WorldWideScience

Sample records for qb3 adds zcube

  1. Theoretical Calculation of Jet Fuel Thermochemistry. 1; Tetrahydrodicylopentadiene (JP10) Thermochemistry Using the CBS-QB3 and G3(MP2)//B3LYP Methods

    Science.gov (United States)

    Zehe, Michael J.; Jaffe, Richard L.

    2010-01-01

    High-level ab initio calculations have been performed on the exo and endo isomers of gas-phase tetrahydrodicyclopentadiene (THDCPD), a principal component of the jet fuel JP10, using the Gaussian Gx and Gx(MPx) composite methods, as well as the CBS-QB3 method, and using a variety of isodesmic and homodesmotic reaction schemes. The impetus for this work is to help resolve large discrepancies existing between literature measurements of the formation enthalpy Delta (sub f)H deg (298) for exo-THDCPD. We find that use of the isodesmic bond separation reaction C10H16 + 14CH4 yields 12C2H6 yields results for the exo isomer (JP10) in between the two experimentally accepted values, for the composite methods G3(MP2), G3(MP2)//B3LYP, and CBS-QB3. Application of this same isodesmic bond separation scheme to gas-phase adamantane yields a value for Delta (sub f)H deg (298) within 5 kJ/mol of experiment. Isodesmic bond separation calculations for the endo isomer give a heat of formation in excellent agreement with the experimental measurement. Combining our calculated values for the gas-phase heat of formation with recent measurements of the heat of vaporization yields recommended values for Delta (sub f)H deg (298)liq of -126.4 and -114.7 kJ/mol for the exo and endo isomers, respectively.

  2. Add Value

    DEFF Research Database (Denmark)

    Kobbelgaard, Cecilie Elisabeth

    2016-01-01

    "Add Value – kend din kunde" er et brætspil, som giver både offentlige og private virksomheder unikke muligheder for at forbedre deres service overfor kunderne. Spillet giver, på en alternativ og handlingsorienteret måde, mulighed for at blive skarpere på kundeoplevelsen – hvor er der værdi...... at hente, og hvor kan der spares på tid og ressourcer? Dette samtidig med, at kunderne får den oplevelse og service, de forventer. Når I spiller "Add Value – kend din kunde" sættes der fokus på Jeres kundeservice ud fra kundens perspektiv, og det er i alle Jeres kontaktflader med kunden. Lige fra kunden...

  3. Firefox add-ons for medical reference.

    Science.gov (United States)

    Hoy, Matthew B

    2010-07-01

    Firefox is a Web browser created by the Mozilla project, an open-source software group. Features of the browser include automated updates, advanced security and standards compliance, and the ability to add functionality through add-ons and extensions. First introduced in 2004, Firefox now accounts for roughly 30% of the browser market. This article will focus primarily on add-ons and extensions available for the browser that are useful to medical researchers.

  4. Inviting Calm Within: ADD, Neurology, and Mindfulness

    Science.gov (United States)

    Riner, Phillip S.; Tanase, Madalina

    2014-01-01

    The fourth edition of the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM IV") describes ADD as behaviorally observed impairments in attention, impulsivity, and hyperactivity. Officially known as AD/HD, we use ADD here because we are dealing primarily with attention, organizational, and impulsivity issues. A more…

  5. 76 FR 47240 - ``Add Us In'' Initiative

    Science.gov (United States)

    2011-08-04

    ... DEPARTMENT OF LABOR Office of Disability Employment Policy ``Add Us In'' Initiative AGENCY: Office of Disability Employment Policy, Department of Labor. Announcement Type: New Notice of Availability... Add Us In initiative is to identify and develop strategies to increase the capacity of small...

  6. Southeast Economic Add-on 1997

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — To collect data on an angler's last trip for revealed preference models and economic valuation purposes. Typically done as an add-on to the MRIP intercept survey and...

  7. Southeast Economic Add-on 2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — To collect data on an angler's last trip for revealed preference models and economic valuation purposes. Typically done as an add-on to the MRIP intercept survey and...

  8. Add Audio and Video to Your Site

    CERN Document Server

    MacDonald, Matthew

    2010-01-01

    Nothing spices up websites like cool sound effects (think ker-thunk as visitors press a button) or embedded videos. Think you need a programmer to add sizzle to your site? Think again. This hands-on guide gives you the techniques you need to add video, music, animated GIFs, and sound effects to your site. This Mini Missing Manual is excerpted from Creating a Web Site: The Missing Manual.

  9. 76 FR 49508 - ``Add Us In'' Initiative

    Science.gov (United States)

    2011-08-10

    ... DEPARTMENT OF LABOR Office of Disability Employment Program ``Add Us In'' Initiative AGENCY: Office of Disability Employment Policy, Department of Labor. ACTION: Correction to the Funding Opportunity Number and Closing Date. SUMMARY: The Office of Disability Employment Policy, Department of Labor...

  10. Infrared speckle observations of the binary Ross 614 AB - combined shift-and-add and zero-and-add analysis

    International Nuclear Information System (INIS)

    Davey, B.L.K.; Bates, R.H.T.; Cocke, W.J.; Mccarthy, D.W. Jr.; Christou, J.C.

    1989-01-01

    One-dimensional infrared speckle scans of Ross 614 AB were recorded at a wavelength of 2.2 microns, and the three bins corresponding to the three best seeing conditions were further processed by applying a shift-and-add algorithm to the set of images contained within each bin, generating three shift-and-add images with differing shift-and-add point-spread functions. A zero-and-add technique was used to deconvolve the three shift-and-add images in order to obtain parameters corresponding to the separation and the brightness ratio of a two-component model of Ross 614 Ab. Least-squares analysis results reveal a separation of 1.04 arcsec and a brightness ratio of 4.3 for the binary system at this wavelength. 31 refs

  11. Non-invasive beamforming add-on module

    KAUST Repository

    Bader, Ahmed; Alouini, Mohamed-Slim

    2017-01-01

    An embodiment of a non-invasive beamforming add-on apparatus couples to an existing antenna port and rectifies the beam azimuth in the upstream and downstream directions. The apparatus comprises input circuitry that is configured to receive one

  12. More notions of forcing add a Souslin tree

    OpenAIRE

    Brodsky, Ari Meir; Rinot, Assaf

    2016-01-01

    An $\\aleph_1$-Souslin tree is a complicated combinatorial object whose existence cannot be decided on the grounds of ZFC alone. But 15 years after Tennenbaum and independently Jech devised notions of forcing for introducing such a tree, Shelah proved that already the simplest forcing notion --- Cohen forcing --- adds an $\\aleph_1$-Souslin tree. In this paper, we identify a rather large class of notions of forcing that, assuming a GCH-type assumption, add a $\\lambda^+$-Souslin tree. This class...

  13. PC add on card for processing of LSC signals

    International Nuclear Information System (INIS)

    Jadhav, S.R.; Nikhare, D.M.; Gurna, R.K.; Paulson, Molly; Kulkarni, C.P.; Vaidya, P.P.

    2001-01-01

    This paper describes PC- add on card developed at Electronics Division for processing of LSC signals. This card uses highly integrated digital and analog circuits, for entire processing of signals available from preamplifiers to get complete beta energy spectrum corresponding to coincident events in Liquid Scintillation Counting. LSC card along with High Voltage PC-add on card gives complete electronics required for LSC system. This card is also used in automatic LSC system along with interface circuits, which are used to control mechanical movements. (author)

  14. Does gesture add to the comprehensibility of people with aphasia?

    NARCIS (Netherlands)

    van Nispen, Karin; Sekine, Kazuki; Rose, Miranda; Ferré, Gaëlle; Tutton, Mark

    2015-01-01

    Gesture can convey information co-occurring with and in the absence of speech. As such, it seems a useful strategy for people with aphasia (PWA) to compensate for their impaired speech. To find out whether gestures used by PWA add to the comprehensibility of their communication we looked at the

  15. Mode-routed fiber-optic add-drop filter

    Science.gov (United States)

    Moslehi, Behzad (Inventor); Black, Richard James (Inventor); Shaw, Herbert John (Inventor)

    2000-01-01

    New elements mode-converting two-mode grating and mode-filtering two-mode coupler are disclosed and used as elements in a system for communications, add-drop filtering, and strain sensing. Methods of fabrication for these new two-mode gratings and mode-filtering two-mode couplers are also disclosed.

  16. Add Control: plant virtualization for control solutions in WWTP.

    Science.gov (United States)

    Maiza, M; Bengoechea, A; Grau, P; De Keyser, W; Nopens, I; Brockmann, D; Steyer, J P; Claeys, F; Urchegui, G; Fernández, O; Ayesa, E

    2013-01-01

    This paper summarizes part of the research work carried out in the Add Control project, which proposes an extension of the wastewater treatment plant (WWTP) models and modelling architectures used in traditional WWTP simulation tools, addressing, in addition to the classical mass transformations (transport, physico-chemical phenomena, biological reactions), all the instrumentation, actuation and automation & control components (sensors, actuators, controllers), considering their real behaviour (signal delays, noise, failures and power consumption of actuators). Its ultimate objective is to allow a rapid transition from the simulation of the control strategy to its implementation at full-scale plants. Thus, this paper presents the application of the Add Control simulation platform for the design and implementation of new control strategies at the WWTP of Mekolalde.

  17. Humor adds the creative touch to CQI teams.

    Science.gov (United States)

    Balzer, J W

    1994-07-01

    The health care industry is looking to continuous quality improvement as a process to both improve patient care and promote cost effectiveness. Interdisciplinary teams are learning to work together and to use data-driven problem solving. Humor adds a creative and welcome touch to the process that makes it easier and more fun to work in teams. The team leader or facilitator who uses humor along the journey sanctions the risk-taking behavior that accompanies creative solutions to tough problems.

  18. Add-on unidirectional elastic metamaterial plate cloak

    Science.gov (United States)

    Lee, Min Kyung; Kim, Yoon Young

    2016-02-01

    Metamaterial cloaks control the propagation of waves to make an object invisible or insensible. To manipulate elastic waves in space, a metamaterial cloak is typically embedded in a base system that includes or surrounds a target object. The embedding is undesirable because it structurally weakens or permanently alters the base system. In this study, we propose a new add-on metamaterial elastic cloak that can be placed over and mechanically coupled with a base structure without embedding. We designed an add-on type annular metamaterial plate cloak through conformal mapping, fabricated it and performed cloaking experiments in a thin-plate with a hole. Experiments were performed in a thin plate by using the lowest symmetric Lamb wave centered at 100 kHz. As a means to check the cloaking performance of the add-on elastic plate cloak, possibly as a temporary stress reliever or a so-called “stress bandage”, the degree of stress concentration mitigation and the recovery from the perturbed wave field due to a hole were investigated.

  19. GnRH-Analoga und Add-back-Verfahren

    Directory of Open Access Journals (Sweden)

    Kleinstein J

    2008-01-01

    Full Text Available GnRH-Analoga haben eine große Bedeutung in der medikamentösen Therapie der Endometriose erlangt. Sie sind in der Lage, Endometrioseassoziierte Schmerzen zu beseitigen und sind Bestandteil der Therapie der endometriosebedingten Infertilität. Aufgrund der Chronizität der Endometriose bedarf es in vielen Fällen der Prolongation der GnRH-A-Therapie über den Zeitraum von 6 Monaten hinaus. Für diese Fälle eignet sich eine Add-back- Therapie nach dem Format von Hormonersatztherapien, um vasomotorischen Nebeneffekten und dem Knochensubstanzverlust entgegenwirken zu können. Dabei wird der Estrogenanteil niedrig dosiert eingesetzt, um innerhalb eines "therapeutischen Fensters" den Hypoestrogenismus auszugleichen, ohne das Endometriosewachstum zu fördern. Prinzipiell kann dazu das Estrogen oral, aber auch transdermal appliziert werden. Die Effektivität der Kombination aus GnRH-A plus Add-back bezüglich der Knochenprotektion konnte bereits für einen Zeitraum von bis zu 10 Jahren bestätigt werden, sodass damit eine Langzeitkonzeption für Frauen mit rezidivierender Endometriose und wiederholten operativen Eingriffen existiert. Alternativen zur klassischen Add-back mit Sexualsteroiden existieren vielfältig, aber ihr Einsatz ist durch Partialwirkungen und eigene Nebenwirkungen limitiert.

  20. Add-on perampanel in Lance-Adams syndrome.

    Science.gov (United States)

    Steinhoff, Bernhard J; Bacher, Matthias; Kurth, Christoph; Staack, Anke M; Kornmeier, Reinhold

    2016-01-01

    Perampanel (PER) is the first-in-class selective, noncompetitive α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist that has been licensed and marketed as antiepileptic drug (AED) indicated for patients with partial-onset and primary generalized tonic-clonic seizures. A positive effect was reported in some patients with epileptic myoclonic jerks in idiopathic generalized epilepsy and in progressive myoclonic epilepsy. We treated a male patient with posthypoxic nonepileptic myoclonus (Lance-Adams syndrome) with add-on PER and achieved an almost complete cessation of jerks. This effect was reproducible and, therefore, we suggest that it might be worth trying PER in comparable cases.

  1. The freedom to choose, eat, add and gain weight

    Directory of Open Access Journals (Sweden)

    D.A. Cabrera-Gaytán

    2018-04-01

    Full Text Available The Federal Commission for Protection Against Health Risks (COFEPRIS launched a regulation for new front nutritional labelling for food and non-alcoholic beverages, recommending that consumers add up their consumptions throughout the day without exceeding a hundred percentage points. The campaign has therefore been called “Add up and do not exceed 100%”. The policy established by the Federal Government is based on assumptions that encourage consumption and will not solve the problem in depth. Following is a descriptive and critical argument against said policy. Resumen: La Comisión Federal para la Protección Contra Riesgos Sanitarios (COFEPRIS, lanzó una regulación del nuevo etiquetado frontal nutrimental en los alimentos y bebidas no alcohólicas, con la recomendación al consumidor sumar a lo largo del día los consumos sin exceder de cien puntos porcentuales, por lo que a la campaña se le ha denominado “Suma y no te pases de 100%”. La política instaurada por el Gobierno Federal, se basa en supuestos que fomentan el consumo y no resolverán de fondo el problema, por lo que se hace una argumentación descriptiva y crítica de esa política. Keywords: Obesity, Public policy, Consumption, Palabras clave: Obesidad, Política pública, Consumo

  2. Using patient lists to add value to integrated data repositories.

    Science.gov (United States)

    Wade, Ted D; Zelarney, Pearlanne T; Hum, Richard C; McGee, Sylvia; Batson, Deborah H

    2014-12-01

    Patient lists are project-specific sets of patients that can be queried in integrated data repositories (IDR's). By allowing a set of patients to be an addition to the qualifying conditions of a query, returned results will refer to, and only to, that set of patients. We report a variety of use cases for such lists, including: restricting retrospective chart review to a defined set of patients; following a set of patients for practice management purposes; distributing "honest-brokered" (deidentified) data; adding phenotypes to biosamples; and enhancing the content of study or registry data. Among the capabilities needed to implement patient lists in an IDR are: capture of patient identifiers from a query and feedback of these into the IDR; the existence of a permanent internal identifier in the IDR that is mappable to external identifiers; the ability to add queryable attributes to the IDR; the ability to merge data from multiple queries; and suitable control over user access and de-identification of results. We implemented patient lists in a custom IDR of our own design. We reviewed capabilities of other published IDRs for focusing on sets of patients. The widely used i2b2 IDR platform has various ways to address patient sets, and it could be modified to add the low-overhead version of patient lists that we describe. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. A subsurface add-on for standard atomic force microscopes

    Energy Technology Data Exchange (ETDEWEB)

    Verbiest, G. J., E-mail: Verbiest@physik.rwth-aachen.de [JARA-FIT and II. Institute of Physics, RWTH Aachen University, 52074 Aachen (Germany); Zalm, D. J. van der; Oosterkamp, T. H.; Rost, M. J., E-mail: Rost@physics.leidenuniv.nl [Kamerlingh Onnes Laboratory, Leiden University, P.O. Box 9504, 2300 RA Leiden (Netherlands)

    2015-03-15

    The application of ultrasound in an Atomic Force Microscope (AFM) gives access to subsurface information. However, no commercially AFM exists that is equipped with this technique. The main problems are the electronic crosstalk in the AFM setup and the insufficiently strong excitation of the cantilever at ultrasonic (MHz) frequencies. In this paper, we describe the development of an add-on that provides a solution to these problems by using a special piezo element with a lowest resonance frequency of 2.5 MHz and by separating the electronic connection for this high frequency piezo element from all other connections. In this sense, we support researches with the possibility to perform subsurface measurements with their existing AFMs and hopefully pave also the way for the development of a commercial AFM that is capable of imaging subsurface features with nanometer resolution.

  4. Symbolic BDD and ADD Algorithms for Energy Games

    Directory of Open Access Journals (Sweden)

    Shahar Maoz

    2016-11-01

    Full Text Available Energy games, which model quantitative consumption of a limited resource, e.g., time or energy, play a central role in quantitative models for reactive systems. Reactive synthesis constructs a controller which satisfies a given specification, if one exists. For energy games a synthesized controller ensures to satisfy not only the safety constraints of the specification but also the quantitative constraints expressed in the energy game. A symbolic algorithm for energy games, recently presented by Chatterjee et al., is symbolic in its representation of quantitative values but concrete in the representation of game states and transitions. In this paper we present an algorithm that is symbolic both in the quantitative values and in the underlying game representation. We have implemented our algorithm using two different symbolic representations for reactive games, Binary Decision Diagrams (BDD and Algebraic Decision Diagrams (ADD. We investigate the commonalities and differences of the two implementations and compare their running times on specifications of energy games.

  5. Non-invasive beamforming add-on module

    KAUST Repository

    Bader, Ahmed

    2017-02-23

    An embodiment of a non-invasive beamforming add-on apparatus couples to an existing antenna port and rectifies the beam azimuth in the upstream and downstream directions. The apparatus comprises input circuitry that is configured to receive one or more signals from a neighboring node of the linear wireless sensor network; first amplifier circuitry configured to adjust an amplitude of a respective received signal in accordance with a weighting coefficient and invoke a desired phase to a carrier frequency of the received signal thereby forming a first amplified signal; and second amplifier circuitry configured to adjust a gain of the first amplified signal towards upstream and downstream neighbors of the linear wireless sensor in the linear wireless sensor network.

  6. Regional identity can add value to agricultural products

    Directory of Open Access Journals (Sweden)

    Bradley C. Christensen

    2015-04-01

    Full Text Available Regional identity creation is being recognized for its economic benefits and as a strategic resource for producer communities. A regional identity is not a brand; it is built through a complicated process of developing cohesion and sharing in the industry community and communicating outside the industry community to opinion-makers and consumers. The California fine wine industry has built successful regional identities and leveraged them to add value to their wines. As regional identities in the wine industry have strengthened, so has the industry, and a symbiotic relationship with other local value-added industries, such as tourism and hospitality, has emerged. Other agricultural producers can learn from the identity creation experiences in the wine industry. With the many challenges faced by California agriculture, identity formation may offer producers new ideas for adding value to their products and finding larger markets.

  7. 40 CFR 75.34 - Units with add-on emission controls.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Units with add-on emission controls... add-on emission controls. (a) The owner or operator of an affected unit equipped with add-on SO2 and... assurance/quality control program for the unit, required by section 1 in appendix B of this part. To provide...

  8. Does aquaculture add resilience to the global food system?

    Science.gov (United States)

    Troell, Max; Naylor, Rosamond L.; Metian, Marc; Beveridge, Malcolm; Tyedmers, Peter H.; Folke, Carl; Arrow, Kenneth J.; Barrett, Scott; Crépin, Anne-Sophie; Ehrlich, Paul R.; Gren, Åsa; Kautsky, Nils; Levin, Simon A.; Nyborg, Karine; Österblom, Henrik; Polasky, Stephen; Scheffer, Marten; Walker, Brian H.; Xepapadeas, Tasos; de Zeeuw, Aart

    2014-01-01

    Aquaculture is the fastest growing food sector and continues to expand alongside terrestrial crop and livestock production. Using portfolio theory as a conceptual framework, we explore how current interconnections between the aquaculture, crop, livestock, and fisheries sectors act as an impediment to, or an opportunity for, enhanced resilience in the global food system given increased resource scarcity and climate change. Aquaculture can potentially enhance resilience through improved resource use efficiencies and increased diversification of farmed species, locales of production, and feeding strategies. However, aquaculture’s reliance on terrestrial crops and wild fish for feeds, its dependence on freshwater and land for culture sites, and its broad array of environmental impacts diminishes its ability to add resilience. Feeds for livestock and farmed fish that are fed rely largely on the same crops, although the fraction destined for aquaculture is presently small (∼4%). As demand for high-value fed aquaculture products grows, competition for these crops will also rise, as will the demand for wild fish as feed inputs. Many of these crops and forage fish are also consumed directly by humans and provide essential nutrition for low-income households. Their rising use in aquafeeds has the potential to increase price levels and volatility, worsening food insecurity among the most vulnerable populations. Although the diversification of global food production systems that includes aquaculture offers promise for enhanced resilience, such promise will not be realized if government policies fail to provide adequate incentives for resource efficiency, equity, and environmental protection. PMID:25136111

  9. Lixisenatide as add-on therapy to basal insulin

    Directory of Open Access Journals (Sweden)

    Brown DX

    2013-12-01

    Full Text Available Dominique Xavier Brown, Emma Louise Butler, Marc Evans Diabetes Department, University Hospital Llandough, Cardiff, UK Abstract: Many patients with type 2 diabetes mellitus do not achieve target glycosylated hemoglobin A1c levels despite optimally titrated basal insulin and satisfactory fasting plasma glucose levels. Current evidence suggests that HbA1c levels are dictated by both basal glucose and postprandial glucose levels. This has led to a consensus that postprandial glucose excursions contribute to poor glycemic control in these patients. Lixisenatide is a once-daily, prandial glucagon-like peptide 1 (GLP-1 receptor agonist with a four-fold affinity for the GLP-1 receptor compared with native GLP-1. Importantly, lixisenatide causes a significant delay in gastric emptying time, an important determinant of the once-daily dosing regimen. An exendin-4 mimetic with six lysine residues removed at the C-terminal, lixisenatide has pronounced postprandial glucose-lowering effects, making it a novel incretin agent for use in combination with optimally titrated basal insulin. Lixisenatide exerts profound effects on postprandial glucose through established mechanisms of glucose-dependent insulin secretion and glucagon suppression in combination with delayed gastric emptying. This review discusses the likely place that lixisenatide will occupy in clinical practice, given its profound effects on postprandial glucose and potential to reduce glycemic variability. Keywords: lixisenatide, add-on therapy, insulin, GLP-1 receptor agonist, postprandial glucose, pharmacodynamics

  10. Does aquaculture add resilience to the global food system?

    Science.gov (United States)

    Troell, Max; Naylor, Rosamond L; Metian, Marc; Beveridge, Malcolm; Tyedmers, Peter H; Folke, Carl; Arrow, Kenneth J; Barrett, Scott; Crépin, Anne-Sophie; Ehrlich, Paul R; Gren, Asa; Kautsky, Nils; Levin, Simon A; Nyborg, Karine; Österblom, Henrik; Polasky, Stephen; Scheffer, Marten; Walker, Brian H; Xepapadeas, Tasos; de Zeeuw, Aart

    2014-09-16

    Aquaculture is the fastest growing food sector and continues to expand alongside terrestrial crop and livestock production. Using portfolio theory as a conceptual framework, we explore how current interconnections between the aquaculture, crop, livestock, and fisheries sectors act as an impediment to, or an opportunity for, enhanced resilience in the global food system given increased resource scarcity and climate change. Aquaculture can potentially enhance resilience through improved resource use efficiencies and increased diversification of farmed species, locales of production, and feeding strategies. However, aquaculture's reliance on terrestrial crops and wild fish for feeds, its dependence on freshwater and land for culture sites, and its broad array of environmental impacts diminishes its ability to add resilience. Feeds for livestock and farmed fish that are fed rely largely on the same crops, although the fraction destined for aquaculture is presently small (∼4%). As demand for high-value fed aquaculture products grows, competition for these crops will also rise, as will the demand for wild fish as feed inputs. Many of these crops and forage fish are also consumed directly by humans and provide essential nutrition for low-income households. Their rising use in aquafeeds has the potential to increase price levels and volatility, worsening food insecurity among the most vulnerable populations. Although the diversification of global food production systems that includes aquaculture offers promise for enhanced resilience, such promise will not be realized if government policies fail to provide adequate incentives for resource efficiency, equity, and environmental protection.

  11. What a signature adds to the consent process.

    LENUS (Irish Health Repository)

    Neary, Peter

    2012-02-03

    BACKGROUND: "Consent is a process by which a patient is informed and becomes a participant in decisions regarding their medical management." It is argued, however, that providing a signature to a form adds little to the quality of this process. METHODS: Views regarding the consent ritual of nonselected patients undergoing endoscopy (cystoscopy or sigmoidoscopy) were prospectively studied together with those of the attending staff. Patient volunteers were randomly assigned to one of two groups and given verbal explanation before the procedure, either alone (group A) or with a request to sign a form in addition (group B). A standardized questionnaire regarding preferences then was applied. RESULTS: A total of 37 patients (22 men) were studied along with seven staff members. Most surveyed felt that signing a consent form helped to empower the patient (group A, 84%; group B, 83%; staff, 100%). Although the patients mainly believed that it functioned primarily to protect the hospital and doctor (group A, 89%; group B, 67%), only one patient (3% of total) felt that such a formality undermined the patient-doctor relationship. Most staff members favored signing a form (86%). The majority of patients either favored it (group A, 47%; group B, 78%) or expressed no strong preference (group A, 32%; group B, 11%). Interestingly, more women than men preferred signing (73 vs. 55%; p = 0.25), perhaps because more women believed that it functioned to preserve autonomy (93 vs. 77% of men). Age was no particular determinant of perspective. CONCLUSION: Although it may be viewed as primarily serving to protect the doctor and hospital, the formal process of signing written consent forms appeals to patients and staff.

  12. Implementation of computerized add-on testing for hospitalized patients in a large academic medical center.

    Science.gov (United States)

    Kim, Ji Yeon; Kamis, Irina K; Singh, Balaji; Batra, Shalini; Dixon, Roberta H; Dighe, Anand S

    2011-05-01

    Physician requests for additional testing on an existing laboratory specimen (add-ons) are resource intensive and generally require a phone call to the laboratory. Verbal orders such as these have been noted to be associated with errors in accuracy. The aim of this study was to compare a novel computerized system for add-on requests to the prior verbal system. We compare the computerized add-on request system to the verbal system with respect to order completeness and workflow. We demonstrate that the computerized add-on system resulted in the complete in-laboratory documentation of the add-on request 100% of the time, compared to 58% with the verbal add-on system. In addition, we show that documentation of a verbal add-on request in the electronic medical record (EMR) occurred for 4% of requests, while in the computerized system EMR documentation occurred 100% of the time. We further demonstrate that the computerized add-on request process was well accepted by providers and did not significantly change the test mix of the add-on requests. In computerized physician order entry (CPOE) implementations, add-on order functionality should be considered so these orders are documented in the EMR.

  13. Embedding objects during 3D printing to add new functionalities.

    Science.gov (United States)

    Yuen, Po Ki

    2016-07-01

    A novel method for integrating and embedding objects to add new functionalities during 3D printing based on fused deposition modeling (FDM) (also known as fused filament fabrication or molten polymer deposition) is presented. Unlike typical 3D printing, FDM-based 3D printing could allow objects to be integrated and embedded during 3D printing and the FDM-based 3D printed devices do not typically require any post-processing and finishing. Thus, various fluidic devices with integrated glass cover slips or polystyrene films with and without an embedded porous membrane, and optical devices with embedded Corning(®) Fibrance™ Light-Diffusing Fiber were 3D printed to demonstrate the versatility of the FDM-based 3D printing and embedding method. Fluid perfusion flow experiments with a blue colored food dye solution were used to visually confirm fluid flow and/or fluid perfusion through the embedded porous membrane in the 3D printed fluidic devices. Similar to typical 3D printed devices, FDM-based 3D printed devices are translucent at best unless post-polishing is performed and optical transparency is highly desirable in any fluidic devices; integrated glass cover slips or polystyrene films would provide a perfect optical transparent window for observation and visualization. In addition, they also provide a compatible flat smooth surface for biological or biomolecular applications. The 3D printed fluidic devices with an embedded porous membrane are applicable to biological or chemical applications such as continuous perfusion cell culture or biocatalytic synthesis but without the need for any post-device assembly and finishing. The 3D printed devices with embedded Corning(®) Fibrance™ Light-Diffusing Fiber would have applications in display, illumination, or optical applications. Furthermore, the FDM-based 3D printing and embedding method could also be utilized to print casting molds with an integrated glass bottom for polydimethylsiloxane (PDMS) device replication

  14. Measuring Narcissism within Add Health: The Development and Validation of a New Scale

    Science.gov (United States)

    Davis, Mark S.; Brunell, Amy B.

    2012-01-01

    This study reports the development of a measure of narcissism within the National Longitudinal Study of Adolescent Health (Add Health) data set. In Study 1, items were selected from Wave III to form the Add Health Narcissism Scale (AHNS). These were factor analyzed, yielding a single factor comprised of five subscales. We correlated the AHNS and…

  15. 24 CFR 983.206 - HAP contract amendments (to add or substitute contract units).

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false HAP contract amendments (to add or... Contract § 983.206 HAP contract amendments (to add or substitute contract units). (a) Amendment to substitute contract units. At the discretion of the PHA and subject to all PBV requirements, the HAP contract...

  16. 12 CFR 502.60 - When will OTS adjust, add, waive, or eliminate a fee?

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false When will OTS adjust, add, waive, or eliminate a fee? 502.60 Section 502.60 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY ASSESSMENTS AND FEES Fees § 502.60 When will OTS adjust, add, waive, or eliminate a fee? Under...

  17. Error-free 320 Gb/s simultaneous add-drop multiplexing

    DEFF Research Database (Denmark)

    Mulvad, Hans Christian Hansen; Oxenløwe, Leif Katsuo; Clausen, Anders

    2007-01-01

    We report on the first demonstration of error-free time-division add-drop multiplexing at 320 Gb/s. The add- and drop-operations are performed simultaneously in a non-linear optical loop mirror with only 100 m of highly non-linear fibre....

  18. Low-dose add-back therapy during postoperative GnRH agonist treatment

    Directory of Open Access Journals (Sweden)

    Hsiao-Wen Tsai

    2016-02-01

    Conclusion: Low dose add-back therapy could effectively ameliorate hypoestrogenic side effects and simultaneously maintain the therapeutic response of GnRH agonist treatment. The treatment dropout was lower compared with a regular dose. Therefore, low dose add-back therapy can be considered a treatment choice during postoperative GnRH agonist treatment.

  19. Cognitive Control and Attentional Selection in Adolescents with ADHD versus ADD

    Science.gov (United States)

    Carr, Laurie; Henderson, John; Nigg, Joel T.

    2010-01-01

    An important research question is whether Attention Deficit Hyperactivity Disorder (ADHD) is related to early- or late-stage attentional control mechanisms and whether this differentiates a nonhyperactive subtype (ADD). This question was addressed in a sample of 145 ADD/ADHD and typically developing comparison adolescents (aged 13-17). Attentional…

  20. 5 CFR 591.227 - What adjustment factors does OPM add to the price indexes?

    Science.gov (United States)

    2010-01-01

    ... CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.227 What adjustment factors does OPM add to the price...

  1. Neural biomarkers for dyslexia, ADHD and ADD in the auditory cortex of children

    OpenAIRE

    Bettina Serrallach; Christine Gross; Valdis Bernhofs; Dorte Engelmann; Jan Benner; Jan Benner; Nadine Gündert; Maria Blatow; Martina Wengenroth; Angelika Seitz; Monika Brunner; Stefan Seither; Stefan Seither; Richard Parncutt; Peter Schneider

    2016-01-01

    Dyslexia, attention deficit hyperactivity disorder (ADHD), and attention deficit disorder (ADD) show distinct clinical profiles that may include auditory and language-related impairments. Currently, an objective brain-based diagnosis of these developmental disorders is still unavailable. We investigated the neuro-auditory systems of dyslexic, ADHD, ADD, and age-matched control children (N=147) using neuroimaging, magnet-encephalography and psychoacoustics. All disorder subgroups exhibited an ...

  2. A role for α-adducin (ADD-1) in nematode and human memory.

    Science.gov (United States)

    Vukojevic, Vanja; Gschwind, Leo; Vogler, Christian; Demougin, Philippe; de Quervain, Dominique J-F; Papassotiropoulos, Andreas; Stetak, Attila

    2012-03-21

    Identifying molecular mechanisms that underlie learning and memory is one of the major challenges in neuroscience. Taken the advantages of the nematode Caenorhabditis elegans, we investigated α-adducin (add-1) in aversive olfactory associative learning and memory. Loss of add-1 function selectively impaired short- and long-term memory without causing acquisition, sensory, or motor deficits. We showed that α-adducin is required for consolidation of synaptic plasticity, for sustained synaptic increase of AMPA-type glutamate receptor (GLR-1) content and altered GLR-1 turnover dynamics. ADD-1, in a splice-form- and tissue-specific manner, controlled the storage of memories presumably through actin-capping activity. In support of the C. elegans results, genetic variability of the human ADD1 gene was significantly associated with episodic memory performance in healthy young subjects. Finally, human ADD1 expression in nematodes restored loss of C. elegans add-1 gene function. Taken together, our findings support a role for α-adducin in memory from nematodes to humans. Studying the molecular and genetic underpinnings of memory across distinct species may be helpful in the development of novel strategies to treat memory-related diseases.

  3. Evolutionary diversification of protein-protein interactions by interface add-ons.

    Science.gov (United States)

    Plach, Maximilian G; Semmelmann, Florian; Busch, Florian; Busch, Markus; Heizinger, Leonhard; Wysocki, Vicki H; Merkl, Rainer; Sterner, Reinhard

    2017-10-03

    Cells contain a multitude of protein complexes whose subunits interact with high specificity. However, the number of different protein folds and interface geometries found in nature is limited. This raises the question of how protein-protein interaction specificity is achieved on the structural level and how the formation of nonphysiological complexes is avoided. Here, we describe structural elements called interface add-ons that fulfill this function and elucidate their role for the diversification of protein-protein interactions during evolution. We identified interface add-ons in 10% of a representative set of bacterial, heteromeric protein complexes. The importance of interface add-ons for protein-protein interaction specificity is demonstrated by an exemplary experimental characterization of over 30 cognate and hybrid glutamine amidotransferase complexes in combination with comprehensive genetic profiling and protein design. Moreover, growth experiments showed that the lack of interface add-ons can lead to physiologically harmful cross-talk between essential biosynthetic pathways. In sum, our complementary in silico, in vitro, and in vivo analysis argues that interface add-ons are a practical and widespread evolutionary strategy to prevent the formation of nonphysiological complexes by specializing protein-protein interactions.

  4. Sensitivity and specificity of the amer dizziness diagnostic scale (adds) for patients with vestibular disorders.

    Science.gov (United States)

    Al Saif, Amer; Alsenany, Samira

    2015-01-01

    [Purpose] To investigate the sensitivity and specificity of a newly developed diagnostic tool, the Amer Dizziness Diagnostic Scale (ADDS), to evaluate and differentially diagnose vestibular disorder and to identify the strengths and weaknesses of the scale and its usefulness in clinical practice. [Subjects and Methods] Two hundred subjects of both genders (72 males, 128 females) aged between 18 to 60 (49.5±7.8) who had a history of vertigo and/or dizziness symptoms for this previous two weeks or less were recruited for the study. All subjects were referred by otolaryngologists, neurologists or family physicians in and around Jeddah, Kingdom of Saudi Arabia. On the first clinic visit, all the patients were evaluated once using the ADDS, following which they underwent routine testing of clinical signs and symptoms, audiometry, and a neurological examination, coupled with tests of Vestibulo-Ocular Reflex function, which often serves as the "gold standard" for determining the probability of a vestibular deficit. [Results] The results show that the ADDS strongly correlated with "true-positive" and "true-negative" responses for determining the probability of a vestibular disorder (r =0.95). A stepwise linear regression was conducted and the results indicate that the ADDS was a significant predictor of "true-positive" and "true-negative" responses in vestibular disorders (R(2) =0.90). Approximately 90% of the variability in the vestibular gold standard test was explained by its relationship to the ADDS. Moreover, the ADDS was found to have a sensitivity of 96% and a specificity of 96%. [Conclusion] This study showed that the Amer Dizziness Diagnostic Scale has high sensitivity and specificity and that it can be used as a method of differential diagnosis for patients with vestibular disorders.

  5. Add-on effect of Brahmi in the management of schizophrenia

    Directory of Open Access Journals (Sweden)

    Sukanto Sarkar

    2012-01-01

    Full Text Available Brahmi(Bacopa monnieri, an Ayurvedic herb has primarily been used to enhance cognitive ability, memory and learning skills. We present a case study of schizophrenia in which add-on Brahmi extracts 500 mg/day for a period of one month resulted in reduction in psychopathology without any treatment-emergent adverse effect. Although preliminary, our case study suggests therapeutic efficacy of add-on Brahmi in schizophrenia, thus opening up a new dimension of its role in alternative medicines.

  6. THE SLOAN DIGITAL SKY SURVEY CO-ADD: A GALAXY PHOTOMETRIC REDSHIFT CATALOG

    International Nuclear Information System (INIS)

    Reis, Ribamar R. R.; Soares-Santos, Marcelle; Annis, James; Dodelson, Scott; Hao Jiangang; Johnston, David; Kubo, Jeffrey; Lin Huan; Seo, Hee-Jong; Simet, Melanie

    2012-01-01

    We present and describe a catalog of galaxy photometric redshifts (photo-z) for the Sloan Digital Sky Survey (SDSS) Co-add Data. We use the artificial neural network (ANN) technique to calculate the photo-z and the nearest neighbor error method to estimate photo-z errors for ∼13 million objects classified as galaxies in the co-add with r 68 = 0.031. After presenting our results and quality tests, we provide a short guide for users accessing the public data.

  7. NPS Adds Another Astronaut Alumnus With NASA’s Newest Class

    OpenAIRE

    Kuska, Dale M.

    2013-01-01

    Article taken from the NPS website: http://www.nps.edu/About/News/NPS-Adds-Another-Astronaut-Alumnus-With-NASAs-Newest-Class.html When NASA Administrator Charles Bolden announced the latest class of NASA’s eight astronaut candidates, June 17, the Naval Postgraduate School (NPS) was able to add yet another space-traveling alumnus to its ranks, now totaling 41 and counting. Lt. Cmdr. Victor Glover, an F/A-18 combat pilot currently serving as a Legislative Fellow in the office of Senat...

  8. An add-in implementation of the RESAMPLING syntax under Microsoft EXCEL.

    Science.gov (United States)

    Meineke, I

    2000-10-01

    The RESAMPLING syntax defines a set of powerful commands, which allow the programming of probabilistic statistical models with few, easily memorized statements. This paper presents an implementation of the RESAMPLING syntax using Microsoft EXCEL with Microsoft WINDOWS(R) as a platform. Two examples are given to demonstrate typical applications of RESAMPLING in biomedicine. Details of the implementation with special emphasis on the programming environment are discussed at length. The add-in is available electronically to interested readers upon request. The use of the add-in facilitates numerical statistical analyses of data from within EXCEL in a comfortable way.

  9. Appropriate statistical methods are required to assess diagnostic tests for replacement, add-on, and triage

    NARCIS (Netherlands)

    Hayen, Andrew; Macaskill, Petra; Irwig, Les; Bossuyt, Patrick

    2010-01-01

    To explain which measures of accuracy and which statistical methods should be used in studies to assess the value of a new binary test as a replacement test, an add-on test, or a triage test. Selection and explanation of statistical methods, illustrated with examples. Statistical methods for

  10. Development of a radiometer based on an Add-ON card for PC

    International Nuclear Information System (INIS)

    Bolanos, L.; Lopez, B.; Fernandez, J.L.; Laria, J.

    1997-01-01

    The design of an add-on card for PC that enables it to record nuclear pulses provided by two channels is described in this paper. This card carries acts as a pulse discriminator, and according to the software it finds many appliances in radioimmunoassay, nuclear medicine, industry and other fields

  11. Polymorphism of the H-FABP, MC4R and ADD1 genes in the ...

    African Journals Online (AJOL)

    4 Receptor (MC4R) and the Adipocyte Determination and Differentiation factor-1 (ADD1) play an important role in meat quality in pigs. The Meishan is one of the most prolific pig breeds in the world, but it is in danger, in China, of being replaced ...

  12. Improving Content and Technology Skills in ADD/ADHD via a Web Enhanced Course

    Science.gov (United States)

    Jordan, LuAnn; Smith, Sean; Dillon, Ann S.; Algozzine, Bob; Beattie, John; Spooner, Fred; Fisher, Ashlee L.

    2004-01-01

    Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder (ADD/ADHD) create concerns in public education and in teacher education programs. Because of continuous advances in technology, distance learning is a viable option for delivering coursework to preservice and inservice teacher education students challenged by geography, time…

  13. Project DyAdd: Visual Attention in Adult Dyslexia and ADHD

    Science.gov (United States)

    Laasonen, Marja; Salomaa, Jonna; Cousineau, Denis; Leppamaki, Sami; Tani, Pekka; Hokkanen, Laura; Dye, Matthew

    2012-01-01

    In this study of the project DyAdd, three aspects of visual attention were investigated in adults (18-55 years) with dyslexia (n = 35) or attention deficit/hyperactivity disorder (ADHD, n = 22), and in healthy controls (n = 35). Temporal characteristics of visual attention were assessed with Attentional Blink (AB), capacity of visual attention…

  14. Strategies for Successfully Teaching Students with ADD or ADHD in Instrumental Lessons

    Science.gov (United States)

    Melago, Kathleen A.

    2014-01-01

    Teachers can easily encounter students with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) in the instrumental lesson setting. Applicable to instrumental lesson settings in the public or private schools, private studios, or college studios, this article focuses on specific strategies ranging from the…

  15. In Building a Script for an Emotion, Do Preschoolers Add Its Cause before Its Behavior Consequence?

    Science.gov (United States)

    Widen, Sherri C.; Russell, James A.

    2011-01-01

    An emotion concept is a script in which an emotion event is an ordered sequence of subevents from situational cause through bodily changes to behavioral consequence. As children build a script for each emotion, in what order do they add each subevent? Preschoolers (N = 108, three to five years), were asked to name the protagonist's emotion in…

  16. Word add-in for ontology recognition: semantic enrichment of scientific literature

    Directory of Open Access Journals (Sweden)

    Naim Oscar

    2010-02-01

    Full Text Available Abstract Background In the current era of scientific research, efficient communication of information is paramount. As such, the nature of scholarly and scientific communication is changing; cyberinfrastructure is now absolutely necessary and new media are allowing information and knowledge to be more interactive and immediate. One approach to making knowledge more accessible is the addition of machine-readable semantic data to scholarly articles. Results The Word add-in presented here will assist authors in this effort by automatically recognizing and highlighting words or phrases that are likely information-rich, allowing authors to associate semantic data with those words or phrases, and to embed that data in the document as XML. The add-in and source code are publicly available at http://www.codeplex.com/UCSDBioLit. Conclusions The Word add-in for ontology term recognition makes it possible for an author to add semantic data to a document as it is being written and it encodes these data using XML tags that are effectively a standard in life sciences literature. Allowing authors to mark-up their own work will help increase the amount and quality of machine-readable literature metadata.

  17. Word add-in for ontology recognition: semantic enrichment of scientific literature.

    Science.gov (United States)

    Fink, J Lynn; Fernicola, Pablo; Chandran, Rahul; Parastatidis, Savas; Wade, Alex; Naim, Oscar; Quinn, Gregory B; Bourne, Philip E

    2010-02-24

    In the current era of scientific research, efficient communication of information is paramount. As such, the nature of scholarly and scientific communication is changing; cyberinfrastructure is now absolutely necessary and new media are allowing information and knowledge to be more interactive and immediate. One approach to making knowledge more accessible is the addition of machine-readable semantic data to scholarly articles. The Word add-in presented here will assist authors in this effort by automatically recognizing and highlighting words or phrases that are likely information-rich, allowing authors to associate semantic data with those words or phrases, and to embed that data in the document as XML. The add-in and source code are publicly available at http://www.codeplex.com/UCSDBioLit. The Word add-in for ontology term recognition makes it possible for an author to add semantic data to a document as it is being written and it encodes these data using XML tags that are effectively a standard in life sciences literature. Allowing authors to mark-up their own work will help increase the amount and quality of machine-readable literature metadata.

  18. Vocabulario enla lengua Castellana, la del Ynga y Xebera (British Library, Ms. Add. 25,323)

    NARCIS (Netherlands)

    Alexander-Bakkerus, A.

    2013-01-01

    The codex Vocabulario enla Lengua Castellana, la del Inga y Xebera (British Library, shelf mark Ms. Add. 25,323), does not only contain a Spanish-Quechua-Xebero vocabulary, but also a rather elaborate description of certain Xebero sounds. Although the author of the manuscript is unknown, we may

  19. ATRX ADD domain links an atypical histone methylation recognition mechanism to human mental-retardation syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Iwase, Shigeki; Xiang, Bin; Ghosh, Sharmistha; Ren, Ting; Lewis, Peter W.; Cochrane, Jesse C.; Allis, C. David; Picketts, David J.; Patel, Dinshaw J.; Li, Haitao; Shi, Yang (Harvard-Med); (Ottawa Hosp.); (MSKCC); (Rockefeller); (CH-Boston); (Tsinghua); (Mass. Gen. Hosp.)

    2011-07-19

    ATR-X (alpha-thalassemia/mental retardation, X-linked) syndrome is a human congenital disorder that causes severe intellectual disabilities. Mutations in the ATRX gene, which encodes an ATP-dependent chromatin-remodeler, are responsible for the syndrome. Approximately 50% of the missense mutations in affected persons are clustered in a cysteine-rich domain termed ADD (ATRX-DNMT3-DNMT3L, ADD{sub ATRX}), whose function has remained elusive. Here we identify ADD{sub ATRX} as a previously unknown histone H3-binding module, whose binding is promoted by lysine 9 trimethylation (H3K9me3) but inhibited by lysine 4 trimethylation (H3K4me3). The cocrystal structure of ADD{sub ATRX} bound to H3{sub 1-15}K9me3 peptide reveals an atypical composite H3K9me3-binding pocket, which is distinct from the conventional trimethyllysine-binding aromatic cage. Notably, H3K9me3-pocket mutants and ATR-X syndrome mutants are defective in both H3K9me3 binding and localization at pericentromeric heterochromatin; thus, we have discovered a unique histone-recognition mechanism underlying the ATR-X etiology.

  20. ATRX ADD Domain Links an Atypical Histone Methylation Recognition Mechanism to Human Mental-Retardation Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    S Iwase; B Xiang; S Ghosh; T Ren; P Lewis; J Cochrane; C Allis; D Picketts; D Patel; et al.

    2011-12-31

    ATR-X (alpha-thalassemia/mental retardation, X-linked) syndrome is a human congenital disorder that causes severe intellectual disabilities. Mutations in the ATRX gene, which encodes an ATP-dependent chromatin-remodeler, are responsible for the syndrome. Approximately 50% of the missense mutations in affected persons are clustered in a cysteine-rich domain termed ADD (ATRX-DNMT3-DNMT3L, ADD{sub ATRX}), whose function has remained elusive. Here we identify ADD{sub ATRX} as a previously unknown histone H3-binding module, whose binding is promoted by lysine 9 trimethylation (H3K9me3) but inhibited by lysine 4 trimethylation (H3K4me3). The cocrystal structure of ADD{sub ATRX} bound to H3{sub 1-15}K9me3 peptide reveals an atypical composite H3K9me3-binding pocket, which is distinct from the conventional trimethyllysine-binding aromatic cage. Notably, H3K9me3-pocket mutants and ATR-X syndrome mutants are defective in both H3K9me3 binding and localization at pericentromeric heterochromatin; thus, we have discovered a unique histone-recognition mechanism underlying the ATR-X etiology.

  1. ADD1/SREBP1c activates the PGC1-alpha promoter in brown adipocytes

    DEFF Research Database (Denmark)

    Hao, Qin; Hansen, Jacob B; Petersen, Rasmus K

    2010-01-01

    Cold adaptation elicits a paradoxical simultaneous induction of fatty acid synthesis and beta-oxidation in brown adipose tissue. We show here that cold exposure coordinately induced liver X receptor alpha (LXRalpha), adipocyte determination and differentiation-dependent factor 1 (ADD1)/sterol...

  2. TEST DESIGN FOR ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) OF ADD-ON NOX CONTROL UTILIZING OZONE INJECTION

    Science.gov (United States)

    The paper discusses the test design for environmental technology verification (ETV) of add-0n nitrogen oxides (NOx) control utilizing ozone injection. (NOTE: ETV is an EPA-established program to enhance domestic and international market acceptance of new or improved commercially...

  3. Neural biomarkers for dyslexia, ADHD and ADD in the auditory cortex of children

    Directory of Open Access Journals (Sweden)

    Bettina Serrallach

    2016-07-01

    Full Text Available Dyslexia, attention deficit hyperactivity disorder (ADHD, and attention deficit disorder (ADD show distinct clinical profiles that may include auditory and language-related impairments. Currently, an objective brain-based diagnosis of these developmental disorders is still unavailable. We investigated the neuro-auditory systems of dyslexic, ADHD, ADD, and age-matched control children (N=147 using neuroimaging, magnet-encephalography and psychoacoustics. All disorder subgroups exhibited an oversized left planum temporale and an abnormal interhemispheric asynchrony (10-40 ms of the primary auditory evoked P1-response. Considering right auditory cortex morphology, bilateral P1 source waveform shapes, and auditory performance, the three disorder subgroups could be reliably differentiated with outstanding accuracies of 89-98%. We therefore for the first time provide differential biomarkers for a brain-based diagnosis of dyslexia, ADHD, and ADD. The method allowed not only a clear discrimination between two subtypes of attentional disorders (ADHD and ADD, a topic controversially discussed for decades in the scientific community, but also revealed the potential for objectively identifying comorbid cases. Noteworthy, in children playing a musical instrument, after three and a half years of training the observed interhemispheric asynchronies were reduced by about 2/3, thus suggesting a strong beneficial influence of music experience on brain development. These findings might have far-reaching implications for both research and practice and enable a profound understanding of the brain-related etiology, diagnosis, and musically based therapy of common auditory-related developmental disorders and learning disabilities.

  4. Ritanserin as add-on medication to neuroleptic therapy for patients with chronic or subchronic schizophrenia

    NARCIS (Netherlands)

    Den Boer, JA; Vahlne, JO; Post, P; Heck, AH; Daubenton, F; Olbrich, R

    The effect of ritanserin, a potent 5HT(2A/2C) receptor antagonist, used as an add-on medication to neuroleptic treatmentin patients with schizophrenia, was compared with that of placebo, in an international, double-blind, parallel-group study. Previously established neuroleptic therapy was

  5. Relationship between ADD1 Gly460Trp gene polymorphism and essential hypertension in Madeira Island.

    Science.gov (United States)

    Sousa, Ana Célia; Palma Dos Reis, Roberto; Pereira, Andreia; Borges, Sofia; Freitas, Ana Isabel; Guerra, Graça; Góis, Teresa; Rodrigues, Mariana; Henriques, Eva; Freitas, Sónia; Ornelas, Ilídio; Pereira, Décio; Brehm, António; Mendonça, Maria Isabel

    2017-10-01

    Essential hypertension (EH) is a complex disease in which physiological, environmental, and genetic factors are involved in its genesis. The genetic variant of the alpha-adducin gene (ADD1) has been described as a risk factor for EH, but with controversial results.The objective of this study was to evaluate the association of ADD1 (Gly460Trp) gene polymorphism with the EH risk in a population from Madeira Island.A case-control study with 1614 individuals of Caucasian origin was performed, including 817 individuals with EH and 797 controls. Cases and controls were matched for sex and age, by frequency-matching method. All participants collected blood for biochemical and genotypic analysis for the Gly460Trp polymorphism. We further investigated which variables were independently associated to EH, and, consequently, analyzed their interactions.In our study, we found a significant association between the ADD1 gene polymorphism and EH (odds ratio 2.484, P = .01). This association remained statistically significant after the multivariate analysis (odds ratio 2.548, P = .02).The ADD1 Gly460Trp gene polymorphism is significantly and independently associated with EH risk in our population. The knowledge of genetic polymorphisms associated with EH is of paramount importance because it leads to a better understanding of the etiology and pathophysiology of this pathology.

  6. How to Add Philosophy Dimensions in Your Basic International Business Course

    Science.gov (United States)

    Thanopoulos, John

    2010-01-01

    This article aims to assist professors in introducing concepts of self, philosophy, religions, the universe, existential dilemmas, etc., in their basic international business classes. Using active learning and five-member student teams, a student organized and administered conference adds a very useful dimension of knowledge sacrificing only one…

  7. Weight gain with add-on second-generation antipsychotics in bipolar disorder: a naturalistic study.

    Science.gov (United States)

    Najar, H; Joas, E; Kardell, M; Pålsson, E; Landén, M

    2017-06-01

    Our aim was to investigate the prevalence and magnitude of weight gain in-patients with bipolar disorder when treated with a second-generation antipsychotic as an add-on treatment to a mood stabilizer in routine clinical practice. Data were derived from the quality register for bipolar disorder in Sweden (BipoläR). Patients with bipolar disorder who started add-on treatment with a SGA (n = 575) were compared at next yearly follow-up with age and sex matched patients who were only treated with a mood stabilizer (n = 566). The primary outcome measure was change in body weight and body mass index (BMI). We also assessed the prevalence of clinically significant weight gain defined as ≥7% gain in body weight. The group that received add-on treatment with antipsychotics neither gained more weight nor were at higher risk for a clinically significant weight gain than the reference group. Instead, factors associated with clinically significant weight gain were female sex, young age, low-baseline BMI, and occurrence of manic/hypomanic episodes. We found no evidence of an overall increased risk of weight gain for patients with bipolar disorder after receiving add-on SGA to a mood stabilizer in a routine clinical setting. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Associations between Dopamine and Serotonin Genes and Job Satisfaction: Preliminary Evidence from the Add Health Study

    Science.gov (United States)

    Song, Zhaoli; Li, Wendong; Arvey, Richard D.

    2011-01-01

    Previous behavioral genetic studies have found that job satisfaction is partially heritable. We went a step further to examine particular genetic markers that may be associated with job satisfaction. Using an oversample from the National Adolescent Longitudinal Study (Add Health Study), we found 2 genetic markers, dopamine receptor gene DRD4 VNTR…

  9. Psychometric Properties and Norms of the German ABC-Community and PAS-ADD Checklist

    Science.gov (United States)

    Zeilinger, Elisabeth L.; Weber, Germain; Haveman, Meindert J.

    2011-01-01

    Aim: The aim of the present study was to standardize and generate psychometric evidence of the German language versions of two well-established English language mental health instruments: the "Aberrant Behavior Checklist-Community" (ABC-C) and the "Psychiatric Assessment Schedule for Adults with Developmental Disabilities" (PAS-ADD) Checklist. New…

  10. Ciprofloxacin and probiotic Escherichia coli Nissle add-on treatment in active ulcerative colitis

    DEFF Research Database (Denmark)

    Petersen, Andreas Munk; Mirsepasi, Hengameh; Halkjær, Sofie Ingdam

    2014-01-01

    BACKGROUND AND AIM: Ulcerative colitis (UC) is a chronic inflammatory bowel disease. The probiotic bacterium Escherichia coli Nissle 1917 (EcN) has been used to maintain and induce clinical remission in UC. Our aim was to test the effect of Ciprofloxacin and/or orally administered EcN as add...

  11. 76 FR 65935 - Brucellosis in Swine; Add Texas to List of Validated Brucellosis-Free States

    Science.gov (United States)

    2011-10-25

    ... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service 9 CFR Part 78 [Docket No. APHIS-2011-0005] Brucellosis in Swine; Add Texas to List of Validated Brucellosis- Free States AGENCY... or birth of weak offspring, reduced milk production, and infertility. There is no economically...

  12. Med-records: an ADD database of AAEC medical records since 1966

    International Nuclear Information System (INIS)

    Barry, J.M.; Pollard, J.P.; Tucker, A.D.

    1986-08-01

    Since its inception in 1958 most of the staff of the AAEC Research Establishment at Lucas Heights have had annual medical examinations. Medical information accrued since 1966 has been collected as an ADD database to allow ad hoc enquiries to be made against the data. Details are given of the database schema and numerous support routines ranging from the integrity checking of input data to analysis and plotting of the summary results

  13. The study of business opportunities and value add of NFC applications in security

    OpenAIRE

    Niemelä, Harri

    2011-01-01

    Niemelä, Harri 2011. The study of business opportunities and value add of NFC applications in security access control solutions. Master´s Thesis. Kemi-Tornio University of Applied Sciences. Business and Culture. Pages 59. Appendices 2. Since wireless technologies and electrical identification is already our everyday life, it is naturally to utilize latest technologies and in this case Near Field Communication technology to security access control purposes what we meet in our life at wo...

  14. Pleasure and pedagogy: the consumption of DVD add-ons among Irish teenagers

    OpenAIRE

    Brereton, Pat; O'Connor, Barbara

    2007-01-01

    This article addresses the issue of young people and media use in the digital age, more specifically the interconnection between new media pleasures and pedagogy as they relate to the consumption of DVD add-ons. Arguing against the view of new media as having predominantly detrimental effects on young people, the authors claim that new media can enable young people to develop media literacy skills and are of the view that media literacy strategies must be based on an understanding and legitim...

  15. Hera-FFX: a Firefox add-on for Semi-automatic Web Accessibility Evaluation

    OpenAIRE

    Fuertes Castro, José Luis; González, Ricardo; Gutiérrez, Emmanuelle; Martínez Normand, Loïc

    2009-01-01

    Website accessibility evaluation is a complex task requiring a combination of human expertise and software support. There are several online and offline tools to support the manual web accessibility evaluation process. However, they all have some weaknesses because none of them includes all the desired features. In this paper we present Hera-FFX, an add-on for the Firefox web browser that supports semi-automatic web accessibility evaluation.

  16. The Dnmt3L ADD Domain Controls Cytosine Methylation Establishment during Spermatogenesis

    Directory of Open Access Journals (Sweden)

    Georgios Vlachogiannis

    2015-02-01

    Full Text Available A critical aspect of mammalian gametogenesis is the reprogramming of genomic DNA methylation. The catalytically inactive adaptor Dnmt3L is essential to ensuring this occurs correctly, but the mechanism by which it functions is unclear. Using gene targeting to engineer a single-amino-acid mutation, we show that the Dnmt3L histone H3 binding domain (ADD is necessary for spermatogenesis. Genome-wide single-base-resolution DNA methylome analysis of mutant germ cells revealed overall reductions in CG methylation at repetitive sequences and non-promoter CpG islands. Strikingly, we also observe an even more severe loss of non-CG methylation, suggesting an unexpected role for the ADD in this process. These epigenetic deficiencies were coupled with defects in spermatogonia, with mutant cells displaying marked changes in gene expression and reactivation of retrotransposons. Our results demonstrate that the Dnmt3L ADD is necessary for Dnmt3L function and full reproductive fitness.

  17. Does Gonadotropin Releasing Hormone Agonists plus add-back therapy bring an aurora to orthodontic treatment?

    Directory of Open Access Journals (Sweden)

    Jiang Lingyong

    2012-01-01

    Full Text Available Introduction: Obviously, long therapy time of orthodontic treatment and a number of its adverse effects, such as pain, root resorption, enamel demineralization, periodontal disease, are the main reasons of complaints from patients. It is the first thing for an orthodontist to shorten the period of treatment and decrease the complications of orthodontic treatment as much as possible. The Hypothesis: We hypothesis Gonadotropin Releasing Hormone Agonists (GnRHa and add-back therapy can create the "therapeutic window", namely, the appropriate estrogen level and assuage the adverse effects of estrogen deficiency which should be avoided as much as possible. Evaluation of the Hypothesis: It is generally acknowledged that estrogen has direct regulating role in bone metabolism by acting on osteoblasts and osteoclasts. Estrogen deficiency can increase the rate of orthodontic tooth movement and also bring about some adverse effects. The appropriate estrogen level, which we call the "therapeutic window" in orthodontic treatment, can speed up the orthodontic tooth movement and eliminate the adverse effects as far as possible. GnRHa can be the maker of estrogen deficiency; meanwhile, add-back therapy can remove the adverse effects by estrogen deficiency. So, we believe that GnRHa plus add-back therapy could be a new adjuvant method of orthodontic treatment and be good for orthodontists and patients.

  18. Development of an add-on kit for scanning confocal microscopy (Conference Presentation)

    Science.gov (United States)

    Guo, Kaikai; Zheng, Guoan

    2017-03-01

    Scanning confocal microscopy is a standard choice for many fluorescence imaging applications in basic biomedical research. It is able to produce optically sectioned images and provide acquisition versatility to address many samples and application demands. However, scanning a focused point across the specimen limits the speed of image acquisition. As a result, scanning confocal microscope only works well with stationary samples. Researchers have performed parallel confocal scanning using digital-micromirror-device (DMD), which was used to project a scanning multi-point pattern across the sample. The DMD based parallel confocal systems increase the imaging speed while maintaining the optical sectioning ability. In this paper, we report the development of an add-on kit for high-speed and low-cost confocal microscopy. By adapting this add-on kit to an existing regular microscope, one can convert it into a confocal microscope without significant hardware modifications. Compared with current DMD-based implementations, the reported approach is able to recover multiple layers along the z axis simultaneously. It may find applications in wafer inspection and 3D metrology of semiconductor circuit. The dissemination of the proposed add-on kit under $1000 budget could also lead to new types of experimental designs for biological research labs, e.g., cytology analysis in cell culture experiments, genetic studies on multicellular organisms, pharmaceutical drug profiling, RNA interference studies, investigation of microbial communities in environmental systems, and etc.

  19. radEq Add-On Module for CFD Solver Loci-CHEM

    Science.gov (United States)

    McCloud, Peter

    2013-01-01

    Loci-CHEM to be applied to flow velocities where surface radiation due to heating from compression and friction becomes significant. The module adds a radiation equilibrium boundary condition to the computational fluid dynamics (CFD) code to produce accurate results. The module expanded the upper limit for accurate CFD solutions of Loci-CHEM from Mach 4 to Mach 10 based on Space Shuttle Orbiter Re-Entry trajectories. Loci-CHEM already has a very promising architecture and performance, but absence of radiation equilibrium boundary condition limited the application of Loci-CHEM to below Mach 4. The immediate advantage of the add-on module is that it allows Loci-CHEM to work with supersonic flows up to Mach 10. This transformed Loci-CHEM from a rocket engine- heritage CFD code with general subsonic and low-supersonic applications, to an aeroheating code with hypersonic applications. The follow-on advantage of the module is that it is a building block for additional add-on modules that will solve for the heating generated at Mach numbers higher than 10.

  20. High optical label switching add-drop multiplexer nodes with nanoseconds latency for 5G metro/access networks

    NARCIS (Netherlands)

    Calabretta, N.; Miao, W.; De Waardt, H.

    2016-01-01

    We present a novel optical add-drop multiplexer for next-generation metro/access networks by exploiting optical label switching technology. Experimental results of a ring network show nanoseconds add/drop operation including multicasting and power equalization of 50Gb/s data.

  1. The MMPI-168(L) and ADD in Assessing Psychopathology in Individuals with Mental Retardation: Between and within Instrument Associations.

    Science.gov (United States)

    McDaniel, William F.; Passmore, Corie E.; Sewell, Hollie M.

    2003-01-01

    A study involving 58 adults with mental retardation and mental disorders found few correlations between the Minnesota Multiphasic Personality Inventory (MMPI) and the Assessment of Dual Diagnosis (ADD). The major exception was the Mania scale of the MMPI, which correlated moderately well with the ADD Schizophrenia and Dementia scales. (Contains…

  2. 36 CFR 1011.5 - What interest, penalty charges and administrative costs will the Presidio Trust add to a debt?

    Science.gov (United States)

    2010-07-01

    ... charges and administrative costs will the Presidio Trust add to a debt? 1011.5 Section 1011.5 Parks... § 1011.5 What interest, penalty charges and administrative costs will the Presidio Trust add to a debt? (a) Interest. (1) The Presidio Trust will assess interest on all delinquent debts unless prohibited...

  3. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Science.gov (United States)

    2010-07-01

    ... Limits if Using Add-On Control Devices and Capture System If you are required to comply with operating... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Operating Limits if Using Add-On Control Devices and Capture System 1 Table 1 to Subpart JJJJ of Part 63 Protection of Environment...

  4. 40 CFR Table 2 to Subpart Oooo of... - Operating Limits if Using Add-On Control Devices and Capture System

    Science.gov (United States)

    2010-07-01

    ... OOOO of Part 63—Operating Limits if Using Add-On Control Devices and Capture System If you are required... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Operating Limits if Using Add-On Control Devices and Capture System 2 Table 2 to Subpart OOOO of Part 63 Protection of Environment...

  5. 40 CFR Table 1 to Subpart Ssss of... - Operating Limits if Using Add-on Control Devices and Capture System

    Science.gov (United States)

    2010-07-01

    ... Using Add-on Control Devices and Capture System If you are required to comply with operating limits by... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Operating Limits if Using Add-on Control Devices and Capture System 1 Table 1 to Subpart SSSS of Part 63 Protection of Environment...

  6. Which thiazide to choose as add-on therapy for hypertension?

    Directory of Open Access Journals (Sweden)

    Barrios V

    2014-07-01

    Full Text Available Vivencio Barrios,1 Carlos Escobar2 1Department of Cardiology, Hospital Ramon y Cajal, 2Department of Cardiology, Hospital La Paz, Madrid, Spain Abstract: Combined therapy is required in the majority of patients with hypertension to achieve blood pressure (BP targets. Although different antihypertensive drugs can be combined, not all combinations are equally effective and safe. In this context, the combination of a renin angiotensin system inhibitor with a diuretic, usually a thiazide, particularly hydrochlorothiazide (HCTZ or thiazide-like diuretics, such as chlorthalidone or indapamide, is recommended. However, not all diuretics are equal. Although HCTZ, chlorthalidone, and indapamide as add-on therapy effectively reduce BP levels, the majority of studies have obtained greater BP reductions with chlorthalidone or indapamide than with HCTZ. Moreover, there are data showing benefits with chlorthalidone or indapamide beyond BP. Thus, chlorthalidone seems to have pleiotropic effects beyond BP reduction. Moreover, compared with placebo, chlorthalidone has small effects on fasting glucose and total cholesterol, and compared with HCTZ, chlorthalidone achieves significantly lower total cholesterol and low-density lipoprotein cholesterol levels. Similarly, indapamide has demonstrated no negative impact on glucose or lipid metabolism. More importantly, although head-to-head clinical trials comparing the effects of indapamide or chlorthalidone with HCTZ are not available, indirect comparisons and post hoc analyses suggest that the use of chlorthalidone or indapamide is associated with a reduction in cardiovascular events. Despite this, the most frequent diuretic used in clinical practice as add-on therapy for hypertension is HCTZ. The purpose of this review is to update the published data on the efficacy and safety of HCTZ, chlorthalidone, and indapamide as add-on therapy in patients with hypertension. Keywords: blood pressure control, hydrochlorothiazide

  7. MetaEasy: A Meta-Analysis Add-In for Microsoft Excel

    Directory of Open Access Journals (Sweden)

    Evangelos Kontopantelis

    2009-04-01

    Full Text Available Meta-analysis is a statistical methodology that combines or integrates the results ofseveral independent clinical trials considered by the analyst to be `combinable' (Huque1988. However, completeness and user-friendliness are uncommon both in specialisedmeta-analysis software packages and in mainstream statistical packages that have to relyon user-written commands. We implemented the meta-analysis methodology in an Mi-crosoft Excel add-in which is freely available and incorporates more meta-analysis models(including the iterative maximum likelihood and prole likelihood than are usually avail-able, while paying particular attention to the user-friendliness of the package.

  8. WITHDRAWN: Oxcarbazepine add-on for drug-resistant partial epilepsy.

    Science.gov (United States)

    Castillo, Sergio M; Schmidt, Dieter B; White, Sarah; Shukralla, Arif

    2016-11-15

    Most people with epilepsy have a good prognosis and their seizures can be well controlled with the use of a single antiepileptic drug, but up to 30% develop refractory epilepsy, especially those with partial seizures. In this review we summarize the current evidence regarding oxcarbazepine when used as an add-on treatment for drug-resistant partial epilepsy. To evaluate the effects of oxcarbazepine when used as an add-on treatment for drug-resistant partial epilepsy. We searched the Cochrane Epilepsy Group's Specialized Register (28 March 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to March 2006). No language restrictions were imposed. We checked the reference lists of retrieved studies for additional reports of relevant studies. We also contacted Novartis (manufacturers of oxcarbazepine) and experts in the field. Randomized, placebo-controlled, double-blinded, add-on trials of oxcarbazepine in patients with drug-resistant partial epilepsy. Two review authors independently assessed trials for inclusion and extracted the relevant data. The following outcomes were assessed : (a) 50% or greater reduction in seizure frequency; (b) treatment withdrawal (any reason); (c) side effects. Primary analyses were intention-to-treat. Summary odds ratios were estimated for each outcome. Two trials were included representing 961 randomized patients.Overall Odds Ratio (OR) (95% Confidence Interval (CIs)) for 50% or greater reduction in seizure frequency compared to placebo 2.96 (2.20, 4.00).Treatment withdrawal OR (95% CIs) compared to placebo 2.17 (1.59, 2.97).Side effects: OR (99% CIs) compared to placebo, ataxia 2.93 (1.72, 4.99); dizziness 3.05 (1.99, 4.67); fatigue 1.80 (1.02, 3.19); nausea 2.88 (1.77, 4.69); somnolence 2.55 (1.84, 3.55); diplopia 4.32 (2.65, 7.04), were significantly associated with oxcarbazepine. Oxcarbazepine has efficacy as an add-on treatment in patients with drug

  9. A high resolution 16 k multi-channel analyzer PC add-on card

    International Nuclear Information System (INIS)

    Kulkarni, C.P.; Paulson, Molly; Vaidya, P.P.

    2001-01-01

    This paper describes the system details of a 16 K channel resolution Multi-Channel Analyzer (MCA) developed at Electronics Division, BARC, which is used in high resolution nuclear spectroscopy systems for pulse height analysis. The high resolution data acquisition PC add-on card is architectured using a state of the art digital circuit design technology which makes use of a Field Programmable Gate Array (FPGA), and some of the most modern and advanced analog counterparts like low power, high speed and high precision comparators, Op-amps, ADCs and DACs etc. The 16 K MCA card gives an economic, compact, and low power alternative for nuclear pulse spectroscopy use. (author)

  10. Identification of a mutation in ADD1/SREBP-1 in the spontaneously hypertensive rat

    Czech Academy of Sciences Publication Activity Database

    Pravenec, Michal; Jansa, Petr; Kostka, Vlastimil; Zídek, Václav; Křen, Vladimír; Forejt, Jiří; Kurtz, T. W.

    2001-01-01

    Roč. 12, č. 4 (2001), s. 295-298 ISSN 0938-8990 R&D Projects: GA ČR(CZ) GA305/00/1646; GA MŠk(CZ) LN00A079; GA ČR(CZ) GV204/98/K015 Grant - others:HHMI(US) 55000331 Institutional research plan: CEZ:AV0Z5011922 Keywords : mutations in genes * ADD1/SREBP-1c * spontaneously hypertensive rat Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 2.318, year: 2001

  11. Analysis of silicon on insulator (SOI) optical microring add-drop filter based on waveguide intersections

    Science.gov (United States)

    Kaźmierczak, Andrzej; Bogaerts, Wim; Van Thourhout, Dries; Drouard, Emmanuel; Rojo-Romeo, Pedro; Giannone, Domenico; Gaffiot, Frederic

    2008-04-01

    We present a compact passive optical add-drop filter which incorporates two microring resonators and a waveguide intersection in silicon-on-insulator (SOI) technology. Such a filter is a key element for designing simple layouts of highly integrated complex optical networks-on-chip. The filter occupies an area smaller than 10μm×10μm and exhibits relatively high quality factors (up to 4000) and efficient signal dropping capabilities. In the present work, the influence of filter parameters such as the microring-resonators radii and the coupling section shape are analyzed theoretically and experimentally

  12. Erythropoietin as an add-on treatment for cognitive side effects of electroconvulsive therapy

    DEFF Research Database (Denmark)

    Schmidt, Lejla Sjanic; Petersen, Jeff Zarp; Vinberg, Maj

    2018-01-01

    trial investigates (1) whether short-term add-on treatment with erythropoietin (EPO) can reduce the cognitive side -effects of ECT and (2) whether such effects are long-lasting. Further, structural and functional magnetic resonance imaging (MRI) will be used to explore the neural underpinnings...... cognitive benefits of EPO are investigated with structural and functional MRI after the final EPO/saline infusion. The primary outcome is change from baseline to after EPO treatment (3 days after eight ECT sessions) in a cognitive composite score spanning attention, psychomotor speed, and executive...... of covariance. Functional MRI data will be preprocessed and analyzed using the FMRIB Software Library....

  13. Theophylline as an add-on to thrombolytic therapy in acute ischaemic stroke (TEA-Stroke)

    DEFF Research Database (Denmark)

    Modrau, Boris; Hjort, Niels; Østergaard, Leif

    2016-01-01

    the collateral supply in acute ischaemic brain tissue and thus facilitate reperfusion despite proximal vessel occlusion. The primary study objective is to evaluate whether theophylline is safe and efficient in acute ischaemic stroke patients as an add-on to thrombolytic therapy.MethodsThe TEA-Stroke Trial...... models, clinical case series and randomized clinical trials are controversial. A Cochrane analysis from 2004 concluded that there was not enough evidence to assess whether theophylline is safe and improves outcomes in patients with acute ischaemic stroke. The TEA-Stroke Trial will clarify whether...

  14. Estimating the postmortem interval (PMI) using accumulated degree-days (ADD) in a temperate region of South Africa.

    Science.gov (United States)

    Myburgh, Jolandie; L'Abbé, Ericka N; Steyn, Maryna; Becker, Piet J

    2013-06-10

    The validity of the method in which total body score (TBS) and accumulated degree-days (ADD) are used to estimate the postmortem interval (PMI) is examined. TBS and ADD were recorded for 232 days in northern South Africa, which has temperatures between 17 and 28 °C in summer and 6 and 20 °C in winter. Winter temperatures rarely go below 0°C. Thirty pig carcasses, which weighed between 38 and 91 kg, were used. TBS was scored using the modified method of Megyesi et al. [1]. Temperature was acquired from an on site data logger and the weather station bureau; differences between these two sources were not statistically significant. Using loglinear random-effects maximum likelihood regression, an r(2) value for ADD (0.6227) was produced and linear regression formulae to estimate PMI from ADD with a 95% prediction interval were developed. The data of 16 additional pigs that were placed a year later were then used to validate the accuracy of this method. The actual PMI and ADD were compared to the estimated PMI and ADD produced by the developed formulae as well as the estimated PMIs within the 95% prediction interval. A validation of the study produced poor results as only one pig of 16 fell within the 95% interval when using the formulae, showing that ADD has limited use in the prediction of PMI in a South African setting. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Avoidant personality disorder in individuals with generalized social anxiety disorder: what does it add?

    Science.gov (United States)

    Marques, Luana; Porter, Eliora; Keshaviah, Aparna; Pollack, Mark H; Van Ameringen, Michael; Stein, Murray B; Simon, Naomi M

    2012-08-01

    Avoidant personality disorder (AvPD) has a high level of symptom overlap and comorbidity with generalized social anxiety disorder (GSAD). We examined whether the presence of comorbid AvPD adds significant clinically relevant information for individuals seeking treatment for GSAD. Results suggested that AvPD was significantly associated with poorer quality of life and greater disability in univariate, but not multivariate analyses. Endorsement of more AvPD symptoms was associated with increased disability, increased risk of intimacy, and lower social support, even after covariate adjustment. Specifically, AvPD item 3, hard to be "open" even with people you are close to, was most strongly correlated with quality of life and disability. A binary diagnosis of AvPD alone adds little beyond a marker of greater GSAD severity and depression among patients with GSAD, while a specific feature of AvPD not captured by the GSAD diagnosis, namely emotional guardedness, may be associated with greater impairment. Published by Elsevier Ltd.

  16. Development of a colonoscopy add-on device for improvement of the intubation process

    Directory of Open Access Journals (Sweden)

    Litten JD

    2011-12-01

    Full Text Available Jonathan D Litten1, JungHun Choi2, David Drozek31Department of Mechanical Engineering; 2Department of Mechanical Engineering and Biomedical Engineering Program; 3College of Osteopathic Medicine, Department of Specialty Medicine, Ohio University, Athens, OH, USAAbstract: A colonoscopy add-on device has been developed to reduce intubation time without modification of the current colonoscope and peripheral devices. One of the main purposes of the system is to minimize trauma caused by the distal tip of the colonoscope. The detachable sensory fixture at the end of the distal tip measures the distance between the distal tip and the colon wall in three directions, and the actuation system attached at the base of the colonoscope controls the distal tip by rotating two dial knobs. The device controls the distal tip to minimize contact between the distal tip and the colon wall, and the distal tip ideally points out the next possible lumen. A compatibility test of the infrared sensory system was carried out, and the design of the actuation system was accomplished. The system is integrated and controlled by a microprocessor. The device was tested in a silicon colon and porcine intestine. The results showed that a colonoscopist successfully reached the cecum with the aid of the colonoscopy add-on device without significant contact between the colon wall and the distal tip. The colonoscopy aid device was very helpful for the novice colonoscopist.Keywords: colonoscope, infrared sensors, intubation, trauma, colonoscopy training model

  17. Do "premium" joint implants add value?: analysis of high cost joint implants in a community registry.

    Science.gov (United States)

    Gioe, Terence J; Sharma, Amit; Tatman, Penny; Mehle, Susan

    2011-01-01

    Numerous joint implant options of varying cost are available to the surgeon, but it is unclear whether more costly implants add value in terms of function or longevity. We evaluated registry survival of higher-cost "premium" knee and hip components compared to lower-priced standard components. Premium TKA components were defined as mobile-bearing designs, high-flexion designs, oxidized-zirconium designs, those including moderately crosslinked polyethylene inserts, or some combination. Premium THAs included ceramic-on-ceramic, metal-on-metal, and ceramic-on-highly crosslinked polyethylene designs. We compared 3462 standard TKAs to 2806 premium TKAs and 868 standard THAs to 1311 premium THAs using standard statistical methods. The cost of the premium implants was on average approximately $1000 higher than the standard implants. There was no difference in the cumulative revision rate at 7-8 years between premium and standard TKAs or THAs. In this time frame, premium implants did not demonstrate better survival than standard implants. Revision indications for TKA did not differ, and infection and instability remained contributors. Longer followup is necessary to demonstrate whether premium implants add value in younger patient groups. Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

  18. Just add water: reproducible singly dispersed silver nanoparticle suspensions on-demand

    International Nuclear Information System (INIS)

    MacCuspie, Robert I.; Allen, Andrew J.; Martin, Matthew N.; Hackley, Vincent A.

    2013-01-01

    Silver nanoparticles (AgNPs) are of interest due to their antimicrobial attributes, which are derived from their inherent redox instability and subsequent release of silver ions. At the same time, this instability is a substantial challenge for achieving stable long-term storage for on-demand use of AgNPs. In this study, we describe and validate a “just add water” approach for achieving suspensions of principally singly dispersed AgNPs. By lyophilizing (freeze drying) the formulated AgNPs into a solid powder, or cake, water is removed thereby eliminating solution-based chemical changes. Storing under inert gas further reduces surface reactions such as oxidation. An example of how to optimize a lyophilization formulation is presented, as well as example formulations for three AgNP core sizes. This “just add water” approach enables ease of use for the researcher desiring on-demand singly dispersed AgNP suspensions from a single master batch. Implementation of this methodology will enable studies to be performed over long periods of time and across different laboratories using particles that are identical chemically and physically and available on-demand. In addition, the approach of freeze drying and on-demand reconstitution by adding water has enabled the development of AgNP reference materials with the required shelf-life stability, one of the principal objectives of this research

  19. SiPM and ADD as advanced detectors for astro-particle physics

    International Nuclear Information System (INIS)

    Mirzoyan, Razmick; Dolgoshein, Boris; Holl, Peter; Klemin, Sergei; Merck, Christine; Moser, Hans-Guenther; Otte, Adam Nepomuk; Ninkovic, Jelena; Popova, Elena; Richter, Rainer; Teshima, Masahiro

    2007-01-01

    In recent years, a few scientific groups are developing a novel type light sensor. These so-called silicon photo multipliers (SiPM) operate at relatively low bias voltage of 20-60 V, show unprecedented amplitude resolution and already now can provide photon detection efficiencies (PDE) comparable to or better than that of classical photo multipliers (PMT). We are developing the novel sensors for the astro-particle physics experiments MAGIC [J. Albert, et al., Astrophys. Lett. 642 (2006) L119. ] and also for EUSO [M. Teshima, et al., EUSO (The Extreme Universe Space Observatory), in: Scientific Objectives Proceedings ICRC, 2003, p. 10690. ]. The front-illuminated SiPM are developing with the group from MEPhI in Moscow and the back-illuminated Avalanche Drift Diodes (ADD) with the semiconductor laboratory (HLL) attached to the MPI for Physics. Our goal is to produce 5-10 mm size ultra-fast, low-noise and very high PDE (60-80%) sensors operating in the wavelength range 300-600 nm. Together with MEPhI, we have already produced and successfully tested 1.3x1.3, 3x3 and 5x5 mm 2 size SiPMs. Very recently, the first ADD test structures were produced and are under evaluation at the HLL. In this report, we want to outline the main parameters of the new sensors for the needs of astro-particle physics experiments

  20. Digital Tomosynthesis System Geometry Analysis Using Convolution-Based Blur-and-Add (BAA) Model.

    Science.gov (United States)

    Wu, Meng; Yoon, Sungwon; Solomon, Edward G; Star-Lack, Josh; Pelc, Norbert; Fahrig, Rebecca

    2016-01-01

    Digital tomosynthesis is a three-dimensional imaging technique with a lower radiation dose than computed tomography (CT). Due to the missing data in tomosynthesis systems, out-of-plane structures in the depth direction cannot be completely removed by the reconstruction algorithms. In this work, we analyzed the impulse responses of common tomosynthesis systems on a plane-to-plane basis and proposed a fast and accurate convolution-based blur-and-add (BAA) model to simulate the backprojected images. In addition, the analysis formalism describing the impulse response of out-of-plane structures can be generalized to both rotating and parallel gantries. We implemented a ray tracing forward projection and backprojection (ray-based model) algorithm and the convolution-based BAA model to simulate the shift-and-add (backproject) tomosynthesis reconstructions. The convolution-based BAA model with proper geometry distortion correction provides reasonably accurate estimates of the tomosynthesis reconstruction. A numerical comparison indicates that the simulated images using the two models differ by less than 6% in terms of the root-mean-squared error. This convolution-based BAA model can be used in efficient system geometry analysis, reconstruction algorithm design, out-of-plane artifacts suppression, and CT-tomosynthesis registration.

  1. [The add-on effect of omalizumab on patients with uncontrolled bronchial asthma].

    Science.gov (United States)

    Minami, Yoshinori; Endo, Satoshi; Okumur, Shunsuke; Sasaki, Takaaki; Yamamoto, Yasushi; Ogasa, Toshiyuki; Osanai, Shinobu; Ohsaki, Yoshinobu

    2011-11-01

    A high-dose administration of inhaled corticosteroid is effective in the majority of patients with bronchial asthma, but is often difficult to attain sufficient control in certain subsets of patients. Omalizumab has recently emerged as a promising drug for bronchial asthma. To assess its add-on effect we administered omalizumab to patients with uncontrolled atopic asthma for more than 16 weeks and gave them questionnaires. The study population comprised 9 patients with frequent asthmatic symptoms despite the administration of high-dose inhaled corticosteroid and other disease controllers. We scored disease control using the Asthma Health Questionnaire-33-Japan and the Asthma Control Test, and evaluated the frequencies of short-acting beta2-agonist use for rescue and drip infusion of theophyllines and/or systemic steroids in a retrospective fashion. Asthmatic scores were significantly improved after 16 weeks of omalizumab therapy. The frequencies of reliever use and drip infusion were also decreased. These trends were present even in patients in whom no aeroallergen-specific IgE antibodies were detected. No statistically significant side effects were observed. Our study confirmed the add-on effect of omalizumab based on evaluation by simple questionnaires. Further studies are needed to clarify whether omalizumab therapy is suitable for patients without specific IgE antibodies.

  2. The Politics, Development and Problems of Small Irrigation Dams in Malawi: Experiences from Mzuzu ADD

    Directory of Open Access Journals (Sweden)

    Bryson Gwiyani Nkhoma

    2011-10-01

    Full Text Available The paper examines the progress made regarding the development of small irrigation dams in Malawi with the view of establishing their significance in improving rural livelihoods in the country. The paper adopts a political economy theory and a qualitative research approach. Evidence from Mzuzu Agricultural Development Division (ADD, where small reservoirs acquire specific relevance, shows that despite the efforts made, the development of small dams is making little progress. The paper highlights that problems of top-down planning, high investment costs, negligence of national and local interests, over-dependency on donors, and conflicts over the use of dams – which made large-scale dams unpopular in the 1990s – continue to affect the development of small irrigation dams in Malawi. The paper argues that small irrigation dams should not be simplistically seen as a panacea to the problems of large-scale irrigation dams. Like any other projects, small dams are historically and socially constructed through interests of different actors in the local settings, and can only succeed if actors, especially those from formal institutions, develop adaptive learning towards apparent conflicting relations that develop among them in the process of implementation. In the case of Mzuzu ADD, it was the failure of the government to develop this adaptive learning to the contestations and conflicts among these actors that undermined successful implementation of small irrigation dams. The paper recommends the need to consider local circumstances, politics, interests, rights and institutions when investing in small irrigation dams.

  3. Add/drop filters based on SiC technology for optical interconnects

    International Nuclear Information System (INIS)

    Vieira, M; Vieira, M A; Louro, P; Fantoni, A; Silva, V

    2014-01-01

    In this paper we demonstrate an add/drop filter based on SiC technology. Tailoring of the channel bandwidth and wavelength is experimentally demonstrated. The concept is extended to implement a 1 by 4 wavelength division multiplexer with channel separation in the visible range. The device consists of a p-i'(a-SiC:H)-n/p-i(a-Si:H)-n heterostructure. Several monochromatic pulsed lights, separately or in a polychromatic mixture illuminated the device. Independent tuning of each channel is performed by steady state violet bias superimposed either from the front and back sides. Results show that, front background enhances the light-to-dark sensitivity of the long and medium wavelength channels and quench strongly the others. Back violet background has the opposite behaviour. This nonlinearity provides the possibility for selective removal or addition of wavelengths. An optoelectronic model is presented and explains the light filtering properties of the add/drop filter, under different optical bias conditions

  4. IMPLEMENTASI PROGRAM ALOKASI DANA DESA (ADD DALAM PEMBERDAYAAN MASYARAKAT DI DESA PUNAGAYA KECAMATAN BANGKALA KABUPATEN JENEPONTO

    Directory of Open Access Journals (Sweden)

    Octrian TSL

    2013-04-01

    Full Text Available Punagaya village through the village fund allocation (ADD will allocate a budget for community development in the areas of sugar production business, the study aims to look at the implementation of the allocation of funds in the rural community empowerment programs and the factors that affect the implementation of the implementation of the allocation of funds within the village community empowerment program in the Village Punagaya sub Bangkala Jeneponto district. This research is descriptive qualitative research sampling technique used was purposive sampling. This study uses data analysis techniques interviews and observations, after which the data collected are then analyzed using frequency tables later be described qualitatively. Number of samples 33 people consisting of 1 person village head, village secretary 1 person, a member of the Committee seminar 5 people, local people 7 people, 4 people Ibu PKK, brown sugar 6 people Makers, Executive Team Live Help ADD 3orang, public figures 6 people. Penelitaian showed that 52% of people believe that the implementation of the Village punagaya village fund allocation in the village punagaya poorly this happens because people do not see the program conducted by the local government to improve the empowerment and increased repair services performed by local governments to use allocation of village funds. Based on the research I did it, it can be concluded that the public has not been empowered by optimal utilization of ADD in the Village District Punagaya Bangkala Jeneponto. It is caused due to problems such as the allocation of funds provided inadequate to meningatkan empowerment, besides the allocation of funds is often given too late and village officials rendahmya influence on the development and management of the allocation of funds is a factor inhibiting village program implementation in the village of village fund allocation Punagaya Sub Bangkala Jeneponto but from the village fund allocation is

  5. Production Of The ADD Type Kaluza-Klein Excitations At Future e+e-, ep And pp Colliders

    International Nuclear Information System (INIS)

    Billur, A. A.; Ciftci, A. K.; Ciftci, R.; Inan, S. C.; Sultansoy, S.

    2007-01-01

    Possible production of ADD type Kaluza-Klein excitations are investigated at future high energy e+e-, ep and pp colliders. Discovery limits and signatures of such excitations are discussed at above colliders comparatively

  6. dAdd1 and dXNP prevent genome instability by maintaining HP1a localization at Drosophila telomeres.

    Science.gov (United States)

    Chavez, Joselyn; Murillo-Maldonado, Juan Manuel; Bahena, Vanessa; Cruz, Ana Karina; Castañeda-Sortibrán, América; Rodriguez-Arnaiz, Rosario; Zurita, Mario; Valadez-Graham, Viviana

    2017-12-01

    Telomeres are important contributors to genome stability, as they prevent linear chromosome end degradation and contribute to the avoidance of telomeric fusions. An important component of the telomeres is the heterochromatin protein 1a (HP1a). Mutations in Su(var)205, the gene encoding HP1a in Drosophila, result in telomeric fusions, retrotransposon regulation loss and larger telomeres, leading to chromosome instability. Previously, it was found that several proteins physically interact with HP1a, including dXNP and dAdd1 (orthologues to the mammalian ATRX gene). In this study, we found that mutations in the genes encoding the dXNP and dAdd1 proteins affect chromosome stability, causing chromosomal aberrations, including telomeric defects, similar to those observed in Su(var)205 mutants. In somatic cells, we observed that dXNP and dAdd1 participate in the silencing of the telomeric HTT array of retrotransposons, preventing anomalous retrotransposon transcription and integration. Furthermore, the lack of dAdd1 results in the loss of HP1a from the telomeric regions without affecting other chromosomal HP1a binding sites; mutations in dxnp also affected HP1a localization but not at all telomeres, suggesting a specialized role for dAdd1 and dXNP proteins in locating HP1a at the tips of the chromosomes. These results place dAdd1 as an essential regulator of HP1a localization and function in the telomere heterochromatic domain.

  7. Addiction surplus: the add-on margin that makes addictive consumptions difficult to contain.

    Science.gov (United States)

    Adams, Peter J; Livingstone, Charles

    2015-01-01

    Addictive consumptions generate financial surpluses over-and-above non-addictive consumptions because of the excessive consumption of addicted consumers. This add-on margin or 'addiction surplus' provides a powerful incentive for beneficiaries to protect their income by ensuring addicted consumers keep consuming. Not only that, addiction surplus provides the financial base that enables producers to sponsor activities which aim to prevent public health initiatives from reducing consumption. This paper examines the potency of addiction surplus to engage industry, governments and communities in an on-going reliance on addiction surplus. It then explores how neo-liberal constructions of a rational consumer disguise the ethical and exploitative dynamics of addiction surplus by examining ways in which addictive consumptions fail to conform to notions of autonomy and rationality. Four measures are identified to contain the distorting effects of addiction surplus. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Eslicarbazepine acetate add-on for drug-resistant partial epilepsy.

    Science.gov (United States)

    Chang, Xian-Chao; Yuan, Hai; Wang, Yi; Xu, Hui-Qin; Hong, Wen-Ke; Zheng, Rong-Yuan

    2017-10-25

    This is an updated version of the Cochrane Review published in the Cochrane Library 2011, Issue 12.The majority of people with epilepsy have a good prognosis, but up to 30% of people continue to have seizures despite several regimens of antiepileptic drugs. In this review, we summarized the current evidence regarding eslicarbazepine acetate (ESL) when used as an add-on treatment for drug-resistant partial epilepsy. To evaluate the efficacy and tolerability of ESL when used as an add-on treatment for people with drug-resistant partial epilepsy. The searches for the original review were run in November 2011. Subsequently, we searched the Cochrane Epilepsy Group Specialized Register (6 December 2016), the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 11) and MEDLINE (1946 to 6 December 2016). There were no language restrictions. We reviewed the reference lists of retrieved studies to search for additional reports of relevant studies. We also contacted the manufacturers of ESL and experts in the field for information about any unpublished or ongoing studies. Randomized placebo controlled double-blind add-on trials of ESL in people with drug-resistant partial epilepsy. Two review authors independently selected trials for inclusion and extracted data. Outcomes investigated included 50% or greater reduction in seizure frequency, seizure freedom, treatment withdrawal, adverse effects, and drug interactions. Primary analyses were by intention to treat (ITT). The dose-response relationship was evaluated in regression models. We included five trials (1799 participants) rated at low risk of bias; all studies were funded by BIAL. The overall risk ratio (RR) with 95% confidence interval (CI) for 50% or greater reduction in seizure frequency was 1.71 (95% CI 1.42 to 2.05). Dose regression analysis showed evidence that ESL reduced seizure frequency with an increase in efficacy with increasing doses of ESL. ESL was significantly associated with seizure freedom

  9. Interaction and dynamics of add-atoms with 2-dimensional structures

    CERN Multimedia

    The interaction and dynamics of add-atoms with graphene, graphene-derivate structures and, later, MoSi$_2$, two-dimensional – single and few – atomic layers will be studied with the Perturbed Angular Correlation – PAC – technique. Graphene is also envisaged as new platform for growing semiconductor nanostructure devices, such as quantum dots and as a particularly powerful catalyst. Understanding nucleation of nanostructures and clusters on graphene and related phases in wet conditions as they are used in chemical methods in research and industry require complementary studies. These systems will therefore be studied systematically using radioactive probe atoms attaching via a transfer media (e.g., water in catalysis process) or being deposited with soft-landing techniques under vacuum and UHV conditions, as put in place at the ASPIC setup at ISOLDE. The hyperfine fields obtained under different environments are expected to reveal basic information on the rich atomic and physical mechanisms associated w...

  10. An exploratory study on the potential value add of social networking to the Entrepreneurial process

    Directory of Open Access Journals (Sweden)

    Alex Antonites

    2011-12-01

    Full Text Available It is widely established in scientific literature that entrepreneurship directly contributes to both employment generation and economic growth. Entrepreneurship is said to be subject to a very specific process which includes opportunity recognition, resource allocation, innovation and networking. Networking specifically, is an essential part of the entrepreneurial process as it is employed to assist entrepreneurs to capitalise on opportunities, allocate resources, find ways to innovate and contest ambiguity. With the advent of Web 2.0 and online social networking platforms the way in which people exchange information and network has changed significantly and has spawned a new social culture on a global level. The purpose of this study is to examine the value that online social networking adds to the entrepreneurial process, specifically focussing on the South African landscape. Keywords and phrases: Entrepreneurship; Networking; Social capital; Social networking; Social media

  11. Circadian rest-activity rhythms during benzodiazepine tapering covered by melatonin versus placebo add-on

    DEFF Research Database (Denmark)

    Baandrup, Lone; Fasmer, Ole Bernt; Glenthøj, Birte Yding

    2016-01-01

    is associated with changes in circadian rhythm parameters. METHOD: Data were derived from a randomized, double-blinded clinical trial with 24 weeks follow-up. Participants were randomized to add-on treatment with prolonged-release melatonin (2 mg) or matching placebo, and usual benzodiazepine dosage...... significantly increased the interdaily stability and at a trend level decreased the intradaily variability compared with placebo. Benzodiazepine dose reduction was not associated with these circadian rhythm parameters. Activity counts were generally higher after benzodiazepine dose reduction compared with pre......BACKGROUND: Patients with severe mental illness often suffer from disruptions in circadian rest-activity cycles, which might partly be attributed to ongoing psychopharmacological medication. Benzodiazepines are frequently prescribed for prolonged periods despite recommendations of only short...

  12. Characterization of RNS multiply-add units for power efficient DSP

    DEFF Research Database (Denmark)

    Cardarilli, Gian Carlo; Nannarelli, Alberto; Petricca, Massimo

    2015-01-01

    ) for a fused multiply-add unit by taking into account four metrics: area, delay, power consumption, and switching activity. The results of the DSE are verified against the TCS and RNS implementation of parallel FIR filters of different characteristics. In both the DSE and the filter implementation, we consider......In the past decades, the Residue Number System (RNS) has been adopted in DSP as an alternative to the traditional two's complement number system (TCS) because of the savings in area, higher speed and reduced power dissipation. In this work, we perform a comprehensive Design Space Exploration (DSE...... two design corners: maximum speed and minimum area. The experimental results demonstrate that for high data rates and high order filters, the RNS implementation is more power efficient than the TCS because of the reduced switching activity and the larger amount of low-power cells placed in the unit....

  13. Associations between dopamine and serotonin genes and job satisfaction: preliminary evidence from the Add Health Study.

    Science.gov (United States)

    Song, Zhaoli; Li, Wendong; Arvey, Richard D

    2011-11-01

    Previous behavioral genetic studies have found that job satisfaction is partially heritable. We went a step further to examine particular genetic markers that may be associated with job satisfaction. Using an oversample from the National Adolescent Longitudinal Study (Add Health Study), we found 2 genetic markers, dopamine receptor gene DRD4 VNTR and serotonin transporter gene 5-HTTLPR, to be weakly but significantly associated with job satisfaction. Furthermore, we found study participants' level of pay to mediate the DRD4 and job satisfaction relationship. However, we found no evidence that self-esteem mediated the relationships between these 2 genes and job satisfaction. The study represents an initial effort to introduce a molecular genetics approach to the fields of organizational psychology and organizational behavior. (c) 2011 APA, all rights reserved.

  14. Phacomatosis pigmento-pigmentaria: should we add a new type of phacomatosis? Fact and controversies.

    Science.gov (United States)

    Wolf, Ronni; Wolf, Danny; Ruocco, Vincenzo; Baroni, Adone; Ruocco, Eleonora

    2013-01-01

    There are currently five types of recognized phacomatosis pigmentovascularis plus one more, phacomatosis pigmentokeratotica, making six types altogether. Should we stop here and consider the classification as being complete? Or, do we leave room to add more types or, alternatively, lump the ones we have together and shorten the list? We present our reasons for adding one or two new types of phacomatoses to the current classification, in full recognition that it is already complicated and somewhat cumbersome. We consider that the benefits of doing so outweigh any additional strain on the already complicated classification. We expect that this might not sit well with some of our colleagues, but we are prepared to do battle. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. SCEW: a Microsoft Excel add-in for easy creation of survival curves.

    Science.gov (United States)

    Khan, Haseeb Ahmad

    2006-07-01

    Survival curves are frequently used for reporting survival or mortality outcomes of experimental pharmacological/toxicological studies and of clinical trials. Microsoft Excel is a simple and widely used tool for creation of numerous types of graphic presentations however it is difficult to create step-wise survival curves in Excel. Considering the familiarity of clinicians and biomedical scientists with Excel, an algorithm survival curves in Excel worksheet (SCEW) has been developed for easy creation of survival curves directly in Excel worksheets. The algorithm has been integrated in the form of Excel add-in for easy installation and usage. The program is based on modification of frequency data for binary break-up using the spreadsheet formula functions whereas a macro subroutine automates the creation of survival curves. The advantages of this program are simple data input, minimal procedural steps and the creation of survival curves in the familiar confines of Excel.

  16. Caloric beverages consumed freely at meal-time add calories to an ad libitum meal.

    Science.gov (United States)

    Panahi, Shirin; El Khoury, Dalia; Luhovyy, Bohdan L; Goff, H Douglas; Anderson, G Harvey

    2013-06-01

    The objective was to compare the effects of ad libitum consumption of commonly consumed meal-time beverages on energy and fluid intakes and post-meal average subjective appetite and blood glucose in healthy adults. In a randomized controlled design, 29 males and females consumed to satiation an ad libitum pizza meal with one of five beverages in unlimited amount including water (0 kcal), 1% milk (44 kcal/100 ml), regular cola (44 kcal/100 ml), orange juice (44 kcal/100 ml) and diet cola (0 kcal). Food and fluid intakes were measured at the meal. Average subjective appetite and blood glucose were measured before and for 2h after the meal. Although energy intake from pizza was similar among all beverage treatments, the amount of fluid consumed (g) varied among the beverages with intake of orange juice higher than regular and diet cola, but not different from water or milk. Meal-time ingestion of caloric beverages, milk, orange juice and regular cola, led to higher total meal-time energy intakes compared to either water or diet cola. Post-meal blood glucose area under the curve (AUC) was lower after milk than after meals with water, orange juice and regular cola and post-meal average subjective appetite AUC was lower after milk than after meals with water. Meal intakes of nutrients including protein, calcium, phosphorus, zinc, vitamins B12, A and D were higher at the meal with milk compared to the other beverages. Thus, caloric beverages consumed ad libitum during a meal add to total meal-time energy intake, but 1% milk favors a lower post-meal blood glucose and average subjective appetite score and adds to nutrient intake. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Numerical Study on Self-Cleaning Canister Filter With Add-On Filter Cap

    Directory of Open Access Journals (Sweden)

    Mohammed Akmal Nizam

    2017-01-01

    Full Text Available Filtration in a turbo machinery system such as a gas turbine will ensure that the air entering the inlet is free from contaminants that could bring damage to the main system. Self-cleaning filter systems for gas turbines are designed for continuously efficient flow filtration. A good filter would be able to maintain its effectiveness over a longer time period, prolonging the duration between filter replacements and providing lower pressure drop over its operating lifetime. With this goal in mind, the current study is focused on the difference in pressure loss of the benchmark Salutary Avenue Self-cleaning filter in comparison to a new design with an add-on filter cap. Geometry for the add-on filter cap will be based from Salutary Avenue Manufacturing Sdn.Bhd. SOLIDWORKS software was used to model the geometry of the filter, while simulation analysis on the flow through the filter was done using Computational Fluid Dynamic (CFD software. The simulations are based on a low velocity condition, in which the parameter for the inlet velocity are set at 0.032 m/s, 0.063 m/s, 0.094 m/s and 0.126 m/s respectively. From the simulation data obtained for the inlet velocities considered, the pressure drop reduction of the modified filter compared to the benchmark was found to be between 7.59% and 30.18%. All in all, the modification of the filter cap produced a lower pressure drop in comparison with the benchmark filter; an improvement of 27.02% for the total pressure drop was obtained.

  18. 40 CFR 63.4567 - How do I establish the emission capture system and add-on control device operating limits during...

    Science.gov (United States)

    2010-07-01

    ... system and add-on control device operating limits during the performance test? 63.4567 Section 63.4567... Emission Rate with Add-on Controls Option § 63.4567 How do I establish the emission capture system and add-on control device operating limits during the performance test? During the performance test required...

  19. 40 CFR 63.3546 - How do I establish the emission capture system and add-on control device operating limits during...

    Science.gov (United States)

    2010-07-01

    ... system and add-on control device operating limits during the performance test? 63.3546 Section 63.3546... device or system of multiple capture devices. The average duct static pressure is the maximum operating... Add-on Controls Option § 63.3546 How do I establish the emission capture system and add-on control...

  20. 40 CFR 63.4767 - How do I establish the emission capture system and add-on control device operating limits during...

    Science.gov (United States)

    2010-07-01

    ... system and add-on control device operating limits during the performance test? 63.4767 Section 63.4767... Rate with Add-on Controls Option § 63.4767 How do I establish the emission capture system and add-on control device operating limits during the performance test? During the performance test required by § 63...

  1. 40 CFR 63.4167 - How do I establish the emission capture system and add-on control device operating limits during...

    Science.gov (United States)

    2010-07-01

    ... system and add-on control device operating limits during the performance test? 63.4167 Section 63.4167... with Add-on Controls Option § 63.4167 How do I establish the emission capture system and add-on control device operating limits during the performance test? During the performance test required by § 63.4160...

  2. 40 CFR 63.4966 - How do I establish the emission capture system and add-on control device operating limits during...

    Science.gov (United States)

    2010-07-01

    ... system and add-on control device operating limits during the performance test? 63.4966 Section 63.4966... outlet gas temperature is the maximum operating limit for your condenser. (e) Emission capture system... with Add-on Controls Option § 63.4966 How do I establish the emission capture system and add-on control...

  3. 40 CFR 63.3169 - What are the requirements for a capture system or add-on control device which is not taken into...

    Science.gov (United States)

    2010-07-01

    ... systems or add-on control devices which you choose not to take into account when demonstrating compliance... system or add-on control device which is not taken into account when demonstrating compliance with the....3169 What are the requirements for a capture system or add-on control device which is not taken into...

  4. Development of FQ-PCR method to determine the level of ADD1 expression in fatty and lean pigs.

    Science.gov (United States)

    Cui, J X; Chen, W; Zeng, Y Q

    2015-10-30

    To determine how adipocyte determination and differentiation factor 1 (ADD1), a gene involved in the determination of pork quality, is regulated in Laiwu and Large pigs, we used TaqMan fluorescence quantitative real-time polymerase chain reaction (FQ-PCR) to detect differential expression in the longissimus muscle of Laiwu (fatty) and Large White (lean) pigs. In this study, the ADD1 and GAPDH cDNA sequences were cloned using a T-A cloning assay, and the clone sequences were consistent with those deposited in GenBank. Thus, the target fragment was successfully recombined into the vector, and its integrity was maintained. The standard curve and regression equation were established through the optimized FQ-PCR protocol. The standard curve of porcine ADD1 and GAPDH cDNA was determined, and its linear range extension could reach seven orders of magnitudes. The results showed that this method was used to quantify ADD1 expression in the longissimus muscle of two breeds of pig, and was found to be accurate, sensitive, and convenient. These results provide information regarding porcine ADD1 mRNA expression and the mechanism of adipocyte differentiation, and this study could help in the effort to meet the demands of consumers interested in the maintenance of health and prevention of obesity. Furthermore, it could lead to new approaches in the prevention and clinical treatment of this disease.

  5. Add-on deep Transcranial Magnetic Stimulation (dTMS) for the treatment of chronic migraine: A preliminary study.

    Science.gov (United States)

    Rapinesi, Chiara; Del Casale, Antonio; Scatena, Paola; Kotzalidis, Georgios D; Di Pietro, Simone; Ferri, Vittoria Rachele; Bersani, Francesco Saverio; Brugnoli, Roberto; Raccah, Ruggero Nessim; Zangen, Abraham; Ferracuti, Stefano; Orzi, Francesco; Girardi, Paolo; Sette, Giuliano

    2016-06-03

    Deep Transcranial Magnetic Stimulation (dTMS) can be an alternative treatment to relieve pain in chronic migraine (CM). The aim of this study was to evaluate the effect of high-frequency dTMS in add-on to standard treatment for CM in patients not responding to effective abortive or preventive drug treatment. We randomized 14 patients with International Classification of Headache Disorders, 3rd Edition (ICHD-3) treatment-resistant CM to add-on dTMS (n=7) or standard abortive or preventive antimigraine treatment (n=7). Three sessions of alternate day 10Hz dTMS consisting of 600 pulses in 10 trains were delivered to the dorsolateral prefrontal cortex (DLPFC), bilaterally, but with left hemisphere prevalence, for 12 sessions spread over one month. The add-on dTMS treatment was well tolerated. Patients treated with dTMS showed significant reduction of pain intensity, frequency of attacks, analgesic overuse, and depressive symptoms during treatment and one month later, compared to the month preceding treatment and at the same time-points compared to the control group. As compared to standard pharmacological treatment alone, add-on high-frequency dTMS of the bilateral DLPFC reduced the frequency and intensity of migraine attack, drug overuse, and depressive symptoms. This study supports the add-on dTMS treatment in treatment-resistant CM. Copyright © 2016. Published by Elsevier Ireland Ltd.

  6. Add-on conservation benefits of marine territorial user rights fishery policies in central Chile.

    Science.gov (United States)

    Gelcich, Stefan; Godoy, Natalio; Prado, Luis; Castilla, Juan Carlos

    2008-01-01

    To combine the rational use of marine benthic resources and economic development of small-scale fishers, Chile passed legislation in 1991 establishing a comanagement policy that grants exclusive territorial user rights for fisheries (TURFs) to artisanal fisher organizations in well-defined inshore coastal areas, known as Management and Exploitation Areas for Benthic Resources (MEABRs). In general the policy has been proclaimed a management and economic success because benthic resource abundances have increased inside MEABRs in comparison with open-access areas. However, there is a lack of studies assessing the impact of this management policy on nontargeted subtidal species and community assemblages and the policy's implications for biodiversity and conservation. This study starts to fill this gap and links the allocation of TURFs for benthic resources with add-on conservation benefits for species that are not directly linked with the fishery policy. Comparative subtidal surveys inside vs. outside MEABRs were used to assess the effects of three MEABRs on managed targeted benthic species, biodiversity (species richness), and community assemblages in central Chile. Surveys focused exclusively on subtidal kelp forest habitats dominated by Lessonia trabeculata, spanning 4-12 m in depth and with similar levels of habitat complexity. The study comprised: (1) quantification of kelp forest complexity, (2) understory survey of sessile species, (3) quantification of conspicuous benthic macroinvertebrates, including those under management, and (4) quantification of reef-fish species inside the kelp habitat. Results showed population enhancement of target-managed invertebrates inside MEABRs. Moreover, reef-fish species were significantly more diverse and abundant inside MEABRs, and community assemblages of nontarget benthic invertebrates and reef fish were significantly different inside vs. outside MEABRs. The comanagement of inshore benthic resources in Chile, through MEABRs

  7. How to Add Value to your Business with CEA: A Practical Approach

    Directory of Open Access Journals (Sweden)

    Daniel Cardenas

    2010-04-01

    Full Text Available Companies are always trying to differentiate themselves from the rest of the pack by applying different strategies such as improving customer service, increasing the efficiency of their operations, or reducing their costs. Most of the time, however, these goals are competing against each other for scarce resources, and managers often need to decide to concentrate on one. A small company can effectively and simultaneously accomplish these goals for a fraction of the cost by implementing communications-enabled business processes or solutions, which are a set of technology components that add real-time networking functionality to applications. One particular implementation of this framework is the one provided by Coral CEA. Coral CEA is a business ecosystem anchored around CEA functionalities that are offered as building blocks, out-of-the-box components that link the capabilities and intelligence of networks platforms with the power of current applications to provide a new set of features and functionalities. In this article, we show how a small company called Rezact, located in the ski resort town of Mont-Tremblant, Quebec, successfully implemented CEA capabilities within its own operations using Coral CEA services.

  8. ATOM - an OMERO add-on for automated import of image data

    Directory of Open Access Journals (Sweden)

    Lipp Peter

    2011-10-01

    Full Text Available Abstract Background Modern microscope platforms are able to generate multiple gigabytes of image data in a single experimental session. In a routine research laboratory workflow, these data are initially stored on the local acquisition computer from which files need to be transferred to the experimenter's (remote image repository (e.g., DVDs, portable hard discs or server-based storage because of limited local data storage. Although manual solutions for this migration, such as OMERO - a client-server software for visualising and managing large amounts of image data - exist, this import process may be a time-consuming and tedious task. Findings We have developed ATOM, a Java-based and thus platform-independent add-on for OMERO enabling automated transfer of image data from a wide variety of acquisition software packages into OMERO. ATOM provides a graphical user interface and allows pre-organisation of experimental data for the transfer. Conclusions ATOM is a convenient extension of the OMERO software system. An automated interface to OMERO will be a useful tool for scientists working with file formats supported by the Bio-Formats file format library, a platform-independent library for reading the most common file formats of microscope images.

  9. A New and Versatile Adjustable Rigidity Actuator with Add-on Locking Mechanism (ARES-XL

    Directory of Open Access Journals (Sweden)

    Manuel Cestari

    2018-01-01

    Full Text Available Adjustable compliant actuators are being designed and implemented in robotic devices because of their ability to minimize large forces due to impacts, to safely interact with the user, and to store and release energy in passive elastic elements. Conceived as a new force-controlled compliant actuator, an adjustable rigidity with embedded sensor and locking mechanism actuator (ARES-XL is presented in this paper. This compliant system is intended to be implemented in a gait exoskeleton for children with neuro muscular diseases (NMDs to exploit the intrinsic dynamics during locomotion. This paper describes the mechanics and initial evaluation of the ARES-XL, a novel variable impedance actuator (VIA that allows the implementation of an add-on locking mechanism to this system, and in combination with its zero stiffness capability and large deflection range, provides this novel joint with improved properties when compared to previous prototypes developed by the authors and other state-of-the-art (SoA devices. The evaluation of the system proves how this design exceeds the main capabilities of a previous prototype as well as providing versatile actuation that could lead to its implementation in multiple joints.

  10. Final Technical Report: Thermoelectric-Enhanced Cookstove Add-on (TECA) for Clean Biomass Cookstoves

    Energy Technology Data Exchange (ETDEWEB)

    Stokes, David [RTI International, Research Triangle Park, NC (United States)

    2015-09-29

    This program seeks to demonstrate a solution to enhance existing biomass cookstove performance through the use of RTI’s Thermoelectric Enhanced Cookstove Add-on (TECA) device. The self-powered TECA device captures a portion of heat from the stove and converts it to electricity through a thermoelectric (TE) device to power a blower. Colorado State University and Envirofit International are partners to support the air injection design and commercialization to enhance combustion in the stove and reduce emissions. Relevance: By demonstrating a proof of concept of the approach with the Envirofit M-5000 stove and TECA device, we hope to apply this technology to existing stoves that are already in use and reduce emissions for stoves that have already found user acceptance to provide a true health benefit. Challenges: The technical challenges include achieving Tier 4 emissions from a biomass stove and for such a stove to operate reliably in the harsh field environment. Additional challenges include the fact that it is difficult to develop a cost effective solution and insure adoption and proper use in the field. Outcomes: In this program we have demonstrated PM emissions at 82 mg/MJd, a 70% reduction as compared to baseline stove operation. We have also developed a stove optimization approach that reduces the number of costly experiments. We have evaluated component-level reliability and will be testing the stove prototype in the field for performance and reliability.

  11. Una riconsiderazione sul ripostiglio di S'Adde 'e S'Ulumu-Usini

    Directory of Open Access Journals (Sweden)

    Salvatore Merella

    2012-12-01

    Full Text Available In this poster the author presents the results of a study on several pieces of ashlar masonry were recently discovered in a locale called S'Iscia 'e Su Puttu, indicating the likely presence of sacred place belonging to the Nuragic - Bronze and Early Iron Age - phase. It is located very close to the site of S'Adde 'e S'Ulumu, where an important hoard of bronze objects was found, once considered to belong to a single individual for the absence of any clear archaeological context. This hoard acquires a new dimension thanks to the new data presented here: it could have reasonably been part of a set of ritual activities carried out in a sacred area formed of buildings and spaces between them, a common pattern in Sardinian communities during the Early Iron phase. This poster was presented at the Workshop Materiali e contesti dell'Età del Ferro sarda (Materials and contexts in the Sardinian Iron Age, organised by the University of Glasgow and the Comune di San Vero Milis on the 25th of May 2012, and supported for by the Royal Society of Edinburgh, the Comune di San Vero Milis, the University of Glasgow and the Carnegie Trust of the Universities of Scotland.

  12. Behavioral symptoms of eating disorders in Native Americans: results from the ADD Health Survey Wave III.

    Science.gov (United States)

    Striegel-Moore, Ruth H; Rosselli, Francine; Holtzman, Niki; Dierker, Lisa; Becker, Anne E; Swaney, Gyda

    2011-09-01

    To examine prevalence and correlates (gender, Body Mass Index) of disordered eating in American Indian/Native American (AI/NA) and white young adults. We examined data from the 10,334 participants (mean age 21.93 years, SD = 1.8) of the National Longitudinal Study of Adolescent Health (ADD Health) Wave III for gender differences among AI/NA participants (236 women, 253 men) and ethnic group differences on measures of eating pathology. Among AI/NA groups, women were significantly more likely than men to report loss of control and embarrassment due to overeating. In gender-stratified analyses, a significantly higher prevalence of AI/NA women reported disordered eating behaviors compared with white women; there were no between group differences in prevalence for breakfast skipping or having been diagnosed with an eating disorder. Among men, disordered eating behaviors were uncommon and no comparison was statistically significant. Our study offers a first glimpse into the problem of eating pathology among AI/NA individuals. Gender differences among AI/NA participants are similar to results reported in white samples. That AI/NA women were as likely as white women to have been diagnosed with an eating disorder is striking in light of well documented under-utilization of mental health care among AI/NA individuals. Copyright © 2010 Wiley Periodicals, Inc.

  13. Studies with lucid dreaming as add-on therapy to Gestalt therapy.

    Science.gov (United States)

    Holzinger, B; Klösch, G; Saletu, B

    2015-06-01

    The aim of the present exploratory clinical study was to evaluate LD as an add-on therapy for treating nightmares. Thirty-two subjects having nightmares (ICD-10: F51.5) at least twice a week participated. Subjects were randomly assigned to group: A) Gestalt therapy group (= GTG), or B) Gestalt and lucid dreaming group therapy (= LDG). Each group lasted ten weeks. Participants kept a sleep/dream diary over the treatment. Examinations with respect to nightmare frequency and sleep quality (Pittsburgh Sleep Quality Index) were carried out at the beginning, after five and ten weeks and at a follow-up three months later. Concerning nightmare frequency, a significant reduction was found in both groups after the ten-week-study and at the follow-up (Wilcoxon test: P ≤ 0.05). Significant reduction in dream recall frequency could only be observed in the GTG (Wilcoxon test: P ≤ 0.05). For subjects having succeeded in learning lucid dreaming, reduction was sooner and higher. Sleep quality improved for both groups at the follow-up (P ≤ 0.05, Wilcoxon test). Only the LDG showed significant improvement at the end of therapy (P ≤ 0.05). Lucid dreaming, in combination with Gestalt therapy, is a potent technique to reduce nightmare frequency and improve the subjective quality of sleep. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. A multiply-add engine with monolithically integrated 3D memristor crossbar/CMOS hybrid circuit.

    Science.gov (United States)

    Chakrabarti, B; Lastras-Montaño, M A; Adam, G; Prezioso, M; Hoskins, B; Payvand, M; Madhavan, A; Ghofrani, A; Theogarajan, L; Cheng, K-T; Strukov, D B

    2017-02-14

    Silicon (Si) based complementary metal-oxide semiconductor (CMOS) technology has been the driving force of the information-technology revolution. However, scaling of CMOS technology as per Moore's law has reached a serious bottleneck. Among the emerging technologies memristive devices can be promising for both memory as well as computing applications. Hybrid CMOS/memristor circuits with CMOL (CMOS + "Molecular") architecture have been proposed to combine the extremely high density of the memristive devices with the robustness of CMOS technology, leading to terabit-scale memory and extremely efficient computing paradigm. In this work, we demonstrate a hybrid 3D CMOL circuit with 2 layers of memristive crossbars monolithically integrated on a pre-fabricated CMOS substrate. The integrated crossbars can be fully operated through the underlying CMOS circuitry. The memristive devices in both layers exhibit analog switching behavior with controlled tunability and stable multi-level operation. We perform dot-product operations with the 2D and 3D memristive crossbars to demonstrate the applicability of such 3D CMOL hybrid circuits as a multiply-add engine. To the best of our knowledge this is the first demonstration of a functional 3D CMOL hybrid circuit.

  15. Predictors of life satisfaction among Asian American adolescents- analysis of add health data.

    Science.gov (United States)

    Huang, Jui-Yen; Wang, Kuan-Yuan; Ringel-Kulka, Tamar

    2015-01-01

    Life satisfaction correlates with adolescent risk taking behavior and their outcomes in adulthood. Despite the fast rise in numbers of Asian adolescents in the U.S., the predictors of their life satisfaction are not well understood. This study examined the relationship between several demographic and contextual factors and global life satisfaction among this population. Data were derived from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative probability sample of US adolescents. Bivariate and multivariable logistic regression was conducted to evaluate hypothesized predictors of global life satisfaction of Asian American adolescents. All analyses were conducted using STATA version 11. After exclusion of cases with missing values, 1021 Asian American adolescents were studied. Self- rated health, self-esteem, perceived neighborhood quality, parental support and peer support were significantly and positively related to better global life satisfaction. However, after controlling for other factors, only self-esteem (adjusted odds ratio [aOR]: 4.76; 95% confidence interval [CI]: 2.86-8.33) and perceived peer support (aOR: 2.76; 95% CI: 1.33-5.76) significantly predicted higher life satisfaction. Peer support and adolescents' self-concept are strongly correlated with Asian American adolescents' subjective well-being. To promote the wellness of this population, culturally sensitive strategies in developing peer relationship and healthy self-concept may be effective. More studies are needed for subgroup comparison of various ethnicities among Asian American adolescents.

  16. How social learning adds up to a culture: from birdsong to human public opinion.

    Science.gov (United States)

    Tchernichovski, Ofer; Feher, Olga; Fimiarz, Daniel; Conley, Dalton

    2017-01-01

    Distributed social learning may occur at many temporal and spatial scales, but it rarely adds up to a stable culture. Cultures vary in stability and diversity (polymorphism), ranging from chaotic or drifting cultures, through cumulative polymorphic cultures, to stable monolithic cultures with high conformity levels. What features can sustain polymorphism, preventing cultures from collapsing into either chaotic or highly conforming states? We investigate this question by integrating studies across two quite separate disciplines: the emergence of song cultures in birds, and the spread of public opinion and social conventions in humans. In songbirds, the learning process has been studied in great detail, while in human studies the structure of social networks has been experimentally manipulated on large scales. In both cases, the manner in which communication signals are compressed and filtered - either during learning or while traveling through the social network - can affect culture polymorphism and stability. We suggest a simple mechanism of a shifting balance between converging and diverging social forces to explain these effects. Understanding social forces that shape cultural evolution might be useful for designing agile communication systems, which are stable and polymorphic enough to promote gradual changes in institutional behavior. © 2017. Published by The Company of Biologists Ltd.

  17. Mozart K.448 acts as a potential add-on therapy in children with refractory epilepsy.

    Science.gov (United States)

    Lin, Lung-Chang; Lee, Wei-Te; Wang, Chien-Hua; Chen, Hsiu-Lin; Wu, Hui-Chuan; Tsai, Chin-Lin; Wei, Ruey-Chang; Mok, Hin-Kiu; Weng, Chia-Fen; Lee, Mei-Wen; Yang, Rei-Cheng

    2011-03-01

    Mozart's Sonata for two pianos in D major, K.448 (Mozart K.448), has been shown to improve mental function, leading to what is known as the Mozart effect. Our previous work revealed that epileptiform discharges in children with epilepsy decreased during and immediately after listening to Mozart K.448. In this study, we evaluated the long-term effects of Mozart K.448 on children with refractory epilepsy. Eleven children with refractory epilepsy were enrolled. All of the patients were diagnosed as having had refractory epilepsy for more than 1 year (range =1 year to 6 years 4 months, mean =3 years 11 months) and had been receiving at least two antiepileptic drugs (AED). During the study period, they listened to Mozart K.448 once a day before bedtime for 6 months. Seizure frequencies were recorded 6 months before they started listening to this music and monthly during the study period. All of the patients remained on the same AEDs during the 6-month study period. Frequencies of seizures were compared before and after listening to Mozart K.448. Eight of eleven patients were seizure free (N=2) or had very good responses (N=6) after 6 months of listening to Mozart K.448. The remaining three (27.3%) showed minimal or no effect (effectiveness Mozart K.448 should be further studied as a potential add-on therapy in the treatment of children with refractory epilepsy. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Technology management-An effective tool to add competitiveness to the business

    Energy Technology Data Exchange (ETDEWEB)

    Layrisse, I.; Izquierdo, A. [Intevep, S.A., Caracas (Venezuela)

    1996-08-01

    Petreleos de Venezuela (PDVSA) and its affiliated companies, aware of the importance of the technology to sustain the viability of a successful corporation in global markets with increasing competition and stringent economies, are devoting important efforts in technology as an effective tool to add competitiveness to its core businesses. These efforts are based in the conception of the technology as a structural aspect of the corporation integrated to each one of its businesses. In this sense technology is considered in an integrated way together with markets, operations, infrastructure, resources, etc., across the value chain of the company, from the conception of its vision and mission to the formulation and execution of its operating plans. In this presentation, the conceptual and methodological aspects employed by PDVSA in the establishment of its technology strategy integrated to its business plan, and subsequent project portfolio definition, are summarized. The experience acquired through this corporative exercise conducted by PDVSA confirms that technology and its management are highly linked to the culture of the companies and of the countries where they operate. The technology management best practices are very helpful in establishing processes and specific methodologies; however, the consideration of other aspects such as leadership, management style, shared values, etc., need to be taken into account with the same emphasis, in order to accomplish the changes needed to create a technology culture fitted to a given setting and ideology.

  19. PKSolver: An add-in program for pharmacokinetic and pharmacodynamic data analysis in Microsoft Excel.

    Science.gov (United States)

    Zhang, Yong; Huo, Meirong; Zhou, Jianping; Xie, Shaofei

    2010-09-01

    This study presents PKSolver, a freely available menu-driven add-in program for Microsoft Excel written in Visual Basic for Applications (VBA), for solving basic problems in pharmacokinetic (PK) and pharmacodynamic (PD) data analysis. The program provides a range of modules for PK and PD analysis including noncompartmental analysis (NCA), compartmental analysis (CA), and pharmacodynamic modeling. Two special built-in modules, multiple absorption sites (MAS) and enterohepatic circulation (EHC), were developed for fitting the double-peak concentration-time profile based on the classical one-compartment model. In addition, twenty frequently used pharmacokinetic functions were encoded as a macro and can be directly accessed in an Excel spreadsheet. To evaluate the program, a detailed comparison of modeling PK data using PKSolver and professional PK/PD software package WinNonlin and Scientist was performed. The results showed that the parameters estimated with PKSolver were satisfactory. In conclusion, the PKSolver simplified the PK and PD data analysis process and its output could be generated in Microsoft Word in the form of an integrated report. The program provides pharmacokinetic researchers with a fast and easy-to-use tool for routine and basic PK and PD data analysis with a more user-friendly interface. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Should we add visual acuity ratios to referral criteria for potential cerebral visual impairment?

    Science.gov (United States)

    van der Zee, Ymie J; Stiers, Peter; Evenhuis, Heleen M

    To determine whether the assessment of visual acuity ratios might improve the referral of children with (sub)normal visual acuity but at risk of cerebral visual impairment. In an exploratory study, we assessed visual acuity, crowding ratio and the ratios between grating acuity (Teller Acuity Cards-II) and optotype acuity (Cambridge Crowding Cards) in 60 typically developing school children (mean age 5y8m±1y1m), 21 children with ocular abnormalities only (5y7m±1y9m) and 26 children with (suspected) brain damage (5y7m±1y11m). Sensitivities and specificities were calculated for targets and controls from the perspective of different groups of diagnosticians: youth health care professionals (target: children with any visual abnormalities), ophthalmologists and low vision experts (target: children at risk of cerebral visual impairment). For youth health care professionals subnormal visual acuity had the best sensitivity (76%) and specificity (70%). For ophthalmologists and low vision experts the crowding ratio had the best sensitivity (67%) and specificity (79 and 86%). Youth health care professionals best continue applying subnormal visual acuity for screening, whereas ophthalmologists and low vision experts best add the crowding ratio to their routine diagnostics, to distinguish children at risk of visual impairment in the context of brain damage from children with ocular pathology only. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  1. Effects of pitavastatin add-on therapy on chronic kidney disease with albuminuria and dyslipidemia.

    Science.gov (United States)

    Ohsawa, Masato; Tamura, Kouichi; Wakui, Hiromichi; Kanaoka, Tomohiko; Azushima, Kengo; Uneda, Kazushi; Haku, Sona; Kobayashi, Ryu; Ohki, Kohji; Haruhara, Kotaro; Kinguchi, Sho; Toya, Yoshiyuki; Umemura, Satoshi

    2015-12-09

    In non-dialysis chronic kidney disease (CKD) patients with dyslipidemia, statin therapy is recommended to prevent cardiovascular complications. Dyslipidemia has been also shown to be an independent risk factor for the progression of CKD. However, it is still unclear whether statin therapy exerts an inhibitory effect on renal deterioration in CKD patients with dyslipidemia. The purpose of the present study was to examine possible therapeutic effects of statin add-on therapy on renal function as well as parameters of lipid and glucose metabolism, arterial stiffness and oxidative stress, in comparison to diet therapy, in CKD patients with dyslipidemia. This study was a randomized, open-label, and parallel-group trial consisted of a 12-months treatment period in non-dialysis CKD patients with alubuminuria and dyslipidemia. Twenty eight patients were randomly assigned either to receive diet counseling alone (diet therapy group) or diet counseling plus pitavastatin (diet-plus-statin therapy group), to achieve the LDL-cholesterol (LDL-C) target of dyslipidemia.

  2. Calling all LEGO lovers! Add a mini control room to your collection

    CERN Multimedia

    Katarina Anthony

    2015-01-01

    The mini LHC Lego project launched in March (see here) now has almost 6,000 supporters - well on its way to the 10,000 votes needed for it to (hopefully!) hit store shelves. This week, the project added a new feature to its line: a mini control centre! The new LEGO Control centre, featuring operators "Kerstin" and "Marco".   The mini LHC project is the brainchild of ATLAS PhD student Nathan Readioff, who designed Lego replicas of the LHC and the ALICE, ATLAS, CMS and LHCb experiments on a micro scale. Each detector model is small enough to fit in the palm of your hand but crammed with detailed internal systems revealed by cutaway walls. Every major detector component is represented by a Lego piece. Now, Nathan has created a control centre to complement the mini LHC project. This would be an add-on feature for Lego’s consideration, should they decide to develop the accelerator into a box set. “The control centre is ...

  3. Effects of Vildagliptin Add-on Insulin Therapy on Nocturnal Glycemic Variations in Uncontrolled Type 2 Diabetes.

    Science.gov (United States)

    Li, Feng-Fei; Shen, Yun; Sun, Rui; Zhang, Dan-Feng; Jin, Xing; Zhai, Xiao-Fang; Chen, Mao-Yuan; Su, Xiao-Fei; Wu, Jin-Dan; Ye, Lei; Ma, Jian-Hua

    2017-10-01

    To investigate whether vildagliptin add-on insulin therapy improves glycemic variations in patients with uncontrolled type 2 diabetes (T2D) compared to patients with placebo therapy. This was a 24-week, single-center, double-blind, placebo-controlled trial. Inadequately controlled T2D patients treated with insulin therapy were recruited between June 2012 and April 2013. The trial included a 2-week screening period and a 24-week randomized period. Subjects were randomly assigned to a vildagliptin add-on insulin therapy group (n = 17) or a matched placebo group (n = 16). Scheduled visits occurred at weeks 4, 8, 12, 16, 20, and 24. Continuous glucose monitoring (CGM) was performed before and at the endpoint of the study. A total of 33 subjects were admitted, with 1 patient withdrawing from the placebo group. After 24 weeks of therapy, HbA1c values were significantly reduced at the endpoint in the vildagliptin add-on group. CGM data showed that patients with vildagliptin add-on therapy had a significantly lower 24-h mean glucose concentration and mean amplitude of glycemic excursion (MAGE). At the endpoint of the study, patients in the vildagliptin add-on group had a significantly lower MAGE and standard deviation compared to the control patients during the nocturnal period (0000-0600). A severe hypoglycemic episode was not observed in either group. Vildagliptin add-on therapy to insulin has the ability to improve glycemic variations, especially during the nocturnal time period, in patients with uncontrolled T2D.

  4. Add-On Effect of Probucol in Atherosclerotic, Cholesterol-Fed Rabbits Treated with Atorvastatin

    Science.gov (United States)

    Keyamura, Yuka; Nagano, Chifumi; Kohashi, Masayuki; Niimi, Manabu; Nozako, Masanori; Koyama, Takashi; Yasufuku, Reiko; Imaizumi, Ayako; Itabe, Hiroyuki; Yoshikawa, Tomohiro

    2014-01-01

    Objective Lowering the blood concentration of low-density lipoprotein (LDL) cholesterol is the primary strategy employed in treating atherosclerotic disorders; however, most commonly prescribed statins prevent cardiovascular events in just 30% to 40% of treated patients. Therefore, additional treatment is required for patients in whom statins have been ineffective. In this study of atherosclerosis in rabbits, we examined the effect of probucol, a lipid-lowering drug with potent antioxidative effects, added to treatment with atorvastatin. Methods and Results Atherosclerosis was induced by feeding rabbits chow containing 0.5% cholesterol for 8 weeks. Probucol 0.1%, atorvastatin 0.001%, and atorvastatin 0.003% were administered solely or in combination for 6 weeks, beginning 2 weeks after the start of atherosclerosis induction. Atorvastatin decreased the plasma concentration of non-high-density lipoprotein cholesterol (non-HDLC) dose-dependently; atorvastatin 0.003% decreased the plasma concentration of non-HDLC by 25% and the area of atherosclerotic lesions by 21%. Probucol decreased the plasma concentration of non-HDLC to the same extent as atorvastatin (i.e., by 22%) and the area of atherosclerotic lesions by 41%. Probucol with 0.003% atorvastatin decreased the plasma concentration of non-HDLC by 38% and the area of atherosclerotic lesions by 61%. Co-administration of probucol with atorvastatin did not affect the antioxidative effects of probucol, which were not evident on treatment with atorvastatin alone, such as prevention of in vitro LDL-oxidation, increase in paraoxonase-1 activity of HDL, and decreases in plasma and plaque levels of oxidized-LDL in vivo. Conclusions Probucol has significant add-on anti-atherosclerotic effects when combined with atorvastatin treatment; suggesting that this combination might be beneficial for treatment of atherosclerosis. PMID:24810608

  5. Establishing a Near Term Lunar Farside Gravity Model via Inexpensive Add-on Navigation Payload

    Science.gov (United States)

    Folta, David; Mesarch, Michael; Miller, Ronald; Bell, David; Jedrey, Tom; Butman, Stanley; Asmar, Sami

    2007-01-01

    The Space Communications and Navigation, Constellation Integration Project (SCIP) is tasked with defining, developing, deploying and operating an evolving multi-decade communications and navigation (C/N) infrastructure including services and subsystems that will support both robotic and human exploration activities at the Moon. This paper discusses an early far side gravitational mapping service and related telecom subsystem that uses an existing spacecraft (WIND) and the Lunar Reconnaissance Orbiter (LRO) to collect data that would address several needs of the SCIP. An important aspect of such an endeavor is to vastly improve the current lunar gravity model while demonstrating the navigation and stationkeeping of a relay spacecraft. We describe a gravity data acquisition activity and the trajectory design of the relay orbit in an Earth-Moon L2 co-linear libration orbit. Several phases of the transfer from an Earth-Sun to the Earth-Moon region are discussed along with transfers within the Earth-Moon system. We describe a proposed, but not integrated, add-on to LRO scheduled to be launched in October of 2008. LRO provided a real host spacecraft against which we designed the science payload and mission activities. From a strategic standpoint, LRO was a very exciting first flight opportunity for gravity science data collection. Gravity Science data collection requires the use of one or more low altitude lunar polar orbiters. Variations in the lunar gravity field will cause measurable variations in the orbit of a low altitude lunar orbiter. The primary means to capture these induced motions is to monitor the Doppler shift of a radio signal to or from the low altitude spacecraft, given that the signal is referenced to a stable frequency reference. For the lunar far side, a secondary orbiting radio signal platform is required. We provide an in-depth look at link margins, trajectory design, and hardware implications. Our approach posed minimum risk to a host mission while

  6. Cholinergic Inputs from Basal Forebrain Add an Excitatory Bias to Odor Coding in the Olfactory Bulb

    Science.gov (United States)

    Rothermel, Markus; Carey, Ryan M.; Puche, Adam; Shipley, Michael T.

    2014-01-01

    Cholinergic modulation of central circuits is associated with active sensation, attention, and learning, yet the neural circuits and temporal dynamics underlying cholinergic effects on sensory processing remain unclear. Understanding the effects of cholinergic modulation on particular circuits is complicated by the widespread projections of cholinergic neurons to telencephalic structures that themselves are highly interconnected. Here we examined how cholinergic projections from basal forebrain to the olfactory bulb (OB) modulate output from the first stage of sensory processing in the mouse olfactory system. By optogenetically activating their axons directly in the OB, we found that cholinergic projections from basal forebrain regulate OB output by increasing the spike output of presumptive mitral/tufted cells. Cholinergic stimulation increased mitral/tufted cell spiking in the absence of inhalation-driven sensory input and further increased spiking responses to inhalation of odorless air and to odorants. This modulation was rapid and transient, was dependent on local cholinergic signaling in the OB, and differed from modulation by optogenetic activation of cholinergic neurons in basal forebrain, which led to a mixture of mitral/tufted cell excitation and suppression. Finally, bulbar cholinergic enhancement of mitral/tufted cell odorant responses was robust and occurred independent of the strength or even polarity of the odorant-evoked response, indicating that cholinergic modulation adds an excitatory bias to mitral/tufted cells as opposed to increasing response gain or sharpening response spectra. These results are consistent with a role for the basal forebrain cholinergic system in dynamically regulating the sensitivity to or salience of odors during active sensing of the olfactory environment. PMID:24672011

  7. Trainees May Add Value to Patient Care by Decreasing Addendum Utilization in Radiology Reports.

    Science.gov (United States)

    Balthazar, Patricia; Konstantopoulos, Christina; Wick, Carson A; DeSimone, Ariadne K; Tridandapani, Srini; Simoneaux, Stephen; Applegate, Kimberly E

    2017-11-01

    The purpose of this study was to evaluate the impact of trainee involvement and other factors on addendum rates in radiology reports. This retrospective study was performed in a tertiary care pediatric hospital. From the institutional radiology data repository, we extracted all radiology reports from January 1 to June 30, 2016, as well as trainee (resident or fellow) involvement, imaging modality, patient setting (emergency, inpatient, or outpatient), order status (routine vs immediate), time of interpretation (regular work hours vs off-hours), radiologist's years of experience, and sex. We grouped imaging modalities as advanced (CT, MRI, and PET) or nonadvanced (any modality that was not CT, MRI, or PET) and radiologist experience level as ≤ 20 years or > 20 years. Our outcome measure was the rate of addenda in radiology reports. Statistical analysis was performed using multivariate logistic regression. From 129,033 reports finalized during the study period, 418 (0.3%) had addenda. Reports generated without trainees were 12 times more likely than reports with trainee involvement to have addenda (odds ratio [OR] = 12.2, p use (OR = 4.7, p use than those in an inpatient setting (OR = 1.5, p = 0.04; and OR = 1.3, p = 0.04, respectively). Routine orders had a slightly higher likelihood of addendum use compared with immediate orders (OR = 1.3, p = 0.01). We found no difference in addendum use by radiologist's sex, radiologist's years of experience, emergency versus outpatient setting, or time of interpretation. Trainees may add value to patient care by decreasing addendum rates in radiology reports.

  8. Immunostaining of skin biopsy adds no diagnostic value in MGUS-associated peripheral neuropathy.

    Science.gov (United States)

    Al-Zuhairy, Ali; Schrøder, Henrik Daa; Plesner, Torben; Abildgaard, Niels; Sindrup, Søren H

    2015-02-15

    For several decades an association between MGUS, IgM-MGUS in particular, and peripheral neuropathy has been suspected. Several histopathology studies have shown binding of IgM to myelin and a secondary widening of myelin lamellae in cutaneous nerves and in the sural nerve of patients with IgM-MGUS, or Waldenström's Macroglobulinaemia (WM), and peripheral neuropathy. In this retrospective study we investigated the value of skin biopsy examination in the diagnosis of MGUS- and WM-associated peripheral neuropathy. A total of 117 patients, who were examined for an M-component in serum with associated nerve symptoms, had a skin biopsy taken and examined for immunoglobulin deposition in cutaneous nerves. Thirty-five patients were diagnosed with MGUS or WM and peripheral neuropathy with no other cause of neuropathy. Nineteen patients had MGUS but no peripheral neuropathy. Of the 35 patients with MGUS or WM and peripheral neuropathy, four had immunoglobulin deposition in the skin biopsy, all of whom had an IgM gammopathy. In the control group of 19 without peripheral neuropathy, three had immunoglobulin deposition in the skin biopsy, all of whom had IgM-MGUS. In both groups, there was a trend towards higher IgM blood levels in patients with immunoglobulin deposition. Half of the patients with IgM gammopathy in the neuropathy group had anti-MAG reactivity, whereas only one in the control group had weak anti-MAG reactivity. Our study indicates that examination of skin biopsies for immunoglobulin deposition does not add significant diagnostic value in the evaluation of neuropathies suspected to be caused by MGUS or WM. IgM immunoglobulin deposition in skin biopsy might merely be an epiphenomenon secondary to high IgM blood levels. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Inflammation in Patients with Schizophrenia: the Therapeutic Benefits of Risperidone Plus Add-On Dextromethorphan

    Science.gov (United States)

    Chen, Shiou-Lan; Lee, Sheng-Yu; Chang, Yun-Hsuan; Chen, Shih-Heng; Chu, Chun-Hsieh; Tzeng, Nian-Sheng; Lee, I-Hui; Chen, Po-See; Yeh, Tzung Lieh; Huang, San-Yuan; Yang, Yen-Kuang; Lu, Ru-Band; Hong, Jau-Shyong

    2013-01-01

    Objectives Increasing evidence suggests that inflammation contributes to the etiology and progression of schizophrenia. Molecules that initiate inflammation, such as virus- and toxin-induced cytokines, are implicated in neuronal degeneration and schizophrenia-like behavior. Using therapeutic agents with anti-inflammatory or neurotrophic effects may be beneficial for treating schizophrenia. Methods One hundred healthy controls and 95 Han Chinese patients with schizophrenia were tested in this double-blind study. Their PANSS scores, plasma interleukin (IL)-1β, TNF-α and brain-derived neurotrophic factor (BDNF) levels were measured before and after pharmacological treatment. Results Pretreatment, plasma levels of IL-1β and TNF-α were significantly higher in patients with schizophrenia than in controls, but plasma BDNF levels were significantly lower. Patients were treated with the atypical antipsychotic risperidone (Risp) only or with Risp+add-on dextromethorphan (DM). PANSS scores and plasma IL-1β levels significantly decreased, but plasma TNF-α and BDNF levels significantly increased after 11 weeks of Risp treatment. Patients in the Risp+DM group showed a greater and earlier reduction of symptoms than did those in the Risp-only group. Moreover, Risp+DM treatment attenuated Risp-induced plasma increases in TNF-α. Conclusion Patients with schizophrenia had a high level of peripheral inflammation and a low level of peripheral BDNF. Long-term Risp treatment attenuated inflammation and potentiated the neurotrophic function but also produced a certain degree of toxicity. Risp+DM was more beneficial and less toxic than Risp-only treatment. PMID:22730040

  10. Silicon-Based Asymmetric Add-Drop Microring Resonators with Ultra-Large Through-Port Extinctions

    International Nuclear Information System (INIS)

    Xi, Xiao; Yun-Tao, Li; Yu-De, Yu; Jin-Zhong, Yu

    2010-01-01

    We theoretically simulate and experimentally demonstrate ultra-large through-port extinctions in silicon-based asymmetrically-coupled add-drop microring resonators (MRs). Through-port responses in an add-drop MR are analyzed by simulations and large extinctions are found when the MR is near-critically coupled. Accurate fabrication techniques are applied in producing a series of 20 μm-radii add-drop microrings with drop-side gap-widths in slight differences. A through-port extinction of about 42.7 dB is measured in an MR with through- and drop-side gap-width to be respectively 280nm and 295nm. The large extinction suggests about a 20.5 dB improvement from the symmetrical add-drop MR of the same size and the through-side gap-width. The experimental results are finally compared with the post-fabrication simulations, which show a gap-width tolerance of > 30 am for the through-port extinction enhancement

  11. Adult Dyslexia and Attention Deficit Disorder in Finland--Project DyAdd: WAIS-III Cognitive Profiles

    Science.gov (United States)

    Laasonen, Marja; Leppamaki, Sami; Tani, Pekka; Hokkanen, Laura

    2009-01-01

    The project Adult Dyslexia and Attention Deficit Disorder in Finland (Project DyAdd) compares adults (n = 119, 18-55 years) with dyslexia, attention-deficit/hyperactivity disorder (ADHD), dyslexia together with ADHD (comorbid), and healthy controls with neuropsychological, psychophysical, and biological methods. The focus of this article is on the…

  12. 40 CFR 63.4566 - How do I determine the add-on control device emission destruction or removal efficiency?

    Science.gov (United States)

    2010-07-01

    ... by volume (ppmv), dry basis. Qsd = Volumetric flow rate of gases entering or exiting the add-on...). 0.0416 = Conversion factor for molar volume, kg-moles per cubic meter (mol/m3) (@ 293 Kelvin (K) and... to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B...

  13. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Operating Limits for Capture Systems... 63—Operating Limits for Capture Systems and Add-On Control Devices If you are required to comply with operating limits by § 63.3093, you must comply with the applicable operating limits in the following table...

  14. Measurement of the Economic Growth and Add-on of the R.M. Solow Adjusted Model

    Directory of Open Access Journals (Sweden)

    Ion Gh. Rosca

    2007-08-01

    Full Text Available Besides the models of M. Keynes, R.F. Harrod, E. Domar, D. Romer, Ramsey-Cass-Koopmans model etc., the R.M. Solow model is part of the category which characterizes the economic growth.The paper aim is the economic growth measurement and add-on of the R.M. Solow adjusted model.

  15. How to Reach and Teach Children with ADD/ADHD: Practical Techniques, Strategies, and Interventions. Third Edition

    Science.gov (United States)

    Rief, Sandra F.

    2016-01-01

    The third edition of "How to Reach and Teach Children and Teens with ADD/ADHD" has been completely revised to offer the most updated and comprehensive guidance to everyone engaged in the positive education of children and teens who have been diagnosed with ADHD or show signs and symptoms of the disorder. This valuable resource contains…

  16. Helping Students with Disabilities Transition to College: 21 Tips for Students with LD and/or ADD/ADHD

    Science.gov (United States)

    Connor, David J.

    2012-01-01

    Making the transition from high school to college poses challenges for most students. Moving from a secure, regulated world of secondary education into an unfamiliar environment requiring greater independence can be a destabilizing experience. For students with learning disabilities (LD) and/or Attention Deficit Disorder (ADD), managing this…

  17. Meeting the food, energy, and water demands of nine billion people: Will climate change add a new dimension?

    Science.gov (United States)

    Climate change will add a new stress to our ability to produce food and supply water and energy for the expanding population. There is an emerging gap between the current production trends in food commodities around the world and the projected needs to meet the demands for the world population. This...

  18. 15 CFR 19.5 - How will Commerce entities add interest, penalty charges, and administrative costs to a Commerce...

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false How will Commerce entities add interest, penalty charges, and administrative costs to a Commerce debt? 19.5 Section 19.5 Commerce and Foreign Trade Office of the Secretary of Commerce COMMERCE DEBT COLLECTION Procedures To Collect Commerce...

  19. 78 FR 17624 - Wireline Competition Bureau Adds New Discussion Topic To Connect America Cost Model Virtual Workshop

    Science.gov (United States)

    2013-03-22

    ... Competition Bureau Adds New Discussion Topic To Connect America Cost Model Virtual Workshop AGENCY: Federal... a new virtual workshop discussion topic, entitled ``Rate of Return for Connect America Cost Model,'' to seek public input on what cost of money should be utilized in the forward-looking cost model that...

  20. 78 FR 23192 - Wireline Competition Bureau Adds New Discussion Topic to Connect America Cost Model Virtual Workshop

    Science.gov (United States)

    2013-04-18

    ... Competition Bureau Adds New Discussion Topic to Connect America Cost Model Virtual Workshop AGENCY: Federal... be filed by posting comments at http://www.fcc.gov/blog/wcb-cost-model-virtual-workshop-2012 . [ssquf....gov/blog/wcb-cost-model-virtual-workshop-2012 . 1. On Tuesday, October 9, 2012, the Wireline...

  1. 78 FR 38265 - Wireline Competition Bureau Adds Two New Discussion Topics to Connect America Cost Model Virtual...

    Science.gov (United States)

    2013-06-26

    ... Competition Bureau Adds Two New Discussion Topics to Connect America Cost Model Virtual Workshop AGENCY... comments in this proceeding to be filed by posting comments at http://www.fcc.gov/blog/wcb-cost-model... via the Internet at http://www.fcc.gov/blog/wcb-cost-model-virtual-workshop-2012 . 1. On Tuesday...

  2. Marriage and Health in the Transition to Adulthood: Evidence for African Americans in the Add Health Study

    Science.gov (United States)

    Harris, Kathleen Mullan; Lee, Hedwig; DeLeone, Felicia Yang

    2010-01-01

    This article explores the relationships among early marriage (before age 26 years), cohabitation, and health for African Americans and Whites during the transition to adulthood using the National Longitudinal Study of Adolescent Health (Add Health). The study examines three categories of health outcomes relevant to young adulthood: physical…

  3. Mechanisms with discrete nitrene species

    Indian Academy of Sciences (India)

    identifying a dissociation path involving singlet acyl- nitrene. However, CCSD(T) and CBS-QB3 studies62 predicted acetyl azide decomposes by methyl group migration to give methyl isocyanate and N2 with a bar- rier of 27 kcal/mol. Experimentally, photolysis of pival- oyl azide gives singlet pivaloyl nitrene,45 which adds to.

  4. Effect of “add-on” interventions on exercise training in individuals with COPD: a systematic review

    Directory of Open Access Journals (Sweden)

    Carlos A. Camillo

    2016-03-01

    Full Text Available The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease (COPD. Electronic databases were searched, identifying trials comparing exercise training with exercise training plus “add-on” therapy. Outcomes included peak oxygen uptake (V′O2peak, work rate and incremental/endurance cycle and field walking tests. Individual trial effects on exercise capacity were extracted and collated into eight subgroups and pooled for meta-analysis. Sensitivity analyses were conducted to explore the stability of effect estimates across studies employing patient-centred designs and those deemed to be of “high” quality (PEDro score >5 out of 10. 74 studies (2506 subjects met review inclusion criteria. Interventions spanned a broad scope of clinical practice and were most commonly evaluated via the 6-min walking distance and V′O2peak. Meta-analysis revealed few clinically relevant and statistically significant benefits of “add-on” therapies on exercise performance compared with exercise training. Benefits favouring “add-on” therapies were observed across six different interventions (additional exercise training, noninvasive ventilation, bronchodilator therapy, growth hormone, vitamin D and nutritional supplementation. The sensitivity analyses included considerably fewer studies, but revealed minimal differences to the primary analysis. The lack of systematic benefits of “add-on” interventions is a probable reflection of methodological limitations, such as “one size fits all” eligibility criteria, that are inherent in many of the included studies of “add-on” therapies. Future clarification regarding the exact value of such therapies may only arise from adequately powered, multicentre clinical trials of tailored interventions for carefully selected COPD patient subgroups defined according to distinct

  5. Randomized, controlled trial of rasagiline as an add-on to dopamine agonists in Parkinson's disease.

    Science.gov (United States)

    Hauser, Robert A; Silver, Dee; Choudhry, Azhar; Eyal, Eli; Isaacson, Stuart

    2014-07-01

    Dopamine agonists (DA) are often used as first-line monotherapy for the symptomatic control of Parkinson's disease (PD). However, DA monotherapy typically becomes inadequate within a few years, at which time the DA dosage must be increased or other antiparkinsonian medications added. Adding a monoamine oxidase-B (MAO-B) inhibitor to DA monotherapy might improve symptomatic control while maintaining good safety and tolerability. We conducted an 18-week, randomized, double-blind, placebo-controlled trial of rasagiline 1 mg/d as an add-on to DA therapy (ropinirole ≥ 6 mg/d or pramipexole ≥ 1.0 mg/d) in early PD patients whose conditions were not adequately controlled on their current treatment regimen. The primary efficacy variable was the change in total Unified Parkinson Disease Rating Scale (UPDRS) score (sum of parts I, II, and III) from baseline to week 18, comparing rasagiline and placebo groups. The modified intent-to-treat (ITT) population included 321 subjects whose mean ± SD age was 62.6 ± 9.7, and duration of PD was 2.1 ± 2.1 years. Results demonstrated a significantly greater improvement in total UPDRS scores from baseline to week 18 in the rasagiline group compared with the placebo group (least squares [LS] mean difference ± SE, -2.4 ± 0.95; 95% confidence interval [CI], -4.3, -0.5; P = 0.012). Mean improvement (LS mean ± SE) was -3.6 ± 0.68 in the rasagiline group and -1.2 ± 0.68 in the placebo group. Rasagiline was well tolerated, and the most common adverse events (AEs; rasagiline vs. placebo) were dizziness (7.4% vs. 6.1%), somnolence (6.8% vs. 6.7%), and headache (6.2% vs. 4.3%). Rasagiline 1 mg/d provided statistically significant improvement when added to dopamine agonist therapy and was well tolerated. © 2014 International Parkinson and Movement Disorder Society.

  6. Characterization of an add-on multileaf collimator for electron beam therapy

    International Nuclear Information System (INIS)

    Gauer, T; Sokoll, J; Cremers, F; Schmidt, R; Harmansa, R; Luzzara, M

    2008-01-01

    An add-on multileaf collimator for electrons (eMLC) has been developed that provides computer-controlled beam collimation and isocentric dose delivery. The design parameters result from the design study by Gauer et al (2006 Phys. Med. Biol. 51 5987-6003) and were configured such that a compact and light-weight eMLC with motorized leaves can be industrially manufactured and stably mounted on a conventional linear accelerator. In the present study, the efficiency of an initial computer-controlled prototype was examined according to the design goals and the performance of energy- and intensity-modulated treatment techniques. This study concentrates on the attachment and gantry stability as well as the dosimetric characteristics of central-axis and off-axis dose, field size dependence, collimator scatter, field abutment, radiation leakage and the setting of the accelerator jaws. To provide isocentric irradiation, the eMLC can be placed either 16 or 28 cm above the isocentre through interchangeable holders. The mechanical implementation of this feature results in a maximum field displacement of less than 0.6 mm at 90 0 and 270 0 gantry angles. Compared to a 10 x 10 cm applicator at 6-14 MeV, the beam penumbra of the eMLC at a 16 cm collimator-to-isocentre distance is 0.8-0.4 cm greater and the depth-dose curves show a larger build-up effect. Due to the loss in energy dependence of the therapeutic range and the much lower dose output at small beam sizes, a minimum beam size of 3 x 3 cm is necessary to avoid suboptimal dose delivery. Dose output and beam symmetry are not affected by collimator scatter when the central axis is blocked. As a consequence of the broader beam penumbra, uniform dose distributions were measured in the junction region of adjacent beams at perpendicular and oblique beam incidence. However, adjacent beams with a high difference in a beam energy of 6 to 14 MeV generate cold and hot spots of approximately 15% in the abutting region. In order to

  7. Characterization of an add-on multileaf collimator for electron beam therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gauer, T; Sokoll, J; Cremers, F; Schmidt, R [Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg-Eppendorf, Hamburg (Germany); Harmansa, R [3D Line, Schwarzenbruck (Germany); Luzzara, M [3D Line, Milan (Italy)], E-mail: t.gauer@uke.uni-hamburg.de

    2008-02-21

    An add-on multileaf collimator for electrons (eMLC) has been developed that provides computer-controlled beam collimation and isocentric dose delivery. The design parameters result from the design study by Gauer et al (2006 Phys. Med. Biol. 51 5987-6003) and were configured such that a compact and light-weight eMLC with motorized leaves can be industrially manufactured and stably mounted on a conventional linear accelerator. In the present study, the efficiency of an initial computer-controlled prototype was examined according to the design goals and the performance of energy- and intensity-modulated treatment techniques. This study concentrates on the attachment and gantry stability as well as the dosimetric characteristics of central-axis and off-axis dose, field size dependence, collimator scatter, field abutment, radiation leakage and the setting of the accelerator jaws. To provide isocentric irradiation, the eMLC can be placed either 16 or 28 cm above the isocentre through interchangeable holders. The mechanical implementation of this feature results in a maximum field displacement of less than 0.6 mm at 90{sup 0} and 270{sup 0} gantry angles. Compared to a 10 x 10 cm applicator at 6-14 MeV, the beam penumbra of the eMLC at a 16 cm collimator-to-isocentre distance is 0.8-0.4 cm greater and the depth-dose curves show a larger build-up effect. Due to the loss in energy dependence of the therapeutic range and the much lower dose output at small beam sizes, a minimum beam size of 3 x 3 cm is necessary to avoid suboptimal dose delivery. Dose output and beam symmetry are not affected by collimator scatter when the central axis is blocked. As a consequence of the broader beam penumbra, uniform dose distributions were measured in the junction region of adjacent beams at perpendicular and oblique beam incidence. However, adjacent beams with a high difference in a beam energy of 6 to 14 MeV generate cold and hot spots of approximately 15% in the abutting region. In

  8. A method to add richness to the National Landslide Database of Great Britain

    Science.gov (United States)

    Taylor, Faith; Freeborough, Katy; Malamud, Bruce; Demeritt, David

    2014-05-01

    2012, 72 of these resulted in additions to the BGS NLD and 4 in amendments to previously collected information. This raises the total number of landslides reported in 2012 from 186 to 258. Using the increased presence of landslides in the news and social media, 2012 had already resulted in the largest number of landslides for a given year being recorded by BGS in the NLD. With the additions from this current study to the NLD, we estimate that the annual total number of landslides was around six times higher in 2012 than the average annual total between 2006 and 2011. Years prior to 2012 plan to be revisited using this method, and more broadly, this method of searching newspaper archives could be applied to many other natural hazards to add richness to databases of historical events and improve our understanding of hazard occurrence and impact.

  9. Marketing strategies to add economic value, reactions on corporate social responsibility advertising in print media: an Indian company case

    OpenAIRE

    Karunamoorthy, S; Selvarasu, A.; Filipe, J.

    2013-01-01

    Corporate social responsibility advertising (CSR Advertising) results from commercial advertising, having social dimensions. This concept works as a marketing tool of cause-related marketing (CR Marketing). In this study, the case of IOCL (an Indian oil company) is presented to show how the company creates innovative advertising ideas, serves the society, contributes to save environmental natural resources and allows to add economic value. In addition to the usual ways of commercial advertisi...

  10. The reliability of in-home measures of height and weight in large cohort studies: Evidence from Add Health

    Directory of Open Access Journals (Sweden)

    Jon Hussey

    2015-05-01

    Full Text Available Background: With the emergence of obesity as a global health issue, an increasing number of major demographic surveys are collecting measured anthropometric data. Yet little is known about the characteristics and reliability of these data. Objective: We evaluate the accuracy and reliability of anthropometric data collected in the home during Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health, compare our estimates to national standard, clinic-based estimates from the National Health and Nutrition Examination Survey (NHANES and, using both sources, provide a detailed anthropometric description of young adults in the United States. Methods: The reliability of Add Health in-home anthropometric measures was estimated from repeat examinations of a random subsample of study participants. A digit preference analysis evaluated the quality of anthropometric data recorded by field interviewers. The adjusted odds of obesity and central obesity in Add Health vs. NHANES were estimated with logistic regression. Results: Short-term reliabilities of in-home measures of height, weight, waist and arm circumference - as well as derived body mass index (BMI, kg/m2 - were excellent. Prevalence of obesity (37Š vs. 29Š and central obesity (47Š vs. 38Š was higher in Add Health than in NHANES, while socio-demographic patterns of obesity and central obesity were comparable in the two studies. Conclusions: Properly trained non-medical field interviewers can collect reliable anthropometric data in a nationwide, home visit study. This national cohort of young adults in the United States faces a high risk of early-onset chronic disease and premature mortality.

  11. Stereotaxic core needle biopsy of breast microcalcifications obtained using a standard mammography table with an add-on unit

    International Nuclear Information System (INIS)

    Ward, S.E.; Taves, D.H.; McCurdy, L.I.

    2000-01-01

    To demonstrate the reliability of stereotaxic biopsy of indeterminate microcalcifications using a standard mammography table with an add-on unit. In 121 cases of indeterminate microcalcifications, core biopsy was performed using a standard mammography table with an add-on stereotaxic unit. Microcalcifications were identified on radiography of core specimens. Microcalcifications and a definitive histologic diagnosis were obtained in 112 core biopsies (92.6%), with no significant complications. In 23 lesions frank malignancy was diagnosed, and all of these diagnoses were confirmed on surgery. Pathologic examination suggested carcinoma in 4 lesions, and open biopsy confirmed malignancy in 3 of these cases. Four lesions showed atypical ductal hyperplasia. Benign disease was diagnosed in 81 lesions, of which 78 remained stable on mammographic follow-up (mean 16 months later) and 3 were subjected to surgical biopsy (of which 1 was malignant and 2 were benign). Nine cases were technically unsatisfactory because microcalcifications were not sampled. Stereotaxic core biopsy performed with an add-on unit is a safe and reliable technique for biopsy of indeterminate microcalcifications. For successful biopsy, microcalcifications must be harvested. Pathologic results should be correlated with mammographic findings. The accuracy rate compares favourably with results reported using prone biopsy tables. In an era of cost containment, this alternative to prone biopsy tables could result m significant savings in terms of capital investment and use of hospital rooms. In this study, surgical biopsy could have been avoided in 64.5% of cases. (author)

  12. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true How do I determine the outlet THC.../outlet Concentration Option § 63.3555 How do I determine the outlet THC emissions and add-on control... section to determine either the outlet THC emissions or add-on control device emission destruction or...

  13. Simultaneous all-optical add and drop multiplexing of 40-Gbit/s OTDM signals using monolithically integrated Mach-Zehnder interferometer

    DEFF Research Database (Denmark)

    Jepsen, Kim Stokholm; Mikkelsen, Benny; Vaa, Michael

    1998-01-01

    Simultaneous all-optical add and drop multiplexing of a 40-Gbit/s OTDM signal using a monolithically integrated semiconductor optical amplifier/Mach Zehnder interferometer (SOA-MZI) is demonstrated. While maintaining a penalty of 1.3 dB for the add operation the sensitivity for the demultiplexed ...... signal is -34.4 dBm...

  14. Evaluation of homoeopathic medicines as add-on to institutional management protocol in Acute Encephalitis Syndrome: An exploratory observational comparative study

    Directory of Open Access Journals (Sweden)

    Raj K Manchanda

    2015-01-01

    Conclusion: This exploratory observational study suggests reduction of mortality and morbidity with add-on homoeopathic medicine. Further randomized controlled trial study with comparable groups is desirable. If findings are confirmed by subsequent research, add-on Homoeopathy might have relevant implication for its management.

  15. 40 CFR Table 4 to Subpart Kkkk of... - Operating Limits If Using the Emission Rate With Add-on Controls Option or the Control Efficiency...

    Science.gov (United States)

    2010-07-01

    ... Rate With Add-on Controls Option or the Control Efficiency/Outlet Concentration Compliance Option 4... Add-on Controls Option or the Control Efficiency/Outlet Concentration Compliance Option If you are... volumetric flow rate at a location upstream of the control device, or duct static pressure at a location...

  16. 40 CFR 63.3556 - How do I establish the emission capture system and add-on control device operating limits during...

    Science.gov (United States)

    2010-07-01

    ... system and add-on control device operating limits during the performance test? 63.3556 Section 63.3556... of key parameters of the valve operating system (e.g., solenoid valve operation, air pressure.../outlet Concentration Option § 63.3556 How do I establish the emission capture system and add-on control...

  17. 40 CFR 63.3967 - How do I establish the emission capture system and add-on control device operating limits during...

    Science.gov (United States)

    2010-07-01

    ... system and add-on control device operating limits during the performance test? 63.3967 Section 63.3967... capture system and add-on control device operating limits during the performance test? During the... the operating limits required by § 63.3892 according to this section, unless you have received...

  18. 40 CFR 63.9324 - How do I establish the emission capture system and add-on control device operating limits during...

    Science.gov (United States)

    2010-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.9324 Section 63... Requirements § 63.9324 How do I establish the emission capture system and add-on control device operating... the operating limits required by § 63.9302 according to this section, unless you have received...

  19. 40 CFR 63.3174 - What are the requirements for a capture system or add-on control device which is not taken into...

    Science.gov (United States)

    2010-07-01

    ... control device which is not taken into account when demonstrating compliance with the applicable emission limitations? You may have capture systems or add-on control devices which you choose not to take into account... system or add-on control device which is not taken into account when demonstrating compliance with the...

  20. The COMT Val158Met Polymorphism Is Associated With Response to Add-on Dextromethorphan Treatment in Bipolar Disorder.

    Science.gov (United States)

    Lee, Sheng-Yu; Chen, Shiou-Lan; Wang, Tzu-Yun; Chang, Yun-Hsuan; Chen, Po See; Huang, San-Yuan; Tzeng, Nian-Sheng; Wang, Liang-Jen; Lee, I Hui; Chen, Kao Ching; Yang, Yen Kuang; Lu, Ru-Band

    2017-02-01

    We previously conducted a randomized, double-blind, controlled, 12-week study evaluating the effect of add-on dextromethorphan (DM), a noncompetitive N-methyl-D-aspartate receptor antagonist, on patients with bipolar disorder (BD) treated using valproate (VPA), which showed negative clinical differences. The genetic variation between each individual may be responsible for interindividual differences. The catechol-O-methyltransferase (COMT) gene has been a candidate gene for BD. In the current study, we investigated whether the COMT Val158Met polymorphism predicts treatment response to VPA + add-on DM and to VPA + placebo. Patients with BD (n = 309) undergoing regular VPA treatments were randomly assigned to groups given either add-on DM (30 mg/d) (n = 102), DM (60 mg/d) (n = 101), or placebo (n = 106) for 12 weeks. The Hamilton Depression Rating Scale and Young Mania Rating Scale were used to evaluate clinical response during weeks 0, 1, 2, 4, 8, and 12. The genotypes of the COMT Val158Met polymorphism were determined using polymerase chain reaction plus restriction fragment length polymorphism analysis. To adjust for within-subject dependence over repeated assessments, multiple linear regression with generalized estimating equation methods was used. When stratified by the COMT Val158Met genotypes, significantly greater decreases in Hamilton Depression Rating Scale scores were found in the VPA + DM (30 mg/d) group in patients with the Val/Met genotype (P = 0.008). We conclude that the COMT Val158Met polymorphism may influence responses to DM (30 mg/d) by decreasing depressive symptoms in BD patients.

  1. Cost-effectiveness of add-on treatments to metformin in a Swedish setting: liraglutide vs sulphonylurea or sitagplitin.

    Science.gov (United States)

    Steen Carlsson, Katarina; Persson, Ulf

    2014-09-01

    To evaluate long-run cost-effectiveness in a Swedish setting for liraglutide compared with sulphonylureas (glimepiride) or sitagliptin, all as add-on to metformin for patients with type 2 diabetes insufficiently controlled with metformin in monotherapy. The IHE Cohort Model of Type 2 Diabetes was used to evaluate clinical and economic outcomes from a societal perspective. Model input data were obtained from two clinical trials, the Swedish National Diabetes Register and the literature. Cost data reflected year 2013 price level. The robustness of results was checked with one-way-sensitivity analysis and probability sensitivity analysis. The cost per QALY gained for liraglutide (1.2 mg) compared to SU (glimepiride 4 mg), both as add-on to metformin, ranged from SEK 226,000 to SEK 255,000 in analyzed patient cohorts. The cost per QALY for liraglutide (1.2 mg) vs sitagliptin (100 mg) as second-line treatment was lower, ranging from SEK 149,000 to SEK 161,000. Costs of preventive treatment were driving costs, but there was also a cost offset from reduced costs of complications of ∼ 20%. Notable cost differences were found for nephropathy, stroke, and heart failure. The predicted life expectancy with liraglutide increased the cost of net consumption for liraglutide. The analysis was an ex-ante analysis using model input data from clinical trials which may not reflect effectiveness in real-world clinical practice in broader patient populations. This limitation was explored in the sensitivity analysis. The lack of specific data on loss of production due to diabetes complications implied that these costs may be under-estimated. Treatment strategies with liraglutide 1.2 mg improved the expected quality-of-life and increased costs when compared to SU and to sitagliptin for second-line add-on treatments. The cost per QALY for liraglutide was in the range considered medium by Swedish authorities.

  2. Cortical atrophy rates in Alzheimer's patients and subjects with mild cognitive impairment from the AddNeuroMed data collection

    DEFF Research Database (Denmark)

    Eskildsen, Simon Fristed; Westman, Eric; Gwadry-Sridhar, Femida

    2010-01-01

    Background: The AddNeuroMed project is a multi-centre European project which aims to identify biomarkers in Alzheimer's disease (AD). In this study we measured the rate of cortical atrophy in AD patients, subjects with mild cognitive impairment (MCI), and healthy controls (HC) using MRI. Methods...... quality control for both the acquisition and image processing were included in the study. Cortical thickness was measured using FACE (fast accurate cortex extraction) and averaged within main lobes using a stereotaxic atlas. Atrophy rates were calculated as percent decrease in cortical thickness and rate...

  3. Usage of OpenStack Virtual Machine and MATLAB HPC Add-on leads to faster turnaround

    KAUST Repository

    Van Waveren, Matthijs

    2017-03-16

    We need to run hundreds of MATLAB® simulations while changing the parameters between each simulation. These simulations need to be run sequentially, and the parameters are defined manually from one simulation to the next. This makes this type of workload unsuitable for a shared cluster. For this reason we are using a cluster running in an OpenStack® Virtual Machine and are using the MATLAB HPC Add-on for submitting jobs to the cluster. As a result we are now able to have a turnaround time for the simulations of the order of a few hours, instead of the 24 hours needed on a local workstation.

  4. A television in the bedroom is associated with higher weekday screen time among youth with attention deficit hyperactivity disorder (ADD/ADHD)

    OpenAIRE

    Lo, Charmaine B.; Waring, Molly E.; Pagoto, Sherry L.; Lemon, Stephenie C.

    2015-01-01

    Objective: A TV in the bedroom has been associated with screen time in youth. Youth with attention deficit hyperactivity disorder (ADD/ADHD) have higher rates of screen time, but associations with bedroom TVs are unknown in this population. We examined the association of having a bedroom TV with screen time among youth with ADD/ADHD. Methods: Data were from the 2007 National Survey of Children's Health. Youth 6–17 years whose parent/guardian reported a physician's diagnosis of ADD/ADHD (n ...

  5. Pubertal Stress and Nutrition and their Association with Sexual Orientation and Height in the Add Health Data.

    Science.gov (United States)

    Skorska, Malvina N; Bogaert, Anthony F

    2017-01-01

    A number of studies have indicated that gay men tend to be shorter, on average, than heterosexual men. Less evidence exists that lesbian women are taller, on average, than heterosexual women. The most popular explanation of the association between sexual orientation and height involves prenatal factors, such that, for example, gay men may have been exposed to lower than typical androgens during fetal development, which impacts their height and sexual orientation as adults. An alternative explanation involves stress, given that stress has been associated with sexual minority identification and with lower height. Another alternative explanation involves nutrition, although its relationship is less clear with sexual minority identification. Using the Add Health data, which is a large, nationally representative and longitudinal sample of American adolescents (n = 14,786), we tested a mediation model, such that sexual orientation → pubertal stress/nutrition → height. Within men, we found that gay men (n = 126) were shorter, on average, than heterosexual men (n = 6412). None of the 24 pubertal stress-related and 15 pubertal nutrition-related variables assessed in the Add Health data mediated the relationship between sexual orientation and height in men. Within women, lesbians (n = 75) did not differ significantly in stature compared to heterosexual women (n = 6267). Thus, prenatal mechanisms (e.g., hormones, maternal immune response) are likely better candidates for explaining the height difference between gay men and heterosexual men.

  6. Omega-3 fatty acids decreased irritability of patients with bipolar disorder in an add-on, open label study

    Directory of Open Access Journals (Sweden)

    Baldassano Claudia F

    2005-02-01

    Full Text Available Abstract This is a report on a 37-patient continuation study of the open ended, Omega-3 Fatty Acid (O-3FA add-on study. Subjects consisted of the original 19 patients, along with 18 new patients recruited and followed in the same fashion as the first nineteen. Subjects carried a DSM-IV-TR diagnosis of Bipolar Disorder and were visiting a Mood Disorder Clinic regularly through the length of the study. At each visit, patients' clinical status was monitored using the Clinical Monitoring Form. Subjects reported on the frequency and severity of irritability experienced during the preceding ten days; frequency was measured by way of percentage of days in which subjects experienced irritability, while severity of that irritability was rated on a Likert scale of 1 – 4 (if present. The irritability component of Young Mania Rating Scale (YMRS was also recorded quarterly on 13 of the 39 patients consistently. Patients had persistent irritability despite their ongoing pharmacologic and psychotherapy. Omega-3 Fatty Acid intake helped with the irritability component of patients suffering from bipolar disorder with a significant presenting sign of irritability. Low dose (1 to 2 grams per day, add-on O-3FA may also help with the irritability component of different clinical conditions, such as schizophrenia, borderline personality disorder and other psychiatric conditions with a common presenting sign of irritability.

  7. ALDH2 polymorphism, associated with attenuating negative symptoms in patients with schizophrenia treated with add-on dextromethorphan.

    Science.gov (United States)

    Lee, Sheng-Yu; Chen, Shiou-Lan; Chang, Yun-Hsuan; Chen, Po-See; Huang, San-Yuan; Tzeng, Nian-Sheng; Wang, Liang-Jen; Lee, I-Hui; Wang, Tzu-Yun; Chen, Kao-Chin; Yang, Yen-Kuang; Hong, Jau-Shyong; Lu, Ru-Band

    2015-10-01

    Increasing the evidence of inflammation's contribution to schizophrenia; using anti-inflammatory or neurotrophic therapeutic agents to see whether they improve schizophrenia treatment. Dextromethorphan (DM), a non-competitive N-methyl-d-aspartate (NMDA) receptor antagonist, might protect monoamine neurons. Whether treating schizophrenia with risperidone plus add-on DM is more effective than risperidone (RISP) alone, and the association between the ALDH2 polymorphism and treatment response were investigated. A double-blind study in which patients with schizophrenia were randomly assigned to the RISP + DM (60 mg/day; n = 74) or the RISP + Placebo (n = 75) group. The Positive and Negative Syndrome Scale (PANSS) and the Scale for the Assessment of Negative Symptoms (SANS) scores were used to evaluate clinical response during weeks 0, 1, 2, 4, 6, 8, and 11. The genotypes of the ALDH2 polymorphism were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. A generalized estimating equation was used to analyze the effects of ALDH2 polymorphism on the clinical performance of DM. PANSS and SANS scores were significantly lower in both groups after 11 weeks of treatment. SANS total scores were significantly lower in the RISP + DM group in patients with the ALDH2*2*2 genotype. RISP plus add-on DM treatment reduced negative schizophrenia symptoms in patients with the ALDH2 polymorphism. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Just add a pinch of salt!--current directions for the use of salt in recipes in Australian magazines.

    Science.gov (United States)

    Webster, Jacqui; Dunford, Elizabeth; Barzi, Federica; Neal, Bruce

    2010-02-01

    Australians currently consume too much salt causing adverse consequences for health. The media play an important role in the provision of nutrition advice to consumers. Previous research shows that many foods advertized in consumer magazines are high in salt, but little research has examined magazine recipes in this context. The aim of this project was to summarize directions for salt use in recipes in leading Australian magazines. In August 2007 and 2008, the top 10 magazines by circulation that included at least five recipes, were examined. Standardized information was collected about directions for salt use in recipes. Three hundred and thirty recipes were identified in 2007 and 417 in 2008. About 68% of recipes included high-salt ingredients, 37% instructed to season with salt, 10% instructed to add a specific quantity of salt and 15% recommended selection of low-salt ingredients. There was substantial variability in directions for salt use in recipes between magazines, but no clear differences between 2007 and 2008. Many recipes advised to add salt in direct contradiction to national dietary guidelines. There is clear potential for editorial guidelines on salt use in recipes to play a role in advancing public health efforts in Australia and other such nations.

  9. Lacosamide as add-on treatment of focal symptomatic epilepsy in a patient with alcoholic liver cirrhosis

    Directory of Open Access Journals (Sweden)

    A. Romigi

    2014-01-01

    Full Text Available The occurrence of epileptic seizures in the presence of hepatic disease is not uncommon in clinical practice. Selecting an appropriate AED for patients affected by liver failure who have new-onset epileptic seizures can be challenging. We describe a 64-year-old man affected by liver cirrhosis. The patient developed partial epilepsy with secondary generalization because of an intracerebral hemorrhage in the left parieto-occipital regions. After the neurosurgery procedure, seizures reappeared and were initially managed with levetiracetam. After one month, the patient experienced clusters of seizures while on stable treatment with levetiracetam. Pregabalin as add-on was not tolerated; therefore, he received a low dose of phenobarbital as add-on treatment. The patient developed hepatic encephalopathy. Phenobarbital was immediately stopped, and oral lacosamide was added. A rapid recovery of encephalopathy with a 6-month seizure freedom was obtained. The patient died 6 months later because of progressive impairment of liver function. Lacosamide may represent an alternative to other AEDs in patients with liver failure; however, further prospective evaluation of its efficacy and safety in this clinical setting is needed.

  10. Antidiabetic Effects of Add-On Gynostemma pentaphyllum Extract Therapy with Sulfonylureas in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    V. T. T. Huyen

    2012-01-01

    Full Text Available Aims. To investigate the antidiabetic effect of the traditional Vietnamese herb Gynostemma pentaphyllum (GP together with sulfonylurea (SU in 25 drug-naïve type 2 diabetic patients. Methods. After 4-week treatment with gliclazide (SU, 30 mg daily, all patients were randomly assigned into 2 groups to add on GP extract or placebo extract, 6 g daily, during eight weeks. Results. After 4-week SU treatment, fasting plasma glucose (FPG and HbA1C decreased significantly (P<0.001. FPG was further reduced after add-on therapy with 2.9 ± 1.7 and 0.9 ± 0.6 mmol/L in the GP and placebo groups, respectively (P<0.001. Therapy with GP extract also reduced 30- and 120-minute oral glucose tolerance test postload values. HbA1C levels decreased approximately 2% units in the GP group compared to 0.7% unit in the placebo group (P<0.001. Conclusion. GP extract in addition to SU offers an alternative to addition of other oral medication to treat type 2 diabetic patients.

  11. Simvastatin as add-on therapy to interferon β-1a for relapsing-remitting multiple sclerosis (SIMCOMBIN study): a placebo-controlled randomised phase 4 trial

    DEFF Research Database (Denmark)

    Sorensen, Per Soelberg; Lycke, Jan; Erälinna, Juha-Pekka

    2011-01-01

    Treatment of relapsing-remitting multiple sclerosis with interferon beta is only partly effective. We aimed to establish whether add-on of simvastatin, a statin with anti-inflammatory properties, improves this efficacy.......Treatment of relapsing-remitting multiple sclerosis with interferon beta is only partly effective. We aimed to establish whether add-on of simvastatin, a statin with anti-inflammatory properties, improves this efficacy....

  12. 42 CFR 83.19 - How can the Secretary cancel or modify a final decision to add a class of employees to the Cohort?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false How can the Secretary cancel or modify a final... to the Cohort § 83.19 How can the Secretary cancel or modify a final decision to add a class of employees to the Cohort? (a) The Secretary can cancel a final decision to add a class to the Cohort, or can...

  13. All-Optical Regenerative OTDM Add/Drop Multiplexing at 40 Gbit/s using Monolithic InP Mach-Zehnder Interferometer

    DEFF Research Database (Denmark)

    Buxens, Alvaro A.; Clausen, Anders; Poulsen, Henrik Nørskov

    2000-01-01

    We report a novel method for simultaneous add-drop multiplexing in OTDM systems which includes regenerative capabilities and perfect clearing of the drop channel time slot. The principle has been demonstrated at 40 Gb/s showing an excellent performance.......We report a novel method for simultaneous add-drop multiplexing in OTDM systems which includes regenerative capabilities and perfect clearing of the drop channel time slot. The principle has been demonstrated at 40 Gb/s showing an excellent performance....

  14. Feasibility study of veterinary antibiotic consumption in Germany--comparison of ADDs and UDDs by animal production type, antimicrobial class and indication.

    Science.gov (United States)

    Merle, Roswitha; Robanus, Matthias; Hegger-Gravenhorst, Christine; Mollenhauer, Yvonne; Hajek, Peter; Käsbohrer, Annemarie; Honscha, Walther; Kreienbrock, Lothar

    2014-01-08

    Within a feasibility study the use of antibiotics in pigs and cattle was determined in 24 veterinary practices in Lower Saxony and on 66 farms in North Rhine-Westphalia in Germany. Focus was laid on the comparison of the Used Daily Doses (UDD) (dose per animal and day prescribed by the veterinarians) with the Defined Animal Daily Doses (ADD) (dose per animal and day calculated by means of recommended dosages and estimated live weights). For piglets and calves most of the UDD (50% and 46% of nUDD, respectively) were above the ADD (i.e. UDD/ADD-ratio above 1.25). Regarding sows, fattening pigs, dairy and beef cattle, most of the UDDs (49% to 65% of nUDD) were lower than the respective ADD (i.e. UDD/ADD-ratio below 0.8). In pigs, the UDDs of beta-lactams, fluoroquinolones and cephalosporins, and in cattle, those of macrolides and beta-lactams were often below the ADDs. Tetracyclines were frequently used above the recommended dose.Enteric diseases were more often treated below the recommended dose than respiratory diseases, possibly due to overestimation of the live weight (diarrhea in young animals, respiratory diseases in elder animals) and consequently overestimation of the recommended dose. Comparisons between UDD and ADD can be used to observe differences between antimicrobials and trends in the usage of antibiotics. But individual treatment comparisons of UDD and ADD must be interpreted carefully, because they may be due to lower live weights than estimated. Correlating such data with data on the occurrence of resistant bacteria in future may help to improve resistance prevention and control.

  15. Globes from global data: Charting international research networks with the GRASS GIS r.out.polycones add-on module.

    Science.gov (United States)

    Löwe, Peter

    2015-04-01

    Many Free and Open Source Software (FOSS) tools have been created for the various application fields within geoscience. While FOSS allows re-implementation of functionalities in new environments by access to the original codebase, the easiest approach to build new software solutions for new problems is the combination or merging of existing software tools. Such mash-ups are implemented by embedding and encapsulating FOSS tools within each another, effectively focusing the use of the embedded software to the specific role it needs to perform in the given scenario, while ignoring all its other capabilities. GRASS GIS is a powerful and established FOSS GIS for raster, vector and volume data processing while the Generic Mapping Tools (GMT) are a suite of powerful Open Source mapping tools, which exceed the mapping capabilities of GRASS GIS. This poster reports on the new GRASS GIS add-on module r.out.polycones. It enables users to utilize non-continuous projections for map production within the GRASS production environment. This is implemented on the software level by encapsulating a subset of GMT mapping capabilities into a GRASS GIS (Version 6.x) add-on module. The module was developed at the German National Library of Science and Technology (TIB) to provide custom global maps of scientific collaboration networks, such as the DataCite consortium, the registration agency for Digital Object Identifiers (DOI) for research data. The GRASS GIS add-on module can be used for global mapping of raster data into a variety of non continuous sinosoidal projections, allowing the creation of printable biangles (gores) to be used for globe making. Due to the well structured modular nature of GRASS modules, technical follow-up work will focus on API-level Python-based integration in GRASS 7 [1]. Based on this, GMT based mapping capabilities in GRASS will be extended beyond non-continuous sinosoidal maps and advanced from raster-layers to content GRASS display monitors. References

  16. Interference Canceller Based on Cycle-and-Add Property for Single User Detection in DS-CDMA

    Science.gov (United States)

    Hettiarachchi, Ranga; Yokoyama, Mitsuo; Uehara, Hideyuki; Ohira, Takashi

    In this paper, performance of a novel interference cancellation technique for the single user detection in a direct-sequence code-division multiple access (DS-CDMA) system has been investigated. This new algorithm is based on the Cycle-and-Add property of PN (Pseudorandom Noise) sequences and can be applied for both synchronous and asynchronous systems. The proposed strategy provides a simple method that can delete interference signals one by one in spite of the power levels of interferences. Therefore, it is possible to overcome the near-far problem (NFP) in a successive manner without using transmit power control (TPC) techniques. The validity of the proposed procedure is corroborated by computer simulations in additive white Gaussian noise (AWGN) and frequency-nonselective fading channels. Performance results indicate that the proposed receiver outperforms the conventional receiver and, in many cases, it does so with a considerable gain.

  17. Equilibrium expert: an add-in to Microsoft Excel for multiple binding equilibrium simulations and parameter estimations.

    Science.gov (United States)

    Raguin, Olivier; Gruaz-Guyon, Anne; Barbet, Jacques

    2002-11-01

    An add-in to Microsoft Excel was developed to simulate multiple binding equilibriums. A partition function, readily written even when the equilibrium is complex, describes the experimental system. It involves the concentrations of the different free molecular species and of the different complexes present in the experiment. As a result, the software is not restricted to a series of predefined experimental setups but can handle a large variety of problems involving up to nine independent molecular species. Binding parameters are estimated by nonlinear least-square fitting of experimental measurements as supplied by the user. The fitting process allows user-defined weighting of the experimental data. The flexibility of the software and the way it may be used to describe common experimental situations and to deal with usual problems such as tracer reactivity or nonspecific binding is demonstrated by a few examples. The software is available free of charge upon request.

  18. Treatment of traumatised refugees with basic body awareness therapy versus mixed physical activity as add-on treatment

    DEFF Research Database (Denmark)

    Nordbrandt, Maja Sticker; Carlsson, Jessica; Lindberg, Laura Glahder

    2015-01-01

    . In clinical studies, physical activity has shown a positive effect on psychiatric illnesses such as depression and anxiety and for patients with chronic pain. However, scientific knowledge about physical activity as part of the treatment for traumatised refugees is very limited and no guidelines exist......-based Cognitive Behavioural Therapy. The first group only receives treatment as usual while the second and the third groups receive either Basic-Body Awareness Therapy or mixed physical activity as add-on treatments. Each physical activity is provided for an individual 1-hour consultation per week...... as well as quality of life, functional capacity, coping with pain, body awareness and physical fitness. DISCUSSION: This study will examine the effect of physical activity for traumatised refugees. This has not yet been done in a randomised controlled setting on such a large scale before. Hereby the study...

  19. Long-term efficacy and safety of vildagliptin add-on therapy in type 2 diabetes mellitus with insulin treatment.

    Science.gov (United States)

    Kanazawa, Ippei; Tanaka, Ken-Ichiro; Notsu, Masakazu; Tanaka, Sayuri; Kiyohara, Nobuaki; Koike, Sayo; Yamane, Yuko; Tada, Yuko; Sasaki, Motofumi; Yamauchi, Mika; Sugimoto, Toshitsugu

    2017-01-01

    The use of dipeptidyl peptidase (DPP)-4 inhibitors in patients with type 2 diabetes treated with insulin may be beneficial. However, the long-term efficacy and safety of vildagliptin add-on therapy in these patients remains unclear. A total of 73 patients with type 2 diabetes treated with insulin were randomly assigned to receive either add-on therapy of vildagliptin (n=37) or conventional therapy without DPP-4 inhibitors (n=36) for glucose control. Hemoglobin A1c (HbA1c) levels, dose and number of insulin injections, number of hypoglycemia episodes, and liver and renal function were monitored for 2years. The baseline characteristics of subjects, including age, dose of insulin injections, or HbA1c levels, did not differ between the two groups. In the vildagliptin group, HbA1c levels significantly decreased and the significance of HbA1c reduction was maintained for 24months (from 8.0±1.2% to 7.4±1.0%, pinsulin injections significantly reduced (-5.6units, p1, and -0.9 times, p1). However, these parameters were unchanged in the control group. The number of patients who experienced three or more episodes of hypoglycemia per year was significantly lower in the vildagliptin group (n=4) than in the control group (n=11) (odds ratio, 0.28; 95% confidence interval, 0.08-0.97; pinsulin treatment for 24months was well tolerated and led to sustained reductions in HbA1c, the dose and number of insulin injections, and the risk of hypoglycemia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Storytelling Adds Meaning

    Science.gov (United States)

    Selby, Victor M.

    2009-01-01

    This article describes several enrichment activities that connect mathematics to science in an algebra 1 curriculum. It provides a basis and suggestions for teachers to include student-produced essays about the role of mathematics in the history of civilization. (Contains 6 figures and 1 table.)

  1. Just add physics

    Science.gov (United States)

    Cawthorne, Trevor

    2012-04-01

    Following John Swanson's Lateral Thoughts article about uncertainty in cookery and other things (“Baking, speed limits and circuits” March p88), I would like to offer this fruit cake recipe, designed for those of us who like to know how precise our cookery should be.

  2. Evaluation of add-on devices for the prevention of phlebitis and other complications associated with the use of peripheral catheters in hospitalised adults: a randomised controlled study.

    Science.gov (United States)

    Martínez, J A; Piazuelo, M; Almela, M; Blecua, P; Gallardo, R; Rodríguez, S; Escalante, Z; Robau, M; Trilla, A

    2009-10-01

    The aim of this study was to assess the role of add-on devices for the prevention of phlebitis and other complications associated with the use of peripheral catheters. Patients admitted to an infectious diseases ward and requiring the insertion of a peripheral catheter for at least 24h were randomly allocated to be managed with or without add-on devices. Incidence of phlebitis and all complications were the primary outcomes. Extravasation, inadvertent withdrawal, obstruction and rupture were considered to be mechanical complications, and analysis was performed using survival methods. Of 683 evaluated catheters, 351 were allocated to the add-on device arm and 332 to the control arm. Despite randomisation, patients in the add-on device group were older (P=0.048), less likely to have human immunodeficiency virus (P=0.02) and more likely to have received antibiotics (P=0.05). After adjustment for these variables, the hazard ratio for phlebitis remained non-significant (hazard ratio: 0.95; 95% confidence interval: 0.7-1.3), but the risk of mechanical complications became lower in the add-on device arm (0.68; 0.5-0.94). This translated into a trend towards a lower risk of any complication (0.83; 0.67-1.01). The beneficial effect on mechanical or all complications was noticeable after six days of catheterisation. Add-on devices do not reduce the incidence of phlebitis but may prevent mechanical complications. However, the impact of add-on devices on the incidence of all complications is at most small and only apparent after the sixth day of catheter use.

  3. Low- vs high- frequency Repetitive Transcranial Magnetic Stimulation as an add-on treatment for refractory depression

    Directory of Open Access Journals (Sweden)

    julien eeche

    2012-03-01

    Full Text Available Objectives: Repetitive transcranial magnetic stimulation (rTMS seems to be effective as an antidepressant treatment, however, some confusion remain about the best parameters to apply and the efficacy of its association with pharmacological antidepressant treatments.Method: In a single blind randomized study14 patients with unipolar resistant depression to one antidepressant treatment were enrolled to received, in combination with venlafaxine (150 mg, either 20 sessions of 10Hz rTMS (2 000 pulses per session applied over le left dorsolateral prefrontal cortex (DLPFC or 20 sessions of 1 Hz rTMS (120 stimulations per sessions applied over the right DLPFC. Results: A similar antidepressant effect was observed in both groups with a comparable antidepressant delay of action (2 weeks and a comparable number of patients in remission after 4 weeks of daily rTMS sessions (66 vs 50 %.Conclusion: Low- and high- frequency rTMS seem to be effective as an add-on treatment to venlafaxine in pharmacological refractory major depression. Due to its short duration and its safety, low frequency rTMS may be a useful alternative treatment for patients with refractory depression.

  4. Evaluation of the Single-precision Floatingpoint Vector Add Kernel Using the Intel FPGA SDK for OpenCL

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Zheming [Argonne National Lab. (ANL), Argonne, IL (United States); Yoshii, Kazutomo [Argonne National Lab. (ANL), Argonne, IL (United States); Finkel, Hal [Argonne National Lab. (ANL), Argonne, IL (United States); Cappello, Franck [Argonne National Lab. (ANL), Argonne, IL (United States)

    2017-04-20

    Open Computing Language (OpenCL) is a high-level language that enables software programmers to explore Field Programmable Gate Arrays (FPGAs) for application acceleration. The Intel FPGA software development kit (SDK) for OpenCL allows a user to specify applications at a high level and explore the performance of low-level hardware acceleration. In this report, we present the FPGA performance and power consumption results of the single-precision floating-point vector add OpenCL kernel using the Intel FPGA SDK for OpenCL on the Nallatech 385A FPGA board. The board features an Arria 10 FPGA. We evaluate the FPGA implementations using the compute unit duplication and kernel vectorization optimization techniques. On the Nallatech 385A FPGA board, the maximum compute kernel bandwidth we achieve is 25.8 GB/s, approximately 76% of the peak memory bandwidth. The power consumption of the FPGA device when running the kernels ranges from 29W to 42W.

  5. Sample-based engine noise synthesis using an enhanced pitch-synchronous overlap-and-add method.

    Science.gov (United States)

    Jagla, Jan; Maillard, Julien; Martin, Nadine

    2012-11-01

    An algorithm for the real time synthesis of internal combustion engine noise is presented. Through the analysis of a recorded engine noise signal of continuously varying engine speed, a dataset of sound samples is extracted allowing the real time synthesis of the noise induced by arbitrary evolutions of engine speed. The sound samples are extracted from a recording spanning the entire engine speed range. Each sample is delimitated such as to contain the sound emitted during one cycle of the engine plus the necessary overlap to ensure smooth transitions during the synthesis. The proposed approach, an extension of the PSOLA method introduced for speech processing, takes advantage of the specific periodicity of engine noise signals to locate the extraction instants of the sound samples. During the synthesis stage, the sound samples corresponding to the target engine speed evolution are concatenated with an overlap and add algorithm. It is shown that this method produces high quality audio restitution with a low computational load. It is therefore well suited for real time applications.

  6. Petro-Canada's project to add petroleum product storage tanks to the Municipality of Montreal-East

    International Nuclear Information System (INIS)

    Lefebvre, G.; Joly, R.; Guay, T.

    2006-01-01

    This paper explored the environmental impacts associated with Petro-Canada's project to add petroleum product storage tanks to its refinery in the east-end of Montreal. The project plan is based on a 6 year horizon from 2006-2012. The additional reservoirs would store new products destined for the petrochemical industry and for consumers, thus improving the flexibility and reliability of the refinery. The products would include low sulfur diesel and ethanol gasoline. The project does not involve any increase in refining capacity, and is estimated to cost $15 million. The main issues associated with this project are ambient air quality, the protection of groundwater and soil, as well as the security of areas inhabited by neighbouring areas in risk of a major accident. Emissions of organic compounds, including benzene, are considered minimal considering the use of sealed floating roofs. Geomembranes will be installed under the storage tanks to ensure the protection of groundwater and soil. Any consequences to the population of neighbouring areas resulting from accidents inside the industrial park will be limited since the reservoirs will be located more than 1 km away from a populated area. Quebec's Ministry of Sustainable Development, Environment and Parks recommended that this project be approved as long as the terms and measures of environmental regulations are respected, and that an emergency plan is submitted before the operation of the first reservoir. 1 tab

  7. Ozone therapy as add-on treatment in fibromyalgia management by rectal insufflation: an open-label pilot study.

    Science.gov (United States)

    Hidalgo-Tallón, Javier; Menéndez-Cepero, Silvia; Vilchez, Juan S; Rodríguez-López, Carmen M; Calandre, Elena P

    2013-03-01

    The objectives of this study were to evaluate the effectiveness and tolerability of ozone therapy by rectal insufflation as add-on therapy in fibromyalgia management. Patients with fibromyalgia received 24 sessions of ozone therapy during a 12-week period. At each session, the administered dose of ozone was 8 mg (200 mL of gas, at a concentration of 40 μg/mL). Ozone sessions were given 5 days a week during the first 2 weeks, twice a week from weeks 3-6, and weekly from weeks 7-12. Fibromyalgia Impact Questionnaire (FIQ) was the main outcome measure, and was administered at baseline and at weeks 4, 8, and 12. Secondary outcome measures, administered at baseline and at endpoint, were the Pittsburgh Sleep Quality Index, the Beck Depression Inventory, the State and Trait Anxiety Inventory, and the SF-12, the abbreviated form of the Short Form Health Survey. Emergent adverse reactions to treatment were recorded. FIQ total scores decreased significantly during the study period, with the decrease being observed in the first 4 weeks of the study. Significant improvement was also seen both in depression scores and in the Physical Summary Score of the SF-12. Transient meteorism after ozone therapy sessions was the most frequently reported side-effect. At the dose and number of sessions used in this study, ozone therapy by rectal insufflation seems to be beneficial for physical symptoms and depression of fibromyalgia.

  8. Athermal silicon optical add-drop multiplexers based on thermo-optic coefficient tuning of sol-gel material.

    Science.gov (United States)

    Namnabat, Soha; Kim, Kyung-Jo; Jones, Adam; Himmelhuber, Roland; DeRose, Christopher T; Trotter, Douglas C; Starbuck, Andrew L; Pomerene, Andrew; Lentine, Anthony L; Norwood, Robert A

    2017-09-04

    Silicon photonics has gained interest for its potential to provide higher efficiency, bandwidth and reduced power consumption compared to electrical interconnects in datacenters and high performance computing environments. However, it is well known that silicon photonic devices suffer from temperature fluctuations due to silicon's high thermo-optic coefficient and therefore, temperature control in many applications is required. Here we present an athermal optical add-drop multiplexer fabricated from ring resonators. We used a sol-gel inorganic-organic hybrid material as an alternative to previously used materials such as polymers and titanium dioxide. In this work we studied the thermal curing parameters of the sol-gel and their effect on thermal wavelength shift of the rings. With this method, we were able to demonstrate a thermal shift down to -6.8 pm/°C for transverse electric (TE) polarization in ring resonators with waveguide widths of 325 nm when the sol-gel was cured at 130°C for 10.5 hours. We also achieved thermal shifts below 1 pm/°C for transverse magnetic (TM) polarization in the C band under different curing conditions. Curing time compared to curing temperature shows to be the most important factor to control sol-gel's thermo-optic value in order to obtain an athermal device in a wide temperature range.

  9. Use of asenapine as add-on therapy in the treatment of bipolar disorder: a comprehensive review and case series.

    Science.gov (United States)

    Dell'Osso, Bernardo; Cremaschi, Laura; Palazzo, Maria Carlotta; Spagnolin, Gregorio; Cattaneo, Alma; Grancini, Benedetta; Maggi, Matteo; Altamura, Alfredo Carlo

    2014-09-01

    Several randomized controlled trials (RCTs), conducted in schizophrenic and bipolar patients, have documented the efficacy and tolerability of asenapine as monotherapy both for short- and long-term treatment. However, evidence on its augmentative use is more limited and related to the manic/mixed phase of bipolar disorder (BD). The present article reviews augmentative asenapine efficacy and safety/tolerability in the treatment of BD. It also includes some original cases of bipolar patients treated with add-on asenapine in the short- and long-term. To date, only a single RCT with manic/mixed patients with partial response to mood-stabilizer monotherapy supports the efficacy and safety/tolerability of augmentative asenapine to lithium/valproate, both in acute and long-term treatment. Additionally, two case reports confirm the overall effectiveness of augmentative asenapine to clozapine and valproate. Our case series, consisting of 4 bipolar patients treated with adjunctive asenapine to mood stabilizers and atypical antipsychotics - with treatment duration ranging from 1 to 14 months - provided clinical results that are consistent with literature data. Taken as a whole, available evidence seems to support the efficacy and safety of adjunctive asenapine in bipolar patients, though additional studies with active comparators are requested to confirm the current body of evidence.

  10. Flexible add-on solution for MR image-guided interventions in a closed-bore scanner environment.

    Science.gov (United States)

    Busse, Harald; Garnov, Nikita; Thörmer, Gregor; Zajonz, Dirk; Gründer, Wilfried; Kahn, Thomas; Moche, Michael

    2010-09-01

    MRI is of great clinical utility for the guidance of various diagnostic and therapeutic procedures. In a standard closed-bore scanner, the simplest approach is to manipulate the instrument outside the bore and move the patient into the bore for reference and control imaging only. Without navigational assistance, however, such an approach can be difficult, inaccurate, and time consuming. Therefore, an add-on navigation solution is described that addresses these limitations. Patient registration is established by an automatic, robust, and fast (<30 sec) localization of table-mounted MR reference markers and the instrument is tracked optically. Good hand-eye coordination is provided by following the virtual instrument on MR images that are reconstructed in real time from the reference data. Needle displacements of 2.2 +/- 0.6 mm and 3.9 +/- 2.4 mm were determined in a phantom (P < 0.05), depending on whether the reference markers were placed at smaller (98-139 mm) or larger (147-188 mm) distances from the isocenter. Clinical functionality of the navigation concept is demonstrated by a double oblique, subscapular hook-wire insertion in a patient with a body mass index of 30.1 kg/m(2). Ease of use, compactness, and flexibility of this technique suggest that it can be used for many other procedures in different body regions. More patient cases are needed to evaluate clinical performance and workflow. 2010 Wiley-Liss, Inc.

  11. Process for Biotransformation of Androsta-4-ene-3, 17-Dione (4-AD) to Androsta-1,4-Diene-3,17-Dione (ADD).

    Science.gov (United States)

    Prakash, Surya; Bajaj, Abhay

    2017-01-01

    Androsta-1,4-diene-3,17-dione (androstadienedione, ADD) is key intermediate for the organic synthesis of a variety of female sex hormones such as estrone, estradiol, estriol and other related derivatives. De novo synthesis of this molecule is not yet reported in any form of living system, i.e., microbial, plant, and animal. The structural complexities due to presence of several chiral carbon centers create significant hurdles in chemical synthesis of such molecules. Microbe-mediated biotransformation offer a highly reliable, cost-effective, and relatively non hazardous way for commercial manufacturing of steroidal key intermediates. Currently microbial biotransformations are extensively being exploited for large-scale production of basic intermediates such as androstenedione (AD), ADD, and several types of hydroxylated derivatives of androstane compounds. In this chapter several aspects of microbial biotransformation process of AD to ADD are discussed.

  12. Combining Two Large MRI Data Sets (AddNeuroMed and ADNI) Using Multivariate Data Analysis to Distinguish between Patients with Alzheimer's Disease and Healthy Controls

    DEFF Research Database (Denmark)

    Westman, Eric; Simmons, Andrew; Muehlboeck, J.-Sebastian

    2010-01-01

    Background: The European Union AddNeuroMed project and the US-based Alzheimer Disease Neuroimaging Initiative (ADNI) are two large multi-centre initiatives designed to analyse and validate biomarkers for AD. This study aims to compare and combine magnetic resonance imaging (MRI) data from the two...... study cohorts using an automated image analysis pipeline and multivariate data analysis. Methods: A total of 664 subjects were included in this study (AddNeuroMed: 126 AD, 115 CTL, ADNI: 194 AD, 229 CTL) Data acquisition for the AddNeuroMed project was set up to be compatible with the ADNI study...... used are robust and that large data sets can be combined if MRI imaging protocols are carefully aligned....

  13. Rate and associated factors of solifenacin add-on after tamsulosin monotherapy in men with voiding and storage lower urinary tract symptoms.

    Science.gov (United States)

    Lee, H N; Lee, K-S; Kim, J C; Chung, B H; Kim, C-S; Lee, J G; Kim, D K; Park, C H; Park, J K; Hong, S J

    2015-04-01

    To explore the rate of add-on therapy with solifenacin in men with voiding and storage lower urinary tract symptoms (LUTS) after tamsulosin monotherapy and to explore predictive factors for starting solifenacin add-on therapy. Men aged ≥ 45 years with IPSS ≥ 12 and symptoms of OAB (OAB-V8 ≥ 8, micturition ≥ 8/24 h, urgency ≥ 2/24 h) were enrolled to receive tamsulosin 0.2 mg once daily. After 4 weeks, men with residual symptoms of OAB and reported 'dissatisfied' or 'a little satisfied' were received solifenacin 5 mg in combination with tamsulosin monotherapy. Subjects completed an IPSS, a Quality of life (QoL) index, OAB V8, and an International Consultation of Incontinence Questionnaire (ICIQ)-Male LUTS, and patient perception of bladder condition (PPBC) at baseline and week 4. Of a total of 305 patients, 254 patients completed 4 weeks of tamsulosin treatment. For 176 patients, solifenacin was added (69.3%). Significant predictive factors of solifenacin add-on therapy included long LUTS duration, high IPSS, number of micturitions per 24 h, more urgency episodes, high urgency severity score in a voiding diary and high OAB V8 score. Based on multivariable analysis, potential predictive factors of solifenacin add-on therapy included long LUTS duration (OR = 1.008, 95% CI: 1.001-1.014), high serum PSA (OR = 1.543, 95% CI: 1.136-2.095) and small prostate size (OR = 0.970, 95% CI: 0.947-0.994) (p tamsulosin monotherapy. Two thirds of men with voiding and storage LUTS needed to add anticholinergics after 4 weeks of tamsulosin monotherapy. Patients with longer lasting symptoms and storage symptoms with small prostate volume may require the anticholinergic add-on. © 2014 John Wiley & Sons Ltd.

  14. Semi-Individualized Homeopathy Add-On Versus Usual Care Only for Premenstrual Disorders: A Randomized, Controlled Feasibility Study.

    Science.gov (United States)

    Klein-Laansma, Christien T; Jong, Mats; von Hagens, Cornelia; Jansen, Jean Pierre C H; van Wietmarschen, Herman; Jong, Miek C

    2018-03-22

    Premenstrual syndrome and premenstrual dysphoric disorder (PMS/PMDD) bother a substantial number of women. Homeopathy seems a promising treatment, but it needs investigation using reliable study designs. The feasibility of organizing an international randomized pragmatic trial on a homeopathic add-on treatment (usual care [UC] + HT) compared with UC alone was evaluated. A multicenter, randomized, controlled pragmatic trial with parallel groups. The study was organized in general and private homeopathic practices in the Netherlands and Sweden and in an outpatient university clinic in Germany. Women diagnosed as having PMS/PMDD, based on prospective daily rating by the daily record of severity of problems (DRSP) during a period of 2 months, were included and randomized. Women were to receive UC + HT or UC for 4 months. Homeopathic medicine selection was according to a previously tested prognostic questionnaire and electronic algorithm. Usual care was as provided by the women's general practitioner according to their preferences. Before and after treatment, the women completed diaries (DRSP), the measure yourself concerns and well-being, and other questionnaires. Intention-to-treat (ITT) and per protocol (PP) analyses were performed. In Germany, the study could not proceed because of legal limitations. In Sweden, recruitment proved extremely difficult. In the Netherlands and Sweden, 60 women were randomized (UC + HT: 28; UC: 32), data of 47/46 women were analyzed (ITT/PP). After 4 months, relative mean change of DRSP scores in the UC + HT group was significantly better than in the UC group (p = 0.03). With respect to recruitment and different legal status, it does not seem feasible to perform a larger, international, pragmatic randomized trial on (semi-)individualized homeopathy for PMS/PMDD. Since the added value of HT compared with UC was demonstrated by significant differences in symptom score changes, further studies are warranted.

  15. Advanced methods for modeling water-levels and estimating drawdowns with SeriesSEE, an Excel add-in

    Science.gov (United States)

    Halford, Keith; Garcia, C. Amanda; Fenelon, Joe; Mirus, Benjamin B.

    2012-12-21

    Water-level modeling is used for multiple-well aquifer tests to reliably differentiate pumping responses from natural water-level changes in wells, or “environmental fluctuations.” Synthetic water levels are created during water-level modeling and represent the summation of multiple component fluctuations, including those caused by environmental forcing and pumping. Pumping signals are modeled by transforming step-wise pumping records into water-level changes by using superimposed Theis functions. Water-levels can be modeled robustly with this Theis-transform approach because environmental fluctuations and pumping signals are simulated simultaneously. Water-level modeling with Theis transforms has been implemented in the program SeriesSEE, which is a Microsoft® Excel add-in. Moving average, Theis, pneumatic-lag, and gamma functions transform time series of measured values into water-level model components in SeriesSEE. Earth tides and step transforms are additional computed water-level model components. Water-level models are calibrated by minimizing a sum-of-squares objective function where singular value decomposition and Tikhonov regularization stabilize results. Drawdown estimates from a water-level model are the summation of all Theis transforms minus residual differences between synthetic and measured water levels. The accuracy of drawdown estimates is limited primarily by noise in the data sets, not the Theis-transform approach. Drawdowns much smaller than environmental fluctuations have been detected across major fault structures, at distances of more than 1 mile from the pumping well, and with limited pre-pumping and recovery data at sites across the United States. In addition to water-level modeling, utilities exist in SeriesSEE for viewing, cleaning, manipulating, and analyzing time-series data.

  16. Two-year, randomized, controlled study of safinamide as add-on to levodopa in mid to late Parkinson's disease.

    Science.gov (United States)

    Borgohain, Rupam; Szasz, Jozsef; Stanzione, Paolo; Meshram, Chandrashekhar; Bhatt, Mohit H; Chirilineau, Dana; Stocchi, Fabrizio; Lucini, Valentina; Giuliani, Rodolfo; Forrest, Emma; Rice, Patricia; Anand, Ravi

    2014-09-01

    In a 6-month double-blind, placebo-controlled study of Parkinson's disease patients with motor fluctuations, safinamide 50 and 100 mg/d significantly increased ON-time without increasing dyskinesia. Further long-term safinamide use in these patients was evaluated over an additional 18 months. Patients continued on their randomized placebo, 50, or 100 mg/d safinamide. The primary endpoint was change in Dyskinesia Rating Scale total score during ON-time over 24 months. Other efficacy endpoints included change in ON-time without troublesome dyskinesia, changes in individual diary categories, depressive symptoms, and quality of life measures. Change in Dyskinesia Rating Scale was not significantly different in safinamide versus placebo groups, despite decreased mean total Dyskinesia Rating Scale with safinamide compared with an almost unchanged score in placebo. Ad hoc subgroup analysis of moderate to severe dyskinetic patients at baseline (36% of patients) showed a decrease with safinamide 100 mg/d compared with placebo (P = 0.0317). Improvements in motor function, activities of daily living, depressive symptoms, clinical status, and quality of life at 6 months remained significant at 24 months. Adverse events and discontinuation rates were similar with safinamide and placebo. This 2-year, controlled study of add-on safinamide in mid-to-late Parkinson's disease with motor fluctuations, although not demonstrating an overall difference in dyskinesias between patients and controls, showed improvement in dyskinesia in patients at least moderately dyskinetic at baseline. The study additionally demonstrated significant clinical benefits in ON-time (without troublesome dyskinesia), OFF-time, activities of daily living, motor symptoms, quality of life, and symptoms of depression. © 2014 International Parkinson and Movement Disorder Society.

  17. Substance Abuse among High-Risk Sexual Offenders: Do Measures of Lifetime History of Substance Abuse Add to the Prediction of Recidivism over Actuarial Risk Assessment Instruments?

    Science.gov (United States)

    Looman, Jan; Abracen, Jeffrey

    2011-01-01

    There has been relatively little research on the degree to which measures of lifetime history of substance abuse add to the prediction of risk based on actuarial measures alone among sexual offenders. This issue is of relevance in that a history of substance abuse is related to relapse to substance using behavior. Furthermore, substance use has…

  18. Continuous glucose monitoring adds information beyond HbA1c in well-controlled diabetes patients with early cardiovascular autonomic neuropathy

    DEFF Research Database (Denmark)

    Fleischer, Jesper; Laugesen, Esben; Cichosz, Simon Lebech

    2017-01-01

    AIMS: Hyperglycemia as evaluated by HbA1c is a risk factor for the development of cardiovascular autonomic neuropathy (CAN). The aim of the present study was to investigate whether continuous glucose monitoring (CGM) may add information beyond HbA1c in patients with type 2 diabetes and CAN. METHO...

  19. Approach to the unfolding and folding dynamics of add A-riboswitch upon adenine dissociation using a coarse-grained elastic network model

    Energy Technology Data Exchange (ETDEWEB)

    Li, Chunhua [College of Life Science and Bioengineering, Beijing University of Technology, Beijing 100124 (China); Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan 45108 (United States); Lv, Dashuai; Zhang, Lei; Yang, Feng; Wang, Cunxin [College of Life Science and Bioengineering, Beijing University of Technology, Beijing 100124 (China); Su, Jiguo, E-mail: jiguosu@ysu.edu.cn, E-mail: zhng@umich.edu [College of Science, Yanshan University, Qinhuangdao 066004 (China); Zhang, Yang, E-mail: jiguosu@ysu.edu.cn, E-mail: zhng@umich.edu [Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan 45108 (United States)

    2016-07-07

    Riboswitches are noncoding mRNA segments that can regulate the gene expression via altering their structures in response to specific metabolite binding. We proposed a coarse-grained Gaussian network model (GNM) to examine the unfolding and folding dynamics of adenosine deaminase (add) A-riboswitch upon the adenine dissociation, in which the RNA is modeled by a nucleotide chain with interaction networks formed by connecting adjoining atomic contacts. It was shown that the adenine binding is critical to the folding of the add A-riboswitch while the removal of the ligand can result in drastic increase of the thermodynamic fluctuations especially in the junction regions between helix domains. Under the assumption that the native contacts with the highest thermodynamic fluctuations break first, the iterative GNM simulations showed that the unfolding process of the adenine-free add A-riboswitch starts with the denature of the terminal helix stem, followed by the loops and junctions involving ligand binding pocket, and then the central helix domains. Despite the simplified coarse-grained modeling, the unfolding dynamics and pathways are shown in close agreement with the results from atomic-level MD simulations and the NMR and single-molecule force spectroscopy experiments. Overall, the study demonstrates a new avenue to investigate the binding and folding dynamics of add A-riboswitch molecule which can be readily extended for other RNA molecules.

  20. Efficacy and Safety of Lamotrigine as Add-On Treatment to Lithium in Bipolar Depression : A Multicenter, Double-Blind, Placebo-Controlled Trial

    NARCIS (Netherlands)

    van der Loos, Marc L. M.; Mulder, Paul G. H.; Hartong, Erwin G. Th. M.; Blom, Marc B. J.; Vergouwen, Anton C.; de Keyzer, Herman J. U. E. M.; Notten, Peter J. H.; Luteijn, Marijke L.; Timmermans, Manuela A.; Nolen, Willem A.

    Objective: Lamotrigine is one of the pharmacologic options for the treatment of bipolar depression but has only been studied as monotherapy. This study compared the acute effects of lamotrigine and placebo as add-on therapy to ongoing treatment with lithium in patients with bipolar depression.

  1. Psychoacoustical evaluation of the pitch-synchronous overlap-and-add speech-waveform manipulation technique using single-format stimuli

    NARCIS (Netherlands)

    Kortekaas, R.W.L.; Kohlrausch, A.G.

    1997-01-01

    This article presents two experiments dealing with a psychoacoustical evaluation of the pitch synchronous overlap-and-add (PSOLA) technique. This technique has been developed for modification of duration and fundamental frequency of speech and is based on simple waveform manipulations. Both

  2. N-Acetylcysteine in the Treatment of Pediatric Trichotillomania: A Randomized, Double-Blind, Placebo-Controlled Add-On Trial

    Science.gov (United States)

    Bloch, Michael H.; Panza, Kaitlyn E.; Grant, Jon E.; Pittenger, Christopher; Leckman, James F.

    2013-01-01

    Objective: To examine the efficacy of N-acetylcysteine (NAC) for the treatment of pediatric trichotillomania (TTM) in a double-blind, placebo-controlled, add-on study. Method: A total of 39 children and adolescents aged 8 to 17 years with pediatric trichotillomania were randomly assigned to receive NAC or matching placebo for 12 weeks. Our primary…

  3. All-Optical Regenerative OTDM Add-Drop Multiplexing at 40 Gb/s using Monolithic InP Mach-Zehnder Interferometer

    DEFF Research Database (Denmark)

    Fischer, St.; Dülk, M.; Gamper, E.

    2000-01-01

    We present a novel method for all-optical add-drop multiplexing having regenerative capability for 40-Gb/s optical time-division multiplexed (OTDM) data using a semiconductor optical amplifier (SOA) based, monolithic Mach-Zehnder interferometer (MZI). Simultaneous dropping of one 10-Gb/s channel ...

  4. Structural consequences of disease-causing mutations in the ATRX-DNMT3-DNMT3L (ADD) domain of the chromatin-associated protein ATRX.

    Science.gov (United States)

    Argentaro, Anthony; Yang, Ji-Chun; Chapman, Lynda; Kowalczyk, Monika S; Gibbons, Richard J; Higgs, Douglas R; Neuhaus, David; Rhodes, Daniela

    2007-07-17

    The chromatin-associated protein ATRX was originally identified because mutations in the ATRX gene cause a severe form of syndromal X-linked mental retardation associated with alpha-thalassemia. Half of all of the disease-associated missense mutations cluster in a cysteine-rich region in the N terminus of ATRX. This region was named the ATRX-DNMT3-DNMT3L (ADD) domain, based on sequence homology with a family of DNA methyltransferases. Here, we report the solution structure of the ADD domain of ATRX, which consists of an N-terminal GATA-like zinc finger, a plant homeodomain finger, and a long C-terminal alpha-helix that pack together to form a single globular domain. Interestingly, the alpha-helix of the GATA-like finger is exposed and highly basic, suggesting a DNA-binding function for ATRX. The disease-causing mutations fall into two groups: the majority affect buried residues and hence affect the structural integrity of the ADD domain; another group affects a cluster of surface residues, and these are likely to perturb a potential protein interaction site. The effects of individual point mutations on the folding state and stability of the ADD domain correlate well with the levels of mutant ATRX protein in patients, providing insights into the molecular pathophysiology of ATR-X syndrome.

  5. 1.25 Gbit/s bidirectional link in an access network employing a reconfigurable optical add/drop multiplexer and a reflective semiconductor optical amplifier

    NARCIS (Netherlands)

    Urban, P.J.; de Laat, M.M.; Klein, E.J.; Koonen, A.M.J.; Khoe, G.D.; de Waardt, H.; Marciniak, M.; Jaworski, M.; Zdabiwicz, M.

    2008-01-01

    In this paper, we demonstrate symmetrical bidirectional transmission of 1.25 Gbit/s wavelength channels in an access network link employing centralized light generation, colourless optical network unit (ONU) and a reconfigurable optical add/drop multiplexer (ROADM). The architecture of ONU is based

  6. Acupuncture and related therapies used as add-on or alternative to prokinetics for functional dyspepsia: overview of systematic reviews and network meta-analysis.

    Science.gov (United States)

    Ho, Robin S T; Chung, Vincent C H; Wong, Charlene H L; Wu, Justin C Y; Wong, Samuel Y S; Wu, Irene X Y

    2017-09-04

    Prokinetics for functional dyspepsia (FD) have relatively higher number needed to treat values. Acupuncture and related therapies could be used as add-on or alternative. An overview of systematic reviews (SRs) and network meta-analyses (NMA) were performed to evaluate the comparative effectiveness of different acupuncture and related therapies. We conducted a comprehensive literature search for SRs of randomized controlled trials (RCTs) in eight international and Chinese databases. Data from eligible RCTs were extracted for random effect pairwise meta-analyses. NMA was used to explore the most effective treatment among acupuncture and related therapies used alone or as add-on to prokinetics, compared to prokinetics alone. From five SRs, 22 RCTs assessing various acupuncture and related therapies were included. No serious adverse events were reported. Two pairwise meta-analyses showed manual acupuncture has marginally stronger effect in alleviating global FD symptoms, compared to domperidone or itopride. Results from NMA showed combination of manual acupuncture and clebopride has the highest probability in alleviating patient reported global FD symptom. Combination of manual acupuncture and clebopride has the highest probability of being the most effective treatment for FD symptoms. Patients who are contraindicated for prokinetics may use manual acupuncture or moxibustion as alternative. Future confirmatory comparative effectiveness trials should compare clebopride add-on manual acupuncture with domperidone add-on manual acupuncture and moxibustion.

  7. Psychometric Evaluation of a Dutch Version of the Mini PAS-ADD for Assessing Psychiatric Disorders in Adults with Different Levels of Intellectual Disability

    Science.gov (United States)

    Janssen, R.; Maes, B.

    2013-01-01

    Background: People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. Method: A Dutch version of the Mini PAS-ADD, which is a screening instrument for…

  8. Safety and tolerability of once-daily tiotropium Respimat(®) as add-on to at least inhaled corticosteroids in adult patients with symptomatic asthma

    DEFF Research Database (Denmark)

    Dahl, Ronald; Engel, Michael; Dusser, Daniel

    2016-01-01

    BACKGROUND: Tiotropium, a long-acting anticholinergic bronchodilator, has demonstrated efficacy and safety as add-on therapy to inhaled corticosteroids (ICS), with or without other maintenance therapies, in patients with symptomatic asthma. OBJECTIVE: To evaluate safety and tolerability of tiotro...

  9. The food-borne pathogen Campylobacter jejuni depends on the AddAB DNA repair system to defend against bile in the intestinal environment.

    Science.gov (United States)

    Gourley, Christopher R; Negretti, Nicholas M; Konkel, Michael E

    2017-10-31

    Accurate repair of DNA damage is crucial to ensure genome stability and cell survival of all organisms. Bile functions as a defensive barrier against intestinal colonization by pathogenic microbes. Campylobacter jejuni, a leading bacterial cause of foodborne illness, possess strategies to mitigate the toxic components of bile. We recently found that growth of C. jejuni in medium with deoxycholate, a component of bile, caused DNA damage consistent with the exposure to reactive oxygen species. We hypothesized that C. jejuni must repair DNA damage caused by reactive oxygen species to restore chromosomal integrity. Our efforts focused on determining the importance of the putative AddAB DNA repair proteins. A C. jejuni addAB mutant demonstrated enhanced sensitivity to deoxycholate and was impaired in DNA double strand break repair. Complementation of the addAB mutant restored resistance to deoxycholate, as well as function of the DNA double strand break repair system. The importance of these findings translated to the natural host, where the AddAB system was found to be required for efficient C. jejuni colonization of the chicken intestine. This research provides new insight into the molecular mechanism utilized by C. jejuni, and possibly other intestinal pathogens, to survive in the presence of bile.

  10. Comparison of a new refractive multifocal intraocular lens with an inferior segmental near add and a diffractive multifocal intraocular lens.

    Science.gov (United States)

    Alio, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José; Moreno, Luis J; Piñero, David P

    2012-03-01

    To compare the visual acuity outcomes and ocular optical performance of eyes implanted with a multifocal refractive intraocular lens (IOL) with an inferior segmental near add or a diffractive multifocal IOL. Prospective, comparative, nonrandomized, consecutive case series. Eighty-three consecutive eyes of 45 patients (age range, 36-82 years) with cataract were divided into 2 groups: group A, 45 eyes implanted with Lentis Mplus LS-312 (Oculentis GmbH, Berlin, Germany); group B, 38 eyes implanted with diffractive IOL Acri.Lisa 366D (Zeiss, Oberkochen, Germany). All patients underwent phacoemulsification followed by IOL implantation in the capsular bag. Distance corrected, intermediate, and near with the distance correction visual acuity outcomes and contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively during a 3-month follow-up. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), corrected distance near and intermediate visual acuity (CDNVA), contrast sensitivity, intraocular aberrations, and defocus curve. A significant improvement in UDVA, CDVA, and UNVA was observed in both groups after surgery (P ≤ 0.04). Significantly better values of UNVA (P<0.01) and CDNVA (P<0.04) were found in group B. In the defocus curve, significantly better visual acuities were present in eyes in group A for intermediate vision levels of defocus (P ≤ 0.04). Significantly higher amounts of postoperative intraocular primary coma and spherical aberrations were found in group A (P<0.01). In addition, significantly better values were observed in photopic contrast sensitivity for high spatial frequencies in group A (P ≤ 0.04). The Lentis Mplus LS-312 and Acri.Lisa 366D IOLs are able to successfully restore visual function after cataract surgery. The Lentis Mplus LS-312 provided better intermediate vision and contrast sensitivity outcomes than the Acri.Lisa 366D. However, the

  11. Emotional Abuse History and Migraine Among Young Adults: A Retrospective Cross-Sectional Analysis of the Add Health Dataset.

    Science.gov (United States)

    Tietjen, Gretchen E; Karmakar, Monita; Amialchuk, Aliaksandr A

    2017-01-01

    To define and examine the relationship between self-reported childhood abuse and migraine among young adults. Headache and migraine have been linked to childhood abuse in numerous studies, but there is incomplete characterization of headache types, and limited assessment of abuse types and frequency. Only one population-based study has examined the relationship between emotional abuse and migraine. None have investigated the temporal relationship between onset of abuse and of migraine. We analyzed data from 14,356 adults aged 24-32 years in Wave 4, which is a cross-sectional subset of the longitudinal Add Health study. Participants were queried regarding abuse (emotional, physical and sexual) during childhood, diagnosis of migraine, depression and anxiety by healthcare providers, and symptoms of current depression. We used logistic regression to estimate the association between childhood abuse and migraine, controlling for socio-demographic factors, current depression, and lifetime diagnosis of anxiety and depression. About 14% (n = 2040) of respondents reported migraine. Participants with migraine (vs no migraine) reported significantly higher rates of childhood abuse overall (60.6% vs 48.9%), including emotional (57.8% vs 45.4%), sexual (8.4% vs 4.6%) and physical (22.4% vs 17.9%) abuse. Emotional abuse had a stronger association with migraine (odds ratio [OR] 1.62; 95% confidence interval [CI] 1.43-1.85) when compared with physical (OR 1.06; 95% CI 0.89-1.68) and sexual abuse (OR 1.06; 95% CI 0.93-1.68), adjusting for socio-demographic factors. The emotional abuse-migraine association remained even when controlling for lifetime diagnosis of depression and anxiety (OR 1.37; 95% CI 1.19-1.57) and for current depression (OR 1.47; 95% CI 1.30-1.67). The odds of migraine increased with increasing number of abuse types reported. There was a U-shaped distribution of odds of migraine associated with frequency of occurrences of emotional abuse, peaking at one time

  12. Operations research to add postpartum family planning to maternal and neonatal health to improve birth spacing in Sylhet District, Bangladesh.

    Science.gov (United States)

    Ahmed, Salahuddin; Norton, Maureen; Williams, Emma; Ahmed, Saifuddin; Shah, Rasheduzzaman; Begum, Nazma; Mungia, Jaime; Lefevre, Amnesty; Al-Kabir, Ahmed; Winch, Peter J; McKaig, Catharine; Baqui, Abdullah H

    2013-08-01

    birth spacing as a priority, and most recently delivered women were not using contraception. At baseline, women in the intervention and comparison groups were similar in terms of age, husband's education, religion, and parity. CHWs visited over 90% of women in both intervention and comparison groups during pregnancy and the first 3 months postpartum. This article provides helpful intervention-design details for program managers intending to add postpartum family planning services to community-based MNH programs. Outcomes of the intervention will be reported in a future paper. Preliminary findings indicate that the package of 5 CHW visits was feasible and did not compromise worker performance. Adding doorstep delivery of contraceptives to the intervention package may enhance impact.

  13. EMDR as Add-On Treatment for Psychiatric and Traumatic Symptoms in Patients with Substance Use Disorder

    Directory of Open Access Journals (Sweden)

    Sara Carletto

    2018-01-01

    significant improvement of post-traumatic and dissociative symptoms, accompanied by a reduction in anxiety and overall psychopathology levels, whereas TAU group showed a significant reduction only in post-traumatic symptoms. Although our results can only be considered preliminary, this study suggests that a combined TF- and AF- EMDR protocol is an effective and well-accepted add-on treatment for patients with SUD.

  14. Effects of vildagliptin as add-on treatment in patients with type 2 diabetes mellitus: insights from long-term clinical studies in Japan.

    Science.gov (United States)

    Odawara, Masato; Sagara, Rieko

    2015-01-01

    Vildagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, is wildly used to treat type 2 diabetes mellitus (T2DM) with mono- or combination-therapy. We review two previously published open-label studies to extract insights on the long-term efficacy and safety of vildagliptin. Two studies were conducted in Japan to assess the efficacy and safety of vildagliptin as an add-on to other oral antidiabetes drugs (OADs) for 52 weeks. These studies were performed under the similar protocol in Japanese patients with T2DM who were inadequately controlled with OAD monotherapy [excluding other dipeptidyl peptidase-4 (DPP-4) inhibitors]. Addition of vildagliptin (50 mg twice daily) to other OAD monotherapy [sulfonylurea (SU), metformin, thiazolidinedione, alpha-glucosidase inhibitor and glinide] reduced glycated hemoglobin (HbA1c) levels by -0.64 %,-0.75 %,-0.92 %,-0.94 % and - 0.64 %, respectively, over 52 weeks of treatment. Overall, the incidence of hypoglycemia was low and was slightly higher in the add-on to SU treatment group compared with the other groups. The incidences of adverse events were comparable among the treatment groups, and vildagliptin was well-tolerated as add-on therapy to other OADs. The evidence from the two studies indicates that vildagliptin as an add-on therapy to other OADs is a clinically reasonable option for Japanese patients with T2DM who respond inadequately to other OAD monotherapy.

  15. Synthesis of highly integrated optical network based on microdisk-resonator add-drop filters in silicon-on-insulator technology

    Science.gov (United States)

    Kaźmierczak, Andrzej; Dortu, Fabian; Giannone, Domenico; Bogaerts, Wim; Drouard, Emmanuel; Rojo-Romeo, Pedro; Gaffiot, Frederic

    2009-10-01

    We analyze a highly compact optical add-drop filter topology based on a pair of microdisk resonators and a bus waveguide intersection. The filter is further assessed on an integrated optical 4×4 network for optical on-chip communication. The proposed network structure, as compact as 50×50 μm, is fabricated in a CMOS-compatible process on a silicon-on-insulator (SOI) substrate. Finally, the experimental results demonstrate the proper operation of the fabricated devices.

  16. Air pollution, deprivation and health: Understanding relationships to add value to local air quality management policy and practice in Wales, UK

    OpenAIRE

    Brunt, H.; Barnes, J.; Jones, S.; Longhurst, J.; Scally, G.; Hayes, E. T.

    2017-01-01

    Background \\ud Air pollution exposure reduces life expectancy. Air pollution, deprivation and poor-health status combinations can create increased and disproportionate disease burdens. Problems and solutions are rarely considered in a broad public health context, but doing so can add value to air quality management efforts by reducing air pollution risks, impacts and inequalities.\\ud \\ud Methods \\ud An ecological study assessed small-area associations between air pollution (nitrogen dioxide a...

  17. Acupuncture and related therapies used as add-on or alternative to prokinetics for functional dyspepsia: overview of systematic reviews and network meta-analysis

    OpenAIRE

    Ho, Robin S. T.; Chung, Vincent C. H.; Wong, Charlene H. L.; Wu, Justin C. Y.; Wong, Samuel Y. S.; Wu, Irene X. Y.

    2017-01-01

    Prokinetics for functional dyspepsia (FD) have relatively higher number needed to treat values. Acupuncture and related therapies could be used as add-on or alternative. An overview of systematic reviews (SRs) and network meta-analyses (NMA) were performed to evaluate the comparative effectiveness of different acupuncture and related therapies. We conducted a comprehensive literature search for SRs of randomized controlled trials (RCTs) in eight international and Chinese databases. Data from ...

  18. Psychometric evaluation of a Dutch version of the Mini PAS-ADD for assessing psychiatric disorders in adults with different levels of intellectual disability

    OpenAIRE

    Janssen, Rianne; Maes, Bea

    2013-01-01

    Background People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. Method A Dutch version of the Mini PAS-ADD, which is a screening instrument for identification of mental health problems in people with ID, was evaluated in terms of internal consistency, interinformant reliability, item grouping and ...

  19. Phantom examination for reduction of radiation dose using new needle screen storage phosphor radiography and add beam filter in digital thoracic radiography on adolescents and larger children

    International Nuclear Information System (INIS)

    Heyne, J.P.; Mentzel, H.J.; Neumann, R.; Lopatta, E.; Zimmermann, U.; Kaiser, W.A.

    2008-01-01

    Purpose: how much can the radiation dose be reduced in thoracic radiography on adolescents and larger children by using needle screen storage phosphor (NIP) radiography and add beam filtration? Materials and methods: a chest phantom with typical anatomical structures, pathological findings, added catheters, and simulated nodules, tumors, and calcifications was X-rayed digitally (DX-S, Agfa Healthcare) in posterior-anterior (p.a.) orientation with and without add beam filter. While keeping the voltage constant, the tube current time product was reduced gradually. In addition to LgM, the surface entrance dose (ED) and the dose area product (DAP) were measured by the Dosimax sensor and Kerma X-plus (both Wellhoefer). Five investigators evaluated the images for characteristics and critical features, pathological findings, and catheter recognizability. Results: the ED of the digital chest radiogram p.a. with 115 kV and 0.71 mAs was 27 μGy, the DAP 3.6 μGy x m 2 , the LgM value 1.56. This initial radiogram was able to be evaluated very well and conforms to the quality guidelines. The dose-reduced chest radiograms with the add beam filter Al 1.0 mm/Cu 0.1 mm were evaluated as sufficiently reduced to a dose of 63% of the initial dose, with the add beam filter Al 1.0 mm/Cu 0.2 mm reduced to 50% (0.52 mAs, DAP 1.82 μGy x m 2 , LgM 1.35). P.a. radiograms were able to be X-rayed on 115 kV with 0.52 mAs. (orig.)

  20. Angiotensin-Converting Enzyme (ACE) I/D and Alpha-Adducin (ADD1) G460W Gene Polymorphisms in Turkish Patients with Severe Chronic Tinnitus.

    Science.gov (United States)

    Yuce, Salim; Sancakdar, Enver; Bağcı, Gokhan; Koc, Sema; Kurtulgan, Hande Kucuk; Bağcı, Binnur; Doğan, Mansur; Uysal, İsmail Onder

    2016-04-01

    Tinnitus is described as a disturbing sound sensation in the absence of external stimulation. We aimed to investigate whether there is any relationship between severe chronic tinnitus and angiotensin-converting enzyme (ACE) I/D and α-adducin (ADD1) G460W gene polymorphisms. The patient group and control group consisted of 89 and 104 individuals, respectively. The evaluation of tinnitus was performed using the Strukturiertes Tinnitus-Interview (STI). The Tinnitus Handicap Inventory (THI) was used to evaluate the tinnitus severity. Polymerase chain reaction (PCR) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) techniques were used for genotyping. With regard to the ACE I/D polymorphism, there was no significant difference in genotype and allele frequencies between the patient group and control group. However, a statistically significant difference was found in genotype (pgene polymorphism. Combined genotype analysis showed that the ACE II /ADD1 GW genotype was statistically significantly higher in the patient group than in the control group (X2: 7.15, p=0.007). The odds ratio value of the GW genotype was 2.5 (95% CI=1.4-4.7) (pgene polymorphism and susceptibility to severe chronic tinnitus. It was found that the GW genotype increased the disease risk by 2.5-fold compared with other genotypes. This indicates that ADD1 G460W polymorphism could be an important factor in the pathophysiology of tinnitus.

  1. Add-on deep transcranial magnetic stimulation (dTMS) in patients with dysthymic disorder comorbid with alcohol use disorder: a comparison with standard treatment.

    Science.gov (United States)

    Girardi, Paolo; Rapinesi, Chiara; Chiarotti, Flavia; Kotzalidis, Georgios D; Piacentino, Daria; Serata, Daniele; Del Casale, Antonio; Scatena, Paola; Mascioli, Flavia; Raccah, Ruggero N; Brugnoli, Roberto; Digiacomantonio, Vittorio; Ferri, Vittoria Rachele; Ferracuti, Stefano; Zangen, Abraham; Angeletti, Gloria

    2015-01-01

    Dorsolateral prefrontal cortex (DLPFC) is dysfunctional in mood and substance use disorders. We predicted higher efficacy for add-on bilateral prefrontal high-frequency deep transcranial magnetic stimulation (dTMS), compared with standard drug treatment (SDT) in patients with dysthymic disorder (DD)/alcohol use disorder (AUD) comorbidity. We carried-out a 6-month open-label study involving 20 abstinent patients with DSM-IV-TR AUD comorbid with previously developed DD. Ten patients received SDT for AUD with add-on bilateral dTMS (dTMS-AO) over the DLPFC, while another 10 received SDT alone. We rated alcohol craving with the Obsessive Compulsive Drinking Scale (OCDS), depression with the Hamilton Depression Rating Scale (HDRS), clinical status with the Clinical Global Impressions scale (CGI), and global functioning with the Global Assessment of Functioning (GAF). At the end of the 20-session dTMS period (or an equivalent period in the SDT group), craving scores and depressive symptoms in the dTMS-AO group dropped significantly more than in the SDT group (P < 0.001 and P < 0.02, respectively). High frequency bilateral DLPFC dTMS with left preference was well tolerated and found to be effective as add-on in AUD. The potential of dTMS for reducing craving in substance use disorder patients deserves to be further investigated.

  2. Psychometric evaluation of a Dutch version of the Mini PAS-ADD for assessing psychiatric disorders in adults with different levels of intellectual disability.

    Science.gov (United States)

    Janssen, R; Maes, B

    2013-08-01

    People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. A Dutch version of the Mini PAS-ADD, which is a screening instrument for identification of mental health problems in people with ID, was evaluated in terms of internal consistency, interinformant reliability, item grouping and criterion validity based on a large-scale random sample (n = 377) and a clinical sample (n = 99) of adults with ID. The Dutch version of the Mini PAS-ADD showed moderate internal consistency, and moderate concordance among informants. Both aspects of the reliability were comparable for different levels of ID. A factor analysis largely confirmed the scale structure. Concurrent validity with the Reiss Screen for Maladaptive Behavior was high for the Depression, Psychosis and Autism scale. The outcome of the criterion-validity analysis indicated high specificity. The sensitivity for specific psychiatric disorders by the corresponding scales was moderate, but the general sensitivity for the presence of psychopathology on the basis of any of the scales was satisfying. The present research reconfirmed the use of the Mini PAS-ADD as a primary screening device for the identification of mental health problems among people with ID. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

  3. Effect of omega-3 fatty acids versus 5-hydroxytryptophan as add on therapy to sertraline in controlling suicidal ideation in patients with depression: A comparative study

    Directory of Open Access Journals (Sweden)

    Jyoti Prakash Sahoo

    2016-04-01

    Full Text Available Background: Omega-3 fatty acids and 5-hydroxytryptophan have been gaining attention as promising alternative treatment for depressive illness. These agents are given as as add on treatment to conventional antidepressant drugs. The present study was carried out to evaluate efficacy of omega-3 fatty acids versus 5-hydroxytryptophan as add on therapy in controlling suicidal ideation in depressive patients on sertraline.Methods: This was a prospective, open label, randomized, parallel group study conducted in department of Psychiatry. Ninety treatment naïve patients (18-65 years age were divided into 3 groups of 30 each. Group I: Sertraline, Group II: Sertraline plus omega-3 fatty acids, Group III: Sertraline plus 5-hydroxytryptophan. Suicidal ideations were assessed with Beck’s scale for suicidal ideation (BSI at weeks 0, 4 and 8. Data were analyzed using repeated measures ANOVA (SPSS version 20.0. Post hoc analysis was done using Bonferroni test.Results: Baseline parameters in patients of all groups were comparable. Administration of sertraline resulted in reduction of Beck’s scale for suicidal ideation scores as compared to baseline. Addition of omega-3 fatty acids and 5-hydroxytryptophan also showed reduction in BSI scores. Effect of sertraline monotherapy was more as compared to omega-3 fatty acids or 5-hydroxytryptophan as add on therapy, which was statistically significant (p value < 0.05.Conclusion: Both omega-3 fatty acids and 5-hydroxytryptophan produce significant effect in controlling suicidal ideations in patients with depression.

  4. Internet-based attentional bias modification training as add-on to regular treatment in alcohol and cannabis dependent outpatients: a study protocol of a randomized control trial.

    Science.gov (United States)

    Heitmann, Janika; van Hemel-Ruiter, Madelon E; Vermeulen, Karin M; Ostafin, Brian D; MacLeod, Colin; Wiers, Reinout W; DeFuentes-Merillas, Laura; Fledderus, Martine; Markus, Wiebren; de Jong, Peter J

    2017-05-23

    The automatic tendency to attend to and focus on substance-related cues in the environment (attentional bias), has been found to contribute to the persistence of addiction. Attentional bias modification (ABM) interventions might, therefore, contribute to treatment outcome and the reduction of relapse rates. Based on some promising research findings, we designed a study to test the clinical relevance of ABM as an add-on component of regular intervention for alcohol and cannabis patients. The current protocol describes a study which will investigate the effectiveness and cost-effectiveness of a newly developed home-delivered, multi-session, internet-based ABM (iABM) intervention as an add-on to treatment as usual (TAU). TAU consists of cognitive behavioural therapy-based treatment according to the Dutch guidelines for the treatment of addiction. Participants (N = 213) will be outpatients from specialized addiction care institutions diagnosed with alcohol or cannabis dependency who will be randomly assigned to one of three conditions: TAU + iABM; TAU + placebo condition; TAU-only. Primary outcome measures are substance use, craving, and rates of relapse. Changes in attentional bias will be measured to investigate whether changes in primary outcome measures can be attributed to the modification of attentional bias. Indices of cost-effectiveness and secondary physical and psychological complaints (depression, anxiety, and stress) are assessed as secondary outcome measures. This randomized control trial will be the first to investigate whether a home-delivered, multi-session iABM intervention is (cost-) effective in reducing relapse rates in alcohol and cannabis dependency as an add-on to TAU, compared with an active and a waiting list control group. If proven effective, this ABM intervention could be easily implemented as a home-delivered component of current TAU. Netherlands Trial Register, NTR5497 , registered on 18th September 2015.

  5. Long-term efficacy and safety of sodium-glucose cotransporter-2 inhibitors as add-on to metformin treatment in the management of type 2 diabetes mellitus

    Science.gov (United States)

    Li, Jian; Gong, Yanping; Li, Chunlin; Lu, Yanhui; Liu, Yu; Shao, Yinghong

    2017-01-01

    Abstract Background: Drug intensification is often required for patients with type 2 diabetes mellitus on stable metformin therapy. Among the potential candidates for a combination therapy, sodium-glucose transporter-2 (SGLT2) inhibitors have shown promising outcomes. This meta-analysis was performed to compare the efficacy and safety of SGLT2 inhibitors with non-SGLT2 combinations as add-on treatment to metformin. Methods: Literature search was carried out in multiple electronic databases for the acquisition of relevant randomized controlled trials (RCTs) by following a priori eligibility criteria. After the assessment of quality of the included RCTs, meta-analyses of mean differences or odds ratios (OR) were performed to achieve overall effect sizes of the changes from baseline in selected efficacy and safety endpoints reported in the individual studies. Between-studies heterogeneity was estimated with between-studies statistical heterogeneity (I2) index. Results: Six RCTs fulfilled the eligibility criteria. SGLT2 inhibitors as add-on to metformin treatment reduced % HbA1c significantly more than non-SGLT2 combinations after 52 weeks (P = .002) as well as after 104 weeks (P SGLT2 inhibitors also reduced fasting plasma glucose levels, body weight, systolic, and diastolic blood pressures after 52 weeks and 104 weeks significantly (P SGLT2 combinations. Incidence of hypoglycemia was significantly lower (P = .02) but incidence of suspected or confirmed genital tract infections was significantly higher (P SGLT2 inhibitors treated in comparison with non-SGLT2 combinations. Conclusion: As add-on to metformin treatment, SGLT2 inhibitors are found significantly more efficacious than non-SGLT2 inhibitor combinations in the management of type 2 diabetes mellitus, although, SGLT2 inhibitor therapy is associated with significantly higher incidence of suspected or confirmed genital tract infections. PMID:28682870

  6. Renal function preservation with pioglitazone or with basal insulin as an add-on therapy for patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Chang, Yu-Hung; Hwu, Der-Wei; Chang, Dao-Ming; An, Ling-Wang; Hsieh, Chang-Hsun; Lee, Yau-Jiunn

    2017-06-01

    Clinical outcome may differ owing to the distinct pharmacological characteristics of insulin sensitizers and insulin. This study was performed to compare the metabolic and renal function changes with add-on pioglitazone treatment versus basal insulin in patients with type 2 diabetes mellitus (DM) in whom sulfonylurea and metformin regimens failed. Patients who were consecutively managed in the diabetes comprehensive program with add-on pioglitazone or detemir/glargine treatment for at least 2 years following sulfonylurea and metformin treatment failure were included. A total of 1002 patients were enrolled (pioglitazone: 559, detemir: 264, glargine: 179). After propensity score matching, there were 105 patients with matchable baseline characteristics in each group. After a mean of 3.5 years of follow-up, the pioglitazone group showed a greater HbA1c reduction than the detemir group and the glargine group. Despite patients in all three groups exhibiting significant body weight gain, those in the pioglitazone group and the glargine group showed greater body weight increases than the patients in the detemir group (2.1, 1.6 and 0.8 kg, respectively, p 1.79-3.88) and 3.13 (95% CI 2.01-4.87), respectively. Our study first showed that treatment with both pioglitazone and basal insulin improved glycemic control, while only pioglitazone treatment was observed to be advantageous in terms of preserving renal function when used as an add-on therapy for patients with type 2 DM in whom sulfonylurea and metformin regimens failed.

  7. Add-on treatment of benzoate for schizophrenia: a randomized, double-blind, placebo-controlled trial of D-amino acid oxidase inhibitor.

    Science.gov (United States)

    Lane, Hsien-Yuan; Lin, Ching-Hua; Green, Michael F; Hellemann, Gerhard; Huang, Chih-Chia; Chen, Po-Wei; Tun, Rene; Chang, Yue-Cung; Tsai, Guochuan E

    2013-12-01

    In addition to dopaminergic hyperactivity, hypofunction of the N-methyl-d-aspartate receptor (NMDAR) has an important role in the pathophysiology of schizophrenia. Enhancing NMDAR-mediated neurotransmission is considered a novel treatment approach. To date, several trials on adjuvant NMDA-enhancing agents have revealed beneficial, but limited, efficacy for positive and negative symptoms and cognition. Another method to enhance NMDA function is to raise the levels of d-amino acids by blocking their metabolism. Sodium benzoate is a d-amino acid oxidase inhibitor. To examine the clinical and cognitive efficacy and safety of add-on treatment of sodium benzoate for schizophrenia. A randomized, double-blind, placebo-controlled trial in 2 major medical centers in Taiwan composed of 52 patients with chronic schizophrenia who had been stabilized with antipsychotic medications for 3 months or longer. Six weeks of add-on treatment of 1 g/d of sodium benzoate or placebo. The primary outcome measure was the Positive and Negative Syndrome Scale (PANSS) total score. Clinical efficacy and adverse effects were assessed biweekly. Cognitive functions were measured before and after the add-on treatment. Benzoate produced a 21% improvement in PANSS total score and large effect sizes (range, 1.16-1.69) in the PANSS total and subscales, Scales for the Assessment of Negative Symptoms-20 items, Global Assessment of Function, Quality of Life Scale and Clinical Global Impression and improvement in the neurocognition subtests as recommended by the National Institute of Mental Health's Measurement and Treatment Research to Improve Cognition in Schizophrenia initiative, including the domains of processing speed and visual learning. Benzoate was well tolerated without significant adverse effects. Benzoate adjunctive therapy significantly improved a variety of symptom domains and neurocognition in patients with chronic schizophrenia. The preliminary results show promise for d-amino acid oxidase

  8. Cost-effectiveness of exenatide twice daily vs insulin glargine as add-on therapy to oral antidiabetic agents in patients with type 2 diabetes in China.

    Science.gov (United States)

    Gu, Shuyan; Wang, Xiaoyong; Qiao, Qing; Gao, Weiguo; Wang, Jian; Dong, Hengjin

    2017-12-01

    To estimate the long-term cost-effectiveness of exenatide twice daily vs insulin glargine once daily as add-on therapy to oral antidiabetic agents (OADs) for Chinese patients with type 2 diabetes (T2DM). The Cardiff Diabetes Model was used to simulate disease progression and estimate the long-term effects of exenatide twice daily vs insulin glargine once daily. Patient profiles and treatment effects required for the model were obtained from literature reviews (English and Chinese databases) and from a meta-analysis of 8 randomized controlled trials comparing exenatide twice daily with insulin glargine once daily add-on to OADs for T2DM in China. Medical expenditure data were collected from 639 patients with T2DM (aged ≥18 years) with and without complications incurred between January 1, 2014 and December 31, 2015 from claims databases in Shandong, China. Costs (2014 Chinese Yuan [¥]) and benefits were estimated, from the payers' perspective, over 40 years at a discount rate of 3%. A series of sensitivity analyses were performed. Patients on exenatide twice daily + OAD had a lower predicted incidence of most cardiovascular and hypoglycaemic events and lower total costs compared with those on insulin glargine once daily + OAD. A greater number of quality-adjusted life years (QALYs; 1.94) at a cost saving of ¥117 706 gained was associated with exenatide twice daily vs insulin glargine once daily. (i.e. cost saving of ¥60 764/QALY) per patient. In Chinese patients with T2DM inadequately controlled by OADs, exenatide twice daily is a cost-effective add-on therapy alternative to insulin glargine once daily, and may address the problem of an excess of medical needs resulting from weight gain and hypoglycaemia in T2DM treatment. © 2017 John Wiley & Sons Ltd.

  9. The integration of the neurosciences, child public health, and education practice: hemisphere-specific remediation strategies as a discipline partnered rehabilitation tool in ADD/ADHD

    Directory of Open Access Journals (Sweden)

    Gerry eLeisman

    2013-07-01

    Full Text Available ADHD is the most common and most studied neurodevelopmental problem. Recent statistics from the CDC state that 11% approximately 1 out of every 9 children in the US and 1 in 5 high school boys are diagnosed with ADHD. Lacking from treatment is an interdisciplinary knowledge-based strategy to intervention with child public health concerns addressed the educational system. This study is based on previous findings that ADHD children possess underactivity between sub-cortical and cortical regions. An imbalance of activity or arousal in one area can result in functional disconnections similar to that seen in split-brain patients. As ADD/ADHD children exhibit deficient performance on tests measuring perceptual laterality, evidence of weak laterality or failure to develop laterality has been found across various modalities (auditory, visual, tactile resulting in abnormal cerebral organization and associated dysfunctional specialization needed for lateralized processing of language and non-language function. This pilot study examines groups of ADD/ADHD and control elementary school children all of whom were administered all the subtests of the Wechsler Individual Achievement Tests, the Brown Parent Questionnaire, and given objective performance measures on tests of motor and sensory coordinative abilities. Results measured after a 12-week remediation program aimed at increasing the activity of the hypothesized underactive right hemisphere function, yielded significant improvement of greater than two years in grade level in all domains except in mathematical reasoning. The treated group also displayed a significant improvement in behavior with a reduction in Brown scale behavioral scores. Non-treated control participants did not exhibit significant differences during the same 12-week period in academic measurements, but did so when compared to the treated group. Results are discussed in the context of the concept of functional disconnectivity in ADD

  10. Efficacy and safety of dipeptidyl peptidase-4 inhibitors as an add-on to insulin treatment in patients with Type 2 diabetes

    DEFF Research Database (Denmark)

    Frandsen, Christian S.; Madsbad, S

    2014-01-01

    diabetes. METHODS: We searched the MEDLINE and PubMed databases to identify all randomized controlled clinical trials evaluating dipeptidyl peptidase-4 inhibitors as an add-on to insulin in patients with Type 2 diabetes, which were selected for review. The abstracts and posters of the recent annual...... and placebo treatment. CONCLUSION: Adding a dipeptidyl peptidase-4 inhibitor treatment to insulin has a moderate effect on HbA1c , a weight-neutral effect and a good safety profile. The risk of hypoglycaemia is not increased despite a significant improvement in HbA1c ....

  11. A single competency-based education and training and competency-based career framework for the Australian health workforce: discussing the potential value add

    Science.gov (United States)

    Brownie, Sharon Mary; Thomas, Janelle

    2014-01-01

    This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project’s genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers’ commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia’s current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented. PMID:25279384

  12. The Add-On Effect of Solifenacin for Patients with Remaining Overactive Bladder after Treatment with Tamsulosin for Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Obstruction

    Directory of Open Access Journals (Sweden)

    Naoya Masumori

    2010-01-01

    Full Text Available Objectives. To investigate the add-on effect of solifenacin for Japanese men with remaining overactive bladder (OAB symptoms after tamsulosin monotherapy for lower urinary tract symptoms (LUTS suggestive of benign prostatic obstruction (BPO in real-life clinical practice. Methods. Patients aged ≥ 50 having remaining OAB symptoms (≥ 3 of OAB symptom score (OABSS with ≥2 of urgency score after at least 4 weeks treatment by 0.2 mg of tamsulosin for BPO/LUTS received 2.5 or 5.0 mg of solifenacin for 12 weeks. The International Prostate Symptom Score (IPSS, QOL index and OABSS, maximum flow rate (Qmax and postvoid residual urine volume (PVR were determined. Results. A total of 48 patients (mean age 72.5 years completed the study. There were significant improvement in IPSS (15.1 to 11.2 and QOL index (4.2 to 3.0 by add-on of solifenacin. Although the IPSS storage symptom score was significantly improved, there were no changes observed in the IPSS voiding symptom score. The OABSS showed significant improvement (8.0 to 4.8. No changes were observed in Qmax and PVR. Conclusions. Under the supervision of an experienced urologist, the additional administration of solifenacin to patients with BPO/LUTS treated with tamsulosin, is effective in controlling remaining OAB symptoms.

  13. Development of 8K-MCA Add-on based on FPGA technique with a control of VB6 software application under windows environment

    International Nuclear Information System (INIS)

    Dang Lanh; Nguyen Nhi Dien; Nguyen Xuan Hai; Nguyen Bach Viet; Pham Ngoc Son; Huynh Minh; Vuong Huu Tan; Pham Dinh Khang; Phan Nam Anh

    2003-01-01

    The multichannel analyzer is the heart of most experimental measurements. Today, it becomes popular and convenient. It can play a role of getting, processing data and easily interfacing to PC. Some standard-alone multichannel analysis systems can be replaced by Add-on MCA card. Especially, MCA card is necessary for application in nuclear physics research. The main aim of this sub-project is to focus on a design and construction of an 8K-MCA Add-on served for studying nuclear structure, for development of Gamma spectroscopy system, and for a production of low-cost electronics instruments as well. Some experimental results were obtained through the aforementioned card combining with other needed functional analog units. A multichannel data processing (MCD) circuit for nuclear spectroscopy application was developed using a field programmable gate arrays (FPGA) as the central processing element. In addition to the first role, A 13-bit analog-to-digital converter (8k ADC) circuit for nuclear spectroscopy application was also developed using a successive approximation ADC with a control of FPGA technology. The FPGA operates a program that builds the distributed functions of data collected by the ADC and then corrects the ADC differential non-linearity (DNL) via the sliding scale method. The acquisition routine runs in 3.7μ s. the conversion time is approximated 2.2μ s, and the integral non-linearity ≤ 0.14%. (author)

  14. US adolescents' friendship networks and health risk behaviors: a systematic review of studies using social network analysis and Add Health data.

    Science.gov (United States)

    Jeon, Kwon Chan; Goodson, Patricia

    2015-01-01

    Background. Documented trends in health-related risk behaviors among US adolescents have remained high over time. Studies indicate relationships among mutual friends are a major influence on adolescents' risky behaviors. Social Network Analysis (SNA) can help understand friendship ties affecting individual adolescents' engagement in these behaviors. Moreover, a systematic literature review can synthesize findings from a range of studies using SNA, as well as assess these studies' methodological quality. Review findings also can help health educators and promoters develop more effective programs. Objective. This review systematically examined studies of the influence of friendship networks on adolescents' risk behaviors, which utilized SNA and the Add Health data (a nationally representative sample). Methods. We employed the Matrix Method to synthesize and evaluate 15 published studies that met our inclusion and exclusion criteria, retrieved from the Add Health website and 3 major databases (Medline, Eric, and PsycINFO). Moreover, we assigned each study a methodological quality score (MQS). Results. In all studies, friendship networks among adolescents promoted their risky behaviors, including drinking alcohol, smoking, sexual intercourse, and marijuana use. The average MQS was 4.6, an indicator of methodological rigor (scale: 1-9). Conclusion. Better understanding of risky behaviors influenced by friends can be useful for health educators and promoters, as programs targeting friendships might be more effective. Additionally, the overall MQ of these reviewed studies was good, as average scores fell above the scale's mid-point.

  15. Having Older Siblings Is Associated with Lower Rates of Depression, ADD/ADHD, Anxiety and Behavior Problems Among Children with ASD.

    Science.gov (United States)

    Montes, Guillermo

    2018-05-01

    Objective Within the social determinants of mental health framework, this article investigated whether children with ASD who have older siblings are less likely to experience depression, anxiety, behavior problems or have ADD/ADHD after controlling for standard social determinants of mental health such as household income, parental education and adverse childhood experiences (ACEs). Methods Using the National Survey of Children's Health 2011-2012, children with ASD spectrum disorders (n = 1624) were categorized into three groups: only child, oldest child and has older siblings. Design corrected cross-tabulations, univariate and multivariate logistic regressions were estimated. Results The three groups of children with ASD were comparable in demographic characteristics (except age), ACEs, and parent-reported ASD severity. Children with ASD who had older siblings were significantly less likely to experience depression, anxiety or behavior problems. They were also less likely to have been diagnosed with ADD or ADHD. Adjusted odds ratios ranged from 0.12 to 0.53 indicating robust associations. Conclusions for Practice Children with ASD who have older siblings were less likely to have comorbid mental health disorders than other children with ASD. Conversely, oldest and only children with ASD were at increased risk for these disorders. Further research is needed to understand how this protection is conferred on children with ASD, and whether it can be adapted into interventions for only and oldest children with ASD.

  16. US adolescents’ friendship networks and health risk behaviors: a systematic review of studies using social network analysis and Add Health data

    Directory of Open Access Journals (Sweden)

    Kwon Chan Jeon

    2015-06-01

    Full Text Available Background. Documented trends in health-related risk behaviors among US adolescents have remained high over time. Studies indicate relationships among mutual friends are a major influence on adolescents’ risky behaviors. Social Network Analysis (SNA can help understand friendship ties affecting individual adolescents’ engagement in these behaviors. Moreover, a systematic literature review can synthesize findings from a range of studies using SNA, as well as assess these studies’ methodological quality. Review findings also can help health educators and promoters develop more effective programs.Objective. This review systematically examined studies of the influence of friendship networks on adolescents’ risk behaviors, which utilized SNA and the Add Health data (a nationally representative sample.Methods. We employed the Matrix Method to synthesize and evaluate 15 published studies that met our inclusion and exclusion criteria, retrieved from the Add Health website and 3 major databases (Medline, Eric, and PsycINFO. Moreover, we assigned each study a methodological quality score (MQS.Results. In all studies, friendship networks among adolescents promoted their risky behaviors, including drinking alcohol, smoking, sexual intercourse, and marijuana use. The average MQS was 4.6, an indicator of methodological rigor (scale: 1–9.Conclusion. Better understanding of risky behaviors influenced by friends can be useful for health educators and promoters, as programs targeting friendships might be more effective. Additionally, the overall MQ of these reviewed studies was good, as average scores fell above the scale’s mid-point.

  17. Effect of heart failure reversal treatment as add-on therapy in patients with chronic heart failure: A randomized, open-label study.

    Science.gov (United States)

    Sane, Rohit; Aklujkar, Abhijeet; Patil, Atul; Mandole, Rahul

    The present study was designed to evaluate effect of heart failure reversal therapy (HFRT) using herbal procedure (panchakarma) and allied therapies, as add-on to standard CHF treatment (SCT) in chronic heart failure (CHF) patients. This open-label, randomized study conducted in CHF patients (aged: 25-65 years, ejection fraction: 30-65%), had 3-phases: 1-week screening, 6-week treatment (randomized [1:1] to HFRT+SCT or SCT-alone) and follow-up (12-week). Twice weekly HFRT (60-75min) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara (concoction dripping treatment) and basti (enema) was administered. Primary endpoints included evaluation of change in metabolic equivalents of task (MET) and peak oxygen uptake (VO 2peak ) from baseline, at end of 6-week treatment and follow-up at week-18 (non-parametric rank ANCOVA analysis). Safety and quality of life (QoL) was assessed. Seventy CHF patients (n=35, each treatment-arm; mean [SD] age: 53.0 [8.6], 80% men) were enrolled in the study. All patients completed treatment phase. Add-on HFRT caused a significant increase in METs (least square mean difference [LSMD], 6-week: 1.536, p=0.0002; 18-week: -1.254, p=0.0089) and VO 2peak (LSMD, 6-week: -5.52, p=0.0002; 18-week: -4.517, p=0.0089) as compared with SCT-alone. Results were suggestive of improved functional capacity in patients with HFRT (QoL; Mean [SD] HFRT+SCT vs. SCT-alone; 6-week: -0.44 [0.34] vs. -0.06 [0.25], p<0.0001 and 18-week: -0.53 [0.35] vs. -0.29 [0.26], p=0.0013). Seven treatment-emergent adverse events (mild severity) were reported in HFRT-arm. Findings of this study highlight therapeutic efficacy of add-on HFRT vs. SCT-alone in CHF patients. The non-invasive HFRT showed no safety concerns. Copyright © 2016. Published by Elsevier B.V.

  18. Real-life efficacy and safety of vildagliptin compared with sulfonylureas as add-on to metformin in patients with type 2 diabetes mellitus in Germany.

    Science.gov (United States)

    Göke, R; Gruenberger, J B; Bader, G; Dworak, M

    2014-05-01

    Metformin is an established first-line treatment for type 2 diabetes mellitus (T2DM) patients, but intensification of oral anti-diabetes therapy is usually required over time. A large observational study of 45,868 T2DM patients in 27 countries (EDGE) was conducted to compare the effectiveness and safety of vildagliptin as add-on therapy to another oral anti-diabetes drug (OAD) vs other dual OAD combinations. This report presents results from a post-hoc analysis of patients in Germany who received vildagliptin or a sulfonylurea (SU) in combination with metformin. Patients inadequately controlled with monotherapy became eligible only after the add-on treatment was finalized. Patients included were assigned to receive either vildagliptin or another OAD (SUs, thiazolidinediones, glinides, α-glucosidase inhibitors, or metformin; DPP-4 inhibitors or glucagon-like peptide-1 [GLP-1] mimetics/analogs were excluded). The primary end-point was the proportion of patients achieving a reduction in HbA1c >0.3% without peripheral edema, hypoglycemia, discontinuation due to gastrointestinal event, or weight gain ≥5%. Of 8887 patients enrolled in Germany, 6439 received vildagliptin and 971 received SUs as add-on to metformin. The primary end-point was reached in 34.9% and 29.6% of patients in the vildagliptin and SU groups, respectively, with an unadjusted odds ratio of 1.27 (95% CI = 1.09, 1.47; p = 0.001). HbA1c decreased in both cohorts from baseline (-0.7% with vildagliptin vs -0.5% with SUs), with a mean between-group difference of -0.2% (95% CI = -0.22, -0.09). The number of hypoglycemic events was 4-fold higher in the SU group than in the vildagliptin group (vildagliptin = 0.11%; SU = 0.41%). In a real-life setting, vildagliptin was associated with a numerically greater reduction in HbA1c, less hypoglycemia, and more patients reaching target HbA1c without hypoglycemia or weight gain compared with SUs. Open-label design and under reporting of adverse

  19. SwathProfiler and NProfiler: Two new ArcGIS Add-ins for the automatic extraction of swath and normalized river profiles

    Science.gov (United States)

    Pérez-Peña, J. V.; Al-Awabdeh, M.; Azañón, J. M.; Galve, J. P.; Booth-Rea, G.; Notti, D.

    2017-07-01

    The present-day great availability of high-resolution Digital Elevation Models has improved tectonic geomorphology analyses in their methodological aspects and geological meaning. Analyses based on topographic profiles are valuable to explore the short and long-term landscape response to tectonic activity and climate changes. Swath and river longitudinal profiles are two of the most used analysis to explore the long and short-term landscape responses. Most of these morphometric analyses are conducted in GIS software, which have become standard tools for analyzing drainage network metrics. In this work we present two ArcGIS Add-Ins to automatically delineate swath and normalized river profiles. Both tools are programmed in Visual Basic . NET and use ArcObjects library-architecture to access directly to vector and raster data. The SwathProfiler Add-In allows analyzing the topography within a swath or band by representing maximum-minimum-mean elevations, first and third quartile, local relief and hypsometry. We have defined a new transverse hypsometric integral index (THi) that analyzes hypsometry along the swath and offer valuable information in these kind of graphics. The NProfiler Add-In allows representing longitudinal normalized river profiles and their related morphometric indexes as normalized concavity (CT), maximum concavity (Cmax) and length of maximum concavity (Lmax). Both tools facilitate the spatial analysis of topography and drainage networks directly in a GIS environment as ArcMap and provide graphical outputs. To illustrate how these tools work, we analyzed two study areas, the Sierra Alhamilla mountain range (Betic Cordillera, SE Spain) and the Eastern margin of the Dead Sea (Jordan). The first study area has been recently studied from a morphotectonic perspective and these new tools can show an added value to the previous studies. The second study area has not been analyzed by quantitative tectonic geomorphology and the results suggest a landscape

  20. Management implications for the perioperative surgical home related to inpatient case cancellations and add-on case scheduling on the day of surgery.

    Science.gov (United States)

    Epstein, Richard H; Dexter, Franklin

    2015-07-01

    The American Society of Anesthesiologists has embraced the concept of the Perioperative Surgical Home as a means through which anesthesiologists can add value to the health systems in which they practice. One key listed element of the Perioperative Surgical Home is to support "scheduling initiatives to reduce cancellations and increase efficiency." In this study, we explored the potential benefits of the Perioperative Surgical Home with respect to inpatient cancellations and add-on case scheduling. We evaluated 6 hypotheses related to the timing of inpatient cancellations and preoperative anesthesia evaluations. Inpatient cancellations were studied during 26 consecutive 4-week intervals between July 2012 and June 2014 at a tertiary care academic hospital. All timestamps related to scheduling, rescheduling, and cancellation activities were retrieved from the operating room (OR) case scheduling system. Timestamps when patients were seen by anesthesia residents were obtained from the preoperative evaluation system database. Batch mean methods were used to calculate means and SE. For cases cancelled, we determined whether, for "most" (>50%) cancellations, a subsequent procedure (of any type) was performed on the patient within 7 days of the cancellation. Comparisons with most and other fractions were assessed using the 1 group, 1-sided Student t test. We evaluated whether a few procedures were highly represented among the cancelled cases via the Herfindahl (Simpson's) index, comparing it with Data from 24,735 scheduled inpatient cases were assessed. Cases cancelled after 7 AM on the day before or at any time on the scheduled day of surgery accounted for 22.6% ± 0.5% (SE) of the scheduled minutes all scheduled cases, and 26.8% ± 0.4% of the case volume (i.e., number of cases). Most (83.1% ± 0.6%, P 50%, P = 0.12), implying that the indication for the cancelled procedure no longer existed or the patient/family decided not to proceed with surgery. When only

  1. Association between genetic variants of the ADD1 and GNB3 genes and blood pressure response to the cold pressor test in a Chinese Han population: the GenSalt Study.

    Science.gov (United States)

    Wang, Laiyuan; Chen, Shufeng; Zhao, Qi; Hixson, James E; Rao, Dabeeru C; Jaquish, Cashell E; Huang, Jianfeng; Lu, Xiangfeng; Chen, Jichun; Cao, Jie; Li, Jianxin; Li, Hongfan; He, Jiang; Liu, De-Pei; Gu, Dongfeng

    2012-08-01

    Genetic factors influence blood pressure (BP) response to the cold pressor test (CPT), which is a phenotype related to hypertension risk. We examined the association between variants of the α-adducin (ADD1) and guanine nucleotide binding protein (G protein) β-polypeptide 3 (GNB3) genes and BP response to the CPT. A total of 1998 Han Chinese participants from the Genetic Epidemiology Network of Salt Sensitivity completed the CPT. The area under the curve (AUC) above the baseline BP during the CPT was used to measure the BP response. Twelve single-nucleotide polymorphisms (SNPs) of the ADD1 and GNB3 genes were selected and genotyped. Both single-marker and haplotype association analyses were conducted using linear mixed models. The rs17833172 and rs3775067 SNPs of the ADD1 gene and the rs4963516 SNP of the GNB3 gene were significantly associated with the BP response to CPT, even after adjusting for multiple testing. For the ADD1 gene, the AA genotype of SNP rs17833172 was associated with lower systolic BP (SBP) reactivity (PAUC (P=0.003). Haplotype analysis indicated that the CCGC haplotype of ADD1 constructed by rs1263359, rs3775067, rs4961 and rs4963 was significantly associated with the BP response to CPT. These data suggest that genetic variants of the ADD1 and GNB3 genes may have important roles in BP response to the CPT. Future studies aimed at replicating these novel findings are warranted.

  2. Scanning the horizon for high value-add manufacturing science: Accelerating manufacturing readiness for the next generation of disruptive, high-value curative cell therapeutics.

    Science.gov (United States)

    Hourd, Paul; Williams, David J

    2018-05-01

    Since the regenerative medicine sector entered the second phase of its development (RegenMed 2.0) more than a decade ago, there is increasing recognition that current technology innovation trajectories will drive the next translational phase toward the production of disruptive, high-value curative cell and gene-based regenerative medicines. To identify the manufacturing science problems that must be addressed to permit translation of these next generation therapeutics. In this short report, a long lens look within the pluripotent stem cell therapeutic space, both embryonic and induced, is used to gain early insights on where critical technology and manufacturing challenges may emerge. This report offers a future perspective on the development and innovation that will be needed within manufacturing science to add value in the production and commercialization of the next generation of advanced cell therapies and precision medicines. Copyright © 2018 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  3. A heuristic model linking yoga philosophy and self-reflection to examine underlying mechanisms of add-on yoga treatment in schizophrenia.

    Science.gov (United States)

    Rao, Naren; Menon, Sangeetha

    2016-06-01

    Preliminary evidence suggests efficacy of yoga as add-on treatment for schizophrenia, but the underlying mechanism by which yoga improves the symptoms of schizophrenia is not completely understood. Yoga improves self-reflection in healthy individuals, and self-reflection abnormalities are typically seen in schizophrenia. However, whether yoga treatment improves impairments in self-reflection typically seen in patients with schizophrenia is not examined. This paper discusses the potential mechanism of yoga in the treatment of schizophrenia and proposes a testable hypothesis for further empirical studies. It is proposed that self-reflection abnormalities in schizophrenia improve with yoga and the neurobiological changes associated with this can be examined using empirical behavioural measures and neuroimaging measures such as magnetic resonance imaging.

  4. Effects of add on PTH(1-84) substitution therapy in hypoparathyroidism: results from a double-blind randomised controlled study

    DEFF Research Database (Denmark)

    Sikjær, Tanja Tvistholm; Rejnmark, Lars; Mosekilde, Leif

    -phosphate levels within the physiological range. Compared with placebo, participants randomised to PTH (1-84) reduced their daily dose of calcium supplements by 68 % (pvitamin D dose by 53% (pneed of calcium supplements...... and 7 were not in need of active vitamin D. With the actual add on therapy there were no change in renal calcium excretion in response to treatment. Compared with placebo, bone mineral density (BMD) decreased significantly at the hip (-1.59 ± 0.57%), lumbar spine (-1.76 ± 1.03%) and whole body (-1...... bone packets. In conclusion, PTH substitution therapy is capable of maintaining normal p-calcium levels with a significantly reduced need for calcium supplements and active vitamin D. In contrast to the effect of PTH(1-84) treatment in patients with osteoporosis, causing an increase in BMD...

  5. Does the Order of Item Difficulty of the Addenbrooke's Cognitive Examination Add Anything to Subdomain Scores in the Clinical Assessment of Dementia?

    Science.gov (United States)

    McGrory, Sarah; Starr, John M; Shenkin, Susan D; Austin, Elizabeth J; Hodges, John R

    2015-01-01

    The Addenbrooke's Cognitive Examination (ACE) is used to measure cognition across a range of domains in dementia. Identifying the order in which cognitive decline occurs across items, and whether this varies between dementia aetiologies could add more information to subdomain scores. ACE-Revised data from 350 patients were split into three groups: Alzheimer's type (n = 131), predominantly frontal (n = 119) and other frontotemporal lobe degenerative disorders (n = 100). Results of factor analysis and Mokken scaling analysis were compared. Principal component analysis revealed one factor for each group. Confirmatory factor analysis found that the one-factor model fit two samples poorly. Mokken analyses revealed different item ordering in terms of difficulty for each group. The different patterns for each diagnostic group could aid in the separation of these different types of dementia.

  6. Does the Order of Item Difficulty of the Addenbrooke's Cognitive Examination Add Anything to Subdomain Scores in the Clinical Assessment of Dementia

    Directory of Open Access Journals (Sweden)

    Sarah McGrory

    2015-04-01

    Full Text Available Background: The Addenbrooke's Cognitive Examination (ACE is used to measure cognition across a range of domains in dementia. Identifying the order in which cognitive decline occurs across items, and whether this varies between dementia aetiologies could add more information to subdomain scores. Method: ACE-Revised data from 350 patients were split into three groups: Alzheimer's type (n = 131, predominantly frontal (n = 119 and other frontotemporal lobe degenerative disorders (n = 100. Results of factor analysis and Mokken scaling analysis were compared. Results: Principal component analysis revealed one factor for each group. Confirmatory factor analysis found that the one-factor model fit two samples poorly. Mokken analyses revealed different item ordering in terms of difficulty for each group. Conclusion: The different patterns for each diagnostic group could aid in the separation of these different types of dementia.

  7. A hybrid WDM/OCDMA ring with a dynamic add/drop function based on Fourier code for local area networks.

    Science.gov (United States)

    Choi, Yong-Kyu; Hosoya, Kenta; Lee, Chung Ghiu; Hanawa, Masanori; Park, Chang-Soo

    2011-03-28

    We propose and experimentally demonstrate a hybrid WDM/OCDMA ring with a dynamic add/drop function based on Fourier code for local area networks. Dynamic function is implemented by mechanically tuning the Fourier encoder/decoder for optical code division multiple access (OCDMA) encoding/decoding. Wavelength division multiplexing (WDM) is utilized for node assignment and 4-chip Fourier code recovers the matched signal from the codes. For an optical source well adapted to WDM channels and its short optical pulse generation, reflective semiconductor optical amplifiers (RSOAs) are used with a fiber Bragg grating (FBG) and gain-switched. To demonstrate we experimentally investigated a two-node hybrid WDM/OCDMA ring with a 4-chip Fourier encoder/decoder fabricated by cascading four FBGs with the bit error rate (BER) of <10(-9) for the node span of 10.64 km at 1.25 Gb/s.

  8. Polarization-independent rapidly tunable optical add-drop multiplexer utilizing non-polarizing beam splitters in Ti:LiNbO3

    Science.gov (United States)

    Shin, Yong-Wook; Sung, Won Ju; Eknoyan, O.; Madsen, C. K.; Taylor, H. F.

    2012-04-01

    A polarization-independent four-port wavelength-tunable optical add drop multiplexer (OADM) that utilizes non-polarizing relaxed beam splitters has been analyzed and demonstrated in Ti:LiNbO3 at the 1530 nm wavelength regime. The design utilizes an asymmetric interferometer configuration with strain induced index grating for polarization coupling along its arms that are shifted in position relative to each other. Experimental results of the filter response agree with theoretical predictions. Electrooptic tuning over a range of 15.7 nm at a rate of 0.08 nm/V has been measured. A temporal response < 46 ns to a 20 V step change in tuning voltage has been demonstrated. Fiber-to-fiber insertion loss is ~ 6.5 dB.

  9. Use of a Microsoft Excel based add-in program to calculate plasma sinistrin clearance by a two-compartment model analysis in dogs.

    Science.gov (United States)

    Steinbach, Sarah M L; Sturgess, Christopher P; Dunning, Mark D; Neiger, Reto

    2015-06-01

    Assessment of renal function by means of plasma clearance of a suitable marker has become standard procedure for estimation of glomerular filtration rate (GFR). Sinistrin, a polyfructan solely cleared by the kidney, is often used for this purpose. Pharmacokinetic modeling using adequate software is necessary to calculate disappearance rate and half-life of sinistrin. The purpose of this study was to describe the use of a Microsoft excel based add-in program to calculate plasma sinistrin clearance, as well as additional pharmacokinetic parameters such as transfer rates (k), half-life (t1/2) and volume of distribution (Vss) for sinistrin in dogs with varying degrees of renal function. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Comparison of conventional inserts and an add-on electron MLC for chest wall irradiation of left-sided breast cancer

    International Nuclear Information System (INIS)

    Vatanen, Tero; Lahtinen, Tapani; Traneus, Erik

    2009-01-01

    Background. Collimation of irregularly shaped clinical electron beams is currently based on electron inserts made of low melting point alloys. The present investigation compares a conventional electron applicator with insert and add-on eMLC-based dose distributions in the postoperative chest wall irradiation of left-sided breast cancer. Material and methods. Voxel Monte Carlo++ (VMC++) calculated dose distributions related to electron fields were compared with 10 left-sided breast cancer patients after radical mastectomy. The prescription dose was 50 Gy at a build-up maximum. The same dose was prescribed for the ipsilateral axillary, parasternal and supraclavicular lymph nodes that were treated with photons and calculated with a pencil beam algorithm. The insert beams were shaped with 1.5 cm thick Wood's metal electron inserts in an electron applicator of a Varian 2100 C/D linac. Doses for the eMLC-shaped beams were calculated for an eMLC prototype with 2 cm thick and 5 mm wide steel leaves. The same collimator-to-surface distance (CSD) of 5.8 cm was used for both collimators. Results. The mean PTV dose was slightly higher for the eMLC plans (50.7 vs 49.5 Gy, p<0.001, respectively). The maximum doses assessed by D5% for the eMLC and insert were 60.9 and 59.1 Gy (p<0.001). The difference was due to the slightly higher doses near the field edges for the eMLC. The left lung V20 volumes were 34.5% and 34.0% (p<0.001). There was only a marginal difference in heart doses. Discussion: Despite a slight increase of maximum dose in PTV the add-on electron MLC for chest wall irradiation results in practically no differences in dose distributions compared with the present insert-based collimation

  11. Metabolic and other effects of pioglitazone as an add-on therapy to metformin in the treatment of polycystic ovary syndrome (PCOS).

    Science.gov (United States)

    Valsamakis, Georgios; Lois, Kostas; Kumar, Sudhesh; Mastorakos, George

    2013-01-01

    Insulin resistance is a key pathogenic defect of the clustered metabolic disturbances seen in polycystic ovary syndrome (PCOS). Metformin is an insulin sensitizer acting in the liver and the peripheral tissues that ameliorates the metabolic and reproductive defects in PCOS. In addition, pioglitazone is an insulin sensitizer used in diabetes mellitus type 2 (T2DM), improving insulin resistance (IR) in adipose tissue and muscles. In T2DM, these drugs are also used as a combined treatment due to their "add-on effect" on insulin resistance. Although the beneficial role of troglitazone (a member of the thiazolidinediones (TZDs) family) in PCOS has been shown in the past, currently only pioglitazone is available in the market. A few small randomized controlled trials have directly compared the effectiveness of pioglitazone in women with PCOS, while there are a limited number of small studies that support the beneficial metabolic add-on effect of pioglitazone on metformin-treated PCOS women as compared to metformin or pioglitazone monotherapy. These findings suggest a potentially promising role for combined pioglitazone/metformin treatment in the management of PCOS in metformin-resistant patients. In view of recent concerns regarding pioglitazone usage and its associated health risk, we aim to compare the pros and cons of each drug regarding their metabolic and other hormonal effects in women with PCOS and to explore the possible beneficial effect of combined therapy in certain cases, taking into consideration the teratogenic effect of pioglitazone. Finally, we discuss the need for a randomized controlled trial that will evaluate the metabolic and other hormonal effects of combined metformin/pioglitazone treatment in PCOS with selective treatment targets.

  12. Computerized cognitive training in children and adolescents with attention deficit/hyperactivity disorder as add-on treatment to stimulants: feasibility study and protocol description

    Directory of Open Access Journals (Sweden)

    Virginia de Oliveira Rosa

    Full Text Available Abstract Background Cognitive training has received increasing attention as a non-pharmacological approach for the treatment of attention deficit/hyperactivity disorder (ADHD in children and adolescents. Few studies have assessed cognitive training as add-on treatment to medication in randomized placebo controlled trials. The purpose of this preliminary study was to explore the feasibility of implementing a computerized cognitive training program for ADHD in our environment, describe its main characteristics and potential efficacy in a small pilot study. Methods Six ADHD patients aged 10-12-years old receiving stimulants and presenting residual symptoms were enrolled in a randomized clinical trial to either a standard cognitive training program or a controlled placebo condition for 12 weeks. The primary outcome was core ADHD symptoms measured using the Swanson, Nolan and Pelham Questionnaire (SNAP-IV scale. Results We faced higher resistance than expected to patient enrollment due to logistic issues to attend face-to-face sessions in the hospital and to fill the requirement of medication status and absence of some comorbidities. Both groups showed decrease in parent reported ADHD symptoms without statistical difference between them. In addition, improvements on neuropsychological tests were observed in both groups – mainly on trained tasks. Conclusions This protocol revealed the need for new strategies to better assess the effectiveness of cognitive training such as the need to implement the intervention in a school environment to have an assessment with more external validity. Given the small sample size of this pilot study, definitive conclusions on the effects of cognitive training as add-on treatment to stimulants would be premature.

  13. Granisetron as an add-on to risperidone for treatment of negative symptoms in patients with stable schizophrenia: randomized double-blind placebo-controlled study.

    Science.gov (United States)

    Khodaie-Ardakani, Mohammad-Reza; Seddighi, Sahar; Modabbernia, Amirhossein; Rezaei, Farzin; Salehi, Bahman; Ashrafi, Mandana; Shams-Alizadeh, Narges; Mohammad-Karimi, Maryam; Esfandiari, Gholam-Reza; Hajiaghaee, Reza; Akhondzadeh, Shahin

    2013-04-01

    Some 5-HT3 antagonists such as ondansetron have shown beneficial effects on negative symptoms of patients with schizophrenia. We aimed to evaluate the efficacy of granisetron (another 5-HT3 antagonist) add-on therapy in the treatment of negative symptoms of patients with stable schizophrenia. In a randomized, double-blind, and placebo-controlled study, forty stable patients with schizophrenia (DSM-IV-TR), were randomized to either granisetron (1 mg twice daily) or placebo (twice daily) in addition to risperidone up to 6 mg/day for eight weeks. The patients were assessed using positive and negative syndrome scale (PANSS) and extrapyramidal symptom rating scale (ESRS) at baseline, week 4 and 8. Hamilton depression rating scale (HDRS) was used to assess depression at baseline and week 8. Thirty-eight patients completed the trial. Granisetron group showed a significantly greater improvement on negative subscale than the placebo group at endpoint [t(38) = 6.046, mean difference (±95% CI) = 3.2(1.8-3.7), P granisetron groups did not differ in their reduction of positive and general psychopathology symptoms scores. HDRS scores and its changes did not differ between the two groups. The ESRS score at week 4 was significantly lower in the granisetron than the placebo group while the two groups showed similar ESRS score at week 8. Frequency of other side effects was similar between the two groups. In summary, granisetron add-on can safely and effectively reduce the primary negative symptoms of patients with schizophrenia. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Computerized cognitive training in children and adolescents with attention deficit/hyperactivity disorder as add-on treatment to stimulants: feasibility study and protocol description.

    Science.gov (United States)

    Rosa, Virginia de Oliveira; Schmitz, Marcelo; Moreira-Maia, Carlos Roberto; Wagner, Flavia; Londero, Igor; Bassotto, Caroline de Fraga; Moritz, Guilherme; de Souza, Caroline Dos Santos; Rohde, Luis Augusto Paim

    2017-01-01

    Cognitive training has received increasing attention as a non-pharmacological approach for the treatment of attention deficit/hyperactivity disorder (ADHD) in children and adolescents. Few studies have assessed cognitive training as add-on treatment to medication in randomized placebo controlled trials. The purpose of this preliminary study was to explore the feasibility of implementing a computerized cognitive training program for ADHD in our environment, describe its main characteristics and potential efficacy in a small pilot study. Six ADHD patients aged 10-12-years old receiving stimulants and presenting residual symptoms were enrolled in a randomized clinical trial to either a standard cognitive training program or a controlled placebo condition for 12 weeks. The primary outcome was core ADHD symptoms measured using the Swanson, Nolan and Pelham Questionnaire (SNAP-IV scale). We faced higher resistance than expected to patient enrollment due to logistic issues to attend face-to-face sessions in the hospital and to fill the requirement of medication status and absence of some comorbidities. Both groups showed decrease in parent reported ADHD symptoms without statistical difference between them. In addition, improvements on neuropsychological tests were observed in both groups - mainly on trained tasks. This protocol revealed the need for new strategies to better assess the effectiveness of cognitive training such as the need to implement the intervention in a school environment to have an assessment with more external validity. Given the small sample size of this pilot study, definitive conclusions on the effects of cognitive training as add-on treatment to stimulants would be premature.

  15. Phenobarbital or potassium bromide as an add-on antiepileptic drug for the management of canine idiopathic epilepsy refractory to imepitoin.

    Science.gov (United States)

    Royaux, E; Van Ham, L; Broeckx, B J G; Van Soens, I; Gielen, I; Deforce, D; Bhatti, S F M

    2017-02-01

    Imepitoin has recently been approved in Europe for the management of dogs with idiopathic epilepsy. Currently, there is no evidence-based information available on the efficacy of antiepileptic drugs used as additions to the therapeutic regimen in dogs with idiopathic epilepsy that are not well controlled with imepitoin. The goal of this study was to evaluate the efficacy of phenobarbital or potassium bromide (KBr) as add-on antiepileptic drugs for controlling dogs refractory to a maximum dose of imepitoin (30 mg/kg twice daily). The study was performed as a prospective, randomised, controlled clinical trial. The efficacy of phenobarbital and KBr was evaluated by comparing monthly seizure frequency (MSF), monthly seizure day frequency (MSDF), the presence of cluster seizures during a retrospective 2-month period with a prospective follow-up of 6 months, and the overall responder rate. Twenty-seven dogs were included in the study, 14 dogs in the phenobarbital group and 13 dogs in the KBr group. Both median MSF and MSDF decreased in the phenobarbital group (both P = 0.001) and in the KBr group (P = 0.004 and P = 0.003, respectively). Overall, the number of dogs with cluster seizures decreased (P = 0.0005). The responder rate was 79% vs. 69% in the phenobarbital and KBr groups, respectively. We conclude that phenobarbital or KBr add-on treatment decreases median MSF and MSDF in epileptic dogs refractory to a maximum dose of imepitoin. Combination therapy was generally well tolerated and resulted in an improvement in seizure management in the majority of the dogs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Cost-Utility Analysis of Heberprot-P as an Add-on Therapy to Good Wound Care for Patients in Slovakia with Advanced Diabetic Foot Ulcer

    Directory of Open Access Journals (Sweden)

    Tomas Tesar

    2017-12-01

    Full Text Available Objectives: To explore whether Heberprot-P (an epidermal growth factor is a cost-effective option for the treatment of advanced diabetic foot ulcer as an add-on therapy to good wound care (GWC in Slovakia from the perspective of health care payers.Methods: A Markov model was constructed to compare the costs and effects of Heberprot-P plus GWC to those of GWC alone from the perspective of health care payers. The 52-week clinical trial period was extended to 5- and 10-year time horizons. Transition probabilities were calculated based on a previous clinical trial of Heberprot, utility values were derived from the scientific literature, and cost vectors were collected from the General Health Insurance Fund database in Slovakia. A one-way deterministic sensitivity analysis was employed to explore the influence of uncertainty for each input parameter on the incremental cost-effectiveness ratio (ICER.Results: Based on the ICER threshold of €30,030 per quality-adjusted life year (QALY recommended by the Slovak Ministry of Health, Heberprot-P therapy plus GWC is not a cost-effective alternative to GWC alone over a 10-year time horizon. The ICER increases if a longer time horizon is applied, as the incremental costs are similar, but the aggregated utility gain from avoided amputation is lower. Based on the sensitivity analysis, the utility multiplier for the health state “no ulcer after small amputation” had the most impact on the ICER; however, the model was robust to changes in all input parameters.Conclusions: Heberprot-P, as an add-on therapy to GWC in the treatment of advanced diabetic foot ulcer, is not a cost-effective alternative to GWC alone. However, if the unit cost of Heberprot-P were to be reduced to <€273, its ICER would be <€30,030.

  17. Cost-effectiveness of omalizumab add-on to standard-of-care therapy in patients with uncontrolled severe allergic asthma in a Brazilian healthcare setting.

    Science.gov (United States)

    Suzuki, Cibele; Lopes da Silva, Nilceia; Kumar, Praveen; Pathak, Purnima; Ong, Siew Hwa

    2017-08-01

    Omalizumab add-on to standard-of-care therapy has proven to be efficacious in severe asthma patients for whom exacerbations cannot be controlled otherwise. Moreover, evidence from different healthcare settings suggests reduced healthcare resource utilization with omalizumab. Based on these findings, this study aimed to assess the cost-effectiveness of the addition of omalizumab to standard-of-care therapy in patients with uncontrolled severe allergic asthma in a Brazilian healthcare setting. A previously published Markov model was adapted using Brazil-specific unit costs to compare the costs and outcomes of the addition of omalizumab to standard-of-care therapy vs standard-of-care therapy alone. Model inputs were largely based on the eXpeRience study. Costs and health outcomes were calculated for lifetime-years and were annually discounted at 5%. Both one-way and probabilistic sensitivity analyses were performed. An additional cost of R$280,400 for 5.20 additional quality-adjusted life-years was estimated with the addition of omalizumab to standard-of-care therapy, resulting in an incremental cost-effectiveness ratio of R$53,890. One-way sensitivity analysis indicated that discount rates, standard-of-care therapy exacerbation rates, and exacerbation-related mortality rates had the largest impact on incremental cost-effectiveness ratios. Assumptions of lifetime treatment adherence and rate of future exacerbations, independent of previous events, might affect the findings. The lack of Brazilian patients in the eXpeRience study may affect the findings, although sample size and baseline characteristics suggest that the modeled population closely resembles Brazilian severe allergic asthma patients. Results indicate that omalizumab as an add-on therapy is more cost-effective than standard-of-care therapy alone for Brazilian patients with uncontrolled severe allergic asthma, based on the World Health Organization's cost-effectiveness threshold of up to 3-times the gross

  18. Add Variety of Production Typewriting

    Science.gov (United States)

    Clippinger, Dorinda A.

    1974-01-01

    To encourage and motivate students and to provide variety in the advanced typewriting class, the following suggestions are offered: have the introduction to production lessons on tape, teach desk organization, have students maintain carbon copy files, dictate instructions, and keep a typewriting reference manual. (AG)

  19. A fuel that adds value

    International Nuclear Information System (INIS)

    Carta Petrolera

    2000-01-01

    Ecopetrol and the ICP (Colombian institute of the petroleum) developed a mixture of coal, raw and water whose objective was the converting the solid coal in liquid, which offers environmental, economic and operational advantages for its use in thermal units, steel industrial, central boilers and cement plants

  20. Expert and Generalist Local Knowledge about Land-cover Change on South Africa's Wild Coast: Can Local Ecological Knowledge Add Value to Science?

    Directory of Open Access Journals (Sweden)

    Nigel Chalmers

    2007-06-01

    Full Text Available Local ecological knowledge (LEK can shed light on ecosystem change, especially in under-researched areas such as South Africa's Wild Coast. However, for ecosystem planning purposes, it is necessary to assess the accuracy and validity of LEK, and determine where such knowledge is situated in a community, and how evenly it is spread. Furthermore, it is relevant to ask: does LEK add value to science, and how do science and local knowledge complement one another? We assessed change in woodland and forest cover in the Nqabara Administrative Area on South Africa's Wild Coast between 1974 and 2001. The inhabitants of Nqabara are "traditional" Xhosa-speaking people who are highly dependent on natural resources for their livelihoods. More recently, however, infrastructural development has influenced traditional lifestyles at Nqabara, although poverty remains high and formal education levels low. We assessed LEK about changes in woodland and forest cover over the past 30 years by interviewing 11 local "experts," who were recognized as such by the Nqabara community, and 40 senior members of randomly selected households in each village. We also analyzed land-cover change, using orthorectified aerial photos taken in 1974 and 2001. Forest and woodland cover had increased by 49% between 1974 and 2001. The 11 "experts" had a nuanced understanding of these changes and their causes. Their understanding was not only remarkably consistent with that of scientists, but it added considerable value to scientific understanding of the ultimate causes of land-cover change in the area. The experts listed combinations of several causal factors, operating at different spatial and temporal scales. The 40 randomly selected respondents also knew that forest and woodland cover had increased, but their understanding of the causes, and the role of fire in particular, was somewhat simplistic. They could identify only three causal factors and generally listed single factors rather

  1. Blood pressure control with amlodipine add-on therapy in patients with hypertension and diabetes: results of the Amlodipine Diabetic Hypertension Efficacy Response Evaluation Trial.

    Science.gov (United States)

    Kloner, Robert A; Neutel, Joel; Roth, Eli M; Weiss, Robert; Weinberger, Myron H; Thakker, Kamlesh M; Schwartz, Brian; Shi, Harry; Gregg, Anne-Marie

    2008-11-01

    Attainment of blood pressure (BP) goals in patients with diabetes is critical both to reduce the risk of cardiovascular events and to delay the progression of renal disease. While therapeutic guidelines advise initial therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, monotherapy with these agents may not be sufficient to attain target BP. The ADHT (Amlodipine Diabetic Hypertension Efficacy Response Evaluation Trial) evaluated the efficacy and safety of adding amlodipine to the treatment regimen of patients with hypertension and diabetes who were already receiving either quinapril or losartan as monotherapy. ADHT was a double-blind, double-dummy, 22-week trial conducted in the US. After a washout period of 7-13 days, patients (aged 30-75 y) with hypertension and diabetes were randomized to receive quinapril 20 mg/day plus placebo or losartan 50 mg/day plus placebo for 4 weeks, titrated to 40 mg or 100 mg (if required), respectively, for an additional 4 weeks to achieve their BP goals (<130/80 mm Hg). At week 8, either amlodipine 5 mg/day or placebo was added for an additional 12 weeks, with titration to 10 mg at week 14 if the BP goal was not achieved. Efficacy of add-on therapy was evaluated in 411 patients (amlodipine 211, placebo 200). BP goal was reached by 27.5% of patients when amlodipine was added to quinapril or losartan monotherapy, compared with 12.5% when placebo was added (OR 2.73; 95% CI 1.61 to 4.64; p < 0.001). When added to quinapril or losartan monotherapy, amlodipine reduced BP by 8.1/5.4 mm Hg, compared with a 1.6/0.7 mm Hg decrease with add-on placebo (p < 0.001). Amlodipine, quinapril, and losartan were well tolerated. Amlodipine is safe and effective when added to quinapril or losartan monotherapy to help lower BP toward therapeutic targets in patients with hypertension and diabetes.

  2. Beyond anxious predisposition: do padecer de nervios and ataque de nervios add incremental validity to predictions of current distress among Mexican mothers?

    Science.gov (United States)

    Alcántara, Carmela; Abelson, James L; Gone, Joseph P

    2012-01-01

    Nervios (PNRV) and ataque de nervios (ATQ) are culture-bound syndromes with overlapping symptoms of anxiety, depression, and dissociation, shown to have inconsistent associations to psychiatric disorder. Few studies test the basic assumption that PNRV and ATQ are uniformly linked to distress outcomes across Latina/o immigrant groups. This study examined: (a) the extent to which acculturative stress, Latino/US American acculturation, and anxious predisposition were associated with lifetime history of ATQ and PNRV, and (b) the extent to which ATQ and PNRV add incremental validity in explaining acculturative stress and psychological distress beyond measures of anxious predisposition. Participants (n = 82) included Mexican mothers who completed surveys on acculturation, trait anxiety, anxiety sensitivity, lifetime ATQ/PNRV, psychological distress, and acculturative stress. Lifetime PNRV, but not lifetime ATQ, was significantly predictive of psychological distress. PNRV was also linked to trait anxiety. Psychometric measures of anxious predisposition (trait anxiety and anxiety sensitivity) were more robust predictors of distress outcomes than lifetime history of ATQ/PNRV. Inquiry into lifetime history of nervios may be a useful point of entry in talking to Mexican immigrant mothers about stress and distress. However, standard tools for assessing anxiety sensitivity and trait anxiety appear most useful in identifying and explaining the presence of psychological distress. Further research is needed to determine the cross-cultural relevance of trait anxiety and anxiety sensitivity, and its implications for the development of anxiety treatments that are effective across cultures. © 2011 Wiley-Liss, Inc.

  3. Twelve-Week Treatment With Liraglutide as Add-on to Insulin in Normal-Weight Patients With Poorly Controlled Type 1 Diabetes

    DEFF Research Database (Denmark)

    Frandsen, Christian S; Dejgaard, Thomas F; Holst, Jens J

    2015-01-01

    OBJECTIVE: This study investigated the efficacy and safety of once-daily liraglutide 1.2 mg versus placebo as add-on to insulin treatment in normal-weight patients with poorly controlled type 1 diabetes. RESEARCH DESIGN AND METHODS: In a randomized (1:1), double-blind, placebo-controlled design, 40...... patients with type 1 diabetes (HbA1c ≥8% [64 mmol/mol]) received once-daily liraglutide 1.2 mg or placebo for 12 weeks. Continuous glucose monitoring was performed before and at the end of treatment. The primary end point was change in HbA1c. Secondary end points included change in insulin dose, weight...... was more frequently associated with gastrointestinal adverse effects. The incidence of hypoglycemia did not differ between groups. CONCLUSIONS: Liraglutide significantly reduces body weight and insulin requirements but has no additional effect on HbA1c in normal-weight patients with type 1 diabetes...

  4. Effectiveness of vildagliptin as add-on to metformin monotherapy among uncontrolled type 2 diabetes mellitus patients in a real-world setting.

    Science.gov (United States)

    Melzer Cohen, Cheli; Davis, Carla; Shalev, Varda; Chodick, Gabriel

    2018-01-01

    Vildagliptin is a dipeptidyl peptidase-4 inhibitor commonly used as a dual oral agent with metformin, thiazolidinediones, or sulfonylurea for the treatment of type 2 diabetes mellitus (T2DM). The efficacy of dual therapy with vildagliptin and metformin has been established in randomized controlled trials, but there is little evidence from observational studies. The aims of the present study were to evaluate the effectiveness of vildagliptin as an add-on therapy to metformin in reducing HbA1c and its affects on body weight and blood lipids in a real-life setting. Included in the present retrospective cohort were T2DM patients (n = 345) who were uncontrolled on metformin monotherapy and intensified treatment with vildagliptin. The efficacy of at least 90 days of dual therapy with vildagliptin and metformin in reducing HbA1c levels, as well as changes in blood lipids and body weight, were evaluated. After 180 days (range 90-365 days) from the index date with a mean daily dose of 92 mg vildagliptin, HbA1c was significantly (P vildagliptin in uncontrolled patients on metformin monotherapy is associated with a significant improvement in the control of HbA1c. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  5. Add-On Aliskiren Elicits Stronger Renoprotection Than High-Dose Valsartan in Type 2 Diabetic KKAy Mice That Do Not Respond to Low-Dose Valsartan

    Science.gov (United States)

    Lei, Bai; Nakano, Daisuke; Fan, Yu-Yan; Kitada, Kento; Hitomi, Hirofumi; Kobori, Hiroyuki; Mori, Hirohito; Masaki, Tsutomu; Nishiyama, Akira

    2012-01-01

    We hypothesized that aliskiren provides renoprotection in diabetic animals that did not receive sufficient renoprotection by AT1-receptor antagonist treatment. Type 2 diabetic KKAy mice were treated with group 1: vehicle or group 2: valsartan (15 mg/kg per day) from 12 to 16 weeks of age. The mice were subsequently divided into 4 groups and treated with the following combinations of drugs for another 6 weeks: 1: group 1 kept receiving vehicle, 2: group 2 continuously received 15 mg/kg per day of valsartan (Val-Val15), 3: group 2 received 50 mg/kg per day of valsartan (Val-Val50), 4: group 2 continuously received 15 mg/kg per day of valsartan with 25 mg/kg per day of aliskiren (Val-Val+Ali). Aliskiren exerted significant anti-albuminuric effects, whereas valsartan failed to ameliorate the albuminuria in the first four weeks. Surprisingly, the increasing dosage of valsartan in the Val-Val50 group showed non-significant tendencies to attenuate the albuminuria compared with vehicle infusion. Val-Val+Ali significantly suppressed the development of albuminuria and podocyte injury. Val-Val50 and Val-Val+Ali showed similar suppression of angiotensin II contents in the kidney of KKAy mice. In conclusion, the anti-albuminuric effect that was observed in the type 2 diabetic mice showing no anti-albuminuric effect by valsartan can be attributed to the add-on aliskiren. PMID:22673148

  6. Does secretin stimulation add to magnetic resonance cholangiopancreatography in characterising pancreatic cystic lesions as side-branch intraductal papillary mucinous neoplasm?

    International Nuclear Information System (INIS)

    Purysko, Andrei S.; Gandhi, Namita S.; Veniero, Joseph C.; Walsh, R.M.; Obuchowski, Nancy A.

    2014-01-01

    To assess the value of secretin during magnetic resonance cholangiopancreatography (MRCP) in demonstrating communication between cystic lesions and the pancreatic duct to help determine the diagnosis of side-branch intraductal papillary mucinous neoplasm (SB-IPMN). This is an IRB-approved, HIPAA-compliant retrospective study of 29 SB-IPMN patients and 13 non-IPMN subjects (control) who underwent secretin-enhanced MRCP (s-MRCP). Two readers blinded to the final diagnosis reviewed three randomised image sets: (1) pre-secretin HASTE, (2) dynamic s-MRCP and (3) post-secretin HASTE. Logistic regression, generalised linear models and ROC analyses were used to compare pre- and post-secretin results. There was no significant difference in median scores for the pre-secretin [reader 1: 1; reader 2: 2 (range -2 to 2)] and post-secretin HASTE [reader 1: 1; reader 2: 1 (range -2 to 2)] in the SB-IPMN group (P = 0.14), while the scores were lower for s-MRCP [reader 1: 0.5 (range -2 to 2); reader 2: 0 (range -1 to 2); P = 0.016]. There was no significant difference in mean maximum diameter of SB-IPMN on pre- and post-secretin HASTE, and s-MRCP (P > 0.05). Secretin stimulation did not add to MRCP in characterising pancreatic cystic lesions as SB-IPMN. (orig.)

  7. Do Simulation-Based Skill Exercises and Post-Encounter Notes Add Additional Value to a Standardized Patient-Based Clinical Skills Examination?

    Directory of Open Access Journals (Sweden)

    Michael D. Prislin

    2011-01-01

    Full Text Available Background. Standardized patient (SP clinical assessments have limited utility in assessing higher-level clinical competencies. This study explores the value of including simulation exercises and postencounter notes in an SP clinical skills examination. Methods. Two exercises involving cardiac auscultation and ophthalmic funduscopy simulations along with written post encounter notes were added to an SP-based performance examination. Descriptive analyses of students' performance and correlations with SP-based performance measures were obtained. Results. Students' abilities to detect abnormalities on physical exam were highly variable. There were no correlations between SP-based and simulation-derived measures of physical examination competency. Limited correlations were found between students' abilities to perform and document physical examinations and their formulation of appropriate differential diagnoses. Conclusions. Clinical simulation exercises add depth to SP-based assessments of performance. Evaluating the content of post encounter notes offers some insight into students' integrative abilities, and this appears to be improved by the addition of simulation-based post encounter skill exercises. However, further refinement of this methodology is needed.

  8. "Effect of pranayama and meditation as an add-on therapy in rehabilitation of patients with Guillain-Barré syndrome--a randomized control pilot study".

    Science.gov (United States)

    Sendhilkumar, Ragupathy; Gupta, Anupam; Nagarathna, Raghuram; Taly, Arun B

    2013-01-01

    To study the add-on effects of pranayama and meditation in rehabilitation of patients with Guillain-Barré syndrome (GBS). This randomized control pilot study was conducted in neurological rehabilitation unit of university tertiary research hospital. Twenty-two GBS patients, who consented for the study and satisfied selection criteria, were randomly assigned to yoga and control groups. Ten patients in each group completed the study. The yoga group received 15 sessions in total over a period of 3 weeks (1 h/session), one session per day on 5 days per week that consisted of relaxation, Pranayama (breathing practices) and Guided meditation in addition to conventional rehabilitation therapeutics. The control group received usual rehabilitation care. All the patients were assessed using Pittsburgh Sleep Quality Index, Numeric pain rating scale, Hospital anxiety and Depression scale and Barthel index score. Mann-Whitney U test and Wilcoxon's signed rank test were used for statistical analysis. Quality of sleep improved significantly with reduction of PSQI score in the yoga group (p = 0.04). There was reduction of pain scores, anxiety and depression in both the groups without statistical significance between groups (pain p > 0.05, anxiety p > 0.05 and depression p > 0.05). Overall functional status improved in both groups without significant difference (p > 0.05). Significant improvement was observed in quality of sleep with yogic relaxation, pranayama, and meditation in GBS patients.

  9. A practical method for three-dimensional reconstruction of joints using a C-arm system and shift-and-add algorithm

    International Nuclear Information System (INIS)

    Li Senhu; Jiang Huabei

    2005-01-01

    Currently, radiography with C-arm systems is playing a major role in the assessment of arthritis. However, the radiographic two-dimensional projection images of joints often interfere with physicians' efforts to better understand and measure the structure changes of joints due to the overlap of bone structures at different depths. An accurate, low-cost, and practical three-dimensional (3D) reconstruction approach of joints will be beneficial in diagnosing arthritis. Toward this end, a novel method is developed in this paper based on a C-arm system. The idea is to apply the shift-and-add algorithm (commonly used in digital tomosynthesis) on the segmented projection images at multiple angles, which results in accurate reconstruction of the 3D structures of joints. The method provides a new solution to precisely distinguish objects from blurring background. The proposed method has been tested and evaluated on simulated cylinders, a chicken bone phantom with known structure, and an in vivo human index finger. The results are demonstrated and discussed

  10. Stereotaxic percutaneous core biopsy versus surgical biopsy of nonpalpable breast lesions using a standard mammographic table with an add-on device

    International Nuclear Information System (INIS)

    Levin, M.F.; Papoff, W.J.; Doan, L.; Eliasziw, M.

    2001-01-01

    To determine the accuracy of using a regular mammographic table with an add-on device for biopsy of nonpalpable breast lesions in women in a community hospital setting. During a 3-year period, 70 consenting women (39-80 years of age) with a nonpalpable mammographically suspicious lesion on routine screening mammography underwent 14-gauge automated percutaneous core biopsies, immediate needle localization and lumpectomy. The needle and surgical biopsy results were independently classified into 1 of 5 categories: cancer, fibroadenomal fibrocystic change, normal or other. The procedure was well tolerated, and all core specimens yielded adequate tissue for pathologic evaluation. There were 3 episodes of vasovagal reaction. There was complete agreement in histologic findings in 64 cases (91%), including 22 of 24 cancers (92%). The overall agreement for categorizing lesions was 91% (k 0.88), and there was 97% agreement (k = 0.94) for the classification of cancer versus benign lesion. The results are similar to those of studies performed with dedicated prone equipment. Stereotaxic core biopsies can be done safely and accurately in a community hospital setting with relatively inexpensive nondedicated mammographic equipment. (author)

  11. Stereotaxic percutaneous core biopsy versus surgical biopsy of nonpalpable breast lesions using a standard mammographic table with an add-on device

    Energy Technology Data Exchange (ETDEWEB)

    Levin, M.F.; Papoff, W.J.; Doan, L.; Eliasziw, M. [St. Thomas-Elgin General Hospital, St. Thomas, Ontario (Canada)

    2001-02-01

    To determine the accuracy of using a regular mammographic table with an add-on device for biopsy of nonpalpable breast lesions in women in a community hospital setting. During a 3-year period, 70 consenting women (39-80 years of age) with a nonpalpable mammographically suspicious lesion on routine screening mammography underwent 14-gauge automated percutaneous core biopsies, immediate needle localization and lumpectomy. The needle and surgical biopsy results were independently classified into 1 of 5 categories: cancer, fibroadenomal fibrocystic change, normal or other. The procedure was well tolerated, and all core specimens yielded adequate tissue for pathologic evaluation. There were 3 episodes of vasovagal reaction. There was complete agreement in histologic findings in 64 cases (91%), including 22 of 24 cancers (92%). The overall agreement for categorizing lesions was 91% (k 0.88), and there was 97% agreement (k = 0.94) for the classification of cancer versus benign lesion. The results are similar to those of studies performed with dedicated prone equipment. Stereotaxic core biopsies can be done safely and accurately in a community hospital setting with relatively inexpensive nondedicated mammographic equipment. (author)

  12. Comparison of the Effects of Continuous Subcutaneous Insulin Infusion and Add-On Therapy with Sitagliptin in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Heng Wan

    2016-01-01

    Full Text Available To identify a new regimen to optimize treatment for patients with newly diagnosed type 2 diabetes (T2DM by short-term continuous subcutaneous insulin infusion (CSII alone. Methods. 60 patients with newly diagnosed T2DM were randomized into two groups (n=30 each and treated for 2 weeks with CSII alone (CSII group or with CSII plus sitagliptin (CSII + Sig group. The glycemic variability of the patients was measured using a continuous glucose monitoring system (CGMS for the last 72 hours. A standard meal test was performed before and after the interventions, and the levels of glycated albumin, fasting glucose, fasting C-peptide, postprandial 2 h blood glucose, and postprandial 2 h C-peptide were examined. Results. Compared with the CSII group, the indicators of glycemic variability, such as the mean amplitude of glycemic excursion (MAGE and the standard deviation of blood glucose (SDBG, were decreased significantly in the CSII + Sig group. The changes before and after treatment in the C-peptide reactivity index (ΔCPI and the secretory unit of islet in transplantation index (ΔSUIT indicated a significant improvement in the CSII + Sig group. Conclusions. Add-on therapy with sitagliptin may be an optimized treatment for patients with newly diagnosed T2DM compared with short-term CSII alone.

  13. Add-on-Statin Extended Release Nicotinic Acid/Laropiprant but Not the Switch to High-Dose Rosuvastatin Lowers Blood Pressure: An Open-Label Randomized Study

    Directory of Open Access Journals (Sweden)

    Anastazia Kei

    2011-01-01

    Full Text Available Introduction. Nicotinic acid (NA and statins have been associated with reductions in blood pressure (BP. Patients and Methods. We recruited 68 normotensive and hypertensive dyslipidemic patients who were treated with a conventional statin dose and had not achieved lipid targets. Patients were randomized to switch to high-dose rosuvastatin (40 mg/day or to add-on current statin treatment with extended release (ER NA/laropiprant (1000/20 mg/day for the first 4 weeks followed by 2000/40 mg/day for the next 8 weeks for 3 months. Results. Switching to rosuvastatin 40 mg/day was not associated with significant BP alterations. In contrast, the addition of ER-NA/laropiprant to current statin treatment resulted in a 7% reduction of systolic BP (from 134±12 to 125±10 mmHg, <.001 versus baseline and =.01 versus rosuvastatin group and a 5% reduction of diastolic BP (from 81±9 to 77±6 mmHg, =.009 versus baseline and =.01 versus rosuvastatin group. These reductions were significant only in the subgroup of hypertensives and were independent of the hypolipidemic effects of ER-NA/laropiprant. Conclusions. Contrary to the switch to high-dose rosuvastatin, the addition of ER-NA/laropiprant to statin treatment was associated with significant reductions in both systolic and diastolic BP.

  14. Comparison of vildagliptin as an add-on therapy and sulfonylurea dose-increasing therapy in patients with inadequately controlled type 2 diabetes using metformin and sulfonylurea (VISUAL study): A randomized trial.

    Science.gov (United States)

    Hong, A Ram; Lee, Jeun; Ku, Eu Jeong; Hwangbo, Yul; Kim, Kyoung Min; Moon, Jae Hoon; Choi, Sung Hee; Jang, Hak Chul; Lim, Soo

    2015-07-01

    The aim of present study is to compare the efficacy and safety of adding vildagliptin with sulfonylurea dose-increasing as an active comparator in patients who had inadequately controlled type 2 diabetes mellitus (T2DM) using metformin plus sulfonylurea in real clinical practice. Patients using metformin plus sulfonylurea were assigned to either vildagliptin add-on (50 mg twice a day, n=172) or sulfonylurea dose-increasing by 50% (n=172) treatment groups. The primary endpoint was a change in HbA(1c) after 24 weeks. The secondary endpoints were patients achieving HbA(1c)≤7.0% (53 mmol/mol) and changes in the fasting plasma glucose (FPG), 2-h postprandial glucose (2pp), lipid profiles, and urine albumin-to-creatinine ratio. Body weight and hypoglycemia were also investigated. The mean HbA(1c) at baseline was 8.6% (70 mmol/mol) in both groups. At week 24, the adjusted mean HbA(1c) levels decreased by -1.19% (-13.09 mmol/mol) with vildagliptin add-on and -0.46% (-5.06 mmol/mol) with sulfonylurea (Pvildagliptin add-on patients achieved HbA(1c)≤7.0% (53 mmol/mol) than did sulfonylurea patients (40.1% vs. 7.9%; Pvildagliptin add-on than with sulfonylurea (Pvildagliptin add-on group exhibited no clinically relevant weight gain and had a lower incidence of hypoglycemia compared with the sulfonylurea group. Vildagliptin add-on therapy might be a suitable option for patients with T2DM that is controlled inadequately by metformin and sulfonylurea, based on its greater glucose control and better safety profile (ClinicalTrial.gov: NCT01099137). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Cost-consequence analysis of sitagliptin versus sulfonylureas as add-on therapy for the treatment of diabetic patients in Italy

    Directory of Open Access Journals (Sweden)

    Lorenzoni V

    2017-11-01

    Full Text Available Valentina Lorenzoni,1 Fabio Baccetti,2 Stefano Genovese,3 Enrico Torre,4 Giuseppe Turchetti1 1Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy; 2SD Diabetology, ASL Toscana Nordovest, Massa Carrara, Italy; 3Cardiovascular and Metabolic Department, IRCCS Multimedica Sesto San Giovanni, Milan, Italy; 4SSD Endocrinologia, Diabetologia e Malattie metaboliche, ASL 3 Genovese, Genoa, Italy Objective: Diabetes mellitus is a chronic disease related to a significant impact in both epidemiologic and economic terms. In Italy, around 3.6 million people are affected by diabetes and this number is expected to increase significantly in the next few years. As recommended by current national and international guidelines, metformin (Met is prescribed as first-line pharmacological treatment, and many pharmacological alternatives are available for patients uncontrolled with Met monotherapy. Despite the availability of many innovative oral antidiabetic drugs (OADs, such as dipeptidyl peptidase 4 inhibitors (DPP4-i and its first-in-class sitagliptin (SITA, which entered the Italian market in the last 10 years, their usage is consistently lower than traditional drugs such as sulfonylureas (SUs. In fact, due to higher acquisition costs, the prescription of innovative OADs in Italy is restricted to specialist, resulting in a prominent usage of traditional OAD that can be prescribed also by general practitioners (GPs. A cost consequence analysis (CCA was performed in order to compare SITA with SU, as second-line therapy in add-on to Met, in terms of costs and related clinical events over 36 months.Methods: A CCA was conducted on a hypothetical cohort of 100,000 type 2 diabetes mellitus (T2DM patients uncontrolled with Met monotherapy, from both the Italian National Health Service (INHS and societal perspective. Therefore, both direct (drugs, self-monitoring, hypoglycemia, major cardiovascular events [MACEs], and switch to insulin and indirect costs

  16. Cost-consequence analysis of sitagliptin versus sulfonylureas as add-on therapy for the treatment of diabetic patients in Italy.

    Science.gov (United States)

    Lorenzoni, Valentina; Baccetti, Fabio; Genovese, Stefano; Torre, Enrico; Turchetti, Giuseppe

    2017-01-01

    Diabetes mellitus is a chronic disease related to a significant impact in both epidemiologic and economic terms. In Italy, around 3.6 million people are affected by diabetes and this number is expected to increase significantly in the next few years. As recommended by current national and international guidelines, metformin (Met) is prescribed as first-line pharmacological treatment, and many pharmacological alternatives are available for patients uncontrolled with Met monotherapy. Despite the availability of many innovative oral antidiabetic drugs (OADs), such as dipeptidyl peptidase 4 inhibitors (DPP4-i) and its first-in-class sitagliptin (SITA), which entered the Italian market in the last 10 years, their usage is consistently lower than traditional drugs such as sulfonylureas (SUs). In fact, due to higher acquisition costs, the prescription of innovative OADs in Italy is restricted to specialist, resulting in a prominent usage of traditional OAD that can be prescribed also by general practitioners (GPs). A cost consequence analysis (CCA) was performed in order to compare SITA with SU, as second-line therapy in add-on to Met, in terms of costs and related clinical events over 36 months. A CCA was conducted on a hypothetical cohort of 100,000 type 2 diabetes mellitus (T2DM) patients uncontrolled with Met monotherapy, from both the Italian National Health Service (INHS) and societal perspective. Therefore, both direct (drugs, self-monitoring, hypoglycemia, major cardiovascular events [MACEs], and switch to insulin) and indirect costs (expressed in terms of productivity losses) were evaluated. Clinical and economic data were collected through Italian national tariffs, literature, and experts' opinions. Three expert clinicians finally validated data inputs. To assess robustness of base case results, a one-way sensitivity analysis (OWSA) and a conservative scenario analysis - excluding MACEs - were carried out. In the base case analysis, the higher drug costs related

  17. Replicative phenotyping adds value to genotypic resistance testing in heavily pre-treated HIV-infected individuals - the Swiss HIV Cohort Study

    Directory of Open Access Journals (Sweden)

    Martinetti Gladys

    2011-01-01

    Full Text Available Abstract Background Replicative phenotypic HIV resistance testing (rPRT uses recombinant infectious virus to measure viral replication in the presence of antiretroviral drugs. Due to its high sensitivity of detection of viral minorities and its dissecting power for complex viral resistance patterns and mixed virus populations rPRT might help to improve HIV resistance diagnostics, particularly for patients with multiple drug failures. The aim was to investigate whether the addition of rPRT to genotypic resistance testing (GRT compared to GRT alone is beneficial for obtaining a virological response in heavily pre-treated HIV-infected patients. Methods Patients with resistance tests between 2002 and 2006 were followed within the Swiss HIV Cohort Study (SHCS. We assessed patients' virological success after their antiretroviral therapy was switched following resistance testing. Multilevel logistic regression models with SHCS centre as a random effect were used to investigate the association between the type of resistance test and virological response (HIV-1 RNA Results Of 1158 individuals with resistance tests 221 with GRT+rPRT and 937 with GRT were eligible for analysis. Overall virological response rates were 85.1% for GRT+rPRT and 81.4% for GRT. In the subgroup of patients with >2 previous failures, the odds ratio (OR for virological response of GRT+rPRT compared to GRT was 1.45 (95% CI 1.00-2.09. Multivariate analyses indicate a significant improvement with GRT+rPRT compared to GRT alone (OR 1.68, 95% CI 1.31-2.15. Conclusions In heavily pre-treated patients rPRT-based resistance information adds benefit, contributing to a higher rate of treatment success.

  18. N-Acetylcysteine in the Treatment of Pediatric Tourette Syndrome: Randomized, Double-Blind, Placebo-Controlled Add-On Trial.

    Science.gov (United States)

    Bloch, Michael H; Panza, Kaitlyn E; Yaffa, Alisa; Alvarenga, Pedro G; Jakubovski, Ewgeni; Mulqueen, Jilian M; Landeros-Weisenberger, Angeli; Leckman, James F

    2016-05-01

    Current pharmacological treatments for Tourette Syndrome (TS), such as antipsychotic agents and α-2 agonists, are moderately effective in the treatment of tics, but have substantial side effects that limit their use. N-acetylcysteine (NAC) modulates glutamatergic systems, and has been used safely as an antioxidant agent with minimal side effects for decades. NAC has been increasingly studied for the treatment of other obsessive-compulsive spectrum disorders. We aim to examine the efficacy of NAC for the treatment of pediatric TS in a double-blind, placebo-controlled, add-on study. Thirty-one children and adolescents 8-17 years of age with TS were randomly assigned to receive NAC or matching placebo for 12 weeks. Our primary outcome was change in severity of tics as measured by the Yale Global Tic Severity Scale (YGTSS), Total tic score. Secondary measures assessed comorbid obsessive-compulsive disorder (OCD), depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD). Linear mixed models in SAS were used to examine differences between NAC and placebo. Of 31 randomized subjects, 14 were assigned to placebo (two females; 11.5 + 2.8 years) and 17 to active NAC (five females; 12.4 + 1.4 years) treatment. No significant difference between NAC and placebo was found in reducing tic severity or any secondary outcomes. We found no evidence for efficacy of NAC in treating tic symptoms. Our findings stand in contrast to studies suggesting benefits of NAC in the treatment of other obsessive-compulsive spectrum disorders in adults, including OCD and trichotillomania, but are similar to a recent placebo-controlled trial of pediatric trichotillomania that found no benefit of NAC.

  19. Impact of communities, health, and emotional-related factors on smoking use: comparison of joint modeling of mean and dispersion and Bayes' hierarchical models on add health survey.

    Science.gov (United States)

    Pu, Jie; Fang, Di; Wilson, Jeffrey R

    2017-02-03

    The analysis of correlated binary data is commonly addressed through the use of conditional models with random effects included in the systematic component as opposed to generalized estimating equations (GEE) models that addressed the random component. Since the joint distribution of the observations is usually unknown, the conditional distribution is a natural approach. Our objective was to compare the fit of different binary models for correlated data in Tabaco use. We advocate that the joint modeling of the mean and dispersion may be at times just as adequate. We assessed the ability of these models to account for the intraclass correlation. In so doing, we concentrated on fitting logistic regression models to address smoking behaviors. Frequentist and Bayes' hierarchical models were used to predict conditional probabilities, and the joint modeling (GLM and GAM) models were used to predict marginal probabilities. These models were fitted to National Longitudinal Study of Adolescent to Adult Health (Add Health) data for Tabaco use. We found that people were less likely to smoke if they had higher income, high school or higher education and religious. Individuals were more likely to smoke if they had abused drug or alcohol, spent more time on TV and video games, and been arrested. Moreover, individuals who drank alcohol early in life were more likely to be a regular smoker. Children who experienced mistreatment from their parents were more likely to use Tabaco regularly. The joint modeling of the mean and dispersion models offered a flexible and meaningful method of addressing the intraclass correlation. They do not require one to identify random effects nor distinguish from one level of the hierarchy to the other. Moreover, once one can identify the significant random effects, one can obtain similar results to the random coefficient models. We found that the set of marginal models accounting for extravariation through the additional dispersion submodel produced

  20. Add-on Therapy With the α-Blockers Tamsulosin and Naftopidil Improves Voiding Function by Enhancing Neuronal Activity in Prostatic Hyperplasia Rats.

    Science.gov (United States)

    Ko, Il-Gyu; Hwang, Lakkyong; Jin, Jun-Jang; Kim, Sang-Hoon; Han, Jin Hee; Jeon, Jung Won; Cho, Sung Tae

    2018-03-01

    Benign prostatic hyperplasia (BPH) impacts quality of life in men by causing lower urinary tract symptoms. α1-Adrenoceptor (α1-AR) blockers improve lower urinary tract symptoms. We investigated the efficacy of add-on therapy with α1-AR blockers on BPH rats. Rats in the drug-treated groups were orally administered each drug once a day for 30 days after orchiectomy. To induce BPH, rats were castrated and testosterone (20 mg/kg) was injected subcutaneously once per day for 30 days. Cystometry was conducted to measure voiding contraction pressure and the interval contraction time, immunohistochemistry was performed to measure c-Fos and nerve growth factor (NGF) expression in the neuronal voiding centers, and nicotinamide adenine dinucleotide phosphate-diaphorase histochemistry was used to measure nitric oxide synthase (NOS) expression. Orchiectomy and testosterone injection decreased voiding contraction pressure and the interval contraction time, suggesting BPH symptoms. Voiding contraction pressure and the interval contraction time were greater in the group that received the combination treatment (tamsulosin with naftopidil) than in the tamsulosin monotherapy or naftopidil monotherapy groups. c-Fos, NGF, and NOS expression in the neuronal voiding centers was enhanced by BPH induction. c-Fos, NGF, and NOS expression was suppressed by the combination treatment (tamsulosin with naftopidil) to a greater extent than was the case for tamsulosin monotherapy or naftopidil monotherapy. Combination therapy of tamsulosin and naftopidil showed greater efficacy for the treatment of BPH than tamsulosin monotherapy or naftopidil monotherapy; therefore, combination therapy can be considered as a novel therapeutic method for BPH.

  1. Short-Term Prognosis of Mechanically Ventilated Patients With Guillain-Barré Syndrome Is Worsened by Corticosteroids as an Add-On Therapy.

    Science.gov (United States)

    Wu, Xiujuan; Zhang, Bing; Li, Chunrong; Shen, Donghui; Liu, Kangding; Zhu, Jie; Zhang, Hong-Liang

    2015-10-01

    Intravenous immunoglobulin (IVIg) has been proven most effective in treating Guillain-Barré syndrome (GBS). Corticosteroids as an add-on therapy have been prescribed in severe GBS cases. However, the efficacy of intravenous corticosteroids combined with IVIg in dealing with severe GBS remains unclear. We explored the therapeutic effects of different therapeutic regimens on the short-term prognosis of GBS patients, especially the severe cases.We retrospectively analyzed the clinical data of 527 adult patients with GBS who were prescribed to different treatments from 2003 to 2014. The therapeutic effect of a treatment was evaluated by the improvement of Hughes Functional Grading Scale (HFGS) and Medical Research Council (MRC) sum score.With comparable incidence of infectious complications (P > 0.05), more mechanically ventilated patients were found improvement after IVIg treatment than combination IVIg with intravenous corticosteroids (MRC: 97% vs. 72.4%, P bedridden patients without mechanical ventilation, incidence of infectious complications (P > 0.05) and ratio of patients who were improved after IVIg were insignificantly different from the combination therapy (MRC: 89.6% vs. 86.5%; HFGS: 69.6% vs. 61.5%; both P > 0.05), even if the intravenous corticosteroids were initiated within 7 days after onset (P > 0.05). In addition, supportive treatment was sufficient for patients who were able to walk with help (HFGS = 3) and mildly affected (HFGS  3), while corticosteroids are detrimental for short-term prognosis in mechanically ventilated patients when used in combination with IVIg. Further prospective and randomized studies are warranted to validate this finding.

  2. Air pollution, deprivation and health: understanding relationships to add value to local air quality management policy and practice in Wales, UK.

    Science.gov (United States)

    Brunt, H; Barnes, J; Jones, S J; Longhurst, J W S; Scally, G; Hayes, E

    2017-09-01

    Air pollution exposure reduces life expectancy. Air pollution, deprivation and poor-health status combinations can create increased and disproportionate disease burdens. Problems and solutions are rarely considered in a broad public health context, but doing so can add value to air quality management efforts by reducing air pollution risks, impacts and inequalities. An ecological study assessed small-area associations between air pollution (nitrogen dioxide and particulate matter), deprivation status and health outcomes in Wales, UK. Air pollution concentrations were highest in 'most' deprived areas. When considered separately, deprivation-health associations were stronger than air pollution-health associations. Considered simultaneously, air pollution added to deprivation-health associations; interactions between air pollution and deprivation modified and strengthened associations with all-cause and respiratory disease mortality, especially in 'most' deprived areas where most-vulnerable people lived and where health needs were greatest. There is a need to reduce air pollution-related risks for all. However, it is also the case that greater health gains can result from considering local air pollution problems and solutions in the context of wider health-determinants and acting on a better understanding of relationships. Informed and co-ordinated air pollution mitigation and public health action in high deprivation and pollution areas can reduce risks and inequalities. To achieve this, greater public health integration and collaboration in local air quality management policy and practice is needed. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Short-Term Prognosis of Mechanically Ventilated Patients With Guillain–Barré Syndrome Is Worsened by Corticosteroids as an Add-On Therapy

    Science.gov (United States)

    Wu, Xiujuan; Zhang, Bing; Li, Chunrong; Shen, Donghui; Liu, Kangding; Zhu, Jie; Zhang, Hong-Liang

    2015-01-01

    Abstract Intravenous immunoglobulin (IVIg) has been proven most effective in treating Guillain–Barré syndrome (GBS). Corticosteroids as an add-on therapy have been prescribed in severe GBS cases. However, the efficacy of intravenous corticosteroids combined with IVIg in dealing with severe GBS remains unclear. We explored the therapeutic effects of different therapeutic regimens on the short-term prognosis of GBS patients, especially the severe cases. We retrospectively analyzed the clinical data of 527 adult patients with GBS who were prescribed to different treatments from 2003 to 2014. The therapeutic effect of a treatment was evaluated by the improvement of Hughes Functional Grading Scale (HFGS) and Medical Research Council (MRC) sum score. With comparable incidence of infectious complications (P > 0.05), more mechanically ventilated patients were found improvement after IVIg treatment than combination IVIg with intravenous corticosteroids (MRC: 97% vs. 72.4%, P bedridden patients without mechanical ventilation, incidence of infectious complications (P > 0.05) and ratio of patients who were improved after IVIg were insignificantly different from the combination therapy (MRC: 89.6% vs. 86.5%; HFGS: 69.6% vs. 61.5%; both P > 0.05), even if the intravenous corticosteroids were initiated within 7 days after onset (P > 0.05). In addition, supportive treatment was sufficient for patients who were able to walk with help (HFGS = 3) and mildly affected (HFGS  3), while corticosteroids are detrimental for short-term prognosis in mechanically ventilated patients when used in combination with IVIg. Further prospective and randomized studies are warranted to validate this finding. PMID:26512609

  4. Prostate cancer volume adds significantly to prostate-specific antigen in the prediction of early biochemical failure after external beam radiation therapy

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Propert, Kathleen J.

    1996-01-01

    Purpose: A new clinical pretreatment quantity that closely approximates the true prostate cancer volume is defined. Methods and Materials: The cancer-specific prostate-specific antigen (PSA), PSA density, prostate cancer volume (V Ca ), and the volume fraction of the gland involved with carcinoma (V Ca fx) were calculated for 227 prostate cancer patients managed definitively with external beam radiation therapy. 1. PSA density PSA/ultrasound prostate gland volume 2. Cancer-specific PSA = PSA - [PSA from benign epithelial tissue] 3. V Ca = Cancer-specific PSA/[PSA in serum per cm 3 of cancer] 4. V Ca fx = V Ca /ultrasound prostate gland volume A Cox multiple regression analysis was used to test whether any of these-clinical pretreatment parameters added significantly to PSA in predicting early postradiation PSA failure. Results: The prostate cancer volume (p = 0.039) and the volume fraction of the gland involved by carcinoma (p = 0.035) significantly added to the PSA in predicting postradiation PSA failure. Conversely, the PSA density and the cancer-specific PSA did not add significantly (p > 0.05) to PSA in predicting postradiation PSA failure. The 20-month actuarial PSA failure-free rates for patients with calculated tumor volumes of ≤0.5 cm 3 , 0.5-4.0 cm 3 , and >4.0 cm 3 were 92, 80, and 47%, respectively (p = 0.00004). Conclusion: The volume of prostate cancer (V Ca ) and the resulting volume fraction of cancer both added significantly to PSA in their ability to predict for early postradiation PSA failure. These new parameters may be used to select patients in prospective randomized trials that examine the efficacy of combining radiation and androgen ablative therapy in patients with clinically localized disease, who are at high risk for early postradiation PSA failure

  5. A certificação agregando valor à cachaça do Brasil Certification adds value to Brazilian "cachaça"

    Directory of Open Access Journals (Sweden)

    Alexandre Nixon Soratto

    2007-12-01

    Full Text Available A certificação é o modo pelo qual uma terceira parte, independente, provê garantia escrita de que um determinado produto está em conformidade com requisitos especificados. Este artigo apresenta orientações para a certificação da cachaça no âmbito do Sistema Brasileiro de Avaliação da Conformidade. Os requisitos específicos à certificação da cachaça são abordados em cada etapa do processo de produção, sob a perspectiva do produtor. Como resultado, é proposto um modelo simplificado de sistema de gestão, com base em procedimentos que auxiliam o setor produtivo no atendimento contínuo aos critérios da certificação. O reconhecimento conquistado pela Marca Nacional de Certificação provê agregação de valor às marcas certificadas, aumenta sua competitividade e a qualidade percebida pelos clientes. Este diferencial positivo facilita as decisões de compra dos consumidores e a entrada em mercados mais exigentes.Certification is a written guarantee by an independent third party that a given product meets specific requirements. This article presents guidelines to obtain certification for "cachaça" (Brazil's traditional white rum or firewater by the Brazilian Conformity Evaluation System. The specific requirements for certifying cachaça are considered in each step of the production process, from the standpoint of the producer. A simplified model of a management system is proposed based on procedures to help producers meet the certification criteria on a continuous basis. The recognition conferred by the National Brand Certification agency adds value to certified brands, increasing their competitiveness and perceived quality. This positive differential facilitates the consumer's purchasing decision and the products' penetration into more demanding markets.

  6. How Can Medical Students Add Value? Identifying Roles, Barriers, and Strategies to Advance the Value of Undergraduate Medical Education to Patient Care and the Health System.

    Science.gov (United States)

    Gonzalo, Jed D; Dekhtyar, Michael; Hawkins, Richard E; Wolpaw, Daniel R

    2017-09-01

    As health systems evolve, the education community is seeking to reimagine student roles that combine learning with meaningful contributions to patient care. The authors sought to identify potential stakeholders regarding the value of student work, and roles and tasks students could perform to add value to the health system, including key barriers and associated strategies to promote value-added roles in undergraduate medical education. In 2016, 32 U.S. medical schools in the American Medical Association's (AMA's) Accelerating Change in Education Consortium met for a two-day national meeting to explore value-added medical education; 121 educators, systems leaders, clinical mentors, AMA staff leadership and advisory board members, and medical students were included. A thematic qualitative analysis of workshop discussions and written responses was performed, which extracted key themes. In current clinical roles, students can enhance value by performing detailed patient histories to identify social determinants of health and care barriers, providing evidence-based medicine contributions at the point-of-care, and undertaking health system research projects. Novel value-added roles include students serving as patient navigators/health coaches, care transition facilitators, population health managers, and quality improvement team extenders. Six priority areas for advancing value-added roles are student engagement, skills, and assessments; balance of service versus learning; resources, logistics, and supervision; productivity/billing pressures; current health systems design and culture; and faculty factors. These findings provide a starting point for collaborative work to positively impact clinical care and medical education through the enhanced integration of value-added medical student roles into care delivery systems.

  7. The Sloan Digital Sky Survey Stripe 82 Imaging Data: Depth-Optimized Co-adds Over 300 deg$^2$ in Five Filters

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Linhua; Fan, Xiaohui; Bian, Fuyan; McGreer, Ian D.; Strauss, Michael A.; Annis, James; Buck, Zoë; Green, Richard; Hodge, Jacqueline A.; Myers, Adam D.; Rafiee, Alireza; Richards, Gordon

    2014-06-25

    We present and release co-added images of the Sloan Digital Sky Survey (SDSS) Stripe 82. Stripe 82 covers an area of ~300 deg(2) on the celestial equator, and has been repeatedly scanned 70-90 times in the ugriz bands by the SDSS imaging survey. By making use of all available data in the SDSS archive, our co-added images are optimized for depth. Input single-epoch frames were properly processed and weighted based on seeing, sky transparency, and background noise before co-addition. The resultant products are co-added science images and their associated weight images that record relative weights at individual pixels. The depths of the co-adds, measured as the 5σ detection limits of the aperture (3.''2 diameter) magnitudes for point sources, are roughly 23.9, 25.1, 24.6, 24.1, and 22.8 AB magnitudes in the five bands, respectively. They are 1.9-2.2 mag deeper than the best SDSS single-epoch data. The co-added images have good image quality, with an average point-spread function FWHM of ~1'' in the r, i, and z bands. We also release object catalogs that were made with SExtractor. These co-added products have many potential uses for studies of galaxies, quasars, and Galactic structure. We further present and release near-IR J-band images that cover ~90 deg(2) of Stripe 82. These images were obtained using the NEWFIRM camera on the NOAO 4 m Mayall telescope, and have a depth of about 20.0-20.5 Vega magnitudes (also 5σ detection limits for point sources).

  8. Depression, Stressful Life Events, and the Impact of Variation in the Serotonin Transporter: Findings from the National Longitudinal Study of Adolescent to Adult Health (Add Health)

    Science.gov (United States)

    Haberstick, Brett C.; Boardman, Jason D.; Wagner, Brandon; Smolen, Andrew; Hewitt, John K.; Killeya-Jones, Ley A.; Tabor, Joyce; Halpern, Carolyn T.; Brummett, Beverly H.; Williams, Redford B.; Siegler, Ilene C.; Hopfer, Christian J.; Mullan Harris, Kathleen

    2016-01-01

    Background The low transcriptionally efficient short-allele of the 5HTTLPR serotonin transporter polymorphism has been implicated to moderate the relationship between the experience of stressful life events (SLEs) and depression. Despite numerous attempts at replicating this observation, results remain inconclusive. Methods We examined this relationship in young-adult Non-Hispanic white males and females between the ages of 22 and 26 (n = 4724) participating in the National Longitudinal Study of Adolescent to Adult Health (Add Health) with follow-up information every six years since 1995. Results Linear and logistic regression models, corrected for multiple testing, indicated that carriers of one or more of the S-alleles were more sensitive to stress than those with two L-alleles and at a higher risk for depression. This relationship behaved in a dose-response manner such that the risk for depression was greatest among those who reported experiencing higher numbers of SLEs. In post-hoc analyses we were not able to replicate an interaction effect for suicide ideation but did find suggestive evidence that the effects of SLEs and 5HTTLPR on suicide ideation differed for males and females. There were no effects of childhood maltreatment. Discussion Our results provide partial support for the original hypothesis that 5-HTTLPR genotype interacts with the experience of stressful life events in the etiology of depression during young adulthood. However, even with this large sample, and a carefully constructed a priori analysis plan, the results were still not definitive. For the purposes of replication, characterizing the 5HTTLPR in other large data sets with extensive environmental and depression measures is needed. PMID:26938215

  9. Circadian rest-activity rhythms during benzodiazepine tapering covered by melatonin versus placebo add-on: data derived from a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Lone Baandrup

    2016-10-01

    Full Text Available Abstract Background Patients with severe mental illness often suffer from disruptions in circadian rest-activity cycles, which might partly be attributed to ongoing psychopharmacological medication. Benzodiazepines are frequently prescribed for prolonged periods despite recommendations of only short-term usage. Melatonin, a naturally occurring nocturnal hormone, has the potential to stabilize disrupted circadian rhythmicity. Our aim was to investigate how prolonged-release melatonin affects rest-activity patterns in medicated patients with severe mental illness and if benzodiazepine dose reduction is associated with changes in circadian rhythm parameters. Method Data were derived from a randomized, double-blinded clinical trial with 24 weeks follow-up. Participants were randomized to add-on treatment with prolonged-release melatonin (2 mg or matching placebo, and usual benzodiazepine dosage was gradually tapered. Here we report the results of 72 h of actigraphic assessment of activity-rest cycles performed pre and post tapering. Changes in rest-activity rhythm parameters between the melatonin and placebo group were analyzed using the univariate general linear model. Change in activity counts per 6 h, from baseline to follow-up, in the whole sample was analyzed using paired samples t-test. Results A subsample of 48 patients participated in the actigraphic assessment: 20 in the melatonin group and 28 in the placebo group. Rest-activity cycles varied from regular to highly disrupted. Melatonin significantly increased the interdaily stability and at a trend level decreased the intradaily variability compared with placebo. Benzodiazepine dose reduction was not associated with these circadian rhythm parameters. Activity counts were generally higher after benzodiazepine dose reduction compared with pre tapering, but differences did not reach statistical significance. Conclusion Our data suggest melatonin as an aid during benzodiazepine withdrawal for

  10. ADD-H-Comprehensive Teacher's Rating Scale (ACTeRS): a measure for attention deficit hyperactivity disorder among children with intellectual disability in India.

    Science.gov (United States)

    Tsheringla, Sherab; Simon, Aby; Russell, Paul Swamidhas Sudhakar; Shankar, SatyaRaj; Russell, Sushila; Mammen, Priya; Nair, M K C

    2014-12-01

    There is no validated measure for assessing Attention Deficit Hyperactivity Disorder (ADHD) in India, and therefore, the authors validated the ADD-H Comprehensive Teacher's Rating Scale (ACTeRS). Teachers/parents/clinicians of 110 children with ADHD completed the ACTeRS. The diagnosis of ADHD was confirmed by an independent multi-disciplinary team using ICD-10 diagnosis for diagnostic accuracy and criterion validity. The convergent and divergent validity were assessed by another rater. The data was analyzed for diagnostic accuracy, reliability and validity appropriately. An ACTeRS score of ≥61 [Sensitivity (Sn) =85.51%; Specificity (Sp) = 90.24%; Area under the curve (AUC) = 0.94] is appropriate for the diagnosis of ADHD. The test-re-test reliability [Intra-class correlation coefficient (ICC) = 0.87], internal consistency (Cronbach's α = 0.80; range of 0.89-0.93), section-total correlation, face and content validity for the ACTeRS were good. Convergent validity of attention deficit, hyperactivity and oppositional subscales of ACTeRS with the corresponding subscales of Swanson, Nolan & Pelham Rating Scale-Revised (SNAP-IV) was moderate (r = 0.60, P = 0.005; r = 0.49, P = 0.02; r = 0.58, P = 0.008 respectively), and negative correlation with the Childhood Autism Rating Scale (r = -0.36; P =0.1) for divergent validity was found. The criterion validity analysis showed a high concordance rate of 82.52% between ACTeRS and International Classification of Diseases, Edition10 (ICD-10) diagnosis of ADHD. A 4-factor structure was replicated. The ACTeRS has adequate psychometric properties for use in the Indian population for identifying ADHD.

  11. Depression, Stressful Life Events, and the Impact of Variation in the Serotonin Transporter: Findings from the National Longitudinal Study of Adolescent to Adult Health (Add Health.

    Directory of Open Access Journals (Sweden)

    Brett C Haberstick

    Full Text Available The low transcriptionally efficient short-allele of the 5HTTLPR serotonin transporter polymorphism has been implicated to moderate the relationship between the experience of stressful life events (SLEs and depression. Despite numerous attempts at replicating this observation, results remain inconclusive.We examined this relationship in young-adult Non-Hispanic white males and females between the ages of 22 and 26 (n = 4724 participating in the National Longitudinal Study of Adolescent to Adult Health (Add Health with follow-up information every six years since 1995.Linear and logistic regression models, corrected for multiple testing, indicated that carriers of one or more of the S-alleles were more sensitive to stress than those with two L-alleles and at a higher risk for depression. This relationship behaved in a dose-response manner such that the risk for depression was greatest among those who reported experiencing higher numbers of SLEs. In post-hoc analyses we were not able to replicate an interaction effect for suicide ideation but did find suggestive evidence that the effects of SLEs and 5HTTLPR on suicide ideation differed for males and females. There were no effects of childhood maltreatment.Our results provide partial support for the original hypothesis that 5-HTTLPR genotype interacts with the experience of stressful life events in the etiology of depression during young adulthood. However, even with this large sample, and a carefully constructed a priori analysis plan, the results were still not definitive. For the purposes of replication, characterizing the 5HTTLPR in other large data sets with extensive environmental and depression measures is needed.

  12. A Study to Determine if Addition of Palatal Petechiae to Centor Criteria Adds More Significance to Clinical Diagnosis of Acute Strep Pharyngitis in Children

    Directory of Open Access Journals (Sweden)

    Kumara V. Nibhanipudi MD, FAAP, FAAEM

    2016-07-01

    Full Text Available Objective. A study to determine if addition of palatal petechiae to Centor criteria adds more value for clinical diagnosis of acute strep pharyngitis in children. Hypothesis. In children, Centor Criteria does not cover all the symptoms and signs of acute strep pharyngitis. We hypothesize that addition of palatal petechiae to Centor Criteria will increase the possibility of clinical diagnosis of group A streptococcal pharyngitis in children. Methods. One hundred patients with a complaint of sore throat were enrolled in the study. All the patients were examined clinically using the Centor Criteria. They were also examined for other signs and symptoms like petechial lesions over the palate, abdominal pain, and skin rash. All the patients were given rapid strep tests, and throat cultures were sent. No antibiotics were given until culture results were obtained. Results. The sample size was 100 patients. All 100 had fever, sore throat, and erythema of tonsils. Twenty of the 100 patients had tonsillar exudates, 85/100 had tender anterior cervical lymph nodes, and 86/100 had no cough. In total, 9 out of the 100 patients had positive throat cultures. We observed that petechiae over the palate, a very significant sign, is not included in the Centor Criteria. Palatal petechiae were present in 8 out of the 100 patients. Six out of these 8 with palatal petechiae had positive throat culture for strep (75%. Only 7 out of 20 with exudates had positive strep culture. Sixteen out of the 100 patients had rapid strep test positive. Those 84/100 who had negative rapid strep also had negative throat culture. Statistics. We used Fisher’s exact test, comparing throat culture positive and negative versus presence of exudates and palatal hemorrhages with positive and negative throat cultures and the resultant P value <.0001. Conclusion. Our study concludes that addition of petechiae over the palate to Centor Criteria will increase the possibility of diagnosing acute

  13. A novel reflux inhibitor lesogaberan (AZD3355) as add-on treatment in patients with GORD with persistent reflux symptoms despite proton pump inhibitor therapy: a randomised placebo-controlled trial

    NARCIS (Netherlands)

    Boeckxstaens, Guy E.; Beaumont, Hanneke; Hatlebakk, Jan G.; Silberg, Debra G.; Björck, Karin; Karlsson, Maria; Denison, Hans

    2011-01-01

    o evaluate the efficacy and tolerability of add-on treatment with lesogaberan (AZD3355), a novel reflux inhibitor, in patients with persistent gastro-oesophageal reflux disease (GORD) symptoms despite proton pump inhibitor (PPI) therapy. double-blind, placebo-controlled, randomised, parallel-group,

  14. Conducting Automated Test Assembly Using the Premium Solver Platform Version 7.0 with Microsoft Excel and the Large-Scale LP/QP Solver Engine Add-In

    Science.gov (United States)

    Cor, Ken; Alves, Cecilia; Gierl, Mark J.

    2008-01-01

    This review describes and evaluates a software add-in created by Frontline Systems, Inc., that can be used with Microsoft Excel 2007 to solve large, complex test assembly problems. The combination of Microsoft Excel 2007 with the Frontline Systems Premium Solver Platform is significant because Microsoft Excel is the most commonly used spreadsheet…

  15. Study on Effectiveness of Low Dose Theophylline as Add-on to Inhaled Corticosteroid for Patients with Sulfur Mustard Induced Bronchiolitis

    Directory of Open Access Journals (Sweden)

    Yunes Panahi

    2013-12-01

    , Saburi A, Shohrati M, Ghanei M. Study on Effectiveness of Low Dose Theophylline as Add-on to Inhaled Corticosteroid for Patients with Sulfur Mustard Induced Bronchiolitis. Asia Pac J Med Toxicol 2013;2:126-130.

  16. Targeting Accuracy, Procedure Times and User Experience of 240 Experimental MRI Biopsies Guided by a Clinical Add-On Navigation System.

    Directory of Open Access Journals (Sweden)

    Harald Busse

    Full Text Available MRI is of great clinical utility for the guidance of special diagnostic and therapeutic interventions. The majority of such procedures are performed iteratively ("in-and-out" in standard, closed-bore MRI systems with control imaging inside the bore and needle adjustments outside the bore. The fundamental limitations of such an approach have led to the development of various assistance techniques, from simple guidance tools to advanced navigation systems. The purpose of this work was to thoroughly assess the targeting accuracy, workflow and usability of a clinical add-on navigation solution on 240 simulated biopsies by different medical operators.Navigation relied on a virtual 3D MRI scene with real-time overlay of the optically tracked biopsy needle. Smart reference markers on a freely adjustable arm ensured proper registration. Twenty-four operators - attending (AR and resident radiologists (RR as well as medical students (MS - performed well-controlled biopsies of 10 embedded model targets (mean diameter: 8.5 mm, insertion depths: 17-76 mm. Targeting accuracy, procedure times and 13 Likert scores on system performance were determined (strong agreement: 5.0.Differences in diagnostic success rates (AR: 93%, RR: 88%, MS: 81% were not significant. In contrast, between-group differences in biopsy times (AR: 4:15, RR: 4:40, MS: 5:06 min:sec differed significantly (p<0.01. Mean overall rating was 4.2. The average operator would use the system again (4.8 and stated that the outcome justifies the extra effort (4.4. Lowest agreement was reported for the robustness against external perturbations (2.8.The described combination of optical tracking technology with an automatic MRI registration appears to be sufficiently accurate for instrument guidance in a standard (closed-bore MRI environment. High targeting accuracy and usability was demonstrated on a relatively large number of procedures and operators. Between groups with different expertise there were

  17. Targeting Accuracy, Procedure Times and User Experience of 240 Experimental MRI Biopsies Guided by a Clinical Add-On Navigation System.

    Science.gov (United States)

    Busse, Harald; Riedel, Tim; Garnov, Nikita; Thörmer, Gregor; Kahn, Thomas; Moche, Michael

    2015-01-01

    MRI is of great clinical utility for the guidance of special diagnostic and therapeutic interventions. The majority of such procedures are performed iteratively ("in-and-out") in standard, closed-bore MRI systems with control imaging inside the bore and needle adjustments outside the bore. The fundamental limitations of such an approach have led to the development of various assistance techniques, from simple guidance tools to advanced navigation systems. The purpose of this work was to thoroughly assess the targeting accuracy, workflow and usability of a clinical add-on navigation solution on 240 simulated biopsies by different medical operators. Navigation relied on a virtual 3D MRI scene with real-time overlay of the optically tracked biopsy needle. Smart reference markers on a freely adjustable arm ensured proper registration. Twenty-four operators - attending (AR) and resident radiologists (RR) as well as medical students (MS) - performed well-controlled biopsies of 10 embedded model targets (mean diameter: 8.5 mm, insertion depths: 17-76 mm). Targeting accuracy, procedure times and 13 Likert scores on system performance were determined (strong agreement: 5.0). Differences in diagnostic success rates (AR: 93%, RR: 88%, MS: 81%) were not significant. In contrast, between-group differences in biopsy times (AR: 4:15, RR: 4:40, MS: 5:06 min:sec) differed significantly (p<0.01). Mean overall rating was 4.2. The average operator would use the system again (4.8) and stated that the outcome justifies the extra effort (4.4). Lowest agreement was reported for the robustness against external perturbations (2.8). The described combination of optical tracking technology with an automatic MRI registration appears to be sufficiently accurate for instrument guidance in a standard (closed-bore) MRI environment. High targeting accuracy and usability was demonstrated on a relatively large number of procedures and operators. Between groups with different expertise there were

  18. Correlation between total vitamin D levels and psychotic psychopathology in patients with schizophrenia: therapeutic implications for add-on vitamin D augmentation.

    Science.gov (United States)

    Yüksel, Rabia Nazik; Altunsoy, Neslihan; Tikir, Baise; Cingi Külük, Merve; Unal, Kubranur; Goka, Sema; Aydemir, Cigdem; Goka, Erol

    2014-12-01

    . We recommend that, serum vitamin D levels should be measured in patients with schizophrenia especially in long term care. Appropriate further treatment with add-on vitamin D supplements and diets that are rich in vitamin D should be considered.

  19. Erythropoietin as an add-on treatment for cognitive side effects of electroconvulsive therapy: a study protocol for a randomized controlled trial.

    Science.gov (United States)

    Schmidt, Lejla Sjanic; Petersen, Jeff Zarp; Vinberg, Maj; Hageman, Ida; Olsen, Niels Vidiendal; Kessing, Lars Vedel; Jørgensen, Martin Balslev; Miskowiak, Kamilla Woznica

    2018-04-19

    Electroconvulsive therapy (ECT) is the most effective treatment for severe depression, but its use is impeded by its cognitive side effects. Novel treatments that can counteract these side effects may therefore improve current treatment strategies for depression. The present randomized trial investigates (1) whether short-term add-on treatment with erythropoietin (EPO) can reduce the cognitive side -effects of ECT and (2) whether such effects are long-lasting. Further, structural and functional magnetic resonance imaging (MRI) will be used to explore the neural underpinnings of such beneficial effects of EPO. Finally, the trial examines whether potential protective effects of EPO on cognition are accompanied by changes in markers of oxidative stress, inflammation, and neuroplasticity. The trial has a double-blind, randomized, placebo-controlled, parallel group design. Patients with unipolar or bipolar disorder with current moderate to severe depression referred to ECT (N = 52) are randomized to receive four high-dose infusions of EPO (40,000 IU/ml) or placebo (saline). The first EPO/saline infusion is administered within 24 h before the first ECT. The following three infusions are administered at weekly intervals immediately after ECT sessions 1, 4, and 7. Cognition assessments are conducted at baseline, after the final EPO/saline infusion (3 days after eight ECT sessions), and at a 3 months follow-up after ECT treatment completion. The neuronal substrates for potential cognitive benefits of EPO are investigated with structural and functional MRI after the final EPO/saline infusion. The primary outcome is change from baseline to after EPO treatment (3 days after eight ECT sessions) in a cognitive composite score spanning attention, psychomotor speed, and executive functions. With a sample size of N = 52 (n = 26 per group), we have ≥ 80% power to detect a clinically relevant between-group difference in the primary outcome measure at an alpha

  20. Impact of communities, health, and emotional-related factors on smoking use: comparison of joint modeling of mean and dispersion and Bayes’ hierarchical models on add health survey

    Directory of Open Access Journals (Sweden)

    Jie Pu

    2017-02-01

    Full Text Available Abstract Background The analysis of correlated binary data is commonly addressed through the use of conditional models with random effects included in the systematic component as opposed to generalized estimating equations (GEE models that addressed the random component. Since the joint distribution of the observations is usually unknown, the conditional distribution is a natural approach. Our objective was to compare the fit of different binary models for correlated data in Tabaco use. We advocate that the joint modeling of the mean and dispersion may be at times just as adequate. We assessed the ability of these models to account for the intraclass correlation. In so doing, we concentrated on fitting logistic regression models to address smoking behaviors. Methods Frequentist and Bayes’ hierarchical models were used to predict conditional probabilities, and the joint modeling (GLM and GAM models were used to predict marginal probabilities. These models were fitted to National Longitudinal Study of Adolescent to Adult Health (Add Health data for Tabaco use. Results We found that people were less likely to smoke if they had higher income, high school or higher education and religious. Individuals were more likely to smoke if they had abused drug or alcohol, spent more time on TV and video games, and been arrested. Moreover, individuals who drank alcohol early in life were more likely to be a regular smoker. Children who experienced mistreatment from their parents were more likely to use Tabaco regularly. Conclusions The joint modeling of the mean and dispersion models offered a flexible and meaningful method of addressing the intraclass correlation. They do not require one to identify random effects nor distinguish from one level of the hierarchy to the other. Moreover, once one can identify the significant random effects, one can obtain similar results to the random coefficient models. We found that the set of marginal models accounting for

  1. Comparison between the therapeutic effect of metformin, glimepiride and their combination as an add-on treatment to insulin glargine in uncontrolled patients with type 2 diabetes.

    Directory of Open Access Journals (Sweden)

    Cheol-Young Park

    Full Text Available To compare the commonly prescribed oral anti-diabetic drug (OAD combinations to use as an add-on therapy with insulin glargine in patients with uncontrolled type 2 diabetes despite submaximal doses of OADs.People with inadequately controlled type 2 diabetes (n = 99 were randomly assigned on a 1∶1∶1 basis to receive insulin glargin, with fixed doses of glimepiride, metformin, and glimepiride plus metformin. Outcomes assessed included HbA1c, the changes in fasting glucose levels, body weight, serum lipids values, insulin dose and symptomatic hypoglycemia.After 24 weeks, HbA1C levels improved from (mean ± SD 8.5±0.9% to 7.7±0.8% (69.0±10.0 mmol/mol to 60.8±8.6 mmol/mol with insulin glargine plus metformin, from 8.4±1.0% to 7.7±1.3% (68.8±10.6 mmol/mol to 61.1±14.4 mmol/mol with insulin glargine plus glimepiride and from 8.7±0.9% to 7.3±0.6% (71.7±9.8 mmol/mol to 56.2±6.7 mmol/mol with insulin glargine plus glimepirde plus metformin. The decrease in HbA1c was more pronounced with insulin glargine plus glimepiride plus metformin than with insulin glargine plus metformin (0.49% [CI, 0.16% to 0.82%]; P = 0.005 (5.10 mmol/mol [CI, 1.64 to 8.61]; P = 0.005 and insulin glargine plus glimepiride (0.59% [CI, 0.13% to 1.05%]; P = 0.012 (5.87 mmol/mol [CI, 1.10 to 10.64]; P = 0.012 (overall P = 0.02. Weight gain and the risk of hypoglycemia of any type did not significantly differ among the treatment groups.The combination therapy of metformin and glimepiride plus glargine insulin resulted in a significant improvement in overall glycemic control as compared with the other combinations.ClinicalTrials.gov, NCT00708578. The approval number of Kangbuk Samsung hospital's institutional review board (IRB: C0825.

  2. How much sugar do consumers add to plain yogurts? Insights from a study examining French consumer behavior and self-reported habits.

    Science.gov (United States)

    Saint-Eve, Anne; Leclercq, Hélène; Berthelo, Sébastien; Saulnier, Benjamin; Oettgen, Walther; Delarue, Julien

    2016-04-01

    In France, 50% of consumers sweeten plain yogurts prior to consumption. This study measured how much sugar consumers added under contextualized testing conditions. Participants (199 French adults who regularly consume plain yogurt adding sugar) were given a plain yogurt (125 g) at the end of a full meal and were allowed to sweeten it with their usual sweetener (caster sugar, honey, or jam). The quantities added were measured indirectly by weighing the sweetener containers before and after use; they were then converted into equivalent quantities of sucrose, or "added sugar." Participants were asked to describe their relative hunger, thirst, and liking for plain yogurt and to estimate the quantity of sweetener they had added. On average, participants added 13.6 g of sugar to their yogurts, which is higher than the 10.2 g of sugar contained in pre-sweetened commercial yogurts (125 g). More sugar was added when subjects used jam (24.4 g/yogurt, n = 36) as opposed to caster sugar (11.0 g/yogurt, n = 134) or honey (12.1 g/yogurt, n = 29). Age, socio-professional category, and BMI had a significant influence on added-sugar quantity. Based on behavior and attitude, participants could be separated into three evenly sized groups: "low sugar users" (n = 67, median = 6.1 g/yogurt), who tended to control their food intake, "medium sugar users" (n = 66, median = 11.4 g/yogurt), and "heavy sugar users" (n = 66, median = 19.9 g/yogurt) who sought immediate satisfaction. To our knowledge, this study is the first to provide robust data on the amount of sugar consumers add to plain yogurts in contextualized conditions (self preparation during a real meal). Our findings show that consumers underestimated by half the quantity of sweetener they added. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Treatment of traumatised refugees with basic body awareness therapy versus mixed physical activity as add-on treatment: Study protocol of a randomised controlled trial.

    Science.gov (United States)

    Nordbrandt, Maja Sticker; Carlsson, Jessica; Lindberg, Laura Glahder; Sandahl, Hinuga; Mortensen, Erik Lykke

    2015-10-22

    Treatment of traumatised refugees is one of the fields within psychiatry, which has received little scientific attention. Evidence based treatment and knowledge on the efficiency of the treatment for this complex patient group is therefore scarce. This leads to uncertainty as to which treatment should be offered and potentially lowers the quality of life for the patients. Chronic pain is very common among traumatised refugees and it is believed to maintain the mental symptoms of trauma. Hence, treating chronic pain is believed to be of high clinical value for this patient group. In clinical studies, physical activity has shown a positive effect on psychiatric illnesses such as depression and anxiety and for patients with chronic pain. However, scientific knowledge about physical activity as part of the treatment for traumatised refugees is very limited and no guidelines exist on this topic. This study will include approximately 310 patients, randomised into three groups. All three groups receive psychiatric treatment as usual for the duration of 6-7 months, consisting of consultations with a medical doctor including pharmacological treatment and manual-based Cognitive Behavioural Therapy. The first group only receives treatment as usual while the second and the third groups receive either Basic-Body Awareness Therapy or mixed physical activity as add-on treatments. Each physical activity is provided for an individual 1-hour consultation per week, for the duration of 20 weeks. The study is being conducted at the Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup in the Capital Region of Denmark. The primary endpoint of the study is symptoms of Post Traumatic Stress Disorder; the secondary endpoints are depression and anxiety as well as quality of life, functional capacity, coping with pain, body awareness and physical fitness. This study will examine the effect of physical activity for traumatised refugees. This has not yet been done in a

  4. Cost-Effectiveness of Canagliflozin versus Sitagliptin as Add-on to Metformin in Patients with Type 2 Diabetes Mellitus in Mexico.

    Science.gov (United States)

    Neslusan, Cheryl; Teschemaker, Anna; Johansen, Pierre; Willis, Michael; Valencia-Mendoza, Atanacio; Puig, Andrea

    2015-12-01

    To assess the cost-effectiveness of canagliflozin versus sitagliptin for the treatment of type 2 diabetes mellitus (T2DM) as an add-on to metformin in Mexico. A validated model (Economic and Health Outcomes [ECHO]-T2DM) was used to estimate the cost-effectiveness of canagliflozin 300 or 100 mg versus sitagliptin 100 mg in patients with T2DM inadequately controlled on metformin monotherapy. Data from a head-to-head, phase III clinical trial, including patients' baseline demographic characteristics, biomarker values, and treatment effects, were used to simulate outcomes and resource use over 20 years from the perspective of the Mexican health care system. Costs of complications and adverse events were tailored to the Mexican setting and discounted at 5%. Cost-effectiveness was assessed using willingness-to-pay thresholds equivalent to 1 times the gross domestic product per capita (locally perceived to be "very cost-effective") and 3 times the gross domestic product per capita (locally perceived to be "cost-effective") on the basis of recommendations of the Mexican government and the World Health Organization. Owing primarily to better glycated hemoglobin (HbA 1c ), body weight, and systolic blood pressure values, canagliflozin 300 and 100 mg were associated with an incremental benefit of 0.16 and 0.06 quality-adjusted life-years (QALYs) versus sitagliptin 100 mg, respectively, over 20 years. The mean differences in cost for canagliflozin 300 and 100 mg versus sitagliptin 100 mg were Mexican pesos (MXP) 1797 (US $134) and MXP 7262 (US $540), respectively, resulting in a cost per QALY gained of MXP 11,210 (US $834) and MXP 128,883 (US $9590), respectively. Both of these cost-effectiveness ratios are below the very cost-effective willingness-to-pay threshold in Mexico. The general finding that canagliflozin is cost-effective versus sitagliptin in Mexico was supported by sensitivity analyses. In Mexico, both doses of canagliflozin are likely to be cost-effective versus

  5. F44. AN ADD-ON TRIAL WITH N-ACETYL-CYSTEINE (NAC) IN EARLY PSYCHOSIS PATIENTS: TOWARDS BIOMARKER GUIDED TREATMENT

    Science.gov (United States)

    Conus, Philippe; Fournier, Margot; Xin, Lijing; Cleusix, Martine; Baumann, Philipp S; Ferrari, Carina; Cousins, Ann; Alameda, Luis; Gholam-Razaee, Mehdi; Golay, Philippe; Jenni, Raoul; Woo, Tsung-Ung Wilson; Keshavan, Matcheri; Eap, Chin B; Wojcik, Joanne; Cuenod, Michel; Buclin, Thierry; Gruetter, Rolf; Seidman, Larry; Do, Kim

    2018-01-01

    Abstract Background Oxidative stress, coupled with dysregulation of inflammation, NMDAR and dopamine, is involved in schizophrenia (SZ) pathophysiology. Earlier add-on clinical trials showed in chronic SZ patients that NAC, a precursor of glutathione (GSH), an important cerebral antioxidant, improved negative symptoms, mismatch negativity and local synchronization. We hypothesized that NAC at an earlier stage of illness would have a greater impact. Methods Early psychosis patients (EP, less than 5 years of illness, N=63; NAC=32, placebo=31) were supplemented with NAC (2.7g/day, 6 months) in a double-blind randomized placebo-controlled trial. Outcome measures: PANSS and neurocognition (MATRICS Consensus Cognitive Battery; n=36); quantification of medial prefronfal cortex glutathione (GSHmPFC) by 1H-magnetic-resonance-spectroscopy, of white matter diffusion properties estimated by generalized fractional anisotropy (gFA) computed from diffusion spectrum imaging (DSI), of blood cells GSH (GSHBC) and GSH peroxidase activity (GPxBC) at start and end of trial Results While PANSS negative and positive were not affected by NAC, NAC improved Processing Speed (NAC > Placebo; F(1, 30)=5.849, p=.022), favoring 2 of 3 processing speed tasks (Trail Making A, F(1, 30)=4.279, p=.048 & Verbal Fluency, F(1, 30)=5.749, p=.023). GSHmPFC (+23%, p=0.005) and GSHBC (+19%, p=0.05) were increased following NAC treatment. In patients with high-baseline GPxBC (>22.3U/gHb), subgroup explorations revealed an improvement of PANSS positive compared to placebo (p=0.02). The change of PANSS positive correlated negatively with that of GPxBC activity, showing that the improvement paralleled the restoration of redox status. NAC group showed 11% increase in fornix white matter integrity as measured by gFA, correlating with an increase in GSHmPFC over the 6-months period. Discussion This is the first clinical trial assessing the impact of NAC treatment in a sample of EP and the potential predictive role

  6. Do Personality Traits Mediate the Relationship Between Childhood Abuse and Migraine? An Exploration of the Relationships in Young Adults Using the Add Health Dataset.

    Science.gov (United States)

    Karmakar, Monita; Elhai, Jon D; Amialchuk, Aliaksandr A; Tietjen, Gretchen E

    2018-02-01

    Personality traits (especially neuroticism) and childhood maltreatment have been independently related to many negative health outcomes later in life, including migraine. Studies have also shown the association between childhood maltreatment and maladaptive personality traits. The mediating role of personality traits on the relationship between childhood maltreatment and depression, psychological distress, and alcohol dependence has been extensively studied. However, this type of mediation has not been studied in the case of the development of migraine. This study investigated (1) the main effects of childhood abuse on personality traits, and of personality traits on migraine, and (2) the mediating role of neuroticism, on the relationship between childhood abuse and migraine in young adults. We analyzed retrospective, cross-sectional data from 13,493 adults aged 24-32 years in Wave 4 of the National Longitudinal Survey of Adolescent Health ("Add Health") data set. Participants were queried regarding maltreatment (emotional, physical, and sexual) during childhood, current Big Five personality traits (using mini International Personality Item Pool), current depression (using Center for Epidemiologic Studies-Depression Scale), perceived stress (Using Cohen's Perceived Stress Scale), and diagnosis of migraine by a health care provider. Linear and logistic regressions were used to assess the main effects of childhood maltreatment on the five personality traits (openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism) and the main effect of the personality traits on self-reported provider diagnosis of migraine. A structural equation model (SEM) was used to examine the mediating role of neuroticism on the relationship between childhood maltreatment and migraine. Linear regression models showed that childhood abuse independently predicted increased neuroticism (β = 0.338, SE=±0.05, P personality traits on migraine revealed that only

  7. Cost-effectiveness analysis of exenatide twice daily (BID) vs insulin glargine once daily (QD) as add-on therapy in Chinese patients with Type 2 diabetes mellitus inadequately controlled by oral therapies.

    Science.gov (United States)

    Deng, Jing; Gu, Shuyan; Shao, Hui; Dong, Hengjin; Zou, Dajin; Shi, Lizheng

    2015-01-01

    To estimate cost-effectiveness of exenatide twice daily (BID) vs insulin glargine once daily (QD) as add-on therapy in Chinese type 2 diabetes patients not well controlled by oral anti-diabetic (OAD) agents. The Cardiff model was populated with data synthesized from three head-to-head randomized clinical trials of up to 30 weeks in China comparing exenatide BID vs insulin glargine as add-on therapies to oral therapies in the Chinese population. The Cardiff model generated outputs including macrovascular and microvascular complications, diabetes-specific mortality, costs, and quality-adjusted life years (QALYs). Cost and QALYs were estimated with a time horizon of 40 years at a discount rate of 3% from a societal perspective. Compared with insulin glargine plus OAD treatments, patients on exenatide BID plus OAD gained 1.88 QALYs, at an incremental cost saving of Chinese Renminbi (RMB) 114,593 (i.e., cost saving of RMB 61078/QALY). The cost-effectiveness results were robust to various sensitivity analyses including probabilistic sensitivity analysis. The variables with the most impact on incremental cost-effectiveness ratio included HbA1c level at baseline, health utilities decrement, and BMI at baseline. Compared with insulin glargine QD, exenatide BID as add-on therapy to OAD is a cost-effective treatment in Chinese patients inadequately controlled by OAD treatments.

  8. Rapid response to methylphenidate as an add-on therapy to mirtazapine in the treatment of major depressive disorder in terminally ill cancer patients: a four-week, randomized, double-blinded, placebo-controlled study.

    Science.gov (United States)

    Ng, Chong Guan; Boks, Marco P M; Roes, Kit C B; Zainal, Nor Zuraida; Sulaiman, Ahmad Hatim; Tan, Seng Beng; de Wit, Niek J

    2014-04-01

    This is a 4 week, randomized, double-blind, placebo-controlled study to examine the effects of methylphenidate as add-on therapy to mirtazapine compared to placebo for treatment of depression in terminally ill cancer patients. It involved 88 terminally ill cancer patients from University of Malaya Medical Centre, Kuala Lumpur, Malaysia. They were randomized and treated with either methylphenidate or placebo as add on to mirtazapine. The change in Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to day 3 was analyzed by linear regression. Changes of MADRS and Clinical Global Impression-Severity Scale (CGI-S) over 28 days were analyzed using mixed model repeated measures (MMRM). Secondary analysis of MADRS response rates, defined as 50% or more reduction from baseline score. A significantly larger reduction of Montgomery-Åsberg Depression Rating Scale (MADRS) score in the methylphenidate group was observed from day 3 (B=4.14; 95% CI=1.83-6.45). Response rate (defined as 50% or more reduction from baseline MADRS score) in the methylphenidate treated group was superior from day 14. Improvement in Clinical Global Impression-Severity Scale (CGI-S) was greater in the methylphenidate treated group from day 3 until day 28. The drop-out rates were 52.3% in the methylphenidate group and 59.1% in the placebo group (relative risk=0.86, 95%CI=0.54-1.37) due to cancer progression. Nervous system adverse events were more common in methylphenidate treated subjects (20.5% vs 9.1%, p=0.13). In conclusions, methylphenidate as add on therapy to mirtazapine demonstrated an earlier antidepressant response in terminally ill cancer patients, although at an increased risk of the nervous system side effects. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

  9. Add-on clinical effects of selective antagonist of 5HT6 receptors AVN-211 (CD-008-0173) in patients with schizophrenia stabilized on antipsychotic treatment: pilot study.

    Science.gov (United States)

    Morozova, Margarita A; Lepilkina, Taisiya A; Rupchev, Georgy E; Beniashvily, Allan G; Burminskiy, Denis S; Potanin, Sergey S; Bondarenko, Evgeny V; Kazey, Vasily I; Lavrovsky, Yan; Ivachtchenko, Alexandre V

    2014-08-01

    The serotoninergic system as a target for add-on treatment seems to be a promising approach in patients with schizophrenia. To clarify if selective 5HT-6 antagonist AVN-211 (CD-008-0173) adds clinical and cognitive effects to stable antipsychotic treatment. A randomized, double-blind, placebo-controlled, add-on, 4r-week trial in 47 schizophrenia patients (21 patients receiving study drug and 26 receiving placebo) who were stabilized on antipsychotic medication was performed. Seventeen patients from the study drug group and 25 patients from the placebo group completed the trial. Treatment effects were measured using clinical rating scales and attention tests. With no differences at baseline, there was a significant difference between the groups in Positive and Negative Syndrome Scale (PANSS) positive subscale score (p = 0.058) in favor of patients in the treatment group at the endpoint. The PANSS positive subscore (p = 0.0068) and Clinical Global Impression-Severity (CGI-S) (p = 0.048) score significantly changed only in the treatment group. Only in the placebo group were significant changes in Calgary Depression Rating Scale (CDRS) total score registered. The indices of attention tests at endpoint did not show differences between the groups, with the exception of the scope of change in the results of the subtest VIII of the Wechsler Adult Intelligence Scale (WAIS), which showed difference between the groups (p = 0.02) and was significantly larger in the treatment group. Only inside the study drug group, significant changes in selectivity and continuous attention were observed regarding total correct responses (p = 0.0038) and reaction time (p = 0.058) in the Continuous Attention Task (CAT) test. Selective 5HT6 antagonist AVN-211 (CD-008-0173) added antipsychotic and some procognitive (attention) effects to antipsychotic medication.

  10. Retention, dosing, tolerability and patient reported seizure outcome of Zonisamide as only add-on treatment under real-life conditions in adult patients with partial onset seizures: Results of the observational study ZOOM.

    Science.gov (United States)

    Hamer, Hajo; Baulac, Michel; McMurray, Rob; Kockelmann, Edgar

    2016-01-01

    Zonisamide is licensed for adjunctive therapy for partial-onset seizures with or without secondary generalisation in patients 6 years and older and as monotherapy for the treatment of partial seizures in adult patients with newly diagnosed epilepsy, and shows a favourable pharmacokinetic profile with low interaction potential with other drugs. The aim of the present study was to gather real-life data on retention and modalities of zonisamide use when administered as only add-on treatment to a current AED monotherapy in adult patients with partial-onset seizures. This multicenter observational study was performed in 4 European countries and comprised three visits: baseline, and after 3 and 6 months. Data on patients' retention, reported efficacy, tolerability and safety, and quality of life was collected. Of 100 included patients, 93 could be evaluated. After 6 months, the retention rate of zonisamide add-on therapy was 82.8%. At this time, a reduction of seizure frequency of at least 50% was observed in 79.7% of patients, with 43.6% reporting seizure freedom over the last 3 months of the study period. Adverse events were reported by 19.4% of patients, with fatigue, agitation, dizziness, and headache being most frequent. Approximately 25% of patients were older than 60 years, many of whom suffered from late-onset epilepsy. Compared to younger patients, these patients showed considerable differences with regard to their antiepileptic drug regimen at baseline, and slightly higher responder and retention rates at 6 months. Despite limitations due to the non-interventional open-label design and the low sample size, the results show that zonisamide as only add-on therapy is well retained, indicating effectiveness in the majority of patients under real-life conditions. Copyright © 2015. Published by Elsevier Ltd.

  11. NORdic trial of oral Methylprednisolone as add-on therapy to Interferon beta-1a for treatment of relapsing-remitting Multiple Sclerosis (NORMIMS study): a randomised, placebo-controlled trial

    DEFF Research Database (Denmark)

    Sorensen, Per Soelberg; Mellgren, Svein Ivar; Svenningsson, Anders

    2009-01-01

    BACKGROUND: Treatment of relapsing-remitting multiple sclerosis with interferon beta is only partly effective, and new more effective and safe strategies are needed. Our aim was to assess the efficacy of oral methylprednisolone as an add-on therapy to subcutaneous interferon beta-1a to reduce...... was 0.22 for methylprednisolone compared with 0.59 for placebo (62% reduction, 95% CI 39-77%; pSleep disturbance and neurological and psychiatric symptoms were the most frequent adverse events recorded in the methylprednisolone group. Bone mineral density had not changed after 96 weeks......, these findings need to be corroborated in larger cohorts....

  12. Safety and effectiveness of tacrolimus add-on therapy for rheumatoid arthritis patients without an adequate response to biological disease-modifying anti-rheumatic drugs (DMARDs): Post-marketing surveillance in Japan.

    Science.gov (United States)

    Takeuchi, Tsutomu; Ishida, Kota; Shiraki, Katsuhisa; Yoshiyasu, Takashi

    2018-01-01

    Post-marketing surveillance (PMS) was conducted to assess the safety and effectiveness of tacrolimus (TAC) add-on therapy for patients with rheumatoid arthritis (RA) and an inadequate response to biological disease-modifying anti-rheumatic drugs (DMARDs). Patients with RA from 180 medical sites across Japan were registered centrally with an electronic investigation system. The observational period was 24 weeks from the first day of TAC administration concomitantly with biological DMARDs. Safety and effectiveness populations included 624 and 566 patients, respectively. Patients were predominantly female (81.1%), with a mean age of 61.9 years. Overall, 125 adverse drug reactions (ADRs) occurred in 94 patients (15.1%), and 15 serious ADRs occurred in 11 patients (1.8%). These incidences were lower compared with previously reported incidences after TAC treatment in PMS, and all of the observed ADRs were already known. A statistically significant improvement was observed in the primary effectiveness variable of Simplified Disease Activity Index after TAC treatment; 62.7% of patients achieved remission or low disease activity at week 24. TAC is well tolerated and effective when used as an add-on to biological DMARDs in Japanese patients with RA who do not achieve an adequate response to biological DMARDs in a real-world clinical setting.

  13. Twelve-week, prospective, open-label, randomized trial on the effects of an anticholinergic agent or antidiuretic agent as add-on therapy to an alpha-blocker for lower urinary tract symptoms

    Directory of Open Access Journals (Sweden)

    Shin YS

    2014-07-01

    Full Text Available Yu Seob Shin,1 Li Tao Zhang,1 Chen Zhao,2 Young Gon Kim,1 Jong Kwan Park1 1Department of Urology, Chonbuk National University Medical School, and Institute for Medical Sciences, Chonbuk National University and Biomedical Research Institute and Clinical Trial Center of Medical Device of Chonbuk National University Hospital, Jeonju, South Korea; 2Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Institute of Andrology, Shanghai, People’s Republic of China Purpose: The effects of an anticholinergic or antidiuretic agent as add-on therapy to an ­alpha-blocker for lower urinary tract symptoms (LUTS according to a voiding diary in 3 days are unknown. We prospectively investigated the efficacy of an anticholinergic or antidiuretic agent as add-on therapy for nocturia in men previously treated with an alpha-blocker for LUTS.Subjects and methods: Patients were randomly subdivided into two groups. All patients had a 4-week washout. Group A had alpha-blocker for 4 weeks, then an alpha-blocker plus an anticholinergic agent for 4 weeks, and, finally, 4 weeks of an alpha-blocker plus an antidiuretic agent. Group B had an alpha-blocker for 4 weeks, then an alpha-blocker plus an antidiuretic agent for 4 weeks, and, finally, 4 weeks of an alpha-blocker plus an anticholinergic agent. In both groups, patients were subdivided into nocturnal polyuria, decreased nocturnal bladder capacity (NBC, or nocturia by both causes subgroups. A 3-day voiding diary, total International Prostate Symptom Score (IPSS, IPSS sub-scores, Overactive Bladder Symptom Score, uroflowmetry, and post-void residual urine volume, were assessed at baseline, and at 4, 8, and 12 weeks.Results: A total of 405 patients completed the study. During treatment, the changes from baseline in total IPSS and IPSS sub-scores were significantly decreased at 4 weeks and were maintained for 12 weeks. In the nocturnal polyuria subgroup of Groups A and B

  14. The Strengthening Exercises in Shoulder Impingement trial (The SExSI-trial) investigating the effectiveness of a simple add-on shoulder strengthening exercise programme in patients with long-lasting subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Clausen, Mikkel Bek; Bandholm, Thomas; Rathleff, Michael Skovdal

    2018-01-01

    with pronounced and long-lasting SIS. However, the current rehabilitation of such strength impairments may be inadequate, with novel rehabilitation programmes including exercise therapy only improving external rotation strength by 4-13%. As these previous studies are the basis of current practice, this suggests...... that the strengthening component could be inadequate in the rehabilitation of these patients, and it seems likely that more emphasis should be placed on intensifying this part of the rehabilitation. The purpose of this study is to investigate the effectiveness of a programme consisting of progressive home...... with pronounced and long-lasting SIS, diagnosed using predefined criteria. Participants will be randomised to receive either an add-on intervention of progressive home-based resistance training using an elastic band in addition to usual care or usual care alone in a 1:1 allocation ratio. The randomisation...

  15. Non-severe Hypoglycemia Risk Difference between Sulfonylurea and Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2-I) as an Add-On to Metformin in Randomized Controlled Trials.

    Science.gov (United States)

    Farahani, Pendar

    2017-05-23

    Non-severe hypoglycemia reduces well-being, lowers quality of life, reduces productivity and increases treatment costs. The non-severe hypoglycemia rate, attributable to sulfonylurea (SU) utilization compared with newer classes such as SGLT2-I, could be of clinical significance. To explore the non-severe hypoglycemia risk difference (RD) for SU use compared with SGLT2-I in randomized controlled trials (RCTs) as an add on to metformin. A search was conducted for RCTs of SGLT2-I. PubMed database were utilized for this search. The search was limited to RCTs reported in English language for canagliflozin, dapagliflozin, and empagliflozin. SU dose comparison was utilized to convert the dose of SUs to glimepiride equivalent doses. Totally, 118 RCTs were reviewed; 6 articles had an arm for a SU as add on to metformin. Six articles belong to 3 RCTs, which reported results for 52 weeks and 104 weeks. Average non-severe hypoglycemia rate for SU arm was 30% (5.5%) [Mean (SD)] for 52 weeks and 35.6% (6.1%) for 104 weeks. RD for non-severe hypoglycemia events for SU compared to SGLT2-I was 26.7% (4.9%) for 52 weeks (p-value less than 0.001) and 30.6% (5.5%) for 104 weeks (p-value less than 0.001). There was a significant correlation between dose of SU and hypoglycemia rate (Pearson correlation 0.995; R-square 99%). This study illustrated that a large proportion of patients who had exposure to SU in RCTs of SGLT2-I experienced non-severe hypoglycemia compared to SGLT2-I. There was a close relation between SU dose and increased probability of non-severe hypoglycemia events. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.

  16. Evaluating the costs of glycemic response with canagliflozin versus dapagliflozin and empagliflozin as add-on to metformin in patients with type 2 diabetes mellitus in the United Arab Emirates.

    Science.gov (United States)

    Schubert, Agata; Buchholt, Anders T; El Khoury, Antoine C; Kamal, Ahmed; Taieb, Vanessa

    2017-06-01

    This study evaluates the cost of achieving glycemic control with three sodium glucose co-transporter 2 (SGLT2) inhibitors, canagliflozin, dapagliflozin, and empagliflozin, in patients with type 2 diabetes mellitus (T2DM) from the payer perspective in the United Arab Emirates (UAE). A systematic literature review identified randomized controlled trials of antihyperglycemic agents as add-on to metformin in patients with T2DM of 26 ± 4 weeks in duration, published by 10 September 2014. A Bayesian network-meta analysis (NMA) compared HbA1c changes with canagliflozin 100 and 300 mg versus dapagliflozin 10 mg and empagliflozin 10 and 25 mg. The cost associated with a 1% placebo-adjusted HbA1c reduction with each SGLT2 inhibitor as add-on to metformin was calculated based on NMA results and UAE drug costs. In the NMA, canagliflozin 100 and 300 mg were associated with HbA1c reductions (-0.67% and -0.79%) compared with dapagliflozin 10 mg (-0.41%) and empagliflozin 10 and 25 mg (-0.57% and -0.64%). Probabilities of canagliflozin 100 mg performing better were 79%, 60%, and 53% versus dapagliflozin 10 mg and empagliflozin 10 and 25 mg, respectively; probabilities for canagliflozin 300 mg performing better were 88%, 72%, and 65%, respectively. The cost per 1%-point reduction in HbA1c was projected to be lower with canagliflozin 100 and 300 mg ($448 and $422) compared with dapagliflozin 10 mg ($785) and empagliflozin 10 and 25 mg ($527 and $563). Canagliflozin may provide a greater glycemic response at a lower effective cost than dapagliflozin or empagliflozin for patients with T2DM inadequately controlled with metformin from the payer perspective in the UAE.

  17. Add-on high frequency deep transcranial magnetic stimulation (dTMS) to bilateral prefrontal cortex in depressive episodes of patients with major depressive disorder, bipolar disorder I, and major depressive with alcohol use disorders.

    Science.gov (United States)

    Rapinesi, Chiara; Kotzalidis, Georgios D; Ferracuti, Stefano; Girardi, Nicoletta; Zangen, Abraham; Sani, Gabriele; Raccah, Ruggero N; Girardi, Paolo; Pompili, Maurizio; Del Casale, Antonio

    2018-04-03

    Dorsolateral prefrontal cortex (DLPFC) is critically involved in mood and alcohol use disorders. We aimed to investigate the safety of intervention with add-on bilateral prefrontal high-frequency deep transcranial magnetic stimulation (dTMS) and between-group differences in treatment response in patients with different types of depressive episodes, including major depressive episodes in the course of major depressive disorder (MDD), bipolar disorder, type I (BD-I), and MDD with alcohol use disorder (MDAUD). We conducted a 6-month open-label study, involving 82 patients with DSM-5 Depressive Episode. Of these, 41 had diagnosis of MDD, 20 BD-I, and 21 MDAUD. All patients received standard drug treatment and add-on dTMS over the bilateral DLPFC with left prevalence for four weeks, with five sessions in each week. We rated mood state with the Hamilton Depression Rating Scale (HDRS) at baseline, one-month, and six-month follow-up visits. Mean total HDRS scores dropped from 22.8 (SD = 5.9) at baseline to 10.4 (SD = 3.6) at 1 month, to 10.0 (SD = 4.5) at 6 months, while response/remission were 70.73% (N = 58) and 19.51% (N = 16) at 1 month and 76.83% (N = 63) and 32.93% (27) at 6 months, respectively, with no between-group differences. No patient experienced any side effects. High-frequency DLPFC dTMS was well tolerated and did not significantly differ on improvement of depression in MDD, BD-I, and MDAUD. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. The efficacy of tramadol/acetaminophen combination tablets (Ultracet®) as add-on and maintenance therapy in knee osteoarthritis pain inadequately controlled by nonsteroidal anti-inflammatory drug (NSAID).

    Science.gov (United States)

    Park, Kyung-Su; Choi, Jin-Jung; Kim, Wan-Uk; Min, June-Ki; Park, Sung-Hwan; Cho, Chul-Soo

    2012-02-01

    The purpose of this study is to compare the efficacy of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (tramadol/APAP) with that of nonsteroidal anti-inflammatory drugs (NSAIDs) as maintenance therapy following tramadol/APAP and NSAID combination therapy in knee osteoarthritis (OA) pain which was inadequately controlled by NSAIDs. Subjects with knee OA for over 1 year and moderate pain (numerical rating scale [NRS] ≥5) despite at least 4 weeks' NSAID therapy (meloxicam 7.5 mg or 15 mg qd or aceclofenac 100 mg bid) received tramadol/APAP add-on (combination with NSAID) for 4 weeks. Thereafter, subjects with significant pain improvement (NRS pain intensity (NRS), pain relief score, and subjects' and investigators' overall medication assessments. Of 143 subjects enrolled, 112 completed the 4-week tramadol/APAP and NSAID combination phase and 97 (67.8%) experienced significant pain improvement. Of the 97 subjects randomized, 36 in tramadol/APAP group and 47 in NSAID group completed the 8-week comparator study. On days 29 and 57, WOMAC scores and pain intensities did not increase in both groups compared to measurements immediately after the combination therapy. At these two time points, there were no significant differences in WOMAC scores, pain intensities, and other secondary measures between the two groups. Overall adverse event rates were similar in both groups. Tramadol/APAP add-on significantly improved knee OA pain which had been inadequately controlled by NSAIDs. In those subjects who showed favorable response to tramadol/APAP and NSAID combination therapy, both tramadol/APAP and NSAIDs were effective at maintaining the pain-reduced state and there was no significant difference in efficacy between tramadol/APAP and NSAIDs.

  19. Pharmacological Interventions for Students with ADD.

    Science.gov (United States)

    Austin, Vance L.

    2003-01-01

    A review of the research on pharmacological interventions for students with attention deficit disorder finds that psychostimulants such as methylphenidate (Ritalin) are effective in improving focus and impulse control, but should be used in conjunction with psychosocial and behavioral interventions. Comprehensive medical screenings and guidelines…

  20. 75 FR 45164 - ``Add Us In'' Program

    Science.gov (United States)

    2010-08-02

    ... of members of the following groups: African American, Asian American (including Asian Americans of West Asian decent, e.g., India, and Asian Americans of East Asian decent, e.g., Japan and Korea... American Samoan Natives)), Lesbian, Gay, Bisexual, Transgender (LGBT) individuals, and women. A targeted...

  1. How do Innovation Intermediaries add Value?

    DEFF Research Database (Denmark)

    Tran, Yen; Hsuan, Juliana; Mahnke, Volker

    2011-01-01

    study of an innovation intermediary's relations to three major clients in the European apparel fashion industry. We identify key contingencies to an innovation intermediary's value added (e.g. NDP speed and complexity of involvement). We also suggest a framework that specifies when a combination of four...... types of specific intermediary capabilities (best-cost capabilities, timing-capabilities, market-response capabilities, and product solution capabilities) increases value added in clients' NDP processes....

  2. What Adds Up?: Math Enrollment and Graduation

    Science.gov (United States)

    Utah System of Higher Education, 2015

    2015-01-01

    College students struggling to pass a college level math course required for Quantitative Literacy (QL) credit1 has been a common issue facing many institutions in higher education. In the fall of 2014, the Utah State Board of Regents solidified a statewide initiative that set goals for each of the Utah System of Higher Education institutions (UU,…

  3. Getting the buggers to add up

    CERN Document Server

    Sykes, Peter

    2012-01-01

    The third edition of this bestselling book for teachers of secondary mathematics has been brought right up to date and benefits from an extra teacher voice. Together, the authors show how active learning and introducing an element of surprise can bring mathematics alive. With a firm focus on problem solving, independent exploration, thinking skills and applying maths to real-life situations, this book contains new ideas, anecdotes and strategies including brand new chapters on functional mathematics, how to make best use of assessment, and teacher and curriculum development. Brimming with usef

  4. Quiet innovation adds flexibility to global lending

    International Nuclear Information System (INIS)

    Pavey, Nigel.

    1993-01-01

    Few major mandates were won or lost in the first quarter of 1993, as the energy industry adopted a conservative approach to its financing needs. However, indications are that energy companies are coming back to the syndicated loan market after this quiet first quarter. Already, Enron, Shell Oil and Coastal have mandated substantial new facilities. Many more companies are expected back in the market over the new few months, including at least one jumbo for a major international name. A number of the industry's top names report that pricing is once again getting more aggressive in response to the high level of liquidity among lenders and a shortage of new mandates over the last few months. (Author)

  5. How can facility managers add value?

    DEFF Research Database (Denmark)

    Jensen, Per Anker; van der Voordt, Theo

    2015-01-01

    Recent years have seen a growing interest in the concept of added value of facilities management (FM) and corporate real estate management (CREM), and how to attain and measure it. There is a wide variety of definitions in use, and recognition of different types of added value, such as user value...

  6. Implementation of the Louisiana ADD Law.

    Science.gov (United States)

    Pounders, Mickey

    Louisiana's state education agency (SEA) was mandated to provide appropriate services for children with attention deficit disorders, by developing statewide training for representatives from public school districts and by selecting and implementing four pilot programs. The SEA implemented the pilot programs, provided an informational training…

  7. Private Sector Adds to the Menu.

    Science.gov (United States)

    Donovan, Sharon

    1997-01-01

    Two school districts, Kennewick School District WA and Salem-Keizer School District OR, are leveraging their food service contractor's resources to establish work-based courses stressing sophisticated management, culinary, and life skills. Under these instructional partnerships, the contractor, cooperating with school officials, develops the…

  8. Add Deterrence to the Strategy Against ISIS

    Science.gov (United States)

    2017-03-31

    economic or social structures of a country or international organization.2 The U.S. 2015 National Military Strategy outlines an objective of...no way of determining their effectiveness. For example, the apparent random drone targeting of ISIS and Al Qaeda leadership from Pakistan to Yemen ...perception-shaping, cyber warfare, media operations, and legal investigative efforts to enhance legitimacy. A part of the strategy emphasizes publicly

  9. Southeast Economic Add-on 2009

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Revealed preference models provide insights into recreational angler behavior and the economic value of recreational fishing trips. This data is for the Southeast...

  10. Northeast Economic Add-On Data 2000

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Revealed preference models provide insights into recreational angler behavior and the economic value of recreational fishing trips. This data is for the Northeast...

  11. Remodeling a tissue: subtraction adds insight.

    Science.gov (United States)

    Axelrod, Jeffrey D

    2012-11-27

    Sculpting a body plan requires both patterning of gene expression and translating that pattern into morphogenesis. Developmental biologists have made remarkable strides in understanding gene expression patterning, but despite a long history of fascination with the mechanics of morphogenesis, knowledge of how patterned gene expression drives the emergence of even simple shapes and forms has grown at a slower pace. The successful merging of approaches from cell biology, developmental biology, imaging, engineering, and mathematical and computational sciences is now accelerating progress toward a fuller and better integrated understanding of the forces shaping morphogenesis.

  12. Spacesuit Materials Add Comfort to Undergarments

    Science.gov (United States)

    2013-01-01

    Phase change materials (PCMs) were one of the technologies NASA used to help astronauts maintain a "just right" temperature in their space gloves. To incorporate PCMs in spacesuit fabrics, Johnson Space Center collaborated with Outlast Technologies Inc. In 2011, Jockey International, headquartered in Kenosha, Wisconsin, released a line of men's and women's undergarments incorporating the NASA technology

  13. More than add women and stir

    DEFF Research Database (Denmark)

    Kjær, Katrine Meldgaard; Leer, Jonatan

    2015-01-01

    Food studies and the study of food and gender have been particularly strong scholarly currents in the US. Here, anthropologist Carole Counihan was one of the first scholars to work with the food-gender intersection. Over the past four decades, she has continued to work with the area in an array o...

  14. ESTRATEGIAS PARA EL APRENDIZAJE DE LENGUAS EN UNIVERSITARIOS CON TRASTORNO DE DÉFICIT DE ATENCIÓN (TDA / LANGUAGE LEARNING STRATEGIES FOR UNIVERSITY STUDENTS WITH ATTENTION DEFICIT DISORDER (ADD

    Directory of Open Access Journals (Sweden)

    M. Cristina Santana-Quintana

    2017-06-01

    Full Text Available RESUMEN: El presente artículo resalta la importancia de las estrategias de aprendizaje de lenguas (EAL como métodos de apoyo relacionados con los procesos de educación inclusiva (EI, así como buscar las específicas para la enseñanza de idiomas en alumnos con trastorno por déficit de atención (TDA con el fin de obtener un aprendizaje significativo y funcional. Después de analizar las EAL y atendiendo a las dificultades a las que se enfrentan los aprendices con TDA en el aprendizaje de las lenguas extranjeras, llegamos a la conclusión de que las más adecuadas son las de compensación y afectivas o socio-afectivas, ya que principalmente estas estrategias de instrucción específica realzan su rendimiento de habilidad, les hace partícipes del proceso de enseñanza-aprendizaje y les prepara para hacer sus propias intervenciones, eliminando el estrés de una clase normal del día a día, captando su atención y aumentando su motivación. ABSTRACT: This paper highlights the importance of language learning strategies (LLS as support methods related to inclusive education (IE processes, and tries to find specific language teaching strategies for students with attention deficit disorder (ADD in order to achieve a meaningful and functional learning. After analyzing the LLS and taking into account the difficulties learners with ADD face when learning foreing languages, we reach the conclusion that the most appropriate are the compensation and affective or socioaffective strategies, since these specific education strategies enhance their skills performance, make them part of the teaching-learning process and prepare them to make their own interventions, eliminating the stress of a regular day-to-day class, catching their attention and increasing their motivation.

  15. Efficacy and Safety of Vildagliptin as an Add-on to Insulin with or without Metformin in Japanese Patients with Type 2 Diabetes Mellitus: A 12-week, Double-Blind, Randomized Study.

    Science.gov (United States)

    Hirose, Takahisa; Suzuki, Manabu; Tsumiyama, Isao

    2015-12-01

    To assess the efficacy and safety of vildagliptin as add-on therapy in Japanese patients with type 2 diabetes mellitus (T2DM), inadequately controlled on stable long-acting, intermediate-acting, or pre-mixed insulin, with or without concomitant metformin. In this 12-week placebo-controlled study, patients were randomized to receive either vildagliptin 50 mg twice daily (bid) or placebo treatment in a 1:1 ratio. The primary endpoint was change in glycated hemoglobin A1c (HbA1c) from baseline to 12-week endpoint. Secondary endpoints included proportion of patients achieving pre-defined HbA1c targets of ≤6.5%, vildagliptin, n = 76; placebo, n = 75). Patient demographics and clinical characteristics were comparable between the groups at baseline. Addition of vildagliptin resulted in statistically significant reductions in HbA1c after 12 weeks (-1.01 ± 0.06%), with a between-treatment difference of -0.91 ± 0.09% (p vildagliptin group (-1.2 ± 0.2 mmol/L), with a between-treatment difference of -1.2 ± 0.3 mmol/L which was significant (p vildagliptin treatment for all pre-defined responder rate categories. The overall incidence of AEs was comparable between groups (vildagliptin, 46.2% vs. placebo, 43.6%). The overall incidence of hypoglycemic events was low and all events were self-treatable without using drug therapy. No severe hypoglycemic events were reported. Treatment with vildagliptin 50 mg bid as add-on to insulin with or without metformin resulted in statistically significant reductions in HbA1c in Japanese patients with T2DM. Overall, vildagliptin was well tolerated with a safety profile similar to that of placebo in this patient population. ClinicalTrials.gov Identifier, NCT02002221 FUNDING: Novartis Pharma K.K.

  16. Efficacy and safety comparison of add-on therapy with liraglutide, saxagliptin and vildagliptin, all in combination with current conventional oral hypoglycemic agents therapy in poorly controlled Chinese type 2 diabetes.

    Science.gov (United States)

    Li, C-J; Yu, Q; Yu, P; Zhang, Q-M; Ding, M; Liu, X-J; Yu, D-M

    2014-09-01

    To compare the efficacy and safety of adding liraglutide, saxagliptin and vildagliptin to current therapy in Chinese type 2 diabetes subjects with poor glycemic control.A 24-week, randomized, open-label, parallel clinical trial was performed. A total 178 patients completed the trial who had been randomly assigned to add-on once daily liraglutide (1.2 mg/day injected subcutaneously), to saxagliptin (5 mg once daily) or to vildagliptin (50 mg twice daily). Glycosylated hemoglobin (HbA1c) values, fasting and postprandial blood glucose (FBG and P2BG), body weight, body mass index (BMI), episodes of hypoglycemia and adverse events were evaluated.Over the 24-week treatment period, greater lowering of mean of HbA1c was achieved with 1.2 mg liraglutide (-1.50%, 95% CI [-1.67, -1.34]) than with saxagliptin (-1.23%, 95% CI [-1.36, -1.11]) and vildagliptin (-1.25%, 95% CI [-1.37, -1.13]). There was no significant between-group difference of percentages of subjects who reached a target HbA1cvildagliptin. The mean reduction of FBG value from baseline was 2.23 mmol/L with liraglutide, much greater than 1.83 mmol/L with saxagliptin (p=0.013), but similar to 2.03 mmol/L with -vildaglitpin group. As to the P2BG value, greater reductions was found with liraglutide (-4.80 mmol/L) than -3.56 mmol/L with saxagliptin (p=0.000) and -3.57 mmol/L with vildagliptin (p=0.000). Moreover, greater mean reductions of body weight and BMI with liraglutide (-6.0 kg and -2.1 kg/m(2)) were achieved than with saxagliptin and vildagliptin (both pvildagliptin group. The incidence of hypoglycemia was recorded low and similar in each treatment group. Nausea was more common with liraglutide (27%) than with saxagliptin (3.2%) and vildagliptin (5.2%), but no significant between-group difference was reported in other AEs.Adding liraglutide demonstrated superiority to saxagliptin and vildagliptin for reductions of HbA1c and weight loss in Chinese subjects with T2DM who had inadequate glycemic

  17. Ursodeoxycholic acid potentiates dipeptidyl peptidase-4 inhibitor sitagliptin by enhancing glucagon-like peptide-1 secretion in patients with type 2 diabetes and chronic liver disease: a pilot randomized controlled and add-on study

    Science.gov (United States)

    Ota, Tsuguhito; Kato, Ken-ichiro; Takeshita, Yumie; Misu, Hirofumi; Kaneko, Shuichi

    2018-01-01

    Objective We evaluated the effects of ursodeoxycholic acid (UDCA) on glucagon-like peptide-1 (GLP-1) secretion and glucose tolerance in patients with type 2 diabetes with chronic liver disease. Research design and methods Japanese patients with type 2 diabetes (glycated hemoglobin (HbA1c) levels ≥7.0%) and chronic liver disease were included in this study. Sixteen patients (HbA1c level, 7.2%±0.6%(55.2 mmol/mol)) were randomized to receive 900 mg UDCA for 12 weeks followed by 50 mg sitagliptin add-on therapy for 12 weeks (UDCA-first group; n=8) or 50 mg sitagliptin for 12 weeks followed by 900 mg UDCA add-on therapy for 12 weeks (sitagliptin-first group; n=8). All patients underwent a liquid high-fat meal test before and after 12 or 24 weeks of treatment. Results The baseline characteristics were similar between the UDCA-first and sitagliptin-first groups. There was a decrease in body weight (72.5±8.4 to 70.6±8.6 kg; P=0.04) and the HbA1c level (7.0%±0.3% to 6.4%±0.5%(53.0 to 46.4 mmol/mol); P=0.01) in the UDCA-first group. The HbA1c level decreased further after sitagliptin administration (6.4%±0.5% to 6.0%±0.4%(46.4 to 42.1 mmol/mol); P<0.01). Although there were no initial changes in the weight and HbA1c level in the sitagliptin-first group, the HbA1c level decreased after UDCA addition (7.1%±1.1% to 6.6%±0.9%(54.1 to 48.6 mmol/mol); P=0.04). UDCA alone increased the area under the curve0–30 for GLP-1 response (115.4±47.2 to 221.9±48.9 pmol·min/L; P<0.01), but not the glucose-dependent insulinotropic polypeptide response, in the UDCA-first group. Conclusions UDCA treatment resulted in a greater reduction in HbA1c levels, and an increased early phase GLP-1 secretion. Trial registration number NCT01337440. PMID:29607050

  18. Safety and efficacy of an add-on therapy with curcumin phytosome and piperine and/or lipoic acid in subjects with a diagnosis of peripheral neuropathy treated with dexibuprofen

    Directory of Open Access Journals (Sweden)

    Di Pierro F

    2013-07-01

    Full Text Available Francesco Di Pierro,1 Roberto Settembre2 1Scientific Department, Velleja Research, Milan, Italy; 2Neurosurgery Department, Di Venere Hospital, Bari, Italy Abstract: We conducted an 8-week, open, randomized controlled clinical trial on 141 subjects affected by neuropathic pain to investigate the role of an adjunctive therapy added to the administration of dexibuprofen (400 mg twice a day and based on a multi-ingredient formula (Lipicur, consisting of lipoic acid plus curcumin phytosome and piperine, in patients with a diagnosis of lumbar sciatica, lumbar disk herniation, and/or lumbar canal stenosis (96 subjects, or with carpal tunnel syndrome (45 subjects. A total of 135 participants completed the study. Treatment with the multi-ingredient formula (Lipicur reduced neuropathic pain by more than 66% in both conditions (subjects with lumbar sciatica and with carpal tunnel syndrome, and these reductions were statistically significant. Moreover, the treatment reduced dexibuprofen use by about 40%. An add-on therapy with only lipoic acid has not shown any significant results. On the basis of its safety and efficacy, Lipicur could be considered an effective complementary therapy to be added to conventional treatments to achieve better efficacy in reducing neuropathic pain. Keywords: curcumin, phytosome, piperine, dexibuprofen, neuropathic pain

  19. The add-on N-acetylcysteine is more effective than dimethicone alone to eliminate mucus during narrow-band imaging endoscopy: a double-blind, randomized controlled trial.

    Science.gov (United States)

    Chen, Ming-Jen; Wang, Horng-Yuan; Chang, Chen-Wang; Hu, Kuang-Chun; Hung, Chien-Yuan; Chen, Chih-Jen; Shih, Shou-Chuan

    2013-02-01

    Recent studies have shown that pronase can improve mucosal visibility, but this agent is not uniformly available for human use worldwide. This study aimed to assess the efficacy of N-acetylcysteine (NAC), a mucolytic agent, in improving mucus elimination as measured by decreased endoscopic water flushes during narrow-band imaging (NBI) endoscopy. A consecutive series of patients scheduled for upper gastrointestinal endoscopy at outpatient clinics were enrolled in this double-blind, randomized controlled trial. The control group drank a preparation of 100 mg dimethicone (5 ml at 20 mg/ml) plus water up to 100 ml, and the NAC group drank 300 mg NAC plus 100 mg dimethicone and water up to 100 ml. During the endoscopy, the endoscopist used as many flushes of water as deemed necessary to produce a satisfactory NBI view of the entire gastric mucosa. In all, 177 patients with a mean age of 51 years were evaluated in this study. Significantly lesser water was used for flushing during NBI endoscopy for the NAC group than the control group; 40 ml (30-70, 0-120) versus 50 ml (30-100, 0-150) (median (interquartile range, range), p = 0.0095). Considering the safety profile of NAC, decreasing the number of water flushes for optimal vision and unavailability of pronase in some areas, the authors suggest the use of add-on NAC to eliminate mucus during NBI endoscopy.

  20. The Efficacy and Safety of Chinese Herbal Medicine Jinlida as Add-On Medication in Type 2 Diabetes Patients Ineffectively Managed by Metformin Monotherapy: A Double-Blind, Randomized, Placebo-Controlled, Multicenter Trial.

    Science.gov (United States)

    Lian, Fengmei; Tian, Jiaxing; Chen, Xinyan; Li, Zhibin; Piao, Chunli; Guo, Junjie; Ma, Licheng; Zhao, Lijuan; Xia, Chengdong; Wang, Chong-Zhi; Yuan, Chun-Su; Tong, Xiaolin

    2015-01-01

    Metformin plays an important role in diabetes treatment. Studies have shown that the combined use of oral hypoglycemic medications is more effective than metformin monotherapy. In this double-blind, randomized, placebo-controlled, multicenter trial, we evaluated whether Jinlida, a Chinese herbal medicine, enhances the glycemic control of metformin in type 2 diabetes patients whose HbA1c was ineffectively controlled with metformin alone. A total of 186 diabetes patients were enrolled in this double-Blind, randomized, placebo-controlled, multicenter trial. Subjects were randomly allocated to receive either Jinlida (9 g) or the placebo TID for 12 consecutive weeks. All subjects in both groups also continuously received their metformin without any dose change. During this 12-week period, the HbA1c, FPG, 2 h PG, body weight, BMI were assessed. HOMA insulin resistance (HOMA-IR) and β-cell function (HOMA-β) were also evaluated. At week 12, compared to the HbA1c level from week 0, the level of the Jinlida group was reduced by 0.92 ± 1.09% and that of the placebo group was reduced by 0.53 ± 0.94%. The 95% CI was 0.69-1.14 for the Jinlida group vs. 0.34-0.72 for the placebo group. There was a very significant HbA1c reduction between the two groups after 12 weeks (p Jinlida group and placebo group were reduced from week 0. There were a very significant FG and 2 h PG level reductions between the two groups after 12 weeks (both p Jinlida group also showed improved β-cell function with a HOMA-β increase (p Jinlida significantly enhanced the hypoglycemic action of metformin when the drug was used alone. This Chinese herbal medicine may have a clinical value as an add-on medication to metformin monotherapy. Chinese Clinical Trial Register ChiCTR-TRC-13003159.

  1. Short-term effect of add on bell pepper (Capsicum annuum var. grossum) juice with integrated approach of yoga therapy on blood glucose levels and cardiovascular functions in patients with type 2 diabetes mellitus: A randomized controlled study.

    Science.gov (United States)

    Nagasukeerthi, Padakandla; Mooventhan, A; Manjunath, N K

    2017-10-01

    Type 2 diabetes mellitus (T2DM) is a major global health problem. Though various studies have reported the beneficial effect of Yoga in patient with T2DM, there is a lack of study in combination with bell pepper and yoga. Hence, the present study aims at evaluating short-term effect of add on bell pepper juice with integrated approach of yoga therapy (IAYT) on blood glucose levels and cardiovascular variables in patients with T2DM. Fifty T2DM subjects with the age varied from 34 to 69-years were recruited and randomly divided into either study group or control group. The study group received 100-ml of bell pepper juice (twice/day) along with IAYT while the control group received only IAYT for 4-consecutive days. Baseline and post-test assessments were taken before and after the intervention. Statistical analysis was performed using statistical package for the social sciences, version-16. Results of this study showed no significant difference in overall (fasting and post prandial) blood glucose level in the study group compared with control group. However, a significant reduction in Post prandial blood glucose (PPBG), systolic blood pressure (SBP), pulse pressure (PP), rate pressure product (RPP) and Double product (Do-P) was observed in the study group compared with control group. Results of this study suggest that though an addition of 100-ml of bell pepper juice (twice/day) along with IAYT is not more effective in reducing fasting blood glucose, it may be more effective in reducing PPBG, SBP, PP, RPP and Do-P than IAYT alone. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. TALEN/CRISPR-mediated eGFP knock-in add-on at the OCT4 locus does not impact differentiation of human embryonic stem cells towards endoderm.

    Directory of Open Access Journals (Sweden)

    Nicole A J Krentz

    Full Text Available Human embryonic stem cells (hESCs have great promise as a source of unlimited transplantable cells for regenerative medicine. However, current progress on producing the desired cell type for disease treatment has been limited due to an insufficient understanding of the developmental processes that govern their differentiation, as well as a paucity of tools to systematically study differentiation in the lab. In order to overcome these limitations, cell-type reporter hESC lines will be required. Here we outline two strategies using Transcription Activator Like Effector Nucleases (TALENs and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR-CRISPR-Associated protein (Cas to create OCT4-eGFP knock-in add-on hESC lines. Thirty-one and forty-seven percent of clones were correctly modified using the TALEN and CRISPR-Cas9 systems, respectively. Further analysis of three correctly targeted clones demonstrated that the insertion of eGFP in-frame with OCT4 neither significantly impacted expression from the wild type allele nor did the fusion protein have a dramatically different biological stability. Importantly, the OCT4-eGFP fusion was easily detected using microscopy, flow cytometry and western blotting. The OCT4 reporter lines remained equally competent at producing CXCR4+ definitive endoderm that expressed a panel of endodermal genes. Moreover, the genomic modification did not impact the formation of NKX6.1+/SOX9+ pancreatic progenitor cells following directed differentiation. In conclusion, these findings demonstrate for the first time that CRISPR-Cas9 can be used to modify OCT4 and highlight the feasibility of creating cell-type specific reporter hESC lines utilizing genome-editing tools that facilitate homologous recombination.

  3. Efficacy and safety of teneligliptin add-on to insulin monotherapy in Japanese patients with type 2 diabetes mellitus: a 16-week, randomized, double-blind, placebo-controlled trial with an open-label period.

    Science.gov (United States)

    Kadowaki, Takashi; Kondo, Kazuoki; Sasaki, Noriyuki; Miyayama, Kyoko; Yokota, Shoko; Terata, Ryuji; Gouda, Maki

    2017-09-01

    To assess the efficacy and safety of teneligliptin as add-on to insulin monotherapy in patients with type 2 diabetes mellitus (T2DM). In a 16-week, double-blind period, 148 Japanese T2DM patients with inadequate glycemic control with insulin and diet/exercise therapies were randomized to placebo or teneligliptin 20 mg. In a subsequent 36-week, open-label period, all patients received teneligliptin once daily. The primary outcome measure was change in HbA1c at the end of the double-blind period. The difference between placebo and teneligliptin in change in HbA1c in the double-blind period (least squares mean ± SE) was -0.80% ± 0.11%; teneligliptin was superior (ANCOVA, P 1). The HbA1c-lowering effect of teneligliptin was maintained throughout the open-label period. The incidence of adverse events was 53.5% with placebo and 44.2% with teneligliptin in the double-blind period, 66.7% in the placebo/teneligliptin group in the open-label period, and 77.9% in the teneligliptin/teneligliptin group over both double-blind/open-label periods. The incidence of hypoglycemic symptoms was 11.1% in the placebo/teneligliptin group in the open-label period and 27.3% in the teneligliptin/teneligliptin group over both double-blind/open-label periods. Teneligliptin was effective and well tolerated in Japanese T2DM patients with inadequate glycemic control. NCT02081599.

  4. Effects of Passion Flower Extract, as an Add-On Treatment to Sertraline, on Reaction Time in Patients ‎with Generalized Anxiety Disorder: A Double-Blind Placebo-Controlled Study.

    Science.gov (United States)

    Nojoumi, Mandana; Ghaeli, Padideh; Salimi, Samrand; Sharifi, Ali; Raisi, Firoozeh

    2016-07-01

    Objective: Because of functional impairment caused by generalized anxiety disorder and due to cognitive side ‎effects of many anti-anxiety agents, in this study we aimed to evaluate the influence of Passion ‎flower standardized extract on reaction time in patients with generalized anxiety disorder.‎ Method: Thirty patients aged 18 to 50 years of age, who were diagnosed with generalized anxiety disorder and ‎fulfilled the study criteria, entered this double-blind placebo-controlled study. Reaction time was ‎measured at baseline and after one month of treatment using computerized software. Correct ‎responses, omission and substitution errors and the mean time of correct responses (reaction time) in ‎both visual and auditory tests were collected. The analysis was performed between the two groups ‎and within each group utilizing SPSS PASW- statics, Version 18. P-value less than 0.05 was ‎considered statistically significant.‎ Results: All the participants were initiated on Sertraline 50 mg/day, and the dosage was increased to 100 ‎mg / day after two weeks. Fourteen patients received Pasipy (Passion Flower) 15 drops three times ‎daily and 16 received placebo concurrently. Inter-group comparison proved no significant difference ‎in any of the test items between assortments while a significant decline was observed in auditory ‎omission errors in passion flower group after on month of treatment using intra-group analysis.‎‎ Conclusion: This study noted that passion flower might be suitable as an add-on in the treatment of generalized ‎anxiety disorder with low side effects. Further studies with longer duration are recommended to ‎confirm the results of this study.‎.

  5. Louisiana SIP: LAC 33:III Ch. 7 - Table 2 - Ambient Air--Methods of Contaminant Measurements; SIP effective 1989-05-08 (LAc49) and 1989-08-14 (LAc50) to 2011-08-03 (LAd34 - Moved to Section 711 and revised [adds PM-2.5])

    Science.gov (United States)

    Louisiana SIP: LAC 33:III Ch. 7 - Table 2 - Ambient Air--Methods of Contaminant Measurements; SIP effective 1989-05-08 (LAc49) and 1989-08-14 (LAc50) to 2011-08-03 (LAd34 - Moved to Section 711 and revised [adds PM-2.5])

  6. Efficacy and safety of the CRTh2 antagonist AZD1981 as add-on therapy to inhaled corticosteroids and long-acting β2-agonists in patients with atopic asthma

    Directory of Open Access Journals (Sweden)

    Bateman ED

    2018-05-01

    Full Text Available Eric D Bateman,1 Christopher O’Brien,2 Paul Rugman,2 Sally Luke,2 Stefan Ivanov,2 Mohib Uddin2,3 1Department of Medicine, University of Cape Town, Cape Town, 7700, South Africa; 2Research and Development, 3Respiratory, Inflammation, and Autoimmunity, IMED Biotech Unit, AstraZeneca, Gothenburg, SE-431 83, Sweden Objectives: To evaluate the efficacy and safety of AZD1981, a potent, specific antagonist of the CRTh2 receptor, as add-on therapy to inhaled corticosteroids (ICS and long-acting β2-agonists (LABA, in patients with persistent asthma with an allergic component.Patients and methods: In this placebo-controlled, parallel-group Phase IIb study, patients with persistent atopic asthma on ICS and LABA were randomized to receive 12 weeks of treatment with placebo or AZD1981 (80 mg daily, 200 mg daily, and 10 mg, 40 mg, 100 mg, or 400 mg twice daily [BID]. The primary end point was the mean change from baseline in predose, prebronchodilator forced expiratory volume in 1 second (FEV1 averaged over weeks 2, 4, 8, and 12 in the AZD1981-treatment group vs the placebo group. Secondary end points included other measures of lung function, symptoms, and asthma control, as well as standard measures of safety.Results: In total, 1,140 patients (99.7% received study treatment. There were improvements in the primary end point across all treatment groups over 12 weeks of treatment. However, the improvement for the highest AZD1981 dose (400 mg BID vs placebo was not statistically significant (0.02 L, P=0.58, preventing interpretation of statistical testing for the lower doses. AZD1981 was well tolerated, and the incidence of adverse events was comparable across placebo and treatment groups.Conclusion: In patients with allergic asthma receiving ICS and LABA therapy, the addition of AZD1981 at doses up to 400 mg BID failed to produce a clinically relevant improvement in lung function or any other measured end point, but appeared to have an acceptable safety

  7. The Efficacy and Safety of Chinese Herbal Medicine Jinlida as Add-On Medication in Type 2 Diabetes Patients Ineffectively Managed by Metformin Monotherapy: A Double-Blind, Randomized, Placebo-Controlled, Multicenter Trial.

    Directory of Open Access Journals (Sweden)

    Fengmei Lian

    Full Text Available Metformin plays an important role in diabetes treatment. Studies have shown that the combined use of oral hypoglycemic medications is more effective than metformin monotherapy. In this double-blind, randomized, placebo-controlled, multicenter trial, we evaluated whether Jinlida, a Chinese herbal medicine, enhances the glycemic control of metformin in type 2 diabetes patients whose HbA1c was ineffectively controlled with metformin alone.A total of 186 diabetes patients were enrolled in this double-Blind, randomized, placebo-controlled, multicenter trial. Subjects were randomly allocated to receive either Jinlida (9 g or the placebo TID for 12 consecutive weeks. All subjects in both groups also continuously received their metformin without any dose change. During this 12-week period, the HbA1c, FPG, 2 h PG, body weight, BMI were assessed. HOMA insulin resistance (HOMA-IR and β-cell function (HOMA-β were also evaluated.At week 12, compared to the HbA1c level from week 0, the level of the Jinlida group was reduced by 0.92 ± 1.09% and that of the placebo group was reduced by 0.53 ± 0.94%. The 95% CI was 0.69-1.14 for the Jinlida group vs. 0.34-0.72 for the placebo group. There was a very significant HbA1c reduction between the two groups after 12 weeks (p < 0.01. Both FG and 2 h PG levels of the Jinlida group and placebo group were reduced from week 0. There were a very significant FG and 2 h PG level reductions between the two groups after 12 weeks (both p < 0.01. The Jinlida group also showed improved β-cell function with a HOMA-β increase (p < 0.05. No statistical significance was observed in the body weight and BMI changes. No serious adverse events were reported.Jinlida significantly enhanced the hypoglycemic action of metformin when the drug was used alone. This Chinese herbal medicine may have a clinical value as an add-on medication to metformin monotherapy.Chinese Clinical Trial Register ChiCTR-TRC-13003159.

  8. Safety Profile of Eslicarbazepine Acetate as Add-On Therapy in Adults with Refractory Focal-Onset Seizures: From Clinical Studies to 6 Years of Post-Marketing Experience.

    Science.gov (United States)

    Gama, Helena; Vieira, Mariana; Costa, Raquel; Graça, Joana; Magalhães, Luís M; Soares-da-Silva, Patrício

    2017-12-01

    Eslicarbazepine acetate was first approved in the European Union in 2009 as adjunctive therapy in adults with partial-onset seizures with or without secondary generalization. The objective of this study was to review the safety profile of eslicarbazepine acetate analyzing the data from several clinical studies to 6 years of post-marketing surveillance. We used a post-hoc pooled safety analysis of four phase III, double-blind, randomized, placebo-controlled studies (BIA-2093-301, -302, -303, -304) of eslicarbazepine acetate as add-on therapy in adults. Safety data of eslicarbazepine acetate in special populations of patients aged ≥65 years with partial-onset seizures (BIA-2093-401) and subjects with moderate hepatic impairment (BIA-2093-111) and renal impairment (BIA-2093-112) are also considered. The incidences of treatment-emergent adverse events, treatment-emergent adverse events leading to discontinuation, and serious adverse events were analyzed. The global safety database of eslicarbazepine acetate was analyzed for all cases from post-marketing surveillance from 1 October, 2009 to 21 October, 2015. From a pooled analysis of four phase III studies, it was concluded that the incidence of treatment-emergent adverse events, treatment-emergent adverse events leading to discontinuation, and adverse drug reactions were dose dependent. Dizziness, somnolence, headache, and nausea were the most common treatment-emergent adverse events (≥10% of patients) and the majority were of mild-to-moderate intensity. No dose-dependent trend was observed for serious adverse events and individual serious adverse events were reported in less than 1% of patients. Hyponatremia was classified as a possibly related treatment-emergent adverse event in phase III studies (1.2%); however, after 6 years of post-marketing surveillance it represents the most frequently (10.2%) reported adverse drug reaction, with more than half of these cases occurring with eslicarbazepine acetate at

  9. Phase II-trial of radiation therapy with 45 Gy, 5-fluorouracil (5-FU) and mitomycin C (MMC) in patients with anal cancer - a rationale to add regional hyperthermia?

    International Nuclear Information System (INIS)

    Graf, R.; Wust, P.; Gellermann, J.; Mohr, B.; Goegler, H.; Riess, H.; Felix, R.

    1996-01-01

    . Therefore, intensified treatment schedules are required for T3, T4 tumors. In consequence, recently a pilot study has been started to add regional hyperthermia with the SIGMA-60 applicator to this treatment regimen. Anal carcinomas are easy-to-heat tumors because of its distal location using available radiofrequency phased-array technology. Excellent tolerance and temperature distributions (measured in tumor contact) have been obtained up to now in 4 patients with T3/T4-tumors

  10. Transarterial embolization (TAE) as add-on to percutaneous radiofrequency ablation (RFA) for the treatment of renal tumors: Review of the literature, overview of state-of-the-art embolization materials and further perspective of advanced image-guided tumor ablation

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, C.M., E-mail: christof.sommer@med.uni-heidelberg.de [Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg (Germany); Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Katharinenhospital, Stuttgart (Germany); Pallwein-Prettner, L., E-mail: leo.pallwein-prettner@bhs.at [Department of Diagnostic and Interventional Radiology, Krankenhaus der Barmherzigen Schwestern Linz, Linz (Austria); Vollherbst, D.F., E-mail: dominik@vollherbst.de [Clinic for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, Heilbronn (Germany); Seidel, R., E-mail: roland.seidel@uks.eu [Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg/Saar (Germany); Rieder, C., E-mail: christian.rieder@mevis.fraunhofer.de [Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen (Germany); Radeleff, B.A., E-mail: boris.radeleff@med.uni-heidelberg.de [Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg (Germany); Kauczor, H.U., E-mail: hu.kauczor@med.uni-heidelberg.de [Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg (Germany); Wacker, F., E-mail: wacker.frank@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover (Germany); Richter, G.M., E-mail: g.richter@klinikum-stuttgart.de [Clinic for Diagnostic and Interventional Radiology, Klinikum Stuttgart, Katharinenhospital, Stuttgart (Germany); Bücker, A., E-mail: arno.buecker@uks.eu [Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg/Saar (Germany); Rodt, T., E-mail: rodt.thomas@mh-hannover.de [Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover (Germany); and others

    2017-01-15

    Highlights: • TAE as add-on to percutaneous RFA is feasible, safe, and very effective. • State-of-the-art embolization materials include tightly-size-calibrated microspheres. • MWA, cryoablation and IRE are TA systems beyond RFA. • Visible beads rank among the most promising innovative embolization materials. • Software-based solutions will be increasingly important for treatment guidance. - Abstract: Percutaneous radiofrequency ablation (RFA) for the treatment of stage I renal cell carcinoma has recently gained significant attention as the now available long-term and controlled data demonstrate that RFA can result in disease-free and cancer-specific survival comparable with partial and/or radical nephrectomy. In the non-controlled single center trials, however, the rates of treatment failure vary. Operator experience and ablation technique may explain some of the different outcomes. In the controlled trials, a major limitation is the lack of adequate randomization. In case reports, original series and overview articles, transarterial embolization (TAE) before percutaneous RFA was promising to increase tumor control and to reduce complications. The purpose of this study was to systematically review the literature on TAE as add-on to percutaneous RFA for renal tumors. Specific data regarding technique, tumor and patient characteristics as well as technical, clinical and oncologic outcomes have been analyzed. Additionally, an overview of state-of-the-art embolization materials and the radiological perspective of advanced image-guided tumor ablation (TA) will be discussed. In conclusion, TAE as add-on to percutaneous RFA is feasible and very effective and safe for the treatment of T1a tumors in difficult locations and T1b tumors. Advanced radiological techniques and technologies such as microwave ablation, innovative embolization materials and software-based solutions are now available, or will be available in the near future, to reduce the limitations of

  11. Environmental decision making: what does public participation add?

    International Nuclear Information System (INIS)

    Beierle, T.C.; Cayford, J.

    2004-01-01

    The role of public participation in environmental policy making has led to much discussion in recent years, accompanied by some cheering, some hand-wringing, a great deal of speculation, and always recognition of its growing importance. Over the past 30 years, participation has moved to centre stage in the play of influences that determine how the environment will be protected and managed. In doing so, it has evolved considerably. Traditional public hearings and public comment procedures have been joined by a broad array of more intensive approaches to participation that emphasize face-to-face deliberation, problem solving, and consensus building. Policy dialogues, stakeholder advisory committees, citizen juries, formal mediations, and a variety of other processes are now familiar components of the public participation mix. The amount of influence the public can wield has changed as well. In the United States, agreements made among interest groups in regulatory negotiations, for example, actually determine the content of proposed environmental regulations. Describing how well public participation has performed in its central role in environmental policy-making is the topic of our book, Democracy in Practice: Public Participation in Environmental Decisions. In the book, we evaluate the success of 239 cases of public participation undertaken in the United States over the last 30 years. Our primary objective was to develop an understanding of the social value of public participation by evaluating cases against a set of social goals, such as conflict resolution, trust formation, and education. Our second objective was to understand what made some processes successful and others not. We were particularly interested in how different approaches to public participation - from public hearings to formal mediations differed in their accomplishments. (author)

  12. Body weight and wages: evidence from Add Health.

    Science.gov (United States)

    Sabia, Joseph J; Rees, Daniel I

    2012-01-01

    This note uses data from the National Longitudinal Study of Adolescent Health to examine the relationship between body weight and wages. Ordinary least squares (OLS) and individual fixed effects estimates provide evidence that overweight and obese white women are paid substantially less per hour than their slimmer counterparts. Two-stage least squares (2SLS) estimation confirms this relationship, suggesting that it is not driven by time-variant unobservables. Copyright © 2011. Published by Elsevier B.V.

  13. Sun adds steps to strategy for increased income

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Sun Co. Inc. has spelled out a new strategic program designed to boost operating income by about $150 million/year starting next year. At the same time, the company reported a third quarter 1992 loss of $320 million due to writedowns associated with implementation of the new strategy and other activities. Operating income for the quarter was $22 million, compared with breakeven in the 1991 third quarter. The key to Sun's new strategy is hinged to growth in its value added business lines: chemicals, lubricants, and transportation, along with branded gasoline marketing in the U.S. Northeast

  14. Pressure ulcer care: nutritional therapy need not add to costs.

    NARCIS (Netherlands)

    Schols, J.M.G.A.; Kleijer, C.N.; Lourens, C.

    2003-01-01

    Fewer patients with pressure ulcers in Dutch nursing homes receive nutritional therapy via sip feeds, possibly because of cost concerns. But this therapy would not cost more if it reduced the duration of nursing care by even one day, this paper argues.

  15. What Does Leaders' Character Add to Transformational Leadership?

    Science.gov (United States)

    Liborius, Patrick

    2017-04-03

    The influence of leaders' character (e.g., integrity, humility/forgiveness) has rarely been examined in leadership research. The current investigation focused on the impact of integrity and humility/forgiveness on both followers' perceptions of leaders' worthiness of being followed (WBF) and stress. Results from a scenario experiment (n = 347) and a field study (n = 110) indicated that these aspects incrementally predict WBF above and beyond the impact of transformational leadership. Similar results were found concerning followers' stress with the exception of leader integrity in the field study. According to relative importance analyses, integrity and transformational leadership predict WBF equally well. The results have conceivable implications for human resources (personnel selection and development). Future research should examine additional outcome variables that are affected by certain leader characteristics as well as potential negative effects of the examined character aspects.

  16. Public Outreach Guerilla Style: Just Add Science to Existing Events

    Science.gov (United States)

    Gelderman, Richard

    2016-01-01

    We report on a campaign to use the visual appeal of astronomy as a gateway drug to inject public outreach into settings where people aren't expecting an encounter with science. Our inspiration came from the team at guerillascience.org, who have earned a reputation for creating, at sites around the world, "experiences and events that are unexpected, thought-provoking, but, above all, that delight and entertain." Our goal is to insert astronomy into existing festivals of music, culture, and art; county and state fairs; sporting events; and local farmer's markets. With volunteers and near-zero budgets, we have been able to meaningfully engage with audience members who would never willingly attend an event advertised as science related. By purposefully relating astronomy to the non-science aspects of the event that caused the audience members to attend, new learning experiences are created that alter the often negative pre-conceived notions about science that many of them held before our encounter.

  17. SWCC Prediction: Seep/W Add-In Functions

    Science.gov (United States)

    2017-06-01

    published by ERDC, visit the ERDC online library at http://acwc.sdp.sirsi.net/client/default. Flood and Coastal Storm Damage Reduction Program ERDC...drying curve to a wetting curve. That study found the following conversions to be appropriate: w dα α2 (3) ERDC/GSL SR-17-4 5 w dn n (4) w...infiltration rate Soil matric potential Seepage 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF

  18. Somatosensory-evoked potentials as an add-on diagnostic ...

    African Journals Online (AJOL)

    Introduction: Lumbo-sacral spinal stenosis (LSS) is a frequent cause for chronic low back pain. The diagnosis is primarily radiological. Neural insult is not frequent in every case. Although the degree and type of LSS can exactly be described with the current imaging studies, the extent of neural impairment cannot be ...

  19. A participatory project management cycle: can it add value to ...

    African Journals Online (AJOL)

    Many agricultural research and development projects appear to be implemented without following any clear plan or management framework. Similarly, many of these projects do not involve the real participation of the local actors, such as the farmers. Subsequently, such projects do not achieve the desired or planned ...

  20. Water Softeners: How Much Sodium Do They Add?

    Science.gov (United States)

    ... diet is by putting away the saltshaker and cutting back on processed foods. With Sheldon G. Sheps, ... Original article: http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/water-softeners-sodium/ ...

  1. Chandra Adds to Story of the Way We Were

    Science.gov (United States)

    2003-05-01

    Data from NASA's Chandra X-ray Observatory have enabled astronomers to use a new way to determine if a young star is surrounded by a planet-forming disk like our early Sun. These results suggest that disks around young stars can evolve rapidly to form planets, or they can be disrupted by close encounters with other stars. Chandra observed two young star systems, TW Hydrae and HD 98800, both of which are in the TW Hydrae Association, a loose cluster of 10 million-year-old stars. Observations at infrared and other wavelengths have shown that several stars in the TW Hydrae Association are surrounded by disks of dust and gas. At a distance of about 180 light years from Earth, these systems are among the nearest analogs to the early solar nebula from which Earth formed. "X-rays give us an excellent new way to probe the disks around stars," said Joel Kastner of the Rochester Institute of Technology in Rochester, NY during a press conference today in Nashville, Tenn. at a meeting of the American Astronomical Society. "They can tell us whether a disk is very near to its parent star and dumping matter onto it, or whether such activity has ceased to be important. In the latter case, presumably the disk has been assimilated into larger bodies - perhaps planets--or disrupted." TW Hydrae and HD 98800A Chandra 0th Order Image of HD98800 Kastner and his colleagues found examples of each type of behavior in their study. One star, TW Hydrae, namesake of the TW Hydrae Association, exhibited features in its X-ray spectrum that provide strong, new evidence that matter is accreting onto the star from a circumstellar disk. They concluded that matter is guided by the star's magnetic field onto one or more hot spots on the surface of the star. In contrast, Chandra observations of the young multiple star system HD 98800 revealed that its brightest star, HD 98800A, is producing X-rays much as the Sun does, from a hot upper atmosphere or corona. HD 98800 is a complex multiple-star system consisting of two pairs of stars, called HD 98800A and HD 98800B. These pairs, each of which is about an Earth-Sun distance apart, orbit each other at about the same distance as Pluto orbits the Sun. "Our X-ray results are fully consistent with other observations that show that accretion of matter from a disk in HD 98800A has dropped to a low level," said Kastner. "So Chandra has thrown new weight behind the evidence that any disk in this system has been greatly diminished or destroyed in ten million years, perhaps by the ongoing formation of planets or by the companion stars." The new X-ray technique for studying disks around stars relies on the ability of Chandra's spectrometers to measure the energies of individual X-rays very precisely. By comparing the number of X-rays emitted by hot gas at specific energies from ions such as oxygen and neon, the temperature and density of particles can be determined. This new technique will help astronomers to distinguish between an accretion disk and a stellar corona as the origin of intense X-ray emission from a young star. Other members of the research team are David Huenemoerder, Norbert Schulz, and Claude Canizares from the Massachusetts Institute of Technology, and David Weintraub from Vanderbilt University. NASA's Marshall Space Flight Center in Huntsville, Ala., manages the Chandra program, and TRW, Inc., Redondo Beach, Calif., is the prime contractor for the spacecraft. The Smithsonian's Chandra X-ray Center controls science and flight operations from Cambridge, Mass., for the Office of Space Science at NASA Headquarters, Washington. The image and additional information are available at: http://chandra.harvard.edu and http://chandra.nasa.gov

  2. Gamma ray flashes add to mystery of upper atmosphere

    Science.gov (United States)

    Atmospheric electricity research has come a long way since Benjamin Franklin's kite-flying days. But what researchers have been learning lately about above-thunderstorm electricity has wrought a whole new era of mysteries.For a start, last summer a Colorado meteorologist sparked interest in a terrestrial phenomenon that the community first observed more than 100 years ago: optical flashes that occur above thunderstorms—at least 30 km above Earth. Walter Lyons with the Ft. Collins-based Mission Research Corporation, demonstrated that such flashes are not anomalies, as conventional scientific wisdom had held. He filmed hundreds of flashes during a 2-week period.

  3. Math at home adds up to achievement in school.

    Science.gov (United States)

    Berkowitz, Talia; Schaeffer, Marjorie W; Maloney, Erin A; Peterson, Lori; Gregor, Courtney; Levine, Susan C; Beilock, Sian L

    2015-10-09

    With a randomized field experiment of 587 first-graders, we tested an educational intervention designed to promote interactions between children and parents relating to math. We predicted that increasing math activities at home would increase children's math achievement at school. We tested this prediction by having children engage in math story time with their parents. The intervention, short numerical story problems delivered through an iPad app, significantly increased children's math achievement across the school year compared to a reading (control) group, especially for children whose parents are habitually anxious about math. Brief, high-quality parent-child interactions about math at home help break the intergenerational cycle of low math achievement. Copyright © 2015, American Association for the Advancement of Science.

  4. How energy derivatives can add value for municipal electrical utilities

    International Nuclear Information System (INIS)

    Tamplen, B.

    1998-01-01

    The challenges that municipal electric utilities (MEUs) face in the new deregulated power market in North America were discussed. This presentation also highlighted the factors that affected the risk that companies in the U.S. Mid-West were exposed to in June 1998. During that time, MEUs had to deal with financial fallouts and price spikes as a result of very high temperatures, generation outages, and transmission line relief. The focus is on price risk and credit risk and how a strong risk management team can be instrumental in avoiding price spikes like those that occurred in June 1998

  5. The SAICA syllabus for Ethics: does it all add up?

    Directory of Open Access Journals (Sweden)

    Deon Rossouw

    2013-07-01

    Full Text Available The South African Institute for Chartered Accountants (SAICA recently (2005 announced guidelines for a syllabus for Ethics that is to be included in the undergraduate studies of students studying towards the Chartered Accountant (CA qualification. The purpose of this paper is to make a critical comparison between the objectives and the outcomes of the SAICA Ethics syllabus to determine whether the proposed outcomes match the proposed objectives. A teaching-learning competency framework for applied ethics will be introduced first, to provide a theoretical framework within which the stated comparison between the proposed objectives and outcomes of the Ethics syllabus can be carried  out.

  6. Valvular heart disease: what does cardiovascular MRI add?

    International Nuclear Information System (INIS)

    Masci, Pier G.; Dymarkowski, Steven; Bogaert, Jan

    2008-01-01

    Although ischemic heart disease remains the leading cause of cardiac-related morbidity and mortality in the industrialized countries, a growing number of mainly elderly patients will experience a problem of valvular heart disease (VHD), often requiring surgical intervention at some stage. Doppler-echocardiography is the most popular imaging modality used in the evaluation of this disease entity. It encompasses, however, some non-negligible constraints which may hamper the quality and thus the interpretation of the exam. Cardiac catheterization has been considered for a long time the reference technique in this field, however, this technique is invasive and considered far from optimal. Cardiovascular magnetic resonance imaging (MRI) is already considered an established diagnostic method for studying ventricular dimensions, function and mass. With improvement of MRI soft- and hardware, the assessment of cardiac valve function has also turned out to be fast, accurate and reproducible. This review focuses on the usefulness of MRI in the diagnosis and management of VHD, pointing out its added value in comparison with more conventional diagnostic means. (orig.)

  7. Valvular heart disease: what does cardiovascular MRI add?

    Energy Technology Data Exchange (ETDEWEB)

    Masci, Pier G.; Dymarkowski, Steven; Bogaert, Jan [Gasthuisberg University Hospital, Department of Radiology, Leuven (Belgium)

    2008-02-15

    Although ischemic heart disease remains the leading cause of cardiac-related morbidity and mortality in the industrialized countries, a growing number of mainly elderly patients will experience a problem of valvular heart disease (VHD), often requiring surgical intervention at some stage. Doppler-echocardiography is the most popular imaging modality used in the evaluation of this disease entity. It encompasses, however, some non-negligible constraints which may hamper the quality and thus the interpretation of the exam. Cardiac catheterization has been considered for a long time the reference technique in this field, however, this technique is invasive and considered far from optimal. Cardiovascular magnetic resonance imaging (MRI) is already considered an established diagnostic method for studying ventricular dimensions, function and mass. With improvement of MRI soft- and hardware, the assessment of cardiac valve function has also turned out to be fast, accurate and reproducible. This review focuses on the usefulness of MRI in the diagnosis and management of VHD, pointing out its added value in comparison with more conventional diagnostic means. (orig.)

  8. Add Interest to Your Social Studies Curriculum without Cost.

    Science.gov (United States)

    Bloom, Marion G.; And Others

    1992-01-01

    Lists a sampling of free materials and their sources for use by social studies teachers. Includes videos, maps, pamphlets, booklets, games, posters, and travel brochures from Norway, Saudi Arabia, Germany, and Korea among others. Provides source addresses, turnaround times, and descriptions of the materials. (DK)

  9. Does secretin add value in pediatric magnetic resonance cholangiopancreatography?

    International Nuclear Information System (INIS)

    Trout, Andrew T.; Podberesky, Daniel J.; Serai, Suraj D.; Towbin, Alexander J.; Ren, Yan; Altaye, Mekebib

    2013-01-01

    Secretin - a hormone that stimulates pancreatic exocrine secretion - is described to improve visualization of the pancreatic duct by magnetic resonance cholangiopancreatography (MRCP). In our pediatric practice, however, we have not observed substantial benefit with the use of secretin. To determine whether secretin dilates and improves visualization of the pancreatic duct in pediatric MRCP. Retrospective evaluation of secretin-enhanced MRCPs performed over a 15-month period. One reviewer measured the pancreatic duct pre- and post-secretin and two reviewers, blinded to the administration of secretin, assessed image quality and subjective duct visibility. Similar assessments of the biliary tree served as internal controls. We reviewed 20 MRCPs in 17 children. Following secretin administration, there was a small (0.3 mm) but statistically significant increase in pancreatic duct diameter (P = 0.002) and small (<0.2 mm) but significant increase in intrahepatic bile duct diameter (P = 0.0104). On subjective review, there was no significant difference in image quality or duct visibility based on the administration of secretin. Secretin induces dilatation of the pancreatic duct but the value of that effect in pediatric MRCP is suspect given the small change in duct diameter and the lack of improvement in image quality and duct visibility. (orig.)

  10. SWCC Prediction: Seep/W Add-In Functions

    Science.gov (United States)

    2017-11-01

    environmental challenges. ERDC develops innovative solutions in civil and military engineering, geospatial sciences, water resources, and environmental ...derived for use with soils from the Brazilian Amazon using 1,162 soils from the region. The Brooks and Corey model was used to model the SWCC, and the...Berlin Heidelberg: Springer. Leij, F. J. 1996. The UNSODA unsaturated soil hydraulic database: user’s manual. Vol. 96, no. 95. National Risk

  11. How do the effects of mutations add up?

    Science.gov (United States)

    Velenich, Andrea; Dai, Mingjie; Gore, Jeff

    2011-03-01

    Genetic mutations affect the fitness of any organism and provide the variability necessary for natural selection to occur. Given the fitness of a wild type organism and the fitness of mutants A and B which differ from the wild type by a single mutation, predicting the fitness of the double mutant AB is a fundamental problem with broad implications in many fields, from evolutionary theory to medicine. Analysis of millions of double gene knockouts in yeast reveals that, on average, the fitness of AB is the product of the fitness of A and the fitness of B. However, most pairs of mutations deviate from this mean behavior in a way that challenges existing theoretical models. We propose a natural generalization of the geometric Fisher's model which accommodates the experimentally observed features and allows us to characterize the fitness landscape of yeast.

  12. NREL Adds Solar Array Field to Help Inform Consumers | NREL

    Science.gov (United States)

    Solar panels at the Energy Department's National Renewable Energy Laboratory (NREL) are ubiquitous to . No matter how long the solar panels undergo testing, all of the power they generate will flow into

  13. A participatory project management cycle: can it add value to ...

    African Journals Online (AJOL)

    South African Journal of Agricultural Extension. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 34 (2005) >. Log in or Register to get access to full text downloads.

  14. Somatosensory-evoked potentials as an add-on diagnostic ...

    African Journals Online (AJOL)

    Gihan A. Eltantawi

    2012-07-19

    Jul 19, 2012 ... H-reflex comes next (59.1%), and finally F-wave, which showed the lowest ... matology and Rehabilitation Department, Faculty of Medi- ... 611 mm and >8 mm and severe if 68 mm. ... As regards the deep and superficial reflexes; ankle reflex was ... Primary LSS was diagnosed in three patients due to short.

  15. U.S. Chamber Adds Business Viewpoint on Schools' Quality

    Science.gov (United States)

    Archer, Jeff

    2007-01-01

    With a new and highly critical report card offering a business perspective on the effectiveness of state education systems, the U.S. Chamber of Commerce is pushing what it sees as a prescription for more innovative, efficient, and better-performing schools. For the chamber, the grades and policy platform further a concerted new effort to shape…

  16. Go Figure: Computer Database Adds the Personal Touch.

    Science.gov (United States)

    Gaffney, Jean; Crawford, Pat

    1992-01-01

    A database for recordkeeping for a summer reading club was developed for a public library system using an IBM PC and Microsoft Works. Use of the database resulted in more efficient program management, giving librarians more time to spend with patrons and enabling timely awarding of incentives. (LAE)

  17. Take Sport Education a Step Further: Add Fitness

    Science.gov (United States)

    Beaudet, Bob; Acquaviva, John; Grube, Dan

    2004-01-01

    The Surgeon General's report on physical activity and health provides abundant evidence that physical activity plays a role in helping to prevent and treat coronary heart disease, osteoporosis, diabetes, hypertension, depression, and obesity. While adolescents are generally not directly at risk for such diseases, the habit of exercise begins to…

  18. Resonant add-drop filter based on a photonic quasicrystal

    DEFF Research Database (Denmark)

    Romero-Vivas, J.; Chigrin, D. N.; Lavrinenko, Andrei

    2005-01-01

    We present a numerical study of optical properties of an octagonal quasi-periodic lattice of dielectric rods. We report on a complete photonic bandgap in TM polarization up to extremely low dielectric constants of rods. The first photonic bandgap remains open down to dielectric constant as small ...

  19. Does aquaculture add resilience to the global food system?

    NARCIS (Netherlands)

    Troell, M.; Naylor, R.L.; Metian, M.; Beveridge, M.; Tyedmers, P.H.; Folke, C.; Arrow, K.J.; Barrett, S.; Crepin, A.S.; Ehrlich, P.; Gren, R.; Kautsky, N.; Levin, S.A.; Nyborg, K.; Osterblom, H.; Polasky, S.; Scheffer, M.; Walker, B.H.; Xepapadeas, T.; Zeeuw, de A.

    2014-01-01

    Aquaculture is the fastest growing food sector and continues to expand alongside terrestrial crop and livestock production. Using portfolio theory as a conceptual framework, we explore how current interconnections between the aquaculture, crop, livestock, and fisheries sectors act as an impediment

  20. Monitoring of the folic add supplementation program in the Netherlands

    NARCIS (Netherlands)

    de Jong-van den Berg, Lolkje T. W.

    In November of 1993, the Dutch government recommended daily folic acid supplementation of 0.4 or 0.5 mg for all women planning pregnancy, starting 4 weeks before conception until 8 weeks after. In 1995, a one-time mass media campaign was conducted, and due to this campaign, the use of folic acid in

  1. STEM Projects: Should We Add the "TEM" to Science?

    Science.gov (United States)

    Hall, Angela

    2012-01-01

    A recent curriculum development from the Nuffield Foundation rose to the challenge of producing a set of resources to establish STEM (Science, Technology, Engineering and Mathematics) as a curriculum focus. The result is two STEM cross-curricular projects: "Games," inspired by the London Olympics, and "Futures," a novel…

  2. Audits Can Add Panache to Your Communication Program.

    Science.gov (United States)

    Banach, William J.

    1982-01-01

    Suggests that school systems "audit" their communication system to assess their communication needs. Provides two tests that audit a school system's environment and its community. The test results indicate whether the system's communication program should emphasize formal or informal communication methods. (RW)

  3. Quantifying a Negative: How Homeland Security Adds Value

    Science.gov (United States)

    2015-12-01

    access to future victims. The Law Enforcement agency could then identifying and quantifying the value of future crimes. For example, if a serial ... killer is captured with evidence of the next victim or an established pattern of victimization, network theory could be used to identify the next

  4. Endoscopic add-on stiffness probe for real-time soft surface characterisation in MIS.

    Science.gov (United States)

    Faragasso, A; Stilli, A; Bimbo, J; Noh, Y; Liu, H; Nanayakkara, T; Dasgupta, P; Wurdemann, H A; Althoefer, K

    2014-01-01

    This paper explores a novel stiffness sensor which is mounted on the tip of a laparoscopic camera. The proposed device is able to compute stiffness when interacting with soft surfaces. The sensor can be used in Minimally Invasive Surgery, for instance, to localise tumor tissue which commonly has a higher stiffness when compared to healthy tissue. The purely mechanical sensor structure utilizes the functionality of an endoscopic camera to the maximum by visually analyzing the behavior of trackers within the field of view. Two pairs of spheres (used as easily identifiable features in the camera images) are connected to two springs with known but different spring constants. Four individual indenters attached to the spheres are used to palpate the surface. During palpation, the spheres move linearly towards the objective lens (i.e. the distance between lens and spheres is changing) resulting in variations of their diameters in the camera images. Relating the measured diameters to the different spring constants, a developed mathematical model is able to determine the surface stiffness in real-time. Tests were performed using a surgical endoscope to palpate silicon phantoms presenting different stiffness. Results show that the accuracy of the sensing system developed increases with the softness of the examined tissue.

  5. Contextualism adds realism: nursing students' perceptions of and performance in numeracy skills tests.

    Science.gov (United States)

    Ramjan, Lucie M

    2011-11-01

    This project investigated nursing students' perceptions of and performance in a de-contextualised diagnostic maths paper (i.e. questions only) and a contextualised diagnostic maths paper (i.e. visual pictures along with questions). Sampling was purposive, the criteria being that participants would be from the population of student nurses (n=700) in their second year, of a three-year Bachelor of Nursing course, undertaking a Unit 'Medical-Surgical Nursing 1' (MSN1) at one of four campuses across the University of Western Sydney (UWS), NSW, Australia. The numerical test scores for both papers were analysed with the assistance of SPSS software and a Professional Development Officer. The survey data were analysed manually and thematically by the researcher. There was a substantive improvement in scores from Test 1 (de-contextualised) to Test 2 (contextualised). It is uncertain whether the change occurred because Test 2 is a genuinely better presentation than Test 1 or just a practice effect. Nevertheless, the contextualised paper was preferred by the majority of students (80%). Students preferred the visual images and revealed that it led to a "deeper learning" of numeracy skills, reduced stress and anxiety levels and simulated 'the real life' clinical setting, thus adding "an element of realism" to the situation. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Does the metabolic syndrome add to the diagnosis and treatment of cardiovascular disease?

    NARCIS (Netherlands)

    de Zeeuw, Dick; Bakker, Stephan J. L.

    Much controversy has surrounded both the pathological basis and the clinical utility of the metabolic syndrome. Key questions still revolve around the definition of this syndrome, its utility as a predictor of cardiovascular risk, and the treatment implications of diagnosis. The metabolic syndrome

  7. Do Credit Rating Agencies Add to the Dynamics of Emerging Market Crises?

    NARCIS (Netherlands)

    Kraussl, R.G.W.

    2005-01-01

    This study investigates the role of credit rating agencies in international financial markets. With an index of speculative market pressure it is analyzed whether sovereign ratings changes have an impact on the financial stability in emerging market economies. The event study analysis indicates that

  8. Bringing up the rear: new premotor interneurons add regional complexity to a segmentally distributed motor pattern

    Science.gov (United States)

    Norris, Brian J.; Doloc-Mihu, Anca; Calabrese, Ronald L.

    2011-01-01

    Central pattern generators (CPGs) pace and pattern many rhythmic activities. We have uncovered a new module in the heartbeat CPG of leeches that creates a regional difference in this segmentally distributed motor pattern. The core CPG consists of seven identified pairs and one unidentified pair of heart interneurons of which 5 pairs are premotor and inhibit 16 pairs of heart motor neurons. The heartbeat CPG produces a side-to-side asymmetric pattern of activity of the premotor heart interneurons corresponding to an asymmetric fictive motor pattern and an asymmetric constriction pattern of the hearts with regular switches between the two sides. The premotor pattern progresses from rear to front on one side and nearly synchronously on the other; the motor pattern shows corresponding intersegmental coordination, but only from segment 15 forward. In the rearmost segments the fictive motor pattern and the constriction pattern progress from front to rear on both sides and converge in phase. Modeling studies suggested that the known inhibitory inputs to the rearmost heart motor neurons were insufficient to account for this activity. We therefore reexamined the constriction pattern of intact leeches. We also identified electrophysiologically two additional pairs of heart interneurons in the rear. These new heart interneurons make inhibitory connections with the rear heart motor neurons, are coordinated with the core heartbeat CPG, and are dye-coupled to their contralateral homologs. Their strong inhibitory connections with the rearmost heart motor neurons and the small side-to-side phase difference of their bursting contribute to the different motor and beating pattern observed in the animal's rear. PMID:21775711

  9. Does the extended Glasgow Outcome Scale add value to the conventional Glasgow Outcome Scale?

    Science.gov (United States)

    Weir, James; Steyerberg, Ewout W; Butcher, Isabella; Lu, Juan; Lingsma, Hester F; McHugh, Gillian S; Roozenbeek, Bob; Maas, Andrew I R; Murray, Gordon D

    2012-01-01

    The Glasgow Outcome Scale (GOS) is firmly established as the primary outcome measure for use in Phase III trials of interventions in traumatic brain injury (TBI). However, the GOS has been criticized for its lack of sensitivity to detect small but clinically relevant changes in outcome. The Glasgow Outcome Scale-Extended (GOSE) potentially addresses this criticism, and in this study we estimate the efficiency gain associated with using the GOSE in place of the GOS in ordinal analysis of 6-month outcome. The study uses both simulation and the reanalysis of existing data from two completed TBI studies, one an observational cohort study and the other a randomized controlled trial. As expected, the results show that using an ordinal technique to analyze the GOS gives a substantial gain in efficiency relative to the conventional analysis, which collapses the GOS onto a binary scale (favorable versus unfavorable outcome). We also found that using the GOSE gave a modest but consistent increase in efficiency relative to the GOS in both studies, corresponding to a reduction in the required sample size of the order of 3-5%. We recommend that the GOSE be used in place of the GOS as the primary outcome measure in trials of TBI, with an appropriate ordinal approach being taken to the statistical analysis.

  10. Bright light treatment as add-on therapy for depression in 28 adolescents: a randomized trial.

    Science.gov (United States)

    Niederhofer, Helmut; von Klitzing, Kai

    2011-01-01

    In the last decade, a significant incidence of depression in the younger population has been observed. Bright light therapy, an effective therapeutic option for depressed adults, could also provide safe, economical, and effective rapid recovery in adolescents. The randomized trial included 28 inpatients (18 females and 10 males) between 14 and 17 years old with depressive complaints. The study was conducted between February and December of 2010 in Rodewisch, Germany. Half of the patients (n = 14) first received placebo (50 lux) 1 hour a day in the morning from 9:00 am to 10:00 am for 1 week and then received bright light therapy (2,500 lux) for 1 week in the morning from 9:00 am to 10:00 am. The other half (n = 14) first received bright light therapy and then received placebo. Patients were encouraged to continue ongoing treatment (fluoxetine 20 mg/day and 2 sessions of psychotherapy/week) because there were no changes in medication/dosage and psychotherapy since 1 month before the 4-week study period. For assessment of depressive symptoms, the Beck Depression Inventory (BDI) was administered 1 week before and 1 day before placebo treatment, on the day between placebo and bright light treatment, and on the day after and 1 week after bright light treatment. Saliva samples of melatonin and cortisol were collected at 8:00 am and 8:00 pm 1 week before and 1 day before placebo treatment, on the day between placebo and bright light treatment, on the day after bright light treatment, and 1 week after bright light treatment and were assayed for melatonin and cortisol to observe any change in circadian timing. The BDI scores improved significantly (P = .015). The assays of saliva showed significant differences between treatment and placebo for evening melatonin (P = .040). No significant adverse reactions were observed. Antidepressant response to bright light treatment in this age group was statistically superior to placebo. World Health Organization International Clinical Trials Registry Platform identifier: DRKS00003309.

  11. Time to Add a Fifth Pillar to Bedside Physical Examination: Inspection, Palpation, Percussion, Auscultation, and Insonation.

    Science.gov (United States)

    Narula, Jagat; Chandrashekhar, Y; Braunwald, Eugene

    2018-04-01

    Inspection, palpation, percussion, and auscultation have been the 4 pillars of clinical bedside medicine. Although these basic methods of physical examination have served us well, traditional bedside examination, for a number of reasons including diminishing interest and expertise, performs well less than what is required of a modern diagnostic strategy. Improving the performance of physical examination is vital given that it is crucial to guide diagnostic possibilities and further testing. Current efforts at improving physical examination skills during medical training have not been very successful, and incorporating appropriate technology at the bedside might improve its performance. Selective use of bedside ultrasound (or insonation) can be one such strategy that could be incorporated as the fifth component of the physical examination. Seeing pathology through imaging might improve interest in physical examination among trainees, and permit appropriate downstream testing and possibly superior decision making. Current ultrasound technology makes this feasible, and further miniaturization of ultrasound devices and reduced cost will allow for routine use at the bedside. It is time to have a wider debate and a possible consensus about updates required to enhance current paradigms of physical examination.

  12. PENGEMBANGAN BAHAN AJAR MEMBACA PEMAHAMAN BERDASARKAN STRATEGI PLAN (PREDICT, LOCATE, ADD, NOTE) UNTUK SISWA KELAS VII

    OpenAIRE

    Sudiati Sudiati; Nurhidayah Nurhidayah

    2017-01-01

    Abstract This study aims to produce reading comprehension learning materials based on the PLAN strategy and to find out the appropriateness for Grade VII students. This was a design and development study. The stages were taken from those of Borg and Gall. The data were qualitative and quantitative in nature. The data trustworthiness was assessed in terms of credibility, transferability, dependability, and confirmability. The research instruments were an interview guide and ...

  13. Active Approach Does not Add to the Effects of in Vivo Exposure

    NARCIS (Netherlands)

    van Uijen, Sophie; van den Hout, Marcel; Engelhard, Iris

    2015-01-01

    In exposure therapy, anxiety patients actively approach feared stimuli to violate their expectations of danger and reduce fear. Prior research has shown that stimulus evaluation and behavior are reciprocally related. This suggests that approach behavior itself may decrease fear. This study tested

  14. Need for Affiliation as a Motivational Add-On for Leadership Behaviors and Managerial Success.

    Science.gov (United States)

    Steinmann, Barbara; Ötting, Sonja K; Maier, Günter W

    2016-01-01

    In a sample of 70 leader-follower dyads, this study examines the separate and interactive effects of the leaders' implicit needs for power, achievement, and affiliation on leadership behaviors and outcomes. Results show that whereas the need for achievement was marginally associated with follower-rated passive leadership, the need for affiliation was significantly related to ratings of the leaders' concern for the needs of their followers. Analyzing motive combinations in terms of interactive effects and accounting for the growing evidence on the value of affiliative concerns in leadership, we assumed the need for affiliation would channel the interplay among the needs for power and achievement in such a way that the leaders would become more effective in leading others. As expected, based on high need for achievement, the followers were more satisfied with their jobs and with their leaders and perceived more transformational leadership behavior if power-motivated leaders equally had a high need for affiliation. Moreover, the leaders indicated higher career success when this was the case. However, in indicators of followers' performance, the three-way interaction among the needs for power, achievement, and affiliation did not account for additional variance.

  15. Does C-reactive Protein Add Prognostic Value to GRACE Score in Acute Coronary Syndromes?

    Energy Technology Data Exchange (ETDEWEB)

    Correia, Luis Cláudio Lemos, E-mail: lccorreia@terra.com.br; Vasconcelos, Isis; Garcia, Guilherme; Kalil, Felipe; Ferreira, Felipe; Silva, André; Oliveira, Ruan; Carvalhal, Manuela; Freitas, Caio; Noya-Rabelo, Márcia Maria [Escola Bahiana de Medicina e Saúde Pública, Salvador, BA (Brazil); Hospital São Rafael, Salvador, BA (Brazil)

    2014-05-15

    The incremental prognostic value of plasma levels of C-reactive protein (CRP) in relation to GRACE score has not been established in patients with acute coronary syndrome (ACS) with non-ST segment elevation. To test the hypothesis that CRP measurements at admission increases the prognostic value of GRACE score in patients with ACS. A total of 290 subjects, consecutively admitted for ACS, with plasma material obtained upon admission CRP measurement using a high-sensitivity method (nephelometry) were studied. Cardiovascular outcomes during hospitalization were defined by the combination of death, nonfatal myocardial infarction or nonfatal refractory angina. The incidence of cardiovascular events during hospitalization was 15% (18 deaths, 11 myocardial infarctions, 13 angina episodes) with CRP showing C-statistics of 0.60 (95% CI = 0.51-0.70, p = 0.034) in predicting these outcomes. After adjustment for the GRACE score, elevated CRP (defined as the best cutoff point) tended to be associated with hospital events (OR = 1.89, 95% CI = 0.92 to 3.88, p = 0.08). However, the addition of the variable elevated CRP in the GRACE model did not result in significant increase in C-statistics, which ranged from 0.705 to 0.718 (p = 0.46). Similarly, there was no significant reclassification of risk with the addition of CRP in the predictor model (net reclassification = 5.7 %, p = 0.15). Although CRP is associated with hospital outcomes, this inflammatory marker does not increase the prognostic value of the GRACE score.

  16. 77 FR 59610 - Flonicamid; Applications To Add New Food Uses on Previously Registered Pesticide Products

    Science.gov (United States)

    2012-09-28

    ... entities may include, but are not limited to: Crop production (NAICS code 111). Animal production (NAICS... to illustrate your concerns and suggest alternatives. vii. Explain your views as clearly as possible... factors, may have atypical or disproportionately high and adverse human health impacts or environmental...

  17. How much does HDL cholesterol add to risk estimation? A report from the SCORE Investigators.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2009-06-01

    Systematic COronary Risk Evaluation (SCORE), the risk estimation system recommended by the European guidelines on cardiovascular disease prevention, estimates 10-year risk of cardiovascular disease mortality based on age, sex, country of origin, systolic blood pressure, smoking status and either total cholesterol (TC) or TC\\/high-density lipoprotein cholesterol (HDL-C) ratio. As, counterintuitively, these two systems perform very similarly, we have investigated whether incorporating HDL-C and TC as separate variables improves risk estimation.

  18. Protein chimerism: novel source of protein diversity in humans adds complexity to bottom-up proteomics.

    Science.gov (United States)

    Casado-Vela, Juan; Lacal, Juan Carlos; Elortza, Felix

    2013-01-01

    Three main molecular mechanisms are considered to contribute expanding the repertoire and diversity of proteins present in living organisms: first, at DNA level (gene polymorphisms and single nucleotide polymorphisms); second, at messenger RNA (pre-mRNA and mRNA) level including alternative splicing (also termed differential splicing or cis-splicing); finally, at the protein level mainly driven through PTM and specific proteolytic cleavages. Chimeric mRNAs constitute an alternative source of protein diversity, which can be generated either by chromosomal translocations or by trans-splicing events. The occurrence of chimeric mRNAs and proteins is a frequent event in cells from the immune system and cancer cells, mainly as a consequence of gene rearrangements. Recent reports support that chimeric proteins may also be expressed at low levels under normal physiological circumstances, thus, representing a novel source of protein diversity. Notably, recent publications demonstrate that chimeric protein products can be successfully identified through bottom-up proteomic analyses. Several questions remain unsolved, such as the physiological role and impact of such chimeric proteins or the potential occurrence of chimeric proteins in higher eukaryotic organisms different from humans. The occurrence of chimeric proteins certainly seems to be another unforeseen source of complexity for the proteome. It may be a process to take in mind not only when performing bottom-up proteomic analyses in cancer studies but also in general bottom-up proteomics experiments. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Does ERP add company value? : A study for The Netherlands and the United Kingdom

    NARCIS (Netherlands)

    Sneller, Lineke

    2010-01-01

    This study is dedicated to one of the main IT developments in the past thirty years, namely Enterprise Resource Planning (ERP). Thousands of companies have invested billions in ERP. The empirical support for the financial value of ERP implementations, however, is scarce. This led to the central

  20. Equality adds quality: On upgrading higher education and research in the field of law

    Directory of Open Access Journals (Sweden)

    Baer Susanne

    2017-01-01

    Full Text Available Much has been attempted, and many projects are still underway aimed at achieving equality in higher education and research. Today, the key argument to demand and support the integration of gender in academia is that equality is indeed about the quality on which academic work is supposed to be based. Although more or less national political, social and cultural contexts matter as much as academic environments, regarding higher education and research, the integration of gender into the field of law seems particularly interesting. Faculties of law enjoy a certain standing and status, are closely connected to power and politics, and are likely to feature resistance to equality efforts, both in the law itself and in the curriculum and research agenda. However, a multidimensional, intersectional gender analysis helps to reframe cases and doctrines, rulings and regulations far beyond the law that evidently affects women, which the headscarf controversies illustrate. In addition to gender competence, team diversity is a procedural device for success, and non-discrimination is a key requirement when diversity is meant to work. After all, such efforts - to expose bias and educate about gender in an academic field, to insist and integrate it continuously, and to not only demand but also do it - produce quality. Thus, gender equality is crucial for the achievement of the best possible results in higher education and research.

  1. International strategies for growth : monetizing gas reserves to add value to the bottom line

    International Nuclear Information System (INIS)

    Mihaichuk, G.

    1998-01-01

    The direction taken by oil and gas companies, including TransCanada International, in their strategy for growth in global energy markets was discussed. The role that gas plays in meeting the objectives was examined and the different ways in which gas reserves and investments in the gas sector are being turned into high-performing vehicles for adding value to the bottom line were described. Deregulation of, and competition within, the gas and electric power industries are the driving factors for changes within the energy industries. Natural gas will be a winner because it is the first choice for new power generation. Many companies have entered the international playing field to take advantage of the opportunities in international markets. The problems and solutions to monetizing natural gas reserves, some of the international political issues such as regulatory uncertainty, cross-border disputes, lack of regional integration, and sanctions, and how these adverse effects may be mitigated through mergers, acquisitions, or joint ventures, are explored. 14 figs

  2. Can a simple test of functional capacity add to the clinical assessment of diabetes?

    Science.gov (United States)

    Stewart, T; Caffrey, D G; Gilman, R H; Mathai, S C; Lerner, A; Hernandez, A; Pinto, M E; Huaylinos, Y; Cabrera, L; Wise, R A; Miranda, J J; Checkley, W

    2016-08-01

    To identify impairment in functional capacity associated with complicated and non-complicated diabetes using the 6-min walk distance test. We enrolled 111 adults, aged ≥40 years, with Type 2 diabetes from a hospital facility and 150 healthy control subjects of similar age and sex from a community site in Lima, Peru. All participants completed a 6-min walk test. The mean age of the 261 participants was 58.3 years, and 43.3% were male. Among those with diabetes, 67 (60%) had non-complicated diabetes and 44 (40%) had complications such as peripheral neuropathy, retinopathy or nephropathy. The mean unadjusted 6-min walk distances were 376 m and 394 m in adults with and without diabetes complications, respectively, vs 469 m in control subjects (Pdiabetes complications walked 84 m less far (95% CI -104 to -63 m) and those without complications walked 60 m less far (-77 to -42 m) than did control subjects. When using HbA1c level as a covariate in multivariable regression, participants walked 13 m less far (-16.9 to -9.9 m) for each % increase in HbA1c . The subjects with diabetes had lower functional capacity compared with healthy control subjects with similar characteristics. Differences in 6-min walk distance were even apparent in the subjects without diabetes complications. Potential mechanisms that could explain this finding are early cardiovascular disease or deconditioning. © 2015 Diabetes UK.

  3. Improving Wi-Fi Based Indoor Positioning Using Bluetooth Add-Ons

    DEFF Research Database (Denmark)

    Baniukevic, Artur; Sabonis, Dovydas; Jensen, Christian S.

    2011-01-01

    enabling indoor LBSs. Existing indoor positioning services typically use a single technology such as Wi-Fi, RFID or Bluetooth. Wi-Fi based indoor positioning is relatively easy to deploy, but does often not offer good positioning accuracy. In contrast, the use of RFID or Bluetooth for positioning requires...... considerable investments in equipment in order to ensure good positioning accuracy. Motivated by these observations, we propose a hybrid approach to indoor positioning. In particular, we introduce Bluetooth hotspots into an indoor space with an existing Wi-Fi infrastructure such that better positioning...

  4. UNC SKYNET adds NRAO 20m Radio Telescope: Dynamic Research and Funding

    Science.gov (United States)

    Langston, Glen; Hosmer, L.; Heatherly, S.; Towner, A. P.; Reichart, D.; Haipslip, J.

    2013-01-01

    The University of North Carolina (UNC) and NRAO have teamed up to deliver dynamic, realtime optical and Radio observations of the universe, using the web-based SKYNET queuing system developed at UNC. A 20m telescope is outfitted with cryogenically cooled receivers and a reprogrammable spectrometer. To get started see: http://www.gb.nrao.edu/20m/fantastic/ for connections to the observing system, educational activities and opportunities to purchase observing time. The SKYNET goal is to provide the finest research tools to high schools, colleges and independent researchers. This is accomplished through the capabilities to use existing observing modes and through reprogram the University of California, Berkeley's Field Programmable Gate Array (FPGA) systems for custom digital hardware development. This provides a door for engineering and computer science students to create real-time, high capability data acquisition and processing tools. We will demo the 20m observing system and its capabilities. The NSF funded this construction project with the goal of making the network self funding. We are looking for collaborators with targeted research projects wanting to take advantage of the powerful observing tools.

  5. Blood pressure load does not add to ambulatory blood pressure level for cardiovascular risk stratification

    DEFF Research Database (Denmark)

    Li, Yan; Thijs, Lutgarde; Boggia, José

    2014-01-01

    Experts proposed blood pressure (BP) load derived from 24-hour ambulatory BP recordings as a more accurate predictor of outcome than level, in particular in normotensive people. We analyzed 8711 subjects (mean age, 54.8 years; 47.0% women) randomly recruited from 10 populations. We expressed BP...... load as percentage (%) of systolic/diastolic readings ≥135/≥85 mm Hg and ≥120/≥70 mm Hg during day and night, respectively, or as the area under the BP curve (mm Hg×h) using the same ceiling values. During a period of 10.7 years (median), 1284 participants died and 1109 experienced a fatal or nonfatal...... cardiovascular end point. In multivariable-adjusted models, the risk of cardiovascular complications gradually increased across deciles of BP level and load (Pbased on 24-hour systolic or diastolic BP level (generalized R(2) statistic ≤0.294%; net...

  6. Recent developments in computer modeling add ecological realism to landscape genetics

    Science.gov (United States)

    Background / Question / Methods A factor limiting the rate of progress in landscape genetics has been the shortage of spatial models capable of linking life history attributes such as dispersal behavior to complex dynamic landscape features. The recent development of new models...

  7. Epilepsy with myoclonic absences - favourable response to add-on rufinamide treatment in 3 cases

    DEFF Research Database (Denmark)

    Häusler, M; Kluger, G; Nikanorova, M

    2011-01-01

    Epilepsy with myoclonic absences (EMA) is a rare epileptic syndrome with frequently poor response to antiepileptic treatment. Rufinamide (RUF) is a relatively new EMEA- and FDA-approved anticonvulsant licensed as an orphan drug for the adjunctive treatment of patients with Lennox-Gastaut syndrome....

  8. Yucca Mountain Site Characterization Project bibliography, January--June 1995. Supplement 4, Add.3: An update

    Energy Technology Data Exchange (ETDEWEB)

    Stephan, P.M. [ed.

    1996-01-01

    Following a reorganization of the Office of Civilian Radioactive Waste Management in 1990, the Yucca Mountain Project was renamed Yucca Mountain Site Characterization Project. The title of this bibliography was also changed to Yucca Mountain Site Characterization Project Bibliography. Prior to August 5, 1988, this project was called the Nevada Nuclear Waste Storage Investigations. This bibliography contains information on this ongoing project that was added to the Department of Energy`s Energy Science and Technology Database from January 1, 1995, through June 30, 1995. The bibliography is categorized by principal project participating organization. Participant-sponsored subcontractor reports, papers, and articles are included in the sponsoring organization`s list. Another section contains information about publications on the Energy Science and Technology Database that were not sponsored by the project but have some relevance to it.

  9. Culture, risk factors and mortality: can Switzerland add missing pieces to the European puzzle?

    Science.gov (United States)

    Faeh, D; Minder, C; Gutzwiller, F; Bopp, M

    2009-08-01

    The aim was to compare cause-specific mortality, self-rated health (SRH) and risk factors in the French and German part of Switzerland and to discuss to what extent variations between these regions reflect differences between France and Germany. Data were used from the general population of German and French Switzerland with 2.8 million individuals aged 45-74 years, contributing 176 782 deaths between 1990 and 2000. Adjusted mortality risks were calculated from the Swiss National Cohort, a longitudinal census-based record linkage study. Results were contrasted with cross-sectional analyses of SRH and risk factors (Swiss Health Survey 1992/3) and with cross-sectional national and international mortality rates for 1980, 1990 and 2000. Despite similar all-cause mortality, there were substantial differences in cause-specific mortality between Swiss regions. Deaths from circulatory disease were more common in German Switzerland, while causes related to alcohol consumption were more prevalent in French Switzerland. Many but not all of the mortality differences between the two regions could be explained by variations in risk factors. Similar patterns were found between Germany and France. Characteristic mortality and behavioural differentials between the German- and the French-speaking parts of Switzerland could also be found between Germany and France. However, some of the international variations in mortality were not in line with the Swiss regional comparison nor with differences in risk factors. These could relate to peculiarities in assignment of cause of death. With its cultural diversity, Switzerland offers the opportunity to examine cultural determinants of mortality without bias due to different statistical systems or national health policies.

  10. How Can Facilities Management Add Value To Organisations As Well As To Society?

    NARCIS (Netherlands)

    Jensen, P.A.; Sarasoja, A.L.; van der Voordt, D.J.M.; Coenen, C.

    2013-01-01

    The purpose of this paper is to present lessons learnt from a 3 year collaborative research project on the added value of Facilities Management (FM) involving institutions in five European countries. The starting point was the so-called FM Value Map developed earlier by the leader of the research

  11. When POS datasets don’t add up: Combatting sample bias

    DEFF Research Database (Denmark)

    Hovy, Dirk; Plank, Barbara; Søgaard, Anders

    2014-01-01

    Several works in Natural Language Processing have recently looked into part-of-speech (POS) annotation of Twitter data and typically used their own data sets. Since conventions on Twitter change rapidly, models often show sample bias. Training on a combination of the existing data sets should help...... overcome this bias and produce more robust models than any trained on the individual corpora. Unfortunately, combining the existing corpora proves difficult: many of the corpora use proprietary tag sets that have little or no overlap. Even when mapped to a common tag set, the different corpora...

  12. Doppler examination of the periorbital arteries adds valuable hemodynamic information in carotid artery disease

    DEFF Research Database (Denmark)

    Sillesen, H; Schroeder, T; Steenberg, H J

    1987-01-01

    The periorbital flow direction and internal carotid artery (ICA) angiogram were compared to the ICA pressure gradient across the stenosis and the distal ICA pressure in 51 patients subjected to carotid endarterectomy. All 17 patients with inverted periorbital flow had stenoses exceeding 50%. The ...... collaterals and, Patients with 50% stenosis or more and insufficient collaterals....

  13. THE EFFICACY AND SAFETY OF OXCARBAZEPINE AS ADD-ON THERAPY IN INTRACTABLE EPILEPSY IN CHILDREN

    OpenAIRE

    Azita TAVASSOLI; Mohammad GHOFRANI; Mohsen ROUZROKH; Eznollah AZARGASHB

    2010-01-01

    Objective1-3% of the population suffer from epilepsy. Up to 30% of them develop refractory epilepsy and their seizures occur more than once per month despite receiving at least 2 first line antiepileptic drugs. In  this group, more efficacious antiepileptics are needed. This study was undertaken to evaluate the efficacy and safety of Oxcarbazepine as an adjunction therapy in children with refractory epilepsy.Materials & MethodsFrom Feb 2004 until Sep 2006, 30 patients with refractory epilepsy...

  14. Does C-reactive Protein Add Prognostic Value to GRACE Score in Acute Coronary Syndromes?

    International Nuclear Information System (INIS)

    Correia, Luis Cláudio Lemos; Vasconcelos, Isis; Garcia, Guilherme; Kalil, Felipe; Ferreira, Felipe; Silva, André; Oliveira, Ruan; Carvalhal, Manuela; Freitas, Caio; Noya-Rabelo, Márcia Maria

    2014-01-01

    The incremental prognostic value of plasma levels of C-reactive protein (CRP) in relation to GRACE score has not been established in patients with acute coronary syndrome (ACS) with non-ST segment elevation. To test the hypothesis that CRP measurements at admission increases the prognostic value of GRACE score in patients with ACS. A total of 290 subjects, consecutively admitted for ACS, with plasma material obtained upon admission CRP measurement using a high-sensitivity method (nephelometry) were studied. Cardiovascular outcomes during hospitalization were defined by the combination of death, nonfatal myocardial infarction or nonfatal refractory angina. The incidence of cardiovascular events during hospitalization was 15% (18 deaths, 11 myocardial infarctions, 13 angina episodes) with CRP showing C-statistics of 0.60 (95% CI = 0.51-0.70, p = 0.034) in predicting these outcomes. After adjustment for the GRACE score, elevated CRP (defined as the best cutoff point) tended to be associated with hospital events (OR = 1.89, 95% CI = 0.92 to 3.88, p = 0.08). However, the addition of the variable elevated CRP in the GRACE model did not result in significant increase in C-statistics, which ranged from 0.705 to 0.718 (p = 0.46). Similarly, there was no significant reclassification of risk with the addition of CRP in the predictor model (net reclassification = 5.7 %, p = 0.15). Although CRP is associated with hospital outcomes, this inflammatory marker does not increase the prognostic value of the GRACE score

  15. How a Physicist Can Add Value In the Oil and Gas Industry

    Science.gov (United States)

    Poitzsch, Martin

    2011-03-01

    The talk will focus on some specific examples of innovative and fit-for-purpose physics applied to solve real-world oil and gas exploration and production problems. In addition, links will be made to some of the skills and areas of practical experience acquired in physics education and research that can prove invaluable for success in such an industrial setting with a rather distinct and unique culture and a highly-collaborative working style. The oil and gas industry is one of the largest and most geographically and organizationally diverse areas of business activity on earth; and as a `mature industry,' it is also characterized by a bewildering mix of technologies dating from the 19th century to the 21st. Oil well construction represents one of the largest volume markets for steel tubulars, Portland cement, and high-quality sand. On the other hand, 3D seismic data processing, shaped-charge perforating, and nuclear well logging have consistently driven forward the state of the art in their respective areas of applied science, as much or more so than defense or other industries. Moreover, a surprising number of physicists have made their careers in the oil industry. To be successful at introducing new technology requires understanding which problems most need to be solved. The most exotic or improbable technologies can take off in this industry if they honestly offer the best solution to a real problem that is costing millions of dollars in risk or inefficiency. On the other hand, any cheaper or simpler solution that performs as well would prevail, no matter how inelegant! The speaker started out in atomic spectroscopy (Harvard), post-doc'ed in laser cooling and trapping of ions for high-accuracy time and frequency metrology (NIST), and then jumped directly into Drilling Engineering with Schlumberger Corp. in Houston. Since then, his career has moved through applied electromagnetics, geological imaging, nuclear magnetic resonance logging, some R and D portfolio management, and more recently, management of applied physics research for evaluating reservoir rocks and fluids and enhancing the productivity of reservoirs.

  16. A review of low add-on and foam application techniques

    CSIR Research Space (South Africa)

    Van der Walt, GHJ

    1984-02-01

    Full Text Available -February 1984 This application system consists of four major components: the engraved roller (A), a rubber roller (B), a doctor blade (C), and the liquor The engraved roller rotates in the liquor bath (D) where its cavities are ffled with Liquor...".'". 5.2 Different Systems for the AppUeatioa of Foam There are several basic mechanisms for the application of foam to textiles. The foam can be applied either to one side or both sides of the fabric. In the former case a doctor blade or knife, or a...

  17. Do More, Add More, Earn More: Teacher Salary Redesign Lessons from 10 First-Mover Districts

    Science.gov (United States)

    Miles, Karen Hawley; Pennington, Kaitlin; Bloom, David

    2015-01-01

    William Taylor, 29, a third generation Washington, D.C. resident stands out for a number of reasons. For one, he is an African American man who taught math at an elementary school for many years. Taylor excelled in the role, so much so that he now coaches his fellow math teachers at Aiton Elementary School, which is located in a high-poverty…

  18. Speeding by young novice drivers: What can personal characteristics and psychosocial theory add to our understanding?

    Science.gov (United States)

    Scott-Parker, Bridie; Hyde, Melissa K; Watson, Barry; King, Mark J

    2013-01-01

    Young novice drivers continue to be overrepresented in fatalities and injuries arising from crashes even with the introduction of countermeasures such as graduated driver licensing (GDL). Enhancing countermeasures requires a better understanding of the variables influencing risky driving. One of the most common risky behaviours performed by drivers of all ages is speeding, which is particularly risky for young novice drivers who, due to their driving inexperience, have difficulty in identifying and responding appropriately to road hazards. Psychosocial theory can improve our understanding of contributors to speeding, thereby informing countermeasure development and evaluation. This paper reports an application of Akers' social learning theory (SLT), augmented by Gerrard and Gibbons' prototype/willingness model (PWM), in addition to personal characteristics of age, gender, car ownership, and psychological traits/states of anxiety, depression, sensation seeking propensity and reward sensitivity, to examine the influences on self-reported speeding of young novice drivers with a Provisional (intermediate) licence in Queensland, Australia. Young drivers (n=378) recruited in 2010 for longitudinal research completed two surveys containing the Behaviour of Young Novice Drivers Scale, and reported their attitudes and behaviours as pre-Licence/Learner (Survey 1) and Provisional (Survey 2) drivers and their sociodemographic characteristics. An Akers' measurement model was created. Hierarchical multiple regressions revealed that (1) personal characteristics (PC) explained 20.3%; (2) the combination of PC and SLT explained 41.1%; (3) the combination of PC, SLT and PWM explained 53.7% of variance in self-reported speeding. Whilst there appeared to be considerable shared variance, the significant predictors in the final model included gender, car ownership, reward sensitivity, depression, personal attitudes, and Learner speeding. These results highlight the capacity for psychosocial theory to improve our understanding of speeding by young novice drivers, revealing relationships between previous behaviour, attitudes, psychosocial characteristics and speeding. The findings suggest multi-faceted countermeasures should target the risky behaviour of Learners, and Learner supervisors should be encouraged to monitor their Learners' driving speed. Novice drivers should be discouraged from developing risky attitudes towards speeding. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. What does a well-being perspective add to our understanding of poverty?

    OpenAIRE

    Shams, Khadija

    2012-01-01

    Drawing on unique survey data for rural Pakistan, we investigate the impact of socio-demographic factors on life satisfaction with particular emphasis on subjective well-being measurement to evaluate poverty and its different components. The data elicits information on overall well-being in terms of households’ satisfaction with the current socio-economic status as well as financial well-being regarding satisfaction with the current income or expenditure. We estimate a happiness model to e...

  20. Pollution prevention in the analytical laboratory--Microscale and other techniques do add up

    International Nuclear Information System (INIS)

    Erickson, M.D.; Alvarado, J.S.; Lu, C.-S.; Peterson, D.P.; Silzer, J.

    1996-01-01

    The principles of pollution prevention in the analytical laboratory have not been addressed sufficiently. Although the amount of reagent used per sample is often only a few milliliters, the aggregate of many routine test each day in thousands of laboratories becomes significant. Current recycling practices are not practical with small streams. Therefore, we have adopted the principles of microscale chemistry, along with other modern analytical approaches, to develop routine analytical methods that significantly curtail waste but still maintain acceptable analytical figures of merit and achieve cost savings through reduced reagent consumption and reduced labor cost

  1. Lose Weight, Add Healthy Years (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    People with obesity are at increased risk for many diseases and chronic conditions. Achieving and maintaining a normal weight is a key factor in a healthy lifestyle. In this podcast, Dr. Cynthia Ogden discusses obesity.

  2. Measurement of the cross-section of Zγ and limits on ADD models at ...

    Indian Academy of Sciences (India)

    The measurement of the inclusive cross-section for Z production at LHC with 7 TeV proton–proton collision is presented. The electron and muon decay modes are used to reconstruct the boson. The total cross-section is measured for photon transverse energy greater than 10 GeV and with photon and charged lepton ...

  3. Technical report for generic site add-on facility for plutonium polishing

    International Nuclear Information System (INIS)

    1998-06-01

    The purpose of this report is to provide environmental data and reference process information associated with incorporating plutonium polishing steps (dissolution, impurity removal, and conversion to oxide powder) into the genetic-site Mixed-Oxide Fuel Fabrication Facility (MOXFF). The incorporation of the plutonium polishing steps will enable the removal of undesirable impurities, such as gallium and americium, known to be associated with the plutonium. Moreover, unanticipated impurities can be removed, including those that may be contained in (1) poorly characterized feed materials, (2) corrosion products added from processing equipment, and (3) miscellaneous materials contained in scrap recycle streams. These impurities will be removed to the extent necessary to meet plutonium product purity specifications for MOX fuels. Incorporation of the plutonium polishing steps will mean that the Pit Disassembly and Conversion Facility (PDCF) will need to produce a plutonium product that can be dissolved at the MOXFF in nitric acid at a suitable rate (sufficient to meet overall production requirements) with the minimal usage of hydrofluoric acid, and its complexing agent, aluminum nitrate. This function will require that if the PDCF product is plutonium oxide powder, that powder must be produced, stored, and shipped without exceeding a temperature of 600 C

  4. Do health claims add value? the role of functionality, effectiveness and brand

    NARCIS (Netherlands)

    Bimbo, Francesco; Bonanno, Alessandro; Viscecchia, Rosaria

    2016-01-01

    European functional food manufacturers experience high costs of production, marketing and compliance with Regulation EC No. 1924/2006, requiring high premiums to recover these costs. We review the literature on consumers' acceptance of health-enhancing food products and identify three factors

  5. Is it a must to add upstream devices for high GVF multiphase

    Energy Technology Data Exchange (ETDEWEB)

    Dou, Jianwen; Guo, Jason; Gokulnath, R.

    2005-07-01

    High accuracies in measurement of the gross liquid and net oil flow rates at high GVF levels in the multiphase flow is identified as one of the most demanding needs of the industry, especially in high water cut environments. The underlying factor that decides the accuracy of the net oil flow rate measurement is the accuracy at which the gross liquid and water cut are measured and the prevailing water cut in the flow. It is an established fact that accuracies falter with increasing GVF in the multiphase flow. The purpose of this paper is to present the performance results of a newly developed Compact High GVF Haimo multiphase meter that addresses the above needs, without having to use an Upstream Separation Device for high GVF application while retaining the accuracies within +2% absolute for water cut and 10% relative for liquid and gas flow rates at 90% confidence level. while also optimising the footprint, the cost, the weight of the solution Further developmental work and trials are in progress to achieve the targeted accuracy levels under very high GVF conditions as well. Contents of the Paper:1) Definitions. 2) MFM 2000 + Upstream Separation Device. 3) Haimo's experience with upstream devices. 4) Motivation to develop the new Compact meter solution. 5) Description of the Compact solution. 6) Performance testing of the Compact solution in a third party test facility. 7) Conclusion and Benefit which are: The objective of working out a new solution for high GVF without having to use a Upstream Separation Device seem to have been achieved with excellent test results; The new configuration of Compact High GVF meter successfully met and exceeded its Acceptance criteria. The main objective was to asses its performance, confirm the quality of the measurements and check its compliance with the Accuracy specifications. The consistency of the absolute error on water cut much lower than 2% for the full range of the GVF and liquid flow rates re-establishes the independence of the water cut measurement technology over the GVF and liquid flow rates, now for high GVF The accuracy results obtained for gas flow, gross liquid flow and water liquid ratio measurements demonstrate the following: 1) Efficiency of the flow conditioner technology and its great advantage of measuring the water liquid ratio (WLR) independently of the Gas volume fraction (GVF). 2) Capability of the flow conditioner to handle the wide turndown of the liquid from the 2 in 1 meter. 3) Capability of the flow conditioner to handle high GVF without compromising on the efficiency to mitigate slugs, deplete gas and provide a representative sample of multiphase fluid with WLR same as that of the incoming multiphase flow (tk)

  6. Linking Financial Service Providers to Commercial Capital : How Do Guarantees Add Value?

    OpenAIRE

    Alexia Latortue; Jasmina Glisovic-Mezieres

    2008-01-01

    In microfinance, experimentation with loan guarantees began largely as an attempt to demonstrate to local banks that Microfinance Institutions (MFIs) are creditworthy. Though loan guarantees are far less common than other funding instruments, such as debt, equity, and grants, they are beginning to be used more often. This brief is based on a joint Consultative Group to Assist the Poorest (...

  7. Synthesis and investigation of rare earth tris-acetylacetonates addUcts with acetylaceoneimine

    International Nuclear Information System (INIS)

    Trembovetskij, G.V.; Smirnov, E.V.; Murav'eva, I.A.; Martynenko, L.I.

    1983-01-01

    Adducts of tris-acetylacetonates of pare earths With acetylacetonimine of the composition MA 3 x2L (M=La, Pr, Nd, Eu, Gd, Tb) and MA 3 XL (M=Dy, Ho, Er, Tm, Yb, LU) have been synthesized. The compounds prepared are studied using the methods of elemental analysis, IR spectroscopy, PMR spectroscopy, X-ray phase analysis. Volatile tris-acetylacetonates of the yttrium subgroUp rare earths have been prepared by thermal decomposition of MA 3 xL in vacuum

  8. How to add value to a generic product on the natural gas market

    International Nuclear Information System (INIS)

    Thorborg, L.

    1999-01-01

    The subject of the deregulated gas market continues to stir the blood. It's the 'leitmotif' of lecturers, discussions and professional journals. And of the Circle Day for members of the Royal Dutch Gas Association (KVGN). A representative of a supermarket chain discussed with the participants of the meeting the possibility of selling gas at the supermarket. The Head of Corporate marketing of British Gas warned the Dutch gas distributors against switching customer. The general manager of EnTrade strongly advocated a really deregulated gas market. During the morning session featuring 'Millennium and marketing' a marketing consultant already pointed at the new attitude that is necessary in the free market: 'Use the turn of the millennium to practice cuddling your customers. Take away your customer's fears that they will be without heating on 1 January 2000'

  9. Private Cross-page Movie Recommendations with the Firefox add-on OMORE

    OpenAIRE

    Bannwart, T; Bouza, A; Reif, G; Bernstein, A

    2009-01-01

    Online stores and Web portals bring information about a myriad of items such as books, CDs, restaurants or movies at the user's fingertips. Although, the Web reduces the barrier to the information, the user is overwhelmed by the number of available items. Therefore, recommender systems aim to guide the user to relevant items. Current recommender systems store user ratings on the server side. This way the scope of the recommendations is limited to this server only. In addition, the user entru...

  10. Beyond Library Power: Reader's Digest Adds Public Libraries to the Mix.

    Science.gov (United States)

    Rockfield, Gary

    1998-01-01

    Describes the Tall Tree Initiative for Library Services, sponsored by the Reader's Digest Foundation and administered by the public and school library systems of Westchester County, New York. The initiative focuses on improving services offered children in the 21st century, and demands a new level of school-public library cooperation. (AEF)

  11. An unusual petition for posthumous sperm retrieval? What does it add to the debate?

    Science.gov (United States)

    Sarig, Shelly; Tabak, Nili

    2008-06-01

    Posthumous sperm retrieval is still a controversial procedure. The Israel Ministry of Health has recently issued guidelines to regulate the procedure and a recent unusual petition in Israel for posthumous retrieval sheds new and interesting light on the dilemmas involved. This paper examines the petition, both in its own right and by comparing it to the more frequent situation where the surviving partner of a suddenly deceased man petitions for his sperm to be collected for insemination into herself. The analysis considers the best interests of the child to be born, the good of other family members, the wishes of the deceased and the interests of society as a whole.

  12. Does MRI add to ultrasound in the assessment of disorders of sex development?

    Energy Technology Data Exchange (ETDEWEB)

    Mansour, S.M., E-mail: sahar_mnsr@yahoo.com [Radiology Department (Women' s imaging unit), Faculty of Medicine, Cairo University,Egypt (Egypt); Hamed, S.T., E-mail: sohathamed@yahoo.com [Radiology Department (Women' s imaging unit), Faculty of Medicine, Cairo University,Egypt (Egypt); Adel, L., E-mail: lamiaadel73@yahoo.com [Radiology Department (Women' s imaging unit), Faculty of Medicine, Cairo University,Egypt (Egypt); Kamal, R.M., E-mail: rashaakamal@hotmail.com [Radiology Department (Women' s imaging unit), Faculty of Medicine, Cairo University,Egypt (Egypt); Ahmed, D.M., E-mail: sahar_mnsr@yahoo.com [National Research Center, Cairo (Egypt)

    2012-09-15

    Objective: The objective of the study was to evaluate the need of magnetic resonance imaging and using different approaches (transabdominal, endoluminal and transperineal) in the proper assessment of disorders of sex development regarding gonadal detection and gender differentiation. Subjects and methods: Twenty five patients with abnormalities of sex disorders were included. They were classified into two groups according to the time of clinical presentation: Group 1 (early onset) included eight cases. Their age ranged from one month to 12 years (mean age = 3.0). They presented with overt genital ambiguity of clitoral hypertrophy in a phenotypic female, non palpable testes or micropenis in a phenotypic male. Group 2 (late onset) included 17 cases. Their age ranged from 16 to 33 years (mean age 18.1). This group presented by distressing puberty symptoms of primary amenorrhea in a female phenotype or undescended testis and behaving as a male. Cases were subjected to Ultrasound and MR imaging examinations. Imaging results were correlated results of chromosomal and hormonal assays as well as laparoscopy findings. Results: The study included: 10/25 cases (40%) of female pseudo-hermaphroditism, 13/25 cases (52%) of male pseudo-hermaphroditism, one case (4%) of true hermaphroditism and one case (4%) of pure gonadal dysgenesis. The accuracy of multi approach ultrasound was 89.8% compared to 85.7% in MR imaging. Conclusion: Ultrasound should be considered the initial screening modality in the assessment of developmental sex disorders. MRI examination could be reserved for gonad identification when ultrasound examination fails to do so and for corrective surgery guidance.

  13. Volunteering in adolescence and young adulthood crime involvement: a longitudinal analysis from the add health study.

    Science.gov (United States)

    Ranapurwala, Shabbar I; Casteel, Carri; Peek-Asa, Corinne

    2016-12-01

    Experiences in adolescence may have a lasting impact on adulthood. The objective of this study is to evaluate the association between adolescent (12-18 years of age) volunteerism with the incidence of illegal behaviors, arrests, and convictions in adulthood (>18 years of age). We conducted a retrospective cohort study using secondary data from the National Longitudinal Study of Adolescent to Adult Health. Students from grades 7-12 were recruited in 1994-1995 (n = 20,745), and then followed in 2001-2002 (n = 14,322) and in 2008-2009 (n = 12,288). In 2000-2001, participants were retrospectively asked about their volunteering experience from 12 to 18 years of age. Consequently, participants were divided into non-volunteers, self-volunteers, adult-required volunteers, and court-ordered volunteers. Groups were compared for rates of illegal behaviors, arrest, and convictions in adulthood (>18 years of age) using weighted generalized linear mixed negative binomial models while accounting for sampling design. Relative to non-volunteers, self-volunteers reported 11 % fewer illegal behaviors (RR: 0.89, 95 % CI: 0.80, 0.99), 31 % fewer arrests (RR: 0.69, 95 %: 0.57, 0.85), and 39 % fewer convictions (RR: 0.61, 95 % CI: 0.47, 0.79) by age 18-28 years, and 28 % fewer illegal behaviors, 53 % fewer arrests, and 36 % fewer convictions by age 24-34. In comparison the adult-required volunteers also reported fewer arrests and convictions; however, they reported more illegal behaviors than the non-volunteers. The court-ordered volunteers reported higher rates of criminal involvement than the non-volunteers, throughout. This study suggests that volunteering in adolescence may reduce crime involvement in adulthood.

  14. How effective project management will add value to your uranium project

    International Nuclear Information System (INIS)

    Bradford, R.; Titley, M.

    2014-01-01

    Up until the recent Fukushima incident in March 2011 project activity in the uranium sector was driven by high uranium prices and merger and acquisition corporate activity. Soon after the incident, project development in the uranium sector collapsed and capital slowly dried up as Uranium prices dropped. New projects were put on hold, significantly reducing growth in the small to medium capital markets. Existing brownfield growth plans were halted as corporate strategies focused on improving the efficiency of existing assets. Recent positive sentiment supported by positive commentary in the uranium market, driven by an improved understanding of the supply and demand fundamentals and the restart of Japan’s nuclear reactors, has seen renewed corporate merger and acquisition activity. Developers are again taking an interest in new uranium project development.

  15. The unified neutral theory of biodiversity: do the numbers add up?

    Science.gov (United States)

    Ricklefs, Robert E

    2006-06-01

    Hubbell's unified neutral theory is a zero-sum ecological drift model in which population sizes change at random in a process resembling genetic drift, eventually leading to extinction. Diversity is maintained within the community by speciation. Hubbell's model makes predictions about the distribution of species abundances within communities and the turnover of species from place to place (beta diversity). However, ecological drift cannot be tested adequately against these predictions without independent estimates of speciation rates, population sizes, and dispersal distances. A more practical prediction from ecological drift is that time to extinction of a population of size N is approximately 2N generations. I test this prediction here using data for passerine birds (Passeriformes). Waiting times to speciation and extinction were estimated from genetic divergence between sister populations and a lineage-through-time plot for endemic South American suboscine passerines. Population sizes were estimated from local counts of birds in two large forest plots extrapolated to the area of wet tropical forest in South America and from atlas data on European passerines. Waiting times to extinction (ca. 2 Ma) are much less than twice the product of average population size (4.0 and 14.4 x 10(6) individuals in South America and Europe) and generation length (five and three years) for songbirds, that is, 40 and 86 Ma, respectively. Thus, drift is too slow to account for turnover in regional avifaunas. Presumably, other processes, involving external drivers, such as climate and physiographic change, and internal drivers, such as evolutionary change in antagonistic interactions, predominate. Hubbell's model is historical and geographic, and his perspective importantly links local and regional process and pattern. Ecological reality can be added to the mix while retaining Hubbell's concept of continuity of communities in space and time.

  16. Effect of biologic therapy on radiological progression in rheumatoid arthritis: what does it add to methotrexate?

    Directory of Open Access Journals (Sweden)

    Jones G

    2012-07-01

    Full Text Available Graeme Jones, Erica Darian-Smith, Michael Kwok, Tania WinzenbergMenzies Research Institute, University of Tasmania, Tasmania, AustraliaAbstract: There have been substantial advances in the treatment of rheumatoid arthritis in recent years. Traditional disease-modifying antirheumatic drugs (DMARDs have been shown to have small effects on the progression of radiographic damage. This quantitative overview summarizes the evidence for biologic DMARDS and radiographic damage either alone or in combination with methotrexate. Two outcomes were used (standardized mean difference and odds of progression. A total of 21 trials were identified of which 18 had useable data. For biologic monotherapy, tocilizumab, adalimumab, and etanercept were significantly better than methotrexate, with tocilizumab ranking first in both outcomes while golimumab was ineffective in both outcomes. For a biologic in combination with methotrexate compared with methotrexate alone, most therapies studied (etanercept, adalimumab, infliximab, certolizumab, tocilizumab, and rituximab were effective at slowing X-ray progression using either outcome, with infliximab ranking first in both outcomes. The exceptions to this were golimumab (no effect on standardized mean difference and abatacept (no effect on odds of progression. This effect was additional to methotrexate; thus, the overall benefit is moderate to large in magnitude, which is clearly of major clinical significance for sufferers of rheumatoid arthritis and supports the use of biologic DMARDs in those with a poor disease prognosis.Keywords: rheumatoid, trials, meta-analysis, radiographs, biologic, disease-modifying antirheumatic drugs, DMARDs

  17. 76 FR 28885 - Brucellosis in Swine; Add Texas to List of Validated Brucellosis-Free States

    Science.gov (United States)

    2011-05-19

    ... chronic conditions, including arthritis. Humans can be treated for brucellosis with antibiotics. The... good cause under 5 U.S.C. 553 for making this action effective less than 30 days after publication in...

  18. Multiple cues add up in defining a figure on a ground.

    Science.gov (United States)

    Devinck, Frédéric; Spillmann, Lothar

    2013-01-25

    We studied the contribution of multiple cues to figure-ground segregation. Convexity, symmetry, and top-down polarity (henceforth called wide base) were used as cues. Single-cue displays as well as ambiguous stimulus patterns containing two or three cues were presented. Error rate (defined by responses to uncued stimuli) and reaction time were used to quantify the figural strength of a given cue. In the first experiment, observers were asked to report which of two regions, left or right, appeared as foreground figure. Error rate did not benefit from adding additional cues if convexity was present, suggesting that responses were based on convexity as the predominant figural determinant. However, reaction time became shorter with additional cues even if convexity was present. For example, when symmetry and wide base were added, figure-ground segregation was facilitated. In a second experiment, stimulus patterns were exposed for 150ms to rule out eye movements. Results were similar to those found in the first experiment. Both experiments suggest that under the conditions of our experiment figure-ground segregation is perceived more readily, when several cues cooperate in defining the figure. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. (Congressional Add) Partnership in Innovative Preparation for Educators and Students (PIPES)

    Science.gov (United States)

    2011-12-30

    developing STEM education programs that increased student engagement , performance, and retention in STEM subjects from 6th through 12th grades...prior work of these organizations the PIPES program model was formulated that encompassed inquiry learning, longitudinal student engagement , and

  20. Impact on health care adds to the social cost of homelessness, MDs say.

    OpenAIRE

    Lowry, F

    1996-01-01

    Homelessness has become a visible part of Canada's urban landscape, infecting adult men and women, youths and families with children alike, and the issue becomes particularly serious as winter approaches. During a workshop in Toronto earlier this year, physicians, researchers and social workers examined the effects of homelessness on health, identifying many of the unique health needs of this vulnerable segment of society.

  1. Just add water: Accuracy of analysis of diluted human milk samples using mid-infrared spectroscopy.

    Science.gov (United States)

    Smith, R W; Adamkin, D H; Farris, A; Radmacher, P G

    2017-01-01

    To determine the maximum dilution of human milk (HM) that yields reliable results for protein, fat and lactose when analyzed by mid-infrared spectroscopy. De-identified samples of frozen HM were obtained. Milk was thawed and warmed (40°C) prior to analysis. Undiluted (native) HM was analyzed by mid-infrared spectroscopy for macronutrient composition: total protein (P), fat (F), carbohydrate (C); Energy (E) was calculated from the macronutrient results. Subsequent analyses were done with 1 : 2, 1 : 3, 1 : 5 and 1 : 10 dilutions of each sample with distilled water. Additional samples were sent to a certified lab for external validation. Quantitatively, F and P showed statistically significant but clinically non-critical differences in 1 : 2 and 1 : 3 dilutions. Differences at higher dilutions were statistically significant and deviated from native values enough to render those dilutions unreliable. External validation studies also showed statistically significant but clinically unimportant differences at 1 : 2 and 1 : 3 dilutions. The Calais Human Milk Analyzer can be used with HM samples diluted 1 : 2 and 1 : 3 and return results within 5% of values from undiluted HM. At a 1 : 5 or 1 : 10 dilution, however, results vary as much as 10%, especially with P and F. At the 1 : 2 and 1 : 3 dilutions these differences appear to be insignificant in the context of nutritional management. However, the accuracy and reliability of the 1 : 5 and 1 : 10 dilutions are questionable.

  2. Pink Collar Blues: For Women Who Work, It Still Doesn't Add Up.

    Science.gov (United States)

    Strum, Philippa

    1980-01-01

    Documents the salary and promotional inequities between women and men in working class, academic, governmental, and professional (law, medicine, and scientific research) jobs. Calls for more affirmative action programs and argues that professional women will be able to fight for equal rights for all classes of working women. (GC)

  3. Digital spot mammography using an add-on upright unit: diagnostic application in daily practice

    International Nuclear Information System (INIS)

    Mesurolle, Benoit; Mignon, Francois; Ariche-Cohen, Michele; Kao, Ellen; Gagnon, Jean H.; Goumot, Pierre-Alain

    2004-01-01

    Introduction: To present the use of digital spot mammography (DSM) in a diagnostic practice. Methods and patients: Digital spot images of 779 women requiring a spot compression or a spot magnification view were collected. The digital images were acquired on a digital spot upright unit using a 61 mmx61 mm field of view. Lesions reported included masses, calcifications, and areas of distortions. Results: 1065 lesions required additional views with DSM. Lesions reported included masses (n=113), masses and microcalcifications (n=53), spiculated masses (n=34), architectural distortions (n=16), and microcalcifications (n=849). DSMs were considered to be adequate in 97.7% of patients. Unsatisfactory exams resulted from difficulties encountered in targeting the area of interest at the beginning of our experience. Conclusion: DSM, most commonly used to perform interventional procedures, can also be used in a diagnostic practice taking advantage of post-processing of images not available with conventional spot compression and magnification

  4. Add More Vegetables to Your Day: 10 Tips to Help You Eat More Vegetables

    Science.gov (United States)

    ... sip on some vegetable soup Heat it and eat it. Try tomato, butternut squash, or garden vegetable soup. Look for reduced- or low-sodium soups. Make your own soups with a low-sodium broth and your favorite vegetables. 8 while you’re out If dinner is away from home, no need to worry. ...

  5. 'Just a lovely luxury?' What can public health attachments add to postgraduate general practice training?

    Science.gov (United States)

    Wills, Jane; Reynolds, Joanna; Swanwick, Tim

    2009-07-01

    Changing trends in the role of general practice and general practitioners (GPs), including a focus on commissioning and practice population health needs, were reflected in the specialty training curriculum published by the Royal College of General Practitioners (RCGP) in 2007. In response to these developments the London Deanery established training attachments to the public health departments of ten primary care trusts (PCTs) across London, incorporated into three-year GP specialty training programmes. These attachments were evaluated in 2008 by London South Bank University. The aims of the evaluation were to assess the attachment's suitability for addressing areas of the RCGP curriculum; and to explore perceptions of its value for GP training and for future practice. Semi-structured interviews were carried out with two cohorts of trainees towards the end of their public health attachment, and with public health trainers and GP training programme directors from participating schemes. The training attachments were generally considered to offer good opportunities for trainees to fulfil both public health competences and to address relevant areas of the RCGP curriculum, through a variety of types of work. However, this did not necessarily influence either the level of importance attributed to public health in comparison with other clinical training posts or the perceived impact of the attachment on the trainees' future practice as GPs. The reported learning outcomes and value of the attachment for the public health trainers and programme directors reflected the changing and perceived future demands on GPs, but these views were not generally shared by trainees. Public health attachments may offer general practice training programme opportunities for the development of skills and knowledge that are relevant to the changing nature of general practice. Yet, there still appears to be a barrier for trainee GPs in acknowledging their role in non-clinical, population-focused healthcare provision. This raises questions for the way in which public health is presented in medical education and how the future GP workforce conceptualise their role and responsibilities.

  6. What does magnetic resonance imaging add to the prenatal ultrasound diagnosis of facial clefts?

    Science.gov (United States)

    Mailáth-Pokorny, M; Worda, C; Krampl-Bettelheim, E; Watzinger, F; Brugger, P C; Prayer, D

    2010-10-01

    Ultrasound is the modality of choice for prenatal detection of cleft lip and palate. Because its accuracy in detecting facial clefts, especially isolated clefts of the secondary palate, can be limited, magnetic resonance imaging (MRI) is used as an additional method for assessing the fetus. The aim of this study was to investigate the role of fetal MRI in the prenatal diagnosis of facial clefts. Thirty-four pregnant women with a mean gestational age of 26 (range, 19-34) weeks underwent in utero MRI, after ultrasound examination had identified either a facial cleft (n = 29) or another suspected malformation (micrognathia (n = 1), cardiac defect (n = 1), brain anomaly (n = 2) or diaphragmatic hernia (n = 1)). The facial cleft was classified postnatally and the diagnoses were compared with the previous ultrasound findings. There were 11 (32.4%) cases with cleft of the primary palate alone, 20 (58.8%) clefts of the primary and secondary palate and three (8.8%) isolated clefts of the secondary palate. In all cases the primary and secondary palate were visualized successfully with MRI. Ultrasound imaging could not detect five (14.7%) facial clefts and misclassified 15 (44.1%) facial clefts. The MRI classification correlated with the postnatal/postmortem diagnosis. In our hands MRI allows detailed prenatal evaluation of the primary and secondary palate. By demonstrating involvement of the palate, MRI provides better detection and classification of facial clefts than does ultrasound alone. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.

  7. Atypical antipsychotics as add-on treatment in late-life depression

    Directory of Open Access Journals (Sweden)

    Cakir S

    2016-09-01

    Full Text Available Sibel Cakir,1 Zeynep Senkal2 1Department of Psychiatry, Mood Disorders, Geriatric Psychiatry Unit, Istanbul Medical School, Istanbul University, 2Department of Psychiatry, Marmara University, Istanbul, Turkey Background: Second-generation antipsychotics (SGAs have been used in the augmentation of treatment-resistant depression. However, little is known about their effectiveness, tolerability, and adverse events in the treatment of late-life depression, which were the aim of this study.Methods: The retrospective data of patients aged >65 years who had a major depressive episode with inadequate response to antidepressant treatment and had adjuvant SGA treatment were analyzed. The outcome measures were the number of the patients who continued to use SGAs in the fourth and twelfth weeks, adverse events, and changes in symptoms of depression. Results: Thirty-five patients were screened: 21 (60% had quetiapine, twelve (34.28% had aripiprazole, and two (5.71% had olanzapine adjuvant treatment. The mean age was 72.17±5.02 years, and 65.7% of the patients were women. The mean daily dose was 85.71±47.80 mg for quetiapine, 3.33±1.23 mg for aripiprazole, and 3.75±1.76 mg for olanzapine. The Geriatric Depression Scale scores of all patients were significantly decreased in the fourth week and were significant in the aripiprazole group (P=0.02. Of the 35 patients, 23 (65.7% patients discontinued the study within 12 weeks. The frequency of adverse events was similar in all SGAs, and the most common were sedation, dizziness, constipation, and orthostatic hypotension with quetiapine, and akathisia and headache because of aripiprazole. Conclusion: This study indicates that dropout ratio of patients with SGAs is high, and a subgroup of patients with late-life depression may benefit from SGAs. Effectiveness is significant in aripiprazole, and adverse events of SGAs were not serious but common in elderly patients. Keywords: treatment resistance, aripiprazole, quetiapine, olanzapine, elderly

  8. Online Citizens - Does the Net Add Something New to the Local Public and Local Politics?

    Directory of Open Access Journals (Sweden)

    Lars Torpe

    2006-09-01

    Full Text Available The article discusses the skeptical view that on-line forms of politial participation have thus far had only little importance for democracy. Based on an analysis of the interplay between the supply of, and the demands for, e-tools for political informaiton and deliberation at the local level in Denmark, it is concluded that the skeptical view is con- firmed to some extent; however, It is also shown that something more - as well as something new - is added to the local political public, both in terms of the citizens involved and the topics discussed. Further- more, the case study indicates that online deliberations have had a number of minor effects on local political opinionformation and deci- sion-making. Thus, the overall conclusion is that a local forum of digital deliberations has the potential to form an alternative channel for raising issues and forming a vehicle for involving more citizens in politics, including citizens with weak resources.

  9. Add-drop double bus microresonator array local oscillators for sharp multiple Fano resonance engineering

    Science.gov (United States)

    Li, Jiahua; Qu, Ye; Wu, Ying

    2018-03-01

    Asymmetric resonances are currently the subject of considerable research efforts in photonic nanostructures. Here we propose a feasible method to achieve multiple Fano resonances and their control in an optical compound system consisting of an array of on-chip microresonators without mutual coupling and two parallel fiber waveguides side-coupled to the microresonator array by means of a local oscillator. We derive analytical and transparent expressions for the power transmission function summing over the two light transporting paths within the framework of quantum optics. It is clearly shown that introducing the local oscillator as an additional light propagating path plays an important role in the formation of narrow and multiple Fano resonance lineshapes. The power transmission spectrum through the combination of both the microresonator array and the local oscillator is very sensitive to the system parameters, for example, the intrinsic decay rate of the resonator, the phase shift factor of the local oscillator, the transmission coefficient of the fiber beam splitter, and the total number of the microresonators. Through detailed analysis, we identify the optimums for generating Fano resonance lineshapes. Also, we assess the experimental feasibility of the scheme using currently available technology. The proposed method is relatively straightforward as it requires only one local oscillator as one interferometer arm and it is mostly fiber-based. We believe that our work will help to understand and improve multiple Fano resonance engineering.

  10. [Memantine as add-on medication to acetylcholinesterase inhibitor therapy for Alzheimer dementia].

    Science.gov (United States)

    Haussmann, R; Donix, M

    2017-01-01

    Currently available data indicate superior therapeutic effects of combination treatment for Alzheimer dementia with memantine and acetylcholine esterase inhibitors in certain clinical contexts. Out of five randomized, placebo-controlled, double-blind trials two showed superior therapeutic effects in comparison to monotherapy with acetylcholinesterase inhibitors regarding various domains. Recently published meta-analyses and cost-benefit analyses also showed positive results. Recently published German guidelines for dementia treatment also take these new data into account and recommend combination treatment in patients with severe dementia on stable donepezil medication. This article gives an overview of current evidence for combination therapy.

  11. Math basics made easy teach yourself how to add, subtract, multiply and divide

    CERN Document Server

    Crisonino, Ginny

    2012-01-01

    There's an unspoken weak spot in our society …  most adults can't do basic math.  . A recent U.S. Department of Education study found that American adults are largely unable to calculate tips, understand their mortgage payments, or even figure out their weekly salary when told their hourly wage.  . Though we live in a world where numbers, percentages and statistics are tossed at us daily - a world that expects us to make sense of these figures -  87% of American adults are deemed "non-proficient" at math, according to a recent Education Department study.  . But there is hope. As the scope of t

  12. The influence of physical activity on cigarette smoking among adolescents: evidence from Add Health.

    Science.gov (United States)

    Ali, Mir M; Amialchuk, Aliaksandr; Heller, Lauren R

    2015-05-01

    This article explored the relationship between physical activity and smoking behavior among adolescents using rich longitudinal survey data from a nationally representative sample of adolescents. Several endogeneity-corrected models were estimated to ascertain the effect of exercise on both the probability of being a smoker and the intensity of cigarette smoking. The analysis indicated that 1 additional weekly occurrence of exercise led to a 0.3% decline in the probability of being a smoker and led to a 4.1% reduction in the number of cigarettes smoked by a smoker during a month, a result that was robust to stratification by gender and race/ethnicity. Consistent with the national guidelines, frequencies of physical activity of at least 7 times per week appeared to exhibit the biggest benefits in terms of reduction in smoking for both genders and across races/ethnicities. Reduction in health-damaging smoking behavior among adolescents could be an additional benefit of being physically active. This research documented a new pathway by which even moderate increases in physical activity could result in improved health outcomes by reducing smoking. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Does MRI add to ultrasound in the assessment of disorders of sex development?

    International Nuclear Information System (INIS)

    Mansour, S.M.; Hamed, S.T.; Adel, L.; Kamal, R.M.; Ahmed, D.M.

    2012-01-01

    Objective: The objective of the study was to evaluate the need of magnetic resonance imaging and using different approaches (transabdominal, endoluminal and transperineal) in the proper assessment of disorders of sex development regarding gonadal detection and gender differentiation. Subjects and methods: Twenty five patients with abnormalities of sex disorders were included. They were classified into two groups according to the time of clinical presentation: Group 1 (early onset) included eight cases. Their age ranged from one month to 12 years (mean age = 3.0). They presented with overt genital ambiguity of clitoral hypertrophy in a phenotypic female, non palpable testes or micropenis in a phenotypic male. Group 2 (late onset) included 17 cases. Their age ranged from 16 to 33 years (mean age 18.1). This group presented by distressing puberty symptoms of primary amenorrhea in a female phenotype or undescended testis and behaving as a male. Cases were subjected to Ultrasound and MR imaging examinations. Imaging results were correlated results of chromosomal and hormonal assays as well as laparoscopy findings. Results: The study included: 10/25 cases (40%) of female pseudo-hermaphroditism, 13/25 cases (52%) of male pseudo-hermaphroditism, one case (4%) of true hermaphroditism and one case (4%) of pure gonadal dysgenesis. The accuracy of multi approach ultrasound was 89.8% compared to 85.7% in MR imaging. Conclusion: Ultrasound should be considered the initial screening modality in the assessment of developmental sex disorders. MRI examination could be reserved for gonad identification when ultrasound examination fails to do so and for corrective surgery guidance

  14. Safety and pharmacokinetics of intravenous levetiracetam infusion as add-on in status epilepticus

    NARCIS (Netherlands)

    Uges, Joris W F; van Huizen, Marc D; Engelsman, Jeroen; Wilms, Erik B; Touw, Daniel J; Peeters, Els; Vecht, Charles J

    PURPOSE: To evaluate the feasibility and safety of intravenous (iv) levetiracetam (LEV) added to the standard therapeutic regimen in adults with status epilepticus (SE), and as secondary objective to assess a population pharmacokinetic (PK) model for ivLEV in patients with SE. METHODS: In 12 adults

  15. Improvement of post-hypoxic action myoclonus with levetiracetam add-on therapy: A case report

    Directory of Open Access Journals (Sweden)

    Božić Ksenija

    2014-01-01

    Full Text Available Introduction. Chronic post-anoxic myoclonus, also known as Lance-Adams syndrome, may develop following hypoxic brain injury, and is resistant to pharmacological therapy. Case report. The patient we presented developed post-anoxic action myoclonus with severe, completely incapacitating myoclonic jerks. Myoclonus did not respond to the treatment with commonly used agents, i.e. valproate and clonazepam alone or in combination. Improvement of the action myoclonus was observed only after adding levetiracetam. Conclusion. Although Lance-Adams syndrome may not be fully curable at this point, levetiracetam appears to be a promising agent that can significantly improve functional level and overall quality of life of patients with this disorder.

  16. Does Supplementation with Omega-3 PUFAs Add to the Prevention of Cardiovascular Disease?

    Science.gov (United States)

    Rizos, Evangelos C; Elisaf, Moses S

    2017-06-01

    Omega-3 fatty acids are increasingly used for the protection of cardiovascular disease. The main but not the sole mechanism of action is the reduction of triglyceride levels. In this review, we summarize the effect of omega-3 supplements on all-cause and cardiovascular mortality, myocardial infarction, and stroke from the relevant randomized controlled trials. Twenty-one randomized controlled trials assessed omega-3 supplementation on mortality and cardiovascular-related outcomes. From these studies, as well as from the relevant meta-analyses, we found that omega-3 supplements do not exert a consistent benefit for cardiovascular protection. There is uncertainty of a clear profit from omega-3 supplementation in cardiovascular disease.

  17. Traveling Companions Add Complexity and Hinder Performance in the Spatial Behavior of Rats

    DEFF Research Database (Denmark)

    Dorfman, Alex; Nielbo, Kristoffer Laigaard; Eilam, David

    2016-01-01

    -mate. It was found that the presence of another rat substantially altered the rats' spatial behavior. Lone rats collected the food items faster while traveling a shorter distance, reflecting a higher efficiency of task completion. When accompanied by a partner, however, the rats traveled together, visiting the same......We sought to uncover the impact of the social environment on the spatial behavior of rats. Food-deprived rats were trained in a spatial task of collecting food items from 16 equispaced objects. Following training, they were tested, first alone and then with a similarly-trained cage...... of rats’ natural behavior. Revisiting an object following food depletion implies that searching for food was not the main driving force in the rats' spatial behavior. Specifically, despite food deprivation, rats were more attentive to one another than to the food. This could be adaptive, since foraging...

  18. It All Adds Up: Learning Early Math through Play and Games

    Science.gov (United States)

    Ramani, Geetha B.; Eason, Sarah H.

    2015-01-01

    Playing and learning mathematics do not have to be mutually exclusive activities, especially in kindergarten. Play and games can give young children opportunities to learn and develop foundational math skills that are aligned with Common Core standards for mathematics through age-appropriate, fun, and engaging activities.

  19. Gantry and isocenter displacements of a linear accelerator caused by an add-on micromultileaf collimator

    DEFF Research Database (Denmark)

    Riis, H. L.; Zimmermann, S. J.; Hjelm-Hansen, M.

    2013-01-01

    Purpose: The delivery of high quality stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) treatments to the patient requires knowledge of the position of the isocenter to submillimeter accuracy. To meet the requirements the deviation between the radiation and mechanical isocenters...... isocenter was measured using a ball-bearing phantom and the electronic portal image device system. These measurements were based on 8 MV photon beams irradiated onto the ball from the four cardinal angles and two opposed collimator angles. The measurements and analysis of the data were carried out...

  20. Is it useful to add acetaminophen to high-potency opioids in cancer-related pain?

    Directory of Open Access Journals (Sweden)

    Oscar Corsi

    2017-06-01

    Full Text Available Resumen El dolor es uno de los síntomas más frecuentes y relevantes en pacientes oncológicos. La estrategia analgésica escalonada de la Organización Mundial de la Salud postula el uso de opioides fuertes asociado a coadyuvantes como el paracetamol o los antiinflamatorios no esteroidales en el peldaño III. Sin embargo, existe la duda si agregar paracetamol a un esquema analgésico basado en opioides fuertes presenta algún beneficio en pacientes oncológicos con dolor moderado a severo. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en múltiples fuentes de información, identificamos dos revisiones sistemáticas que en conjunto incluyen cinco estudios aleatorizados. Extrajimos los datos relevantes y resumimos los resultados utilizando el método GRADE. Concluimos que agregar paracetamol a los opioides fuertes podría hacer poca o nula diferencia en el control del dolor en pacientes oncológicos.

  1. Do oblique views add value in the diagnosis of spondylolysis in adolescents?

    Science.gov (United States)

    Beck, Nicholas A; Miller, Robert; Baldwin, Keith; Zhu, X; Spiegel, David; Drummond, Denis; Sankar, Wudbhav N; Flynn, John M

    2013-05-15

    Anteroposterior, lateral, and right and left oblique lumbar spine radiographs are often a standard part of the evaluation of children who are clinically suspected of having spondylolysis. Recent concerns regarding radiation exposure and costs have brought the value of oblique radiographs into question. The purpose of the present study was to determine the diagnostic value of oblique views in the diagnosis of spondylolysis. Radiographs of fifty adolescents with L5 spondylolysis without spondylolisthesis and fifty controls were retrospectively reviewed. All controls were confirmed not to have spondylolysis on the basis of computed tomographic scanning, magnetic resonance imaging, or bone scanning. Anteroposterior, lateral, and right and left oblique radiographs of the lumbar spine were arranged into two sets of slides: one showing four views (anteroposterior, lateral, right oblique, and left oblique) and one showing two views (anteroposterior and lateral only). The slides were randomly presented to four pediatric spine surgeons for diagnosis, with four-view slides being presented first, followed by two-view slides. The slides for twenty random patients were later reanalyzed in order to calculate of intra-rater agreement. A power analysis demonstrated that this study was adequately powered. Inter-rater and intra-rater agreement were assessed on the basis of the percentage of overall agreement and intraclass correlation coefficients (ICCs). PCXMC software was used to generate effective radiation doses. Study charges were determined from radiology billing data. There was no significant difference in sensitivity and specificity between four-view and two-view radiographs in the diagnosis of spondylolysis. The sensitivity was 0.59 for two-view studies and 0.53 for four-view studies (p = 0.33). The specificity was 0.96 for two-view studies and 0.94 for four-view studies (p = 0.60). Inter-rater agreement, intra-rater agreement, and agreement with gold-standard ICC values were in the moderate range and also demonstrated no significant differences. Percent overall agreement was 78% for four-view studies and 82% for two-view studies. The radiation effective dose was 1.26 mSv for four-view studies and 0.72 mSv for two-view studies (difference, 0.54 mSv). The charge for four-view studies was $145 more than that for two-view studies. There is no difference in sensitivity and specificity between four-view and two-view studies. Although oblique views have long been considered standard practice by some, our data could not identify a diagnostic benefit that might outweigh the additional cost and radiation exposure.

  2. How Effective Project Management Will Add Value to Your Uranium Asset

    International Nuclear Information System (INIS)

    Bradford, Russell; Titley, Malcolm

    2014-01-01

    Key learnings: • Timely stakeholder communication and education; • Mineralogy and testwork; • Learn from other Uranium developers. Feasibility work can cost anywhere from $1m up to $30m, construction and operation costs run into $100m’s. Spend investors money wisely to ensure a good product.

  3. Beyond a climate-centric view of plant distribution: edaphic variables add value to distribution models.

    Science.gov (United States)

    Beauregard, Frieda; de Blois, Sylvie

    2014-01-01

    Both climatic and edaphic conditions determine plant distribution, however many species distribution models do not include edaphic variables especially over large geographical extent. Using an exceptional database of vegetation plots (n = 4839) covering an extent of ∼55,000 km2, we tested whether the inclusion of fine scale edaphic variables would improve model predictions of plant distribution compared to models using only climate predictors. We also tested how well these edaphic variables could predict distribution on their own, to evaluate the assumption that at large extents, distribution is governed largely by climate. We also hypothesized that the relative contribution of edaphic and climatic data would vary among species depending on their growth forms and biogeographical attributes within the study area. We modelled 128 native plant species from diverse taxa using four statistical model types and three sets of abiotic predictors: climate, edaphic, and edaphic-climate. Model predictive accuracy and variable importance were compared among these models and for species' characteristics describing growth form, range boundaries within the study area, and prevalence. For many species both the climate-only and edaphic-only models performed well, however the edaphic-climate models generally performed best. The three sets of predictors differed in the spatial information provided about habitat suitability, with climate models able to distinguish range edges, but edaphic models able to better distinguish within-range variation. Model predictive accuracy was generally lower for species without a range boundary within the study area and for common species, but these effects were buffered by including both edaphic and climatic predictors. The relative importance of edaphic and climatic variables varied with growth forms, with trees being more related to climate whereas lower growth forms were more related to edaphic conditions. Our study identifies the potential for non-climate aspects of the environment to pose a constraint to range expansion under climate change.

  4. Beyond a climate-centric view of plant distribution: edaphic variables add value to distribution models.

    Directory of Open Access Journals (Sweden)

    Frieda Beauregard

    Full Text Available Both climatic and edaphic conditions determine plant distribution, however many species distribution models do not include edaphic variables especially over large geographical extent. Using an exceptional database of vegetation plots (n = 4839 covering an extent of ∼55,000 km2, we tested whether the inclusion of fine scale edaphic variables would improve model predictions of plant distribution compared to models using only climate predictors. We also tested how well these edaphic variables could predict distribution on their own, to evaluate the assumption that at large extents, distribution is governed largely by climate. We also hypothesized that the relative contribution of edaphic and climatic data would vary among species depending on their growth forms and biogeographical attributes within the study area. We modelled 128 native plant species from diverse taxa using four statistical model types and three sets of abiotic predictors: climate, edaphic, and edaphic-climate. Model predictive accuracy and variable importance were compared among these models and for species' characteristics describing growth form, range boundaries within the study area, and prevalence. For many species both the climate-only and edaphic-only models performed well, however the edaphic-climate models generally performed best. The three sets of predictors differed in the spatial information provided about habitat suitability, with climate models able to distinguish range edges, but edaphic models able to better distinguish within-range variation. Model predictive accuracy was generally lower for species without a range boundary within the study area and for common species, but these effects were buffered by including both edaphic and climatic predictors. The relative importance of edaphic and climatic variables varied with growth forms, with trees being more related to climate whereas lower growth forms were more related to edaphic conditions. Our study identifies the potential for non-climate aspects of the environment to pose a constraint to range expansion under climate change.

  5. Recruitment of Refugees for Health Research: A Qualitative Study to Add Refugees' Perspectives.

    Science.gov (United States)

    Gabriel, Patricia; Kaczorowski, Janusz; Berry, Nicole

    2017-01-29

    Research is needed to understand refugees' health challenges and barriers to accessing health services during settlement. However, there are practical and ethical challenges for engaging refugees as participants. Despite this, there have been no studies to date specifically investigating refugee perspectives on factors affecting engagement in health research. Language-concordant focus groups in British Columbia, Canada, with four government-assisted refugee language groups (Farsi/Dari, Somali, Karen, Arabic) inquired about willingness to participate in health research. Twenty-three variables associated with the willingness of refugees to participate in health research were elicited. Variables related to research design included recruitment strategies, characteristics of the research team members and the nature of the research. Variables related to individual participants included demographic features such as gender and education, attitudes towards research and previous experience with research. This research can be used to increase opportunities for refugees' engagement in research and includes recommendations for subgroups of refugees that may have more difficulties engaging in research.

  6. Biomedical engineering - A means to add new dimension to medicine and research

    Science.gov (United States)

    Doerr, D. F.

    1992-01-01

    Biomedical engineering is an evolving science that seeks to insert technically oriented and trained personnel to assist medical professionals in solving technological problems in the pursuit of innovations in the delivery of health care. Consequently, engineering solutions are brought to bear on problems that previously were outside the training of physicians and beyond the understanding or appreciation of the conventionally educated electrical or mechanical engineers. This physician/scientist/engineer team has a capability to extend medicine and research far beyond the capability of a single entity operating alone. How biomedical engineering has added a new dimension to medical science at the Kennedy Space Center is described.

  7. What reported food-evoked emotions may add : A model to predict consumer food choice

    NARCIS (Netherlands)

    Gutjar, Swetlana; Dalenberg, Jelle R.; de Graaf, Cees; de Wijk, Rene A.; Palascha, Aikaterini; Renken, Remco J.; Jager, Gerry

    2015-01-01

    Food-evoked emotions provide information that goes beyond the information from traditional hedonic ratings. The objectives of our study were: (i) to investigate how intrinsic (sensory) and extrinsic (packaging) cues affect consumers' emotional responses to foods, and (ii) to explore whether

  8. What reported food-evoked emotions may add: A model to predict consumer food choice

    NARCIS (Netherlands)

    Gutjar, S.; Dalenberg, J.R.; Graaf, de C.; Wijk, de R.A.; Palascha, A.; Renken, Remco J.; Jager, G.

    2015-01-01

    Food-evoked emotions provide information that goes beyond the information from traditional hedonic ratings. The objectives of our study were: (i) to investigate how intrinsic (sensory) and extrinsic (packaging) cues affect consumers’ emotional responses to foods, and (ii) to explore whether

  9. Digital tomosynthesis parallel imaging computational analysis with shift and add and back projection reconstruction algorithms.

    Science.gov (United States)

    Chen, Ying; Balla, Apuroop; Rayford II, Cleveland E; Zhou, Weihua; Fang, Jian; Cong, Linlin

    2010-01-01

    Digital tomosynthesis is a novel technology that has been developed for various clinical applications. Parallel imaging configuration is utilised in a few tomosynthesis imaging areas such as digital chest tomosynthesis. Recently, parallel imaging configuration for breast tomosynthesis began to appear too. In this paper, we present the investigation on computational analysis of impulse response characterisation as the start point of our important research efforts to optimise the parallel imaging configurations. Results suggest that impulse response computational analysis is an effective method to compare and optimise imaging configurations.

  10. Does Wearable Medical Technology With Video Recording Capability Add Value to On-Call Surgical Evaluations?

    Science.gov (United States)

    Gupta, Sameer; Boehme, Jacqueline; Manser, Kelly; Dewar, Jannine; Miller, Amie; Siddiqui, Gina; Schwaitzberg, Steven D

    2016-10-01

    Background Google Glass has been used in a variety of medical settings with promising results. We explored the use and potential value of an asynchronous, near-real time protocol-which avoids transmission issues associated with real-time applications-for recording, uploading, and viewing of high-definition (HD) visual media in the emergency department (ED) to facilitate remote surgical consults. Study Design First-responder physician assistants captured pertinent aspects of the physical examination and diagnostic imaging using Google Glass' HD video or high-resolution photographs. This visual media were then securely uploaded to the study website. The surgical consultation then proceeded over the phone in the usual fashion and a clinical decision was made. The surgeon then accessed the study website to review the uploaded video. This was followed by a questionnaire regarding how the additional data impacted the consultation. Results The management plan changed in 24% (11) of cases after surgeons viewed the video. Five of these plans involved decision making regarding operative intervention. Although surgeons were generally confident in their initial management plan, confidence scores increased further in 44% (20) of cases. In addition, we surveyed 276 ED patients on their opinions regarding concerning the practice of health care providers wearing and using recording devices in the ED. The survey results revealed that the majority of patients are amenable to the addition of wearable technology with video functionality to their care. Conclusions This study demonstrates the potential value of a medically dedicated, hands-free, HD recording device with internet connectivity in facilitating remote surgical consultation. © The Author(s) 2016.

  11. Personal values and pain tolerance: does a values intervention add to acceptance?

    Science.gov (United States)

    Branstetter-Rost, Ann; Cushing, Christopher; Douleh, Tanya

    2009-08-01

    Previous research suggests that acceptance is a promising alternative to distraction and control techniques in successfully coping with pain. Acceptance interventions based upon Acceptance and Commitment Therapy (ACT) have been shown to lead to greater tolerance of acute pain as well as increased adjustment and less disability among individuals with chronic pain. However, in these previous intervention studies, the ACT component of values has either not been included or not specifically evaluated. The current study compares the effects of an ACT-based acceptance intervention with and without the values component among individuals completing the cold-pressor task. Results indicate that inclusion of the values component (n = 34) of ACT leads to significantly greater pain tolerance than acceptance alone (n = 30). Consistent with previous research, both conditions were associated with greater pain tolerance than control (n = 35). Despite the difference in tolerance, pain threshold did not differ, and participants in the control condition provided lower ratings of pain severity. The findings from this study support the important role of values and values clarification in acceptance-based interventions such as ACT, and provide direction for clinicians working with individuals with chronic pain conditions. This article evaluates the additive effect of including a personalized-values exercise in an acceptance-based treatment for pain. Results indicate that values interventions make a significant contribution and improvement to acceptance interventions, which may be of interest to clinicians who provide psychological treatment to individuals with chronic pain.

  12. It's not going to be that fun: negative experiences can add meaning to life.

    Science.gov (United States)

    Vohs, Kathleen D; Aaker, Jennifer L; Catapano, Rhia

    2018-04-22

    People seek to spend time in positive experiences, enjoying and savoring. Yet there is no escaping negative experiences, from the mundane (e.g. arguing) to the massive (e.g. death of a child). Might negative experiences confer a hidden benefit to well-being? We propose that they do, in the form of enhanced meaning in life. Research suggests that negative experiences can serve to boost meaning because they stimulate comprehension (understanding how the event fits into a broader narrative of the self, relationships, and the world), a known pillar of meaning in life. Findings on counterfactual thinking, reflecting on events' implications, and encompassing experiences into broad-based accounts of one's identity support the role of comprehension in contributing to life's meaning from unwanted, unwelcome experiences. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. How can Facilities Management Add Value to Organisations as well as to Society

    DEFF Research Database (Denmark)

    Jensen, Per Anker; Sarasoja, Anna-Liisa; van der Voordt, Theo

    2013-01-01

    The purpose of this paper is to present lessons learnt from a 3 year collaborative research project on the added value of Facilities Management (FM) involving institutions in five European countries. The starting point was the so-called FM Value Map developed earlier by the leader of the research...... group. The project applied three basic theoretical perspectives: FM, Corporate Real Estate Management (CREM) and Business to Business (B2B) marketing and started with a major literature review on added value based on each of these perspectives. The collaboration included a series of workshops...... and preparation of research papers covering theoretical, methodological and empirical aspects. The results were published as an anthology in May 2012. The three basic perspectives of FM, CREM and B2B marketing provide both overlapping and complementary focus areas in relation to adding value. Four conceptual...

  14. Tramadol versus methadone for the management of acute opioid withdrawal: an add-on study

    Directory of Open Access Journals (Sweden)

    M Salehi

    2006-07-01

    Full Text Available BACKGROUND: Opioid agonists such as methadone have been used widely in controlling opioid withdrawal symptoms. Tramadol, a partial opioid agonist, also has been prescribed to manage acute and chronic pain. We sought to compare the efficacy of tramadol and methadone in reducing the severity of opioid withdrawal symptoms. METHODS: In a double blind clinical trial 70 opioid dependent patients who used daily opium equal to 15 mg methadone randomly were assigned in two groups. In one group, methadone was started at 15 mg/day while in the other group 450 mg/day tramadol was prescribed. Both drugs were tapered in a week and placebo was prescribed in the 2nd week. The severity of withdrawal symptoms were assessed five times by short opioid withdrawal scale (SOWS. Data were analyzed by Repeated Measures Analysis of Variance, Mann-Whitney U, and Wilcoxon tests. RESULTS: There were statistically significant differences between two groups in the severity of anxiety (P = 0.015, irritability (P = 0.044, palpitation (P = 0.018, agitation (P = 0.037, and dysphoria (P = 0.044 that all were more common in methadone group. Comparison of side effects revealed statistically significant differences in sweating (P = 0.003 and drowsiness (P = 0.019 between two groups that were more frequent in methadone group. DISCUSSION: Tramadol was more efficacious in controlling opioid withdrawal symptoms with lower side effects. KEYWORDS: Methadone, tramadol, opioid withdrawal.

  15. Impaired Neonatal Outcome after Emergency Cerclage Adds Controversy to Prolongation of Pregnancy.

    Directory of Open Access Journals (Sweden)

    Ruben-J Kuon

    Full Text Available Emergency cervical cerclage is one of the treatment options for the reduction of preterm birth. The aim of this study is to assess neonatal outcome after cerclage with special focus on adverse effects in very low birth weight infants.Retrospective cohort study. Classification of cerclages in history-indicated (HIC, n = 38, ultrasound-indicated (UIC, n = 29 and emergency/ physical examination-indicated (PEIC, n = 33 cerclage. Descriptive analysis of pregnancy and neonatal outcome (admission to NICU, duration of hospitalization, respiratory outcome (intubation, CPAP, FiO2max, neonatal complications (ROP, IVH. Statistical comparison of perinatal parameters and outcome of neonates <1500 g after cerclage with a birth weight matched control group.Neonates <1500 g after PEIC show significantly impaired outcome, i.e. prolonged respiratory support (total ventilation in days, CPAP, FiO2max and higher rates of neonatal complications (IVH ≥ II, ROP ≥ 2. Placental pathologic evaluation revealed a significantly higher rate of chorioamnionitis (CAM after PEIC. Neonates <1500 g after UIC or HIC show no significant difference in neonatal complications or CAM.In our study PEIC is associated with adverse neonatal outcome in infants <1500 g. The high incidence of CAM indicates a potential inflammatory factor in the pathogenesis. Large well-designed RCTs are required to give conclusive answers to the question whether to prolong or to deliver.

  16. Immunostaining of skin biopsy adds no diagnostic value in MGUS-associated peripheral neuropathy

    DEFF Research Database (Denmark)

    Al-Zuhairy, Ali; Schrøder, Henrik Daa; Plesner, Torben

    2015-01-01

    BACKGROUND AND PURPOSE: For several decades an association between MGUS, IgM-MGUS in particular, and peripheral neuropathy has been suspected. Several histopathology studies have shown binding of IgM to myelin and a secondary widening of myelin lamellae in cutaneous nerves and in the sural nerve...... of patients with IgM-MGUS, or Waldenström's Macroglobulinaemia (WM), and peripheral neuropathy. In this retrospective study we investigated the value of skin biopsy examination in the diagnosis of MGUS- and WM-associated peripheral neuropathy. METHODS: A total of 117 patients, who were examined for an M......-component in serum with associated nerve symptoms, had a skin biopsy taken and examined for immunoglobulin deposition in cutaneous nerves. Thirty-five patients were diagnosed with MGUS or WM and peripheral neuropathy with no other cause of neuropathy. Nineteen patients had MGUS but no peripheral neuropathy. RESULTS...

  17. Three-question set from Michigan Neuropathy Screening Instrument adds independent prognostic information on cardiovascular outcomes

    DEFF Research Database (Denmark)

    Seferovic, Jelena P; Pfeffer, Marc A; Claggett, Brian

    2018-01-01

    AIMS/HYPOTHESIS: The self-administered Michigan Neuropathy Screening Instrument (MNSI) is used to diagnose diabetic peripheral neuropathy. We examined whether the MNSI might also provide information on risk of death and cardiovascular outcomes. METHODS: In this post hoc analysis of the Aliskiren...

  18. Add-On Complementary Medicine in Cancer Care: Evidence in Literature and Experiences of Integration

    Directory of Open Access Journals (Sweden)

    Elio Rossi

    2017-01-01

    Full Text Available Background: According to the literature an increasing number of cancer patients demand for complementary therapies during their disease. Research has demonstrated that some of these therapies are effective and safe as adjunctive treatments in specific symptoms of these patients. Methods: The aims of the paper are to review the main and recent papers of international literature on the effectiveness of complementary medicine (CM therapies on side effects of anti-cancer protocols and improvement in the quality of life of oncological patients, and to describe the integration of evidence-based acupuncture, herbal medicine and homeopathy treatments in Public Cancer Network of the region of Tuscany. Results: After the review of literature and the approval of a Regional Resolution, some CM will be introduced in Cancer Departments in Tuscany to additionally treat cancer-related symptoms and side effects of conventional cancer therapy: acupuncture for nausea and post-chemotherapy and post-surgery vomiting, pain, hot flashes of iatrogenic menopause, xerostomia; homeopathy for hot flashes of iatrogenic menopause and the side effects of radiotherapy; herbal medicine for cancer-related fatigue, nausea and vomiting, pain, mucositis, anxiety, and depression. Conclusions: The integration of evidence-based complementary treatments allows for an effective response to the demand coming from cancer patients and combines safety and equity of access in public health systems.

  19. Add-On Complementary Medicine in Cancer Care: Evidence in Literature and Experiences of Integration.

    Science.gov (United States)

    Rossi, Elio; Di Stefano, Mariella; Firenzuoli, Fabio; Monechi, Maria Valeria; Baccetti, Sonia

    2017-01-24

    Background : According to the literature an increasing number of cancer patients demand for complementary therapies during their disease. Research has demonstrated that some of these therapies are effective and safe as adjunctive treatments in specific symptoms of these patients. Methods : The aims of the paper are to review the main and recent papers of international literature on the effectiveness of complementary medicine (CM) therapies on side effects of anti-cancer protocols and improvement in the quality of life of oncological patients, and to describe the integration of evidence-based acupuncture, herbal medicine and homeopathy treatments in Public Cancer Network of the region of Tuscany. Results : After the review of literature and the approval of a Regional Resolution, some CM will be introduced in Cancer Departments in Tuscany to additionally treat cancer-related symptoms and side effects of conventional cancer therapy: acupuncture for nausea and post-chemotherapy and post-surgery vomiting, pain, hot flashes of iatrogenic menopause, xerostomia; homeopathy for hot flashes of iatrogenic menopause and the side effects of radiotherapy; herbal medicine for cancer-related fatigue, nausea and vomiting, pain, mucositis, anxiety, and depression. Conclusions : The integration of evidence-based complementary treatments allows for an effective response to the demand coming from cancer patients and combines safety and equity of access in public health systems.

  20. The Add-On Impact of Mobile Applications in Learning Strategies: A Review Study

    Science.gov (United States)

    Jeng, Yu-Lin; Wu, Ting-Ting; Huang, Yueh-Min; Tan, Qing; Yang, Stephen J. H.

    2010-01-01

    Mobile devices are more powerful and portable nowadays with plenty of useful tools for assisting people to handle daily life. With the advance of mobile technology, the issue of mobile learning has been widely investigated in e-learning research. Many researches consider it is important to integrate pedagogical and technical strengths of mobile…