a randomized controlled clinical trial.

    Science.gov (United States)

    Weidlich, Patricia; Moreira, Carlos Heitor C; Fiorini, Tiago; Musskopf, Marta L; da Rocha, José M; Oppermann, Maria Lucia R; Aass, Anne M; Gjermo, Per; Susin, Cristiano; Rösing, Cassiano K; Oppermann, Rui V

    2013-01-01

    This randomized controlled clinical trial was carried out to assess the effect of comprehensive nonsurgical periodontal treatment and strict plaque control performed during pregnancy on the reduction of preterm and/or low birth weight rates (PTLBW). Three hundred and three women were randomly allocated to receive periodontal treatment either during pregnancy (n = 147, test group) or after delivery (n = 156, control group). During pregnancy, the control group received only one session of supragingival scaling and oral hygiene instruction. In contrast, the test group received comprehensive periodontal treatment including multiple sessions of scaling and root planing, oral hygiene instructions, and frequent maintenance visits. At baseline, periodontal inflammation was observed in approximately 50% of sites and attachment loss affected controls, women in the test group had significant reductions in the percentage of sites with plaque (48.5% vs. 10.3%, p control significantly improved periodontal health; however, no reduction of PTLBW rates was observed. Thus, remaining periodontal inflammation posttreatment cannot explain the lack of effect of periodontal treatment on PTLBW. Clinical relevance This study demonstrated that periodontal diseases may be successfully treated during pregnancy. Our results do not support a potential beneficial effect of periodontal treatment on PTLBW.

  4. [The importance of test control for the post-graduate education in clinical rhinology].

    Science.gov (United States)

    Nosulia, E V; Kim, I A; Kosiakov, S Ia; Piskunov, G Z; Vinnikov, A K

    2014-01-01

    This publication deals with the problems pertaining to the improvement of the system of the post-graduate education in otorhinolaryngology with special reference to one of its topical fields, clinical rhinology. The authors emphasize the importance of one of the principal components of the post-graduate education under the present-day conditions, namely organization of control and self-control of learning the new material, self-monitoring and individual correction of the level of knowledge. Special attention is given to the training tests that can be used to adequately simulate the decision-making process with respect to a concrete clinical situation. It is concluded that the systematic application of test control is one of the most important prerequisites for the enhancement of the effectiveness of the post-graduate education in clinical otorhinolaryngology.

  5. Exploring Preschoolers' Engagement and Perceived Physical Competence in an Autonomy-Based Object Control Skill Intervention: A Preliminary Study

    Science.gov (United States)

    Logan, Samuel; Robinson, Leah; Webster, E. Kipling; Barber, Laura

    2013-01-01

    The purpose of this study was to describe children's engagement during two (high and low) autonomy-based climates. Twenty-five preschool children participated in a nine-week object control skill intervention. Children completed the object control subscale of the Test of Gross Motor Development 2nd Edition and the perceived physical competence…

  6. Comparison of clinical and parasitological data from controlled human malaria infection trials.

    Directory of Open Access Journals (Sweden)

    Meta Roestenberg

    Full Text Available BACKGROUND: Exposing healthy human volunteers to Plasmodium falciparum-infected mosquitoes is an accepted tool to evaluate preliminary efficacy of malaria vaccines. To accommodate the demand of the malaria vaccine pipeline, controlled infections are carried out in an increasing number of centers worldwide. We assessed their safety and reproducibility. METHODS: We reviewed safety and parasitological data from 128 malaria-naïve subjects participating in controlled malaria infection trials conducted at the University of Oxford, UK, and the Radboud University Nijmegen Medical Center, The Netherlands. Results were compared to a report from the US Military Malaria Vaccine Program. RESULTS: We show that controlled human malaria infection trials are safe and demonstrate a consistent safety profile with minor differences in the frequencies of arthralgia, fatigue, chills and fever between institutions. But prepatent periods show significant variation. Detailed analysis of Q-PCR data reveals highly synchronous blood stage parasite growth and multiplication rates. CONCLUSIONS: Procedural differences can lead to some variation in safety profile and parasite kinetics between institutions. Further harmonization and standardization of protocols will be useful for wider adoption of these cost-effective small-scale efficacy trials. Nevertheless, parasite growth rates are highly reproducible, illustrating the robustness of controlled infections as a valid tool for malaria vaccine development.

  7. Preliminary Report on Experimental Investigation of Engine Dynamics and Controls for a 48-inch Ram-jet Engine

    Science.gov (United States)

    Vasu, George; Hart, Clint E; Dunbar, William R

    1956-01-01

    Engine dynamics and controls data are presented for a ram-jet engine which was operated in a free-jet facility at a Mach number of 2.76 and altitudes from 68,000 to 82,000 feet. The predominant engine dynamic characteristics was dead time, with values ranging from 0.018 to 0.053 sec. The control systems were designed to hold a constant ratio of a diffuser static pressure to an inlet-cone reference static pressure. Response times and percent overshoot to fuel-flow disturbances that would have caused subcritical operation without control are included for a wide range of control settings. For all settings, the control response was fast enough (0.08 to 0.5 sec) to prevent subcritical operation.

  8. Improving oral presentation skills with a clinical reasoning curriculum: a prospective controlled study.

    Science.gov (United States)

    Wiese, Jeff; Varosy, Paul; Tierney, Lawrence

    2002-02-15

    The oral case presentation is an essential part of clinical medicine, but teaching medical students to present clinical data remains difficult. Presentation skills depend on the ability to obtain, process, and organize patient data. Clinical reasoning is fundamental to the development of these skills. We compared a clinical reasoning curriculum with standard ward instruction for improving presentation skills and clinical performance. Between October 1998 and May 1999, 62 third-year medical students at three hospitals were assigned to a 4-week clinical reasoning curriculum (n = 27) or a control group (n = 35) that underwent routine instruction. The curriculum consisted of four 1-hour group sessions and 1 hour of individual videotaped instruction, and taught students to use the principles of clinical reasoning, such as generation and refinement of diagnostic hypothesis, interpretation of diagnostic tests, and causal reasoning, to determine data for inclusion in the oral presentation. We videotaped students presenting two standardized case histories; one at baseline and a second 4 weeks later. Two independent evaluators who were blinded to the group assignments reviewed the videotapes and scored them for presentation quality and efficiency, and general speaking ability. Mean (+/- SD) presentation times at baseline were similar in the two groups (intervention group: 8 +/- 2 minutes; control group: 8 +/- 2 minutes; P = 0.74). Presentation time in students who were taught clinical reasoning decreased by 3 +/- 2 minutes, but increased by 2 +/- 2 minutes in control students. The difference in the changes between the groups was statistically significant (mean difference = 4 minutes; 95% confidence interval [CI]: 3 to 5 minutes; P Presentation quality scores at baseline were similar in both groups (intervention group: 17 +/- 8 points; control group: 20 +/- 7 points; P = 0.11). Students who were taught the clinical reasoning curriculum had an improvement of 9 +/- 6 points in

  9. Antibiotics and the social history of the controlled clinical trial, 1950-1970.

    Science.gov (United States)

    Podolsky, Scott H

    2010-07-01

    The histories of antibiotics, controlled clinical trials, and attempts by academics to inculcate an explicitly rational therapeutics among clinicians in the United States were linked during a formative period from 1950 to 1970. Maxwell Finland and Harry Dowling would serve at the epicenter of such efforts in the context of first the broad-spectrum antibiotics, and then, and still more critically, the since-forgotten influx of "fixed-dose combination" antibiotics. With their attention focused less upon individual clinicians than upon pharmaceutical marketers, clinical investigators, the American Medical Association, and the federal government, Finland, Dowling and their supporters would wield the "controlled clinical trial" against the pharmaceutical "testimonial" as a means of ensuring a rational therapeutics. In doing so, they would play an important role in the direction the subsequent Kefauver hearings (1959-1962) would take toward mandating proof of drug efficacy via controlled clinical trials prior to new drug approval. Understanding such a trajectory allows us to better appreciate not only the social history of the controlled clinical trial and the priorities of leaders in infectious disease in the United States during this time, but the consequences of their efforts as well.

  10. Wireless remote control clinical image workflow: utilizing a PDA for offsite distribution

    Science.gov (United States)

    Liu, Brent J.; Documet, Luis; Documet, Jorge; Huang, H. K.; Muldoon, Jean

    2004-04-01

    Last year we presented in RSNA an application to perform wireless remote control of PACS image distribution utilizing a handheld device such as a Personal Digital Assistant (PDA). This paper describes the clinical experiences including workflow scenarios of implementing the PDA application to route exams from the clinical PACS archive server to various locations for offsite distribution of clinical PACS exams. By utilizing this remote control application, radiologists can manage image workflow distribution with a single wireless handheld device without impacting their clinical workflow on diagnostic PACS workstations. A PDA application was designed and developed to perform DICOM Query and C-Move requests by a physician from a clinical PACS Archive to a CD-burning device for automatic burning of PACS data for the distribution to offsite. In addition, it was also used for convenient routing of historical PACS exams to the local web server, local workstations, and teleradiology systems. The application was evaluated by radiologists as well as other clinical staff who need to distribute PACS exams to offsite referring physician"s offices and offsite radiologists. An application for image workflow management utilizing wireless technology was implemented in a clinical environment and evaluated. A PDA application was successfully utilized to perform DICOM Query and C-Move requests from the clinical PACS archive to various offsite exam distribution devices. Clinical staff can utilize the PDA to manage image workflow and PACS exam distribution conveniently for offsite consultations by referring physicians and radiologists. This solution allows the radiologist to expand their effectiveness in health care delivery both within the radiology department as well as offisite by improving their clinical workflow.

  11. Infection surveillance and control programs in the Department of Veterans Affairs nursing home care units: a preliminary assessment.

    Science.gov (United States)

    Tsan, Linda; Hojlo, Christa; Kearns, Martha A; Davis, Chester; Langberg, Robert; Claggett, Maurice; Coughlin, Nancy; Miller, Michael; Gaynes, Robert; Gibert, Cynthia; Montgomery, Ona; Richards, Chesley; Danko, Linda; Roselle, Gary

    2006-03-01

    A survey was conducted to assess the capacity and current practices of the infection surveillance and control programs at the Department of Veterans Affairs' 130 nursing home care units (VA NHCUs) covering a total of 15,006 beds in 2003. All 130 VA NHCUs responded to the survey, although not all NHCUs answered every question. The majority of the VA NHCUs provided specialized services that might pose increased risks of infection. For every 8 to 10 VA NHCU beds, there was 1 regular-pressure or negative-pressure infection control room available. Each VA NHCU had an active ongoing infection surveillance and control program managed by highly educated infection control personnel (ICP), of which 96% had a minimum of a bachelor degree. A median of 12 hours per week of these ICP efforts was devoted to the infection surveillance and control activities. The most frequently used surveillance methods were targeted surveillance for specific infections and for specific organisms. Most VA NHCUs conducted surveillance for antibiotic-resistant organisms. However, VA NHCUs did not use a uniform set of definitions for nosocomial infections for their infection surveillance and control purposes. We conclude that VA NHCUs have a considerable infrastructure and capacity for infection surveillance and control. This information can be used to develop a nationwide VA NHCU nosocomial infection surveillance system.

  12. Preliminary analysis of the PreFlexMS molten salt once-through steam generator dynamics and control strategy

    Science.gov (United States)

    Trabucchi, Stefano; Casella, Francesco; Maioli, Tommaso; Elsido, Cristina; Franzini, Davide; Ramond, Mathieu

    2017-06-01

    Concentrated Solar Power plants (CSP) coupled with thermal storage have the potential to guarantee both flexible and continuous energy production, thus being competitive with conventional fossil fuel and hydro power plants, in terms of dispatchability and provision of ancillary services. Hence, the plant equipment and control design have to be focused on flexible operation on one hand, and on plant safety concerning the molten salt freezing on the other hand. The PreFlexMS European project aims to introduce a molten salt Once-Through Steam Generator (OTSG) within a Rankine cycle based power unit, a technology that has greater flexibility potential if compared to steam drum boilers, currently used in CSP plants. The dynamic modelling and simulation from the early design stages is, thus, of paramount importance, to assess the plant dynamic behavior and controllability, and to predict the achievable closed-loop dynamic performance, potentially saving money and time during the detailed design, construction and commissioning phases. The present paper reports the main results of the analysis carried out during the first part of the project, regarding the system analysis and control design. In particular, two different control systems have been studied and tested with the plant dynamic model: a decentralized control strategy based on PI controllers and a Linear Model Predictive Control (LMPC).

  13. A Virtual Reality Game for Chronic Pain Management: A Randomized, Controlled Clinical Study.

    Science.gov (United States)

    Jin, Weina; Choo, Amber; Gromala, Diane; Shaw, Chris; Squire, Pamela

    2016-01-01

    Although Virtual Reality (VR) applications have been shown to reduce many forms of acute pain, such research of VR applications and their effects on chronic pain is still at its infancy. In this study, we designed a VR game Cryoslide, and examined its analgesic effect on chronic pain patients, its end users, in a clinical setting. In this randomized, controlled crossover clinical study of 20 chronic pain patients, Cryoslide significantly reduced perceived pain compared to the baseline and the control group. The results demonstrate that Cryoslide can be effectively used as an analgesic intervention for chronic pain management to lessen pain intensity during short-term symptom spikes.

  14. [Study on clinical effectiveness of acupuncture and moxibustion on acute Bell's facial paralysis: randomized controlled clinical observation].

    Science.gov (United States)

    Wu, Bin; Li, Ning; Liu, Yi; Huang, Chang-qiong; Zhang, Yong-ling

    2006-03-01

    To investigate the adverse effects of acupuncture on the prognosis, and effectiveness of acupuncture combined with far infrared ray in the patient of acute Bell's facial paralysis within 48 h. Clinically randomized controlled trial was used, and the patients were divided into 3 groups: group A (early acupuncture group), group B (acupuncture combined with far infrared ray) and group C (acupuncture after 7 days). The facial nerve functional classification at the attack, 7 days after the attack and after treatment, the clinically cured rate of following-up of 6 months, and the average cured time, the cured time of complete facial paralysis were observed in the 3 groups. There were no significant differences among the 3 groups in the facial nerve functional classification 7 days after the attack, the clinically cured rate of following-up of 6 months and the average cured time (P > 0.05), but the cured time of complete facial paralysis in the group A and the group B were shorter than that in the group C (P facial paralysis can be treated with acupuncture and moxibustion, and traditional moxibustion can be replaced by far infrared way.

  15. Preliminary results of a randomized controlled trial carried out with a fixed combination of S-adenosyl-L-methionine and betaine versus amitriptyline in patients with mild depression

    Science.gov (United States)

    Di Pierro, Francesco; Settembre, Roberto

    2015-01-01

    Background S-adenosyl-L-methionine (SAMe), a safe, endogenous, pleiotropic methyl donor well known for its antidepressant role, has been assumed to have a possible role in increasing plasma levels of compounds known to be able to raise cardiovascular risk. Although the issue is still being debated, betaine (trimethylglycine), a specific methyl donor involved in the homocysteine circuit, may be able to reduce such a risk and/or, by determining a sparing effect on endogenous SAMe, may be able to improve the clinical efficiency of SAMe itself. Indeed, preliminary results have shown clinical improvement determined by an add-on therapy with betaine administered along with SAMe, versus SAMe alone, to patients affected by mild/moderate depression. Aim To evaluate the safety and antidepressant role played by the association of SAMe plus betaine versus amitriptyline administered in untreated individuals with a recent diagnosis of mild depression. Methods This small, open-label, randomized, observational study enrolled 64 individuals with a diagnosis of mild depression according to the Zung Self-Rating Depression Scale. After randomization, they were treated with either Laroxyl® (amitriptyline, 75 mg/day) or DDM Metile® (enteric-coated SAMe, 500 mg/day, plus betaine, 250 mg/day) for 12 months. Assessment of clinical scores and tolerability was performed at T=0 and after 3, 6, and 12 months. Results After 3 months, both treatments showed a small and not statistically significant improvement. After 6 and 12 months, both treated groups demonstrated a more noticeable improved response, although the group treated with SAMe plus betaine showed better results in terms of score, number of individuals in remission, and side effects. Compliance was overlapping in both treatments. Conclusion The association of SAMe plus betaine seems to be a safe and effective tool to counteract mild depression and also when used as monotherapy in subjects with a recent diagnosis. PMID:25678811

  16. Comparison of clinical outcomes of frozen-thawed blastocysts transfer in natural and hormonally controlled cycles

    Institute of Scientific and Technical Information of China (English)

    Gao Hui; Sun Zheng-yi; Deng Cheng-yan; Yu Qi; He Fang-fang

    2007-01-01

    Objectives:To assess the clinical outcomes of frozen-thawed blastocysts transfer in natural and hormonally controlled cycles.Methods: A retrospective analysis of natural and hormonally controlled cycle for 246 frozen-thawed blastocyst transfer cycles, the clinical pregnancy rate, implantation rate, early abortion rate were compared.Results: Of the 192 hormonally controlled cycles, the cancel rate, clinical pregnancy rate per ET, implantation rate and abortion rate were 7.3% (14/192), 53.9% (96/178), 38.8% (131/338)and 11.5% (11/96)respectively,whereas in 54 natural cycles, these rates were 16.7%(9/54), 68.9%(31/45), 52.9%(45/85) and 16.1%(5/31)respectively.There was no significant difference between the two groups with regard to the clinical pregnancy and abortion rate per ET, but the cancel rate and implantation rate were higher in natural cycles.However, the pregnancy and implantation rates of patients without PCOS in hormonal control cycles(57.2%, 40.9%) were similar with those in natural cycles(P>0.05).Conclusion: These findings suggested that both hormonally controlled and natural cycles had similar pregnancy outcomes in frozen-thawed blastocysts transfer.

  17. Preliminary Evaluation of the Control of Microbial Fouling by Laboratory and Pilot-Scale Air-Stripping Columns

    Science.gov (United States)

    1985-03-01

    Corparisons, Journal AWWA, August 1981, p. 420. 11. American Public Health Association American Water Works Association Water Polution Control ...or control measures to be taken in future applications of these water treatment methods. Measures to prevent buildup of microbial slimes will allow...tap water --the town of Natick uses well water as the public water supply-- and flow was monitored with a "Gilmont model E6677" water flowmeter. The

  18. Preliminary Remarks Regarding the Prevalence of ESBL-Producing Strains of E. coli and K. Pneumoniae, Isolated from Cows with Clinical Endometritis

    Directory of Open Access Journals (Sweden)

    Cristina Ioana CRIVEI

    2017-05-01

    In this preliminary study, by phenotypic methods was confirmed a prevalence of 35.3% for the ESBL strains of E. coli and K. pneumoniae, which requires further research to confirm by molecular biology the identification of ESBL resistance genes, but also for the plasmids encoding these gene transmission.

  19. Smoking cessation intervention within the framework of a lung cancer screening program: preliminary results and clinical perspectives from the "Cosmos-II" Trial.

    Science.gov (United States)

    Filippo, Lococo; Principe, Rosastella; Cesario, Alfredo; Apolone, Giovanni; Carleo, Francesco; Ialongo, Pasquale; Veronesi, Giulia; Cardillo, Giuseppe

    2015-02-01

    Data coming from the literature investigating the effectiveness and interaction between smoking cessation (SC) and lung cancer screening (LCScr) are still sparse and inconsistent. Herein, we report the preliminary results from the ongoing lung cancer screening trial ("Cosmos-II") focusing our analysis on the inter-relationship between the SC program and the LCScr.

  20. Design control for clinical translation of 3D printed modular scaffolds.

    Science.gov (United States)

    Hollister, Scott J; Flanagan, Colleen L; Zopf, David A; Morrison, Robert J; Nasser, Hassan; Patel, Janki J; Ebramzadeh, Edward; Sangiorgio, Sophia N; Wheeler, Matthew B; Green, Glenn E

    2015-03-01

    The primary thrust of tissue engineering is the clinical translation of scaffolds and/or biologics to reconstruct tissue defects. Despite this thrust, clinical translation of tissue engineering therapies from academic research has been minimal in the 27 year history of tissue engineering. Academic research by its nature focuses on, and rewards, initial discovery of new phenomena and technologies in the basic research model, with a view towards generality. Translation, however, by its nature must be directed at specific clinical targets, also denoted as indications, with associated regulatory requirements. These regulatory requirements, especially design control, require that the clinical indication be precisely defined a priori, unlike most academic basic tissue engineering research where the research target is typically open-ended, and furthermore requires that the tissue engineering therapy be constructed according to design inputs that ensure it treats or mitigates the clinical indication. Finally, regulatory approval dictates that the constructed system be verified, i.e., proven that it meets the design inputs, and validated, i.e., that by meeting the design inputs the therapy will address the clinical indication. Satisfying design control requires (1) a system of integrated technologies (scaffolds, materials, biologics), ideally based on a fundamental platform, as compared to focus on a single technology, (2) testing of design hypotheses to validate system performance as opposed to mechanistic hypotheses of natural phenomena, and (3) sequential testing using in vitro, in vivo, large preclinical and eventually clinical tests against competing therapies, as compared to single experiments to test new technologies or test mechanistic hypotheses. Our goal in this paper is to illustrate how design control may be implemented in academic translation of scaffold based tissue engineering therapies. Specifically, we propose to (1) demonstrate a modular platform approach

  1. Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy.

    Science.gov (United States)

    Larsson, Ingrid; Fridlund, Bengt; Arvidsson, Barbro; Teleman, Annika; Bergman, Stefan

    2014-01-01

    To compare and evaluate the treatment outcomes of a nurse-led rheumatology clinic and a rheumatologist-led clinic in patients with low disease activity or in remission who are undergoing biological therapy. Patients with chronic inflammatory arthritis treated with biological therapy are usually monitored by rheumatologists. Nurse-led rheumatology clinics have been proposed in patients with low disease activity or in remission. Randomized controlled trial. A 12-month follow-up trial was conducted between October 2009 and August 2011, where 107 patients were randomized into two groups with a 6-month follow-up to a nurse-led rheumatology clinic based on person-centred care (intervention group; n = 53) or to a rheumatologist-led clinic (control group; n = 54). The hypothesis was that the nurse-led clinic outcomes would not be inferior to those obtained from a rheumatologist-led clinic at the 12-month follow-up. The primary outcome was disease activity measured by Disease Activity Score 28. A total of 47 patients in the intervention group and 50 in the control group completed the 12-month trial. The trial revealed no statistically significant differences between groups in mean change of Disease Activity Score 28, Visual Analogue Scales for pain, the Health Assessment Questionnaire, satisfaction with or confidence in obtaining rheumatology care. Patients with stable chronic inflammatory arthritis undergoing biological therapy could be monitored by a nurse-led rheumatology clinic without difference in outcome as measured by the Disease Activity Score 28. © 2013 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

  2. Establishing quality control ranges for antimicrobial susceptibility testing of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus: a cornerstone to develop reference strains for Korean clinical microbiology laboratories.

    Science.gov (United States)

    Hong, Sung Kuk; Choi, Seung Jun; Shin, Saeam; Lee, Wonmok; Pinto, Naina; Shin, Nari; Lee, Kwangjun; Hong, Seong Geun; Kim, Young Ah; Lee, Hyukmin; Kim, Heejung; Song, Wonkeun; Lee, Sun Hwa; Yong, Dongeun; Lee, Kyungwon; Chong, Yunsop

    2015-11-01

    Quality control (QC) processes are being performed in the majority of clinical microbiology laboratories to ensure the performance of microbial identification and antimicrobial susceptibility testing by using ATCC strains. To obtain these ATCC strains, some inconveniences are encountered concerning the purchase cost of the strains and the shipping time required. This study was focused on constructing a database of reference strains for QC processes using domestic bacterial strains, concentrating primarily on antimicrobial susceptibility testing. Three strains (Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus) that showed legible results in preliminary testing were selected. The minimal inhibitory concentrations (MICs) and zone diameters (ZDs) of eight antimicrobials for each strain were determined according to the CLSI M23. All resulting MIC and ZD ranges included at least 95% of the data. The ZD QC ranges obtained by using the CLSI method were less than 12 mm, and the MIC QC ranges extended no more than five dilutions. This study is a preliminary attempt to construct a bank of Korean QC strains. With further studies, a positive outcome toward cost and time reduction can be anticipated.

  3. Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial

    OpenAIRE

    Dantas, Diego de Sousa; Assis, Sanderson José Costa de; Baroni, Marina Pegoraro; Lopes, Johnnatas Mikael; Cacho, Enio Walker Azevedo; Cacho,Roberta de Oliveira; Pereira, Silvana Alves

    2017-01-01

    [Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured b...

  4. Pilot proof of concept clinical trials of Stochastic Targeted (STAR) glycemic control

    OpenAIRE

    Evans, Alicia; Shaw, Geoffrey M; Le Compte, Aaron; Tan, Chia*-Siong; Ward, Logan; Steel, James,; Pretty, Christopher G; Pfeifer, Leesa; Penning, Sophie; Suhaimi, Fatanah; Signal, Matthew; Desaive, Thomas; Chase, J. Geoffrey

    2011-01-01

    ABSTRACT: INTRODUCTION: Tight glycemic control (TGC) has shown benefits but has been difficult to achieve consistently. STAR (Stochastic TARgeted) is a flexible, model-based TGC approach directly accounting for intra- and inter- patient variability with a stochastically derived maximum 5% risk of blood glucose (BG) < 4.0 mmol/L. This research assesses the safety, efficacy, and clinical burden of a STAR TGC controller modulating both insulin and nutrition inputs in pilot trials. METHODS: Seven...

  5. The counseling african americans to control hypertension (caatch) trial: baseline demographic, clinical, psychosocial, and behavioral characteristics

    OpenAIRE

    Diaz-Gloster Marleny; Cassells Andrea; Tobin Jonathan N; Fernandez Senaida; Kalida Chamanara; Ogedegbe Gbenga

    2011-01-01

    Abstract Background Effectiveness of combined physician and patient-level interventions for blood pressure (BP) control in low-income, hypertensive African Americans with multiple co-morbid conditions remains largely untested in community-based primary care practices. Demographic, clinical, psychosocial, and behavioral characteristics of participants in the Counseling African American to Control Hypertension (CAATCH) Trial are described. CAATCH evaluates the effectiveness of a multi-level, mu...

  6. Role of betahistine in glycemic control of obese subjects: a placebo- controlled clinical trial

    OpenAIRE

    Hayder H. Al-Anbari; Ahmed S. Sahib; Amer O. Al-Mukhtar

    2016-01-01

    Background: Poor glycemic control, insulin resistance and abnormal beta cell function are of the most important complications that associated with obesity, targeting of such complications with pharmacological agents depending on the already existing central mechanism may decrease the incidence of morbidity and mortality among obese subjects. Betahistine is an anti-vertigo drug, commonly prescribed to patients with balance disorders or to improve vertigo symptoms associated with Meniere's dise...

  7. Physical activities of Patients with adolescent idiopathic scoliosis (AIS): preliminary longitudinal case-control study historical evaluation of possible risk factors.

    Science.gov (United States)

    McMaster, Marianne E; Lee, Amanda Jane; Burwell, R Geoffrey

    2015-01-01

    To our knowledge there are no publications that have evaluated physical activities in relation to the etiopathogenesis of adolescent idiopathic scoliosis (AIS) other than sports scolioses. In a preliminary longitudinal case-control study, mother and child were questioned and the children examined by one observer. The aim of the study was to examine possible risk factors for AIS. Two study groups were assessed for physical activities: 79 children diagnosed as having progressive AIS at one spinal deformity centre (66 girls, 13 boys) and a Control Group of 77 school children (66 girls, 11 boys), the selection involving six criteria. A structured history of physical activities was obtained, every child allocated to a socioeconomic group and examined for toe touching. Unlike the Patients, the Controls were not X-rayed and were examined for surface vertical spinous process asymmetry (VSPA). Statistical analyses showed progressive AIS to be positively associated with social deprivation, early introduction to indoor heated swimming pools and ability to toe touch. AIS is negatively associated with participation in dance, skating, gymnastics or karate and football or hockey classes, which might suggest preventive possibilities. There is a significantly increased independent odds of AIS in children who went to an indoor heated swimming pool within the first year of life (odds ratio 3.88, 95% CI 1.77-8.48; p = 0·001). Furthermore fourteen (61%) Controls with VSPA compared with 9 (17%) Controls without VSPA had been introduced to the swimming pool within their first year of life (P swimming pools for both AIS and VSPA, suggests that the AIS findings do not result from sample selection.

  8. Association of statin therapy with blood pressure control in hypertensive hypercholesterolemic outpatients in clinical practice

    Science.gov (United States)

    Morgado, Manuel; Rolo, Sandra; Macedo, Ana Filipa; Castelo-Branco, Miguel

    2011-01-01

    Background: Some clinical evidence revealed that statins, apart from lowering cholesterol levels, also have an antihypertensive effect. Our aim was to evaluate the existence of a possible association of statin therapy with blood pressure (BP) control in clinical practice. Materials and Methods: Patients attending a hypertension/dyslipidemia clinic were prospectively evaluated. Those patients with a diagnosis of stage 1 hypertension and hypercholesterolemia who consented to participate were included in the study, either in the statin group (when taking a statin) or in the control group (when not taking a statin). Exclusion criteria included dementia, pregnancy, or breastfeeding, and history or evidence of stage 2 hypertension. Detailed clinical information was prospectively obtained from medical records. A total of 110 hypertensive patients were assigned to the study (82 in the statin group and 28 in the control group). Results: Although there were no significant differences (P > 0.05) in both groups concerning gender, body mass index, antihypertensive pharmacotherapy, and serum levels of high-density lipoprotein cholesterol and triglycerides, a higher BP control was observed in the statin group (P = 0.002). Significantly lower systolic BP (–6.7 mmHg, P = 0.020) and diastolic BP (–6.4 mmHg, P = 0.002) levels were reported in the statin group. Serum levels of low-density lipoprotein were also significantly lower in the statin group (P < 0.001). Conclusions: This observational study detected an association of statin therapy with BP control in hypertensive hypercholesterolemic patients in clinical practice. These findings raise the possibility that statin therapy may be useful for BP control in the studied population. PMID:21716752

  9. Reliability and validity of the Turkish version of the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D): a preliminary study.

    Science.gov (United States)

    Kundakçi, Turgut; Sar, Vedat; Kiziltan, Emre; Yargiç, Ilhan L; Tutkun, Hamdi

    2014-01-01

    A total of 34 consecutive patients with dissociative identity disorder or dissociative disorder not otherwise specified were evaluated using the Turkish version of the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). They were compared with a matched control group composed of 34 patients who had a nondissociative psychiatric disorder. Interrater reliability was evaluated by 3 clinicians who assessed videotaped interviews conducted with 5 dissociative and 5 nondissociative patients. All subjects who were previously diagnosed by clinicians as having a dissociative disorder were identified as positive, and all subjects who were previously diagnosed as not having a dissociative disorder were identified as negative. The scores of the main symptom clusters and the total score of the SCID-D differentiated dissociative patients from the nondissociative group. There were strong correlations between the SCID-D and the Dissociative Experiences Scale total and subscale scores. These results are promising for the validity and reliability of the Turkish version of the SCID-D. However, as the present study was conducted on a predominantly female sample with very severe dissociation, these findings should not be generalized to male patients, to dissociative disorders other than dissociative identity disorder, or to broader clinical or nonclinical populations.

  10. Preliminary clinical study of left ventricular myocardial strain in patients with non-ischemic dilated cardiomyopathy by three-dimensional speckle tracking imaging

    Directory of Open Access Journals (Sweden)

    Duan Fengxia

    2012-03-01

    Full Text Available Abstract Background Non-ischemic dilated cardiomyopathy (DCM is the most common cardiomyopathy worldwide, with significant mortality. Correct evaluation of the patient's myocardial function has important clinical significance in the diagnosis, therapeutic effect assessment and prognosis in non-ischemic DCM patients. This study evaluated the feasibility of three-dimensional speckle tracking imaging (3D-STE for assessment of the left ventricular myocardial strain in patients with non-ischemic dilated cardiomyopathy (DCM. Methods Apical full-volume images were acquired from 65 patients with non-ischemic DCM (DCM group and 59 age-matched normal controls (NC group, respectively. The following parameters were measured by 3D-STE: the peak systolic radial strain (RS, circumferential strain (CS, longitudinal strain (LS of each segment. Then all the parameters were compared between the two groups. Results The peak systolic strain in different planes had certain regularities in normal groups, radial strain (RS was the largest in the mid region, the smallest in the apical region, while circumferential strain (CS and longitudinal strain (LS increased from the basal to the apical region. In contrast, the regularity could not be applied to the DCM group. RS, CS, LS were significantly decreased in DCM group as compared with NC group (P Conclusions 3D-STE is a reliable tool for evaluation of left ventricular myocardial strain in patients with non-ischemic DCM, with huge advantage in clinical application.

  11. RANDOMIZED CONTROLLED TRIALS OF MATERNAL-FETAL SURGERY : A CHALLENGE TO CLINICAL EQUIPOISE

    NARCIS (Netherlands)

    Rodrigues, H. C. M. L.; van den Berg, P. P.

    2014-01-01

    This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception

  12. Parenting clinically anxious versus healthy control children aged 4-12 years

    NARCIS (Netherlands)

    van der Sluis, C.M.; van Steensel, F.J.A.; Bögels, S.M.

    2015-01-01

    This study investigated whether parenting behaviors differed between parents of 68 clinically anxious children and 106 healthy control children aged 4-12 years. The effects of parent gender, child gender and child age on parenting were explored. Mothers and fathers completed a questionnaire to asses

  13. Survey and Practice of Reporting Quality of Randomized Controlled Clinical Trials on Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    LI Ting-qian; MAO Bing; WANG Gang; CHANG Jing; WANG Lei

    2008-01-01

    @@ Evidence obtained from randomized controlled trials (RCTs) has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully understand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner.

  14. Second-generation antidepressants in social anxiety disorder: meta-analysis of controlled clinical trials.

    Science.gov (United States)

    de Menezes, Gabriela Bezerra; Coutinho, Evandro Silva Freire; Fontenelle, Leonardo F; Vigne, Paula; Figueira, Ivan; Versiani, Márcio

    2011-05-01

    A growing number of controlled clinical trials suggest that different second-generation antidepressants (SGA) may be effective in the treatment of social anxiety disorder (SAD). The aim of the present study is to evaluate the effectiveness of SGA in SAD and to investigate possible differences in their efficacy. We performed a systematic review and meta-analysis of all double-blind, randomized, controlled clinical trials involving second-generation antidepressants in adult patients with SAD published on PubMed/MEDLINE, PsycINFO, and Current Controlled Trials databases until July 2009. Our analyses were based on changes in Liebowitz Social Anxiety Scale (LSAS), Clinical Global Impression (CGI), and standardized mean difference (SMD). Twenty-seven controlled clinical trials, comprising ten different SGA, were selected. When comparing the reduction of LSAS scores, the group receiving active drugs showed a significantly greater reduction compared to those observed in the placebo group [pooled weighted mean -11.9 (IC 95% -14.5 to -9.4)]. The combined relative risk (RR) for the different drugs revealed a 62% increase in treatment response (final CGI ≤2) for those using SGAs, compared to those receiving placebo [RR 1.62 (95% CI 1.44-1.81)]. The combined SMD for the SGAs was -0.43 (IC 95% -0.49 to -0.37). Second-generation antidepressants are efficacious treatment for patients with SAD. However, our results do not suggest differences of efficacy among different drugs.

  15. Prenatal Pregnancy Complications and Psychiatric Symptoms: Children with ASD versus Clinic Controls

    Science.gov (United States)

    Tudor, Megan E.; DeVincent, Carla J.; Gadow, Kenneth D.

    2012-01-01

    The current study examined the association between prenatal pregnancy complications (PPC) and childhood psychiatric symptoms in children with an autism spectrum disorder (ASD) and non-ASD children who were referred to a psychiatric clinic (Controls). Parents completed a "DSM-IV"-referenced rating scale and developmental history questionnaire.…

  16. The Kjeldahl method as a primary reference procedure for total protein in certified reference materials used in clinical chemistry. II. Selection of direct Kjeldahl analysis and its preliminary performance parameters.

    Science.gov (United States)

    Vinklárková, Bára; Chromý, Vratislav; Šprongl, Luděk; Bittová, Miroslava; Rikanová, Milena; Ohnútková, Ivana; Žaludová, Lenka

    2015-01-01

    To select a Kjeldahl procedure suitable for the determination of total protein in reference materials used in laboratory medicine, we reviewed in our previous article Kjeldahl methods adopted by clinical chemistry and found an indirect two-step analysis by total Kjeldahl nitrogen corrected for its nonprotein nitrogen and a direct analysis made on isolated protein precipitates. In this article, we compare both procedures on various reference materials. An indirect Kjeldahl method gave falsely lower results than a direct analysis. Preliminary performance parameters qualify the direct Kjeldahl analysis as a suitable primary reference procedure for the certification of total protein in reference laboratories.

  17. Some Preliminary Results on an SEIARD Epidemic Model with Vaccination and Antiviral Treatment Controls and Dead-Infective Culling Action

    Science.gov (United States)

    De la Sen, M.; Nistal, R.; Alonso-Quesada, S.; Garrido, A. J.

    2016-08-01

    This paper studies the non-negativity and stability properties of the solutions of a newly proposed SEIADR model which incorporates asymptomatic and dead-infective subpopulations to those defining the standard SEIR model and, in parallel, it incorporates feedback vaccination and antiviral treatment controls.

  18. Short-term effects of whole-body vibration on postural control in unilateral chronic stroke patients: preliminary evidence.

    NARCIS (Netherlands)

    Nes, I.J.W. van; Geurts, A.C.H.; Hendricks, H.T.; Duysens, J.E.J.

    2004-01-01

    The short-term effects of whole-body vibration as a novel method of somatosensory stimulation on postural control were investigated in 23 chronic stroke patients. While standing on a commercial platform, patients received 30-Hz oscillations at 3 mm of amplitude in the frontal plane. Balance was asse

  19. A preliminary identification of insect successive wave in Egypt on control and zinc phosphide-intoxicated animals in different seasons

    Directory of Open Access Journals (Sweden)

    Marah Mohammad Abd El-Bar

    2016-09-01

    Full Text Available The presented study aimed primarily to document a baseline data of the decay process of rabbits and guinea pigs and their associated arthropod fauna, which are placed in an urban city: El Abbassyia, Cairo Governorate, Egypt, during winter and summer seasons, and to compare these data with the corresponding figure for zinc phosphide-intoxicated carrions. Generally, control rabbits and control guinea pigs were faster in their decay comparing the corresponding figure of the zinc phosphide–intoxicated group. A delay in colonization of insects was noticed either in the winter season for both groups, or additionally for the zinc phosphide groups. The associated insect fauna was represented in 6 orders, 20 families, and 36 genera and species. Necrophagous arthropods that supported decomposition of carcasses were mainly of orders Diptera and Coleoptera. Calliphoridae was the first insect family that colonized the different carcasses. The mean numbers of control immature dipterous maggots and similarly, the control coleopteran larvae significantly exceeded the corresponding mean numbers for the zinc phosphide-intoxicated groups in both winter and summer seasons in either rabbits or guinea pig groups. Moreover, the mean numbers of dipterous maggots or coleopteran larvae of rabbits significantly surpassed the corresponding figures for guinea pigs in both seasons. This study may add as a reference for the succession wave arthropod fauna in Cairo Governorate in winter and summer seasons. Moreover, it is the first record of the arthropod successive wave on zinc phosphide–intoxicated remains.

  20. A Preliminary Controlled Comparison of Programs Designed to Reduce Risk of Eating Disorders Targeting Perfectionism and Media Literacy

    Science.gov (United States)

    Wilksch, Simon M.; Durbridge, Mitchell R.; Wade, Tracey D.

    2008-01-01

    The study aims to find out whether programs targeting perfectionism and media literacy are more effective than control classes in reducing eating disorder risk factors. Finding reveals that perfectionism programs are well suited to individuals of mid- to late adolescent age and shows the importune of making prevention programs developmentally…

  1. Translating Research on Myoelectric Control into Clinics-Are the Performance Assessment Methods Adequate?

    Science.gov (United States)

    Vujaklija, Ivan; Roche, Aidan D; Hasenoehrl, Timothy; Sturma, Agnes; Amsuess, Sebastian; Farina, Dario; Aszmann, Oskar C

    2017-01-01

    Missing an upper limb dramatically impairs daily-life activities. Efforts in overcoming the issues arising from this disability have been made in both academia and industry, although their clinical outcome is still limited. Translation of prosthetic research into clinics has been challenging because of the difficulties in meeting the necessary requirements of the market. In this perspective article, we suggest that one relevant factor determining the relatively small clinical impact of myocontrol algorithms for upper limb prostheses is the limit of commonly used laboratory performance metrics. The laboratory conditions, in which the majority of the solutions are being evaluated, fail to sufficiently replicate real-life challenges. We qualitatively support this argument with representative data from seven transradial amputees. Their ability to control a myoelectric prosthesis was tested by measuring the accuracy of offline EMG signal classification, as a typical laboratory performance metrics, as well as by clinical scores when performing standard tests of daily living. Despite all subjects reaching relatively high classification accuracy offline, their clinical scores varied greatly and were not strongly predicted by classification accuracy. We therefore support the suggestion to test myocontrol systems using clinical tests on amputees, fully fitted with sockets and prostheses highly resembling the systems they would use in daily living, as evaluation benchmark. Agreement on this level of testing for systems developed in research laboratories would facilitate clinically relevant progresses in this field.

  2. Neuromuscular control of trunk stability: clinical implications for sports injury prevention.

    Science.gov (United States)

    Zazulak, Bohdanna; Cholewicki, Jacek; Reeves, N Peter

    2008-09-01

    Recent prospective evidence supports the hypothesis that impaired trunk control is a contributing factor to sports injuries of the spine as well as to segments of the kinetic chain. The current concepts regarding neuromuscular control of trunk stability are best described from a systems engineering perspective. In the analysis of current neuromuscular training protocols for sports injury prevention, these principles are applied to identify components that optimize neuromuscular control of trunk stability. Current perspectives of neuromuscular learning can be applied clinically to aid in the formulation of injury prevention strategies.

  3. An artificial neural network estimation of gait balance control in the elderly using clinical evaluations.

    Science.gov (United States)

    Lugade, Vipul; Lin, Victor; Farley, Arthur; Chou, Li-Shan

    2014-01-01

    The use of motion analysis to assess balance is essential for determining the underlying mechanisms of falls during dynamic activities. Clinicians evaluate patients using clinical examinations of static balance control, gait performance, cognition, and neuromuscular ability. Mapping these data to measures of dynamic balance control, and the subsequent categorization and identification of community dwelling elderly fallers at risk of falls in a quick and inexpensive manner is needed. The purpose of this study was to demonstrate that given clinical measures, an artificial neural network (ANN) could determine dynamic balance control, as defined by the interaction of the center of mass (CoM) with the base of support (BoS), during gait. Fifty-six elderly adults were included in this study. Using a feed-forward neural network with back propagation, combinations of five functional domains, the number of hidden layers and error goals were evaluated to determine the best parameters to assess dynamic balance control. Functional domain input parameters included subject characteristics, clinical examinations, cognitive performance, muscle strength, and clinical balance performance. The use of these functional domains demonstrated the ability to quickly converge to a solution, with the network learning the mapping within 5 epochs, when using up to 30 hidden nodes and an error goal of 0.001. The ability to correctly identify the interaction of the CoM with BoS demonstrated correlation values up to 0.89 (Pbalance control. A neural network could provide physicians and patients with a cost effective means to identify dynamic balance issues and possible risk of falls from routinely collected clinical examinations.

  4. Medical Devices; Immunology and Microbiology Devices; Classification of the Assayed Quality Control Material for Clinical Microbiology Assays. Final order.

    Science.gov (United States)

    2017-07-27

    The Food and Drug Administration (FDA, Agency, or we) is classifying the assayed quality control material for clinical microbiology assays into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the assayed quality control material for clinical microbiology assays' classification. The Agency is classifying the device into class II (special controls) to provide a reasonable assurance of safety and effectiveness of the device.

  5. Brain-machine interface via real-time fMRI: preliminary study on thought-controlled robotic arm.

    Science.gov (United States)

    Lee, Jong-Hwan; Ryu, Jeongwon; Jolesz, Ferenc A; Cho, Zang-Hee; Yoo, Seung-Schik

    2009-01-23

    Real-time functional MRI (rtfMRI) has been used as a basis for brain-computer interface (BCI) due to its ability to characterize region-specific brain activity in real-time. As an extension of BCI, we present an rtfMRI-based brain-machine interface (BMI) whereby 2-dimensional movement of a robotic arm was controlled by the regulation (and concurrent detection) of regional cortical activations in the primary motor areas. To do so, the subjects were engaged in the right- and/or left-hand motor imagery tasks. The blood oxygenation level dependent (BOLD) signal originating from the corresponding hand motor areas was then translated into horizontal or vertical robotic arm movement. The movement was broadcasted visually back to the subject as a feedback. We demonstrated that real-time control of the robotic arm only through the subjects' thought processes was possible using the rtfMRI-based BMI trials.

  6. Acceptance and commitment therapy (ACT) for clinically distressed health care workers: Waitlist-controlled evaluation of an ACT workshop in a routine practice setting.

    Science.gov (United States)

    Waters, Cerith S; Frude, Neil; Flaxman, Paul E; Boyd, Jane

    2017-08-30

    To examine the effects of a 1-day acceptance and commitment therapy (ACT) workshop on the mental health of clinically distressed health care employees, and to explore ACT's processes of change in a routine practice setting. A quasi-controlled design, with participants block allocated to an ACT intervention or waiting list control group based on self-referral date. Participants were 35 health care workers who had self-referred for the ACT workshop via a clinical support service for staff. Measures were completed by ACT and control group participants at pre-intervention and 3 months post-intervention. Participants allocated to the waitlist condition went on to receive the ACT intervention and were also assessed 3 months later. At 3 months post-intervention, participants in the ACT group reported a significantly lower level of psychological distress compared to the control group (d = 1.41). Across the 3-month evaluation period, clinically significant change was exhibited by 50% of ACT participants, compared to 0% in the control group. When the control group received the same ACT intervention, 69% went on to exhibit clinically significant change. The ACT intervention also resulted in significant improvements in psychological flexibility, defusion, and mindfulness skills, but did not significantly reduce the frequency of negative cognitions. Bootstrapped mediation analyses indicated that the reduction in distress in the ACT condition was primarily associated with an increase in mindfulness skills, especially observing and non-reactivity. These findings provide preliminary support for providing brief ACT interventions as part of routine clinical support services for distressed workers. A 1-day ACT workshop delivered in the context of a routine staff support service was effective for reducing psychological distress among health care workers. The brief nature of this group intervention means it may be particularly suitable for staff support and primary care mental

  7. Covariate-adjusted borrowing of historical control data in randomized clinical trials.

    Science.gov (United States)

    Han, Baoguang; Zhan, Jia; John Zhong, Z; Liu, Dawei; Lindborg, Stacy

    2017-07-01

    The borrowing of historical control data can be an efficient way to improve the treatment effect estimate of the current control group in a randomized clinical trial. When the historical and current control data are consistent, the borrowing of historical data can increase power and reduce Type I error rate. However, when these 2 sources of data are inconsistent, it may result in a combination of biased estimates, reduced power, and inflation of Type I error rate. In some situations, inconsistency between historical and current control data may be caused by a systematic variation in the measured baseline prognostic factors, which can be appropriately addressed through statistical modeling. In this paper, we propose a Bayesian hierarchical model that can incorporate patient-level baseline covariates to enhance the appropriateness of the exchangeability assumption between current and historical control data. The performance of the proposed method is shown through simulation studies, and its application to a clinical trial design for amyotrophic lateral sclerosis is described. The proposed method is developed for scenarios involving multiple imbalanced prognostic factors and thus has meaningful implications for clinical trials evaluating new treatments for heterogeneous diseases such as amyotrophic lateral sclerosis. Copyright © 2017 John Wiley & Sons, Ltd.

  8. Acupuncture Improves Intestinal Absorption of Iron in Iron-deficient Obese Patients: A Randomized Controlled Preliminary Trial

    Science.gov (United States)

    Xie, Xin-Cai; Cao, Yan-Qiang; Gao, Qian; Wang, Chen; Li, Man; Wei, Shou-Gang

    2017-01-01

    Background: Obesity has an adverse effect on iron status. Hepcidin-mediated inhibition of iron absorption in the duodenum is a potential mechanism. Iron-deficient obese patients have diminished response to oral iron therapy. This study was designed to assess whether acupuncture could promote the efficacy of oral iron supplementation for the treatment of obesity-related iron deficiency (ID). Methods: Sixty ID or ID anemia (IDA) patients with obesity were screened at Beijing Hospital of Traditional Chinese Medicine and were randomly allocated to receive either oral iron replacement allied with acupuncture weight loss treatment (acupuncture group, n = 30) or oral iron combined with sham-acupuncture treatment (control group, n = 30). Anthropometric parameters were measured and blood samples were tested pre- and post-treatment. Differences in the treatment outcomes of ID/IDA were compared between the two groups. Results: After 8 weeks of acupuncture treatment, there was a significant decrease in body weight, body mass index, waist circumference, and waist/hip circumference ratio of patients in the acupuncture group, while no significant changes were observed in the control group. Oral iron supplementation brought more obvious improvements of iron status indicators including absolute increases in serum iron (11.08 ± 2.19 μmol/L vs. 4.43 ± 0.47 μmol/L), transferrin saturation (11.26 ± 1.65% vs. 1.01 ± 0.23%), and hemoglobin (31.47 ± 1.19 g/L vs. 21.00 ± 2.69 g/L) in the acupuncture group than control group (all P acupuncture group than those in the control group. Conclusion: Acupuncture-based weight loss can enhance the therapeutic effects of iron replacement therapy for obesity-related ID/IDA through improving intestinal iron absorption, probably by downregulating the systemic leptin-hepcidin levels. PMID:28229980

  9. Preliminary efficacy and feasibility of embedding high intensity interval training into the school day: A pilot randomized controlled trial

    OpenAIRE

    Costigan, S.A.; Eather, N.; Plotnikoff, R.C.; Taaffe, D R; E. Pollock; S.G. Kennedy; Lubans, D. R.

    2015-01-01

    Current physical activity and fitness levels among adolescents are low, increasing the risk of chronic disease. Although the efficacy of high intensity interval training (HIIT) for improving metabolic health is now well established, it is not known if this type of activity can be effective to improve adolescent health. The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day. A 3-arm pilot randomized controlled trial was conducted in o...

  10. Preliminary Clinical Study of Real-time Three-dimensional Echocardiographic Volume-time Curve in Evaluating Left Ventricular Diastolic Function

    Institute of Scientific and Technical Information of China (English)

    FEI Hongwen; HE Yale; HOU Yueshuang; XU Yan; HUANG Xinsheng; FENG Bixia

    2007-01-01

    The volume-time curve change in patients with normal left ventricular (LV) diastolic function and diastolic dysfunction was evaluated by real-time three-dimensional echocardiography (RT3DE). LV diastolic dysfunction was defined by E'<A' in pulse-wave tissue Doppler for inter-ventricular septal (IVS) of mitral annulus. In 24 patients with LV diastolic dysfunction, including 12 patients with delayed relaxation (delayed relaxation group) and 12 patients with pseudo-normal function (pseudo-normal group) and 24 normal volunteers (control group), data of full-volume image were acquired by real-time three-dimensional echocardiography and subjected to volume-time curve analysis. EDV (end-diastolic volume), ESV (end-systolic volume), LVEF (left ventricular ejection fraction), PER (peak ejection rate), PFR (peak filling rate) from RT3DE were examined in the three groups. Compared to the control group, PFR (diastolic filling index of RT3DE) was significantly reduced in the delayed relaxation group and pseudo-normal group (P<0.05). There were no significant differences in EDV, ESV, LVEF, PER (P>0.05). It is concluded that PFR, as a diastolic filling index of RT3DE, can reflect the early diastolic function and serve as a new non-invasive, quick and accurate tool for clinical assessment of LV diastolic function.

  11. A preliminary controlled comparison of programs designed to reduce risk of eating disorders targeting perfectionism and media literacy.

    Science.gov (United States)

    Wilksch, Simon M; Durbridge, Mitchell R; Wade, Tracey D

    2008-08-01

    The primary objective was to compare the efficacy of two eight-lesson programs, targeting perfectionism and media literacy compared to control classes in reducing eating disorder risk. Students from six classes (N = 127, mean age 15.0 years, SD 0.4) and two schools participated. Linear mixed-model analyses were conducted by group (3: perfectionism, media literacy, control), time (2: postprogram, 3-month follow-up) and eating disorder risk status (2: high, low), with baseline observations included as a covariate. An interaction effect favoring the perfectionism program at 3-month follow-up was found for concern over mistakes (effect size 0.45). A main effect for group, also favoring the perfectionism program, was found for personal standards (effect size 0.44). High-risk participants (i.e., those with high levels of shape and weight concern at baseline) benefited most from the perfectionism program with reliable change indices indicating favorable rates of improvement beyond chance on all of the variables, whereas the media literacy and control participants experienced a comparable rate of change during the course of the study. Targeting perfectionism represents a promising prevention option that requires further investigation in children of mid-adolescence age, and further investigation is required to determine the demographic most likely to benefit from media literacy.

  12. Control System Design Implementation and Preliminary Demonstration for a Tendon-Actuated Lightweight In-Space MANipulator (TALISMAN)

    Science.gov (United States)

    Komendera, Erik E.; Doggett, William R.; Dorsey, John T.; Debus, Thomas J.; Holub, Kris; Dougherty, Sean P.

    2015-01-01

    Satellite servicing is a high priority task for NASA and the space industry, addressing the needs of a variety of missions, and potentially lowering the overall cost of missions through refurbishment and reuse. However, the ability to service satellites is severely limited by the lack of long reach manipulation capability and inability to launch new devices due the end of the Space Transport System, or Space Shuttle Program. This paper describes the design and implementation of a control system for a Tendon-Actuated Lightweight In-Space MANipulator (TALISMAN), including; defining the forward and inverse kinematics, endpoint velocity to motor velocity, required cable tensions, and a proportional-integral-derivative (PID) controller. The tensions and velocities necessary to maneuver and capture small and large payloads are also discussed. To demonstrate the utility of the TALISMAN for satellite servicing, this paper also describes a satellite servicing demonstration using two TALISMAN prototypes to grasp and inspect a satellite mockup. Potential avenues for improving the control system are discussed.

  13. Role of technology in supporting quality control and treatment fidelity in a family caregiver clinical trial.

    Science.gov (United States)

    Farran, Carol J; Etkin, Caryn D; McCann, Judith J; Paun, Olimpia; Eisenstein, Amy R; Wilbur, Joellen

    2011-11-01

    This article describes how a family caregiver lifestyle physical activity clinical trial uses research technology to enhance quality control and treatment fidelity. This trial uses a range of Internet, Blaise(®) Windows-based software and Echo Server technologies to support quality control issues, such as data collection, data entry, and study management advocated by the clinical trials literature, and to ensure treatment fidelity concerning intervention implementation (i.e., design, training, delivery, receipt, and enactment) as proposed by the National Institutes of Health Behavior Change Consortium. All research staff are trained to use these technologies. Strengths of this technological approach to support quality control and treatment fidelity include the comprehensive plan, involvement of all staff, and ability to maintain accurate and timely data. Limitations include the upfront time and costs for developing and testing these technological methods, and having support staff readily available to address technological issues if they occur.

  14. Effectiveness of Treadmill Training on Balance Control in Elderly People: A Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Soraya Pirouzi

    2014-11-01

    Full Text Available Physical exercise would improve postural stability, which is an essential factor in preventing accidental fall among the elderly population. The aim of this study is to examine the effectiveness of treadmill walking on balance improvement among the elderly people. A total of 30 community dwelling older adults with a Berg Balance Scale score of 36-48 and the ability to walk without aid were considered and divided into control (n=15 and experimental (n=15 groups. Individuals in the experimental group participated in 30 minutes of forward and backward treadmill training based on three times a week interval for a period of four weeks. Individuals in the control group were instructed to continue with their daily routine activity. Before and after training, gait speed was measured by six-minute walk test and balance ability was evaluated by Fullerton Advanced Balance Scale (FABS and Berg Balance Scale (BBS tests. Postural sway items such as the Center of Pressure (COP, average displacement and velocity were evaluated by using a force platform system. Data were collected in quiet standing, tandem position and standing on foam pads before and after intervention. After intervention, balance variables in the experimental group indicated a significant improvement in quiet standing on firm and foam surfaces, but no considerable improvement was shown in tandem position. A between-group comparison showed a significant reduction in COP velocity in the sagittal plane (P=0.030 during quiet standing and in the frontal plane (P=0.001 during standing on foam, whereas no significant reduction in COP parameters during tandem position was found. It is recommended that twelve sessions of forward and backward treadmill walk are effective in balance improvement in elderly people. Trial Registration Number: IRCT201209199440N2

  15. Effectiveness of treadmill training on balance control in elderly people: a randomized controlled clinical trial.

    Science.gov (United States)

    Pirouzi, Soraya; Motealleh, Ali Reza; Fallahzadeh, Fatemeh; Fallahzadeh, Mohammad Amin

    2014-11-01

    Physical exercise would improve postural stability, which is an essential factor in preventing accidental fall among the elderly population. The aim of this study is to examine the effectiveness of treadmill walking on balance improvement among the elderly people. A total of 30 community dwelling older adults with a Berg Balance Scale score of 36-48 and the ability to walk without aid were considered and divided into control (n=15) and experimental (n=15) groups. Individuals in the experimental group participated in 30 minutes of forward and backward treadmill training based on three times a week interval for a period of four weeks. Individuals in the control group were instructed to continue with their daily routine activity. Before and after training, gait speed was measured by six-minute walk test and balance ability was evaluated by Fullerton Advanced Balance Scale (FABS) and Berg Balance Scale (BBS) tests. Postural sway items such as the Center of Pressure (COP), average displacement and velocity were evaluated by using a force platform system. Data were collected in quiet standing, tandem position and standing on foam pads before and after intervention. After intervention, balance variables in the experimental group indicated a significant improvement in quiet standing on firm and foam surfaces, but no considerable improvement was shown in tandem position. A between-group comparison showed a significant reduction in COP velocity in the sagittal plane (P=0.030) during quiet standing and in the frontal plane (P=0.001) during standing on foam, whereas no significant reduction in COP parameters during tandem position was found. It is recommended that twelve sessions of forward and backward treadmill walk are effective in balance improvement in elderly people. IRCT201209199440N2.

  16. Informed conditioning on clinical covariates increases power in case-control association studies.

    Science.gov (United States)

    Zaitlen, Noah; Lindström, Sara; Pasaniuc, Bogdan; Cornelis, Marilyn; Genovese, Giulio; Pollack, Samuela; Barton, Anne; Bickeböller, Heike; Bowden, Donald W; Eyre, Steve; Freedman, Barry I; Friedman, David J; Field, John K; Groop, Leif; Haugen, Aage; Heinrich, Joachim; Henderson, Brian E; Hicks, Pamela J; Hocking, Lynne J; Kolonel, Laurence N; Landi, Maria Teresa; Langefeld, Carl D; Le Marchand, Loic; Meister, Michael; Morgan, Ann W; Raji, Olaide Y; Risch, Angela; Rosenberger, Albert; Scherf, David; Steer, Sophia; Walshaw, Martin; Waters, Kevin M; Wilson, Anthony G; Wordsworth, Paul; Zienolddiny, Shanbeh; Tchetgen, Eric Tchetgen; Haiman, Christopher; Hunter, David J; Plenge, Robert M; Worthington, Jane; Christiani, David C; Schaumberg, Debra A; Chasman, Daniel I; Altshuler, David; Voight, Benjamin; Kraft, Peter; Patterson, Nick; Price, Alkes L

    2012-01-01

    Genetic case-control association studies often include data on clinical covariates, such as body mass index (BMI), smoking status, or age, that may modify the underlying genetic risk of case or control samples. For example, in type 2 diabetes, odds ratios for established variants estimated from low-BMI cases are larger than those estimated from high-BMI cases. An unanswered question is how to use this information to maximize statistical power in case-control studies that ascertain individuals on the basis of phenotype (case-control ascertainment) or phenotype and clinical covariates (case-control-covariate ascertainment). While current approaches improve power in studies with random ascertainment, they often lose power under case-control ascertainment and fail to capture available power increases under case-control-covariate ascertainment. We show that an informed conditioning approach, based on the liability threshold model with parameters informed by external epidemiological information, fully accounts for disease prevalence and non-random ascertainment of phenotype as well as covariates and provides a substantial increase in power while maintaining a properly controlled false-positive rate. Our method outperforms standard case-control association tests with or without covariates, tests of gene x covariate interaction, and previously proposed tests for dealing with covariates in ascertained data, with especially large improvements in the case of case-control-covariate ascertainment. We investigate empirical case-control studies of type 2 diabetes, prostate cancer, lung cancer, breast cancer, rheumatoid arthritis, age-related macular degeneration, and end-stage kidney disease over a total of 89,726 samples. In these datasets, informed conditioning outperforms logistic regression for 115 of the 157 known associated variants investigated (P-value = 1 × 10(-9)). The improvement varied across diseases with a 16% median increase in χ(2) test statistics and a

  17. Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial.

    Science.gov (United States)

    Mummaneni, Praveen V; Burkus, J Kenneth; Haid, Regis W; Traynelis, Vincent C; Zdeblick, Thomas A

    2007-03-01

    The authors report the results of a prospective randomized multicenter study in which the results of cervical disc arthroplasty were compared with anterior cervical discectomy and fusion (ACDF) in patients treated for symptomatic single-level cervical degenerative disc disease (DDD). Five hundred forty-one patients with single-level cervical DDD and radiculopathy were enrolled at 32 sites and randomly assigned to one of two treatment groups: 276 patients in the investigational group underwent anterior cervical discectomy and decompression and arthroplasty with the PRESTIGE ST Cervical Disc System (Medtronic Sofamor Danek); 265 patients in the control group underwent decompressive ACDF. Eighty percent of the arthroplasty-treated patients (223 of 276) and 75% of the control patients (198 of 265) completed clinical and radiographic follow-up examinations at routine intervals for 2 years after surgery. Analysis of all currently available postoperative 12- and 24-month data indicated a two-point greater improvement in the neck disability index score in the investigational group than the control group. The arthroplasty group also had a statistically significant higher rate of neurological success (p = 0.005) as well as a lower rate of secondary revision surgeries (p = 0.0277) and supplemental fixation (p = 0.0031). The mean improvement in the 36-Item Short Form Health Survey Physical Component Summary scores was greater in the investigational group at 12 and 24 months, as was relief of neck pain. The patients in the investigational group returned to work 16 days sooner than those in the control group, and the rate of adjacent-segment reoperation was significantly lower in the investigational group as well (p = 0.0492, log-rank test). The cervical disc implant maintained segmental sagittal angular motion averaging more than 7 degrees. In the investigational group, there were no cases of implant failure or migration. The PRESTIGE ST Cervical Disc System maintained

  18. A single-session preliminary evaluation of an affordable BCI-controlled arm exoskeleton and motor-proprioception platform

    Directory of Open Access Journals (Sweden)

    Ahmed Mohamed Elnady

    2015-03-01

    Full Text Available Traditional, hospital-based stroke rehabilitation can be labour-intensive and expensive. Furthermore, outcomes from rehabilitation are inconsistent across individuals and recovery is hard to predict. Given these uncertainties, numerous technological approaches have been tested in an effort to improve rehabilitation outcomes and reduce the cost of stroke rehabilitation. These techniques include brain-computer interface (BCI, robotic exoskeletons, functional electrical stimulation (FES, and proprioceptive feedback. However, to the best of our knowledge, no studies have combined all these approaches into a rehabilitation platform that facilitates goal-directed motor movements. Therefore, in this paper, we combined all these technologies to test the feasibility of using a BCI-driven exoskeleton with FES (robotic training device to facilitate motor task completion among individuals with stroke. The robotic training device operated to assist a predefined goal-directed motor task. Because it is hard to predict who can utilize this type of technology, we considered whether the ability to adapt skilled movements with proprioceptive feedback would predict who could learn to control a BCI driven robotic device. To accomplish this aim, we developed a motor task that requires proprioception for completion to assess motor-proprioception ability. Next, we tested the feasibility of robotic training system in individuals with chronic stroke (n = 9 and found that the training device was well tolerated by all the participants. Ability on the motor-proprioception task did not predict the time to completion of the BCI driven task. Both participants who could accurately target (n = 6 and those who could not (n = 3, were able to learn to control the BCI device, with each BCI trial lasting on average 2.47 minutes. Our results showed that the participants’ ability to use proprioception to control motor output did not affect their ability to use the BCI

  19. Preliminary efficacy and feasibility of embedding high intensity interval training into the school day: A pilot randomized controlled trial

    Science.gov (United States)

    Costigan, S.A.; Eather, N.; Plotnikoff, R.C.; Taaffe, D.R.; Pollock, E.; Kennedy, S.G.; Lubans, D.R.

    2015-01-01

    Current physical activity and fitness levels among adolescents are low, increasing the risk of chronic disease. Although the efficacy of high intensity interval training (HIIT) for improving metabolic health is now well established, it is not known if this type of activity can be effective to improve adolescent health. The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day. A 3-arm pilot randomized controlled trial was conducted in one secondary school in Newcastle, Australia. Participants (n = 65; mean age = 15.8(0.6) years) were randomized into one of three conditions: aerobic exercise program (AEP) (n = 21), resistance and aerobic exercise program (RAP) (n = 22) and control (n = 22). The 8-week intervention consisted of three HIIT sessions per week (8–10 min/session), delivered during physical education (PE) lessons or at lunchtime. Assessments were conducted at baseline and post-intervention to detect changes in cardiorespiratory fitness (multi-stage shuttle-run), muscular fitness (push-up, standing long jump tests), body composition (Body Mass Index (BMI), BMI-z scores, waist circumference) and physical activity motivation (questionnaire), by researchers blinded to treatment allocation. Intervention effects for outcomes were examined using linear mixed models, and Cohen's d effect sizes were reported. Participants in the AEP and RAP groups had moderate intervention effects for waist circumference (p = 0.024), BMI-z (p = 0.037) and BMI (not significant) in comparison to the control group. A small intervention effect was also evident for cardiorespiratory fitness in the RAP group. PMID:26844177

  20. Preliminary evaluation of Community-Led Total Sanitation for the control of Taenia solium cysticercosis in Katete District of Zambia.

    Science.gov (United States)

    Bulaya, Carol; Mwape, Kabemba E; Michelo, Charles; Sikasunge, Chummy S; Makungu, Chitwambi; Gabriel, Sarah; Dorny, Pierre; Phiri, Isaac K

    2015-01-30

    Taenia solium taeniasis/cysticercosis is a zoonotic disease endemic in sub-Saharan Africa. It is associated with poor sanitary practices, free-range pig husbandry and lack of disease awareness in endemic communities. A comparative research was conducted with pre and post-intervention assessments in nine villages to evaluate Community-Led Total Sanitation (CLTS) as an intervention measure for the control of porcine cysticercosis in Katete District in the Eastern Province of Zambia. Blood samples were collected from pigs for circulating antigen detection and a questionnaire focused on the household was administered to a total of 153 respondents whose pigs were examined (64 pre-intervention, 89 post-intervention), in order to obtain information on general demographic characteristics, pig husbandry practices, sanitation practices and associated knowledge and awareness of T. solium infections. The first sampling was conducted prior to the implementation of the CLTS and second sampling eight months after triggering of CLTS in the selected villages. A total of 379 pig serum samples were examined using the B158/B60 Ag-ELISA to detect T. solium cysticercosis, 104 pre-intervention and 275 post-intervention, of which 14 (13.5%) and 45 (16.4%) were positive, respectively. Wald test p-values were computed to assess significant differences in the variables of interest mentioned above for the pre and post CLTS. The research revealed that CLTS as a control measure did not significantly improve T. solium infections in pigs. The research also revealed that the sanitation practices and awareness of cysticercosis did not change. It is recommended that a longer term evaluation be undertaken when the villages have been declared open defaecation free. In addition, the research recommends that health education, mass drug treatment and pig vaccination be incorporated, as an essential component of prevention and control programmes for T. solium infections.

  1. Preliminary Comparison of Pneumatic Models of Tourniquet for Prehospital Control of Limb Bleeding in a Manikin Model.

    Science.gov (United States)

    Gibson, Rudy; Aden, James K; Dubick, Michael A; Kragh, John F

    2016-01-01

    Emergency tourniquet use has been associated with hemorrhage control and improved survival during the wars since 2001, but little is known of the differential performance of pneumatic tourniquet models. The purpose of this study was to compare the performance of three models of pneumatic tourniquets in a laboratory setting to aid a possible decision to field test suitable models for medic preference. A laboratory experiment was designed to test the effectiveness of tourniquets on a manikin thigh. Three models (one Emergency and Military Tourniquet [EMT] and two Tactical Pneumatic Tourniquets differing in width: 2 in. and 3 in. [TPT3]) were compared with the standard-issue Combat Application Tourniquet of a strap-and-windlass design. Two users conducted 40 tests each on a right-thigh manikin (HapMed Leg Tourniquet Trainer) with a simulated above-knee amputation injury. Measurements included effectiveness in hemorrhage control, pulse stoppage distal to the tourniquet, time to stop bleeding, blood loss, and pressure. All four models were 100% effective in both hemorrhage control and pulse stoppage distal to the tourniquet. The TPT3 had the slowest mean time to stop bleeding and the highest mean blood loss. The EMT had the least mean pressure. An interuser difference was found only for mean pressure. All models of tourniquet performed equally well for both the critical outcome of effectiveness and the important outcome of pulse stoppage, whereas results for secondary outcomes (time, pressure, and blood loss) differed by model. The EMT had best performance for every type of measurement. 2016.

  2. Preliminary efficacy and feasibility of embedding high intensity interval training into the school day: A pilot randomized controlled trial

    Directory of Open Access Journals (Sweden)

    S.A. Costigan

    2015-01-01

    Full Text Available Current physical activity and fitness levels among adolescents are low, increasing the risk of chronic disease. Although the efficacy of high intensity interval training (HIIT for improving metabolic health is now well established, it is not known if this type of activity can be effective to improve adolescent health. The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day. A 3-arm pilot randomized controlled trial was conducted in one secondary school in Newcastle, Australia. Participants (n = 65; mean age = 15.8(0.6 years were randomized into one of three conditions: aerobic exercise program (AEP (n = 21, resistance and aerobic exercise program (RAP (n = 22 and control (n = 22. The 8-week intervention consisted of three HIIT sessions per week (8–10 min/session, delivered during physical education (PE lessons or at lunchtime. Assessments were conducted at baseline and post-intervention to detect changes in cardiorespiratory fitness (multi-stage shuttle-run, muscular fitness (push-up, standing long jump tests, body composition (Body Mass Index (BMI, BMI-z scores, waist circumference and physical activity motivation (questionnaire, by researchers blinded to treatment allocation. Intervention effects for outcomes were examined using linear mixed models, and Cohen's d effect sizes were reported. Participants in the AEP and RAP groups had moderate intervention effects for waist circumference (p = 0.024, BMI-z (p = 0.037 and BMI (not significant in comparison to the control group. A small intervention effect was also evident for cardiorespiratory fitness in the RAP group.

  3. Preliminary efficacy and feasibility of embedding high intensity interval training into the school day: A pilot randomized controlled trial.

    Science.gov (United States)

    Costigan, S A; Eather, N; Plotnikoff, R C; Taaffe, D R; Pollock, E; Kennedy, S G; Lubans, D R

    2015-01-01

    Current physical activity and fitness levels among adolescents are low, increasing the risk of chronic disease. Although the efficacy of high intensity interval training (HIIT) for improving metabolic health is now well established, it is not known if this type of activity can be effective to improve adolescent health. The primary aim of this study is to assess the effectiveness and feasibility of embedding HIIT into the school day. A 3-arm pilot randomized controlled trial was conducted in one secondary school in Newcastle, Australia. Participants (n = 65; mean age = 15.8(0.6) years) were randomized into one of three conditions: aerobic exercise program (AEP) (n = 21), resistance and aerobic exercise program (RAP) (n = 22) and control (n = 22). The 8-week intervention consisted of three HIIT sessions per week (8-10 min/session), delivered during physical education (PE) lessons or at lunchtime. Assessments were conducted at baseline and post-intervention to detect changes in cardiorespiratory fitness (multi-stage shuttle-run), muscular fitness (push-up, standing long jump tests), body composition (Body Mass Index (BMI), BMI-z scores, waist circumference) and physical activity motivation (questionnaire), by researchers blinded to treatment allocation. Intervention effects for outcomes were examined using linear mixed models, and Cohen's d effect sizes were reported. Participants in the AEP and RAP groups had moderate intervention effects for waist circumference (p = 0.024), BMI-z (p = 0.037) and BMI (not significant) in comparison to the control group. A small intervention effect was also evident for cardiorespiratory fitness in the RAP group.

  4. High-dose intravenous immunoglobulin in inflammatory myopathies: experience based on controlled clinical trials.

    Science.gov (United States)

    Dalakas, M C

    2003-10-01

    Controlled clinical trials with high-dose intravenous immunoglobulin (IVIg) have been conducted in patients with DM and IBM, but not PM. A double-blind placebo-controlled study in DM patients, resistant or partially responsive to conventional therapies, showed that IVIg is very effective in improving both the muscle strength and the skin rash. The clinical benefit, which was impressive in patients with early disease, was associated with improvement in the muscle cytoarchitecture. Quantitative histological studies in repeated muscle biopsies showed a statistically significant increased in the size of muscle fibers and the number of capillaries with normalization of the capillary diameter. Resolution of the aberrant immunopathological parameters including interception of complement activation products and downregulation of T cells, ICAM-I, VCAM, TGF-beta and MHC-I molecules was also noted. In IBM, IVIg showed marginal, and non statistically significant, improvements in muscle strength. Up to 20% of patients however, demonstrated clinical improvement with increased activities of daily living while certain muscle groups, such as the muscles of swallowing, showed significant improvements compared to placebo implying mild regional benefits. In PM, small uncontrolled series have shown improvements in muscle strength in up to 70% of the IVIg-treated patients. Because PM, as a stand-alone clinical entity, is a very rare disease, completion of controlled trials will be very difficult.

  5. Projected effects of proposed chloride-control projects on shallow ground water; preliminary results for the Wichita River basin, Texas

    Science.gov (United States)

    Garza, Sergio

    1983-01-01

    The U.S. Army Corps of Engineers' plan to control the natural chloride pollution in the Wichita River basin includes the construction of Truscott Brine Lake on a tributary of the North Wichita River. In connection with the proposed brine lake, the U.S. Geological Survey was requested to: (1) Define the existing ground-water conditions in the shallow fresh-water system of the project area; and (2) project the post-construction effects of the proposed lake on the fresh-water aquifer, especially in relation to hydraulic-head changes but also with respect to possible changes in the chemical quality of the ground water.

  6. Synthesis of feedback control law for stabilization of chaotic system oscillations by means of analytic programming - Preliminary study

    Science.gov (United States)

    Senkerik, Roman; Oplatkova, Zuzana; Zelinka, Ivan; Davendra, Donald; Jasek, Roman

    2012-11-01

    This research deals with a synthesis of control law for selected discrete chaotic system - logistic equation by means of analytic programming. The novelty of the approach is that a tool for symbolic regression - analytic programming - is used for the purpose of stabilization of higher periodic orbits - oscillations between several values of chaotic system. The paper consists of the descriptions of analytic programming as well as used chaotic system and detailed proposal of cost function used in optimization process. For experimentation, Self-Organizing Migrating Algorithm (SOMA) with analytic programming and Differential evolution (DE) as second algorithm for meta-evolution were used.

  7. The preliminary design of bearings for the control system of a high-temperature lithium-cooled nuclear reactor

    Science.gov (United States)

    Yacobucci, H. G.; Waldron, W. D.; Walowit, J. A.

    1973-01-01

    The design of bearings for the control system of a fast reactor concept is presented. The bearings are required to operate at temperatures up to 2200 F in one of two fluids, lithium or argon. Basic bearing types are the same regardless of the fluid. Crowned cylindrical journals were selected for radially loaded bearings and modified spherical bearings were selected for bearings under combined thrust and radial loads. Graphite and aluminum oxide are the materials selected for the argon atmosphere bearings while cermet compositions (carbides or nitrides bonded with refractory metals) were selected for the lithium lubricated bearings. Mounting of components is by shrink fit or by axial clamping utilizing differential thermal expansion.

  8. Association between Zika virus infection and microcephaly in Brazil, January to May, 2016: preliminary report of a case-control study.

    Science.gov (United States)

    de Araújo, Thalia Velho Barreto; Rodrigues, Laura Cunha; de Alencar Ximenes, Ricardo Arraes; de Barros Miranda-Filho, Demócrito; Montarroyos, Ulisses Ramos; de Melo, Ana Paula Lopes; Valongueiro, Sandra; de Albuquerque, Maria de Fátima Pessoa Militão; Souza, Wayner Vieira; Braga, Cynthia; Filho, Sinval Pinto Brandão; Cordeiro, Marli Tenório; Vazquez, Enrique; Di Cavalcanti Souza Cruz, Danielle; Henriques, Cláudio Maierovitch Pessanha; Bezerra, Luciana Caroline Albuquerque; da Silva Castanha, Priscila Mayrelle; Dhalia, Rafael; Marques-Júnior, Ernesto Torres Azevedo; Martelli, Celina Maria Turchi

    2016-12-01

    The microcephaly epidemic, which started in Brazil in 2015, was declared a Public Health Emergency of International Concern by WHO in 2016. We report the preliminary results of a case-control study investigating the association between microcephaly and Zika virus infection during pregnancy. We did this case-control study in eight public hospitals in Recife, Brazil. Cases were neonates with microcephaly. Two controls (neonates without microcephaly), matched by expected date of delivery and area of residence, were selected for each case. Serum samples of cases and controls and cerebrospinal fluid samples of cases were tested for Zika virus-specific IgM and by quantitative RT-PCR. Laboratory-confirmed Zika virus infection during pregnancy was defined as detection of Zika virus-specific IgM or a positive RT-PCR result in neonates. Maternal serum samples were tested by plaque reduction neutralisation assay for Zika virus and dengue virus. We estimated crude odds ratios (ORs) and 95% CIs using a median unbiased estimator for binary data in an unconditional logistic regression model. We estimated ORs separately for cases with and without radiological evidence of brain abnormalities. Between Jan 15, 2016, and May 2, 2016, we prospectively recruited 32 cases and 62 controls. 24 (80%) of 30 mothers of cases had Zika virus infection compared with 39 (64%) of 61 mothers of controls (p=0·12). 13 (41%) of 32 cases and none of 62 controls had laboratory-confirmed Zika virus infection; crude overall OR 55·5 (95% CI 8·6-∞); OR 113·3 (95% CI 14·5-∞) for seven cases with brain abnormalities; and OR 24·7 (95% CI 2·9-∞) for four cases without brain abnormalities. Our data suggest that the microcephaly epidemic is a result of congenital Zika virus infection. We await further data from this ongoing study to assess other potential risk factors and to confirm the strength of association in a larger sample size. Brazilian Ministry of Health, Pan American Health Organization

  9. Whole Body Vibration Exercise Protocol versus a Standard Exercise Protocol after ACL Reconstruction: A Clinical Randomized Controlled Trial with Short Term Follow-Up

    Directory of Open Access Journals (Sweden)

    Gereon Berschin

    2014-09-01

    Full Text Available The suitability and effectiveness of whole body vibration (WBV exercise in rehabilitation after injury of the anterior cruciate ligament (ACL was studied using a specially designed WBV protocol. We wanted to test the hypothesis if WBV leads to superior short term results regarding neuromuscular performance (strength and coordination and would be less time consuming than a current standard muscle strengthening protocol. In this prospective randomized controlled clinical trial, forty patients who tore their ACL and underwent subsequent ligament reconstruction were enrolled. Patients were randomized to the whole body vibration (n=20 or standard rehabilitation exercise protocol (n=20. Both protocols started in the 2nd week after surgery. Isometric and isokinetic strength measurements, clinical assessment, Lysholm score, neuromuscular performance were conducted weeks 2, 5, 8 and 11 after surgery. Time spent for rehabilitation exercise was reduced to less than a half in the WBV group. There were no statistically significant differences in terms of clinical assessment, Lysholm score, isokinetic and isometric strength. The WBV group displayed significant better results in the stability test. In conclusion, preliminary data indicate that our whole body vibration muscle exercise protocol seems to be a good alternative to a standard exercise program in ACL-rehabilitation. Despite of its significant reduced time requirement it is at least equally effective compared to a standard rehabilitation protocol.

  10. Preliminary antiplaque efficacy of aloe vera mouthwash on 4 day plaque re-growth model: randomized control trial.

    Science.gov (United States)

    Gupta, Rajendra Kumar; Gupta, Devanand; Bhaskar, Dara John; Yadav, Ankit; Obaid, Khursheed; Mishra, Sumit

    2014-04-01

    Due to increasing resistance to antibiotics and rising incidence of oral diseases, there is a need for alternative treatment modalities to combat oral diseases. The aim of the present study was to access the effect of Aloe vera mouthwash on the dental plaque in the experimental period of 4 days and to compare it with the bench mark control chlorhexidine and placebo (saline water). A total of 300 systemically healthy subjects were randomly allocated into 3 groups: Aloe vera mouthwash group (n=100), control group (=100)-chlorhexidene group and saline water-Placebo (n=100). To begin with, Gingival index (GI) and plaque index (PI) were recorded. Then, baseline plaque scores were brought to zero by professionally cleaning the teeth with scaling and polishing. After randomization of the participants into three groups they were refrained from regular mechanical oral hygiene measures. Subjects were asked to swish with respective mouthwash (Aloe vera mouthwash, 0.2%chlorhexidine gluconate mouthwash, or normal saline