WorldWideScience

Sample records for random linear combinations

  1. OPTIMAL LINEAR COMBINED FILTERING OF RANDOM SEQUENCES BASED ON THE RECURSIVE LEAST SQUARES METHOD

    Directory of Open Access Journals (Sweden)

    V. M. Artemiev

    2015-01-01

    Full Text Available The problem of the synthesis of linear combined filter for the criterion of minimizing current losses on the basis of the recursive least squares method is being solved. This approach does not requirea priori knowledge of the statistical characteristics of impacts that is an advantage compared with the Kalman filter. A comparative evaluation of the filters’ accuracy is provided using the values of variances of the filtering errors.

  2. Approximation with positive linear operators and linear combinations

    CERN Document Server

    Gupta, Vijay

    2017-01-01

    This book presents a systematic overview of approximation by linear combinations of positive linear operators, a useful tool used to increase the order of approximation. Fundamental and recent results from the past decade are described with their corresponding proofs. The volume consists of eight chapters that provide detailed insight into the representation of monomials of the operators Ln , direct and inverse estimates for a broad class of positive linear operators, and case studies involving finite and unbounded intervals of real and complex functions. Strong converse inequalities of Type A in terminology of Ditzian–Ivanov for linear combinations of Bernstein and Bernstein–Kantorovich operators and various Voronovskaja-type estimates for some linear combinations are analyzed and explained. Graduate students and researchers in approximation theory will find the list of open problems in approximation of linear combinations useful. The book serves as a reference for graduate and postgraduate courses as we...

  3. Squares of Random Linear Codes

    DEFF Research Database (Denmark)

    Cascudo Pueyo, Ignacio; Cramer, Ronald; Mirandola, Diego

    2015-01-01

    Given a linear code $C$, one can define the $d$-th power of $C$ as the span of all componentwise products of $d$ elements of $C$. A power of $C$ may quickly fill the whole space. Our purpose is to answer the following question: does the square of a code ``typically'' fill the whole space? We give...

  4. Linear combinations come alive in crossover designs.

    Science.gov (United States)

    Shuster, Jonathan J

    2017-10-30

    Before learning anything about statistical inference in beginning service courses in biostatistics, students learn how to calculate the mean and variance of linear combinations of random variables. Practical precalculus examples of the importance of these exercises can be helpful for instructors, the target audience of this paper. We shall present applications to the "1-sample" and "2-sample" methods for randomized short-term 2-treatment crossover studies, where patients experience both treatments in random order with a "washout" between the active treatment periods. First, we show that the 2-sample method is preferred as it eliminates "conditional bias" when sample sizes by order differ and produces a smaller variance. We also demonstrate that it is usually advisable to use the differences in posttests (ignoring baseline and post washout values) rather than the differences between the changes in treatment from the start of the period to the end of the period ("delta of delta"). Although the intent is not to provide a definitive discussion of crossover designs, we provide a section and references to excellent alternative methods, where instructors can provide motivation to students to explore the topic in greater detail in future readings or courses. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Decoding Algorithms for Random Linear Network Codes

    DEFF Research Database (Denmark)

    Heide, Janus; Pedersen, Morten Videbæk; Fitzek, Frank

    2011-01-01

    We consider the problem of efficient decoding of a random linear code over a finite field. In particular we are interested in the case where the code is random, relatively sparse, and use the binary finite field as an example. The goal is to decode the data using fewer operations to potentially a...

  6. Inpainting with sparse linear combinations of exemplars

    Energy Technology Data Exchange (ETDEWEB)

    Wohlberg, Brendt [Los Alamos National Laboratory

    2008-01-01

    We introduce a new exemplar-based inpainting algorithm based on representing the region to be inpainted as a sparse linear combination of blocks extracted from similar parts of the image being inpainted. This method is conceptually simple, being computed by functional minimization, and avoids the complexity of correctly ordering the filling in of missing regions of other exemplar-based methods. Initial performance comparisons on small inpainting regions indicate that this method provides similar or better performance than other recent methods.

  7. Inpainting With Sparse Linear Combinations of Exemplars

    Science.gov (United States)

    2010-05-01

    Alamos, NM 87545, USA ABSTRACT We introduce a new exemplar-based inpainting algorithm that represents the region to be inpainted as a sparse linear combi...exemplar-based methods. Initial performance comparisons on small inpaint - ing regions indicate that this method provides similar or better performance than...other recent methods. Index Terms— Image restoration, Inpainting , Exemplar 1. INTRODUCTION Exemplar based methods are becoming increasingly popular

  8. Random effect selection in generalised linear models

    DEFF Research Database (Denmark)

    Denwood, Matt; Houe, Hans; Forkman, Björn

    We analysed abattoir recordings of meat inspection codes with possible relevance to onfarm animal welfare in cattle. Random effects logistic regression models were used to describe individual-level data obtained from 461,406 cattle slaughtered in Denmark. Our results demonstrate that the largest ...

  9. Generalized linear longitudinal mixed models with linear covariance structure and multiplicative random effects

    DEFF Research Database (Denmark)

    Holst, René; Jørgensen, Bent

    2015-01-01

    The paper proposes a versatile class of multiplicative generalized linear longitudinal mixed models (GLLMM) with additive dispersion components, based on explicit modelling of the covariance structure. The class incorporates a longitudinal structure into the random effects models and retains...... a marginal as well as a conditional interpretation. The estimation procedure is based on a computationally efficient quasi-score method for the regression parameters combined with a REML-like bias-corrected Pearson estimating function for the dispersion and correlation parameters. This avoids...... the multidimensional integral of the conventional GLMM likelihood and allows an extension of the robust empirical sandwich estimator for use with both association and regression parameters. The method is applied to a set of otholit data, used for age determination of fish....

  10. Linear combination of forecasts with numerical adjustment via MINIMAX non-linear programming

    Directory of Open Access Journals (Sweden)

    Jairo Marlon Corrêa

    2016-03-01

    Full Text Available This paper proposes a linear combination of forecasts obtained from three forecasting methods (namely, ARIMA, Exponential Smoothing and Artificial Neural Networks whose adaptive weights are determined via a multi-objective non-linear programming problem, which seeks to minimize, simultaneously, the statistics: MAE, MAPE and MSE. The results achieved by the proposed combination are compared with the traditional approach of linear combinations of forecasts, where the optimum adaptive weights are determined only by minimizing the MSE; with the combination method by arithmetic mean; and with individual methods

  11. Non-linear continuous time random walk models★

    Science.gov (United States)

    Stage, Helena; Fedotov, Sergei

    2017-11-01

    A standard assumption of continuous time random walk (CTRW) processes is that there are no interactions between the random walkers, such that we obtain the celebrated linear fractional equation either for the probability density function of the walker at a certain position and time, or the mean number of walkers. The question arises how one can extend this equation to the non-linear case, where the random walkers interact. The aim of this work is to take into account this interaction under a mean-field approximation where the statistical properties of the random walker depend on the mean number of walkers. The implementation of these non-linear effects within the CTRW integral equations or fractional equations poses difficulties, leading to the alternative methodology we present in this work. We are concerned with non-linear effects which may either inhibit anomalous effects or induce them where they otherwise would not arise. Inhibition of these effects corresponds to a decrease in the waiting times of the random walkers, be this due to overcrowding, competition between walkers or an inherent carrying capacity of the system. Conversely, induced anomalous effects present longer waiting times and are consistent with symbiotic, collaborative or social walkers, or indirect pinpointing of favourable regions by their attractiveness. Contribution to the Topical Issue "Continuous Time Random Walk Still Trendy: Fifty-year History, Current State and Outlook", edited by Ryszard Kutner and Jaume Masoliver.

  12. Combined forecasts from linear and nonlinear time series models

    NARCIS (Netherlands)

    N. Terui (Nobuhiko); H.K. van Dijk (Herman)

    1999-01-01

    textabstractCombined forecasts from a linear and a nonlinear model are investigated for time series with possibly nonlinear characteristics. The forecasts are combined by a constant coefficient regression method as well as a time varying method. The time varying method allows for a locally

  13. Combined Forecasts from Linear and Nonlinear Time Series Models

    NARCIS (Netherlands)

    N. Terui (Nobuhiko); H.K. van Dijk (Herman)

    1999-01-01

    textabstractCombined forecasts from a linear and a nonlinear model are investigated for time series with possibly nonlinear characteristics. The forecasts are combined by a constant coefficient regression method as well as a time varying method. The time varying method allows for a locally

  14. Linear and Order Statistics Combiners for Pattern Classification

    Science.gov (United States)

    Tumer, Kagan; Ghosh, Joydeep; Lau, Sonie (Technical Monitor)

    2001-01-01

    Several researchers have experimentally shown that substantial improvements can be obtained in difficult pattern recognition problems by combining or integrating the outputs of multiple classifiers. This chapter provides an analytical framework to quantify the improvements in classification results due to combining. The results apply to both linear combiners and order statistics combiners. We first show that to a first order approximation, the error rate obtained over and above the Bayes error rate, is directly proportional to the variance of the actual decision boundaries around the Bayes optimum boundary. Combining classifiers in output space reduces this variance, and hence reduces the 'added' error. If N unbiased classifiers are combined by simple averaging. the added error rate can be reduced by a factor of N if the individual errors in approximating the decision boundaries are uncorrelated. Expressions are then derived for linear combiners which are biased or correlated, and the effect of output correlations on ensemble performance is quantified. For order statistics based non-linear combiners, we derive expressions that indicate how much the median, the maximum and in general the i-th order statistic can improve classifier performance. The analysis presented here facilitates the understanding of the relationships among error rates, classifier boundary distributions, and combining in output space. Experimental results on several public domain data sets are provided to illustrate the benefits of combining and to support the analytical results.

  15. Perturbation Solutions for Random Linear Structural Systems subject to Random Excitation using Stochastic Differential Equations

    DEFF Research Database (Denmark)

    Köyluoglu, H.U.; Nielsen, Søren R.K.; Cakmak, A.S.

    1994-01-01

    The paper deals with the first and second order statistical moments of the response of linear systems with random parameters subject to random excitation modelled as white-noise multiplied by an envelope function with random parameters. The method of analysis is basically a second order perturbat......The paper deals with the first and second order statistical moments of the response of linear systems with random parameters subject to random excitation modelled as white-noise multiplied by an envelope function with random parameters. The method of analysis is basically a second order...... for multi-degree-of-freedom (MDOF) systems and the method is illustrated for a single-degree-of-freedom (SDOF) oscillator. The results are compared to those of exact results for a random oscillator subject to white noise excitation with random intensity....

  16. Efficient $\\chi ^{2}$ Kernel Linearization via Random Feature Maps.

    Science.gov (United States)

    Yuan, Xiao-Tong; Wang, Zhenzhen; Deng, Jiankang; Liu, Qingshan

    2016-11-01

    Explicit feature mapping is an appealing way to linearize additive kernels, such as χ2 kernel for training large-scale support vector machines (SVMs). Although accurate in approximation, feature mapping could pose computational challenges in high-dimensional settings as it expands the original features to a higher dimensional space. To handle this issue in the context of χ2 kernel SVMs learning, we introduce a simple yet efficient method to approximately linearize χ2 kernel through random feature maps. The main idea is to use sparse random projection to reduce the dimensionality of feature maps while preserving their approximation capability to the original kernel. We provide approximation error bound for the proposed method. Furthermore, we extend our method to χ2 multiple kernel SVMs learning. Extensive experiments on large-scale image classification tasks confirm that the proposed approach is able to significantly speed up the training process of the χ2 kernel SVMs at almost no cost of testing accuracy.

  17. Information inefficiency in a random linear economy model

    CERN Document Server

    Jerico, Joao Pedro

    2016-01-01

    We study the effects of introducing information inefficiency in a model for a random linear economy with a representative consumer. This is done by considering statistical, instead of classical, economic general equilibria. Employing two different approaches we show that inefficiency increases the consumption set of a consumer but decreases her expected utility. In this scenario economic activity grows while welfare shrinks, that is the opposite of the behavior obtained by considering a rational consumer.

  18. Logistic ensembles of Random Spherical Linear Oracles for microarray classification.

    Science.gov (United States)

    Peterson, Leif E; Coleman, Matthew A

    2009-01-01

    Random Spherical Linear Oracles (RSLO) for DNA microarray gene expression data are proposed for classifier fusion. RSLO employs random hyperplane splits of samples in the principal component score space based on the first three principal components (X, Y, Z) of the input feature set. Hyperplane splits are used to assign training(testing) samples to separate logistic regression mini-classifiers, which increases the diversity of voting results since errors are not shared across mini-classifiers. We recommend use of RSLO with 3-4 10-fold CV and re-partitioning samples randomly every ten iterations prior to each 10-fold CV. This equates to a total of 30-40 iterations.

  19. Intravitreal bevacizumab injection alone or combined with triamcinolone versus macular photocoagulation in bilateral diabetic macular edema; application of bivariate generalized linear mixed model with asymmetric random effects in a subgroup of a clinical trial

    Directory of Open Access Journals (Sweden)

    Mehdi Yaseri

    2014-01-01

    Full Text Available Purpose: To compare the efficacy of intravitreal bevacizumab (IVB injection alone or with intravitreal triamcinolone acetonide (IVB/IVT versus macular photocoagulation (MPC in bilateral diabetic macular edema (DME. Methods: In this study we revisited data from a subset of subjects previously enrolled in a randomized clinical trial. The original study included 150 eyes randomized to three treatment arms: 1.25 mg IVB alone, combined injection of 1.25 mg IVB and 2 mg IVT, and focal or modified grid MPC. To eliminate the possible effects of systemic confounders, we selected fellow eyes of bilaterally treated subjects who had undergone different treatments; eventually 30 eyes of 15 patients were re-evaluated at baseline, 6, 12, 18, and 24 months. Using mixed model analysis, we compared the treatment protocols regarding visual acuity (VA and central macular thickness (CMT. Results: Improvement in VA in the IVB group was significantly greater compared to MPC at months 6 and 12 (P = 0.037 and P = 0.035, respectively but this difference did not persist thereafter up to 24 months. Other levels of VA were comparable at different follow-up intervals (all P > 0.05. The only significant difference in CMT was observed in favor of the IVB group as compared to IVB/IVT group at 24 months (P = 0.048. Conclusion: Overall VA was superior in IVB group as compared to MPC up to 12 months. Although the IVB group showed superiority regarding CMT reduction over 24 months as compared to IVB/IVT group, it was comparable to the MPC group through the same period of follow up.

  20. Intravitreal bevacizumab injection alone or combined with triamcinolone versus macular photocoagulation in bilateral diabetic macular edema; application of bivariate generalized linear mixed model with asymmetric random effects in a subgroup of a clinical trial.

    Science.gov (United States)

    Yaseri, Mehdi; Zeraati, Hojjat; Mohammad, Kazem; Soheilian, Masoud; Ramezani, Alireza; Eslani, Medi; Peyman, Gholam A

    2014-01-01

    To compare the efficacy of intravitreal bevacizumab (IVB) injection alone or with intravitreal triamcinolone acetonide (IVB/IVT) versus macular photocoagulation (MPC) in bilateral diabetic macular edema (DME). In this study we revisited data from a subset of subjects previously enrolled in a randomized clinical trial. The original study included 150 eyes randomized to three treatment arms: 1.25 mg IVB alone, combined injection of 1.25 mg IVB and 2 mg IVT, and focal or modified grid MPC. To eliminate the possible effects of systemic confounders, we selected fellow eyes of bilaterally treated subjects who had undergone different treatments; eventually 30 eyes of 15 patients were re-evaluated at baseline, 6, 12, 18, and 24 months. Using mixed model analysis, we compared the treatment protocols regarding visual acuity (VA) and central macular thickness (CMT). Improvement in VA in the IVB group was significantly greater compared to MPC at months 6 and 12 (P = 0.037 and P = 0.035, respectively) but this difference did not persist thereafter up to 24 months. Other levels of VA were comparable at different follow-up intervals (all P > 0.05). The only significant difference in CMT was observed in favor of the IVB group as compared to IVB/IVT group at 24 months (P = 0.048). Overall VA was superior in IVB group as compared to MPC up to 12 months. Although the IVB group showed superiority regarding CMT reduction over 24 months as compared to IVB/IVT group, it was comparable to the MPC group through the same period of follow up.

  1. Linear combination reading program for capture gamma rays

    Science.gov (United States)

    Tanner, Allan B.

    1971-01-01

    This program computes a weighting function, Qj, which gives a scalar output value of unity when applied to the spectrum of a desired element and a minimum value (considering statistics) when applied to spectra of materials not containing the desired element. Intermediate values are obtained for materials containing the desired element, in proportion to the amount of the element they contain. The program is written in the BASIC language in a format specific to the Hewlett-Packard 2000A Time-Sharing System, and is an adaptation of an earlier program for linear combination reading for X-ray fluorescence analysis (Tanner and Brinkerhoff, 1971). Following the program is a sample run from a study of the application of the linear combination technique to capture-gamma-ray analysis for calcium (report in preparation).

  2. Linear minimax estimation for random vectors with parametric uncertainty

    KAUST Repository

    Bitar, E

    2010-06-01

    In this paper, we take a minimax approach to the problem of computing a worst-case linear mean squared error (MSE) estimate of X given Y , where X and Y are jointly distributed random vectors with parametric uncertainty in their distribution. We consider two uncertainty models, PA and PB. Model PA represents X and Y as jointly Gaussian whose covariance matrix Λ belongs to the convex hull of a set of m known covariance matrices. Model PB characterizes X and Y as jointly distributed according to a Gaussian mixture model with m known zero-mean components, but unknown component weights. We show: (a) the linear minimax estimator computed under model PA is identical to that computed under model PB when the vertices of the uncertain covariance set in PA are the same as the component covariances in model PB, and (b) the problem of computing the linear minimax estimator under either model reduces to a semidefinite program (SDP). We also consider the dynamic situation where x(t) and y(t) evolve according to a discrete-time LTI state space model driven by white noise, the statistics of which is modeled by PA and PB as before. We derive a recursive linear minimax filter for x(t) given y(t).

  3. Random linear network coding for streams with unequally sized packets

    DEFF Research Database (Denmark)

    Taghouti, Maroua; Roetter, Daniel Enrique Lucani; Pedersen, Morten Videbæk

    2016-01-01

    State of the art Random Linear Network Coding (RLNC) schemes assume that data streams generate packets with equal sizes. This is an assumption that results in the highest efficiency gains for RLNC. A typical solution for managing unequal packet sizes is to zero-pad the smallest packets. However...... of packets, which are strategies that require additional signalling. Performance is evaluated using CAIDA TCP packets and 4k video traces. Our results show that our mechanisms reduce significantly the padding overhead even for small field sizes. Finally, our strategies provide a natural trade-off between...

  4. Interactive Multiobjective Fuzzy Random Linear Programming through Fractile Criteria

    Directory of Open Access Journals (Sweden)

    Hitoshi Yano

    2012-01-01

    Full Text Available We propose an interactive fuzzy decision making method for multiobjective fuzzy random linear programming problems through fractile criteria optimization. In the proposed method, it is assumed that the decision maker has fuzzy goals for not only objective functions but also permissible probability levels in a fractile optimization model, and such fuzzy goals are quantified by eliciting the corresponding membership functions. Using the fuzzy decision, such two kinds of membership functions are integrated. In the integrated membership space, the satisfactory solution is obtained from among an extended Pareto optimal solution set through the interaction with the decision maker. An illustrative numerical example is provided to demonstrate the feasibility and efficiency of the proposed method.

  5. Peer-Assisted Content Distribution with Random Linear Network Coding

    DEFF Research Database (Denmark)

    Hundebøll, Martin; Ledet-Pedersen, Jeppe; Sluyterman, Georg

    2014-01-01

    Peer-to-peer networks constitute a widely used, cost-effective and scalable technology to distribute bandwidth-intensive content. The technology forms a great platform to build distributed cloud storage without the need of a central provider. However, the majority of todays peer-to-peer systems...... require complex algorithms to schedule what parts of obtained content to forward to other peers. Random Linear Network Coding can greatly simplify these algorithm by removing the need for coordination between the distributing nodes. In this paper we propose and evaluate the structure of the BRONCO peer-to-peer....... Furthermore, we evaluate the performance of different parameters and suggest a suitable trade-off between CPU utilization and network overhead. Within the limitations of the used test environment, we have shown that networkc coding is usable in peer-assisted content distribution and we suggest further...

  6. Generalized linear models with random effects unified analysis via H-likelihood

    CERN Document Server

    Lee, Youngjo; Pawitan, Yudi

    2006-01-01

    Since their introduction in 1972, generalized linear models (GLMs) have proven useful in the generalization of classical normal models. Presenting methods for fitting GLMs with random effects to data, Generalized Linear Models with Random Effects: Unified Analysis via H-likelihood explores a wide range of applications, including combining information over trials (meta-analysis), analysis of frailty models for survival data, genetic epidemiology, and analysis of spatial and temporal models with correlated errors.Written by pioneering authorities in the field, this reference provides an introduction to various theories and examines likelihood inference and GLMs. The authors show how to extend the class of GLMs while retaining as much simplicity as possible. By maximizing and deriving other quantities from h-likelihood, they also demonstrate how to use a single algorithm for all members of the class, resulting in a faster algorithm as compared to existing alternatives. Complementing theory with examples, many of...

  7. A Quaternion Weighted Fourier Linear Combiner for Modeling Physiological Tremor.

    Science.gov (United States)

    Adhikari, Kabita; Tatinati, Sivanagaraja; Ang, Wei Tech; Veluvolu, Kalyana C; Nazarpour, Kianoush

    2016-11-01

    This paper offers a new approach to model physiological tremor aiming at attenuating undesired vibrations of the tip of microsurgical instruments. Several tremor modeling algorithms, such as the weighted Fourier linear combiner (wFLC), have proved effective. They, however, treat the three-dimensional (3-D) tremor signal as three independent 1-D signals in the x-, y-, and z-axes. In addition, the force f by which a surgeon holds the instrument has never been taken into account in modeling. Hence, conventional algorithms are inherently blind to any potential multidimensional couplings. We first show that there exists statistically significant subject- and task-dependent coherence between data in the x-, y-, z -, and f-axes. We hypothesize that a filter that models the tremor in 4-D ( x , y, z, and f ) yields a more accurate model of tremor. We, therefore, developed a quaternion version of the wFLC algorithm and termed it QwFLC. We tested the proposed QwFLC algorithm with real physiological tremor data that were recorded from five novice subjects and four experienced microsurgeons. Although compared to wFLC, QwFLC requires six times larger computational resources, we showed that QwFLC can improve the modeling by up to 67% and that the improvement is proportional to the total coherence between the tremor in xyz and the force signal. By taking into account interactions of the 3-D tremor and the force data, the tremor modeling performance enhances significantly.

  8. Solving a mixture of many random linear equations by tensor decomposition and alternating minimization.

    Science.gov (United States)

    2016-09-01

    We consider the problem of solving mixed random linear equations with k components. This is the noiseless setting of mixed linear regression. The goal is to estimate multiple linear models from mixed samples in the case where the labels (which sample...

  9. Brain injury prediction: assessing the combined probability of concussion using linear and rotational head acceleration.

    Science.gov (United States)

    Rowson, Steven; Duma, Stefan M

    2013-05-01

    Recent research has suggested possible long term effects due to repetitive concussions, highlighting the importance of developing methods to accurately quantify concussion risk. This study introduces a new injury metric, the combined probability of concussion, which computes the overall risk of concussion based on the peak linear and rotational accelerations experienced by the head during impact. The combined probability of concussion is unique in that it determines the likelihood of sustaining a concussion for a given impact, regardless of whether the injury would be reported or not. The risk curve was derived from data collected from instrumented football players (63,011 impacts including 37 concussions), which was adjusted to account for the underreporting of concussion. The predictive capability of this new metric is compared to that of single biomechanical parameters. The capabilities of these parameters to accurately predict concussion incidence were evaluated using two separate datasets: the Head Impact Telemetry System (HITS) data and National Football League (NFL) data collected from impact reconstructions using dummies (58 impacts including 25 concussions). Receiver operating characteristic curves were generated, and all parameters were significantly better at predicting injury than random guessing. The combined probability of concussion had the greatest area under the curve for all datasets. In the HITS dataset, the combined probability of concussion and linear acceleration were significantly better predictors of concussion than rotational acceleration alone, but not different from each other. In the NFL dataset, there were no significant differences between parameters. The combined probability of concussion is a valuable method to assess concussion risk in a laboratory setting for evaluating product safety.

  10. Linear combination methods for prediction of drug skin permeation

    Directory of Open Access Journals (Sweden)

    Stefan Scheler

    2015-01-01

    Full Text Available Many in-vitro methods for prediction of skin permeability have been reported in literature. Cerasome electrokinetic chromatography is one of the most sophisticated approaches representing a maximum level of similarity to the lipid phase of the stratum corneum. One goal of this study was to investigate the affinity pattern of Cerasome and to compare it with the permeability profile of human skin. Another purpose was to study the applicability of Hansen solubility parameters for modelling skin permeation and to investigate the predictive and explanatory potential of this method. Visualisation in Hansen diagrams revealed very similar profiles of Cerasome electrokinetic chromatography retention factors and skin permeability coefficients. In both cases, the characteristic pattern with two clusters of highly retained or highly permeable substances could be shown to be mainly caused by two groups of compounds, one of them with high affinity to ceramides, fatty acids and lecithin and the other being more affine to cholesterol. If based on a sufficiently comprehensive experimental dataset, model-independent predictions of skin permeability data using three-component Hansen solubility parameters are able to achieve similar accuracy as calculations made with an Abraham linear free energy relationship model in which the compounds are characterized by seven physicochemical descriptors.

  11. Research on the reliability of friction system under combined additive and multiplicative random excitations

    Science.gov (United States)

    Sun, Jiaojiao; Xu, Wei; Lin, Zifei

    2018-01-01

    In this paper, the reliability of a non-linearly damped friction oscillator under combined additive and multiplicative Gaussian white noise excitations is investigated. The stochastic averaging method, which is usually applied to the research of smooth system, has been extended to the study of the reliability of non-smooth friction system. The results indicate that the reliability of friction system can be improved by Coulomb friction and reduced by random excitations. In particular, the effect of the external random excitation on the reliability is larger than the effect of the parametric random excitation. The validity of the analytical results is verified by the numerical results.

  12. Richly parameterized linear models additive, time series, and spatial models using random effects

    CERN Document Server

    Hodges, James S

    2013-01-01

    A First Step toward a Unified Theory of Richly Parameterized Linear ModelsUsing mixed linear models to analyze data often leads to results that are mysterious, inconvenient, or wrong. Further compounding the problem, statisticians lack a cohesive resource to acquire a systematic, theory-based understanding of models with random effects.Richly Parameterized Linear Models: Additive, Time Series, and Spatial Models Using Random Effects takes a first step in developing a full theory of richly parameterized models, which would allow statisticians to better understand their analysis results. The aut

  13. Theoretical study of polymeric mixtures with different sequence statistics. I. Ising class: Linear random copolymers with different statistical sequences and ternary blends of linear random copolymers with homopolymers

    Energy Technology Data Exchange (ETDEWEB)

    Qi, Shuyan [Department of Chemical Engineering, Department of Chemistry, and Materials Science Division, Lawrence Berkeley National Laboratory, University of California, Berkeley, California 94720 (United States); Chakraborty, Arup K. [Department of Chemical Engineering, Department of Chemistry, and Materials Science Division, Lawrence Berkeley National Laboratory, University of California, Berkeley, California 94720 (United States)

    2000-01-15

    We derive a Landau free energy functional for polymeric mixtures containing components with different sequence statistics. We then apply this general field theory to two mixtures that belong to the Ising universality class: mixtures of two different linear random copolymers, and ternary systems of linear random copolymers and two homopolymers. We discuss the instability conditions for the homogeneous state of these mixtures, and calculate the structure factors for different components in the homogeneous state. The structure factors show interesting features which can directly be compared with scattering experiments carried out with selectively deuterated samples. We also work out the eigenmodes representing the least stable concentration fluctuations for these mixtures. The nature of these concentration fluctuations provides information regarding the ordered phases and the kinetic pathways that lead to them. We find various demixing modes for different characteristics of the two mixtures (e.g., average compositions, statistical correlation lengths, and volume fractions). (c) 2000 American Institute of Physics.

  14. A Penalized Linear and Nonlinear Combined Conjugate Gradient Method for the Reconstruction of Fluorescence Molecular Tomography

    OpenAIRE

    Shang Shang; Jing Bai; Xiaolei Song; Hongkai Wang; Jaclyn Lau

    2007-01-01

    Conjugate gradient method is verified to be efficient for nonlinear optimization problems of large-dimension data. In this paper, a penalized linear and nonlinear combined conjugate gradient method for the reconstruction of fluorescence molecular tomography (FMT) is presented. The algorithm combines the linear conjugate gradient method and the nonlinear conjugate gradient method together based on a restart strategy, in order to take advantage of the two kinds of conjugate gradient methods and...

  15. Selecting Optimal Parameters of Random Linear Network Coding for Wireless Sensor Networks

    DEFF Research Database (Denmark)

    Heide, Janus; Zhang, Qi; Fitzek, Frank

    2013-01-01

    This work studies how to select optimal code parameters of Random Linear Network Coding (RLNC) in Wireless Sensor Networks (WSNs). With Rateless Deluge [1] the authors proposed to apply Network Coding (NC) for Over-the-Air Programming (OAP) in WSNs, and demonstrated that with NC a significant...

  16. Inhomogeneous Linear Random Differential Equations with Mutual Correlations between Multiplicative, Additive and Initial-Value Terms

    NARCIS (Netherlands)

    Roerdink, J.B.T.M.

    1981-01-01

    The cumulant expansion for linear stochastic differential equations is extended to the general case in which the coefficient matrix, the inhomogeneous part and the initial condition are all random and, moreover, statistically interdependent. The expansion now involves not only the autocorrelation

  17. On Linear Combinations of Two Orthogonal Polynomial Sequences on the Unit Circle

    Directory of Open Access Journals (Sweden)

    Suárez C

    2010-01-01

    Full Text Available Let be a monic orthogonal polynomial sequence on the unit circle. We define recursively a new sequence of polynomials by the following linear combination: , , . In this paper, we give necessary and sufficient conditions in order to make be an orthogonal polynomial sequence too. Moreover, we obtain an explicit representation for the Verblunsky coefficients and in terms of and . Finally, we show the relation between their corresponding Carathéodory functions and their associated linear functionals.

  18. A Solution Method for Linear and Geometrically Nonlinear MDOF Systems with Random Properties subject to Random Excitation

    DEFF Research Database (Denmark)

    Micaletti, R. C.; Cakmak, A. S.; Nielsen, Søren R. K.

    structural properties. The resulting state-space formulation is a system of ordinary stochastic differential equations with random coefficient and deterministic initial conditions which are subsequently transformed into ordinary stochastic differential equations with deterministic coefficients and random...... initial conditions. This transformation facilitates the derivation of differential equations which govern the evolution of the unconditional statistical moments of response. Primary consideration is given to linear systems and systems with odd polynomial nonlinearities, for in these cases...... there is a significant reduction in the number of equations to be solved. The method is illustrated for a five-story shear-frame structure with nonlinear interstory restoring forces and random damping and stiffness properties. The results of the proposed method are compared to those estimated by extensive Monte Carlo...

  19. Time-Frequency Analysis of Non-Stationary Biological Signals with Sparse Linear Regression Based Fourier Linear Combiner

    Directory of Open Access Journals (Sweden)

    Yubo Wang

    2017-06-01

    Full Text Available It is often difficult to analyze biological signals because of their nonlinear and non-stationary characteristics. This necessitates the usage of time-frequency decomposition methods for analyzing the subtle changes in these signals that are often connected to an underlying phenomena. This paper presents a new approach to analyze the time-varying characteristics of such signals by employing a simple truncated Fourier series model, namely the band-limited multiple Fourier linear combiner (BMFLC. In contrast to the earlier designs, we first identified the sparsity imposed on the signal model in order to reformulate the model to a sparse linear regression model. The coefficients of the proposed model are then estimated by a convex optimization algorithm. The performance of the proposed method was analyzed with benchmark test signals. An energy ratio metric is employed to quantify the spectral performance and results show that the proposed method Sparse-BMFLC has high mean energy (0.9976 ratio and outperforms existing methods such as short-time Fourier transfrom (STFT, continuous Wavelet transform (CWT and BMFLC Kalman Smoother. Furthermore, the proposed method provides an overall 6.22% in reconstruction error.

  20. Time-Frequency Analysis of Non-Stationary Biological Signals with Sparse Linear Regression Based Fourier Linear Combiner.

    Science.gov (United States)

    Wang, Yubo; Veluvolu, Kalyana C

    2017-06-14

    It is often difficult to analyze biological signals because of their nonlinear and non-stationary characteristics. This necessitates the usage of time-frequency decomposition methods for analyzing the subtle changes in these signals that are often connected to an underlying phenomena. This paper presents a new approach to analyze the time-varying characteristics of such signals by employing a simple truncated Fourier series model, namely the band-limited multiple Fourier linear combiner (BMFLC). In contrast to the earlier designs, we first identified the sparsity imposed on the signal model in order to reformulate the model to a sparse linear regression model. The coefficients of the proposed model are then estimated by a convex optimization algorithm. The performance of the proposed method was analyzed with benchmark test signals. An energy ratio metric is employed to quantify the spectral performance and results show that the proposed method Sparse-BMFLC has high mean energy (0.9976) ratio and outperforms existing methods such as short-time Fourier transfrom (STFT), continuous Wavelet transform (CWT) and BMFLC Kalman Smoother. Furthermore, the proposed method provides an overall 6.22% in reconstruction error.

  1. A new neural network model for solving random interval linear programming problems.

    Science.gov (United States)

    Arjmandzadeh, Ziba; Safi, Mohammadreza; Nazemi, Alireza

    2017-05-01

    This paper presents a neural network model for solving random interval linear programming problems. The original problem involving random interval variable coefficients is first transformed into an equivalent convex second order cone programming problem. A neural network model is then constructed for solving the obtained convex second order cone problem. Employing Lyapunov function approach, it is also shown that the proposed neural network model is stable in the sense of Lyapunov and it is globally convergent to an exact satisfactory solution of the original problem. Several illustrative examples are solved in support of this technique. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. A linear combination of pharmacophore hypotheses as a new tool in search of new active compounds--an application for 5-HT1A receptor ligands.

    Directory of Open Access Journals (Sweden)

    Dawid Warszycki

    Full Text Available This study explores a new approach to pharmacophore screening involving the use of an optimized linear combination of models instead of a single hypothesis. The implementation and evaluation of the developed methodology are performed for a complete known chemical space of 5-HT1AR ligands (3616 active compounds with K i < 100 nM acquired from the ChEMBL database. Clusters generated from three different methods were the basis for the individual pharmacophore hypotheses, which were assembled into optimal combinations to maximize the different coefficients, namely, MCC, accuracy and recall, to measure the screening performance. Various factors that influence filtering efficiency, including clustering methods, the composition of test sets (random, the most diverse and cluster population-dependent and hit mode (the compound must fit at least one or two models from a final combination were investigated. This method outmatched both single hypothesis and random linear combination approaches.

  3. Short communication: Alteration of priors for random effects in Gaussian linear mixed model

    DEFF Research Database (Denmark)

    Vandenplas, Jérémie; Christensen, Ole Fredslund; Gengler, Nicholas

    2014-01-01

    such alterations. Therefore, the aim of this study was to propose a method to alter both the mean and (co)variance of the prior multivariate normal distributions of random effects of linear mixed models while using currently available software packages. The proposed method was tested on simulated examples with 3......Linear mixed models, for which the prior multivariate normal distributions of random effects are assumed to have a mean equal to 0, are commonly used in animal breeding. However, some statistical analyses (e.g., the consideration of a population under selection into a genomic scheme breeding......, multiple-trait predictions of lactation yields, and Bayesian approaches integrating external information into genetic evaluations) need to alter both the mean and (co)variance of the prior distributions and, to our knowledge, most software packages available in the animal breeding community do not permit...

  4. Truncated Linear Statistics Associated with the Top Eigenvalues of Random Matrices

    Science.gov (United States)

    Grabsch, Aurélien; Majumdar, Satya N.; Texier, Christophe

    2017-04-01

    Given a certain invariant random matrix ensemble characterised by the joint probability distribution of eigenvalues P(λ _1,\\ldots ,λ _N), many important questions have been related to the study of linear statistics of eigenvalues L=\\sum _{i=1}^Nf(λ _i), where f(λ ) is a known function. We study here truncated linear statistics where the sum is restricted to the N_1analysis of the statistical physics of fluctuating one-dimensional interfaces, we consider the case of the Laguerre ensemble of random matrices with f(λ )=√{λ }. Using the Coulomb gas technique, we study the N→ ∞ limit with N_1/N fixed. We show that the constraint that \\tilde{L}=\\sum _{i=1}^{N_1}f(λ _i) is fixed drives an infinite order phase transition in the underlying Coulomb gas. This transition corresponds to a change in the density of the gas, from a density defined on two disjoint intervals to a single interval. In this latter case the density presents a logarithmic divergence inside the bulk. Assuming that f(λ ) is monotonous, we show that these features arise for any random matrix ensemble and truncated linear statitics, which makes the scenario described here robust and universal.

  5. Selection of locations of knots for linear splines in random regression test-day models.

    Science.gov (United States)

    Jamrozik, J; Bohmanova, J; Schaeffer, L R

    2010-04-01

    Using spline functions (segmented polynomials) in regression models requires the knowledge of the location of the knots. Knots are the points at which independent linear segments are connected. Optimal positions of knots for linear splines of different orders were determined in this study for different scenarios, using existing estimates of covariance functions and an optimization algorithm. The traits considered were test-day milk, fat and protein yields, and somatic cell score (SCS) in the first three lactations of Canadian Holsteins. Two ranges of days in milk (from 5 to 305 and from 5 to 365) were taken into account. In addition, four different populations of Holstein cows, from Australia, Canada, Italy and New Zealand, were examined with respect to first lactation (305 days) milk only. The estimates of genetic and permanent environmental covariance functions were based on single- and multiple-trait test-day models, with Legendre polynomials of order 4 as random regressions. A differential evolution algorithm was applied to find the best location of knots for splines of orders 4 to 7 and the criterion for optimization was the goodness-of-fit of the spline covariance function. Results indicated that the optimal position of knots for linear splines differed between genetic and permanent environmental effects, as well as between traits and lactations. Different populations also exhibited different patterns of optimal knot locations. With linear splines, different positions of knots should therefore be used for different effects and traits in random regression test-day models when analysing milk production traits.

  6. A COMPARATIVE ANALYSIS OF CONSTRUCTIVE SCHEMES OF LINEAR IMPACTOR ELECTROMECHANICAL CONVERTERS COMBINED TYPE

    Directory of Open Access Journals (Sweden)

    V.F. Bolyukh

    2015-08-01

    Full Text Available The concept of linear impactor electromechanical converter combined type with a single inductor excited by capacitive energy storage aperiodic pulse is proposed. The concept combines induction and electromagnetic converters. For the synthesis of the converter parameters the Monte Carlo method is used. As the objective function is selected the maximum value of the total pulse the electrodynamic and electromagnetic force acting on the combined anchor. The features and characteristics of electro-magnetic field converters are identified. Considered several of selection policies and by means of integral index identified the most and least efficient design of the converter circuit.

  7. Possibility/Necessity-Based Probabilistic Expectation Models for Linear Programming Problems with Discrete Fuzzy Random Variables

    Directory of Open Access Journals (Sweden)

    Hideki Katagiri

    2017-10-01

    Full Text Available This paper considers linear programming problems (LPPs where the objective functions involve discrete fuzzy random variables (fuzzy set-valued discrete random variables. New decision making models, which are useful in fuzzy stochastic environments, are proposed based on both possibility theory and probability theory. In multi-objective cases, Pareto optimal solutions of the proposed models are newly defined. Computational algorithms for obtaining the Pareto optimal solutions of the proposed models are provided. It is shown that problems involving discrete fuzzy random variables can be transformed into deterministic nonlinear mathematical programming problems which can be solved through a conventional mathematical programming solver under practically reasonable assumptions. A numerical example of agriculture production problems is given to demonstrate the applicability of the proposed models to real-world problems in fuzzy stochastic environments.

  8. Carbide-derived carbon (CDC) linear actuator properties in combination with conducting polymers

    Science.gov (United States)

    Kiefer, Rudolf; Aydemir, Nihan; Torop, Janno; Kilmartin, Paul A.; Tamm, Tarmo; Kaasik, Friedrich; Kesküla, Arko; Travas-Sejdic, Jadranka; Aabloo, Alvo

    2014-03-01

    Carbide-derived Carbon (CDC) material is applied for super capacitors due to their nanoporous structure and their high charging/discharging capability. In this work we report for the first time CDC linear actuators and CDC combined with polypyrrole (CDC-PPy) in ECMD (Electrochemomechanical deformation) under isotonic (constant force) and isometric (constant length) measurements in aqueous electrolyte. CDC-PPy actuators showing nearly double strain under cyclic voltammetric and square wave potential measurements in comparison to CDC linear actuators. The new material is investigated by SEM (scanning electron microscopy) and EDX (energy dispersive X-ray analysis) to reveal how the conducting polymer layer and the CDC layer interfere together.

  9. Hybrid random walk-linear discriminant analysis method for unwrapping quantitative phase microscopy images of biological samples

    Science.gov (United States)

    Kim, Diane N. H.; Teitell, Michael A.; Reed, Jason; Zangle, Thomas A.

    2015-11-01

    Standard algorithms for phase unwrapping often fail for interferometric quantitative phase imaging (QPI) of biological samples due to the variable morphology of these samples and the requirement to image at low light intensities to avoid phototoxicity. We describe a new algorithm combining random walk-based image segmentation with linear discriminant analysis (LDA)-based feature detection, using assumptions about the morphology of biological samples to account for phase ambiguities when standard methods have failed. We present three versions of our method: first, a method for LDA image segmentation based on a manually compiled training dataset; second, a method using a random walker (RW) algorithm informed by the assumed properties of a biological phase image; and third, an algorithm which combines LDA-based edge detection with an efficient RW algorithm. We show that the combination of LDA plus the RW algorithm gives the best overall performance with little speed penalty compared to LDA alone, and that this algorithm can be further optimized using a genetic algorithm to yield superior performance for phase unwrapping of QPI data from biological samples.

  10. Robust Management of Combined Heat and Power Systems via Linear Decision Rules

    DEFF Research Database (Denmark)

    Zugno, Marco; Morales González, Juan Miguel; Madsen, Henrik

    2014-01-01

    The heat and power outputs of Combined Heat and Power (CHP) units are jointly constrained. Hence, the optimal management of systems including CHP units is a multicommodity optimization problem. Problems of this type are stochastic, owing to the uncertainty inherent both in the demand for heat and...... linear decision rules to guarantee both tractability and a correct representation of the dynamic aspects of the problem. Numerical results from an illustrative example confirm the value of the proposed approach....

  11. High-power spectral beam combining of linearly polarized Tm:fiber lasers.

    Science.gov (United States)

    Shah, Lawrence; Sims, R Andrew; Kadwani, Pankaj; Willis, Christina C C; Bradford, Joshua B; Sincore, Alex; Richardson, Martin

    2015-02-01

    To date, high-power scaling of Tm:fiber lasers has been accomplished by maximizing the power from a single fiber aperture. In this work, we investigate power scaling by spectral beam combination of three linearly polarized Tm:fiber MOPA lasers using dielectric mirrors with a steep transition from highly reflective to highly transmissive that enable a minimum wavelength separation of 6 nm between individual laser channels within the wavelength range from 2030 to 2050 nm. Maximum output power is 253 W with M(2)<2, ultimately limited by thermal lensing in the beam combining elements.

  12. Joint L-/C-Band Code and Carrier Phase Linear Combinations for Galileo

    Directory of Open Access Journals (Sweden)

    Patrick Henkel

    2008-01-01

    Full Text Available Linear code combinations have been considered for suppressing the ionospheric error. In the L-band, this leads to an increased noise floor. In a combined L- and C-band (5010–5030 MHz approach, the ionosphere can be eliminated and the noise floor reduced at the same time. Furthermore, combinations that involve both code- and carrier-phase measurements are considered. A new L-band code-carrier combination with a wavelength of 3.215 meters and a noise level of 3.92 centimeters is found. The double difference integer ambiguities of this combination can be resolved by extending the system of equations with an ionosphere-free L-/C-band code combination. The probability of wrong fixing is reduced by several orders of magnitude when C-band measurements are included. Carrier smoothing can be used to further reduce the residual variance of the solution. The standard deviation is reduced by a factor 7.7 if C-band measurements are taken into account. These initial findings suggest that the combined use of L- and C-band measurements, as well as the combined code and phase processing are an attractive option for precise positioning.

  13. Throughput vs. Delay in Lossy Wireless Mesh Networks with Random Linear Network Coding

    DEFF Research Database (Denmark)

    Hundebøll, Martin; Pahlevani, Peyman; Roetter, Daniel Enrique Lucani

    2014-01-01

    This work proposes a new protocol applying on– the–fly random linear network coding in wireless mesh net- works. The protocol provides increased reliability, low delay, and high throughput to the upper layers, while being oblivious to their specific requirements. This seemingly conflicting goals ...... and evaluated in a real test bed with Raspberry Pi devices. We show that order of magnitude gains in throughput over plain TCP are possible with moderate losses and up to two fold improvement in per packet delay in our results....

  14. Equivalent Linearization Analysis of Geometrically Nonlinear Random Vibrations Using Commercial Finite Element Codes

    Science.gov (United States)

    Rizzi, Stephen A.; Muravyov, Alexander A.

    2002-01-01

    Two new equivalent linearization implementations for geometrically nonlinear random vibrations are presented. Both implementations are based upon a novel approach for evaluating the nonlinear stiffness within commercial finite element codes and are suitable for use with any finite element code having geometrically nonlinear static analysis capabilities. The formulation includes a traditional force-error minimization approach and a relatively new version of a potential energy-error minimization approach, which has been generalized for multiple degree-of-freedom systems. Results for a simply supported plate under random acoustic excitation are presented and comparisons of the displacement root-mean-square values and power spectral densities are made with results from a nonlinear time domain numerical simulation.

  15. Dynamic Average Consensus and Consensusability of General Linear Multiagent Systems with Random Packet Dropout

    Directory of Open Access Journals (Sweden)

    Wen-Min Zhou

    2013-01-01

    Full Text Available This paper is concerned with the consensus problem of general linear discrete-time multiagent systems (MASs with random packet dropout that happens during information exchange between agents. The packet dropout phenomenon is characterized as being a Bernoulli random process. A distributed consensus protocol with weighted graph is proposed to address the packet dropout phenomenon. Through introducing a new disagreement vector, a new framework is established to solve the consensus problem. Based on the control theory, the perturbation argument, and the matrix theory, the necessary and sufficient condition for MASs to reach mean-square consensus is derived in terms of stability of an array of low-dimensional matrices. Moreover, mean-square consensusable conditions with regard to network topology and agent dynamic structure are also provided. Finally, the effectiveness of the theoretical results is demonstrated through an illustrative example.

  16. Improving biomedical information retrieval by linear combinations of different query expansion techniques.

    Science.gov (United States)

    Abdulla, Ahmed AbdoAziz Ahmed; Lin, Hongfei; Xu, Bo; Banbhrani, Santosh Kumar

    2016-07-25

    Biomedical literature retrieval is becoming increasingly complex, and there is a fundamental need for advanced information retrieval systems. Information Retrieval (IR) programs scour unstructured materials such as text documents in large reserves of data that are usually stored on computers. IR is related to the representation, storage, and organization of information items, as well as to access. In IR one of the main problems is to determine which documents are relevant and which are not to the user's needs. Under the current regime, users cannot precisely construct queries in an accurate way to retrieve particular pieces of data from large reserves of data. Basic information retrieval systems are producing low-quality search results. In our proposed system for this paper we present a new technique to refine Information Retrieval searches to better represent the user's information need in order to enhance the performance of information retrieval by using different query expansion techniques and apply a linear combinations between them, where the combinations was linearly between two expansion results at one time. Query expansions expand the search query, for example, by finding synonyms and reweighting original terms. They provide significantly more focused, particularized search results than do basic search queries. The retrieval performance is measured by some variants of MAP (Mean Average Precision) and according to our experimental results, the combination of best results of query expansion is enhanced the retrieved documents and outperforms our baseline by 21.06 %, even it outperforms a previous study by 7.12 %. We propose several query expansion techniques and their combinations (linearly) to make user queries more cognizable to search engines and to produce higher-quality search results.

  17. Phenotype Recognition with Combined Features and Random Subspace Classifier Ensemble

    Directory of Open Access Journals (Sweden)

    Pham Tuan D

    2011-04-01

    Full Text Available Abstract Background Automated, image based high-content screening is a fundamental tool for discovery in biological science. Modern robotic fluorescence microscopes are able to capture thousands of images from massively parallel experiments such as RNA interference (RNAi or small-molecule screens. As such, efficient computational methods are required for automatic cellular phenotype identification capable of dealing with large image data sets. In this paper we investigated an efficient method for the extraction of quantitative features from images by combining second order statistics, or Haralick features, with curvelet transform. A random subspace based classifier ensemble with multiple layer perceptron (MLP as the base classifier was then exploited for classification. Haralick features estimate image properties related to second-order statistics based on the grey level co-occurrence matrix (GLCM, which has been extensively used for various image processing applications. The curvelet transform has a more sparse representation of the image than wavelet, thus offering a description with higher time frequency resolution and high degree of directionality and anisotropy, which is particularly appropriate for many images rich with edges and curves. A combined feature description from Haralick feature and curvelet transform can further increase the accuracy of classification by taking their complementary information. We then investigate the applicability of the random subspace (RS ensemble method for phenotype classification based on microscopy images. A base classifier is trained with a RS sampled subset of the original feature set and the ensemble assigns a class label by majority voting. Results Experimental results on the phenotype recognition from three benchmarking image sets including HeLa, CHO and RNAi show the effectiveness of the proposed approach. The combined feature is better than any individual one in the classification accuracy. The

  18. Throughput-Delay Analysis of Random Linear Network Coding for Wireless Broadcasting

    CERN Document Server

    Swapna, B T; Shroff, Ness B

    2011-01-01

    In an unreliable single-hop broadcast network setting, we investigate the throughput and decoding-delay performance of random linear network coding as a function of the coding window size and the network size. Our model consists of a source transmitting packets of a single flow to a set of $n$ users over independent erasure channels. The source performs random linear network coding (RLNC) over $k$ (coding window size) packets and broadcasts them to the users. We note that the broadcast throughput of RLNC must vanish with increasing $n$, for any fixed $k.$ Hence, in contrast to other works in the literature, we investigate how the coding window size $k$ must scale for increasing $n$. Our analysis reveals that the coding window size of $\\Theta(\\ln(n))$ represents a phase transition rate, below which the throughput converges to zero, and above which it converges to the broadcast capacity. Further, we characterize the asymptotic distribution of decoding delay and provide approximate expressions for the mean and v...

  19. Coupling field maps of combined function bending magnets to linear optics for the SESAME storage ring

    CERN Document Server

    Milanese, A

    2013-01-01

    This note provides several analyses of the combined function bending magnets of the SESAME storage ring. The objective is to develop tools to couple the magnetic design to the linear optics specifications. Such tools can be used to carry out a 3D field optimization, at the design phase and following magnetic measurements, in particular in order to fine tune the end shims on the poles. The analyses take as input field maps on the midplane, which are then processed in different ways to obtain linear transfer matrices for the optics, in the horizontal and vertical planes. Some peculiarities of this kind of magnet are also highlighted, for example, the slight variation of gradient along the arc. For convenience, the relative codes and scripts are included in the appendix.

  20. Equivalence of effective medium and random resistor network models for disorder-induced unsaturating linear magnetoresistance

    Science.gov (United States)

    Ramakrishnan, Navneeth; Lai, Ying Tong; Lara, Silvia; Parish, Meera M.; Adam, Shaffique

    2017-12-01

    A linear unsaturating magnetoresistance at high perpendicular magnetic fields, together with a quadratic positive magnetoresistance at low fields, has been seen in many different experimental materials, ranging from silver chalcogenides and thin films of InSb to topological materials like graphene and Dirac semimetals. In the literature, two very different theoretical approaches have been used to explain this classical magnetoresistance as a consequence of sample disorder. The phenomenological random resistor network model constructs a grid of four terminal resistors, each with a varying random resistance. The effective medium theory model imagines a smoothly varying disorder potential that causes a continuous variation of the local conductivity. Here, we demonstrate numerically that both models belong to the same universality class and that a restricted class of the random resistor network is actually equivalent to the effective medium theory. Both models are also in good agreement with experiments on a diverse range of materials. Moreover, we show that in both cases, a single parameter, i.e., the ratio of the fluctuations in the carrier density to the average carrier density, completely determines the magnetoresistance profile.

  1. Arrhythmia recognition and classification using combined linear and nonlinear features of ECG signals.

    Science.gov (United States)

    Elhaj, Fatin A; Salim, Naomie; Harris, Arief R; Swee, Tan Tian; Ahmed, Taqwa

    2016-04-01

    Arrhythmia is a cardiac condition caused by abnormal electrical activity of the heart, and an electrocardiogram (ECG) is the non-invasive method used to detect arrhythmias or heart abnormalities. Due to the presence of noise, the non-stationary nature of the ECG signal (i.e. the changing morphology of the ECG signal with respect to time) and the irregularity of the heartbeat, physicians face difficulties in the diagnosis of arrhythmias. The computer-aided analysis of ECG results assists physicians to detect cardiovascular diseases. The development of many existing arrhythmia systems has depended on the findings from linear experiments on ECG data which achieve high performance on noise-free data. However, nonlinear experiments characterize the ECG signal more effectively sense, extract hidden information in the ECG signal, and achieve good performance under noisy conditions. This paper investigates the representation ability of linear and nonlinear features and proposes a combination of such features in order to improve the classification of ECG data. In this study, five types of beat classes of arrhythmia as recommended by the Association for Advancement of Medical Instrumentation are analyzed: non-ectopic beats (N), supra-ventricular ectopic beats (S), ventricular ectopic beats (V), fusion beats (F) and unclassifiable and paced beats (U). The characterization ability of nonlinear features such as high order statistics and cumulants and nonlinear feature reduction methods such as independent component analysis are combined with linear features, namely, the principal component analysis of discrete wavelet transform coefficients. The features are tested for their ability to differentiate different classes of data using different classifiers, namely, the support vector machine and neural network methods with tenfold cross-validation. Our proposed method is able to classify the N, S, V, F and U arrhythmia classes with high accuracy (98.91%) using a combined support

  2. Wannier-Stark ladder in the linear absorption of a random system with scale-free disorder

    NARCIS (Netherlands)

    Diaz, E.; Dominguez-Adame, F.; Kosevich, Yu. A.; Malyshev, V.A.

    We study numerically the linear optical response of a quasiparticle moving on a one-dimensional disordered lattice in the presence of a linear bias. The random site potential is assumed to be long-range correlated with a power-law spectral density S(k)similar to 1/k(alpha), alpha > 0. This type of

  3. Increased statistical power with combined independent randomization tests used with multiple-baseline design.

    Science.gov (United States)

    Tyrrell, Pascal N; Corey, Paul N; Feldman, Brian M; Silverman, Earl D

    2013-06-01

    Physicians often assess the effectiveness of treatments on a small number of patients. Multiple-baseline designs (MBDs), based on the Wampold-Worsham (WW) method of randomization and applied to four subjects, have relatively low power. Our objective was to propose another approach with greater power that does not suffer from the time requirements of the WW method applied to a greater number of subjects. The power of a design that involves the combination of two four-subject MBDs was estimated using computer simulation and compared with the four- and eight-subject designs. The effect of a delayed linear response to treatment on the power of the test was also investigated. Power was found to be adequate (>80%) for a standardized mean difference (SMD) greater than 0.8. The effect size associated with 80% power from combined tests was smaller than that of the single four-subject MBD (SMD=1.3) and comparable with the eight-subject MBD (SMD=0.6). A delayed linear response to the treatment resulted in important reductions in power (20-35%). By combining two four-subject MBD tests, an investigator can detect better effect sizes (SMD=0.8) and be able to complete a comparatively timelier and feasible study. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. A linearization approach for the model-based analysis of combined aggregate and individual patient data.

    Science.gov (United States)

    Ravva, Patanjali; Karlsson, Mats O; French, Jonathan L

    2014-04-30

    The application of model-based meta-analysis in drug development has gained prominence recently, particularly for characterizing dose-response relationships and quantifying treatment effect sizes of competitor drugs. The models are typically nonlinear in nature and involve covariates to explain the heterogeneity in summary-level literature (or aggregate data (AD)). Inferring individual patient-level relationships from these nonlinear meta-analysis models leads to aggregation bias. Individual patient-level data (IPD) are indeed required to characterize patient-level relationships but too often this information is limited. Since combined analyses of AD and IPD allow advantage of the information they share to be taken, the models developed for AD must be derived from IPD models; in the case of linear models, the solution is a closed form, while for nonlinear models, closed form solutions do not exist. Here, we propose a linearization method based on a second order Taylor series approximation for fitting models to AD alone or combined AD and IPD. The application of this method is illustrated by an analysis of a continuous landmark endpoint, i.e., change from baseline in HbA1c at week 12, from 18 clinical trials evaluating the effects of DPP-4 inhibitors on hyperglycemia in diabetic patients. The performance of this method is demonstrated by a simulation study where the effects of varying the degree of nonlinearity and of heterogeneity in covariates (as assessed by the ratio of between-trial to within-trial variability) were studied. A dose-response relationship using an Emax model with linear and nonlinear effects of covariates on the emax parameter was used to simulate data. The simulation results showed that when an IPD model is simply used for modeling AD, the bias in the emax parameter estimate increased noticeably with an increasing degree of nonlinearity in the model, with respect to covariates. When using an appropriately derived AD model, the linearization

  5. Estimation of chlorophyll concentration in waters near Hokkaido using the linear combination method.

    Science.gov (United States)

    Shi, Chong; Nakajima, Teruyuki

    2017-10-02

    An inversion algorithm is implemented to retrieve the surface chlorophyll a (Chl) concentration using satellite observation data from the MODIS instrument. The algorithm employs a simple and flexible index (LCI) to combine with the Chl without explicit correction for aerosol scattering. To investigate the sensitivity of LCI to Chl and other influence factors, an oceanic radiative transfer model coupled with a comprehensive bio-optical module is developed. It is studied that the LCI is significantly linear to Chl and not sensitive to other influence factors, except in very low oceanic salinity or scattering angle conditions, where over a 12% relative difference of derived Chl exists. Inversion results show the retrieved Chl are highly consistent with the MODIS operational data products in waters near Hokkaido, with the correlation coefficient, root mean square deviation, and average percentage difference of 0.9702, 0.3756 mg m(-3), and 13.89%, respectively. Investigation of the validity of this algorithm with a variety of atmospheric conditions indicates that the residual influence of atmosphere on the LCI index, after Rayleigh scattering correction, is generally within ± 0.001, allowing the retrieval error of Chl at less than 25% in most cases. A good comparison between retrieval and in situ measurements is also identified and implies that the retrieval accuracy via the LCI method depends on the linear combination coefficients used and the bio-optical module selected, while effects of polarization can be ignored.

  6. Analysis and Optimization of Sparse Random Linear Network Coding for Reliable Multicast Services

    DEFF Research Database (Denmark)

    Tassi, Andrea; Chatzigeorgiou, Ioannis; Roetter, Daniel Enrique Lucani

    2016-01-01

    techniques, and without any assumption on the implementation of the RLNC decoder in use, we provide an efficient way to characterize the performance of users targeted by ultra-reliable layered multicast services. The proposed modeling allows to efficiently derive the average number of coded packet...... transmissions needed to recover one or more service layers. We design a convex resource allocation framework that allows to minimize the complexity of the RLNC decoder by jointly optimizing the transmission parameters and the sparsity of the code. The designed optimization framework also ensures service......Point-to-multipoint communications are expected to play a pivotal role in next-generation networks. This paper refers to a cellular system transmitting layered multicast services to a multicast group of users. Reliability of communications is ensured via different random linear network coding (RLNC...

  7. Numerical Demultiplexing of Color Image Sensor Measurements via Non-linear Random Forest Modeling.

    Science.gov (United States)

    Deglint, Jason; Kazemzadeh, Farnoud; Cho, Daniel; Clausi, David A; Wong, Alexander

    2016-06-27

    The simultaneous capture of imaging data at multiple wavelengths across the electromagnetic spectrum is highly challenging, requiring complex and costly multispectral image devices. In this study, we investigate the feasibility of simultaneous multispectral imaging using conventional image sensors with color filter arrays via a novel comprehensive framework for numerical demultiplexing of the color image sensor measurements. A numerical forward model characterizing the formation of sensor measurements from light spectra hitting the sensor is constructed based on a comprehensive spectral characterization of the sensor. A numerical demultiplexer is then learned via non-linear random forest modeling based on the forward model. Given the learned numerical demultiplexer, one can then demultiplex simultaneously-acquired measurements made by the color image sensor into reflectance intensities at discrete selectable wavelengths, resulting in a higher resolution reflectance spectrum. Experimental results demonstrate the feasibility of such a method for the purpose of simultaneous multispectral imaging.

  8. Numerical Demultiplexing of Color Image Sensor Measurements via Non-linear Random Forest Modeling

    Science.gov (United States)

    Deglint, Jason; Kazemzadeh, Farnoud; Cho, Daniel; Clausi, David A.; Wong, Alexander

    2016-06-01

    The simultaneous capture of imaging data at multiple wavelengths across the electromagnetic spectrum is highly challenging, requiring complex and costly multispectral image devices. In this study, we investigate the feasibility of simultaneous multispectral imaging using conventional image sensors with color filter arrays via a novel comprehensive framework for numerical demultiplexing of the color image sensor measurements. A numerical forward model characterizing the formation of sensor measurements from light spectra hitting the sensor is constructed based on a comprehensive spectral characterization of the sensor. A numerical demultiplexer is then learned via non-linear random forest modeling based on the forward model. Given the learned numerical demultiplexer, one can then demultiplex simultaneously-acquired measurements made by the color image sensor into reflectance intensities at discrete selectable wavelengths, resulting in a higher resolution reflectance spectrum. Experimental results demonstrate the feasibility of such a method for the purpose of simultaneous multispectral imaging.

  9. A Cloud-Assisted Random Linear Network Coding Medium Access Control Protocol for Healthcare Applications

    Directory of Open Access Journals (Sweden)

    Elli Kartsakli

    2014-03-01

    Full Text Available Relay sensor networks are often employed in end-to-end healthcare applications to facilitate the information flow between patient worn sensors and the medical data center. Medium access control (MAC protocols, based on random linear network coding (RLNC, are a novel and suitable approach to efficiently handle data dissemination. However, several challenges arise, such as additional delays introduced by the intermediate relay nodes and decoding failures, due to channel errors. In this paper, we tackle these issues by adopting a cloud architecture where the set of relays is connected to a coordinating entity, called cloud manager. We propose a cloud-assisted RLNC-based MAC protocol (CLNC-MAC and develop a mathematical model for the calculation of the key performance metrics, namely the system throughput, the mean completion time for data delivery and the energy efficiency. We show the importance of central coordination in fully exploiting the gain of RLNC under error-prone channels.

  10. Estimating a DIF decomposition model using a random-weights linear logistic test model approach.

    Science.gov (United States)

    Paek, Insu; Fukuhara, Hirotaka

    2015-09-01

    A differential item functioning (DIF) decomposition model separates a testlet item DIF into two sources: item-specific differential functioning and testlet-specific differential functioning. This article provides an alternative model-building framework and estimation approach for a DIF decomposition model that was proposed by Beretvas and Walker (2012). Although their model is formulated under multilevel modeling with the restricted pseudolikelihood estimation method, our approach illustrates DIF decomposition modeling that is directly built upon the random-weights linear logistic test model framework with the marginal maximum likelihood estimation method. In addition to demonstrating our approach's performance, we provide detailed information on how to implement this new DIF decomposition model using an item response theory software program; using DIF decomposition may be challenging for practitioners, yet practical information on how to implement it has previously been unavailable in the measurement literature.

  11. Testing concordance of instrumental variable effects in generalized linear models with application to Mendelian randomization

    Science.gov (United States)

    Dai, James Y.; Chan, Kwun Chuen Gary; Hsu, Li

    2014-01-01

    Instrumental variable regression is one way to overcome unmeasured confounding and estimate causal effect in observational studies. Built on structural mean models, there has been considerale work recently developed for consistent estimation of causal relative risk and causal odds ratio. Such models can sometimes suffer from identification issues for weak instruments. This hampered the applicability of Mendelian randomization analysis in genetic epidemiology. When there are multiple genetic variants available as instrumental variables, and causal effect is defined in a generalized linear model in the presence of unmeasured confounders, we propose to test concordance between instrumental variable effects on the intermediate exposure and instrumental variable effects on the disease outcome, as a means to test the causal effect. We show that a class of generalized least squares estimators provide valid and consistent tests of causality. For causal effect of a continuous exposure on a dichotomous outcome in logistic models, the proposed estimators are shown to be asymptotically conservative. When the disease outcome is rare, such estimators are consistent due to the log-linear approximation of the logistic function. Optimality of such estimators relative to the well-known two-stage least squares estimator and the double-logistic structural mean model is further discussed. PMID:24863158

  12. Multi-criteria approach with linear combination technique and analytical hierarchy process in land evaluation studies

    Directory of Open Access Journals (Sweden)

    Orhan Dengiz

    2018-01-01

    Full Text Available Land evaluation analysis is a prerequisite to achieving optimum utilization of the available land resources. Lack of knowledge on best combination of factors that suit production of yields has contributed to the low production. The aim of this study was to determine the most suitable areas for agricultural uses. For that reasons, in order to determine land suitability classes of the study area, multi-criteria approach was used with linear combination technique and analytical hierarchy process by taking into consideration of some land and soil physico-chemical characteristic such as slope, texture, depth, derange, stoniness, erosion, pH, EC, CaCO3 and organic matter. These data and land mapping unites were taken from digital detailed soil map scaled as 1:5.000. In addition, in order to was produce land suitability map GIS was program used for the study area. This study was carried out at Mahmudiye, Karaamca, Yazılı, Çiçeközü, Orhaniye and Akbıyık villages in Yenişehir district of Bursa province. Total study area is 7059 ha. 6890 ha of total study area has been used as irrigated agriculture, dry farming agriculture, pasture while, 169 ha has been used for non-agricultural activities such as settlement, road water body etc. Average annual temperature and precipitation of the study area are 16.1oC and 1039.5 mm, respectively. Finally after determination of land suitability distribution classes for the study area, it was found that 15.0% of the study area has highly (S1 and moderately (S2 while, 85% of the study area has marginally suitable and unsuitable coded as S3 and N. It was also determined some relation as compared results of linear combination technique with other hierarchy approaches such as Land Use Capability Classification and Suitability Class for Agricultural Use methods.

  13. Fast solution of elliptic partial differential equations using linear combinations of plane waves.

    Science.gov (United States)

    Pérez-Jordá, José M

    2016-02-01

    Given an arbitrary elliptic partial differential equation (PDE), a procedure for obtaining its solution is proposed based on the method of Ritz: the solution is written as a linear combination of plane waves and the coefficients are obtained by variational minimization. The PDE to be solved is cast as a system of linear equations Ax=b, where the matrix A is not sparse, which prevents the straightforward application of standard iterative methods in order to solve it. This sparseness problem can be circumvented by means of a recursive bisection approach based on the fast Fourier transform, which makes it possible to implement fast versions of some stationary iterative methods (such as Gauss-Seidel) consuming O(NlogN) memory and executing an iteration in O(Nlog(2)N) time, N being the number of plane waves used. In a similar way, fast versions of Krylov subspace methods and multigrid methods can also be implemented. These procedures are tested on Poisson's equation expressed in adaptive coordinates. It is found that the best results are obtained with the GMRES method using a multigrid preconditioner with Gauss-Seidel relaxation steps.

  14. Power and sample size for the S:T repeated measures design combined with a linear mixed-effects model allowing for missing data.

    Science.gov (United States)

    Tango, Toshiro

    2017-02-13

    Tango (Biostatistics 2016) proposed a new repeated measures design called the S:T repeated measures design, combined with generalized linear mixed-effects models and sample size calculations for a test of the average treatment effect that depend not only on the number of subjects but on the number of repeated measures before and after randomization per subject used for analysis. The main advantages of the proposed design combined with the generalized linear mixed-effects models are (1) it can easily handle missing data by applying the likelihood-based ignorable analyses under the missing at random assumption and (2) it may lead to a reduction in sample size compared with the simple pre-post design. In this article, we present formulas for calculating power and sample sizes for a test of the average treatment effect allowing for missing data within the framework of the S:T repeated measures design with a continuous response variable combined with a linear mixed-effects model. Examples are provided to illustrate the use of these formulas.

  15. An Improved Isotropic Periodic Sum Method That Uses Linear Combinations of Basis Potentials

    KAUST Repository

    Takahashi, Kazuaki Z.

    2012-11-13

    Isotropic periodic sum (IPS) is a technique that calculates long-range interactions differently than conventional lattice sum methods. The difference between IPS and lattice sum methods lies in the shape and distribution of remote images for long-range interaction calculations. The images used in lattice sum calculations are identical to those generated from periodic boundary conditions and are discretely positioned at lattice points in space. The images for IPS calculations are "imaginary", which means they do not explicitly exist in a simulation system and are distributed isotropically and periodically around each particle. Two different versions of the original IPS method exist. The IPSn method is applied to calculations for point charges, whereas the IPSp method calculates polar molecules. However, both IPSn and IPSp have their advantages and disadvantages in simulating bulk water or water-vapor interfacial systems. In bulk water systems, the cutoff radius effect of IPSn strongly affects the configuration, whereas IPSp does not provide adequate estimations of water-vapor interfacial systems unless very long cutoff radii are used. To extend the applicability of the IPS technique, an improved IPS method, which has better accuracy in both homogeneous and heterogeneous systems has been developed and named the linear-combination-based isotropic periodic sum (LIPS) method. This improved IPS method uses linear combinations of basis potentials. We performed molecular dynamics (MD) simulations of bulk water and water-vapor interfacial systems to evaluate the accuracy of the LIPS method. For bulk water systems, the LIPS method has better accuracy than IPSn in estimating thermodynamic and configurational properties without the countercharge assumption, which is used for IPSp. For water-vapor interfacial systems, LIPS has better accuracy than IPSp and properly estimates thermodynamic and configurational properties. In conclusion, the LIPS method can successfully estimate

  16. Multiple linear combination (MLC) regression tests for common variants adapted to linkage disequilibrium structure.

    Science.gov (United States)

    Yoo, Yun Joo; Sun, Lei; Poirier, Julia G; Paterson, Andrew D; Bull, Shelley B

    2017-02-01

    By jointly analyzing multiple variants within a gene, instead of one at a time, gene-based multiple regression can improve power, robustness, and interpretation in genetic association analysis. We investigate multiple linear combination (MLC) test statistics for analysis of common variants under realistic trait models with linkage disequilibrium (LD) based on HapMap Asian haplotypes. MLC is a directional test that exploits LD structure in a gene to construct clusters of closely correlated variants recoded such that the majority of pairwise correlations are positive. It combines variant effects within the same cluster linearly, and aggregates cluster-specific effects in a quadratic sum of squares and cross-products, producing a test statistic with reduced degrees of freedom (df) equal to the number of clusters. By simulation studies of 1000 genes from across the genome, we demonstrate that MLC is a well-powered and robust choice among existing methods across a broad range of gene structures. Compared to minimum P-value, variance-component, and principal-component methods, the mean power of MLC is never much lower than that of other methods, and can be higher, particularly with multiple causal variants. Moreover, the variation in gene-specific MLC test size and power across 1000 genes is less than that of other methods, suggesting it is a complementary approach for discovery in genome-wide analysis. The cluster construction of the MLC test statistics helps reveal within-gene LD structure, allowing interpretation of clustered variants as haplotypic effects, while multiple regression helps to distinguish direct and indirect associations. © 2016 The Authors Genetic Epidemiology Published by Wiley Periodicals, Inc.

  17. A comparison of random forest regression and multiple linear regression for prediction in neuroscience.

    Science.gov (United States)

    Smith, Paul F; Ganesh, Siva; Liu, Ping

    2013-10-30

    Regression is a common statistical tool for prediction in neuroscience. However, linear regression is by far the most common form of regression used, with regression trees receiving comparatively little attention. In this study, the results of conventional multiple linear regression (MLR) were compared with those of random forest regression (RFR), in the prediction of the concentrations of 9 neurochemicals in the vestibular nucleus complex and cerebellum that are part of the l-arginine biochemical pathway (agmatine, putrescine, spermidine, spermine, l-arginine, l-ornithine, l-citrulline, glutamate and γ-aminobutyric acid (GABA)). The R(2) values for the MLRs were higher than the proportion of variance explained values for the RFRs: 6/9 of them were ≥ 0.70 compared to 4/9 for RFRs. Even the variables that had the lowest R(2) values for the MLRs, e.g. ornithine (0.50) and glutamate (0.61), had much lower proportion of variance explained values for the RFRs (0.27 and 0.49, respectively). The RSE values for the MLRs were lower than those for the RFRs in all but two cases. In general, MLRs seemed to be superior to the RFRs in terms of predictive value and error. In the case of this data set, MLR appeared to be superior to RFR in terms of its explanatory value and error. This result suggests that MLR may have advantages over RFR for prediction in neuroscience with this kind of data set, but that RFR can still have good predictive value in some cases. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Non-linear blend coding in the moth antennal lobe emerges from random glomerular networks

    Directory of Open Access Journals (Sweden)

    Alberto eCapurro

    2012-04-01

    Full Text Available Neural responses to odor blends often interact at different stages of the olfactory pathway. The first olfactory processing center in insects, the antennal lobe (AL, exhibits a complex network connectivity. We attempt to determine if non-linear blend interactions can arise purely as a function of the AL network connectivity itself, without necessitating additional factors such as competitive ligand binding at the periphery or intrinsic cellular properties. To assess this, we compared blend interactions among responses from single neurons recorded intracellularly in the AL of the moth M. sexta with those generated using a population-based computational model constructed from the morphologically-based connectivity pattern of projection neurons (PNs and local interneurons (LNs with randomized connection probabilities, from which we excluded detailed intrinsic neuronal properties. The model accurately predicted most of the proportions of blend interaction types observed in the physiological data. Our simulations also indicate that input from LNs is important in establishing both the type of blend interaction and the nature of the neuronal response (excitation or inhibition exhibited by AL neurons. For LNs, the only input that significantly impacted the blend interaction type was received from other LNs, while for PNs the input from olfactory sensory neurons (OSNs and other PNs contributed agonistically with the LN input to shape the AL output. Our results demonstrate that non-linear blend interactions can be a natural consequence of AL connectivity, and highlight the importance of lateral inhibition as a key feature of blend coding to be addressed in future experimental and computational studies.

  19. Linear and Nonlinear Rheology Combined with Dielectric Spectroscopy of Hybrid Polymer Nanocomposites for Semiconductive Applications

    Directory of Open Access Journals (Sweden)

    Roland Kádár

    2017-01-01

    Full Text Available The linear and nonlinear oscillatory shear, extensional and combined rheology-dielectric spectroscopy of hybrid polymer nanocomposites for semiconductive applications were investigated in this study. The main focus was the influence of processing conditions on percolated poly(ethylene-butyl acrylate (EBA nanocomposite hybrids containing graphite nanoplatelets (GnP and carbon black (CB. The rheological response of the samples was interpreted in terms of dispersion properties, filler distortion from processing, filler percolation, as well as the filler orientation and distribution dynamics inside the matrix. Evidence of the influence of dispersion properties was found in linear viscoelastic dynamic frequency sweeps, while the percolation of the nanocomposites was detected in nonlinearities developed in dynamic strain sweeps. Using extensional rheology, hybrid samples with better dispersion properties lead to a more pronounced strain hardening behavior, while samples with a higher volume percentage of fillers caused a drastic reduction in strain hardening. The rheo-dielectric time-dependent response showed that in the case of nanocomposites containing only GnP, the orientation dynamics leads to non-conductive samples. However, in the case of hybrids, the orientation of the GnP could be offset by the dispersing of the CB to bridge the nanoplatelets. The results were interpreted in the framework of a dual PE-BA model, where the fillers would be concentrated mainly in the BA regions. Furthermore, better dispersed hybrids obtained using mixing screws at the expense of filler distortion via extrusion processing history were emphasized through the rheo-dielectric tests.

  20. Comparison of the Predictive Performance and Interpretability of Random Forest and Linear Models on Benchmark Data Sets.

    Science.gov (United States)

    Marchese Robinson, Richard L; Palczewska, Anna; Palczewski, Jan; Kidley, Nathan

    2017-08-28

    The ability to interpret the predictions made by quantitative structure-activity relationships (QSARs) offers a number of advantages. While QSARs built using nonlinear modeling approaches, such as the popular Random Forest algorithm, might sometimes be more predictive than those built using linear modeling approaches, their predictions have been perceived as difficult to interpret. However, a growing number of approaches have been proposed for interpreting nonlinear QSAR models in general and Random Forest in particular. In the current work, we compare the performance of Random Forest to those of two widely used linear modeling approaches: linear Support Vector Machines (SVMs) (or Support Vector Regression (SVR)) and partial least-squares (PLS). We compare their performance in terms of their predictivity as well as the chemical interpretability of the predictions using novel scoring schemes for assessing heat map images of substructural contributions. We critically assess different approaches for interpreting Random Forest models as well as for obtaining predictions from the forest. We assess the models on a large number of widely employed public-domain benchmark data sets corresponding to regression and binary classification problems of relevance to hit identification and toxicology. We conclude that Random Forest typically yields comparable or possibly better predictive performance than the linear modeling approaches and that its predictions may also be interpreted in a chemically and biologically meaningful way. In contrast to earlier work looking at interpretation of nonlinear QSAR models, we directly compare two methodologically distinct approaches for interpreting Random Forest models. The approaches for interpreting Random Forest assessed in our article were implemented using open-source programs that we have made available to the community. These programs are the rfFC package ( https://r-forge.r-project.org/R/?group_id=1725 ) for the R statistical

  1. Modeling and control of switching max-plus-linear systems with random and deterministic switching

    NARCIS (Netherlands)

    Van den Boom, T.J.J.; De Schutter, B.

    2012-01-01

    Switching max-plus-linear (SMPL) systems are discrete-event systems that can switch between different modes of operation. In each mode the system is described by a max-plus-linear state equation and a max-plus-linear output equation, with different system matrices for each mode. The switching may

  2. Mean anisotropy of homogeneous Gaussian random fields and anisotropic norms of linear translation-invariant operators on multidimensional integer lattices

    Directory of Open Access Journals (Sweden)

    Phil Diamond

    2003-01-01

    Full Text Available Sensitivity of output of a linear operator to its input can be quantified in various ways. In Control Theory, the input is usually interpreted as disturbance and the output is to be minimized in some sense. In stochastic worst-case design settings, the disturbance is considered random with imprecisely known probability distribution. The prior set of probability measures can be chosen so as to quantify how far the disturbance deviates from the white-noise hypothesis of Linear Quadratic Gaussian control. Such deviation can be measured by the minimal Kullback-Leibler informational divergence from the Gaussian distributions with zero mean and scalar covariance matrices. The resulting anisotropy functional is defined for finite power random vectors. Originally, anisotropy was introduced for directionally generic random vectors as the relative entropy of the normalized vector with respect to the uniform distribution on the unit sphere. The associated a-anisotropic norm of a matrix is then its maximum root mean square or average energy gain with respect to finite power or directionally generic inputs whose anisotropy is bounded above by a≥0. We give a systematic comparison of the anisotropy functionals and the associated norms. These are considered for unboundedly growing fragments of homogeneous Gaussian random fields on multidimensional integer lattice to yield mean anisotropy. Correspondingly, the anisotropic norms of finite matrices are extended to bounded linear translation invariant operators over such fields.

  3. Conic sampling: an efficient method for solving linear and quadratic programming by randomly linking constraints within the interior.

    Science.gov (United States)

    Serang, Oliver

    2012-01-01

    Linear programming (LP) problems are commonly used in analysis and resource allocation, frequently surfacing as approximations to more difficult problems. Existing approaches to LP have been dominated by a small group of methods, and randomized algorithms have not enjoyed popularity in practice. This paper introduces a novel randomized method of solving LP problems by moving along the facets and within the interior of the polytope along rays randomly sampled from the polyhedral cones defined by the bounding constraints. This conic sampling method is then applied to randomly sampled LPs, and its runtime performance is shown to compare favorably to the simplex and primal affine-scaling algorithms, especially on polytopes with certain characteristics. The conic sampling method is then adapted and applied to solve a certain quadratic program, which compute a projection onto a polytope; the proposed method is shown to outperform the proprietary software Mathematica on large, sparse QP problems constructed from mass spectometry-based proteomics.

  4. Linear combination of auditory steady-state responses evoked by co-modulated tones

    DEFF Research Database (Denmark)

    Guérit, François; Marozeau, Jeremy; Epp, Bastian

    2017-01-01

    Up to medium intensities and in the 80–100-Hz region, the auditory steady-state response (ASSR) to a multi-tone carrier is commonly considered to be a linear sum of the dipoles from each tone specific ASSR generator. Here, this hypothesis was investigated when a unique modulation frequency is used...... for all carrier components. Listeners were presented with a co-modulated dual-frequency carrier (1 and 4 kHz), from which the modulator starting phase Ui of the 1-kHz component was systematically varied. The results support the hypothesis of a linear superposition of the dipoles originating from different...

  5. A Combined Patient and Provider Intervention for Management of Osteoarthritis in Veterans: A Randomized Clinical Trial.

    Science.gov (United States)

    Allen, Kelli D; Yancy, William S; Bosworth, Hayden B; Coffman, Cynthia J; Jeffreys, Amy S; Datta, Santanu K; McDuffie, Jennifer; Strauss, Jennifer L; Oddone, Eugene Z

    2016-01-19

    Management of osteoarthritis requires both medical and behavioral strategies, but some recommended therapies are underused. To examine the effectiveness of a combined patient and provider intervention for improving osteoarthritis outcomes. Cluster randomized clinical trial with assignment to osteoarthritis intervention and usual care groups. (ClinicalTrials.gov: NCT01130740). Department of Veterans Affairs Medical Center in Durham, North Carolina. 30 providers (clusters) and 300 outpatients with symptomatic hip or knee osteoarthritis. The telephone-based patient intervention focused on weight management, physical activity, and cognitive behavioral pain management. The provider intervention involved delivery of patient-specific osteoarthritis treatment recommendations to primary care providers through the electronic medical record. The primary outcome was total score on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 12 months. Secondary outcomes were WOMAC function and pain subscale scores, physical performance (Short Physical Performance Battery), and depressive symptoms (Patient Health Questionnaire-8). Linear mixed models that were adjusted for clustering of providers assessed between-group differences in improvement in outcomes. At 12 months, WOMAC scores were 4.1 points lower (indicating improvement) in the osteoarthritis intervention group versus usual care (95% CI, -7.2 to -1.1 points; P = 0.009). WOMAC function subscale scores were 3.3 points lower in the intervention group (CI, -5.7 to -1.0 points; P = 0.005). WOMAC pain subscale scores (P = 0.126), physical performance, and depressive symptoms did not differ between groups. Although more patients in the osteoarthritis intervention group received provider referral for recommended osteoarthritis treatments, the numbers who received them did not differ. The study was conducted in a single Veterans Affairs medical center. The combined patient and provider intervention resulted in

  6. Random vibration of linear and nonlinear structural systems with singular matrices: A frequency domain approach

    Science.gov (United States)

    Kougioumtzoglou, I. A.; Fragkoulis, V. C.; Pantelous, A. A.; Pirrotta, A.

    2017-09-01

    A frequency domain methodology is developed for stochastic response determination of multi-degree-of-freedom (MDOF) linear and nonlinear structural systems with singular matrices. This system modeling can arise when a greater than the minimum number of coordinates/DOFs is utilized, and can be advantageous, for instance, in cases of complex multibody systems where the explicit formulation of the equations of motion can be a nontrivial task. In such cases, the introduction of additional/redundant DOFs can facilitate the formulation of the equations of motion in a less labor intensive manner. Specifically, relying on the generalized matrix inverse theory, a Moore-Penrose (M-P) based frequency response function (FRF) is determined for a linear structural system with singular matrices. Next, relying on the M-P FRF a spectral input-output (excitation-response) relationship is derived in the frequency domain for determining the linear system response power spectrum. Further, the above methodology is extended via statistical linearization to account for nonlinear systems. This leads to an iterative determination of the system response mean vector and covariance matrix. Furthermore, to account for singular matrices, the generalization of a widely utilized formula that facilitates the application of statistical linearization is proved as well. The formula relates to the expectation of the derivatives of the system nonlinear function and is based on a Gaussian response assumption. Several linear and nonlinear MDOF structural systems with singular matrices are considered as numerical examples for demonstrating the validity and applicability of the developed frequency domain methodology.

  7. Sign changes in linear combinations of derivatives and convolutions of Polya frequency functions

    Directory of Open Access Journals (Sweden)

    Steven Nahmias

    1979-01-01

    combinations of derivatives and convolutions of Polya frequency functions using the variation diminishing properties of totally positive functions. These constitute extensions of earlier results of Karlin and Proschan.

  8. Multidimensional Classification of Examinees Using the Mixture Random Weights Linear Logistic Test Model

    Science.gov (United States)

    Choi, In-Hee; Wilson, Mark

    2015-01-01

    An essential feature of the linear logistic test model (LLTM) is that item difficulties are explained using item design properties. By taking advantage of this explanatory aspect of the LLTM, in a mixture extension of the LLTM, the meaning of latent classes is specified by how item properties affect item difficulties within each class. To improve…

  9. Application of Best Linear Unbiased Prediction to Interpolation of Random Fields and to Network Design.

    Science.gov (United States)

    1980-04-01

    dubbed their whole body of techniques Kriging, see Delfiner (1975) and further references given there. In another paper (Cabannes 1979b) , meant to...predictors and related predictors. Dept. of Mathematics, M.I.T., report #16. (3) Delfiner , P. (1975): Linear estimation of nonstationary spatial

  10. A hybrid learning scheme combining EM and MASMOD algorithms for fuzzy local linearization modeling.

    Science.gov (United States)

    Gan, Q; Harris, C J

    2001-01-01

    Fuzzy local linearization (FLL) is a useful divide-and-conquer method for coping with complex problems such as modeling unknown nonlinear systems from data for state estimation and control. Based on a probabilistic interpretation of FLL, the paper proposes a hybrid learning scheme for FLL modeling, which uses a modified adaptive spline modeling (MASMOD) algorithm to construct the antecedent parts (membership functions) in the FLL model, and an expectation-maximization (EM) algorithm to parameterize the consequent parts (local linear models). The hybrid method not only has an approximation ability as good as most neuro-fuzzy network models, but also produces a parsimonious network structure (gain from MASMOD) and provides covariance information about the model error (gain from EM) which is valuable in applications such as state estimation and control. Numerical examples on nonlinear time-series analysis and nonlinear trajectory estimation using FLL models are presented to validate the derived algorithm.

  11. Simulations of Nanocrystals Under Pressure: Combining Electronic Enthalpy and Linear-Scaling Density-Functional Theory

    OpenAIRE

    Corsini, NR; Greco, A.; Hine, ND; Molteni, C.; Haynes, PD

    2013-01-01

    We present an implementation in a linear-scaling density-functional theory code of an electronic enthalpy method, which has been found to be natural and efficient for the ab initio calculation of finite systems under hydrostatic pressure. Based on a definition of the system volume as that enclosed within an electronic density isosurface [M. Cococcioni, F. Mauri, G. Ceder, and N. Marzari, Phys. Rev. Lett. 94, 145501 (2005)], it supports both geometry optimizations and molecular dynamics simula...

  12. Linear theory of random textures of 3He-A in an aerogel

    Science.gov (United States)

    Fomin, I. A.

    2016-07-01

    The spatial variation of the orbital part of the order parameter of 3He-A in an aerogel has been represented as random walk of a unit vector l( r) over a sphere under the action of random anisotropy created by the system of strands of the aerogel. The statistical properties of the resulting random texture have been studied. For distances at which the variation of l is much smaller than its magnitude, the average square of variation of l has been expressed in terms of the correlation function of the component of the random anisotropy tensor. Under simplifying assumptions on the structure of this correlation function, an analytical dependence of on r has been obtained for isotropic and axially anisotropic aerogels. The average values of the squares of the projections of l on the axes of anisotropy for an anisotropic aerogel have been represented in terms of the parameters of the aerogel. The characteristic scale at which the long-range order is broken, as well as the magnitude of global anisotropy sufficient for the recovery of the long-range order, has been numerically estimated within a simple model. The values obtained have been compared to other estimates.

  13. Optimizing Linear Functions with Randomized Search Heuristics - The Robustness of Mutation

    DEFF Research Database (Denmark)

    Witt, Carsten

    2012-01-01

    The analysis of randomized search heuristics on classes of functions is fundamental for the understanding of the underlying stochastic process and the development of suitable proof techniques. Recently, remarkable progress has been made in bounding the expected optimization time of the simple (1...

  14. Tight Bounds on the Optimization Time of a Randomized Search Heuristic on Linear Functions

    DEFF Research Database (Denmark)

    Witt, Carsten

    2013-01-01

    The analysis of randomized search heuristics on classes of functions is fundamental to the understanding of the underlying stochastic process and the development of suitable proof techniques. Recently, remarkable progress has been made in bounding the expected optimization time of a simple...

  15. Linear bioconvection in a suspension of randomly swimming, gyrotactic micro-organisms

    DEFF Research Database (Denmark)

    Bees, Martin Alan; Hill, N.A.

    1998-01-01

    We have analyzed the initiation of pattern formation in a layer of finite depth for Pedley and Kessler's new model [J. Fluid Mech. 212, 155 (1990)] of bioconvection. This is the first analysis of bioconvection in a realistic geometry using a model that deals with random swimming in a rational man...... experimental measurements of key parameters are needed for a proper comparison. (C) 1998 American Institute of Physics....

  16. Combining predictions from linear models when training and test inputs differ

    NARCIS (Netherlands)

    T. van Ommen (Thijs); N.L. Zhang (Nevin); J. Tian (Jin)

    2014-01-01

    textabstractMethods for combining predictions from different models in a supervised learning setting must somehow estimate/predict the quality of a model's predictions at unknown future inputs. Many of these methods (often implicitly) make the assumption that the test inputs are identical to the

  17. Phase-Locking and Coherent Power Combining of Broadband Linearly Chirped Optical Waves

    Science.gov (United States)

    2012-11-05

    X. Yu, J. E. Kansky, S. E. J. Shaw, D. V. Murphy, and C. Higgs , “Coherent beam combining of large number of PM fibres in 2-D fibre array,” Electron...a). The fre- quency vs. current behavior of the semiconductor laser is highly nonlinear owing to its thermal tuning mechanism . The laser is biased

  18. Combining interscalene brachial plexus block with intravenous-inhalation combined anesthesia for upper extremity fractures surgery: a randomized controlled trial.

    Science.gov (United States)

    Yuan, Lan; Tang, Wei; Fu, Guo-qiang; Wang, Jian; Guo, Jun; Chen, Wen-ting

    2014-12-01

    A parallel-group randomized controlled trial (RCT) was conducted to evaluate the effect of combining the interscalene brachial plexus block (IBPB) with Intravenous-inhalation combined anesthesia to isolated Intravenous-inhalation anesthesia in the upper extremity fractures surgery of elderly patients. One hundred elderly patients who underwent upper extremity surgery were randomly assigned to received isolated Intravenous-inhalation combined anesthesia (group CI, n = 50) and IBPB associated with Intravenous-inhalation combined anesthesia (group NB, n = 50). Associated side effects, recovery time after operation, as well as the dose of intraoperative vasoactive agents and auxiliary drugs were noted. The two groups were not significantly different in gender (P = 0.539), ages (P = 0.683) and weight (P = 0.212). Five patients (10%) in the group NB and 17 patients (34%) in the group CI suffered from preoperative hypotension (P = 0.004). Besides, lower incidence of other adverse effects such as mental stress, incision pain and hypertension were also found in the group NB; however, the differences were not statistically significant (P > 0.05). The consumption of general anesthetics in the group NB was significantly less than that of the group CI (propofol, P = 0.004; lsoflurane, P < 0.001), and the recovery time of the group NB was significantly shorter than that of the group CI (P = 0.020). Combining IBPB with Intravenous-inhalation combined anesthesia in elderly patients hold a greater potential for upper extremity fractures surgery due to its improved clinical effectiveness and fewer side effects. Copyright © 2014. Published by Elsevier Ltd.

  19. An application of locally linear model tree algorithm with combination of feature selection in credit scoring

    Science.gov (United States)

    Siami, Mohammad; Gholamian, Mohammad Reza; Basiri, Javad

    2014-10-01

    Nowadays, credit scoring is one of the most important topics in the banking sector. Credit scoring models have been widely used to facilitate the process of credit assessing. In this paper, an application of the locally linear model tree algorithm (LOLIMOT) was experimented to evaluate the superiority of its performance to predict the customer's credit status. The algorithm is improved with an aim of adjustment by credit scoring domain by means of data fusion and feature selection techniques. Two real world credit data sets - Australian and German - from UCI machine learning database were selected to demonstrate the performance of our new classifier. The analytical results indicate that the improved LOLIMOT significantly increase the prediction accuracy.

  20. Faster Simulation Methods for the Non-Stationary Random Vibrations of Non-Linear MDOF Systems

    DEFF Research Database (Denmark)

    Askar, A.; Köylüoglu, H. U.; Nielsen, Søren R. K.

    In this paper semi-analytical forward-difference Monte Carlo simulation procedures are proposed for the determination of the lower order statistics and the Joint Probability Density Function (JPDF) of the stochastic response of geometrically nonlinear multi-degree-of-freedom structural systems...... of motion. All of the proposed procedures yield the exact results as the time step goes to zero. The proposed procedures are based on analytical convolutions of the excitation process, hereby, reducing the generation of stochastic processes and numerical integration to the generation of random vectors only...

  1. Faster Simulation Methods for the Nonstationary Random Vibrations of Non-linear MDOF Systems

    DEFF Research Database (Denmark)

    Askar, A.; Köylüo, U.; Nielsen, Søren R.K.

    1996-01-01

    In this paper semi-analytical forward-difference Monte Carlo simulation procedures are proposed for the determination of the lower order statistics and the Joint Probability Density Function (JPDF) of the stochastic response of geometrically nonlinear multi-degree-of-freedom structural systems...... of motion. All of the proposed procedures yield the exact results as the time step goes to zero. The proposed procedures are based on analytical convolutions of the excitation process, hereby, reducing the generation of stochastic processes and numerical integration to the generation of random vectors only...

  2. Effects of high-intensity pulse irradiation with linear polarized near-infrared rays and stretching on muscle tone in patients with cerebrovascular disease: a randomized controlled trial.

    Science.gov (United States)

    Takeuchi, Nobuyuki; Takezako, Nobuhiro; Shimonishi, Yuko; Usuda, Shigeru

    2017-08-01

    [Purpose] The purpose of this study was to clarify the influence of high-intensity pulse irradiation with linear polarized near-infrared rays (HI-LPNR) and stretching on hypertonia in cerebrovascular disease patients. [Subjects and Methods] The subjects were 40 cerebrovascular disease patients with hypertonia of the ankle joint plantar flexor muscle. The subjects were randomly allocated to groups undergoing treatment with HI-LPNR irradiation (HI-LPNR group), stretching (stretching group), HI-LPNR irradiation followed by stretching (combination group), and control group (10 subjects each). In all groups, the passive range of motion of ankle dorsiflexion and passive resistive joint torque of ankle dorsiflexion were measured before and after the specified intervention. [Results] The changes in passive range of motion, significant increase in the stretching and combination groups compared with that in the control group. The changes in passive resistive joint torque, significant decrease in HI-LPNR, stretching, and combination groups compared with that in the control group. [Conclusion] HI-LPNR irradiation and stretching has effect of decrease muscle tone. However, combination of HI-LPNR irradiation and stretching has no multiplier effect.

  3. Linear Fresnel Reflector based Solar Radiation Concentrator for Combined Heating and Power

    Science.gov (United States)

    Chatterjee, Aveek; Bernal, Eva; Seshadri, Satya; Mayer, Oliver; Greaves, Mikal

    2011-12-01

    We have designed and realized a test rig to characterize concentrated solar-based CHP (combined heat and power) generator. Cost benefit analysis has been used to compare alternate technologies, which can cogenerate electrical and thermal power. We have summarized the experimental setup and methods to characterize a concentrated solar thermal (CST) unit. In this paper, we demonstrate the performance data of a concentrated solar thermal system.

  4. Prediction of B-cell Linear Epitopes with a Combination of Support Vector Machine Classification and Amino Acid Propensity Identification

    Directory of Open Access Journals (Sweden)

    Hsin-Wei Wang

    2011-01-01

    Full Text Available Epitopes are antigenic determinants that are useful because they induce B-cell antibody production and stimulate T-cell activation. Bioinformatics can enable rapid, efficient prediction of potential epitopes. Here, we designed a novel B-cell linear epitope prediction system called LEPS, Linear Epitope Prediction by Propensities and Support Vector Machine, that combined physico-chemical propensity identification and support vector machine (SVM classification. We tested the LEPS on four datasets: AntiJen, HIV, a newly generated PC, and AHP, a combination of these three datasets. Peptides with globally or locally high physicochemical propensities were first identified as primitive linear epitope (LE candidates. Then, candidates were classified with the SVM based on the unique features of amino acid segments. This reduced the number of predicted epitopes and enhanced the positive prediction value (PPV. Compared to four other well-known LE prediction systems, the LEPS achieved the highest accuracy (72.52%, specificity (84.22%, PPV (32.07%, and Matthews' correlation coefficient (10.36%.

  5. Constraints on general slowing: a meta-analysis using hierarchical linear models with random coefficients.

    Science.gov (United States)

    Sliwinski, M J; Hall, C B

    1998-03-01

    General slowing (GS) theories are often tested by meta-analysis that model mean latencies of older adults as a function of mean latencies of younger adults. Ordinary least squares (OLS) regression is inappropriate for this purpose because it fails to account for the nested structure of multitask response time (RT) data. Hierarchical linear models (HLM) are an alternative method for analyzing such data. OLS analysis of data from 21 studies that used iterative cognitive tasks supported GS; however, HLM analysis demonstrated significant variance in slowing across experimental tasks and a process-specific effect by showing less slowing for memory scanning than for visual-search and mental-rotation tasks. The authors conclude that HLM is more suitable than OLS methods for meta-analyses of RT data and for testing GS theories.

  6. Imipramine and Pregabalin Combination for Painful Polyneuropathy. A Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Holbech, Jakob V; Bach, Flemming W; Finnerup, Nanna B

    2015-01-01

    Monotherapy with first-line drugs for neuropathic pain often fails to provide sufficient pain relief or has unacceptable side effects because of the need for high doses. The aim of this trial was to test whether the combination of imipramine and pregabalin in moderate doses would relieve pain more...... effectively than monotherapy with either of the drugs. This was a randomized, double-blind, placebo-controlled, crossover, multicenter trial consisting of four 5-week treatment periods in patients with painful polyneuropathy. Treatment arms were imipramine 75 mg/d vs pregabalin 300 mg/d vs combination therapy...... randomized, and 69 patients were included in the data analysis. The effect on average pain in comparison with placebo was: combination (-1.67 NRS points, P pregabalin (-0.48 NRS points, P = 0.03). The combination therapy had significantly lower pain...

  7. Impedance cardiography filtering using scale Fourier linear combiner based on RLS algorithm.

    Science.gov (United States)

    Dromer, O; Alata, O; Bernard, O

    2009-01-01

    The Cardiac Output (CO) can be calculated from the thoracic cardio-impedance signal from several methods, and all of them are linked to the frequency information, information that is limited by the type of filtering used before. A methodology is proposed to evaluate the effect of the commonly used methods of filtering, and an improvement of the SFLC LMS-based algorithm by the use of RLS algorithm is also tested. Performances of algorithms are then evaluated considering different types of noise such as white noise or combination of sinusoidal noises to simulate the effect of respiration and body movements.

  8. Patient, Provider, and Combined Interventions for Managing Osteoarthritis in Primary Care: A Cluster Randomized Trial.

    Science.gov (United States)

    Allen, Kelli D; Oddone, Eugene Z; Coffman, Cynthia J; Jeffreys, Amy S; Bosworth, Hayden B; Chatterjee, Ranee; McDuffie, Jennifer; Strauss, Jennifer L; Yancy, William S; Datta, Santanu K; Corsino, Leonor; Dolor, Rowena J

    2017-03-21

    A single-site study showed that a combined patient and provider intervention improved outcomes for patients with knee osteoarthritis, but it did not assess separate effects of the interventions. To examine whether patient-based, provider-based, and patient-provider interventions improve osteoarthritis outcomes. Cluster randomized trial with assignment to patient, provider, and patient-provider interventions or usual care. (ClinicalTrials.gov: NCT01435109). 10 Duke University Health System community-based primary care clinics. 537 outpatients with symptomatic hip or knee osteoarthritis. The telephone-based patient intervention focused on weight management, physical activity, and cognitive behavioral pain management. The provider intervention involved electronic delivery of patient-specific osteoarthritis treatment recommendations to providers. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score at 12 months. Secondary outcomes were objective physical function (Short Physical Performance Battery) and depressive symptoms (Patient Health Questionnaire). Linear mixed models assessed the difference in improvement among groups. No difference was observed in WOMAC score changes from baseline to 12 months in the patient (-1.5 [95% CI, -5.1 to 2.0]; P = 0.40), provider (2.5 [CI, -0.9 to 5.9]; P = 0.152), or patient-provider (-0.7 [CI, -4.2 to 2.8]; P = 0.69) intervention groups compared with usual care. All groups had improvements in WOMAC scores at 12 months (range, -3.7 to -7.7). In addition, no differences were seen in objective physical function or depressive symptoms at 12 months in any of the intervention groups compared with usual care. The study involved 1 health care network. Data on provider referrals were not collected. Contrary to a previous study of a combined patient and provider intervention for osteoarthritis in a Department of Veterans Affairs medical center, this study found no statistically

  9. Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial

    NARCIS (Netherlands)

    van Tubergen, A.; Landewé, R.; van der Heijde, D.; Hidding, A.; Wolter, N.; Asscher, M.; Falkenbach, A.; Genth, E.; Thè, H. G.; van der Linden, S.

    2001-01-01

    To determine the efficacy of combined spa-exercise therapy in addition to standard treatment with drugs and weekly group physical therapy in patients with ankylosing spondylitis (AS). A total of 120 Dutch outpatients with AS were randomly allocated into 3 groups of 40 patients each. Group 1 (mean

  10. T3, a Combinator-based Random Testing Tool for Java: Benchmarking

    NARCIS (Netherlands)

    Prasetya, I.S.W.B.

    2014-01-01

    T3 is the next generation of the light weight automated testing tool T2 for Java. In the heart T3 is still a random testing tool; but it now comes with some new features: pair-wise testing, concurrent generators, and a combinator-based approach ala QuickCheck. This paper presents the result of

  11. Visualization of Global Sensitivity Analysis Results Based on a Combination of Linearly Dependent and Independent Directions

    Science.gov (United States)

    Davies, Misty D.; Gundy-Burlet, Karen

    2010-01-01

    A useful technique for the validation and verification of complex flight systems is Monte Carlo Filtering -- a global sensitivity analysis that tries to find the inputs and ranges that are most likely to lead to a subset of the outputs. A thorough exploration of the parameter space for complex integrated systems may require thousands of experiments and hundreds of controlled and measured variables. Tools for analyzing this space often have limitations caused by the numerical problems associated with high dimensionality and caused by the assumption of independence of all of the dimensions. To combat both of these limitations, we propose a technique that uses a combination of the original variables with the derived variables obtained during a principal component analysis.

  12. Comparison of strategies for combining dynamic linear models with artificial neural networks for detecting diarrhea in slaughter pigs

    DEFF Research Database (Denmark)

    Jensen, Dan Børge; Kristensen, Anders Ringgaard

    2016-01-01

    , can provide early and automatic detection of diarrhea. To determine the best approach to achieve this goal, we compared 36 different strategies for combining a multivariate dynamic linear model (DLM) with an artificial neural network (ANN). We used data collected in 16 pens between November 2013...... (SP), and the sensitivity (SE). The best performance was seen when using a training window with a total of 42 hours for the numerical forecast errors, which produced an error rate=0.16, a specificity=0.88, and a sensitivity=0.80. For the other tested strategies, the ranges of error rates...

  13. A Combined MPI-CUDA Parallel Solution of Linear and Nonlinear Poisson-Boltzmann Equation

    Directory of Open Access Journals (Sweden)

    José Colmenares

    2014-01-01

    Full Text Available The Poisson-Boltzmann equation models the electrostatic potential generated by fixed charges on a polarizable solute immersed in an ionic solution. This approach is often used in computational structural biology to estimate the electrostatic energetic component of the assembly of molecular biological systems. In the last decades, the amount of data concerning proteins and other biological macromolecules has remarkably increased. To fruitfully exploit these data, a huge computational power is needed as well as software tools capable of exploiting it. It is therefore necessary to move towards high performance computing and to develop proper parallel implementations of already existing and of novel algorithms. Nowadays, workstations can provide an amazing computational power: up to 10 TFLOPS on a single machine equipped with multiple CPUs and accelerators such as Intel Xeon Phi or GPU devices. The actual obstacle to the full exploitation of modern heterogeneous resources is efficient parallel coding and porting of software on such architectures. In this paper, we propose the implementation of a full Poisson-Boltzmann solver based on a finite-difference scheme using different and combined parallel schemes and in particular a mixed MPI-CUDA implementation. Results show great speedups when using the two schemes, achieving an 18.9x speedup using three GPUs.

  14. A combined MPI-CUDA parallel solution of linear and nonlinear Poisson-Boltzmann equation.

    Science.gov (United States)

    Colmenares, José; Galizia, Antonella; Ortiz, Jesús; Clematis, Andrea; Rocchia, Walter

    2014-01-01

    The Poisson-Boltzmann equation models the electrostatic potential generated by fixed charges on a polarizable solute immersed in an ionic solution. This approach is often used in computational structural biology to estimate the electrostatic energetic component of the assembly of molecular biological systems. In the last decades, the amount of data concerning proteins and other biological macromolecules has remarkably increased. To fruitfully exploit these data, a huge computational power is needed as well as software tools capable of exploiting it. It is therefore necessary to move towards high performance computing and to develop proper parallel implementations of already existing and of novel algorithms. Nowadays, workstations can provide an amazing computational power: up to 10 TFLOPS on a single machine equipped with multiple CPUs and accelerators such as Intel Xeon Phi or GPU devices. The actual obstacle to the full exploitation of modern heterogeneous resources is efficient parallel coding and porting of software on such architectures. In this paper, we propose the implementation of a full Poisson-Boltzmann solver based on a finite-difference scheme using different and combined parallel schemes and in particular a mixed MPI-CUDA implementation. Results show great speedups when using the two schemes, achieving an 18.9x speedup using three GPUs.

  15. Non-linear imaging and characterization of atherosclerotic arterial tissue using combined SHG and FLIM microscopy.

    Science.gov (United States)

    Cicchi, Riccardo; Baria, Enrico; Matthäus, Christian; Lange, Marta; Lattermann, Annika; Brehm, Bernhard R; Popp, Jürgen; Pavone, Francesco Saverio

    2015-04-01

    Atherosclerosis is one of the leading causes of death in the Western World and its characterization is extremely interesting from the diagnostic point of view. Here, we employed combined SHG-FLIM microscopy to characterize arterial tissue with atherosclerosis. The shorter mean fluorescence lifetime measured within plaque depositions (1260 ± 80 ps) with respect to normal arterial wall (1480 ± 100 ps) allowed discriminating collagen from lipids. SHG measurements and image analysis demonstrated that the normal arterial wall has a more anisotropic Aspect Ratio (0.37 ± 0.02) with respect to plaque depositions (0.61 ± 0.02) and that the correlation length can be used for discriminating collagen fibre bundles (2.0 ± 0.6 µm) from cholesterol depositions (4.1 ± 0.6 µm). The presented method has the potential to find place in a clinical setting as well as to be applied in vivo in the near future. Graphic composition of SHG and FLIM images representing normal arterial wall and plaque depositions. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Numerical analysis of non-linear vibrations of a fractionally damped cylindrical shell under the conditions of combinational internal resonance

    Directory of Open Access Journals (Sweden)

    Rossikhin Yury A.

    2018-01-01

    Full Text Available Non-linear damped vibrations of a cylindrical shell embedded into a fractional derivative medium are investigated for the case of the combinational internal resonance, resulting in modal interaction, using two different numerical methods with further comparison of the results obtained. The damping properties of the surrounding medium are described by the fractional derivative Kelvin-Voigt model utilizing the Riemann-Liouville fractional derivatives. Within the first method, the generalized displacements of a coupled set of nonlinear ordinary differential equations of the second order are estimated using numerical solution of nonlinear multi-term fractional differential equations by the procedure based on the reduction of the problem to a system of fractional differential equations. According to the second method, the amplitudes and phases of nonlinear vibrations are estimated from the governing nonlinear differential equations describing amplitude-and-phase modulations for the case of the combinational internal resonance. A good agreement in results is declared.

  17. Bayesian Piecewise Linear Mixed Models With a Random Change Point: An Application to BMI Rebound in Childhood.

    Science.gov (United States)

    Brilleman, Samuel L; Howe, Laura D; Wolfe, Rory; Tilling, Kate

    2017-11-01

    Body mass index (BMI) rebound refers to the beginning of the second rise in BMI during childhood. Accurate estimation of an individual's timing of BMI rebound is important because it is associated with health outcomes in later life. We estimated BMI trajectories for 6545 children from the Avon Longitudinal Study of Parents and Children. We used a novel Bayesian two-phase piecewise linear mixed model where the "change point" was an individual-level random effect corresponding to the individual-specific timing of BMI rebound. The model's individual-level random effects (intercept, prechange slope, postchange slope, change point) were multivariate normally distributed with an unstructured variance-covariance matrix, thereby, allowing for correlation between all random effects. Average age at BMI rebound (mean change point) was 6.5 (95% credible interval: 6.4 to 6.6) years. The standard deviation of the individual-specific timing of BMI rebound (random effects) was 2.0 years for females and 1.6 years for males. Correlation between the prechange slope and change point was 0.57, suggesting that faster rates of decline in BMI prior to rebound were associated with rebound occurring at an earlier age. Simulations showed that estimates from the model were less biased than those from models, assuming a common change point for all individuals or a nonlinear trajectory based on fractional polynomials. Our model flexibly estimated the individual-specific timing of BMI rebound, while retaining parameters that are meaningful and easy to interpret. It is applicable in any situation where one wishes to estimate a change-point process which varies between individuals.

  18. Generalized randomly amplified linear system driven by gaussian noises: extreme heavy tail and algebraic correlation decay in plasma turbulence.

    Science.gov (United States)

    Steinbrecher, György; Weyssow, B

    2004-03-26

    The extreme heavy tail and the power-law decay of the turbulent flux correlation observed in hot magnetically confined plasmas are modeled by a system of coupled Langevin equations describing a continuous time linear randomly amplified stochastic process where the amplification factor is driven by a superposition of colored noises which, in a suitable limit, generate a fractional Brownian motion. An exact analytical formula for the power-law tail exponent beta is derived. The extremely small value of the heavy tail exponent and the power-law distribution of laminar times also found experimentally are obtained, in a robust manner, for a wide range of input values, as a consequence of the (asymptotic) self-similarity property of the noise spectrum. As a by-product, a new representation of the persistent fractional Brownian motion is obtained.

  19. Theoretical study of polymeric mixtures with different sequence statistics. II. Brazovskii class: Linear random copolymers with diblock copolymers

    Energy Technology Data Exchange (ETDEWEB)

    Qi, Shuyan [Department of Chemical Engineering, Department of Chemistry, and Materials Science Division, Lawrence Berkeley National Laboratory, University of California, Berkeley, California 94720 (United States); Chakraborty, Arup K. [Department of Chemical Engineering, Department of Chemistry, and Materials Science Division, Lawrence Berkeley National Laboratory, University of California, Berkeley, California 94720 (United States)

    2000-01-15

    We use a Landau theory to study the instability of the homogeneous state of a mixture of linear random copolymers and diblock copolymers. Interesting features of the calculated structure factors for different components of the mixture are found, which can be directly compared with scattering experiments with selectively deuterated samples. We also investigate the least stable concentration fluctuations and find four different types of segregation modes at the spinodal depending upon the characteristics of the mixture (e.g., average compositions, statistical correlation lengths and volume fractions). The different segregation modes are also indicative of the kinetic pathways leading to the formation of ordered microstructures. Experiments probing these pathways are suggested. (c) 2000 American Institute of Physics.

  20. The Effect of Creative Tasks on Electrocardiogram: Using Linear and Nonlinear Features in Combination with Classification Approaches.

    Science.gov (United States)

    Zakeri, Sahar; Abbasi, Ataollah; Goshvarpour, Ateke

    2017-01-01

    Objective: Interest in the subject of creativity and its impacts on human life is growing extensively. However, only a few surveys pay attention to the relation between creativity and physiological changes. This paper presents a novel approach to distinguish between creativity states from electrocardiogram signals. Nineteen linear and nonlinear features of the cardiac signal were extracted to detect creativity states. Method: ECG signals of 52 participants were recorded while doing three tasks of Torrance Tests of Creative Thinking (TTCT/ figural B). To remove artifacts, notch filter 50 Hz and Chebyshev II were applied. According to TTCT scores, participants were categorized into the high and low creativity groups: Participants with scores higher than 70 were assigned into the high creativity group and those with scores less than 30 were considered as low creativity group. Some linear and nonlinear features were extracted from the ECGs. Then, Support Vector Machine (SVM) and Adaptive Neuro-Fuzzy Inference System (ANFIS) were used to classify the groups. Results: Applying the Wilcoxon test, significant differences were observed between rest and each three tasks of creativity. However, better discrimination was performed between rest and the first task. In addition, there were no statistical differences between the second and third task of the test. The results indicated that the SVM effectively detects all the three tasks from the rest, particularly the task 1 and reached the maximum accuracy of 99.63% in the linear analysis. In addition, the high creative group was separated from the low creative group with the accuracy of 98.41%. Conclusion : the combination of SVM classifier with linear features can be useful to show the relation between creativity and physiological changes.

  1. The Effect of Creative Tasks on Electrocardiogram: Using Linear and Nonlinear Features in Combination with Classification Approaches

    Directory of Open Access Journals (Sweden)

    Sahar Zakeri

    2017-02-01

    Full Text Available Objective: Interest in the subject of creativity and its impacts on human life is growing extensively. However, only a few surveys pay attention to the relation between creativity and physiological changes. This paper presents a novel approach to distinguish between creativity states from electrocardiogram signals. Nineteen linear and nonlinear features of the cardiac signal were extracted to detect creativity states. Method: ECG signals of 52 participants were recorded while doing three tasks of Torrance Tests of Creative Thinking (TTCT/ figural B. To remove artifacts, notch filter 50 Hz and Chebyshev II were applied. According to TTCT scores, participants were categorized into the high and low creativity groups: Participants with scores higher than 70 were assigned into the high creativity group and those with scores less than 30 were considered as low creativity group. Some linear and nonlinear features were extracted from the ECGs. Then, Support Vector Machine (SVM and Adaptive Neuro-Fuzzy Inference System (ANFIS were used to classify the groups.Results: Applying the Wilcoxon test, significant differences were observed between rest and each three tasks of creativity. However, better discrimination was performed between rest and the first task. In addition, there were no statistical differences between the second and third task of the test. The results indicated that the SVM effectively detects all the three tasks from the rest, particularly the task 1 and reached the maximum accuracy of 99.63% in the linear analysis. In addition, the high creative group was separated from the low creative group with the accuracy of 98.41%.Conclusion: the combination of SVM classifier with linear features can be useful to show the relation between creativity and physiological changes.

  2. Substituting random forest for multiple linear regression improves binding affinity prediction of scoring functions: Cyscore as a case study.

    Science.gov (United States)

    Li, Hongjian; Leung, Kwong-Sak; Wong, Man-Hon; Ballester, Pedro J

    2014-08-27

    State-of-the-art protein-ligand docking methods are generally limited by the traditionally low accuracy of their scoring functions, which are used to predict binding affinity and thus vital for discriminating between active and inactive compounds. Despite intensive research over the years, classical scoring functions have reached a plateau in their predictive performance. These assume a predetermined additive functional form for some sophisticated numerical features, and use standard multivariate linear regression (MLR) on experimental data to derive the coefficients. In this study we show that such a simple functional form is detrimental for the prediction performance of a scoring function, and replacing linear regression by machine learning techniques like random forest (RF) can improve prediction performance. We investigate the conditions of applying RF under various contexts and find that given sufficient training samples RF manages to comprehensively capture the non-linearity between structural features and measured binding affinities. Incorporating more structural features and training with more samples can both boost RF performance. In addition, we analyze the importance of structural features to binding affinity prediction using the RF variable importance tool. Lastly, we use Cyscore, a top performing empirical scoring function, as a baseline for comparison study. Machine-learning scoring functions are fundamentally different from classical scoring functions because the former circumvents the fixed functional form relating structural features with binding affinities. RF, but not MLR, can effectively exploit more structural features and more training samples, leading to higher prediction performance. The future availability of more X-ray crystal structures will further widen the performance gap between RF-based and MLR-based scoring functions. This further stresses the importance of substituting RF for MLR in scoring function development.

  3. Polarimetric SAR Image Classification Using Multifeatures Combination and Extremely Randomized Clustering Forests

    Directory of Open Access Journals (Sweden)

    Zou Tongyuan

    2010-01-01

    Full Text Available Abstract Terrain classification using polarimetric SAR imagery has been a very active research field over recent years. Although lots of features have been proposed and many classifiers have been employed, there are few works on comparing these features and their combination with different classifiers. In this paper, we firstly evaluate and compare different features for classifying polarimetric SAR imagery. Then, we propose two strategies for feature combination: manual selection according to heuristic rules and automatic combination based on a simple but efficient criterion. Finally, we introduce extremely randomized clustering forests (ERCFs to polarimetric SAR image classification and compare it with other competitive classifiers. Experiments on ALOS PALSAR image validate the effectiveness of the feature combination strategies and also show that ERCFs achieves competitive performance with other widely used classifiers while costing much less training and testing time.

  4. Combination therapy containing ritonavir plus saquinavir has superior short-term antiretroviral efficacy: a randomized trial

    DEFF Research Database (Denmark)

    Kirk, O; Katzenstein, T L; Gerstoft, J

    1999-01-01

    OBJECTIVES: To compare the efficacy and safety of indinavir 800 mg three times a day, ritonavir 600 mg twice a day, and a combination of ritonavir 400 mg twice a day and saquinavir 400 mg twice a day, when administered with two nucleoside analogues. DESIGN: A randomized, open-labelled, controlled...... is generally safe, and has superior short-term antiviral efficacy compared with indinavir and ritonavir also combined with two nucleoside analogues in antiretroviral drug-naive patients. Further follow-up is needed to determine the durability of the viral response....

  5. Linear response of mutans streptococci to increasing frequency of xylitol chewing gum use: a randomized controlled trial [ISRCTN43479664

    Directory of Open Access Journals (Sweden)

    Yamaguchi David K

    2006-03-01

    Full Text Available Abstract Background Xylitol is a naturally occurring sugar substitute that has been shown to reduce the level of mutans streptococci in plaque and saliva and to reduce tooth decay. It has been suggested that the degree of reduction is dependent on both the amount and the frequency of xylitol consumption. For xylitol to be successfully and cost-effectively used in public health prevention strategies dosing and frequency guidelines should be established. This study determined the reduction in mutans streptococci levels in plaque and unstimulated saliva to increasing frequency of xylitol gum use at a fixed total daily dose of 10.32 g over five weeks. Methods Participants (n = 132 were randomized to either active groups (10.32 g xylitol/day or a placebo control (9.828 g sorbitol and 0.7 g maltitol/day. All groups chewed 12 pieces of gum per day. The control group chewed 4 times/day and active groups chewed xylitol gum at a frequency of 2 times/day, 3 times/day, or 4 times/day. The 12 gum pieces were evenly divided into the frequency assigned to each group. Plaque and unstimulated saliva samples were taken at baseline and five-weeks and were cultured on modified Mitis Salivarius agar for mutans streptococci enumeration. Results There were no significant differences in mutans streptococci level among the groups at baseline. At five-weeks, mutans streptococci levels in plaque and unstimulated saliva showed a linear reduction with increasing frequency of xylitol chewing gum use at the constant daily dose. Although the difference observed for the group that chewed xylitol 2 times/day was consistent with the linear model, the difference was not significant. Conclusion There was a linear reduction in mutans streptococci levels in plaque and saliva with increasing frequency of xylitol gum use at a constant daily dose. Reduction at a consumption frequency of 2 times per day was small and consistent with the linear-response line but was not statistically

  6. Single-blind, randomized, pilot study combining shiatsu and amitriptyline in refractory primary headaches.

    Science.gov (United States)

    Villani, Veronica; Prosperini, Luca; Palombini, Fulvio; Orzi, Francesco; Sette, Giuliano

    2017-06-01

    Complementary alternative medicine, such as shiatsu, can represent a suitable treatment for primary headaches. However, evidence-based data about the effect of combining shiatsu and pharmacological treatments are still not available. Therefore, we tested the efficacy and safety of combining shiatsu and amitriptyline to treat refractory primary headaches in a single-blind, randomized, pilot study. Subjects with a diagnosis of primary headache and who experienced lack of response to ≥2 different prophylactic drugs were randomized in a 1:1:1 ratio to receive shiatsu plus amitriptyline, shiatsu alone, or amitriptyline alone for 3 months. Primary endpoint was the proportion of patients experiencing ≥50%-reduction in headache days. Secondary endpoints were days with headache per month, visual analogue scale, and number of pain killers taken per month. After randomization, 37 subjects were allocated to shiatsu plus amitriptyline (n = 11), shiatsu alone (n = 13), and amitriptyline alone (n = 13). Randomization ensured well-balanced demographic and clinical characteristics at baseline. Although all the three groups improved in terms of headache frequency, visual analogue scale score, and number of pain killers (p < 0.05), there was no between-group difference in primary endpoint (p = ns). Shiatsu (alone or in combination) was superior to amitriptyline in reducing the number of pain killers taken per month (p < 0.05). Seven (19%) subjects reported adverse events, all attributable to amitriptyline, while no side effects were related with shiatsu treatment. Shiatsu is a safe and potentially useful alternative approach for refractory headache. However, there is no evidence of an additive or synergistic effect of combining shiatsu and amitriptyline. These findings are only preliminary and should be interpreted cautiously due to the small sample size of the population included in our study. Trial registration 81/2010 (Ethical Committee, S. Andrea Hospital

  7. Linear combination fitting data

    Data.gov (United States)

    U.S. Environmental Protection Agency — The dataset shows the weighted percentage of arsenic speciation for untreated and treated soil samples with amendments designed to immobilize arsenic in soils. This...

  8. The association of defensin HNP-2 with negatively charged membranes: A combined fluorescence and linear dichroism study.

    Science.gov (United States)

    Pridmore, Catherine J; Rodger, Alison; Sanderson, John M

    2016-04-01

    The association of defensin HNP-2 with negatively charged membranes has been studied using a new approach that combines fluorescence and linear dichroism (LD) spectroscopies with simulated LD spectra in order to characterise the binding kinetics and bound configurations of the peptide. Binding to membranes composed of mixtures of diacylglycerophosphocholines (PC) with either diacylglycerophosphoglycerol (PG) or diacylglycerophosphoserine (PS) was conducted at lipid:peptide ratios that yielded binding, but not membrane fusion. HNP-2 association with membranes under these conditions was a 2 stage-process, with both stages exhibiting first order kinetics. The fast initial step, with a half-life of 3 min. Conversion between the states was estimated to have an enthalpy of activation of approximately 10 kJ mol(-1) and an entropy of activation of -0.2 kJ K mol(-1). LD spectra corresponding to each of the membrane bound states were generated by non-linear regression using a standard kinetic model. These spectra are interpreted in comparison with spectra calculated using the program Dichrocalc and reveal that the peptide associates with membranes in a small number of stable configurations. All of these configurations have a significant proportion of β-sheet structure residing in the plane of the membrane. Two configurations support structures previously proposed for defensins in membranes. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Performance of an Axisymmetric Rocket Based Combined Cycle Engine During Rocket Only Operation Using Linear Regression Analysis

    Science.gov (United States)

    Smith, Timothy D.; Steffen, Christopher J., Jr.; Yungster, Shaye; Keller, Dennis J.

    1998-01-01

    The all rocket mode of operation is shown to be a critical factor in the overall performance of a rocket based combined cycle (RBCC) vehicle. An axisymmetric RBCC engine was used to determine specific impulse efficiency values based upon both full flow and gas generator configurations. Design of experiments methodology was used to construct a test matrix and multiple linear regression analysis was used to build parametric models. The main parameters investigated in this study were: rocket chamber pressure, rocket exit area ratio, injected secondary flow, mixer-ejector inlet area, mixer-ejector area ratio, and mixer-ejector length-to-inlet diameter ratio. A perfect gas computational fluid dynamics analysis, using both the Spalart-Allmaras and k-omega turbulence models, was performed with the NPARC code to obtain values of vacuum specific impulse. Results from the multiple linear regression analysis showed that for both the full flow and gas generator configurations increasing mixer-ejector area ratio and rocket area ratio increase performance, while increasing mixer-ejector inlet area ratio and mixer-ejector length-to-diameter ratio decrease performance. Increasing injected secondary flow increased performance for the gas generator analysis, but was not statistically significant for the full flow analysis. Chamber pressure was found to be not statistically significant.

  10. Classification of Potential Water Bodies Using Landsat 8 OLI and a Combination of Two Boosted Random Forest Classifiers.

    Science.gov (United States)

    Ko, Byoung Chul; Kim, Hyeong Hun; Nam, Jae Yeal

    2015-06-11

    This study proposes a new water body classification method using top-of-atmosphere (TOA) reflectance and water indices (WIs) of the Landsat 8 Operational Land Imager (OLI) sensor and its corresponding random forest classifiers. In this study, multispectral images from the OLI sensor are represented as TOA reflectance and WI values because a classification result using two measures is better than raw spectral images. Two types of boosted random forest (BRF) classifiers are learned using TOA reflectance and WI values, respectively, instead of the heuristic threshold or unsupervised methods. The final probability is summed linearly using the probabilities of two different BRFs to classify image pixels to water class. This study first demonstrates that the Landsat 8 OLI sensor has higher classification rate because it provides improved signal-to-ratio radiometric by using 12-bit quantization of the data instead of 8-bit as available from other sensors. In addition, we prove that the performance of the proposed combination of two BRF classifiers shows robust water body classification results, regardless of topology, river properties, and background environment.

  11. Classification of Potential Water Bodies Using Landsat 8 OLI and a Combination of Two Boosted Random Forest Classifiers

    Directory of Open Access Journals (Sweden)

    Byoung Chul Ko

    2015-06-01

    Full Text Available This study proposes a new water body classification method using top-of-atmosphere (TOA reflectance and water indices (WIs of the Landsat 8 Operational Land Imager (OLI sensor and its corresponding random forest classifiers. In this study, multispectral images from the OLI sensor are represented as TOA reflectance and WI values because a classification result using two measures is better than raw spectral images. Two types of boosted random forest (BRF classifiers are learned using TOA reflectance and WI values, respectively, instead of the heuristic threshold or unsupervised methods. The final probability is summed linearly using the probabilities of two different BRFs to classify image pixels to water class. This study first demonstrates that the Landsat 8 OLI sensor has higher classification rate because it provides improved signal-to-ratio radiometric by using 12-bit quantization of the data instead of 8-bit as available from other sensors. In addition, we prove that the performance of the proposed combination of two BRF classifiers shows robust water body classification results, regardless of topology, river properties, and background environment.

  12. Multiple trait model combining random regressions for daily feed intake with single measured performance traits of growing pigs

    Directory of Open Access Journals (Sweden)

    Künzi Niklaus

    2002-01-01

    Full Text Available Abstract A random regression model for daily feed intake and a conventional multiple trait animal model for the four traits average daily gain on test (ADG, feed conversion ratio (FCR, carcass lean content and meat quality index were combined to analyse data from 1 449 castrated male Large White pigs performance tested in two French central testing stations in 1997. Group housed pigs fed ad libitum with electronic feed dispensers were tested from 35 to 100 kg live body weight. A quadratic polynomial in days on test was used as a regression function for weekly means of daily feed intake and to escribe its residual variance. The same fixed (batch and random (additive genetic, pen and individual permanent environmental effects were used for regression coefficients of feed intake and single measured traits. Variance components were estimated by means of a Bayesian analysis using Gibbs sampling. Four Gibbs chains were run for 550 000 rounds each, from which 50 000 rounds were discarded from the burn-in period. Estimates of posterior means of covariance matrices were calculated from the remaining two million samples. Low heritabilities of linear and quadratic regression coefficients and their unfavourable genetic correlations with other performance traits reveal that altering the shape of the feed intake curve by direct or indirect selection is difficult.

  13. Pregabalin and Speech Pathology Combination Therapy for Refractory Chronic Cough: A Randomized Controlled Trial.

    Science.gov (United States)

    Vertigan, Anne E; Kapela, Sarah L; Ryan, Nicole M; Birring, Surinder S; McElduff, Patrick; Gibson, Peter G

    2016-03-01

    Chronic refractory cough (CRC) is a difficult problem to treat. Speech pathology treatment (SPT) improves symptoms but resolution is incomplete. Centrally acting neuromodulators also improve cough symptoms, but not cough reflex sensitivity, and the effect is short-lived. We hypothesized that combined SPT and centrally acting neuromodulators would have a superior outcome than SPT alone. Our goal was to determine whether combined pregabalin and SPT is more effective than SPT alone. Randomized placebo controlled trial. Forty patients with CRC were randomly assigned to receive either combined SPT and pregabalin 300 mg daily or combined SPT and placebo. Outcome measures were collected at baseline, end of treatment, and 4 weeks after the end of treatment. Primary outcome measures were cough frequency using the Leicester Cough Monitor, cough severity using a visual analog scale (coughVAS), and cough-related quality of life (QOL) using the Leicester Cough Questionnaire (LCQ). Cough severity, cough frequency, and cough QOL improved in both groups. The degree of improvement in LCQ and coughVAS was greater with combined SPT and pregabalin than SPT alone; the mean difference in LCQ was 3.5, 95%CI of difference 1.1 to 5.8; the mean difference in coughVAS was 25.1, 95% CI of difference 10.6 to 39.6. There was no significant difference in improvement in cough frequency between groups. There was no deterioration in symptoms once pregabalin was withdrawn. Median capsaicin cough sensitivity improved from 15.7 to 47.5 μM with combined SPT and pregabalin and from 3.92 to 15.7 μM with SPT alone. Combined SPT and pregabalin reduces symptoms and improves QOL compared with SPT alone in patients with CRC. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  14. Exploration of linear modelling techniques and their combination with multivariate adaptive regression splines to predict gastro-intestinal absorption of drugs.

    Science.gov (United States)

    Deconinck, E; Coomans, D; Vander Heyden, Y

    2007-01-04

    In general, linear modelling techniques such as multiple linear regression (MLR), principal component regression (PCR) and partial least squares (PLS), are used to model QSAR data. This type of data can be very complex and linear modelling techniques often model only a limited part of the information captured in the data. In this study, it was tried to combine linear techniques with the flexible non-linear technique multivariate adaptive regression splines (MARS). Models were built using an MLR model, combined with either a stepwise procedure or a genetic algorithm for variable selection, a PCR model or a PLS model as starting points for the MARS algorithm. The descriptive and predictive power of the models was evaluated in a QSAR context and compared to the performances of the individual linear models and the single MARS model. In general, the combined methods resulted in significant improvements compared to the linear models and can be considered valuable techniques in modelling complex QSAR data. For the used data set the best model was obtained using a combination of PLS and MARS. This combination resulted in a model with a Pearson correlation coefficient of 0.90 and a cross-validation error, evaluated with 10-fold cross-validation of 9.9%, pointing at good descriptive and high predictive properties.

  15. Single-Tooth Osteotomy Combined Wide Linear Corticotomy Under Local Anesthesia for Correcting Anterior Protrusion With Ectopically Erupted Canine.

    Science.gov (United States)

    Iskenderoglu, Nur Serife; Choi, Byung-Joon; Seo, Kyung Won; Lee, Yeon-Ji; Lee, Baek-Soo; Kim, Seong-Hun

    2017-01-01

    This article presents the alternative surgical treatments of both anterior protrusion by carrying out retraction on mandibular anterior fragment, meanwhile applying retraction force on maxilla anterior teeth and ectopically erupted canine with using platelet-rich fibrin (PRF). Anterior segmental osteotomy was combined with linear corticotomy under local anesthesia. The correction of right ectopic canine was achieved through 2 stages. First, dento-osseous osteotomy on palatal side was performed. Then second osteotomy with immediate manual repositioning of the canine with concomitant first premolar extraction was enhanced with PRF, which was prepared by centrifuging patient's blood, applied into buccal side of high canine during osteotomy. Mandibular retraction was accomplished by anterior segmental osteotomy. Single-tooth osteotomy is a more effective surgical method for ankylosed or ectopically erupted tooth in orthodontic treatment. It can reduce the total orthodontic treatment time and root resorption, 1 common complication. Significant improved bone formation was seen with the addition of PRF on noncritical size defects in the animal model. It is reasonable to think that PRF can promote bone regeneration. So early bone formation also can reduce the complication such as postoperative infection. As an alternative to anterior protrusion and ectopically erupted canine treatment, segmental osteotomy and corticotomy combined platelet-rich plasma can enhance orthodontic treatment outcome.

  16. Approximate Forward Difference Equations for the Lower Order Non-Stationary Statistics of Geometrically Non-Linear Systems subject to Random Excitation

    DEFF Research Database (Denmark)

    Köylüoglu, H. U.; Nielsen, Søren R. K.; Cakmak, A. S.

    Geometrically non-linear multi-degree-of-freedom (MDOF) systems subject to random excitation are considered. New semi-analytical approximate forward difference equations for the lower order non-stationary statistical moments of the response are derived from the stochastic differential equations...... of motion, and, the accuracy of these equations is numerically investigated. For stationary excitations, the proposed method computes the stationary statistical moments of the response from the solution of non-linear algebraic equations....

  17. Combination treatment in Alzheimer's disease: results of a randomized, controlled trial with cerebrolysin and donepezil.

    Science.gov (United States)

    Alvarez, X Antón; Cacabelos, R; Sampedro, C; Couceiro, V; Aleixandre, M; Vargas, M; Linares, C; Granizo, E; García-Fantini, M; Baurecht, W; Doppler, E; Moessler, H

    2011-08-01

    Treatment with neurotrophic agents might enhance and/or prolong the effects of cholinesterase inhibitors (ChEIs) in Alzheimer's disease (AD). We compared the safety and efficacy of the neurotrophic compound Cerebrolysin (10 ml; n=64), donepezil (10 mg; n=66) and a combination of both treatments (n=67) in mild-to-moderate (mini-mental state examination-MMSE score 12-25) probable AD patients enrolled in a randomized, double-blind trial. Primary endpoints were global outcome (Clinician's Interview-Based Impression of Change plus caregiver input; CIBIC+) and cognition (change from baseline in AD Assessment Scale-cognitive subscale+; ADAS-cog+) at week 28. Changes in functioning (AD Cooperative Study-Activities of Daily Living scale, ADCS-ADL) and behaviour (Neuropsychiatric Inventory, NPI) were secondary endpoints. Treatment effects in cognitive, functional and behavioral domains showed no significant group differences; whereas improvements in global outcome favored Cerebrolysin and the combination therapy. Cognitive performance improved in all treatment groups (mean±SD for Cerebrolysin: -1.7±7.5; donepezil: -1.2±6.1; combination: -2.3±6.0) with best scores in the combined therapy group at all study visits. Cerebrolysin was as effective as donepezil, and the combination of neurotrophic (Cerebrolysin) and cholinergic (donepezil) treatment was safe in mild-to-moderate AD. The convenience of exploring long-term synergistic effects of this combined therapy is suggested.

  18. Evidence synthesis for decision making 2: a generalized linear modeling framework for pairwise and network meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Dias, Sofia; Sutton, Alex J; Ades, A E; Welton, Nicky J

    2013-07-01

    We set out a generalized linear model framework for the synthesis of data from randomized controlled trials. A common model is described, taking the form of a linear regression for both fixed and random effects synthesis, which can be implemented with normal, binomial, Poisson, and multinomial data. The familiar logistic model for meta-analysis with binomial data is a generalized linear model with a logit link function, which is appropriate for probability outcomes. The same linear regression framework can be applied to continuous outcomes, rate models, competing risks, or ordered category outcomes by using other link functions, such as identity, log, complementary log-log, and probit link functions. The common core model for the linear predictor can be applied to pairwise meta-analysis, indirect comparisons, synthesis of multiarm trials, and mixed treatment comparisons, also known as network meta-analysis, without distinction. We take a Bayesian approach to estimation and provide WinBUGS program code for a Bayesian analysis using Markov chain Monte Carlo simulation. An advantage of this approach is that it is straightforward to extend to shared parameter models where different randomized controlled trials report outcomes in different formats but from a common underlying model. Use of the generalized linear model framework allows us to present a unified account of how models can be compared using the deviance information criterion and how goodness of fit can be assessed using the residual deviance. The approach is illustrated through a range of worked examples for commonly encountered evidence formats.

  19. A linear time algorithm for detecting long genomic regions enriched with a specific combination of epigenetic states.

    Science.gov (United States)

    Ichikawa, Kazuki; Morishita, Shinichi

    2015-01-01

    Epigenetic modifications are essential for controlling gene expression. Recent studies have shown that not only single epigenetic modifications but also combinations of multiple epigenetic modifications play vital roles in gene regulation. A striking example is the long hypomethylated regions enriched with modified H3K27me3 (called, "K27HMD" regions), which are exposed to suppress the expression of key developmental genes relevant to cellular development and differentiation during embryonic stages in vertebrates. It is thus a biologically important issue to develop an effective optimization algorithm for detecting long DNA regions (e.g., >4 kbp in size) that harbor a specific combination of epigenetic modifications (e.g., K27HMD regions). However, to date, optimization algorithms for these purposes have received little attention, and available methods are still heuristic and ad hoc. In this paper, we propose a linear time algorithm for calculating a set of non-overlapping regions that maximizes the sum of similarities between the vector of focal epigenetic states and the vectors of raw epigenetic states at DNA positions in the set of regions. The average elapsed time to process the epigenetic data of any of human chromosomes was less than 2 seconds on an Intel Xeon CPU. To demonstrate the effectiveness of the algorithm, we estimated large K27HMD regions in the medaka and human genomes using our method, ChromHMM, and a heuristic method. We confirmed that the advantages of our method over those of the two other methods. Our method is flexible enough to handle other types of epigenetic combinations. The program that implements the method is called "CSMinfinder" and is made available at: http://mlab.cb.k.u-tokyo.ac.jp/~ichikawa/Segmentation/

  20. A Combined Polling and Random Access Technique for Enhanced Anti-Collision Performance in RFID Systems

    Science.gov (United States)

    Kim, Jeong Geun

    In this paper we propose a novel RFID anti-collision technique that intelligently combines polling and random access schemes. These two fundamentally different medium access control protocols are coherently integrated in our design while functionally complementing each other. The polling mode is designed to enable fast collision-free identification for the tags that exist within reader's coverage across the sessions. In contrast, the random access mode attempts to read the tags uncovered by the polling mode. Our proposed technique is particularly suited for a class of RFID applications in which a stationary reader periodically attempts to identify the tags with slow mobility. Numerical results show that our proposed technique yields much faster identification time against the existing approaches under various operating conditions.

  1. Comparative Efficacy of Newer Antidepressants in Combination with Pregabalin for Fibromyalgia Syndrome: A Controlled, Randomized Study.

    Science.gov (United States)

    Ramzy, Eiad A

    2017-01-01

    This controlled, randomized study investigated the hypothesis that the combined use of pregabalin plus paroxetine for fibromyalgia management would be associated with comparable Somatic Symptoms Scale-8 (SSS-8) and Center for Epidemiological Studies Depression Scale (CESDS) scores, but higher tolerability than the combined use of pregabalin plus either amitriptyline or venlafaxine. After institutional ethics committee approval, 75 female subjects diagnosed with fibromyalgia and in receipt of pregabalin (75 mg/day) were randomly allocated to concurrently receive amitriptyline (25 mg/day; n = 24), venlafaxine (75 mg/day; n = 25), or paroxetine (25 mg/day; n = 26). All patients were assessed bimonthly for 6 consecutive months for changes in SSS-8 and CESDS scores, life satisfaction, mood, sleep quality, fatigue, medication tolerability, and adverse events. Compared with pregabalin plus amitriptyline or venlafaxine, the combined use of pregabalin plus paroxetine in fibromyalgia patients resulted in significantly lower SSS-8 and CESDS scores from 18 (P fibromyalgia and to enhance the quality of life in affected individuals. © 2016 World Institute of Pain.

  2. A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students.

    Science.gov (United States)

    Turrisi, Rob; Larimer, Mary E; Mallett, Kimberly A; Kilmer, Jason R; Ray, Anne E; Mastroleo, Nadine R; Geisner, Irene Markman; Grossbard, Joel; Tollison, Sean; Lostutter, Ty W; Montoya, Heidi

    2009-07-01

    The current study is a multisite randomized alcohol prevention trial to evaluate the efficacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes). Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention efficacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested. The overall results revealed that the combined-intervention group had significantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects. The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session.

  3. Linear and nonlinear control of a three pole combined radial and axial active magnetic bearing - a comparison

    National Research Council Canada - National Science Library

    FLEISCHER, Erik; HOFMANN, Wilfried

    2015-01-01

    .... While the linear approach has been designed around the CLARKE-Transformation to stabilize the bearing, the nonlinear one is based on feedback linearization to achieve a stable system even in the...

  4. Linear and nonlinear control of a three pole combined radial and axial active magnetic bearing - a comparison

    National Research Council Canada - National Science Library

    FLEISCHER, Erik; HOFMANN, Wilfried

    .... While the linear approach has been designed around the CLARKE-Transformation to stabilize the bearing, the nonlinear one is based on feedback linearization to achieve a stable system even in the...

  5. Pseudo-random Aloha for inter-frame soft combining in RFID systems

    DEFF Research Database (Denmark)

    Castiglione, Paolo; Ricciato, Fabio; Popovski, Petar

    2013-01-01

    In this work we consider a recently proposed variant of the classical Framed Slotted-ALOHA where slot selection is based on a pseudo-random function of the message to be transmitted and of the frame index. We couple this feature with convolutional encoding, that allows to perform Inter-frame Soft...... cancellation (instead of combining). Numerical simulation results show that the ISoC scheme brings a noticeable throughput gain over traditional schemes in a dense RFID scenario with multiple concurrent Tag transmissions....

  6. Iceberg calving of Thwaites Glacier, West Antarctica: full-Stokes modeling combined with linear elastic fracture mechanics

    Science.gov (United States)

    Yu, Hongju; Rignot, Eric; Morlighem, Mathieu; Seroussi, Helene

    2017-05-01

    Thwaites Glacier (TG), West Antarctica, has been losing mass and retreating rapidly in the past few decades. Here, we present a study of its calving dynamics combining a two-dimensional flow-band full-Stokes (FS) model of its viscous flow with linear elastic fracture mechanics (LEFM) theory to model crevasse propagation and ice fracturing. We compare the results with those obtained with the higher-order (HO) and the shallow-shelf approximation (SSA) models coupled with LEFM. We find that FS/LEFM produces surface and bottom crevasses that are consistent with the distribution of depth and width of surface and bottom crevasses observed by NASA's Operation IceBridge radar depth sounder and laser altimeter, whereas HO/LEFM and SSA/LEFM do not generate crevasses that are consistent with observations. We attribute the difference to the nonhydrostatic condition of ice near the grounding line, which facilitates crevasse formation and is accounted for by the FS model but not by the HO or SSA models. We find that calving is enhanced when pre-existing surface crevasses are present, when the ice shelf is shortened or when the ice shelf front is undercut. The role of undercutting depends on the timescale of calving events. It is more prominent for glaciers with rapid calving rates than for glaciers with slow calving rates. Glaciers extending into a shorter ice shelf are more vulnerable to calving than glaciers developing a long ice shelf, especially as the ice front retreats close to the grounding line region, which leads to a positive feedback to calving events. We conclude that the FS/LEFM combination yields substantial improvements in capturing the stress field near the grounding line of a glacier for constraining crevasse formation and iceberg calving.

  7. Chinese massage combined with core stability exercises for nonspecific low back pain: a randomized controlled trial.

    Science.gov (United States)

    Zhang, Yingjie; Tang, Shujie; Chen, Guangmin; Liu, Yuanmei

    2015-02-01

    To determine the effect of Chinese massage combined with core stability exercises on nonspecific low back pain. In the prospective study, ninety-two participants with nonspecific low back pain were divided into experimental and control group at random, and 46 in each. The experimental group were treated using Chinese massage combined with core stability exercises, while the control group were treated using Chinese massage alone. The two groups were evaluated using visual analog scale and Oswestry disability index at baseline, immediately after two and eight weeks. In addition, the recurrence rate of nonspecific low back pain was evaluated one year after the last intervention. Two weeks after treatment, both VAS and ODI scores decreased significantly in two groups (p0.05). Eight weeks later, the VAS and ODI scores decreased significantly in both groups (pCore stability exercises can improve the therapeutic effect of Chinese massage in treating nonspecific low back pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Combined treatment with headgear and the Frog appliance for maxillary molar distalization: a randomized controlled trial.

    Science.gov (United States)

    Burhan, Ahmad Sharafeddin

    2013-04-01

    To evaluate the efficiency of the Frog appliance (FA) alone or in combination with headgear for distalizing the maxillary molars. Fifty patients (25 males and 25 females) aged 12.6 - 16.7 years who received treatment for Class II malocclusion at the Orthodontic Clinic of Al-Baath University were selected for this study and randomly divided into 2 equal groups. Maxillary molar distalization was achieved using the FA alone (group 1) or a combination of the FA with high-pull headgear worn at night (group 2). Lateral cephalograms were obtained before and after treatment. The maxillary molars moved distally by 5.51 and 5.93 mm in groups 1 and 2, respectively. Distal movements were associated with axial tipping by 4.96° and 1.25°, and with loss of anchorage by mesial movement of the second maxillary premolars by 2.70 and 0.90 mm in groups 1 and 2, respectively. The combined use of the FA and nighttime high-pull headgear decreased the distalization time and improved the ratio of maxillary molar distalization movement relative to the overall opening space between the first maxillary molars and second premolars. The FA can effectively distalize the maxillary molars, this distalization associates with some unfavorable changes. Nighttime use of high-pull headgear combined with the FA can reduce these unfavorable changes and improve treatment outcomes.

  9. Effectiveness of combined exercise training to improve functional fitness in older adults: A randomized controlled trial.

    Science.gov (United States)

    Sousa, Nelson; Mendes, Romeu; Abrantes, Catarina; Sampaio, Jaime; Oliveira, José

    2014-10-01

    The present randomized controlled trial evaluated the impact of different exercise training modalities on functional fitness responses in apparently healthy older men. A total of 59 community-dwelling older men were randomly assigned to an aerobic training group (ATG, n=19), a combined aerobic and resistance training group (CTG, n=20) or a control group (n=20). Both exercise training programs were moderate-to-vigorous intensity, 3 days/week for 9 months. Six independent functional fitness tests (back scratch, chair sit-and-reach, 30-s chair stand, arm curl, 8-ft up-and-go, 6-min walk) were measured on five different occasions. The data were analyzed using a mixed-model ANOVA. ANOVA showed a significant main effect of group (Pfunctional fitness tests, with significant differences between both training groups and controls. However, the ATG only improved the chair sit-and-reach and the 30-s chair stand performance, whereas CTG improved in all functional fitness tests. ANOVA also identified a significant main effect of time for 8-ft up-and-go (P=0.031) in the CTG. Only the combined exercise program was effective in improving all functional fitness components related to daily living activities. © 2014 Japan Geriatrics Society.

  10. Bee venom acupuncture, NSAIDs or combined treatment for chronic neck pain: study protocol for a randomized, assessor-blind trial

    National Research Council Canada - National Science Library

    Seo, Byung-Kwan; Lee, Jun-Hwan; Kim, Pil-Kun; Baek, Yong-Hyeon; Jo, Dae-Jean; Lee, Sanghun

    2014-01-01

    ... in a rigorous randomized clinical trial (RCT). This pilot study will provide the clinical evidence to evaluate the feasibility and refine the protocol for a full-scale RCT on combined treatment of bee venom acupuncture (BVA...

  11. [Acupuncture combined with auricle cutting method for blood stasis-type psoriasis: a randomized controlled trial].

    Science.gov (United States)

    Li, Ting; Liu, Zhi-Yan; Yang, Huan; Ma, Zhong; Qu, Hong-Yan; Li, Yu; Huang, Hai-Bin; Liu, Juan; Li, Jie; Wu, Ji-Xin

    2014-05-01

    To verify the clinical efficacy of acupuncture combined with auricle cutting method for treatment of blood stasis-type psoriasis. Fifty-six cases of blood stasis-type psoriasis were randomly divided into a combined therapy group, a auricle cutting group, an acupuncture group and a control group, 14 cases in each one. Based on regular treatment of TCM decoction in four groups, the combined therapy group was treated with acupuncture and auricle cutting method, and the auricle cutting group was treated with sham-acupuncture and auricle cutting, and the acupuncture group was treated with acupuncture and sham auricle cutting, and the control group was treated with sham-acupuncture and sham auricle cutting. The acupuncture was applied at Dazhui (GV 14), Feishu (BL 13), Ganshu (BL 18) and Geshu (BL 17), etc., and manipulated with routine technique; in the sham acupuncture, the needle was inserted into dermis layer so that the needles could be swung without being dropped out. In the auricle cutting, erbeixin (P1) of unilateral auricle was selected and cut by Chan needle to perform bloodletting; in the sham auricle cutting, the neighborhood approximately 0.5 cm next to erbeixin (P) of auricle was selected as cutting area. The treatment was given once a day, seven days as a treatment session for totally two sessions. Psoriasis area and severity index (PASI) before and after treatment was observed and efficacy of each group was compared. The effective rate was 57.1% (8/14) in the combined therapy group, which was superior to 14.3% (2/14) in the auricle cutting group, 7.1% (1/14) in the acupuncture group and 0.0% (0/14) in the control group (all P cutting, P cutting method and TCM decoction, among which the interaction effect of auricle cutting and acupuncture combined with TCM decoction is the most significant.

  12. Aerobic training alone or combined with strength training affects fitness in elderly: Randomized trial.

    Science.gov (United States)

    Burich, Rasmus; Teljigović, Sanel; Boyle, Eleanor; Sjøgaard, Gisela

    2015-01-01

    To investigate if combined strength and aerobic training can enhance aerobic capacity in the elderly to a similar extent as aerobic training alone when training duration is matched. Elderly men and women (age 63.2 ± 4.7) were randomized into two intervention groups: an aerobic group (AG, n = 17) and a combined group (CG, n = 16). Subjects trained 40 minutes three times a week for 12 weeks. Both groups trained 20 minutes at 65% of heart rate reserve on ergometer cycles followed by another 20 minutes on the ergometer cycles for AG and 20-minute strength training for the lower body for CG. The primary outcome was VO2max. Secondary outcomes were maximal voluntary contraction (MVC) in isometric knee extension, 1 repetition maximum in three leg exercises, body fat, waist-to-hip ratio, blood pressure and score on the Health Survey Short Form 36 (SF-36). Both groups improved VO2max (p Elderly can substitute a part of their aerobic training with strength training and still improve VO2max to a clinically significant degree when strength training is performed with large muscle groups subsequently to the aerobic training. Combined training additionally improves strength and self-assessed general health more than aerobic training alone.

  13. Combined Randomized-Local Hough Transform versus UpWrite Transform in stamp detection

    Directory of Open Access Journals (Sweden)

    Daniela Tondini

    2003-10-01

    Full Text Available The conventional Hough Transform used for detection of objects with known shape and size has proved its robustness. One typical task for this transform can be the detection of stamp(s on an envelope. Unfortunately, the Hough Transform has an important drawback: the heavy computational effort and, as consequence, a big execution time. This paper introduces a variant of Hough Transform that speeds up the process. One important aid is given by a filtering step based on a fast analysis of a rough deformation model. This method is a combination of Randomized and Local Hough Transform. Experiments were made comparing the modified Hough Transform approach with the UpWrite Transform and they proved that the first approach preserves the quality of the Hough Transform results at a higher speed.

  14. Combination therapy containing ritonavir plus saquinavir has superior short-term antiretroviral efficacy: a randomized trial

    DEFF Research Database (Denmark)

    Kirk, O; Katzenstein, T L; Gerstoft, J

    1999-01-01

    trial. Two hundred and eighty-four patients started randomized treatment. The primary end-point was the proportion of patients with HIV RNA of 200 copies/ml or less (Roche Amplicor) and HIV RNA of 20 copies/ml or less (Roche ultradirect assay) at 6 months. Analysis was performed as intent......-to-treat, and missing values were accounted for as failures. RESULTS: As of 1 May 1998, 269 patients should have completed 24 weeks of treatment. The proportion of patients with HIV RNA of 200 copies/ml or less was 71% (indinavir), 67% (ritonavir), and 82% (ritonavir + saquinavir), P = 0.07. In antiretroviral drug...... is generally safe, and has superior short-term antiviral efficacy compared with indinavir and ritonavir also combined with two nucleoside analogues in antiretroviral drug-naive patients. Further follow-up is needed to determine the durability of the viral response....

  15. Effects of combined harmonic and random excitations on a Brusselator model

    Science.gov (United States)

    Xu, Yong; Ma, Jinzhong; Wang, Haiyan; Li, Yongge; Kurths, Jürgen

    2017-10-01

    We discuss the constructive role of combined harmonic and random excitation on stochastic resonance (SR) in a Brusselator model. We first numerically investigate SR determined by the Signal-to-Noise Ratio (SNR) in this model. Effects of different parameters on SR are described in detail. Our simulation results show that the intensity of the Gaussian colored noise and the amplitude of the periodic force can enhance SR. Moreover, an analytical framework is presented for the SNR of the Brusselator model, leading to a theoretical expression of SNR. We observe a good agreement between the theoretical and numerical results, and the effectiveness of the proposed theoretical method is verified. This theoretical analysis provides a global view on how the dynamics of a periodically forced system with noise changes in the vicinity of a Hopf bifurcation.

  16. Hemostasis pad combined with compression device after transradial coronary procedures: A randomized controlled trial.

    Science.gov (United States)

    Kang, Si-Hyuck; Han, Donghoon; Kim, Sehun; Yoon, Chang-Hwan; Park, Jin-Joo; Suh, Jung-Won; Cho, Young-Seok; Youn, Tae-Jin; Chae, In-Ho

    2017-01-01

    Arterial access and hemostasis are important processes during percutaneous coronary procedures. In this study, we tested if the use of chitosan-based pads on top of compression devices could improve hemostasis efficacy compared with compression devices alone after transradial coronary angiography or interventions. This study was a single-center open-label randomized controlled trial. Patients who underwent coronary angiography or intervention with the transradial approach were randomly assigned to the study (compression device and a chitosan-based pad) or control (compression devices alone) group in a 2:1 fashion. The primary endpoint was time to hemostasis, categorized into ≤5, 6-10, 11-20, and >20 minutes. Between April and July 2016, 95 patients were enrolled (59 were assigned to the study arm and 36 to the control arm). Time to hemostasis, the primary endpoint, was significantly lower in the study group than in the control group (phemostasis pad in combination with rotatory compression devices is a safe and effective hemostasis strategy after radial artery access. ClinicalTrials.gov NCT02954029.

  17. A Combined Weighting Method Based on Hybrid of Interval Evidence Fusion and Random Sampling

    Directory of Open Access Journals (Sweden)

    Ying Yan

    2017-01-01

    Full Text Available Due to the complexity of system and lack of expertise, epistemic uncertainties may present in the experts’ judgment on the importance of certain indices during group decision-making. A novel combination weighting method is proposed to solve the index weighting problem when various uncertainties are present in expert comments. Based on the idea of evidence theory, various types of uncertain evaluation information are uniformly expressed through interval evidence structures. Similarity matrix between interval evidences is constructed, and expert’s information is fused. Comment grades are quantified using the interval number, and cumulative probability function for evaluating the importance of indices is constructed based on the fused information. Finally, index weights are obtained by Monte Carlo random sampling. The method can process expert’s information with varying degrees of uncertainties, which possesses good compatibility. Difficulty in effectively fusing high-conflict group decision-making information and large information loss after fusion is avertible. Original expert judgments are retained rather objectively throughout the processing procedure. Cumulative probability function constructing and random sampling processes do not require any human intervention or judgment. It can be implemented by computer programs easily, thus having an apparent advantage in evaluation practices of fairly huge index systems.

  18. Hemostasis pad combined with compression device after transradial coronary procedures: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Si-Hyuck Kang

    Full Text Available Arterial access and hemostasis are important processes during percutaneous coronary procedures. In this study, we tested if the use of chitosan-based pads on top of compression devices could improve hemostasis efficacy compared with compression devices alone after transradial coronary angiography or interventions.This study was a single-center open-label randomized controlled trial. Patients who underwent coronary angiography or intervention with the transradial approach were randomly assigned to the study (compression device and a chitosan-based pad or control (compression devices alone group in a 2:1 fashion. The primary endpoint was time to hemostasis, categorized into ≤5, 6-10, 11-20, and >20 minutes.Between April and July 2016, 95 patients were enrolled (59 were assigned to the study arm and 36 to the control arm. Time to hemostasis, the primary endpoint, was significantly lower in the study group than in the control group (p<0.001. Both groups showed low rates of vascular complications.This study suggests that the use of a hemostasis pad in combination with rotatory compression devices is a safe and effective hemostasis strategy after radial artery access.ClinicalTrials.gov NCT02954029.

  19. Citicoline Combination Therapy for Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial.

    Science.gov (United States)

    Roohi-Azizi, Mahtab; Arabzadeh, Somaye; Amidfar, Meysam; Salimi, Samrand; Zarindast, Mohammad Reza; Talaei, Ali; Akhondzadeh, Shahin

    Residual symptoms of major depressive disorder are a source of long-term morbidity. New therapeutic strategies are required to alleviate this morbidity and enhance patient quality of life. Citicoline has been used for vascular accidents and has been effective in cognitive rehabilitation. It has been used successfully to reduce craving in patients with substance abuse disorder and for mood management of bipolar disorder. Here, we test citicoline effectiveness as an adjuvant therapy in major depression. A double-blind randomized trial was designed on 50 patients with major depressive disorder who were under treatment with citalopram. Patients were allocated to 2 groups and received citicoline (100 mg twice a day) or placebo as an adjuvant treatment for 6 weeks. Depressive symptoms were assessed by the Hamilton Depression Rating Scale (HDRS) at baseline and at weeks 2, 4, and 6. Significantly greater improvement was observed in the HDRS scores of the citicoline group compared with the placebo group from baseline to weeks 2, 4, and 6 (Ps = 0.030, 0.032, and 0.021, respectively). Repeated-measures general linear model demonstrated a significant effect for time × treatment interaction on the HDRS score (F2.10,101.22 = 3.12, P = 0.04). Remission rate was significantly higher in the citicoline group compared with the placebo group (P = 0.045). Citicoline was an effective adjuvant to citalopram in the therapy of major depressive disorder.

  20. Randomized Controlled Trial of the Combined Effects of Web and Quitline Interventions for Smokeless Tobacco Cessation

    Science.gov (United States)

    Danaher, Brian G.; Severson, Herbert H.; Zhu, Shu-Hong; Andrews, Judy A.; Cummins, Sharon E.; Lichtenstein, Edward; Tedeschi, Gary J.; Hudkins, Coleen; Widdop, Chris; Crowley, Ryann; Seeley, John R.

    2015-01-01

    Background Use of smokeless tobacco (moist snuff and chewing tobacco) is a significant public health problem but smokeless tobacco users have few resources to help them quit. Web programs and telephone-based programs (Quitlines) have been shown to be effective for smoking cessation. We evaluate the effectiveness of a Web program, a Quitline, and the combination of the two for smokeless users recruited via the Web. Objectives To test whether offering both a Web and Quitline intervention for smokeless tobacco users results in significantly better long-term tobacco abstinence outcomes than offering either intervention alone; to test whether the offer of Web or Quitline results in better outcome than a self-help manual only Control condition; and to report the usage and satisfaction of the interventions when offered alone or combined. Methods Smokeless tobacco users (N= 1,683) wanting to quit were recruited online and randomly offered one of four treatment conditions in a 2×2 design: Web Only, Quitline Only, Web + Quitline, and Control (printed self-help guide). Point-prevalence all tobacco abstinence was assessed at 3- and 6-months post enrollment. Results 69% of participants completed both the 3- and 6-month assessments. There was no significant additive or synergistic effect of combining the two interventions for Complete Case or the more rigorous Intent To Treat (ITT) analyses. Significant simple effects were detected, individually the interventions were more efficacious than the control in achieving repeated 7-day point prevalence all tobacco abstinence: Web (ITT, OR = 1.41, 95% CI = 1.03, 1.94, p = .033) and Quitline (ITT: OR = 1.54, 95% CI = 1.13, 2.11, p = .007). Participants were more likely to complete a Quitline call when offered only the Quitline intervention (OR = 0.71, 95% CI = .054, .093, p = .013), the number of website visits and duration did not differ when offered alone or in combination with Quitline. Rates of program helpfulness (p Web and

  1. Combining interactive multiple goal linear programming with an inter-stakeholder communication matrix to generate land use options

    NARCIS (Netherlands)

    Nidumolu, U.B.; Keulen, van H.; Lubbers, M.T.M.H.; Mapfumo, P.

    2007-01-01

    An Interactive Multiple Goal Linear Programming (IMGLP) model is developed that considers objectives of multiple stakeholders, i.e. different farmer groups, district agricultural officers and agricultural scientists for agricultural land use analysis. The analysis focuses on crop selection;

  2. Overall non-linear correction of phase shifting mechanism in white light interferometry system based on displacement feedback control combined with fuzzy PID control

    Science.gov (United States)

    Song, Ningfang; Luo, Xinkai; Li, Huipeng; Li, Jiao

    2015-10-01

    The non-linearity of the phase shifting mechanism in white light interferometry system can seriously affect the measuring accuracy of the system. In this paper, the correcting method is to combine the displacement feedback control technology with the fuzzy PID control technology. Displacement feedback control mechanism and fuzzy PID controller are designed and then try to figure it out through Matlab simulation and experiment.. The result shows that combining the displacement feedback control technology with the fuzzy PID control technology can fulfill decent overall non-linear correction in the white light interferometry measuring system. Meanwhile, the accuracy of the correction is high and the non-linearity drop from 2% to 0.1%.

  3. Power and Sample Size Calculations for Testing Linear Combinations of Group Means under Variance Heterogeneity with Applications to Meta and Moderation Analyses

    Science.gov (United States)

    Shieh, Gwowen; Jan, Show-Li

    2015-01-01

    The general formulation of a linear combination of population means permits a wide range of research questions to be tested within the context of ANOVA. However, it has been stressed in many research areas that the homogeneous variances assumption is frequently violated. To accommodate the heterogeneity of variance structure, the…

  4. Utilization of random process spectral properties for the calculation of fatigue life under combined loading

    Directory of Open Access Journals (Sweden)

    Svoboda J.

    2009-12-01

    Full Text Available The contribution includes the results of experimental works aiming to find a new methodology for the calculation of fatigue life of structures subjected to operational loading from a combination of forces and moments of random character. Considering the fracture mechanics theory, then the damaging of material is both in the micro- and macro-plastic area connected with the rise of plastic deformation and hence with the plastic transformation rate which depends on the amount of supplied energy. The power spectral density (PSD indicating the power at individual frequencies in the monitored frequency band yields information about the supplied amount of energy. Therefore, it can be assumed that there is a dependence between the PSD shape and the size of damage and that the supplied power which is proportional to the value of dispersion s^2 under the PSD curve could be a new criterion for the calculation of fatigue life under combined loading. The searching for links between the spectral properties of the loading process and the fatigue life of structure under load is dealt with by new Grant GA No. 101/09/0904 of the Czech Technical University in Prague and the Institute of Thermomechanics of the Academy of Sciences of the Czech Republic, v.v.i.

  5. Combinations of Stressors in Midlife: Examining Role and Domain Stressors Using Regression Trees and Random Forests

    Science.gov (United States)

    2013-01-01

    Objectives. Global perceptions of stress (GPS) have major implications for mental and physical health, and stress in midlife may influence adaptation in later life. Thus, it is important to determine the unique and interactive effects of diverse influences of role stress (at work or in personal relationships), loneliness, life events, time pressure, caregiving, finances, discrimination, and neighborhood circumstances on these GPS. Method. Exploratory regression trees and random forests were used to examine complex interactions among myriad events and chronic stressors in middle-aged participants’ (N = 410; mean age = 52.12) GPS. Results. Different role and domain stressors were influential at high and low levels of loneliness. Varied combinations of these stressors resulting in similar levels of perceived stress are also outlined as examples of equifinality. Loneliness emerged as an important predictor across trees. Discussion. Exploring multiple stressors simultaneously provides insights into the diversity of stressor combinations across individuals—even those with similar levels of global perceived stress—and answers theoretical mandates to better understand the influence of stress by sampling from many domain and role stressors. Further, the unique influences of each predictor relative to the others inform theory and applied work. Finally, examples of equifinality and multifinality call for targeted interventions. PMID:23341437

  6. Combining social cognitive treatment, cognitive remediation, and functional skills training in schizophrenia: a randomized controlled trial.

    Science.gov (United States)

    Peña, Javier; Ibarretxe-Bilbao, Naroa; Sánchez, Pedro; Iriarte, Maria B; Elizagarate, Edorta; Garay, Maria A; Gutiérrez, Miguel; Iribarren, Aránzazu; Ojeda, Natalia

    2016-01-01

    This study examined the efficacy of an integrative cognitive remediation program (REHACOP) in improving cognition and functional outcome in patients with schizophrenia. The program combines cognitive remediation, social cognitive intervention, and functional skills training. Few studies have attempted this approach. One hundred and eleven patients diagnosed with schizophrenia were randomly assigned to either the cognitive remediation group (REHACOP) or an active control group (occupational activities) for 4 months (three sessions per week, 90 min). Primary outcomes were change on general neurocognitive performance and social cognition, including theory of mind (ToM), emotion perception (EP), attributional style, and social perception (SP). Secondary outcomes included changes on clinical symptoms (Positive and Negative Syndrome Scale) and functional outcome (UCSD Performance-Based Skills Assessment and the Global Assessment of Functioning). The trial was registered with clinicaltrials.gov (NCT02796417). No baseline group differences were found. Significant differences were found in the mean change between the REHACOP group and control group in neurocognition ([Formula: see text]), SP ([Formula: see text]), ToM ([Formula: see text]), EP ([Formula: see text]), negative symptoms ([Formula: see text]), emotional distress ([Formula: see text]), Global Assessment of Functioning ([Formula: see text]), and UCSD Performance-Based Skills Assessment ([Formula: see text]). The combination of cognitive remediation, social cognitive intervention, and functional skills training demonstrated statistically significant and clinically meaningful changes in neurocognition, social cognition, negative, and functional disability.

  7. Continuous spinal anesthesia versus combined spinal epidural block for major orthopedic surgery: prospective randomized study

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    Full Text Available CONTEXT AND OBJECTIVES: In major orthopedic surgery of the lower limbs, continuous spinal anesthesia (CSA and combined spinal epidural anesthesia (CSE are safe and reliable anesthesia methods. In this prospective randomized clinical study, the blockading properties and side effects of CSA were compared with single interspace CSE, among patients scheduled for major hip or knee surgery. DESIGN AND SETTING: Prospective clinical study conducted at the Institute for Regional Anesthesia, Hospital de Base, São José do Rio Preto. METHODS: 240 patients scheduled for hip arthroplasty, knee arthroplasty or femoral fracture treatment were randomly assigned to receive either CSA or CSE. Blockades were performed in the lateral position at the L3-L4 interspace. Puncture success, technical difficulties, paresthesia, highest level of sensory and motor blockade, need for complementary doses of local anesthetic, degree of technical difficulties, cardiocirculatory changes and postdural puncture headache (PDPH were recorded. At the end of the surgery, the catheter was removed and cerebrospinal fluid leakage was evaluated. RESULTS: Seven patients were excluded (three CSA and four CSE. There was significantly lower incidence of paresthesia in the CSE group. The resultant sensory blockade level was significantly higher with CSE. Complete motor blockade occurred in 110 CSA patients and in 109 CSE patients. Arterial hypotension was observed significantly more often in the CSE group. PDPH was observed in two patients of each group. CONCLUSION: Our results suggest that both CSA and CSE provided good surgical conditions with low incidence of complications. The sensory blockade level and hemodynamic changes were lower with CSA.

  8. Successful white hair removal with combined coloring and intense pulsed Light (IPL): a randomized clinical trial.

    Science.gov (United States)

    Alijanpoor, Robabeh; Poorsattar BejehMir, Arash; Mokmeli, Soheila

    2011-11-01

    The purpose of this study was to introduce adjunct therapy to intense pulsed light (IPL) and to assess it in terms of safety, expense, feasibility, and efficacy. Currently there is no satisfactory, efficient method for long-term white hair removal. We conducted a randomized clinical trial of hirsute patients with excessive white hair on the chin and cheeks. In addition to IPL, the patients were randomly assigned to have their white hair colored with either black eyeliner or black hair dye as an adjunct to IPL aided for of six sessions (with a 4-week interval between sessions). The primary efficacy outcome, which was defined as the outcome after six sessions of therapy, was scored as poor (60%) response to white hair removal in predefined areas. The secondary outcome was recurrence 6 months after the final therapy session. In the eyeliner group (n=31), 15 (48.4%) individuals showed a fair response, and 16 (51.6%) individuals showed a good response. In the color-dye group (n=31), 1 (3.2%), 17 (54.8%) and 13 (41.9%) participants scored poor, fair, and good, respectively. There were no differences in clinician judgment of the treatment success between the eyeliner and color-dye groups after the six therapy sessions (p=0.895). Thirty-one patients had 6 months of visits (11 in the hair dye and 20 in the eyeliner group). Three participants in the color-dye group and five participants in the eyeliner group failed to show improvement 6 months after the laser surgery. There was no distinguishable pattern of failure between the two study groups (p=1). This study supports that hair coloring is an efficient and feasible technique that can be combined with IPL to eliminate white facial hair.

  9. Combined use of dexmedetomidine and propofol in monitored anesthesia care: a randomized controlled study.

    Science.gov (United States)

    Kim, Kyu Nam; Lee, Hee Jong; Kim, Soo Yeon; Kim, Ji Yoon

    2017-03-01

    Although propofol and dexmedetomidine have been widely used for monitored anesthesia care, their adverse effects necessitate the search for better methods. Therefore, we performed this randomized controlled trial to evaluate the combined use of propofol and dexmedetomidine. Eighty-seven adult patients undergoing hand surgery under brachial plexus block were randomly allocated to receive 1.6 μg/ml of the target effect site concentration of propofol (P group) and infusion of 0.4 μg/kg/h dexmedetomidine following a loading dose of 1.0 μg/kg for 10 min (D group). The M group received a half-dose of both drugs simultaneously. The maintenance dose was adjusted to maintain an Observer Assessment of Alertness/Sedation score of 3. Cardiorespiratory variables, adverse effects, and drug efficacy were observed. The significantly higher mean arterial pressure (mmHg) in the D group [P group 86.9 (12.6), D group 96.0 (12.2), M group 85.6 (10.6), p = 0.004)] and a significantly higher heart rate (beat/min) in the P group were observed [P group 67.3 (9.0), D group 57.8 (6.9), M group 59.2 (7.4), p propofol and dexmedetomidine provided cardiovascular stability with decreased adverse effects. Additionally, it led to a similar onset time of propofol and achieved higher satisfaction scores. KCT0001284 . Retrospectively registered 25 November 2014.

  10. Signal processing related to the vestibulo-ocular reflex during combined angular rotation and linear translation of the head

    Science.gov (United States)

    McCrea, R. A.; Chen-Huang, C.; Peterson, B. W. (Principal Investigator)

    1999-01-01

    The contributions of vestibular nerve afferents and central vestibular pathways to the angular (AVOR) and linear (LVOR) vestibulo-ocular reflex were studied in squirrel monkeys during fixation of near and far targets. Irregular vestibular afferents did not appear to be necessary for the LVOR, since when they were selectively silenced with galvanic currents the LVOR was essentially unaffected during both far- and near-target viewing. The linear translation signals generated by secondary AVOR neurons in the vestibular nuclei were, on average, in phase with head velocity, inversely related to viewing distance, and were nearly as strong as AVOR-related signals. We suggest that spatial-temporal transformation of linear head translation signals to angular eye velocity commands is accomplished primarily by the addition of viewing distance multiplied, centrally integrated, otolith regular afferent signals to angular VOR pathways.

  11. Wave localization of linear gravity waves in shallow water: Global measurements and agreement between random matrix theory and experiments

    Science.gov (United States)

    Schmessane, Andrea; Laboratory of matter out equilibrium Team

    2012-11-01

    Wave localization explains how a perturbation is trapped by the randomness present in a propagation medium. As it propagates, the localized wave amplitude decreases strongly by multiple internal reflections with randomly positioned scatterers, effectively trapping the perturbation inside the random region. The characteristic length where a localized wave is propagated before being extinguish by randomness is called localization length. We carried experiments in a quasi-onedimensional channel with random bottom in a shallow water regime for surface gravity water waves, using a Perfilometry Fourier Transform method, which enables us to obtain global surface measurements. We discuss keys aspects of the control of variables, the experimental setup and the implementation of the measurement method. Thus, we can control, measure and evaluate fundamental variables present in the localization phenomenon such as the type of randomness, scattering intensity and sample length, which allows us to characterize wave localization. We use the scattering matrix method to compare the experimental measurements with theoretical and numerical predictions, using the Lyapunov exponent of the scattering matrix, and discuss their agreement. Conicyt

  12. A Test of a Linear Programming Model as an Optimal Solution to the Problem of Combining Methods of Reading Instruction

    Science.gov (United States)

    Mills, James W.; And Others

    1973-01-01

    The Study reported here tested an application of the Linear Programming Model at the Reading Clinic of Drew University. Results, while not conclusive, indicate that this approach yields greater gains in speed scores than a traditional approach for this population. (Author)

  13. Combined fuzzy logic and random walker algorithm for PET image tumor delineation.

    Science.gov (United States)

    Soufi, Motahare; Kamali-Asl, Alireza; Geramifar, Parham; Abdoli, Mehrsima; Rahmim, Arman

    2016-02-01

    The random walk (RW) technique serves as a powerful tool for PET tumor delineation, which typically involves significant noise and/or blurring. One challenging step is hard decision-making in pixel labeling. Fuzzy logic techniques have achieved increasing application in edge detection. We aimed to combine the advantages of fuzzy edge detection with the RW technique to improve PET tumor delineation. A fuzzy inference system was designed for tumor edge detection from RW probabilities. Three clinical PET/computed tomography datasets containing 12 liver, 13 lung, and 18 abdomen tumors were analyzed, with manual expert tumor contouring as ground truth. The standard RW and proposed combined method were compared quantitatively using the dice similarity coefficient, the Hausdorff distance, and the mean standard uptake value. The dice similarity coefficient of the proposed method versus standard RW showed significant mean improvements of 21.0±7.2, 12.3±5.8, and 18.4%±6.1% for liver, lung, and abdominal tumors, respectively, whereas the mean improvements in the Hausdorff distance were 3.6±1.4, 1.3±0.4, 1.8±0.8 mm, and the mean improvements in SUVmean error were 15.5±6.3, 11.7±8.6, and 14.1±6.8% (all P's<0.001). For all tumor sizes, the proposed method outperformed the RW algorithm. Furthermore, tumor edge analysis demonstrated further enhancement of the performance of the algorithm, relative to the RW method, with decreasing edge gradients. The proposed technique improves PET lesion delineation at different tumor sites. It depicts greater effectiveness in tumors with smaller size and/or low edge gradients, wherein most PET segmentation algorithms encounter serious challenges. Favorable execution time and accurate performance of the algorithm make it a great tool for clinical applications.

  14. Laminaria japonica combined with probiotics improves intestinal microbiota: a randomized clinical trial.

    Science.gov (United States)

    Ko, Seok-Jae; Kim, Jinsung; Han, Gajin; Kim, Seul-Ki; Kim, Hong-Geol; Yeo, Inkwon; Ryu, Bongha; Park, Jae-Woo

    2014-01-01

    Laminaria japonica--a widely used ingredient in seaweed kimchi--and lactic acid bacteria (LAB)--a main component of traditional fermented Korean food--may alter human intestinal microbiota composition and have a positive effect on various digestive problems. However, few clinical trials have investigated the potential benefits of L. japonica when combined with LAB for human intestinal microbiota. Therefore, this study was designed to evaluate the effects of L. japonica and representative LAB on the human intestine. Forty participants with no known digestive diseases were randomly assigned to one of the two combination groups: (1) L. japonica with LAB and (2) L. japonica with placebo LAB. The study agents were administered for 4 weeks with a 2-week follow-up period. The primary outcome measure was the number of each of the seven LAB species in the human intestine, and the secondary outcome measures included the Korean version of the Gastrointestinal Symptom Rating Scale, the World Health Organization Quality of Life, and bowel functions. The primary outcome was evaluated before and after administration of the study agents (0 and 4 weeks), and the secondary outcomes were evaluated at 0, 4, and 6 weeks. Four of the seven LAB species were found to be significantly increased in the L. japonica with the LAB group and five species were significantly different from those of the placebo group. The secondary outcome measures did not change significantly. In conclusion, L. japonica with LAB facilitated the proliferation of beneficial human intestinal microbiota. ( ClinicalTrials.gov NCT01651741).

  15. Effects of combined training vs aerobic training on cognitive functions in COPD: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Aquino G

    2016-04-01

    Full Text Available Giovanna Aquino,1 Enzo Iuliano,1 Alessandra di Cagno,2 Angela Vardaro,3 Giovanni Fiorilli,1 Stefano Moffa,1 Alfonso Di Costanzo,1 Giuseppe De Simone,3 Giuseppe Calcagno1 1Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, 2Department of Health Science, University ForoItalico, Rome, 3“Villa Margherita”, Benevento, Italy Aim: The aim of this study was to investigate the effects of high-intensity aerobic training (AT and high-intensity aerobic training combined with resistance training (ie, combined training [CT] on cognitive function in patients with COPD. Methods: Twenty-eight Caucasian male patients (68.35±9.64 years; mean ± SD with COPD were recruited and randomized into two groups, AT and CT. Both groups performed physical reconditioning for 4 weeks, with a frequency of five training sessions per week. The CT group completed two daily sessions of 30 minutes: one aerobic session and one strength session, respectively; The AT group performed two 30-minute aerobic endurance exercise sessions on treadmill. Physical and cognitive function tests were performed before and after the training intervention performances. Results: Exercise training improved the following cognitive functions: long-term memory, verbal fluency, attentional capacity, apraxia, and reasoning skills (P<0.01. Moreover, the improvements in the CT group were significantly greater than those in the AT group in long-term memory, apraxia, and reasoning skills (P<0.05. Conclusion: CT may be a possible strategy to prevent cognitive decline and associated comorbidities in male patients with COPD. Keywords: physical training, cognition, resistance training, rehabilitation, respiratory disease

  16. [Efficacy comparison of different points combination in the treatment of menopausal insomnia: a randomized controlled trial].

    Science.gov (United States)

    Yang, Song-Bai; Mei, Zhi-Gang; Cai, San-Jin; Lei, Hua-Ping; Sun, Cheng-Hong; Chen, Ling; Zhou, Chuang

    2014-01-01

    To compare the efficacy of different points combination in the treatment of menopausal insomnia. Ninety-six cases of menopausal insomnia were randomized into 3 groups, Xinshu (BL 15), Shenshu (BL 23), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6) were chosen in the restore interaction between the heart and the kidney group (group A, 32 cases); Zhaohai (KI 6), Jiaoxin (KI 8), Shenmai (BL 62), Pucan (BL 61) were chosen in the acupuncturing qiao mai group (group B, 32 cases); auricular Shenmen (TF4) and sensitive spot at the distribution area of auricular vagus nervus were chosen in the ear acupuncture group (group C, 32 cases). Six days made one session and the treatments were finished after 4 courses. The polysomnography (PSG) and Pittsburgh sleep quality index (PSQI) were employed before and after treatment to evaluate the alleviation of insomnia. The parameters of the sleep latency (SL), rapid wave sleep latency (RL) and sleep efficiency (SE) were significantly improved in the three groups, and the differences were statistically significant (P acupuncture has a better curative effect than the restore interaction between the heart and the kidney group and acupuncturing qiao mai group, it is worth of being promoted.

  17. SUMOhunt: Combining Spatial Staging between Lysine and SUMO with Random Forests to Predict SUMOylation

    Science.gov (United States)

    2013-01-01

    Modification with SUMO protein has many key roles in eukaryotic systems which renders the identification of its target proteins and sites of considerable importance. Information regarding the SUMOylation of a protein may tell us about its subcellular localization, function, and spatial orientation. This modification occurs at particular and not all lysine residues in a given protein. In competition with biochemical means of modified-site recognition, computational methods are strong contenders in the prediction of SUMOylation-undergoing sites on proteins. In this research, physicochemical properties of amino acids retrieved from AAIndex, especially those involved in docking of modifier and target proteins and optimal presentation of target lysine, in combination with sequence information and random forest-based classifier presented in WEKA have been used to develop a prediction model, SUMOhunt, with statistics significantly better than all previous predictors. In this model 97.56% accuracy, 100% sensitivity, 94% specificity, and 0.95 MCC have been achieved which shows that proposed amino acid properties have a significant role in SUMO attachment. SUMOhunt will hence bring great reliability and efficiency in SUMOylation prediction. PMID:25937950

  18. Reporting Quality of Randomized, Controlled Trials Evaluating Combined Chemoradiotherapy in Nasopharyngeal Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yu-Pei; Chen, Lei; Li, Wen-Fei [Department of Radiation Oncology, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Guangzhou (China); Lee, Anne W.M. [Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen (China); Vermorken, Jan B. [Department of Medical Oncology, Antwerp University Hospital, Edegem (Belgium); Wee, Joseph [Department of Radiation Oncology, National Cancer Centre Singapore (Singapore); O' Sullivan, Brian [Department of Radiation Oncology, University of Toronto, Ontario Cancer Institute, University Health Network, Toronto, Ontario (Canada); Eisbruch, Avraham [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Lin, Jin-Ching [Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan (China); Mai, Hai-Qiang [Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Guangzhou (China); Zhang, Li [Department of Medical Oncology, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Guangzhou (China); Guo, Ying [Clinical Trials Centre, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Guangzhou (China); Lin, Ai-Hua [Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou (China); Sun, Ying [Department of Radiation Oncology, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre of Cancer Medicine, Guangzhou (China); and others

    2017-05-01

    Purpose: To comprehensively assess the reporting quality of randomized, controlled trials (RCTs) in nasopharyngeal carcinoma (NPC), and to identify significant predictors of quality. Methods and Materials: Two investigators searched MEDLINE and EMBASE for RCTs published between January 1988 and December 2015 that assessed the effect of combined chemoradiotherapy for NPC. The overall quality of each report was assessed using a 28-point overall quality score (OQS) based on the 2010 Consolidated Standards of Reporting Trials (CONSORT) statement. To provide baseline data for further evaluation, we also investigated the reporting quality of certain important issues in detail, including key methodologic items (allocation concealment, blinding, intention-to-treat principle), endpoints, follow-up, subgroup analyses, and adverse events. Results: We retrieved 24 relevant RCTs including 6591 patients. Median 2010 OQS was 15.5 (range, 10-24). Half of the items in the 2010 OQS were poorly reported in at least 40% of trials. Multivariable regression models revealed that publication after 2010 and high impact factor were significant predictors of improved 2010 OQS. Additionally, many issues that we consider significant were not reported adequately. Conclusions: Despite publication of the CONSORT statement more than a decade ago, overall reporting quality for RCTs in NPC was unsatisfactory. Additionally, substantial selectivity and heterogeneity exists in reporting of certain crucial issues. This survey provides the first prompt for NPC trial investigators to improve reporting quality according to the CONSORT statement; increased scrutiny and diligence by editors and peer reviewers is also required.

  19. Disease named entity recognition by combining conditional random fields and bidirectional recurrent neural networks

    Science.gov (United States)

    Wei, Qikang; Chen, Tao; Xu, Ruifeng; He, Yulan; Gui, Lin

    2016-01-01

    The recognition of disease and chemical named entities in scientific articles is a very important subtask in information extraction in the biomedical domain. Due to the diversity and complexity of disease names, the recognition of named entities of diseases is rather tougher than those of chemical names. Although there are some remarkable chemical named entity recognition systems available online such as ChemSpot and tmChem, the publicly available recognition systems of disease named entities are rare. This article presents a system for disease named entity recognition (DNER) and normalization. First, two separate DNER models are developed. One is based on conditional random fields model with a rule-based post-processing module. The other one is based on the bidirectional recurrent neural networks. Then the named entities recognized by each of the DNER model are fed into a support vector machine classifier for combining results. Finally, each recognized disease named entity is normalized to a medical subject heading disease name by using a vector space model based method. Experimental results show that using 1000 PubMed abstracts for training, our proposed system achieves an F1-measure of 0.8428 at the mention level and 0.7804 at the concept level, respectively, on the testing data of the chemical-disease relation task in BioCreative V. Database URL: http://219.223.252.210:8080/SS/cdr.html PMID:27777244

  20. [Acupuncture combined with western medicine for CP/CPPS:a randomized controlled trial].

    Science.gov (United States)

    Chen, Guo; Xiang, Juan; Ouyang, Lizhi; Wang, Xuzhe; Zhang, Sainan; Chen, Haijiao; Chen, Junjun; Li, Tielang

    2016-12-12

    To compare the clinical efficacy differences among acupuncture combined with western medicine, acupuncture alone and western medicine alone for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Ninety patients were randomly assigned into a needle-medicine group, an acupuncture group and a western medicine group, 30 patients in each group. The patients in the needle-medicine group were treated with acupuncture combined with western medicine; the scalp points included Shenting (GV 24), Xinhui (GV 22), Qianding (GV 21), Baihui (GV 20), Chengguang (BL 6), Tongtian (BL 7), etc. The body points were Zhongji (CV 3), Guanyuan (CV 4), Pangguangshu (BL 28), Ciliao (BL 32), etc. The acupuncture was given 30 min per treatment, once a day. Besides, oral administration of 0.2g levofloxacin (twice per day) and 0.2 mg tamsulosin (once a day) was applied. The patients in the acupuncture group and western medicine group were treated by acupuncture and western medicine respectively. 12-d treatment was taken as one session, and totally 2 sessions were given. The clinical efficacy of the three groups after treatment was compared as well as the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) total score and pain score, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) before and after treatment. During the trial two patients dropped out, as a result, 30 patients in the needle-medicine group, 29 patients in the acupuncture group and 29 patients in the western medicine group were included in the analysis. After treatment, 21 patients were cured, 6 patients were markedly effective, 2 patients were effective and 1 patient failed in the needle-medicine group;12 patients were cured, 10 patients were markedly effective, 5 patients were effective and 2 patients failed in the acupuncture group; 11 patients were cured, 12 patients were markedly effective, 4 patients were effective and 2 patients failed in the medicine group; the efficacy

  1. Randomized comparative trial of efficacy of paracetamol, ibuprofen and paracetamol-ibuprofen combination for treatment of febrile children

    OpenAIRE

    Falgun Indravadan Vyas; Devang Ashwinkumar Rana; Patel, Piyush M.; Varsha Jitendra Patel; Bhavsar, Rekha H.

    2014-01-01

    Objective: Paracetamol and ibuprofen are widely used for fever in children as monotherapy and as combined therapy. None of the treatments is proven clearly superior to others. Hence, the study was planned to compare the efficacy of paracetamol, ibuprofen and paracetamol-ibuprofen combination for treatment of febrile children. Materials and Methods: This was an investigator blind, randomized, comparative, parallel clinical trial conducted in 99 febrile children, 6 months to 12 years of age, al...

  2. A Randomized Controlled Trial of Cognitive-Behavioral Therapy, Light Therapy, and Their Combination for Seasonal Affective Disorder

    Science.gov (United States)

    Rohan, Kelly J.; Roecklein, Kathryn A.; Tierney Lindsey, Kathryn; Johnson, Leigh G.; Lippy, Robert D.; Lacy, Timothy J.; Barton, Franca B.

    2007-01-01

    This first controlled psychotherapy trial for seasonal affective disorder (SAD) compared SAD-tailored cognitive-behavioral therapy (CBT), light therapy (LT), and their combination to a concurrent wait-list control. Adults (N = 61) with major depression, recurrent with seasonal pattern, were randomized to one of four 6-week conditions: CBT (1.5-hr…

  3. Laparoscopic Surgical Treatment of Severe Obesity Combined with Gastroesophageal Reflux Disease: A Pilot Randomized Two-Arm Controlled Clinical Study

    Science.gov (United States)

    Ospanov, Oral B.; Orekeshova, Akzhunis M.; Fursov, Roman A.; Yelemesov, Aset A.

    2016-01-01

    Obesity and gastroesophageal reflux disease (GERD) are serious medical, social, and economic problems of modern society. A pilot randomized two-arm controlled clinical study was conducted to compare laparoscopic plication of the greater gastric curvature combined with Nissen fundoplication (LFN+LGP) versus only Nissen fundoplication (LFN). The…

  4. Trauma-focused treatment for posttraumatic stress disorder combined with CBT for severe substance use disorder: a randomized controlled trial

    NARCIS (Netherlands)

    van Dam, D.; Ehring, T.; Vedel, E.; Emmelkamp, P.M.G.

    2013-01-01

    Background: This randomized controlled trial (RCT) investigated the effectiveness of a combined treatment for co-morbid Posttraumatic Stress Disorder (PTSD) and severe Substance Use Disorder (SUD). Methods: Structured Writing Therapy for PTSD (SWT), an evidence-based traumafocused intervention, was

  5. Aerobic and combined exercise sessions reduce glucose variability in type 2 diabetes: crossover randomized trial.

    Directory of Open Access Journals (Sweden)

    Franciele R Figueira

    Full Text Available To evaluate the effects of aerobic (AER or aerobic plus resistance exercise (COMB sessions on glucose levels and glucose variability in patients with type 2 diabetes. Additionally, we assessed conventional and non-conventional methods to analyze glucose variability derived from multiple measurements performed with continuous glucose monitoring system (CGMS.Fourteen patients with type 2 diabetes (56±2 years wore a CGMS during 3 days. Participants randomly performed AER and COMB sessions, both in the morning (24 h after CGMS placement, and at least 7 days apart. Glucose variability was evaluated by glucose standard deviation, glucose variance, mean amplitude of glycemic excursions (MAGE, and glucose coefficient of variation (conventional methods as well as by spectral and symbolic analysis (non-conventional methods.Baseline fasting glycemia was 139±05 mg/dL and HbA1c 7.9±0.7%. Glucose levels decreased immediately after AER and COMB protocols by ∼16%, which was sustained for approximately 3 hours. Comparing the two exercise modalities, responses over a 24-h period after the sessions were similar for glucose levels, glucose variance and glucose coefficient of variation. In the symbolic analysis, increases in 0 V pattern (COMB, 67.0±7.1 vs. 76.0±6.3, P = 0.003 and decreases in 1 V pattern (COMB, 29.1±5.3 vs. 21.5±5.1, P = 0.004 were observed only after the COMB session.Both AER and COMB exercise modalities reduce glucose levels similarly for a short period of time. The use of non-conventional analysis indicates reduction of glucose variability after a single session of combined exercises.Aerobic training, aerobic-resistance training and glucose profile (CGMS in type 2 diabetes (CGMS exercise. ClinicalTrials.gov ID: NCT00887094.

  6. Advances in SCA and RF-DNA Fingerprinting Through Enhanced Linear Regression Attacks and Application of Random Forest Classifiers

    Science.gov (United States)

    2014-09-18

    when 3 or more images were used for classification. All three easily outperform the Naive Bayes Maximum Likelihood method. In [85], the Random Forest is...Maximum Likelihood (MDA/ML) . . . . . . . . . . . . . . . . . . . . . . . . 22 2.5.1.2 Naive Bayes . . . . . . . . . . . . . . . . . . . . . . . . 24...probabilities [59], log-likelihood is used here. Given a known distribution, ML provides optimal classification performance [125]. 2.5.1.2 Naive Bayes If N

  7. Failure modelling of trabecular bone using a non-linear combined damage and fracture voxel finite element approach.

    Science.gov (United States)

    Harrison, Noel M; McDonnell, Pat; Mullins, Liam; Wilson, Niall; O'Mahoney, Denis; McHugh, Peter E

    2013-04-01

    Trabecular bone tissue failure can be considered as consisting of two stages: damage and fracture; however, most failure analyses of 3D high-resolution trabecular bone samples are confined to damage mechanisms only, that is, without fracture. This study aims to develop a computational model of trabecular bone consisting of an explicit representation of complete failure, incorporating damage criteria, fracture criteria, cohesive forces, asymmetry and large deformation capabilities. Following parameter studies on a test specimen, and experimental testing of bone sample to complete failure, the asymmetric critical tissue damage and fracture strains of ovine vertebral trabecular bone were calibrated and validated to be compression damage -1.16 %, tension damage 0.69 %, compression fracture -2.91 % and tension fracture 1.98 %. Ultimate strength and post-ultimate strength softening were captured by the computational model, and the failure of individual struts in bending and shear was also predicted. This modelling approach incorporated a cohesive parameter that provided a facility to calibrate ductile-brittle behaviour of bone tissue in this non-linear geometric and non-linear constitutive property analyses tool. Finally, the full accumulation of tissue damage and tissue fracture has been monitored from range of small magnitude (normal daily loading) through to specimen yielding, ultimate strength and post-ultimate strength softening.

  8. The reliability of linear position transducer, force plate and combined measurement of explosive power-time variables during a loaded jump squat in elite athletes.

    Science.gov (United States)

    Hansen, Keir T; Cronin, John B; Newton, Michael J

    2011-03-01

    The purpose of this study was to determine the between day reliability of power-time measures calculated with data collected using the linear position transducer or the force plate independently, or a combination of the two technologies. Twenty-five male rugby union players performed three jump squats on two occasions one week apart. Ground reaction forces were measured via a force plate and position data were collected using a linear position transducer. From these data, a number of power-time variables were calculated for each method. The force plate, linear position transducer and a combined method were all found to be a reliable means of measuring peak power (ICC = 0.87-0.95, CV = 3.4%-8.0%). The absolute consistency of power-time measures varied between methods (CV = 8.0%-53.4%). Relative consistency of power-time measures was generally comparable between methods and measures, and for many variables was at an acceptable level (ICC = 0.77-0.94). Although a number of time-dependent power variables can be reliably calculated from data acquired from the three methods investigated, the reliability of a number of these measures is below that which is acceptable for use in research and for practical applications.

  9. Application of single-step genomic best linear unbiased prediction with a multiple-lactation random regression test-day model for Japanese Holsteins.

    Science.gov (United States)

    Baba, Toshimi; Gotoh, Yusaku; Yamaguchi, Satoshi; Nakagawa, Satoshi; Abe, Hayato; Masuda, Yutaka; Kawahara, Takayoshi

    2017-08-01

    This study aimed to evaluate a validation reliability of single-step genomic best linear unbiased prediction (ssGBLUP) with a multiple-lactation random regression test-day model and investigate an effect of adding genotyped cows on the reliability. Two data sets for test-day records from the first three lactations were used: full data from February 1975 to December 2015 (60 850 534 records from 2 853 810 cows) and reduced data cut off in 2011 (53 091 066 records from 2 502 307 cows). We used marker genotypes of 4480 bulls and 608 cows. Genomic enhanced breeding values (GEBV) of 305-day milk yield in all the lactations were estimated for at least 535 young bulls using two marker data sets: bull genotypes only and both bulls and cows genotypes. The realized reliability (R 2 ) from linear regression analysis was used as an indicator of validation reliability. Using only genotyped bulls, R 2 was ranged from 0.41 to 0.46 and it was always higher than parent averages. The very similar R 2 were observed when genotyped cows were added. An application of ssGBLUP to a multiple-lactation random regression model is feasible and adding a limited number of genotyped cows has no significant effect on reliability of GEBV for genotyped bulls. © 2016 Japanese Society of Animal Science.

  10. Combination Therapy Showed Limited Superiority Over Monotherapy for Alzheimer Disease: A Meta-analysis of 14 Randomized Trials.

    Science.gov (United States)

    Tsoi, Kelvin K F; Chan, Joyce Y C; Leung, Nelson W Y; Hirai, Hoyee W; Wong, Samuel Y S; Kwok, Timothy C Y

    2016-09-01

    Acetylcholinesterase inhibitor (AChEI) and memantine are recognized drug treatments with limited clinical efficacy. Combination therapy for patients with Alzheimer disease (AD) was suggested, but the additional benefit of combination therapy is still controversial. To evaluate the additional benefit of combination therapy over monotherapy with either AChEI or memantine. Prospective randomized controlled trials were searched from the OVID databases. The trials were eligible if study subjects were diagnosed with AD, and were randomized to compare combination therapy with monotherapy. Any clinical assessment measured using validated scales on cognitive function, activities of daily living, behavioral problems, and global changes were the primary outcomes, and any reported adverse events were the secondary outcomes. Quality of studies and risk of bias were evaluated. Fourteen randomized trials were identified between 2004 and 2015 from the United States, Canada, Germany, Japan, China, and Korea. A total of 5019 patients with AD were randomly assigned to receive combination therapy of AChEI and memantine or monotherapy with AChEI or memantine. Combination therapy showed no significant benefit on cognitive function (mean difference [MD] of MMSE = 0.06, 95% CI -0.52 to 0.65), activities of daily living (MD of ADCS-ADL = -0.15, 95% CI -1.08 to 0.78), neuropsychiatric symptoms and behavioral problems (MD of NPI = -1.85, 95% CI -4.83 to 1.13), and global changes (MD of CIBIC-plus = 0.01, 95% CI -0.25 to 0.28). In subgroup analyses, combination therapy can improve cognitive function more than memantine alone; and it can significantly relieve neuropsychiatric symptoms and behavioral problems when concomitantly used with donepezil. No additional adverse event was reported in the combination therapy. Combination therapy only showed the benefit on neuropsychiatric symptoms and behavioral problems in moderate-to-severe AD, but no other superiority in terms of cognitive

  11. The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial

    Directory of Open Access Journals (Sweden)

    Ho Suleen S

    2012-08-01

    Full Text Available Abstract Background Evidence suggests that exercise training improves CVD risk factors. However, it is unclear whether health benefits are limited to aerobic training or if other exercise modalities such as resistance training or a combination are as effective or more effective in the overweight and obese. The aim of this study is to investigate whether 12 weeks of moderate-intensity aerobic, resistance, or combined exercise training would induce and sustain improvements in cardiovascular risk profile, weight and fat loss in overweight and obese adults compared to no exercise. Methods Twelve-week randomized parallel design examining the effects of different exercise regimes on fasting measures of lipids, glucose and insulin and changes in body weight, fat mass and dietary intake. Participants were randomized to either: Group 1 (Control, n = 16; Group 2 (Aerobic, n = 15; Group 3 (Resistance, n = 16; Group 4 (Combination, n = 17. Data was analysed using General Linear Model to assess the effects of the groups after adjusting for baseline values. Within-group data was analyzed with the paired t-test and between-group effects using post hoc comparisons. Results Significant improvements in body weight (−1.6%, p = 0.044 for the Combination group compared to Control and Resistance groups and total body fat compared to Control (−4.4%, p = 0.003 and Resistance (−3%, p = 0.041. Significant improvements in body fat percentage (−2.6%, p = 0.008, abdominal fat percentage (−2.8%, p = 0.034 and cardio-respiratory fitness (13.3%, p = 0.006 were seen in the Combination group compared to Control. Levels of ApoB48 were 32% lower in the Resistance group compared to Control (p = 0.04. Conclusion A 12-week training program comprising of resistance or combination exercise, at moderate-intensity for 30 min, five days/week resulted in improvements in the cardiovascular risk profile in overweight and obese

  12. The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial.

    Science.gov (United States)

    Ho, Suleen S; Dhaliwal, Satvinder S; Hills, Andrew P; Pal, Sebely

    2012-08-28

    Evidence suggests that exercise training improves CVD risk factors. However, it is unclear whether health benefits are limited to aerobic training or if other exercise modalities such as resistance training or a combination are as effective or more effective in the overweight and obese. The aim of this study is to investigate whether 12 weeks of moderate-intensity aerobic, resistance, or combined exercise training would induce and sustain improvements in cardiovascular risk profile, weight and fat loss in overweight and obese adults compared to no exercise. Twelve-week randomized parallel design examining the effects of different exercise regimes on fasting measures of lipids, glucose and insulin and changes in body weight, fat mass and dietary intake. Participants were randomized to either: Group 1 (Control, n = 16); Group 2 (Aerobic, n = 15); Group 3 (Resistance, n = 16); Group 4 (Combination, n = 17). Data was analysed using General Linear Model to assess the effects of the groups after adjusting for baseline values. Within-group data was analyzed with the paired t-test and between-group effects using post hoc comparisons. Significant improvements in body weight (-1.6%, p = 0.044) for the Combination group compared to Control and Resistance groups and total body fat compared to Control (-4.4%, p = 0.003) and Resistance (-3%, p = 0.041). Significant improvements in body fat percentage (-2.6%, p = 0.008), abdominal fat percentage (-2.8%, p = 0.034) and cardio-respiratory fitness (13.3%, p = 0.006) were seen in the Combination group compared to Control. Levels of ApoB48 were 32% lower in the Resistance group compared to Control (p = 0.04). A 12-week training program comprising of resistance or combination exercise, at moderate-intensity for 30 min, five days/week resulted in improvements in the cardiovascular risk profile in overweight and obese participants compared to no exercise. From our observations, combination exercise gave greater benefits for weight loss

  13. Utilization of random process spectral properties for the calculation of fatigue life under combined loading

    National Research Council Canada - National Science Library

    Svoboda J; Balda M; Fröhlich V

    2009-01-01

    ... of forces and moments of random character. Considering the fracture mechanics theory, then the damaging of material is both in the micro- and macro-plastic area connected with the rise of plastic deformation and hence with the plastic...

  14. INVERSION SYMMETRY, ARCHITECTURE AND DISPERSITY, AND THEIR EFFECTS ON THERMODYNAMICS IN BULK AND CONFINED REGIONS: FROM RANDOMLY BRANCHED POLYMERS TO LINEAR CHAINS, STARS AND DENDRIMERS

    Directory of Open Access Journals (Sweden)

    P.D.Gujrati

    2002-01-01

    Full Text Available Theoretical evidence is presented in this review that architectural aspects can play an important role, not only in the bulk but also in confined geometries by using our recursive lattice theory, which is equally applicable to fixed architectures (regularly branched polymers, stars, dendrimers, brushes, linear chains, etc. and variable architectures, i.e. randomly branched structures. Linear chains possess an inversion symmetry (IS of a magnetic system (see text, whose presence or absence determines the bulk phase diagram. Fixed architectures possess the IS and yield a standard bulk phase diagram in which there exists a theta point at which two critical lines C and C' meet and the second virial coefficient A2 vanishes. The critical line C appears only for infinitely large polymers, and an order parameter is identified for this criticality. The critical line C' exists for polymers of all sizes and represents phase separation criticality. Variable architectures, which do not possess the IS, give rise to a topologically different phase diagram with no theta point in general. In confined regions next to surfaces, it is not the IS but branching and monodispersity, which becomes important in the surface regions. We show that branching plays no important role for polydisperse systems, but become important for monodisperse systems. Stars and linear chains behave differently near a surface.

  15. Linear Representation of Emotions in Whole Persons by Combining Facial and Bodily Expressions in the Extrastriate Body Area.

    Science.gov (United States)

    Yang, Xiaoli; Xu, Junhai; Cao, Linjing; Li, Xianglin; Wang, Peiyuan; Wang, Bin; Liu, Baolin

    2017-01-01

    Our human brain can rapidly and effortlessly perceive a person's emotional state by integrating the isolated emotional faces and bodies into a whole. Behavioral studies have suggested that the human brain encodes whole persons in a holistic rather than part-based manner. Neuroimaging studies have also shown that body-selective areas prefer whole persons to the sum of their parts. The body-selective areas played a crucial role in representing the relationships between emotions expressed by different parts. However, it remains unclear in which regions the perception of whole persons is represented by a combination of faces and bodies, and to what extent the combination can be influenced by the whole person's emotions. In the present study, functional magnetic resonance imaging data were collected when participants performed an emotion distinction task. Multi-voxel pattern analysis was conducted to examine how the whole person-evoked responses were associated with the face- and body-evoked responses in several specific brain areas. We found that in the extrastriate body area (EBA), the whole person patterns were most closely correlated with weighted sums of face and body patterns, using different weights for happy expressions but equal weights for angry and fearful ones. These results were unique for the EBA. Our findings tentatively support the idea that the whole person patterns are represented in a part-based manner in the EBA, and modulated by emotions. These data will further our understanding of the neural mechanism underlying perceiving emotional persons.

  16. Limit theorems for linear spectrum statistics of orthogonal polynomial ensembles and their applications in random matrix theory

    Science.gov (United States)

    Pan, Guangming; Wang, Shaochen; Zhou, Wang

    2017-10-01

    In this paper, we consider the asymptotic behavior of Xfn (n )≔∑i=1 nfn(xi ) , where xi,i =1 ,…,n form orthogonal polynomial ensembles and fn is a real-valued, bounded measurable function. Under the condition that Var Xfn (n )→∞ , the Berry-Esseen (BE) bound and Cramér type moderate deviation principle (MDP) for Xfn (n ) are obtained by using the method of cumulants. As two applications, we establish the BE bound and Cramér type MDP for linear spectrum statistics of Wigner matrix and sample covariance matrix in the complex cases. These results show that in the edge case (which means fn has a particular form f (x ) I (x ≥θn ) where θn is close to the right edge of equilibrium measure and f is a smooth function), Xfn (n ) behaves like the eigenvalues counting function of the corresponding Wigner matrix and sample covariance matrix, respectively.

  17. Combined Effect of Random Transmit Power Control and Inter-Path Interference Cancellation on DS-CDMA Packet Mobile Communications

    Science.gov (United States)

    Kudoh, Eisuke; Ito, Haruki; Wang, Zhisen; Adachi, Fumiyuki

    In mobile communication systems, high speed packet data services are demanded. In the high speed data transmission, throughput degrades severely due to severe inter-path interference (IPI). Recently, we proposed a random transmit power control (TPC) to increase the uplink throughput of DS-CDMA packet mobile communications. In this paper, we apply IPI cancellation in addition to the random TPC. We derive the numerical expression of the received signal-to-interference plus noise power ratio (SINR) and introduce IPI cancellation factor. We also derive the numerical expression of system throughput when IPI is cancelled ideally to compare with the Monte Carlo numerically evaluated system throughput. Then we evaluate, by Monte-Carlo numerical computation method, the combined effect of random TPC and IPI cancellation on the uplink throughput of DS-CDMA packet mobile communications.

  18. Combined cognitive and parent training interventions for adolescents with ADHD and their mothers: A randomized controlled trial.

    Science.gov (United States)

    Steeger, Christine M; Gondoli, Dawn M; Gibson, Bradley S; Morrissey, Rebecca A

    2016-01-01

    This study examined the individual and combined effects of two nonpharmacological treatments for attention deficit/hyperactivity disorder (ADHD): Cogmed working memory training (CWMT) for adolescents and behavioral parent training (BPT) for mothers. Ninety-one adolescents (ages 11-15) and their mothers were randomized to one of four CWMT and BPT treatment and active control (placebo) group combinations of 5-week interventions. At pre- and posttest, mothers and teachers completed rating forms, and adolescents completed neuropsychological measures of working memory (WM). Individual intervention effects showed that treatment CWMT significantly improved WM spans, whereas there were no significant differences for treatment or control BPT on reports of parent-related outcomes. Combined treatment effects indicated an overall pattern of greatest improvements for the control CWMT/treatment BPT group, as compared to the other three groups, on adolescent WM deficit, behavioral regulation problems, and global executive deficit. Most significant effects for outcomes were main effects of improvements over time. A combination of CWMT and BPT did not result in increased treatment gains. However, potential effects of combined treatment may have been masked by greater perceived benefits arising from lack of struggle in the nonadaptive, CWMT active control condition. Future combined intervention research should focus on specific, theoretically driven WM deficits among individuals with ADHD, should include possible adaptations to the standard CWMT program, should examine effectiveness of cognitive treatments combined with contextual interventions and should utilize appropriate control groups to fully understand the unique and combined effects of interventions.

  19. The Opioid-Sparing Effect of Perioperative Dexmedetomidine Combined with Oxycodone Infusion during Open Hepatectomy: A Randomized Controlled Trial

    OpenAIRE

    Benhou Zhang; Benhou Zhang; Guifang Wang; Xiaopeng Liu; Tian-Long Wang; Ping Chi

    2018-01-01

    Background: A large right subcostal incision performed by open hepatectomy is associated with significant post-operative pain and distress. However, post-operative analgesia solutions still need to be devised. We investigated the effects of intra- and post-operative infusion of dexmedetomidine (Dex) combined with oxycodone during open hepatectomy.Methods: In this prospective, randomized and double-blind investigation, 52 patients undergoing selective open hepatectomy were divided into Dex gro...

  20. Substrate modification combined with pulmonary vein isolation improves outcome of catheter ablation in patients with persistent atrial fibrillation: a prospective randomized comparison.

    Science.gov (United States)

    Willems, Stephan; Klemm, Hanno; Rostock, Thomas; Brandstrup, Benedikt; Ventura, Rodolfo; Steven, Daniel; Risius, Tim; Lutomsky, Boris; Meinertz, Thomas

    2006-12-01

    To investigate the effectiveness of additional substrate modification (SM) by left atrial (LA) linear lesions as compared with pulmonary vein isolation (PVI) alone in patients with persistent atrial fibrillation (AF) in a prospective randomized study. Percutaneous PVI has evolved as an accepted treatment for paroxysmal AF but seemed to be less effective in patients with persistent AF. The benefit of PVI alone and additional linear lesions has not been validated in a randomized study so far. Sixty-two patients with persistent AF (median duration 7, range 1-18 months) were randomly assigned to either PVI alone (n = 30) or additional SM (n =32) consisting of a roof line connecting both left superior and right superior PV and LA isthmus ablation between left inferior PV and mitral annulus. Procedures including SM were performed using a three-dimensional mapping system (EnSite NavX, St Jude Medical, St Paul, MN, USA). Anti-arrhythmic drugs were discontinued within 8 weeks after ablation in both groups. Follow-up included daily trans-telephonic ECG transmitted irrespective of the patient's symptoms. PVI was successful in 98% of all targeted veins in both groups. Additional SM did not increase fluoroscopy time (72.1+/-18.7 vs. 72.9+/-17.3 min, P=0.92) because of the use of three-dimensional navigation in the PVI+SM group. AF recurrences within the first 4 weeks following ablation were more common after PVI alone (77%) than additional SM (44%, P=0.002). After a follow-up time of 487 (429-570) days, only 20% of patients undergoing stand alone PVI remained in sinus rhythm when compared with 69% following PVI combined with SM (P=0.0001). Two patients assigned to PVI+SM experienced procedure-related complications (cardiac tamponade and minor stroke) which resolved without sequelae. PVI alone is insufficient in the treatment of persistent AF. However, additional left linear lesions increase the success rate significantly. Early AF-relapses are associated with a negative outcome

  1. Global atmospheric response to specific linear combinations of the main SST modes. Part I: numerical experiments and preliminary results

    Directory of Open Access Journals (Sweden)

    S. Trzaska

    1996-10-01

    Full Text Available This article investigates through numerical experiments the controversial question of the impact of El Niño-Southern Oscillation (ENSO phenomena on climate according to large-scale and regional-scale interhemispheric thermal contrast. Eight experiments (two considering only inversed Atlantic thermal anomalies and six combining ENSO warm phase with large-scale interhemispheric contrast and Atlantic anomaly patterns were performed with the Météo-France atmospheric general circulation model. The definition of boundary conditions from observed composites and principal components is presented and preliminary results concerning the month of August, especially over West Africa and the equatorial Atlantic are discussed. Results are coherent with observations and show that interhemispheric and regional scale sea-surface-temperature anomaly (SST patterns could significantly modulate the impact of ENSO phenomena: the impact of warm-phase ENSO, relative to the atmospheric model intercomparison project (AMIP climatology, seems stronger when embedded in global and regional SSTA patterns representative of the post-1970 conditions [i.e. with temperatures warmer (colder than the long-term mean in the southern hemisphere (northern hemisphere]. Atlantic SSTAs may also play a significant role.

  2. Exploring the Efficacy of Replacing Linear Paper-Based Patient Cases in Problem-Based Learning With Dynamic Web-Based Virtual Patients: Randomized Controlled Trial

    Science.gov (United States)

    2014-01-01

    Background Problem-based learning (PBL) is well established in medical education and beyond, and continues to be developed and explored. Challenges include how to connect the somewhat abstract nature of classroom-based PBL with clinical practice and how to maintain learner engagement in the process of PBL over time. Objective A study was conducted to investigate the efficacy of decision-PBL (D-PBL), a variant form of PBL that replaces linear PBL cases with virtual patients. These Web-based interactive cases provided learners with a series of patient management pathways. Learners were encouraged to consider and discuss courses of action, take their chosen management pathway, and experience the consequences of their decisions. A Web-based application was essential to allow scenarios to respond dynamically to learners’ decisions, to deliver the scenarios to multiple PBL classrooms in the same timeframe, and to record centrally the paths taken by the PBL groups. Methods A randomized controlled trial in crossover design was run involving all learners (N=81) in the second year of the graduate entry stream for the undergraduate medicine program at St George’s University of London. Learners were randomized to study groups; half engaged in a D-PBL activity whereas the other half had a traditional linear PBL activity on the same subject material. Groups alternated D-PBL and linear PBL over the semester. The measure was mean cohort performance on specific face-to-face exam questions at the end of the semester. Results D-PBL groups performed better than linear PBL groups on questions related to D-PBL with the difference being statistically significant for all questions. Differences between the exam performances of the 2 groups were not statistically significant for the questions not related to D-PBL. The effect sizes for D-PBL–related questions were large and positive (>0.6) except for 1 question that showed a medium positive effect size. The effect sizes for questions

  3. Exploring the efficacy of replacing linear paper-based patient cases in problem-based learning with dynamic Web-based virtual patients: randomized controlled trial.

    Science.gov (United States)

    Poulton, Terry; Ellaway, Rachel H; Round, Jonathan; Jivram, Trupti; Kavia, Sheetal; Hilton, Sean

    2014-11-05

    Problem-based learning (PBL) is well established in medical education and beyond, and continues to be developed and explored. Challenges include how to connect the somewhat abstract nature of classroom-based PBL with clinical practice and how to maintain learner engagement in the process of PBL over time. A study was conducted to investigate the efficacy of decision-PBL (D-PBL), a variant form of PBL that replaces linear PBL cases with virtual patients. These Web-based interactive cases provided learners with a series of patient management pathways. Learners were encouraged to consider and discuss courses of action, take their chosen management pathway, and experience the consequences of their decisions. A Web-based application was essential to allow scenarios to respond dynamically to learners' decisions, to deliver the scenarios to multiple PBL classrooms in the same timeframe, and to record centrally the paths taken by the PBL groups. A randomized controlled trial in crossover design was run involving all learners (N=81) in the second year of the graduate entry stream for the undergraduate medicine program at St George's University of London. Learners were randomized to study groups; half engaged in a D-PBL activity whereas the other half had a traditional linear PBL activity on the same subject material. Groups alternated D-PBL and linear PBL over the semester. The measure was mean cohort performance on specific face-to-face exam questions at the end of the semester. D-PBL groups performed better than linear PBL groups on questions related to D-PBL with the difference being statistically significant for all questions. Differences between the exam performances of the 2 groups were not statistically significant for the questions not related to D-PBL. The effect sizes for D-PBL-related questions were large and positive (>0.6) except for 1 question that showed a medium positive effect size. The effect sizes for questions not related to D-PBL were all small (≤0

  4. A randomized study of combining maze surgery for atrial fibrillation with mitral valve surgery

    NARCIS (Netherlands)

    Jessurun, ER; Van Hemel, NM; Defauw, JJ; De La Riviere, AB; Stofmeel, MAM; Kingma, JH; Ernst, JMPG

    Aim Mitral valve surgery seldom suppresses atrial fibrillation (AF), present prior to surgery. Maze III surgery eliminates AF in >80% of cases, the reason why combining this procedure with mitral valve surgery in patients with AF seems worthwhile. We prospectively studied the outcome of combining

  5. Combining linear polarization spectroscopy and the Representative Layer Theory to measure the Beer-Lambert law absorbance of highly scattering materials.

    Science.gov (United States)

    Gobrecht, Alexia; Bendoula, Ryad; Roger, Jean-Michel; Bellon-Maurel, Véronique

    2015-01-01

    Visible and Near Infrared (Vis-NIR) Spectroscopy is a powerful non destructive analytical method used to analyze major compounds in bulk materials and products and requiring no sample preparation. It is widely used in routine analysis and also in-line in industries, in-vivo with biomedical applications or in-field for agricultural and environmental applications. However, highly scattering samples subvert Beer-Lambert law's linear relationship between spectral absorbance and the concentrations. Instead of spectral pre-processing, which is commonly used by Vis-NIR spectroscopists to mitigate the scattering effect, we put forward an optical method, based on Polarized Light Spectroscopy to improve the absorbance signal measurement on highly scattering samples. This method selects part of the signal which is less impacted by scattering. The resulted signal is combined in the Absorption/Remission function defined in Dahm's Representative Layer Theory to compute an absorbance signal fulfilling Beer-Lambert's law, i.e. being linearly related to concentration of the chemicals composing the sample. The underpinning theories have been experimentally evaluated on scattering samples in liquid form and in powdered form. The method produced more accurate spectra and the Pearson's coefficient assessing the linearity between the absorbance spectra and the concentration of the added dye improved from 0.94 to 0.99 for liquid samples and 0.84-0.97 for powdered samples. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Randomized controlled trial of the combined monoaminergic and opioid investigational compound GRT9906 in painful polyneuropathy

    DEFF Research Database (Denmark)

    Sindrup, Søren Hein; Konder, R; Lehmann, R

    2012-01-01

    GRT9906 is an investigational novel compound with μ-opioid receptor agonism and inhibition of noradrenalin/serotonin re-uptake. In this randomized, double-blind, placebo-controlled, three-way cross-over trial in painful polyneuropathy, the efficacy and safety of GRT9906 was assessed and compared...

  7. Normalizing Social Media Texts by Combining Word Embeddings and Edit Distances in a Random Forest Regressor

    NARCIS (Netherlands)

    van der Goot, Rob

    2016-01-01

    In this work, we adapt the traditional framework for spelling correction to the more novel task of normalization of social media content. To generate possible normalization candidates, we complement the traditional approach with a word embeddings model. To rank the candidates we will use a random

  8. Global atmospheric response to specific linear combinations of the main SST modes.. Part I: numerical experiments and preliminary results

    Science.gov (United States)

    Trzaska, S.; Moron, V.; Fontaine, B.

    1996-10-01

    This article investigates through numerical experiments the controversial question of the impact of El Niño-Southern Oscillation (ENSO) phenomena on climate according to large-scale and regional-scale interhemispheric thermal contrast. Eight experiments (two considering only inversed Atlantic thermal anomalies and six combining ENSO warm phase with large-scale interhemispheric contrast and Atlantic anomaly patterns) were performed with the Météo-France atmospheric general circulation model. The definition of boundary conditions from observed composites and principal components is presented and preliminary results concerning the month of August, especially over West Africa and the equatorial Atlantic are discussed. Results are coherent with observations and show that interhemispheric and regional scale sea-surface-temperature anomaly (SST) patterns could significantly modulate the impact of ENSO phenomena: the impact of warm-phase ENSO, relative to the atmospheric model intercomparison project (AMIP) climatology, seems stronger when embedded in global and regional SSTA patterns representative of the post-1970 conditions [i.e. with temperatures warmer (colder) than the long-term mean in the southern hemisphere (northern hemisphere)]. Atlantic SSTAs may also play a significant role. Acknowledgements. We gratefully appreciate the on-line DMSP database facility at APL (Newell et al., 1991) from which this study has benefited greatly. We wish to thank E. Friis-Christensen for his encouragement and useful discussions. A. Y. would like to thank the Danish Meteorological Institute, where this work was done, for its hospitality during his stay there and the Nordic Baltic Scholarship Scheme for its financial support of this stay. Topical Editor K.-H. Glassmeier thanks M. J. Engebretson and H. Lühr for their help in evaluating this paper.--> Correspondence to: A. Yahnin-->

  9. Randomized comparative trial of efficacy of paracetamol, ibuprofen and paracetamol-ibuprofen combination for treatment of febrile children.

    Science.gov (United States)

    Vyas, Falgun Indravadan; Rana, Devang Ashwinkumar; Patel, Piyush M; Patel, Varsha Jitendra; Bhavsar, Rekha H

    2014-01-01

    Paracetamol and ibuprofen are widely used for fever in children as monotherapy and as combined therapy. None of the treatments is proven clearly superior to others. Hence, the study was planned to compare the efficacy of paracetamol, ibuprofen and paracetamol-ibuprofen combination for treatment of febrile children. This was an investigator blind, randomized, comparative, parallel clinical trial conducted in 99 febrile children, 6 months to 12 years of age, allocated to three groups. First group received paracetamol 15 mg/kg, second group received ibuprofen 10 mg/kg and third group received both paracetamol and ibuprofen, all as a single dose by the oral route. Patients were followed-up at intervals of 1, 2, 3 and 4 h post dose by tympanic thermometry. Mean tympanic temperature after 4 h of drug administration was significantly lower in the combination group compared with paracetamol group (P children any time post dose until 4 h was highest in the combination group. Difference between combination and paracetamol was significant for the 1(st) h (P = 0.04). Highest fall of temperature was noted in the 1(st) h of drug administration in all the groups. No serious adverse events were observed in any of the groups. Paracetamol and ibuprofen combination caused quicker temperature reduction than either paracetamol or ibuprofen alone. If quicker reduction of body temperature is the desired goal of therapy, the use of combination of paracetamol + ibuprofen may be advocated.

  10. Combining walking and relaxation for stress reduction-A randomized cross-over trial in healthy adults.

    Science.gov (United States)

    Matzer, Franziska; Nagele, Eva; Lerch, Nikolaus; Vajda, Christian; Fazekas, Christian

    2017-08-25

    Both physical activity and relaxation have stress-relieving potential. This study investigates their combined impact on the relaxation response while considering participants' initial stress level. In a randomized cross-over trial, 81 healthy adults completed 4 types of short-term interventions for stress reduction, each lasting for 1 hr: (1) physical activity (walking) combined with resting, (2) walking combined with balneotherapy, (3) combined resting and balneotherapy, and (4) resting only. Saliva cortisol, blood pressure, state of mood, and relaxation were measured preintervention and postintervention. Stress levels were determined by validated questionnaires. All interventions were associated with relaxation responses in the variables saliva cortisol, blood pressure, state of mood, and subjective relaxation. No significant differences were found regarding the reduction of salivary cortisol (F = 1.30; p = .281). The systolic blood pressure was reduced best when walking was combined with balneotherapy or resting (F = 7.34; p < .001). Participants with high stress levels (n = 25) felt more alert after interventions including balneotherapy, whereas they reported an increase of tiredness when walking was combined with resting (F = 3.20; p = .044). Results suggest that combining physical activity and relaxation (resting or balneotherapy) is an advantageous short-term strategy for stress reduction as systolic blood pressure is reduced best while similar levels of relaxation can be obtained. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Oral Tranexamic Acid with Fluocinolone-Based Triple Combination Cream Versus Fluocinolone-Based Triple Combination Cream Alone in Melasma: An Open Labeled Randomized Comparative Trial.

    Science.gov (United States)

    Padhi, Tanmay; Pradhan, Swetalina

    2015-01-01

    Melasma is a common acquired cause of facial hyperpigmentation with no definitive therapy. Tranexamic acid, a plasmin inhibitor, has demonstrated depigmenting properties and combining this oral drug with other modalities of treatment has shown promising results. To compare the efficacy of a combination of oral tranexamic acid and fluocinolone-based triple combination cream with that of fluocinolone-based triple combination cream alone in melasma among Indian patients. 40 patients of melasma of either sex attending to dermatology OPD were enrolled in this study. Participants were randomly divided into two groups with 20 patients in each group. Group A patients were asked to apply the cream only and Group B patients received oral tranexamic acid 250 mg twice daily and applied a triple combination cream containing fluocinolone acetonide 0.01%, tretinoin 0.05%, and hydroquinone 2% once daily for 8 weeks. Response was evaluated using melasma area severity index (MASI) at baseline, 4 weeks, and 8 weeks. 40 patients completed the study. The MASI scores at baseline, 4 weeks and 8 weeks in group A were 15.425 + 1.09, 11.075 + 9.167 and 6.995 + 6.056 respectively and in group B 18.243 + 1.05, 6.135 + 4.94 and 2.19 + 3.38. Intergroup comparison showed a faster reduction in pigmentation in Group B as compared to Group A and the results were statistically significant at 4 weeks (P value 0.014) and 8 weeks (P value 0.000). The efficacy was maintained throughout the 6-month follow-up period. Addition of oral tranexamic acid to fluocinolone-based triple combination cream results in a faster and sustained improvement in the treatment of melasma.

  12. Oral tranexamic acid with fluocinolone-based triple combination cream versus fluocinolone-based triple combination cream alone in melasma: An open labeled randomized comparative trial

    Directory of Open Access Journals (Sweden)

    Tanmay Padhi

    2015-01-01

    Full Text Available Background : Melasma is a common acquired cause of facial hyperpigmentation with no definitive therapy. Tranexamic acid, a plasmin inhibitor, has demonstrated depigmenting properties and combining this oral drug with other modalities of treatment has shown promising results. Objectives : To compare the efficacy of a combination of oral tranexamic acid and fluocinolone-based triple combination cream with that of fluocinolone-based triple combination cream alone in melasma among Indian patients. Materials and Methods : 40 patients of melasma of either sex attending to dermatology OPD were enrolled in this study. Participants were randomly divided into two groups with 20 patients in each group. Group A patients were asked to apply the cream only and Group B patients received oral tranexamic acid 250 mg twice daily and applied a triple combination cream containing fluocinolone acetonide 0.01%, tretinoin 0.05%, and hydroquinone 2% once daily for 8 weeks. Response was evaluated using melasma area severity index (MASI at baseline, 4 weeks, and 8 weeks. Results : 40 patients completed the study. The MASI scores at baseline, 4 weeks and 8 weeks in group A were 15.425 + 1.09, 11.075 + 9.167 and 6.995 + 6.056 respectively and in group B 18.243 + 1.05, 6.135 + 4.94 and 2.19 + 3.38. Intergroup comparison showed a faster reduction in pigmentation in Group B as compared to Group A and the results were statistically significant at 4 weeks (P value 0.014 and 8 weeks (P value 0.000. The efficacy was maintained throughout the 6-month follow-up period. Conclusion: Addition of oral tranexamic acid to fluocinolone-based triple combination cream results in a faster and sustained improvement in the treatment of melasma.

  13. A note on the periodic and chaotic responses of an SDOF system with piecewise linear stiffness subjected to combined harmonic- and flow-induced excitations

    Science.gov (United States)

    Lin, Wang; Qiao, Ni

    2008-03-01

    In this note, the periodic and chaotic responses of two single-degree-of-freedom (SDOF) models are investigated and some interesting results obtained. The first model (original model) has been developed by Narayanan and Sekar [Periodic and chaotic responses of an SDOF system with piecewise linear stiffness subjected to combined harmonic and flow induced excitations, Journal of Sound and Vibration 184 (2) (1997) 281-298] and the second one corresponds to a modified system. The original model, involving a one-sided clearance ( y0) between the mass and the linear spring, is subjected to combined harmonic ( F cos ωt) and flow-induced excitations. Narayanan and Sekar (1997) has shown that periodic, quasi-periodic and chaotic motions of this original model may occur in a range of flow velocities for the case: y0=0 and F≠0. In the present work, numerical calculations are carried out for several other important cases of the original system, showing some interesting, and sometimes unexpected results. The modified model, in particular, involving both-sided clearances, is analyzed numerically subsequently. The effect of flow velocity, clearances on the global dynamics of this modified system is discussed finally.

  14. Accuracy of 1H magnetic resonance spectroscopy for quantification of 2-hydroxyglutarate using linear combination and J-difference editing at 9.4T.

    Science.gov (United States)

    Neuberger, Ulf; Kickingereder, Philipp; Helluy, Xavier; Fischer, Manuel; Bendszus, Martin; Heiland, Sabine

    2017-12-01

    Non-invasive detection of 2-hydroxyglutarate (2HG) by magnetic resonance spectroscopy is attractive since it is related to tumor metabolism. Here, we compare the detection accuracy of 2HG in a controlled phantom setting via widely used localized spectroscopy sequences quantified by linear combination of metabolite signals vs. a more complex approach applying a J-difference editing technique at 9.4T. Different phantoms, comprised out of a concentration series of 2HG and overlapping brain metabolites, were measured with an optimized point-resolved-spectroscopy sequence (PRESS) and an in-house developed J-difference editing sequence. The acquired spectra were post-processed with LCModel and a simulated metabolite set (PRESS) or with a quantification formula for J-difference editing. Linear regression analysis demonstrated a high correlation of real 2HG values with those measured with the PRESS method (adjusted R-squared: 0.700, pJ-difference editing method (adjusted R-squared: 0.908, pJ-difference editing method however had a significantly higher explanatory value over the regression model with the PRESS method (pJ-difference editing 2HG was discernible down to 1mM, whereas with the PRESS method 2HG values were not discernable below 2mM and with higher systematic errors, particularly in phantoms with high concentrations of N-acetyl-asparate (NAA) and glutamate (Glu). In summary, quantification of 2HG with linear combination of metabolite signals shows high systematic errors particularly at low 2HG concentration and high concentration of confounding metabolites such as NAA and Glu. In contrast, J-difference editing offers a more accurate quantification even at low 2HG concentrations, which outweighs the downsides of longer measurement time and more complex postprocessing. Copyright © 2017. Published by Elsevier GmbH.

  15. Conjunctival Autograft Alone or Combined With Adjuvant Beta-Radiation? A Randomized Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Arruda Viani, Gustavo, E-mail: gusviani@gmail.com [Department of Radiation Oncology, Marilia Medical School, Marilia, Sao Paulo (Brazil); Carrara Fonseca, Ellen [Department of Radiation Oncology, Marilia Medical School, Marilia, Sao Paulo (Brazil); Department of Ophthalmology, Marilia Medical School, Marilia, Sao Paulo (Brazil); De Fendi, Ligia Issa [Department of Ophthalmology, Marilia Medical School, Marilia, Sao Paulo (Brazil); Melani Rocha, Eduardo [Department of Ophthalmology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto (Brazil)

    2012-03-01

    Purpose: To evaluate the effectiveness and safety of postoperative low single-dose of beta-irradiation ({beta}-RT) in pterygium comparing conjunctival autograft (CAG) surgery with CAG plus adjuvant {beta}-RT in a randomized clinical trial. Methods: This trial was designed as a prospective, randomized, single-center study. Surgery was performed in all cases according to the CAG technique. One hundred and eight pterygia were postoperatively randomized to CAG + {beta}-RT or CAG alone. In the case of {beta}-RT, a (90) Sr eye applicator was used to deliver 10 Gy to the sclera surface at a dose rate of between 200 and 250 cGy/min. After treatment, both an ophthalmologist and a radiation oncologist performed the follow-up examinations. The accumulated data were analyzed using a group sequential test. Results: Between February 2008 and September 2008, 116 eyes with primary pterygium were operated on according to the trial protocol. Adjuvant treatment was performed within 24 h postoperatively. Eight patients were lost to follow-up, resulting in 108 patients who could be analyzed. At a mean follow-up of 18 months (range, 8-33), in the 54 eyes randomized to receive CAG + {beta}-RT, 5 relapses occurred compared with 12 recurrences in the 54 eyes in CAG, for a crude control rate of 90.8 % vs. 78%; p = 0.032, respectively. The treatment complications as hyperemia, total dehiscence of the autograft and dellen were significantly more frequent in the CAG (p < 0.05). The arm of {beta}-RT resulted in better cosmetic results and improves of symptoms than CAG. Conclusions: A low single-dose of {beta}-RT of 10 Gy after CAG surgery was a simple, effective, and safe treatment that reduced the risk of primary pterygium recurrence, improved symptoms after surgery, resulting in a better cosmetic effect than only CAG.

  16. [Combination of acupuncture, cupping and medicine for treatment of fibromyalgia syndrome: a multi-central randomized controlled trial].

    Science.gov (United States)

    Jang, Zhen-Ya; Li, Chang-Du; Qiu, Ling; Guo, Jun-Hua; He, Ling-Na; Yue, Yang; Li, Fang-Ze; Qin, Wen-Yi

    2010-04-01

    To evaluate the clinical effect of combination of acupuncture, cupping and medicine for treatment of fibromyalgia syndrome. By using multi-central randomized controlled method, 186 cases were randomly divided into an acupuncture combined with cupping and western medicine group (group A), an acupuncture combined with cupping group (group B) and a western medicine group (group C) and treated continuously for 4 weeks. The treatment of acupuncture combined with cupping was produced by acupuncture at five mental points and moving cupping on the Hechelu of the back, once evrey other day, thrice each week, and the western medicine therapy by oral administration of Amitriptyline, once each day. The scores of McGill Pain Questionnaire (MPQ), the amount of tenderness point and the time of producing effect were compared and the therapeutic effects were assessed with the Hamilton Depression Scale (HAMD). The cured and markedly effective rate was 65.0% (39/60) in the group A, which was superior to 15.9% (10/63) in the group B and 16.1% (9/56) in the group C (both P treatment, the scores of MPQ and HAMD and the amount of tenderness point all decreased in the three groups, group A being significantly better than group B and group C, and the time of producing effect in the group A was more earlier than those in the group B and the group C. The therapeutic effect of combination of acupuncture, cupping and medicine on fibromyalgia syndrome is superior to that of the simple acupuncture combined with cupping or the simple medicine.

  17. Effect of upper extremity proprioceptive neuromuscular facilitation combined with elastic resistance bands on respiratory muscle strength: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Guilherme P. T. Areas

    2013-12-01

    Full Text Available BACKGROUND: Elastic resistance bands (ERB combined with proprioceptive neuromuscular facilitation (PNF are often used in resistance muscle training programs, which have potential effects on peripheral muscle strength. However, the effects of the combination of ERB and PNF on respiratory muscle strength warrant further investigation. OBJECTIVES: The assessment of the effects of PNF combined with ERB on respiratory muscle strength. METHOD: Twenty healthy, right-handed females were included. Subjects were randomized to either the resistance training program group (TG, n=10 or the control group (CG, n=10. Maximal expiratory pressure (MEP and inspiratory pressure (MIP were measured before and after four weeks of an upper extremity resistance training program. The training protocol consisted of upper extremity PNF combined with ERB, with resistance selected from 1 repetition maximum protocol. RESULTS: PNF combined with ERB showed significant increases in MIP and MEP (p<0.05. In addition, there were significant differences between the TG and CG regarding ∆MIP (p=0.01 and ∆MEP (p=0.04. CONCLUSIONS: PNF combined with ERB can have a positive impact on respiratory muscle strength. These results may be useful with respect to cardiopulmonary chronic diseases that are associated with reduced respiratory muscle strength.

  18. A prospective randomized study comparing percutaneous nephrolithotomy under combined spinal-epidural anesthesia with percutaneous nephrolithotomy under general anesthesia.

    Science.gov (United States)

    Singh, Vishwajeet; Sinha, Rahul Janak; Sankhwar, S N; Malik, Anita

    2011-01-01

    A prospective randomized study was executed to compare the surgical parameters and stone clearance in patients who underwent percutaneous nephrolithotomy (PNL) under combined spinal-epidural anesthesia (CSEA) versus those who underwent PNL under general anesthesia (GA). Between January 2008 to December 2009, 64 patients with renal calculi were randomized into 2 groups and evaluated for the purpose of this study. Group 1 consisted of patients who underwent PNL under CSEA and Group 2 consisted of patients who underwent PNL under GA. The operative time, stone clearance rate, visual pain analog score, mean analgesic dose and mean hospital stay were compared amongst other parameters. The difference between visual pain analog score after the operation and the dose of analgesic requirement was significant on statistical analysis between both groups. PNL under CSEA is as effective and safe as PNL under GA. Patients who undergo PNL under CESA require lesser analgesic dose and have a shorter hospital stay. Copyright © 2011 S. Karger AG, Basel.

  19. Randomized comparative trial of efficacy of paracetamol, ibuprofen and paracetamol-ibuprofen combination for treatment of febrile children

    Directory of Open Access Journals (Sweden)

    Falgun Indravadan Vyas

    2014-01-01

    Full Text Available Objective: Paracetamol and ibuprofen are widely used for fever in children as monotherapy and as combined therapy. None of the treatments is proven clearly superior to others. Hence, the study was planned to compare the efficacy of paracetamol, ibuprofen and paracetamol-ibuprofen combination for treatment of febrile children. Materials and Methods: This was an investigator blind, randomized, comparative, parallel clinical trial conducted in 99 febrile children, 6 months to 12 years of age, allocated to three groups. First group received paracetamol 15 mg/kg, second group received ibuprofen 10 mg/kg and third group received both paracetamol and ibuprofen, all as a single dose by the oral route. Patients were followed-up at intervals of 1, 2, 3 and 4 h post dose by tympanic thermometry. Results: Mean tympanic temperature after 4 h of drug administration was significantly lower in the combination group compared with paracetamol group (P < 0.05; however, the difference was not clinically significant (<1΀C. The rate of fall of temperature was highest in the combination group. Number of afebrile children any time post dose until 4 h was highest in the combination group. Difference between combination and paracetamol was significant for the 1 st h (P = 0.04. Highest fall of temperature was noted in the 1 st h of drug administration in all the groups. No serious adverse events were observed in any of the groups. Conclusion: Paracetamol and ibuprofen combination caused quicker temperature reduction than either paracetamol or ibuprofen alone. If quicker reduction of body temperature is the desired goal of therapy, the use of combination of paracetamol + ibuprofen may be advocated.

  20. Chinese Massage Combined with Herbal Ointment for Athletes with Nonspecific Low Back Pain: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Ling Jun Kong

    2012-01-01

    Full Text Available Non-specific low back pain (NLBP is an increasing health problem for athletes. This randomized controlled trial was designed to investigate the effects of Chinese massage combined with herbal ointment for NLBP. 110 athletes with NLBP were randomly assigned to experimental group with Chinese massage combined with herbal ointment or control group with simple massage therapy. The primary outcome was pain by Chinese Short Form McGill Pain Questionnaire (C-SFMPQ. The secondary outcome was local muscle stiffness by Myotonometer. After 4 weeks, the experimental group experienced significant improvements in C-SFMPQ and in local muscle stiffness compared with control group (between-group difference in mean change from baseline, −1.24 points, P=0.005 in sensory scores; −3.14 points, P<0.001 in affective scores; −4.39 points, P<0.001 in total scores; −0.64 points, P=0.002 in VAS; −1.04 points, P=0.005 in local muscle stiffness during relaxation state. The difference remained at one month followup, but it was only significant in affective scores (−2.83 points, P<0.001 at three months followup. No adverse events were observed. These findings suggest that Chinese massage combined with herbal ointment may be a beneficial complementary and alternative therapy for athletes with NLBP.

  1. Effect of Combined Use of Calcium and Vitamin B6 on Premenstrual Syndrome Symptoms: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Seyedeh Zahra Masoumi

    2016-03-01

    Full Text Available Introduction: Premenstrual syndrome is one of the most common disorders in women, which includes a group of psychological and physical symptoms. The aim of this study was to examine the impact of combined use of calcium and vitamin B6 on premenstrual syndrome symptoms. Methods: This double blind randomized controlled was carried out on 76 students of Hamadan University of Medical Sciences. Students were randomly allocated to two groups. (38 people in each group. Student in intervention groups received calcium tablet (500mg and vitamin B6 (40 mg and student in intervention groups received only vitamin B6 twice a day for two consecutive months. The symptoms were assessed by Beck depression inventory (BDI and daily symptom records (DSR questionnaires. Analyses were carried out by test-retest method, Chi-square, Mann-Whitney, Independent t-test, and paired t-test using SPSS software ver.13. Results: The result showed that although the severity of symptoms decreased in both groups, but this reduction was more significant in the combined calcium and vitamin B6 group. Conclusion: According to the result, using of combination of calcium and vitamin B6 leads to better controlling of the premenstrual syndrome symptoms. Therefore it is recommended for women who suffer from these syndromes.

  2. Antipsychotic Medication Alone versus Combined with Psychosocial Intervention on Outcomes of Early Stage Schizophrenia: A Randomized, One-year Study

    Science.gov (United States)

    Guo, Xiaofeng; Zhai, Jinguo; Liu, Zhening; Fang, Maosheng; Wang, Bo; Wang, Chuanyue; Hu, Bin; Sun, Xueli; Lv, Luxian; Lu, Zheng; Ma, Cui; He, Xiaolin; Guo, Tiansheng; Xie, Shiping; Wu, Renrong; Xue, Zhimin; Chen, Jindong; Twamley, Elizabeth W.; Jin, Hua; Zhao, Jingping

    2013-01-01

    Context Antipsychotic drugs are limited in their ability to improve the overall outcome of schizophrenia. Adding psychosocial treatment may produce greater improvement in functional outcome than does medication treatment alone. Objective To evaluate the effectiveness of antipsychotic medication alone versus combined with psychosocial intervention on outcomes of early stage schizophrenia. Design, Setting, and Participants Randomized controlled trial of a clinical sample of 1268 patients with early stage schizophrenia, conducted at 10 clinical sites in China from 2005–2007. Intervention Patients were randomly assigned to antipsychotic medication treatment only or antipsychotic medication plus 12 months of psychosocial intervention, consisting of psycho-education, family intervention, skills training and cognitive-behavioral therapy, administered over 48 group sessions. Main Outcome Measures The rate of treatment discontinuation or change due to any cause, relapse or remission, and assessments of insight, treatment adherence, quality of life and social functioning. Results The rates of treatment discontinuation or change due to any cause were 32.8% in the combined treatment group and 46.8% in the medication alone group. Comparisons with medication treatment alone showed lower risk for any cause discontinuation with combined treatment (hazard ratios [HR], 0.62; 95% confidence interval [CI], 0.52–0.74; ppsychosocial intervention had a lower rate of treatment discontinuation or change, lower risk of relapse, and improved insight, quality of life and social functioning. PMID:20819983

  3. Identification of two linear B-cell epitopes from West Nile virus NS1 by screening a phage-displayed random peptide library

    Directory of Open Access Journals (Sweden)

    Qin Yong-Li

    2011-07-01

    Full Text Available Abstract Background The West Nile virus (WNV nonstructural protein 1 (NS1 is an important antigenic protein that elicits protective antibody responses in animals and can be used for the serological diagnosis of WNV infection. Although previous work has demonstrated the vital role of WNV NS1-specific antibody responses, the specific epitopes in the NS1 have not been identified. Results The present study describes the identification of two linear B-cell epitopes in WNV NS1 through screening a phage-displayed random 12-mer peptide library with two monoclonal antibodies (mAbs 3C7 and 4D1 that directed against the NS1. The mAbs 3C7 and 4D1 recognized phages displaying peptides with the consensus motifs LTATTEK and VVDGPETKEC, respectively. Exact sequences of both motifs were found in the NS1 (895LTATTEK901 and 925VVDGPETKEC934. Further identification of the displayed B cell epitopes were conducted using a set of truncated peptides expressed as MBP fusion proteins. The data indicated that 896TATTEK901 and925VVDGPETKEC934 are minimal determinants of the linear B cell epitopes recognized by the mAbs 3C7 and 4D1, respectively. Antibodies present in the serum of WNV-positive horses recognized the minimal linear epitopes in Western blot analysis, indicating that the two peptides are antigenic in horses during infection. Furthermore, we found that the epitope recognized by 3C7 is conserved only among WNV strains, whereas the epitope recognized by 4D1 is a common motif shared among WNV and other members of Japanese encephalitis virus (JEV serocomplex. Conclusions We identified TATTEK and VVDGPETKEC as NS1-specific linear B-cell epitopes recognized by the mAbs 3C7 and 4D1, respectively. The knowledge and reagents generated in this study may have potential applications in differential diagnosis and the development of epitope-based marker vaccines against WNV and other viruses of JEV serocomplex.

  4. Randomized Controlled Trial of Fish Oil and Montelukast and Their Combination on Airway Inflammation and Hyperpnea-Induced Bronchoconstriction

    Science.gov (United States)

    Tecklenburg-Lund, Sandra; Mickleborough, Timothy D.; Turner, Louise A.; Fly, Alyce D.; Stager, Joel M.; Montgomery, Gregory S.

    2010-01-01

    Background Both fish oil and montelukast have been shown to reduce the severity of exercise-induced bronchoconstriction (EIB). The purpose of this study was to compare the effects of fish oil and montelukast, alone and in combination, on airway inflammation and bronchoconstriction induced by eucapnic voluntary hyperpnea (EVH) in asthmatics. Methods In this model of EIB, twenty asthmatic subjects with documented hyperpnea-induced bronchoconstriction (HIB) entered a randomized double-blind trial. All subjects entered on their usual diet (pre-treatment, n = 20) and then were randomly assigned to receive either one active 10 mg montelukast tablet and 10 placebo fish oil capsules (n = 10) or one placebo montelukast tablet and 10 active fish oil capsules totaling 3.2 g EPA and 2.0 g DHA (n = 10) taken daily for 3-wk. Thereafter, all subjects (combination treatment; n = 20) underwent another 3-wk treatment period consisting of a 10 mg active montelukast tablet or 10 active fish oil capsules taken daily. Results While HIB was significantly inhibited (pmontelukast, fish oil and combination treatment compared to pre-treatment, there was no significant difference (p>0.017) between treatment groups; percent fall in forced expiratory volume in 1-sec was −18.4±2.1%, −9.3±2.8%, −11.6±2.8% and −10.8±1.7% on usual diet (pre-treatment), fish oil, montelukast and combination treatment respectively. All three treatments were associated with a significant reduction (p0.017) in these biomarkers between treatments. Conclusion While fish oil and montelukast are both effective in attenuating airway inflammation and HIB, combining fish oil with montelukast did not confer a greater protective effect than either intervention alone. Fish oil supplementation should be considered as an alternative treatment for EIB. Trial Registration ClinicalTrials.gov NCT00676468 PMID:20976161

  5. Effect of Kangaroo Care Combined with Music on the Mother-premature Neonate Attachment: A Randomized Controlled Trial.

    Science.gov (United States)

    Vahdati, Maryam; Mohammadizadeh, Majid; Talakoub, Sedigheh

    2017-01-01

    Premature birth may complicate the development and quality of the mother-infant attachment relationship. Music and kangaroo care are two common complementary cares performed in the neonatal intensive care unit (NICU). The present study investigated the effect of kangaroo care combined with music on the mother-premature neonate attachment. In this clinical trial, 64 mothers with premature neonates were selected and assigned to the control and study groups through random allocation. In the control group, kangaroo care, and in the study group, kangaroo care combined with music was adopted. The level of mother-premature neonate attachment was measured and compared before and after the intervention in both the groups using Avant's Maternal Attachment Assessment Scale. There was a significant increase in the mean overall score of attachment in the kangaroo care combined with music group (70.72 (11.46)) after the intervention compared to the kangaroo care without music group (53.61 (9.76)). The mean overall score of mother-neonate attachment in the kangaroo care combined with music group was higher than the kangaroo care group. This difference can be related to the effectiveness of music combined with kangaroo care.

  6. Classification of gilthead sea bream (Sparus aurata) from 1H NMR lipid profiling combined with principal component and linear discriminant analysis.

    Science.gov (United States)

    Rezzi, Serge; Giani, Ivan; Héberger, Károly; Axelson, David E; Moretti, Vittorio M; Reniero, Fabiano; Guillou, Claude

    2007-11-28

    The combination of (1)H NMR fingerprinting of lipids from gilthead sea bream (Sparus aurata) with nonsupervised and supervised multivariate analysis was applied to differentiate wild and farmed fish and to classify farmed specimen according to their areas of production belonging to the Mediterranean basin. Principal component analysis (PCA) applied on processed (1)H NMR profiles made a clear distinction between wild and farmed samples. Linear discriminant analysis (LDA) allowed classification of samples according to the geographic origin, as well as for the wild and farmed status using both PCA scores and NMR data as variables. Variable selection for LDA was achieved with forward selection (stepwise) with a predefined 5% error level. The methods allowed the classification of 100% of the samples according to their wild and farmed status and 85-97% to geographic origin. Probabilistic neural network (PNN) analyses provided complementary means for the successful discrimination among classes investigated.

  7. Profiling of phenolic constituents in Polygonum multiflorum Thunb. by combination of ultra-high-pressure liquid chromatography with linear ion trap-Orbitrap mass spectrometry.

    Science.gov (United States)

    Qiu, Xiaohui; Zhang, Jing; Huang, Zhihai; Zhu, Dayuan; Xu, Wen

    2013-05-31

    A simple and effective method was developed for characterization of phenolic constituents in the roots of Polygonum multiflorum by combination of ultra-high-pressure liquid chromatography with linear ion trap-Orbitrap tandem mass spectrometry (UHPLC-LTQ-Orbitrap). Stilbenes, anthraquinones, tannins and naphthalenes were differentiated by diagnostic fragment ions with accurate mass measurements and characteristic fragmentation pathways. Based on the proposed strategy, fifty-nine constituents were characterized or tentatively identified, of which twenty-two constituents were the first to be reported in P. multiflorum and twelve compounds were characterized as potential new compounds. The identification and structure elucidation of these chemicals provided essential data for further phytochemical studies and quality control of P. multiflorum. The results also demonstrated that our novel method can be extended to screen and characterize other phenolic constituents and their metabolites in botanical extracts. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Vertical electric sounding inversion using genetic algorithms combined with linearized inversion; Inversao de sondagem eletrica vertical utilizando algoritmos geneticos combinado com inversao linearizada

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Nirardo Roberto; Porsani, Milton Jose [Bahia Univ., Salvador, BA (Brazil)

    1997-07-01

    Inversion of DC resistivity sounding is a nonlinear problem. Local or global optimization methods are commonly used to solve it. Local methods are fast but require that the start method be close to the true solution and may be trapped in local minimum. Global methods are robust, but computationally expensive since the space is usually very large. Here we combine the genetic algorithm (AG) with the linearized inversion method, Gauss-Newton, to overcome their limitations and explore the advantages of the two methods. The algorithm was tested with a 1-D Schlumberger resistivity sounding data and its performance was compared with pure AG. The joint operation improves the convergence even when using a reduced population of methods. (author)

  9. Solid phase microextraction of diclofenac using molecularly imprinted polymer sorbent in hollow fiber combined with fiber optic-linear array spectrophotometry

    Science.gov (United States)

    Pebdani, Arezou Amiri; Shabani, Ali Mohammad Haji; Dadfarnia, Shayessteh; Khodadoust, Saeid

    2015-08-01

    A simple solid phase microextraction method based on molecularly imprinted polymer sorbent in the hollow fiber (MIP-HF-SPME) combined with fiber optic-linear array spectrophotometer has been applied for the extraction and determination of diclofenac in environmental and biological samples. The effects of different parameters such as pH, times of extraction, type and volume of the organic solvent, stirring rate and donor phase volume on the extraction efficiency of the diclofenac were investigated and optimized. Under the optimal conditions, the calibration graph was linear (r2 = 0.998) in the range of 3.0-85.0 μg L-1 with a detection limit of 0.7 μg L-1 for preconcentration of 25.0 mL of the sample and the relative standard deviation (n = 6) less than 5%. This method was applied successfully for the extraction and determination of diclofenac in different matrices (water, urine and plasma) and accuracy was examined through the recovery experiments.

  10. Solid phase microextraction of diclofenac using molecularly imprinted polymer sorbent in hollow fiber combined with fiber optic-linear array spectrophotometry.

    Science.gov (United States)

    Pebdani, Arezou Amiri; Shabani, Ali Mohammad Haji; Dadfarnia, Shayessteh; Khodadoust, Saeid

    2015-08-05

    A simple solid phase microextraction method based on molecularly imprinted polymer sorbent in the hollow fiber (MIP-HF-SPME) combined with fiber optic-linear array spectrophotometer has been applied for the extraction and determination of diclofenac in environmental and biological samples. The effects of different parameters such as pH, times of extraction, type and volume of the organic solvent, stirring rate and donor phase volume on the extraction efficiency of the diclofenac were investigated and optimized. Under the optimal conditions, the calibration graph was linear (r(2)=0.998) in the range of 3.0-85.0 μg L(-1) with a detection limit of 0.7 μg L(-1) for preconcentration of 25.0 mL of the sample and the relative standard deviation (n=6) less than 5%. This method was applied successfully for the extraction and determination of diclofenac in different matrices (water, urine and plasma) and accuracy was examined through the recovery experiments. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. An intuitionistic fuzzy multi-objective non-linear programming model for sustainable irrigation water allocation under the combination of dry and wet conditions

    Science.gov (United States)

    Li, Mo; Fu, Qiang; Singh, Vijay P.; Ma, Mingwei; Liu, Xiao

    2017-12-01

    Water scarcity causes conflicts among natural resources, society and economy and reinforces the need for optimal allocation of irrigation water resources in a sustainable way. Uncertainties caused by natural conditions and human activities make optimal allocation more complex. An intuitionistic fuzzy multi-objective non-linear programming (IFMONLP) model for irrigation water allocation under the combination of dry and wet conditions is developed to help decision makers mitigate water scarcity. The model is capable of quantitatively solving multiple problems including crop yield increase, blue water saving, and water supply cost reduction to obtain a balanced water allocation scheme using a multi-objective non-linear programming technique. Moreover, it can deal with uncertainty as well as hesitation based on the introduction of intuitionistic fuzzy numbers. Consideration of the combination of dry and wet conditions for water availability and precipitation makes it possible to gain insights into the various irrigation water allocations, and joint probabilities based on copula functions provide decision makers an average standard for irrigation. A case study on optimally allocating both surface water and groundwater to different growth periods of rice in different subareas in Heping irrigation area, Qing'an County, northeast China shows the potential and applicability of the developed model. Results show that the crop yield increase target especially in tillering and elongation stages is a prevailing concern when more water is available, and trading schemes can mitigate water supply cost and save water with an increased grain output. Results also reveal that the water allocation schemes are sensitive to the variation of water availability and precipitation with uncertain characteristics. The IFMONLP model is applicable for most irrigation areas with limited water supplies to determine irrigation water strategies under a fuzzy environment.

  12. Combination therapy containing ritonavir plus saquinavir has superior short-term antiretroviral efficacy: a randomized trial

    DEFF Research Database (Denmark)

    Kirk, O; Katzenstein, T L; Gerstoft, J

    1999-01-01

    trial. Two hundred and eighty-four patients started randomized treatment. The primary end-point was the proportion of patients with HIV RNA of 200 copies/ml or less (Roche Amplicor) and HIV RNA of 20 copies/ml or less (Roche ultradirect assay) at 6 months. Analysis was performed as intent......-to-treat, and missing values were accounted for as failures. RESULTS: As of 1 May 1998, 269 patients should have completed 24 weeks of treatment. The proportion of patients with HIV RNA of 200 copies/ml or less was 71% (indinavir), 67% (ritonavir), and 82% (ritonavir + saquinavir), P = 0.07. In antiretroviral drug......-naive patients (n = 119), the corresponding figures were 63, 57, and 89% (P RNA of 200 copies/ml or less (P = 0.90). The same pattern was observed in the ultradirect analysis. All three regimens were generally safe...

  13. Boosted regression trees, multivariate adaptive regression splines and their two-step combinations with multiple linear regression or partial least squares to predict blood-brain barrier passage: a case study.

    Science.gov (United States)

    Deconinck, E; Zhang, M H; Petitet, F; Dubus, E; Ijjaali, I; Coomans, D; Vander Heyden, Y

    2008-02-18

    The use of some unconventional non-linear modeling techniques, i.e. classification and regression trees and multivariate adaptive regression splines-based methods, was explored to model the blood-brain barrier (BBB) passage of drugs and drug-like molecules. The data set contains BBB passage values for 299 structural and pharmacological diverse drugs, originating from a structured knowledge-based database. Models were built using boosted regression trees (BRT) and multivariate adaptive regression splines (MARS), as well as their respective combinations with stepwise multiple linear regression (MLR) and partial least squares (PLS) regression in two-step approaches. The best models were obtained using combinations of MARS with either stepwise MLR or PLS. It could be concluded that the use of combinations of a linear with a non-linear modeling technique results in some improved properties compared to the individual linear and non-linear models and that, when the use of such a combination is appropriate, combinations using MARS as non-linear technique should be preferred over those with BRT, due to some serious drawbacks of the BRT approaches.

  14. Estimating Dbh of Trees Employing Multiple Linear Regression of the best Lidar-Derived Parameter Combination Automated in Python in a Natural Broadleaf Forest in the Philippines

    Science.gov (United States)

    Ibanez, C. A. G.; Carcellar, B. G., III; Paringit, E. C.; Argamosa, R. J. L.; Faelga, R. A. G.; Posilero, M. A. V.; Zaragosa, G. P.; Dimayacyac, N. A.

    2016-06-01

    Diameter-at-Breast-Height Estimation is a prerequisite in various allometric equations estimating important forestry indices like stem volume, basal area, biomass and carbon stock. LiDAR Technology has a means of directly obtaining different forest parameters, except DBH, from the behavior and characteristics of point cloud unique in different forest classes. Extensive tree inventory was done on a two-hectare established sample plot in Mt. Makiling, Laguna for a natural growth forest. Coordinates, height, and canopy cover were measured and types of species were identified to compare to LiDAR derivatives. Multiple linear regression was used to get LiDAR-derived DBH by integrating field-derived DBH and 27 LiDAR-derived parameters at 20m, 10m, and 5m grid resolutions. To know the best combination of parameters in DBH Estimation, all possible combinations of parameters were generated and automated using python scripts and additional regression related libraries such as Numpy, Scipy, and Scikit learn were used. The combination that yields the highest r-squared or coefficient of determination and lowest AIC (Akaike's Information Criterion) and BIC (Bayesian Information Criterion) was determined to be the best equation. The equation is at its best using 11 parameters at 10mgrid size and at of 0.604 r-squared, 154.04 AIC and 175.08 BIC. Combination of parameters may differ among forest classes for further studies. Additional statistical tests can be supplemented to help determine the correlation among parameters such as Kaiser- Meyer-Olkin (KMO) Coefficient and the Barlett's Test for Spherecity (BTS).

  15. ESTIMATING DBH OF TREES EMPLOYING MULTIPLE LINEAR REGRESSION OF THE BEST LIDAR-DERIVED PARAMETER COMBINATION AUTOMATED IN PYTHON IN A NATURAL BROADLEAF FOREST IN THE PHILIPPINES

    Directory of Open Access Journals (Sweden)

    C. A. G. Ibanez

    2016-06-01

    Full Text Available Diameter-at-Breast-Height Estimation is a prerequisite in various allometric equations estimating important forestry indices like stem volume, basal area, biomass and carbon stock. LiDAR Technology has a means of directly obtaining different forest parameters, except DBH, from the behavior and characteristics of point cloud unique in different forest classes. Extensive tree inventory was done on a two-hectare established sample plot in Mt. Makiling, Laguna for a natural growth forest. Coordinates, height, and canopy cover were measured and types of species were identified to compare to LiDAR derivatives. Multiple linear regression was used to get LiDAR-derived DBH by integrating field-derived DBH and 27 LiDAR-derived parameters at 20m, 10m, and 5m grid resolutions. To know the best combination of parameters in DBH Estimation, all possible combinations of parameters were generated and automated using python scripts and additional regression related libraries such as Numpy, Scipy, and Scikit learn were used. The combination that yields the highest r-squared or coefficient of determination and lowest AIC (Akaike’s Information Criterion and BIC (Bayesian Information Criterion was determined to be the best equation. The equation is at its best using 11 parameters at 10mgrid size and at of 0.604 r-squared, 154.04 AIC and 175.08 BIC. Combination of parameters may differ among forest classes for further studies. Additional statistical tests can be supplemented to help determine the correlation among parameters such as Kaiser- Meyer-Olkin (KMO Coefficient and the Barlett’s Test for Spherecity (BTS.

  16. Effect of Combined versus Monotherapy with Deferoxamine and Deferiprone in Iron Overloaded Thalassemia Patients: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Sasan Hejazi

    2016-06-01

    Full Text Available Background: Patients with transfusional iron overload have depended on iron chelation therapy and improving chelation regimens have been of the highest priority. The aim of this study was to compare effect of combined versus monotherapy with Deferoxamine (DFO and Deferiprone (DFP in iron overloaded beta thalassemia (BT major patients Materials and Methods We studied 36 BT major patients (mean age 7.6±4.6; range 3–16 years attending the Ormieh Motahari hospital for regular transfusional support. Patients were randomly allocated to receive one of the following two treatments: DFO in combination with DFP (n=12, DFO alone (n=12 and DFP alone (n=12. Serum ferritin level, liver enzymes, blood urea nitrogen, and creatinine and side effects were monitored over a 12 months period. Results: After one year, serum ferritin decreased more significantly in patients on DFO+DFP therapy compared to patients who only received DFO or DFP alone (P

  17. Randomized controlled trial of fish oil and montelukast and their combination on airway inflammation and hyperpnea-induced bronchoconstriction.

    Directory of Open Access Journals (Sweden)

    Sandra Tecklenburg-Lund

    2010-10-01

    Full Text Available Both fish oil and montelukast have been shown to reduce the severity of exercise-induced bronchoconstriction (EIB. The purpose of this study was to compare the effects of fish oil and montelukast, alone and in combination, on airway inflammation and bronchoconstriction induced by eucapnic voluntary hyperpnea (EVH in asthmatics.In this model of EIB, twenty asthmatic subjects with documented hyperpnea-induced bronchoconstriction (HIB entered a randomized double-blind trial. All subjects entered on their usual diet (pre-treatment, n = 20 and then were randomly assigned to receive either one active 10 mg montelukast tablet and 10 placebo fish oil capsules (n = 10 or one placebo montelukast tablet and 10 active fish oil capsules totaling 3.2 g EPA and 2.0 g DHA (n = 10 taken daily for 3-wk. Thereafter, all subjects (combination treatment; n = 20 underwent another 3-wk treatment period consisting of a 10 mg active montelukast tablet or 10 active fish oil capsules taken daily.While HIB was significantly inhibited (p0.017 between treatment groups; percent fall in forced expiratory volume in 1-sec was -18.4 ± 2.1%, -9.3±2.8%, -11.6 ± 2.8% and -10.8 ± 1.7% on usual diet (pre-treatment, fish oil, montelukast and combination treatment respectively. All three treatments were associated with a significant reduction (p0.017 in these biomarkers between treatments.While fish oil and montelukast are both effective in attenuating airway inflammation and HIB, combining fish oil with montelukast did not confer a greater protective effect than either intervention alone. Fish oil supplementation should be considered as an alternative treatment for EIB.ClinicalTrials.gov NCT00676468.

  18. A Comparative Assessment of the Influences of Human Impacts on Soil Cd Concentrations Based on Stepwise Linear Regression, Classification and Regression Tree, and Random Forest Models.

    Science.gov (United States)

    Qiu, Lefeng; Wang, Kai; Long, Wenli; Wang, Ke; Hu, Wei; Amable, Gabriel S

    2016-01-01

    Soil cadmium (Cd) contamination has attracted a great deal of attention because of its detrimental effects on animals and humans. This study aimed to develop and compare the performances of stepwise linear regression (SLR), classification and regression tree (CART) and random forest (RF) models in the prediction and mapping of the spatial distribution of soil Cd and to identify likely sources of Cd accumulation in Fuyang County, eastern China. Soil Cd data from 276 topsoil (0-20 cm) samples were collected and randomly divided into calibration (222 samples) and validation datasets (54 samples). Auxiliary data, including detailed land use information, soil organic matter, soil pH, and topographic data, were incorporated into the models to simulate the soil Cd concentrations and further identify the main factors influencing soil Cd variation. The predictive models for soil Cd concentration exhibited acceptable overall accuracies (72.22% for SLR, 70.37% for CART, and 75.93% for RF). The SLR model exhibited the largest predicted deviation, with a mean error (ME) of 0.074 mg/kg, a mean absolute error (MAE) of 0.160 mg/kg, and a root mean squared error (RMSE) of 0.274 mg/kg, and the RF model produced the results closest to the observed values, with an ME of 0.002 mg/kg, an MAE of 0.132 mg/kg, and an RMSE of 0.198 mg/kg. The RF model also exhibited the greatest R2 value (0.772). The CART model predictions closely followed, with ME, MAE, RMSE, and R2 values of 0.013 mg/kg, 0.154 mg/kg, 0.230 mg/kg and 0.644, respectively. The three prediction maps generally exhibited similar and realistic spatial patterns of soil Cd contamination. The heavily Cd-affected areas were primarily located in the alluvial valley plain of the Fuchun River and its tributaries because of the dramatic industrialization and urbanization processes that have occurred there. The most important variable for explaining high levels of soil Cd accumulation was the presence of metal smelting industries. The

  19. A Comparative Assessment of the Influences of Human Impacts on Soil Cd Concentrations Based on Stepwise Linear Regression, Classification and Regression Tree, and Random Forest Models.

    Directory of Open Access Journals (Sweden)

    Lefeng Qiu

    Full Text Available Soil cadmium (Cd contamination has attracted a great deal of attention because of its detrimental effects on animals and humans. This study aimed to develop and compare the performances of stepwise linear regression (SLR, classification and regression tree (CART and random forest (RF models in the prediction and mapping of the spatial distribution of soil Cd and to identify likely sources of Cd accumulation in Fuyang County, eastern China. Soil Cd data from 276 topsoil (0-20 cm samples were collected and randomly divided into calibration (222 samples and validation datasets (54 samples. Auxiliary data, including detailed land use information, soil organic matter, soil pH, and topographic data, were incorporated into the models to simulate the soil Cd concentrations and further identify the main factors influencing soil Cd variation. The predictive models for soil Cd concentration exhibited acceptable overall accuracies (72.22% for SLR, 70.37% for CART, and 75.93% for RF. The SLR model exhibited the largest predicted deviation, with a mean error (ME of 0.074 mg/kg, a mean absolute error (MAE of 0.160 mg/kg, and a root mean squared error (RMSE of 0.274 mg/kg, and the RF model produced the results closest to the observed values, with an ME of 0.002 mg/kg, an MAE of 0.132 mg/kg, and an RMSE of 0.198 mg/kg. The RF model also exhibited the greatest R2 value (0.772. The CART model predictions closely followed, with ME, MAE, RMSE, and R2 values of 0.013 mg/kg, 0.154 mg/kg, 0.230 mg/kg and 0.644, respectively. The three prediction maps generally exhibited similar and realistic spatial patterns of soil Cd contamination. The heavily Cd-affected areas were primarily located in the alluvial valley plain of the Fuchun River and its tributaries because of the dramatic industrialization and urbanization processes that have occurred there. The most important variable for explaining high levels of soil Cd accumulation was the presence of metal smelting industries

  20. Preoperative Pain Neuroscience Education Combined With Knee Joint Mobilization for Knee Osteoarthritis: A Randomized Controlled Trial.

    Science.gov (United States)

    Lluch, Enrique; Dueñas, Lirios; Falla, Deborah; Baert, Isabel; Meeus, Mira; Sánchez-Frutos, José; Nijs, Jo

    2018-01-01

    This study aimed to first compare the effects of a preoperative treatment combining pain neuroscience education (PNE) with knee joint mobilization versus biomedical education with knee joint mobilization on central sensitization (CS) in patients with knee osteoarthritis, both before and after surgery. Second, we wanted to compare the effects of both interventions on knee pain, disability, and psychosocial variables. Forty-four patients with knee osteoarthritis were allocated to receive 4 sessions of either PNE combined with knee joint mobilization or biomedical education with knee joint mobilization before surgery. All participants completed self-administered questionnaires and quantitative sensory testing was performed at baseline, after treatment and at a 1 month follow-up (all before surgery), and at 3 months after surgery. Significant and clinically relevant differences before and after surgery were found after treatments for both knee pain and disability, and some measures of CS (ie, widespread hyperalgesia, CS inventory), with no significant between-group differences. Other indicators of CS (ie, conditioned pain modulation, temporal summation) did not change over time following either treatment, and in some occasions the observed changes were not in the expected direction. Patients receiving PNE with knee joint mobilization achieved greater improvements in psychosocial variables (pain catastrophizing, kinesiophobia) both before and after surgery. Preoperative PNE combined with knee joint mobilization did not produce any additional benefits over time for knee pain and disability, and CS measures compared with biomedical education with knee joint mobilization. Superior effects in the PNE with knee joint mobilization group were only observed for psychosocial variables related to pain catastrophizing and kinesiophobia.

  1. Randomized comparison between the combination of acetaminophen and ibuprofen and each constituent alone for analgesia following tonsillectomy in children.

    Science.gov (United States)

    Merry, Alan F; Edwards, Kylie-Ellen; Ahmad, Zahoor; Barber, Colin; Mahadevan, Murali; Frampton, Chris

    2013-12-01

    Combined acetaminophen and ibuprofen may be more effective than either constituent alone for pain in adults. The combination was compared with the individual constituents for analgesia following tonsillectomy in children. One hundred and fifty-two children (6-14 yr) undergoing tonsillectomy were randomized to receive either combination acetaminophen (48 mg·kg(-1)·day(-1)) and ibuprofen (24 mg·kg(-1)·day(-1)) or the same doses of acetaminophen alone or ibuprofen alone, every six hours for 48 hr. The primary outcome measure was a time-corrected area under the curve (AUCt) calculated from assessments on a 100-mm visual analogue scale (with Wong Baker FACES(®) as anchors). At each assessment the children rated pain while at rest and on swallowing at multiple time points over the study duration. Secondary outcome measures were a global pain rating, requirement for rescue analgesia, sleep disturbance, and frequency of adverse events. The mean [standard error of the mean (SEM)] AUCt values at rest were; combination 29.6 (1.9), acetaminophen 30.4 (2.0), ibuprofen 34 (1.9). The mean (SEM) AUCt values on swallowing were; combination 39.1 (2.0), acetaminophen 39.9 (2.0), ibuprofen 43.7 (1.9). The mean (95% confidence interval) differences in AUCt values between groups on swallowing were: combination vs acetaminophen -0.9 (-6.2 to 4.5); combination vs ibuprofen -4.6 (-9.9 to 0.67) and at rest were: combination vs acetaminophen -0.81 (-6.11 to 4.48); combination vs ibuprofen -4.37 (-9.62 to 0.88). Differences between groups were not clinically important for the pain scores, similarly for the secondary outcomes. The combination of ibuprofen and acetaminophen was not superior to its individual components in the regimen studied in this pediatric population undergoing tonsillectomy. The study was registered with the Australia New Zealand Clinical Trial Registry (ACTRN12607000005459) on January 4, 2007.

  2. Intrathecal Fentanyl Lidocaine combination for cesarean section: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Raji B

    2007-09-01

    Full Text Available Background: Spinal anesthesia can be associated with hemodynamic changes and some other complications. The aim of this study was to evaluate the effect of adding fentanyl to lidocaine on the spinal anesthesia time and its complications for cesarean section.Methods: Sixty pregnant women with gestational age of 37- 42 weeks and ASA physical status I and II undergoing elective cesarean section under spinal anesthesia were enrolled in a randomized double blinded clinical trial. They were randomly allocated to receive spinal anesthesia with lidocaine-normal saline (LS: 75 mg lidocaine 5% with 0.3 ml normal saline lidocaine-fentanyl (LF group (75 mg lidocaine 5% with 50 μg fentanyl. The duration of initiation of sensory block to achieve T4 level, time to return of sensory level to T12, time to first analgesic request, ephedrine requirement, nausea and vomiting during and after the surgery, pruritus, respirator depression, headache and apgar score of the new born  at 1st and 5th minutes were assessed. Results: There was no significant difference between time to achieve T4 level, ephedrine dose, post operative nausea and vomiting (PONV, pruritus and headache in study groups. Time to return of sensory level to T12 was significantly longer in LF group (152.6±14.7 vs. 66.2±11.2 min, P=0.0009. Time to first analgesic request was also longer in LF group (164.2±20.8 vs. 68.1±11.3 min, P=0.0009. The incidence of nausea and vomiting during surgery was significantly more in LF group (20% vs. 0%, P=0.023. No case of respiratory depression was observed in groups. The 1st and 5th minute's apgar score were comparable between groups and were between 7 and 10.Conclusions: Addition of fentanyl to intrathecal lidocaine in patients undergoing elective cesarean section results in increasing of the block duration and time to first analgesic request without significant maternal or neonatal side-effects, without effect on 1st and 5th minutes apgar score

  3. Combining rational and random strategies in β-glucosidase Zm-p60.1 protein library construction.

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    Dušan Turek

    Full Text Available Saturation mutagenesis is a cornerstone technique in protein engineering because of its utility (in conjunction with appropriate analytical techniques for assessing effects of varying residues at selected positions on proteins' structures and functions. Site-directed mutagenesis with degenerate primers is the simplest and most rapid saturation mutagenesis technique. Thus, it is highly appropriate for assessing whether or not variation at certain sites is permissible, but not necessarily the most time- and cost-effective technique for detailed assessment of variations' effects. Thus, in the presented study we applied the technique to randomize position W373 in β-glucosidase Zm-p60.1, which is highly conserved among β-glucosidases. Unexpectedly, β-glucosidase activity screening of the generated variants showed that most variants were active, although they generally had significantly lower activity than the wild type enzyme. Further characterization of the library led us to conclude that a carefully selected combination of randomized codon-based saturation mutagenesis and site-directed mutagenesis may be most efficient, particularly when constructing and investigating randomized libraries with high fractions of positive hits.

  4. Prevention of post-spinal hypotension using crystalloid, colloid and ephedrine with three different combinations: A double blind randomized study

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2012-01-01

    Full Text Available Background: The benefit of prophylactic combination therapy using crystalloid and colloid preload with ephedrine has not been cleared to prevent maternal hypotension after spinal anesthesia at cesarean delivery. This study evaluated the efficacy of three combinational methods to prevent hypotension following spinal anesthesia. Materials and Methods: In this prospective double blind trial, 150 candidates of elective cesarean delivery under spinal anesthesia were randomly allocated to three treatment groups; 1---Ringer′s Lactate (RL solution (15 ml/kg plus Hemaxel (7 ml/kg preload, 2---RL solution (15 ml/kg preload plus ephedrine (15 mg, IV, bolus, 3---Hemaxel (7 ml/kg preload plus ephedrine (15 mg, IV, bolus. Maternal hemodynamic changes during 60 min after spinal injection, nausea/vomiting, and neonatal condition were compared among the groups. Results: The cumulative incidence of hypotension was 44%, 40%, and 46% in groups 1 to 3, respectively. There were not significant differences in supplementary ephedrine requirement among groups which received or among groups which did not receive prophylactic ephedrine. Groups were not different in the incidence of hypertension and nausea or vomiting. There were no significant differences among groups in Apgar scores at 1 or 5 min and umbilical artery PH. Conclusion: Combination of preventive methods decreased the occurrence of hypotension following spinal anesthesia to an acceptable level. Overall, the most effective method was a combination of crystalloid preload with ephedrine.

  5. A Randomized Controlled Trial to Evaluate a Potential Hepatitis B Booster Vaccination Strategy Using Combined Hepatitis A and B Vaccine.

    Science.gov (United States)

    Li, Fangjun; Hu, Yuansheng; Zhou, Youming; Chen, Lixin; Xia, Wei; Song, Yufei; Tan, Zhengliang; Gao, Lidong; Yang, Zhong; Zeng, Gang; Han, Xing; Li, Junhua; Li, Jing

    2017-05-01

    Booster doses could play a major role in no responders or low responders to primary hepatitis B (HB) vaccine. Planed time point for hepatitis A vaccination in China provides a good opportunity to carry out HB booster dose by using combined hepatitis A and B vaccine. A randomized, double-blinded clinical trial was conducted to compare the immunogenicity and safety of toddlers 18-24 months of age receiving 3 different vaccination regimens: 2 doses of inactivated hepatitis A vaccine (group 1), 1 dose of inactivated hepatitis A vaccine plus 1 dose of combined hepatitis A and B vaccine (group 2) or 2 doses of combined hepatitis A and B vaccine (group 3). All 3 groups showed 100% seroprotection for antihepatitis A virus antibody after vaccination. Seroprotection rate for anti-HB antibody before vaccination ranged from 79.5% to 92.9% in the 3 groups. After second inoculation, anti-HBs seroprotection increased from 92.9% to 100% in group 2 with postvaccination geometric mean concentration (GMC) of 2258.3 mIU/mL and from 79.5% to 98.9% in group 3 with postvaccination GMC of 2055.3 mIU/mL. The adverse events were not statistically different among groups (P = 0.345). Combined hepatitis A and B vaccine could stimulate high level of both antihepatitis A virus and anti-HBs antibodies and not increase adverse events, providing a new choice for HB booster.

  6. Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients.

    Science.gov (United States)

    Hu, Ruiming; Xu, Feng; Sheng, Youyu; Qi, Sisi; Han, Yumei; Miao, Ying; Rui, Wenlong; Yang, Qinping

    2015-01-01

    Finasteride at 1 mg/day and 5% topical minoxidil are effective in male androgenetic alopecia (MAGA). However, studies describing their effects in Chinese individuals are scarce. 450 Chinese MAGA patients were randomly assigned to receive finasteride (n = 160), minoxidil (n = 130) and combined medication (n = 160) for 12 months. The patients returned to the clinic every 3 months for efficacy evaluation. And efficacy was evaluated in 428 men at treatment end, including 154, 122, and 152 in the finasteride, 5% minoxidil, and combination groups, respectively. All groups showed similar baseline characteristics, including age at enrollment, and duration and severity of alopecia (p > 0.05). At 12 months, 80.5, 59, and 94.1% men treated with finasteride, 5% minoxidil and the combination therapy showed improvement, respectively. Adverse reactions were rare (finasteride, 1.8%; minoxidil, 6.1%), and disappeared right after drug withdrawal. In conclusion, finasteride is superior to 5% minoxidil, while the combined medication showed the best efficacy. © 2015 Wiley Periodicals, Inc.

  7. Randomized clinical trial of artemisinin versus non-artemisinin combination therapy for uncomplicated falciparum malaria in Madagascar

    Directory of Open Access Journals (Sweden)

    Ratsimbasoa Arsène

    2007-05-01

    Full Text Available Abstract Background Data concerning antimalarial combination treatment for uncomplicated malaria in Madagascar are largely lacking. Randomized clinical trial was designed to assess therapeutic efficacies of chloroquine (CQ, amodiaquine (AQ, sulphadoxine-pyrimethamine (SP, amodiaquine plus sulphadoxine-pyrimethamine combination (AQ+SP and artesunate plus amodiaquine combination (AQ+AS. Methods 287 children between 6 months and 15 years of age, with uncomplicated falciparum malaria, were enrolled in the study. Primary endpoints were the day-14 and day-28 risks of parasitological failure, either unadjusted or adjusted by genotyping. Results All treatment regimens, except for CQ treatment, gave clinical cure rates above 97% by day-14 and 92% by day-28 (PCR-corrected. AQ+SP was as effective as AQ+AS. The risk of new infection within the month after therapy was generally higher for AQ+AS than AQ+SP. Conclusion These findings show that the inexpensive and widely available combination AQ+SP may be valuable in for the treatment of uncomplicated malaria in Madagascar and could have an important role in this country, where much of the drugs administered go to patients who do not have malaria.

  8. Triple combination as adjuvant to cryotherapy in the treatment of solar lentigines: investigator-blinded, randomized clinical trial.

    Science.gov (United States)

    Hexsel, D; Hexsel, C; Porto, M D; Siega, C

    2015-01-01

    Post-inflammatory hyperpigmentation is a frequent concern when treating solar lentigines. To assess the safety and efficacy of a triple combination cream with fluocinolone acetonide 0.01%, hydroquinone 4% and tretinoin 0.05% as adjuvant to cryotherapy in the treatment of solar lentigines in hands dorsum, and in the prevention of post-inflammatory hyperpigmentation after cryotherapy. This prospective, randomized, controlled, investigator-blinded, single-centre study enrolled 50 patients. Twenty-five patients received a 2-week daily triple combination cream plus sunscreen pre-treatment and 25 received sunscreen alone. After that, cryotherapy was performed in all patients followed by a 3-week recovery period. After this period, patients received the same initial treatment and were followed up for 8 weeks. Melanin and erythema levels of a target and a control lentigo were objectively measured using a narrowband reflectance spectrophotometer. Lentigines count, colour homogeneity and global improvement were also assessed. The number of solar lentigines reduced in the first 2 weeks only in patients who used the triple combination 25 ± 7 vs. 22 ± 8 (P cryotherapy were the reported adverse reactions. Triple combination cream can be used to enhance the resolution of solar lentigines, and to significantly reduce melanin levels and lentigines count, improving treatment results. It was well-tolerated and did not increase the occurrence of neither erythema nor other side-effects after the cryotherapy. © 2014 European Academy of Dermatology and Venereology.

  9. Predictors of remission in depression to individual and combined treatments (PReDICT: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Dunlop Boadie W

    2012-07-01

    -week course of treatment, during which they receive a combination of CBT and antidepressant medication. Predictors of the primary outcome, remission, will be identified for overall and treatment-specific effects, and a statistical model incorporating multiple predictors will be developed to predict outcomes. Discussion The PReDICT study’s evaluation of biological, psychological, and clinical factors that may differentially impact treatment outcomes represents a sizeable step toward developing personalized treatments for MDD. Identified predictors should help guide the selection of initial treatments, and identify those patients most vulnerable to recurrence, who thus warrant maintenance or combination treatments to achieve and maintain wellness. Trial registration Clinicaltrials.gov Identifier: NCT00360399. Registered 02 AUG 2006. First patient randomized 09 FEB 2007.

  10. Effect of health education combining diet and exercise supervision in Chinese women with perimenopausal symptoms: a randomized controlled trial.

    Science.gov (United States)

    Xi, S; Mao, L; Chen, X; Bai, W

    2017-04-01

    This study aimed to evaluate the effect of health education combining diet and exercise supervision on menopausal symptoms and diet/exercise habits. The randomized controlled study enrolled 60 patients with perimenopausal syndrome (Kupperman Menopause Index (KMI) score ≥15). The participants were randomized into either an intervention group (n = 30) or a control group (n = 30). Women were interviewed with questionnaires about perimenopausal symptoms, diet pattern and exercise habit. Their height and weight were measured. Women in the intervention group received health education, diet supervision and exercise supervision twice a week while those in the control group continued as normal. The total KMI score, scores of individual symptoms, diet pattern and exercise habit were measured after intervention. The total KMI score, the individual KMI scores for paresthesia, irritability, depression/suspicious, fatigue, arthralgia/myalgia, and palpitations of the intervention group were significantly lower compared with the control group after intervention. The intake of cereal, meat, fats and oils of the intervention group were significantly lower at week 12 compared with baseline. The percentage of women with a regular exercise habit was significantly higher in the intervention group than in the control group after intervention. Twelve weeks intervention of health education combining diet and exercise supervision could improve perimenopausal symptoms and help the patients establish good living habits.

  11. A randomized controlled trial of combined 5-fluorouracil and low-molecular-weight heparin in management of established proliferative vitreoretinopathy.

    Science.gov (United States)

    Charteris, David G; Aylward, G William; Wong, David; Groenewald, Carl; Asaria, Riaz H Y; Bunce, Catey

    2004-12-01

    To determine the efficacy of a combination of 5-fluorouracil and low-molecular-weight heparin (LMWH) to improve the outcome of surgery for established proliferative vitreoretinopathy (PVR). Double-masked, prospective, randomized, placebo-controlled clinical trial. Three tertiary-referral teaching hospital vitreoretinal surgical units. One hundred fifty-seven patients with established PVR (grade C, anterior or posterior) undergoing vitrectomy surgery. All patients underwent vitreoretinal surgery and silicone oil exchange with or without membrane peeling and/or retinectomy. Patients were randomly allocated to perioperative infusion with or without 5-fluorouracil (200 microg/ml) and LMWH (5 IU/ml) in Hartmann's solution for 1 hour. The primary outcome measure was defined as posterior retinal reattachment after removal of silicone oil without any reoperations at 6 months. Secondary outcome measures recorded were posterior retinal reattachment, localized/tractional retinal detachment, visual acuity, macular pucker, hypotony, glaucoma, keratopathy, and cataract. Removal of silicone oil and reoperations were also recorded. Overall, at 6 months 84% of patients had full retinal reattachment and 94% had stable posterior retinal reattachment. There was no significant difference in success in the primary outcome measure (56%, treatment group; 51%, placebo group; P = 0.59) or in secondary outcome measures or rates of complications. Secondary macular pucker occurred less often in the treatment group (6% vs. 17% at 6 months, P = 0.068). A perioperative infusion of combined 5-fluorouracil and LMWH does not significantly increase the success rate of vitreoretinal surgery for established PVR.

  12. Traditional Chinese medicine combination therapy for patients with steroid-dependent ulcerative colitis: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Zheng, Kai; Shen, Hong; Jia, Jia; Lu, Yuelin; Zhu, Lei; Zhang, Lu; Shen, Zhaofeng

    2017-01-10

    Approximately 20% of patients with ulcerative colitis become steroid dependent. Azathioprine is recommended in steroid-dependent ulcerative colitis, but its side effects limit its use. Chinese herbal medicine has been widely used to treat ulcerative colitis in China. However, its effectiveness in steroid-dependent patients has not been evaluated. This study aims to investigate the efficacy of traditional Chinese medicine combination therapy with 5-aminosalicylic acid in patients with steroid-dependent ulcerative colitis. This is a parallel, multicenter, randomized controlled trial. One hundred and twenty eligible patients will be randomly assigned to a traditional Chinese medicine group or azathioprine group. All patients will be given basic treatment, which includes steroids and 5-aminosalicylic acid. Patients allocated to the traditional Chinese medicine group will receive basic treatment plus Chinese herbal medicine granules, while patients in the azathioprine group will receive basic treatment plus azathioprine. The whole study will last 24 weeks. The primary outcome measure is the steroid-free remission rate. Secondary outcome measures are health-related quality of life, efficacy of endoscopic response, degree of mucosal healing, and inflammation indicators. Results from this study may provide evidence for the effectiveness of traditional Chinese medicine combined with 5-aminosalicylic acid in patients with steroid-dependent ulcerative colitis. The findings will provide a basis for further confirmatory studies. Chinese Clinical Trial Register, ChiCTR-IPR-15005760 . Registered on 2 January 2015.

  13. Effects of Duhuojisheng Tang and combined therapies on prolapse of lumbar intervertebral disc: a systematic review of randomized control trails.

    Science.gov (United States)

    Ma, Yanxu; Cui, Jingyan; Huang, Minghua; Meng, Kai; Zhao, Yuhao

    2013-04-01

    A systematic review of the literature was conducted to evaluate the curative effect and safety of Duhuojisheng Tang on prolapse of the lumbar intervertebral disc. The databases of PubMed, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Chinese Biomedical Literature Database (CBM) and Chinese Medical Citation Index (CMCI) were searched up to January 30, 2012. Randomized controlled trials were selected to compare Duhuojisheng Tang with one or more of the following treatments: traction, acupuncture, massage, cupping and Western medical treatment. The quality-evaluating standard and the software RevMan 5.1 in Cochrane coordinative net were used to analyze the data. The effective indexes of the results were clinical curative rate, effectiveness of alleviating clinical symptoms and adverse reaction. Thirty-one randomized controlled trials of low quality, involving 3915 patients were systematically evaluated. Statistical analyses showed that good curative effect was achieved in both the group using Duhuojisheng Tang alone and with combined therapies. Using Duhuojisheng Tang alone or combined with other therapies can effectively improve pain, leg-raising height and other clinical symptoms of patients with prolapse of lumbar intervertebral disc. Due to low methodological quality of the articles, no exact recommendations can be made.

  14. Randomized Phase II trial of nintedanib, afatinib and sequential combination in castration-resistant prostate cancer.

    Science.gov (United States)

    Molife, L Rhoda; Omlin, Aurelius; Jones, Rob J; Karavasilis, Vasilios; Bloomfield, David; Lumsden, Graeme; Fong, Peter C; Olmos, David; O'Sullivan, Joe M; Pedley, Ian; Hickish, Tamas; Jenkins, Peter; Thompson, Emilda; Oommen, Nikhil; Wheatley, Duncan; Heath, Catherine; Temple, Graham; Pelling, Katy; de Bono, Johann S

    2014-02-01

    The aim of this article was to evaluate afatinib (BIBW 2992), an ErbB family blocker, and nintedanib (BIBF 1120), a triple angiokinase inhibitor, in castration-resistant prostate cancer patients. Patients were randomized to receive nintedanib (250 mg twice daily), afatinib (40 mg once daily [q.d.]), or alternating sequential 7-day nintedanib (250 mg twice daily) and afatinib (70 mg q.d. [Combi70]), which was reduced to 40 mg q.d. (Combi40) due to adverse events. The primary end point was progression-free rate at 12 weeks. Of the 85 patients treated 46, 20, 16 and three received nintedanib, afatinib, Combi40 and Combi70, respectively. At 12 weeks, the progression-free rate was 26% (seven out of 27 patients) for nintedanib, and 0% for afatinib and Combi40 groups. Two patients had a ≥50% decline in PSA (nintedanib and the Combi40 groups). The most common drug-related adverse events were diarrhea, nausea, vomiting and lethargy. Nintedanib and/or afatinib demonstrated limited anti-tumor activity in unselected advanced castration-resistant prostate cancer patients.

  15. Combining double random phase encoding for color image watermarking in quaternion gyrator domain

    Science.gov (United States)

    Shao, Zhuhong; Duan, Yuping; Coatrieux, Gouenou; Wu, Jiasong; Meng, Jinyu; Shu, Huazhong

    2015-05-01

    Quaternion representation of color image has attracted great attention due to its capability to treat holistically the three color channels. In a more general way, it has successfully been used in multi-channel signal processing applications over the past few decades. In this study, a joint encryption/watermarking system with more security based on double random phase encoding (DRPE) in quaternion gyrator transform domain is addressed. In the proposed scheme, an RGB-scale watermark image together with a grayscale watermark image or not is encoded into a quaternion matrix and encrypted through the DRPE, the encrypted data is then fused into the middle coefficients of the quaternion gyrator-transformed host image. In the process of extracting watermarks, it is impossible to retrieve them without authorized keys. Compared with the three channels independently processing approach implemented in fractional Fourier domain, the proposed algorithm achieves lower complexity by reason of avoiding repetitive operations. Experimental results have demonstrated the feasibility of the proposed algorithm and its superior performance in terms of noise robustness.

  16. Combined olmesartan, amlodipine, and hydrochlorothiazide therapy in randomized patients with hypertension: a subgroup analysis of the TRINITY study by age.

    Science.gov (United States)

    Lewin, Andrew J; Izzo, Joseph L; Melino, Michael; Lee, James; Fernandez, Victor; Heyrman, Reinilde

    2013-07-01

    Hypertension is often inadequately controlled in older people. This prespecified subgroup analysis assessed the efficacy and safety of an olmesartan medoxomil (OM) 40 mg/amlodipine besylate (AML) 10 mg/hydrochlorothiazide (HCTZ) 25 mg triple-combination treatment compared with the 3 components as dual-combination treatments in participants with hypertension who were 9 %). Participants were randomized, stratified by age, diabetes status, and race to one of four treatment assignments: OM 40/AML 10/HCTZ 25 mg, OM 40/AML 10 mg, OM 40/HCTZ 25 mg, or AML 10/HCTZ 25 mg. Least squares (LS) mean change from baseline in seated diastolic blood pressure (SeDBP) at week 12 (last observation carried forward) in each age subgroup (prespecified analysis). Of the 2492 randomized participants in the study (total cohort), 2021 (81.1 %) were <65 and 471 (18.9 %) were ≥ 65 years of age, including 79 (3.2 %) who were ≥ 75 years of age. OM 40/AML 10/HCTZ 25 mg triple-combination treatment resulted in a significantly greater reduction in LS mean SeDBP at week 12 than dual-combination component treatments in participants in both cohorts: <65 years (21.0 vs. 14.2-17.2 mmHg; p < 0.0001) and ≥ 65 years (23.7 vs. 17.3-20.0 mmHg; p ≤ 0.002). Similarly, triple-combination treatment resulted in a greater reduction in LS mean seated systolic blood pressure (SeSBP) at week 12 than dual-combination component treatments: <65 years (38.2 vs. 28.3-31.4 mmHg; p < 0.0001) and ≥ 65 years (39.2 vs. 29.3-31.1 mmHg; p < 0.0001). Triple-combination treatment was more effective than dual-combination treatments in enabling participants to reach SeBP goal (<140/90 mmHg [<130/80 mmHg in participants with diabetes, chronic kidney disease, or chronic cardiovascular disease]) in both age subgroups (<65 years: 65 vs. 34-50 %, respectively, p < 0.0001 and ≥ 65 years: 63 vs. 32-39 %; p ≤ 0.0004). All 4 treatments were safe and well tolerated with low discontinuation rates in both age subgroups. There were

  17. Randomized Controlled Trial on the Effects of a Combined Sleep Hygiene Education and Behavioral Approach Program on Sleep Quality in Workers with Insomnia

    National Research Council Canada - National Science Library

    KAKU, Akiko; NISHINOUE, Nao; TAKANO, Tomoki; ETO, Risa; KATO, Noritada; ONO, Yutaka; TANAKA, Katsutoshi

    2012-01-01

    To evaluate the effects of a combined sleep hygiene education and behavioral approach program on sleep quality in workers with insomnia, we conducted a randomized controlled trial at a design engineering unit in Japan...

  18. Analytical linear theory for the interaction of a planar shock wave with a two- or three-dimensional random isotropic density field

    Science.gov (United States)

    Huete Ruiz de Lira, C.; Velikovich, A. L.; Wouchuk, J. G.

    2011-05-01

    We present an analytical linear model describing the interaction of a planar shock wave with an isotropic random pattern of density nonuniformities. This kind of interaction is important in inertial confinement fusion where shocks travel into weakly inhomogeneous cryogenic deuterium-wicked foams, and also in astrophysics, where shocks interact with interstellar density clumps. The model presented here is based on the exact theory of space and time evolution of the perturbed quantities generated by a corrugated shock wave traveling into a small-amplitude single-mode density field. Corresponding averages in both two and three dimensions are obtained as closed analytical expressions for the turbulent kinetic energy, acoustic energy flux, density amplification, and vorticity generation downstream. They are given as explicit functions of the two parameters (adiabatic exponent γ and shock strength M1) that govern the dynamics of the problem. In addition, these explicit formulas are simplified in the important asymptotic limits of weak and strong shocks and highly compressible fluids.

  19. Linear growth increased in young children in an urban slum of Haiti: a randomized controlled trial of a lipid-based nutrient supplement.

    Science.gov (United States)

    Iannotti, Lora L; Dulience, Sherlie Jean Louis; Green, Jamie; Joseph, Saminetha; François, Judith; Anténor, Marie-Lucie; Lesorogol, Carolyn; Mounce, Jacqueline; Nickerson, Nathan M

    2014-01-01

    Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children. We aimed to test the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children. Healthy, singleton infants aged 6-11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally. Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.

  20. Comparison of steroid-pulse therapy and combined with mizoribine in IgA nephropathy: a randomized controlled trial.

    Science.gov (United States)

    Masutani, Kosuke; Tsuchimoto, Akihiro; Yamada, Tomomi; Hirakawa, Makoto; Mitsuiki, Koji; Katafuchi, Ritsuko; Hirakata, Hideki; Kitazono, Takanari; Tsuruya, Kazuhiko

    2016-12-01

    The significance of immunosuppressants as an adjunct treatment with corticosteroids for IgA nephropathy (IgAN) has not been well demonstrated. This study was performed to compare two treatment regimens, steroid-pulse therapy or combined with mizoribine (MZR) in progressive IgAN. Study design was a prospective randomized controlled trial of 40 patients with moderate to severe glomerular injuries who were randomly administered either pulse methylprednisolone followed by a 25-month course of oral prednisolone (P group, n = 20) or in combination with MZR (150 mg/day for 24 months, M + P group, n = 20). The primary endpoint was a reduction of proteinuria by ≥50 % of the baseline value. Secondary endpoints were increased serum creatinine (Cr) by ≥50 %, or a decrease in estimated glomerular filtration rate by ≤50 %. Twenty-five months after the initiation of treatment, urinary protein excretion significantly declined from the median of 0.98 to 0.17 g/gCr in the P group (P proteinuria between two groups (P = 0.81). All patients reached the primary endpoint, and the cumulative incidence of the reduction of proteinuria was not significantly different (P = 0.76). No patient reached the secondary endpoint during the 25 months of treatment. Both therapeutic regimens significantly reduced the levels of proteinuria. We could not find the additional effect of MZR in combination with steroid-pulses in this small-scale controlled trial. Steroid-pulse therapy with a 25-month course of oral steroids seems to be effective for progressive IgAN.

  1. A randomized trial of upper limb botulimun toxin versus placebo injection, combined with physiotherapy, in children with hemiplegia.

    Science.gov (United States)

    Ferrari, Adriano; Maoret, Anna Rosa; Muzzini, Simonetta; Alboresi, Silvia; Lombardi, Francesco; Sgandurra, Giuseppina; Paolicelli, Paola Bruna; Sicola, Elisa; Cioni, Giovanni

    2014-10-01

    The main goal of this study was to investigate the efficacy of Botulinum Toxin A (BoNT-A), combined with an individualized intensive physiotherapy/orthoses treatment, in improving upper limb activity and competence in daily activity in children with hemiplegia, and to compare its effectiveness with that of non-pharmacological instruments. It was a Randomized Clinical Trial of 27 children with spastic hemiplegic cerebral palsy, outpatients of two high speciality Centres for child rehabilitation. Each child was assigned by simple randomization to experimental group (BoNT-A) or control group (placebo). Assisting Hand Assessment (AHA) was chosen as primary outcome measure; other measures were selected according to ICF dimensions. Participants were assessed at baseline (T0), at T1, T2, T3 (1-3-6 months after injection, respectively). Every patient was given a specific physiotherapeutic treatment, consisting of individualized goal directed exercises, task oriented activities, daily stretching manoeuvres, functional and/or static orthoses. BoNT-A group showed a significant increase of AHA raw scores at T2, compared to control group (T2-T0: p=.025) and functional goals achievement (GAS) was also slightly better in the same group (p=.033). Other measures indicated some improvement in both groups, without significant intergroup differences. Children with intermediate severity of hand function at House scale for upper limb impairment seem to have a better benefit from BoNT-A protocol. BoNT-A was effective in improving manipulation in the activity domain, in association with individualized goal-directed physiotherapy and orthoses; the combined treatment is recommended. The study brings more evidence for the efficacy of a combined treatment botulinum toxin injection-physiotherapy-orthoses, and it gives some suggestions for candidate selection and individualized treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Efficacy of an orlistat-resveratrol combination for weight loss in subjects with obesity: A randomized controlled trial.

    Science.gov (United States)

    Arzola-Paniagua, María Angélica; García-Salgado López, Enrique Raúl; Calvo-Vargas, Cesar G; Guevara-Cruz, Martha

    2016-07-01

    To evaluate the efficacy of an orlistat-resveratrol (O-R) combination in subjects with obesity over a 6-month period. This study was a double-blind, parallel, randomized controlled clinical trial. Patients fulfilling the selection criteria (age from 20 to 60 years and body mass index (BMI) ≥30 and ≤39.9 kg/m(2) ) consumed an energy-reduced diet with 500 fewer calories than their usual diet for 2 weeks. Then the participants were randomly assigned to four groups, placebo, resveratrol, orlistat, or O-R, and they consumed the energy-reduced diet for 6 months. The study consisted of seven visits. During each visit, a 24-h recall was performed, along with measurements of anthropometric and serum biochemical parameters. A total of 161 participants were selected. Of these, 84 participants completed the study. A significant weight loss of -6.82 kg (95% CI -8.37 to -5.26) was observed in the O-R group compared with -3.50 kg (-5.05 to -1.95, P = 0.021) in the placebo group. In contrast, the -6.02 kg (-7.68 to -4.36) orlistat and -4.68 kg (-6.64 to -2.71) resveratrol monotherapy losses did not significantly differ from the placebo. Significant decreases in BMI, waist circumference, fat mass, triglycerides, leptin, and leptin/adiponectin ratio were observed with the O-R combination. The O-R combination was the most effective weight loss treatment. © 2016 The Obesity Society.

  3. Nifurtimox-eflornithine combination therapy for second-stage Trypanosoma brucei gambiense sleeping sickness: a randomized clinical trial in Congo.

    Science.gov (United States)

    Priotto, Gerardo; Kasparian, Serena; Ngouama, Daniel; Ghorashian, Sara; Arnold, Ute; Ghabri, Salah; Karunakara, Unni

    2007-12-01

    Human African trypanosomiasis caused by Trypanosoma brucei gambiense is a fatal disease. Current treatment options for patients with second-stage disease are either highly toxic or impracticable in field conditions. We compared the efficacy and safety of the nifurtimox-eflornithine drug combination with the standard eflornithine regimen for the treatment of second-stage disease. A randomized, open-label, active-control, phase III clinical trial comparing 2 arms was conducted at the Sleeping Sickness Treatment Center, which was run by Medecins Sans Frontieres, in Nkayi, Bouenza Province, Republic of Congo. Patients were screened for inclusion and randomly assigned to receive eflornithine alone (400 mg/kg per day given intravenously every 6 h for 14 days) or eflornithine (400 mg/kg per day given intravenously every 12 h for 7 days) plus nifurtimox (15 mg/kg per day given orally every 8 h for 10 days). Patients were observed for 18 months. The study's outcomes were cure and adverse events attributable to treatment. A total of 103 patients with second-stage disease were enrolled. Cure rates were 94.1% for the eflornithine group and 96.2% for the nifurtimox-eflornithine group. Drug reactions were frequent in both arms, and severe reactions affected 25.5% of patients in the eflornithine group and 9.6% of those in the nifurtimox-eflornithine group, resulting in 2 and 1 treatment suspensions, respectively. There was 1 death in the eflornithine arm and no deaths in the nifurtimox-eflornithine arm. The nifurtimox-eflornithine combination appears to be a promising first-line therapy for second-stage sleeping sickness. If our findings are corroborated by ongoing findings from additional sites (a multicenter extension of this study), the new nifurtimox-eflornithine combination therapy will mark a major and multifaceted advance over current therapies.

  4. Amp-PCR: combining a random unbiased Phi29-amplification with a specific real-time PCR, performed in one tube to increase PCR sensitivity.

    Directory of Open Access Journals (Sweden)

    Lena Erlandsson

    Full Text Available In clinical situations where a diagnostic real-time PCR assay is not sensitive enough, leading to low or falsely negative results, or where detection earlier in a disease progression would benefit the patient, an unbiased pre-amplification prior to the real-time PCR could be beneficial. In Amp-PCR, an unbiased random Phi29 pre-amplification is combined with a specific real-time PCR reaction. The two reactions are separated physically by a wax-layer (AmpliWax® and are run in sequel in the same sealed tube. Amp-PCR can increase the specific PCR signal at least 100×10(6-fold and make it possible to detect positive samples normally under the detection limit of the specific real-time PCR. The risk of contamination is eliminated and Amp-PCR could replace nested-PCR in situations where increased sensitivity is needed e.g. in routine PCR diagnostic analysis. We show Amp-PCR to work on clinical samples containing circular and linear viral dsDNA genomes, but can work well on DNA of any origin, both from non-cellular (virus and cellular sources (bacteria, archae, eukaryotes.

  5. Combining Text Messaging and Telephone Counseling to Increase Varenicline Adherence and Smoking Abstinence Among Cigarette Smokers Living with HIV: A Randomized Controlled Study.

    Science.gov (United States)

    Tseng, Tuo-Yen; Krebs, Paul; Schoenthaler, Antoinette; Wong, Selena; Sherman, Scott; Gonzalez, Mirelis; Urbina, Antonio; Cleland, Charles M; Shelley, Donna

    2017-07-01

    Smoking represents an important health risk for people living with HIV (PLHIV). Low adherence to smoking cessation pharmacotherapy may limit treatment effectiveness. In this study, 158 participants recruited from three HIV care centers in New York City were randomized to receive 12-weeks of varenicline (Chantix) either alone as standard care (SC) or in combination with text message (TM) support or TM plus cell phone-delivered adherence-focused motivational and behavioral therapy (ABT). Generalized linear mixed-effect models found a significant decline in varenicline adherence from week 1-12 across treatment groups. At 12-weeks, the probability of smoking abstinence was significantly higher in SC+TM+ABT than in SC. The study demonstrates the feasibility of delivering adherence-focused interventions to PLHIV who smoke. Findings suggest intensive behavioral support is an important component of an effective smoking cessation intervention for this population, and a focus on improving adherence self-efficacy may lead to more consistent adherence and higher smoking abstinence.

  6. Combined Interval Training and Post-exercise Nutrition in Type 2 Diabetes: A Randomized Control Trial.

    Science.gov (United States)

    Francois, Monique E; Durrer, Cody; Pistawka, Kevin J; Halperin, Frank A; Chang, Courtney; Little, Jonathan P

    2017-01-01

    Background: High-intensity interval training (HIIT) can improve several aspects of cardiometabolic health. Previous studies have suggested that adaptations to exercise training can be augmented with post-exercise milk or protein consumption, but whether this nutritional strategy can impact the cardiometabolic adaptations to HIIT in type 2 diabetes is unknown. Objective: To determine if the addition of a post-exercise milk or protein beverage to a high-intensity interval training (HIIT) intervention improves cardiometabolic health in individuals with type 2 diabetes. Design: In a proof-of-concept, double-blind clinical trial 53 adults with uncomplicated type 2 diabetes were randomized to one of three nutritional beverages (500 mL skim-milk, macronutrient control, or flavored water placebo) consumed after exercise (3 days/week) during a 12 week low-volume HIIT intervention. HIIT involved 10 X 1-min high-intensity intervals separated by 1-min low-intensity recovery periods. Two sessions per week were cardio-based (at ~90% of heart rate max) and one session involved resistance-based exercises (at RPE of 5-6; CR-10 scale) in the same interval pattern. Continuous glucose monitoring (CGM), glycosylated hemoglobin (HbA1c), body composition (dual-energy X-ray absorptiometry), cardiorespiratory fitness ([Formula: see text]), blood pressure, and endothelial function (%FMD) were measured before and after the intervention. Results: There were significant main effects of time (all p 0.71) for CGM 24-h mean glucose (-0.5 ± 1.1 mmol/L), HbA1c (-0.2 ± 0.4%), percent body fat (-0.8 ± 1.6%), and lean mass (+1.1 ± 2.8 kg). Similarly, [Formula: see text] (+2.5 ± 1.6 mL/kg/min) and %FMD (+1.4 ± 1.9%) were increased, and mean arterial blood pressure reduced (-6 ± 7 mmHg), after 12 weeks of HIIT (all p 0.11). Conclusion: High-intensity interval training is a potent stimulus for improving several important metabolic and cardiovascular risk factors in type 2 diabetes. The benefits of

  7. Combined Interval Training and Post-exercise Nutrition in Type 2 Diabetes: A Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Monique E. Francois

    2017-07-01

    Full Text Available Background: High-intensity interval training (HIIT can improve several aspects of cardiometabolic health. Previous studies have suggested that adaptations to exercise training can be augmented with post-exercise milk or protein consumption, but whether this nutritional strategy can impact the cardiometabolic adaptations to HIIT in type 2 diabetes is unknown.Objective: To determine if the addition of a post-exercise milk or protein beverage to a high-intensity interval training (HIIT intervention improves cardiometabolic health in individuals with type 2 diabetes.Design: In a proof-of-concept, double-blind clinical trial 53 adults with uncomplicated type 2 diabetes were randomized to one of three nutritional beverages (500 mL skim-milk, macronutrient control, or flavored water placebo consumed after exercise (3 days/week during a 12 week low-volume HIIT intervention. HIIT involved 10 X 1-min high-intensity intervals separated by 1-min low-intensity recovery periods. Two sessions per week were cardio-based (at ~90% of heart rate max and one session involved resistance-based exercises (at RPE of 5–6; CR-10 scale in the same interval pattern. Continuous glucose monitoring (CGM, glycosylated hemoglobin (HbA1c, body composition (dual-energy X-ray absorptiometry, cardiorespiratory fitness (V˙O2peak, blood pressure, and endothelial function (%FMD were measured before and after the intervention.Results: There were significant main effects of time (all p < 0.05 but no difference between groups (Interaction: all p > 0.71 for CGM 24-h mean glucose (−0.5 ± 1.1 mmol/L, HbA1c (−0.2 ± 0.4%, percent body fat (−0.8 ± 1.6%, and lean mass (+1.1 ± 2.8 kg. Similarly, V˙O2peak (+2.5 ± 1.6 mL/kg/min and %FMD (+1.4 ± 1.9% were increased, and mean arterial blood pressure reduced (−6 ± 7 mmHg, after 12 weeks of HIIT (all p < 0.01 with no difference between beverage groups (Interaction: all p > 0.11.Conclusion: High-intensity interval training is a

  8. Internal correction of spectral interferences and mass bias for selenium metabolism studies using enriched stable isotopes in combination with multiple linear regression.

    Science.gov (United States)

    Lunøe, Kristoffer; Martínez-Sierra, Justo Giner; Gammelgaard, Bente; Alonso, J Ignacio García

    2012-03-01

    The analytical methodology for the in vivo study of selenium metabolism using two enriched selenium isotopes has been modified, allowing for the internal correction of spectral interferences and mass bias both for total selenium and speciation analysis. The method is based on the combination of an already described dual-isotope procedure with a new data treatment strategy based on multiple linear regression. A metabolic enriched isotope ((77)Se) is given orally to the test subject and a second isotope ((74)Se) is employed for quantification. In our approach, all possible polyatomic interferences occurring in the measurement of the isotope composition of selenium by collision cell quadrupole ICP-MS are taken into account and their relative contribution calculated by multiple linear regression after minimisation of the residuals. As a result, all spectral interferences and mass bias are corrected internally allowing the fast and independent quantification of natural abundance selenium ((nat)Se) and enriched (77)Se. In this sense, the calculation of the tracer/tracee ratio in each sample is straightforward. The method has been applied to study the time-related tissue incorporation of (77)Se in male Wistar rats while maintaining the (nat)Se steady-state conditions. Additionally, metabolically relevant information such as selenoprotein synthesis and selenium elimination in urine could be studied using the proposed methodology. In this case, serum proteins were separated by affinity chromatography while reverse phase was employed for urine metabolites. In both cases, (74)Se was used as a post-column isotope dilution spike. The application of multiple linear regression to the whole chromatogram allowed us to calculate the contribution of bromine hydride, selenium hydride, argon polyatomics and mass bias on the observed selenium isotope patterns. By minimising the square sum of residuals for the whole chromatogram, internal correction of spectral interferences and mass

  9. Ozone Gas Bath Combined with Endovenous Laser Therapy for Lower Limb Venous Ulcers: A Randomized Clinical Trial.

    Science.gov (United States)

    Zhou, Yi-Ting; Zhao, Xu-Dong; Jiang, Jian-Wei; Li, Xin-Sheng; Wu, Zhen-Hai

    2016-10-01

    Endovenous laser therapy (EVLT) is safe and effective for lower limb venous ulcers. However, severe necrosis and infection in the ulcer area are contraindications of puncture and EVLT. Local bath with ozone gas has been shown to improve the condition of ulcer areas. The aim of this study was to evaluate the clinical efficacy of ozone gas bath combined with EVLT in comparison with EVLT alone for the treatment for lower limb venous ulcers. Ninety-two patients with venous ulcers were randomized to receive ozone gas bath combined with EVLT (OEVLT group) or EVLT alone (EVLT group). In the OEVLT group, the venous ulcers were preconditioned with ozone gas bath prior to EVLT. The minimum follow-up time was 12 months. The two groups were compared in terms of complete occlusion of the treated veins, ulcer healing ratio, ratio of ulcer recurrence, patient satisfaction, complications, and side effects. There was no significant difference in venous occlusion between the two groups. The ratio of ulcer healing in the OEVLT group was significantly higher than the EVLT group at 12 months follow-up. Patients in the OEVLT group showed better satisfaction and a lower recurrence ratio than the OEVLT group. No severe complications or side effects occurred in either groups. Ozone gas bath combined with EVLT showed improved efficacy for the treatment of lower limb venous ulcers and lower recurrence ratio comparison with EVLT alone. This procedure is a safe and technically feasible.

  10. Combined laser acupuncture and desmopressin for treating resistant cases of monosymptomatic nocturnal enuresis: a randomized comparative study.

    Science.gov (United States)

    Moursy, Essam Eldin S; Kamel, Naglaa F; Kaseem, Ahmed F

    2014-12-01

    Monosymptomatic nocturnal enuresis (MNE) is a common sociomedical problem affecting children that may persist until adulthood despite various lines of therapy. The aim of this study was to assess the efficacy of combined laser acupuncture and desmopressin in managing patients with resistant MNE, compared with their efficacy when used as monotherapy. The study included 186 patients with a mean age of 15.7 years (range 10-21 years) presenting with persistent MNE. All patients were evaluated clinically and investigated with urine analysis, plain X-ray of the urinary tract and abdominal ultrasonography. They were randomized into three equal groups based on the line of management: group A, managed with laser acupuncture alone; group B, managed with desmopressin alone; and group C, managed with a combination of laser acupuncture and desmopressin, with a treatment course of 3 months and follow-up period of 6 months to record the efficacy of therapy, side-effects and bladder capacity. A statistically significant higher cure rate was reported in group C patients, being reported in 33, 35 and 46 patients in groups A, B and C, respectively. Improvement was reported in 18, 17 and 13 cases in groups A, B and C, respectively, but the difference was not statistically significant. Bladder capacity significantly increased only in patients receiving acupuncture (groups A and C). Combined laser acupuncture and desmopressin is a promising and valid option to manage resistant cases of MNE.

  11. A Masked, Randomized, Phase 3 Comparison of Triple Fixed-Combination Bimatoprost/Brimonidine/Timolol versus Fixed-Combination Brimonidine/Timolol for Lowering Intraocular Pressure

    Directory of Open Access Journals (Sweden)

    Curt Hartleben

    2017-01-01

    Full Text Available Objective. To evaluate the efficacy and safety of triple fixed-combination bimatoprost 0.01%/brimonidine 0.15%/timolol 0.5% (TFC versus dual fixed-combination brimonidine 0.2%/timolol 0.5% (DFC in primary open-angle glaucoma and ocular hypertension. Methods. Patients with intraocular pressure (IOP ≥23 and ≤34 mmHg were randomized to twice-daily TFC or DFC. The primary variable is the change in worse eye mean IOP from baseline at week 12 (modified intent-to-treat (mITT population. Secondary endpoints are mean IOP and mean change from baseline at weeks 1, 2, 4, 8, and 12 (mITT population. TFC superiority was demonstrated if the primary variable favored TFC (p≤0.05. Sensitivity analyses were conducted, and safety was assessed at all visits. Results. TFC (n=93 provided greater IOP reductions from baseline than DFC (n=97 at week 12 (treatment difference, 0.85 mmHg; p=0.028 and all other visits. TFC was also superior to DFC in patients with high baseline IOP (i.e., IOP ≥ 25 mmHg; p≤0.011. Conjunctival hyperemia, ocular irritation, and dry eye were reported more often with TFC (p≤0.016; however, discontinuations for ocular adverse events were similar between treatments. Conclusions. TFC demonstrated IOP-lowering benefits that outweigh the risk of predominantly mild ocular side effects, which may be particularly relevant in patients who require greater IOP lowering to prevent/delay disease progression. This trial is registered with ClinicalTrials.gov registry number: NCT01241240.

  12. Randomized comparison of bleeding patterns in women using a combined contraceptive vaginal ring or a low-dose combined oral contraceptive on a menstrually signaled regimen.

    Science.gov (United States)

    Weisberg, Edith; Merki-Feld, Gabriele S; McGeechan, Kevin; Fraser, Ian S

    2015-02-01

    To compare bleeding patterns for 12 months continuous use of a contraceptive ring [contraceptive vaginal ring (CVR)] and pill [combined oral contraceptive (COC)] on a menstrually signaled regimen and the effectiveness of 4 days "treatment withdrawal" to stop bleeding. Women, 66 to each group, were randomized to continuous use of a CVR (15 mcg ethinyl estradiol/150 mcg etonogestrel) or a low-dose pill (20 mcg ethinyl estradiol/100 mcg levonorgestrel) for 360 days on a menstrually signaled regimen. Bleeding/spotting days, daily use of ring or pill, was recorded. Endpoint was the total number of bleeding/spotting days for each method over four 90-day reference periods (RP) plus the analysis of bleeding patterns using modified World Health Organization criteria. There was a reduction in the mean (±S.D.) number of bleeding/spotting days from RP1 (CVR 14.2±10; pill 16.6±10.9) to RP4 (CVR 8.8±9.6; pill 8.8±9.1). Fifteen percent of CVR and 4% COC users experienced amenorrhea or infrequent bleeding throughout the study. Amenorrhea increased over time (RP1 vs. RP4: CVR 10% vs. 21% and COC 2% vs. 30%). Compliance with the menstrually signaled regimen was poor. Ceasing hormones for 4 days stopped a bleeding episode within 5 days in the majority of episodes and many stopped spontaneously. Bleeding patterns with continuous use of the CVR and COC are similar and improve over 1 year of use. The unpredictability, but short duration, of bleeding episodes should be stressed during counseling. This information for clinicians and women about breakthrough bleeding patterns with use of a CVR or combined pill over 12 months using a menstrually signaled regimen will give women an indication of what to expect with continuous use. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. LANTERN: a randomized study of QVA149 versus salmeterol/fluticasone combination in patients with COPD

    Directory of Open Access Journals (Sweden)

    Zhong N

    2015-06-01

    Full Text Available Nanshan Zhong,1 Changzheng Wang,2 Xiangdong Zhou,3 Nuofu Zhang,1 Michael Humphries,4 Linda Wang,4 Chau Thach,5 Francesco Patalano,6 Donald Banerji5On behalf of the LANTERN Investigators 1State Key Laboratory of Respiratory Diseases, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 2Institute of Respiratory Disease, Xin Qiao Hospital, 3Department of Respiratory Medicine, Southwest Hospital, Third Military Medical University, Chongqing City, Chongqing, 4Beijing Novartis Pharma Co. Ltd., Shanghai, People’s Republic of China; 5Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA; 6Novartis Pharma AG, Basel, SwitzerlandBackground: The current Global initiative for chronic Obstructive Lung Disease (GOLD treatment strategy recommends the use of one or more bronchodilators according to the patient’s airflow limitation, their history of exacerbations, and symptoms. The LANTERN study evaluated the effect of the long-acting β2-agonist (LABA/long-acting muscarinic antagonist (LAMA dual bronchodilator, QVA149 (indacaterol/glycopyrronium, as compared with the LABA/inhaled corticosteroid, salmeterol/fluticasone (SFC, in patients with moderate-to-severe COPD with a history of ≤1 exacerbation in the previous year.Methods: In this double-blind, double-dummy, parallel-group study, 744 patients with moderate-to-severe COPD with a history of ≤1 exacerbations in the previous year were randomized (1:1 to QVA149 110/50 µg once daily or SFC 50/500 µg twice daily for 26 weeks. The primary endpoint was noninferiority of QVA149 versus SFC for trough forced expiratory volume in 1 second (FEV1 at week 26.Results: Overall, 676 patients completed the study. The primary objective of noninferiority between QVA149 and SFC in trough FEV1 at week 26 was met. QVA149 demonstrated statistically significant superiority to SFC for trough FEV1 (treatment difference [∆]=75 mL; P<0.001. QVA149 demonstrated a statistically significant

  14. Virtual In-Silico Modeling Guided Catheter Ablation Predicts Effective Linear Ablation Lesion Set for Longstanding Persistent Atrial Fibrillation: Multicenter Prospective Randomized Study

    Directory of Open Access Journals (Sweden)

    Jaemin Shim

    2017-10-01

    Full Text Available Objective: Radiofrequency catheter ablation for persistent atrial fibrillation (PeAF still has a substantial recurrence rate. This study aims to investigate whether an AF ablation lesion set chosen using in-silico ablation (V-ABL is clinically feasible and more effective than an empirically chosen ablation lesion set (Em-ABL in patients with PeAF.Methods: We prospectively included 108 patients with antiarrhythmic drug-resistant PeAF (77.8% men, age 60.8 ± 9.9 years, and randomly assigned them to the V-ABL (n = 53 and Em-ABL (n = 55 groups. Five different in-silico ablation lesion sets [1 pulmonary vein isolation (PVI, 3 linear ablations, and 1 electrogram-guided ablation] were compared using heart-CT integrated AF modeling. We evaluated the feasibility, safety, and efficacy of V-ABL compared with that of Em-ABL.Results: The pre-procedural computing time for five different ablation strategies was 166 ± 11 min. In the Em-ABL group, the earliest terminating blinded in-silico lesion set matched with the Em-ABL lesion set in 21.8%. V-ABL was not inferior to Em-ABL in terms of procedure time (p = 0.403, ablation time (p = 0.510, and major complication rate (p = 0.900. During 12.6 ± 3.8 months of follow-up, the clinical recurrence rate was 14.0% in the V-ABL group and 18.9% in the Em-ABL group (p = 0.538. In Em-ABL group, clinical recurrence rate was significantly lower after PVI+posterior box+anterior linear ablation, which showed the most frequent termination during in-silico ablation (log-rank p = 0.027.Conclusions: V-ABL was feasible in clinical practice, not inferior to Em-ABL, and predicts the most effective ablation lesion set in patients who underwent PeAF ablation.

  15. Self-consistent linear-muffin-tin-orbitals coherent-potential technique for bulk and surface calculations: Cu-Ni, Ag-Pd, and Au-Pt random alloys

    DEFF Research Database (Denmark)

    Abrikosov, I. A.; Skriver, Hans Lomholt

    1993-01-01

    We present an efficient technique for calculating surface properties of random alloys based on the coherent-potential approximation within a tight-binding linear-muffin-tin-orbitals basis. The technique has been applied in the calculation of bulk thermodynamic properties as well as (001) surface...

  16. Duloxetine-bupropion combination for treatment-resistant atypical depression: a double-blind, randomized, placebo-controlled trial.

    Science.gov (United States)

    Fornaro, Michele; Martino, Matteo; Mattei, Chiara; Prestia, Davide; Vinciguerra, Valentina; De Berardis, Domenico; De Pasquale, Concetta; Iasevoli, Felice; Mungo, Sergio; Fornaro, Pantaleo

    2014-08-01

    The efficacy, safety, and tolerability of combined bupropion versus placebo using duloxetine as active reference drug, in patients with a DSM-IV diagnosis of major depression with atypical features and a history of treatment resistance, were evaluated in this preliminary six-week study. Patients (n=46) had a baseline Hamilton Depression Scale (HAM-D) ≥14 and were randomly assigned to 150/300 mg/day bupropion vs. placebo, which was added to 60 to 120 mg/day duloxetine depending on baseline depression severity. Atypical features of depression were assessed using the additional eight-item module of the Structured Interview Guide for the HAM-D with the Atypical Depression Supplement. By week 6, only five (21.7%) patients receiving duloxetine+placebo vs. six (26.1%) patients on the bupropion combination achieved response. No significant difference in final HAM-D scores between the two groups was observed between those patients achieving response. The presence of a higher number of atypical features significantly predicted non-response, with the relevant binary logistic regression model correctly classifying 17 out 22 (77.3%) of non-responders [Exp(B)=0.294; p=0.016] vs. 17 out 23 (73.9%) [Exp(B)=0.353; p=0.028] non-responder cases in the "+placebo" and "+bupropion" groups, respectively. In those patients receiving bupropion, treatment-emergent adverse events leading to withdrawal were more common among those receiving lower doses of the combination drug, and no life-threating dangers were noted. Additional studies, including an adequate course of duloxetine trial, are nonetheless aimed to allow a firm conclusion about the usefulness of the combination of duloxetine and bupropion for treatment-resistant cases of major depression with atypical features. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

  17. Flutamide versus a cyproterone acetate-ethinyl estradiol combination in moderate acne: a pilot randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Adalatkhah H

    2011-07-01

    Full Text Available Hassan Adalatkhah1, Farhad Pourfarzi2, Homayoun Sadeghi-Bazargani31Department of Dermatology, 2Department of Social Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil; 3Statistics and Epidemiology Department, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, IranBackground: The use of oral flutamide is rarely investigated in acne therapy. The aim of this study was to compare the efficacy of oral flutamide with that of a cyproterone-estradiol combination in treating acne lesions.Methods: A randomized clinical trial enrolled patients with moderate acne into two equal groups to receive either oral flutamide or the cyproterone-estradiol combination for 6 months. Lesion count, Acne Severity Index, and Global Acne Grading system (GAGS scores were used to assess improvement in acne lesions. The dichotomous measurement scale for primary endpoint assessment was defined as improvement from moderate to mild acne based on GAGS score. Patient satisfaction and dermal fat were also assessed. Intention to treat and per protocol analyses were done, reporting related effect sizes.Results: Both treatments resulted in substantial improvement in acne lesions. Although flutamide seemed to have higher efficacy, an intention to treat analysis did not find the two treatment protocols to be different. The relative risk in intention to treat analysis was 1.8 (95% confidence interval [CI] 0.89–1.6, and was 1.33 (95% CI 1.03–1.72 for the per protocol analysis. The number needed to treat for flutamide compared with the cyproterone-estradiol combination was 7.7 and 4.2 in the intention to treat and per protocol analyses, respectively.Conclusion: Flutamide appears to be more effective than a cyproterone-estradiol combination in some aspects of acne treatment, but this requires confirmation in a larger trial.Keywords: acne vulgaris, flutamide, cyproterone acetate, ethinyl estradiol, androgen antagonists

  18. Combination of music with lifestyle modification versus lifestyle modification alone on blood pressure reduction - A randomized controlled trial.

    Science.gov (United States)

    Kunikullaya, Kirthana Ubrangala; Goturu, Jaisri; Muradi, Vijayadas; Hukkeri, Preethi Avinash; Kunnavil, Radhika; Doreswamy, Venkatesh; Prakash, Vadagenahalli S; Murthy, Nandagudi Srinivasa

    2016-05-01

    To evaluate the change in blood pressure (BP) after 3 months of music intervention combined with lifestyle modifications, in comparison with conventional lifestyle modifications. A Prospective randomized control trial was conducted on hundred prehypertensives or stage I hypertensives who were randomly divided into two groups (n = 50 each). Both the groups were given lifestyle modifications while one had added music intervention (raga bhimpalas) for 3 months. Main outcome measures were 24 h ambulatory BP monitoring, stress levels, and biomarkers of hypertension. Mean (SD) of diastolic BP (DBP) pre and post intervention were overall = 85.1(6.8) and 83(8.7){P = 0.004}, awake = 87.7(7.6) and 85.9(9.2){P = 0.021}. Regression analysis showed association between diastolic BP change and post-intervention stress score in the music intervention group. Significant change in BP was seen among those who were prehypertensives prior to intervention. Music decreased DBP and when used as an adjunct benefitted subjects with initial BP in prehypertension range. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Effect of combining multiple micronutrients with iron supplementation on Hb response in children: systematic review of randomized controlled trials.

    Science.gov (United States)

    Gera, Tarun; Sachdev, Harsh Pal Singh; Nestel, Penelope

    2009-06-01

    To study the effect of combining multiple (two or more) micronutrients with Fe supplementation on Hb response, when compared with placebo and with Fe supplementation, in children. Electronic databases, personal files, hand search of reviews, bibliographies of books, and abstracts and proceedings of international conferences. Randomized controlled trials evaluating change in Hb levels with interventions that included Fe and multiple-micronutrient supplementation in comparison to placebo alone or Fe alone were analysed in two systematic reviews. Twenty-five trials were included in the review comparing Fe and micronutrient supplementation with placebo. The pooled estimate (random effects model) for change in Hb with Fe and micronutrient supplementation (weighted mean difference) was 0.65 g/dl (95 % CI 0.50, 0.80, P micronutrients' and malarial non-hyperendemic region were significant predictors of greater Hb response and heterogeneity. Thirteen trials were included in the review comparing Fe and micronutrient supplementation with Fe alone. The pooled estimate for change in Hb with Fe and micronutrient supplementation (weighted mean difference) was 0.14 g/dl (95 % CI 0.00, 0.28, P = 0.04). None of the variables were found to be significant predictors of Hb response. Synthesized evidence indicates that addition of multiple micronutrients to Fe supplementation may only marginally improve Hb response compared with Fe supplementation alone. However, addition of 'other micronutrients' may have a negative effect. Routine addition of unselected multiple micronutrients to Fe therefore appears unjustified for nutritional anaemia control programmes.

  20. Progressive muscle relaxation combined with Chinese medicine five-element music on depression for cancer patients: A randomized controlled trial.

    Science.gov (United States)

    Liao, Juan; Wu, Yu; Zhao, Yang; Zhao, Yuan-Chen; Zhang, Xu; Zhao, Nan; Lee, Chun-Ging; Yang, Yu-Fei

    2017-05-11

    To evaluate the effects of progressive muscle relaxation training (PMRT) combined with fifive elements music therapy of Chinese medicine (CM) for improving anxiety and depression of cancer patients. From June 2015 to March 2016, 60 cancer patients were included into the study. The patients were randomly assigned to a control group and a treatment group by envelope randomization, receiving PMRT and PMRT plus CM five elements music therapy, respectively, for 8 weeks. Hospital Anxiety and Depression Scale (HADS), Benefit Finding Scales (BFS), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), and Intervention Expectations Questionnaire (IEQU) were adopted to assess the depression of the two groups before and after the treatment. Four cases dropped out during the study, and 29 cases in the treatment group and 27 in the control group were included in the fifinal analysis. Prior to the treatments, the baselines of the 4 questionnaires in the two groups showed no difference. After the 8-week treatment, the treatment group presented better levels of HADS, BFS and FACIT-Sp scores compared with the control group (Pmusic therapy mitigated anxiety and depression of cancer patients. Cancer patients have been found to respond well to psychological intervention in areas regarding stabilisation of emotions, disease awareness, and therapeutic compliance. This brings about a great difference in improving their quality of life and psychological state, offers an effective approach to better self-management in cancer treatment.

  1. Treatment of panic disorder with agoraphobia: randomized placebo-controlled trial of four psychosocial treatments combined with imipramine or placebo.

    Science.gov (United States)

    Marchand, Andre; Coutu, Marie-France; Dupuis, Gilles; Fleet, Richard; Borgeat, Francois; Todorov, Christo; Mainguy, Nicole

    2008-01-01

    Few randomized controlled trials have included panic disorder patients with moderate to severe agoraphobia. Therefore, this population was studied using pharmacotherapy as well as psychotherapy. At the time of the study, imipramine was widely used as a pharmacological treatment. Also, current practice guidelines for patients with panic disorder find selective serotonin reuptake inhibitors and tricyclic antidepressants roughly comparable in terms of efficacy. Therefore, the main objective of this study is to compare four psychosocial treatments-cognitive and graded in vivo exposure treatments, graded in vivo exposure, cognitive treatment, and supportive therapy-to evaluate the benefits of combining cognitive therapy with exposure in vivo. These treatments were combined with imipramine or placebo for a total of eight experimental conditions. Participants presented moderate to severe agoraphobia. The method involved a randomized, double-blind, placebo-controlled trial with 137 participants who completed a 14-session protocol involving the treatments just mentioned. Measures were taken at baseline and posttreatment and at 3-, 6-, and 12-month follow-up. All treatment conditions were statistically and clinically effective in reducing self-reported panic-agoraphobia symptoms over the 1-year follow-up. No statistical differences were observed between imipramine and placebo conditions. This study found that all treatment modalities helped reduce panic and agoraphobic symptomatology over a 1-year follow-up period. These surprising results support the need to document the relations among the various components of an intervention. This would make it possible to assess the relative efficacy of the treatment components rather than of the intervention as a whole.

  2. Treatment of Symptomatic Geographic Tongue with Triamcinolone Acetonide Alone and in Combination with Retinoic Acid: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Shamsolmoulouk Najafi

    2016-08-01

    Full Text Available Objectives: Geographic tongue or migratory glossitis is an inflammatory disorder with unknown etiology. Considering the accompanied burning pain, taste dysfunction, and lack of definite cure, it is important to treat this condition symptomatically. The objective of the current study was to compare the efficacy of a combination of 0.05% retinoic acid and 0.1% triamcinolone acetonide with that of triamcinolone acetonide alone for treatment of symptomatic geographic tongue.Materials and Methods: This randomized controlled double-blind clinical trial was performed on 28 patients with symptomatic geographic tongue, who were referred to two dental clinics. Participants were randomly divided into two groups and treated with triamcinolone alone or retinoic acid plus triamcinolone for 10 days. Patients were assessed for the level of pain, burning sensation and size of lesion at the beginning and at the end of the study. Participants were followed up for two months after cessation of treatment (at the end of each month. SPSS 11 was applied to compare the two therapeutic modalities.Results: Twenty-eight participants with a mean age of 40 years were evaluated including Seven (25% males and 21(75% females. There was a positive family history of geographic tongue in 21 patients. Despite the diminished pain and burning sensation as well as smaller size of lesions following treatment (P<0.05, no statistically significant differences were found between the two groups (P> 0.05. No side effect was reported. Conclusion: The combination of triamcinolone and retinoic acid was not more effective than triamcinolone alone for symptomatic treatment of geographic tongue.

  3. Polaprezinc combined with clarithromycin-based triple therapy for Helicobacter pylori-associated gastritis: A prospective, multicenter, randomized clinical trial.

    Science.gov (United States)

    Tan, Bei; Luo, Han-Qing; Xu, Hong; Lv, Nong-Hua; Shi, Rui-Hua; Luo, He-Sheng; Li, Jian-Sheng; Ren, Jian-Lin; Zou, Yi-You; Li, Yan-Qing; Ji, Feng; Fang, Jing-Yuan; Qian, Jia-Ming

    2017-01-01

    The efficacy and safety of polaprezinc combined with triple therapy was compared with triple therapy alone in the eradication of Helicobacter pylori. A randomized, parallel-group, open-label, controlled, prospective multicenter study was conducted in 11 cities in China. Treatment-naive patients with H. pylori-associated gastritis were randomly assigned to one of three arms for a 14-day treatment: Arm A triple therapy (omeprazole 20 mg, amoxicillin 1 g, and clarithromycin 500 mg, each twice daily) plus polaprezinc 75 mg twice daily; Arm B triple therapy plus polaprezinc 150 mg twice daily, or Arm C triple therapy alone. The rate of H. pylori eradication was the primary endpoint. Secondary endpoints were symptom improvement and lower incidence of adverse events. 303 patients completed the study- 106, 96, and 101 patients in Arms A, B, and C, respectively. Intention-to-treat (ITT) analysis showed that the rate of H. pylori eradication was significantly higher for Arms A (77.0%) and B (75.9%) compared to Arm C (58.6%) (P P = 0.90). Per-protocol (PP) analysis showed that the rate of H. pylori eradication was significantly higher for Arms A (81.1%) and B (83.3%) compared to Arm C (61.4%) (P P = 0.62). All three groups reported significant symptom improvement at 7, 14, and 28 days after treatment, compared to baseline (P P = 0.04) and C (1.9%) (P = 0.02). There were no serious adverse events in any group. It appears that standard dose polaprezinc combined with triple therapy can significantly improve the H. pylori eradication rate, without an increase in toxicity.

  4. Combination Therapy Is Superior to Sequential Monotherapy for the Initial Treatment of Hypertension: A Double-Blind Randomized Controlled Trial.

    Science.gov (United States)

    MacDonald, Thomas M; Williams, Bryan; Webb, David J; Morant, Steve; Caulfield, Mark; Cruickshank, J Kennedy; Ford, Ian; Sever, Peter; Mackenzie, Isla S; Padmanabhan, Sandosh; McCann, Gerald P; Salsbury, Jackie; McInnes, Gordon; Brown, Morris J

    2017-11-18

    Guidelines for hypertension vary in their preference for initial combination therapy or initial monotherapy, stratified by patient profile; therefore, we compared the efficacy and tolerability of these approaches. We performed a 1-year, double-blind, randomized controlled trial in 605 untreated patients aged 18 to 79 years with systolic blood pressure (BP) ≥150 mm Hg or diastolic BP ≥95 mm Hg. In phase 1 (weeks 0-16), patients were randomly assigned to initial monotherapy (losartan 50-100 mg or hydrochlorothiazide 12.5-25 mg crossing over at 8 weeks), or initial combination (losartan 50-100 mg plus hydrochlorothiazide 12.5-25 mg). In phase 2 (weeks 17-32), all patients received losartan 100 mg and hydrochlorothiazide 12.5 to 25 mg. In phase 3 (weeks 33-52), amlodipine with or without doxazosin could be added to achieve target BP. Hierarchical primary outcomes were the difference from baseline in home systolic BP, averaged over phases 1 and 2 and, if significant, at 32 weeks. Secondary outcomes included adverse events, and difference in home systolic BP responses between tertiles of plasma renin. Home systolic BP after initial monotherapy fell 4.9 mm Hg (range: 3.7-6.0 mm Hg) less over 32 weeks (P150/95 mm Hg. URL: http://www.ClinicalTrials.gov. Unique identifier: NCT00994617. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  5. Whole person-evoked fMRI activity patterns in human fusiform gyrus are accurately modeled by a linear combination of face- and body-evoked activity patterns.

    Science.gov (United States)

    Kaiser, Daniel; Strnad, Lukas; Seidl, Katharina N; Kastner, Sabine; Peelen, Marius V

    2014-01-01

    Visual cues from the face and the body provide information about another's identity, emotional state, and intentions. Previous neuroimaging studies that investigated neural responses to (bodiless) faces and (headless) bodies have reported overlapping face- and body-selective brain regions in right fusiform gyrus (FG). In daily life, however, faces and bodies are typically perceived together and are effortlessly integrated into the percept of a whole person, raising the possibility that neural responses to whole persons are qualitatively different than responses to isolated faces and bodies. The present study used fMRI to examine how FG activity in response to a whole person relates to activity in response to the same face and body but presented in isolation. Using multivoxel pattern analysis, we modeled person-evoked response patterns in right FG through a linear combination of face- and body-evoked response patterns. We found that these synthetic patterns were able to accurately approximate the response patterns to whole persons, with face and body patterns each adding unique information to the response patterns evoked by whole person stimuli. These results suggest that whole person responses in FG primarily arise from the coactivation of independent face- and body-selective neural populations.

  6. Linear combination of one-step predictive information with an external reward in an episodic policy gradient setting: a critical analysis

    Directory of Open Access Journals (Sweden)

    Keyan eZahedi

    2013-11-01

    Full Text Available One of the main challenges in the field of embodied artificial intelligence is the open-ended autonomous learning of complex behaviours. Our approach is to use task-independent, information-driven intrinsic motivation(s to support task-dependent learning. The work presented here is a preliminary step in which we investigate the predictive information (the mutual information of the past and future of the sensor stream as an intrinsic drive, ideally supporting any kind of task acquisition. Previous experiments have shown that the predictive information (PI is a good candidate to support autonomous, open-ended learning of complex behaviours, because a maximisation of the PI corresponds to an exploration of morphology- and environment-dependent behavioural regularities. The idea is that these regularities can then be exploited in order to solve any given task. Three different experiments are presented and their results lead to the conclusion that the linear combination of the one-step PI with an external reward function is not generally recommended in an episodic policy gradient setting. Only for hard tasks a great speed-up can be achieved at the cost of an asymptotic performance lost.

  7. Indoor radio channel modeling and mitigation of fading effects using linear and circular polarized antennas in combination for smart home system at 868 MHz

    Science.gov (United States)

    Wunderlich, S.; Welpot, M.; Gaspard, I.

    2014-11-01

    The markets for smart home products and services are expected to grow over the next years, driven by the increasing demands of homeowners considering energy monitoring, management, environmental controls and security. Many of these new systems will be installed in existing homes and offices and therefore using radio based systems for cost reduction. A drawback of radio based systems in indoor environments are fading effects which lead to a high variance of the received signal strength and thereby to a difficult predictability of the encountered path loss of the various communication links. For that reason it is necessary to derive a statistical path loss model which can be used to plan a reliable and cost effective radio network. This paper presents the results of a measurement campaign, which was performed in six buildings to deduce realistic radio channel models for a high variety of indoor radio propagation scenarios in the short range devices (SRD) band at 868 MHz. Furthermore, a potential concept to reduce the variance of the received signal strength using a circular polarized (CP) patch antenna in combination with a linear polarized antenna in an one-to-one communication link is presented.

  8. Restoring the Duality between Principal Components of a Distance Matrix and Linear Combinations of Predictors, with Application to Studies of the Microbiome.

    Directory of Open Access Journals (Sweden)

    Glen A Satten

    Full Text Available Appreciation of the importance of the microbiome is increasing, as sequencing technology has made it possible to ascertain the microbial content of a variety of samples. Studies that sequence the 16S rRNA gene, ubiquitous in and nearly exclusive to bacteria, have proliferated in the medical literature. After sequences are binned into operational taxonomic units (OTUs or species, data from these studies are summarized in a data matrix with the observed counts from each OTU for each sample. Analysis often reduces these data further to a matrix of pairwise distances or dissimilarities; plotting the first two or three principal components (PCs of this distance matrix often reveals meaningful groupings in the data. However, once the distance matrix is calculated, it is no longer clear which OTUs or species are important to the observed clustering; further, the PCs are hard to interpret and cannot be calculated for subsequent observations. We show how to construct approximate decompositions of the data matrix that pair PCs with linear combinations of OTU or species frequencies, and show how these decompositions can be used to construct biplots, select important OTUs and partition the variability in the data matrix into contributions corresponding to PCs of an arbitrary distance or dissimilarity matrix. To illustrate our approach, we conduct an analysis of the bacteria found in 45 smokeless tobacco samples.

  9. Combining High-Contrast Imaging with Doppler Radial Velocity: a Survey of Subgiant Stars that Exhibit Long-term Linear Trends

    Science.gov (United States)

    Crepp, Justin R.; Johnson, J. A.

    2010-01-01

    We are commencing a high-contrast imaging survey at Keck that will target several dozen nearby subgiant stars that show evidence for the existence of a distant companion, as is indicated by a long-term, linear radial velocity (RV) trend. The goal of the survey is to place very tight constraints on the mass and orbit of the body responsible for accelerating each star. Our targets are massive, former A-stars and 28% have a known exoplanet. The typical time baseline for Doppler measurements is 3+ years and a number of targets have minimum periods of 12 years. By combining complementary detection techniques, we will be able to determine with high statistical confidence whether the (outer-most) companion is stellar or substellar in nature for most of the sample. This "inside-out" approach will provide a measure of the occurrence rate of multi-planet systems and brown dwarfs around massive stars. In this poster, we present further motivation on the topic, including several representative RV curves and the anticipated mass, inclination, and semi-major axis constraints imposed by imaging and RV.

  10. Simulation of nonlinear benchmarks and sheet metal forming processes using linear and quadratic solid–shell elements combined with advanced anisotropic behavior models

    Directory of Open Access Journals (Sweden)

    Wang Peng

    2016-01-01

    Full Text Available A family of prismatic and hexahedral solid‒shell (SHB elements with their linear and quadratic versions is presented in this paper to model thin 3D structures. Based on reduced integration and special treatments to eliminate locking effects and to control spurious zero-energy modes, the SHB solid‒shell elements are capable of modeling most thin 3D structural problems with only a single element layer, while describing accurately the various through-thickness phenomena. In this paper, the SHB elements are combined with fully 3D behavior models, including orthotropic elastic behavior for composite materials and anisotropic plastic behavior for metallic materials, which allows describing the strain/stress state in the thickness direction, in contrast to traditional shell elements. All SHB elements are implemented into ABAQUS using both standard/quasi-static and explicit/dynamic solvers. Several benchmark tests have been conducted, in order to first assess the performance of the SHB elements in quasi-static and dynamic analyses. Then, deep drawing of a hemispherical cup is performed to demonstrate the capabilities of the SHB elements in handling various types of nonlinearities (large displacements and rotations, anisotropic plasticity, and contact. Compared to classical ABAQUS solid and shell elements, the results given by the SHB elements show good agreement with the reference solutions.

  11. Distribution of spectral linear statistics on random matrices beyond the large deviation function—Wigner time delay in multichannel disordered wires

    Science.gov (United States)

    Grabsch, Aurélien; Texier, Christophe

    2016-11-01

    An invariant ensemble of N × N random matrices can be characterised by a joint distribution for eigenvalues P({λ }1,\\cdots ,{λ }N). The distribution of linear statistics, i.e. of quantities of the form L=(1/N){\\sum }if({λ }i) where f(x) is a given function, appears in many physical problems. In the N\\to ∞ limit, L scales as L˜ {N}η , where the scaling exponent η depends on the ensemble and the function f(x). Its distribution can be written in the form {P}N(s={N}-η L)≃ {A}N,β (s)\\exp \\{-(β {N}2/2){{Φ }}(s)\\}, where β \\in \\{1,2,4\\} is the Dyson index. The Coulomb gas technique naturally provides the large deviation function {{Φ }}(s), which can be efficiently obtained thanks to a ‘thermodynamic identity’ introduced earlier. We conjecture the pre-exponential function {A}N,β (s). We check our conjecture on several well controlled cases within the Laguerre and the Jacobi ensembles. Then we apply our main result to a situation where the large deviation function has no minimum (and L has infinite moments): this arises in the statistical analysis of the Wigner time delay for semi-infinite multichannel disordered wires (Laguerre ensemble). The statistical analysis of the Wigner time delay then crucially depends on the pre-exponential function {A}N,β (s), which ensures the decay of the distribution for large argument.

  12. Randomized, double-blind, placebo-controlled phase II study of AMG 386 combined with weekly paclitaxel in patients with recurrent ovarian cancer.

    Science.gov (United States)

    Karlan, Beth Y; Oza, Amit M; Richardson, Gary E; Provencher, Diane M; Hansen, Vincent L; Buck, Martin; Chambers, Setsuko K; Ghatage, Prafull; Pippitt, Charles H; Brown, John V; Covens, Allan; Nagarkar, Raj V; Davy, Margaret; Leath, Charles A; Nguyen, Hoa; Stepan, Daniel E; Weinreich, David M; Tassoudji, Marjan; Sun, Yu-Nien; Vergote, Ignace B

    2012-02-01

    To estimate the efficacy and toxicity of AMG 386, an investigational peptide-Fc fusion protein that neutralizes the interaction between the Tie2 receptor and angiopoietin-1/2, plus weekly paclitaxel in patients with recurrent ovarian cancer. Patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer were randomly assigned 1:1:1 to receive paclitaxel (80 mg/m(2) once weekly [QW], 3 weeks on/1 week off) plus intravenous AMG 386 10 mg/kg QW (arm A), AMG 386 3 mg/kg QW (arm B), or placebo QW (arm C). The primary end point was progression-free survival (PFS). Secondary end points included overall survival, objective response, CA-125 response, safety, and pharmacokinetics. One hundred sixty-one patients were randomly assigned. Median PFS was 7.2 months (95% CI, 5.3 to 8.1 months) in arm A, 5.7 months (95% CI, 4.6 to 8.0 months) in arm B, and 4.6 months (95% CI, 1.9 to 6.7 months) in arm C. The hazard ratio for arms A and B combined versus arm C was 0.76 (95% CI, 0.52 to 1.12; P = .165). Further analyses suggested an exploratory dose-response effect for PFS across arms (Tarone's test, P = .037). Objective response rates for arms A, B, and C were 37%, 19%, and 27%, respectively. The incidence of grade ≥ 3 adverse events (AEs) in arms A, B, and C was 65%, 55%, and 64%, respectively. Frequent AEs included hypertension (8%, 6%, and 5% in arms A, B, and C, respectively), peripheral edema (71%, 51%, and 22% in arms A, B, and C, respectively), and hypokalemia (21%, 15%, and 5% in arms A, B, and C, respectively). AMG 386 exhibited linear pharmacokinetic properties at the tested doses. AMG 386 combined with weekly paclitaxel was tolerable, with a manageable and distinct toxicity profile. The data suggest evidence of antitumor activity and a dose-response effect, warranting further studies in ovarian cancer.

  13. Oral Tranexamic Acid with Fluocinolone-Based Triple Combination Cream Versus Fluocinolone-Based Triple Combination Cream Alone in Melasma: An Open Labeled Randomized Comparative Trial

    National Research Council Canada - National Science Library

    Padhi, Tanmay; Pradhan, Swetalina

    2015-01-01

    .... To compare the efficacy of a combination of oral tranexamic acid and fluocinolone-based triple combination cream with that of fluocinolone-based triple combination cream alone in melasma among Indian patients...

  14. Combination of taping with Back School in patients with chronic low back pain: a randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Andres Tana

    2016-11-01

    Full Text Available Introduction: 70-85% of the general population suffers from back pain. Back School programs have being effective in the treatment of chronic low back pain. Taping may be useful in reducing pain and normalizing muscle function. The objective of this study was to evaluate the effectiveness of the combination of taping with Back School at short- and long-term. Methods: Randomized controlled clinical trial. The experimental group used tape and made Back Scholl and the control group only made Back School. At the beginning and the end of treatment, pain was evaluated with a visual analogue scale, the flexibility determined with the Modified Finger Tip-to-Floor Test and functionality was calculated with the Roland Morris Disability Questionnaire. Depression was recorded with the Depression Beck Inventory just at the beginning. Results: 220 patients were enrolled, only 42 in the experimental group and 33 in the control group completed the treatment. The variation of pain between the first and the fifth session showed no differences between groups regardless of time (p = 0.329. There were no differences between groups in functionality (p = 0.75, flexibility (p = 0.20 and depression. Conclusion: The combination of taping and Back School compared with only Back School was not more effective in reducing pain, increasing functionality and flexibility in patients with chronic low back pain. Key words: Taping; chronic low back pain; spine school; therapy exercises; flexibility; depression.

  15. Premedication with oral alprazolam and melatonin combination: a comparison with either alone--a randomized controlled factorial trial.

    Science.gov (United States)

    Pokharel, Krishna; Tripathi, Mukesh; Gupta, Pramod Kumar; Bhattarai, Balkrishna; Khatiwada, Sindhu; Subedi, Asish

    2014-01-01

    We assessed if the addition of melatonin to alprazolam has superior premedication effects compared to either drug alone. A prospective, double blind placebo controlled trial randomly assigned 80 adult patients (ASA 1&2) with a Visual Analogue Score (VAS) for anxiety ≥ 3 to receive a tablet containing a combination of alprazolam 0.5 mg and melatonin 3 mg, alprazolam 0.5 mg, melatonin 3 mg, or placebo orally 90 min before a standard anesthetic. Primary end points were change in anxiety and sedation score at 15, 30, and 60 min after premedication, and number of patients with loss of memory for the five pictures shown at various time points when assessed after 24 h. One-way ANOVA, Friedman repeated measures analysis of variance, Kruskal Wallis and chi square tests were used as relevant. Combination drug produced the maximum reduction in anxiety VAS (3 (1.0-4.3)) from baseline at 60 min (P alprazolam alone. Addition of melatonin to alprazolam had superior anxiolysis compared with either drugs alone or placebo. Adding melatonin neither worsened sedation score nor the amnesic effect of alprazolam alone. This study was registered, approved, and released from ClinicalTrials.gov. Identifier number: NCT01486615.

  16. Premedication with Oral Alprazolam and Melatonin Combination: A Comparison with Either Alone—A Randomized Controlled Factorial Trial

    Science.gov (United States)

    Pokharel, Krishna; Tripathi, Mukesh; Gupta, Pramod Kumar; Khatiwada, Sindhu; Subedi, Asish

    2014-01-01

    We assessed if the addition of melatonin to alprazolam has superior premedication effects compared to either drug alone. A prospective, double blind placebo controlled trial randomly assigned 80 adult patients (ASA 1&2) with a Visual Analogue Score (VAS) for anxiety ≥3 to receive a tablet containing a combination of alprazolam 0.5 mg and melatonin 3 mg, alprazolam 0.5 mg, melatonin 3 mg, or placebo orally 90 min before a standard anesthetic. Primary end points were change in anxiety and sedation score at 15, 30, and 60 min after premedication, and number of patients with loss of memory for the five pictures shown at various time points when assessed after 24 h. One-way ANOVA, Friedman repeated measures analysis of variance, Kruskal Wallis and chi square tests were used as relevant. Combination drug produced the maximum reduction in anxiety VAS (3 (1.0–4.3)) from baseline at 60 min (P alprazolam alone. Addition of melatonin to alprazolam had superior anxiolysis compared with either drugs alone or placebo. Adding melatonin neither worsened sedation score nor the amnesic effect of alprazolam alone. This study was registered, approved, and released from ClinicalTrials.gov. Identifier number: NCT01486615. PMID:24527443

  17. Cryotherapy versus imiquimod 5% cream combined with a keratolytic lotion in cutaneous warts in children: A randomized study.

    Science.gov (United States)

    Stefanaki, Christina; Lagogiani, Irini; Kouris, Anargyros; Kontochristopoulos, George; Antoniou, Christina; Katsarou, Alexandra

    2016-01-01

    Although cutaneous warts are extremely common in children effective treatment does not exist. We combined imiquimod with a salicylic acid solution 15% (SA) on areas, with thick keratin, like palms and soles to increase its penetration through the epithelium. Patients were randomly divided into two groups. The first group was subjected to cryotherapy with liquid nitrogen every two weeks for a maximum of 3 months. The second group was subjected to treatment with imiquimod 5% daily for 6-10 h onto the warts for five consecutive days per week for a maximum of 3 months. Eighty-six children were included, 35 girls and 51 boys, 49 in the cryotherapy group and 37 in the imiquimod and SA group. At the end of the third month no statistically significant difference could be noted between the imiquimod 5% and salicylic acid and cryotherapy groups (p = 0.154). Thirty (81.1%) children treated with imiquimod 5% and salicylic acid were free from their warts in comparison to 33 (67.3%) children treated with cryotherapy. Imiquimod 5% cream as a monotherapy or in combination with SA can be used safely in children with warts and is equally effective and more effective than cryotherapy in plantar warts. Our study is not placebo controlled and spontaneous resolution cannot be ruled out.

  18. Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial.

    Science.gov (United States)

    Arentz, Susan; Smith, Caroline A; Abbott, Jason; Fahey, Paul; Cheema, Birinder S; Bensoussan, Alan

    2017-09-01

    Polycystic ovary syndrome (PCOS) is a common, complex reproductive endocrinopathy characterized by menstrual irregularities, hyperandrogenism and polycystic ovaries. Lifestyle modification is a first-line intervention; however, there are barriers to success for this form of self-care, and women often seek adjunct therapies including herbal medicines. This pragmatic, randomized controlled trial, delivered in communities of Australia in overweight women with PCOS, compared the effectiveness and safety of a lifestyle intervention plus herbal medicine against lifestyle alone. All participants were helped to construct a personalized lifestyle plan. The herbal intervention consisted of two tablets. Tablet 1 contained Cinnamomum verum, Glycyrrhiza glabra, Hypericum perforatum and Paeonia lactiflora. Tablet 2 contained Tribulus terrestris. The primary outcome was oligomenorrhoea/amenorrhoea. Secondary outcomes were hormones; anthropometry; quality of life; depression, anxiety and stress; pregnancy; birth outcomes; and safety. One hundred and twenty-two women gave their consent. At 3 months, women in the combination group recorded a reduction in oligomenorrhoea of 32.9% (95% confidence interval 23.3-42.6, p pregnancy rates (p = 0.01). This trial provides evidence of improved effectiveness and safety for lifestyle intervention when combined with herbal medicines in women with PCOS. © 2017 The Authors. Phytotherapy Research published by John Wiley & Sons Ltd. © 2017 The Authors. Phytotherapy Research published by John Wiley & Sons Ltd.

  19. Computer-Aided Lung Nodule Recognition by SVM Classifier Based on Combination of Random Undersampling and SMOTE

    Directory of Open Access Journals (Sweden)

    Yuan Sui

    2015-01-01

    Full Text Available In lung cancer computer-aided detection/diagnosis (CAD systems, classification of regions of interest (ROI is often used to detect/diagnose lung nodule accurately. However, problems of unbalanced datasets often have detrimental effects on the performance of classification. In this paper, both minority and majority classes are resampled to increase the generalization ability. We propose a novel SVM classifier combined with random undersampling (RU and SMOTE for lung nodule recognition. The combinations of the two resampling methods not only achieve a balanced training samples but also remove noise and duplicate information in the training sample and retain useful information to improve the effective data utilization, hence improving performance of SVM algorithm for pulmonary nodules classification under the unbalanced data. Eight features including 2D and 3D features are extracted for training and classification. Experimental results show that for different sizes of training datasets our RU-SMOTE-SVM classifier gets the highest classification accuracy among the four kinds of classifiers, and the average classification accuracy is more than 92.94%.

  20. Trauma-focused treatment for posttraumatic stress disorder combined with CBT for severe substance use disorder: a randomized controlled trial.

    Science.gov (United States)

    van Dam, Debora; Ehring, Thomas; Vedel, Ellen; Emmelkamp, Paul M G

    2013-06-19

    This randomized controlled trial (RCT) investigated the effectiveness of a combined treatment for co-morbid Posttraumatic Stress Disorder (PTSD) and severe Substance Use Disorder (SUD). Structured Writing Therapy for PTSD (SWT), an evidence-based traumafocused intervention, was added on to Treatment As Usual (TAU), consisting of an intensive cognitive behavioral inpatient or day group treatment for SUD. The outcomes of the combined treatment (TAU + SWT) were compared to TAU alone in a sample of 34 patients. Results showed a general reduction of SUD symptoms for both TAU + SWT and TAU. Treatment superiority of TAU + SWT was neither confirmed by interaction effects (time x condition) for SUD or PTSD symptoms, nor by a group difference for SUD diagnostic status at post-treatment. However, planned contrasts revealed that improvements for PTSD severity over time were only significant within the TAU + SWT group. In addition, within the TAU + SWT group the remission of PTSD diagnoses after treatment was significant, which was not the case for TAU. Finally, at post-treatment a trend was noticed for between group differences for the number of PTSD diagnoses favoring TAU + SWT above TAU. In sum, the current study provides preliminary evidence that adding a trauma-focused treatment on to standard SUD treatment may be beneficial.

  1. Random Network Coding over Composite Fields

    DEFF Research Database (Denmark)

    Geil, Olav; Lucani Rötter, Daniel Enrique

    2017-01-01

    Random network coding is a method that achieves multicast capacity asymptotically for general networks [1, 7]. In this approach, vertices in the network randomly and linearly combine incoming information in a distributed manner before forwarding it through their outgoing edges. To ensure success...

  2. Exercise training combined with electromyostimulation in the rehabilitation of patients with chronic heart failure: A randomized trial.

    Science.gov (United States)

    Soska, Vladimir; Dobsak, Petr; Pohanka, Michal; Spinarova, Lenka; Vitovec, Jiri; Krejci, Jan; Hude, Petr; Homolka, Pavel; Novakova, Marie; Eicher, Jean-Christophe; Wolf, Jean-Eric; Dusek, Ladislav; Siegelova, Jarmila

    2014-01-01

    Both aerobic training (AT) and electromyostimulation (EMS) of leg muscles improve exercise tolerance in patients suffering from chronic heart failure (CHF). It was speculated that combination of both methods might have an additive effect. This study was performed to evaluate the effects of a combination of AT and EMS in rehabilitation (RHB) of CHF patients. Patients (n=71; age 59 ± 10.2 yrs, NYHA II/III, EF 32 ± 7.1%) were randomized into 3 groups: a) group AT, b) group EMS, and c) group AT+EMS. AT protocol included standard activity on bicycle 3x a week at the level of individual anaerobic threshold. EMS (10 Hz, mode 20s "on"/20s "off") was applied to leg extensors for 2 h/day. Total time of given type of RHB was 12 weeks. Data analysis revealed statistically significant improvements of patients in all experimental groups (averaged difference after 12 weeks of exercise as related to initial value: ∆VO2peak: +12.9%, ∆VO2AT: +9.3%, ∆Wpeak: +22.7%). No statistically significant difference among experimental groups was found. Quality of life (Minnesota Living with Heart Failure - MLHF) global score was significantly improved in all 3 groups: AT (∆MLHF: -27.9%; P=0.001), AT+EMS (∆MLHF: -29.1%; P=0.002), and EMS (∆MLHF: -16.6%; P=0.008). MLHF score in EMS group showed the smallest time-related improvement compared to AT and AT+EMS groups, and this difference in improvement between the groups was statistically significant (P=0.021). No significant difference was found between the two types of exercise training.and nor did, their combination have any significant additional improvement.

  3. A randomized, crossover study to evaluate the pharmacokinetics of amantadine and oseltamivir administered alone and in combination.

    Directory of Open Access Journals (Sweden)

    Dennis Morrison

    2007-12-01

    Full Text Available The threat of potential pandemic influenza requires a reevaluation of licensed therapies for the prophylaxis or treatment of avian H5N1 infection that may adapt to man. Among the therapies considered for use in pandemic influenza is the co-administration of ion channel and neuraminidase inhibitors, both to potentially increase efficacy as well as to decrease the emergence of resistant isolates. To better understand the potential for drug interactions, a cross-over, randomized, open-label trial was conducted with amantadine, 100 mg po bid, and oseltamivir, 75 mg po bid, given alone or in combination for 5 days. Each subject (N = 17 served as their own control and was administered each drug alone or in combination, with appropriate wash-out. Co-administration with oseltamivir had no clinically significant effect on the pharmacokinetics (PK of amantadine [mean ratios (90% CI for AUC(0-12 0.93 (0.89, 0.98 and C(max 0.96 (0.90, 1.02]. Similarly, amantadine co-administration did not affect oseltamivir PK [AUC(0-12 0.92 (0.86, 0.99 and C(max 0.85 (0.73, 0.99] or the PK of the metabolite, oseltamivir carboxylate [AUC(0-12 0.98 (0.95, 1.02 and C(max 0.95 (0.89, 1.01]. In this small trial there was no evidence of an increase in adverse events. Although many more subjects would need to be studied to rule out a synergistic increase in adverse events, the combination in this small human drug-drug interaction trial appears safe and without pharmacokinetic consequences.ClinicalTrials.gov NCT00416962.

  4. Premedication with Oral Alprazolam and Melatonin Combination: A Comparison with Either Alone—A Randomized Controlled Factorial Trial

    Directory of Open Access Journals (Sweden)

    Krishna Pokharel

    2014-01-01

    Full Text Available We assessed if the addition of melatonin to alprazolam has superior premedication effects compared to either drug alone. A prospective, double blind placebo controlled trial randomly assigned 80 adult patients (ASA 1&2 with a Visual Analogue Score (VAS for anxiety ≥3 to receive a tablet containing a combination of alprazolam 0.5 mg and melatonin 3 mg, alprazolam 0.5 mg, melatonin 3 mg, or placebo orally 90 min before a standard anesthetic. Primary end points were change in anxiety and sedation score at 15, 30, and 60 min after premedication, and number of patients with loss of memory for the five pictures shown at various time points when assessed after 24 h. One-way ANOVA, Friedman repeated measures analysis of variance, Kruskal Wallis and chi square tests were used as relevant. Combination drug produced the maximum reduction in anxiety VAS (3 (1.0–4.3 from baseline at 60 min (P<0.05. Sedation scores at various time points and number of patients not recognizing the picture shown at 60 min after premedication were comparable between combination drug and alprazolam alone. Addition of melatonin to alprazolam had superior anxiolysis compared with either drugs alone or placebo. Adding melatonin neither worsened sedation score nor the amnesic effect of alprazolam alone. This study was registered, approved, and released from ClinicalTrials.gov. Identifier number: NCT01486615.

  5. Comparison of two combinations of opioid and non-opioid analgesics for acute periradicular abscess: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Manuela Favarin Santini

    Full Text Available Abstract Acute periradicular abscess is a condition characterized by the formation and propagation of pus in the periapical tissues and generally associated with debilitating pain. Objective: The aim of this study was to compare the overall analgesic effectiveness of two combinations of opioid and non-opioid analgesics for acute periradicular abscess. Material and Methods: This study included 26 patients who sought emergency care in a Brazilian dental school. The patients were randomly divided into two groups: Co/Ac - oral prescription of codeine (30 mg plus acetaminophen (500 mg, every 4 h, for 3 days or Tr/Ac - oral prescription of tramadol hydrochloride (37.5 mg plus acetaminophen (500 mg on the same schedule. Two factors were evaluated: (1 pain scores recorded by the patients in a pain diary 6, 12, 24, 48, and 72 h after treatment, using the Visual Analogue Scale; and (2 the occurrence of adverse effects. Results: In both groups, there was a reduction in pain scores over time. For the Co/Ac group, there was a significant reduction in the scores 12, 24, 48, and 72 hours after treatment (P0.05, i.e., both treatments were effective in controlling pain caused by APA; however, the combination of Tr/Ac caused more adverse reactions as two patients had to stop using the medication. Conclusion: This study suggests that, considering both analgesic efficacy and safety, the combination of codeine and acetaminophen is more effective to control moderate to severe pain from acute periradicular abscesses.

  6. Effects of interferential therapy parameter combinations upon experimentally induced pain in pain-free participants: a randomized controlled trial.

    Science.gov (United States)

    Dounavi, Myrto D; Chesterton, Linda S; Sim, Julius

    2012-07-01

    Little evidence exists regarding parameter selection for hypoalgesia using interferential therapy (IFT). This study investigated segmental and extrasegmental hypoalgesic effects of different IFT parameter combinations upon experimentally induced pressure pain threshold (PPT) in pain-free volunteers. The participants were randomly assigned to 6 groups: control, placebo, bipolar constant amplitude modulation frequency (AMF), bipolar sweep AMF, quadripolar constant AMF, and quadripolar sweep AMF. The study was conducted in a university laboratory. One hundred eighty adults who were healthy and pain-free participated in the study. Interferential therapy was delivered to all groups at high, to-tolerance intensity and at high AMF. Stimulation to the dominant forearm was delivered for 30 minutes, with monitoring for a further 30 minutes. Pain pressure threshold was measured at the area of first dorsal interosseous muscle of the dominant and nondominant hands (segmental measurements) and over the tibialis anterior muscle (extrasegmental measurement) at baseline and at 10-minute intervals using a pressure algometer. Square root transformed PPT data were analyzed using repeated-measures analysis of variance. There was a significant change in PPT over time, but no significant between-subjects difference in segmental or extrasegmental PPT between any of the IFT groups and the placebo or control group. Thus, IFT delivered in any of these parameter combinations did not significantly affect the PPT of pain-free participants compared with the control or placebo group. Success of blinding was not evaluated. This study showed that IFT delivered at high, to-tolerance intensity and high AMF does not produce significant segmental and extrasegmental hypoalgesic effects on PPT in participants who were healthy compared with a control or placebo group. Further research is warranted to investigate the hypoalgesic effect of different IFT parameter combinations and to explain its possible

  7. Infliximab Versus Conventional Combination Treatment and Seven-Year Work Loss in Early Rheumatoid Arthritis: Results of a Randomized Swedish Trial.

    Science.gov (United States)

    Eriksson, Jonas K; Wallman, Johan K; Miller, Heather; Petersson, Ingemar F; Ernestam, Sofia; Vivar, Nancy; van Vollenhoven, Ronald F; Neovius, Martin

    2016-12-01

    To compare long-term work loss in methotrexate-refractory early rheumatoid arthritis (RA) patients randomized to the addition of infliximab or conventional combination treatment. This study was a multicenter, 2-arm, parallel, randomized, active-controlled, open-label trial. RA patients with infliximab or conventional combination treatment with sulfasalazine plus hydroxychloroquine. Yearly sick leave and disability pension days >7 years after randomization were retrieved from nationwide registers kept by the Swedish Social Insurance Agency. Of 210 working-age patients, 109 were randomized to infliximab (mean age 48.4 years, 73% women) and 101 to conventional treatment (mean age 48.7 years, 77% women). The year before randomization, the mean number of annual work days lost was 127 in the infliximab arm and 118 in the conventional treatment group (mean difference 9 [95% confidence interval (95% CI) -23, 39]). Compared to the year before randomization, the mean changes at 7 years were -25 days in the infliximab and -26 days in the conventional treatment group (adjusted mean difference 10 [95% CI -25, 46]). The cumulative mean for work-loss days was 846 in the infliximab group and 701 in the conventional treatment group (adjusted mean difference 104 [95% CI -56, 284]). Long-term work loss improved significantly in early RA patients randomized to infliximab plus methotrexate or conventional combination therapy. No difference was detected between strategies, and the level of work-loss days remained twice that observed in the general population. © 2016, American College of Rheumatology.

  8. The effectiveness of ibuprofen and lorazepam combination therapy in treating the symptoms of acute Migraine: A randomized clinical trial

    Science.gov (United States)

    Rad, Reza Ebrahimi; Ghaffari, Fatemeh; Fotokian, Zahra; Ramezani, Azadeh

    2017-01-01

    Background Migraine is a common, episodic and debilitating disease. The migraineur not only suffers from pain, but also lives with a diminished to poor quality of life. Several medicinal therapies are used to abate the debilitating symptoms of this disease. Objective The present study was conducted to determine the effectiveness of Ibuprofen and Lorazepam combination therapy in treating the symptoms of acute migraine. Methods The present randomized clinical trial study used the pretest-posttest design with three comparison treatments, to examine 90 patients with an average of two to six attacks per month and an initial diagnosis of migraine based on the International Headache Society (HIS) criteria. The study was conducted on patients during the first half of 2014 with a diagnosis of acute migraine attack who were referred to Babol Ayatollah Rouhani Hospital in Iran. The patients were randomly divided into three groups of 30. The first group was administered 200 mg Ibuprofen capsules, the second group 400 mg Ibuprofen capsules and the third group a combination of 200 mg Ibuprofen capsules and 1 mg Lorazepam tablets. The medications were taken in the presence of the researcher. A checklist was used to assess the severity of headache and other migraine symptoms such as nausea, vomiting, photophobia and phonophobia in the patients, before and two hours after the intervention. Data were analyzed in SPSS-18 using the Mann-Whitney test, the McNemar test, Wilcoxon’s test, the NOVA and the Chi-squared test at the significance level of p<0.05, and power analysis with 30 patients in each group to perform this study was 0.8(1-β). Results The mean age of participants was reported as 52±8 years and the condition was more frequent in women (56%). All three treatment regimens reduced the severity of headache significantly in the patients (p<0.001); nevertheless, the combination therapy used, produced the lowest mean severity of headache (p<0.001). The highest reduction in

  9. Management of Neuropathic Chronic Pain with Methadone Combined with Ketamine: A Randomized, Double Blind, Active-Controlled Clinical Trial.

    Science.gov (United States)

    Rigo, Flavia Karine; Trevisan, Gabriela; Godoy, Maria C; Rossato, Mateus Fortes; Dalmolin, Gerusa D; Silva, Mariane A; Menezes, Mirian S; Caumo, Wolnei; Ferreira, Juliano

    2017-03-01

    Methadone and ketamine are used in neuropathic pain management. However, the benefits of both drugs association are uncertain in the treatment of neuropathic pain. Our primary objective was test the hypothesis that oral methadone combined with oral ketamine is more effective than oral methadone or ketamine alone in reducing neuropathic pain. We conducted a randomized, double blind, active-controlled parallel-group clinical trial. Forty-two patients with neuropathic pain refractory to conventional therapy were randomly assigned to receive oral methadone (n = 14), ketamine (n = 14), or methadone plus ketamine (n = 14) over a 3-month period. During these 90 days, we observed pain scores using a visual analogical scale (VAS), allodynia, burning/shooting pain, and some side effects. All treatments were effective in reducing pain scores by at least 40%. However, a significant improvement in pain was observed only in the ketamine alone group compared with both the methadone or methadone/ketamine groups. No significant differences were observed among the treatment groups for the reduction of burning or shooting pain, while ketamine alone was more effective than methadone or methadone/ketamine for the reduction of allodynia. Formal assessment for awareness of the allocation was not performed, some co-intervention bias may have occurred, our results could be only relevant to the patient population investigated and the use of VAS as the primary outcome detect changes in pain intensity but not to assess neuropathic pain symptoms. This study indicates that ketamine was better than methadone or methadone/ketamine for treating neuropathic pain.Key words: Multimodal analgesia, refractory pain, NMDA receptor, opioid.

  10. A new combined strategy to implement a community occupational therapy intervention: designing a cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Adang Eddy

    2011-03-01

    Full Text Available Abstract Background Even effective interventions for people with dementia and their caregivers require specific implementation efforts. A pilot study showed that the highly effective community occupational therapy in dementia (COTiD program was not implemented optimally due to various barriers. To decrease these barriers and make implementation of the program more effective a combined implementation (CI strategy was developed. In our study we will compare the effectiveness of this CI strategy with the usual educational (ED strategy. Methods In this cluster randomized, single-blinded, controlled trial, each cluster consists of at least two occupational therapists, a manager, and a physician working at Dutch healthcare organizations that deliver community occupational therapy. Forty-five clusters, stratified by healthcare setting (nursing home, hospital, mental health service, have been allocated randomly to either the intervention group (CI strategy or the control group (ED strategy. The study population consists of the professionals included in each cluster and community-dwelling people with dementia and their caregivers. The primary outcome measures are the use of community OT, the adherence of OTs to the COTiD program, and the cost effectiveness of implementing the COTiD program in outpatient care. Secondary outcome measures are patient and caregiver outcomes and knowledge of managers, physicians and OTs about the COTiD program. Discussion Implementation research is fairly new in the field of occupational therapy, making this a unique study. This study does not only evaluate the effects of the CI-strategy on professionals, but also the effects of professionals' degree of implementation on client and caregiver outcomes. Clinical trials registration NCT01117285

  11. Combined influence of CT random noise and HU-RSP calibration curve nonlinearities on proton range systematic errors

    Science.gov (United States)

    Brousmiche, S.; Souris, K.; Orban de Xivry, J.; Lee, J. A.; Macq, B.; Seco, J.

    2017-11-01

    Proton range random and systematic uncertainties are the major factors undermining the advantages of proton therapy, namely, a sharp dose falloff and a better dose conformality for lower doses in normal tissues. The influence of CT artifacts such as beam hardening or scatter can easily be understood and estimated due to their large-scale effects on the CT image, like cupping and streaks. In comparison, the effects of weakly-correlated stochastic noise are more insidious and less attention is drawn on them partly due to the common belief that they only contribute to proton range uncertainties and not to systematic errors thanks to some averaging effects. A new source of systematic errors on the range and relative stopping powers (RSP) has been highlighted and proved not to be negligible compared to the 3.5% uncertainty reference value used for safety margin design. Hence, we demonstrate that the angular points in the HU-to-RSP calibration curve are an intrinsic source of proton range systematic error for typical levels of zero-mean stochastic CT noise. Systematic errors on RSP of up to 1% have been computed for these levels. We also show that the range uncertainty does not generally vary linearly with the noise standard deviation. We define a noise-dependent effective calibration curve that better describes, for a given material, the RSP value that is actually used. The statistics of the RSP and the range continuous slowing down approximation (CSDA) have been analytically derived for the general case of a calibration curve obtained by the stoichiometric calibration procedure. These models have been validated against actual CSDA simulations for homogeneous and heterogeneous synthetical objects as well as on actual patient CTs for prostate and head-and-neck treatment planning situations.

  12. Combined effects of repeated oral hygiene motivation and type of toothbrush on orthodontic patients: a blind randomized clinical trial.

    Science.gov (United States)

    Marini, Ida; Bortolotti, Francesco; Parenti, Serena Incerti; Gatto, Maria Rosaria; Bonetti, Giulio Alessandri

    2014-09-01

    To investigate the effects on plaque index (PI) scores of manual or electric toothbrush with or without repeated oral hygiene instructions (OHI) and motivation on patients wearing fixed orthodontic appliances. One month after the orthodontic fixed appliance bonding on both arches, 60 patients were randomly assigned to four groups; groups E1 (n  =  15) and E2 (n  =  15) received a powered rotating-oscillating toothbrush, and groups M1 (n  =  15) and M2 (n  =  15) received a manual toothbrush. Groups E1 and M1 received OHI and motivation at baseline (T0) and after 4, 8, 12, 16, and 20 weeks (T4, T8, T12, T16, and T20, respectively) by a Registered Dental Hygienist; groups E2 and M2 received OHI and motivation only at baseline. At each time point a blinded examiner scored plaque of all teeth using the modified Quigley-Hein PI. In all groups the PI score decreased significantly over time, and there were differences among groups at T8, T12, T16, and T20. At T8, PI scores of group E1 were lower than those of group E2, and at T12, T16, and T20, PI scores of groups M1 and E1 were lower compared to those of groups M2 and E2. A linear mixed model showed that the effect of repeated OHI and motivation during time was statistically significant, independently from the use of manual or electric toothbrush. The present results showed that repeated OHI and motivation are crucial in reducing PI score in orthodontic patients, independent of the type of toothbrush used.

  13. Discontinuation of benzodiazepines among older insomniac adults treated with cognitive-behavioural therapy combined with gradual tapering: a randomized trial.

    Science.gov (United States)

    Baillargeon, Lucie; Landreville, Philippe; Verreault, René; Beauchemin, Jean-Pierre; Grégoire, Jean-Pierre; Morin, Charles M

    2003-11-11

    Long-term use of hypnotics is not recommended because of risks of dependency and adverse effects on health. The usual clinical management of benzodiazepine dependency is gradual tapering, but when used alone this method is not highly effective in achieving long-term discontinuation. We compared the efficacy of tapering plus cognitive-behavioural therapy for insomnia with tapering alone in reducing the use of hypnotics by older adults with insomnia. People with chronic insomnia who had been taking a benzodiazepine every night for more than 3 months were recruited through media advertisements or were referred by their family doctors. They were randomly assigned to undergo either cognitive-behavioural therapy plus gradual tapering of the drug (combined treatment) or gradual tapering only. The cognitive-behavioural therapy was provided by a psychologist in 8 weekly small-group sessions. The tapering was supervised by a physician, who met weekly with each participant over an 8-week period. The main outcome measure was benzodiazepine discontinuation, confirmed by blood screening performed at each of 3 measurement points (immediately after completion of treatment and at 3- and 12-month follow-ups). Of the 344 potential participants, 65 (mean age 67.4 years) met the inclusion criteria and entered the study. The 2 study groups (35 subjects in the combined treatment group and 30 in the tapering group) were similar in terms of demographic characteristics, duration of insomnia and hypnotic dosage. Immediately after completion of treatment, a greater proportion of patients in the combined treatment group had withdrawn from benzodiazepine use completely (77% [26/34] v. 38% [11/29]; odds ratio [OR] 5.3, 95% confidence interval [CI] 1.8-16.2; OR after adjustment for initial benzodiazepine daily dose 7.9, 95% CI 2.4-30.9). At the 12-month follow-up, the favourable outcome persisted (70% [23/33] v. 24% [7/29]; OR 7.2, 95% CI 2.4-23.7; adjusted OR 7.6, 95% CI 2.5-26.6); similar

  14. Effect of exercise training combined with isoflavone supplementation on bone and lipids in postmenopausal women: a randomized clinical trial.

    Science.gov (United States)

    Chilibeck, Philip D; Vatanparast, Hassanali; Pierson, Roger; Case, Allison; Olatunbosun, Olufemi; Whiting, Susan J; Beck, Thomas J; Pahwa, Punam; Biem, H Jay

    2013-04-01

    We determined the effects of 2 years of exercise training and soy isoflavone supplementation on bone mass and lipids in postmenopausal women provided with calcium and vitamin D. Women were randomized to four groups: exercise training (Ex); isoflavone supplementation (Iso: 165 mg/d [105 mg/d aglycone equivalent]); combined Ex and Iso (ExIso); and placebo (control). Exercise included resistance training (2 days/week) and walking (4 days/week). Our primary outcomes were lumbar spine and hip bone mineral density (BMD). Secondary outcomes included hip geometry, tibia and radius speed of sound (SOS), dynamic balance (6 m backward tandem walking), blood lipids, mammography, and endometrial thickness. A total of 351 women (Ex = 86, Iso = 90, ExIso = 87, control = 88) were randomized, with 298 analyzed at 2 years (Ex = 77, Iso = 76, ExIso = 72, control = 73). There was a significant interaction for total hip BMD (p bone SOS. Exercise groups improved dynamic balance as measured by a decrease in backward tandem walking time over 6 m (p = 0.017). Isoflavone groups decreased low density lipoproteins (Iso: -0.20 [-0.37, -0.02] mmol/L; ExIso: -0.23 [-0.40, -0.06] mmol/L; p = 0.003) compared to non-isoflavone groups (Ex: 0.01 [-0.16, 0.18] mmol/L; control: -0.09 [-0.27, 0.08] mmol/L) and had lower adverse reports of menopausal symptoms (14% versus 33%; p = 0.01) compared to non-isoflavone groups. Isoflavone supplementation did not increase endometrial thickness or abnormal mammograms. We conclude exercise training and isoflavone supplementation maintain hip BMD compared to control, but these two interventions interfere with each other when combined. Isoflavone supplementation decreased LDL and adverse events related to menopausal symptoms. Copyright © 2013 American Society for Bone and Mineral Research.

  15. A prospective, randomized controlled trial of conscious sedation using propofol combined with inhaled nitrous oxide for dental treatment.

    Science.gov (United States)

    Yokoe, Chizuko; Hanamoto, Hiroshi; Sugimura, Mitsutaka; Morimoto, Yoshinari; Kudo, Chiho; Niwa, Hitoshi

    2015-03-01

    Adverse reactions during propofol sedation include a decrease in arterial blood pressure, propofol-induced pain on injection, and airway complications. The purpose of this study was to investigate whether combined use of intravenous propofol and inhaled nitrous oxide could decrease the hypotensive and other adverse effects of propofol. We designed and implemented a prospective, randomized controlled trial. Patients undergoing dental procedures requiring intravenous sedation were randomly allocated to 2 groups: group P comprised those receiving sedation with propofol alone, and group N+P comprised those receiving sedation with 40% nitrous oxide inhalation and propofol. During the dental procedures, the sedation level was maintained at an Observer's Assessment of Alertness/Sedation scale score of 4 by adjusting propofol's target plasma concentration. Nitrous oxide inhalation was the predictor variable, whereas the hemodynamic changes, amount and concentration of propofol, and adverse events were the outcome variables. Eighty-eight patients were successfully analyzed without any complications. The total amount of propofol was significantly less in group N+P (249.8 ± 121.7 mg) than in group P (310.3 ± 122.4 mg) (P = .022), and the mean concentration of propofol was significantly less in group N+P (1.81 ± 0.34 μg/mL) than in group P (2.05 ± 0.44 μg/mL) (P = .006). The mean blood pressure reduction in group N+P (11.0 ± 8.0 mm Hg) was significantly smaller than that in group P (15.8 ± 10.2 mm Hg) (P = .034). Pain associated with the propofol injection and memory of the procedure were less in group N+P (P = .011 and P = .048, respectively). Nitrous oxide did not affect respiratory conditions or recovery characteristics. The results of this study suggest that nitrous oxide inhalation combined with propofol sedation attenuates the hypotensive effect and pain associated with propofol injections, along with potentiating the amnesic effect. Copyright © 2015 American

  16. Efficacy of Oseltamivir-Zanamivir Combination Compared to Each Monotherapy for Seasonal Influenza: A Randomized Placebo-Controlled Trial

    Science.gov (United States)

    Duval, Xavier; van der Werf, Sylvie; Blanchon, Thierry; Mosnier, Anne; Bouscambert-Duchamp, Maude; Tibi, Annick; Enouf, Vincent; Charlois-Ou, Cécile; Vincent, Corine; Andreoletti, Laurent; Tubach, Florence; Lina, Bruno; Mentré, France; Leport, Catherine

    2010-01-01

    Background Neuraminidase inhibitors are thought to be efficacious in reducing the time to alleviation of symptoms in outpatients with seasonal influenza. The objective of this study was to compare the short-term virological efficacy of oseltamivir-zanamivir combination versus each monotherapy plus placebo. Methods and Findings We conducted a randomized placebo-controlled trial with 145 general practitioners throughout France during the 2008–2009 seasonal influenza epidemic. Patients, general practitioners, and outcome assessors were all blinded to treatment assignment. Adult outpatients presenting influenza-like illness for less than 36 hours and a positive influenza A rapid test diagnosis were randomized to oseltamivir 75 mg orally twice daily plus zanamivir 10 mg by inhalation twice daily (OZ), oseltamivir plus inhaled placebo (O), or zanamivir plus oral placebo (Z). Treatment efficacy was assessed virologically according to the proportion of patients with nasal influenza reverse transcription (RT)-PCR below 200 copies genome equivalent (cgeq)/µl at day 2 (primary outcome), and clinically to the time to alleviation of symptoms until day 14. Overall 541 patients (of the 900 planned) were included (OZ, n = 192; O, n = 176; Z, n = 173), 49% male, mean age 39 years. In the intention-to-treat analysis conducted in the 447 patients with RT-PCR-confirmed influenza A, 46%, 59%, and 34% in OZ (n = 157), O (n = 141), and Z (n = 149) arms had RT-PCR<200 cgeq/µl (−13.0%, 95% confidence interval [CI] −23.1 to −2.9, p = 0.025; +12.3%, 95% CI 2.39–22.2, p = 0.028 for OZ/O and OZ/Z comparisons). Mean day 0 to day 2 viral load decrease was 2.14, 2.49, and 1.68 log10 cgeq/µl (p = 0.060, p = 0.016 for OZ/O and OZ/Z). Median time to alleviation of symptoms was 4.0, 3.0, and 4.0 days (+1.0, 95% CI 0.0–4.0, p = 0.018; +0.0, 95% CI −3.0 to 3.0, p = 0.960 for OZ/O and OZ/Z). Four severe adverse events were observed. Nausea

  17. Efficacy of oseltamivir-zanamivir combination compared to each monotherapy for seasonal influenza: a randomized placebo-controlled trial.

    Directory of Open Access Journals (Sweden)

    Xavier Duval

    2010-11-01

    Full Text Available Neuraminidase inhibitors are thought to be efficacious in reducing the time to alleviation of symptoms in outpatients with seasonal influenza. The objective of this study was to compare the short-term virological efficacy of oseltamivir-zanamivir combination versus each monotherapy plus placebo.We conducted a randomized placebo-controlled trial with 145 general practitioners throughout France during the 2008-2009 seasonal influenza epidemic. Patients, general practitioners, and outcome assessors were all blinded to treatment assignment. Adult outpatients presenting influenza-like illness for less than 36 hours and a positive influenza A rapid test diagnosis were randomized to oseltamivir 75 mg orally twice daily plus zanamivir 10 mg by inhalation twice daily (OZ, oseltamivir plus inhaled placebo (O, or zanamivir plus oral placebo (Z. Treatment efficacy was assessed virologically according to the proportion of patients with nasal influenza reverse transcription (RT-PCR below 200 copies genome equivalent (cgeq/µl at day 2 (primary outcome, and clinically to the time to alleviation of symptoms until day 14. Overall 541 patients (of the 900 planned were included (OZ,  =192; O, n=176; Z, n=173, 49% male, mean age 39 years. In the intention-to-treat analysis conducted in the 447 patients with RT-PCR-confirmed influenza A, 46%, 59%, and 34% in OZ (n=157, O (n=141, and Z (n=149 arms had RT-PCR<200 cgeq/µl (-13.0%, 95% confidence interval [CI] -23.1 to -2.9, p=0.025; +12.3%, 95% CI 2.39-22.2, p=0.028 for OZ/O and OZ/Z comparisons. Mean day 0 to day 2 viral load decrease was 2.14, 2.49, and 1.68 log(10 cgeq/µl (p=0.060, p=0.016 for OZ/O and OZ/Z. Median time to alleviation of symptoms was 4.0, 3.0, and 4.0 days (+1.0, 95% CI 0.0-4.0, p=0.018; +0.0, 95% CI -3.0 to 3.0, p=0.960 for OZ/O and OZ/Z. Four severe adverse events were observed. Nausea and/or vomiting tended to be more frequent in the combination arm (OZ, n=13; O, n=4; and Z, n=5 patients

  18. Efficacy of combined physical and occupational therapy in patients with conservatively treated distal radius fracture: randomized controlled trial.

    Science.gov (United States)

    Filipova, Verica; Lonzarić, Dragan; Jesenšek Papež, Breda

    2015-12-01

    To evaluate the efficacy of combined physical and occupational therapy in comparison with physical therapy alone in patients with conservatively treated distal radius fracture. Sixty-one participants, conservatively treated after a distal radius fracture, were included in a randomized and single-blind trial. Group A had physical therapy only (n = 31) and group B had physical and occupational therapy (n = 30). The assessment was performed three times: upon inclusion in the study in the first week after removal of the cast (T1), immediately after the end of the rehabilitation (T2), and 1 month after completing the rehabilitation (T3). The passive wrist range-of-motion, grip strength, and Disabilities of Arm, Shoulder and Hand (DASH) score were used as rehabilitation outcomes. Rehabilitation outcomes were analyzed using two-way mixed analysis of variance. The effect of time was statistically significant (p therapy) factor was statistically significant for grip strength only (p = 0.038). The interaction effect was statistically significant for rotation (p = 0.034) and grip strength (p = 0.021). A comparison between time points T3:T1 showed statistically significant difference in grip strength in favor of group B 67 % (95 % CI 60-74 %) versus group A 53 % (95 % CI 45-61 %), p = 0.024. The combined therapy resulted in a statistically significant increase of grip strength in comparison with isolated physical therapy in the period of 12-16 weeks after the fracture. This effectiveness was not confirmed with DASH score results.

  19. Pain Reduction in Myofascial Pain Syndrome by Anodal Transcranial Direct Current Stimulation Combined with Standard Treatment: A Randomized Controlled Study

    Science.gov (United States)

    Sakrajai, Piyaraid; Janyacharoen, Taweesak; Jensen, Mark P.; Sawanyawisuth, Kittisak; Auvichayapat, Narong; Tunkamnerdthai, Orathai; Keeratitanont, Keattichai; Auvichayapat, Paradee

    2014-01-01

    Background Myofascial pain syndrome (MPS) in the shoulder is among the most prevalent pain problems in the middle-aged population worldwide. Evidence suggests that peripheral and central sensitization may play an important role in the development and maintenance of shoulder MPS. Given previous research supporting the potential efficacy of anodal transcranial direct current stimulation (tDCS) for modulating pain-related brain activity in individuals with refractory central pain, we hypothesized that anodal tDCS when applied over the primary motor cortex (M1) combined with standard treatment will be more effective for reducing pain in patients with MPS than standard treatment alone. Method Study participants were randomized to receive either (1) standard treatment with 5-consecutive days of 1 mA anodal tDCS over M1 for 20 min or (2) standard treatment plus sham tDCS. Measures of pain intensity, shoulder passive range of motion, analgesic medication use, and self-reported physical functioning were administered before treatment and again at post-treatment and 1-, 2-, 3-and 4-week follow-up. Results Thirty-one patients with MPS were enrolled. Participants assigned to the active tDCS condition reported significantly more pre- to post-treatment reductions in pain intensity that were maintained at 1-week post-treatment, and significant improvement in shoulder adduction PROM at 1-week follow-up than participants assigned to the sham tDCS condition. Conclusion 5 consecutive days of anodal tDCS over M1 combined with standard treatment appears to reduce pain intensity, and may improve PROM, faster than standard treatment alone. Further tests of the efficacy and duration of effects of tDCS in the treatment of MPS are warranted. PMID:25373724

  20. Oral tranexamic acid with fluocinolone-based triple combination cream versus fluocinolone-based triple combination cream alone in melasma: An open labeled randomized comparative trial

    OpenAIRE

    Tanmay Padhi; Swetalina Pradhan

    2015-01-01

    Background : Melasma is a common acquired cause of facial hyperpigmentation with no definitive therapy. Tranexamic acid, a plasmin inhibitor, has demonstrated depigmenting properties and combining this oral drug with other modalities of treatment has shown promising results. Objectives : To compare the efficacy of a combination of oral tranexamic acid and fluocinolone-based triple combination cream with that of fluocinolone-based triple combination cream alone in melasma among Indian patients...

  1. Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial

    Science.gov (United States)

    Smith, Caroline A.; Abbott, Jason; Fahey, Paul; Cheema, Birinder S.; Bensoussan, Alan

    2017-01-01

    Polycystic ovary syndrome (PCOS) is a common, complex reproductive endocrinopathy characterized by menstrual irregularities, hyperandrogenism and polycystic ovaries. Lifestyle modification is a first‐line intervention; however, there are barriers to success for this form of self‐care, and women often seek adjunct therapies including herbal medicines. This pragmatic, randomized controlled trial, delivered in communities of Australia in overweight women with PCOS, compared the effectiveness and safety of a lifestyle intervention plus herbal medicine against lifestyle alone. All participants were helped to construct a personalized lifestyle plan. The herbal intervention consisted of two tablets. Tablet 1 contained Cinnamomum verum, Glycyrrhiza glabra, Hypericum perforatum and Paeonia lactiflora. Tablet 2 contained Tribulus terrestris. The primary outcome was oligomenorrhoea/amenorrhoea. Secondary outcomes were hormones; anthropometry; quality of life; depression, anxiety and stress; pregnancy; birth outcomes; and safety. One hundred and twenty‐two women gave their consent. At 3 months, women in the combination group recorded a reduction in oligomenorrhoea of 32.9% (95% confidence interval 23.3–42.6, p herbal medicines in women with PCOS. © 2017 The Authors. Phytotherapy Research published by John Wiley & Sons Ltd PMID:28685911

  2. A combined analysis of 2 randomized clinical studies of tretinoin gel 0.05% for the treatment of acne.

    Science.gov (United States)

    Webster, Guy; Cargill, D Innes; Quiring, John; Vogelson, Cullen T; Slade, Herbert B

    2009-03-01

    Acne vulgaris is a widely prevalent skin disorder primarily treated with retinoids, which have been shown to cause skin irritation. This report describes the combined analysis of 2 similar phase 3 studies designed to evaluate the efficacy and safety of an aqueous gel formulation of tretinoin relative to its vehicle (both studies) and a marketed microsphere formulation of tretinoin (one study) for once-daily topical treatment of acne. Randomized participants 10 years and older with mild to moderate acne (N=1537) received tretinoin gel 0.05% (n=674), tretinoin gel microsphere 0.1% (n=376), or vehicle (n=487) once daily for 12 weeks. Tretinoin gel was more effective than vehicle in reducing inflammatory (Ptretinoin gel 0.05% group compared with the vehicle group (Ptretinoin gel 0.05% was approximately 12% less than tretinoin gel microsphere 0.1%. Adverse events (AEs) were generally mild to moderate and rarely resulted in participant discontinuation. Incidence of skin-related AEs in the tretinoin gel 0.05% group (31%) was significantly lower compared with the tretinoin gel microsphere 0.1% group (52%)(Ptretinoin gel 0.05% applied once daily is a well-tolerated and effective therapy for acne vulgaris and is associated with a low incidence of skin-related AEs.

  3. Identification of velvet antler by random amplified polymorphism DNA combined with non-gel sieving capillary electrophoresis.

    Science.gov (United States)

    Yuan, Guangxin; Sun, Jiyan; Li, Hongyu; Fu, Guilian; Xu, Guangyu; Li, Mingcheng; Zhang, Lihua; Fan, Xintian

    2016-01-01

    Mitochondrial DNA of velvet antler was amplified with random amplified polymorphic DNA (RAPD) technique and the PCR products were detected with non-gel sieving capillary electrophoresis to establish a RAPD-HPCE method used for identifying the authenticity of velvet antler or it counterfeits. Factors that could affect the PCR amplification and capillary electrophoresis were optimized. Under the optimized conditions, namely, 20 mmol L(-1) NaH2PO4-Na2HPO4-2 mmol L(-1) EDTA buffer solution [0.8% (W/V) HPMC, 15 mmol L(-1) TBAP and pH 7.3], -10 kV injection voltage and -8 kV separation voltage, Cervus nippon Temminck antler, Cervus elaphus Linnaeus antler, Rangifer tarandus antler, Cervus canadensis antler and Elaphurus davidianus antler were analyzed. The analysis on the similarity of obtained elctrophoretograms showed that there were significant differences in similarities of different velvet antlers, which could be used for the quick identification of the authenticity of velvet antler samples. It can be found that the technique of RAPD combined with HPCE is advantageous in rich polymorphism, high detection rate, simple and convenient performance, high efficiency, rapidness and sensitivity, indicating that it should be suitable for the quick identification of the authenticity of velvet antler samples.

  4. A Combined Random Forests and Active Contour Model Approach for Fully Automatic Segmentation of the Left Atrium in Volumetric MRI

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    Chao Ma

    2017-01-01

    Full Text Available Segmentation of the left atrium (LA from cardiac magnetic resonance imaging (MRI datasets is of great importance for image guided atrial fibrillation ablation, LA fibrosis quantification, and cardiac biophysical modelling. However, automated LA segmentation from cardiac MRI is challenging due to limited image resolution, considerable variability in anatomical structures across subjects, and dynamic motion of the heart. In this work, we propose a combined random forests (RFs and active contour model (ACM approach for fully automatic segmentation of the LA from cardiac volumetric MRI. Specifically, we employ the RFs within an autocontext scheme to effectively integrate contextual and appearance information from multisource images together for LA shape inferring. The inferred shape is then incorporated into a volume-scalable ACM for further improving the segmentation accuracy. We validated the proposed method on the cardiac volumetric MRI datasets from the STACOM 2013 and HVSMR 2016 databases and showed that it outperforms other latest automated LA segmentation methods. Validation metrics, average Dice coefficient (DC and average surface-to-surface distance (S2S, were computed as 0.9227±0.0598 and 1.14±1.205 mm, versus those of 0.6222–0.878 and 1.34–8.72 mm, obtained by other methods, respectively.

  5. PAAPPAS community trial protocol: a randomized study of obesity prevention for adolescents combining school with household intervention

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    Michele R. Sgambato

    2016-08-01

    Full Text Available Abstract Background The prevalence of childhood obesity is increasing at a high rate in Brazil, making prevention a health priority. Schools are the central focus of interventions aiming the prevention and treatment of childhood obesity, however, randomized trials and cohort studies have not yet provided clear evidence of strategies to reduce prevalence of obesity. The aim of this study is to present a protocol to evaluate the efficacy of combining school and household level interventions to reduce excessive weight gain among students. Methods The intervention target fifth and sixth graders from 18 public schools (9 interventions and 9 controls in the municipality of Duque de Caxias, metropolitan area of Rio de Janeiro, Brazil. A sample size of 2500 students will be evaluated at school for their weight status and those from the intervention group who are overweight or obese will be followed monthly at home by community health agents. Demographic, socioeconomic, anthropometric, eating behavior and food consumption data will be collected at school using a standardized questionnaire programmed in personal digital assistant. At school, all students from the intervention group will be encouraged to change eating habits and food consumption and to increase physical activity and reducing sedentary behavior. Discussion This study will provide evidence whether integration of school with primary health care can prevent excessive weight gain among adolescents. Positive results will inform a sustainable strategy to be disseminated in the health care system in Brazil. Trial registration ClinicalTrials.gov, NCT02711488 . Date of registration: March 11, 2016.

  6. 28-Day safety and tolerability of umeclidinium in combination with vilanterol in COPD: a randomized placebo-controlled trial.

    Science.gov (United States)

    Feldman, Gregory; Walker, Robert R; Brooks, Jean; Mehta, Rashmi; Crater, Glenn

    2012-12-01

    Umeclidinium (UMEC; GSK573719) is a new long-acting muscarinic antagonist (LAMA) currently in development in combination with vilanterol (VI), an inhaled, long-acting beta₂ agonist for the treatment of chronic obstructive pulmonary disease (COPD). The primary aim of this study was to evaluate the safety and tolerability of repeat dosing of UMEC and VI in combination once daily for 28 days in patients with COPD. This was a multicenter, double-blind, placebo-controlled, parallel group study. Patients aged ≥40 years with post-bronchodilator FEV₁ ≤80% of predicted normal values and FEV₁/FVC ratio ≤0.70, and a smoking history of ≥10 pack-years, were randomized 4:1 to once-daily UMEC/VI (500/25 mcg; n = 42) or placebo (n = 9). UMEC/VI was non-inferior to placebo in weighted mean pulse rate over 0-6 h at Day 28 (primary endpoint: difference of -0.5 bpm, 95% CI: -5.5 to 4.5). There was no evidence of a difference between UMEC/VI compared with placebo in blood pressure, minimum and maximum pulse rate, or QTcF assessments. Adverse events (AEs) were reported by 11 (26%) patients in the UMEC/VI group and one (11%) patient in the placebo group. No serious AEs were reported. Both UMEC and VI showed rapid absorption (median t(max) ∼6 min for both drugs) with no evidence of accumulation for AUC or C(max) on Day 28 compared with Day 1 for UMEC or VI. There was no correlation between individual steady-state C(max) and pulse rate on Day 28. Change from baseline in trough FEV₁ on Day 29 showed numerically greater improvements with UMEC/VI compared with placebo. Once-daily dosing with UMEC in combination with VI in patients with moderate-to-very-severe COPD was well tolerated over 28 days. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Randomized trial of combined cabergoline and coasting in preventing ovarian hyperstimulation syndrome during in vitro fertilization/intracytoplasmic sperm injection cycles.

    Science.gov (United States)

    Bassiouny, Yasmin A; Dakhly, Dina M R; Bayoumi, Yomna A; Salaheldin, Noha M; Gouda, Hisham M; Hassan, Ayman A

    2018-02-01

    To assess the efficacy of coasting alone, cabergoline alone, or combining both interventions for preventing ovarian hyperstimulation syndrome (OHSS) among high-risk patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment cycles. The present randomized controlled trial was conducted at the IVF unit of a university hospital in Cairo between October 28, 2013, and July 31, 2015. Patients undergoing IVF/ICSI considered at risk of OHSS were randomly allocated to coasting, cabergoline, or combined coasting and cabergoline. The primary outcome was the rate and degree of symptomatically assessed OHSS. Data were analyzed on a per-protocol basis. There were 100 patients recruited to each group. The occurrence of early OHSS was lowest in the combination group compared with the other groups (P=0.002). Combining coasting and cabergoline was associated with a lower OHSS rate compared with either therapy alone. CLINICALTRIALS.GOV: NCT01984320. © 2017 International Federation of Gynecology and Obstetrics.

  8. Random-effects linear modeling and sample size tables for two special crossover designs of average bioequivalence studies: the four-period, two-sequence, two-formulation and six-period, three-sequence, three-formulation designs.

    Science.gov (United States)

    Diaz, Francisco J; Berg, Michel J; Krebill, Ron; Welty, Timothy; Gidal, Barry E; Alloway, Rita; Privitera, Michael

    2013-12-01

    Due to concern and debate in the epilepsy medical community and to the current interest of the US Food and Drug Administration (FDA) in revising approaches to the approval of generic drugs, the FDA is currently supporting ongoing bioequivalence studies of antiepileptic drugs, the EQUIGEN studies. During the design of these crossover studies, the researchers could not find commercial or non-commercial statistical software that quickly allowed computation of sample sizes for their designs, particularly software implementing the FDA requirement of using random-effects linear models for the analyses of bioequivalence studies. This article presents tables for sample-size evaluations of average bioequivalence studies based on the two crossover designs used in the EQUIGEN studies: the four-period, two-sequence, two-formulation design, and the six-period, three-sequence, three-formulation design. Sample-size computations assume that random-effects linear models are used in bioequivalence analyses with crossover designs. Random-effects linear models have been traditionally viewed by many pharmacologists and clinical researchers as just mathematical devices to analyze repeated-measures data. In contrast, a modern view of these models attributes an important mathematical role in theoretical formulations in personalized medicine to them, because these models not only have parameters that represent average patients, but also have parameters that represent individual patients. Moreover, the notation and language of random-effects linear models have evolved over the years. Thus, another goal of this article is to provide a presentation of the statistical modeling of data from bioequivalence studies that highlights the modern view of these models, with special emphasis on power analyses and sample-size computations.

  9. Anti Bacterial Efficacy of Terminalia Chebula, Terminalia Bellirica, Embilica Officinalis and Triphala on Salivary Streptococcus Mutans Count - A Linear Randomized Cross Over Trial.

    Science.gov (United States)

    Saxena, Smariti; Lakshminarayan, Nagesh; Gudli, Shanmukha; Kumar, Manish

    2017-02-01

    From the oral health perspective, it is well established that microorganisms have an important role in caries aetiology. From the dawn of civilization, herbal plants have served an array of roles. Triphala a tradtional herbal Ayurvedic formula consists of three native fruits of india including Terminalia Chebula (T. chebula), Terminalia Bellirica (T. bellirica) and Embilica Officinalis (E. officinalis). As per Ayurvedic Formulary of India (AFI) Triphala is prepared by combining a 1:1:1 mixture of ground dry fruits called myrobalans. Till date, an inadequate number of clinical researches on herb based mouth rinses have been reported in Asia, especially in India and other Southeast Asian countries (where these products are most accepted and widely used). The present study was planned to assess the effectiveness of Triphala with its three constituents. The objective of this study was to determine the effect of Triphala, T. chebula, T. bellirica and E. officinalis aqueous extract rinses separately on Streptococcusmutans count at various time intervals. This is a double-blind, linear cross over, within group experimental trial conducted among subjects visiting the Department of Public Health Dentistry aged 15 to 40 years. In this design, subjects received all of the treatments sequentially in time. The independent variables to be assessed in this study were all the four interventions of herbal preparations used and the dependent variable assessed is anti bacterial efficacy. Each subject receives two or more different treatments. All the subjects were exposed to all four interventions: 1) T. chebula; 2) T. bellirica; 3) E. officinalis; and 4) Triphala and were provided 15 ml of the freshly prepared 10% rinse. The subjects were instructed not to eat or drink between salivary samples collection. Post rinse unstimulated salivary samples were collected at five minutes and 60 minutes intervals. All the salivary samples were transferred immediately to microbiological

  10. Dressings combined with injection of meglumine antimoniate in the treatment of cutaneous leishmaniasis: a randomized controlled clinical trial.

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    Alireza Khatami

    Full Text Available BACKGROUND: Cutaneous leishmaniasis (CL is a neglected infectious disease and a major health problem in several developing countries. Despite some reasonable explanation for their potential benefits, there is only trace evidence regarding the role of dressings in the treatment of CL. METHODS: This randomized, assessor-blind, controlled, clinical trial was conducted in an endemic area for CL caused by Leishmania major in Iran to assess the efficacy of administration of weekly intralesional meglumine antimoniate (i.l.MA either alone or combined with application of a silver or a non-silver polyester dressing on their lesions for 6 weeks. After screening of 241 patients with CL lesions, 83 eligible patients with 158 lesions were randomly allocated in three arms of the study. Eligibility criteria included parasitologically confirmed CL, age of 12 to 60 years; willingness to participate, duration of lesion<3 months, number of lesions<5, largest ulcer diameter<5 cm. Pregnant or lactating women were excluded. The primary outcome was absolute risk reduction (ARR based on the proportion of complete healing, which was defined as more than 75% reduction in the size of the lesion compared with baseline in each group at the termination of treatment and 1 month later. FINDINGS: ARR (95% Confidence Interval [CI] in i.l.MA versus i.l.MA+non-silver dressing groups was 5.98% (-7.07% to 20.25%, between i.l.MA versus i.l.MA+silver dressing groups was -0.23% (-13.53% to 14.82%, and between i.l.MA+non-silver dressing versus i.l.MA+silver dressing groups was -6.21%(-18.28% to 6.52% after 6 weeks of treatment. ARR (95% CI in i.l.MA versus i.l.MA+non-silver dressing groups was -2.22% (-22.12% to 18.10%, between i.l.MA versus i.l.MA+silver dressing groups was 3.64% (-15.36% to 22.82%, and between i.l.MA+non-silver dressing versus i.l.MA+silver dressing groups was 5.86% (-12.86% to 24.31% 1 month later. CONCLUSION: It could not be demonstrated that the efficacy of i

  11. Price discounts significantly enhance fruit and vegetable purchases when combined with nutrition education: a randomized controlled supermarket trial.

    Science.gov (United States)

    Waterlander, Wilma E; de Boer, Michiel R; Schuit, Albertine J; Seidell, Jacob C; Steenhuis, Ingrid H M

    2013-04-01

    Reducing fruit and vegetable (F&V) prices is a frequently considered policy to improve dietary habits in the context of health promotion. However, evidence on the effectiveness of this intervention is limited. The objective was to examine the effects of a 50% price discount on F&Vs or nutrition education or a combination of both on supermarket purchases. A 6-mo randomized controlled trial within Dutch supermarkets was conducted. Regular supermarket shoppers were randomly assigned to 1 of 4 conditions: 50% price discounts on F&Vs, nutrition education, 50% price discounts plus nutrition education, or no intervention. A total of 199 participants provided baseline data; 151 (76%) were included in the final analysis. F&V purchases were measured by using supermarket register receipts at baseline, at 1 mo after the start of the intervention, at 3 mo, at 6 mo (end of the intervention period), and 3 mo after the intervention ended (9 mo). Adjusted multilevel models showed significantly higher F&V purchases (per household/2 wk) as a result of the price discount (+3.9 kg; 95% CI: 1.5, 6.3 kg) and the discount plus education intervention (+5.6 kg; 95% CI: 3.2, 7.9 kg) at 6 mo compared with control. Moreover, the percentage of participants who consumed recommended amounts of F&Vs (≥400 g/d) increased from 42.5% at baseline to 61.3% at 6 mo in both discount groups (P = 0.03). Education alone had no significant effect. Discounting F&Vs is a promising intervention strategy because it resulted in substantially higher F&V purchases, and no adverse effects were observed. Therefore, pricing strategies form an important focus for future interventions or policy. However, the long-term effects and the ultimate health outcomes require further investigation. This trial was registered at the ISRCTN Trial Register as number ISRCTN56596945 and at the Dutch Trial Register (http://www.trialregister.nl/trialreg/index.asp) as number NL22568.029.08.

  12. A Placebo-Controlled Double-Blinded Randomized Pilot Study of Combination Phytotherapy in Biochemically Recurrent Prostate Cancer.

    Science.gov (United States)

    van Die, M Diana; Williams, Scott G; Emery, Jon; Bone, Kerry M; Taylor, Jeremy M G; Lusk, Elizabeth; Pirotta, Marie V

    2017-05-01

    Men with biochemical recurrence of prostate cancer following local therapies often use natural supplements in an attempt to delay metastases and/or avoid the need for more aggressive treatments with undesirable side-effects. While there is a growing body of research into phytotherapeutic agents in this cohort, with some promising results, as yet no definitive recommendations can be made. This pilot study was undertaken to assess the feasibility of a fully-powered study to examine the effects of this phytotherapeutic intervention (containing turmeric, resveratrol, green tea and broccoli sprouts) on PSA doubling time in men with biochemical recurrence with a moderate PSA rise rate. A double blind, randomized, placebo-controlled parallel trial was conducted with 22 men with biochemically recurrent prostate cancer and a moderate rise rate (PSA doubling time of 4-15 months and no evidence of metastases from conventional imaging methods). Patients were randomized to either the active treatment arm or placebo for 12 weeks. The primary endpoints were feasibility of study recruitment and procedures, and measurement of proposed secondary endpoints (prostate symptoms, quality of life, anxiety, and depression as measured on the EORTC QLQ-C30 and PR-25, the IPSS and HADS). Data were collected to estimate PSA-log slopes and PSA-doubling times, using a mixed model, for both the pre-intervention and post-intervention periods. Adherence to study protocol was excellent, and the phytotherapeutic intervention was well-tolerated, with similar numbers of mild-to-moderate adverse events in the active and placebo arms. Both the intervention and data collection methods were acceptable to participants. No statistical difference between groups on clinical outcomes was expected in this pilot study. There was between-subject variation in the PSA post treatment, but on average the active treatment group experienced a non-significant increase in the log-slope of PSA (pre-treatment doubling time

  13. SMALL-DOSE CYTOKINES IN COMBINATION WITH 5-FLUOROURACIL IN OLISSEMINATED RENAL CELL CARCINOMA: FINAL RESULTS OF A RANDOMIZED TRIAL

    Directory of Open Access Journals (Sweden)

    L. V. Demidov

    2009-01-01

    Full Text Available Background: High and intermediate IL-2 regimens are difficult to recommend because of great toxicity and efficacy is not sufficient. We suggest that a combination of very low-dose cytokines is effective and safe in metastatic renal cell carcinoma (MRCC patients (pts. A prospective randomized study was started in 2003. The primary end-point was a response rate. Methods: The eligibility criteria included histopathologically confirmed MRCC, ECOG PS 0-2, no autoimmune diseases, no brain metastases, and normal organ function. All pts were randomized in three arms: IL-2 alone, 1.5 MIU, iv, t.i.w., weeks 1—3 or IL-2 1.0 MIU, iv, t.i.w., weeks 1—3 plus IFN 5 MIU, sc, t.i.w, weeks 1—3 or biochemotherapy group 5-FU, 500 mg/m2, iv, once a week, weeks 1—3 plus IL-2 1.0 MIU, iv, t.i.w., weeks 1—3 plus IFN 5 MIU, sc, t.i.w., weeks 1—3. Courses were repeated every three weeks. A response was assessed according to the RECIST every 2 courses.Results: 64 pts were enrolled, of whom 63 were analyzed. Their median age was 55.4 years (range 16—74. 42.9% of the patients had pre- viously received chemo- or immunotherapy. 55.6 percent of the pts had poor prognosis (according to Motzer et al., 2002. Bone metastases were present in 52.4% of the pts. Sixteen patients treated with IL-2 alone showed no CR, PR, 2 SD, or 14 PD. Of 23 patients in the IL-2+IFN group, there were 5 PR, 8 SD, and 10 PD, with a response rate of 21.7%. Amongst 24 patients in the 5-FU+IL-2+IFN group, there were 1 CR, 3 PR, 10 SD, and 10 PD, with a response rate of 16.7%. One-year survival was 20.0%, 81.3% and 81.0%, respectively. The influenza-like syndrome was the most common side effect in the pts who received IFN (89.1%, grade 1, CTC. Hypotension associated with IL-2 (all groups was seen in 56.3% (50%, grade 1 and 6.3%, grade 2. The other adverse reactions were 12.7% grade 1 neutropenia and vomiting in 4.7% pts (Group 3.Conclusion: All regimens are well tolerated. Small-dose IL-2

  14. The Opioid-Sparing Effect of Perioperative Dexmedetomidine Combined with Oxycodone Infusion during Open Hepatectomy: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Benhou Zhang

    2018-01-01

    Full Text Available Background: A large right subcostal incision performed by open hepatectomy is associated with significant post-operative pain and distress. However, post-operative analgesia solutions still need to be devised. We investigated the effects of intra- and post-operative infusion of dexmedetomidine (Dex combined with oxycodone during open hepatectomy.Methods: In this prospective, randomized and double-blind investigation, 52 patients undergoing selective open hepatectomy were divided into Dex group (DEX infusion at an initial loading dose of 0.5 μg⋅kg-1 over 10 min before intubation then adjusted to a maintenance dose of 0.3 μg⋅kg-1⋅h-1 until incision suturing or control (Con group (0.9% sodium chloride was administered. Patient-controlled analgesia was administered for 48 h after surgery (Dex group: 60 mg oxycodone and 360 μg DEX diluted to 120 ml and administered at a bolus dose of 2 ml, with 5 min lockout interval and a 1 h limit of 20 ml. Con group: 60 mg oxycodone alone with the same regimen. The primary outcome was post-operative oxycodone consumption. The secondary outcomes included requirement of narcotic and vasoactive drugs, hemodynamics, incidence of adverse effects, satisfaction, first exhaust time, pain intensity, and the Ramsay Sedation Scale.Results: Post-operative oxycodone consumption was significantly reduced in Dex group from 4 to 48 h after surgery (P < 0.05. Heart rate in Dex group was statistically decreased from T1 (just before intubation to T6 (20 min after arriving at the post-anesthesia care unit, while mean arterial pressure was significantly decreased from T1 to T3 (during surgical incision; P < 0.05. The consumption of propofol and remifentanil were significantly decreased in Dex group (P < 0.05. The VAS scores at rest at 1, 4, and 8 h and with cough at 24, and 48 h after surgery were lower, the first exhaust time were shorter, satisfaction with pain control was statistically higher and the incidence of nausea

  15. Primary and booster vaccination in Latin American children with a DTPw-HBV/Hib combination: a randomized controlled trial

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    Collard Alix

    2010-10-01

    Full Text Available Abstract Background Diphtheria-tetanus-whole-cell pertussis (DTPw-based combination vaccines are an attractive option to rapidly achieve high coverage and protection against other important pathogens, such as hepatitis B virus (HBV and Haemophilus influenzae type B (Hib. To ensure adequate antigen supply, GlaxoSmithKline Biologicals has introduced a new DTPw antigen source and developed a new DTPw-HBV/Hib combination vaccine containing a reduced amount of Hib polyribosylribitol phosphate (PRP. This study was undertaken to compare the immunogenicity and reactogenicity of this new DTPw-HBV/Hib vaccine with a licensed DTPw-HBV/Hib vaccine (Tritanrix™-HBV/Hib. Methods This was a randomized, partially-blind, multicenter study in three countries in Latin America (Argentina, Chile and Nicaragua. Healthy children received either the new DTPw-HBV/Hib vaccine (1 of 3 lots; n = 439; double-blind or Tritanrix™-HBV/Hib (n = 146; single-blind co-administered with oral poliovirus vaccine (OPV at 2, 4 and 6 months, with a booster dose at 18-24 months. Results One month after the end of the 3-dose primary vaccination course, the new DTPw-HBV/Hib vaccine was non-inferior to Tritanrix™-HBV/Hib in terms of seroprotection/vaccine response rates for all component antigens; ≥97.3% and ≥93.9% of subjects in the two groups, respectively, had seroprotective levels of antibodies against diphtheria, tetanus, hepatitis B and Hib and a vaccine response to the pertussis component. Persistence of antibodies against all vaccine antigens was comparable between groups, with marked increases in all antibody concentrations after booster administration in both groups. Both vaccines were generally well-tolerated as primary and booster doses. Conclusions Results confirm the suitability of this new DTPw-HBV/Hib vaccine comprising antigens from a new source and a reduced PRP content for inclusion into routine childhood vaccination programs. Trial registration http

  16. Combining motivational and volitional strategies to promote unsupervised walking in patients with fibromyalgia: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Pastor, María-Ángeles; López-Roig, Sofía; Lledó, Ana; Peñacoba, Cecilia; Velasco, Lilian; Schweiger-Gallo, Inge; Cigarán, Margarita; Ecija, Carmen; Limón, Ramón; Sanz, Yolanda

    2014-04-11

    Fibromyalgia patients are often advised to engage in regular low- to moderate-intensity physical exercise. The need of fibromyalgia patients to walk has been stressed in previous research. Behavioral self-regulation theories suggest that a combination of motivational aspects (to develop or strengthen a behavioral intention: Theory of Planned Behavior) and volitional aspects (engagement of intention in behavior: implementation intentions) is more effective than a single intervention. In this paper, we describe a protocol for identifying the motivational processes (using the Theory of Planned Behavior) involved in the practice of walking (phase I) and for studying the efficacy of an intervention that combines motivational and volitional contents to enhance the acquisition and continuation of this exercise behavior (phase II). The paper also shows the characteristics of eligible individuals (women who do not walk) and ineligible populations (women who walk or do not walk because of comorbidity without medical recommendation to walk). Both groups consist of members of any of four patients' associations in Spain who are between 18 and 70 years of age and meet the London Fibromyalgia Epidemiology Study Screening Questionnaire criteria for fibromyalgia. Furthermore, using this study protocol, we will explore the characteristics of participants (eligible women who agreed to participate in the study) and nonparticipants (eligible women who refused to participate). Two studies will be conducted: Phase I will be a cross-sectional study, and phase II will be a triple-blind, randomized longitudinal study with two treatment groups and one active control group. The questionnaires were sent to a total of 2,227 members of four patients' associations in Spain. A total of 920 participants with fibromyalgia returned the questionnaires, and 582 were ultimately selected to participate. The first data gathered have allowed us to identify the characteristics of the study population and

  17. Does physiotherapeutic intervention affect motor outcome in high-risk infants? An approach combining a randomized controlled trial and process evaluation

    NARCIS (Netherlands)

    Hielkema, Tjitske; Blauw-Hospers, Cornill H.; Dirks, Tineke; Drijver-Messelink, Marieke; Bos, Arend F.; Hadders-Algra, Mijna

    AIM The aim of this study was to examine the effects of intervention in infants at risk of developmental disorders onmotor outcome, as measured by the InfantMotor Profile (IMP) and using the combined approach of a randomized controlled trial and process evaluation. METHOD At a corrected age of 3

  18. Cancer-Related Fatigue and Rehabilitation : A Randomized Controlled Multicenter Trial Comparing Physical Training Combined With Cognitive-Behavioral Therapy With Physical Training Only and With No Intervention

    NARCIS (Netherlands)

    van Weert, E.; May, A.M.; Korstjens, I.; Post, W.J.; van der Schans, C.P.; van den Borne, B.; Mesters, I.; Ros, W.J.G.; Hoekstra-Weebers, J.E.H.M.

    2010-01-01

    Background. Research suggests that cancer rehabilitation reduces fatigue in survivors of cancer. To date, it is unclear what type of rehabilitation is most beneficial. Objective. This randomized controlled trial compared the effect on cancer-related fatigue of physical training combined with

  19. The combined effect of lower-limb multilevel botulinum toxin type A and comprehensive rehabilitation on mobility in children with cerebral palsy: A randomized clinical trial

    NARCIS (Netherlands)

    Scholtes, V.A.; Dallmeijer, A.J.; Knol, D.L.; Speth, L.A.; Maathuis, C.G.; Jongerius, P.H.; Becher, J.G.

    2006-01-01

    Objective: To evaluate the combined effect on mobility of treatment with multilevel botulinum toxin type A (BTX-A) and comprehensive rehabilitation in children with cerebral palsy (CP). Design: Randomized clinical trial using a multiple baseline design. The intervention group was treated 6 weeks

  20. The combined effect of lower-limb multilevel botulinum toxin type A and comprehensive rehabilitation on mobility in children with cerebral palsy : A randomized clinical trial

    NARCIS (Netherlands)

    Scholtes, Vanessa A.; Dallmeijer, Annet J.; Knol, Dirk L.; Speth, Lucianne A.; Maathuis, Carel G.; Jongerius, Peter H.; Becher, Jules G.

    2006-01-01

    Objective: To evaluate the combined effect on mobility of treatment with multilevel botulinum toxin type A (BTX-A) and comprehensive rehabilitation in children with cerebral palsy (CP). Design: Randomized clinical trial using a multiple baseline design. The intervention group was treated 6 weeks

  1. Assessing the quality of reports about randomized controlled trials of scalp acupuncture combined with another treatment for stroke.

    Science.gov (United States)

    You, Young-Nim; Cho, Myung-Rae; Kim, Jae-Hong; Park, Ju-Hyung; Park, Gwang-Cheon; Song, Min-Yeong; Choi, Jin-Bong; Han, Jae-Young

    2017-09-06

    This study was designed to assess the quality of reporting on randomized controlled trials (RCTs) of scalp acupuncture for the treatment of stroke. The following 8 databases were systematically investigated from their inception to December 2015: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, National Institute of Informatics Scholarly and Academic Information Navigator, National Digital Science Library, Korean Traditional Knowledge Portal, and Korean Studies Information Service System. RCTs utilizing scalp acupuncture as an intervention for stroke were selected, and the quality of reports was assessed based on the Consolidated Standards of Reporting Trials 2010 statement (CONSORT) and Standards for Reporting Interventions in Controlled Trials of Acupuncture 2010 (STRICTA). For each study, the overall quality score (OQS) of 13 CONSORT items, a combined key methodological index score (MIS) of 5 CONSORT items, and the OQS of 17 STRICTA items were measured. The original reports of 63 RCTs were ultimately obtained, and the median CONSORT OQS was 7 (minimum 2, maximum 11). Particularly, the items 'trial design', 'sample size', 'ancillary analyses', and 'harms' had a positive rate of less than 10%. The median MIS was 1 (minimum 0, maximum 5), with 'allocation concealment and implementation' and 'intent-to-treat analysis (ITT) analysis' having a positive rate of less than 10%. The median STRICTA OQS was 11 (minimum 6, maximum 14), and only the items 'sample size' and 'intent-to-treat analysis' were reported, with a positive rate of less than 10%. The mean CONSORT OQS increased by approximately 0.81 for each 5-year period in which manuscripts were published (95% confidence interval: 0.43 to 1.19; p scalp acupuncture treatment for stroke was moderate to low. Furthermore, reporting of some items was either insufficient or inadequate in the majority of studies. In order to improve and standardize the quality of RCTs investigating scalp acupuncture

  2. Nabiximols combined with motivational enhancement/cognitive behavioral therapy for the treatment of cannabis dependence: A pilot randomized clinical trial.

    Directory of Open Access Journals (Sweden)

    Jose M Trigo

    Full Text Available The current lack of pharmacological treatments for cannabis use disorder (CUD warrants novel approaches and further investigation of promising pharmacotherapy. We previously showed that nabiximols (27 mg/ml Δ9-tetrahydrocannabinol (THC/ 25 mg/ml cannabidiol (CBD, Sativex® can decrease cannabis withdrawal symptoms. Here, we assessed in a pilot study the tolerability and safety of self-titrated nabiximols vs. placebo among 40 treatment-seeking cannabis-dependent participants.Subjects participated in a double blind randomized clinical trial, with as-needed nabiximols up to 113.4 mg THC/105 mg CBD or placebo daily for 12 weeks, concurrently with Motivational Enhancement Therapy and Cognitive Behavioral Therapy (MET/CBT. Primary outcome measures were tolerability and abstinence, secondary outcome measures were days and amount of cannabis use, withdrawal, and craving scores. Participants received up to CDN$ 855 in compensation for their time.Medication was well tolerated and no serious adverse events (SAEs were observed. Rates of adverse events did not differ between treatment arms (F1,39 = 0.205, NS. There was no significant change in abstinence rates at trial end. Participants were not able to differentiate between subjective effects associated with nabiximols or placebo treatments (F1,40 = 0.585, NS. Cannabis use was reduced in the nabiximols (70.5% and placebo groups (42.6%. Nabiximols reduced cannabis craving but no significant differences between the nabiximols and placebo groups were observed on withdrawal scores.Nabiximols in combination with MET/CBT was well tolerated and allowed for reduction of cannabis use. Future clinical trials should explore the potential of high doses of nabiximols for cannabis dependence.

  3. [Randomized Controlled Clinical Trials for Treatment of Child Amblyopia with Otopoint Pellet-pressure Combined with Chinese Medical Herbs].

    Science.gov (United States)

    Han, Zhi-hong; Qiu, Min

    2015-06-01

    To observe the clinical effedt of auricular pressure combined with Chinese herbal medicine for amblyopia. A total of 66 child patients with amblyopia were randomly divided into Chinese herbal medicine (control) and herbal medicine+ auricular pressure (treatment) groups, with 33 patients in each group. The patients in the control group were treated with Chinese medical herbs as Danggui (Radix Angelicae Sinensis), Gouqizi (Fructus Lycii), Baijuhua (Flos Chrysanthemi), Baizhu (Rhizoma Atractylodis Macrocephalae), Shudi (Radix Rehmanniae Proeparata), Baishao (Radix Paeoniae Alba) , etc. according to syndrome differentiation, while the patients in the treatment group were treated by auricular pressure of otopoints Yan (Eye), Gan (Liver), Shen (Kidney), Xin (Heart), Mu 1 (Eye-1), Mu 2(Eye-2), and Pi (Spleen) and herbal medicines (being the same to the control group). The treatment was conducted for 6 months. After the treatment, the clinical effect, improvement degree of vision, onset time of improvement, and recurrence rate in the 3 and 6 months' follow-up visit were analyzed. Of the 45 and 47 eyes in the treatment and control groups, 22 and 15 were basically cured, 12 and 5 had marked improvement, 9 and 20 were improved, 2 and 7 failed in the treatment, with the effective rates being 75. 56% and 42.55%, respectively. In comparison with pre-treatment, the visual acuity in both control group and treatment group were improved (Ptreatment group were 26 and 31 eyes, 10 and 11 eyes, respectively. The recurrence rate 6 months after the treatment was 50. 00 % in the control group and 16. 28% in the treatment group. The effective rate of the treatment group was significantly superior to that of the control group (Ptreatment is effective in improving visual acuity, and had a higher efficacy, faster action, and lower recurrence rate in amblyopia children in comparison with simple herbal medicine treatment.

  4. Treatment of metabolic syndrome by combination of physical activity and diet needs an optimal protein intake: a randomized controlled trial.

    Science.gov (United States)

    Dutheil, Frédéric; Lac, Gérard; Courteix, Daniel; Doré, Eric; Chapier, Robert; Roszyk, Laurence; Sapin, Vincent; Lesourd, Bruno

    2012-09-17

    The recommended dietary allowance (RDA) for protein intake has been set at 1.0-1.3 g/kg/day for senior. To date, no consensus exists on the lower threshold intake (LTI = RDA/1.3) for the protein intake (PI) needed in senior patients ongoing both combined caloric restriction and physical activity treatment for metabolic syndrome. Considering that age, caloric restriction and exercise are three increasing factors of protein need, this study was dedicated to determine the minimal PI in this situation, through the determination of albuminemia that is the blood marker of protein homeostasis. Twenty eight subjects (19 M, 9 F, 61.8 ± 6.5 years, BMI 33.4 ± 4.1 kg/m²) with metabolic syndrome completed a three-week residential programme (Day 0 to Day 21) controlled for nutrition (energy balance of -500 kcal/day) and physical activity (3.5 hours/day). Patients were randomly assigned in two groups: Normal-PI (NPI: 1.0 g/kg/day) and High-PI (HPI: 1.2 g/kg/day). Then, patients returned home and were followed for six months. Albuminemia was measured at D0, D21, D90 and D180. At baseline, PI was spontaneously 1.0 g/kg/day for both groups. Albuminemia was 40.6 g/l for NPI and 40.8 g/l for HPI. A marginal protein under-nutrition appeared in NPI with a decreased albuminemia at D90 below 35 g/l (34.3 versus 41.5 g/l for HPI, p metabolic syndrome, the lower threshold intake for protein must be set at 1.2 g/kg/day to maintain blood protein homeostasis.

  5. Parecoxib, propacetamol, and their combination for analgesia after total hip arthroplasty: a randomized non-inferiority trial.

    Science.gov (United States)

    Camu, F; Borgeat, A; Heylen, R J; Viel, E J; Boye, M E; Cheung, R Y

    2017-01-01

    This study assessed non-inferiority of parecoxib vs. combination parecoxib+propacetamol and compared the opioid-sparing effects of parecoxib, propacetamol, and parecoxib+propacetamol vs. placebo after total hip arthroplasty. In this randomized, placebo-controlled, parallel-group, non-inferiority study, patients received one of four IV treatments after surgery: parecoxib 40 mg bid (n = 72); propacetamol 2 g qid (n = 71); parecoxib 40 mg bid plus propacetamol 2 g qid (n = 72); or placebo (n = 38) with supplemental IV patient-controlled analgesia (morphine). Patients and investigators were blinded to treatment. Pain intensity at rest and with movement was assessed regularly, together with functional recovery (modified Brief Pain Inventory-Short Form) and opioid-related side effects (Opioid-Related Symptom Distress Scale) questionnaires up to 48 h. After 24 h, cumulative morphine consumption was reduced by 59.8% (P < 0.001), 38.9% (P < 0.001), and 26.8% (P = 0.005) in the parecoxib+propacetamol, parecoxib, and propacetamol groups, respectively, compared with placebo. Parecoxib did not meet criteria for non-inferiority to parecoxib+propacetamol. Parecoxib+propacetamol and parecoxib significantly reduced least-squares mean pain intensity scores at rest and with movement compared with propacetamol (P < 0.05). One day after surgery, parecoxib+propacetamol significantly reduced opioid-related symptom distress and decreased pain interference with function compared with propacetamol or placebo. Parecoxib and parecoxib+propacetamol provided significant opioid-sparing efficacy compared with placebo; non-inferiority of parecoxib to parecoxib+propacetamol was not demonstrated. Opioid-sparing efficacy was accompanied by significant reductions in pain intensity on movement, improved functional outcome, and less opioid-related symptom distress. Study medications were well tolerated. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  6. Omeprazole versus doxycycline combination therapy with topical erythromycin the treatment of acne vulgaris: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Fariba Jaffary

    2017-04-01

    Full Text Available Background: Acne vulgaris is self-limiting, multifactorial disease involving sebaceous glands. Omeprazole is a proton pump inhibitor with in vitro antibacterial effects against staphylococcus aureus and anti-androgen that can be potential treatment of acne vulgaris. This study was designed to evaluate the efficacy of oral omeprazole and erythromycin 4% compared to doxycycline combination therapy in the treatment of acne vulgaris. Methods: In this clinical trial study, patients with moderate acne were referred to Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Science, Iran, during August 2014 until November 2015 and were randomized into two groups receiving topical erythromycin 4% plus omeprazole (34 patients or doxycycline (35 patients for 3 months. Moderate acne, lack of sensitivity to proton pump inhibitors, lack of warfarin, phenytoin, diazepam consumption, lack of active liver or kidney disease, being older than 12 years, were considered as inclusion criteria. Pregnant or lactating patients, patients with drug allergy history, patients taking oral contraceptives, acne topical medications (including retinoids or systemic treatment within 30 days of study, patients with oligomenorrhea, hirsutism, acne conglobata, acne fulminant or body acne alone were excluded from the study. All patients were tested for Helicobacter pylori test at the beginning of the study. Results: Both inflammatory and non-inflammatory lesions decreased in both groups with negative correlation with age (P< 0.05. There was no significant correlation between positive Helicobacter pylori test and inflammatory or non-inflammatory lesion reduction (P= 0.794, P= 0.514. Also, patient satisfaction and rate of total drug side effects was not different between two treatment groups. Rate of skin reactions was 20.58% in omeprazole treated group and 11.42% in doxycycline group. For side effects, other than skin it was 2.94% versus 14.28% respectively

  7. Combining the CORS and BiCORSTAB Iterative Methods with MLFMA and SAI Preconditioning for Solving Large Linear Systems in Electromagnetics

    NARCIS (Netherlands)

    Carpentieri, Bruno; Jing, Yan-Fei; Huang, Ting-Zhu; Pi, Wei-Chao; Sheng, Xin-Qing

    We report on experiments with a novel family of Krylov subspace methods for solving dense, complex, non-Hermitian systems of linear equations arising from the Galerkin discretization of surface integral equation models in Electromagnetics. By some experiments on realistic radar-cross-section

  8. Fatigue damage estimation in non-linear systems using a combination of Monte Carlo simulation and the First Order Reliability Method

    DEFF Research Database (Denmark)

    Jensen, Jørgen Juncher

    2015-01-01

    For non-linear systems the estimation of fatigue damage under stochastic loadings can be rather time-consuming. Usually Monte Carlo simulation (MCS) is applied, but the coefficient-of-variation (COV) can be large if only a small set of simulations can be done due to otherwise excessive CPU time...

  9. Linear algebra

    CERN Document Server

    Said-Houari, Belkacem

    2017-01-01

    This self-contained, clearly written textbook on linear algebra is easily accessible for students. It begins with the simple linear equation and generalizes several notions from this equation for the system of linear equations and introduces the main ideas using matrices. It then offers a detailed chapter on determinants and introduces the main ideas with detailed proofs. The third chapter introduces the Euclidean spaces using very simple geometric ideas and discusses various major inequalities and identities. These ideas offer a solid basis for understanding general Hilbert spaces in functional analysis. The following two chapters address general vector spaces, including some rigorous proofs to all the main results, and linear transformation: areas that are ignored or are poorly explained in many textbooks. Chapter 6 introduces the idea of matrices using linear transformation, which is easier to understand than the usual theory of matrices approach. The final two chapters are more advanced, introducing t...

  10. Choosing among Tucker or Chained Linear Equating in Two Testing Situations: Rater Comparability Scoring and Randomly Equivalent Groups with an Anchor

    Science.gov (United States)

    Puhan, Gautam

    2012-01-01

    Tucker and chained linear equatings were evaluated in two testing scenarios. In Scenario 1, referred to as rater comparability scoring and equating, the anchor-to-total correlation is often very high for the new form but moderate for the reference form. This may adversely affect the results of Tucker equating, especially if the new and reference…

  11. Predictive Toxicology: Modeling Chemical Induced Toxicological Response Combining Circular Fingerprints with Random Forest and Support Vector Machine

    Directory of Open Access Journals (Sweden)

    Alexios eKoutsoukas

    2016-03-01

    Full Text Available Modern drug discovery and toxicological research are under pressure, as the cost of developing and testing new chemicals for potential toxicological risk is rising. Extensive evaluation of chemical products for potential adverse effects is a challenging task, due to the large number of chemicals and the possible hazardous effects on human health. Safety regulatory agencies around the world are dealing with two major challenges. First, the growth of chemicals introduced every year in household products and medicines that need to be tested, and second the need to protect public welfare. Hence, alternative and more efficient toxicological risk assessment methods are in high demand. The Toxicology in the 21st Century (Tox21 consortium a collaborative effort was formed to develop and investigate alternative assessment methods. A collection of 10,000 compounds composed of environmental chemicals and approved drugs were screened for interference in biochemical pathways and released for crowdsourcing data analysis. The physicochemical space covered by Tox21 library was explored, measured by Molecular Weight (MW and the octanol/water partition coefficient (cLogP. It was found that on average chemical structures had MW of 272.6 Daltons. In case of cLogP the average value was 2.476. Next relationships between assays were examined based on compounds activity profiles across the assays utilizing the Pearson correlation coefficient r. A cluster was observed between the Androgen and Estrogen Receptors and their ligand bind domains accordingly indicating presence of cross talks among the receptors. The highest correlations observed were between NR.AR and NR.AR_LBD, where it was r=0.66 and between NR.ER and NR.ER_LBD, where it was r=0.5.Our approach to model the Tox21 data consisted of utilizing circular molecular fingerprints combined with Random Forest and Support Vector Machine by modeling each assay independently. In all of the 12 sub-challenges our modeling

  12. Picosecond spin dynamics of Gd(0001) studied by linear dichroism of 4f shell. A time-resolved experiment combined laser and synchrotron radiation

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, Helena Prima; Schmidt, Roland; Weinelt, Martin [Max-Born-Institute, Berlin (Germany); Melnikov, Alexev; Lisowski, Martin; Bovensiepen, Uwe [Freie Universitaet, Berlin (Germany)

    2007-07-01

    We have studied ultrafast magnetization dynamics in Gd(0001) films alignment by time-resolved X-ray photoemission spectroscopy. Absorption of a 50 fs laser-pump-pulse at 800 nm leads to optical excitation of the Gd valence electrons. We probe the relaxation dynamics by linear dichroism in photoemission from the Gd 4f electrons using a 60 eV, 50 ps probe-pulse at the synchrotron user facility BESSY, Germany. Linear dichroism in photoemission is proportional to the magnetic moment of the 4f{sup 7} electrons. The breakdown of the magnetic ordering upon fs laser excitation has been reported basedmagneto-optical studies to occur within 100 fs. The recovery of the equilibrium magnetization is driven by cooling of the lattice and spinlattice interaction. It proceeds on a 100 ps time scale. Here we show the breakdown of the magnetic moment after laser excitation within the probe pulse duration and the subsequent recovery to the equilibrium value. As linear dichroism is a measure of the alignment of the Gd 4f moments, its breakdown is a further proof of laser-induced demagnetization.

  13. Linear algebra

    CERN Document Server

    Stoll, R R

    1968-01-01

    Linear Algebra is intended to be used as a text for a one-semester course in linear algebra at the undergraduate level. The treatment of the subject will be both useful to students of mathematics and those interested primarily in applications of the theory. The major prerequisite for mastering the material is the readiness of the student to reason abstractly. Specifically, this calls for an understanding of the fact that axioms are assumptions and that theorems are logical consequences of one or more axioms. Familiarity with calculus and linear differential equations is required for understand

  14. Citalopram, Methylphenidate, or Their Combination in Geriatric Depression: A Randomized, Double-Blind, Placebo-Controlled Trial

    National Research Council Canada - National Science Library

    Lavretsky, Helen; Reinlieb, Michelle; St. Cyr, Natalie; Siddarth, Prabha; Ercoli, Linda M; Senturk, Damla

    2015-01-01

    ... patients.Method:The authors conducted a 16-week randomized double-blind placebo-controlled trial for geriatric depression in 143 older outpatients diagnosed with major depression comparing treatment response in three treatment groups...

  15. Linear Algebra and Linear Models

    Indian Academy of Sciences (India)

    This monograph provides an introduction to the basic aspects of the theory oflinear estima- tion and that of testing linear hypotheses. The primary objective is to provide a basic knowledge of analysis of linear models to advanced undergraduate or first year Master's students. The second edition virtually covers the same ...

  16. Classification of Potential Water Bodies Using Landsat 8 OLI and a Combination of Two Boosted Random Forest Classifiers

    OpenAIRE

    Ko, Byoung; Kim, Hyeong; Nam, Jae

    2015-01-01

    This study proposes a new water body classification method using top-of-atmosphere (TOA) reflectance and water indices (WIs) of the Landsat 8 Operational Land Imager (OLI) sensor and its corresponding random forest classifiers. In this study, multispectral images from the OLI sensor are represented as TOA reflectance and WI values because a classification result using two measures is better than raw spectral images. Two types of boosted random forest (BRF) classifiers are learned using TOA r...

  17. Paroxetine, Cognitive Therapy or Their Combination in the Treatment of Social Anxiety Disorder with and without Avoidant Personality Disorder: A Randomized Clinical Trial.

    Science.gov (United States)

    Nordahl, Hans M; Vogel, Patrick A; Morken, Gunnar; Stiles, Tore C; Sandvik, Pål; Wells, Adrian

    2016-01-01

    The most efficacious treatments for social anxiety disorder (SAD) are the SSRIs and cognitive therapy (CT). Combined treatment is advocated for SAD but has not been evaluated in randomized trials using CT and SSRI. Our aim was to evaluate whether one treatment is more effective than the other and whether combined treatment is more effective than the single treatments. A total of 102 patients were randomly assigned to paroxetine, CT, the combination of CT and paroxetine, or pill placebo. The medication treatment lasted 26 weeks. Of the 102 patients, 54% fulfilled the criteria for an additional diagnosis of avoidant personality disorder. Outcomes were measured at posttreatment and 12-month follow-up assessments. CT was superior to paroxetine alone and to pill placebo at the end of treatment, but it was not superior to the combination treatment. At the 12-month follow-up, the CT group maintained benefits and was significantly better than placebo and paroxetine alone, whereas there were no significant differences among combination treatment, paroxetine alone, and placebo. Recovery rates at 12 months were much higher in the CT group (68%) compared to 40% in the combination group, 24% in the paroxetine group, and 4% in the pill placebo group. CT was the most effective treatment for SAD at both posttreatment and follow-up compared to paroxetine and better than combined treatment at the 12-month follow-up on the Liebowitz Social Anxiety Scale. Combined treatment provided no advantage over single treatments; rather there was less effect of the combined treatment compared to CT alone. © 2016 The Author(s) Published by S. Karger AG, Basel.

  18. Linear algebra

    CERN Document Server

    Liesen, Jörg

    2015-01-01

    This self-contained textbook takes a matrix-oriented approach to linear algebra and presents a complete theory, including all details and proofs, culminating in the Jordan canonical form and its proof. Throughout the development, the applicability of the results is highlighted. Additionally, the book presents special topics from applied linear algebra including matrix functions, the singular value decomposition, the Kronecker product and linear matrix equations. The matrix-oriented approach to linear algebra leads to a better intuition and a deeper understanding of the abstract concepts, and therefore simplifies their use in real world applications. Some of these applications are presented in detailed examples. In several ‘MATLAB-Minutes’ students can comprehend the concepts and results using computational experiments. Necessary basics for the use of MATLAB are presented in a short introduction. Students can also actively work with the material and practice their mathematical skills in more than 300 exerc...

  19. Linear Models

    CERN Document Server

    Searle, Shayle R

    2012-01-01

    This 1971 classic on linear models is once again available--as a Wiley Classics Library Edition. It features material that can be understood by any statistician who understands matrix algebra and basic statistical methods.

  20. Linear programming

    CERN Document Server

    Solow, Daniel

    2014-01-01

    This text covers the basic theory and computation for a first course in linear programming, including substantial material on mathematical proof techniques and sophisticated computation methods. Includes Appendix on using Excel. 1984 edition.

  1. Linear algebra

    CERN Document Server

    Berberian, Sterling K

    2014-01-01

    Introductory treatment covers basic theory of vector spaces and linear maps - dimension, determinants, eigenvalues, and eigenvectors - plus more advanced topics such as the study of canonical forms for matrices. 1992 edition.

  2. Cost-effectiveness and cost-utility of combination therapy in early rheumatoid arthritis: randomized comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone. COBRA Trial Group. Combinatietherapie Bij Reumatoïde Artritis.

    Science.gov (United States)

    Verhoeven, A C; Bibo, J C; Boers, M; Engel, G L; van der Linden, S

    1998-10-01

    Assessment of the cost-effectiveness and cost-utility of early intervention in rheumatoid arthritis (RA) patients, with combined step-down prednisolone, methotrexate and sulphasalazine, compared to sulphasalazine alone. Multicentre 56 week randomized double-blind trial with full economic analysis of direct costs and utility analysis with rating scale and standard gamble measurement techniques. The combined-treatment group included 76 patients and the sulphasalazine group 78 patients. The mean total costs per patient in the first 56 weeks of follow-up were $5519 for combined treatment and $6511 for treatment with sulphasalazine alone (P = 0.37). Out-patient care, in-patient care and non-health care each contributed about one-third to the total costs. The combined-treatment group appeared to generate savings in the length of hospital stay for RA, non-protocol drugs and costs of home help, but comparisons were not statistically significant. Protocol drugs and monitoring were slightly more expensive in the combined-treatment group. Clinical, radiographic and functional outcomes significantly favoured combined treatment at week 28 (radiography also at week 56). Utility scores also favoured combined treatment. Combined treatment is cost-effective due to enhanced efficacy at lower or equal direct costs.

  3. LINEAR ACCELERATOR

    Science.gov (United States)

    Christofilos, N.C.; Polk, I.J.

    1959-02-17

    Improvements in linear particle accelerators are described. A drift tube system for a linear ion accelerator reduces gap capacity between adjacent drift tube ends. This is accomplished by reducing the ratio of the diameter of the drift tube to the diameter of the resonant cavity. Concentration of magnetic field intensity at the longitudinal midpoint of the external sunface of each drift tube is reduced by increasing the external drift tube diameter at the longitudinal center region.

  4. An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial protocol

    OpenAIRE

    Baillie, Andrew J; Sannibale, Claudia; Stapinski, Lexine A.; Teesson, Maree; Rapee, Ronald M; Haber, Paul S

    2013-01-01

    Background Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for...

  5. A two-way enriched clinical trial design: combining advantages of placebo lead-in and randomized withdrawal.

    Science.gov (United States)

    Ivanova, Anastasia; Tamura, Roy N

    2015-12-01

    A new clinical trial design, designated the two-way enriched design (TED), is introduced, which augments the standard randomized placebo-controlled trial with second-stage enrichment designs in placebo non-responders and drug responders. The trial is run in two stages. In the first stage, patients are randomized between drug and placebo. In the second stage, placebo non-responders are re-randomized between drug and placebo and drug responders are re-randomized between drug and placebo. All first-stage data, and second-stage data from first-stage placebo non-responders and first-stage drug responders, are utilized in the efficacy analysis. The authors developed one, two and three degrees of freedom score tests for treatment effect in the TED and give formulae for asymptotic power and for sample size computations. The authors compute the optimal allocation ratio between drug and placebo in the first stage for the TED and compare the operating characteristics of the design to the standard parallel clinical trial, placebo lead-in and randomized withdrawal designs. Two motivating examples from different disease areas are presented to illustrate the possible design considerations. © The Author(s) 2011.

  6. Addition of non-invasive ventilatory support to combined aerobic and resistance training improves dyspnea and quality of life in heart failure patients: a randomized controlled trial.

    Science.gov (United States)

    Bittencourt, Hugo Souza; Cruz, Cristiano Gonçalves; David, Bruno Costa; Rodrigues-Jr, Erenaldo; Abade, Camille Magalhães; Junior, Roque Aras; Carvalho, Vitor Oliveira; Dos Reis, Francisco Borges Faria; Gomes Neto, Mansueto

    2017-11-01

    To test the hypothesis that combined aerobic and resistance training and non-invasive ventilatory support result in additional benefits compared with combined aerobic and resistance training alone in heart failure patients. A randomized, single-blind, controlled study. Cardiac rehabilitation center. A total of 46 patients with New York Heart Association class II/III heart failure were randomly assigned to a 10-week program of combined aerobic and resistance training, plus non-invasive ventilatory support ( n = 23) or combined aerobic and resistance training alone ( n = 23). Before and after intervention, results for the following were obtained: 6-minute walk test, forced vital capacity, forced expiratory volume at one second, maximal inspiratory muscle pressure, and maximal expiratory muscle pressure, with evaluation of dyspnea by the London Chest Activity of Daily Living scale, and quality of life with the Minnesota Living With Heart Failure questionnaire. Of the 46 included patients, 40 completed the protocol. The combined aerobic and resistance training plus non-invasive ventilatory support, as compared with combined aerobic and resistance training alone, resulted in significantly greater benefit for dyspnea (mean change: 4.8 vs. 1.3, p = 0.004), and quality of life (mean change: 19.3 vs. 6.8, p = 0.017 ). In both groups, the 6-minute walk test improved significantly (mean change: 45.7 vs. 44.1, p = 0.924), but without a statistically significant difference. Non-invasive ventilatory support combined with combined aerobic and resistance training provides additional benefits for dyspnea and quality of life in moderate heart failure patients. ClinicalTrials.gov identifier: NCT02384798. Registered 03 April 2015.

  7. Patient-reported outcomes from SYNERGY, a randomized, double-blind, multicenter study evaluating combinations of mirabegron and solifenacin compared with monotherapy and placebo in OAB patients.

    Science.gov (United States)

    Robinson, Dudley; Kelleher, Con; Staskin, David; Mueller, Elizabeth R; Falconer, Christian; Wang, Jianye; Ridder, Arwin; Stoelzel, Matthias; Paireddy, Asha; van Maanen, Rob; Hakimi, Zalmai; Herschorn, Sender

    2017-07-13

    To evaluate patient-reported outcomes (PROs) of combinations of solifenacin and mirabegron compared with solifenacin and mirabegron monotherapy and with placebo in patients with overactive bladder (OAB) from the SYNERGY trial. Following a 4-week placebo run-in, period patients (≥18 years) with OAB were randomized 2:2:1:1:1:1 to receive solifenacin 5 mg + mirabegron 25 mg (combination 5 + 25 mg), solifenacin 5 mg + mirabegron 50 mg, (combination 5 + 50 mg), solifenacin 5 mg, mirabegron 25 mg, mirabegron 50 mg or placebo for 12 weeks, followed by a 2-week washout period. At each visit, PROs related to quality of life, symptom bother, and treatment satisfaction were assessed, including OAB-q Symptom Bother score, health-related quality of life (HRQOL) Total score, treatment satisfaction-visual analogue scale (TS-VAS), and patient perception of bladder condition (PPBC) questionnaires. Overall, 3527 patients were randomized into the study, with 3494 receiving double-blind treatment. At end of treatment (EoT), both combination groups showed greater improvements in OAB-q Symptom Bother score compared with the monotherapy groups (nominal P < 0.001). Statistically significant improvements in HRQOL Total scores were observed in the combination groups versus monotherapy groups (P ≤ 0.002). For both combination groups, the OAB-q Symptom Bother score responder rates at EoT were statistically significantly higher versus mirabegron monotherapy (P < 0.05). The mean adjusted changes from baseline to EoT for PPBC were greater in the combination groups compared with monotherapy groups. PROs showed that combination therapy provided clear improvements and an additive effect for many HRQOL parameters, including OAB-q Symptom Bother score, HRQOL Total score, and PPBC. © 2017 Wiley Periodicals, Inc.

  8. Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial

    OpenAIRE

    Bawazeer, Manal; Aljeraisy, Majed; Albanyan, Esam; Abdullah, Alanazi; Al Thaqafi, Wesam; Alenazi, Jaber; Al otaibi, Zaam; Al Ghaihab, Mohammed

    2014-01-01

    Background: This study investigated the effect of combining oral dexamethasone with either nebulized racemic epinephrine or salbutamol compared to bronchodilators alone for the treatment of infants with bronchiolitis. Materials and Methods: This was a double-blind, randomized controlled trial on infants (1 to 12 months) who were diagnosed in the emergency department with moderate-to-severe bronchiolitis. The primary outcome was the rate of hospital admission within 7 days of the first dose of...

  9. The Impact of Combined Music and Tai Chi on Depressive Symptoms Among Community-Dwelling Older Persons: A Cluster Randomized Controlled Trial.

    Science.gov (United States)

    Liao, S J; Tan, M P; Chong, M C; Chua, Y P

    2018-02-13

    The effectiveness of pharmacological treatment may be limited in older persons. Several studies using Tai Chi or music therapy separately confirmed positive effects in the reduction of depressive symptoms. We conducted a cluster randomized controlled trial to evaluate the possible synergistic effect of combined music and Tai Chi on depressive symptoms. One hundred and seven older adults with mild to moderate depressive symptoms were recruited from Ya'an city. Fifty-five participants were cluster randomized to combined music and Tai Chi group for three months, while the other fifty-two individuals were randomized to the control group that entailed routine health education delivered monthly by community nurses. The primary outcome of depressive symptoms was measured with the Geriatric Depression Scale (GDS) at baseline and monthly for three months. At three-month follow-up, a statistically significant improvement in depressive symptoms was found in the intervention group compared with control group (F(3,315) = 69.661, P < 0.001). Following adjustments for socio-demographic data, the true effect of intervention on depressive symptoms was significant (F = 41.725, P < 0.01, η p 2 = 0.574). Combined music and Tai Chi reduced depressive symptoms among community-dwelling older persons. This represents an economically viable solution to the management of depression in highly populous developing nations.

  10. Combining ring-opening metathesis polymerization and thiol-ene coupling chemistries: facile access to novel functional linear and nonlinear macromolecules.

    Science.gov (United States)

    Lowe, Andrew B; Liu, Meina; van Hensbergen, Johannes Arend; Burford, Robert P

    2014-02-01

    The aim of this article is to highlight recent examples in which two powerful synthetic tools, namely ring-opening metathesis polymerization (ROMP) and thiol-ene (including the thiol-Michael variant) click chemistry have been combined to facilitate the preparation of novel functional materials of varying topology. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Linear regression

    CERN Document Server

    Olive, David J

    2017-01-01

    This text covers both multiple linear regression and some experimental design models. The text uses the response plot to visualize the model and to detect outliers, does not assume that the error distribution has a known parametric distribution, develops prediction intervals that work when the error distribution is unknown, suggests bootstrap hypothesis tests that may be useful for inference after variable selection, and develops prediction regions and large sample theory for the multivariate linear regression model that has m response variables. A relationship between multivariate prediction regions and confidence regions provides a simple way to bootstrap confidence regions. These confidence regions often provide a practical method for testing hypotheses. There is also a chapter on generalized linear models and generalized additive models. There are many R functions to produce response and residual plots, to simulate prediction intervals and hypothesis tests, to detect outliers, and to choose response trans...

  12. Linear algebra

    CERN Document Server

    Sahai, Vivek

    2013-01-01

    Beginning with the basic concepts of vector spaces such as linear independence, basis and dimension, quotient space, linear transformation and duality with an exposition of the theory of linear operators on a finite dimensional vector space, this book includes the concept of eigenvalues and eigenvectors, diagonalization, triangulation and Jordan and rational canonical forms. Inner product spaces which cover finite dimensional spectral theory and an elementary theory of bilinear forms are also discussed. This new edition of the book incorporates the rich feedback of its readers. We have added new subject matter in the text to make the book more comprehensive. Many new examples have been discussed to illustrate the text. More exercises have been included. We have taken care to arrange the exercises in increasing order of difficulty. There is now a new section of hints for almost all exercises, except those which are straightforward, to enhance their importance for individual study and for classroom use.

  13. Linear algebra

    CERN Document Server

    Edwards, Harold M

    1995-01-01

    In his new undergraduate textbook, Harold M Edwards proposes a radically new and thoroughly algorithmic approach to linear algebra Originally inspired by the constructive philosophy of mathematics championed in the 19th century by Leopold Kronecker, the approach is well suited to students in the computer-dominated late 20th century Each proof is an algorithm described in English that can be translated into the computer language the class is using and put to work solving problems and generating new examples, making the study of linear algebra a truly interactive experience Designed for a one-semester course, this text adopts an algorithmic approach to linear algebra giving the student many examples to work through and copious exercises to test their skills and extend their knowledge of the subject Students at all levels will find much interactive instruction in this text while teachers will find stimulating examples and methods of approach to the subject

  14. Randomized Controlled Trial of Sertraline, Prolonged Exposure Therapy and Their Combination in OEF/OIF with PTSD

    Science.gov (United States)

    2015-12-01

    include exposure therapy (such as PE) and selective serotonin reuptake inhibitors (SSRIs; such as SERT). To date, there have been no randomized, direct... Depression and Anxiety, 2004. 19(2): p. 112-120. 9. Cahill, S.P., et al. Cognitive-behavioral therapy for adults, in Effective treatments for PTSD

  15. OVULATION INDUCTION IN PREMATURE OVARIAN FAILURE - A PLACEBO-CONTROLLED RANDOMIZED TRIAL COMBINING PITUITARY SUPPRESSION WITH GONADOTROPIN STIMULATION

    NARCIS (Netherlands)

    VANKASTEREN, YM; HOEK, A; SCHOEMAKER, J

    Objectives: To determine the effect of pituitary suppression with a GnRH agonist (GnRH-a) on the success of ovulation induction with exogenous gonadotropins in patients with premature ovarian failure (POF). Design: Placebo-controlled, randomized, double-blind study. The data were analyzed with a

  16. Randomized, Open-Label Phase II Study Evaluating the Efficacy and Safety of Talimogene Laherparepvec in Combination With Ipilimumab Versus Ipilimumab Alone in Patients With Advanced, Unresectable Melanoma.

    Science.gov (United States)

    Chesney, Jason; Puzanov, Igor; Collichio, Frances; Singh, Parminder; Milhem, Mohammed M; Glaspy, John; Hamid, Omid; Ross, Merrick; Friedlander, Philip; Garbe, Claus; Logan, Theodore F; Hauschild, Axel; Lebbé, Celeste; Chen, Lisa; Kim, Jenny J; Gansert, Jennifer; Andtbacka, Robert H I; Kaufman, Howard L

    2017-10-05

    Purpose We evaluated the combination of talimogene laherparepvec plus ipilimumab versus ipilimumab alone in patients with advanced melanoma in a phase II study. To our knowledge, this was the first randomized trial to evaluate addition of an oncolytic virus to a checkpoint inhibitor. Methods Patients with unresectable stages IIIB to IV melanoma, with no more than one prior therapy if BRAF wild-type, no more than two prior therapies if BRAF mutant, measurable/injectable disease, and without symptomatic autoimmunity or clinically significant immunosuppression were randomly assigned 1:1 to receive talimogene laherparepvec plus ipilimumab or ipilimumab alone. Talimogene laherparepvec treatment began in week 1 (first dose, ≤ 4 mL × 10(6) plaque-forming units/mL; after 3 weeks, ≤ 4 mL × 10(8) plaque-forming units/mL every 2 weeks). Ipilimumab (3 mg/kg every 3 weeks; up to four doses) began week 1 in the ipilimumab alone arm and week 6 in the combination arm. The primary end point was objective response rate evaluated by investigators per immune-related response criteria. Results One hundred ninety-eight patients were randomly assigned to talimogene laherparepvec plus ipilimumab (n = 98), or ipilimumab alone( n = 100). Thirty-eight patients (39%) in the combination arm and 18 patients (18%) in the ipilimumab arm had an objective response (odds ratio, 2.9; 95% CI, 1.5 to 5.5; P = .002). Responses were not limited to injected lesions; visceral lesion decreases were observed in 52% of patients in the combination arm and 23% of patients in the ipilimumab arm. Frequently occurring adverse events (AEs) included fatigue (combination, 59%; ipilimumab alone, 42%), chills (combination, 53%; ipilimumab alone, 3%), and diarrhea (combination, 42%; ipilimumab alone, 35%). Incidence of grade ≥ 3 AEs was 45% and 35%, respectively. Three patients in the combination arm had fatal AEs; none were treatment related. Conclusion The study met its primary end point; the objective

  17. Linear algebra

    CERN Document Server

    Allenby, Reg

    1995-01-01

    As the basis of equations (and therefore problem-solving), linear algebra is the most widely taught sub-division of pure mathematics. Dr Allenby has used his experience of teaching linear algebra to write a lively book on the subject that includes historical information about the founders of the subject as well as giving a basic introduction to the mathematics undergraduate. The whole text has been written in a connected way with ideas introduced as they occur naturally. As with the other books in the series, there are many worked examples.Solutions to the exercises are available onlin

  18. Fixed herbal drug combination with and without butterbur (Ze 185) for the treatment of patients with somatoform disorders: randomized, placebo-controlled pharmaco-clinical trial.

    Science.gov (United States)

    Melzer, Jörg; Schrader, Ewald; Brattström, Axel; Schellenberg, Rüdiger; Saller, Reinhard

    2009-09-01

    Herbal drugs are often used in patients with somatoform disorders yet, the available evidence is limited. The aim of the present short-term study was to evaluate in a pharmaco-clinical trial the additional benefit of butterbur in a fixed herbal drug combination (Ze 185 = 4-combination versus 3-combination without butterbur and placebo) in patients with somatoform disorders.For a 2-week treatment in patients with somatization disorder (F45.0) and undifferentiated somatoform disorder (F45.1), 182 patients were randomized for a 3-arm trial (butterbur root, valerian root, passionflower herb, lemon balm leaf versus valerian root, passionflower herb, lemon balm leaf versus placebo). Anxiety (visual analogue scale - VAS) and depression (Beck's Depression Inventory - BDI) served as primary parameters, Clinical Global Impression (CGI) was a secondary parameter.The 4-combination was significantly superior to the 3-combination and placebo (4-combination > 3-combination > placebo) in all the primary and secondary parameters (PP-population). Analysis of the ITT population confirmed these results. As to safety, no serious adverse events occurred. In total 9 non-serious adverse events were documented but the distribution did not differ significantly between the treatment groups.This herbal preparation (Ze185) showed to be an efficacious and safe short-term treatment in patients with somatoform disorders.

  19. Electroacupuncture and Rosiglitazone Combined Therapy as a Means of Treating Insulin Resistance and Type 2 Diabetes Mellitus: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Rong-Tsung Lin

    2013-01-01

    Full Text Available Aims. To evaluate the efficacy of rosiglitazone (TZD and electroacupuncture (EA combined therapy as a treatment for type 2 diabetes mellitus (T2DM patients by randomized single-blind placebo controlled clinical trial. Methods. A total of 31 newly diagnostic T2DM patients, who fulfilled the study's eligibility criteria, were recruited. The individuals were randomly assigned into two groups, the control group (TZD, N=15 and the experimental group (TZD + EA, N=16. Changes in their plasma free fatty acid (FFA, glucose, and insulin levels, together with their homeostasis model assessment (HOMA indices, were statistically compared before and after treatment. Hypoglycemic activity (% was also compared between these two groups. Results. There was no significant difference in hypoglycemic activity between the TZD and TZD + EA group. The effectiveness of the combined therapy seems to derive from an improvement in insulin resistance and a significant lowering of the secreted insulin rather than the effect of TZD alone on T2DM. The combined treatment had no significant adverse effects. A lower plasma FFA concentration is likely to be the mechanism that causes this effect. Conclusion. This combined therapy seems to suppress endogenous insulin secretion by improving insulin resistance via a mechanism involving a reduction in plasma FFA. This trial is registered with ClinicalTrials.gov NCT01577095.

  20. Randomized trial of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) on symptoms of benign prostatic hyperplasia (BPH).

    Science.gov (United States)

    Preuss, H G; Marcusen, C; Regan, J; Klimberg, I W; Welebir, T A; Jones, W A

    2001-01-01

    Because benign prostatic hyperplasia (BPH) is relatively common, it is important to discover safe and effective means to treat this often debilitating perturbation. Accordingly, we examined the effectiveness of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) in treating symptoms of BPH. We undertook a randomized, placebo-controlled, double-blind study. Patients were enrolled from 3 urological practices in the USA. 144 subjects were randomized for study. 17 subjects eventually withdrew, leaving 70 patients in the test group and 57 in the placebo group to complete the study. Inclusion criteria consisted of a diagnosis of BPH, no evidence of cancer, and a maximal urinary flow rate between 5 and 15 ml/second. Patients received either placebo or the combined natural products for 3 months. Evaluations were performed via the American Urological Association (AUA) Symptom Index score, urinary flow rate, PSA measurement, and residual bladder volume. Nocturia showed a markedly significant decrease in severity in patients receiving the combined natural products compared to those taking placebo (p saw palmetto, B-sitosterol, vitamin E) compared to placebo can significantly lessen nocturia and frequency and diminish overall symptomatology of BPH as indicated by an improvement in the total AUA Symptom Index score. The combination of natural products caused no significant adverse side effects.

  1. Pregabalin and dexamethasone in combination with paracetamol for postoperative pain control after abdominal hysterectomy. A randomized clinical trial

    DEFF Research Database (Denmark)

    Rasmussen, M L; Dierking, G; Lech, K

    2008-01-01

    BACKGROUND: Multimodal analgesia may be important for optimal postoperative pain treatment and facilitation of early mobilization and recovery. We investigated the analgesic effect of pregabalin and dexamethasone in combination with paracetamol after abdominal hysterectomy. METHODS: One hundred a...

  2. Data mining methods in the prediction of Dementia: A real-data comparison of the accuracy, sensitivity and specificity of linear discriminant analysis, logistic regression, neural networks, support vector machines, classification trees and random forests.

    Science.gov (United States)

    Maroco, João; Silva, Dina; Rodrigues, Ana; Guerreiro, Manuela; Santana, Isabel; de Mendonça, Alexandre

    2011-08-17

    Dementia and cognitive impairment associated with aging are a major medical and social concern. Neuropsychological testing is a key element in the diagnostic procedures of Mild Cognitive Impairment (MCI), but has presently a limited value in the prediction of progression to dementia. We advance the hypothesis that newer statistical classification methods derived from data mining and machine learning methods like Neural Networks, Support Vector Machines and Random Forests can improve accuracy, sensitivity and specificity of predictions obtained from neuropsychological testing. Seven non parametric classifiers derived from data mining methods (Multilayer Perceptrons Neural Networks, Radial Basis Function Neural Networks, Support Vector Machines, CART, CHAID and QUEST Classification Trees and Random Forests) were compared to three traditional classifiers (Linear Discriminant Analysis, Quadratic Discriminant Analysis and Logistic Regression) in terms of overall classification accuracy, specificity, sensitivity, Area under the ROC curve and Press'Q. Model predictors were 10 neuropsychological tests currently used in the diagnosis of dementia. Statistical distributions of classification parameters obtained from a 5-fold cross-validation were compared using the Friedman's nonparametric test. Press' Q test showed that all classifiers performed better than chance alone (p classification accuracy (Median (Me) = 0.76) an area under the ROC (Me = 0.90). However this method showed high specificity (Me = 1.0) but low sensitivity (Me = 0.3). Random Forest ranked second in overall accuracy (Me = 0.73) with high area under the ROC (Me = 0.73) specificity (Me = 0.73) and sensitivity (Me = 0.64). Linear Discriminant Analysis also showed acceptable overall accuracy (Me = 0.66), with acceptable area under the ROC (Me = 0.72) specificity (Me = 0.66) and sensitivity (Me = 0.64). The remaining classifiers showed overall classification accuracy above a median value of 0.63, but for most

  3. Evaluating an Organizational-Level Occupational Health Intervention in a Combined Regression Discontinuity and Randomized Control Design.

    Science.gov (United States)

    Sørensen, By Ole H

    2016-10-01

    Organizational-level occupational health interventions have great potential to improve employees' health and well-being. However, they often compare unfavourably to individual-level interventions. This calls for improving methods for designing, implementing and evaluating organizational interventions. This paper presents and discusses the regression discontinuity design because, like the randomized control trial, it is a strong summative experimental design, but it typically fits organizational-level interventions better. The paper explores advantages and disadvantages of a regression discontinuity design with an embedded randomized control trial. It provides an example from an intervention study focusing on reducing sickness absence in 196 preschools. The paper demonstrates that such a design fits the organizational context, because it allows management to focus on organizations or workgroups with the most salient problems. In addition, organizations may accept an embedded randomized design because the organizations or groups with most salient needs receive obligatory treatment as part of the regression discontinuity design. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Identification of Random Dynamic Force Using an Improved Maximum Entropy Regularization Combined with a Novel Conjugate Gradient

    Directory of Open Access Journals (Sweden)

    ChunPing Ren

    2017-01-01

    Full Text Available We propose a novel mathematical algorithm to offer a solution for the inverse random dynamic force identification in practical engineering. Dealing with the random dynamic force identification problem using the proposed algorithm, an improved maximum entropy (IME regularization technique is transformed into an unconstrained optimization problem, and a novel conjugate gradient (NCG method was applied to solve the objective function, which was abbreviated as IME-NCG algorithm. The result of IME-NCG algorithm is compared with that of ME, ME-CG, ME-NCG, and IME-CG algorithm; it is found that IME-NCG algorithm is available for identifying the random dynamic force due to smaller root mean-square-error (RMSE, lower restoration time, and fewer iterative steps. Example of engineering application shows that L-curve method is introduced which is better than Generalized Cross Validation (GCV method and is applied to select regularization parameter; thus the proposed algorithm can be helpful to alleviate the ill-conditioned problem in identification of dynamic force and to acquire an optimal solution of inverse problem in practical engineering.

  5. Efficacy of systemic and intratympanic corticosteroid combination therapy versus intratympanic or systemic therapy in patients with idiopathic sudden sensorineural hearing loss: a randomized controlled trial.

    Science.gov (United States)

    Ashtiani, Mohammadtaghi Khorsandi; Firouzi, Farzad; Bastaninejad, Shahin; Dabiri, Sasan; Nasirmohtaram, Sevil; Saeedi, Niloufar; Ghazavi, Hossein; Sahebi, Leyla

    2017-11-17

    The present study was conducted to compare the rates of recovery from idiopathic sudden deafness after the treatment with oral and intratympanic corticosteroids in both mono and combination therapies. Triple-blind randomized clinical trial. Tertiary referral hospital. A total of 112 patients who were admitted to the ENT emergency department randomly divided into three groups: an oral corticosteroid plus intratympanic placebo (systemic corticosteroid monotherapy group); an intratympanic corticosteroid plus oral placebo group (IT monotherapy group); and a combination therapy group (IT plus systemic combination group). All patients were treated additionally with antiviral and proton pomp inhibitor. An audiometry was performed once before beginning the therapies and again at the end of the therapy. Of the total of 112 patients, 32 received intratympanic (IT) corticosteroids, 45 were receiving systemic corticosteroids, and 35 were receiving a combination of the two. A total of 74 patients (66.1%) responded positively [response to treatment was calculated as gain of at least 10 dB in 10 dB in average threshold or with the minimum improvement of 15% in speech discrimination scores (SDS)] to corticosteroid therapy. No significant differences were observed between the three groups (IT, systemic group, and combination therapy group) in their overall response to treatment (p = 0.5). Patients who suffered from concomitant tinnitus and dizziness responded less positively to the treatment (p < 0.002). Positive family history of SSNHL seems to be negative prognostic factors in the response to treatment (p < 0.001). The response to treatment was not related to the pattern (p = 0.04) and initial severity of hearing loss (p = 0.9). This study did not find any difference in the rate of hearing improvement between systemic, intratympanic, and combined corticosteroid therapy for sudden hearing loss. 1b.

  6. Combining imagination and reason in the treatment of depression: a randomized controlled trial of internet-based cognitive-bias modification and internet-CBT for depression.

    Science.gov (United States)

    Williams, Alishia D; Blackwell, Simon E; Mackenzie, Anna; Holmes, Emily A; Andrews, Gavin

    2013-10-01

    Computerized cognitive-bias modification (CBM) protocols are rapidly evolving in experimental medicine yet might best be combined with Internet-based cognitive behavioral therapy (iCBT). No research to date has evaluated the combined approach in depression. The current randomized controlled trial aimed to evaluate both the independent effects of a CBM protocol targeting imagery and interpretation bias (CBM-I) and the combined effects of CBM-I followed by iCBT. Patients diagnosed with a major depressive episode were randomized to an 11-week intervention (1 week/CBM-I + 10 weeks/iCBT; n = 38) that was delivered via the Internet with no face-to-face patient contact or to a wait-list control (WLC; n = 31). Intent-to-treat marginal models using restricted maximum likelihood estimation demonstrated significant reductions in primary measures of depressive symptoms and distress corresponding to medium-large effect sizes (Cohen's d = 0.62-2.40) following CBM-I and the combined (CBM-I + iCBT) intervention. Analyses demonstrated that the change in interpretation bias at least partially mediated the reduction in depression symptoms following CBM-I. Treatment superiority over the WLC was also evident on all outcome measures at both time points (Hedges gs = .59-.98). Significant reductions were also observed following the combined intervention on secondary measures associated with depression: disability, anxiety, and repetitive negative thinking (Cohen's d = 1.51-2.23). Twenty-seven percent of patients evidenced clinically significant change following CBM-I, and this proportion increased to 65% following the combined intervention. The current study provides encouraging results of the integration of Internet-based technologies into an efficacious and acceptable form of treatment delivery. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  7. Folic Acid, Vitamin B6, and Vitamin B12 in Combination and Age-Related Cataract in a Randomized Trial of Women.

    Science.gov (United States)

    Christen, William G; Glynn, Robert J; Chew, Emily Y; Albert, Christine M; Manson, JoAnn E

    2016-01-01

    To examine the incidence of cataract and cataract extraction in a trial of folic acid and vitamins B6 and B12. In a randomized, double-masked, placebo-controlled trial, 5442 female health professionals aged 40 years or older with preexisting cardiovascular disease (CVD) or three or more CVD risk factors were randomly assigned to receive a combination of folic acid (2.5 mg/day), vitamin B6 (50 mg/day), and vitamin B12 (1 mg/day), or placebo. A total of 3925 of these women did not have a diagnosis of cataract at baseline and were included in this analysis. The primary endpoint was age-related cataract, defined as an incident age-related lens opacity, responsible for a reduction in best-corrected visual acuity to 20/30 or worse, based on self-report confirmed by medical record review. Extraction of incident age-related cataract was a secondary endpoint of the trial. During an average of 7.3 years of treatment and follow-up, 408 cataracts and 275 cataract extractions were documented. There were 215 cataracts in the combination treatment group and 193 in the placebo group (hazard ratio, HR, 1.10, 95% confidence interval, CI, 0.90-1.33; p = 0.36). For the secondary endpoint of cataract extraction, there were 155 in the combination treatment group and 120 in the placebo group (HR 1.28, 95% CI 1.01-1.63; p = 0.04). In this large-scale randomized trial of women at high risk of CVD, daily supplementation with a combination of folic acid, vitamin B6, and vitamin B12 had no significant effect on cataract, but may have increased the risk of cataract extraction.

  8. Add-on effects of fluvastatin in simeprevir/pegylated-interferon/ribavirin combination therapy for patients with genotype 1 hepatitis C virus infection: A randomized controlled study.

    Science.gov (United States)

    Suda, Goki; Ito, Jun; Nagasaka, Atsushi; Yamamoto, Yoshiya; Furuya, Ken; Okamoto, Munenori; Terashita, Katsumi; Kobayashi, Tomoe; Tsunematsu, Izumi; Yoshida, Junichi; Meguro, Takashi; Ohara, Masatsugu; Kawagishi, Naoki; Kimura, Megumi; Umemura, Machiko; Izumi, Takaaki; Tsukuda, Yoko; Nakai, Masato; Sho, Takuya; Natsuizaka, Mitsuteru; Morikawa, Kenichi; Ogawa, Koji; Sakamoto, Naoya

    2017-07-19

    The Japan Society of Hepatology guidelines indicate that hepatitis C virus (HCV) protease inhibitor combination therapy with simeprevir (SMV), pegylated-interferon (Peg-IFN), and ribavirin (RBV) is a therapeutic option for patients who fail to respond to a direct direct-acting antiviral-containing regimen. However, treatment outcomes have room for improvement. Fluvastatin (FLV) add-on treatment in Peg-IFN and RBV combination therapy for HCV-infected patients significantly improved the sustained virologic response (SVR), but the add-on effect of FLV on SMV combination therapy is not well understood. This was a prospective, randomized, multicenter study in which a total of 61 HCV genotype 1b-infected patients were recruited and 60 eligible patients were randomly allocated to two groups that received 12 weeks of SMV/Peg-IFN/RBV followed by 12 weeks of Peg-IFN/RBV with or without 24 weeks of FLV. The SVR rate and adverse events were compared between the two groups. Thirty-one patients were allocated to the FLV add-on group and 29 patients were allocated to the control group. Baseline clinical factors, including median age, baseline platelet count, alanine aminotransferase level, HCV RNA titer, Fibrosis-4 index, and rate of IL28B minor genotype, were all similar between the two groups. The rapid virologic response, end-of-treatment response rates, SVR rates at 24 weeks after treatment, and safety profiles were also similar between the two groups. This prospective, randomized, multicenter study indicated that FLV had no add-on effect when given with SMV/Peg-IFN/RBV combination therapy for genotype 1b HCV-infected patients. © 2017 The Japan Society of Hepatology.

  9. Long-term intermittent dobutamine infusion, combined with oral amiodarone for end-stage heart failure: a randomized double-blind study.

    Science.gov (United States)

    Nanas, John N; Tsagalou, Eleftheria P; Kanakakis, John; Nanas, Serafim N; Terrovitis, John V; Moon, Thomas; Anastasiou-Nana, Maria I

    2004-04-01

    To examine the effects of long-term intermittent dobutamine infusion, combined with oral amiodarone in patients with congestive heart failure (CHF) refractory to standard medical treatment. Prospective, randomized, double-blind, placebo-controlled clinical trial. Inpatient and outpatient heart failure clinic in a university teaching hospital. Thirty patients with end-stage CHF refractory to standard medical treatment who could be weaned from dobutamine therapy after a first 72-h infusion were randomized in a double-blind manner to receive IV infusions of placebo (group 1; 14 patients) vs dobutamine in a dose of 10 micro g/kg/min (group 2; 16 patients) for 8 h every 14 days. All patients received standard medical therapy and also were treated with oral amiodarone, 400 mg/d, which was started at least 2 weeks before randomization. Kaplan-Meier survival analysis showed a 60% reduction in the risk of death from any cause in the group treated with the combination of dobutamine and amiodarone, compared with the group treated with placebo and amiodarone (hazard ratio, 0.403; 95% confidence interval, 0.164 to 0.992; p = 0.048). The 1-year and 2-year survival rates were 69% and 44%, respectively, in the dobutamine-treated group, vs 28% and 21%, respectively, in the placebo-treated group (p amiodarone added to the conventional drugs improved the survival of patients with advanced CHF that was refractory to conventional treatment.

  10. Safety, tolerability, pharmacodynamics and pharmacokinetics of umeclidinium and vilanterol alone and in combination: a randomized crossover trial.

    Directory of Open Access Journals (Sweden)

    Dennis L Kelleher

    Full Text Available Umeclidinium bromide (GSK573719; UMEC, a new long-acting muscarinic receptor antagonist (LAMA, is in development with vilanterol (GW642444; VI, a selective long-acting β(2 agonist (LABA, as a once-daily inhaled combination therapy for the treatment of chronic obstructive pulmonary disease (COPD. A single dose healthy volunteer study was conducted to assess the safety and tolerability, pharmacodynamics (PD and pharmacokinetics (PK of inhaled umeclidinium (500 µg and vilanterol (50 µg when administered separately and in combination using a novel dry powder inhaler (NDPI. Co-administration of single inhaled doses of umeclidinium and vilanterol to healthy Japanese subjects was well tolerated and not associated with meaningful changes in systemic exposure or PD effects compared with administration of either compound individually. Pharmacokinetic assessments showed rapid absorption for both drugs (Tmax = 5 min for both umeclidinium and vilanterol followed by rapid elimination with median tlast of 4-5 h for umeclidinium and median tlast of 1.5-2.0 h for vilanterol. Assessments of pharmacokinetic interaction were inconclusive since for umeclidinium, Cmax following combination was higher than umeclidinium alone but not AUC whereas for vilanterol, AUC following combination was higher than vilanterol alone but not Cmax. There were no obvious trends observed between individual maximum supine heart rate and umeclidinium Cmax or vilanterol Cmax when delivered as umeclidinium 500 µg and vilanterol 50 µg combination or when delivered as umeclidinium or vilanterol alone.Clinicaltrials.gov NCT00976144.

  11. Safety, tolerability, pharmacodynamics and pharmacokinetics of umeclidinium and vilanterol alone and in combination: a randomized crossover trial.

    Science.gov (United States)

    Kelleher, Dennis L; Mehta, Rashmi S; Jean-Francois, Bernadette M; Preece, Andrew F; Blowers, James; Crater, Glenn D; Thomas, Paul

    2012-01-01

    Umeclidinium bromide (GSK573719; UMEC), a new long-acting muscarinic receptor antagonist (LAMA), is in development with vilanterol (GW642444; VI), a selective long-acting β(2) agonist (LABA), as a once-daily inhaled combination therapy for the treatment of chronic obstructive pulmonary disease (COPD). A single dose healthy volunteer study was conducted to assess the safety and tolerability, pharmacodynamics (PD) and pharmacokinetics (PK) of inhaled umeclidinium (500 µg) and vilanterol (50 µg) when administered separately and in combination using a novel dry powder inhaler (NDPI). Co-administration of single inhaled doses of umeclidinium and vilanterol to healthy Japanese subjects was well tolerated and not associated with meaningful changes in systemic exposure or PD effects compared with administration of either compound individually. Pharmacokinetic assessments showed rapid absorption for both drugs (Tmax = 5 min for both umeclidinium and vilanterol) followed by rapid elimination with median tlast of 4-5 h for umeclidinium and median tlast of 1.5-2.0 h for vilanterol. Assessments of pharmacokinetic interaction were inconclusive since for umeclidinium, Cmax following combination was higher than umeclidinium alone but not AUC whereas for vilanterol, AUC following combination was higher than vilanterol alone but not Cmax. There were no obvious trends observed between individual maximum supine heart rate and umeclidinium Cmax or vilanterol Cmax when delivered as umeclidinium 500 µg and vilanterol 50 µg combination or when delivered as umeclidinium or vilanterol alone. Clinicaltrials.gov NCT00976144.

  12. Linear programming

    CERN Document Server

    Karloff, Howard

    1991-01-01

    To this reviewer’s knowledge, this is the first book accessible to the upper division undergraduate or beginning graduate student that surveys linear programming from the Simplex Method…via the Ellipsoid algorithm to Karmarkar’s algorithm. Moreover, its point of view is algorithmic and thus it provides both a history and a case history of work in complexity theory. The presentation is admirable; Karloff's style is informal (even humorous at times) without sacrificing anything necessary for understanding. Diagrams (including horizontal brackets that group terms) aid in providing clarity. The end-of-chapter notes are helpful...Recommended highly for acquisition, since it is not only a textbook, but can also be used for independent reading and study. —Choice Reviews The reader will be well served by reading the monograph from cover to cover. The author succeeds in providing a concise, readable, understandable introduction to modern linear programming. —Mathematics of Computing This is a textbook intend...

  13. Combined study of Schwinger-boson mean-field theory and linearized tensor renormalization group on Heisenberg ferromagnetic mixed spin (S, σ chains

    Directory of Open Access Journals (Sweden)

    Xin Yan

    2015-07-01

    Full Text Available The Schwinger-boson mean-field theory (SBMFT and the linearized tensor renormalization group (LTRG methods are complementarily applied to explore the thermodynamics of the quantum ferromagnetic mixed spin (S, σ chains. It is found that the system has double excitations, i.e. a gapless and a gapped excitation; the low-lying spectrum can be approximated by ω k ∼ S σ 2 ( S + σ J k 2 with J the ferromagnetic coupling; and the gap between the two branches is estimated to be △ ∼ J. The Bose-Einstein condensation indicates a ferromagnetic ground state with magnetization m tot z = N ( S + σ . At low temperature, the spin correlation length is inversely proportional to temperature (T, the susceptibility behaviors as χ = a 1 ∗ 1 T 2 + a 2 ∗ 1 T , and the specific heat has the form of C = c 1 ∗ T − c 2 ∗ T + c 3 ∗ T 3 2 , with ai (i = 1, 2 and ci (i = 1, 2, 3 the temperature independent constants. The SBMFT results are shown to be in qualitatively agreement with those by the LTRG numerical calculations for S = 1 and σ = 1/2. A comparison of the LTRG results with the experimental data of the model material MnIINiII(NO24(en2(en = ethylenediamine, is made, in which the coupling parameters of the compound are obtained. This study provides useful information for deeply understanding the physical properties of quantum ferromagnetic mixed spin chain materials.

  14. Simulation of bending stress variation in long buried thick-walled pipes under the earth’s movement using combined linear dynamics and beam theories

    Directory of Open Access Journals (Sweden)

    Salau Tajudeen A.O.

    2014-01-01

    Full Text Available This study reported a simulation approach to the understanding of the interactions between a buried pipe and the soil system by computing the bending stress variation of harmonically-excited buried pipes. The established principles of linear dynamics theory and simple beam theory were utilised in the analysis of the problem of buried pipe bending stress accumulation and its dynamics. With regards to the parameters that influence the bending stress variations, the most important are the isolation factor, uniform external load, and the corresponding limiting conditions. The simulated mathematical expressions, containing static and dynamic parameters of the buried pipe and earth, were coded in Fortran programming language and applied in the simulation experiment. The results obtained showed that harmonically-excited buried thick-walled pipe became stable and effective when the ratio of the natural frequency of vibration to the forced frequency is greater than 2.0, whenever the damped factor is used as the control parameter for the maximum bending stress. The mirror image of the stress variation produces variation in the location of the maximum bending stress in quantitative terms. The acceptable pipe materials for the simulated cases must have yield strength in bending greater than or equal to 13.95 MPa. The results obtained in this work fill a gap in the literature and will be useful to pipeline engineers and designers, as well as to environmental scientists in initialising and controlling environmental issues and policy formulation concerning the influence of buried pipe on the soil and water in the environment.

  15. Omeprazole-Domperidone Fixed Dose Combination vs Omeprazole Monotherapy: A Phase 4, Open-Label, Comparative, Parallel Randomized Controlled Study in Mild to Moderate Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    KY Marakhouski

    2017-05-01

    Full Text Available Aim: To compare the efficacy and safety of omeprazole-domperidone combination vs omeprazole monotherapy in gastroesophageal reflux disease (GERD. Methods: In a comparative, randomized controlled, phase 4 study, outpatients with GERD were randomly allocated to either group 1 (omeprazole 20 mg + domperidone 30 mg or group 2 (omeprazole 20 mg in an equal ratio; 2 capsules daily in the morning were administered for 8 weeks. Results: Sixty patients were enrolled. Esophagitis reversal was observed in 92% patients in group 1 vs 65.2% in group 2. Approximately, 83.3% patients in group 1 vs 43.3% patients in group 2 demonstrated full cupping of reflux symptoms at 8 weeks. Combined therapy resulted in significantly longer period of heartburn-free days (23 vs 12 days on omeprazole. There were no safety concerns. Conclusions: Omeprazole-domperidone combination was more effective than omeprazole alone in providing complete cupping of reflux symptoms and healing of esophagitis in patients with GERD. Both the treatments were well tolerated with few reports of adverse events. Trial registration: This trial is registered with http://clinicaltrials.gov , number NCT02140073.

  16. Randomized controlled trial to evaluate the efficacy of oral lycopene in combination with vitamin E and selenium in the treatment of oral leukoplakia

    Directory of Open Access Journals (Sweden)

    Jyotsna Sandeep Patel

    2014-01-01

    Full Text Available Aims and Objectives: A randomized controlled study was carried out to evaluate the efficacy of lycopene in combination with vitamin E and selenium in the treatment of oral leukoplakia in patients visiting the Government Dental College and Hospital, Mumbai. Materials and Methods: Forty-one patients of leukoplakia were randomly categorized (irrespective of size and severity of the lesions in two groups: Group A and B. Group A consisting of 21 patients were administered combination of lycopene (3 mg, vitamin E (200 I.U. and selenium (100 mcg twice daily and group B consisting of 20 patients were given placebo capsules once daily for a period of 3 months. Post-treatment follow-up period was 3-4 months. The product used in the study was LYC-O-MATO soft gels, manufactured by Mano pharmaceuticals, Chennai, India. The treatment outcome was evaluated both clinically and histologically and the results were statistically evaluated using Student′s unpaired ′t′ test. Results: The results showed that the patients receiving lycopene in combination with vitamin E and selenium have statistically significant improvements both clinically and histologically as compared to those receiving placebo and with no side effects. Conclusion: The study results proved the efficacy and safety of lycopene along with selenium and vitamin E in the management of oral leukoplakia.

  17. Combined use of hyperbaric and hypobaric ropivacaine significantly improves hemodynamic characteristics in spinal anesthesia for caesarean section: a prospective, double-blind, randomized, controlled study.

    Directory of Open Access Journals (Sweden)

    ZheFeng Quan

    Full Text Available To observe the hemodynamic changes of parturients in the combined use of hyperbaric (4 mg and hypobaric (6 mg ropivacaine during spinal anesthesia for caesarean section in this randomized double-blind study.Parturients (n = 136 undergoing elective cesarean delivery were randomly and equally allocated to receive either combined hyperbaric and hypobaric ropivacaine (Group A or hyperbaric ropivacaine (Group B. Outcome measures were: hemodynamic characteristics, maximum height of sensory block, time to achieve T8 sensory blockade level, incidence of complications, Apgar scores at 1 and 5 min, and neonatal blood gas analysis.Group A had a lower level of sensory blockade (T6 [T6-T7] and longer time to achieve T8 sensory blockade level (8 ± 1.3 min than did patients in Group B (T3 [T2-T4] and 5 ± 1.0 min, respectively; P < 0.001, both. The incidence rates for hypotension, nausea, and vomiting were significantly lower in Group A (13%, 10%, and 3%, respectively than Group B (66%, 31%, and 13%; P < 0.001, P = 0.003, P = 0.028.Combined use of hyperbaric (4 mg and hypobaric (6 mg ropivacaine significantly decreased the incidences of hypotension and complications in spinal anesthesia for caesarean section by extending induction time and decreasing the level of sensory blockade.Chinese Clinical Trial Register ChiCTR-TRC-13004622.

  18. Effect of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia: A randomized, 1-year study.

    Science.gov (United States)

    Guo, Xiaofeng; Zhai, Jinguo; Liu, Zhening; Fang, Maosheng; Wang, Bo; Wang, Chuanyue; Hu, Bin; Sun, Xueli; Lv, Luxian; Lu, Zheng; Ma, Cui; He, Xiaolin; Guo, Tiansheng; Xie, Shiping; Wu, Renrong; Xue, Zhimin; Chen, Jindong; Twamley, Elizabeth W; Jin, Hua; Zhao, Jingping

    2010-09-01

    Antipsychotic drugs are limited in their ability to improve the overall outcome of schizophrenia. Adding psychosocial treatment may produce greater improvement in functional outcome than does medication treatment alone. To evaluate the effectiveness of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia. Randomized controlled trial. Ten clinical sites in China. Clinical sample of 1268 patients with early-stage schizophrenia treated from January 1, 2005, through October 31, 2007. Intervention Patients were randomly assigned to receive antipsychotic medication treatment only or antipsychotic medication plus 12 months of psychosocial intervention consisting of psychoeducation, family intervention, skills training, and cognitive behavior therapy administered during 48 group sessions. The rate of treatment discontinuation or change due to any cause, relapse or remission, and assessments of insight, treatment adherence, quality of life, and social functioning. The rates of treatment discontinuation or change due to any cause were 32.8% in the combined treatment group and 46.8% in the medication-alone group. Comparisons with medication treatment alone showed lower risk of any-cause discontinuation with combined treatment (hazard ratio, 0.62; 95% confidence interval, 0.52-0.74; P psychosocial intervention have a lower rate of treatment discontinuation or change, a lower risk of relapse, and improved insight, quality of life, and social functioning. clinicaltrials.gov Identifier: NCT00654576.

  19. Effects of a psychosocial intervention programme combined with exercise in community-dwelling older adults with chronic pain: A randomized controlled trial.

    Science.gov (United States)

    Hirase, T; Kataoka, H; Nakano, J; Inokuchi, S; Sakamoto, J; Okita, M

    2017-11-21

    Although researchers have recommended exercise training and psychosocial intervention to manage chronic pain, an effective intervention for Japanese community-dwelling older adults with chronic pain has not been established. This randomized controlled trial examined whether exercise training combined with psychosocial intervention more effectively improves pain, psychological status and physical activity than does exercise training alone in this population. We randomized 128 older adults with chronic pain to either an intervention group (n = 64) involving exercise training combined with psychosocial intervention, or a control group (n = 64) involving only exercise training. Exercise training comprised weekly 60-min sessions for 12 weeks. Psychosocial intervention involved changing participants' focus on pain using self-management education and cognitive behavioural therapy, and participants recorded their daily pain intensity and step counts. Pain intensity, psychological status and physical activity were assessed before and 12 weeks after the intervention. A time-by-group interaction emerged for psychological status (p = 0.003) and physical activity (p psychosocial intervention improves key outcome indicators more effectively than does exercise training alone in older adults with chronic pain. Although research has shown that combined exercise and psychosocial intervention is optimal for managing chronic pain, our study is the first, to the best of our knowledge, to test a specific intervention of this type in community-dwelling older adults with chronic pain in Japan. © 2017 European Pain Federation - EFIC®.

  20. Use of a high-frequency linear transducer and MTI filtered color flow mapping in the assessment of fetal heart anatomy at the routine 11 to 13 + 6-week scan: a randomized trial.

    Science.gov (United States)

    Votino, C; Kacem, Y; Dobrescu, O; Dessy, H; Cos, T; Foulon, W; Jani, J

    2012-02-01

    To prospectively assess the contribution of a high-frequency linear transducer and of moving target indicator (MTI) filtered color flow mapping in the visualization of cardiac fetal anatomy at the routine 11 to 13 + 6-week scan. This was a cross-sectional prospective study, including 300 singleton fetuses at 11 to 13 + 6 weeks' gestation. Patients were randomized into four groups and a detailed fetal cardiac examination was conducted transabdominally using either a conventional curvilinear transducer, a conventional curvilinear transducer and MTI filtered color flow mapping, a high-frequency linear transducer or a high-frequency linear transducer and MTI filtered color flow mapping. Regression analysis was used to investigate the effect on the ability to visualize different cardiac structures of the following parameters: gestational age at ultrasound examination; fetal crown-rump length (CRL); maternal body mass index (BMI); transducer-heart distance; the technique used at ultrasound; and the position of the placenta. The four-chamber view was visualized in 89.0% of fetuses and regression analysis showed this rate was correlated with CRL and the use of MTI filtered color flow mapping during ultrasonography, and inversely correlated with BMI and transducer-heart distance. Use of a conventional curvilinear transducer and MTI filtered color flow mapping allowed visualization of the four-chamber view in 97.3% of fetuses, while this was only possible in 84.0% of fetuses using a high-frequency linear transducer. The left and right outflow tracts were visualized in 62.3 and 57.7% of fetuses, respectively. Regression analysis showed that the ability to visualize the left or the right outflow tract was correlated with the use of MTI filtered color flow mapping during scanning and was inversely correlated with transducer-heart distance. The use of a conventional curvilinear transducer and MTI filtered color flow mapping allowed visualization of the left and right outflow

  1. A Combined Motivation and Parent-Child Interaction Therapy Package Reduces Child Welfare Recidivism in a Randomized Dismantling Field Trial

    Science.gov (United States)

    Chaffin, Mark; Funderburk, Beverly; Bard, David; Valle, Linda Anne; Gurwitch, Robin

    2011-01-01

    Objective: A package of parent-child interaction therapy (PCIT) combined with a self-motivational (SM) orientation previously was found in a laboratory trial to reduce child abuse recidivism compared with services as usual (SAU). Objectives of the present study were to test effectiveness in a field agency rather than in a laboratory setting and to…

  2. Nifedipine plus candesartan combination increases blood pressure control regardless of race and improves the side effect profile: DISTINCT randomized trial results.

    Science.gov (United States)

    Kjeldsen, Sverre E; Sica, Domenic; Haller, Hermann; Cha, Gloria; Gil-Extremera, Blas; Harvey, Peter; Heyvaert, Frank; Lewin, Andrew J; Villa, Giuseppe; Mancia, Giuseppe

    2014-12-01

    DISTINCT (reDefining Intervention with Studies Testing Innovative Nifedipine GITS - Candesartan Therapy) aimed to determine the dose-response and tolerability of nifedipine GITS and/or candesartan cilexetil therapy in participants with hypertension. In this 8-week, multinational, multicentre, randomized, double-blind, placebo-controlled study, adults with mean seated DBP of at least 95 to less than 110 mmHg received combination or monotherapy with nifedipine GITS (N) 20, 30 or 60 mg and candesartan cilexetil (C) 4, 8, 16 or 32 mg, or placebo. The primary endpoint, change in DBP from baseline to Week 8, was analysed using the response surface model (RSM); this analysis was repeated for mean seated SBP. Overall, 1381 participants (mean baseline SBP/DBP: 156.5/99.6 mmHg) were randomized. Both N and C contributed independently to SBP/DBP reductions [P < 0.0001 (RSM)]. A positive dose-response was observed, with all combinations providing statistically better blood pressure (BP) reductions from baseline versus respective monotherapies (P < 0.05) and N60C32 achieving the greatest reduction [-23.8/-16.5 mmHg; P < 0.01 versus placebo (-5.3/-6.7 mmHg) and component monotherapies]. Even very low-dose (N20 and C4) therapy provided significant BP-lowering, and combination therapy was similarly effective in different racial groups. N/C combination demonstrated a lower incidence of vasodilatory adverse events than N monotherapy (18.3 versus 23.6%), including headache (5.5 versus 11.0%; P = 0.003, chi-square test) and peripheral oedema over time (3.6 versus 5.8%; n.s.). N/C combination was effective in participants with hypertension and showed an improved side effect profile compared with N monotherapy.

  3. Personalized Web-Based Advice in Combination With Well-Child Visits to Prevent Overweight in Young Children: Cluster Randomized Controlled Trial.

    Science.gov (United States)

    van Grieken, Amy; Vlasblom, Eline; Wang, Lu; Beltman, Maaike; Boere-Boonekamp, Magda M; L'Hoir, Monique P; Raat, Hein

    2017-07-27

    Overweight is a major health issue, and parent-targeted interventions to promote healthy development in children are needed. The study aimed to evaluate E-health4Uth Healthy Toddler, an intervention that educates parents of children aged 18 to 24 months regarding health-related behaviors, as compared with usual care. The effect of this intervention on the following primary outcomes was evaluated when the children were 36 months of age: health-related behaviors (breakfast daily, activity and outside play, sweetened beverage consumption, television (TV) viewing and computer time), body mass index (BMI), and the prevalence of overweight and obesity. The BeeBOFT (acronym for breastfeeding, breakfast daily, outside playing, few sweet drinks, less TV viewing) study is a cluster randomized controlled trial involving 51 Youth Health Care (YHC) teams. In total, 1094 parents participated in the control group, and 1008 parents participated in the E-health4Uth Healthy Toddler intervention group. The intervention consisted of Web-based personalized advice given to parents who completed an eHealth module and discussion of the advice during a regular well-child visit. In this study the eHealth module was offered to parents before two regular well-child visits at 18 and 24 months of age. During the well-child visits, the parents' personalized advice was combined with face-to-face counseling provided by the YHC professional. Parents in the control group received usual care, consisting of the regular well-child visits during which general information on child health-related behavior was provided to parents. Parents completed questionnaires regarding family characteristics and health-related behaviors when the child was 1 month (inclusion), 6 months, 14 months, and 36 months (follow-up) of age. The child's height and weight were measured by trained health care professionals from birth through 36 months of age at fixed time points. Multilevel linear and logistic regression models were

  4. A combined in silico/in vitro approach unveils common molecular requirements for efficient BVDV RdRp binding of linear aromatic N-polycyclic systems.

    Science.gov (United States)

    Carta, A; Briguglio, I; Piras, S; Corona, P; Ibba, R; Laurini, E; Fermeglia, M; Pricl, S; Desideri, N; Atzori, E M; La Colla, P; Collu, G; Delogu, I; Loddo, R

    2016-07-19

    In this work, we present and discuss a comprehensive set of both newly and previously synthesized compounds belonging to 5 distinct molecular classes of linear aromatic N-polycyclic systems that efficiently inhibits bovine viral diarrhea virus (BVDV) infection. A coupled in silico/in vitro investigation was employed to formulate a molecular rationale explaining the notable affinity of all molecules to BVDV RNA dependent RNA polymerase (RdRp) NS5B. We initially developed a three-dimensional common-feature pharmacophore model according to which two hydrogen bond acceptors and one hydrophobic aromatic feature are shared by all molecular series in binding the viral polymerase. The pharmacophoric information was used to retrieve a putative binding site on the surface of the BVDV RdRp and to guide compound docking within the protein binding site. The affinity of all compounds towards the enzyme was scored via molecular dynamics-based simulations, showing high correlation with in vitro EC50 data. The determination of the interaction spectra of the protein residues involved in inhibitor binding highlighted amino acids R295 and Y674 as the two fundamental H-bond donors, while two hydrophobic cavities HC1 (residues A221, I261, I287, and Y289) and HC2 (residues V216, Y303, V306, K307, P408, and A412) fulfill the third pharmacophoric requirement. Three RdRp (K263, R295 and Y674) residues critical for drug binding were selected and mutagenized, both in silico and in vitro, into alanine, and the affinity of a set of selected compounds towards the mutant RdRp isoforms was determined accordingly. The agreement between predicted and experimental data confirmed the proposed common molecular rationale shared by molecules characterized by different chemical scaffolds in binding to the BVDV RdRp, ultimately yielding compound 6b (EC50 = 0.3 μM; IC50 = 0.48 μM) as a new, potent inhibitor of this Pestivirus. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Effects of animal source food and micronutrient fortification in complementary food products on body composition, iron status, and linear growth: a randomized trial in Cambodia.

    Science.gov (United States)

    Skau, Jutta K H; Touch, Bunthang; Chhoun, Chamnan; Chea, Mary; Unni, Uma S; Makurat, Jan; Filteau, Suzanne; Wieringa, Frank T; Dijkhuizen, Marjoleine A; Ritz, Christian; Wells, Jonathan C; Berger, Jacques; Friis, Henrik; Michaelsen, Kim F; Roos, Nanna

    2015-04-01

    Poor nutritional quality of complementary foods often limits growth. Animal source foods, such as milk or meat, are often unaffordable. Local affordable alternatives are needed. We evaluate the efficacy of 2 newly developed, rice-based complementary food products: WinFood (WF) with small fish and edible spiders and WinFood-Lite (WF-L) fortified with small fish, against 2 existing fortified corn-soy blend products, CSB+ (purely plant based) and CSB++ (8% dried skimmed milk). In total, 419 infants aged 6 mo were enrolled in this randomized, single-blinded study for 9 mo, designed primarily to assess increments in fat-free mass by a deuterium dilution technique and change in plasma ferritin and soluble transferrin receptor. Secondary endpoints were changes in anthropometric variables, including knee-heel length. Data were analyzed by the intention-to-treat approach. There was no difference in fat-free mass increment in WF or WF-L compared with CSB+ [WF: +0.04 kg (95% CI: -0.20, 0.28 kg); WF-L: +0.14 kg (95% CI: -0.10, 0.38 kg)] or CSB++ [WF: -0.03 kg (95% CI: -0.27, 0.21 kg); WF-L: +0.07 kg (95% CI: -0.18, 0.31 kg)] and no effect on iron status. The 1.7-mm (95% CI: -0.1, 3.5 mm) greater increase in knee-heel length in WF-L than in CSB+ was not significant. No difference was found between the locally produced products (WF and WF-L) and the CSBs. Micronutrient fortification may be necessary, and small fish may be an affordable alternative to milk to improve complementary foods. The dietary role of edible spiders needs to be further explored. This trial was registered at controlled-trials.com as ISRCTN19918531. © 2015 American Society for Nutrition.

  6. Involved-Field Radiotherapy versus Elective Nodal Irradiation in Combination with Concurrent Chemotherapy for Locally Advanced Non-Small Cell Lung Cancer: A Prospective Randomized Study

    Science.gov (United States)

    Chen, Ming; Bao, Yong; Ma, Hong-Lian; Wang, Jin; Wang, Yan; Peng, Fang; Zhou, Qi-Chao; Xie, Cong-Hua

    2013-01-01

    This prospective randomized study is to evaluate the locoregional failure and its impact on survival by comparing involved field radiotherapy (IFRT) with elective nodal irradiation (ENI) in combination with concurrent chemotherapy for locally advanced non-small cell lung cancer. It appears that higher dose could be delivered in IFRT arm than that in ENI arm, and IFRT did not increase the risk of initially uninvolved or isolated nodal failures. Both a tendency of improved locoregional progression-free survival and a significant increased overall survival rate are in favor of IFRT arm in this study. PMID:23762840

  7. Glycolic Acid peels/azelaic Acid 20% cream combination and low potency triple combination lead to similar reduction in melasma severity in ethnic skin: results of a randomized controlled study.

    Science.gov (United States)

    Mahajan, Rahul; Kanwar, Amrinder Jit; Parsad, Davinder; Kumaran, Muthu Sendhil; Sharma, Reena

    2015-01-01

    Numerous therapeutic options have been tried in the management of melasma. This prospective randomized study was planned to assess the efficacy of low potency triple combination (TC) cream (TC-hydroquinone 2%/tretinoin 0.05%/fluocinolone 0.01%) versus glycolic acid (GA) peels/azelaic acid (AA) 20% cream (GA/AA) combination in melasma. Forty patients with melasma were recruited into this study and randomized into two groups. Group A consisting 20 patients received TC cream once a day for night time application for 3 months. Group B comprising of 20 patients received GA/AA 20% cream combination for 3 months. The disease severity was monitored with digital photography, melasma area and severity index (MASI) score, which was calculated at baseline, 6 weeks and 12 weeks, and visual analog scale (VAS) score, which was calculated at baseline and 12 weeks. Of 40 patients, 38 were completed the study. A significant reduction in MASI and VAS was recorded after 6 weeks and 12 weeks of treatment in both groups A and B (P = 0.001). However, there was no significant difference in the mean MASI scores between the two groups at baseline, 6 weeks and 12 weeks. Similarly, there was no difference in the mean VAS scores between the two groups at baseline and 12 weeks. Four patients in group A and 3 in group B experienced adverse effects such as irritation, dryness, and photosensitivity. Both low potency TC cream and GA/AA 20% cream combination are effective in treating melasma among Indian patients.

  8. Linear systems

    CERN Document Server

    Bourlès, Henri

    2013-01-01

    Linear systems have all the necessary elements (modeling, identification, analysis and control), from an educational point of view, to help us understand the discipline of automation and apply it efficiently. This book is progressive and organized in such a way that different levels of readership are possible. It is addressed both to beginners and those with a good understanding of automation wishing to enhance their knowledge on the subject. The theory is rigorously developed and illustrated by numerous examples which can be reproduced with the help of appropriate computation software. 60 exe

  9. Safety, Tolerability, Pharmacodynamics and Pharmacokinetics of Umeclidinium and Vilanterol Alone and in Combination: A Randomized Crossover Trial

    OpenAIRE

    Kelleher, Dennis L.; Mehta, Rashmi S.; Jean-Francois, Bernadette M.; Preece, Andrew F.; Blowers, James; Crater, Glenn D.; Thomas, Paul

    2012-01-01

    Umeclidinium bromide (GSK573719; UMEC), a new long-acting muscarinic receptor antagonist (LAMA), is in development with vilanterol (GW642444; VI), a selective long-acting ?2 agonist (LABA), as a once-daily inhaled combination therapy for the treatment of chronic obstructive pulmonary disease (COPD). A single dose healthy volunteer study was conducted to assess the safety and tolerability, pharmacodynamics (PD) and pharmacokinetics (PK) of inhaled umeclidinium (500 ?g) and vilanterol (50 ?g) w...

  10. A prospective randomized trial comparing Foley catheter, oxytocin, and combination Foley catheter-oxytocin for labour induction with unfavourable cervix.

    Science.gov (United States)

    El Khouly, Nabih I

    2017-04-01

    The purpose of this study was to evaluate the effectiveness and safety of transcervical Foley catheter with and without oxytocin versus oxytocin alone for labour induction with unfavourable cervix. This trial enrolled 108 women with singleton pregnancies presented for labour induction with unfavourable cervix. Patients were randomly assigned to receive Foley catheter alone (I), Foley catheter plus oxytocin (II) or oxytocin alone (III). Outcomes were analysed in terms of success of induction, induction delivery interval, route of delivery, dose and duration of oxytocin, and complications. Successful normal vaginal delivery was more common in group I (p = .02) compared to group III. Induction delivery time was statistically shorter in group II and group III (p oxytocin dose and duration (p oxytocin increases success rate of normal vaginal delivery; however, it has a longer induction delivery interval with similar complications.

  11. Combined bioavailable isoflavones and probiotics improve bone status and estrogen metabolism in postmenopausal osteopenic women: a randomized controlled trial

    DEFF Research Database (Denmark)

    Lambert, Max Norman Tandrup; Thybo, Catrine Bundgaard; Lykkeboe, Simon

    2017-01-01

    estrogen receptor affinity show potential to prevent and treat osteoporosis while minimizing or eliminating carcinogenic side effects. Objective: In this study, we sought to determine the beneficial effects of a bioavailable isoflavone and probiotic treatment against postmenopausal osteopenia. Design: We...... used a novel red clover extract (RCE) rich in isoflavone aglycones and probiotics to concomitantly promote uptake and a favorable intestinal bacterial profile to enhance isoflavone bioavailability. This was a 12-mo, double-blind, parallel design, placebo-controlled, randomized controlled trial of 78...... postmenopausal osteopenic women supplemented with calcium (1200 mg/d), magnesium (550 mg/d), and calcitriol (25 mg/d) given either RCE (60 mg isoflavone aglycones/d and probiotics) or a masked placebo [control (CON)]. Results: RCE significantly attenuated bone mineral density (BMD) loss at the L2–L4 lumbar spine...

  12. Combination of Deep Recurrent Neural Networks and Conditional Random Fields for Extracting Adverse Drug Reactions from User Reviews

    Directory of Open Access Journals (Sweden)

    Elena Tutubalina

    2017-01-01

    Full Text Available Adverse drug reactions (ADRs are an essential part of the analysis of drug use, measuring drug use benefits, and making policy decisions. Traditional channels for identifying ADRs are reliable but very slow and only produce a small amount of data. Text reviews, either on specialized web sites or in general-purpose social networks, may lead to a data source of unprecedented size, but identifying ADRs in free-form text is a challenging natural language processing problem. In this work, we propose a novel model for this problem, uniting recurrent neural architectures and conditional random fields. We evaluate our model with a comprehensive experimental study, showing improvements over state-of-the-art methods of ADR extraction.

  13. Evaluation of the efficacy of a combined formulation (Grippostad-C) in the therapy of symptoms of common cold: a randomized, double-blind, multicenter trial.

    Science.gov (United States)

    Koytchev, R; Vlahov, V; Bacratcheva, N; Giesel, B; Gawronska-Szklarz, B; Wojcicki, J; Mrozikiewiczs, A; van der Meer, M; Alken, R G

    2003-03-01

    The aim of the present trial was to evaluate the efficacy of a combined product in the treatment of common cold and to examine the contribution of the separate components. In the published literature there is conflicting data on the efficacy of agents used in the treatment of common cold, especially when given in drug combinations. A prospective, randomized, double-blind, multicenter, 4-arm, controlled trial was carried out in 1,167 patients with common cold treated with one of the following medications: Grippostad-C, a combination of acetaminophen, caffeine, chlorpheniramine and ascorbic acid (verum), ascorbic acid (control), chlorpheniramine and ascorbic acid (reference 1), as well as acetaminophen, caffeine, and ascorbic acid (reference 2). A score of common cold symptoms (headache, throat pain, extremities and joint pain, cough, blocked nose, and disturbances of sleep quality) was the primary outcome. The test drug was first compared with the control using a hierarchic test strategy, then with reference 1, followed by reference 2 with the aim of proving superiority. A clinically relevant and statistically significant difference was demonstrated at each level of the hierarchy. Grippostad-C was significantly superior to all other treatment groups, the combination of acetaminophen, caffeine, and ascorbic acid was significantly superior to the control, and the combination of chlorpheniramine and ascorbic acid was not statistically different from the control. The efficacy of Grippostad-C for the treatment of common cold was proven. The findings demonstrate that the combination is superior to each of its separate components and each of the components has its own distinctive contribution to the efficacy of the combination product.

  14. Effect of the combination of music and nature sounds on pain and anxiety in cardiac surgical patients: a randomized study.

    Science.gov (United States)

    Bauer, Brent A; Cutshall, Susanne A; Anderson, Patricia G; Prinsen, Sharon K; Wentworth, Laura J; Olney, Tammy J; Messner, Penny K; Brekke, Karen M; Li, Zhuo; Sundt, Thoralf M; Kelly, Ryan F; Bauer, Brent A

    2011-01-01

    Postoperative pain and anxiety are common in cardiac surgery patients. Studies have suggested that music can decrease anxiety in hospitalized patients. Primary Study Objective This study focused on the efficacy and feasibility of special music, which included nature sounds, for pain and anxiety. In this randomized controlled trial, postoperative cardiovascular surgery patients were randomly assigned to a music group to receive 20 minutes of standard postoperative care and music twice daily on postoperative days 2 through 4 or to a control group to receive 20 minutes of standard care with a quiet resting period twice daily on postoperative days 2 through 4. Cardiovascular surgical unit of Saint Marys Hospital, Rochester, Minnesota. One hundred patients completed the study (music group, n = 49; control group, n = 51). Intervention The music was delivered through CD players in the patients' rooms. Pain, anxiety, satisfaction, and relaxation were evaluated from visual analog scales. Data showed a significant decrease in mean (SD) pain scores after the second session of day 2 for the music group (change, ?1.4 [1.4]) compared with the control group (change, ?0.4 [1.4]) (P = .001). Mean relaxation scores improved more at the first session of day 2 for the music group (change, 1.9 [2.7]) compared with the control group (change, 0.3 [2.9]) (P = .03). The music group also showed lower anxiety and increased satisfaction overall, but these differences were not statistically significant. No major barriers to using the therapy were identified. Recorded music and nature sounds can be integrated into the postoperative care of cardiovascular surgery patients. The recordings may provide an additional means for addressing common symptoms of pain and anxiety while providing a means of relaxation for these patients.

  15. A comparative evaluation of intranasal midazolam, ketamine and their combination for sedation of young uncooperative pediatric dental patients: a triple blind randomized crossover trial.

    Science.gov (United States)

    Bahetwar, S K; Pandey, R K; Saksena, A K; Chandra, Girish

    2011-01-01

    The purpose of this study was to evaluate and compare the efficacy and safety of intranasal (IN) administration of midazolam (M), ketamine (K) and their combination (MK) to produce moderate sedation in young, uncooperative pediatric dental patients. In this three stage crossover trial forty five uncooperative ASA type-1 children, who required dental treatment, were randomly assigned to receive one of the three drugs/combination by IN route during three subsequent visits. The efficacy and safety of the agents were assessed by overall success rate and by monitoring of vital signs, respectively. The onset of sedation was rapid with K as compared to M and MK. The difference was statistically significant (P pediatric dental patients who have been otherwise indicated for treatment under general anesthesia.

  16. Monochromatic excimer light versus combination of topical steroid with vitamin D3 analogue in the treatment of nonsegmental vitiligo: a randomized blinded comparative study.

    Science.gov (United States)

    Abdel Latif, Azmy Ahmed; Ibrahim, Shady Mahmoud Attia

    2015-01-01

    Vitiligo is a difficult disease to treat, socially stigmatizing its patients. Monochromatic excimer light (MEL) was developed for use in dermatology and adapted for the treatment of vitiligo. Comparing the efficacy of MEL versus topical combination therapy of vitamin D3 analogue and steroid in the treatment of nonsegmental vitiligo. Forty-four patients with localized and stable nonsegmental vitiligo participated in the present study. In each patient, two lesions were selected and divided randomly into two groups, group A was treated with daily topical combination of calcipotriol and betamethasone and group B was treated with biweekly sessions of MEL for 3 months. Efficacy based on repigmentation percentages were blindly evaluated by two independent physicians and patient's satisfaction. There was significant improvement in both treatment modalities at the end of the study, but without significant differences in both groups. There was a significant difference between both groups regarding the onset of repigmentation (p-value vitiligo. © 2015 Wiley Periodicals, Inc.

  17. Deep peeling using phenol versus percutaneous collagen induction combined with trichloroacetic acid 20% in atrophic post-acne scars; a randomized controlled trial.

    Science.gov (United States)

    Leheta, Tahra Mohamed; Abdel Hay, Rania Mounir; El Garem, Yehia Farouk

    2014-04-01

    Deep peeling using phenol and percutaneous collagen induction (PCI) are used in treating acne scars. To compare deep peeling using phenol and PCI combined with trichloroacetic acid (TCA) 20% in treating atrophic acne scars. 24 patients with post-acne atrophic scars were randomly divided into two groups; group 1 was subjected to one session of deep peeling using phenol, and group 2 was subjected to four sessions of PCI combined with TCA 20%. As a secondary outcome measure, side effects were recorded and patients were asked to assess their % of improvement by a questionnaire completed 8 months after the procedure. Scar severity scores improved by a mean of 75.12% (p scars, within the same group after treatment, revealed a significant highest degree of improvement in the rolling type (p = 0.005) in group 2. Deep peeling using phenol and PCI with TCA 20% were effective in treating post-acne atrophic scars.

  18. A randomized trial comparing initial HAART regimens of nelfinavir/nevirapine and ritonavir/saquinavir in combination with two nucleoside reverse transcriptase inhibitors

    DEFF Research Database (Denmark)

    Kirk, Ole; Lundgren, Jens D; Pedersen, Court

    2003-01-01

    BACKGROUND: A triple-class HAART regimen may be associated with a better virological effect than conventional regimens, but may also lead to toxicity and more profound resistance. METHODS: Randomized, controlled, open-label trial of 233 protease inhibitor- and non-nucleoside reverse transcriptase...... inhibitor-naive HIV-infected patients allocated to a regimen of nelfinavir and nevirapine (1250/200 mg twice daily; n = 118) or ritonavir and saquinavir (400/400 mg twice daily; n = 115), both in combination with two nucleoside reverse transcriptase inhibitors. The primary end-point was HIV RNA ....037. CONCLUSION: A regimen of nelfinavir/nevirapine had a favourable virological effect and tolerability over a 48-week period compared with ritonavir/saquinavir, when administered in combination with two nucleoside reverse transcriptase inhibitors. However, more extensive follow-up is required to determine...

  19. Effects on office and home blood pressure of the lercanidipine-enalapril combination in patients with Stage 2 hypertension: a European randomized, controlled clinical trial.

    Science.gov (United States)

    Mancia, Giuseppe; Coca, Antonio; Chazova, Irina; Girerd, Xavier; Haller, Hermann; Pauletto, Paolo; Pupek-Musialik, Danuta; Svyshchenko, Yevgeniya

    2014-08-01

    The aim of this study was to evaluate the efficacy and safety of combinations of lercanidipine (L) and enalapril (E) at different doses on office and home blood pressure (BP) in patients with Stage 2 hypertension. This was a randomized, double-blind, placebo-controlled, factorial study conducted in 100 centres from seven countries. Patients with office DBP 100-109 mmHg and home DBP at least 85 mmHg at the end of a 2-week placebo run-in period were randomized to a 10-week treatment with placebo, L (10 or 20 mg), E (10 or 20 mg) or the four L-E combinations. The efficacy parameters were office DBP at trough (primary), SBP at trough and home SBP and DBP. Office BP was measured at each visit in both the sitting and the standing position, while home BP was measured twice in the morning and twice in the evening for at least 3 days before treatment and at study end. Safety parameters included adverse events, laboratory tests and 12-lead ECG. A total of 1039 patients were randomized (48% men, mean age 54 years, mean BMI 30 kg/m, 40% obese patients). Baseline BP was similar in all groups and lower for home than for office values (149/95 and 159/103 mmHg, respectively). A marked placebo effect was observed on office but not on home BP. Combination therapy was superior to placebo at all doses for both office and home BP. The greatest effect was observed in the L20/E20 group, in which the SBP/DBP fall amounted to -19.2/-15.2 and -13.2/-7.5 mmHg for sitting office and home BP, respectively. Similar reductions were observed on standing office BP. The L20/E20 combination was associated with less cough, palpitations and leg oedema than monotherapies, with no increased rate of dizziness or hypotension. In Stage 2 hypertension, a fixed-dose combination of L and E ensures a control of both office and out-of-office BP, with a favourable tolerability profile.

  20. Combined application of eicosapentaenoic acid and docosahexaenoic acid on depression in women: a meta-analysis of double-blind randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Yang JR

    2015-08-01

    Full Text Available Jia-run Yang, Dong Han, Zheng-xue Qiao, Xue Tian, Dong Qi, Xiao-hui QiuDepartment of Medical Psychology, Public Health Institute of Harbin Medical University, Harbin, Heilongjiang Province, People’s Republic of ChinaObjectives: Previous randomized controlled trials (RCTs suggest that depression can be effectively treated by omega-3 polyunsaturated fatty acids (PUFAs. Therefore, we conducted this meta-analysis to systematically evaluate the clinical applicability of the combination of docosahexaenoic acid (DHA and eicosapentaenoic acid (EPA, which are the two major bioactive types of PUFAs, in depressed women.Methods: RCTs that compared the combination of DHA and EPA to placebo for short-course treatment of depression in women were systematically reviewed up to March 2015. Outcome measurement was the standardized difference in means in clinical measure of depression severity. Random effect model was performed. Meta-regression analysis was performed to assess the effects of baseline depression scores.Results: Data were obtained from eight RCTs. In these RCTs, 182 patients received placebo and 185 patients received DHA and EPA. The pooled standardized difference in mean was 0.65 with 95% CI = [0.18, 1.12]. There was no relation between the efficacy and the baseline depression scores. The sensitivity analysis found that the combination of EPA and DHA as monotherapy yielded a standardized difference in means of 0.65 (95% CI =0.41, 0.90 without heterogeneity.Discussion: These results indicate a beneficial effect of the combination of EPA and DHA on depressed mood in women compared with placebo. The clinical applicability of EPA and DHA showed greater promise and should be further explored.Keywords: depression, omega-3 polyunsaturated fatty acids, PUFAs, docosahexaenoic acid, DHA, eicosapentaenoic acid, EPA

  1. Investigation on random vibration of a drillstring

    Science.gov (United States)

    Qiu, Hongyuan; Yang, Jianming; Butt, Stephen; Zhong, Jinghan

    2017-10-01

    This paper investigates the axial-torsional coupled vibration of a drill-string under combined deterministic and random excitations. Finite element method (FEM) is used to model the system. The random excitation at the bit-rock interaction, which is considered in the bit axial direction, is treated as Gaussian white noise. Statistic linearization is first applied to find a equivalent linear dynamic system which is then solved with stochastic Newmark algorithm. The statistics of the responses, including the means and standard deviations of the bit axial displacement and rotational velocity are obtained and analyzed.

  2. A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

    Directory of Open Access Journals (Sweden)

    Tahsin Gorgulu

    2016-02-01

    Full Text Available ABSTRACT Background Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless procedures using cyanoacrylate, but these have higher risks of hematoma and hemorrhage. We combined a CO2 laser and cyanoacrylate to shorten the operation time and to decrease bleeding complications. Materials and Methods : Circumcisions were performed under general anesthesia with CO2 laser and cyanoacrylate combination in 75 6–9-year-old boys between May 2013 and August 2014 only for religious reasons. As a control, we compared them retrospectively with 75 age-matched patients who were circumcised using the conventional guillotine method in our clinic. Results No hematomas, bleeding, or wound infections were observed. One wound dehiscence (1.33% occurred during the early postoperative period and healed without any additional procedures. The median operating time was 7 (range 6–9 minutes. The conventional guillotine group comprised one hematoma (1.3%, two wound dehiscences (2.6%, and two hemorrhages (2.6%, and the median operating time was 22 (range 20–26 minutes. The difference in surgical time was significant (p<0.001, with no significant difference in the rate of complications between the two groups. Conclusion The combined CO2 laser and cyanoacrylate procedure not only decreased the operating time markedly, but also eliminated the disadvantages associated with each individual procedure alone.

  3. Tinnitus Management: Randomized Controlled Trial Comparing Extended-Wear Hearing Aids, Conventional Hearing Aids, and Combination Instruments.

    Science.gov (United States)

    Henry, James A; McMillan, Garnett; Dann, Serena; Bennett, Keri; Griest, Susan; Theodoroff, Sarah; Silverman, Shien Pei; Whichard, Susan; Saunders, Gabrielle

    2017-06-01

    Whereas hearing aids have long been considered effective for providing relief from tinnitus, controlled clinical studies evaluating this premise have been very limited. The purpose of this study was to systematically determine the relative efficacy of conventional receiver-in-the-canal hearing aids (HA), the same hearing aids with a sound generator (HA+SG), and extended-wear, deep fit hearing aids (EWHA), to provide relief from tinnitus through a randomized controlled trial. Each of these ear-level devices was a product of Phonak, LLC. Participants were randomized to HA, HA+SG, or EWHA and wore bilaterally fit devices for about 4 months. Fittings, adjustments, and follow-up appointments were conducted to comply with company guidelines and to ensure that all participants attended appointments on the same schedule. At 4-5 months, participants returned to complete final outcome measures, which concluded their study participation. Participants were 55 individuals (mean age: 63.1 years) with mild to moderately-severe hearing loss who: (a) did not currently use hearing aids; (b) reported tinnitus that was sufficiently bothersome to warrant intervention; and (c) were suitable candidates for each of the study devices. The primary outcome measure was the Tinnitus Functional Index (TFI). Secondary outcome measures included hearing-specific questionnaires and the Quick Speech in Noise test (QuickSIN). The goal of the analysis was to evaluate efficacy of the EWHA and HA+SG devices versus the HA standard device. There were 18 participants in each of the HA and EWHA groups and 19 in the HA+SG group. Gender, age, and baseline TFI severity were balanced across treatment groups. Nearly all participants had a reduction in tinnitus symptoms during the study. The average TFI change (improvement) from baseline was 21 points in the HA group, 31 points in the EWHA group, and 33 points in the HA+SG group. A "clinically significant" improvement in reaction to tinnitus (at least 13-point

  4. Effect of Aloe vera topical gel combined with tretinoin in treatment of mild and moderate acne vulgaris: a randomized, double-blind, prospective trial.

    Science.gov (United States)

    Hajheydari, Zohreh; Saeedi, Majid; Morteza-Semnani, Katayoun; Soltani, Aida

    2014-04-01

    Topical retinoids are considered first-line therapy in the treatment of acne vulgaris, yet can be associated with cutaneous irritations. Combination therapy with natural preparations could be effective in treatment and decreasing adverse events. The aim of this study was to compare the efficacy and safety of the combination of tretinoin (TR) cream (0.05%) and Aloe vera topical gel (50%) with TR and vehicle. The randomized, double-blind, prospective 8-week trial evaluated inflammatory and non-inflammatory lesion scores and tolerability in 60 subjects with mild to moderate acne vulgaris (global acne grading system scale). Several formulations of A. vera leaf gel were prepared and the most stable one was selected for clinical study based on physicochemical evaluations. The combination therapy showed superior efficacy to TR and placebo. TR/Aloe vera gel (AVG) was significantly more effective in reducing non-inflammatory (p = 0.001), inflammatory (p = 0.011) and total (p = 0.003) lesion scores than control group. The highest percentage of adverse cutaneous effect was reported for scaling. At the end of study, erythema in the TR/AVG-treated group was significantly less severe (p = 0.046). The combination TR/AVG was well tolerated and significantly more effective than TR and vehicle for the treatment of mild to moderate acne vulgaris.

  5. A comparison of paracetamol, ibuprofen or their combination for pain relief following extractions in children under general anaesthesia: a randomized controlled trial.

    Science.gov (United States)

    Gazal, Giath; Mackie, Iain C

    2007-05-01

    This study was designed to compare the effectiveness of different oral analgesics for relieving pain and distress in children following the extraction of teeth under general anaesthesia (GA). The analgesics included paracetamol alone, ibuprofen alone, and paracetamol and ibuprofen in combination. Two hundred and one subjects were randomly allocated to one of four groups. Forty-seven children were included in the ibuprofen alone (5 mg kg(-1)) group, 51 in the paracetamol/ibuprofen combination (15/5 mg kg(-1)) group, 48 in the high-dose paracetamol (20 mg kg(-1)) group, and 55 children were included in the usual-dose paracetamol (15 mg kg(-1)) group (control group). Evaluation of distress for children was made immediately pre-operatively, on recovery from anaesthesia and again after 15 min by using a five-point face scale. Furthermore, each child was observed immediately postoperatively and 15 min postoperatively for signs of pain using the Children's Hospital of Eastern Ontario Pain Scale. There were significant decreases in the mean pain and distress scores for both the ibuprofen alone and paracetamol/ibuprofen combination groups compared to the control group (usual-dose paracetamol) at 15 min postoperatively. This study provides evidence to support the oral administration of ibuprofen alone or in combination with paracetamol for postoperative analgesia in children who are having teeth extracted under GA.

  6. Switch Rates During Acute Treatment for Bipolar II Depression With Lithium, Sertraline, or the Two Combined: A Randomized Double-Blind Comparison.

    Science.gov (United States)

    Altshuler, Lori L; Sugar, Catherine A; McElroy, Susan L; Calimlim, Brian; Gitlin, Michael; Keck, Paul E; Aquino-Elias, Ana; Martens, Brian E; Fischer, E Grace; English, Teri L; Roach, Janine; Suppes, Trisha

    2017-03-01

    The authors compared medication-induced mood switch risk (primary outcome), as well as treatment response and side effects (secondary outcomes) with three acute-phase treatments for bipolar II depression. In a 16-week, double-blind, multisite comparison study, 142 participants with bipolar II depression were randomly assigned to receive lithium monotherapy (N=49), sertraline monotherapy (N=45), or combination treatment with lithium and sertraline (N=48). At each visit, mood was assessed using standardized rating scales. Rates of switch were compared, as were rates of treatment response and the presence and severity of treatment-emergent side effects. Twenty participants (14%) experienced a switch during the study period (hypomania, N=17; severe hypomania, N=3). Switch rates did not differ among the three treatment groups, even after accounting for dropout. No patient had a manic switch or was hospitalized for a switch. Most switches occurred within the first 5 weeks of treatment. The treatment response rate for the overall sample was 62.7% (N=89), without significant differences between groups after accounting for dropout. The lithium/sertraline combination group had a significantly higher overall dropout rate than the monotherapy groups but did not have an accelerated time to response. Lithium monotherapy, sertraline monotherapy, and lithium/sertraline combination therapy were associated with similar switch and treatment response rates in participants with bipolar II depression. The dropout rate was higher in the lithium/sertraline combination treatment group, without any treatment acceleration advantage.

  7. Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Helene M Wolsk

    Full Text Available We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20% reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance.To perform a combined analysis of the two trials and investigate whether maternal 25-hydroxy-vitamin D (25(OHD level at trial entry modified the intervention effect.VDAART (N = 806 and COPSAC2010. (N = 581 randomized pregnant women to daily high-dose vitamin D3 (4,000 IU/d and 2,400 IU/d, respectively or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI. We conducted random effects combined analyses of the treatment effect, individual patient data (IPD meta-analyses, and analyses stratified by 25(OHD level at study entry.The analysis showed a 25% reduced risk of asthma/recurrent wheeze at 0-3yrs: adjusted odds ratio (aOR = 0.74 (95% CI, 0.57-0.96, p = 0.02. The effect was strongest among women with 25(OHD level ≥30ng/ml at study entry: aOR = 0.54 (0.33-0.88, p = 0.01, whereas no significant effect was observed among women with 25(OHD level <30ng/ml at study entry: aOR = 0.84 (0.62-1.15, p = 0.25. The IPD meta-analyses showed similar results. There was no effect on the secondary end-points.This combined analysis shows that vitamin D supplementation during pregnancy results in a significant reduced risk of asthma/recurrent wheeze in the offspring, especially among women with 25(OHD level ≥ 30 ng/ml at randomization, where the risk was almost halved. Future studies should examine the possibility of raising 25(OHD levels to at least 30 ng/ml early in pregnancy or using higher doses than used in our studies.COPSAC2010: ClinicalTrials.gov NCT00856947; VDAART: ClinicalTrials.gov NCT00920621.

  8. Treating low back pain resulted from lumbar degenerative instability using Chinese Tuina combined with core stability exercises: A randomized controlled trial.

    Science.gov (United States)

    Tang, Shujie; Qian, Xiuling; Zhang, Yingjie; Liu, Yuanmei

    2016-04-01

    The therapeutic effect of Tuina combined with core stability exercises on low back pain resulted from lumbar degenerative instability is unclear. This article aims to evaluate whether core stability exercises can improve the effect of Tuina in this regard. This trial was designed as a randomized controlled trial and carried out in Qingzhou hospital of Traditional Chinese medicine between June 2011 and June 2013. Eighty-eight patients with low-grade lumbar degenerative instability were included and divided randomly into experimental and control groups, 44 in each. The experimental group were treated using Tuina combined with core stability exercises, but the control group using Tuina alone. The evaluation of Visual analogue scale (VAS), Japanese Orthopaedic Association scores (JOA) and recurrence rate were performed. Two weeks after treatment, JOA scores increased (p0.05) between the two groups. At the end of six weeks, VAS scores (pcore stability exercises has better effect than Tuina alone in treating low back pain resulted from low-grade lumbar degenerative instability. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Effect of combining therapy with traditional chinese medicine-based psychotherapy and herbal medicines in women with menopausal syndrome: a randomized controlled clinical trial.

    Science.gov (United States)

    Yang, Hongyan; Yang, Jing; Wen, Zehuai; Zha, Qinglin; Nie, Guangning; Huang, Xuchun; Zhang, Chunlin; Lu, Aiping; Jiang, Miao; Wang, Xiaoyun

    2012-01-01

    This multicenter, randomized, controlled clinical study was designed to address the effectiveness of combined traditional-Chinese-medicine- (TCM-) based psychotherapy and Chinese herbal medicine (CHM) in the treatment of menopausal syndrome. Altogether 424 eligible women diagnosed as menopausal syndrome and categorized as Kidney-Yin/Kidney-Yang deficiency pattern in TCM were randomly assigned into 4 groups and accepted TCM-based psychotherapy (PSY), CHM, PSY + CHM, or placebo therapies, respectively, for 12 weeks, and another 12 weeks were taken as the followup. Kupperman Index (KI) and the Menopause-Specific Quality of Life (MENQOL) with its four subscales (vasomotor, physical, psychosocial, and sexual) were employed for efficacy assessment. Results showed that 400 participants completed 12-week treatment, of which 380 finished the record of KI and MENQOF at week 24. The average adjusted number of KI score decreased between baseline and 12 weeks in all groups. Statistically significant differences were detected in the average adjusted change between the PSY + CHM group and placebo at overall time points (P < 0.05). No severe adverse events occurred in each group and no significant differences were indicated between any of the three groups and placebo in adverse event proportion. We concluded that TCM psychotherapy combined with CHM has a favorable outcome in treating menopausal syndrome.

  10. A single-blinded, randomized pilot study of botulinum toxin type A combined with non-pharmacological treatment for spastic foot.

    Science.gov (United States)

    Baricich, Alessio; Carda, Stefano; Bertoni, Michele; Maderna, Luca; Cisari, Carlo

    2008-11-01

    To explore the effect of treatment after botulinum toxin type A combined with treatments for the spastic foot. Single-blind, randomized trial, with 3-month follow-up. Twenty-three chronic hemiplegic adult patients with spastic equinus foot. Following botulinum toxin type A injection at the medial and lateral gastrocnemius, patients were assigned randomly to 3 groups, and treated with taping, electrical stimulation or stretching. They were evaluated before treatment (t0), and at 10 (t1), 20 (t2) and 90 (t3) days after treatment. Outcome measures were: Modified Ashworth Scale; passive range of motion at the ankle; measurement of muscle action potential at the gastrocnemius medialis; and measurement of maximum ankle dorsiflexion angle in stance using gait analysis. The group treated with electrical stimulation performed better at t1 on the Modified Ashworth Scale. The taping and electrical stimulation groups performed better in all outcome measures at t3. The taping group performed better mainly for maximum ankle dorsiflexion angle in stance. The stretching group showed a less durable result, with some worsening at the t3 evaluation compared with the assessment performed before treatment. This pilot study indicates that combining botulinum toxin type A administration for the ankle plantar flexors with taping and electrical stimulation might be beneficial.

  11. Prolonged exposure, paroxetine and the combination in the treatment of PTSD following a motor vehicle accident. A randomized clinical trial - The "TRAKT" study.

    Science.gov (United States)

    Popiel, Agnieszka; Zawadzki, Bogdan; Pragłowska, Ewa; Teichman, Yona

    2015-09-01

    Little is known about direct comparisons of the efficacy of trauma-focused psychotherapies and SSRIs. This is the first randomized clinical trial comparing the efficacy of prolonged exposure (PE), paroxetine (Ph) and their combination (Comb) in a sample of adults diagnosed with PTSD following motor vehicle accidents (MVA). A total of 228 people were randomly assigned to a twelve-week treatment of PE (N = 114), Ph (N = 57) or Comb (N = 57). The ITT analyses showed that the remission rate of PTSD was significantly greater after PE (65.5%) compared with Ph (43.3%), whereas Comb (51.2%) did not differ from either. The differences in dropout rates were not significant between treatments (18.4% - PE; 12.2% - Ph; 22.8% - Comb), while the differences in numbers of refusers were significant (3.5% PE paroxetine and combination treatment in PTSD PE was more effective than Ph in achieving remission of PTSD. The additive effect of Comb over any monotherapy was not shown. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. [Acute lumbar sprain treated with massage combined with acupuncture at different distal acupoints: a randomized controlled trial].

    Science.gov (United States)

    Cao, Ye; Wang, Yueqiu

    2015-05-01

    To observe treatment efficacy of acupuncture at different distal acupoints for acute lumbar sprain after massage. One hundred and fifty patients with acute lumbar sprain were randomly divided into a Yaotongdian (Extra) group, a Houxi (SI 3) group, a Weizhong (BL 40) group, a Chengshan (BL 57) group and a Shuigou (GV 26) group, total 5 groups, 30 cases in each one. After the same massage treatment and based on groups divided, different distal acupoints above-mentioned were selected to be acupunctured. Visual analogue scale (VAS) scores, lumbar activity and treatment efficacy of patients in 5 groups were evaluated. With acupuncture at distal acupoints after massage,VAS scores of patients in 5 groups were decreased compared with those after massage treatment (all Plumbar activity was all obviously improved (all Plumbar activity and cured and markedly effective rates were not statistically significant(all P>0.05). Based on massage treatment, acupuncture at distal acupoints could further improve the treatment efficacy for acute lumbar sprain, but there is no obvious effective difference among every distal acupoint. As long as choosing acupoints with lower pain threshold and stimulating enough, good efficacy could be acquired for acute lumbar sprain.

  13. A prospective randomized controlled study comparing two doses of gestodene in cyclic combined HRT preparations on endometrial physiology.

    Science.gov (United States)

    Okon, M A; Lee, S; Laird, S M; Li, T C

    2001-06-01

    Postmenopausal women taking oestradiol 17-beta 2 mg daily were randomized to receive either 25 or 50 microg gestodene from day 17 to 28 of the cycle in a double-blind study. Placental protein P14 (PP14) and CA 125 concentrations in uterine flushing, endometrial morphology and irregular bleeding after 12 cycles of study were observed. Eleven and 12 women in the 25 and 50 microg groups respectively completed the study. There were no significant differences in pre-treatment biochemical and morphological indices between the groups. The median PP14 concentration increased from 332 to 5800 ng/ml (P gestodene groups respectively. No between-group significant rise of PP14 was observed. Similarly, no significant change was seen between the initial and post-treatment concentrations of CA 125 for either group. All biopsies were atrophic at inception of the study, and both regimens produced secretory endometrial transformation in the majority of biopsies. No between-group difference was observed in the morphometric indices measured, or any significant correlation between the concentrations of PP14 or CA 125 and morphology. The mean number of days of withdrawal bleeding (3.8 and 4.2 days for 25 and 50 microg respectively) were similar. In conclusion, both regimens produced a significant rise in uterine flushing concentrations of PP14, but not CA 125. PP14 is a sensitive biochemical marker in the assessment of endometrial response to hormone replacement therapy.

  14. PRECEDENT: a randomized phase II trial comparing vintafolide (EC145) and pegylated liposomal doxorubicin (PLD) in combination versus PLD alone in patients with platinum-resistant ovarian cancer.

    Science.gov (United States)

    Naumann, R Wendel; Coleman, Robert L; Burger, Robert A; Sausville, Edward A; Kutarska, Elzbieta; Ghamande, Sharad A; Gabrail, Nashat Y; Depasquale, Stephen E; Nowara, Elzbieta; Gilbert, Lucy; Gersh, Robert H; Teneriello, Michael G; Harb, Wael A; Konstantinopoulos, Panagiotis A; Penson, Richard T; Symanowski, James T; Lovejoy, Chandra D; Leamon, Christopher P; Morgenstern, David E; Messmann, Richard A

    2013-12-10

    Vintafolide (EC145) is a folic acid-desacetylvinblastine conjugate that binds to the folate receptor (FR), which is expressed on the majority of epithelial ovarian cancers. This randomized phase II trial evaluated vintafolide combined with pegylated liposomal doxorubicin (PLD) compared with PLD alone. The utility of an FR-targeted imaging agent, (99m)Tc-etarfolatide (EC20), in selecting patients likely to benefit from vintafolide was also examined. Women with recurrent platinum-resistant ovarian cancer who had undergone ≤ two prior cytotoxic regimens were randomly assigned at a 2:1 ratio to PLD (50 mg/m(2) intravenously [IV] once every 28 days) with or without vintafolide (2.5 mg IV three times per week during weeks 1 and 3). Etarfolatide scanning was optional. The primary objective was to compare progression-free survival (PFS) between the groups. The intent-to-treat population comprised 149 patients. Median PFS was 5.0 and 2.7 months for the vintafolide plus PLD and PLD-alone arms, respectively (hazard ratio [HR], 0.63; 95% CI, 0.41 to 0.96; P = .031). The greatest benefit was observed in patients with 100% of lesions positive for FR, with median PFS of 5.5 compared with 1.5 months for PLD alone (HR, 0.38; 95% CI, 0.17 to 0.85; P = .013). The group of patients with FR-positive disease (10% to 90%) experienced some PFS improvement (HR, 0.873), whereas patients with disease that did not express FR experienced no PFS benefit (HR, 1.806). Vintafolide plus PLD is the first combination to demonstrate an improvement over standard therapy in a randomized trial of patients with platinum-resistant ovarian cancer. Etarfolatide can identify patients likely to benefit from vintafolide.

  15. Theory-Based Interventions Combining Mental Simulation and Planning Techniques to Improve Physical Activity: Null Results from Two Randomized Controlled Trials.

    Science.gov (United States)

    Meslot, Carine; Gauchet, Aurélie; Allenet, Benoît; François, Olivier; Hagger, Martin S

    2016-01-01

    Interventions to assist individuals in initiating and maintaining regular participation in physical activity are not always effective. Psychological and behavioral theories advocate the importance of both motivation and volition in interventions to change health behavior. Interventions adopting self-regulation strategies that foster motivational and volitional components may, therefore, have utility in promoting regular physical activity participation. We tested the efficacy of an intervention adopting motivational (mental simulation) and volitional (implementation intentions) components to promote a regular physical activity in two studies. Study 1 adopted a cluster randomized design in which participants (n = 92) were allocated to one of three conditions: mental simulation plus implementation intention, implementation intention only, or control. Study 2 adopted a 2 (mental simulation vs. no mental simulation) × 2 (implementation intention vs. no implementation intention) randomized controlled design in which fitness center attendees (n = 184) were randomly allocated one of four conditions: mental simulation only, implementation intention only, combined, or control. Physical activity behavior was measured by self-report (Study 1) or fitness center attendance (Study 2) at 4- (Studies 1 and 2) and 19- (Study 2 only) week follow-up periods. Findings revealed no statistically significant main or interactive effects of the mental simulation and implementation intention conditions on physical activity outcomes in either study. Findings are in contrast to previous research which has found pervasive effects for both intervention strategies. Findings are discussed in light of study limitations including the relatively small sample sizes, particularly for Study 1, deviations in the operationalization of the intervention components from previous research and the lack of a prompt for a goal intention. Future research should focus on ensuring uniformity in the format of the

  16. Case studies combined with or without concept maps improve critical thinking in hospital-based nurses: a randomized-controlled trial.

    Science.gov (United States)

    Huang, Yu-Chuan; Chen, Hsing-Hsia; Yeh, Mei-Ling; Chung, Yu-Chu

    2012-06-01

    Critical thinking (CT) is essential to the exercise of professional judgment. As nurses face increasingly complex health-care situations, critical thinking can promote appropriate clinical decision-making and improve the quality of nursing care. This study aimed to evaluate the effects of a program of case studies, alone (CS) or combined with concept maps (CSCM), on improving CT in clinical nurses. The study was a randomized controlled trial. The experimental group participated in a 16-week CSCM program, whereas the control group participated in a CS program of equal duration. A randomized-controlled trial with a multistage randomization process was used to select and to assign participants, ultimately resulting in 67 nurses in each group. Data were collected before and after the program using the California Critical Thinking Skill Test (CCTST) and the California Critical Thinking Disposition Inventory (CCTDI). After the programs, there were significant differences between the two groups in the critical thinking skills of analysis, evaluation, inference, deduction, and induction. There was also an overall significant difference, and a significant difference in the specific disposition of open-mindedness. This study supports the application of case studies combined with concept maps as a hospital-based teaching strategy to promote development of critical thinking skills and encourage dispositions for nurses. The CSCM resulted in greater improvements in all critical thinking skills of as well as the overall and open-minded affective dispositions toward critical thinking, compared with the case studies alone. An obvious improvement in the CSCM participants was the analytic skill and disposition. Further longitudinal studies and data collection from multisite evaluations in a range of geographic locales are warranted. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Combining Exergame Training with Omega-3 Fatty Acid Supplementation: Protocol for a Randomized Controlled Study assessing the Effect on Neuronal Structure/Function in the Elderly Brain

    Directory of Open Access Journals (Sweden)

    Alexandra Schättin

    2016-11-01

    Full Text Available A common problem in the older population is the risk of falling that might lead to injury, immobility, and reduced survival. Age-related neuronal changes, e.g. decline in grey- and white-matter, affect neuronal, cognitive, and motor functioning. The improvement of these factors might decrease fall events in elderly. Studies showed that the sole administration of video game-based physical exercise, a so-called exergame, or omega-3 fatty acid (FA may improve motor and/or cognitive functioning through neuronal changes in the brain of older adults. The aim of this study is to assess the effects of a combination of exergame training with omega-3 FA supplementation on the elderly brain. We hypothesize that an intervention using a combination approach differently effects on the neuronal structure and function of the elderly’s brain as compared to the sole administration of exergame training. The study is a parallel, double-blinded, randomized controlled trial lasting 26 weeks. Sixty autonomous living, non-smoking, and right-handed healthy older (>65 years adults who live independently or in a senior residency are included, randomized, and allocated to one of two study groups. The experimental group receives a daily amount of 13.5ml fish oil (including 2.9g of omega-3 FA, whereas the control group receives a daily amount of 13.5ml olive oil for 26 weeks. After 16 weeks, both groups start with an exergame training program three times per week. Measurements are performed on three time-points by treatment blinded investigators: pre-intervention measurement, blood sample after 16 week, and post-intervention measurements. The main outcomes are motor evoked potentials of the right M. tibialis anterior (transcranial magnetic stimulation and response-related potentials (electroencephalography during a cognitive test. For secondary outcomes, reaction times during cognitive tests and spatio-temporal parameters during gait performance are measured. Statistics

  18. Retreatment of hepatitis C non-responsive to interferon. A placebo controlled randomized trial of ribavirin monotherapy versus combination therapy with Ribavirin and Interferon in 121 patients in the Benelux [ISRCTN53821378].

    NARCIS (Netherlands)

    B.J. Veldt (Bart); J.T. Brouwer (Johannes); M. Adler (Michael); F. Nevens (Frederik); P. Michielsen (Peter); J. Delwaide (Jean); B.E. Hansen (Bettina); S.W. Schalm (Solko)

    2003-01-01

    textabstractBACKGROUND: Evidence based medicine depends on unbiased selection of completed randomized controlled trials. For completeness it is important to publish all trials. This report describes the first large randomised controlled trial where combination therapy was compared

  19. Treatment of traumatized refugees with Sertraline versus Venlafaxine in combination with psychotherapy – study protocol for a randomized clinical trial

    Science.gov (United States)

    2013-01-01

    Background Sufficient evidence is lacking to draw final conclusions on the efficiency of medical and psychological treatments of traumatized refugees with PTSD. The pharmacological treatments of choice today for post-traumatic stress disorder are antidepressants from the subgroup selective serotonin reuptake inhibitors, especially Sertraline. The evidence for the use of selective serotonin reuptake inhibitors in the treatment of complex post-traumatic stress disorder in traumatized refugees is very limited. Venlafaxine is a dual-action antidepressant that works on several pathways in the brain. It influences areas in the brain which are responsible for the enhanced anxiety and hyper-arousal experienced by traumatized refugees and which some studies have found to be enlarged among patients suffering from post-traumatic stress disorder. Design This study will include approximately 150 patients, randomized into two different groups treated with either Sertraline or Venlafaxine. Patients in both groups will receive the same manual-based cognitive behavioral therapy, which has been especially adapted to this group of patients. The treatment period will be 6 to 7 months. The trial endpoints will be post-traumatic stress disorder and depressive symptoms and social functioning, all measured on validated ratings scales. Furthermore the study will examine the relation between a psycho-social resources and treatment outcome based on 15 different possible outcome predictors. Discussion This study is expected to bring forward new knowledge on treatment and clinical evaluation of traumatized refugees and the results are expected to be used in reference programs and clinical guidelines. Trial registration ClinicalTrials.gov NCT01569685 PMID:23663588

  20. An Open-Label, Multicenter, Randomized, Phase II Study of Pazopanib in Combination with Pemetrexed in First-Line Treatment of Patients with Advanced-Stage Non-Small-Cell Lung Cancer

    DEFF Research Database (Denmark)

    Scagliotti, Giorgio V; Felip, Enriqueta; Besse, Benjamin

    2013-01-01

    This randomized open-label phase II study evaluated the efficacy, safety, and tolerability of pazopanib in combination with pemetrexed compared with the standard cisplatin/pemetrexed doublet in patients with previously untreated, advanced, nonsquamous non-small-cell lung cancer.......This randomized open-label phase II study evaluated the efficacy, safety, and tolerability of pazopanib in combination with pemetrexed compared with the standard cisplatin/pemetrexed doublet in patients with previously untreated, advanced, nonsquamous non-small-cell lung cancer....

  1. Efficacious and safe management of moderate to severe scalp seborrhoeic dermatitis using clobetasol propionate shampoo 0·05% combined with ketoconazole shampoo 2%: a randomized, controlled study.

    Science.gov (United States)

    Ortonne, J-P; Nikkels, A F; Reich, K; Ponce Olivera, R M; Lee, J H; Kerrouche, N; Sidou, F; Faergemann, J

    2011-07-01

    Topical antifungals and corticosteroids are the mainstay of treatment for seborrhoeic dermatitis. The short-contact clobetasol propionate 0·05% shampoo (CP) is an efficacious and safe once-daily treatment for scalp psoriasis. To evaluate the efficacy and safety of CP alone and combined with ketoconazole shampoo 2% (KC) in the treatment of moderate to severe scalp seborrhoeic dermatitis. This randomized and investigator-blinded study consisted of three phases, each lasting 4 weeks. During the treatment phase, subjects were randomized to receive KC twice weekly (K2), CP twice weekly (C2), CP twice weekly alternating with KC twice weekly (C2 + K2) or CP four times weekly alternating with KC twice weekly (C4+K2). All subjects received KC once weekly during the maintenance phase and were untreated during the follow-up phase. At the end of the treatment phase, all three CP-containing regimens were significantly more efficacious than K2 in decreasing the overall disease severity (P < 0·05). Both combination regimens were also significantly more efficacious than K2 in decreasing each individual sign of the disease (P < 0·05). While the C2 and C4 + K2 groups experienced slight worsening during the maintenance phase, the efficacy of C2 + K2 was sustained and remained the highest among all groups. All regimens were well tolerated without inducing any skin atrophy. Similarly low incidences of telangiectasia, burning and adverse events were observed among the four groups. The combination therapy of twice-weekly CP alternating with twice-weekly KC provided significantly greater efficacy than KC alone and a sustained effect in the treatment of moderate to severe scalp seborrhoeic dermatitis. © 2011 The Authors. BJD © 2011 British Association of Dermatologists 2011.

  2. Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial.

    Science.gov (United States)

    Longland, Thomas M; Oikawa, Sara Y; Mitchell, Cameron J; Devries, Michaela C; Phillips, Stuart M

    2016-03-01

    A dietary protein intake higher than the Recommended Dietary Allowance during an energy deficit helps to preserve lean body mass (LBM), particularly when combined with exercise. The purpose of this study was to conduct a proof-of-principle trial to test whether manipulation of dietary protein intake during a marked energy deficit in addition to intense exercise training would affect changes in body composition. We used a single-blind, randomized, parallel-group prospective trial. During a 4-wk period, we provided hypoenergetic (~40% reduction compared with requirements) diets providing 33 ± 1 kcal/kg LBM to young men who were randomly assigned (n = 20/group) to consume either a lower-protein (1.2 g · kg(-1) · d(-1)) control diet (CON) or a higher-protein (2.4 g · kg(-1) · d(-1)) diet (PRO). All subjects performed resistance exercise training combined with high-intensity interval training for 6 d/wk. A 4-compartment model assessment of body composition was made pre- and postintervention. As a result of the intervention, LBM increased (P mass than did the CON group (PRO: -4.8 ± 1.6 kg; CON: -3.5 ± 1.4kg; P mass when combined with a high volume of resistance and anaerobic exercise. Changes in serum cortisol were associated with changes in body fat and LBM, but did not explain much variance in either measure. This trial was registered at clinicaltrials.gov as NCT01776359. © 2016 American Society for Nutrition.

  3. Comparative evaluation of safety and efficacy of glimepiride and sitagliptin in combination with metformin in patients with type 2 diabetes mellitus: Indian multicentric randomized trial - START Study

    Directory of Open Access Journals (Sweden)

    T V Devarajan

    2017-01-01

    Full Text Available Background and Objective: Modern sulfonylureas like glimepiride offer effective glycemic control with extrapancreatic benefits and good tolerability. The objective of the present study was to evaluate and compare safety and efficacy of glimepiride and sitagliptin in combination with metformin in patients with type 2 diabetes mellitus (T2DM. Methods: In this open-label, randomized, comparative, multicenter study, a total of 305 T2DM patients who were either drug naïve or uncontrolled on metformin were randomized to glimepiride 1 or 2 mg/sustained-release metformin 1000 mg once daily (glimepiride group, n = 202 or sitagliptin 50 mg/metformin 500 mg twice daily (sitagliptin group, n = 103 for 12 weeks. Primary endpoint was change in glycosylated hemoglobin (HbA1c. Secondary endpoints were change in fasting plasma glucose (FPG, postprandial plasma glucose (PPG, body mass index (BMI and to assess overall safety profile. Results: At 12 weeks, there was a statistically significant difference in the mean HbA1c reduction in glimepiride group (0.42% as compared to sitagliptin group (0.30% (P = 0.001. Mean reduction in FPG and PPG was also statistically significant in the glimepiride group as compared to the sitagliptin group (P = 0.008. There was no significant difference in terms of change in BMI (0.07 ± 0.39 kg/m2 vs. 0.08 ± 0.31 kg/m2 in glimepiride and sitagliptin groups, respectively, (P = 0.644 between both the groups. The incidences of hypoglycemic events were also comparable among both the groups. Conclusion: In T2DM patients, glimepiride/metformin combination exhibited significant reduction in glycemic parameters as compared to sitagliptin/metformin combination. Moreover, there was no significant difference between both the groups in terms of change in BMI and incidence of hypoglycemia.

  4. Shortening cardioplegic arrest time in patients undergoing combined coronary and valve surgery: results from a multicentre randomized controlled trial: the SCAT trial.

    Science.gov (United States)

    Rogers, Chris A; Capoun, Radek; Scott, Lauren J; Taylor, Jodi; Jain, Anil; Angelini, Gianni D; Narayan, Pradeep; Suleiman, M-Saadeh; Sarkar, Kunal; Ascione, Raimondo

    2017-08-01

    Combined coronary artery bypass grafting and valve surgery requires a prolonged period of cardioplegic arrest (CA) predisposing to myocardial injury and postoperative cardiac-specific complications. The aim of this trial was to reduce the CA time in patients undergoing combined coronary artery bypass grafting and valve surgery and assess if this was associated with less myocardial injury and related complications. Participants were randomized to (i) coronary artery bypass grafting performed on the beating heart with cardiopulmonary bypass support followed by CA for the valve procedure (hybrid) or (ii) both procedures under CA (conventional). To assess complications related to myocardial injury, we used the composite of death, myocardial infarction, arrhythmia, need for pacing or inotropes for >12 h. To assess myocardial injury, we used serial plasma troponin T and markers of metabolic stress in myocardial biopsies. Hundred and sixty patients (80 hybrid and 80 conventional) were randomized. Mean age was 66.5 years and 74% were male. Valve procedures included aortic (61.8%) and mitral (33.1%) alone or in combination (5.1%). CA time was 16% lower in the hybrid group [median 98 vs 89 min, geometric mean ratio (GMR) 0.84, 95% confidence interval (CI) 0.77-0.93, P  = 0.0004]. Complications related to myocardial injury occurred in 131/160 patients (64/80 conventional, 67/80 hybrid), odds ratio 1.24, 95% CI 0.54-2.86, P  = 0.61. Release of troponin T was similar between groups (GMR 1.04, 95% CI 0.87-1.24, P  = 0.68). Adenosine monophosphate was 28% lower in the hybrid group (GMR 0.72, 95% CI 0.51-1.02, P  = 0.056). The hybrid procedure reduced the CA time but myocardial injury outcomes were not superior to conventional approach. ISRCTN65770930.

  5. Effects of Transcranial Direct Current Stimulation, Transcranial Pulsed Current Stimulation, and Their Combination on Brain Oscillations in Patients with Chronic Visceral Pain: A Pilot Crossover Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Aurore Thibaut

    2017-11-01

    Full Text Available ObjectiveChronic visceral pain (CVP syndromes are persistently painful disorders with a remarkable lack of effective treatment options. This study aimed at evaluating the effects of different neuromodulation techniques in patients with CVP on cortical activity, through electreocephalography (EEG and on pain perception, through clinical tests.DesignA pilot crossover randomized controlled study.SettingsOut-patient.SubjectsAdults with CVP (>3 months.MethodsParticipants received four interventions in a randomized order: (1 transcranial pulsed current stimulation (tPCS and active transcranial direct current stimulation (tDCS combined, (2 tPCS alone, (3 tDCS alone, and (4 sham condition. Resting state quantitative electroencephalography (qEEG and pain assessments were performed before and after each intervention. Results were compared with a cohort of 47 healthy controls.ResultsWe enrolled six patients with CVP for a total of 21 visits completed. Compared with healthy participants, patients with CVP showed altered cortical activity characterized by increased power in theta, alpha and beta bands, and a significant reduction in the alpha/beta ratio. Regarding tES, the combination of tDCS with tPCS had no effect on power in any of the bandwidths, nor brain regions. Comparing tPCS with tDCS alone, we found that tPCS induced higher increase in power within the theta and alpha bandwidths.ConclusionThis study confirms that patients with CVP present abnormal EEG-indexed cortical activity compared with healthy controls. Moreover, we showed that combining two types of neurostimulation techniques had no effect, whereas the two interventions, when applied individually, have different neural signatures.

  6. Recovery of overall exercise ability, quality of life, and continence after 12-week combined exercise intervention in elderly patients who underwent radical prostatectomy: a randomized controlled study.

    Science.gov (United States)

    Park, Sung-Woo; Kim, Tae Nam; Nam, Jong-Kil; Ha, Hong Koo; Shin, Dong Gil; Lee, Wan; Kim, Mi-Sook; Chung, Moon Kee

    2012-08-01

    To examine the changes from a combined exercise intervention after radical prostatectomy (RP) in elderly patients with prostate cancer, because randomized controlled trials addressing exercise intervention after RP have been lacking. From May 2009 to May 2010, all patients who underwent laparoscopic RP were assessed for eligibility. A total of 66 patients were randomized to an exercise or a control group. The exercise group received a combined exercise intervention (resistance, flexibility, and Kegel exercises) twice a week for 12 weeks, and the control group received only Kegel exercises. The primary outcome was physical function, and the secondary outcomes were continence status and quality of life after the exercise intervention. A total of 49 patients completed follow-up to the end of study. After the 12-week exercise intervention, except for grip strength, all physical functions were better in the exercise group than in the control group. The 24-hour pad test results (12.2 g in the exercise group, 46.2 g in the control group) and continence rate (73.1% in exercise group, 43.5% in the control group) recovered more promptly in the exercise group. On a questionnaire study using the International Consultation on Incontinence questionnaire, Beck Depression Inventory, and Medical Outcomes Study 36-item short-form health survey, only the exercise group showed improvement at the last follow-up visit. A 12-week combined exercise intervention after RP results in improvement of physical function, continence rate, and quality of life. These results could help with prompt recovery of daily activities. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Musculoskeletal and prostate effects of combined testosterone and finasteride administration in older hypogonadal men: a randomized, controlled trial.

    Science.gov (United States)

    Borst, Stephen E; Yarrow, Joshua F; Conover, Christine F; Nseyo, Unyime; Meuleman, John R; Lipinska, Judyta A; Braith, Randy W; Beck, Darren T; Martin, Jeffrey S; Morrow, Matthew; Roessner, Shirley; Beggs, Luke A; McCoy, Sean C; Cannady, Darryl F; Shuster, Jonathan J

    2014-02-15

    Testosterone acts directly at androgen receptors and also exerts potent actions following 5α-reduction to dihydrotestosterone (DHT). Finasteride (type II 5α-reductase inhibitor) lowers DHT and is used to treat benign prostatic hyperplasia. However, it is unknown whether elevated DHT mediates either beneficial musculoskeletal effects or prostate enlargement resulting from higher-than-replacement doses of testosterone. Our purpose was to determine whether administration of testosterone plus finasteride to older hypogonadal men could produce musculoskeletal benefits without prostate enlargement. Sixty men aged ≥60 yr with a serum testosterone concentration of ≤300 ng/dl or bioavailable testosterone ≤70 ng/dl received 52 wk of treatment with testosterone enanthate (TE; 125 mg/wk) vs. vehicle, paired with finasteride (5 mg/day) vs. placebo using a 2 × 2 factorial design. Over the course of 12 mo, TE increased upper and lower body muscle strength by 8-14% (P = 0.015 to finasteride did not alter any of these effects. Over 12 mo, testosterone also increased prostate volume 11.4 cm(3) (P = 0.0051), an effect that was completely prevented by finasteride (P = 0.0027). We conclude that a higher-than-replacement TE combined with finasteride significantly increases muscle strength and BMD and reduces body fat without causing prostate enlargement. These results demonstrate that elevated DHT mediates testosterone-induced prostate enlargement but is not required for benefits in musculoskeletal or adipose tissue.

  8. A JASTRO study group report. A randomized phase III trial of hyperthermia in combination with radiotherapy for superficial tumors

    Energy Technology Data Exchange (ETDEWEB)

    Hiraoka, Masahiro; Nishimura, Yasumasa; Mitsumori, Michihide [Kyoto Univ. (Japan). Faculty of Medicine] [and others

    1998-06-01

    Result of study about local effect of hyperthermia in combination with radiotherapy for superficial tumors was reported. The irradiation was more than 90% isodose for lesion, and total dose was 60 Gy in cases with anamnesis and 40-50 Gy and without anamnesis at a rate of five times a week and 2 Gy at one time. Hyperthermia was carried out four times; once a week, at 42.5 degrees on tumor side edge, and for 40 minutes. Total 53 cases (neck lymph node metastasis 30 cases, relapse breast cancer 11, advanced breast cancer 1, other superficial tumor 11) were divided into 2 groups. Radiotherapy without hyperthermia (group R) was 27 cases, radiotherapy with hyperthermia (group H) was 26 cases. CR and CR+PR within 2 months after treatment were as follows: Group R: 50%, 85%, Group H: 64%, 100%. The CR+PR was superior in group H (p=0.0497). The CR at maximum effect after treatment was 65% of group R and 86% of group H (p=0.17). The local control rate after CR was not different in both groups. (K.H.)

  9. Randomized phase II adjuvant factorial study of dose-dense temozolomide alone and in combination with isotretinoin, celecoxib, and/or thalidomide for glioblastoma.

    Science.gov (United States)

    Penas-Prado, Marta; Hess, Kenneth R; Fisch, Michael J; Lagrone, Lore W; Groves, Morris D; Levin, Victor A; De Groot, John F; Puduvalli, Vinay K; Colman, Howard; Volas-Redd, Gena; Giglio, Pierre; Conrad, Charles A; Salacz, Michael E; Floyd, Justin D; Loghin, Monica E; Hsu, Sigmund H; Gonzalez, Javier; Chang, Eric L; Woo, Shiao Y; Mahajan, Anita; Aldape, Kenneth D; Yung, W K Alfred; Gilbert, Mark R

    2015-02-01

    Chemoradiation, followed by adjuvant temozolomide, is the standard treatment for newly diagnosed glioblastoma. Adding other active agents may enhance treatment efficacy. The primary objective of this factorial phase II study was to determine if one of 3 potential chemotherapy agents added to dose-dense temozolomide (ddTMZ) improves progression-free survival (PFS) for patients with newly diagnosed glioblastoma. A prior phase I trial established the safety of combining ddTMZ with isotretinoin, celecoxib, and/or thalidomide. Adults with good performance status and no evidence of progression post chemoradiation were randomized into 8 arms: ddTMZ alone (7 days on/7 days off) or doublet, triplet, and quadruplet combinations with isotretinoin, celecoxib, and thalidomide. The study enrolled 155 participants with a median age of 53 years (range, 18-84 y). None of the agents demonstrated improved PFS when compared with arms not containing that specific agent. There was no difference in PFS for triplet compared with doublet regimens, although a trend for improved overall survival (OS) was seen (20.1 vs 17.0 months, P = .15). Compared with ddTMZ, the ddTMZ + isotretinoin doublet had worse PFS (10.5 vs 6.5 months, P = .043) and OS (21.2 vs 11.7 months, P = .037). Trends were also seen for worse outcomes with isotretinoin-containing regimens, but there was no impact with celecoxib or thalidomide combinations. Treatment was well tolerated with expected high rates of lymphopenia. The results do not establish a benefit for these combinations but indicate that adding isotretinoin to ddTMZ may be detrimental. This study demonstrated the feasibility and utility of the factorial design in efficiently testing drug combinations in newly diagnosed glioblastoma. NCT00112502. © The Author(s) 2014. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Efficacy of functional microarray of microneedles combined with topical tranexamic acid for melasma: A randomized, self-controlled, split-face study.

    Science.gov (United States)

    Xu, Yang; Ma, Renyan; Juliandri, Juliandri; Wang, Xiaoyan; Xu, Bai; Wang, Daguang; Lu, Yan; Zhou, Bingrong; Luo, Dan

    2017-05-01

    To evaluate the efficacy of a functional microarray of microneedles (MNs) plus topical tranexamic acid (TA) for melasma in middle-aged women in China.Thirty female subjects with melasma were enrolled in this study. The left or right side of the face was chosen randomly to be pretreated with a functional microarray of MNs, followed by topical 0.5% TA solution once per week for 12 weeks. The other half-face was the control, treated with a sham device plus topical 0.5% TA solution. At baseline and at weeks 4, 8, and 12 of treatment, clinical (photographic) evaluations and parameters determined by Visia were recorded. At baseline and week 12, patient satisfaction scores and the biophysical parameters measured by Mexameter were also recorded. Side effects were evaluated at baseline and at the end of the 12 weeks.In total, 28 women (93.3%) completed the study. The brown spots' scores measured by Visia were significantly lower on the combined therapy side than on the control side at 12 weeks after starting treatment; there was no significant difference between sides at 4 or 8 weeks. After 12 weeks, melanin index (MI) decreased significantly in both 2 groups, and the MI was significantly less on the combined side at week 12. Transepidermal water loss, roughness, skin hydration, skin elasticity, and erythema index showed no significant differences between 2 sides at baseline, 4, 8, and 12 weeks after treatment. Physicians' evaluations of photographs showed better results at week 12 with combined therapy: >25% improvement was observed in the MNs plus TA side in 25 patients, and in the TA side in only 10 patients. Subjective satisfaction scores on both sides increased significantly. The participants were more satisfied with the results of the combined therapy side than the control side. No obvious adverse reactions were observed throughout the study.Combined therapy with a functional microarray of MNs and topical TA solution is a promising treatment for melasma.

  11. Transcranial direct current stimulation combined with aerobic exercise to optimize analgesic responses in fibromyalgia: A randomized placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Mariana Emerenciano Mendonça

    2016-03-01

    Full Text Available Fibromyalgia is a chronic pain syndrome that is associated with maladaptive plasticity in neural central circuits. One of the neural circuits that are involved in pain in fibromyalgia is the primary motor cortex. We tested a combination intervention that aimed to modulate the motor system: transcranial direct current stimulation (tDCS of the primary motor cortex (M1 and aerobic exercise (AE. In this phase II, sham-controlled randomized clinical trial, 45 subjects were assigned to 1 of 3 groups: tDCS + AE, AE only, and tDCS only. The following outcomes were assessed: intensity of pain, level of anxiety, quality of life, mood, pressure pain threshold, and cortical plasticity, as indexed by transcranial magnetic stimulation. There was a significant effect for the group-time interaction for intensity of pain, demonstrating that tDCS/AE was superior to AE (F(13,364=2.25, p=0.007 and tDCS (F(13.364=2.33, p=0.0056 alone. Post hoc adjusted analysis showed a difference between tDCS/AE and tDCS group after the first week of stimulation and after one month intervention period (p=0.02 and p=0.03, respectively. Further, after treatment there was a significant difference between groups in anxiety and mood levels. The combination treatment effected the greatest response. The three groups had no differences regarding responses in motor cortex plasticity, as assessed by TMS. The combination of tDCS with aerobic exercise is superior compared with each individual intervention (cohen’s d effect sizes > 0.55. The combination intervention had a significant effect on pain, anxiety and mood. Based on the similar effects on cortical plasticity outcomes, the combination intervention might have affected other neural circuits, such as those that control the affective-emotional aspects of pain.

  12. Switching from latanoprost to fixed-combination latanoprost-timolol: a 21-day, randomized, double-masked, active-control study in patients with glaucoma and ocular hypertension.

    Science.gov (United States)

    Olander, Kenneth; Zimmerman, Thom J; Downes, Nina; Schoenfelder, John

    2004-10-01

    Approximately 40% of patients with glaucoma are concomitantly prescribed >or=2 different intraocular pressure (IOP)-lowering medications. An effective and well-tolerated fixed combination of agents requiring once-daily instillation may improve patient compliance. The purpose of this study was to compare the efficacy and safety profile of the fixed combination latanoprost 0.005% + timolol maleate 0.5% QD with those of latanoprost 0.005% monotherapy QD in patients whose elevated IOP (>or=21 mm Hg) was inadequately controlled by latanoprost. This 21-day, randomized, double-masked, active-control study was conducted at 49 study sites in Argentina, Brazil, Colombia, Mexico, Peru, the United States, and Venezuela. Adults with glaucoma or ocular hypertension who had failed to reach an IOP of or=2 mm Hg from the baseline level on day 21. Proportions of patients demonstrating IOP decreases >or=3, >or=4, or >or=5 mm Hg from the baseline level and of patients reaching an 10P vs 51.4%, respectively; P or=3, >or=4, or >or=5 mm Hg (for each target level, P vs latanoprost group) or final IOP 18 mm Hg (fixed -combination, 35.1%; latanoprost, 17.8%; P < 0.001). Both treatments were well tolerated. Similar proportions of patients in the fixed-combination and latanoprost groups reported at least 1 treatment-emergent AE (10.9% and 12.1%, respectively). In this selected population of patients with an inadequate initial IOP response to latanoprost, switching to fixed-combination latanoprosttimolol resulted in a greater decrease in IOP and similar tolerability compared with continuing latanoprost therapy.

  13. GnRH antagonist rescue protocol combined with cabergoline versus cabergoline alone in the prevention of ovarian hyperstimulation syndrome: a randomized controlled trial.

    Science.gov (United States)

    Fouda, Usama M; Sayed, Ahmed M; Elshaer, Hesham S; Hammad, Bahaa Eldin M; Shaban, Mona M; Elsetohy, Khaled A; Youssef, Mohamed A

    2016-05-17

    The aim of this study was to compare the efficacy of antagonist rescue protocol (replacing GnRH agonist with GnRH antagonist and reducing the dose of gonadotropins) combined with cabergoline versus cabergoline alone in the prevention of ovarian hyperstimulation syndrome (OHSS) in patients pretreated with GnRH agonist long protocol who were at high risk for OHSS. Two hundred and thirty six patients were randomized in a 1:1 ratio to the cabergoline group or the antagonist rescue combined with cabergoline group. Both groups received oral cabergoline (0.5 mg/day) for eight days beginning on the day of HCG administration. In the antagonist rescue combined with cabergoline group, when the leading follicle reached 16 mm, GnRH agonist (triptorelin) was replaced with GnRH antagonist (cetrorelix acetate) and the dose of HP-uFSH was reduced to 75 IU/day. HCG (5,000 IU/I.M) was administered when the serum estradiol level dropped below 3500 pg/ml. The study was open label and the outcome assessors (laboratory staff and the doctor who performed oocyte retrieval) were blind to treatment allocation. The incidence of moderate/severe OHSS was significantly lower in the antagonist rescue combined with cabergoline group [5.08 % Vs 13.56 %, P value =0.025, OR = 0.342, 95 % CI, 0.129-0.906]. Four cycles were cancelled in the cabergoline group. There were no significant differences between the groups with respect to the number of retrieved oocytes, metaphase II oocytes, high quality embryos and fertilization rate. Moreover, the implantation and pregnancy rates were comparable between both groups. GnRH antagonist rescue protocol combined with cabergoline is more effective than cabergoline alone in the prevention of OHSS. Clinical trial.gov ( NCT02461875 ).

  14. Randomized controlled trial comparing hyaluronic acid, platelet-rich plasma and the combination of both in the treatment of mild and moderate osteoarthritis of the knee

    Directory of Open Access Journals (Sweden)

    Lana JFSD

    2016-11-01

    Full Text Available Objective: This study aims to evaluate the clinical effects of Platelet Rich Plasma (PRP and Hyaluronic Acid (HA as individual treatments for mild to moderate Osteoarthritis (OA, and also examine the potential synergistic effects of PRP in combination with HA. Research continues to emerge examining the potential therapeutic efficacy of HA and PRP as autologous injectable treatments for joint arthritis. However, there is a paucity of research investigating the effects of combining HA and PRP on pain and functional status in patients with OA. Design: In this multicenter, randomized, controlled, double blind, prospective trial, 105 patients with mild to moderate knee osteoarthritis who met the study criteria were randomly allocated to one of three interventions: HA (n=36, PRP (n=36, or HA+PRP (n=33. Each patient received 3 intaarticular knee injections of their assigned substance, with 2 week intervals between each injection. Clinical outcomes were evaluated using the Western Ontario and McMaster Universities Arthritis Index (WOMAC and Visual Analogue Scale (VAS questionnaire at baseline and after 1,3,6, and 12 months. Results: The study showed that the PRP group have significant reduction in VAS scores at 1 (p= 0.003, 3 (p= 0.0001, 6 (p= 0.0001 and 12 (p= 0.000 months when compared to HA. In addition, the PRP group illustrated greater improvement in WOMAC physical activity scale at 12 months (p= 0.008 when compared to the HA group. Combining HA and PRP resulted in a significant decreases in pain (p=0.0001 and functional limitation (p=0.0001 when compared to HA alone at 1 year post treatment; and significantly increased physical function at 1 (p=0.0004 and 3 (p=.011 months when compared to PRP alone. Conclusion: The findings of the study support the use of autologous PRP as an effective treatment of mild to moderate knee osteoarthritis. It also shows that the combination of HA and PRP resulted to better outcomes than HA alone up to 1 year and PRP

  15. Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials.

    Science.gov (United States)

    Wolsk, Helene M; Chawes, Bo L; Litonjua, Augusto A; Hollis, Bruce W; Waage, Johannes; Stokholm, Jakob; Bønnelykke, Klaus; Bisgaard, Hans; Weiss, Scott T

    2017-01-01

    We recently published two independent randomized controlled trials of vitamin D supplementation during pregnancy, both indicating a >20% reduced risk of asthma/recurrent wheeze in the offspring by 3 years of age. However, neither reached statistical significance. To perform a combined analysis of the two trials and investigate whether maternal 25-hydroxy-vitamin D (25(OH)D) level at trial entry modified the intervention effect. VDAART (N = 806) and COPSAC2010. (N = 581) randomized pregnant women to daily high-dose vitamin D3 (4,000 IU/d and 2,400 IU/d, respectively) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI). We conducted random effects combined analyses of the treatment effect, individual patient data (IPD) meta-analyses, and analyses stratified by 25(OH)D level at study entry. The analysis showed a 25% reduced risk of asthma/recurrent wheeze at 0-3yrs: adjusted odds ratio (aOR) = 0.74 (95% CI, 0.57-0.96), p = 0.02. The effect was strongest among women with 25(OH)D level ≥30ng/ml at study entry: aOR = 0.54 (0.33-0.88), p = 0.01, whereas no significant effect was observed among women with 25(OH)D level vitamin D supplementation during pregnancy results in a significant reduced risk of asthma/recurrent wheeze in the offspring, especially among women with 25(OH)D level ≥ 30 ng/ml at randomization, where the risk was almost halved. Future studies should examine the possibility of raising 25(OH)D levels to at least 30 ng/ml early in pregnancy or using higher doses than used in our studies. COPSAC2010: ClinicalTrials.gov NCT00856947; VDAART: ClinicalTrials.gov NCT00920621.

  16. Effects of Robot-assisted Gait Training Combined with Functional Electrical Stimulation on Recovery of Locomotor Mobility in Chronic Stroke Patients: A Randomized Controlled Trial.

    Science.gov (United States)

    Bae, Young-Hyeon; Ko, Young Jun; Chang, Won Hyuk; Lee, Ju Hyeok; Lee, Kyeong Bong; Park, Yoo Jung; Ha, Hyun Geun; Kim, Yun-Hee

    2014-12-01

    [Purpose] The purpose of the present study was to investigate the effects of robot-assisted gait training combined with functional electrical stimulation on locomotor recovery in patients with chronic stroke. [Subjects] The 20 subjects were randomly assigned into either an experimental group (n = 10) that received a combination of robot-assisted gait training and functional electrical stimulation on the ankle dorsiflexor of the affected side or a control group (n = 10) that received robot-assisted gait training only. [Methods] Both groups received the respective therapies for 30 min/day, 3 days/week for 5 weeks. The outcome was measured using the Modified Motor Assessment Scale (MMAS), Timed Up-and-Go Test (TUG), Berg Balance Scale (BBS), and gait parameters through gait analysis (Vicon 370 motion analysis system, Oxford Metrics Ltd., Oxford, UK). All the variables were measured before and after training. [Results] Step length and maximal knee extension were significantly greater than those before training in the experimental group only. Maximal Knee flexion showed a significant difference between the experimental and control groups. The MMAS, BBS, and TUG scores improved significantly after training compared with before training in both groups. [Conclusion] We suggest that the combination of robot-assisted gait training and functional electrical stimulation encourages patients to actively participate in training because it facilitates locomotor recovery without the risk of adverse effects.

  17. Effect of methylphenidate and/or levodopa combined with physiotherapy on mood and cognition after stroke: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Delbari, Ahmad; Salman-Roghani, Reza; Lokk, Johan

    2011-01-01

    Stimulant medications can enhance mood and cognition in stroke rehabilitation, but human clinical trial results are inconclusive. We sought to prospectively study the effects of levodopa (LD) and/or methylphenidate (MPH) in combination with physiotherapy on mood and cognition following stroke in human subjects. Ischemic stroke patients were enrolled in our study 15 to 180 days after stroke onset. The patients were randomized into four medication groups (MPH, LD, MPH + LD, or placebo) and received a 15-day course of medication therapy (1 dose daily) and 45-min standard physiotherapy treatment daily. Mood and cognitive function were assessed at the study onset and 15, 90 and 180 days after study enrollment. The strongest improvement of mood and cognition was found between baseline and the first follow-up immediately after the intervention. A significant improvement in mood was also found in the combined treatment group (MPH + LD) at 90 and 180 days, compared to the placebo group. A 15-day course of daily MPH + LD combined with physiotherapy over a 3-week period was safe and significantly improved mood status in ischemic stroke patients. Future studies are needed which determine the optimal therapeutic window for and dosage of psychostimulants as well as identify those stroke patients who might benefit the most from treatment. Copyright © 2011 S. Karger AG, Basel.

  18. Combined transcranial direct current stimulation and home-based occupational therapy for upper limb motor impairment following intracerebral hemorrhage: a double-blind randomized controlled trial.

    Science.gov (United States)

    Mortensen, Jesper; Figlewski, Krystian; Andersen, Henning

    2016-01-01

    To investigate the combined effect of transcranial direct current stimulation (tDCS) and home-based occupational therapy on activities of daily living (ADL) and grip strength, in patients with upper limb motor impairment following intracerebral hemorrhage (ICH). A double-blind randomized controlled trial with one-week follow-up. Patients received five consecutive days of occupational therapy at home, combined with either anodal (n = 8) or sham (n = 7) tDCS. The primary outcome was ADL performance, which was assessed with the Jebsen-Taylor test (JTT). Both groups improved JTT over time (p occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is a promising add-on intervention regarding training of upper limb motor impairment. It is well tolerated by patients and can easily be applied for home-based training. Larger studies with long-term follow-up are needed to further explore possible effects of tDCS in patients with ICH. Five consecutive days of tDCS combined with occupational therapy provided greater improvements in grip strength compared with occupational therapy alone. tDCS is well tolerated by patients and can easily be applied for home-based rehabilitation.

  19. A Randomized, Controlled Trial to Assess the Efficacy of Arthroscopic Debridement in Combination with Oral Medication Versus Oral Medication in Patients with Gouty Knee Arthritis.

    Science.gov (United States)

    Wang, Xin; Wanyan, Pingping; Wang, Jian Min; Tian, Jin Hui; Hu, Long; Shen, Xi Ping; Yang, Ke Hu

    2015-12-01

    Gouty knee arthritis refers to a form of inflammatory diseases caused by deposits of needle-like crystals of uric acid in knee joint. The aim of this study was to assess the efficacy and safety of arthroscopic debridement in combination with oral medication versus oral medication alone for the treatment of gouty knee arthritis. A total of 60 patients with gouty knee arthritis were randomized to receive either arthroscopic surgery in combination with oral medication or oral medication alone. Efficacy was assessed with the angle of motion, functions, and visual analog scale (VAS). These indices were measured prior to treatment and at 2, 4, 12, 24, and 48 weeks posttreatment. Surgery- and medication-related complications were observed. Significant differences in flexion and extension of the knee joint, lymphoma scores, and VAS were detected between the two groups at 2, 4, and 12 weeks posttreatment (P  0.05) . Significant differences in these indices were detected at different time points in each group (P  0.05). Arthroscopic surgery in combination with oral medication is superior to single oral medication in the flexion and extension of the knee joint, lymphoma scores, and pain relief (VAS) before 24 weeks, although no statistical differences were detected in the efficacy after 24 weeks, and in medication-related safety between the two groups. Although arthroscopic debridement cannot replace systemic uric acid-lowering treatments such as medication and dietary control, it is still an effective approach.

  20. Linear optics based nanoscopy.

    Science.gov (United States)

    Gur, Aviram; Fixler, Dror; Micó, Vicente; Garcia, Javier; Zalevsky, Zeev

    2010-10-11

    Classically, optical systems are considered to have a fundamental resolution limit due to wave nature of light. This article presents a novel method for observing sub-wavelength features in a conventional optical microscope using linear optics. The operation principle is based on a random and time varying flow of nanoparticles moving in proximity to the inspected sample. Those particles excite the evanescent waves and couple them into harmonic waves. The sub-wavelength features are encoded and later on digitally decoded by proper image processing of a sequence of images. The achievable final resolution limit corresponds to the size of the nanoparticles. Experimental proof of principle validation of the technique is reported.

  1. Clindamycin lotion alone versus combination lotion of clindamycin phosphate plus tretinoin versus combination lotion of clindamycin phosphate plus salicylic acid in the topical treatment of mild to moderate acne vulgaris: A randomized control trial

    Directory of Open Access Journals (Sweden)

    NilFroushzadeh Mohammad

    2009-01-01

    Full Text Available Background: Acne vulgaris is a common skin disease that affects 85% to 100% of people at some time during their lives. It is characterized by noninflammatory follicular papules or comedones and by inflammatory papules, pustules, and nodules in its more severe forms. Aims: To compare the efficacy of combination treatment of clindamycin+salicylic acid, versus clindamycin+tretinoin versus clindamycin alone in the treatment of the mild-to-moderate acne vulgaris. Methods: This was a single-blinded, randomized clinical trial.Forty-two female patients (age range: 15-25 years with mild-to-moderate acne vulgaris were selected randomly and subsequently randomized to 3 groups. Group A patients were treated with 1% clindamycin lotion (C lotion twice daily. Group B patients were treated with 1% clindamycin+0.025% tretinoin lotion once nightly (CT lotion. Group C patients were treated with 1% clindamycin+2% salicylic acid lotion twice daily (CS lotion for 12 weeks. For comparison of efficacy of these treatments, and regarding the skewed distribution of the data, Kruskal-Wallis Test and Mann-Whitney U test were used. SPSS software was used for statistical analysis. Results: There was a significant difference between 3 types of treatment in the respect of the total lesion count (TLC improvement ( P = 0.039. The efficacy of treatment on Acne Severity Index (ASI was maximum for CS lotion (81.80% reduction in ASI. CT lotion reduced ASI by as much as 73.73% during 12 weeks of treatment. The efficacy of C lotion was calculated to be 37.87% in the reduction of ASI. Conclusions: Our data suggested that the efficacy of CS lotion was significantly more than C lotion with respect to the TLC and ASI, although there was no significant difference between CS and CT lotion.

  2. Clindamycin lotion alone versus combination lotion of clindamycin phosphate plus tretinoin versus combination lotion of clindamycin phosphate plus salicylic acid in the topical treatment of mild to moderate acne vulgaris: a randomized control trial.

    Science.gov (United States)

    NilFroushzadeh, Mohammad Ali; Siadat, Amir Hossein; Baradaran, Elahe Haft; Moradi, Shahram

    2009-01-01

    Acne vulgaris is a common skin disease that affects 85% to 100% of people at some time during their lives. It is characterized by noninflammatory follicular papules or comedones and by inflammatory papules, pustules, and nodules in its more severe forms. To compare the efficacy of combination treatment of clindamycin+salicylic acid, versus clindamycin+tretinoin versus clindamycin alone in the treatment of the mild-to-moderate acne vulgaris. This was a single-blinded, randomized clinical trial.Forty-two female patients (age range: 15-25 years) with mild-to-moderate acne vulgaris were selected randomly and subsequently randomized to 3 groups. Group A patients were treated with 1% clindamycin lotion (C lotion) twice daily. Group B patients were treated with 1% clindamycin+0.025% tretinoin lotion once nightly (CT lotion). Group C patients were treated with 1% clindamycin+2% salicylic acid lotion twice daily (CS lotion) for 12 weeks. For comparison of efficacy of these treatments, and regarding the skewed distribution of the data, Kruskal-Wallis Test and Mann-Whitney U test were used. SPSS software was used for statistical analysis. There was a significant difference between 3 types of treatment in the respect of the total lesion count (TLC) improvement (P = 0.039). The efficacy of treatment on Acne Severity Index (ASI) was maximum for CS lotion (81.80% reduction in ASI). CT lotion reduced ASI by as much as 73.73% during 12 weeks of treatment. The efficacy of C lotion was calculated to be 37.87% in the reduction of ASI. Our data suggested that the efficacy of CS lotion was significantly more than C lotion with respect to the TLC and ASI, although there was no significant difference between CS and CT lotion.

  3. Randomized cross-over study of patient preference for oral or intravenous vinorelbine in combination with carboplatin in the treatment of advanced NSCLC

    DEFF Research Database (Denmark)

    Jensen, Lars Henrik; Osterlind, Kell; Rytter, Carsten

    2008-01-01

    BACKGROUND: Most chemotherapeutics are administrated intravenously (iv), but some are also available in an oral (po) formulation. This study was designed with the primary objective to estimate the patients' preference for po or iv vinorelbine in combination with carboplatin for the palliative...... treatment of non-small cell lung cancer (NSCLC). Secondary aims were to evaluate toxicity, efficacy, and subjective reasons the preference. PATIENTS AND METHODS: Sixty-one patients were randomized in a cross-over trial to two cycles of carboplatin day 1 and vinorelbine day 1 and day 8 iv followed by two...... cycles of carboplatin and vinorelbine po, or the opposite. Patients, who did not show progressive disease after four cycles, had a free choice of iv or po vinorelbine for the next two cycles. RESULTS: Forty-three patients were evaluable for preference and 32 (74%, 95% CI 61-88%) chose po (p

  4. Efficacy and safety of sitagliptin added to ongoing metformin and pioglitazone combination therapy in a randomized, placebo-controlled, 26-week trial in patients with type 2 diabetes.

    Science.gov (United States)

    Fonseca, Vivian; Staels, Bart; Morgan, Jerry D; Shentu, Yue; Golm, Gregory T; Johnson-Levonas, Amy O; Kaufman, Keith D; Goldstein, Barry J; Steinberg, Helmut

    2013-01-01

    To assess efficacy and safety of sitagliptin, a dipeptidyl peptidase-4 inhibitor, in combination therapy with metformin (≥1500 mg/day) and pioglitazone (≥30 mg/day) in patients with type 2 diabetes (T2DM) with inadequate glycemic control (hemoglobin A1c [HbA1c] ≥7.5% and ≤11%). This placebo-controlled, double-blind study included 313 patients, mean baseline HbA1c=8.7%, who were randomized to receive sitagliptin 100 mg/day or placebo for 26 weeks. The addition of sitagliptin led to significant (Pmetformin and pioglitazone improved glycemic control and was generally well tolerated. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Chinese Herbal Medicine Combined with Conventional Therapy for Blood Pressure Variability in Hypertension Patients: A Systematic Review of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Zhuo Chen

    2015-01-01

    Full Text Available Objective. The aim of this systematic review is to evaluate effect of Chinese medicine combined with conventional therapy on blood pressure variability (BPV in hypertension patients. Methods. All randomized clinical trials (RCTs comparing Chinese medicine with no intervention or placebo on the basis of conventional therapy were included. Data extraction, analyses, and quality assessment were performed according to the Cochrane standards. Results. We included 13 RCTs and assessed risk of bias for all the trials. Chinese medicine has a significant effect in lowering blood pressure (BP, reducing BPV in the form of standard deviation (SD or coefficient of variability (CV, improving nighttime BP decreased rate, and reversing abnormal rhythm of BP. Conclusions. Chinese medicine was safe and showed beneficial effects on BPV in hypertension patients. However, more rigorous trials with high quality are warranted to give high level of evidence before recommending Chinese medicine as an alternative or complementary medicine to improve BPV in hypertension patients.

  6. Prospective Randomized Controlled Trial of Hindfoot and Ankle Fusions Treated With rhPDGF-BB in Combination With a β-TCP-Collagen Matrix.

    Science.gov (United States)

    Daniels, Timothy R; Younger, Alastair S E; Penner, Murray J; Wing, Kevin J; Le, Ian L D; Russell, Iain S; Lalonde, Karl-André; Evangelista, Peter T; Quiton, Jovelyn D; Glazebrook, Mark; DiGiovanni, Christopher W

    2015-07-01

    Ankle and hindfoot arthrodesis is often supplemented with autograft to promote bony union. Autograft harvest can lead to increased perioperative morbidity. Purified recombinant human platelet-derived growth factor BB homodimer (rhPDGF-BB) has stimulated bone formation in mandibular defects and hindfoot fusion. This randomized controlled trial evaluated the efficacy and safety of rhPDGF-BB combined with an injectable, osteoconductive beta-tricalcium phosphate (β-TCP)-collagen matrix versus autograft in ankle and hindfoot fusions. Seventy-five patients requiring ankle or hindfoot fusion were randomized 5:1 for rhPDGF-BB/β-TCP-collagen (treatment, n = 63) or autograft (control, n = 12). Prospective analysis included 142 autograft control subjects from another clinical trial with identical study protocols. Standardized operative and postoperative protocols were used. Patients underwent standard internal fixation augmented with autograft or 0.3 mg/mL rhPDGF-BB/β-TCP-collagen. Radiologic, clinical, and quality-of-life outcomes were assessed over 52 weeks. Primary outcome was joint fusion (50% or more osseous bridging on computed tomography) at 24 weeks. Secondary outcomes included radiographs, clinical healing status, visual analog scale pain score, American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Scale score, Foot Function Index score, and Short Form-12 score. Noninferiority P values were calculated. Complete fusion of all involved joints at 24 weeks as indicated by computed tomography was achieved in 53 of 63 (84%) rhPDGF-BB/β-TCP-collagen-treated patients and 100 of 154 (65%) autograft-treated patients (P BB/β-TCP-collagen patients versus 19.7 ± 11.5 weeks for autograft patients (P BB/β-TCP-collagen patients and 120 of 154 (78%) autograft patients (P BB/β-TCP-collagen was a safe, effective alternative to autograft for ankle and hindfoot fusions, eliminating the pain and morbidity associated with autograft harvesting. Level I, prospective randomized

  7. Intratissue percutaneous electolysis combined with active physical therapy for the treatment of adductor longus enthesopathy-related groin pain: a randomized trial.

    Science.gov (United States)

    Moreno, Carlos; Mattiussi, Gabriele; Núñez, Francisco J; Messina, Giovanni; Rejc, Enrico

    2017-10-01

    Adductor longus enthesopathy-related groin pain (ALErGP) is the most common cause of groin pain in soccer players. The aim of this study was to evaluate the therapeutic utility of intratissue percutaneous electrolysis (EPI®) technique in combination with an active physical therapy (APT) program to treat ALErGP. Twenty-four non-professional male soccer players diagnosed with ALErGP were included in this study and randomly divided into two groups. Group A was treated with EPI® technique in combination with a standardized APT program. Group B only underwent the APT program. The Numeric Rating Scale (NRS) and the Patient Specific Functional Scale (PSFS) were used to assess the effectiveness of the two interventions. The follow-up covered a 6-month period. Both groups significantly improved pain and functional scores after treatment and maintained this therapeutic result throughout the follow-up. The combined intervention of APT program and EPI® ensured a greater and faster reduction of pain in group A. In addition, functional recovery tended to be greater in group A than B after the treatment and throughout the follow-up by 7.8±3.8% (P=0.093). EPI® treatment in association with APT ensured a greater and more rapid reduction of pain and tended to promote greater functional recovery in soccer players with ALErGP compared to APT only. This positive therapeutic result lasted for at least 6 months after the end of the treatment. These findings support the combined use of EPI® and APT to treat ALErGP.

  8. The combined effects of on-road and simulator training with feedback on older drivers' on-road performance: Evidence from a randomized-controlled trial.

    Science.gov (United States)

    Sawula, Erica; Polgar, Jan; Porter, Michel M; Gagnon, Sylvain; Weaver, Bruce; Nakagawa, Satoru; Stinchcombe, Arne; Bédard, Michel

    2017-10-24

    A number of training programs that seek to improve driving performance among older drivers are available accompanied by a growing interest in their effectiveness. The purpose of the present investigation was to examine the combined effect of 1) basic in-class training (BT); 2) on-road training with individualized feedback (OR); and 3) training on a driving simulator (S). Using a randomized controlled trial study design, 78 older drivers were randomly assigned to one of three groups (BT, BT+OR, or BT+OR+S). All participants completed a pre- and post-intervention on-road driving evaluation on a standardized route. The driving evaluations were recorded using video and GPS equipment and were scored by a blind assessor. The results indicated a significant reduction of approximately 30% in overall number of driving errors/omissions among participants in the BT+OR and the BT+OR+S groups in comparison to participants in the BT group. This study adds to the mounting evidence demonstrating the effectiveness of individualized driver training in improving safe driving among older adults.

  9. Two-year follow-up of a randomized trial of spectacles alone or combined with Bangerter filters for treating anisometropic amblyopia.

    Science.gov (United States)

    Agervi, Pia; Kugelberg, Ulla; Kugelberg, Maria; Zetterström, Charlotta

    2013-02-01

    To compare spectacle correction alone to spectacle correction with Bangerter filters as treatments for anisometropic amblyopia in children 1 year after completion of a 1-year randomized trial. In a randomized clinical trial, 80 children (mean age, 4.4 years) with anisometropic amblyopia and a best median visual acuity (VA) in the amblyopic eye of 0.4 logarithm of the minimum angle of resolution (logMAR) were assigned to treatment with either spectacles or spectacles in combination with a Bangerter filter for 1 year. After 1 year, treatment with spectacles continued. If the VA differed by ≥ 2 lines, treatment with Bangerter filters was continued if originally prescribed. The main outcome measure was the median change in VA of the amblyopic eye after 2 years. The median change in VA of the amblyopic eye did not differ significantly between the groups (0.4 log unit for both groups) at the 2-year visit. At that time, the VA in the amblyopic eyes and the fellow eyes was 0.0 median logMAR in both groups. Between years 1 and 2, the median VA improved in the amblyopic eyes; in the spectacles group (p = 0.0181) and in the Bangerter filter group (p = 0.0342). The median anisometropia decreased in both groups (p spectacles alone did not differ significantly from that after treatment with spectacles and a Bangerter filter for anisometropic amblyopia. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

  10. The HIKCUPS trial: a multi-site randomized controlled trial of a combined physical activity skill-development and dietary modification program in overweight and obese children

    Directory of Open Access Journals (Sweden)

    Warren Janet M

    2007-01-01

    Full Text Available Abstract Background Childhood obesity is one of the most pressing health issues of our time. Key health organizations have recommended research be conducted on the effectiveness of well-designed interventions to combat childhood obesity that can be translated into a variety of settings. This paper describes the design and methods used in the Hunter Illawarra Kids Challenge Using Parent Support (HIKCUPS trial, an ongoing multi-site randomized controlled trial, in overweight/obese children comparing the efficacy of three interventions: 1 a parent-centered dietary modification program; 2 a child-centered physical activity skill-development program; and 3 a program combining both 1 and 2 above. Methods/Design Each intervention consists of three components: i 10-weekly face-to-face group sessions; ii a weekly homework component, completed between each face-to-face session and iii three telephone calls at monthly intervals following completion of the 10-week program. Details of the programs' methodological aspects of recruitment, randomization and statistical analyses are described here a priori. Discussion Importantly this paper describes how HIKCUPS addresses some of the short falls in the current literature pertaining to the efficacy of child obesity interventions. The HIKCUPS trial is funded by the National Medical Research Council, Australia.

  11. Immediate Effects of Combining Local Techniques in the Craniomandibular Area and Hamstring Muscle Stretching in Subjects with Temporomandibular Disorders: A Randomized Controlled Study.

    Science.gov (United States)

    Rodriguez-Blanco, Cleofás; Cocera-Morata, Francisco Miguel; Heredia-Rizo, Alberto Marcos; Ricard, François; Almazán-Campos, Ginés; Oliva-Pascual-Vaca, Ángel

    2015-08-01

    To assess the immediate effects on vertical mouth opening, orofacial mechanosensitivity, and lumbar and suboccipital mobility after adding a myofascial induction technique to a multimodal protocol in subjects with temporomandibular disorders (TMD). A randomized and double-blind controlled trial was carried out. University-based physical therapy research clinic. Sixty subjects (35±11.22 years) with TMD, and restricted mobility of the mandibular condyles and the first cervical vertebrae, were recruited and randomized to either a control group (CG) (n=30) or an experimental group (EG) (n=30). The CG underwent a neuromuscular technique over the masseter muscles and passive hamstring muscle stretching. A suboccipital muscle inhibition technique was added to this protocol in the EG. Primary measurements were made of vertical mouth opening and pressure pain threshold of the masseter muscles. Secondary outcome measures included pressure algometry of the trigeminal nerve, suboccipital range of motion, and lumbar spine mobility, assessed with the sit-and-reach (SAR) test and lumbar forward bending. All evaluations were collected at baseline and immediately after intervention. In the intragroup comparison, the EG observed an increase in suboccipital flexion (p0.05). The inclusion of a myofascial induction maneuver in a protocol combining local (neuromuscular treatment) and distal techniques (hamstring stretching) in subjects with TMD has no impact on improving mouth opening, suboccipital and lumbar mobility, and orofacial sensitivity to mechanical pressure.

  12. Combined effect of metformin with ascorbic acid versus acetyl salicylic acid on diabetes-related cardiovascular complication; a 12-month single blind multicenter randomized control trial.

    Science.gov (United States)

    Gillani, Syed Wasif; Sulaiman, Syed Azhar Syed; Abdul, Mohi Iqbal Mohammad; Baig, Mirza R

    2017-08-14

    We aimed to investigate the efficacy of ascorbic acid and acetylsalicylic acid among type II diabetes mellitus patients using metformin (only) for diabetes management therapy. A 12-month single blinded multicenter randomized control trial was designed to investigate the measured variables [Glycated Hemoglobin (HbA1c), Renal function, Albumin Creatinine Ratio (ACR) etc.]. The trial was randomized into 2 experimental parallel arms (ascorbic acid vs acetylsalicylic acid) were blinded with study supplements in combination with metformin and findings were compared to control arm with metformin alone and blinded with placebo. Withdrawal criteria was defined to maintain the equity and balance in the participants in the whole trial. Patients with metformin and ascorbic acid (parallel arm I) was twice more likely to reduce HbA1c than metformin alone (control arm) in a year (OR 2.31 (95% CI 1.87-4.42) p ascorbic acid with metformin is more effective against reducing risks for diabetes related long-term complications (including ACR). TRIAL details Registration No: NTR-6100, Registry Name: Netherlands Trial Registry, URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6100 , Date of Registration: 20th October, 2016, Date of first Enrollment: 1 November, 2015.

  13. Anesthetic Efficacy of Gow-Gates Nerve Block, Inferior Alveolar Nerve Block, and Their Combination in Mandibular Molars with Symptomatic Irreversible Pulpitis: A Prospective, Randomized Clinical Trial.

    Science.gov (United States)

    Saatchi, Masoud; Shafiee, Maryam; Khademi, Abbasali; Memarzadeh, Bahareh

    2018-03-01

    The purpose of this prospective, randomized clinical trial was to evaluate the anesthetic efficacy of the Gow-Gates nerve block (GGNB), the inferior alveolar nerve block (IANB), an