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Sample records for subject-specific random effects

  1. The effect of teacher interpersonal behaviour on students' subject-specific motivation

    NARCIS (Netherlands)

    den Brok, P.; Levy, J.; Brekelmans, M.; Wubbels, Th.

    2006-01-01

    This study brings together insights from research on teaching and learning in specific subjects, learning environments research and effectiveness research by linking teacher interpersonal behaviour to students’ subject-related attitudes. Teaching was studied in terms of a model originating from

  2. The effect of teacher interpersonal behaviour on students' subject-specific motivation

    OpenAIRE

    den Brok, P.; Levy, J.; Brekelmans, M.; Wubbels, Th.

    2006-01-01

    This study brings together insights from research on teaching and learning in specific subjects, learning environments research and effectiveness research by linking teacher interpersonal behaviour to students’ subject-related attitudes. Teaching was studied in terms of a model originating from clinical psychology that was adapted to education. Teacher interpersonal behaviour was analysed interms of two, independent behaviour dimensions called Influence and Proximity. This study investigated ...

  3. Finite Element Analysis Examining the Effects of Cam FAI on Hip Joint Mechanical Loading Using Subject-Specific Geometries During Standing and Maximum Squat.

    Science.gov (United States)

    Ng, K C Geoffrey; Rouhi, Gholamreza; Lamontagne, Mario; Beaulé, Paul E

    2012-10-01

    Cam femoroacetabular impingement (FAI) can impose elevated mechanical loading in the hip, potentially leading to an eventual mechanical failure of the joint. Since in vivo data on the pathomechanisms of FAI are limited, it is still unclear how this deformity leads to osteoarthritis. The purpose of this study was to examine the effects of cam FAI on hip joint mechanical loading using finite element analysis, by incorporating subject-specific geometries, kinematics, and kinetics. The research objectives were to address and determine: (1) if hips with cam FAI demonstrate higher maximum shear stresses, in comparison with control hips; (2) the magnitude of the peak maximum shear stresses; and (3) the locations of the peak maximum shear stresses. Using finite element analysis, two patient models were control-matched and simulated during quasi-static positions from standing to squatting. Intersegmental hip forces, from a previous study, were applied to the subject-specific hip geometries, segmented from CT data, to evaluate the maximum shear stresses on the acetabular cartilage and underlying bone. Peak maximum shear stresses were found at the anterosuperior region of the underlying bone during squatting. The peaks at the anterosuperior acetabulum were substantially higher for the patients (15.2 ± 1.8 MPa) in comparison with the controls (4.5 ± 0.1 MPa). Peaks were not situated on the cartilage, but instead located on the underlying bone. The results correspond with the locations of initial cartilage degradation observed during surgical treatment and from MRI. These findings support the pathomechanism of cam FAI. Changes may originate from the underlying subchondral bone properties rather than direct shear stresses to the articular cartilage.

  4. Effect of blasts on subject-specific computational models of skin and bone sections at various locations on the human body

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    Arnab Chanda

    2015-11-01

    Full Text Available Blast injuries are very common among soldiers deployed in politically unstable regions such as Afghanistan and Iraq, and also in a battle field anywhere in the world. Understanding the mechanics of interaction of blasts with the skin and bone at various parts of the human body is the key to designing effective personal protective equipment (PPE's which can mitigate blast impacts. In the current work, subject-specific 3D computational models of the skin (with the three layers namely the epidermis, dermis and the hypodermis (muscles and bone sections from various parts of the human body (such as the elbow, finger, wrist, cheek bone, forehead, shin etc. have been developed to study the effect of blast loading. Non-linear material properties have been adopted for the skin and stress impulses at the different skin layers and bone sections are estimated. To date, such an extensive study on the effect of blast loading on the human skin and bone has not been attempted. The results of this study would be indispensable for medical practitioners to understand the effect of blast trauma and plan effective post-traumatic surgical strategies, and also for developing better PPE designs for the military in the future.

  5. Short- and Long-Term Effectiveness of a Subject's Specific Novel Brain and Vestibular Rehabilitation Treatment Modality in Combat Veterans Suffering from PTSD.

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    Carrick, Frederick Robert; Pagnacco, Guido; McLellan, Kate; Solis, Ross; Shores, Jacob; Fredieu, Andre; Brock, Joel Brandon; Randall, Cagan; Wright, Cameron; Oggero, Elena

    2015-01-01

    Treatment for post-traumatic stress disorder (PTSD) in combat veterans that have a long-term positive clinical effect has the potential to modify the treatment of PTSD. This outcome may result in changed and saved lives of our service personnel and their families. In a previous before-after-intervention study, we demonstrated high statistical and substantively significant short-term changes in the Clinician Administered DSM-IV PTSD Scale (CAPS) scores after a 2-week trial of a subject's particular novel brain and vestibular rehabilitation (VR) program. The long-term maintenance of PTSD severity reduction was the subject of this study. We studied the short- and long-term effectiveness of a subject's particular novel brain and VR treatment of PTSD in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. We analyzed the difference in the CAPS scores pre- and post-treatment (1 week and 3 months) using our subjects as their matched controls. The generalized least squares (GLS) technique demonstrated that with our 26 subjects in the 3 timed groups the R (2) within groups was 0.000, R (2) between groups was 0.000, and overall the R (2) was 0.000. The GLS regression was strongly statistically significant z = 21.29, p < 0.001, 95% CI [58.7, 70.63]. The linear predictive margins over time demonstrated strong statistical and substantive significance of decreasing PTSD severity scores for all timed CAPS tests. Our investigation has the promise of the development of superior outcomes of treatments in this area that will benefit a global society. The length of the treatment intervention involved (2 weeks) is less that other currently available treatments and has profound implications for cost, duration of disability, and outcomes in the treatment of PTSD in combat veterans.

  6. Short and long term effectiveness of a subject's specific novel brain and vestibular rehabilitation treatment modality in combat veterans suffering from PTSD

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    Frederick Robert Carrick

    2015-06-01

    Full Text Available AbstractIntroduction: Treatment for post-traumatic stress disorder (PTSD in combat veterans that have a long-term positive clinical effect has the potential to modify the treatment of PTSD. This outcome may result in changed and saved lives of our service personnel and their families. In a previous before-after-intervention study we demonstrated high statistical and substantively significant short-term changes in the Clinician Administered DSM-IV PTSD Scale (CAPS scores after a two week trial of a subject's particular novel brain and vestibular rehabilitation (VR program. The long-term maintenance of PTSD severity reduction was the subject of this study.Material and Methods:We studied the short and long term effectiveness of a subject's particular novel brain and VR treatment of PTSD in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. We analyzed the difference in the CAPS scores pre and post treatment (one week and three months using our subjects as their matched controls. Results:The generalized least squares (GLS technique demonstrated that with our 26 subjects in the 3 timed groups the R2 within groups was 0.000, R2 between groups was 0.000 and overall the R2 was 0.000. The GLS regression was strongly statistically significant z = 21.29, p < 0.001, 95% CI [58.7, 70.63]. The linear predictive margins over time demonstrated strong statistical and substantive significance of decreasing PTSD severity scores for all timed CAPS tests.Discussion:Our investigation has the promise of the development of superior outcomes of treatments in this area that will benefit a global society. The length of the treatment intervention involved (two weeks is less that other currently available treatments and has profound implications for cost, duration of disability and outcomes in the treatment of PTSD in combat veterans.

  7. Teaching university lecturers how to teach subject:specific writing

    OpenAIRE

    Manderstedt, Lena; Palo, Annbritt

    2015-01-01

    Teaching university lecturers how to teach subject-specific writingLena Manderstedt, Annbritt PaloStandards of student literacy are falling, due to an increased number of students described as non-traditional entrants not knowing how to write (Lea & Street, 1998). Extensive research into academic literacy practices has been carried out, including genre pedagogy (Martin, 2009), the effectiveness of feedback (Hattie & Timperley, 2007) and the role of assessment as a key to develop and i...

  8. Achilles tendon stress is more sensitive to subject-specific geometry than subject-specific material properties: A finite element analysis.

    Science.gov (United States)

    Hansen, Wencke; Shim, Vickie B; Obst, Steven; Lloyd, David G; Newsham-West, Richard; Barrett, Rod S

    2017-05-03

    This study used subject-specific measures of three-dimensional (3D) free Achilles tendon geometry in conjunction with a finite element method to investigate the effect of variation in subject-specific geometry and subject-specific material properties on tendon stress during submaximal isometric loading. Achilles tendons of eight participants (Aged 25-35years) were scanned with freehand 3D ultrasound at rest and during a 70% maximum voluntary isometric contraction. Ultrasound images were segmented, volume rendered and transformed into subject-specific 3D finite element meshes. The mean (±SD) lengths, volumes and cross-sectional areas of the tendons at rest were 62±13mm, 3617±984mm3 and 58±11mm2 respectively. The measured tendon strain at 70% MVIC was 5.9±1.3%. Subject-specific material properties were obtained using an optimisation approach that minimised the difference between measured and modelled longitudinal free tendon strain. Generic geometry was represented by the average mesh and generic material properties were taken from the literature. Local stresses were subsequently computed for combinations of subject-specific and generic geometry and material properties. For a given geometry, changing from generic to subject-specific material properties had little effect on the stress distribution in the tendon. In contrast, changing from generic to subject-specific geometry had a 26-fold greater effect on tendon stress distribution. Overall, these findings indicate that the stress distribution experienced by the living free Achilles tendon of a young and healthy population during voluntary loading are more sensitive to variation in tendon geometry than variation in tendon material properties. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Are Autonomous and Controlled Motivations School-Subjects-Specific?

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    Julien Chanal

    Full Text Available This research sought to test whether autonomous and controlled motivations are specific to school subjects or more general to the school context. In two cross-sectional studies, 252 elementary school children (43.7% male; mean age = 10.7 years, SD = 1.3 years and 334 junior high school children (49.7% male, mean age = 14.07 years, SD = 1.01 years were administered a questionnaire assessing their motivation for various school subjects. Results based on structural equation modeling using the correlated trait-correlated method minus one model (CTCM-1 showed that autonomous and controlled motivations assessed at the school subject level are not equally school-subject-specific. We found larger specificity effects for autonomous (intrinsic and identified than for controlled (introjected and external motivation. In both studies, results of factor loadings and the correlations with self-concept and achievement demonstrated that more evidence of specificity was obtained for autonomous regulations than for controlled ones. These findings suggest a new understanding of the hierarchical and multidimensional academic structure of autonomous and controlled motivations and of the mechanisms involved in the development of types of regulations for school subjects.

  10. Are Autonomous and Controlled Motivations School-Subjects-Specific?

    Science.gov (United States)

    Chanal, Julien; Guay, Frédéric

    2015-01-01

    This research sought to test whether autonomous and controlled motivations are specific to school subjects or more general to the school context. In two cross-sectional studies, 252 elementary school children (43.7% male; mean age = 10.7 years, SD = 1.3 years) and 334 junior high school children (49.7% male, mean age = 14.07 years, SD = 1.01 years) were administered a questionnaire assessing their motivation for various school subjects. Results based on structural equation modeling using the correlated trait-correlated method minus one model (CTCM-1) showed that autonomous and controlled motivations assessed at the school subject level are not equally school-subject-specific. We found larger specificity effects for autonomous (intrinsic and identified) than for controlled (introjected and external) motivation. In both studies, results of factor loadings and the correlations with self-concept and achievement demonstrated that more evidence of specificity was obtained for autonomous regulations than for controlled ones. These findings suggest a new understanding of the hierarchical and multidimensional academic structure of autonomous and controlled motivations and of the mechanisms involved in the development of types of regulations for school subjects.

  11. Are Autonomous and Controlled Motivations School-Subjects-Specific?

    Science.gov (United States)

    Chanal, Julien; Guay, Frédéric

    2015-01-01

    This research sought to test whether autonomous and controlled motivations are specific to school subjects or more general to the school context. In two cross-sectional studies, 252 elementary school children (43.7% male; mean age = 10.7 years, SD = 1.3 years) and 334 junior high school children (49.7% male, mean age = 14.07 years, SD = 1.01 years) were administered a questionnaire assessing their motivation for various school subjects. Results based on structural equation modeling using the correlated trait-correlated method minus one model (CTCM-1) showed that autonomous and controlled motivations assessed at the school subject level are not equally school-subject-specific. We found larger specificity effects for autonomous (intrinsic and identified) than for controlled (introjected and external) motivation. In both studies, results of factor loadings and the correlations with self-concept and achievement demonstrated that more evidence of specificity was obtained for autonomous regulations than for controlled ones. These findings suggest a new understanding of the hierarchical and multidimensional academic structure of autonomous and controlled motivations and of the mechanisms involved in the development of types of regulations for school subjects. PMID:26247788

  12. EEG topographies provide subject-specific correlates of motor control.

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    Pirondini, Elvira; Coscia, Martina; Minguillon, Jesus; Millán, José Del R; Van De Ville, Dimitri; Micera, Silvestro

    2017-10-16

    Electroencephalography (EEG) of brain activity can be represented in terms of dynamically changing topographies (microstates). Notably, spontaneous brain activity recorded at rest can be characterized by four distinctive topographies. Despite their well-established role during resting state, their implication in the generation of motor behavior is debated. Evidence of such a functional role of spontaneous brain activity would provide support for the design of novel and sensitive biomarkers in neurological disorders. Here we examined whether and to what extent intrinsic brain activity contributes and plays a functional role during natural motor behaviors. For this we first extracted subject-specific EEG microstates and muscle synergies during reaching-and-grasping movements in healthy volunteers. We show that, in every subject, well-known resting-state microstates persist during movement execution with similar topographies and temporal characteristics, but are supplemented by novel task-related microstates. We then show that the subject-specific microstates' dynamical organization correlates with the activation of muscle synergies and can be used to decode individual grasping movements with high accuracy. These findings provide first evidence that spontaneous brain activity encodes detailed information about motor control, offering as such the prospect of a novel tool for the definition of subject-specific biomarkers of brain plasticity and recovery in neuro-motor disorders.

  13. Changes in Predicted Muscle Coordination with Subject-Specific Muscle Parameters for Individuals after Stroke

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    Brian A. Knarr

    2014-01-01

    Full Text Available Muscle weakness is commonly seen in individuals after stroke, characterized by lower forces during a maximal volitional contraction. Accurate quantification of muscle weakness is paramount when evaluating individual performance and response to after stroke rehabilitation. The objective of this study was to examine the effect of subject-specific muscle force and activation deficits on predicted muscle coordination when using musculoskeletal models for individuals after stroke. Maximum force generating ability and central activation ratio of the paretic plantar flexors, dorsiflexors, and quadriceps muscle groups were obtained using burst superimposition for four individuals after stroke with a range of walking speeds. Two models were created per subject: one with generic and one with subject-specific activation and maximum isometric force parameters. The inclusion of subject-specific muscle data resulted in changes in the model-predicted muscle forces and activations which agree with previously reported compensation patterns and match more closely the timing of electromyography for the plantar flexor and hamstring muscles. This was the first study to create musculoskeletal simulations of individuals after stroke with subject-specific muscle force and activation data. The results of this study suggest that subject-specific muscle force and activation data enhance the ability of musculoskeletal simulations to accurately predict muscle coordination in individuals after stroke.

  14. Subject-specific geometrical detail rather than cost function formulation affects hip loading calculation.

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    Wesseling, Mariska; De Groote, Friedl; Bosmans, Lode; Bartels, Ward; Meyer, Christophe; Desloovere, Kaat; Jonkers, Ilse

    2016-11-01

    This study assessed the relative importance of introducing an increasing level of medical image-based subject-specific detail in bone and muscle geometry in the musculoskeletal model, on calculated hip contact forces during gait. These forces were compared to introducing minimization of hip contact forces in the optimization criterion. With an increasing level of subject-specific detail, specifically MRI-based geometry and wrapping surfaces representing the hip capsule, hip contact forces decreased and were more comparable to contact forces measured using instrumented prostheses (average difference of 0.69 BW at the first peak compared to 1.04 BW for the generic model). Inclusion of subject-specific wrapping surfaces in the model had a greater effect than altering the cost function definition.

  15. Sensitivity of subject-specific models to errors in musculo-skeletal geometry

    NARCIS (Netherlands)

    Carbone, Vincenzo; van der Krogt, Marjolein; Koopman, Hubertus F.J.M.; Verdonschot, Nicolaas Jacobus Joseph

    2012-01-01

    Subject-specific musculo-skeletal models of the lower extremity are an important tool for investigating various biomechanical problems, for instance the results of surgery such as joint replacements and tendon transfers. The aim of this study was to assess the potential effects of errors in

  16. Modelling of subject specific based segmental dynamics of knee joint

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    Nasir, N. H. M.; Ibrahim, B. S. K. K.; Huq, M. S.; Ahmad, M. K. I.

    2017-09-01

    This study determines segmental dynamics parameters based on subject specific method. Five hemiplegic patients participated in the study, two men and three women. Their ages ranged from 50 to 60 years, weights from 60 to 70 kg and heights from 145 to 170 cm. Sample group included patients with different side of stroke. The parameters of the segmental dynamics resembling the knee joint functions measured via measurement of Winter and its model generated via the employment Kane's equation of motion. Inertial parameters in the form of the anthropometry can be identified and measured by employing Standard Human Dimension on the subjects who are in hemiplegia condition. The inertial parameters are the location of centre of mass (COM) at the length of the limb segment, inertia moment around the COM and masses of shank and foot to generate accurate motion equations. This investigation has also managed to dig out a few advantages of employing the table of anthropometry in movement biomechanics of Winter's and Kane's equation of motion. A general procedure is presented to yield accurate measurement of estimation for the inertial parameters for the joint of the knee of certain subjects with stroke history.

  17. Medical Image Processing for Fully Integrated Subject Specific Whole Brain Mesh Generation

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    Chih-Yang Hsu

    2015-05-01

    Full Text Available Currently, anatomically consistent segmentation of vascular trees acquired with magnetic resonance imaging requires the use of multiple image processing steps, which, in turn, depend on manual intervention. In effect, segmentation of vascular trees from medical images is time consuming and error prone due to the tortuous geometry and weak signal in small blood vessels. To overcome errors and accelerate the image processing time, we introduce an automatic image processing pipeline for constructing subject specific computational meshes for entire cerebral vasculature, including segmentation of ancillary structures; the grey and white matter, cerebrospinal fluid space, skull, and scalp. To demonstrate the validity of the new pipeline, we segmented the entire intracranial compartment with special attention of the angioarchitecture from magnetic resonance imaging acquired for two healthy volunteers. The raw images were processed through our pipeline for automatic segmentation and mesh generation. Due to partial volume effect and finite resolution, the computational meshes intersect with each other at respective interfaces. To eliminate anatomically inconsistent overlap, we utilized morphological operations to separate the structures with a physiologically sound gap spaces. The resulting meshes exhibit anatomically correct spatial extent and relative positions without intersections. For validation, we computed critical biometrics of the angioarchitecture, the cortical surfaces, ventricular system, and cerebrospinal fluid (CSF spaces and compared against literature values. Volumina and surface areas of the computational mesh were found to be in physiological ranges. In conclusion, we present an automatic image processing pipeline to automate the segmentation of the main intracranial compartments including a subject-specific vascular trees. These computational meshes can be used in 3D immersive visualization for diagnosis, surgery planning with haptics

  18. Subject-specific distortions in haptic perception of force direction

    NARCIS (Netherlands)

    van Beek, F.E.; Bergmann Tiest, W.M.; Gabrielse, F.L.; Lagerberg, B.W.J.; Verhoogt, T.K.; Wolfs, B.G.A.; Kappers, A.M.L.

    2014-01-01

    In a previous study, we found that the accuracy of human haptic perception of force direction is not very high. We also found an effect of physical force direction on the error subjects made, resulting in ‘error patterns’. In the current study, we assessed the between- and within-subject variation

  19. Can subject-specific single-fibre electrically evoked auditory brainstem response data be predicted from a model?

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    Malherbe, Tiaan K; Hanekom, Tania; Hanekom, Johan J

    2013-07-01

    This article investigates whether prediction of subject-specific physiological data is viable through an individualised computational model of a cochlear implant. Subject-specific predictions could be particularly useful to assess and quantify the peripheral factors that cause inter-subject variations in perception. The results of such model predictions could potentially be translated to clinical application through optimisation of mapping parameters for individual users, since parameters that affect perception would be reflected in the model structure and parameters. A method to create a subject-specific computational model of a guinea pig with a cochlear implant is presented. The objectives of the study are to develop a method to construct subject-specific models considering translation of the method to in vivo human models and to assess the effectiveness of subject-specific models to predict peripheral neural excitation on subject level. Neural excitation patterns predicted by the model are compared with single-fibre electrically evoked auditory brainstem responses obtained from the inferior colliculus in the same animal. Results indicate that the model can predict threshold frequency location, spatial spread of bipolar and tripolar stimulation and electrode thresholds relative to one another where electrodes are located in different cochlear structures. Absolute thresholds and spatial spread using monopolar stimulation are not predicted accurately. Improvements to the model should address this. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  20. Developmental Dynamics of General and School-Subject-Specific Components of Academic Self-Concept, Academic Interest, and Academic Anxiety

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    Gogol, Katarzyna; Brunner, Martin; Preckel, Franzis; Goetz, Thomas; Martin, Romain

    2016-01-01

    The present study investigated the developmental dynamics of general and subject-specific (i.e., mathematics, French, and German) components of students' academic self-concept, anxiety, and interest. To this end, the authors integrated three lines of research: (a) hierarchical and multidimensional approaches to the conceptualization of each construct, (b) longitudinal analyses of bottom-up and top-down developmental processes across hierarchical levels, and (c) developmental processes across subjects. The data stemmed from two longitudinal large-scale samples (N = 3498 and N = 3863) of students attending Grades 7 and 9 in Luxembourgish schools. Nested-factor models were applied to represent each construct at each grade level. The analyses demonstrated that several characteristics were shared across constructs. All constructs were multidimensional in nature with respect to the different subjects, showed a hierarchical organization with a general component at the apex of the hierarchy, and had a strong separation between the subject-specific components at both grade levels. Further, all constructs showed moderate differential stabilities at both the general (0.42 < r < 0.55) and subject-specific levels (0.45 < r < 0.73). Further, little evidence was found for top-down or bottom-up developmental processes. Rather, general and subject-specific components in Grade 9 proved to be primarily a function of the corresponding components in Grade 7. Finally, change in several subject-specific components could be explained by negative effects across subjects. PMID:27014162

  1. Developmental Dynamics of General and School-Subject-Specific Components of Academic Self-Concept, Academic Interest, and Academic Anxiety

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    Katarzyna eGogol

    2016-03-01

    Full Text Available The present study investigated the developmental dynamics of general and subject-specific (i.e., mathematics, French, and German components of students’ academic self-concept, anxiety, and interest. To this end, the authors integrated three lines of research: (a hierarchical and multidimensional approaches to the conceptualization of each construct, (b longitudinal analyses of bottom-up and top-down developmental processes across hierarchical levels, and (c ipsative developmental processes across subjects. The data stemmed from two longitudinal large-scale samples (N = 3,498 and N = 3,863 of students attending Grades 7 and 9 in Luxembourgish schools. Nested-factor models were applied to represent each construct at each grade level. The analyses demonstrated that several characteristics were shared across constructs. All constructs were multidimensional in nature with respect to the different subjects, showed a hierarchical organization with a general component at the apex of the hierarchy, and had a strong separation between the subject-specific components at both grade levels. Further, all constructs showed moderate differential stabilities at both the general (.42 < r < .55 and subject-specific levels (.45 < r < .73. Further, little evidence was found for top-down or bottom-up developmental processes. Rather, general and subject-specific components in Grade 9 proved to be primarily a function of the corresponding components in Grade 7. Finally, change in several subject-specific components could be explained by negative, ipsative effects across subjects.

  2. Muscle Synergies Facilitate Computational Prediction of Subject-Specific Walking Motions

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    Meyer, Andrew J.; Eskinazi, Ilan; Jackson, Jennifer N.; Rao, Anil V.; Patten, Carolynn; Fregly, Benjamin J.

    2016-01-01

    Researchers have explored a variety of neurorehabilitation approaches to restore normal walking function following a stroke. However, there is currently no objective means for prescribing and implementing treatments that are likely to maximize recovery of walking function for any particular patient. As a first step toward optimizing neurorehabilitation effectiveness, this study develops and evaluates a patient-specific synergy-controlled neuromusculoskeletal simulation framework that can predict walking motions for an individual post-stroke. The main question we addressed was whether driving a subject-specific neuromusculoskeletal model with muscle synergy controls (5 per leg) facilitates generation of accurate walking predictions compared to a model driven by muscle activation controls (35 per leg) or joint torque controls (5 per leg). To explore this question, we developed a subject-specific neuromusculoskeletal model of a single high-functioning hemiparetic subject using instrumented treadmill walking data collected at the subject’s self-selected speed of 0.5 m/s. The model included subject-specific representations of lower-body kinematic structure, foot–ground contact behavior, electromyography-driven muscle force generation, and neural control limitations and remaining capabilities. Using direct collocation optimal control and the subject-specific model, we evaluated the ability of the three control approaches to predict the subject’s walking kinematics and kinetics at two speeds (0.5 and 0.8 m/s) for which experimental data were available from the subject. We also evaluated whether synergy controls could predict a physically realistic gait period at one speed (1.1 m/s) for which no experimental data were available. All three control approaches predicted the subject’s walking kinematics and kinetics (including ground reaction forces) well for the model calibration speed of 0.5 m/s. However, only activation and synergy controls could predict the

  3. Sensitivity of subject-specific models to Hill muscle-tendon model parameters in simulations of gait

    NARCIS (Netherlands)

    Carbone, Vincenzo; van der Krogt, Marjolein; Koopman, Hubertus F.J.M.; Verdonschot, Nicolaas Jacobus Joseph

    2016-01-01

    Subject-specific musculoskeletal (MS) models of the lower extremity are essential for applications such as predicting the effects of orthopedic surgery. We performed an extensive sensitivity analysis to assess the effects of potential errors in Hill muscle–tendon (MT) model parameters for each of

  4. Sensitivity of subject-specific models to Hill muscle-tendon model parameters in simulations of gait

    NARCIS (Netherlands)

    Carbone, V.; Krogt, M.M. van der; Koopman, H.F.J.M.; Verdonschot, N.J.

    2016-01-01

    Subject-specific musculoskeletal (MS) models of the lower extremity are essential for applications such as predicting the effects of orthopedic surgery. We performed an extensive sensitivity analysis to assess the effects of potential errors in Hill muscle-tendon (MT) model parameters for each of

  5. Ultrasound fusion image error correction using subject-specific liver motion model and automatic image registration.

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    Yang, Minglei; Ding, Hui; Zhu, Lei; Wang, Guangzhi

    2016-12-01

    Ultrasound fusion imaging is an emerging tool and benefits a variety of clinical applications, such as image-guided diagnosis and treatment of hepatocellular carcinoma and unresectable liver metastases. However, respiratory liver motion-induced misalignment of multimodal images (i.e., fusion error) compromises the effectiveness and practicability of this method. The purpose of this paper is to develop a subject-specific liver motion model and automatic registration-based method to correct the fusion error. An online-built subject-specific motion model and automatic image registration method for 2D ultrasound-3D magnetic resonance (MR) images were combined to compensate for the respiratory liver motion. The key steps included: 1) Build a subject-specific liver motion model for current subject online and perform the initial registration of pre-acquired 3D MR and intra-operative ultrasound images; 2) During fusion imaging, compensate for liver motion first using the motion model, and then using an automatic registration method to further correct the respiratory fusion error. Evaluation experiments were conducted on liver phantom and five subjects. In the phantom study, the fusion error (superior-inferior axis) was reduced from 13.90±2.38mm to 4.26±0.78mm by using the motion model only. The fusion error further decreased to 0.63±0.53mm by using the registration method. The registration method also decreased the rotation error from 7.06±0.21° to 1.18±0.66°. In the clinical study, the fusion error was reduced from 12.90±9.58mm to 6.12±2.90mm by using the motion model alone. Moreover, the fusion error decreased to 1.96±0.33mm by using the registration method. The proposed method can effectively correct the respiration-induced fusion error to improve the fusion image quality. This method can also reduce the error correction dependency on the initial registration of ultrasound and MR images. Overall, the proposed method can improve the clinical practicability of

  6. Subject-specific computational modeling of DBS in the PPTg area

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    Zitella, Laura M.; Teplitzky, Benjamin A.; Yager, Paul; Hudson, Heather M.; Brintz, Katelynn; Duchin, Yuval; Harel, Noam; Vitek, Jerrold L.; Baker, Kenneth B.; Johnson, Matthew D.

    2015-01-01

    Deep brain stimulation (DBS) in the pedunculopontine tegmental nucleus (PPTg) has been proposed to alleviate medically intractable gait difficulties associated with Parkinson's disease. Clinical trials have shown somewhat variable outcomes, stemming in part from surgical targeting variability, modulating fiber pathways implicated in side effects, and a general lack of mechanistic understanding of DBS in this brain region. Subject-specific computational models of DBS are a promising tool to investigate the underlying therapy and side effects. In this study, a parkinsonian rhesus macaque was implanted unilaterally with an 8-contact DBS lead in the PPTg region. Fiber tracts adjacent to PPTg, including the oculomotor nerve, central tegmental tract, and superior cerebellar peduncle, were reconstructed from a combination of pre-implant 7T MRI, post-implant CT, and post-mortem histology. These structures were populated with axon models and coupled with a finite element model simulating the voltage distribution in the surrounding neural tissue during stimulation. This study introduces two empirical approaches to evaluate model parameters. First, incremental monopolar cathodic stimulation (20 Hz, 90 μs pulse width) was evaluated for each electrode, during which a right eyelid flutter was observed at the proximal four contacts (−1.0 to −1.4 mA). These current amplitudes followed closely with model predicted activation of the oculomotor nerve when assuming an anisotropic conduction medium. Second, PET imaging was collected OFF-DBS and twice during DBS (two different contacts), which supported the model predicted activation of the central tegmental tract and superior cerebellar peduncle. Together, subject-specific models provide a framework to more precisely predict pathways modulated by DBS. PMID:26236229

  7. Subject-specific computational modeling of DBS in the PPTg area

    Directory of Open Access Journals (Sweden)

    Laura M. Zitella

    2015-07-01

    Full Text Available Deep brain stimulation (DBS in the pedunculopontine tegmental nucleus (PPTg has been proposed to alleviate medically intractable gait difficulties associated with Parkinson’s disease. Clinical trials have shown somewhat variable outcomes, stemming in part from surgical targeting variability, modulating fiber pathways implicated in side effects, and a general lack of mechanistic understanding of DBS in this brain region. Subject-specific computational models of DBS are a promising tool to investigate the underlying therapy and side effects. In this study, a parkinsonian rhesus macaque was implanted unilaterally with an 8-contact DBS lead in the PPTg region. Fiber tracts adjacent to PPTg, including the oculomotor nerve, central tegmental tract, and superior cerebellar peduncle, were reconstructed from a combination of pre-implant 7T MRI, post-implant CT, and post-mortem histology. These structures were populated with axon models and coupled with a finite element model simulating the voltage distribution in the surrounding neural tissue during stimulation. This study introduces two empirical approaches to evaluate model parameters. First, incremental monopolar cathodic stimulation (20Hz, 90µs pulse width was evaluated for each electrode, during which a right eyelid flutter was observed at the proximal four contacts (-1.0 to -1.4mA. These current amplitudes followed closely with model predicted activation of the oculomotor nerve when assuming an anisotropic conduction medium. Second, PET imaging was collected OFF-DBS and twice during DBS (two different contacts, which supported the model predicted activation of the central tegmental tract and superior cerebellar peduncle. Together, subject-specific models provide a framework to more precisely predict pathways modulated by DBS.

  8. Atlas-Based Automatic Generation of Subject-Specific Finite Element Tongue Meshes.

    Science.gov (United States)

    Bijar, Ahmad; Rohan, Pierre-Yves; Perrier, Pascal; Payan, Yohan

    2016-01-01

    Generation of subject-specific 3D finite element (FE) models requires the processing of numerous medical images in order to precisely extract geometrical information about subject-specific anatomy. This processing remains extremely challenging. To overcome this difficulty, we present an automatic atlas-based method that generates subject-specific FE meshes via a 3D registration guided by Magnetic Resonance images. The method extracts a 3D transformation by registering the atlas' volume image to the subject's one, and establishes a one-to-one correspondence between the two volumes. The 3D transformation field deforms the atlas' mesh to generate the subject-specific FE mesh. To preserve the quality of the subject-specific mesh, a diffeomorphic non-rigid registration based on B-spline free-form deformations is used, which guarantees a non-folding and one-to-one transformation. Two evaluations of the method are provided. First, a publicly available CT-database is used to assess the capability to accurately capture the complexity of each subject-specific Lung's geometry. Second, FE tongue meshes are generated for two healthy volunteers and two patients suffering from tongue cancer using MR images. It is shown that the method generates an appropriate representation of the subject-specific geometry while preserving the quality of the FE meshes for subsequent FE analysis. To demonstrate the importance of our method in a clinical context, a subject-specific mesh is used to simulate tongue's biomechanical response to the activation of an important tongue muscle, before and after cancer surgery.

  9. Evaluation of a subject-specific female gymnast model and simulation of an uneven parallel bar swing.

    Science.gov (United States)

    Sheets, Alison L; Hubbard, Mont

    2008-11-14

    A gymnast model and forward dynamics simulation of a dismount preparation swing on the uneven parallel bars were evaluated by comparing experimental and predicted joint positions throughout the maneuver. The bar model was a linearly elastic spring with a frictional bar/hand interface, and the gymnast model consisted of torso/head, arm and two leg segments. The hips were frictionless balls and sockets, and shoulder movement was planar with passive compliant structures approximated by a parallel spring and damper. Subject-specific body segment moments of inertia, and shoulder compliance were estimated. Muscles crossing the shoulder and hip were represented as torque generators, and experiments quantified maximum instantaneous torques as functions of joint angle and angular velocity. Maximum torques were scaled by joint torque activations as functions of time to produce realistic motions. The downhill simplex method optimized activations and simulation initial conditions to minimize the difference between experimental and predicted bar-center, shoulder, hip, and ankle positions. Comparing experimental and simulated performances allowed evaluation of bar, shoulder compliance, joint torque, and gymnast models. Errors in all except the gymnast model are random, zero mean, and uncorrelated, verifying that all essential system features are represented. Although the swing simulation using the gymnast model matched experimental joint positions with a 2.15cm root-mean-squared error, errors are correlated. Correlated errors indicate that the gymnast model is not complex enough to exactly reproduce the experimental motion. Possible model improvements including a nonlinear shoulder model with active translational control and a two-segment torso would not have been identified if the objective function did not evaluate the entire system configuration throughout the motion. The model and parameters presented in this study can be effectively used to understand and improve an uneven

  10. Subject-specific planning of femoroplasty: a combined evolutionary optimization and particle diffusion model approach.

    Science.gov (United States)

    Basafa, Ehsan; Armand, Mehran

    2014-07-18

    A potential effective treatment for prevention of osteoporotic hip fractures is augmentation of the mechanical properties of the femur by injecting it with agents such as (PMMA) bone cement - femoroplasty. The operation, however, is only in research stage and can benefit substantially from computer planning and optimization. We report the results of computational planning and optimization of the procedure for biomechanical evaluation. An evolutionary optimization method was used to optimally place the cement in finite element (FE) models of seven osteoporotic bone specimens. The optimization, with some inter-specimen variations, suggested that areas close to the cortex in the superior and inferior of the neck and supero-lateral aspect of the greater trochanter will benefit from augmentation. We then used a particle-based model for bone cement diffusion simulation to match the optimized pattern, taking into account the limitations of the actual surgery, including limited volume of injection to prevent thermal necrosis. Simulations showed that the yield load can be significantly increased by more than 30%, using only 9 ml of bone cement. This increase is comparable to previous literature reports where gross filling of the bone was employed instead, using more than 40 ml of cement. These findings, along with the differences in the optimized plans between specimens, emphasize the need for subject-specific models for effective planning of femoral augmentation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. A Computational Framework to Optimize Subject-Specific Hemodialysis Blood Flow Rate to Prevent Intimal Hyperplasia

    Science.gov (United States)

    Mahmoudzadeh, Javid; Wlodarczyk, Marta; Cassel, Kevin

    2017-11-01

    Development of excessive intimal hyperplasia (IH) in the cephalic vein of renal failure patients who receive chronic hemodialysis treatment results in vascular access failure and multiple treatment complications. Specifically, cephalic arch stenosis (CAS) is known to exacerbate hypertensive blood pressure, thrombosis, and subsequent cardiovascular incidents that would necessitate costly interventional procedures with low success rates. It has been hypothesized that excessive blood flow rate post access maturation which strongly violates the venous homeostasis is the main hemodynamic factor that orchestrates the onset and development of CAS. In this article, a computational framework based on a strong coupling of computational fluid dynamics (CFD) and shape optimization is proposed that aims to identify the effective blood flow rate on a patient-specific basis that avoids the onset of CAS while providing the adequate blood flow rate required to facilitate hemodialysis. This effective flow rate can be achieved through implementation of Miller's surgical banding method after the maturation of the arteriovenous fistula and is rooted in the relaxation of wall stresses back to a homeostatic target value. The results are indicative that this optimized hemodialysis blood flow rate is, in fact, a subject-specific value that can be assessed post vascular access maturation and prior to the initiation of chronic hemodialysis treatment as a mitigative action against CAS-related access failure. This computational technology can be employed for individualized dialysis treatment.

  12. Obesity and Obesity Shape Markedly Influence Spine Biomechanics: A Subject-Specific Risk Assessment Model.

    Science.gov (United States)

    Ghezelbash, Farshid; Shirazi-Adl, Aboulfazl; Plamondon, André; Arjmand, Navid; Parnianpour, Mohamad

    2017-10-01

    Underlying mechanisms of obesity-related back pain remain unexplored. Thus, we aim to determine the effect of obesity and its shapes on the spinal loads and the associated risks of injury. Obesity shapes were initially constructed by principal component analysis based on datasets on 5852 obese individuals. Spinal loads, cycles to vertebral failure and trunk stability margin were estimated in a subject-specific trunk model taking account of personalized musculature, passive ligamentous spine, obesity shapes, segmental weights, spine kinematics and bone mineral density. Three obesity shapes (mean and extreme abdominal circumferences) at three body weights (BWs) of 86, 98 and 109 kg were analyzed. Additional BW (12 kg) increased spinal loads by ~11.8%. Higher waist circumferences at identical BW increased spinal forces to the tune of ~20 kg additional BW and the risk of vertebral fatigue compression fracture by 3-7 times when compared with smaller waist circumferences. Forward flexion, greater BW and load in hands increased the trunk stability margin. Spinal loads markedly increased with BW, especially at greater waist circumferences. The risk of vertebral fatigue fracture also substantially increased at greater waist circumferences though not at smaller ones. Obesity and its shape should be considered in spine biomechanics.

  13. Experimental Investigation of Subject-Specific On-Body Radio Propagation Channels for Body-Centric Wireless Communications

    Directory of Open Access Journals (Sweden)

    Mohammad Monirujjaman Khan

    2014-01-01

    Full Text Available In this paper, subject-specific narrowband (2.45 GHz and ultra-wideband (3–10.6 GHz on-body radio propagation studies in wireless body area networks (WBANs were performed by characterizing the path loss for eight different human subjects of different shapes and sizes. The body shapes and sizes of the test subjects used in this study are characterised as thin, medium build, fatty, shorter, average height and taller. Experimental investigation was made in an indoor environment using a pair of printed monopoles (for the narrowband case and a pair of tapered slot antennas (for the ultra-wideband (UWB case. Results demonstrated that, due to the different sizes, heights and shapes of the test subjects, the path loss exponent value varies up to maximum of 0.85 for the narrowband on-body case, whereas a maximum variation of the path loss exponent value of 1.15 is noticed for the UWB case. In addition, the subject-specific behaviour of the on-body radio propagation channels was compared between narrowband and UWB systems, and it was deduced that the on-body radio channels are subject-specific for both narrowband and UWB system cases, when the same antennas (same characteristics are used. The effect of the human body shape and size variations on the eight different on-body radio channels is also studied for both the narrowband and UWB cases.

  14. Subject-specific musculoskeletal modeling in the evaluation of shoulder muscle and joint function.

    Science.gov (United States)

    Wu, Wen; Lee, Peter V S; Bryant, Adam L; Galea, Mary; Ackland, David C

    2016-11-07

    Upper limb muscle force estimation using Hill-type muscle models depends on musculotendon parameter values, which cannot be readily measured non-invasively. Generic and scaled-generic parameters may be quickly and easily employed, but these approaches do not account for an individual subject's joint torque capacity. The objective of the present study was to develop a subject-specific experimental testing and modeling framework to evaluate shoulder muscle and joint function during activities of daily living, and to assess the capacity of generic and scaled-generic musculotendon parameters to predict muscle and joint function. Three-dimensional musculoskeletal models of the shoulders of 6 healthy subjects were developed to calculate muscle and glenohumeral joint loading during abduction, flexion, horizontal flexion, nose touching and reaching using subject-specific, scaled-generic and generic musculotendon parameters. Muscle and glenohumeral joint forces calculated using generic and scaled-generic models were significantly different to those of subject-specific models (pMuscles in generic musculoskeletal models operated further from the plateau of their force-length curves than those of scaled-generic and subject-specific models, while muscles in subject-specific models operated over a wider region of their force length curves than those of the generic or scaled-generic models, reflecting diversity of subject shoulder strength. The findings of this study suggest that generic and scaled-generic musculotendon parameters may not provide sufficient accuracy in prediction of shoulder muscle and joint loading when compared to models that employ subject-specific parameter-estimation approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Automatized spleen segmentation in non-contrast-enhanced MR volume data using subject-specific shape priors

    Science.gov (United States)

    Gloger, Oliver; Tönnies, Klaus; Bülow, Robin; Völzke, Henry

    2017-07-01

    To develop the first fully automated 3D spleen segmentation framework derived from T1-weighted magnetic resonance (MR) imaging data and to verify its performance for spleen delineation and volumetry. This approach considers the issue of low contrast between spleen and adjacent tissue in non-contrast-enhanced MR images. Native T1-weighted MR volume data was performed on a 1.5 T MR system in an epidemiological study. We analyzed random subsamples of MR examinations without pathologies to develop and verify the spleen segmentation framework. The framework is modularized to include different kinds of prior knowledge into the segmentation pipeline. Classification by support vector machines differentiates between five different shape types in computed foreground probability maps and recognizes characteristic spleen regions in axial slices of MR volume data. A spleen-shape space generated by training produces subject-specific prior shape knowledge that is then incorporated into a final 3D level set segmentation method. Individually adapted shape-driven forces as well as image-driven forces resulting from refined foreground probability maps steer the level set successfully to the segment the spleen. The framework achieves promising segmentation results with mean Dice coefficients of nearly 0.91 and low volumetric mean errors of 6.3%. The presented spleen segmentation approach can delineate spleen tissue in native MR volume data. Several kinds of prior shape knowledge including subject-specific 3D prior shape knowledge can be used to guide segmentation processes achieving promising results.

  16. Bayesian longitudinal segmentation of hippocampal substructures in brain MRI using subject-specific atlases

    DEFF Research Database (Denmark)

    Iglesias, Juan Eugenio; Van Leemput, Koen; Augustinack, Jean

    2016-01-01

    images and computational atlases, automatic segmentation of hippocampal subregions is becoming feasible in MRI scans. Here we introduce a generative model for dedicated longitudinal segmentation that relies on subject-specific atlases. The segmentations of the scans at the different time points...

  17. A subject-specific musculoskeletal modeling framework to predict in vivo mechanics of total knee arthroplasty

    NARCIS (Netherlands)

    Marra, M.A.; Vanheule, V.; Fluit, R.; Koopman, B.H.; Rasmussen, J.; Verdonschot, N.J.; Andersen, M.S.

    2015-01-01

    Musculoskeletal (MS) models should be able to integrate patient-specific MS architecture and undergo thorough validation prior to their introduction into clinical practice. We present a methodology to develop subject-specific models able to simultaneously predict muscle, ligament, and knee joint

  18. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces

    Science.gov (United States)

    Gerus, Pauline; Sartori, Massimo; Besier, Thor F.; Fregly, Benjamin J.; Delp, Scott L.; Banks, Scott A.; Pandy, Marcus G.; D’Lima, Darryl D.; Lloyd, David G.

    2013-01-01

    Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model. PMID:24074941

  19. A Subject-Specificity Analysis of Radio Channels in Wireless Body Area Networks

    Directory of Open Access Journals (Sweden)

    Yang Hao

    2011-07-01

    Full Text Available This paper presents an analysis of subject-specific radio channels in wireless body area networks (WBANs using a simulation tool based on the parallel finite-difference time-domain (FDTD technique. This technique is well suited to model radio propagations around complex, inhomogeneous objects such as the human body. The impacts of different subjects varying in size on on-body, inter-body, and off-body radio channels are studied. The analysis demonstrates that the characteristics of on-body radio channels are subject-specific and are associated with human gender, height, and body mass index. On the other hand, when waves propagate away from the body, such as in the inter-body and off-body cases, the impacts of different subjects on the channel characteristics are found to be negligible.

  20. Image driven subject-specific finite element models of spinal biomechanics.

    Science.gov (United States)

    Zanjani-Pour, Sahand; Winlove, C Peter; Smith, Christopher W; Meakin, Judith R

    2016-04-11

    Finite element (FE) modelling is an established technique for investigating spinal biomechanics. Using image data to produce FE models with subject-specific geometry and displacement boundary conditions may help extend their use to the assessment spinal loading in individuals. Lumbar spine magnetic resonance images from nine participants in the supine, standing and sitting postures were obtained and 2D poroelastic FE models of the lumbar spine were created from the supine data. The rigid body translation and rotation of the vertebral bodies as the participant moved to standing or sitting were applied to the model. The resulting pore pressure in the centre of the L4/L5 disc was determined and the sensitivity to the material properties and vertebral body displacements was assessed. Although the limitations of using a 2D model mean the predicted pore pressures are unlikely to be accurate, the results showed that subject-specific variation in geometry and motion during postural change leads to variation in pore pressure. The model was sensitive to the Young׳s modulus of the annulus matrix, the permeability of the nucleus, and the vertical translation of the vertebrae. This study demonstrates the feasibility of using image data to drive subject-specific lumbar spine FE models and indicates where further development is required to provide a method for assessing spinal biomechanics in a wide range of individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Automatic tissue segmentation of neonate brain MR Images with subject-specific atlases

    Science.gov (United States)

    Cherel, Marie; Budin, Francois; Prastawa, Marcel; Gerig, Guido; Lee, Kevin; Buss, Claudia; Lyall, Amanda; Zaldarriaga Consing, Kirsten; Styner, Martin

    2015-03-01

    Automatic tissue segmentation of the neonate brain using Magnetic Resonance Images (MRI) is extremely important to study brain development and perform early diagnostics but is challenging due to high variability and inhomogeneity in contrast throughout the image due to incomplete myelination of the white matter tracts. For these reasons, current methods often totally fail or give unsatisfying results. Furthermore, most of the subcortical midbrain structures are misclassified due to a lack of contrast in these regions. We have developed a novel method that creates a probabilistic subject-specific atlas based on a population atlas currently containing a number of manually segmented cases. The generated subject-specific atlas is sharp and adapted to the subject that is being processed. We then segment brain tissue classes using the newly created atlas with a single-atlas expectation maximization based method. Our proposed method leads to a much lower failure rate in our experiments. The overall segmentation results are considerably improved when compared to using a non-subject-specific, population average atlas. Additionally, we have incorporated diffusion information obtained from Diffusion Tensor Images (DTI) to improve the detection of white matter that is not visible at this early age in structural MRI (sMRI) due to a lack of myelination. Although this necessitates the acquisition of an additional sequence, the diffusion information improves the white matter segmentation throughout the brain, especially for the mid-brain structures such as the corpus callosum and the internal capsule.

  2. TLEM 2.0 - a comprehensive musculoskeletal geometry dataset for subject-specific modeling of lower extremity.

    Science.gov (United States)

    Carbone, V; Fluit, R; Pellikaan, P; van der Krogt, M M; Janssen, D; Damsgaard, M; Vigneron, L; Feilkas, T; Koopman, H F J M; Verdonschot, N

    2015-03-18

    When analyzing complex biomechanical problems such as predicting the effects of orthopedic surgery, subject-specific musculoskeletal models are essential to achieve reliable predictions. The aim of this paper is to present the Twente Lower Extremity Model 2.0, a new comprehensive dataset of the musculoskeletal geometry of the lower extremity, which is based on medical imaging data and dissection performed on the right lower extremity of a fresh male cadaver. Bone, muscle and subcutaneous fat (including skin) volumes were segmented from computed tomography and magnetic resonance images scans. Inertial parameters were estimated from the image-based segmented volumes. A complete cadaver dissection was performed, in which bony landmarks, attachments sites and lines-of-action of 55 muscle actuators and 12 ligaments, bony wrapping surfaces, and joint geometry were measured. The obtained musculoskeletal geometry dataset was finally implemented in the AnyBody Modeling System (AnyBody Technology A/S, Aalborg, Denmark), resulting in a model consisting of 12 segments, 11 joints and 21 degrees of freedom, and including 166 muscle-tendon elements for each leg. The new TLEM 2.0 dataset was purposely built to be easily combined with novel image-based scaling techniques, such as bone surface morphing, muscle volume registration and muscle-tendon path identification, in order to obtain subject-specific musculoskeletal models in a quick and accurate way. The complete dataset, including CT and MRI scans and segmented volume and surfaces, is made available at http://www.utwente.nl/ctw/bw/research/projects/TLEMsafe for the biomechanical community, in order to accelerate the development and adoption of subject-specific models on large scale. TLEM 2.0 is freely shared for non-commercial use only, under acceptance of the TLEMsafe Research License Agreement. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. An anthropometric based subject-specific finite element model of the human breast for predicting large deformations

    Directory of Open Access Journals (Sweden)

    Silvia ePianigiani

    2015-12-01

    Full Text Available The large deformation of the human breast threatens proper nodules tracking when the subject mammograms are used as pre-planning data for biopsy. However, techniques capable of accurately supporting the surgeons during biopsy are missing. Finite Element (FE models are at the basis of currently investigated methodologies to track nodules displacement. Nonetheless, the impact of breast material modeling on the mechanical response of its tissues (e.g. tumors is not clear. This study proposes a subject-specific FE model of the breast, obtained by anthropometric measurements, to predict breast large deformation. A healthy breast subject-specific FE parametric model was developed and validated by Cranio-caudal (CC and Medio Lateral Oblique (MLO mammograms. The model was successively modified, including nodules, and utilized to investigate the effect of nodules size, typology and material modeling on nodules shift under the effect of CC, MLO and gravity loads. Results show that a Mooney-Rivlin material model can estimate healthy breast large deformation. For a pathological breast, under CC compression, the nodules displacement is very close to zero when a linear elastic material model is used. Finally, when nodules are modeled including tumor material properties, under CC or MLO or gravity loads, nodules shift shows ∼15% average relative difference.

  4. Incorporation of Inter-Subject Information to Improve the Accuracy of Subject-Specific P300 Classifiers.

    Science.gov (United States)

    Xu, Minpeng; Liu, Jing; Chen, Long; Qi, Hongzhi; He, Feng; Zhou, Peng; Wan, Baikun; Ming, Dong

    2016-05-01

    Although the inter-subject information has been demonstrated to be effective for a rapid calibration of the P300-based brain-computer interface (BCI), it has never been comprehensively tested to find if the incorporation of heterogeneous data could enhance the accuracy. This study aims to improve the subject-specific P300 classifier by adding other subject's data. A classifier calibration strategy, weighted ensemble learning generic information (WELGI), was developed, in which elementary classifiers were constructed by using both the intra- and inter-subject information and then integrated into a strong classifier with a weight assessment. 55 subjects were recruited to spell 20 characters offline using the conventional P300-based BCI, i.e. the P300-speller. Four different metrics, the P300 accuracy and precision, the round accuracy, and the character accuracy, were performed for a comprehensive investigation. The results revealed that the classifier constructed on the training dataset in combination with adding other subject's data was significantly superior to that without the inter-subject information. Therefore, the WELGI is an effective classifier calibration strategy which uses the inter-subject information to improve the accuracy of subject-specific P300 classifiers, and could also be applied to other BCI paradigms.

  5. Interpreting parameters in the logistic regression model with random effects

    DEFF Research Database (Denmark)

    Larsen, Klaus; Petersen, Jørgen Holm; Budtz-Jørgensen, Esben

    2000-01-01

    interpretation, interval odds ratio, logistic regression, median odds ratio, normally distributed random effects......interpretation, interval odds ratio, logistic regression, median odds ratio, normally distributed random effects...

  6. Field Induced Memory Effects in Random Nematics

    Directory of Open Access Journals (Sweden)

    Amid Ranjkesh

    2014-01-01

    Full Text Available We studied numerically external field induced memory effects in randomly perturbed nematic liquid crystals. Random anisotropy nematic-type lattice model was used. The impurities imposing orientational disorder were randomly spatially distributed with the concentration p below the percolation threshold. Simulations were carried for finite temperatures, where we varied p, interaction strength between LC molecules, and impurities and external field B. In the {B,T} plane we determined lines separating short range—quasi long range and quasi long range—long range order. Furthermore, crossover regime separating external field and random field dominated regime was estimated. We calculated remanent nematic ordering in samples at B=0 as a function of the previously experienced external field strength B.

  7. Effective Lagrangians and chiral random matrix theory

    Energy Technology Data Exchange (ETDEWEB)

    Halasz, M.A.; Verbaarschot, J.J.M. [Department of Physics, State University of New York, Stony Brook, New York 11794 (United States)

    1995-08-15

    Recently, sum rules were derived for the inverse eigenvalues of the Dirac operator. They were obtained in two different ways: (i) starting from the low-energy effective Lagrangian and (ii) starting from a random matrix theory with the symmetries of the Dirac operator. This suggests that the effective theory can be obtained directly from the random matrix theory. Previously, this was shown for three or more colors with fundamental fermions. In this paper we construct the effective theory from a random matrix theory for two colors in the fundamental representation and for an arbitrary number of colors in the adjoint representation. We construct a fermionic partition function for Majorana fermions in Euclidean spacetime. Their reality condition is formulated in terms of complex conjugation of the second kind.

  8. Airflow in a Multiscale Subject-Specific Breathing Human Lung Model

    CERN Document Server

    Choi, Jiwoong; Hoffman, Eric A; Tawhai, Merryn H; Lin, Ching-Long

    2013-01-01

    The airflow in a subject-specific breathing human lung is simulated with a multiscale computational fluid dynamics (CFD) lung model. The three-dimensional (3D) airway geometry beginning from the mouth to about 7 generations of airways is reconstructed from the multi-detector row computed tomography (MDCT) image at the total lung capacity (TLC). Along with the segmented lobe surfaces, we can build an anatomically-consistent one-dimensional (1D) airway tree spanning over more than 20 generations down to the terminal bronchioles, which is specific to the CT resolved airways and lobes (J Biomech 43(11): 2159-2163, 2010). We then register two lung images at TLC and the functional residual capacity (FRC) to specify subject-specific CFD flow boundary conditions and deform the airway surface mesh for a breathing lung simulation (J Comput Phys 244:168-192, 2013). The 1D airway tree bridges the 3D CT-resolved airways and the registration-derived regional ventilation in the lung parenchyma, thus a multiscale model. Larg...

  9. 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 ...

  10. Three-dimensional computational modeling of subject-specific cerebrospinal fluid flow in the subarachnoid space.

    Science.gov (United States)

    Gupta, Sumeet; Soellinger, Michaela; Boesiger, Peter; Poulikakos, Dimos; Kurtcuoglu, Vartan

    2009-02-01

    This study aims at investigating three-dimensional subject-specific cerebrospinal fluid (CSF) dynamics in the inferior cranial space, the superior spinal subarachnoid space (SAS), and the fourth cerebral ventricle using a combination of a finite-volume computational fluid dynamics (CFD) approach and magnetic resonance imaging (MRI) experiments. An anatomically accurate 3D model of the entire SAS of a healthy volunteer was reconstructed from high resolution T2 weighted MRI data. Subject-specific pulsatile velocity boundary conditions were imposed at planes in the pontine cistern, cerebellomedullary cistern, and in the spinal subarachnoid space. Velocimetric MRI was used to measure the velocity field at these boundaries. A constant pressure boundary condition was imposed at the interface between the aqueduct of Sylvius and the fourth ventricle. The morphology of the SAS with its complex trabecula structures was taken into account through a novel porous media model with anisotropic permeability. The governing equations were solved using finite-volume CFD. We observed a total pressure variation from -42 Pa to 40 Pa within one cardiac cycle in the investigated domain. Maximum CSF velocities of about 15 cms occurred in the inferior section of the aqueduct, 14 cms in the left foramen of Luschka, and 9 cms in the foramen of Magendie. Flow velocities in the right foramen of Luschka were found to be significantly lower than in the left, indicating three-dimensional brain asymmetries. The flow in the cerebellomedullary cistern was found to be relatively diffusive with a peak Reynolds number (Re)=72, while the flow in the pontine cistern was primarily convective with a peak Re=386. The net volumetric flow rate in the spinal canal was found to be negligible despite CSF oscillation with substantial amplitude with a maximum volumetric flow rate of 109 mlmin. The observed transient flow patterns indicate a compliant behavior of the cranial subarachnoid space. Still, the estimated

  11. Subject-specific modelling of lower limb muscles in children with cerebral palsy.

    Science.gov (United States)

    Oberhofer, K; Stott, N S; Mithraratne, K; Anderson, I A

    2010-01-01

    Recent studies suggest that the architecture of spastic muscles in children with cerebral palsy is considerably altered; however, only little is known about the structural changes that occur other than in the gastrocnemius muscle. In the present study, Magnetic Resonance Imaging (MRI) and subject-specific modelling techniques were used to compare the lengths and volumes of six lower limb muscles between children with cerebral palsy and typically developing children. MRI scans of the lower limbs of two children with spastic hemiplegia cerebral palsy, four children with spastic diplegia cerebral palsy (mean age 9.6 years) and a group of typically developing children (mean age 10.2 years) were acquired. Subject-specific models of six lower limb muscles were developed from the MRI data using a technique called Face Fitting. Muscle volumes and muscle lengths were derived from the models and normalised to body mass and segmental lengths, respectively. Normalised muscle volumes in the children with cerebral palsy were smaller than in the control group with the difference being 22% in the calf muscles, 26% in the hamstrings and 22% in the quadriceps, respectively. Only the differences in the hamstrings and the quadriceps were statistically significant (P=0.036, P=0.038). Normalised muscle lengths in the children with cerebral palsy were significantly shorter (Pmuscle in either group. The present results show that lower limb muscles in ambulatory children with cerebral palsy are significantly altered, suggesting an overall mechanical deficit due to predominant muscle atrophy. Further investigations of the underlying causes of the muscle atrophy are required to better define management and treatment strategies for children with cerebral palsy.

  12. Validation of subject-specific cardiovascular system models from porcine measurements.

    Science.gov (United States)

    Revie, James A; Stevenson, David J; Chase, J Geoffrey; Hann, Christopher E; Lambermont, Bernard C; Ghuysen, Alexandre; Kolh, Philippe; Shaw, Geoffrey M; Heldmann, Stefan; Desaive, Thomas

    2013-02-01

    A previously validated mathematical model of the cardiovascular system (CVS) is made subject-specific using an iterative, proportional gain-based identification method. Prior works utilised a complete set of experimentally measured data that is not clinically typical or applicable. In this paper, parameters are identified using proportional gain-based control and a minimal, clinically available set of measurements. The new method makes use of several intermediary steps through identification of smaller compartmental models of CVS to reduce the number of parameters identified simultaneously and increase the convergence stability of the method. This new, clinically relevant, minimal measurement approach is validated using a porcine model of acute pulmonary embolism (APE). Trials were performed on five pigs, each inserted with three autologous blood clots of decreasing size over a period of four to five hours. All experiments were reviewed and approved by the Ethics Committee of the Medical Faculty at the University of Liege, Belgium. Continuous aortic and pulmonary artery pressures (P(ao), P(pa)) were measured along with left and right ventricle pressure and volume waveforms. Subject-specific CVS models were identified from global end diastolic volume (GEDV), stroke volume (SV), P(ao), and P(pa) measurements, with the mean volumes and maximum pressures of the left and right ventricles used to verify the accuracy of the fitted models. The inputs (GEDV, SV, P(ao), P(pa)) used in the identification process were matched by the CVS model to errors pressures not used to fit the model compared experimental measurements to median absolute errors of 4.3% and 4.4%, which are equivalent to the measurement errors of currently used monitoring devices in the ICU (∼5-10%). These results validate the potential for implementing this approach in the intensive care unit. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. Evaluation of a subject-specific finite-element model of the equine metacarpophalangeal joint under physiological load.

    Science.gov (United States)

    Harrison, Simon M; Whitton, R Chris; Kawcak, Chris E; Stover, Susan M; Pandy, Marcus G

    2014-01-03

    The equine metacarpophalangeal (MCP) joint is frequently injured, especially by racehorses in training. Most injuries result from repetitive loading of the subchondral bone and articular cartilage rather than from acute events. The likelihood of injury is multi-factorial but the magnitude of mechanical loading and the number of loading cycles are believed to play an important role. Therefore, an important step in understanding injury is to determine the distribution of load across the articular surface during normal locomotion. A subject-specific finite-element model of the MCP joint was developed (including deformable cartilage, elastic ligaments, muscle forces and rigid representations of bone), evaluated against measurements obtained from cadaver experiments, and then loaded using data from gait experiments. The sensitivity of the model to force inputs, cartilage stiffness, and cartilage geometry was studied. The FE model predicted MCP joint torque and sesamoid bone flexion angles within 5% of experimental measurements. Muscle-tendon forces, joint loads and cartilage stresses all increased as locomotion speed increased from walking to trotting and finally cantering. Perturbations to muscle-tendon forces resulted in small changes in articular cartilage stresses, whereas variations in joint torque, cartilage geometry and stiffness produced much larger effects. Non-subject-specific cartilage geometry changed the magnitude and distribution of pressure and the von Mises stress markedly. The mean and peak cartilage stresses generally increased with an increase in cartilage stiffness. Areas of peak stress correlated qualitatively with sites of common injury, suggesting that further modelling work may elucidate the types of loading that precede joint injury and may assist in the development of techniques for injury mitigation. © 2013 Published by Elsevier Ltd.

  14. The relationship between porosity and specific surface in human cortical bone is subject specific.

    Science.gov (United States)

    Lerebours, C; Thomas, C D L; Clement, J G; Buenzli, P R; Pivonka, P

    2015-03-01

    A characteristic relationship for bone between bone volume fraction (BV/TV) and specific surface (BS/TV) has previously been proposed based on 2D histological measurements. This relationship has been suggested to be bone intrinsic, i.e., to not depend on bone type, bone site and health state. In these studies, only limited data comes from cortical bone. The aim of this paper was to investigate the relationship between BV/TV and BS/TV in human cortical bone using high-resolution micro-CT imaging and the correlations with subject-specific biometric data such as height, weight, age and sex. Images from femoral cortical bone samples of the Melbourne Femur Collection were obtained using synchrotron radiation micro-CT (SPring8, Japan). Sixteen bone samples from thirteen individuals were analysed in order to find bone volume fraction values ranging from 0.20 to 1. Finally, morphological models of the tissue microstructure were developed to help explain the relationship between BV/TV and BS/TV. Our experimental findings indicate that the BV/TV vs BS/TV relationship is subject specific rather than intrinsic. Sex and pore density were statistically correlated with the individual curves. However no correlation was found with body height, weight or age. Experimental cortical data points deviate from interpolating curves previously proposed in the literature. However, these curves are largely based on data points from trabecular bone samples. This finding challenges the universality of the curve: highly porous cortical bone is significantly different to trabecular bone of the same porosity. Finally, our morphological models suggest that changes in BV/TV within the same sample can be explained by an increase in pore area rather than in pore density. This is consistent with the proposed mechanisms of age-related endocortical bone loss. In addition, these morphological models highlight that the relationship between BV/TV and BS/TV is not linear at high BV/TV as suggested in the

  15. In-human subject-specific evaluation of a control-theoretic plasma volume regulation model.

    Science.gov (United States)

    Bighamian, Ramin; Kinsky, Michael; Kramer, George; Hahn, Jin-Oh

    2017-12-01

    The goal of this study was to conduct a subject-specific evaluation of a control-theoretic plasma volume regulation model in humans. We employed a set of clinical data collected from nine human subjects receiving fluid bolus with and without co-administration of an inotrope agent, including fluid infusion rate, plasma volume, and urine output. Once fitted to the data associated with each subject, the model accurately reproduced the fractional plasma volume change responses in all subjects: the error between actual versus model-reproduced fractional plasma volume change responses was only 1.4 ± 1.6% and 1.2 ± 0.3% of the average fractional plasma volume change responses in the absence and presence of inotrope co-administration. In addition, the model parameters determined by the subject-specific fitting assumed physiologically plausible values: (i) initial plasma volume was estimated to be 36 ± 11 mL/kg and 37 ± 10 mL/kg in the absence and presence of inotrope infusion, respectively, which was comparable to its actual counterpart of 37 ± 4 mL/kg and 43 ± 6 mL/kg; (ii) volume distribution ratio, specifying the ratio with which the inputted fluid is distributed in the intra- and extra-vascular spaces, was estimated to be 3.5 ± 2.4 and 1.9 ± 0.5 in the absence and presence of inotrope infusion, respectively, which accorded with the experimental observation that inotrope could enhance plasma volume expansion in response to fluid infusion. We concluded that the model was equipped with the ability to reproduce plasma volume response to fluid infusion in humans with physiologically plausible model parameters, and its validity may persist even under co-administration of inotropic agents. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Subject-Specific Sparse Dictionary Learning for Atlas-Based Brain MRI Segmentation.

    Science.gov (United States)

    Roy, Snehashis; He, Qing; Sweeney, Elizabeth; Carass, Aaron; Reich, Daniel S; Prince, Jerry L; Pham, Dzung L

    2015-09-01

    Quantitative measurements from segmentations of human brain magnetic resonance (MR) images provide important biomarkers for normal aging and disease progression. In this paper, we propose a patch-based tissue classification method from MR images that uses a sparse dictionary learning approach and atlas priors. Training data for the method consists of an atlas MR image, prior information maps depicting where different tissues are expected to be located, and a hard segmentation. Unlike most atlas-based classification methods that require deformable registration of the atlas priors to the subject, only affine registration is required between the subject and training atlas. A subject-specific patch dictionary is created by learning relevant patches from the atlas. Then the subject patches are modeled as sparse combinations of learned atlas patches leading to tissue memberships at each voxel. The combination of prior information in an example-based framework enables us to distinguish tissues having similar intensities but different spatial locations. We demonstrate the efficacy of the approach on the application of whole-brain tissue segmentation in subjects with healthy anatomy and normal pressure hydrocephalus, as well as lesion segmentation in multiple sclerosis patients. For each application, quantitative comparisons are made against publicly available state-of-the art approaches.

  17. The FachRef-Assistant: Personalised, subject specific, and transparent stock management

    Directory of Open Access Journals (Sweden)

    Eike T. Spielberg

    2017-07-01

    Full Text Available We present in this paper a personalized web application for the weeding of printed resources: the FachRef-Assistant. It offers an extensive range of tools for evidence based stock management, based on the thorough analysis of usage statistics. Special attention is paid to the criteria individualization, transparency of the parameters used, and generic functions. Currently, it is designed to work with the Aleph-System from ExLibris, but efforts were spent to keep the application as generic as possible. For example, all procedures specific to the local library system have been collected in one Java package. The inclusion of library specific properties such as collections and systematics has been designed to be highly generic as well by mapping the individual entries onto an in-memory database. Hence simple adaption of the package and the mappings would render the FachRef-Assistant compatible to other library systems. The personalization of the application allows for the inclusion of subject specific usage properties as well as of variations between different collections within one subject area. The parameter sets used to analyse the stock and to prepare weeding and purchase proposal lists are included in the output XML-files to facilitate a high degree of transparency, objectivity and reproducibility.

  18. Subject Specific Sparse Dictionary Learning for Atlas Based Brain MRI Segmentation

    Science.gov (United States)

    Roy, Snehashis; He, Qing; Sweeney, Elizabeth; Carass, Aaron; Reich, Daniel S.; Prince, Jerry L.; Pham, Dzung L.

    2015-01-01

    Quantitative measurements from segmentations of human brain magnetic resonance (MR) images provide important biomarkers for normal aging and disease progression. In this paper, we propose a patch-based tissue classification method from MR images that uses a sparse dictionary learning approach and atlas priors. Training data for the method consists of an atlas MR image, prior information maps depicting where different tissues are expected to be located, and a hard segmentation. Unlike most atlas-based classification methods that require deformable registration of the atlas priors to the subject, only affine registration is required between the subject and training atlas. A subject specific patch dictionary is created by learning relevant patches from the atlas. Then the subject patches are modeled as sparse combinations of learned atlas patches leading to tissue memberships at each voxel. The combination of prior information in an example-based framework enables us to distinguish tissues having similar intensities but different spatial locations. We demonstrate the efficacy of the approach on the application of whole brain tissue segmentation in subjects with healthy anatomy and normal pressure hydrocephalus, as well as lesion segmentation in multiple sclerosis patients. For each application, quantitative comparisons are made against publicly available, state-of-the art approaches. PMID:26340685

  19. A corpus-based lexical analysis of subject-specific university textbooks for English majors

    Directory of Open Access Journals (Sweden)

    Konul Hajiyeva

    2015-01-01

    Full Text Available This study is a corpus-based lexical analysis of subject-specific university textbooks which purports to explore lexical text coverage and frequency distribution of words from the Academic Word List and the British National Corpus frequency-based word families. For this study a 508,802-word corpus was created, the findings of which reflect that the Academic Word List word families constitute only a small coverage (6.5% of the words in the entire corpus, whereas the first two thousand high-frequency word families give the coverage of 88.92%. In terms of the text coverage, the results reveal that if 98% coverage of a text is needed for unassisted comprehension, then a vocabulary size of 9000 word families is required. The results also substantiate the claims that the Academic Word List is not as general an academic vocabulary as it was initially intended to be and, more importantly, supports the assumption that students need a more restricted core academic vocabulary. It is therefore argued that 127 academic word families which are relatively frequent in the overall university textbook corpus can be used as a part of the university word list for second-year English majors who have to read and comprehend university textbooks.

  20. Subject-specific body segment parameter estimation using 3D photogrammetry with multiple cameras

    Science.gov (United States)

    Morris, Mark; Sellers, William I.

    2015-01-01

    Inertial properties of body segments, such as mass, centre of mass or moments of inertia, are important parameters when studying movements of the human body. However, these quantities are not directly measurable. Current approaches include using regression models which have limited accuracy: geometric models with lengthy measuring procedures or acquiring and post-processing MRI scans of participants. We propose a geometric methodology based on 3D photogrammetry using multiple cameras to provide subject-specific body segment parameters while minimizing the interaction time with the participants. A low-cost body scanner was built using multiple cameras and 3D point cloud data generated using structure from motion photogrammetric reconstruction algorithms. The point cloud was manually separated into body segments, and convex hulling applied to each segment to produce the required geometric outlines. The accuracy of the method can be adjusted by choosing the number of subdivisions of the body segments. The body segment parameters of six participants (four male and two female) are presented using the proposed method. The multi-camera photogrammetric approach is expected to be particularly suited for studies including populations for which regression models are not available in literature and where other geometric techniques or MRI scanning are not applicable due to time or ethical constraints. PMID:25780778

  1. Subject-specific increases in serum S-100B distinguish sports-related concussion from sports-related exertion

    National Research Council Canada - National Science Library

    Kiechle, Karin; Bazarian, Jeffrey J; Merchant-Borna, Kian; Stoecklein, Veit; Rozen, Eric; Blyth, Brian; Huang, Jason H; Dayawansa, Samantha; Kanz, Karl; Biberthaler, Peter

    2014-01-01

    .... To compare subject-specific changes in the astroglial protein, S100B, before and after SRC among collegiate and semi-professional contact sport athletes, and compare these changes to differences...

  2. A Mixed Effects Randomized Item Response Model

    Science.gov (United States)

    Fox, J.-P.; Wyrick, Cheryl

    2008-01-01

    The randomized response technique ensures that individual item responses, denoted as true item responses, are randomized before observing them and so-called randomized item responses are observed. A relationship is specified between randomized item response data and true item response data. True item response data are modeled with a (non)linear…

  3. Bayesian Nonparametric Regression Analysis of Data with Random Effects Covariates from Longitudinal Measurements

    KAUST Repository

    Ryu, Duchwan

    2010-09-28

    We consider nonparametric regression analysis in a generalized linear model (GLM) framework for data with covariates that are the subject-specific random effects of longitudinal measurements. The usual assumption that the effects of the longitudinal covariate processes are linear in the GLM may be unrealistic and if this happens it can cast doubt on the inference of observed covariate effects. Allowing the regression functions to be unknown, we propose to apply Bayesian nonparametric methods including cubic smoothing splines or P-splines for the possible nonlinearity and use an additive model in this complex setting. To improve computational efficiency, we propose the use of data-augmentation schemes. The approach allows flexible covariance structures for the random effects and within-subject measurement errors of the longitudinal processes. The posterior model space is explored through a Markov chain Monte Carlo (MCMC) sampler. The proposed methods are illustrated and compared to other approaches, the "naive" approach and the regression calibration, via simulations and by an application that investigates the relationship between obesity in adulthood and childhood growth curves. © 2010, The International Biometric Society.

  4. PENGEMBANGAN SUBJECT SPECIFIC PEDAGOGY (SSP IPA TERPADU UNTUK MENINGKATKAN HASIL BELAJAR SISWA

    Directory of Open Access Journals (Sweden)

    Fitri Yuliawati

    2016-05-01

    Full Text Available Background of this research is the analysis of the results of interviews some junior secondary schools in Yogyakarta and the conclusion that teachers do not use an integrated science teaching and teachers still find difficulties in the application of learning science in an integrated manner. It can be influenced by several factors, such as the lack of reference used by teachers in presenting the material Integrated Science relevantly, most of science teachers are from educational background of chemistry, physics, and biology instead of science education, so that teachers find difficulties to create an integrated learning of science. In addition, teachers feel difficulty in determining the depth of the material, limits of integration in integrated science teaching, and did not know the concept of integrated science teaching. This research is a development research. Learning tools developed included : student books, lesson plans, student activity sheets and evaluation tools. The development of the learning which is done in this study use the models of 4D development which includes the step of Define (definition which at this stage conducted a needs analysis. Design : it is the stage of Subject Specific Pedagogy (SSP software design. Development, it is the stage of development after the draft was made followed by a learning device validation by experts. This stage is also conducted to seek input from all the responses, reactions and comments from teachers, students, and observers so that it can be used for further improvement of science teaching later. The Disseminate, it is the stage of field tests are widely but not done. Data collection instruments used in this study include : test items and questionnaire. The conclusion of this development research are as follows : the results of the validation SSP integrated science by learning tools expert, material experts and media experts indicate the category of Very Good (SB so that SSP integrated

  5. A subject-specific framework for in vivo myeloarchitectonic analysis using high resolution quantitative MRI.

    Science.gov (United States)

    Waehnert, Miriam D; Dinse, Juliane; Schäfer, Andreas; Geyer, Stefan; Bazin, Pierre-Louis; Turner, Robert; Tardif, Christine Lucas

    2016-01-15

    Structural magnetic resonance imaging can now resolve laminar features within the cerebral cortex in vivo. A variety of intracortical contrasts have been used to study the cortical myeloarchitecture with the purpose of mapping cortical areas in individual subjects. In this article, we first briefly review recent advances in MRI analysis of cortical microstructure to portray the potential and limitations of the current state-of-the-art. We then present an integrated framework for the analysis of intracortical structure, composed of novel image processing tools designed for high resolution cortical images. The main features of our framework are the segmentation of quantitative T1 maps to delineate the cortical boundaries (Bazin et al., 2014), and the use of an equivolume layering model to define an intracortical coordinate system that follows the anatomical layers of the cortex (Waehnert et al., 2014). We evaluate the framework with 150μm isotropic post mortem T2(∗)-weighted images and 0.5mm isotropic in vivo T1 maps, a quantitative index of myelin content. We study the laminar structure of the primary visual cortex (Brodmann area 17) in the post mortem and in vivo data, as well as the central sulcus region in vivo, in particular Brodmann areas 1, 3b and 4. We also investigate the impact of the layering models on the relationship between T1 and cortical curvature. Our experiments demonstrate that the equivolume intracortical surfaces and transcortical profiles best reflect the laminar structure of the cortex in areas of curvature in comparison to the state-of-the-art equidistant and Laplace implementations. This framework generates a subject specific intracortical coordinate system, the basis for subsequent architectonic analyses of the cortex. Any structural or functional contrast co-registered to the T1 maps, used to segment the cortex, can be sampled on the curved grid for analysis. This work represents an important step towards in vivo structural brain mapping

  6. Validation of subject-specific automated p-FE analysis of the proximal femur.

    Science.gov (United States)

    Trabelsi, Nir; Yosibash, Zohar; Milgrom, Charles

    2009-02-09

    The use of subject-specific finite element (FE) models in clinical practice requires a high level of automation and validation. In Yosibash et al. [2007a. Reliable simulations of the human proximal femur by high-order finite element analysis validated by experimental observations. J. Biomechanics 40, 3688-3699] a novel method for generating high-order finite element (p-FE) models from CT scans was presented and validated by experimental observations on two fresh frozen femurs (harvested from a 30 year old male and 21 year old female). Herein, we substantiate the validation process by enlarging the experimental database (54 year old female femur), improving the method and examine its robustness under different CT scan conditions. A fresh frozen femur of a 54 year old female was scanned under two different environments: in air and immersed in water (dry and wet CT). Thereafter, the proximal femur was quasi-statically loaded in vitro by a 1000N load. The two QCT scans were manipulated to generate p-FE models that mimic the experimental conditions. We compared p-FE displacements and strains of the wet CT model to the dry CT model and to the experimental results. In addition, the material assignment strategy was reinvestigated. The inhomogeneous Young's modulus was represented in the FE model using two different methods, directly extracted from the CT data and using continuous spatial functions as in Yosibash et al. [2007a. Reliable simulations of the human proximal femur by high-order finite element analysis validated by experimental observations. J. Biomechanics 40, 3688-3699]. Excellent agreement between dry and wet FE models was found for both displacements and strains, i.e. the method is insensitive to CT conditions and may be used in vivo. Good agreement was also found between FE results and experimental observations. The spatial functions representing Young's modulus are local and do not influence strains and displacements prediction. Finally, the p-FE results of

  7. Applying Randomness Effectively Based on Random Forests for Classification Task of Datasets of Insufficient Information

    Directory of Open Access Journals (Sweden)

    Hyontai Sug

    2012-01-01

    Full Text Available Random forests are known to be good for data mining of classification tasks, because random forests are robust for datasets having insufficient information possibly with some errors. But applying random forests blindly may not produce good results, and a dataset in the domain of rotogravure printing is one of such datasets. Hence, in this paper, some best classification accuracy based on clever application of random forests to predict the occurrence of cylinder bands in rotogravure printing is investigated. Since random forests could generate good results with an appropriate combination of parameters like the number of randomly selected attributes for each split and the number of trees in the forests, an effective data mining procedure considering the property of the target dataset by way of trial random forests is investigated. The effectiveness of the suggested procedure is shown by experiments with very good results.

  8. Economics of Scholarly Publishing: Exploring the Causes of Subscription Price Variations of Scholarly Journals in Business Subject-Specific Areas

    Science.gov (United States)

    Liu, Lewis G.

    2011-01-01

    This empirical research investigates subscription price variations of scholarly journals in five business subject-specific areas using the semilogarithmic regression model. It has two main purposes. The first is to address the unsettled debate over whether or not and to what extent commercial publishers reap monopoly profits by overcharging…

  9. Subject-specific tendon-aponeurosis definition in Hill-type model predicts higher muscle forces in dynamic tasks.

    Directory of Open Access Journals (Sweden)

    Pauline Gerus

    Full Text Available Neuromusculoskeletal models are a common method to estimate muscle forces. Developing accurate neuromusculoskeletal models is a challenging task due to the complexity of the system and large inter-subject variability. The estimation of muscles force is based on the mechanical properties of tendon-aponeurosis complex. Most neuromusculoskeletal models use a generic definition of the tendon-aponeurosis complex based on in vitro test, perhaps limiting their validity. Ultrasonography allows subject-specific estimates of the tendon-aponeurosis complex's mechanical properties. The aim of this study was to investigate the influence of subject-specific mechanical properties of the tendon-aponeurosis complex on a neuromusculoskeletal model of the ankle joint. Seven subjects performed isometric contractions from which the tendon-aponeurosis force-strain relationship was estimated. Hopping and running tasks were performed and muscle forces were estimated using subject-specific tendon-aponeurosis and generic tendon properties. Two ultrasound probes positioned over the muscle-tendon junction and the mid-belly were combined with motion capture to estimate the in vivo tendon and aponeurosis strain of the medial head of gastrocnemius muscle. The tendon-aponeurosis force-strain relationship was scaled for the other ankle muscles based on tendon and aponeurosis length of each muscle measured by ultrasonography. The EMG-driven model was calibrated twice - using the generic tendon definition and a subject-specific tendon-aponeurosis force-strain definition. The use of subject-specific tendon-aponeurosis definition leads to a higher muscle force estimate for the soleus muscle and the plantar-flexor group, and to a better model prediction of the ankle joint moment compared to the model estimate which used a generic definition. Furthermore, the subject-specific tendon-aponeurosis definition leads to a decoupling behaviour between the muscle fibre and muscle-tendon unit

  10. Utilization of PowerPoint Presentation Software in Library Instruction of Subject Specific Reference Sources.

    Science.gov (United States)

    Bushong, Sara

    This paper reports on a study conducted to determine if PowerPoint presentation is the most effective medium to explain two reference books: "The Storyteller's Sourcebook" and "A Guide to Folktales in the English Language." A secondary purpose was to see if the students who saw the PowerPoint presentation received higher…

  11. Quantitative evaluation of a subject-specific essay-writing intervention

    African Journals Online (AJOL)

    According to an attitude survey conducted at the conclusion of the intervention students were generally positive about the effect of the intervention on their academic writing abilities. They showed appreciation for all the 'signature' features of a genre-focused approach, and their responses seem to refute the criticism that ...

  12. An automated image-based method of 3D subject-specific body segment parameter estimation for kinetic analyses of rapid movements.

    Science.gov (United States)

    Sheets, Alison L; Corazza, Stefano; Andriacchi, Thomas P

    2010-01-01

    Accurate subject-specific body segment parameters (BSPs) are necessary to perform kinetic analyses of human movements with large accelerations, or no external contact forces or moments. A new automated topographical image-based method of estimating segment mass, center of mass (CM) position, and moments of inertia is presented. Body geometry and volume were measured using a laser scanner, then an automated pose and shape registration algorithm segmented the scanned body surface, and identified joint center (JC) positions. Assuming the constant segment densities of Dempster, thigh and shank masses, CM locations, and moments of inertia were estimated for four male subjects with body mass indexes (BMIs) of 19.7-38.2. The subject-specific BSP were compared with those determined using Dempster and Clauser regression equations. The influence of BSP and BMI differences on knee and hip net forces and moments during a running swing phase were quantified for the subjects with the smallest and largest BMIs. Subject-specific BSP for 15 body segments were quickly calculated using the image-based method, and total subject masses were overestimated by 1.7-2.9%.When compared with the Dempster and Clauser methods, image-based and regression estimated thigh BSP varied more than the shank parameters. Thigh masses and hip JC to thigh CM distances were consistently larger, and each transverse moment of inertia was smaller using the image-based method. Because the shank had larger linear and angular accelerations than the thigh during the running swing phase, shank BSP differences had a larger effect on calculated intersegmental forces and moments at the knee joint than thigh BSP differences did at the hip. It was the net knee kinetic differences caused by the shank BSP differences that were the largest contributors to the hip variations. Finally, BSP differences produced larger kinetic differences for the subject with larger segment masses, suggesting that parameter accuracy is more

  13. Effects of Mild Curvature on ANCOVA and Randomized Blocks.

    Science.gov (United States)

    Klockars, Alan J.; Potter, Nina Salcedo

    The type I error control and power of a number of analysis of covariance (ANCOVA) and randomized block (RB) designs with curvilinear data were studied for tests of the additive treatment effect and interaction. For tests of additive effects, the analysis was also conducted using systematic assignment to treatments and using random assignment with…

  14. Spatio-Temporal Regularization for Longitudinal Registration to Subject-Specific 3d Template

    OpenAIRE

    Guizard, Nicolas; Fonov, Vladimir S.; Garc?a-Lorenzo, Daniel; Nakamura, Kunio; Aubert-Broche, B?reng?re; Collins, D. Louis

    2015-01-01

    Neurodegenerative diseases such as Alzheimer's disease present subtle anatomical brain changes before the appearance of clinical symptoms. Manual structure segmentation is long and tedious and although automatic methods exist, they are often performed in a cross-sectional manner where each time-point is analyzed independently. With such analysis methods, bias, error and longitudinal noise may be introduced. Noise due to MR scanners and other physiological effects may also introduce variabilit...

  15. Spatio-Temporal Regularization for Longitudinal Registration to Subject-Specific 3d Template.

    Directory of Open Access Journals (Sweden)

    Nicolas Guizard

    Full Text Available Neurodegenerative diseases such as Alzheimer's disease present subtle anatomical brain changes before the appearance of clinical symptoms. Manual structure segmentation is long and tedious and although automatic methods exist, they are often performed in a cross-sectional manner where each time-point is analyzed independently. With such analysis methods, bias, error and longitudinal noise may be introduced. Noise due to MR scanners and other physiological effects may also introduce variability in the measurement. We propose to use 4D non-linear registration with spatio-temporal regularization to correct for potential longitudinal inconsistencies in the context of structure segmentation. The major contribution of this article is the use of individual template creation with spatio-temporal regularization of the deformation fields for each subject. We validate our method with different sets of real MRI data, compare it to available longitudinal methods such as FreeSurfer, SPM12, QUARC, TBM, and KNBSI, and demonstrate that spatially local temporal regularization yields more consistent rates of change of global structures resulting in better statistical power to detect significant changes over time and between populations.

  16. Spatio-Temporal Regularization for Longitudinal Registration to Subject-Specific 3d Template.

    Science.gov (United States)

    Guizard, Nicolas; Fonov, Vladimir S; García-Lorenzo, Daniel; Nakamura, Kunio; Aubert-Broche, Bérengère; Collins, D Louis

    2015-01-01

    Neurodegenerative diseases such as Alzheimer's disease present subtle anatomical brain changes before the appearance of clinical symptoms. Manual structure segmentation is long and tedious and although automatic methods exist, they are often performed in a cross-sectional manner where each time-point is analyzed independently. With such analysis methods, bias, error and longitudinal noise may be introduced. Noise due to MR scanners and other physiological effects may also introduce variability in the measurement. We propose to use 4D non-linear registration with spatio-temporal regularization to correct for potential longitudinal inconsistencies in the context of structure segmentation. The major contribution of this article is the use of individual template creation with spatio-temporal regularization of the deformation fields for each subject. We validate our method with different sets of real MRI data, compare it to available longitudinal methods such as FreeSurfer, SPM12, QUARC, TBM, and KNBSI, and demonstrate that spatially local temporal regularization yields more consistent rates of change of global structures resulting in better statistical power to detect significant changes over time and between populations.

  17. Subject Specific Optimisation of the Stiffness of Footwear Material for Maximum Plantar Pressure Reduction.

    Science.gov (United States)

    Chatzistergos, Panagiotis E; Naemi, Roozbeh; Healy, Aoife; Gerth, Peter; Chockalingam, Nachiappan

    2017-08-01

    Current selection of cushioning materials for therapeutic footwear and orthoses is based on empirical and anecdotal evidence. The aim of this investigation is to assess the biomechanical properties of carefully selected cushioning materials and to establish the basis for patient-specific material optimisation. For this purpose, bespoke cushioning materials with qualitatively similar mechanical behaviour but different stiffness were produced. Healthy volunteers were asked to stand and walk on materials with varying stiffness and their capacity for pressure reduction was assessed. Mechanical testing using a surrogate heel model was employed to investigate the effect of loading on optimum stiffness. Results indicated that optimising the stiffness of cushioning materials improved pressure reduction during standing and walking by at least 16 and 19% respectively. Moreover, the optimum stiffness was strongly correlated to body mass (BM) and body mass index (BMI), with stiffer materials needed in the case of people with higher BM or BMI. Mechanical testing confirmed that optimum stiffness increases with the magnitude of compressive loading. For the first time, this study provides quantitative data to support the importance of stiffness optimisation in cushioning materials and sets the basis for methods to inform optimum material selection in the clinic.

  18. The Analysis of Random Effects in Modeling Studies.

    Science.gov (United States)

    Scheirer, C. James; Geller, Sanford E.

    1979-01-01

    Argues that in research on the effects of modeling, models must be analyzed as a random factor in order to avoid a positive bias in the results. The concept of a random factor is discussed, worked examples are provided, and a practical solution to the problem is proposed. (JMB)

  19. Generic rules of mechano-regulation combined with subject specific loading conditions can explain bone adaptation after THA.

    Directory of Open Access Journals (Sweden)

    Tomasz D Szwedowski

    Full Text Available Bone adaptation after total hip arthroplasty is associated with the change in internal load environment, and can result in compromised bone stock, which presents a considerable challenge should a revision procedure be required. Under the assumption of a generic mechano-regulatory algorithm for governing bone adaptation, the aim of this study was to understand the contribution of subject specific loading conditions towards explaining the local periprosthetic remodelling variations in patients. CT scans of 3 consecutive THA patients were obtained and used for the construction of subject specific finite element models using verified musculoskeletal loading and physiological boundary conditions. Using either strain energy density or equivalent strain as mechano-transduction signals, predictions of bone adaptation were compared to DEXA derived BMD changes from 7 days to 12 months post-implantation. Individual changes in BMD of up to 33.6% were observed within the 12 month follow-up period, together with considerable inter-patient variability of up to 26%. Estimates of bone adaptation using equivalent strain and balanced loading conditions led to the best agreement with in vivo measured BMD, with RMS errors of only 3.9%, 7.3% and 7.3% for the individual subjects, compared to errors of over 10% when the loading conditions were simplified.This study provides evidence that subject specific loading conditions and physiological boundary constraints are essential for explaining inter-patient variations in bone adaptation patterns. This improved knowledge of the rules governing the adaptation of bone following THA helps towards understanding the interplay between mechanics and biology for better identifying patients at risk of excessive or problematic periprosthetic bone atrophy.

  20. Large-scale subject-specific cerebral arterial tree modeling using automated parametric mesh generation for blood flow simulation.

    Science.gov (United States)

    Ghaffari, Mahsa; Tangen, Kevin; Alaraj, Ali; Du, Xinjian; Charbel, Fady T; Linninger, Andreas A

    2017-12-01

    In this paper, we present a novel technique for automatic parametric mesh generation of subject-specific cerebral arterial trees. This technique generates high-quality and anatomically accurate computational meshes for fast blood flow simulations extending the scope of 3D vascular modeling to a large portion of cerebral arterial trees. For this purpose, a parametric meshing procedure was developed to automatically decompose the vascular skeleton, extract geometric features and generate hexahedral meshes using a body-fitted coordinate system that optimally follows the vascular network topology. To validate the anatomical accuracy of the reconstructed vasculature, we performed statistical analysis to quantify the alignment between parametric meshes and raw vascular images using receiver operating characteristic curve. Geometric accuracy evaluation showed an agreement with area under the curves value of 0.87 between the constructed mesh and raw MRA data sets. Parametric meshing yielded on-average, 36.6% and 21.7% orthogonal and equiangular skew quality improvement over the unstructured tetrahedral meshes. The parametric meshing and processing pipeline constitutes an automated technique to reconstruct and simulate blood flow throughout a large portion of the cerebral arterial tree down to the level of pial vessels. This study is the first step towards fast large-scale subject-specific hemodynamic analysis for clinical applications. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. The Accuracy of 3D Optical Reconstruction and Additive Manufacturing Processes in Reproducing Detailed Subject-Specific Anatomy

    Directory of Open Access Journals (Sweden)

    Paolo Ferraiuoli

    2017-10-01

    Full Text Available 3D reconstruction and 3D printing of subject-specific anatomy is a promising technology for supporting clinicians in the visualisation of disease progression and planning for surgical intervention. In this context, the 3D model is typically obtained from segmentation of magnetic resonance imaging (MRI, computed tomography (CT or echocardiography images. Although these modalities allow imaging of the tissues in vivo, assessment of quality of the reconstruction is limited by the lack of a reference geometry as the subject-specific anatomy is unknown prior to image acquisition. In this work, an optical method based on 3D digital image correlation (3D-DIC techniques is used to reconstruct the shape of the surface of an ex vivo porcine heart. This technique requires two digital charge-coupled device (CCD cameras to provide full-field shape measurements and to generate a standard tessellation language (STL file of the sample surface. The aim of this work was to quantify the error of 3D-DIC shape measurements using the additive manufacturing process. The limitations of 3D printed object resolution, the discrepancy in reconstruction of the surface of cardiac soft tissue and a 3D printed model of the same surface were evaluated. The results obtained demonstrated the ability of the 3D-DIC technique to reconstruct localised and detailed features on the cardiac surface with sub-millimeter accuracy.

  2. Effects of random fields in an antiferromagnetic Ising bilayer film

    Science.gov (United States)

    Kaneyoshi, T.

    2017-10-01

    The magnetic properties (phase diagrams and magnetizations) of an antiferromagnetic Ising bilayer film with random fields are investigated by the use of the effective field theory with correlations. It is examined how an uncompensated magnetization can be realized in the system, due to the effects of random fields in the two layers. They show the tricritical, compensation point and reentrant phenomena, depending on these parameters.

  3. Effective trapping of random walkers in complex networks.

    Science.gov (United States)

    Hwang, S; Lee, D-S; Kahng, B

    2012-04-01

    Exploring the World Wide Web has become one of the key issues in information science, specifically in view of its application to the PageRank-like algorithms used in search engines. The random walk approach has been employed to study such a problem. The probability of return to the origin (RTO) of random walks is inversely related to how information can be accessed during random surfing. We find analytically that the RTO probability for a given starting node shows a crossover from a slow to a fast decay behavior with time and the crossover time increases with the degree of the starting node. We remark that the RTO probability becomes almost constant in the early-time regime as the degree exponent approaches two. This result indicates that a random surfer can be effectively trapped at the hub and supports the necessity of the random jump strategy empirically used in the Google's search engine.

  4. Using hierarchical linear models to test differences in Swedish results from OECD’s PISA 2003: Integrated and subject-specific science education

    Directory of Open Access Journals (Sweden)

    Maria Åström

    2012-06-01

    Full Text Available The possible effects of different organisations of the science curriculum in schools participating in PISA 2003 are tested with a hierarchical linear model (HLM of two levels. The analysis is based on science results. Swedish schools are free to choose how they organise the science curriculum. They may choose to work subject-specifically (with Biology, Chemistry and Physics, integrated (with Science or to mix these two. In this study, all three ways of organising science classes in compulsory school are present to some degree. None of the different ways of organising science education displayed statistically significant better student results in scientific literacy as measured in PISA 2003. The HLM model used variables of gender, country of birth, home language, preschool attendance, an economic, social and cultural index as well as the teaching organisation.

  5. Development and validation of a subject-specific finite element model of the functional spinal unit to predict vertebral strength.

    Science.gov (United States)

    Lee, Chu-Hee; Landham, Priyan R; Eastell, Richard; Adams, Michael A; Dolan, Patricia; Yang, Lang

    2017-09-01

    Finite element models of an isolated vertebral body cannot accurately predict compressive strength of the spinal column because, in life, compressive load is variably distributed across the vertebral body and neural arch. The purpose of this study was to develop and validate a patient-specific finite element model of a functional spinal unit, and then use the model to predict vertebral strength from medical images. A total of 16 cadaveric functional spinal units were scanned and then tested mechanically in bending and compression to generate a vertebral wedge fracture. Before testing, an image processing and finite element analysis framework (SpineVox-Pro), developed previously in MATLAB using ANSYS APDL, was used to generate a subject-specific finite element model with eight-node hexahedral elements. Transversely isotropic linear-elastic material properties were assigned to vertebrae, and simple homogeneous linear-elastic properties were assigned to the intervertebral disc. Forward bending loading conditions were applied to simulate manual handling. Results showed that vertebral strengths measured by experiment were positively correlated with strengths predicted by the functional spinal unit finite element model with von Mises or Drucker-Prager failure criteria ( R 2  = 0.80-0.87), with areal bone mineral density measured by dual-energy X-ray absorptiometry ( R 2  = 0.54) and with volumetric bone mineral density from quantitative computed tomography ( R 2  = 0.79). Large-displacement non-linear analyses on all specimens did not improve predictions. We conclude that subject-specific finite element models of a functional spinal unit have potential to estimate the vertebral strength better than bone mineral density alone.

  6. Subject-specific modulation of local field potential spectral power during brain-machine interface control in primates

    Science.gov (United States)

    So, Kelvin; Dangi, Siddharth; Orsborn, Amy L.; Gastpar, Michael C.; Carmena, Jose M.

    2014-04-01

    Objective. Intracortical brain-machine interfaces (BMIs) have predominantly utilized spike activity as the control signal. However, an increasing number of studies have shown the utility of local field potentials (LFPs) for decoding motor related signals. Currently, it is unclear how well different LFP frequencies can serve as features for continuous, closed-loop BMI control. Approach. We demonstrate 2D continuous LFP-based BMI control using closed-loop decoder adaptation, which adapts decoder parameters to subject-specific LFP feature modulations during BMI control. We trained two macaque monkeys to control a 2D cursor in a center-out task by modulating LFP power in the 0-150 Hz range. Main results. While both monkeys attained control, they used different strategies involving different frequency bands. One monkey primarily utilized the low-frequency spectrum (0-80 Hz), which was highly correlated between channels, and obtained proficient performance even with a single channel. In contrast, the other monkey relied more on higher frequencies (80-150 Hz), which were less correlated between channels, and had greater difficulty with control as the number of channels decreased. We then restricted the monkeys to use only various sub-ranges (0-40, 40-80, and 80-150 Hz) of the 0-150 Hz band. Interestingly, although both monkeys performed better with some sub-ranges than others, they were able to achieve BMI control with all sub-ranges after decoder adaptation, demonstrating broad flexibility in the frequencies that could potentially be used for LFP-based BMI control. Significance. Overall, our results demonstrate proficient, continuous BMI control using LFPs and provide insight into the subject-specific spectral patterns of LFP activity modulated during control.

  7. Implementing nursing diagnostics effectively: cluster randomized trial.

    NARCIS (Netherlands)

    Müller-Staub, M.; Needham, I.; Odenbreit, M.; Lavin, M.A.; Achterberg, T. van

    2008-01-01

    AIM: This paper is a report of a study to investigate the effect of guided clinical reasoning. This method was chosen as a follow-up educational measure (refresher) after initial implementation of standardized language. BACKGROUND: Research has demonstrated nurses' need for education in diagnostic

  8. Subject-specific finite element modeling of the tibiofemoral joint based on CT, magnetic resonance imaging and dynamic stereo-radiography data in vivo.

    Science.gov (United States)

    Carey, Robert E; Zheng, Liying; Aiyangar, Ameet K; Harner, Christopher D; Zhang, Xudong

    2014-04-01

    In this paper, we present a new methodology for subject-specific finite element modeling of the tibiofemoral joint based on in vivo computed tomography (CT), magnetic resonance imaging (MRI), and dynamic stereo-radiography (DSX) data. We implemented and compared two techniques to incorporate in vivo skeletal kinematics as boundary conditions: one used MRI-measured tibiofemoral kinematics in a nonweight-bearing supine position and allowed five degrees of freedom (excluding flexion-extension) at the joint in response to an axially applied force; the other used DSX-measured tibiofemoral kinematics in a weight-bearing standing position and permitted only axial translation in response to the same force. Verification and comparison of the model predictions employed data from a meniscus transplantation study subject with a meniscectomized and an intact knee. The model-predicted cartilage-cartilage contact areas were examined against "benchmarks" from a novel in situ contact area analysis (ISCAA) in which the intersection volume between nondeformed femoral and tibial cartilage was characterized to determine the contact. The results showed that the DSX-based model predicted contact areas in close alignment with the benchmarks, and outperformed the MRI-based model: the contact centroid predicted by the former was on average 85% closer to the benchmark location. The DSX-based FE model predictions also indicated that the (lateral) meniscectomy increased the contact area in the lateral compartment and increased the maximum contact pressure and maximum compressive stress in both compartments. We discuss the importance of accurate, task-specific skeletal kinematics in subject-specific FE modeling, along with the effects of simplifying assumptions and limitations.

  9. Random Effects Structure for Confirmatory Hypothesis Testing: Keep It Maximal

    Science.gov (United States)

    Barr, Dale J.; Levy, Roger; Scheepers, Christoph; Tily, Harry J.

    2013-01-01

    Linear mixed-effects models (LMEMs) have become increasingly prominent in psycholinguistics and related areas. However, many researchers do not seem to appreciate how random effects structures affect the generalizability of an analysis. Here, we argue that researchers using LMEMs for confirmatory hypothesis testing should minimally adhere to the…

  10. The blocked-random effect in pictures and words.

    Science.gov (United States)

    Toglia, M P; Hinman, P J; Dayton, B S; Catalano, J F

    1997-06-01

    Picture and word recall was examined in conjunction with list organization. 60 subjects studied a list of 30 items, either words or their pictorial equivalents. The 30 words/pictures, members of five conceptual categories, each represented by six exemplars, were presented either blocked by category or in a random order. While pictures were recalled better than words and a standard blocked-random effect was observed, the interaction indicated that the recall advantage of a blocked presentation was restricted to the word lists. A similar pattern emerged for clustering. These findings are discussed in terms of limitations upon the pictorial superiority effect.

  11. Pengembangan Subject Specific Pedagogy (SSP Tematik Berbasis Local Wisdom Untuk Membangun Karakter Hormat dan Kepedulian Siswa SD

    Directory of Open Access Journals (Sweden)

    Amaliyah Ulfah

    2018-01-01

    Full Text Available This study aims at generating possible thematic Subject Specific Pedagogy (SSP based on local wisdom and examining the results teachers and students perception on the pedagogical approach developed in the preliminary field testing. Drawing upon the notion of research and development by Borg & Gall, this research was conducted through different stages involving information gathering, planning, developing preliminary product, preliminary field testing, and revising. The subjects were a small group of second grade students of SD Muhammadiyah Bodon and SD Muhammadiyah Sidoarum Yogyakarta. Each consists of 10 students. The data gathering instrument consists of product validation, character observation sheets, and teacher assessment sheets. The data gathering instrument consists of product validation tool, character observation sheets, and teachers’ assessment sheets. The SSP product generated in this study consists of lesson plans, teaching materials, worksheets, and expert perception. According to the experts of media, materials, and evaluation, the SSP product is in good categories. First grade teachers result a good score to the syllabus and lesson plans, while the worksheets and evaluation are in very good category. The results from the students responses to the textbooks is 78, which is in very good category, while the students worksheets score 71 which includes in excellent category. Therefore, the developed thematic SSP based on local wisdom can be declared appropriate for use in learning.

  12. Three-dimensional analysis of talar trochlea morphology: Implications for subject-specific kinematics of the talocrural joint.

    Science.gov (United States)

    Nozaki, Shuhei; Watanabe, Kota; Katayose, Masaki

    2016-11-01

    Three-dimensional (3D) behavior of the talocrural joint is primarily determined by the articular surface morphology of the talar trochlea and tibiofibular mortise. However, morphological features of the anterior and posterior regions of the talar trochlea remain unclear. The objectives of this study were to evaluate anterior and posterior radii of the medial and lateral talar trochlea and to estimate subject-specific kinematics of the talocrural joint. Fifty dry tali were scanned using computed tomography to create 3D bone models. Radii of curvature of the anterior and posterior region at both the medial and lateral trochlea were calculated. Orientations of the dorsiflexion and plantarflexion axis passing through the centers of the circles fitted to the anterior region of the medial and lateral trochlea and through the centers of the circles fitted to the posterior region of the medial and lateral trochlea were evaluated, respectively. The anterior radius of the medial trochlea was significantly smaller than that of the lateral trochlea by a mean of 7.8 mm (P dorsiflexion, whereas bilateral asymmetric shape of posterior trochlea would induce opposite axial rotations among subjects during ankle plantarflexion, which would help the physical therapists to restore talocrural joint motions to ideal state for patients with ankle injuries. Clin. Anat. 29:1066-1074, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Can learning by qualitative modelling be deployed as an effective method for learning subject-specific content?

    NARCIS (Netherlands)

    Schlatter, E.; Bredeweg, B.; Drie, J.P. van; Jong, P.F. de

    2017-01-01

    Modelling can help understanding dynamic systems, but learning how to model is a difficult and time-consuming task. The challenge is to foster modelling skills, while not limiting the learning of regular subject matter, or better, to also improve this learning. We investigate how learning by

  14. An effective Hamiltonian approach to quantum random walk

    Indian Academy of Sciences (India)

    In this article we present an effective Hamiltonian approach for discrete time quantum random walk. A form of the Hamiltonian ... TARUN KANTI GHOSH2. Inter-University Centre for Astronomy and Astrophysics, Ganeshkhind, Pune 411 007, India; Department of Physics, Indian Institute of Technology, Kanpur 208 016, India ...

  15. Randomized Trial on the Effectiveness of Dexamethasone in TMJ Arthrocentesis

    NARCIS (Netherlands)

    Huddleston-Slater, J.J.R.; Vos, L.M.; Stroy, L.P.P.; Stegenga, B.

    The aim of this study was to compare the effectiveness of dexamethasone administration following arthrocentesis of the temporomandibular joint (TMJ) with a placebo (saline). Twenty-eight participants with TMJ arthralgia were randomly assigned to two groups of a parallel double-blind RCT. In both

  16. Application of Random-Effects Probit Regression Models.

    Science.gov (United States)

    Gibbons, Robert D.; Hedeker, Donald

    1994-01-01

    Develops random-effects probit model for case in which outcome of interest is series of correlated binary responses, obtained as product of longitudinal response process where individual is repeatedly classified on binary outcome variable or in multilevel or clustered problems in which individuals within groups are considered to share…

  17. A Randomized Controlled Trial Study on the Effect of Adding ...

    African Journals Online (AJOL)

    A Randomized Controlled Trial Study on the Effect of Adding Dexmedetomidine to Bupivacaine in Supraclavicular Block Using Ultrasound Guidance. ... BACKGROUND: The benefits of regional anesthetic techniques are well established. Use of additives to local anesthetics can prolong these benefits. The aim of this study ...

  18. Computer-Assisted Dieting: Effects of a Randomized Nutrition Intervention

    Science.gov (United States)

    Schroder, Kerstin E. E.

    2011-01-01

    Objectives: To compare the effects of a computer-assisted dieting intervention (CAD) with and without self-management training on dieting among 55 overweight and obese adults. Methods: Random assignment to a single-session nutrition intervention (CAD-only) or a combined CAD plus self-management group intervention (CADG). Dependent variables were…

  19. Regressor and random-effects dependencies in multilevel models

    NARCIS (Netherlands)

    Ebbes, P.; Bockenholt, U; Wedel, M.

    The objectives of this paper are (1) to review methods that can be used to test for different types of random effects and regressor dependencies, (2) to present results from Monte Carlo studies designed to investigate the performance of these methods, and (3) to discuss estimation methods that can

  20. Performance of Random Effects Model Estimators under Complex Sampling Designs

    Science.gov (United States)

    Jia, Yue; Stokes, Lynne; Harris, Ian; Wang, Yan

    2011-01-01

    In this article, we consider estimation of parameters of random effects models from samples collected via complex multistage designs. Incorporation of sampling weights is one way to reduce estimation bias due to unequal probabilities of selection. Several weighting methods have been proposed in the literature for estimating the parameters of…

  1. Application of Poisson random effect models for highway network screening.

    Science.gov (United States)

    Jiang, Ximiao; Abdel-Aty, Mohamed; Alamili, Samer

    2014-02-01

    In recent years, Bayesian random effect models that account for the temporal and spatial correlations of crash data became popular in traffic safety research. This study employs random effect Poisson Log-Normal models for crash risk hotspot identification. Both the temporal and spatial correlations of crash data were considered. Potential for Safety Improvement (PSI) were adopted as a measure of the crash risk. Using the fatal and injury crashes that occurred on urban 4-lane divided arterials from 2006 to 2009 in the Central Florida area, the random effect approaches were compared to the traditional Empirical Bayesian (EB) method and the conventional Bayesian Poisson Log-Normal model. A series of method examination tests were conducted to evaluate the performance of different approaches. These tests include the previously developed site consistence test, method consistence test, total rank difference test, and the modified total score test, as well as the newly proposed total safety performance measure difference test. Results show that the Bayesian Poisson model accounting for both temporal and spatial random effects (PTSRE) outperforms the model that with only temporal random effect, and both are superior to the conventional Poisson Log-Normal model (PLN) and the EB model in the fitting of crash data. Additionally, the method evaluation tests indicate that the PTSRE model is significantly superior to the PLN model and the EB model in consistently identifying hotspots during successive time periods. The results suggest that the PTSRE model is a superior alternative for road site crash risk hotspot identification. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Effective cutoffs for detecting random, partially random, and nonrandom 350-item MMPI--a short form protocols.

    Science.gov (United States)

    Pinsoneault, Terry B

    2014-06-01

    The ability of the 350-item short form Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) validity scales to detect random protocols was investigated using samples of 250 nonrandom protocols, 250 half-random protocols, and 250 all-random protocols. As the manual warns, long form cutoffs of the Variable Response Inconsistency scale (VRIN) of 75T and the Infrequency scale (F) of 90T were ineffective in detecting random protocols. Alternative cutoffs for F₁ and the truncated VRIN and F scales were investigated. Short form subscales of VRIN and F were developed to improve detection of partially random protocols. An algorithm using alternative cutoffs for the scales and the new subscales was quite effective, detecting 95% of the all-random protocols, 87% of the half-random protocols, and 98% of the nonrandom protocols. A follow-up cross-validation study was conducted that confirmed the effectiveness of the algorithm.

  3. Chiral random matrix theory and effective theories of QCD

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, K.; Iida, S

    2000-05-08

    The correlations of the QCD Dirac eigenvalues are studied with use of an extended chiral random matrix model. The inclusion of spatial dependence which the original model lacks enables us to investigate the effects of diffusion modes. We get analytical expressions of level correlation functions with non-universal behavior caused by diffusion modes which is characterized by Thouless energy. Pion mode is shown to be responsible for these diffusion effects when QCD vacuum is considered a disordered medium.

  4. Subject-specific 2D/3D image registration and kinematics-driven musculoskeletal model of the spine.

    Science.gov (United States)

    Eskandari, A H; Arjmand, N; Shirazi-Adl, A; Farahmand, F

    2017-05-24

    An essential input to the musculoskeletal (MS) trunk models that estimate muscle and spine forces is kinematics of the thorax, pelvis, and lumbar vertebrae. While thorax and pelvis kinematics are usually measured via skin motion capture devices (with inherent errors on the proper identification of the underlying bony landmarks and the relative skin-sensor-bone movements), those of the intervening lumbar vertebrae are commonly approximated at fixed proportions based on the thorax-pelvis kinematics. This study proposes an image-based kinematics measurement approach to drive subject-specific (musculature, geometry, mass, and center of masses) MS models. Kinematics of the thorax, pelvis, and individual lumbar vertebrae as well as disc inclinations, gravity loading, and musculature were all measured via different imaging techniques. The model estimated muscle and lumbar forces in various upright and flexed postures in which kinematics were obtained using upright fluoroscopy via 2D/3D image registration. Predictions of this novel image-kinematics-driven model (Img-KD) were compared with those of the traditional kinematics-driven (T-KD) model in which individual lumbar vertebral rotations were assumed based on thorax-pelvis orientations. Results indicated that while differences between Img-KD and T-KD models remained small for the force in the global muscles (attached to the thoracic cage) (muscles (attached to the lumbar vertebrae). Assuming that the skin-based measurements of thorax and pelvis kinematics are accurate enough, the T-KD model predictions of spinal forces remain reliable. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Prediction of the structural response of the femoral shaft under dynamic loading using subject-specific finite element models.

    Science.gov (United States)

    Park, Gwansik; Kim, Taewung; Forman, Jason; Panzer, Matthew B; Crandall, Jeff R

    2017-08-01

    The goal of this study was to predict the structural response of the femoral shaft under dynamic loading conditions using subject-specific finite element (SS-FE) models and to evaluate the prediction accuracy of the models in relation to the model complexity. In total, SS-FE models of 31 femur specimens were developed. Using those models, dynamic three-point bending and combined loading tests (bending with four different levels of axial compression) of bare femurs were simulated, and the prediction capabilities of five different levels of model complexity were evaluated based on the impact force time histories: baseline, mass-based scaled, structure-based scaled, geometric SS-FE, and heterogenized SS-FE models. Among the five levels of model complexity, the geometric SS-FE and the heterogenized SS-FE models showed statistically significant improvement on response prediction capability compared to the other model formulations whereas the difference between two SS-FE models was negligible. This result indicated the geometric SS-FE models, containing detailed geometric information from CT images with homogeneous linear isotropic elastic material properties, would be an optimal model complexity for prediction of structural response of the femoral shafts under the dynamic loading conditions. The average and the standard deviation of the RMS errors of the geometric SS-FE models for all the 31 cases was 0.46 kN and 0.66 kN, respectively. This study highlights the contribution of geometric variability on the structural response variation of the femoral shafts subjected to dynamic loading condition and the potential of geometric SS-FE models to capture the structural response variation of the femoral shafts.

  6. Subject-specific bone attenuation correction for brain PET/MR: can ZTE-MRI substitute CT scan accurately?

    Science.gov (United States)

    Khalifé, Maya; Fernandez, Brice; Jaubert, Olivier; Soussan, Michael; Brulon, Vincent; Buvat, Irène; Comtat, Claude

    2017-10-01

    In brain PET/MR applications, accurate attenuation maps are required for accurate PET image quantification. An implemented attenuation correction (AC) method for brain imaging is the single-atlas approach that estimates an AC map from an averaged CT template. As an alternative, we propose to use a zero echo time (ZTE) pulse sequence to segment bone, air and soft tissue. A linear relationship between histogram normalized ZTE intensity and measured CT density in Hounsfield units (HU ) in bone has been established thanks to a CT-MR database of 16 patients. Continuous AC maps were computed based on the segmented ZTE by setting a fixed linear attenuation coefficient (LAC) to air and soft tissue and by using the linear relationship to generate continuous μ values for the bone. Additionally, for the purpose of comparison, four other AC maps were generated: a ZTE derived AC map with a fixed LAC for the bone, an AC map based on the single-atlas approach as provided by the PET/MR manufacturer, a soft-tissue only AC map and, finally, the CT derived attenuation map used as the gold standard (CTAC). All these AC maps were used with different levels of smoothing for PET image reconstruction with and without time-of-flight (TOF). The subject-specific AC map generated by combining ZTE-based segmentation and linear scaling of the normalized ZTE signal into HU was found to be a good substitute for the measured CTAC map in brain PET/MR when used with a Gaussian smoothing kernel of 4~mm corresponding to the PET scanner intrinsic resolution. As expected TOF reduces AC error regardless of the AC method. The continuous ZTE-AC performed better than the other alternative MR derived AC methods, reducing the quantification error between the MRAC corrected PET image and the reference CTAC corrected PET image.

  7. Effective diffusion equation in a random velocity field

    Science.gov (United States)

    Vinals, Jorge; Sekerka, Robert F.

    1992-01-01

    The effects are studied of assumed random velocity fields on diffusion in a binary fluid. Random velocity fields can result, for example, from the high-frequency components of residual accelerations onboard spacecraft (often called g-jitter). An effective diffusion equation is derived for an average concentration which includes spatial and temporal correlations induced by the fluctuating velocity fields assumed to be Gaussianly distributed. The resulting equation becomes nonlocal, and if correlations between different components of the velocity field exist, it is also anisotropic. The simple limiting case of short correlation times is discussed and an effective diffusivity is obtained which reflects the enhanced mixing caused by the velocity fields. The results obtained in the limit of short correlation times are valid even if the probability distribution of the velocity field is not Gaussian.

  8. Subject-specific increases in serum S-100B distinguish sports-related concussion from sports-related exertion.

    Directory of Open Access Journals (Sweden)

    Karin Kiechle

    Full Text Available The on-field diagnosis of sports-related concussion (SRC is complicated by the lack of an accurate and objective marker of brain injury.To compare subject-specific changes in the astroglial protein, S100B, before and after SRC among collegiate and semi-professional contact sport athletes, and compare these changes to differences in S100B before and after non-contact exertion.Longitudinal cohort study.From 2009-2011, we performed a prospective study of athletes from Munich, Germany, and Rochester, New York, USA. Serum S100B was measured in all SRC athletes at pre-season baseline, within 3 hours of injury, and at days 2, 3 and 7 post-SRC. Among a subset of athletes, S100B was measured after non-contact exertion but before injury. All samples were collected identically and analyzed using an automated electrochemiluminescent assay to quantify serum S100B levels.Forty-six athletes (30 Munich, 16 Rochester underwent baseline testing. Thirty underwent additional post-exertion S100B testing. Twenty-two athletes (16 Rochester, 6 Munich sustained a SRC, and 17 had S100B testing within 3 hours post-injury. The mean 3-hour post-SRC S100B was significantly higher than pre-season baseline (0.099±0.008 µg/L vs. 0.058±0.006 µg/L, p = 0.0002. Mean post-exertion S100B was not significantly different than the preseason baseline. S100B levels at post-injury days 2, 3 and 7 were significantly lower than the 3-hour level, and not different than baseline. Both the absolute change and proportional increase in S100B 3-hour post-injury were accurate discriminators of SRC from non-contact exertion without SRC (AUC 0.772 and 0.904, respectively. A 3-hour post-concussion S100B >0.122 µg/L and a proportional S100B increase of >45.9% over baseline were both 96.7% specific for SRC.Relative and absolute increases in serum S100B can accurately distinguish SRC from sports-related exertion, and may be a useful adjunct to the diagnosis of SRC.

  9. Effects of Check and Connect on Attendance, Behavior, and Academics: A Randomized Effectiveness Trial

    Science.gov (United States)

    Maynard, Brandy R.; Kjellstrand, Elizabeth K.; Thompson, Aaron M.

    2014-01-01

    Objectives: This study examined the effects of Check & Connect (C&C) on the attendance, behavior, and academic outcomes of at-risk youth in a field-based effectiveness trial. Method: A multisite randomized block design was used, wherein 260 primarily Hispanic (89%) and economically disadvantaged (74%) students were randomized to treatment…

  10. Hemodynamic performance of coil embolization and stentassisted coil embolization treatments: a numerical comparative study based on subject-specific models of cerebral aneurysms

    Science.gov (United States)

    Wang, Shengzhang; Zhang, Yisen; Lu, Gang; Yang, Xinjian; Zhang, Xiaolong; Ding, Guanghong

    2011-11-01

    Hemodynamic characteristics such as blood velocity, blood pressure, flow impingement, wall shear stress and oscillatory shear index are considered to play important roles in the initiation, growth, rupture and recurrence of the cerebral aneurysms. Endovascular therapy is widely implemented to treat the cerebral aneurysms by releasing coils into the aneurysm sac for limiting the blood flow to the sac and stent-assisted coil embolization is adopted to occlude the wide-necked or complex aneurysms. Some researchers believe that stents are not only a mechanical device but may act as a biological system and contribute to vessel wall healing. Hemodynamics simulation helps people understand the effect of hemodynamic characteristics on the recurrence of the coiled aneurysm and it also benefits the interventional planning of neurosurgeons. This study constructed the numerical model for a subject-specific ICA aneurysm treated with stent-assisted coil embolization, which combined the coiled model of the aneurysm with a porous stent placement, and simulated the pulsatile blood flow in these aneurysm models. When a stent was placed across the aneurysm orifice in the coiled aneurysm, the high wall shear stress around the distal aneurysm root was reduced more than that of the coiled aneurysm without a stent. The simulated results point to the conclusion that the stent not only protects the parent artery from occlusion due to extension of coils or thrombosis, but may also reduce the recurrence risk of the stent-assisted coiled aneurysm.

  11. Subject-specific finite element modelling of the human foot complex during walking: sensitivity analysis of material properties, boundary and loading conditions.

    Science.gov (United States)

    Akrami, Mohammad; Qian, Zhihui; Zou, Zhemin; Howard, David; Nester, Chris J; Ren, Lei

    2017-11-14

    The objective of this study was to develop and validate a subject-specific framework for modelling the human foot. This was achieved by integrating medical image-based finite element modelling, individualised multi-body musculoskeletal modelling and 3D gait measurements. A 3D ankle-foot finite element model comprising all major foot structures was constructed based on MRI of one individual. A multi-body musculoskeletal model and 3D gait measurements for the same subject were used to define loading and boundary conditions. Sensitivity analyses were used to investigate the effects of key modelling parameters on model predictions. Prediction errors of average and peak plantar pressures were below 10% in all ten plantar regions at five key gait events with only one exception (lateral heel, in early stance, error of 14.44%). The sensitivity analyses results suggest that predictions of peak plantar pressures are moderately sensitive to material properties, ground reaction forces and muscle forces, and significantly sensitive to foot orientation. The maximum region-specific percentage change ratios (peak stress percentage change over parameter percentage change) were 1.935-2.258 for ground reaction forces, 1.528-2.727 for plantar flexor muscles and 4.84-11.37 for foot orientations. This strongly suggests that loading and boundary conditions need to be very carefully defined based on personalised measurement data.

  12. [Randomized controlled trials terminated prematurely: beneficial therapy effects].

    Science.gov (United States)

    Kluth, L A; Rink, M; Ahyai, S A; Fisch, M; Shariat, S F; Dahm, P

    2013-08-01

    Randomized controlled trials (RCTs) stopped prematurely for beneficial therapy effects are becoming increasingly more prevalent in the urological literature and often receive great attention in the public and medical media. Urologists who practice evidence-based medicine should be aware of the potential bias and the different reasons why and how early termination of RCTs can and will affect the results. This review provides insights into the challenges clinical urologists face by interpreting the results of prematurely terminated RCTs.

  13. Effects of random noise in a dynamical model of love

    Energy Technology Data Exchange (ETDEWEB)

    Xu Yong, E-mail: hsux3@nwpu.edu.cn [Department of Applied Mathematics, Northwestern Polytechnical University, Xi' an 710072 (China); Gu Rencai; Zhang Huiqing [Department of Applied Mathematics, Northwestern Polytechnical University, Xi' an 710072 (China)

    2011-07-15

    Highlights: > We model the complexity and unpredictability of psychology as Gaussian white noise. > The stochastic system of love is considered including bifurcation and chaos. > We show that noise can both suppress and induce chaos in dynamical models of love. - Abstract: This paper aims to investigate the stochastic model of love and the effects of random noise. We first revisit the deterministic model of love and some basic properties are presented such as: symmetry, dissipation, fixed points (equilibrium), chaotic behaviors and chaotic attractors. Then we construct a stochastic love-triangle model with parametric random excitation due to the complexity and unpredictability of the psychological system, where the randomness is modeled as the standard Gaussian noise. Stochastic dynamics under different three cases of 'Romeo's romantic style', are examined and two kinds of bifurcations versus the noise intensity parameter are observed by the criteria of changes of top Lyapunov exponent and shape of stationary probability density function (PDF) respectively. The phase portraits and time history are carried out to verify the proposed results, and the good agreement can be found. And also the dual roles of the random noise, namely suppressing and inducing chaos are revealed.

  14. Estimating overall exposure effects for the clustered and censored outcome using random effect Tobit regression models

    Science.gov (United States)

    Wang, Wei; Griswold, Michael E.

    2016-01-01

    The random effect Tobit model is a regression model that accommodates both left- and/or right-censoring and within-cluster dependence of the outcome variable. Regression coefficients of random effect Tobit models have conditional interpretations on a constructed latent dependent variable and do not provide inference of overall exposure effects on the original outcome scale. Marginalized random effects model (MREM) permits likelihood-based estimation of marginal mean parameters for the clustered data. For random effect Tobit models, we extend the MREM to marginalize over both the random effects and the normal space and boundary components of the censored response to estimate overall exposure effects at population level. We also extend the ‘Average Predicted Value’ method to estimate the model-predicted marginal means for each person under different exposure status in a designated reference group by integrating over the random effects and then use the calculated difference to assess the overall exposure effect. The maximum likelihood estimation is proposed utilizing a quasi-Newton optimization algorithm with Gauss-Hermite quadrature to approximate the integration of the random effects. We use these methods to carefully analyze two real datasets. PMID:27449636

  15. Incorporation of CT-based measurements of trunk anatomy into subject-specific musculoskeletal models of the spine influences vertebral loading predictions.

    Science.gov (United States)

    Bruno, Alexander G; Mokhtarzadeh, Hossein; Allaire, Brett T; Velie, Kelsey R; De Paolis Kaluza, M Clara; Anderson, Dennis E; Bouxsein, Mary L

    2017-10-01

    We created subject-specific musculoskeletal models of the thoracolumbar spine by incorporating spine curvature and muscle morphology measurements from computed tomography (CT) scans to determine the degree to which vertebral compressive and shear loading estimates are sensitive to variations in trunk anatomy. We measured spine curvature and trunk muscle morphology using spine CT scans of 125 men, and then created four different thoracolumbar spine models for each person: (i) height and weight adjusted (Ht/Wt models); (ii) height, weight, and spine curvature adjusted (+C models); (iii) height, weight, and muscle morphology adjusted (+M models); and (iv) height, weight, spine curvature, and muscle morphology adjusted (+CM models). We determined vertebral compressive and shear loading at three regions of the spine (T8, T12, and L3) for four different activities. Vertebral compressive loads predicted by the subject-specific CT-based musculoskeletal models were between 54% lower to 45% higher from those estimated using musculoskeletal models adjusted only for subject height and weight. The impact of subject-specific information on vertebral loading estimates varied with the activity and spinal region. Vertebral loading estimates were more sensitive to incorporation of subject-specific spinal curvature than subject-specific muscle morphology. Our results indicate that individual variations in spine curvature and trunk muscle morphology can have a major impact on estimated vertebral compressive and shear loads, and thus should be accounted for when estimating subject-specific vertebral loading. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2164-2173, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  16. Variational Calculation of Effective Parameters in Random Porous Media

    Science.gov (United States)

    Hristopulos, Dionissios T.; Christakos, George

    1998-03-01

    Effective parameters are used in stochastic hydrology and petroleum engineering as estimates of the coarse-grained behavior of fluid flow and transport. Stochastic effective parameter estimation involves averaging over the local heterogeneity. Explicit evaluation methods are often based on low order perturbation expansions. We obtain more general estimates using a variational scheme that employs auxiliary probability measures. The average over the local fluctuations is evaluated by means of the logarithm transform and the replica trick. The equations satisfied by the effective parameters are obtained variationally from an effective free energy functional. We use this method for the evaluation of the effective permeability of random porous media with Gaussian local fluctuations. The resulting equations are solved explicitly in specific cases, and the results are compared with leading-order perturbation estimates and experimental data. Explicit finite-size expressions are obtained using momentum-space filters. The implications of the finite size behavior for the scaleup problem are discussed.

  17. Nonparametric Estimation of Distributions in Random Effects Models

    KAUST Repository

    Hart, Jeffrey D.

    2011-01-01

    We propose using minimum distance to obtain nonparametric estimates of the distributions of components in random effects models. A main setting considered is equivalent to having a large number of small datasets whose locations, and perhaps scales, vary randomly, but which otherwise have a common distribution. Interest focuses on estimating the distribution that is common to all datasets, knowledge of which is crucial in multiple testing problems where a location/scale invariant test is applied to every small dataset. A detailed algorithm for computing minimum distance estimates is proposed, and the usefulness of our methodology is illustrated by a simulation study and an analysis of microarray data. Supplemental materials for the article, including R-code and a dataset, are available online. © 2011 American Statistical Association.

  18. Evidence of Anderson localization effects in random Raman lasing

    Science.gov (United States)

    Hokr, Brett H.; Cerjan, Alexander; Thompson, Jonathan V.; Yuan, Luqi; Liew, Seng Fatt; Bixler, Joel N.; Noojin, Gary D.; Thomas, Robert J.; Cao, Hui; Stone, A. Douglas; Rockwell, Benjamin A.; Scully, Marlan O.; Yakovlev, Vladislav V.

    2016-03-01

    Anderson localization, also known as strong localization, is the absence of diffusion in turbid media resulting from wave interference. The effect was originally predicted for electron motion, and is widely known to exist in systems of less than 3 dimensions. However, Anderson localization of optical photons in 3 dimensional systems remains an elusive and controversial topic. Random Raman lasing offers the unique combination of large gain and virtually zero absorption. The lack of absorption makes long path length, localized modes preferred. The presence of gain offsets what little absorption is present, and preferentially amplifies localized modes due to their large Q factors compared with typical low Q modes present in complex media. Random Raman lasers exhibit several experimentally measured properties that diverge from classical, particle-like, diffusion. First, the temporal width of the emission being 1 to a few nanoseconds in duration when it is pumped with a 50 ps laser is a full order of magnitude longer than is predicted by Monte Carlo simulations. Second, the random Raman laser emission is highly multi-mode, consisting of hundreds of simultaneous lasing modes. This is in contrast to early theoretical results and back of the envelope arguments that both suggest that only a few modes should be present. We will present the evidence that suggests a divergence from classical diffusion theory. One likely explanation, that is consistent with all of these anomalies, is the presence of high-Q localized modes consistent with Anderson localization.

  19. Preference option randomized design (PORD) for comparative effectiveness research: Statistical power for testing comparative effect, preference effect, selection effect, intent-to-treat effect, and overall effect.

    Science.gov (United States)

    Heo, Moonseong; Meissner, Paul; Litwin, Alain H; Arnsten, Julia H; McKee, M Diane; Karasz, Alison; McKinley, Paula; Rehm, Colin D; Chambers, Earle C; Yeh, Ming-Chin; Wylie-Rosett, Judith

    2017-01-01

    Comparative effectiveness research trials in real-world settings may require participants to choose between preferred intervention options. A randomized clinical trial with parallel experimental and control arms is straightforward and regarded as a gold standard design, but by design it forces and anticipates the participants to comply with a randomly assigned intervention regardless of their preference. Therefore, the randomized clinical trial may impose impractical limitations when planning comparative effectiveness research trials. To accommodate participants' preference if they are expressed, and to maintain randomization, we propose an alternative design that allows participants' preference after randomization, which we call a "preference option randomized design (PORD)". In contrast to other preference designs, which ask whether or not participants consent to the assigned intervention after randomization, the crucial feature of preference option randomized design is its unique informed consent process before randomization. Specifically, the preference option randomized design consent process informs participants that they can opt out and switch to the other intervention only if after randomization they actively express the desire to do so. Participants who do not independently express explicit alternate preference or assent to the randomly assigned intervention are considered to not have an alternate preference. In sum, preference option randomized design intends to maximize retention, minimize possibility of forced assignment for any participants, and to maintain randomization by allowing participants with no or equal preference to represent random assignments. This design scheme enables to define five effects that are interconnected with each other through common design parameters-comparative, preference, selection, intent-to-treat, and overall/as-treated-to collectively guide decision making between interventions. Statistical power functions for testing

  20. Gender, Previous Knowledge, Personality Traits and Subject-Specific Motivation as Predictors of Students' Math Grade in Upper-Secondary School

    Science.gov (United States)

    Peklaj, Cirila; Podlesek, Anja; Pecjak, Sonja

    2015-01-01

    The aim of the study was to examine the relationships between gender, previous knowledge, different personality traits, subject-specific motivational dimensions and students' math grade in secondary school. A total of 386 first-year students (142 boys and 244 girls) from secondary schools in Slovenia (mean age was 15.7 years) participated in the…

  1. Outdoor dynamic subject-specific evaluation of internal stresses in the residual limb: hydraulic energy-stored prosthetic foot compared to conventional energy-stored prosthetic feet.

    Science.gov (United States)

    Portnoy, Sigal; Kristal, Anat; Gefen, Amit; Siev-Ner, Itzhak

    2012-01-01

    The prosthetic foot plays an important role in propelling, breaking, balancing and supporting body loads while the amputee ambulates on different grounds. It is therefore important to quantify the effect of the prosthetic foot mechanism on biomechanical parameters, in order to prevent pressure ulcers and deep tissue injury. Our aim was to monitor the internal stresses in the residuum of transtibial amputation (TTA) prosthetic-users ambulating on different terrains, which the amputees encounter during their daily activities, i.e. paved floor, grass, ascending and descending stairs and slope. We specifically aimed to compare between the internal stresses in the TTA residuum of amputees ambulating with a novel hydraulic prosthetic foot compared to conventional energy storage and return (ESR) prosthetic feet. Monitoring of internal stresses was accomplished using a portable subject-specific real-time internal stress monitor. We found significant decrease (phydraulic foot, compared to walking with ESR feet. The loading rate calculated while ambulating with the hydraulic foot was at least three times lower than the loading rate calculated while ambulating with the ESR foot. Although the average decrease in internal stresses was ≈ 2-fold larger when replacing single-toe ESR feet with the hydraulic foot than when replacing split-toed ESR feet with the hydraulic foot, the differences were statistically insignificant. Our findings suggest that using a hydraulic prosthetic foot may protect the distal tibial end of the TTA residuum from high stresses, therefore preventing pressure-related injury and pain. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. HIV-1 envelope glycoprotein resistance to monoclonal antibody 2G12 is subject-specific and context-dependent in macaques and humans.

    Science.gov (United States)

    Malherbe, Delphine C; Sanders, Rogier W; van Gils, Marit J; Park, Byung; Gomes, Michelle M; Schuitemaker, Hanneke; Barnett, Susan; Haigwood, Nancy L

    2013-01-01

    HIV-1 Envelope (Env) protein is the sole target of neutralizing antibodies (NAbs) that arise during infection to neutralize autologous variants. Under this immune pressure, HIV escape variants are continuously selected and over the course of infection Env becomes more neutralization resistant. Many common alterations are known to affect sensitivity to NAbs, including residues encoding potential N-linked glycosylation sites (PNGS). Knowledge of Env motifs associated with neutralization resistance is valuable for the design of an effective Env-based vaccine so we characterized Envs isolated longitudinally from a SHIV(SF162P4) infected macaque for sensitivity to neutralizing monoclonal antibodies (MAbs) B12, 2G12, 4E10 and 2F5. The early Env, isolated from plasma at day 56 after infection, was the most sensitive and the late Env, from day 670, was the most resistant to MAbs. We identified four PNGS in these Envs that accumulated over time at positions 130, 139, 160 and 397. We determined that removal of these PNGS significantly increased neutralization sensitivity to 2G12, and conversely, we identified mutations by in silico analyses that contributed resistance to 2G12 neutralization. In order to expand our understanding of these PNGS, we analyzed Envs from clade B HIV-infected human subjects and identified additional glycan and amino acid changes that could affect neutralization by 2G12 in a context-dependent manner. Taken together, these in vitro and in silico analyses of clade B Envs revealed that 2G12 resistance is achieved by previously unrecognized PNGS substitutions in a context-dependent manner and by subject-specific pathways.

  3. HIV-1 envelope glycoprotein resistance to monoclonal antibody 2G12 is subject-specific and context-dependent in macaques and humans.

    Directory of Open Access Journals (Sweden)

    Delphine C Malherbe

    Full Text Available HIV-1 Envelope (Env protein is the sole target of neutralizing antibodies (NAbs that arise during infection to neutralize autologous variants. Under this immune pressure, HIV escape variants are continuously selected and over the course of infection Env becomes more neutralization resistant. Many common alterations are known to affect sensitivity to NAbs, including residues encoding potential N-linked glycosylation sites (PNGS. Knowledge of Env motifs associated with neutralization resistance is valuable for the design of an effective Env-based vaccine so we characterized Envs isolated longitudinally from a SHIV(SF162P4 infected macaque for sensitivity to neutralizing monoclonal antibodies (MAbs B12, 2G12, 4E10 and 2F5. The early Env, isolated from plasma at day 56 after infection, was the most sensitive and the late Env, from day 670, was the most resistant to MAbs. We identified four PNGS in these Envs that accumulated over time at positions 130, 139, 160 and 397. We determined that removal of these PNGS significantly increased neutralization sensitivity to 2G12, and conversely, we identified mutations by in silico analyses that contributed resistance to 2G12 neutralization. In order to expand our understanding of these PNGS, we analyzed Envs from clade B HIV-infected human subjects and identified additional glycan and amino acid changes that could affect neutralization by 2G12 in a context-dependent manner. Taken together, these in vitro and in silico analyses of clade B Envs revealed that 2G12 resistance is achieved by previously unrecognized PNGS substitutions in a context-dependent manner and by subject-specific pathways.

  4. An investigation to determine if a single validated density-elasticity relationship can be used for subject specific finite element analyses of human long bones.

    Science.gov (United States)

    Eberle, Sebastian; Göttlinger, Michael; Augat, Peter

    2013-07-01

    Subject-specific FE-models of human long bones have to predict mechanical parameters with sufficient accuracy to be applicable in a clinical setting. One of the main aspects in subject-specific FE-models of bones regarding accuracy is the modeling of the material inhomogeneity. The goal of this study was therefore to develop FE-models of human femurs and investigate if a single validated density-elasticity relationship can be used for subject specific finite element analyses of human long bones, when the task is to predict the bone's mechanical response to load. To this aim, 23 human cadaver femurs were tested in axial compression with a load of 1000 N. Strains, local displacements, and axial bone stiffness were determined. Subject-specific FE-models were developed for each bone based on quantitative CT-scans. Three different density-elasticity relationships were retrieved from the literature, and were implemented in the FE-models. The predicted mechanical values depended largely on the used equation. The most reasonable equation showed a mean error of -11% in strain prediction, a mean error of -23% in local displacement prediction, and a mean error of +23% in axial stiffness prediction. The scatter of the predictions was very low in all three categories of measurements with a 1.96 standard deviation of about 30% to the mean errors. In conclusion, a framework for subject-specific FE-models was developed that was able to predict surface strains and bone deformation with good accuracy by using a single density-elasticity relationship. However, it was also found that the most appropriate density-elasticity relationship was specimen-specific. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  5. Effects of auriculotherapy on labour pain: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Reginaldo Roque Mafetoni

    Full Text Available Abstract OBJECTIVE Assessing the effects of auriculotherapy in pain control and its outcomes on the duration of labour. METHOD This is a randomized, controlled, double-blind trial with preliminary data. Thirty pregnant women with gestational age ≥ 37 weeks, cervical dilatation ≥ 4 cm and two or more contractions in 10 minutes were selected and randomly divided into three groups: auriculotherapy, placebo and control. Auriculotherapy was applied using crystal beads on four strategic points. RESULTS No statistical significance was found between the groups with regard to pain; however, the women from the auriculotherapy group had lower intensity and less perception of pain at 30, 60 and 120 minutes of treatment. The average duration of labour was shorter in the auriculotherapy group (248.7 versus placebo 414.8 versus control 296.3 minutes; caesarean section rates were higher in the placebo group (50% and the same in the other groups (10%. CONCLUSION Mothers who received auriculotherapy presented a tendency for greater pain control and shorter labour duration; however, caesarean section rates in this group were similar to the control group. This trial precedes a larger study in progress. Registration of Brazilian Clinical Trials: RBR-47hhbj.

  6. Effects of professional oral health care on elderly: randomized trial.

    Science.gov (United States)

    Morino, T; Ookawa, K; Haruta, N; Hagiwara, Y; Seki, M

    2014-11-01

    To better understand the role of the professional oral health care for elderly in improving geriatric oral health, the effects of short-term professional oral health care (once per week for 1 month) on oral microbiological parameters were assessed. Parallel, open-labelled, randomize-controlled trial was undertaken in a nursing home for elderly in Shizuoka, Japan. Thirty-four dentate elderly over 74 years were randomly assigned from ID number to the intervention (17/34) and control (17/34) groups. The outcomes were changes in oral microbiological parameters (number of bacteria in unstimulated saliva; whole bacteria, Streptococcus, Fusobacterium and Prevotella: opportunistic pathogens detection: and index of oral hygiene evaluation [Dental Plaque Index, DPI]) within the intervention period. Each parameter was evaluated at before and after intervention period. Four elderly were lost from mortality (1), bone fracture (1), refused to participate (1) and multi-antibiotics usage (1). Finally, 30 elderly were analysed (14/intervention and 16/control). At baseline, no difference was found between the control and intervention groups. After the intervention period, the percentage of Streptococcus species increased significantly in the intervention group (Intervention, 86% [12/14]; Control, 50% [8/16]: Fisher's, right-tailed, P oral health care can improve oral conditions in the elderly. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. The effectiveness of propolis on gingivitis: a randomized controlled trial.

    Science.gov (United States)

    Bretz, Walter A; Paulino, Niraldo; Nör, Jacques E; Moreira, Alexandre

    2014-12-01

    A randomized, double-blind, controlled clinical trial was conducted to evaluate the effectiveness of a propolis rinse on induced gingivitis by using the co-twin study design. Twenty-one twin pairs (n=42) were enrolled in a gingivitis study with oral hygiene promotion (14 days) and gingivitis induction (21 days). During the gingivitis induction phase, one member of the twin pair was randomly assigned to a 2% typified propolis rinse, and the other was assigned a color-matched 0.05% sodium fluoride plus 0.05% cetylpyridinium chloride rinse (positive control). Patients rinsed twice daily with 20 mL for 30 seconds for 21 days. Gingivitis was measured on days -14 (baseline), 0 (after hygiene phase), and 21 (after no-hygiene phase) by using the Papillary Bleeding Score (PBS) and by standard digital imaging of the gum tissues (G-parameter). The 38 persons who completed the study (age 13-22 years) were well balanced according to PBS at baseline and G-parameter after the initial hygiene phase. After 21 days without oral hygiene, the propolis rinse and positive control rinse groups did not differ significantly for average PBS measurements or G-parameter. Use of a 2% typified propolis rinse was equivalent to a positive control rinse during a 21-day no-hygiene period.

  8. Digital media promoting new approaches to subject specific didactics in visual arts education in primary school, high school, teacher education and university education

    DEFF Research Database (Denmark)

    Skov, Kirsten

    Digital media promoting new approaches to subject specific didactics in visual arts education in primary school, high school, teacher education and university education The symposium addresses current developments in visual arts education based on empirical projects from different levels of the e......Digital media promoting new approaches to subject specific didactics in visual arts education in primary school, high school, teacher education and university education The symposium addresses current developments in visual arts education based on empirical projects from different levels......, social aesthetics, community art and co-creation all represent an approach to art production and appreciation where content, media and visual expressions unfold in societal, digital, collaborative, and transgressive constellations involving the art maker and audiences in social and relational projects...

  9. Effects of nattokinase on blood pressure: a randomized, controlled trial.

    Science.gov (United States)

    Kim, Ji Young; Gum, Si Nae; Paik, Jean Kyung; Lim, Hyo Hee; Kim, Kyong-Chol; Ogasawara, Kazuya; Inoue, Kenichi; Park, Sungha; Jang, Yangsoo; Lee, Jong Ho

    2008-08-01

    The objective of this study was to examine the effects of nattokinase supplementation on blood pressure in subjects with pre-hypertension or stage 1 hypertension. In a randomized, double-blind, placebo-controlled trial, 86 participants ranging from 20 to 80 years of age with an initial untreated systolic blood pressure (SBP) of 130 to 159 mmHg received nattokinase (2,000 FU/capsule) or a placebo capsule for 8 weeks. Seventy-three subjects completed the protocol. Compared with the control group, the net changes in SBP and diastolic blood pressure (DBP) were -5.55 mmHg (95% confidence interval [CI], -10.5 to -0.57 mmHg; pnattokinase group compared with the control group (pnattokinase supplementation resulted in a reduction in SBP and DBP. These findings suggest that increased intake of nattokinase may play an important role in preventing and treating hypertension.

  10. KEMAMPUAN SUBJECT SPECIFIC PEDAGOGY CALON GURU BIOLOGI PESERTA PROGRAM PENDIDIKAN PROFESIONAL GURU (PPG YANG BERLATAR BELAKANG BASIC SAINS PRA DAN POST WORKSHOP

    Directory of Open Access Journals (Sweden)

    Yenny Anwar

    2012-10-01

    Full Text Available Penelitian ini bertujuan untuk menggambarkan/mendeskripsikan kemampuan Subjek Spesifik Pedagogi mahasiswa calon guru biologi yang mengikuti program Pendidikan Profesional Guru (PPG angkatan 2012-2013 melalui pendekatan konsekutif.  Hasil sementara menunjukkan  bahwa Kemampuan Subject Specific Pedagogy mahasiswa calon guru biologi yang berlatar belakang Biologi murni program Basic Science masih minim, dapat dilihat dari hasil CoRes dan PaP-eRs buatan mereka sebelum mengikuti workshop. Setelah workshop semester I diperoleh hasil yang menunjukkan peningkatan yang cukup baik.   This study aimed to describe / describes the ability of prospective students Subject Specific Pedagogy biology teachers who follow the Professional Teacher Education Program (PTEP 2012-2013 armed consecutive approach. Preliminary results indicate that the ability of prospective students Subject Specific Pedagogy biology teacher who belongs to the pure Biology Basic Science program is minimal, it can be seen from the cores and pap-ers made ​​them before the workshop. After the workshop the first half of the obtained results that showed a pretty good improvement.

  11. Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial

    Science.gov (United States)

    2010-01-01

    Introduction To elucidate in polymyalgia rheumatica (PMR) the role of tumor necrosis factor (TNF) α and the therapeutic potential of blockade with soluble TNF-α receptor, we carried out the first randomized controlled trial with etanercept in PMR. Methods Twenty newly diagnosed, glucocorticoid (GC) naïve patients with PMR and 20 matched non-PMR control subjects completed the trial. Subjects were randomized in a 1:1 ratio to monotherapy with etanercept (25 mg s.c. biweekly) or placebo (saline) for 14 days. Study outcomes were assessed at baseline and after 14 days. The primary outcome was the change in PMR activity score (PMR-AS). Secondary outcomes were: changes in erythrocyte sedimentation rate (ESR) and plasma levels of TNF-α and interleukin (IL) 6; patients' functional status (health assessment questionnaire) and cumulative tramadol intake during the trial. Results At baseline, plasma TNF-α was higher in patients than in controls (P etanercept treatment (P etanercept decreased PMR-AS by 24% (P = 0.011), reflecting significant improvements in shoulder mobility, physician's global assessment and C-reactive protein, and insignificant (P > 0.05) improvements in duration of morning stiffness and patient's assessment of pain. In parallel, ESR and IL-6 were reduced (P 0.05). Functional status did not change and tramadol intake did not differ between patient groups. In controls, no changes occurred in both groups. Conclusions Etanercept monotherapy ameliorates disease activity in GC naïve patients with PMR. However, the effect is modest, indicating a minor role of TNF-α in PMR. Trial registration ClinicalTrials.gov (NCT00524381). PMID:20854662

  12. Generation of subject-specific, dynamic, multisegment ankle and foot models to improve orthotic design: a feasibility study

    Directory of Open Access Journals (Sweden)

    Oosterwaal Michiel

    2011-11-01

    Full Text Available Abstract Background Currently, custom foot and ankle orthosis prescription and design tend to be based on traditional techniques, which can result in devices which vary greatly between clinicians and repeat prescription. The use of computational models of the foot may give further insight in the biomechanical effects of these devices and allow a more standardised approach to be taken to their design, however due to the complexity of the foot the models must be highly detailed and dynamic. Methods/Design Functional and anatomical datasets will be collected in a multicentre study from 10 healthy participants and 15 patients requiring orthotic devices. The patient group will include individuals with metarsalgia, flexible flat foot and drop foot. Each participant will undergo a clinical foot function assessment, 3D surface scans of the foot under different loading conditions, and detailed gait analysis including kinematic, kinetic, muscle activity and plantar pressure measurements in both barefoot and shod conditions. Following this each participant will undergo computed tomography (CT imaging of their foot and ankle under a range of loads and positions while plantar pressures are recorded. A further subgroup of participants will undergo magnetic resonance imaging (MRI of the foot and ankle. Imaging data will be segmented to derive the geometry of the bones and the orientation of the joint axes. Insertion points of muscles and ligaments will be determined from the MRI and CT-scans and soft tissue material properties computed from the loaded CT data in combination with the plantar pressure measurements. Gait analysis data will be used to drive the models and in combination with the 3D surface scans for scaling purposes. Predicted plantar pressures and muscle activation patterns predicted from the models will be compared to determine the validity of the models. Discussion This protocol will lead to the generation of unique datasets which will be used

  13. Sequential methods for random-effects meta-analysis

    Science.gov (United States)

    Higgins, Julian P T; Whitehead, Anne; Simmonds, Mark

    2011-01-01

    Although meta-analyses are typically viewed as retrospective activities, they are increasingly being applied prospectively to provide up-to-date evidence on specific research questions. When meta-analyses are updated account should be taken of the possibility of false-positive findings due to repeated significance tests. We discuss the use of sequential methods for meta-analyses that incorporate random effects to allow for heterogeneity across studies. We propose a method that uses an approximate semi-Bayes procedure to update evidence on the among-study variance, starting with an informative prior distribution that might be based on findings from previous meta-analyses. We compare our methods with other approaches, including the traditional method of cumulative meta-analysis, in a simulation study and observe that it has Type I and Type II error rates close to the nominal level. We illustrate the method using an example in the treatment of bleeding peptic ulcers. Copyright © 2010 John Wiley & Sons, Ltd. PMID:21472757

  14. Effective medium approximation for effective propagation constant calculation in a dense random medium. [electromagnetic wave scattering

    Science.gov (United States)

    Zhu, P. Y.; Fung, A. K.

    1986-01-01

    The effective medium approximation (EMA) formalism developed for scalar wave calculations in solid state physics is generalized to electromagnetic wave scattering in a dense random medium. Results are applied to compute the effective propagation constant in a dense medium involving discrete spherical scatterers. When compared with a common quasicrystalline approximation (QCA), it is found that EMA accounts for backward scattering and the effect of correlation among three scatterers which are not available in QCA. It is also found that there is not much difference in the calculated normalized phase velocity between the use of these two approximations. However, there is a significant difference in the computed effective loss tangent in a nonabsorptive random medium. The computed effective loss tangent using EMA and measurements from a snow medium are compared, showing good agreement.

  15. Effects of auriculotherapy on labour pain: a randomized clinical trial.

    Science.gov (United States)

    Mafetoni, Reginaldo Roque; Shimo, Antonieta Keiko Kakuda

    2016-01-01

    Assessing the effects of auriculotherapy in pain control and its outcomes on the duration of labour. This is a randomized, controlled, double-blind trial with preliminary data. Thirty pregnant women with gestational age ≥ 37 weeks, cervical dilatation ≥ 4 cm and two or more contractions in 10 minutes were selected and randomly divided into three groups: auriculotherapy, placebo and control. Auriculotherapy was applied using crystal beads on four strategic points. No statistical significance was found between the groups with regard to pain; however, the women from the auriculotherapy group had lower intensity and less perception of pain at 30, 60 and 120 minutes of treatment. The average duration of labour was shorter in the auriculotherapy group (248.7 versus placebo 414.8 versus control 296.3 minutes); caesarean section rates were higher in the placebo group (50%) and the same in the other groups (10%). Mothers who received auriculotherapy presented a tendency for greater pain control and shorter labour duration; however, caesarean section rates in this group were similar to the control group. This trial precedes a larger study in progress. Registration of Brazilian Clinical Trials: RBR-47hhbj. Avaliar os efeitos da auriculoterapia no controle da dor e seus desfechos na duração do trabalho de parto. Trata-se de um ensaio controlado, randomizado e duplo-cego, com dados preliminares. Foram selecionadas 30 parturientes com idade gestacional ≥ 37 semanas, dilatação cervical ≥ 4 cm e duas ou mais contrações em 10 minutos, divididas aleatoriamente em três grupos: auriculoterapia, placebo ou controle. A auriculoterapia foi aplicada com microesferas de cristais em quatro pontos estratégicos. Não houve significância estatística entre os grupos com relação à dor; no entanto, as mulheres do grupo de auriculoterapia, apresentaram menor intensidade e menor percepção da dor aos 30, 60 e 120 minutos do tratamento. A média de duração do trabalho de

  16. Effectiveness of myofascial release: systematic review of randomized controlled trials.

    Science.gov (United States)

    Ajimsha, M S; Al-Mudahka, Noora R; Al-Madzhar, J A

    2015-01-01

    Myofascial release (MFR) is a form of manual therapy that involves the application of a low load, long duration stretch to the myofascial complex, intended to restore optimal length, decrease pain, and improve function. Anecdotal evidence shows great promise for MFR as a treatment for various conditions. However, research to support the anecdotal evidence is lacking. To critically analyze published randomized controlled trials (RCTs) to determine the effectiveness of MFR as a treatment option for different conditions. Electronic databases: MEDLINE, CINAHL, Academic Search Premier, Cochrane library, and Physiotherapy Evidence Database (PEDro), with key words myofascial release and myofascial release therapy. No date limitations were applied to the searches. Articles were selected based upon the use of the term myofascial release in the abstract or key words. The final selection was made by applying the inclusion and exclusion criteria to the full text. Studies were included if they were English-language, peer-reviewed RCTs on MFR for various conditions and pain. Data collected were number of participants, condition being treated, treatment used, control group, outcome measures and results. Studies were analyzed using the PEDro scale and the Center for Evidence-Based Medicine's Levels of Evidence scale. The literature regarding the effectiveness of MFR was mixed in both quality and results. Although the quality of the RCT studies varied greatly, the result of the studies was encouraging, particularly with the recently published studies. MFR is emerging as a strategy with a solid evidence base and tremendous potential. The studies in this review may help as a respectable base for the future trials. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Randomized trial testing the effect of peer education at increasing fruit and vegetable intake

    National Research Council Canada - National Science Library

    Buller, D B; Morrill, C; Taren, D; Aickin, M; Sennott-Miller, L; Buller, M K; Larkey, L; Alatorre, C; Wentzel, T M

    1999-01-01

    .... In a randomized trial, peer education was tested for effectiveness at increasing fruit and vegetable intake among lower socioeconomic, multicultural labor and trades employees. Employees (n = 2091...

  18. Hip-Hop to Health Jr. Randomized Effectiveness Trial

    Science.gov (United States)

    Kong, Angela; Buscemi, Joanna; Stolley, Melinda R.; Schiffer, Linda A.; Kim, Yoonsang; Braunschweig, Carol L.; Gomez-Perez, Sandra L.; Blumstein, Lara B.; Van Horn, Linda; Dyer, Alan R.; Fitzgibbon, Marian L.

    2015-01-01

    Introduction The preschool years provide a unique window of opportunity to intervene on obesity-related lifestyle risk factors during the formative years of a child’s life. The purpose of this study was to assess the impact of a preschool-based obesity prevention effectiveness trial at 1-year follow-up. Design RCT. Settings/participants Primarily African American children (aged 3–5 years, N=618) attending Head Start preschool programs administered by Chicago Public Schools. Methods Eighteen preschools were randomly assigned in 2007–2008 to receive either: (1) a 14-week teacher-delivered intervention focused on healthy lifestyle behaviors; or (2) a 14-week teacher-delivered general health curriculum (control group). Main outcome measures The primary outcome, BMI, was measured at baseline, post-intervention, and 1-year follow-up. Diet and screen time behaviors were also assessed at these time points. Multilevel mixed effects models were used to test for between-group differences. Data were analyzed in 2014. Results Significant between-group differences were observed in diet, but not in BMI z-score or screen time at 1-year follow-up. Diet differences favored the intervention arm over controls in overall diet quality (p=0.02) and in subcomponents of diet quality, as measured by the Healthy Eating Index-2005, and in fruit intake (servings/day, excludes juice) (p=0.02). Diet quality worsened more among controls than the intervention group at 1-year follow-up. Conclusions The adaptation of Hip-Hop to Health Jr. produced modest benefits in diet quality, but did not significantly impact weight gain trajectory. Not unlike other effectiveness trials, this real-world version delivered by Head Start teachers produced fewer benefits than the more rigorous efficacy trial. It is important to understand and build upon the lessons learned from these types of trials so that we can design, implement, and disseminate successful evidence-based programs more widely and effectively

  19. Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial

    DEFF Research Database (Denmark)

    Kreiner, Frederik; Galbo, Henrik

    2010-01-01

    To elucidate in polymyalgia rheumatica (PMR) the role of tumor necrosis factor (TNF) a and the therapeutic potential of blockade with soluble TNF-a receptor, we carried out the first randomized controlled trial with etanercept in PMR.......To elucidate in polymyalgia rheumatica (PMR) the role of tumor necrosis factor (TNF) a and the therapeutic potential of blockade with soluble TNF-a receptor, we carried out the first randomized controlled trial with etanercept in PMR....

  20. Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial

    DEFF Research Database (Denmark)

    Kreiner, Frederik; Galbo, Henrik

    2010-01-01

    To elucidate in polymyalgia rheumatica (PMR) the role of tumor necrosis factor (TNF) α and the therapeutic potential of blockade with soluble TNF-α receptor, we carried out the first randomized controlled trial with etanercept in PMR.......To elucidate in polymyalgia rheumatica (PMR) the role of tumor necrosis factor (TNF) α and the therapeutic potential of blockade with soluble TNF-α receptor, we carried out the first randomized controlled trial with etanercept in PMR....

  1. Using subject-specific three-dimensional (3D) anthropometry data in digital human modelling: case study in hand motion simulation.

    Science.gov (United States)

    Tsao, Liuxing; Ma, Liang

    2016-11-01

    Digital human modelling enables ergonomists and designers to consider ergonomic concerns and design alternatives in a timely and cost-efficient manner in the early stages of design. However, the reliability of the simulation could be limited due to the percentile-based approach used in constructing the digital human model. To enhance the accuracy of the size and shape of the models, we proposed a framework to generate digital human models using three-dimensional (3D) anthropometric data. The 3D scan data from specific subjects' hands were segmented based on the estimated centres of rotation. The segments were then driven in forward kinematics to perform several functional postures. The constructed hand models were then verified, thereby validating the feasibility of the framework. The proposed framework helps generate accurate subject-specific digital human models, which can be utilised to guide product design and workspace arrangement. Practitioner Summary: Subject-specific digital human models can be constructed under the proposed framework based on three-dimensional (3D) anthropometry. This approach enables more reliable digital human simulation to guide product design and workspace arrangement.

  2. Fully automatized renal parenchyma volumetry using a support vector machine based recognition system for subject-specific probability map generation in native MR volume data

    Science.gov (United States)

    Gloger, Oliver; Tönnies, Klaus; Mensel, Birger; Völzke, Henry

    2015-11-01

    In epidemiological studies as well as in clinical practice the amount of produced medical image data strongly increased in the last decade. In this context organ segmentation in MR volume data gained increasing attention for medical applications. Especially in large-scale population-based studies organ volumetry is highly relevant requiring exact organ segmentation. Since manual segmentation is time-consuming and prone to reader variability, large-scale studies need automatized methods to perform organ segmentation. Fully automatic organ segmentation in native MR image data has proven to be a very challenging task. Imaging artifacts as well as inter- and intrasubject MR-intensity differences complicate the application of supervised learning strategies. Thus, we propose a modularized framework of a two-stepped probabilistic approach that generates subject-specific probability maps for renal parenchyma tissue, which are refined subsequently by using several, extended segmentation strategies. We present a three class-based support vector machine recognition system that incorporates Fourier descriptors as shape features to recognize and segment characteristic parenchyma parts. Probabilistic methods use the segmented characteristic parenchyma parts to generate high quality subject-specific parenchyma probability maps. Several refinement strategies including a final shape-based 3D level set segmentation technique are used in subsequent processing modules to segment renal parenchyma. Furthermore, our framework recognizes and excludes renal cysts from parenchymal volume, which is important to analyze renal functions. Volume errors and Dice coefficients show that our presented framework outperforms existing approaches.

  3. Effectiveness of topic-specific infobuttons: a randomized controlled trial.

    Science.gov (United States)

    Del Fiol, Guilherme; Haug, Peter J; Cimino, James J; Narus, Scott P; Norlin, Chuck; Mitchell, Joyce A

    2008-01-01

    Infobuttons are decision support tools that provide links within electronic medical record systems to relevant content in online information resources. The aim of infobuttons is to help clinicians promptly meet their information needs. The objective of this study was to determine whether infobutton links that direct to specific content topics ("topic links") are more effective than links that point to general overview content ("nonspecific links"). Randomized controlled trial with a control and an intervention group. Clinicians in the control group had access to nonspecific links, while those in the intervention group had access to topic links. Infobutton session duration, number of infobutton sessions, session success rate, and the self-reported impact that the infobutton session produced on decision making. The analysis was performed on 90 subjects and 3,729 infobutton sessions. Subjects in the intervention group spent 17.4% less time seeking for information (35.5 seconds vs. 43 seconds, p = 0.008) than those in the control group. Subjects in the intervention group used infobuttons 20.5% (22 sessions vs. 17.5 sessions, p = 0.21) more often than in the control group, but the difference was not significant. The information seeking success rate was equally high in both groups (89.4% control vs. 87.2% intervention, p = 0.99). Subjects reported a high positive clinical impact (i.e., decision enhancement or knowledge update) in 62% of the sessions. Limitations The exclusion of users with a low frequency of infobutton use and the focus on medication-related information needs may limit the generalization of the results. The session outcomes measurement was based on clinicians' self-assessment and therefore prone to bias. The results support the hypothesis that topic links are more efficient than nonspecific links regarding the time seeking for information. It is unclear whether the statistical difference demonstrated will result in a clinically significant impact

  4. Boundary effects on effective conductivity of random heterogeneous media with spherical inclusions

    Science.gov (United States)

    Rabinovich, A.; Dagan, G.; Miloh, T.

    2012-10-01

    It is common to determine the effective conductivity of heterogeneous media by assuming stationarity of the random local properties. This assumption is not obeyed in a boundary layer of a body of finite size. The effect of different types of boundaries is examined for a two-phase medium with spherical inclusions of given conductivity distributed randomly in a matrix of a different conductivity. Exact solutions are derived for the apparent conductivity and the boundary layer thickness. The interaction between the spheres and the boundaries is fully incorporated in the solutions using a spherical harmonics expansion and the method of images. As applications, the corrections for the effective conductivity are given for two cases of finite bodies: the Maxwell sphere and a cylinder of flow parallel to the axis.

  5. Cluster randomized trials in comparative effectiveness research: randomizing hospitals to test methods for prevention of healthcare-associated infections.

    Science.gov (United States)

    Platt, Richard; Takvorian, Samuel U; Septimus, Edward; Hickok, Jason; Moody, Julia; Perlin, Jonathan; Jernigan, John A; Kleinman, Ken; Huang, Susan S

    2010-06-01

    The need for evidence about the effectiveness of therapeutics and other medical practices has triggered new interest in methods for comparative effectiveness research. Describe an approach to comparative effectiveness research involving cluster randomized trials in networks of hospitals, health plans, or medical practices with centralized administrative and informatics capabilities. We discuss the example of an ongoing cluster randomized trial to prevent methicillin-resistant Staphylococcus aureus (MRSA) infection in intensive care units (ICUs). The trial randomizes 45 hospitals to: (a) screening cultures of ICU admissions, followed by Contact Precautions if MRSA-positive, (b) screening cultures of ICU admissions followed by decolonization if MRSA-positive, or (c) universal decolonization of ICU admissions without screening. All admissions to adult ICUs. The primary outcome is MRSA-positive clinical cultures occurring >or=2 days following ICU admission. Secondary outcomes include blood and urine infection caused by MRSA (and, separately, all pathogens), as well as the development of resistance to decolonizing agents. Recruitment of hospitals is complete. Data collection will end in Summer 2011. This trial takes advantage of existing personnel, procedures, infrastructure, and information systems in a large integrated hospital network to conduct a low-cost evaluation of prevention strategies under usual practice conditions. This approach is applicable to many comparative effectiveness topics in both inpatient and ambulatory settings.

  6. Identification and estimation of nonseparable single-index models in panel data with correlated random effects

    NARCIS (Netherlands)

    Cizek, Pavel; Lei, Jinghua

    The identification in a nonseparable single-index models with correlated random effects is considered in panel data with a fixed number of time periods. The identification assumption is based on the correlated random effects structure. Under this assumption, the parameters of interest are identified

  7. Identification and Estimation of Nonseparable Single-Index Models in Panel Data with Correlated Random Effects

    NARCIS (Netherlands)

    Cizek, P.; Lei, J.

    2013-01-01

    Abstract: The identification of parameters in a nonseparable single-index models with correlated random effects is considered in the context of panel data with a fixed number of time periods. The identification assumption is based on the correlated random-effect structure: the distribution of

  8. Local lattice relaxations in random metallic alloys: Effective tetrahedron model and supercell approach

    DEFF Research Database (Denmark)

    Ruban, Andrei; Simak, S.I.; Shallcross, S.

    2003-01-01

    We present a simple effective tetrahedron model for local lattice relaxation effects in random metallic alloys on simple primitive lattices. A comparison with direct ab initio calculations for supercells representing random Ni0.50Pt0.50 and Cu0.25Au0.75 alloys as well as the dilute limit of Au-ri...

  9. Technology diffusion in hospitals : A log odds random effects regression model

    NARCIS (Netherlands)

    Blank, J.L.T.; Valdmanis, V.G.

    2013-01-01

    This study identifies the factors that affect the diffusion of hospital innovations. We apply a log odds random effects regression model on hospital micro data. We introduce the concept of clustering innovations and the application of a log odds random effects regression model to describe the

  10. Technology diffusion in hospitals: A log odds random effects regression model

    NARCIS (Netherlands)

    J.L.T. Blank (Jos); V.G. Valdmanis (Vivian G.)

    2015-01-01

    textabstractThis study identifies the factors that affect the diffusion of hospital innovations. We apply a log odds random effects regression model on hospital micro data. We introduce the concept of clustering innovations and the application of a log odds random effects regression model to

  11. A random effect multiplicative heteroscedastic model for bacterial growth

    Directory of Open Access Journals (Sweden)

    Quinto Emiliano J

    2010-02-01

    Full Text Available Abstract Background Predictive microbiology develops mathematical models that can predict the growth rate of a microorganism population under a set of environmental conditions. Many primary growth models have been proposed. However, when primary models are applied to bacterial growth curves, the biological variability is reduced to a single curve defined by some kinetic parameters (lag time and growth rate, and sometimes the models give poor fits in some regions of the curve. The development of a prediction band (from a set of bacterial growth curves using non-parametric and bootstrap methods permits to overcome that problem and include the biological variability of the microorganism into the modelling process. Results Absorbance data from Listeria monocytogenes cultured at 22, 26, 38, and 42°C were selected under different environmental conditions of pH (4.5, 5.5, 6.5, and 7.4 and percentage of NaCl (2.5, 3.5, 4.5, and 5.5. Transformation of absorbance data to viable count data was carried out. A random effect multiplicative heteroscedastic model was considered to explain the dynamics of bacterial growth. The concept of a prediction band for microbial growth is proposed. The bootstrap method was used to obtain resamples from this model. An iterative procedure is proposed to overcome the computer intensive task of calculating simultaneous prediction intervals, along time, for bacterial growth. The bands were narrower below the inflection point (0-8 h at 22°C, and 0-5.5 h at 42°C, and wider to the right of it (from 9 h onwards at 22°C, and from 7 h onwards at 42°C. A wider band was observed at 42°C than at 22°C when the curves reach their upper asymptote. Similar bands have been obtained for 26 and 38°C. Conclusions The combination of nonparametric models and bootstrap techniques results in a good procedure to obtain reliable prediction bands in this context. Moreover, the new iterative algorithm proposed in this paper allows one to

  12. Effective sampling of random surfaces by baby universe surgery

    NARCIS (Netherlands)

    Ambjørn, J.; Białas, P.; Jurkiewicz, J.; Burda, Z.; Petersson, B.

    1994-01-01

    We propose a new, very efficient algorithm for sampling of random surfaces in the Monte Carlo simulations, based on so-called baby universe surgery, i.e. cutting and pasting of baby universe. It drastically reduces slowing down as compared to the standard local flip algorithm, thereby allowing

  13. Color effects from scattering on random surface structures in dielectrics

    DEFF Research Database (Denmark)

    Clausen, Jeppe; Christiansen, Alexander B; Garnæs, Jørgen

    2012-01-01

    We show that cheap large area color filters, based on surface scattering, can be fabricated in dielectric materials by replication of random structures in silicon. The specular transmittance of three different types of structures, corresponding to three different colors, have been characterized...

  14. The Damage Effects in Steel Bridges under Highway Random Loading

    DEFF Research Database (Denmark)

    Agerskov, Henning; Nielsen, Jette Andkjær

    1996-01-01

    In the present investigation, fatigue damage accumulation in steel bridges under highway random loading is studied. In the experimental part of the investigation, fatigue test series on welded plate test specimens have been carried through. The fatigue tests have been carried out using load...

  15. Digital media promoting new approaches to subject specific didactics in visual arts education in primary school, high school, teacher education and university education

    DEFF Research Database (Denmark)

    Buhl, Mie; Örtegren, Hans; Haïkö, Tarja

    The symposium discusses eventual paradigmatic shift within Art Education at different levels when new tools for creation are applied in educational settings. The symposium addresses current developments in visual arts education based on empirical projects from different levels of the educational...... system. The purpose is to discuss to which extend digital media can be seen as an integrated part of existing theory mainly based on developments from analog media or rather give rise to think subject specific didactics differently. Recent developments like visual culture, contemporary arts, social...... aesthetics, community art and co-creation all represent an approach to art production and appreciation where content, media and visual expressions unfold in societal, digital, collaborative, and transgressive constellations involving the art maker and audiences in social and relational projects processes...

  16. The Hamburg selection procedure for dental students - introduction of the HAM-Nat as subject-specific test for study aptitude.

    Science.gov (United States)

    Kothe, Christian; Hissbach, Johanna; Hampe, Wolfgang

    2013-01-01

    The present study examines the question whether the selection of dental students should be based solely on average school-leaving grades (GPA) or whether it could be improved by using a subject-specific aptitude test. The HAM-Nat Natural Sciences Test was piloted with freshmen during their first study week in 2006 and 2007. In 2009 and 2010 it was used in the dental student selection process. The sample size in the regression models varies between 32 and 55 students. Used as a supplement to the German GPA, the HAM-Nat test explained up to 12% of the variance in preclinical examination performance. We confirmed the prognostic validity of GPA reported in earlier studies in some, but not all of the individual preclinical examination results. The HAM-Nat test is a reliable selection tool for dental students. Use of the HAM-Nat yielded a significant improvement in prediction of preclinical academic success in dentistry.

  17. Ipsilateral transversus abdominis plane block provides effective analgesia after appendectomy in children: a randomized controlled trial.

    LENUS (Irish Health Repository)

    Carney, John

    2010-10-01

    The transversus abdominis plane (TAP) block provides effective postoperative analgesia in adults undergoing major abdominal surgery. Its efficacy in children remains unclear, with no randomized clinical trials in this population. In this study, we evaluated its analgesic efficacy over the first 48 postoperative hours after appendectomy performed through an open abdominal incision, in a randomized, controlled, double-blind clinical trial.

  18. Effect of Playful Balancing Training - A Pilot Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop; Jessen, Jari Due

    2013-01-01

    We used the modular playware in the form of modular interactive tiles for playful training of community-dwelling elderly with balancing problem. During short-term play on the modular interactive tiles, the elderly were playing physical, interactive games that were challenging their dynamic balance......, agility, endurance, and sensor-motoric reaction. A population of 12 elderly (average age: 79) with balancing problems (DGI average score: 18.7) was randomly assigned to control group or tiles training group, and tested before and after intervention. The tiles training group had statistical significant...

  19. Effects of Cofactors on Conformation Transition of Random Peptides Consisting of a Reduced Amino Acid Alphabet.

    Science.gov (United States)

    Lu, Ming-Feng; Xie, Ying; Zhang, Yue-Jie; Xing, Xue-Yan

    2015-01-01

    This study aims to explore the structure characteristic of random polypeptides constructed by origin early amino acid alphabet, as well as the effects of cofactors on conformation transition of random peptides. DNA library R8-4 encoding VNM random peptides were constructed by small cassette strategy. Subsequently, a random polypeptide library was constructed using in vitro translation. Expression and purification of VNM random peptides were also performed by a conventional method of recombinant. CD spectrum analysis indicated that VNM random polypeptides have a secondary structure characteristic of protein, such as the content of α-helix is greater than 60%, random coil is about 20% β sheet, and β turn is less than 10%. CD spectrum changed with the addition of 10-40 µM ATP and NADP, but slightly changed by NAD; no influence was observed with MgSO4. Bis-ANS binding assay indicated that fluorescent intensity of bis-ANS was strengthened slightly by 10 VNM random peptides. Fluorescent intensity was strengthened fourfold by adding 10-40 µM ATP, NAD, and NADH, whereas the inducing effect of NADPH and MgSO4 were negligible. VNM random peptides have a classic secondary structure and hydrophobic domain in water solution. Moreover, conformation transition and hydrophobic domain could be induced by cofactor, indicating the preliminary evidence for the hypothesis that "the origin of primitive protein was induced by small molecule."

  20. Effect of Reducing Indoor Air Pollution on Women's Respiratory Symptoms and Lung Function: The RESPIRE Randomized Trial, Guatemala

    National Research Council Canada - National Science Library

    Smith-Sivertsen, Tone; Díaz, Esperanza; Pope, Dan; Lie, Rolv T; Díaz, Anaite; McCracken, John; Bakke, Per; Arana, Byron; Smith, Kirk R; Bruce, Nigel

    2009-01-01

    .... The Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) is a randomized intervention trial evaluating the respiratory health effects of reducing indoor air pollution from open cooking fires...

  1. Antiarrhythmic effect of statin therapy and atrial fibrillation a meta-analysis of randomized controlled trials

    National Research Council Canada - National Science Library

    Fauchier, Laurent; Pierre, Bertrand; de Labriolle, Axel; Grimard, Caroline; Zannad, Noura; Babuty, Dominique

    2008-01-01

    To improve the evaluation of the possible antiarrhythmic effect of statins, we performed a meta-analysis of randomized trials with statins on the end point of incidence or recurrence of atrial fibrillation (AF...

  2. The effects of motivation feedback in patients with severe mental illness : A cluster randomized controlled trial

    NARCIS (Netherlands)

    Jochems, E.C.; van der Feltz-Cornelis, C.M.; van Dam, A.; Duivenvoorden, H.J.; Mulder, C.L.

    2015-01-01

    Objective: To evaluate the effectiveness of providing clinicians with regular feedback on the patient’s motivation for treatment in increasing treatment engagement in patients with severe mental illness. Methods: Design: cluster randomized controlled trial (Dutch Trials Registry NTR2968).

  3. Rgbp: An R Package for Gaussian, Poisson, and Binomial Random Effects Models with Frequency Coverage Evaluations

    Directory of Open Access Journals (Sweden)

    Hyungsuk Tak

    2017-06-01

    Full Text Available Rgbp is an R package that provides estimates and verifiable confidence intervals for random effects in two-level conjugate hierarchical models for overdispersed Gaussian, Poisson, and binomial data. Rgbp models aggregate data from k independent groups summarized by observed sufficient statistics for each random effect, such as sample means, possibly with covariates. Rgbp uses approximate Bayesian machinery with unique improper priors for the hyper-parameters, which leads to good repeated sampling coverage properties for random effects. A special feature of Rgbp is an option that generates synthetic data sets to check whether the interval estimates for random effects actually meet the nominal confidence levels. Additionally, Rgbp provides inference statistics for the hyper-parameters, e.g., regression coefficients.

  4. A GPU-based framework for modeling real-time 3D lung tumor conformal dosimetry with subject-specific lung tumor motion

    Energy Technology Data Exchange (ETDEWEB)

    Min Yugang; Santhanam, Anand; Ruddy, Bari H [University of Central Florida, FL (United States); Neelakkantan, Harini; Meeks, Sanford L [M D Anderson Cancer Center Orlando, FL (United States); Kupelian, Patrick A, E-mail: anand.santhanam@orlandohealth.co [Department of Radiation Oncology, University of California, Los Angeles, CA (United States)

    2010-09-07

    In this paper, we present a graphics processing unit (GPU)-based simulation framework to calculate the delivered dose to a 3D moving lung tumor and its surrounding normal tissues, which are undergoing subject-specific lung deformations. The GPU-based simulation framework models the motion of the 3D volumetric lung tumor and its surrounding tissues, simulates the dose delivery using the dose extracted from a treatment plan using Pinnacle Treatment Planning System, Phillips, for one of the 3DCTs of the 4DCT and predicts the amount and location of radiation doses deposited inside the lung. The 4DCT lung datasets were registered with each other using a modified optical flow algorithm. The motion of the tumor and the motion of the surrounding tissues were simulated by measuring the changes in lung volume during the radiotherapy treatment using spirometry. The real-time dose delivered to the tumor for each beam is generated by summing the dose delivered to the target volume at each increase in lung volume during the beam delivery time period. The simulation results showed the real-time capability of the framework at 20 discrete tumor motion steps per breath, which is higher than the number of 4DCT steps (approximately 12) reconstructed during multiple breathing cycles.

  5. Comparisons of node-based and element-based approaches of assigning bone material properties onto subject-specific finite element models.

    Science.gov (United States)

    Chen, G; Wu, F Y; Liu, Z C; Yang, K; Cui, F

    2015-08-01

    Subject-specific finite element (FE) models can be generated from computed tomography (CT) datasets of a bone. A key step is assigning material properties automatically onto finite element models, which remains a great challenge. This paper proposes a node-based assignment approach and also compares it with the element-based approach in the literature. Both approaches were implemented using ABAQUS. The assignment procedure is divided into two steps: generating the data file of the image intensity of a bone in a MATLAB program and reading the data file into ABAQUS via user subroutines. The node-based approach assigns the material properties to each node of the finite element mesh, while the element-based approach assigns the material properties directly to each integration point of an element. Both approaches are independent from the type of elements. A number of FE meshes are tested and both give accurate solutions; comparatively the node-based approach involves less programming effort. The node-based approach is also independent from the type of analyses; it has been tested on the nonlinear analysis of a Sawbone femur. The node-based approach substantially improves the level of automation of the assignment procedure of bone material properties. It is the simplest and most powerful approach that is applicable to many types of analyses and elements. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  6. SUBJECT-SPECIFIC MODELS REVEAL THE EXISTANCE OF A RELATIONSHIP BETWEEN MORPHOLOGY OF THE ANKLE JOINT COMPLEX AND ITS PASSIVE MECHANICAL PROPERTIES

    Science.gov (United States)

    Imhauser, Carl W.; Siegler, Sorin; Udupa, Jayaram K.; Toy, Jason

    2008-01-01

    The morphology of the bones, articular surfaces and ligaments and the passive mechanical characteristics of the ankle complex were reported to vary greatly among individuals. The goal of this study was to test the hypothesis that the variations observed in the passive mechanical properties of the healthy ankle complex are strongly influenced by morphological variations. To evaluate this hypothesis six numerical models of the ankle joint complex were developed from morphological data obtained from MRI of six cadaver lower limbs, and from average reported data on the mechanical properties of ligaments and articular cartilage. The passive mechanical behavior of each model, under a variety of loading conditions, was found to closely match the experimental data obtained from each corresponding specimen. Since all models used identical material properties and were subjected to identical loads and boundary conditions, it was concluded that the observed variations in passive mechanical characteristics were due to variations in morphology, thus confirming the hypothesis. In addition, the average and large variations in passive mechanical behavior observed between the models were similar to those observed experimentally between cadaver specimens. The results suggest that individualized subject-specific treatment procedures for ankle complex disorders are potentially superior to one-size-fits-all approach. PMID:18316088

  7. PREDICTING LONGITUDINAL TRAJECTORIES OF HEALTH PROBABILITIES WITH RANDOM-EFFECTS MULTINOMIAL LOGIT REGRESSION

    OpenAIRE

    Liu, Xian; Engel, Charles C.

    2012-01-01

    Researchers often encounter longitudinal health data characterized with three or more ordinal or nominal categories. Random-effects multinomial logit models are generally applied to account for potential lack of independence inherent in such clustered data. When parameter estimates are used to describe longitudinal processes, however, random effects, both between and within individuals, need to be retransformed for correctly predicting outcome probabilities. This study attempts to go beyond e...

  8. A random effects meta-analysis model with Box-Cox transformation.

    Science.gov (United States)

    Yamaguchi, Yusuke; Maruo, Kazushi; Partlett, Christopher; Riley, Richard D

    2017-07-19

    In a random effects meta-analysis model, true treatment effects for each study are routinely assumed to follow a normal distribution. However, normality is a restrictive assumption and the misspecification of the random effects distribution may result in a misleading estimate of overall mean for the treatment effect, an inappropriate quantification of heterogeneity across studies and a wrongly symmetric prediction interval. We focus on problems caused by an inappropriate normality assumption of the random effects distribution, and propose a novel random effects meta-analysis model where a Box-Cox transformation is applied to the observed treatment effect estimates. The proposed model aims to normalise an overall distribution of observed treatment effect estimates, which is sum of the within-study sampling distributions and the random effects distribution. When sampling distributions are approximately normal, non-normality in the overall distribution will be mainly due to the random effects distribution, especially when the between-study variation is large relative to the within-study variation. The Box-Cox transformation addresses this flexibly according to the observed departure from normality. We use a Bayesian approach for estimating parameters in the proposed model, and suggest summarising the meta-analysis results by an overall median, an interquartile range and a prediction interval. The model can be applied for any kind of variables once the treatment effect estimate is defined from the variable. A simulation study suggested that when the overall distribution of treatment effect estimates are skewed, the overall mean and conventional I 2 from the normal random effects model could be inappropriate summaries, and the proposed model helped reduce this issue. We illustrated the proposed model using two examples, which revealed some important differences on summary results, heterogeneity measures and prediction intervals from the normal random effects model. The

  9. Can we apply the Mendelian randomization methodology without considering epigenetic effects?

    Directory of Open Access Journals (Sweden)

    Karmaus Wilfried

    2009-05-01

    Full Text Available Abstract Introduction Instrumental variable (IV methods have been used in econometrics for several decades now, but have only recently been introduced into the epidemiologic research frameworks. Similarly, Mendelian randomization studies, which use the IV methodology for analysis and inference in epidemiology, were introduced into the epidemiologist's toolbox only in the last decade. Analysis Mendelian randomization studies using instrumental variables (IVs have the potential to avoid some of the limitations of observational epidemiology (confounding, reverse causality, regression dilution bias for making causal inferences. Certain limitations of randomized controlled trials, such as problems with generalizability, feasibility and ethics for some exposures, and high costs, also make the use of Mendelian randomization in observational studies attractive. Unlike conventional randomized controlled trials (RCTs, Mendelian randomization studies can be conducted in a representative sample without imposing any exclusion criteria or requiring volunteers to be amenable to random treatment allocation. Within the last decade, epigenetics has gained recognition as an independent field of study, and appears to be the new direction for future research into the genetics of complex diseases. Although previous articles have addressed some of the limitations of Mendelian randomization (such as the lack of suitable genetic variants, unreliable associations, population stratification, linkage disequilibrium (LD, pleiotropy, developmental canalization, the need for large sample sizes and some potential problems with binary outcomes, none has directly characterized the impact of epigenetics on Mendelian randomization. The possibility of epigenetic effects (non-Mendelian, heritable changes in gene expression not accompanied by alterations in DNA sequence could alter the core instrumental variable assumptions of Mendelian randomization. This paper applies conceptual

  10. Cost-effectiveness of online positive psychology: Randomized controlled trial

    NARCIS (Netherlands)

    Bolier, Linda; Majo, Cristina; Smit, Filip; Westerhof, Gerben Johan; Haverman, Merel; Walburg, J.A.; Riper, Heleen; Bohlmeijer, Ernst Thomas

    2014-01-01

    As yet, no evidence is available about the cost-effectiveness of positive psychological interventions. When offered via the Internet, these interventions may be particularly cost-effective, because they are highly scalable and do not rely on scant resources such as therapists’ time. Alongside a

  11. Semi-parametric estimation of random effects in a logistic regression model using conditional inference

    DEFF Research Database (Denmark)

    Petersen, Jørgen Holm

    2016-01-01

    This paper describes a new approach to the estimation in a logistic regression model with two crossed random effects where special interest is in estimating the variance of one of the effects while not making distributional assumptions about the other effect. A composite likelihood is studied...

  12. Bounding the per-protocol effect in randomized trials: An application to colorectal cancer screening

    NARCIS (Netherlands)

    S.A. Swanson (Sonja); Holme (Øyvind); M. Løberg (Magnus); M. Kalager (Mette); M. Bretthauer (Michael); G. Hoff (G.); E. Aas (Eline); M.A. Hernán (M.)

    2015-01-01

    textabstractBackground: The per-protocol effect is the effect that would have been observed in a randomized trial had everybody followed the protocol. Though obtaining a valid point estimate for the per-protocol effect requires assumptions that are unverifiable and often implausible, lower and upper

  13. The random effects prep continues to mispredict the probability of replication

    NARCIS (Netherlands)

    Iverson, G.J.; Lee, M.D.; Wagenmakers, E.-J.

    2010-01-01

    In their reply, Lecoutre and Killeen (2010) argue for a random effects version of prep, in which the observed effect from one experiment is used to predict the probability that an effect from a different but related experiment will have the same sign. They present a figure giving the impression that

  14. Comparison of strain measurement in the mouse forearm using subject-specific finite element models, strain gaging, and digital image correlation.

    Science.gov (United States)

    Begonia, Mark; Dallas, Mark; Johnson, Mark L; Thiagarajan, Ganesh

    2017-08-01

    Mechanical loading in bone leads to the activation of bone-forming pathways that are most likely associated with a minimum strain threshold being experienced by the osteocyte. To investigate the correlation between cellular response and mechanical stimuli, researchers must develop accurate ways to measure/compute strain both externally on the bone surface and internally at the osteocyte level. This study investigates the use of finite element (FE) models to compute bone surface strains on the mouse forearm. Strains from three FE models were compared to data collected experimentally through strain gaging and digital image correlation (DIC). Each FE model was assigned subject-specific bone properties and consisted of one-dimensional springs representing the interosseous membrane. After three-point bending was performed on the ulnae and radii, moment of inertia was determined from microCT analysis of the bone region between the supports and then used along with standard beam analyses to calculate the Young's modulus. Non-contact strain measurements from DIC were determined to be more suitable for validating numerical results than experimental data obtained through conventional strain gaging. When comparing strain responses in the three ulnae, we observed a 3-14% difference between numerical and DIC strains while the strain gage values were 37-56% lower than numerical values. This study demonstrates a computational approach for capturing bone surface strains in the mouse forearm. Ultimately, strains from these macroscale models can be used as inputs for microscale and nanoscale FE models designed to analyze strains directly in the osteocyte lacunae.

  15. A discrete random effects probit model with application to the demand for preventive care.

    Science.gov (United States)

    Deb, P

    2001-07-01

    I have developed a random effects probit model in which the distribution of the random intercept is approximated by a discrete density. Monte Carlo results show that only three to four points of support are required for the discrete density to closely mimic normal and chi-squared densities and provide unbiased estimates of the structural parameters and the variance of the random intercept. The empirical application shows that both observed family characteristics and unobserved family-level heterogeneity are important determinants of the demand for preventive care. Copyright 2001 John Wiley & Sons, Ltd.

  16. Effect of a dilute random field on a continuous-symmetry order parameter

    Science.gov (United States)

    Proctor, T. C.; Chudnovsky, E. M.

    2015-04-01

    X Y and Heisenberg spins, subjected to strong random fields acting at a few points in space with a concentration cr≪1 , are studied numerically on three-dimensional lattices containing over 4 ×106 sites. Glassy behavior with a strong dependence on initial conditions is found. Beginning with a random initial orientation of spins, the system evolves into ferromagnetic domains inversely proportional to cr in size. The area of the hysteresis loop m (H ) scales as cr2. These findings are explained by mapping the effect of a strong dilute random field onto the effect of a weak continuous random field. Our theory applies directly to ferromagnets with magnetic impurities, and is conceptually relevant to strongly pinned vortex lattices in superconductors and pinned charge-density waves.

  17. Estimating safety effects of pavement management factors utilizing Bayesian random effect models.

    Science.gov (United States)

    Jiang, Ximiao; Huang, Baoshan; Zaretzki, Russell L; Richards, Stephen; Yan, Xuedong

    2013-01-01

    Previous studies of pavement management factors that relate to the occurrence of traffic-related crashes are rare. Traditional research has mostly employed summary statistics of bidirectional pavement quality measurements in extended longitudinal road segments over a long time period, which may cause a loss of important information and result in biased parameter estimates. The research presented in this article focuses on crash risk of roadways with overall fair to good pavement quality. Real-time and location-specific data were employed to estimate the effects of pavement management factors on the occurrence of crashes. This research is based on the crash data and corresponding pavement quality data for the Tennessee state route highways from 2004 to 2009. The potential temporal and spatial correlations among observations caused by unobserved factors were considered. Overall 6 models were built accounting for no correlation, temporal correlation only, and both the temporal and spatial correlations. These models included Poisson, negative binomial (NB), one random effect Poisson and negative binomial (OREP, ORENB), and two random effect Poisson and negative binomial (TREP, TRENB) models. The Bayesian method was employed to construct these models. The inference is based on the posterior distribution from the Markov chain Monte Carlo (MCMC) simulation. These models were compared using the deviance information criterion. Analysis of the posterior distribution of parameter coefficients indicates that the pavement management factors indexed by Present Serviceability Index (PSI) and Pavement Distress Index (PDI) had significant impacts on the occurrence of crashes, whereas the variable rutting depth was not significant. Among other factors, lane width, median width, type of terrain, and posted speed limit were significant in affecting crash frequency. The findings of this study indicate that a reduction in pavement roughness would reduce the likelihood of traffic

  18. An effective Hamiltonian approach to quantum random walk

    Indian Academy of Sciences (India)

    2017-02-09

    Feb 9, 2017 ... We showed that in the case of two-step walk, the time evolution operator effectively can have multiplicative form. In the case of a square lattice, quantum walk has been studied computationally for different coins and the results for both the additive and the multiplica- tive approaches have been compared.

  19. Family Maltreatment, Substance Problems, and Suicidality: Randomized Prevention Effectiveness Trial

    Science.gov (United States)

    2007-02-01

    used with them.) Three years after program participation, PREP couples had higher levels of relationship satisfaction and sexual satisfaction and...Short-term effects on premarital relationships . Manuscript submitted for publication...Empirical Evidence: Better) Attitudes toward interpersonal violence, adversarial sexual beliefs, acceptance of rape myths, and sex role

  20. Gender peer effects in university: evidence from a randomized experiment

    NARCIS (Netherlands)

    Oosterbeek, H.; van Ewijk, R.

    2010-01-01

    Recent studies for primary and secondary education find positive effects of the share of girls in the classroom on achievement of boys and girls. This study examines whether these results can be extrapolated to post-secondary education. We conduct an experiment in which the shares of girls in

  1. Gender peer effects in university: Evidence from a randomized experiment

    NARCIS (Netherlands)

    Oosterbeek, H.; van Ewijk, R.

    2014-01-01

    Recent studies for primary and secondary education find positive effects of the share of females in the classroom on achievement of males and females. This study examines whether these results can be extrapolated to higher education. We conduct an experiment in which the shares of females in

  2. Childhood Resiliency Effects from Schoolwide Treatment: A Cluster Randomized Trial

    Science.gov (United States)

    Hinerman, Krystal M.; Hull, Darrell M.; Hayes, DeMarquis; Powell, Marvin G.; Ferguson, Sarah; Naslund-Hadley, Emma I.

    2014-01-01

    The purpose of the Childhood Resiliency Effects from Schoolwide Treatment (CREST) Pilot was to implement a comprehensive school wide social and character development program aimed at decreasing violence among students and assisting students exposed to violence in Belize City. This one-year pilot program implemented portions of the Positive Action…

  3. Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review

    OpenAIRE

    Perraton, Luke; Machotka, Zuzana; Kumar, Saravana

    2009-01-01

    Luke Perraton, Zuzana Machotka, Saravana KumarInternational Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, AustraliaAim: Previous systematic reviews have found hydrotherapy to be an effective management strategy for fibromyalgia syndrome (FMS). The aim of this systematic review was to summarize the components of hydrotherapy programs used in randomized controlled trials.Method: A systematic review of randomized controlled trials was conducted. Onl...

  4. Effect of yoga on quality of life of CLBP patients: A randomized control study

    OpenAIRE

    Tekur Padmini; Chametcha Singphow; Hongasandra Ramarao; Raghuram Nagarathna

    2010-01-01

    Context: In two of the earlier Randomized Control Trials on yoga for chronic lower back pain (CLBP), 12 to 16 weeks of intervention were found effective in reducing pain and disability. Aim: To study the efficacy of a residential short term intensive yoga program on quality of life in CLBP. Materials and Methods: About 80 patients with CLBP (females 37) registered for a week long treatment at SVYASA Holistic Health Centre in Bengaluru, India. They were randomized into two groups (40 each). T...

  5. Electric Crosstalk Effect in Valence Change Resistive Random Access Memory

    Science.gov (United States)

    Sun, Jing; Wang, Hong; Wu, Shiwei; Song, Fang; Wang, Zhan; Gao, Haixia; Ma, Xiaohua

    2017-08-01

    Electric crosstalk phenomenon in valence change resistive switching memory (VCM) is systematically investigated. When a voltage is applied on the VCM device, an electric field is formed in the isolated region between the devices, which causes the oxygen vacancies in conductive filaments (CFs) to drift apart, leading to a consequent resistance degradation of the neighboring devices. The effects of distance between memory cells, electrodes widths and physical dimensions of CFs on the memory performance are investigated in this work. Furthermore, the strategies to mitigate electric crosstalk effects are developed. According to the simulation results, the crosstalk phenomenon can become more severe as the distance between memory cells or the electrode width decreases. In order to optimize the device performance, it is helpful to control the location of the break points of CFs in the device close to the top electrode. Alternatively, taking the integration density into account, switching materials with a small field accelerated parameter can also contribute to obtaining a stable performance.

  6. Random operators disorder effects on quantum spectra and dynamics

    CERN Document Server

    Aizenman, Michael

    2015-01-01

    This book provides an introduction to the mathematical theory of disorder effects on quantum spectra and dynamics. Topics covered range from the basic theory of spectra and dynamics of self-adjoint operators through Anderson localization-presented here via the fractional moment method, up to recent results on resonant delocalization. The subject's multifaceted presentation is organized into seventeen chapters, each focused on either a specific mathematical topic or on a demonstration of the theory's relevance to physics, e.g., its implications for the quantum Hall effect. The mathematical chapters include general relations of quantum spectra and dynamics, ergodicity and its implications, methods for establishing spectral and dynamical localization regimes, applications and properties of the Green function, its relation to the eigenfunction correlator, fractional moments of Herglotz-Pick functions, the phase diagram for tree graph operators, resonant delocalization, the spectral statistics conjecture, and rela...

  7. A spatial error model with continuous random effects and an application to growth convergence

    Science.gov (United States)

    Laurini, Márcio Poletti

    2017-10-01

    We propose a spatial error model with continuous random effects based on Matérn covariance functions and apply this model for the analysis of income convergence processes (β -convergence). The use of a model with continuous random effects permits a clearer visualization and interpretation of the spatial dependency patterns, avoids the problems of defining neighborhoods in spatial econometrics models, and allows projecting the spatial effects for every possible location in the continuous space, circumventing the existing aggregations in discrete lattice representations. We apply this model approach to analyze the economic growth of Brazilian municipalities between 1991 and 2010 using unconditional and conditional formulations and a spatiotemporal model of convergence. The results indicate that the estimated spatial random effects are consistent with the existence of income convergence clubs for Brazilian municipalities in this period.

  8. Random-effects regression analysis of correlated grouped-time survival data.

    Science.gov (United States)

    Hedeker, D; Siddiqui, O; Hu, F B

    2000-04-01

    Random-effects regression modelling is proposed for analysis of correlated grouped-time survival data. Two analysis approaches are considered. The first treats survival time as an ordinal outcome, which is either right-censored or not. The second approach treats survival time as a set of dichotomous indicators of whether the event occurred for time periods up to the period of the event or censor. For either approach both proportional hazards and proportional odds versions of the random-effects model are developed, while partial proportional hazards and odds generalizations are described for the latter approach. For estimation, a full-information maximum marginal likelihood solution is implemented using numerical quadrature to integrate over the distribution of multiple random effects. The quadrature solution allows some flexibility in the choice of distributions for the random effects; both normal and rectangular distributions are considered in this article. An analysis of a dataset where students are clustered within schools is used to illustrate features of random-effects analysis of clustered grouped-time survival data.

  9. Multivariable Mendelian randomization: the use of pleiotropic genetic variants to estimate causal effects.

    Science.gov (United States)

    Burgess, Stephen; Thompson, Simon G

    2015-02-15

    A conventional Mendelian randomization analysis assesses the causal effect of a risk factor on an outcome by using genetic variants that are solely associated with the risk factor of interest as instrumental variables. However, in some cases, such as the case of triglyceride level as a risk factor for cardiovascular disease, it may be difficult to find a relevant genetic variant that is not also associated with related risk factors, such as other lipid fractions. Such a variant is known as pleiotropic. In this paper, we propose an extension of Mendelian randomization that uses multiple genetic variants associated with several measured risk factors to simultaneously estimate the causal effect of each of the risk factors on the outcome. This "multivariable Mendelian randomization" approach is similar to the simultaneous assessment of several treatments in a factorial randomized trial. In this paper, methods for estimating the causal effects are presented and compared using real and simulated data, and the assumptions necessary for a valid multivariable Mendelian randomization analysis are discussed. Subject to these assumptions, we demonstrate that triglyceride-related pathways have a causal effect on the risk of coronary heart disease independent of the effects of low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

  10. Analysis of subsystem randomness effects on the mid-frequency vibrations of built-up structures

    Science.gov (United States)

    Ji, Lin; Huang, Zhenyu

    2013-06-01

    The paper concerns the analysis of subsystem randomness effects on the mid-frequency vibration responses of built-up systems. The system model considered, in the first instance, is a long-wavelength finite element (FE) subsystem connected with a short-wavelength statistical energy analysis (SEA) subsystem via discrete couplings. The randomness effects of the SEA subsystem on both the displacement response of the FE subsystem and the energy response of the SEA subsystem are then investigated under the frame of the hybrid FE/SEA theory [P. Shorter, R. Langley, Vibro-acoustic analysis of complex systems, Journal of Sound and Vibration, 288 (2005) 669-700]. It is found that the subsystem randomness effects may be well indicated by a dimensionless parameter α, which is a function of the number of coupling points, the dynamic mismatch between the FE and SEA subsystems and the modal overlap factor of the SEA subsystem. The smaller the value of α is, the more insignificant the randomness effects are. As a result, a so-called "α-criterion" is derived which states that, if a built-up structure satisfies the condition of α≪1, the randomness effects of the SEA subsystem can be neglected. In this case, the SEA subsystem can be simply treated as an infinite (or semi-infinite as appropriate) structure regardless of its mode count being sufficiently high or not. Numerical examples are presented to illustrate the validity of the present theory.

  11. Transient Adverse Side Effects During Neurofeedback Training: A Randomized, Sham-Controlled, Double Blind Study.

    Science.gov (United States)

    Rogel, Ainat; Guez, Jonathan; Getter, Nir; Keha, Eldad; Cohen, Tzlil; Amor, Tali; Todder, Doron

    2015-09-01

    The benefits of clinical neurofeedback training are well known, however, its adverse side-effects are less studied. This research focuses on the transient adverse side effects of neurofeedback training via a double-blind, sham/controlled methodology. Thirty healthy undergraduate students volunteers were randomly divided into three treatment groups: increasing a modified Sensory Motor Rhythm, increasing Upper Alpha, and Sham/control group who receive a random reward. The training sessions were administered for a total of ten sessions. Questionnaires of transient adverse side effects were completed by all volunteers before each session. The results suggest that similar to most medical treatments, neurofeedback can cause transient adverse side effects. Moreover, most participants reported experiencing some side effects. The side effects can be divided into non-specific side effect, associated with the neurofeedback training in general and specific ones associated with the particular protocol. Sensory Motor Rhythm protocol seems to be the most sensitive to side effects.

  12. Open, randomized trial of the effects of aripiprazole versus risperidone on social cognition in schizophrenia

    NARCIS (Netherlands)

    Maat, Arija; Cahn, Wiepke; Gijsman, Harm J.; Hovens, Johannes E.; Kahn, Rene S.; Aleman, Andre

    To date, only few studies have examined the impact of medication on social cognition and none have examined the effects of aripiprazole in this respect. The goal of this 8-week, randomized, multicenter, open-label study was to examine the effects of aripiprazole and risperidone on social cognition

  13. Power for Detecting Treatment by Moderator Effects in Two- and Three-Level Cluster Randomized Trials

    Science.gov (United States)

    Spybrook, Jessaca; Kelcey, Benjamin; Dong, Nianbo

    2016-01-01

    Recently, there has been an increase in the number of cluster randomized trials (CRTs) to evaluate the impact of educational programs and interventions. These studies are often powered for the main effect of treatment to address the "what works" question. However, program effects may vary by individual characteristics or by context,…

  14. Maternal Smoking During Pregnancy and Childhood Growth Trajectory: A Random Effects Regression Analysis

    OpenAIRE

    Suzuki, Kohta; Kondo, Naoki; Sato, Miri; Tanaka, Taichiro; Ando, Daisuke; Yamagata, Zentaro

    2012-01-01

    Background Although maternal smoking during pregnancy has been reported to have an effect on childhood overweight/obesity, the impact of maternal smoking on the trajectory of the body mass of their offspring is not very clear. Previously, we investigated this effect by using a fixed-effect model. However, this analysis was limited because it rounded and categorized the age of the children. Therefore, we used a random-effects hierarchical linear regression model in the present study. Methods T...

  15. Effects of zinc supplementation on subscales of anorexia in children: A randomized controlled trial.

    Science.gov (United States)

    Khademian, Majid; Farhangpajouh, Neda; Shahsanaee, Armindokht; Bahreynian, Maryam; Mirshamsi, Mehran; Kelishadi, Roya

    2014-01-01

    This study aims to assess the effects of zinc supplementation on improving the appetite and its subscales in children. This study was conducted in 2013 in Isfahan, Iran. It had two phases. At the first step, after validation of the Child Eating Behaviour Questionaire (CEBQ), it was completed for 300 preschool children, who were randomly selected. The second phase was conducted as a randomized controlled trial. Eighty of these children were randomly selected, and were randomly assigned to two groups of equal number receiving zinc (10 mg/day) or placebo for 12 weeks. Overall 77 children completed the trial (39 in the case and 3 in the control group).The results showed that zinc supplement can improve calorie intake in children by affecting some CEBQ subscales like Emotional over Eating and Food Responsible. Zinc supplementation had positive impact in promoting the calorie intake and some subscales of anorexia.

  16. Multi-scale random sets: from morphology to effective properties and to fracture statistics

    Energy Technology Data Exchange (ETDEWEB)

    Jeulin, Dominique, E-mail: dominique.jeulin@mines-paristech.fr [Centre de Morphologie Mathematique, Mathematiques et Systemes, Mines ParisTech 35 rue Saint-Honore, F77300 Fontainebleau (France)

    2011-09-15

    Complex microstructures in materials often involve multi-scale heterogeneous textures, modelled by random sets derived from Mathematical Morphology. Starting from 2D or 3D images, a complete morphological characterization by image analysis is performed, and used for the identification of a model of random structure. From morphological models, simulations of realistic microstructures are introduced in a numerical solver to compute appropriate fields (electric, elastic stress or strain, ...) and to estimate the effective properties by numerical homogenization, accounting for scale dependent statistical fluctuations of the fields. Our approach is illustrated by various examples of multi-scale models: Boolean random sets based on Cox point processes and various random grains (spheres, cylinders), showing a very low percolation threshold, and therefore a high conductivity or high elastic moduli for a low volume fraction of a second phase. Multiscale Cox point processes are also a source of instructive models of fracture statistics, such as multiscale weakest link models.

  17. Disentangling the effects of alternation rate and maximum run length on judgments of randomness

    Directory of Open Access Journals (Sweden)

    Sabine G. Scholl

    2011-08-01

    Full Text Available Binary sequences are characterized by various features. Two of these characteristics---alternation rate and run length---have repeatedly been shown to influence judgments of randomness. The two characteristics, however, have usually been investigated separately, without controlling for the other feature. Because the two features are correlated but not identical, it seems critical to analyze their unique impact, as well as their interaction, so as to understand more clearly what influences judgments of randomness. To this end, two experiments on the perception of binary sequences orthogonally manipulated alternation rate and maximum run length (i.e., length of the longest run within the sequence. Results show that alternation rate consistently exerts a unique effect on judgments of randomness, but that the effect of alternation rate is contingent on the length of the longest run within the sequence. The effect of maximum run length was found to be small and less consistent. Together, these findings extend prior randomness research by integrating literature from the realms of perception, categorization, and prediction, as well as by showing the unique and joint effects of alternation rate and maximum run length on judgments of randomness.

  18. Effect of Polydispersity on Diffusion in Random Obstacle Matrices

    Science.gov (United States)

    Cho, Hyun Woo; Kwon, Gyemin; Sung, Bong June; Yethiraj, Arun

    2012-10-01

    The dynamics of tracers in disordered matrices is of interest in a number of diverse areas of physics such as the biophysics of crowding in cells and cell membranes, and the diffusion of fluids in porous media. To a good approximation the matrices can be modeled as a collection of spatially frozen particles. In this Letter, we consider the effect of polydispersity (in size) of the matrix particles on the dynamics of tracers. We study a two dimensional system of hard disks diffusing in a sea of hard disk obstacles, for different values of the polydispersity of the matrix. We find that for a given average size and area fraction, the diffusion of tracers is very sensitive to the polydispersity. We calculate the pore percolation threshold using Apollonius diagrams. The diffusion constant, D, follows a scaling relation D˜(ϕc-ϕm)μ-β for all values of the polydispersity, where ϕm is the area fraction and ϕc is the value of ϕm at the percolation threshold.

  19. A dynamic random effects multinomial logit model of household car ownership

    DEFF Research Database (Denmark)

    Bue Bjørner, Thomas; Leth-Petersen, Søren

    2007-01-01

    Using a large household panel we estimate demand for car ownership by means of a dynamic multinomial model with correlated random effects. Results suggest that the persistence in car ownership observed in the data should be attributed to both true state dependence and to unobserved heterogeneity...... (random effects). It also appears that random effects related to single and multiple car ownership are correlated, suggesting that the IIA assumption employed in simple multinomial models of car ownership is invalid. Relatively small elasticities with respect to income and car costs are estimated....... It should, however, be noted that the level of state dependence is considerably larger for households with single car ownership as compared with multiple car ownership. This suggests that the holding of a second car will be more affected by changes in the socioeconomic conditions of the household...

  20. 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

  1. Predicting longitudinal trajectories of health probabilities with random-effects multinomial logit regression.

    Science.gov (United States)

    Liu, Xian; Engel, Charles C

    2012-12-20

    Researchers often encounter longitudinal health data characterized with three or more ordinal or nominal categories. Random-effects multinomial logit models are generally applied to account for potential lack of independence inherent in such clustered data. When parameter estimates are used to describe longitudinal processes, however, random effects, both between and within individuals, need to be retransformed for correctly predicting outcome probabilities. This study attempts to go beyond existing work by developing a retransformation method that derives longitudinal growth trajectories of unbiased health probabilities. We estimated variances of the predicted probabilities by using the delta method. Additionally, we transformed the covariates' regression coefficients on the multinomial logit function, not substantively meaningful, to the conditional effects on the predicted probabilities. The empirical illustration uses the longitudinal data from the Asset and Health Dynamics among the Oldest Old. Our analysis compared three sets of the predicted probabilities of three health states at six time points, obtained from, respectively, the retransformation method, the best linear unbiased prediction, and the fixed-effects approach. The results demonstrate that neglect of retransforming random errors in the random-effects multinomial logit model results in severely biased longitudinal trajectories of health probabilities as well as overestimated effects of covariates on the probabilities. Copyright © 2012 John Wiley & Sons, Ltd.

  2. Using observation-level random effects to model overdispersion in count data in ecology and evolution

    Directory of Open Access Journals (Sweden)

    Xavier A. Harrison

    2014-10-01

    Full Text Available Overdispersion is common in models of count data in ecology and evolutionary biology, and can occur due to missing covariates, non-independent (aggregated data, or an excess frequency of zeroes (zero-inflation. Accounting for overdispersion in such models is vital, as failing to do so can lead to biased parameter estimates, and false conclusions regarding hypotheses of interest. Observation-level random effects (OLRE, where each data point receives a unique level of a random effect that models the extra-Poisson variation present in the data, are commonly employed to cope with overdispersion in count data. However studies investigating the efficacy of observation-level random effects as a means to deal with overdispersion are scarce. Here I use simulations to show that in cases where overdispersion is caused by random extra-Poisson noise, or aggregation in the count data, observation-level random effects yield more accurate parameter estimates compared to when overdispersion is simply ignored. Conversely, OLRE fail to reduce bias in zero-inflated data, and in some cases increase bias at high levels of overdispersion. There was a positive relationship between the magnitude of overdispersion and the degree of bias in parameter estimates. Critically, the simulations reveal that failing to account for overdispersion in mixed models can erroneously inflate measures of explained variance (r2, which may lead to researchers overestimating the predictive power of variables of interest. This work suggests use of observation-level random effects provides a simple and robust means to account for overdispersion in count data, but also that their ability to minimise bias is not uniform across all types of overdispersion and must be applied judiciously.

  3. The effective density of randomly moving electrons and related characteristics of materials with degenerate electron gas

    Directory of Open Access Journals (Sweden)

    V. Palenskis

    2014-04-01

    Full Text Available Interpretation of the conductivity of metals, of superconductors in the normal state and of semiconductors with highly degenerate electron gas remains a significant issue if consideration is based on the classical statistics. This study is addressed to the characterization of the effective density of randomly moving electrons and to the evaluation of carrier diffusion coefficient, mobility, and other parameters by generalization of the widely published experimental results. The generalized expressions have been derived for various kinetic parameters attributed to the non-degenerate and degenerate electron gas, by analyzing a random motion of the single type carriers in homogeneous materials. The values of the most important kinetic parameters for different metals are also systematized and discussed. It has been proved that Einstein's relation between the diffusion coefficient and the drift mobility of electrons is held for any level of degeneracy if the effective density of randomly moving carriers is properly taken into account.

  4. Effects of excluding a set of random effects on prediction error variance of breeding value.

    Science.gov (United States)

    Cantet, R J

    1997-01-12

    The effects of excluding a set of random effects (U-effects) uncorrelated to breeding values (BV) on prediction error variance (PEV) is studied analytically. Two situations are considered for model comparison: (a) existence of a 'true' model, (b) uncertainty about which of the competing models is 'true'. Models compared are the 'long' one, which includes BV + U-effects, and the 'short' one which includes BV's as the only random systematic effect. Expressions for PEV(BV) were obtained for the long model (PEVL); the short model (PEVS); and the short model assuming the long model is the correct one (PEVSI). It is shown that in general PEVS ≤ PEVL ≤ PEVSI. Results are exemplified by means of an example including a computer simulation. RESUMEN: En este trabajo se estudia analiticamente el efecto de excluir una variable aleatoria (efecto U) no correlacionada con el valor de cría (BV), sobre la varianza del error de predicción de este último (PEV(BV)). Para ello se utilizan dos enfoques de comparación de modelos: (a) existencia de un modelo 'verdadero', (b) incertidumbre respecto de cuál de ambos modelos alternativos es el correcto. Los modelos que se comparan son: el 'largo', que incluye BV+U, y el 'corto', el cuál solo incluye BV. Se obtienen las expresiones para PEV(BV) en las siguientes situaciones: (1) en el modelo largo (PEVL), (2) en el modelo corto (PEVS), y (3) en el modelo corto pero asumiendo que el largo es el verdadero (PEVSI). Se demuestra que en general PEVS ≤ PEVL ≤ PEVSI. Los resultados obtenidos son ilustrados mediante un ejemplo que incluye una simulación estocástica. ZUSAMMENFASSUNG: Veränderung der Fehlervarianz der Zuchtwertvoraussage durch Vernachlässigung einer Gruppe zufäliger Wirkungen. Es wird die Auswirkung der Ausschaltung einer Gruppe zufälliger Wirkungen (U-effects), die mit Zuchtwerten (BV) nicht korreliert sind, auf die Varianz des Voraussage-Fehlers (PEV) analytisch untersucht. Zwei Modelle werden betrachtet: (a

  5. Effectiveness of Stepped Care for Chronic Fatigue Syndrome: A Randomized Noninferiority Trial

    Science.gov (United States)

    Tummers, Marcia; Knoop, Hans; Bleijenberg, Gijs

    2010-01-01

    Objective: In this randomized noninferiority study, the effectiveness and efficiency of stepped care for chronic fatigue syndrome (CFS) was compared to care as usual. Stepped care was formed by guided self-instruction, followed by cognitive behavior therapy (CBT) if the patient desired it. Care as usual encompassed CBT after a waiting period.…

  6. Effects of Aerobic Exercise on Overweight Children's Cognitive Functioning: A Randomized Controlled Trial

    Science.gov (United States)

    Davis, Catherine L.; Tomporowski, Phillip D.; Boyle, Colleen A.; Waller, Jennifer L.; Miller, Patricia H.; Naglieri, Jack A.; Gregoski, Mathew

    2007-01-01

    The study tested the effect of aerobic exercise training on executive function in overweight children. Ninety-four sedentary, overweight but otherwise healthy children (mean age = 9.2 years, body mass index [greater than or equal to] 85th percentile) were randomized to a low-dose (20 min/day exercise), high-dose (40 min/day exercise), or control…

  7. The effect of financial rewards on students' achievement: Evidence from a randomized experiment

    NARCIS (Netherlands)

    Leuven, E.; Oosterbeek, H.; van der Klaauw, B.

    2010-01-01

    This paper reports on a randomized field experiment in which first-year university students could earn financial rewards for passing all first-year requirements within one year. Financial incentives turn out to have positive effects on achievement of high-ability students, whereas they have a

  8. The Effect of Teacher-Family Communication on Student Engagement: Evidence from a Randomized Field Experiment

    Science.gov (United States)

    Kraft, Matthew A.; Dougherty, Shaun M.

    2013-01-01

    In this study, we evaluate the efficacy of teacher communication with parents and students as a means of increasing student engagement. We estimate the causal effect of teacher communication by conducting a randomized field experiment in which sixth- and ninth-grade students were assigned to receive a daily phone call home and a text/written…

  9. Healthy Families New York (HFNY) Randomized Trial: Effects on Early Child Abuse and Neglect

    Science.gov (United States)

    DuMont, Kimberly; Mitchell-Herzfeld, Susan; Greene, Rose; Lee, Eunju; Lowenfels, Ann; Rodriguez, Monica; Dorabawila, Vajeera

    2008-01-01

    Objective: To evaluate the effects of a home visiting program modeled after Healthy Families America on parenting behaviors in the first 2 years of life. Methods: A sample of 1173 families at risk for child abuse and neglect who met the criteria for Healthy Families New York (HFNY) was randomly assigned to either an intervention group that was…

  10. The Effectiveness of Two Grammar Treatment Procedures for Children with SLI: A Randomized Clinical Trial

    Science.gov (United States)

    Smith-Lock, Karen M.; Leitão, Suze; Prior, Polly; Nickels, Lyndsey

    2015-01-01

    Purpose: This study compared the effectiveness of two grammar treatment procedures for children with specific language impairment. Method: A double-blind superiority trial with cluster randomization was used to compare a cueing procedure, designed to elicit a correct production following an initial error, to a recasting procedure, which required…

  11. Effect of fish oil on cognitive performance in older subjects: a randomized, controlled trial

    NARCIS (Netherlands)

    van de Rest, O.; Geleijnse, J.M.; Kok, F. J.; van Staveren, W.A.; Dullemeijer, C.; Olde Rikkert, M.G.M.; Beekman, A.T.F.; de Groot, C.P.

    2008-01-01

    Background: High intake of n-3 polyunsaturated fatty acids may protect against age-related cognitive decline. However, results from epidemiologic studies are inconclusive, and results from randomized trials in elderly subjects without dementia are lacking. Objective: To investigate the effect of

  12. Effectiveness of the random sequential absorption algorithm in the analysis of volume elements with nanoplatelets

    DEFF Research Database (Denmark)

    Pontefisso, Alessandro; Zappalorto, Michele; Quaresimin, Marino

    2016-01-01

    In this work, a study of the Random Sequential Absorption (RSA) algorithm in the generation of nanoplatelet Volume Elements (VEs) is carried out. The effect of the algorithm input parameters on the reinforcement distribution is studied through the implementation of statistical tools, showing...

  13. A Mixture Proportional Hazards Model with Random Effects for Response Times in Tests

    Science.gov (United States)

    Ranger, Jochen; Kuhn, Jörg-Tobias

    2016-01-01

    In this article, a new model for test response times is proposed that combines latent class analysis and the proportional hazards model with random effects in a similar vein as the mixture factor model. The model assumes the existence of different latent classes. In each latent class, the response times are distributed according to a…

  14. Moving from Efficacy to Effectiveness in Cognitive Behavioral Therapy for Psychosis: A Randomized Clinical Practice Trial

    Science.gov (United States)

    Lincoln, Tania M.; Ziegler, Michael; Mehl, Stephanie; Kesting, Marie-Luise; Lullmann, Eva; Westermann, Stefan; Rief, Winfried

    2012-01-01

    Objective: Randomized controlled trials have attested the efficacy of cognitive behavioral therapy (CBT) in reducing psychotic symptoms. Now, studies are needed to investigate its effectiveness in routine clinical practice settings. Method: Eighty patients with schizophrenia spectrum disorders who were seeking outpatient treatment were randomized…

  15. The effects of motivation feedback in patients with severe mental illness: A cluster randomized controlled trial

    NARCIS (Netherlands)

    E.C. Jochems (Eline); C.M. van der Feltz-Cornelis (Christina); A. van Dam (Arno); H.J. Duivenvoorden (Hugo); C.L. Mulder (Niels)

    2015-01-01

    textabstractObjective: To evaluate the effectiveness of providing clinicians with regular feedback on the patient’s motivation for treatment in increasing treatment engagement in patients with severe mental illness.Methods: Design: cluster randomized controlled trial (Dutch Trials Registry NTR2968).

  16. Effectiveness of an early intervention for panic symptoms: Randomized controlled trial

    NARCIS (Netherlands)

    Meulenbeek, Petrus Antonius Maria

    2012-01-01

    EFFECTIVENESS OF AN EARLY INTERVENTION FOR PANIC SYMPTOMS: RANDOMIZED CONTROLLED TRIAL Peter Meulenbeek¹,3,4, Godelief Willemse², Filip Smit²,3, Pim Cuijpers²,3 ¹ GGNet, the Netherlands; UTwente ² Trimbos instituut, Netherlands Institute of Mental Health and Addiction ³ Vrije Universiteit van

  17. Bayesian estimation in animal breeding using the Dirichlet process prior for correlated random effects

    Directory of Open Access Journals (Sweden)

    Pretorius Albertus

    2003-03-01

    Full Text Available Abstract In the case of the mixed linear model the random effects are usually assumed to be normally distributed in both the Bayesian and classical frameworks. In this paper, the Dirichlet process prior was used to provide nonparametric Bayesian estimates for correlated random effects. This goal was achieved by providing a Gibbs sampler algorithm that allows these correlated random effects to have a nonparametric prior distribution. A sampling based method is illustrated. This method which is employed by transforming the genetic covariance matrix to an identity matrix so that the random effects are uncorrelated, is an extension of the theory and the results of previous researchers. Also by using Gibbs sampling and data augmentation a simulation procedure was derived for estimating the precision parameter M associated with the Dirichlet process prior. All needed conditional posterior distributions are given. To illustrate the application, data from the Elsenburg Dormer sheep stud were analysed. A total of 3325 weaning weight records from the progeny of 101 sires were used.

  18. Cost effectiveness of arthrocentesis as initial treatment for temporomandibular joint arthralgia: A randomized controlled trial

    NARCIS (Netherlands)

    Vos, L.M.; Stant, A.D.; Quik, E.H.; Huddleston Slater, J.J.R.; Stegenga, B.

    2013-01-01

    Objective: To determine the cost effectiveness of arthrocentesis as initial treatment compared to care as usual (CAU) for temporomandibular joint (TMJ) arthralgia. Materials and methods: 80 patients were randomly allocated to arthrocentesis as initial treatment (n = 40) or CAU (n = 40).

  19. Exploring Mechanisms of Effective Teacher Coaching: A Tale of Two Cohorts From a Randomized Experiment

    Science.gov (United States)

    Blazar, David; Kraft, Matthew A.

    2015-01-01

    Although previous research has shown that teacher coaching can improve teaching practices and student achievement, little is known about specific features of effective coaching programs. We estimate the impact of MATCH Teacher Coaching (MTC) on a range of teacher practices using a blocked randomized trial and explore how changes in the coaching…

  20. High Performance Ambipolar Field-Effect Transistor of Random Network Carbon Nanotubes

    NARCIS (Netherlands)

    Bisri, Satria Zulkarnaen; Gao, Jia; Derenskyi, Vladimir; Gomulya, Widianta; Iezhokin, Igor; Gordiichuk, Pavlo; Herrmann, Andreas; Loi, Maria Antonietta

    2012-01-01

    Ambipolar field-effect transistors of random network carbon nanotubes are fabricated from an enriched dispersion utilizing a conjugated polymer as the selective purifying medium. The devices exhibit high mobility values for both holes and electrons (3 cm(2)/V.s) with a high on/off ratio (10(6)). The

  1. Effect of a mobile app intervention on vegetable consumption in overweight adults: a randomized controlled trial

    OpenAIRE

    Mummah, Sarah; Robinson, Thomas N; Mathur, Maya; Farzinkhou, Sarah; Sutton, Stephen; Gardner, Christopher D

    2017-01-01

    Abstract Background Mobile applications (apps) have been heralded as transformative tools to deliver behavioral health interventions at scale, but few have been tested in rigorous randomized controlled trials. We tested the effect of a mobile app to increase vegetable consumption among overweight adults attempting weight loss maintenance. Methods Overweight adults ...

  2. Effect of particle shape on the random packing density of amorphous solids

    NARCIS (Netherlands)

    Kyrylyuk, A.V.|info:eu-repo/dai/nl/269067590; Philipse, A.P.|info:eu-repo/dai/nl/073532894

    2011-01-01

    The packing density of a particulate solid strongly depends on the shape of the particles that are jammed at random close packing (RCP). To investigate the effect of particle shape on the RCP density of an amorphous solid, we studied jammed packings of binary mixtures of a-thermal or granular

  3. Effects of PMTO in foster families with children with behavior problems : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Maaskant, A.M.; van Rooij, F.B.; Overbeek, G.J.; Oort, F.J.; Arntz, M.; Hermanns, J.M.A.

    The present randomized controlled trial examined the effectiveness of Parent Management Training Oregon for foster parents with foster children (aged 4–12) with severe externalizing behavior problems in long-term foster care arrangements. Foster children’s behavior problems are challenging for

  4. Infant orthopedics in UCLP: effect on feeding, weight, and length: a randomized clinical trial (Dutchcleft).

    NARCIS (Netherlands)

    Prahl, C.; Kuijpers-Jagtman, A.M.; Hof, M.A. van 't; Prahl-Andersen, B.

    2005-01-01

    OBJECTIVE: To study the effects of infant orthopedics (IO) on feeding, weight, and length. DESIGN: Prospective two-arm randomized controlled trial in three academic Cleft Palate Centers. Treatment allocation was concealed and performed by means of a computerized balanced allocation method. SETTING:

  5. P2 : A random effects model with covariates for directed graphs

    NARCIS (Netherlands)

    van Duijn, M.A.J.; Snijders, T.A.B.; Zijlstra, B.J.H.

    A random effects model is proposed for the analysis of binary dyadic data that represent a social network or directed graph, using nodal and/or dyadic attributes as covariates. The network structure is reflected by modeling the dependence between the relations to and from the same actor or node.

  6. The effect of early entrepreneurship education: evidence from a randomized field experiment

    NARCIS (Netherlands)

    Rosendahl Huber, L.; Sloof, R.; van Praag, M.

    2012-01-01

    The aim of this study is to analyze the effectiveness of early entrepreneurship education. To this end, we conduct a randomized field experiment to evaluate a leading entrepreneurship education program that is taught worldwide in the final grade of primary school. We focus on pupils' development of

  7. Firm-Related Training Tracks: A Random Effects Ordered Probit Model

    Science.gov (United States)

    Groot, Wim; van den Brink, Henriette Maassen

    2003-01-01

    A random effects ordered response model of training is estimated to analyze the existence of training tracks and time varying coefficients in training frequency. Two waves of a Dutch panel survey of workers are used covering the period 1992-1996. The amount of training received by workers increased during the period 1994-1996 compared to…

  8. Testing Mediators of Intervention Effects in Randomized Controlled Trials: An Evaluation of Three Depression Prevention Programs

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Seeley, John R.; Gau, Jeff M.

    2010-01-01

    Objective: Evaluate a new 5-step method for testing mediators hypothesized to account for the effects of depression prevention programs. Method: In this indicated prevention trial, at-risk teens with elevated depressive symptoms were randomized to a group cognitive-behavioral (CB) intervention, group supportive expressive intervention, CB…

  9. Does epicatechin contribute to the acute vascular function effects of dark chocolate? A randomized, crossover study

    NARCIS (Netherlands)

    Dower, James I.; Geleijnse, Marianne; Kroon, Paul A.; Philo, Mark; Mensink, Marco; Kromhout, Daan; Hollman, Peter C.H.

    2016-01-01

    Scope: Cocoa, rich in flavan-3-ols, improves vascular function, but the contribution of specific flavan-3-ols is unknown. We compared the effects of pure epicatechin, a major cocoa flavan-3-ol, and chocolate. Methods and results: In a randomized crossover study, twenty healthy men (40-80 years)

  10. Effect of fish oil on cognitive performance in older subjects: a randomized, controlled trial.

    NARCIS (Netherlands)

    Rest, O van de; Geleijnse, J.M.; Kok, F.J.; Staveren, W.A. van; Dullemeijer, C.; Olderikkert, M.G.; Beekman, A.T.; Groot, CP de

    2008-01-01

    BACKGROUND: High intake of n-3 polyunsaturated fatty acids may protect against age-related cognitive decline. However, results from epidemiologic studies are inconclusive, and results from randomized trials in elderly subjects without dementia are lacking. OBJECTIVE: To investigate the effect of

  11. Therapeutic Effect of Virtual Reality on Post-Stroke Patients: Randomized Clinical Trial.

    Science.gov (United States)

    Pedreira da Fonseca, Erika; Ribeiro da Silva, Nildo Manoel; Pinto, Elen Beatriz

    2017-01-01

    The study aimed to check the therapeutic effect of virtual reality associated with conventional physiotherapy on gait balance and the occurrence of falls after a stroke. This was a randomized, blinded clinical trial conducted with post-stroke patients, randomized into two groups-treatment group and control group-and subjected to balance assessments by the Dynamic Gait Index and investigation of falls before and after 20 intervention sessions. Statistically significant difference was considered at P rehabilitation in post-stroke patients, with repercussions on the reduction of falls. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  12. The effect of spatial randomness on the average fixation time of mutants

    Science.gov (United States)

    Farhang-Sardroodi, Suzan; Darooneh, Amir H.; Nikbakht, Moladad; Kohandel, Mohammad

    2017-01-01

    The mean conditional fixation time of a mutant is an important measure of stochastic population dynamics, widely studied in ecology and evolution. Here, we investigate the effect of spatial randomness on the mean conditional fixation time of mutants in a constant population of cells, N. Specifically, we assume that fitness values of wild type cells and mutants at different locations come from given probability distributions and do not change in time. We study spatial arrangements of cells on regular graphs with different degrees, from the circle to the complete graph, and vary assumptions on the fitness probability distributions. Some examples include: identical probability distributions for wild types and mutants; cases when only one of the cell types has random fitness values while the other has deterministic fitness; and cases where the mutants are advantaged or disadvantaged. Using analytical calculations and stochastic numerical simulations, we find that randomness has a strong impact on fixation time. In the case of complete graphs, randomness accelerates mutant fixation for all population sizes, and in the case of circular graphs, randomness delays mutant fixation for N larger than a threshold value (for small values of N, different behaviors are observed depending on the fitness distribution functions). These results emphasize fundamental differences in population dynamics under different assumptions on cell connectedness. They are explained by the existence of randomly occurring “dead zones” that can significantly delay fixation on networks with low connectivity; and by the existence of randomly occurring “lucky zones” that can facilitate fixation on networks of high connectivity. Results for death-birth and birth-death formulations of the Moran process, as well as for the (haploid) Wright Fisher model are presented. PMID:29176825

  13. Re-evaluation of randomized control trials of lithium monotherapy: a cohort effect.

    Science.gov (United States)

    Deshauer, D; Fergusson, D; Duffy, A; Albuquerque, J; Grof, P

    2005-08-01

    The reported reduction of lithium's efficacy in the prophylaxis of bipolar illness has been attributed to various factors, including diagnostic changes and heterogeneous study designs. We attempted to quantify the impact of pre-randomization enrichment designs and diagnostic drift on randomized controlled trials (RCTs) of lithium maintenance therapy. Using the Cochrane RCT search filter, MEDLINE, EMBASE, and PSYCHINFO were searched (1966 to June 2004) for all available randomized studies using the text word 'lithium'. Studies of 1 year minimum duration in bipolar disorder involving lithium and placebo arms were identified. Superiority trials without a placebo arm, discontinuation and mirror image studies were excluded. Standardized scales were used to assess randomization and allocation concealment. Nine RCTs enrolling 1432 bipolar I and II patients, randomizing 341 to lithium and 386 to placebo were identified, with 705 reported pre-randomization dropouts. The pooled odds of remaining recurrence free in two non-enriched RCTS using Research Diagnostic Criteria (RDC) or Feighner criteria were 3.2:1 (95% CI 0.65--15.46) trending in favor of lithium over placebo, and 22.0:1 (95% CI 7.0--68.7) for three trials using lithium enrichment and excluding atypical bipolar disorder. The odds of remaining recurrence free using DSM-IV criteria and lamotrigine enrichment were 1.9:1 (95% CI 1.2-2.8). Lithium maintenance RCTs differ in patient selection, design, and outcome. A cohort effect can be associated with the use of pre-randomization enrichment phases and, to a lesser extent, with diagnostic drift, compromising straightforward comparisons across three decades of lithium monotherapy in bipolar illness.

  14. Investigating the Dynamic Effects of Counterfeits with a Random Changepoint Simultaneous Equation Model

    OpenAIRE

    Yi Qian; Hui Xie

    2011-01-01

    Using a unique panel dataset and a new model, this article investigates the dynamic effects of counterfeit sales on authentic-product price dynamics. We propose a Bayesian random-changepoint simultaneous equation model that simultaneously takes into account three important features in empirical studies: (1) Endogeneity of a market entry, (2) Nonstationarity of the entry effects and (3) Heterogeneity of the firms' response behaviors. Besides accounting for the endogeneity of counterfeiting, th...

  15. Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial

    OpenAIRE

    Dias, Letícia A. R.; Driusso, Patricia; Daniella L. C. C. Aita; Quintana, Silvana M.; Bø, Kari; Cristine H. J. Ferreira

    2011-01-01

    BACKGROUND: The use of the pelvic floor muscle training for urinary incontinence treatment is well established but little is known about its effects in labor and newborn outcomes. OBJECTIVES: To evaluate the effects of antenatal pelvic floor muscle training and strength in labor and newborn outcomes in low-income pregnant women. METHODS: This is a randomized controlled trial that recruited forty-two nulliparous healthy pregnant women aged between 18-36 years old and able to contract the pelvi...

  16. Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis: A randomized controlled trial.

    Science.gov (United States)

    Blikman, Lyan Jm; van Meeteren, Jetty; Twisk, Jos Wr; de Laat, Fred Aj; de Groot, Vincent; Beckerman, Heleen; Stam, Henk J; Bussmann, Johannes Bj

    2017-10-01

    Fatigue is a frequently reported and disabling symptom in multiple sclerosis (MS). To investigate the effectiveness of an individual energy conservation management (ECM) intervention on fatigue and participation in persons with primary MS-related fatigue. A total of 86 severely fatigued and ambulatory adults with a definite diagnosis of MS were randomized in a single-blind, two-parallel-arm randomized clinical trial to the ECM group or the information-only control group in outpatient rehabilitation departments. Blinded assessments were carried out at baseline and at 8, 16, 26 and 52 weeks after randomization. Primary outcomes were fatigue (fatigue subscale of Checklist Individual Strength - CIS20r) and participation (Impact on Participation and Autonomy scale - IPA). Modified intention-to-treat analysis was based on 76 randomized patients (ECM, n = 36; MS nurse, n=40). No significant ECM effects were found for fatigue (overall difference CIS20r between the groups = -0.81; 95% confidence interval (CI), -3.71 to 2.11) or for four out of five IPA domains. An overall unfavourable effect was found in the ECM group for the IPA domain social relations (difference between the groups = 0.19; 95% CI, 0.03 to 0.35). The individual ECM format used in this study did not reduce MS-related fatigue and restrictions in participation more than an information-only control condition.

  17. Minimizing nocebo effects by conditioning with verbal suggestion: A randomized clinical trial in healthy humans.

    Science.gov (United States)

    Bartels, Danielle J P; van Laarhoven, Antoinette I M; Stroo, Michiel; Hijne, Kim; Peerdeman, Kaya J; Donders, A Rogier T; van de Kerkhof, Peter C M; Evers, Andrea W M

    2017-01-01

    Nocebo effects, i.e., adverse treatment effects which are induced by patients' expectations, are known to contribute to the experience of physical symptoms such as pain and itch. A better understanding of how to minimize nocebo responses might eventually contribute to enhanced treatment effects. However, little is known about how to reduce nocebo effects. In the current randomized controlled study, we tested whether nocebo effects can be minimized by positive expectation induction with respect to electrical and histaminic itch stimuli. First, negative expectations about electrical itch stimuli were induced by verbal suggestion and conditioning (part 1: induction of nocebo effect). Second, participants were randomized to either the experimental group or one of the control groups (part 2: reversing nocebo effect). In the experimental group, positive expectations were induced by conditioning with verbal suggestion. In the control groups either the negative expectation induction was continued or an extinction procedure was applied. Afterwards, a histamine application test was conducted. Positive expectation induction resulted in a significantly smaller nocebo effect in comparison with both control groups. Mean change itch NRS scores showed that the nocebo effect was even reversed, indicating a placebo effect. Comparable effects were also found for histamine application. This study is the first to demonstrate that nocebo effects can be minimized and even reversed by conditioning with verbal suggestion. The results of the current study indicate that learning via counterconditioning and verbal suggestion represents a promising strategy for diminishing nocebo responses.

  18. Behavioral effects of neurofeedback in adolescents with ADHD: a randomized controlled trial.

    Science.gov (United States)

    Bink, Marleen; van Nieuwenhuizen, Chijs; Popma, Arne; Bongers, Ilja L; van Boxtel, Geert J M

    2015-09-01

    Neurofeedback has been proposed as a potentially effective intervention for reducing Attention Deficit Hyperactivity Disorder (ADHD) symptoms. However, it remains unclear whether neurofeedback is of additional value to treatment as usual (TAU) for adolescents with clinical ADHD symptoms. Using a multicenter parallel-randomized controlled trial design, adolescents with ADHD symptoms were randomized to receive either a combination of TAU and neurofeedback (NFB + TAU, n = 45) or TAU-only (n = 26). Randomization was computer generated and stratified for age group (ages 12 through 16, 16 through 20, 20 through 24). Neurofeedback treatment consisted of approximately 37 sessions of theta/sensorimotor rhythm (SMR)-training on the vertex (Cz). Primary behavioral outcome measures included the ADHD-rating scale, Youth Self Report, and Child Behavior Checklist all assessed pre- and post-intervention. Behavioral problems decreased equally for both groups with medium to large effect sizes, range of partial η2 = 0.08-0.31, p neurofeedback and TAU was as effective as TAU-only for adolescents with ADHD symptoms. Considering the absence of additional behavioral effects in the current study, in combination with the limited knowledge of specific treatment effects, it is questionable whether theta/SMR neurofeedback for adolescents with ADHD and comorbid disorders in clinical practice should be used. Further research is warranted to investigate possible working mechanisms and (long-term) specific treatment effects of neurofeedback.

  19. Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression.

    Science.gov (United States)

    Bowden, Jack; Davey Smith, George; Burgess, Stephen

    2015-04-01

    The number of Mendelian randomization analyses including large numbers of genetic variants is rapidly increasing. This is due to the proliferation of genome-wide association studies, and the desire to obtain more precise estimates of causal effects. However, some genetic variants may not be valid instrumental variables, in particular due to them having more than one proximal phenotypic correlate (pleiotropy). We view Mendelian randomization with multiple instruments as a meta-analysis, and show that bias caused by pleiotropy can be regarded as analogous to small study bias. Causal estimates using each instrument can be displayed visually by a funnel plot to assess potential asymmetry. Egger regression, a tool to detect small study bias in meta-analysis, can be adapted to test for bias from pleiotropy, and the slope coefficient from Egger regression provides an estimate of the causal effect. Under the assumption that the association of each genetic variant with the exposure is independent of the pleiotropic effect of the variant (not via the exposure), Egger's test gives a valid test of the null causal hypothesis and a consistent causal effect estimate even when all the genetic variants are invalid instrumental variables. We illustrate the use of this approach by re-analysing two published Mendelian randomization studies of the causal effect of height on lung function, and the causal effect of blood pressure on coronary artery disease risk. The conservative nature of this approach is illustrated with these examples. An adaption of Egger regression (which we call MR-Egger) can detect some violations of the standard instrumental variable assumptions, and provide an effect estimate which is not subject to these violations. The approach provides a sensitivity analysis for the robustness of the findings from a Mendelian randomization investigation. © The Author 2015; Published by Oxford University Press on behalf of the International Epidemiological Association.

  20. A meta-analysis of health effects of randomized controlled worksite interventions: does social stratification matter?

    Science.gov (United States)

    Montano, Diego; Hoven, Hanno; Siegrist, Johannes

    2014-05-01

    The aim of this review was to assess what types of socioeconomic positions (SEP) are being considered in randomized controlled intervention studies and estimate the moderation of SEP in workplace intervention effects on body mass index (BMI), fruit and vegetable consumption, musculoskeletal symptoms, and job stress. A meta-analysis of randomized controlled workplace interventions was undertaken. Studies were classified by participants' SEP. The overall standardized mean difference (SMD) for each outcome was estimated with random-effects models. Additionally, a random-effects model with SEP as moderating variable was calculated in order to assess intervention effect modification (EM). This review covers 36 studies. Altogether 40 reports of intervention effects were considered. The overall mean differences in the models, without SEP as moderating variable, were significant for all outcomes. BMI, self-reported musculoskeletal symptoms, and self-reported job stress decreased [SMD -0.16, 95% confidence interval (95% CI) -0.29- -0.02, SMD -0.32, 95% CI -0.51- -0.14, and SMD -0.37, 95% CI -0.71- -0.04, respectively], whereas daily consumption of fruit and vegetables increased (SMD 0.12, 95% CI 0.01-0.22). There were no statistically significant differences between occupational classes for the health outcomes considered (SMD -0.102, 95% CI -0.264-0.060, EM -0.141, 95% CI -0.406-0.125; SMD 0.117, 95% CI -0.049-0.282, EM 0.000, 95% CI -0.230-0.231; SMD -0.301, 95% CI -0.494- -0.107, EM -0.369, 95% CI -1.169-0.430; and SMD -0.200, 95% CI -0.524-0.124, EM -0.598, 95% CI -1.208-0.012, respectively). Workplace interventions can achieve small positive effects on major health outcomes. We could not confirm whether these effects are moderated by occupational class.

  1. An evaluation of the effectiveness of recruitment methods: the staying well after depression randomized controlled trial.

    Science.gov (United States)

    Krusche, Adele; Rudolf von Rohr, Isabelle; Muse, Kate; Duggan, Danielle; Crane, Catherine; Williams, J Mark G

    2014-04-01

    Randomized controlled trials (RCTs) are widely accepted as being the most efficient way of investigating the efficacy of psychological therapies. However, researchers conducting RCTs commonly report difficulties in recruiting an adequate sample within planned timescales. In an effort to overcome recruitment difficulties, researchers often are forced to expand their recruitment criteria or extend the recruitment phase, thus increasing costs and delaying publication of results. Research investigating the effectiveness of recruitment strategies is limited, and trials often fail to report sufficient details about the recruitment sources and resources utilized. We examined the efficacy of strategies implemented during the Staying Well after Depression RCT in Oxford to recruit participants with a history of recurrent depression. We describe eight recruitment methods utilized and two further sources not initiated by the research team and examine their efficacy in terms of (1) the return, including the number of potential participants who contacted the trial and the number who were randomized into the trial; (2) cost-effectiveness, comprising direct financial cost and manpower for initial contacts and randomized participants; and (3) comparison of sociodemographic characteristics of individuals recruited from different sources. Poster advertising, web-based advertising, and mental health worker referrals were the cheapest methods per randomized participant; however, the ratio of randomized participants to initial contacts differed markedly per source. Advertising online, via posters, and on a local radio station were the most cost-effective recruitment methods for soliciting participants who subsequently were randomized into the trial. Advertising across many sources (saturation) was found to be important. It may not be feasible to employ all the recruitment methods used in this trial to obtain participation from other populations, such as those currently unwell, or in

  2. A randomized controlled trial of the effectiveness of multisystemic therapy in the Netherlands: post-treatment changes and moderator effects

    NARCIS (Netherlands)

    Asscher, J.J.; Dekovic, M.; Manders, W.A.; Prins, P.J.M.; van der Laan, P.H.

    2013-01-01

    Objective: In the present randomized controlled trial, the effectiveness of multisystemic therapy (MST) in The Netherlands was examined. Moderator tests were conducted for ethnicity, age and gender. Methods: The sample consisted of N = 256 adolescents, referred because of conduct problems, and

  3. Completion report : Effect of Comprehensive Yogic Breathing program on type 2 diabetes: A randomized control trial

    Directory of Open Access Journals (Sweden)

    V P Jyotsna

    2014-01-01

    Full Text Available Background: Yoga has been shown to be benefi cial in diabetes in many studies, though randomized control trials are few. The aim of this randomized control trial was to see the effect of Sudarshan Kriya and related practices (comprehensive yogic breathing program on quality of life, glycemic control, and cardiac autonomic functions in diabetes. Diabetes mellitus is a risk factor for sudden cardiac death. Cardiac autonomic neuropathy has been implicated in the causation of sudden cardiac death. Therefore, a maneuver to prevent progression of cardiac autonomic neuropathy holds signifi cance. Materials and Methods: A total of 120 patients of diabetes on oral medication and diet and exercise advice were randomized into two groups: (1 Continued to receive standard treatment for diabetes. (2 Patients administered comprehensive yogic breathing program and monitored to regularly practice yoga in addition to standard treatment of diabetes. At 6 months, quality of life and postprandial plasma glucose signifi cantly improved in the group practicing yoga compared to baseline, but there was no significant improvement in the fasting plasma glucose and glycated hemoglobin. Results: On per protocol analysis, sympathetic cardiac autonomic functions signifi cantly improved from baseline in the group practicing comprehensive yogic breathing. Conclusion: This randomized control trial points towards the beneficial effect of yogic breathing program in preventing progression of cardiac neuropathy. This has important implications as cardiac autonomic neuropathy has been considered as one of the factors for sudden cardiac deaths.Keywords: comprehensive yogic breathing program, diabetes mellitus, cardiac autonomic function

  4. Estimating required information size by quantifying diversity in random-effects model meta-analyses

    DEFF Research Database (Denmark)

    Wetterslev, Jørn; Thorlund, Kristian; Brok, Jesper

    2009-01-01

    -analysis. RESULTS: We devise a measure of diversity (D2) in a meta-analysis, which is the relative variance reduction when the meta-analysis model is changed from a random-effects into a fixed-effect model. D2 is the percentage that the between-trial variability constitutes of the sum of the between...... an intervention effect suggested by trials with low-risk of bias. METHODS: Information size calculations need to consider the total model variance in a meta-analysis to control type I and type II errors. Here, we derive an adjusting factor for the required information size under any random-effects model meta...... and interpreted using several simulations and clinical examples. In addition we show mathematically that diversity is equal to or greater than inconsistency, that is D2 >or= I2, for all meta-analyses. CONCLUSION: We conclude that D2 seems a better alternative than I2 to consider model variation in any random...

  5. Effect of non-random mating on genomic and BLUP selection schemes

    Directory of Open Access Journals (Sweden)

    Nirea Kahsay G

    2012-04-01

    Full Text Available Abstract Background The risk of long-term unequal contribution of mating pairs to the gene pool is that deleterious recessive genes can be expressed. Such consequences could be alleviated by appropriately designing and optimizing breeding schemes i.e. by improving selection and mating procedures. Methods We studied the effect of mating designs, random, minimum coancestry and minimum covariance of ancestral contributions on rate of inbreeding and genetic gain for schemes with different information sources, i.e. sib test or own performance records, different genetic evaluation methods, i.e. BLUP or genomic selection, and different family structures, i.e. factorial or pair-wise. Results Results showed that substantial differences in rates of inbreeding due to mating design were present under schemes with a pair-wise family structure, for which minimum coancestry turned out to be more effective to generate lower rates of inbreeding. Specifically, substantial reductions in rates of inbreeding were observed in schemes using sib test records and BLUP evaluation. However, with a factorial family structure, differences in rates of inbreeding due mating designs were minor. Moreover, non-random mating had only a small effect in breeding schemes that used genomic evaluation, regardless of the information source. Conclusions It was concluded that minimum coancestry remains an efficient mating design when BLUP is used for genetic evaluation or when the size of the population is small, whereas the effect of non-random mating is smaller in schemes using genomic evaluation.

  6. Effective group training for patients with unexplained physical symptoms: a randomized controlled trial with a non-randomized one-year follow-up.

    Directory of Open Access Journals (Sweden)

    Lyonne N L Zonneveld

    Full Text Available BACKGROUND: Although cognitive-behavioral therapy for Unexplained Physical Symptoms (UPS is effective in secondary care, studies done in primary care produced implementation problems and conflicting results. We evaluated the effectiveness of a cognitive-behavioral group training tailored to primary care patients and provided by a secondary community mental-health service reaching out into primary care. METHODOLOGY/PRINCIPAL FINDINGS: The effectiveness of this training was explored in a randomized controlled trial. In this trial, 162 patients with UPS classified as undifferentiated somatoform disorder or as chronic pain disorder were randomized either to the training or a waiting list. Both lasted 13 weeks. The preservation of the training's effect was analyzed in non-randomized follow-ups, for which the waiting group started the training after the waiting period. All patients attended the training were followed-up after three months and again after one year. The primary outcomes were the physical and the mental summary scales of the SF-36. Secondary outcomes were the other SF-36-scales and the SCL-90-R. The courses of the training's effects in the randomized controlled trial and the follow-ups were analyzed with linear mixed modeling. In the randomized controlled trial, the training had a significantly positive effect on the quality of life in the physical domain (Cohen's d = 0.38;p = .002, but this overall effect was not found in the mental domain. Regarding the secondary outcomes, the training resulted in reporting an improved physical (Cohen's d = 0.43;p = 0.01, emotional (Cohen's d = 0.44;p = 0.01, and social (Cohen's d = 0.36;p = 0.01 functioning, less pain and better functioning despite pain (Cohen's d = 0.51;p =

  7. Distribution of the phenotypic effects of random homologous recombination between two virus species.

    Directory of Open Access Journals (Sweden)

    Florence Vuillaume

    2011-05-01

    Full Text Available Recombination has an evident impact on virus evolution and emergence of new pathotypes, and has generated an immense literature. However, the distribution of phenotypic effects caused by genome-wide random homologous recombination has never been formally investigated. Previous data on the subject have promoted the implicit view that most viral recombinant genomes are likely to be deleterious or lethal if the nucleotide identity of parental sequences is below 90%. We decided to challenge this view by creating a bank of near-random recombinants between two viral species of the genus Begomovirus (Family Geminiviridae exhibiting 82% nucleotide identity, and by testing infectivity and in planta accumulation of recombinant clones randomly extracted from this bank. The bank was created by DNA-shuffling-a technology initially applied to the random shuffling of individual genes, and here implemented for the first time to shuffle full-length viral genomes. Together with our previously described system allowing the direct cloning of full-length infectious geminivirus genomes, it provided a unique opportunity to generate hundreds of "mosaic" virus genomes, directly testable for infectivity. A subset of 47 randomly chosen recombinants was sequenced, individually inoculated into tomato plants, and compared with the parental viruses. Surprisingly, our results showed that all recombinants were infectious and accumulated at levels comparable or intermediate to that of the parental clones. This indicates that, in our experimental system, despite the fact that the parental genomes differ by nearly 20%, lethal and/or large deleterious effects of recombination are very rare, in striking contrast to the common view that has emerged from previous studies published on other viruses.

  8. Using the question-behavior effect to promote disease prevention behaviors: two randomized controlled trials.

    Science.gov (United States)

    Conner, Mark; Godin, Gaston; Norman, Paul; Sheeran, Paschal

    2011-05-01

    To test the efficacy of interventions based on the question-behavior effect in promoting the adoption of disease prevention behaviors. In Study 1, adults from the general public were randomly allocated to complete a questionnaire about health checks (question-behavior effect condition) or not (control) and later received an invitation to attend for screening. In Study 2, health care professionals were randomly allocated to complete a questionnaire about influenza vaccination or not and later had the opportunity to receive a vaccination. We objectively assessed health check attendance (Study 1) and influenza vaccination (Study 2). In Study 1, intention-to-treat analyses indicated that health check attendance was significantly higher in the question-behavior effect condition (68.3%) compared with the control condition (53.5%). In Study 2, intention-to-treat analyses indicated that influenza vaccination was significantly higher among participants in the question-behavior effect condition (42.0%) compared with the control condition (36.3%), and this effect persisted after controlling for demographic variables. Explanatory analyses indicated that the effects in both studies were attributable to completing rather than merely receiving the questionnaire and were stronger for those with positive attitudes or intentions about the target behavior. The question-behavior effect represents a simple, cost-effective means to increase disease prevention behaviors among the general public and health professionals. Implications for promoting health behaviors are discussed. (c) 2011 APA, all rights reserved.

  9. 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...

  10. The effect of smoking on obesity: Evidence from a randomized trial.

    Science.gov (United States)

    Courtemanche, Charles; Tchernis, Rusty; Ukert, Benjamin

    2017-11-16

    This paper aims to identify the causal effect of smoking on body mass index (BMI) using data from the Lung Health Study, a randomized trial of smoking cessation treatments. Since nicotine is a metabolic stimulant and appetite suppressant, quitting or reducing smoking could lead to weight gain. Using randomized treatment assignment to instrument for smoking, we estimate that quitting smoking leads to an average long-run weight gain of 1.8-1.9 BMI units, or 11-12 pounds at the average height. Semi-parametric models provide evidence of a diminishing marginal effect of smoking on BMI, while subsample regressions show that the impact is largest for younger individuals, those with no college degree, and those in the lowest quartile of baseline BMI. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. LED Lighting System Reliability Modeling and Inference via Random Effects Gamma Process and Copula Function

    Directory of Open Access Journals (Sweden)

    Huibing Hao

    2015-01-01

    Full Text Available Light emitting diode (LED lamp has attracted increasing interest in the field of lighting systems due to its low energy and long lifetime. For different functions (i.e., illumination and color, it may have two or more performance characteristics. When the multiple performance characteristics are dependent, it creates a challenging problem to accurately analyze the system reliability. In this paper, we assume that the system has two performance characteristics, and each performance characteristic is governed by a random effects Gamma process where the random effects can capture the unit to unit differences. The dependency of performance characteristics is described by a Frank copula function. Via the copula function, the reliability assessment model is proposed. Considering the model is so complicated and analytically intractable, the Markov chain Monte Carlo (MCMC method is used to estimate the unknown parameters. A numerical example about actual LED lamps data is given to demonstrate the usefulness and validity of the proposed model and method.

  12. 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...

  13. Finite size effects in the averaged eigenvalue density of Wigner random-sign real symmetric matrices

    OpenAIRE

    Dhesi, G; Ausloos, M.

    2016-01-01

    © 2016 American Physical Society.Nowadays, strict finite size effects must be taken into account in condensed matter problems when treated through models based on lattices or graphs. On the other hand, the cases of directed bonds or links are known to be highly relevant in topics ranging from ferroelectrics to quotation networks. Combining these two points leads us to examine finite size random matrices. To obtain basic materials properties, the Green's function associated with the matrix has...

  14. The Effects of Student Coaching in College: An Evaluation of a Randomized Experiment in Student Mentoring

    OpenAIRE

    Eric Bettinger; Rachel Baker

    2011-01-01

    College completion and college success often lag behind college attendance. One theory as to why students do not succeed in college is that they lack key information about how to be successful or fail to act on the information that they have. We present evidence from a randomized experiment which tests the effectiveness of individualized student coaching. Over the course of two separate school years, InsideTrack, a student coaching service, provided coaching to students from public, private, ...

  15. Comparison of effects of intravenous midazolam and ketamine on emergence agitation in children: Randomized controlled trial

    OpenAIRE

    Kim, Kyung Mi; Lee, Ki Hwa; Kim, Yong Han; KO, Myoung Jin; Jung, Jae-Wook; Kang, Eunsu

    2016-01-01

    Objective A prospective, double-blind, randomized controlled trial to compare the effect of preoperative midazolam or ketamine on the incidence of emergence agitation (EA) following sevoflurane anaesthesia in children. Methods Paediatric patients (2–6 years old) undergoing ophthalmic surgery were allocated to receive premedication with either 0.1 mg/kg midazolam or 1 mg/kg ketamine. Incidence of EA and postoperative pain scores were recorded at 10-min intervals in the postanaesthetic care uni...

  16. Effectiveness of hand hygiene education among a random sample of women from the community

    OpenAIRE

    Ubheeram, J.; Biranjia-Hurdoyal, S.D.

    2017-01-01

    Summary Objective. The effectiveness of hand hygiene education was investigated by studying the hand hygiene awareness and bacterial hand contamination among a random sample of 170 women in the community. Methods. Questionnaire was used to assess the hand hygiene awareness score, followed by swabbing of the dominant hand. Bacterial identification was done by conventional biochemical tests. Results. Better hand hygiene awareness score was significantly associated with age, scarce bacterial gro...

  17. Effect of a mobile app intervention on vegetable consumption in overweight adults: a randomized controlled trial

    OpenAIRE

    Mummah, Sarah; Robinson, Thomas N.; Mathur, Maya; Farzinkhou, Sarah; Sutton, Stephen; Gardner, Christopher D.

    2017-01-01

    Background Mobile applications (apps) have been heralded as transformative tools to deliver behavioral health interventions at scale, but few have been tested in rigorous randomized controlled trials. We tested the effect of a mobile app to increase vegetable consumption among overweight adults attempting weight loss maintenance. Methods Overweight adults (n=135) aged 18?50 years with BMI=28?40 kg/m2 near Stanford, CA were recruited from an ongoing 12-month weight loss trial (parent trial) an...

  18. Effect of a mobile app intervention on vegetable consumption in overweight adults: a randomized controlled trial.

    Science.gov (United States)

    Mummah, Sarah; Robinson, Thomas N; Mathur, Maya; Farzinkhou, Sarah; Sutton, Stephen; Gardner, Christopher D

    2017-09-15

    Mobile applications (apps) have been heralded as transformative tools to deliver behavioral health interventions at scale, but few have been tested in rigorous randomized controlled trials. We tested the effect of a mobile app to increase vegetable consumption among overweight adults attempting weight loss maintenance. Overweight adults (n=135) aged 18-50 years with BMI=28-40 kg/m 2 near Stanford, CA were recruited from an ongoing 12-month weight loss trial (parent trial) and randomly assigned to either the stand-alone, theory-based Vegethon mobile app (enabling goal setting, self-monitoring, and feedback and using "process motivators" including fun, surprise, choice, control, social comparison, and competition) or a wait-listed control condition. The primary outcome was daily vegetables servings, measured by an adapted Harvard food frequency questionnaire (FFQ) 8 weeks post-randomization. Daily vegetable servings from 24-hour dietary recalls, administered by trained, certified, and blinded interviewers 5 weeks post-randomization, was included as a secondary outcome. All analyses were conducted according to principles of intention-to-treat. Daily vegetable consumption was significantly greater in the intervention versus control condition for both measures (adjusted mean difference: 2.0 servings; 95% CI: 0.1, 3.8, p=0.04 for FFQ; and 1.0 servings; 95% CI: 0.2, 1.9; p=0.02 for 24-hour recalls). Baseline vegetable consumption was a significant moderator of intervention effects (p=0.002) in which effects increased as baseline consumption increased. These results demonstrate the efficacy of a mobile app to increase vegetable consumption among overweight adults. Theory-based mobile interventions may present a low-cost, scalable, and effective approach to improving dietary behaviors and preventing associated chronic diseases. ClinicalTrials.gov NCT01826591. Registered 27 March 2013.

  19. The Effectiveness of Cupping Therapy on Relieving Chronic Neck and Shoulder Pain: A Randomized Controlled Trial

    OpenAIRE

    Lee-Mei Chi; Li-Mei Lin; Chien-Lin Chen; Shu-Fang Wang; Hui-Ling Lai; Tai-Chu Peng

    2016-01-01

    The research aimed to investigate the effectiveness of cupping therapy (CT) in changes on skin surface temperature (SST) for relieving chronic neck and shoulder pain (NSP) among community residents. A single-blind experimental design constituted of sixty subjects with self-perceived NSP. The subjects were randomly allocated to two groups. The cupping group received CT at SI 15, GB 21, and LI 15 acupuncture points, and the control group received no intervention. Pain was assessed using the SST...

  20. Effects of Assertiveness Training and Expressive Writing on Acculturative Stress in International Students: A Randomized Trial

    OpenAIRE

    Tavakoli, Shedeh; Lumley, Mark A.; Hijazi, Alaa M.; Slavin-Spenny, Olga M.; Parris, George P.

    2009-01-01

    International university students often experience acculturative stress, and culturally appropriate techniques to manage stress are needed. This randomized trial tested the effects of group assertiveness training, private expressive writing, their combination, and a wait-list control on the acculturative stress, affect, and health of 118 international students at an urban, American university. Interventions were conducted at the start of a semester, and assessments were conducted at baseline ...

  1. Cultivating teacher mindfulness: Effects of a randomized controlled trial on work, home, and sleep outcomes.

    Science.gov (United States)

    Crain, Tori L; Schonert-Reichl, Kimberly A; Roeser, Robert W

    2017-04-01

    The effects of randomization to a workplace mindfulness training (WMT) or a waitlist control condition on teachers' well-being (moods and satisfaction at work and home), quantity of sleep, quality of sleep, and sleepiness during the day were examined in 2 randomized, waitlist controlled trials (RCTs). The combined sample of the 2 RCTs, conducted in Canada and the United States, included 113 elementary and secondary school teachers (89% female). Measures were collected at baseline, postprogram, and 3-month follow-up; teachers were randomly assigned to condition after baseline assessment. Results showed that teachers randomized to WMT reported less frequent bad moods at work and home, greater satisfaction at work and home, more sleep on weekday nights, better quality sleep, and decreased insomnia symptoms and daytime sleepiness. Training-related group differences in mindfulness and rumination on work at home at postprogram partially mediated the reductions in negative moods at home and increases in sleep quality at follow-up. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review

    Directory of Open Access Journals (Sweden)

    Luke Perraton

    2009-11-01

    Full Text Available Luke Perraton, Zuzana Machotka, Saravana KumarInternational Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, AustraliaAim: Previous systematic reviews have found hydrotherapy to be an effective management strategy for fibromyalgia syndrome (FMS. The aim of this systematic review was to summarize the components of hydrotherapy programs used in randomized controlled trials.Method: A systematic review of randomized controlled trials was conducted. Only trials that have reported significant FMS-related outcomes were included. Data relating to the components of hydrotherapy programs (exercise type, duration, frequency and intensity, environmental factors, and service delivery were analyzed.Results: Eleven randomized controlled trials were included in this review. Overall, the quality of trials was good. Aerobic exercise featured in all 11 trials and the majority of hydrotherapy programs included either a strengthening or flexibility component. Great variability was noted in both the environmental components of hydrotherapy programs and service delivery.Conclusions: Aerobic exercise, warm up and cool-down periods and relaxation exercises are common features of hydrotherapy programs that report significant FMS-related outcomes. Treatment duration of 60 minutes, frequency of three sessions per week and an intensity equivalent to 60%–80% maximum heart rate were the most commonly reported exercise components. Exercise appears to be the most important component of an effective hydrotherapy program for FMS, particularly when considering mental health-related outcomes.Keywords: hydrotherapy, fibromyalgia syndrome, exercise, effective, components

  3. Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial.

    Science.gov (United States)

    Dias, Letícia A R; Driusso, Patricia; Aita, Daniella L C C; Quintana, Silvana M; Bø, Kari; Ferreira, Cristine H J

    2011-01-01

    The use of the pelvic floor muscle training for urinary incontinence treatment is well established but little is known about its effects in labor and newborn outcomes. To evaluate the effects of antenatal pelvic floor muscle training and strength in labor and newborn outcomes in low-income pregnant women. This is a randomized controlled trial that recruited forty-two nulliparous healthy pregnant women aged between 18-36 years old and able to contract the pelvic floor muscles. The participants were included in the study with 20 weeks of gestational age and had their pelvic floor muscles measured by vaginal squeeze pressure. They were randomly allocated into two groups: training group and a non-intervention control group. Then, all participants had their labor and newborn outcomes evaluated through consultation of medical records by a blinded researcher. There were no statistically significant differences between the groups regarding gestational age at birth, type of labor, duration of the second stage of labor, total time of labor, prevalence of laceration, weight and size of the baby, and Apgar score. No correlation was observed between pelvic floor muscle strength and the second stage or the total length of labor. This randomized controlled trial did not find any effect of pelvic floor muscle training or pelvic floor muscle strength on labor and newborn outcomes.

  4. Random effects modeling of multiple binomial responses using the multivariate binomial logit-normal distribution.

    Science.gov (United States)

    Coull, B A; Agresti, A

    2000-03-01

    The multivariate binomial logit-normal distribution is a mixture distribution for which, (i) conditional on a set of success probabilities and sample size indices, a vector of counts is independent binomial variates, and (ii) the vector of logits of the parameters has a multivariate normal distribution. We use this distribution to model multivariate binomial-type responses using a vector of random effects. The vector of logits of parameters has a mean that is a linear function of explanatory variables and has an unspecified or partly specified covariance matrix. The model generalizes and provides greater flexibility than the univariate model that uses a normal random effect to account for positive correlations in clustered data. The multivariate model is useful when different elements of the response vector refer to different characteristics, each of which may naturally have its own random effect. It is also useful for repeated binary measurement of a single response when there is a nonexchangeable association structure, such as one often expects with longitudinal data or when negative association exists for at least one pair of responses. We apply the model to an influenza study with repeated responses in which some pairs are negatively associated and to a developmental toxicity study with continuation-ratio logits applied to an ordinal response with clustered observations.

  5. Effect of music in endoscopy procedures: systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wang, Man Cai; Zhang, Ling Yi; Zhang, Yu Long; Zhang, Ya Wu; Xu, Xiao Dong; Zhang, You Cheng

    2014-10-01

    Endoscopies are common clinical examinations that are somewhat painful and even cause fear and anxiety for patients. We performed this systematic review and meta-analysis of randomized controlled trials to determine the effect of music on patients undergoing various endoscopic procedures. We searched the Cochrane Library, Issue 6, 2013, PubMed, and EMBASE databases up to July 2013. Randomized controlled trials comparing endoscopies, with and without the use of music, were included. Two authors independently abstracted data and assessed risk of bias. Subgroup analyses were performed to examine the impact of music on different types of endoscopic procedures. Twenty-one randomized controlled trials involving 2,134 patients were included. The overall effect of music on patients undergoing a variety of endoscopic procedures significantly improved pain score (weighted mean difference [WMD] = -1.53, 95% confidence interval [CI] [-2.53, -0.53]), anxiety (WMD = -6.04, 95% CI [-9.61, -2.48]), heart rate (P = 0.01), arterial pressure (P music group, compared with the control group. Furthermore, music had little effect for patients undergoing colposcopy and bronchoscopy in the subanalysis. Our meta-analysis suggested that music may offer benefits for patients undergoing endoscopy, except in colposcopy and bronchoscopy. Wiley Periodicals, Inc.

  6. Effects of traditional cupping therapy in patients with carpal tunnel syndrome: a randomized controlled trial.

    Science.gov (United States)

    Michalsen, Andreas; Bock, Silke; Lüdtke, Rainer; Rampp, Thomas; Baecker, Marcus; Bachmann, Jürgen; Langhorst, Jost; Musial, Frauke; Dobos, Gustav J

    2009-06-01

    We investigated the effectiveness of cupping, a traditional method of treating musculoskeletal pain, in patients with carpal tunnel syndrome (CTS) in an open randomized trial. n = 52 outpatients (58.5 +/- 8.0 years) with neurologically confirmed CTS were randomly assigned to either a verum (n = 26) or a control group (n = 26). Verum patients were treated with a single application of wet cupping, and control patients with a single local application of heat within the region overlying the trapezius muscle. Patients were followed up on day 7 after treatment. The primary outcome, severity of CTS symptoms (VAS), was reduced from 61.5 +/- 20.5 to 24.6 +/- 22.7 mm at day 7 in the cupping group and from 67.1 +/- 20.2 to 51.7 +/- 23.9 mm in the control group [group difference -24.5mm (95%CI -36.1; -2.9, P cupping therapy may be effective in relieving the pain and other symptoms related to CTS. The efficacy of cupping in the long-term management of CTS and related mechanisms remains to be clarified. The results of a randomized trial on the clinical effects of traditional cupping therapy in patients with carpal tunnel syndrome are presented. Cupping of segmentally related shoulder zones appears to alleviate the symptoms of carpal tunnel syndrome.

  7. The Effect of Blocked, Random and Mixed Practice Schedules on Speech Motor Learning of Tongue Twisters in Unimpaired Speakers.

    Science.gov (United States)

    Jones, Kelly; Croot, Karen

    2016-10-01

    There are few investigations comparing practice schedules in speech motor learning, despite certain schedules being recommended for the clinical treatment of speech motor disorders. This study compared effects of random, blocked and mixed practice on tongue twister accuracy in unimpaired speakers. We hypothesized that blocked practice would benefit acquisition of learning, but that random practice and mixed blocked-then-random practice would yield superior retention of learning. We found that the random and blocked-random practice schedules yielded superior accuracy at the end of the acquisition phase of learning and at a 1-week retention test. Exploratory post hoc analyses raised the possibility that the retention effects were most evident when tongue twisters were elicited in a random schedule. Theoretical accounts of these results are discussed.

  8. Randomized Controlled Trial of Social Media: Effect of Increased Intensity of the Intervention.

    Science.gov (United States)

    Fox, Caroline S; Gurary, Ellen B; Ryan, John; Bonaca, Marc; Barry, Karen; Loscalzo, Joseph; Massaro, Joseph

    2016-04-27

    A prior randomized controlled trial of social media exposure at Circulation determined that social media did not increase 30-day page views. Whether insufficient social media intensity contributed to these results is uncertain. Original article manuscripts were randomized to social media exposure compared with no social media exposure (control) at Circulation beginning in January 2015. Social media exposure consisted of Facebook and Twitter posts on the journal's accounts. To increase social media intensity, a larger base of followers was built using advertising and organic growth, and posts were presented in triplicate and boosted on Facebook and retweeted on Twitter. The primary outcome was 30-day page views. Stopping rules were established at the point that 50% of the manuscripts were randomized and had 30-day follow-up to compare groups on 30-day page views. The trial was stopped for futility on September 26, 2015. Overall, 74 manuscripts were randomized to receive social media exposure, and 78 manuscripts were randomized to the control arm. The intervention and control arms were similar based on article type (P=0.85), geographic location of the corresponding author (P=0.33), and whether the manuscript had an editorial (P=0.80). Median number of 30-day page views was 499.5 in the social media arm and 450.5 in the control arm; there was no evidence of a treatment effect (P=0.38). There were no statistically significant interactions of treatment by manuscript type (P=0.86), by corresponding author (P=0.35), by trimester of publication date (P=0.34), or by editorial status (P=0.79). A more intensive social media strategy did not result in increased 30-day page views of original research. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  9. Maternal smoking during pregnancy and childhood growth trajectory: a random effects regression analysis.

    Science.gov (United States)

    Suzuki, Kohta; Kondo, Naoki; Sato, Miri; Tanaka, Taichiro; Ando, Daisuke; Yamagata, Zentaro

    2012-01-01

    Although maternal smoking during pregnancy has been reported to have an effect on childhood overweight/obesity, the impact of maternal smoking on the trajectory of the body mass of their offspring is not very clear. Previously, we investigated this effect by using a fixed-effect model. However, this analysis was limited because it rounded and categorized the age of the children. Therefore, we used a random-effects hierarchical linear regression model in the present study. The study population comprised children born between 1 April 1991 and 31 March 1999 in Koshu City, Japan and their mothers. Maternal smoking during early pregnancy was the exposure studied. The body mass index (BMI) z-score trajectory of children born to smoking and non-smoking mothers, by gender, was used as the outcome. We modeled BMI trajectory using a 2-level random intercept and slope regression. The participating mothers delivered 1619 babies during the study period. For male children, there was very strong evidence that the effect of age in months on the increase in BMI z-score was enhanced by maternal smoking during pregnancy (P smoking during pregnancy (P = 0.054), which suggests that the effect of maternal smoking during pregnancy on the early-life BMI trajectory of offspring differed by gender. These results may be valuable for exploring the mechanism of fetal programming and might therefore be clinically important.

  10. Core polarization effects in the Hartree--Fock--random phase approximation schemes

    Energy Technology Data Exchange (ETDEWEB)

    Lipparini, E.; Stringari, S.

    1987-02-01

    Core polarization effects in odd nuclei are investigated in the framework of the Hartree--Fock and random phase approximation schemes. The results of the particle vibration coupling model are recovered by linearizing the equations of motion in the interaction Hamiltonian between the external and the core particles. The formalism is used to study the renormalization of diagonal and off-diagonal M1 matrix elements. It is found that M1 polarization effects exhibit a very strong dependence on the range of the force. Copyright 1987 Academic Press, Inc.

  11. Effects of aggregation on the permittivity of random media containing monodisperse spheres

    Science.gov (United States)

    Doyle, Timothy E.; Tew, Adam T.; Jain, Rahul; Robinson, David A.

    2009-12-01

    Numerical simulations were used to calculate the effective permittivities of three-dimensional random particle suspensions containing up to 2440 particles and exhibiting two types of particle aggregation. The particles were modeled as 200 μm spheres that were aggregated into either large spherical clusters or into foam-type microstructures with large spherical voids. Multiple scattering of 0.01-10.0 GHz electromagnetic fields was simulated using a first-principles iterative multipole approach with matrix and particle permittivities of 1.0 and 8.5, respectively. The computational results showed both significant and highly significant trends. Aggregation into spherical clusters decreased the effective permittivity by up to 3.2±0.2%, whereas aggregation into foam-type microstructures increased the effective permittivity by up to 3.0±1.6%. The effective permittivity trends exhibited little change with frequency. These results were compared to effective medium approximations that predicted higher permittivities than those from the simulations and showed opposite trends for cluster aggregation. Three theories are proposed to explain the simulation results. The first theory invokes a waveguidelike mechanism. The simulations indicate that the wave fields propagate more through the continuous paths of greater or lesser particle density created by aggregation, rather than through the isolated particle clusters or large voids. This quasicontinuous phase, or quasimatrix, therefore behaves like a random waveguide structure in the material. A second theory is proposed where the quasicontinuous phase governs the behavior of the system by a percolationlike process. In this theory, the multipole interactions are modeled as the percolation of virtual charges tunneling from one particle to another. A third mechanism for the permittivity changes is also proposed involving collective polarization effects associated with the particle clusters or large voids. The simulation results

  12. A cluster randomized controlled trial of the effectiveness and cost-effectiveness of Intermediate Care Clinics for Diabetes (ICCD: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Armstrong Natalie

    2012-09-01

    Full Text Available Abstract Background World-wide healthcare systems are faced with an epidemic of type 2 diabetes. In the United Kingdom, clinical care is primarily provided by general practitioners (GPs rather than hospital specialists. Intermediate care clinics for diabetes (ICCD potentially provide a model for supporting GPs in their care of people with poorly controlled type 2 diabetes and in their management of cardiovascular risk factors. This study aims to (1 compare patients with type 2 diabetes registered with practices that have access to an ICCD service with those that have access only to usual hospital care; (2 assess the cost-effectiveness of the intervention; and (3 explore the views and experiences of patients, health professionals and other stakeholders. Methods/Design This two-arm cluster randomized controlled trial (with integral economic evaluation and qualitative study is set in general practices in three UK Primary Care Trusts. Practices are randomized to one of two groups with patients referred to either an ICCD (intervention or to hospital care (control. Intervention group: GP practices in the intervention arm have the opportunity to refer patients to an ICCD - a multidisciplinary team led by a specialist nurse and a diabetologist. Patients are reviewed and managed in the ICCD for a short period with a goal of improving diabetes and cardiovascular risk factor control and are then referred back to practice. or Control group: Standard GP care, with referral to secondary care as required, but no access to ICCD. Participants are adults aged 18 years or older who have type 2 diabetes that is difficult for their GPs to control. The primary outcome is the proportion of participants reaching three risk factor targets: HbA1c (≤7.0%; blood pressure ( Discussion Forty-nine practices have been randomized, 1,997 patients have been recruited to the trial, and 20 patients have been recruited to the qualitative study. Results will be available late 2012

  13. Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review

    Science.gov (United States)

    Perraton, Luke; Machotka, Zuzana; Kumar, Saravana

    2009-01-01

    Aim Previous systematic reviews have found hydrotherapy to be an effective management strategy for fibromyalgia syndrome (FMS). The aim of this systematic review was to summarize the components of hydrotherapy programs used in randomized controlled trials. Method A systematic review of randomized controlled trials was conducted. Only trials that have reported significant FMS-related outcomes were included. Data relating to the components of hydrotherapy programs (exercise type, duration, frequency and intensity, environmental factors, and service delivery) were analyzed. Results Eleven randomized controlled trials were included in this review. Overall, the quality of trials was good. Aerobic exercise featured in all 11 trials and the majority of hydrotherapy programs included either a strengthening or flexibility component. Great variability was noted in both the environmental components of hydrotherapy programs and service delivery. Conclusions Aerobic exercise, warm up and cool-down periods and relaxation exercises are common features of hydrotherapy programs that report significant FMS-related outcomes. Treatment duration of 60 minutes, frequency of three sessions per week and an intensity equivalent to 60%–80% maximum heart rate were the most commonly reported exercise components. Exercise appears to be the most important component of an effective hydrotherapy program for FMS, particularly when considering mental health-related outcomes. PMID:21197303

  14. Effects of prenatal yoga on women's stress and immune function across pregnancy: A randomized controlled trial.

    Science.gov (United States)

    Chen, Pao-Ju; Yang, Luke; Chou, Cheng-Chen; Li, Chia-Chi; Chang, Yu-Cune; Liaw, Jen-Jiuan

    2017-04-01

    The effects of prenatal yoga on biological indicators have not been widely studied. Thus, we compared changes in stress and immunity salivary biomarkers from 16 to 36 weeks' gestation between women receiving prenatal yoga and those receiving routine prenatal care. For this longitudinal, prospective, randomized controlled trial, we recruited 94 healthy pregnant women at 16 weeks' gestation through convenience sampling from a prenatal clinic in Taipei. Participants were randomly assigned to intervention (n=48) or control (n=46) groups using Clinstat block randomization. The 20-week intervention comprised two weekly 70-min yoga sessions led by a midwife certified as a yoga instructor; the control group received only routine prenatal care. In both groups, participants' salivary cortisol and immunoglobulin A levels were collected before and after yoga every 4 weeks from 16 to 36 weeks' gestation. The intervention group had lower salivary cortisol (pyoga than the control group. Specifically, the intervention group had significantly higher long-term salivary immunoglobulin A levels than the control group (p=0.018), and infants born to women in the intervention group weighed more than those born to the control group (pyoga significantly reduced pregnant women's stress and enhanced their immune function. Clinicians should learn the mechanisms of yoga and its effects on pregnant women. Our findings can guide clinicians to help pregnant women alleviate their stress and enhance their immune function. Copyright © 2017. Published by Elsevier Ltd.

  15. The effect of cluster size variability on statistical power in cluster-randomized trials.

    Directory of Open Access Journals (Sweden)

    Stephen A Lauer

    Full Text Available The frequency of cluster-randomized trials (CRTs in peer-reviewed literature has increased exponentially over the past two decades. CRTs are a valuable tool for studying interventions that cannot be effectively implemented or randomized at the individual level. However, some aspects of the design and analysis of data from CRTs are more complex than those for individually randomized controlled trials. One of the key components to designing a successful CRT is calculating the proper sample size (i.e. number of clusters needed to attain an acceptable level of statistical power. In order to do this, a researcher must make assumptions about the value of several variables, including a fixed mean cluster size. In practice, cluster size can often vary dramatically. Few studies account for the effect of cluster size variation when assessing the statistical power for a given trial. We conducted a simulation study to investigate how the statistical power of CRTs changes with variable cluster sizes. In general, we observed that increases in cluster size variability lead to a decrease in power.

  16. Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review.

    Science.gov (United States)

    Perraton, Luke; Machotka, Zuzana; Kumar, Saravana

    2009-11-30

    Previous systematic reviews have found hydrotherapy to be an effective management strategy for fibromyalgia syndrome (FMS). The aim of this systematic review was to summarize the components of hydrotherapy programs used in randomized controlled trials. A systematic review of randomized controlled trials was conducted. Only trials that have reported significant FMS-related outcomes were included. Data relating to the components of hydrotherapy programs (exercise type, duration, frequency and intensity, environmental factors, and service delivery) were analyzed. Eleven randomized controlled trials were included in this review. Overall, the quality of trials was good. Aerobic exercise featured in all 11 trials and the majority of hydrotherapy programs included either a strengthening or flexibility component. Great variability was noted in both the environmental components of hydrotherapy programs and service delivery. Aerobic exercise, warm up and cool-down periods and relaxation exercises are common features of hydrotherapy programs that report significant FMS-related outcomes. Treatment duration of 60 minutes, frequency of three sessions per week and an intensity equivalent to 60%-80% maximum heart rate were the most commonly reported exercise components. Exercise appears to be the most important component of an effective hydrotherapy program for FMS, particularly when considering mental health-related outcomes.

  17. 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.

  18. The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Jochems EC

    2015-12-01

    Full Text Available Eline C Jochems,1,2 Christina M van der Feltz-Cornelis,1–3 Arno van Dam,3,4 Hugo J Duivenvoorden,5 Cornelis L Mulder1,6 1Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus MC University Medical Center, Rotterdam, the Netherlands; 2GGz Breburg, Top Clinical Center for Body, Mind and Health, Tilburg, the Netherlands; 3Tilburg University, Faculty of Social Sciences, Tranzo Department, Tilburg, the Netherlands; 4GGZ Westelijk Noord Brabant, Bergen op Zoom, the Netherlands; 5Erasmus MC University Medical Center, Rotterdam, the Netherlands; 6BavoEuropoort, Parnassia Psychiatric Institute, Rotterdam, the Netherlands Objective: To evaluate the effectiveness of providing clinicians with regular feedback on the patient’s motivation for treatment in increasing treatment engagement in patients with severe mental illness.Methods: Design: cluster randomized controlled trial (Dutch Trials Registry NTR2968. Participants: adult outpatients with a primary diagnosis of a psychotic disorder or a personality disorder and their clinicians, treated in 12 community mental health teams (the clusters of two mental health institutions in the Netherlands. Interventions: monthly motivation feedback (MF generated by clinicians additional to treatment as usual (TAU and TAU by the community mental health teams. Primary outcome: treatment engagement at patient level, assessed at 12 months by clinicians. Randomization: teams were allocated to MF or TAU by a computerized randomization program that randomized each team to a single treatment by blocks of varying size. All participants within these teams received similar treatment. Clinicians and patients were not blind to treatment allocation at the 12-month assessment.Results: The 294 randomized patients (148 MF, 146 TAU and 57 clinicians (29 MF, 28 TAU of 12 teams (6 MF, 6 TAU were analyzed according to the intention-to-treat principle. No statistically significant differences

  19. Finite size effects in the averaged eigenvalue density of Wigner random-sign real symmetric matrices

    Science.gov (United States)

    Dhesi, G. S.; Ausloos, M.

    2016-06-01

    Nowadays, strict finite size effects must be taken into account in condensed matter problems when treated through models based on lattices or graphs. On the other hand, the cases of directed bonds or links are known to be highly relevant in topics ranging from ferroelectrics to quotation networks. Combining these two points leads us to examine finite size random matrices. To obtain basic materials properties, the Green's function associated with the matrix has to be calculated. To obtain the first finite size correction, a perturbative scheme is hereby developed within the framework of the replica method. The averaged eigenvalue spectrum and the corresponding Green's function of Wigner random sign real symmetric N ×N matrices to order 1 /N are finally obtained analytically. Related simulation results are also presented. The agreement is excellent between the analytical formulas and finite size matrix numerical diagonalization results, confirming the correctness of the first-order finite size expression.

  20. Effect of Rosa damascene aromatherapy on sleep quality in cardiac patients: a randomized controlled trial.

    Science.gov (United States)

    Hajibagheri, Ali; Babaii, Atye; Adib-Hajbaghery, Mohsen

    2014-08-01

    Sleep disorders are common among patients hospitalized in coronary care unit (CCU). This study aimed to investigate the effect of Rosa damascene aromatherapy on sleep quality of patients hospitalized in CCU. In this randomized controlled trial, 60 patients who met the inclusion criteria were conveniently sampled and randomly allocated to the experimental and control groups. Patients in the control group received routine care. In the experimental group, patients received routine care and Rosa damascene aromatherapy for three subsequent nights. In the both groups the sleep quality was assessed using the Pittsburgh Sleep Quality Index. After the study, the mean scores of five domains of Pittsburg Sleep Quality Index as well as the mean of total score of the index in the experimental group were significantly lower than the control group. Rosa damascene aromatherapy can significantly improve the sleep quality of patients hospitalized in CCUs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Effect of massage therapy on pain, anxiety, relaxation, and tension after colorectal surgery: A randomized study.

    Science.gov (United States)

    Dreyer, Nikol E; Cutshall, Susanne M; Huebner, Marianne; Foss, Diane M; Lovely, Jenna K; Bauer, Brent A; Cima, Robert R

    2015-08-01

    The purpose of this randomized controlled trial was to evaluate the effect of postoperative massage in patients undergoing abdominal colorectal surgery. One hundred twenty-seven patients were randomized to receive a 20-min massage (n = 61) or social visit and relaxation session (no massage; n = 66) on postoperative days 2 and 3. Vital signs and psychological well-being (pain, tension, anxiety, satisfaction with care, relaxation) were assessed before and after each intervention. The study results indicated that postoperative massage significantly improved the patients' perception of pain, tension, and anxiety, but overall satisfaction was unchanged. In conclusion, massage may be beneficial during postoperative recovery for patients undergoing abdominal colorectal surgery. Further studies are warranted to optimize timing and duration and to determine other benefits in this clinical setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Effects of exercise and diet in nonobese asthma patients - a randomized controlled trial

    DEFF Research Database (Denmark)

    Tønnesen, Louise Lindhardt; Meteran, Howraman; Hostrup, Morten

    2017-01-01

    the effects of an 8-week intervention of either exercise (high-intensity interval training), diet (high protein/low glycemic index), or a combination of the 2, on asthma control and clinical outcomes in nonobese patients with asthma. METHODS: Nonobese adult patients with asthma (n = 149) were randomized to 1......BACKGROUND: Behavioral interventions focusing on exercise and healthy diet improve asthma control in obese patients with asthma, but whether these interventions can lead to improvements in nonobese patients remains unclear. OBJECTIVES: In a randomized, controlled parallel-group design, we studied...... of 4 groups: an exercise group, a diet group, an exercise + diet group, or a control group. Outcomes included Asthma Control Questionnaire (ACQ) score, asthma-related quality-of-life (Asthma-Related Quality-of-Life Questionnaire [AQLQ]) score, inflammatory cell counts in induced sputum, FEV1...

  3. Stressed Cooper pairing in QCD at high isospin density: effective Lagrangian and random matrix theory

    Science.gov (United States)

    Kanazawa, Takuya; Wettig, Tilo

    2014-10-01

    We generalize QCD at asymptotically large isospin chemical potential to an arbitrary even number of flavors. We also allow for small quark chemical potentials, which stress the coincident Fermi surfaces of the paired quarks and lead to a sign problem in Monte Carlo simulations. We derive the corresponding low-energy effective theory in both p- and ɛ-expansion and quantify the severity of the sign problem. We construct the random matrix theory describing our physical situation and show that it can be mapped to a known random matrix theory at low baryon density so that new insights can be gained without additional calculations. In particular, we explain the Silver Blaze phenomenon at high isospin density. We also introduce stressed singular values of the Dirac operator and relate them to the pionic condensate. Finally we comment on extensions of our work to two-color QCD.

  4. Effectivity of artrihpi irrigation for diabetic ulcer healing: A randomized controlled trial

    Science.gov (United States)

    Gayatri, Dewi; Asmorohadi, Aries; Dahlia, Debie

    2018-02-01

    The healing process of diabetic ulcer is often impeded by inflammation, infection, and decreased immune state. High pressure irrigation (10-15 psi) may be used to control the infection level. This research was designed to identify the effectiveness of artrihpi irrigation device towards diabetic ulcers in public hospitals in the Central Java. This research is a randomized control trial with cross over design. Sixty four subjects were selected using block randomization technique, and were divided into control and intervention group. The intervention was given in 6 days along with wound healing evaluation in every 3 days. The results demonstrated that there was a significant difference decrease scoring healing after treatment, even though the difference scoring healing between both groups was not statistically significant. However, it means difference was found that in the intervention artrihpi the wound healing was better than the spuit. These results illustrates the artrihpi may be solution of using high pressure irrigation to help healing process diabetic ulcers.

  5. A Bayesian Analysis of a Random Effects Small Business Loan Credit Scoring Model

    Directory of Open Access Journals (Sweden)

    Patrick J. Farrell

    2011-09-01

    Full Text Available One of the most important aspects of credit scoring is constructing a model that has low misclassification rates and is also flexible enough to allow for random variation. It is also well known that, when there are a large number of highly correlated variables as is typical in studies involving questionnaire data, a method must be found to reduce the number of variables to those that have high predictive power. Here we propose a Bayesian multivariate logistic regression model with both fixed and random effects for small business loan credit scoring and a variable reduction method using Bayes factors. The method is illustrated on an interesting data set based on questionnaires sent to loan officers in Canadian banks and venture capital companies

  6. Systemic effects of controlled exposure to diesel exhaust: a meta-analysis from randomized controlled trials.

    Science.gov (United States)

    Vieira, Jefferson Luis; Macedo, Francisco Yuri; Benjo, Alexandre Miguel; Guimarães, Guilherme V; Contreras, Johanna Paola; Bocchi, Edimar A

    2017-03-01

    Ambient air pollution is associated with adverse cardiovascular events. This meta-analysis aimed to investigate the short-term association between air pollution and cardiovascular effects on healthy volunteers. We searched databases to identify randomized trials with controlled human exposures to either of two models for studying ambient particulate matter: diesel-exhaust or concentrated ambient particles. Estimates of size effect were performed using standardized mean difference (SMD). Heterogeneity was assessed with I2 statistics. Outcomes were vascular function estimated by forearm blood flow (FBF), blood pressure, heart rate, and blood analysis. Database searches yielded 17 articles (n = 342) with sufficient information for meta-analyses. High levels of heterogeneity for the some outcomes were analyzed using random-effects model. The pooled effect estimate showed that short-term exposure to air pollution impaired FBF response from 2.7 to 2.5 mL/100 mL tissue/min (SMD 0.404; p = .006). There was an increase in 5000 platelet/mm3 following pollution exposure (SMD 0.390; p = .050) but no significant differences for other outcomes. Controlled human exposures to air pollution are associated with the surrogates of vascular dysfunction and increase in platelet count, which might be related to adverse cardiovascular events. Given the worldwide prevalence of exposure to air pollution, these findings are relevant for public health. KEY MESSAGES Controlled exposure to air pollution impairs vasomotor response, which is a surrogate for adverse cardiovascular events. This is the first meta-analysis from randomized clinical trials showing short-term association between air pollution and cardiovascular effects on healthy volunteers. Given the worldwide prevalence of exposure to air pollution, this finding is important for public health.

  7. Effects of music on immunity and physiological responses in healthcare workers: a randomized controlled trial.

    Science.gov (United States)

    Lai, Hui-Ling; Liao, Kuang-Wen; Huang, Chiung-Yu; Chen, Pin-Wen; Peng, Tai-Chu

    2013-04-01

    Research-based evidence supports the effectiveness of soothing music in improving stress-related psycho-physiological indices in a clinical setting. However, there is currently insufficient scientific knowledge of the effects of music on immune markers of stress in humans. Therefore, the aims of the study were to compare the effects of music and quiet rest on the levels of interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), interleukin-10 (IL-10), heart rate and mean arterial pressure among healthcare workers. By using a randomized controlled trial design, 60 nurses were randomly assigned to the stimulating or sedating music or rest groups for 30 min. Participants' psychoneuroimmunological parameters were measured using enzyme-linked immunosorbent assays. General estimating equation was used to analyse data. Results revealed that IL-6, TNF-α and IL-10 were not detectable in this population. No significance differences in heart rate were found among the three groups. However, the stimulating music group had significantly higher mean arterial pressure levels than the sedating music group but no differences between the quiet rest group and the sedating music group. Music with different tempi had little effect on mean arterial pressure. Any effect of music on immune markers of stress requires further research. Copyright © 2012 John Wiley & Sons, Ltd.

  8. Spatial panel data models of aquaculture production in West Sumatra province with random-effects

    Science.gov (United States)

    Sartika, Wimi; Susetyo, Budi; Syafitri, Utami Dyah

    2017-03-01

    Spatial Panel Regression is a statistical model that used to analyze the effect of several independent variables on the dependent variable based on using panel data and take the spatial effect into account. There are two approaches on predicting spatial panel data, Fixed Effect Spatial Autoregressive (SAR-FE) and Random Effect Spatial Autoregressive (SAR-RE). SAR-FE has the assumption that the intercept has vary acrros spatial unit, while the SAR-RE's assumption is the interception is on residual model and it only has a general intercept. The purpose of this study is to modeling the production of West Sumatra fishery using Spatial Panel Regression. The model uses secondary data which is published by "Badan Pusat Statistik" on the results of aquaculture production in West Sumatra. The test results shown that the level of West Sumatra 2004-2012 aquaculture production was precisely modeled by the approach of Spatial Autoregressive Random Effect. From SAR-RE model, the most influence factors on aquaculture production in West Sumatra province in 2004-2012 was the number of motor boats, the area of fish seeds, fish seed production, and the number of fishermen public waters.

  9. Sequential change detection and monitoring of temporal trends in random-effects meta-analysis.

    Science.gov (United States)

    Dogo, Samson Henry; Clark, Allan; Kulinskaya, Elena

    2017-06-01

    Temporal changes in magnitude of effect sizes reported in many areas of research are a threat to the credibility of the results and conclusions of meta-analysis. Numerous sequential methods for meta-analysis have been proposed to detect changes and monitor trends in effect sizes so that meta-analysis can be updated when necessary and interpreted based on the time it was conducted. The difficulties of sequential meta-analysis under the random-effects model are caused by dependencies in increments introduced by the estimation of the heterogeneity parameter τ2 . In this paper, we propose the use of a retrospective cumulative sum (CUSUM)-type test with bootstrap critical values. This method allows retrospective analysis of the past trajectory of cumulative effects in random-effects meta-analysis and its visualization on a chart similar to CUSUM chart. Simulation results show that the new method demonstrates good control of Type I error regardless of the number or size of the studies and the amount of heterogeneity. Application of the new method is illustrated on two examples of medical meta-analyses. © 2016 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd. © 2016 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd.

  10. A Randomized Control Intervention Investigating the Effects of Acute Exercise on Emotional Regulation.

    Science.gov (United States)

    Edwards, Meghan K; Rhodes, Ryan E; Loprinzi, Paul D

    2017-09-01

    Exercise may help to cope with hectic or demanding events after a stressful situation occurs. Limited research has evaluated whether exercise, prior to a stressor, helps to facilitate subsequent emotional regulation. This pilot study addresses this novel paradigm. We employed a randomized controlled trial evaluating the effects of acute exercise on emotional regulation. Participants were randomly assigned to stretch (control group, N = 10), walk (N = 9), or jog (N = 8) for 15-minutes, after which they were exposed to a film clip intended to elicit a negative emotional response. Participants' emotions were monitored before and during exercise, as well as after the film clip. Emotional responses were evaluated using the Exercise Induced Feeling Inventory and Affective Circumplex Scale. A group x time splitplot interaction effect was significant for anger (p = .046) and anxiousness (p = .038). Follow-up analyses showed that only the stretching group (p = .048) had a significantly increased anger score from baseline to post-film clip, suggesting a protective emotional effect from walking and jogging. Exercise was effective in regulating anger and anxiousness after a stressful event. These findings provide evidence for potential preventive effects of exercise in facilitating emotional regulation.

  11. Effect of cocoa and theobromine consumption on serum HDL-cholesterol concentrations: a randomized controlled trial.

    Science.gov (United States)

    Neufingerl, Nicole; Zebregs, Yvonne E M P; Schuring, Ewoud A H; Trautwein, Elke A

    2013-06-01

    Evidence from clinical studies has suggested that cocoa may increase high-density lipoprotein (HDL)-cholesterol concentrations. However, it is unclear whether this effect is attributable to flavonoids or theobromine, both of which are major cocoa components. We investigated whether pure theobromine increases serum HDL cholesterol and whether there is an interaction effect between theobromine and cocoa. The study had a 2-center, double-blind, randomized, placebo-controlled, full factorial parallel design. After a 2-wk run-in period, 152 healthy men and women (aged 40-70 y) were randomly allocated to consume one 200-mL drink/d for 4 wk that contained 1) cocoa, which naturally provided 150 mg theobromine and 325 mg flavonoids [cocoa intervention (CC)], 2) 850 mg pure theobromine [theobromine intervention (TB)], 3) cocoa and added theobromine, which provided 1000 mg theobromine and 325 mg flavonoids [theobromine and cocoa intervention (TB+CC)], or 4) neither cocoa nor theobromine (placebo). Blood lipids and apolipoproteins were measured at the start and end of interventions. In a 2-factor analysis, there was a significant main effect of the TB (P Theobromine independently increased serum HDL-cholesterol concentrations by 0.16 mmol/L. The lack of significant cocoa and interaction effects suggested that theobromine may be the main ingredient responsible for the HDL cholesterol-raising effect. This trial was registered at clinicaltrials.gov as NCT01481389.

  12. The effect of vertical scaling on the estimation of the fractal dimension of randomly rough surfaces

    Science.gov (United States)

    Schouwenaars, Rafael; Jacobo, Víctor H.; Ortiz, Armando

    2017-12-01

    Fractal analysis of randomly rough surface is an interesting tool to establish relationships between surface geometry and properties. Nonetheless, the observation that different methods to determine the fractal dimension D yield different results has raised questions about its physical meaning. This work shows that such variations are caused by the mathematical details of the methods used, particularly by the effect of vertical scaling. For the triangular prism method (TPM), applied to fractional Brownian motion, the effect of vertical scaling on the numerical estimation of D can be addressed through analytic calculations. The analytic approach was compared to simulations of surface topography obtained by the random midpoint algorithm (RMA) using TPM, box count method (BCM), differential box count (DBC) and detrended fluctuation analysis (DFA). The effect of scaling for TPM is considerable and coincides with the mathematical predictions. BCM and DBC show no effect of scaling but provide poor estimates at high D. A small effect was found for DFA. It is concluded that TPM provides a precise estimate of D which is independent of vertical scaling for infinite image resolution. At finite resolutions, the estimation error on D can be minimised by choosing an optimal vertical scaling factor.

  13. A practical guide and power analysis for GLMMs: detecting among treatment variation in random effects.

    Science.gov (United States)

    Kain, Morgan P; Bolker, Ben M; McCoy, Michael W

    2015-01-01

    In ecology and evolution generalized linear mixed models (GLMMs) are becoming increasingly used to test for differences in variation by treatment at multiple hierarchical levels. Yet, the specific sampling schemes that optimize the power of an experiment to detect differences in random effects by treatment/group remain unknown. In this paper we develop a blueprint for conducting power analyses for GLMMs focusing on detecting differences in variance by treatment. We present parameterization and power analyses for random-intercepts and random-slopes GLMMs because of their generality as focal parameters for most applications and because of their immediate applicability to emerging questions in the field of behavioral ecology. We focus on the extreme case of hierarchically structured binomial data, though the framework presented here generalizes easily to any error distribution model. First, we determine the optimal ratio of individuals to repeated measures within individuals that maximizes power to detect differences by treatment in among-individual variation in intercept, among-individual variation in slope, and within-individual variation in intercept. Second, we explore how power to detect differences in target variance parameters is affected by total variation. Our results indicate heterogeneity in power across ratios of individuals to repeated measures with an optimal ratio determined by both the target variance parameter and total sample size. Additionally, power to detect each variance parameter was low overall (in most cases >1,000 total observations per treatment needed to achieve 80% power) and decreased with increasing variance in non-target random effects. With growing interest in variance as the parameter of inquiry, these power analyses provide a crucial component for designing experiments focused on detecting differences in variance. We hope to inspire novel experimental designs in ecology and evolution investigating the causes and implications of

  14. The Effect of Random Error on Diagnostic Accuracy Illustrated with the Anthropometric Diagnosis of Malnutrition.

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    Emmanuel Grellety

    Full Text Available It is often thought that random measurement error has a minor effect upon the results of an epidemiological survey. Theoretically, errors of measurement should always increase the spread of a distribution. Defining an illness by having a measurement outside an established healthy range will lead to an inflated prevalence of that condition if there are measurement errors.A Monte Carlo simulation was conducted of anthropometric assessment of children with malnutrition. Random errors of increasing magnitude were imposed upon the populations and showed that there was an increase in the standard deviation with each of the errors that became exponentially greater with the magnitude of the error. The potential magnitude of the resulting error of reported prevalence of malnutrition were compared with published international data and found to be of sufficient magnitude to make a number of surveys and the numerous reports and analyses that used these data unreliable.The effect of random error in public health surveys and the data upon which diagnostic cut-off points are derived to define "health" has been underestimated. Even quite modest random errors can more than double the reported prevalence of conditions such as malnutrition. Increasing sample size does not address this problem, and may even result in less accurate estimates. More attention needs to be paid to the selection, calibration and maintenance of instruments, measurer selection, training & supervision, routine estimation of the likely magnitude of errors using standardization tests, use of statistical likelihood of error to exclude data from analysis and full reporting of these procedures in order to judge the reliability of survey reports.

  15. Randomized controlled trial on the effectiveness of a multicomponent intervention on migraine: A study protocol.

    Science.gov (United States)

    Renjith, Vishnu; Pai, Aparna; Radhakrishnan, Kurupath; Nayak, Baby S; Devi, Elsa Sanatombi; Ladd, Elissa; George, Anice

    2017-10-11

    To describe a randomized controlled trial protocol that evaluates the effectiveness of a multicomponent intervention in improving the outcomes (quality of life, disability, intensity, frequency and duration) of patients with migraine. Migraine affects various facets of Quality of Life and results in moderate to high levels of disability among migraineurs. Migraine pain can be intense and unremitting that can interfere with the daily routine and reduce the ability to think and function normally. Many people can lower their risk of a migraine by simply avoiding stress, getting enough sleep, eating regularly and by avoiding triggers. Hence, the present study aims at evaluating the effectiveness of a multicomponent intervention in managing migraine headaches. The multicomponent intervention includes behavioural lifestyle modification program and sessions of pranayama (a form of yogic breathing exercise). The study is a prospective, randomized, controlled, single-blinded trial with parallel arms. The study participants are randomized to intervention and control arms. The participants randomized to the intervention arm would receive the specific multicomponent intervention based on the protocol. The participants in the control arm would receive routine care. They are followed up for 24 weeks and the outcomes are assessed. Various studies report that non-pharmacological therapies and integrative therapies play a major role in the management of migraine headaches. The findings of the study are expected to open up new horizons in health care arena emphasizing the use of non-pharmacological therapy for less focused areas of primary care health problems such as migraine. The trial is registered with the Clinical Trials Registry India (CTRI). The CTRI India is one of the primary registries in the WHO registry network (Ctri.nic.in, ). CTRI reference ID: CTRI/2015/10/006282. © 2017 John Wiley & Sons Ltd.

  16. On the relative relevance of subject-specific geometries and degeneration-specific mechanical properties for the study of cell death in human intervertebral disc models

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    Andrea eMalandrino

    2015-02-01

    Full Text Available Capturing patient- or condition-specific intervertebral disc (IVD properties in finite element models is outmost important in order to explore how biomechanical and biophysical processes may interact in spine diseases. However, disc degenerative changes are often modelled through equations similar to those employed for healthy organs, which might not be valid. As for the simulated effects of degenerative changes, they likely depend on specific disc geometries. Accordingly, we explored the ability of continuum tissue models to simulate disc degenerative changes. We further used the results in order to assess the interplay between these simulated changes and particular IVD morphologies, in relation to disc cell nutrition, a potentially important actor in disc tissue regulation. A protocol to derive patient-specific computational models from clinical images was applied to different spine specimens. In vitro IVD creep tests were used to optimize poro-hyperelastic input material parameters in these models, in function of the IVD degeneration grade. The use of condition-specific tissue model parameters in the specimen-specific geometrical models was validated against independent kinematic measurements in vitro. Then, models were coupled to a transport-cell viability model in order to assess the respective effects of tissue degeneration and disc geometry on cell viability. While classic disc poromechanical models failed in representing known degenerative changes, additional simulation of tissue damage allowed model validation and gave degeneration-dependent material properties related to osmotic pressure and water loss, and to increased fibrosis. Surprisingly, nutrition-induced cell death was independent of the grade-dependent material properties, but was favoured by increased diffusion distances in large IVDs. Our results suggest that in situ geometrical screening of IVD morphology might help to anticipate particular mechanisms of disc degeneration.

  17. Effect of Educational Package on Lifestyle of Primiparous Mothers during Postpartum Period: A Randomized Controlled Clinical Trial

    Science.gov (United States)

    Khodabandeh, Farzaneh; Mirghafourvand, Mojgan; KamaliFard, Mahin; Mohammad-Alizadeh-Charandabi, Sakineh; Asghari Jafarabadi, Mohammad

    2017-01-01

    A healthy lifestyle is important for mothers during the postpartum period. This study was conducted to determine the effects of a lifestyle educational package in primiparous women. This randomized clinical trial was conducted on 220 mothers assigned to two groups using block randomization. In the intervention group, the mothers received…

  18. The Effect of Interference on Temporal Order Memory for Random and Fixed Sequences in Nondemented Older Adults

    Science.gov (United States)

    Tolentino, Jerlyn C.; Pirogovsky, Eva; Luu, Trinh; Toner, Chelsea K.; Gilbert, Paul E.

    2012-01-01

    Two experiments tested the effect of temporal interference on order memory for fixed and random sequences in young adults and nondemented older adults. The results demonstrate that temporal order memory for fixed and random sequences is impaired in nondemented older adults, particularly when temporal interference is high. However, temporal order…

  19. Cognitive-Behavioral Treatment for Panic Disorder with Agoraphobia: A Randomized, Controlled Trial and Cost-Effectiveness Analysis

    Science.gov (United States)

    Roberge, Pasquale; Marchand, Andre; Reinharz, Daniel; Savard, Pierre

    2008-01-01

    A randomized, controlled trial was conducted to examine the cost-effectiveness of cognitive-behavioral treatment (CBT) for panic disorder with agoraphobia. A total of 100 participants were randomly assigned to standard (n = 33), group (n = 35), and brief (n = 32) treatment conditions. Results show significant clinical and statistical improvement…

  20. A Cluster Randomized Controlled Trial Testing the Effectiveness of Houvast: A Strengths-Based Intervention for Homeless Young Adults

    Science.gov (United States)

    Krabbenborg, Manon A. M.; Boersma, Sandra N.; van der Veld, William M.; van Hulst, Bente; Vollebergh, Wilma A. M.; Wolf, Judith R. L. M.

    2017-01-01

    Objective: To test the effectiveness of Houvast: a strengths-based intervention for homeless young adults. Method: A cluster randomized controlled trial was conducted with 10 Dutch shelter facilities randomly allocated to an intervention and a control group. Homeless young adults were interviewed when entering the facility and when care ended.…

  1. Randomized Controlled Trial in Clinical Settings to Evaluate Effectiveness of Coping Skills Education Used with Progressive Tinnitus Management

    Science.gov (United States)

    Henry, James A.; Thielman, Emily J.; Zaugg, Tara L.; Kaelin, Christine; Schmidt, Caroline J.; Griest, Susan; McMillan, Garnett P.; Myers, Paula; Rivera, Izel; Baldwin, Robert; Carlson, Kathleen

    2017-01-01

    Purpose: This randomized controlled trial evaluated, within clinical settings, the effectiveness of coping skills education that is provided with progressive tinnitus management (PTM). Method: At 2 Veterans Affairs medical centers, N = 300 veterans were randomized to either PTM intervention or 6-month wait-list control. The PTM intervention…

  2. The effectiveness of participatory ergonomics to prevent low-back and neck pain - results of a cluster randomized controlled trial

    NARCIS (Netherlands)

    Driessen, M.T.; Proper, K.I.; Anema, J.R.; Knol, D.L.; Bongers, P.M.; van der Beek, A.J.

    2011-01-01

    Objective The aim of this randomized controlled trial (RCT) was to investigate the effectiveness of the Stay@ Work participatory ergonomics (PE) program to prevent low-back and neck pain. Methods A total of 37 departments were randomly allocated to either the intervention (PE) or control group (no

  3. The effect of hormone replacement therapy on serum homocysteine levels in perimenopausal women : a randomized controlled trial

    NARCIS (Netherlands)

    Hak, AE; Bak, AAA; Lindemans, J; Planellas, J; Bennink, HJTC; Hofman, A; Grobbee, DE; Witteman, JCM

    2001-01-01

    Serum homocysteine levels may be lowered by hormone replacement therapy, but randomized controlled trial data are scarce. We performed a single center randomized placebo-controlled trial to assess the 6 months effect of hormone replacement therapy compared with placebo on fasting serum homocysteine

  4. Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results from a 2-Year Randomized Trial

    Science.gov (United States)

    Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2011-01-01

    Objective: To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method: Early course schizophrenia outpatients (N = 58) were randomly assigned to cognitive enhancement therapy (CET) or an enriched supportive therapy (EST) control and…

  5. Utility and Cost-Effectiveness of Motivational Messaging to Increase Survey Response in Physicians: A Randomized Controlled Trial

    Science.gov (United States)

    Chan, Randolph C. H.; Mak, Winnie W. S.; Pang, Ingrid H. Y.; Wong, Samuel Y. S.; Tang, Wai Kwong; Lau, Joseph T. F.; Woo, Jean; Lee, Diana T. F.; Cheung, Fanny M.

    2018-01-01

    The present study examined whether, when, and how motivational messaging can boost the response rate of postal surveys for physicians based on Higgin's regulatory focus theory, accounting for its cost-effectiveness. A three-arm, blinded, randomized controlled design was used. A total of 3,270 doctors were randomly selected from the registration…

  6. Effectiveness of adjuvant occupational therapy in employees with depression: design of a randomized controlled trial.

    Science.gov (United States)

    Hees, Hiske L; Koeter, Maarten W J; de Vries, Gabe; Ooteman, Wendy; Schene, Aart H

    2010-09-17

    Major depressive disorder is among the medical conditions with the highest negative impact on work outcome. However, little is known regarding evidence-based interventions targeting the improvement of work outcomes in depressed employees. In this paper, the design of a randomized controlled trial is presented in order to evaluate the effectiveness of adjuvant occupational therapy in employees with depression. This occupational intervention is based on an earlier intervention, which was designed and proven effective by our research group, and is the only intervention to date that specifically targets work outcome in depressed employees. In a two-arm randomized controlled trial, a total of 117 participants are randomized to either 'care as usual' or ' care as usual' with the addition of occupational therapy. Patients included in the study are employees who are absent from work due to depression for at least 25% of their contract hours, and who have a possibility of returning to their own or a new job. The occupational intervention consists of six individual sessions, eight group sessions and a work-place visit over a 16-week period. By increasing exposure to the working environment, and by stimulating communication between employer and employee, the occupational intervention aims to enhance self-efficacy and the acquisition of more adaptive coping strategies. Assessments take place at baseline, and at 6, 12, and 18-month follow-ups. Primary outcome measure is work participation (hours of absenteeism and time until work resumption). Secondary outcome measures are work functioning, symptomatology, health-related quality of life, and neurocognitive functioning. In addition, cost-effectiveness is evaluated from a societal perspective. Finally, mechanisms of change (intermediate outcomes) and potential patient-treatment matching variables are investigated. This study hopes to provide valuable knowledge regarding an intervention to treat depression, one of the most common

  7. Effect of tailoring in an internet-based intervention for smoking cessation: randomized controlled trial.

    Science.gov (United States)

    Wangberg, Silje C; Nilsen, Olav; Antypas, Konstantinos; Gram, Inger Torhild

    2011-12-15

    Studies suggest that tailored materials are superior to nontailored materials in supporting health behavioral change. Several trials on tailored Internet-based interventions for smoking cessation have shown good effects. There have, however, been few attempts to isolate the effect of the tailoring component of an Internet-based intervention for smoking cessation and to compare it with the effectiveness of the other components. The study aim was to isolate the effect of tailored emails in an Internet-based intervention for smoking cessation by comparing two versions of the intervention, with and without tailored content. We conducted a two-arm, randomized controlled trial of the open and free Norwegian 12-month follow-up, fully automated Internet-based intervention for smoking cessation, slutta.no. We collected information online on demographics, smoking, self-efficacy, use of the website, and participant evaluation at enrollment and subsequently at 1, 3, and 12 months. Altogether, 2298 self-selected participants aged 16 years or older registered at the website between August 15, 2006 and December 7, 2007 and were randomly assigned to either a multicomponent, nontailored Internet-based intervention for smoking cessation (control) or a version of the same Internet-based intervention with tailored content delivered on the website and via email. Of the randomly assigned participants, 116 (of 419, response rate = 27.7%) in the intervention group and 128 (of 428, response rate = 29.9%) in the control group had participated over the 12 months and responded at the end of follow-up. The 7-day intention-to-treat abstinence rate at 1 month was 15.2% (149/982) among those receiving the tailored intervention, compared with 9.4% (94/999) among those who received the nontailored intervention (P Internet-based intervention for smoking cessation seems to increase the success rates in the short term, but not in the long term.

  8. Word Length Effect in Free Recall of Randomly Assembled Word Lists

    Directory of Open Access Journals (Sweden)

    Mikhail eKatkov

    2014-10-01

    Full Text Available In serial recall experiments, human subjects are requested to retrieve a list of words in the same order as they were presented. In a classical study, participants were reported to recall more words from study lists composed of short words compared to lists of long words, the word length effect. The world length effect was also observed in free recall experiments, where subjects can retrieve the words in any order. Here we analyzed a large dataset from free recall experiments of unrelated words, where short and long words were randomly mixed, and found a seemingly opposite effect: long words are recalled better than the short ones. We show that our recently proposed mechanism of associative retrieval can explain both these observations. Moreover, the direction of the effect depends solely on the way study lists are composed.

  9. Differential Peer Effects, Student Achievement, and Student Absenteeism: Evidence From a Large-Scale Randomized Experiment.

    Science.gov (United States)

    Eren, Ozkan

    2017-04-01

    Using data from a well-executed randomized experiment, I examine the effects of gender composition and peer achievement on high school students' outcomes in disadvantaged neighborhoods. Results show that having a higher proportion of female peers in the classroom improves girls' math test scores only in less-advanced courses. For male students, the estimated gender peer effects are positive but less precisely estimated. I also find no effect of average classroom achievement on female math test scores. Males, on the other hand, seem to benefit from a higher-achieving classroom. I propose mechanisms relating to lower gender stereotype influences and gender-specific attitudes toward competition as potential explanations for peer effects findings. Finally, having a higher proportion of female students in the classroom decreases student absenteeism among male students but has no impact on female attendance.

  10. Effectiveness of humor intervention for patients with schizophrenia: a randomized controlled trial.

    Science.gov (United States)

    Cai, Chunfeng; Yu, Liping; Rong, Lan; Zhong, Hanling

    2014-12-01

    The primary aim of this pilot study was to evaluate the possible therapeutic effects of a 10-session humor intervention program in improving rehabilitative outcomes and the effects of the intervention on patients' sense of humor among patients with schizophrenia. Thirty subjects were randomly assigned into either the intervention (humor skill training) group (n = 15) or the control (doing handwork) group (n = 15). The results were analyzed using descriptive statistics, t-tests and ANOVA. Repeated measures analysis of variance (ANOVA) tests were conducted to examine the differences across conditions and time. A group by time interaction effect was observed on all of the outcomes, except positive symptoms of PANSS. The time main effect was also significant on the total score (p humor skill training in a mental health service can improve rehabilitative outcomes and sense of humor for schizophrenia patients who were in the rehabilitation stage. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Between-centre differences and treatment effects in randomized controlled trials: A case study in traumatic brain injury

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    Roberts Ian

    2011-08-01

    Full Text Available Abstract Background In Traumatic Brain Injury (TBI, large between-centre differences in outcome exist and many clinicians believe that such differences influence estimation of the treatment effect in randomized controlled trial (RCTs. The aim of this study was to assess the influence of between-centre differences in outcome on the estimated treatment effect in a large RCT in TBI. Methods We used data from the MRC CRASH trial on the efficacy of corticosteroid infusion in patients with TBI. We analyzed the effect of the treatment on 14 day mortality with fixed effect logistic regression. Next we used random effects logistic regression with a random intercept to estimate the treatment effect taking into account between-centre differences in outcome. Between-centre differences in outcome were expressed with a 95% range of odds ratios (OR for centres compared to the average, based on the variance of the random effects (tau2. A random effects logistic regression model with random slopes was used to allow the treatment effect to vary by centre. The variation in treatment effect between the centres was expressed in a 95% range of the estimated treatment ORs. Results In 9978 patients from 237 centres, 14-day mortality was 19.5%. Mortality was higher in the treatment group (OR = 1.22, p = 0.00010. Using a random effects model showed large between-centre differences in outcome (95% range of centre effects: 0.27- 3.71, but did not substantially change the estimated treatment effect (OR = 1.24, p = 0.00003. There was limited, although statistically significant, between-centre variation in the treatment effect (OR = 1.22, 95% treatment OR range: 1.17-1.26. Conclusion Large between-centre differences in outcome do not necessarily affect the estimated treatment effect in RCTs, in contrast to current beliefs in the clinical area of TBI.

  12. The effects of acupressure on primary dysmenorrhea: a randomized controlled trial.

    Science.gov (United States)

    Mirbagher-Ajorpaz, Neda; Adib-Hajbaghery, Mohsen; Mosaebi, Fatemeh

    2011-02-01

    The current study was conducted to evaluate the effect of acupressure on primary dysmenorrhea in Iranian medical sciences students. A randomized controlled pre and post-test design was employed to verify the effects of SP6 acupressure on dysmenorrhea. A total of 30 young college female students with primary dysmenorrhea were randomly allocated to intervention (n = 15) and control (n = 15) groups. The intervention group received SP6 acupressure during menstruation cycle and the control group received light touch on the SP6 acupoint. Using a Visual Analog Scale, the severity of dysmenorrhea was assessed prior to and immediately, 30 min, 1, 2, and 3 h following treatment. Data were analyzed using X(2), t-test and ANOVA statistical tests. Significant differences were observed in the scores of dysmenorrhea between the two groups immediately after (3.50 ± 1.42 vs. 5.06 ± 1.43, p = 0.004) and also 3 h after treatment (1.66 ± 1.98 vs. 4.80 ± 1.37, p = 0.000). Acupressure on the SP6 meridian can be an effective non-invasive nursing intervention for alleviating primary dysmenorrhea and its effects last for 3 h post-treatment. Copyright © 2010 Elsevier Ltd. All rights reserved.

  13. Effectiveness and moderators of the preventive intervention kids in divorce situations: A randomized controlled trial.

    Science.gov (United States)

    Pelleboer-Gunnink, Hannah A; Van der Valk, Inge E; Branje, Susan J T; Van Doorn, Muriel D; Deković, Maja

    2015-10-01

    Children of divorced parents have an increased risk of a variety of problems in comparison to children from intact families. Therefore, several intervention programs have been developed directed at children of divorced parents. Yet, empirical data on the effectiveness of these interventions are limited. This study evaluated the school-based, child-directed prevention program Kids In Divorce Situations (KIDS) using a randomized controlled trial. The sample consisted of 156 children randomly assigned at the school level into an experimental (80 children) and control condition (76 children). In addition, 131 mothers and 76 fathers participated in the study. Four assessments took place: a pretest, a posttest, and two follow-up assessments conducted 6 months and 1 year after finishing KIDS. Latent growth analyses demonstrated that the intervention significantly reduced child-reported emotional problems and enhanced child-reported communication with the father and mother-reported communication with the child. The effect sizes ranged from .30-.63. Few moderation effects of gender, time since divorce, or perceived parental conflict on the intervention effects were found. After parental divorce, a limited school-based intervention for children can be efficacious in promoting children's emotional well-being and parent-child communication. (c) 2015 APA, all rights reserved).

  14. Random-effects meta-analysis: the number of studies matters.

    Science.gov (United States)

    Guolo, Annamaria; Varin, Cristiano

    2017-06-01

    This paper investigates the impact of the number of studies on meta-analysis and meta-regression within the random-effects model framework. It is frequently neglected that inference in random-effects models requires a substantial number of studies included in meta-analysis to guarantee reliable conclusions. Several authors warn about the risk of inaccurate results of the traditional DerSimonian and Laird approach especially in the common case of meta-analysis involving a limited number of studies. This paper presents a selection of likelihood and non-likelihood methods for inference in meta-analysis proposed to overcome the limitations of the DerSimonian and Laird procedure, with a focus on the effect of the number of studies. The applicability and the performance of the methods are investigated in terms of Type I error rates and empirical power to detect effects, according to scenarios of practical interest. Simulation studies and applications to real meta-analyses highlight that it is not possible to identify an approach uniformly superior to alternatives. The overall recommendation is to avoid the DerSimonian and Laird method when the number of meta-analysis studies is modest and prefer a more comprehensive procedure that compares alternative inferential approaches. R code for meta-analysis according to all of the inferential methods examined in the paper is provided.

  15. Technology diffusion in hospitals: a log odds random effects regression model.

    Science.gov (United States)

    Blank, Jos L T; Valdmanis, Vivian G

    2015-01-01

    This study identifies the factors that affect the diffusion of hospital innovations. We apply a log odds random effects regression model on hospital micro data. We introduce the concept of clustering innovations and the application of a log odds random effects regression model to describe the diffusion of technologies. We distinguish a number of determinants, such as service, physician, and environmental, financial and organizational characteristics of the 60 Dutch hospitals in our sample. On the basis of this data set on Dutch general hospitals over the period 1995-2002, we conclude that there is a relation between a number of determinants and the diffusion of innovations underlining conclusions from earlier research. Positive effects were found on the basis of the size of the hospitals, competition and a hospital's commitment to innovation. It appears that if a policy is developed to further diffuse innovations, the external effects of demand and market competition need to be examined, which would de facto lead to an efficient use of technology. For the individual hospital, instituting an innovations office appears to be the most prudent course of action. © 2013 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

  16. Effects of a counselling intervention to improve contraception in deprived neighbourhoods: a randomized controlled trial.

    Science.gov (United States)

    Díez, Elia; López, Maria J; Marí-Dell'Olmo, Marc; Nebot, Laia; Pérez, Gloria; Villalbi, Joan R; Carreras, Ramon

    2017-04-18

    This study aims to evaluate the effects of a community-based counselling intervention to improve contraception use among immigrant and native residents in deprived neighbourhoods. : Randomized controlled trial. Women aged 14-49 years and men aged 14-39 years from two low-income neighbourhoods with high proportion of immigration in Barcelona (Catalonia, Spain) who had not undergone irreversible contraception and were not planning a pregnancy were recruited (2011-13). A culturally developed and theoretically based brief counselling intervention was delivered in community settings. The primary outcome was the consistent use of effective contraceptive methods (optimal use). Secondary outcomes were the incorrect use of effective methods and the use of less effective methods stratified by sex and migrant status. Differences within subgroups from baseline to the 3-month follow-up were analysed by intention to treat and per protocol. The effects were assessed with adjusted robust Poisson regressions. : The study enrolled and randomized 746 eligible participants. There were no differences between the intervention and control groups in demographic characteristics. Optimal use significantly increased in men, women, immigrants and natives in the intervention group, with no changes in the control group. In the intervention group, inconsistent use of effective methods decreased by 54.9% and that of less effective methods by 47.2%. The overall adjusted prevalence ratio of optimal use in the intervention group versus the control group was 1.138 (95% CI: 1.010-1.284). : This brief counselling intervention increased the consistent use of effective contraception in low-income neighbourhoods with a high proportion of immigration.

  17. The effectiveness of lifestyle triple P in the Netherlands: a randomized controlled trial.

    Science.gov (United States)

    Gerards, Sanne M P L; Dagnelie, Pieter C; Gubbels, Jessica S; van Buuren, Stef; Hamers, Femke J M; Jansen, Maria W J; van der Goot, Odilia H M; de Vries, Nanne K; Sanders, Matthew R; Kremers, Stef P J

    2015-01-01

    Lifestyle Triple P is a general parenting intervention which focuses on preventing further excessive weight gain in overweight and obese children. The objective of the current study was to assess the effectiveness of the Lifestyle Triple P intervention in the Netherlands. We used a parallel randomized controlled design to test the effectiveness of the intervention. In total, 86 child-parent triads (children 4-8 years old, overweight or obese) were recruited and randomly assigned (allocation ratio 1:1) to the Lifestyle Triple P intervention or the control condition. Parents in the intervention condition received a 14-week intervention consisting of ten 90-minute group sessions and four individual telephone sessions. Primary outcome measure was the children's body composition (BMI z-scores, waist circumference and skinfolds). The research assistant who performed the measurements was blinded for group assignment. Secondary outcome measures were the children's dietary behavior and physical activity level, parenting practices, parental feeding style, parenting style, and parental self-efficacy. Outcome measures were assessed at baseline and 4 months (short-term) and 12 months (long-term) after baseline. Multilevel multiple regression analyses were conducted to determine the effect of the intervention on primary and secondary outcome measures. No intervention effects were found on children's body composition. Analyses of secondary outcomes showed positive short-term intervention effects on children's soft-drink consumption and parental responsibility regarding physical activity, encouragement to eat, psychological control, and efficacy and satisfaction with parenting. Longer-term intervention effects were found on parent's report of children's time spent on sedentary behavior and playing outside, parental monitoring food intake, and responsibility regarding nutrition. Although the Lifestyle Triple P intervention showed positive effects on some parent reported child

  18. The effectiveness of lifestyle triple P in the Netherlands: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Sanne M P L Gerards

    Full Text Available Lifestyle Triple P is a general parenting intervention which focuses on preventing further excessive weight gain in overweight and obese children. The objective of the current study was to assess the effectiveness of the Lifestyle Triple P intervention in the Netherlands.We used a parallel randomized controlled design to test the effectiveness of the intervention. In total, 86 child-parent triads (children 4-8 years old, overweight or obese were recruited and randomly assigned (allocation ratio 1:1 to the Lifestyle Triple P intervention or the control condition. Parents in the intervention condition received a 14-week intervention consisting of ten 90-minute group sessions and four individual telephone sessions. Primary outcome measure was the children's body composition (BMI z-scores, waist circumference and skinfolds. The research assistant who performed the measurements was blinded for group assignment. Secondary outcome measures were the children's dietary behavior and physical activity level, parenting practices, parental feeding style, parenting style, and parental self-efficacy. Outcome measures were assessed at baseline and 4 months (short-term and 12 months (long-term after baseline. Multilevel multiple regression analyses were conducted to determine the effect of the intervention on primary and secondary outcome measures.No intervention effects were found on children's body composition. Analyses of secondary outcomes showed positive short-term intervention effects on children's soft-drink consumption and parental responsibility regarding physical activity, encouragement to eat, psychological control, and efficacy and satisfaction with parenting. Longer-term intervention effects were found on parent's report of children's time spent on sedentary behavior and playing outside, parental monitoring food intake, and responsibility regarding nutrition.Although the Lifestyle Triple P intervention showed positive effects on some parent reported

  19. The Effects of Inhalation Aromatherapy on Anxiety in Patients With Myocardial Infarction: A Randomized Clinical Trial

    Science.gov (United States)

    Najafi, Zahra; Taghadosi, Mohsen; Sharifi, Khadijeh; Farrokhian, Alireza; Tagharrobi, Zahra

    2014-01-01

    Background: Anxiety is an important mental health problem in patients with cardiac disease. Anxiety reduces patients’ quality of life and increases the risk of different cardiac complications. Objectives: The aim of this study was to investigate the effects of inhalation aromatherapy on anxiety in patients with myocardial infarction. Patients and Methods: This was a randomized clinical trial conduced on 68 patients with myocardial infarction hospitalized in coronary care units of a large-scale teaching hospital affiliated to Kashan University of Medical Sciences, Kashan, Iran in 2013. By using the block randomization technique, patients were randomly assigned to experimental (33 patients receiving inhalation aromatherapy with lavender aroma twice a day for two subsequent days) and control (35 patients receiving routine care of study setting including no aromatherapy) groups. At the beginning of study and twenty minutes after each aromatherapy session, anxiety state of patients was assessed using the Spielberger’s State Anxiety Inventory. Data was analyzed using SPSS v. 16.0. We used Chi-square, Fisher’s exact, independent-samples T-test and repeated measures analysis of variance to analyze the study data. Results: The study groups did not differ significantly regarding baseline anxiety mean and demographic characteristics. However, after the administration of aromatherapy, anxiety mean in the experimental group was significantly lower than the control group. Conclusions: Inhalation aromatherapy with lavender aroma can reduce anxiety in patients with myocardial infarction. Consequently, healthcare providers, particularly nurses, can use this strategy to improve postmyocardial infarction anxiety management. PMID:25389481

  20. Neurocognitive effects of neurofeedback in adolescents with ADHD: a randomized controlled trial.

    Science.gov (United States)

    Bink, Marleen; van Nieuwenhuizen, Chijs; Popma, Arne; Bongers, Ilja L; van Boxtel, Geert J M

    2014-05-01

    Neurofeedback aims to reduce symptoms of attention-deficit/hyperactivity disorder (ADHD), mainly attention problems. However, the additional influence of neurofeedback over treatment as usual (TAU) on neurocognitive functioning for adolescents with ADHD remains unclear. By using a multicenter parallel randomized controlled trial (RCT) design, male adolescents with a DSM-IV-TR diagnosis of ADHD (mean age = 16.1 years; range, 12-24) were randomized to receive either a combination of TAU and neurofeedback (n = 45) or TAU (n = 26). Randomization was computer generated and stratified by age group (ages 12 through 15, 16 through 20, and 21 through 24 years). The neurofeedback intervention consisted of approximately 37 sessions over a period of 25 weeks of theta/sensorimotor rhythm training on the vertex (Cz). Primary neurocognitive outcomes included performance parameters derived from the D2 Test of Attention, the Digit Span backward, the Stroop Color-Word Test and the Tower of London, all assessed preintervention and postintervention. Data were collected between December 2009 and July 2012. At postintervention, outcomes of attention and/or motor speed were improved, with faster processing times for both intervention conditions and with medium to large effect sizes (range, ηp2 = .08-.54; P values neurofeedback over TAU was observed. Hence, this study does not provide evidence for using theta/sensorimotor rhythm neurofeedback to enhance neurocognitive performance as additional intervention to TAU for adolescents with ADHD symptoms. Trialregister.nl identifier: 1759. © Copyright 2014 Physicians Postgraduate Press, Inc.

  1. Potential effects of chocolate on human pregnancy: a randomized controlled trial.

    Science.gov (United States)

    Di Renzo, Gian Carlo; Brillo, Eleonora; Romanelli, Maila; Porcaro, Giuseppina; Capanna, Federica; Kanninen, Tomi T; Gerli, Sandro; Clerici, Graziano

    2012-10-01

    This trial was undertaken to evaluate the effects of high-cocoa-content chocolate supplementation in pregnancy on several haematochemical and clinical parameters. The study had as reference population the pregnant women requesting an obstetric control at Outpatient Clinic of Obstetrics and Gynaecology of the S. Maria della Misericordia University Hospital, Perugia, Italy. Candidates who participated in this study were all Caucasian women aged 18-40 years, who had a single gestation pregnancy between 11th + 0 and 13th + 0 week gestational age. We conducted a single-center randomized controlled trial. The pregnant women selected were randomized into Group A, which received daily doses of 30 g of chocolate (70% cocoa), and Group B, which was free to increase their diet with other foods. Ninety women were randomized. Significant difference was found between the two groups for diastolic blood pressure (p = 0.05), systolic (p < 0.0001) and levels of liver enzymes, with values lower in Group A than in Group B. Total cholesterol levels and weight gain in Group A did not increase more than in Group B. A modest daily intake of high-cocoa-content chocolate contributes to reduce blood pressure, glycemic and liver pattern during pregnancy without affecting the weight gain.

  2. Effects of telmisartan on proteinuria or albuminuria: a meta-analysis of randomized trials.

    Science.gov (United States)

    Takagi, Hisato; Yamamoto, Hirotaka; Iwata, Kotaro; Goto, Shin-Nosuke; Umemoto, Takuya

    2013-08-20

    Although telmisartan is suggested to improve proteinuria/albuminuria (or prevents progression of proteinuria/albuminuria), conclusive evidence is still lacking. We perform the first meta-analysis of randomized controlled trials of telmisartan therapy on proteinuria/albuminuria. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through February 2012. Eligible studies were prospective randomized controlled trials of telmisartan therapy versus other angiotensin receptor blocker (ARB), angiotensin converting enzyme inhibitor (ACEI), other anti-hypertensive drug therapy, placebo, or no medication and reporting urinary protein/albumin excretion (UPE/UAE) or urinary protein/albumin to creatinine ratio (UPCR/UACR) levels as an outcome. For each study, data regarding percent changes from baseline to final UPE/UAE/UPCR/UACR levels in both the telmisartan and control groups were used to generate mean differences (MDs) and 95% confidence intervals (CIs). Of 49 potentially relevant articles screened initially, 20 reports of randomized trials enrolling a total of 25,425 patients were included. Pooled analysis suggested a significant reduction in percent changes of UPE/UAE/UPCR/UACR in the 7 ARB-control (MD, -19.99%; 95% CI, -28.68% to -11.30%; p25,000 patients, telmisartan therapy is likely effective in the improvement of proteinuria/albuminuria or in the prevention of progression in proteinuria/albuminuria. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. A Team Study of a Multiple-Power Wireless Random Channel Access Mechanism with Capture Effect

    Directory of Open Access Journals (Sweden)

    Abdelillah Karouit

    2013-01-01

    Full Text Available We present a team analysis of a slotted random wireless channel access mechanism. Under the proposed scheme, denoted wireless random access mechanism with multiple power levels (MPL-WRA, each mobile station contends for a transmission opportunity following the principles of a slotted access mechanism incorporating a random transmitting power value selected among various available power levels. In this way, a capture effect may be produced allowing the packet to be decoded whenever the signal-to-interference-plus-noise ratio is higher than a given threshold. In order to analyze the performance and optimization of the proposed setup, we build a Markovian model integrating the wireless access mechanism supplemented by the use of multiple power levels in an attractive and simple cross-layer fashion. We follow a team problem approach allowing us to fine tune the design parameters of the overall system configuration. Throughout an extensive numerical analysis, our main results set the basis for the social optimal system configuration of the proposed mechanism taking into account the physical constraints of using multiple power levels and the actual practical implementation of a slotted access mechanism. We end the paper with concluding remarks and future research directions including guidelines for the actual implementation of our proposal.

  4. Monte Carlo particle transport in random media: The effects of mixing statistics

    Science.gov (United States)

    Larmier, Coline; Zoia, Andrea; Malvagi, Fausto; Dumonteil, Eric; Mazzolo, Alain

    2017-07-01

    Particle transport in random media obeying a given mixing statistics is key in several applications in nuclear reactor physics and more generally in diffusion phenomena emerging in optics and life sciences. Exact solutions for the ensemble-averaged physical observables are hardly available, and several approximate models have been thus developed, providing a compromise between the accurate treatment of the disorder-induced spatial correlations and the computational time. In order to validate these models, it is mandatory to use reference solutions in benchmark configurations, typically obtained by explicitly generating by Monte Carlo methods several realizations of random media, simulating particle transport in each realization, and finally taking the ensemble averages for the quantities of interest. In this context, intense research efforts have been devoted to Poisson (Markov) mixing statistics, where benchmark solutions have been derived for transport in one-dimensional geometries. In a recent work, we have generalized these solutions to two and three-dimensional configurations, and shown how dimension affects the simulation results. In this paper we will examine the impact of mixing statistics: to this aim, we will compare the reflection and transmission probabilities, as well as the particle flux, for three-dimensional random media obtained by using Poisson, Voronoi and Box stochastic tessellations. For each tessellation, we will furthermore discuss the effects of varying the fragmentation of the stochastic geometry, the material compositions, and the cross sections of the background materials.

  5. Effect of natural hirudin on random pattern skin flap survival in a porcine model.

    Science.gov (United States)

    Zhao, H; Shi, Q; Sun, Z Y; Yin, G Q; Yang, H L

    2012-01-01

    The effect of local administration of hirudin on random pattern skin flap survival was investigated in a porcine model. Three random pattern skin flaps (4 × 14 cm) were created on each flank of five Chinese minipigs. The experimental group (10 flaps) received 20 antithrombin units of hirudin, injected subdermally into the distal half immediately after surgery and on days 1 and 2; a control group (10 flaps) was injected with saline and a sham group (10 flaps) was not injected. All flaps were followed for 10 days postoperatively. Macroscopically, the congested/necrotic length in the experimental group was significantly decreased compared with the other two groups by day 3. Histopathological evaluation revealed venous congestion and inflammation in the control and sham groups from day 1, but minimal changes in the experimental group. By day 10, the mean ± SD surviving area was significantly greater in the experimental group (67.6 ± 2.1%) than in the control (45.2 ± 1.4%) or sham (48.3 ± 1.1%) groups. Local administration of hirudin can significantly increase the surviving area in overdimensioned random pattern skin flaps, in a porcine model.

  6. A randomized comparative effectiveness trial of using cable television to deliver diabetes prevention programming

    Science.gov (United States)

    Ackermann, Ronald T; Sandy, Lewis G; Beauregard, Tom; Coblitz, Mark; Norton, Kristi L; Vojta, Deneen

    2014-01-01

    Objective To evaluate the use and effectiveness of two “in-home” strategies for delivering diabetes prevention programming using cable television. Methods An individually randomized, two-arm intervention trial including adults with diabetes risk factors living in two US cities. Interventions involved a 16-session lifestyle intervention delivered via “video-on-demand” cable television, offered alone versus in combination with web-based lifestyle support tools. Repeated measures longitudinal linear regression with imputation of missing observations was used to compare changes in body weight. Results A total of 306 individuals were randomized and offered the interventions. After 5 months, 265 (87%) participants viewed at least 1, and 110 (36%) viewed ≥9 of the video episodes. A total of 262 (86%) participants completed a 5-month weight measurement. In intention-to-treat analysis with imputation of missing observations, mean weight loss at 5 months for both treatment groups combined was 3.3% (95% CI 0.7-5.0%), regardless of intervention participation (with no differences between randomized groups (P = 0.19)), and was 4.9% (95% CI 2.1-6.5%) for participants who viewed ≥9 episodes. Conclusions In-home delivery of evidence-based diabetes prevention programming in a reality television format, offered with or without online behavioral support tools, can achieve modest weight losses consistent with past implementation studies of face-to-face programs using similar content. PMID:24740868

  7. The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial.

    Science.gov (United States)

    Dhurandhar, Emily J; Dawson, John; Alcorn, Amy; Larsen, Lesli H; Thomas, Elizabeth A; Cardel, Michelle; Bourland, Ashley C; Astrup, Arne; St-Onge, Marie-Pierre; Hill, James O; Apovian, Caroline M; Shikany, James M; Allison, David B

    2014-08-01

    Breakfast is associated with lower body weight in observational studies. Public health authorities commonly recommend breakfast consumption to reduce obesity, but the effectiveness of adopting these recommendations for reducing body weight is unknown. We tested the relative effectiveness of a recommendation to eat or skip breakfast on weight loss in adults trying to lose weight in a free-living setting. We conducted a multisite, 16-wk, 3-parallel-arm randomized controlled trial in otherwise healthy overweight and obese adults [body mass index (in kg/m²) between 25 and 40] aged 20-65 y. Our primary outcome was weight change. We compared weight change in a control group with weight loss in experimental groups told to eat breakfast or to skip breakfast [no breakfast (NB)]. Randomization was stratified by prerandomization breakfast eating habits. A total of 309 participants were randomly assigned. A total of 283 of the 309 participants who were randomly assigned completed the intervention. Treatment assignment did not have a significant effect on weight loss, and there was no interaction between initial breakfast eating status and treatment. Among skippers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were -0.71 ± 1.16, -0.76 ± 1.26, and -0.61 ± 1.18 kg for the control, breakfast, and NB groups, respectively. Among breakfast consumers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were -0.53 ± 1.16, -0.59 ± 1.06, and -0.71 ± 1.17 kg for the control, breakfast, and NB groups, respectively. Self-reported compliance with the recommendation was 93.6% for the breakfast group and 92.4% for the NB group. A recommendation to eat or skip breakfast for weight loss was effective at changing self-reported breakfast eating habits, but contrary to widely espoused views this had no discernable effect on weight loss in free-living adults who were attempting to lose weight. © 2014 American Society for

  8. The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial123

    Science.gov (United States)

    Dhurandhar, Emily J; Dawson, John; Alcorn, Amy; Larsen, Lesli H; Thomas, Elizabeth A; Cardel, Michelle; Bourland, Ashley C; Astrup, Arne; St-Onge, Marie-Pierre; Hill, James O; Apovian, Caroline M; Shikany, James M; Allison, David B

    2014-01-01

    Background: Breakfast is associated with lower body weight in observational studies. Public health authorities commonly recommend breakfast consumption to reduce obesity, but the effectiveness of adopting these recommendations for reducing body weight is unknown. Objective: We tested the relative effectiveness of a recommendation to eat or skip breakfast on weight loss in adults trying to lose weight in a free-living setting. Design: We conducted a multisite, 16-wk, 3-parallel-arm randomized controlled trial in otherwise healthy overweight and obese adults [body mass index (in kg/m2) between 25 and 40] aged 20–65 y. Our primary outcome was weight change. We compared weight change in a control group with weight loss in experimental groups told to eat breakfast or to skip breakfast [no breakfast (NB)]. Randomization was stratified by prerandomization breakfast eating habits. A total of 309 participants were randomly assigned. Results: A total of 283 of the 309 participants who were randomly assigned completed the intervention. Treatment assignment did not have a significant effect on weight loss, and there was no interaction between initial breakfast eating status and treatment. Among skippers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were −0.71 ± 1.16, −0.76 ± 1.26, and −0.61 ± 1.18 kg for the control, breakfast, and NB groups, respectively. Among breakfast consumers, mean (±SD) baseline weight-, age-, sex-, site-, and race-adjusted weight changes were −0.53 ± 1.16, −0.59 ± 1.06, and −0.71 ± 1.17 kg for the control, breakfast, and NB groups, respectively. Self-reported compliance with the recommendation was 93.6% for the breakfast group and 92.4% for the NB group. Conclusions: A recommendation to eat or skip breakfast for weight loss was effective at changing self-reported breakfast eating habits, but contrary to widely espoused views this had no discernable effect on weight loss in free-living adults who

  9. Effect of dietary protein supplementation on blood pressure: a randomized, controlled trial.

    Science.gov (United States)

    He, Jiang; Wofford, Marion R; Reynolds, Kristi; Chen, Jing; Chen, Chung-Shiuan; Myers, Leann; Minor, Deborah L; Elmer, Patricia J; Jones, Daniel W; Whelton, Paul K

    2011-08-02

    Observational studies have reported an inverse association between dietary protein intake and blood pressure (BP). We compared the effect of soy protein, milk protein, and carbohydrate supplementation on BP among healthy adults. We conducted a randomized, double-blind crossover trial with 3 intervention phases among 352 adults with prehypertension or stage 1 hypertension in New Orleans, LA, and Jackson, MS, from September 2003 to April 2008. The trial participants were assigned to take 40 g/d soy protein, milk protein, or carbohydrate supplementation each for 8 weeks in a random order. A 3-week washout period was implemented between the interventions. Three BPs were measured at 2 baseline and 2 termination visits during each of 3 intervention phases with a random-zero sphygmomanometer. Compared with carbohydrate controls, soy protein and milk protein supplementations were significantly associated with -2.0 mm Hg (95% confidence interval -3.2 to -0.7 mm Hg, P=0.002) and -2.3 mm Hg (-3.7 to -1.0 mm Hg, P=0.0007) net changes in systolic BP, respectively. Diastolic BP was also reduced, but this change did not reach statistical significance. There was no significant difference in the BP reductions achieved between soy or milk protein supplementation. The results from this randomized, controlled trial indicate that both soy and milk protein intake reduce systolic BP compared with a high-glycemic-index refined carbohydrate among patients with prehypertension and stage 1 hypertension. Furthermore, these findings suggest that partially replacing carbohydrate with soy or milk protein might be an important component of nutrition intervention strategies for the prevention and treatment of hypertension. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00107744.

  10. Effect of Magnesium Supplement on Pregnancy Outcomes: A Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Elaheh Zarean

    2017-01-01

    Full Text Available Background: Magnesium (Mg is an essential mineral required to regulate body temperature, nucleic acid, and protein synthesis with an important role in maintaining nerve and muscle cell electrical potentials. It may reduce fetal growth restriction and preeclampsia as well as increase birth weight. This study aimed to assess the effects of consuming Mg supplementation during pregnancy on pregnancy outcomes. Materials and Methods: This is a randomized controlled trial with three sixty populated groups of pregnant women. Participants were randomized to treatment or control groups through random table numbers. Participants with Mg serum levels more than 1.9 mg/dl considered as control group A randomly. They just received one multimineral tablet once a day until the end of pregnancy participants with hypomagnesemia consider as Group B and C. Participants in Group B received one multimineral tablet daily until the end of pregnancy. Participants in Group C received 200 mg effervescent Mg tablet from Vitafit Company once daily for 1 month, and also they consumed one multimineral tablet from Alhavi Company, which contains 100 mg Mg, once a day until the end of pregnancy. Intrauterine growth retardation, preterm labor, maternal body mass index, neonatal weight, pregnancy-induced hypertension, preeclampsia, gestational diabetes mellitus, cramps of the leg Apgar score were compared between three groups. Results: In all pregnancy outcomes, Group C that received effervescent Mg tablet plus multimineral showed a better result than other groups, and frequency of complications of pregnancy was fewer than the other two groups and showed a significant difference. Conclusion: Mg supplement during pregnancy likely decrease probability occurrence of many complications of pregnancy.

  11. Effect of Magnesium Supplement on Pregnancy Outcomes: A Randomized Control Trial

    Science.gov (United States)

    Zarean, Elaheh; Tarjan, Amal

    2017-01-01

    Background: Magnesium (Mg) is an essential mineral required to regulate body temperature, nucleic acid, and protein synthesis with an important role in maintaining nerve and muscle cell electrical potentials. It may reduce fetal growth restriction and preeclampsia as well as increase birth weight. This study aimed to assess the effects of consuming Mg supplementation during pregnancy on pregnancy outcomes. Materials and Methods: This is a randomized controlled trial with three sixty populated groups of pregnant women. Participants were randomized to treatment or control groups through random table numbers. Participants with Mg serum levels more than 1.9 mg/dl considered as control group A randomly. They just received one multimineral tablet once a day until the end of pregnancy participants with hypomagnesemia consider as Group B and C. Participants in Group B received one multimineral tablet daily until the end of pregnancy. Participants in Group C received 200 mg effervescent Mg tablet from Vitafit Company once daily for 1 month, and also they consumed one multimineral tablet from Alhavi Company, which contains 100 mg Mg, once a day until the end of pregnancy. Intrauterine growth retardation, preterm labor, maternal body mass index, neonatal weight, pregnancy-induced hypertension, preeclampsia, gestational diabetes mellitus, cramps of the leg Apgar score were compared between three groups. Results: In all pregnancy outcomes, Group C that received effervescent Mg tablet plus multimineral showed a better result than other groups, and frequency of complications of pregnancy was fewer than the other two groups and showed a significant difference. Conclusion: Mg supplement during pregnancy likely decrease probability occurrence of many complications of pregnancy. PMID:28904937

  12. The Effect of Acupressure on Sleep Quality in Menopausal Women: A Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Zahra Abedian

    2015-07-01

    Full Text Available Background: One of the common problems in menopausal women is sleep disorder. Traditional Chinese acupressure is a noninvasive and safe technique. Menopausal women can easily learn the technique and a self-care method to manage their sleep disorder. This study was carried out to evaluate the effectiveness of acupressure on sleep quality of postmenopausal women in Mashhad during 2009. Methods: This double blind, randomized clinical trial was performed on 120 qualified menopausal women at the age of 41-65 years. Their sleep quality was measured according to the Pittsburgh Sleep Quality Index (PSQI. Participants were randomly assigned to an acupressure group (n=37, a sham acupressure group (n=36 and a control group (n=32 by two time randomized method (systematic and simple randomized. These interventions were carried out for four consecutive weeks. The participants in the acupressure and sham acupressure groups learned to carry out the acupressure technique as a self-care at home with simultaneous massage techniques that were to be performed 2 hours before sleep, whereas only conversation was used in the control group. The data were analyzed by the SPSS software version 17. Results: The results indicated significant differences in total PSQI scores among the three groups (P<0.001. Tukey’s test revealed that there were significant differences between the acupressure group and the control group (P<0.001, the acupressure group and sham acupressure group (P<0.001, and the sham acupressure and the control group (P<0.001. Conclusion: Acupressure can be used as a complementary treatment to relieve sleep disorders in menopausal women; and is offered as an efficient method to manage sleep quality. Trial Registration Number: IRCT2013100614910N1.

  13. Effectiveness and Cost-Effectiveness of Different Weekly Frequencies of Pilates for Chronic Low Back Pain: Randomized Controlled Trial.

    Science.gov (United States)

    Miyamoto, Gisela Cristiane; Moura, Katherinne Ferro; Franco, Yuri Rafael dos Santos; Oliveira, Naiane Teixeira Bastos de; Amaral, Diego Diulgeroglo Vicco; Branco, Amanda Nery Castelo; Silva, Maria Liliane da; Lin, Christine; Cabral, Cristina Maria Nunes

    2016-03-01

    The Pilates method has been recommended to patients with low back pain, but the evidence on effectiveness is inconclusive. In addition, there is still no evidence for the cost-effectiveness of this method or for the ideal number of sessions to achieve the highest effectiveness. The aim of this study will be to investigate the effectiveness and cost-effectiveness of the Pilates method with different weekly frequencies in the treatment of patients with nonspecific low back pain. This is a randomized controlled trial with blinded assessor. This study will be conducted at a physical therapy clinic in São Paulo, Brazil. Two hundred ninety-six patients with nonspecific low back pain between the ages of 18 and 80 years will be assessed and randomly allocated to 4 groups (n=74 patients per group). All groups will receive an educational booklet. The booklet group will not receive additional exercises. Pilates group 1 will follow a Pilates-based program once a week, Pilates group 2 will follow the same program twice a week, and Pilates group 3 will follow the same program 3 times a week. The intervention will last 6 weeks. A blinded assessor will evaluate pain, quality-adjusted life-years, general and specific disability, kinesiophobia, pain catastrophizing, and global perceived effect 6 weeks, 6 months, and 12 months after randomization. Therapists and patients will not be blinded. This will be the first study to investigate different weekly frequencies of treatment sessions for nonspecific low back pain. The results of this study will contribute to a better definition of treatment programs for this population. © 2016 American Physical Therapy Association.

  14. Mendelian randomization analysis to examine for a causal effect of urate on bone mineral density.

    Science.gov (United States)

    Dalbeth, Nicola; Topless, Ruth; Flynn, Tanya; Cadzow, Murray; Bolland, Mark J; Merriman, Tony R

    2015-06-01

    In observational studies, serum urate concentrations are positively associated with bone mineral density (BMD) and reduced risk of fragility fractures, raising the possibility that urate is a direct mediator of bone density. We used Mendelian randomization analysis to examine whether urate has a causal effect on BMD. We analyzed data from the Generation 3 cohort in the Framingham Heart Study (FHS) (N = 2501 total; 1265 male, 1236 female). A weighted genetic urate score was calculated using the SLC2A9, ABCG2, SLC17A1, SLC22A11, and SLC22A12 single-nucleotide polymorphisms (SNPs) that explains 3.4% of the variance in serum urate. Mendelian randomization analysis was performed using the two-stage least squares method with >80% power at α = 0.05 to detect an effect size equivalent to that observed in the ordinary least squares analysis between serum urate and total femur BMD. A strong association between serum urate and BMD was observed in the crude ordinary least squares analysis (total femur crude beta = 0.47, p = 1.7E-51). In the two-stage least squares analysis using the weighted genetic urate score as the instrumental variable, no significant relationship was observed between serum urate and BMD (total femur crude beta =-0.36, p = 0.06). Similar findings were observed in both the male and female subgroups, and there was no evidence for causality when individual SNPs were analyzed. Serum urate is strongly associated with BMD. However, controlling for confounders by Mendelian randomization analysis does not provide evidence that increased urate has a causal effect on increasing BMD. © 2014 American Society for Bone and Mineral Research.

  15. Effectiveness of myofascial release in the management of plantar heel pain: a randomized controlled trial.

    Science.gov (United States)

    Ajimsha, M S; Binsu, D; Chithra, S

    2014-06-01

    Previous studies have reported that stretching of the calf musculature and the plantar fascia are effective management strategies for plantar heel pain (PHP). However, it is unclear whether myofascial release (MFR) can improve the outcomes in this population. To investigate whether myofascial release (MFR) reduces the pain and functional disability associated with plantar heel pain (PHP) in comparison with a control group receiving sham ultrasound therapy (SUST). Randomized, controlled, double blinded trial. Nonprofit research foundation clinic in India. Sixty-six patients, 17 men and 49 women with a clinical diagnosis of PHP were randomly assigned into MFR or a control group and given 12 sessions of treatment per client over 4 weeks. The Foot Function Index (FFI) scale was used to assess pain severity and functional disability. The primary outcome measure was the difference in FFI scale scores between week 1 (pretest score), week 4 (posttest score), and follow-up at week 12 after randomization. Additionally, pressure pain thresholds (PPT) were assessed over the affected gastrocnemii and soleus muscles, and over the calcaneus, by an assessor blinded to the treatment allocation. The simple main effects analysis showed that the MFR group performed better than the control group in weeks 4 and 12 (P<0.001). Patients in the MFR and control groups reported a 72.4% and 7.4% reduction, respectively, in their pain and functional disability in week 4 compared with that in week 1, which persisted as 60.6% in the follow-up at week 12 in the MFR group compared to the baseline. The mixed ANOVA also revealed significant group-by-time interactions for changes in PPT over the gastrocnemii and soleus muscles, and the calcaneus (P<0.05). This study provides evidence that MFR is more effective than a control intervention for PHP. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Effects of price discounts and tailored nutrition education on supermarket purchases: a randomized controlled trial.

    Science.gov (United States)

    Ni Mhurchu, Cliona; Blakely, Tony; Jiang, Yannan; Eyles, Helen C; Rodgers, Anthony

    2010-03-01

    Traditional methods to improve population diets have largely relied on individual responsibility, but there is growing interest in structural interventions such as pricing policies. The aim was to evaluate the effect of price discounts and tailored nutrition education on supermarket food and nutrient purchases. A 2 x 2 factorial randomized controlled trial was conducted in 8 New Zealand supermarkets. A total of 1104 shoppers were randomly assigned to 1 of the following 4 interventions that were delivered over 6 mo: price discounts (12.5%) on healthier foods, tailored nutrition education, discounts plus education, or control (no intervention). The primary outcome was change in saturated fat purchased at 6 mo. Secondary outcomes were changes in other nutrients and foods purchased at 6 and 12 mo. Outcomes were assessed by using electronic scanner sales data. At 6 mo, the difference in saturated fat purchased for price discounts on healthier foods compared with that purchased for no discount on healthier foods was -0.02% (95% CI: -0.40%, 0.36%; P = 0.91). The corresponding difference for tailored nutrition education compared with that for no education was -0.09% (95% CI: -0.47%, 0.30%; P = 0.66). However, those subjects who were randomly assigned to receive price discounts bought significantly more predefined healthier foods at 6 mo (11% more; mean difference: 0.79 kg/wk; 95% CI: 0.43, 1.16; P discounts nor tailored nutrition education had a significant effect on nutrients purchased. However, the significant and sustained effect of discounts on food purchases suggests that pricing strategies hold promise as a means to improve population diets.

  17. Is customized vestibular rehabilitation effective in patients with multiple sclerosis? A randomized controlled trial.

    Science.gov (United States)

    Ozgen, Gulnur; Karapolat, Hale; Akkoc, Yesim; Yuceyar, Nur

    2016-08-01

    Balance disorders are among the most common problems encountered by patients diagnosed with multiple sclerosis (MS). The purpose of this randomized, controlled trial was to investigate the effects of customized vestibular rehabilitation (VR) on balance, functional capacity, quality of life, and depression in patients with MS. This study was designed as a prospective, randomized, controlled trial. The study was carried out in a single tertiary referral center. Forty consecutive patients referred with a diagnosis of MS were randomized into two groups: an exercise group (N.=20) and a control group (N.=20). The experimental group underwent customized VR and the wait-listed control group received the usual medical care. All of the patients were assessed with objective balance tests (Romberg Test, Tandem Romberg Test, Foam Romberg Test, Static Posturography, Six-Meter Walk Test, Five Times Sit-to-Stand Test, Berg Balance Scale, Timed Up and Go Test, Functional Gait Assessment, and Dynamic Gait Index), subjective balance parameters (Activities-Specific Balance Confidence Scale and Dizziness Handicap Inventory), and functional capacity (Six-Minute Walking Test), quality of life (Multiple Sclerosis Quality of Life-54), and depression (Beck Depression Inventory) scales. At the end of the trial, the exercise group exhibited significant changes in most of the evaluated parameters compared to the control group [except the Tandem Romberg with eyes closed and the Foam Romberg, standing with eyes open (P0.05). The intergroup comparisons of differences indicated significant recoveries in favor of the exercise group in all of the evaluated parameters (P<0.05). This study confirms the effects of customized VR programs on balance, quality of life, and functional capacity in patients with MS. Customized VR is an effective method for treating balance disorders in patients with MS.

  18. Effect of Kinesio taping on elbow muscle strength in healthy individuals: A randomized trial1.

    Science.gov (United States)

    Karahan, Ali Y; Yildirim, Pelin; Kucuksarac, Seher; Ordahan, Banu; Turkoglu, Gözde; Soran, Neslihan; Ozen, Kemal E; Zinnuroglu, Murat

    2017-01-01

    The effect of the application of kinesiotape on muscle strength is still uncertain. This trial represents the first randomized-controlled trial to investigate the immediate and delayed effects of kinesiotape application on triceps muscle strength in healthy subjects. The trial was randomized and placebo-controlled. Young adult (18-35 years of age), healthy men were randomly assigned in a 1:1 ratio to either a kinesiotape group or a sham tape for the control group. ``Y''-shaped kinesiotape was applied to the triceps muscle in the sitting position. ``I''-shaped tape was used for the control group, and the sham tape was placed horizontally on the triceps muscle. A hand-held digital dynamometer was used to evaluate the peak force of elbow extension and flexion. Assessments were carried out before taping, an hour after taping, and after the first week. The mean ages of the participants in the kinesiotape and control groups were 26.2 ± 4.8 and 26.7 ± 4.8, respectively. The mean values of the peak force before taping, after the first hour, and after first week were statistically analyzed using one-way repeated measures. No statistical significance was found for in-group analysis of either the kinesiotape group or the control group (p> 0.05). In addition, there was no statistical significance in the between-group assessments (p> 0.05). The triceps muscle is appropriate for studying the effects of kinesiotape on muscle strength because elbow extension is provided by only one fusiform-shaped muscle. The results of this study did not show any significant changes in immediate or delayed muscle strength according to the initial measurements and between-group assessments.

  19. Cognitive effects of calligraphy therapy for older people: a randomized controlled trial in Hong Kong

    Directory of Open Access Journals (Sweden)

    Kwok TCY

    2011-10-01

    Full Text Available Timothy CY Kwok1,2, Xue Bai1,3, Henry SR Kao4,5, Jessie CY Li1, Florence KY Ho11Jockey Club Centre for Positive Ageing; 2Department of Medicine and Therapeutics, The Chinese University of Hong Kong; 3Department of Social Work and Social Administration; 4Department of Psychology, The University of Hong Kong, Hong Kong; 5Department of Psychology, Fu Jen Catholic University, TaiwanBackground: This pilot study investigated the effects of calligraphy therapy on cognitive function in older Hong Kong Chinese people with mild cognitive impairment.Methods: A single-blind, randomized controlled trial was carried out in a sample of 31 adults aged 65 years or older with mild cognitive impairment. They were randomly assigned to receive either intensive calligraphy training led by a trained research assistant for eight weeks (calligraphy group, n = 14 or no calligraphy treatment (control group, n = 17. Participants' cognitive function was assessed by the Chinese version of the Mini-Mental State Examination (CMMSE before and after calligraphy treatment. Repeated measures analysis of variance and paired samples t-tests were used to analyze the data.Results: A significant interaction effect of time and intervention was detected [F (1, 29 = 9.11, P = 0.005, η2= 0.24]. The calligraphy group was found to have a prominent increase in CMMSE global score, and scores in the cognitive areas of orientation, attention, and calculation after two months (∆M = 2.36, P < 0.01, whereas their counterparts in the control group experienced a decline in CMMSE score (∆M = -0.41, P < 0.05.Conclusion: Calligraphy therapy was effective for enhancing cognitive function in older people with mild cognitive impairment and should be incorporated as part of routine programs in both community and residential care settings.Keywords: calligraphy therapy, Chinese elderly, mild cognitive impairment, cognitive function, randomized controlled trial

  20. Coherent light scattering of heterogeneous randomly rough films and effective medium in the theory of electromagnetic wave multiple scattering

    Energy Technology Data Exchange (ETDEWEB)

    Berginc, G [THALES, 2 avenue Gay-Lussac 78995 ELANCOURT (France)

    2013-11-30

    We have developed a general formalism based on Green's functions to calculate the coherent electromagnetic field scattered by a random medium with rough boundaries. The approximate expression derived makes it possible to determine the effective permittivity, which is generalised for a layer of an inhomogeneous random medium with different types of particles and bounded with randomly rough interfaces. This effective permittivity describes the coherent propagation of an electromagnetic wave in a random medium with randomly rough boundaries. We have obtained an expression, which contains the Maxwell – Garnett formula at the low-frequency limit, and the Keller formula; the latter has been proved to be in good agreement with experiments for particles whose dimensions are larger than a wavelength. (coherent light scattering)

  1. A Note on the Existence of the Posteriors for One-way Random Effect Probit Models.

    Science.gov (United States)

    Lin, Xiaoyan; Sun, Dongchu

    2010-01-01

    The existence of the posterior distribution for one-way random effect probit models has been investigated when the uniform prior is applied to the overall mean and a class of noninformative priors are applied to the variance parameter. The sufficient conditions to ensure the propriety of the posterior are given for the cases with replicates at some factor levels. It is shown that the posterior distribution is never proper if there is only one observation at each factor level. For this case, however, a class of proper priors for the variance parameter can provide the necessary and sufficient conditions for the propriety of the posterior.

  2. Random Voting Effects in Social-Digital Spaces: A case study of Reddit Post Submissions

    OpenAIRE

    Glenski, Maria; Johnston, Thomas J.; Weninger, Tim

    2015-01-01

    At a time when information seekers first turn to digital sources for news and opinion, it is critical that we understand the role that social media plays in human behavior. This is especially true when information consumers also act as information producers and editors by their online activity. In order to better understand the effects that editorial ratings have on online human behavior, we report the results of a large-scale in-vivo experiment in social media. We find that small, random rat...

  3. Effects of an Integrated Stress Management Program (ISMP) for Psychologically Distressed Students: A Randomized Controlled Trial.

    Science.gov (United States)

    Kim, Sunah; Lee, Hyangkyu; Kim, Hyunlye; Noh, Dabok; Lee, Hyunhwa

    2016-07-01

    This study aimed to evaluate the effects of an integrated stress management program (ISMP) on college life stress, stress coping, psychological distress, and cortisol among male college students. Out of 137 initially enrolled students, 99 participants were identified as distressed subjects and randomly assigned to either the ISMP or control group. Ultimately, 84 participants (43: experimental, 41: control) completed pretest-posttest. The experimental group received eight 2-hr sessions over 4 weeks. Stress and psychological distress decreased significantly, whereas stress coping and cortisol did not improve significantly. Further studies with longer follow-up periods and physiological interventions are required. © 2015 Wiley Periodicals, Inc.

  4. Effects of music on physiological and behavioral responses of premature infants: a randomized controlled trial.

    Science.gov (United States)

    Alipour, Zahra; Eskandari, Narges; Ahmari Tehran, Hoda; Eshagh Hossaini, Seyed Kamal; Sangi, Sareh

    2013-08-01

    Despite persuasive theories about the beneficial effects of music and singing in developmental care for premature infants, few small studies are available in this regard. We conducted this study to investigate the physiological and behavioral responses of premature infants to recorded lullaby music and silence. In a randomized controlled trial, 90 premature infants in the neonatal care unit of a hospital in Qom (Iran) were randomly allocated to intervention (lullaby and silence) or control groups. Lullaby music was played via headphones at a volume of 50-60 dB. In the silence group, headphones were placed on the infants' ears while no music was played. The three groups were surveyed for physiological responses including oxygen saturation, respiratory and heart rates, and behavioral states every five minutes before, during, and after the intervention. The three groups were not significantly different in terms of mean values of respiratory and heart rates, oxygen saturation, and behavioral states of infants. Similarly, no significant within group differences in respiratory and heart rates, oxygen saturation, and behavioral states were observed at different times. Our findings did not support the beneficial effects of music for premature infants. However, music is a noninvasive, non-pharmaceutical, and relatively low-cost intervention that can be implemented at infants' bedside. Thus further research is warranted to determine whether the effects noted in previous studies can be consistently replicated in diverse settings and with diverse groups of preterm infants. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Effects of simvastatin on serum adiponectin: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Chen, Weibin; Huang, Zhuo; Bi, Minghui; Xu, Xuejing; Zhao, Nengjiang

    2017-03-13

    Effects of simvastatin on serum level of adiponectin, a protein conferring benefits in both cardiovascular and metabolic system, are not fully determined. A meta-analysis of randomized controlled trials (RCTs) was performed. Studies were identified by searching of Pubmed, Embase, and the Cochrane Library databases. Heterogeneity among the RCTs was determined by Cochrane's Q test and I(2) statistics. Meta-analysis was performed with random-effect model or fixed-effect model according to the heterogeneity. Meta-regression and subgroup analyses were performed to analyze the source of heterogeneity. Twelve RCTs with 16 comparisons and 1042 patients were included. Overall, serum adiponectin was not significantly affected by simvastatin (WMD: 0.42 μg/mL; 95% CI, -0.66-1.50 μg/mL). However, significant heterogeneity was detected (Cochrane's Q test: p simvastatin treatment on serum adiponectin (Coefficient 0.04, p = 0.03). Subgroup analyses demonstrated that simvastatin treatment was associated with increased adiponectin in studies with treatment duration of 12 weeks (WMD: 3.65 μg/mL; p simvastatin of 12 weeks may increase the serum level adiponectin in patients at risk for cardiovascular diseases, but not for the short term treatment of ≤ 8 weeks.

  6. Few effects of far transfer of working memory training in ADHD: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Jens Egeland

    Full Text Available OBJECTIVE: Studies have shown that children with ADHD profit from working memory training, although few studies have investigated transfer effects comprehensively. The current Randomized Controlled Trial analyzes transfer to other neuropsychological (NP domains, academic performance and everyday functioning at home and school. METHOD: Sixty-seven children with ADHD were randomized into a control group or a training group. The training group underwent Cogmed's RoboMemo program. All participants were assessed pre-training, immediately after and eight months later with a battery of NP tests, measures of mathematical and reading skills, as well as rating scales filled out by parents and teachers. RESULTS: There was a significant training effect in psychomotor speed, but not to any other NP measures. Reading and mathematics were improved. There were no training induced changes in symptom rating scales either at home or at school. The increased reading scores remained significant eight months later. CONCLUSION: The study is the most comprehensive study of transfer effects to date, and with mixed results compared to previous research. More research is needed regarding how to improve the training program and the conditions and thresholds for successful training. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN19133620.

  7. 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.

  8. Unexpected Effects of a System-Distributed Mobile Application in Maternity Care: A Randomized Controlled Trial.

    Science.gov (United States)

    Ledford, Christy J W; Womack, Jasmyne J; Rider, Heather A; Seehusen, Angela B; Conner, Stephen J; Lauters, Rebecca A; Hodge, Joshua A

    2017-09-01

    As pregnant mothers increasingly engage in shared decision making regarding prenatal decisions, such as induction of labor, the patient's level of activation may influence pregnancy outcomes. One potential tool to increase patient activation in the clinical setting is mobile applications. However, research is limited in comparing mobile apps with other modalities of patient education and engagement tools. This study was designed to test the effectiveness of a mobile app as a replacement for a spiral notebook guide as a patient education and engagement tool in the prenatal clinical setting. This randomized controlled trial was conducted in the Women's Health Clinic and Family Health Clinic of three hospitals. Repeated-measures analysis of covariance was used to test intervention effects in the study sample of 205 patients. Mothers used a mobile app interface to more frequently record information about their pregnancy; however, across time, mothers using a mobile app reported a significant decrease in patient activation. The unexpected negative effects in the group of patients randomized to the mobile app prompt these authors to recommend that health systems pause before distributing their own version of mobile apps that may decrease patient activation. Mobile apps can be inherently empowering and engaging, but how a system encourages their use may ultimately determine their adoption and success.

  9. The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial.

    Science.gov (United States)

    Huang, Shih-Tzu; Good, Marion; Zauszniewski, Jaclene A

    2010-11-01

    To examine effects of sedative music on cancer pain. A randomized controlled trial. Two large medical centers in Kaoshiung City, in southern Taiwan. 126 hospitalized persons with cancer pain. Participants were randomly assigned to an experimental (n=62) or a control group (n=64), with computerized minimization, stratifying on gender, pain, and hospital unit. Music choices included folk songs, Buddhist hymns (Taiwanese music), plus harp, and piano (American). The experimental group listened to music for 30 min; the control group rested in bed. Sensation and distress of pain were rated on 100mm VAS before and after the 30-min test. Using MANCOVA, there was significantly less posttest pain in the music versus the control group, pmusic was very helpful for pain. Thirty minutes of music provided 50% relief in 42% of the music group compared to 8% of the controls. The number needed to treat (NNT) to find one with 50% sensation relief was three patients. More patients chose Taiwanese music (71%) than American music (29%), but both were liked and effective. Offering a choice of familiar, culturally appropriate music was a key element of the intervention. Findings extend the Good and Moore theory (1996) to cancer pain. Soft music was safe, effective, and liked by participants. It provided greater relief of cancer pain than analgesics alone. Thus nurses should offer calming, familiar music to supplement analgesic medication for persons with cancer pain. Copyright 2010 Elsevier Ltd. All rights reserved.

  10. Bayesian hierarchical models for cost-effectiveness analyses that use data from cluster randomized trials.

    Science.gov (United States)

    Grieve, Richard; Nixon, Richard; Thompson, Simon G

    2010-01-01

    Cost-effectiveness analyses (CEA) may be undertaken alongside cluster randomized trials (CRTs) where randomization is at the level of the cluster (for example, the hospital or primary care provider) rather than the individual. Costs (and outcomes) within clusters may be correlated so that the assumption made by standard bivariate regression models, that observations are independent, is incorrect. This study develops a flexible modeling framework to acknowledge the clustering in CEA that use CRTs. The authors extend previous Bayesian bivariate models for CEA of multicenter trials to recognize the specific form of clustering in CRTs. They develop new Bayesian hierarchical models (BHMs) that allow mean costs and outcomes, and also variances, to differ across clusters. They illustrate how each model can be applied using data from a large (1732 cases, 70 primary care providers) CRT evaluating alternative interventions for reducing postnatal depression. The analyses compare cost-effectiveness estimates from BHMs with standard bivariate regression models that ignore the data hierarchy. The BHMs show high levels of cost heterogeneity across clusters (intracluster correlation coefficient, 0.17). Compared with standard regression models, the BHMs yield substantially increased uncertainty surrounding the cost-effectiveness estimates, and altered point estimates. The authors conclude that ignoring clustering can lead to incorrect inferences. The BHMs that they present offer a flexible modeling framework that can be applied more generally to CEA that use CRTs.

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

    Science.gov (United States)

    Hazlett-Stevens, Holly; Oren, Yelena

    2017-06-01

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

  12. Effect of Pentoxifylline on Microalbuminuria in Diabetic Patients: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Shahrzad Shahidi

    2015-01-01

    Full Text Available Background. Pentoxifylline is a nonspecific phosphodiesterase inhibitor with anti-inflammatory properties. Human studies have proved its antiproteinuric effect in patients with glomerular diseases, but this study was designed to assess the effects of add-on pentoxifylline to available treatment on reduction of microalbuminuria in diabetic patients without glomerular diseases. Methods. In a double-blind placebo-controlled, randomized study we evaluated the influence of pentoxifylline on microalbuminuria in type 2 diabetic patients. 40 diabetic patients with estimated glomerular filtration rate (eGFR of more than 60 mL/min/1.73 m2 in eight weeks and microalbuminuria were randomized to two groups which will receive pentoxifylline 1200 mg/day or placebo added to regular medications for 6 months. albuminuria; eGFR was evaluated at three- and six-month follow-up period. Results. Baseline characteristics were similar between the two groups. At six months, the mean estimated GFR and albuminuria were not different between two groups at 3- and 6-month follow-up. Trend of albumin to creatinine ratio, systolic and diastolic blood pressure, and eGFR in both groups were decreased, but no significant differences were noted between two groups (P value > 0.05. Conclusion. Pentoxifylline has not a significant additive antimicroalbuminuric effect compared with placebo in patients with type 2 diabetes with early stage of kidney disease; however, further clinical investigations are necessary to be done.

  13. Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects: The PROMOTE Study A Randomized Controlled Trial

    Science.gov (United States)

    HENSEL, Kendi L.; BUCHANAN, Steve; BROWN, Sarah K.; RODRIGUEZ, Mayra; CRUSER, des Anges

    2014-01-01

    Objective To evaluate the efficacy of Osteopathic Manipulative Treatment (OMT) to reduce low back pain and improve functioning during the third trimester in pregnancy and improve selected outcomes of labor and delivery. Study Design PROMOTE was a randomized, placebo-controlled trial of 400 women in their third trimester. Women were randomized to usual care only (UCO), usual care plus OMT (OMT), or usual care plus placebo ultrasound treatment (PUT). The study included seven treatments over nine weeks. The OMT protocol included specific techniques administered by board-certified OMT specialists. Outcomes were assessed using self-report measures for pain and back-related functioning, and medical records for delivery outcomes. Results There were 136 women in the OMT group, 131 in PUT, and 133 in UCO. Characteristics at baseline were similar across groups. Findings indicate significant treatment effects for pain and back related functioning (P<.001 for both), with outcomes for the OMT group similar to that of the PUT, but both groups were significantly improved compared to UCO. For secondary outcome of meconium- stained amniotic fluid there were no differences between the groups. Conclusion OMT was effective for mitigating pain and functional deterioration compared to the UCO group; however OMT did not differ significantly from PUT. This may be attributed to PUT being a more active treatment than intended. There was no higher likelihood of conversion to high risk status based on treatment group. Therefore, OMT is a safe, effective adjunctive modality to improve pain and functioning during their third trimester. PMID:25068560

  14. Effects of honey supplementation on inflammatory markers among chronic smokers: a randomized controlled trial.

    Science.gov (United States)

    Ghazali, Wan Syaheedah Wan; Romli, Aminah Che; Mohamed, Mahaneem

    2017-03-28

    Honey has been demonstrated to possess anti-inflammatory property. This is a randomized, controlled, open-label trial to determine the effects of 12-week honey oral supplementation on plasma inflammatory markers such as high sensitive C-reactive protein, interleukin-6 and tumor necrosis factor-α among chronic smokers. A total of 32 non-smokers and 64 chronic smokers from Quit Smoking Clinic and Health Campus, Universiti Sains Malaysia participated in the study. Smokers were then randomized into 2 groups: smokers with honey group that received Malaysian Tualang honey (20 g/day daily for 12 weeks) and smokers without honey group. Blood was obtained from non-smokers and smokers at pre-intervention, and from smokers at post-intervention for measurement of the inflammatory markers. At pre-intervention, smokers had significantly higher high sensitive C-reactive protein than non-smokers. In smokers with honey group, tumor necrosis factor-α was significantly increased while high sensitive C-reactive protein was significantly reduced at post-intervention than at pre-intervention. This study suggests that honey supplementation has opposite effects on tumor necrosis factor-α and high sensitive C-reactive protein indicating the inconclusive effect of honey on inflammation among chronic smokers which needs further study on other inflammatory markers. The Trial has been registered in the Australian New Zealand Clinical Trials Registry: ACTRN12615001236583 . Registered 11 November 2015 (Retrospectively Registered).

  15. Effectiveness of preemptive lysine clonixinate in tooth extraction: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Pedro Aravena

    2013-12-01

    Full Text Available Aim: To evaluate the effectiveness of prophylaxis with single-dose analgesic clonixinate lysine (CL 125mg in patients undergoing tooth extraction. Methods: A double-blind randomized placebo-controlled trial. Were included in the study patients ASA I and II with dental extraction indication in the city of Valdivia, Chile in October 2012. Were randomly assigned in two groups: the treatment group received a doses of 125mg of CL fifteen minutes before the surgery, and a control group who received placebo. Both groups used a CL as a rescue analgesic. Using a survey, patients reported the degree of pain via a visual analog scale (VAS during the first day, at 24 and 48 hours after surgery. In addition, registered the number of CL capsules consumed as a ransom for 3 days after the surgery. We compared the analgesic effect observed in (VAS and the number of additional analgesic consumption between the two groups using t-test (p<0.05. Results: Fifty-four patients were operated and there was no statistically significant difference between the pain scores between the two groups. Premedication patients reported the use of equal number of rescue capsules comparing with the control group. Conclusion: CL analgesic prophylaxis proved no more effective in reducing pain after tooth extraction when comparing to the use of placebo in a postoperative doses.

  16. The effectiveness of core stabilization exercise in adolescent idiopathic scoliosis: A randomized controlled trial.

    Science.gov (United States)

    Gür, Gözde; Ayhan, Cigdem; Yakut, Yavuz

    2017-06-01

    Core stabilization training is used to improve postural balance in musculoskeletal problems. The purpose of this study was to investigate the effectiveness of stabilization training in adolescent idiopathic scoliosis. A randomized controlled trial, pretest-posttest design. In total, 25 subjects with adolescent idiopathic scoliosis were randomly divided into two groups: stabilization group ( n = 12) and control group ( n = 13). The stabilization group received core stabilization in addition to traditional rehabilitation, and the control group received traditional rehabilitation for 10 weeks. Assessment included Cobb's angle on radiograph, apical vertebral rotation in Adam's test, trunk asymmetry (Posterior Trunk Symmetry Index), cosmetic trunk deformity (Trunk Appearance Perception Scale), and quality of life (Scoliosis Research Society-22 questionnaire). Inter-group comparisons showed significantly greater improvements in the mean change in lumbar apical vertebral rotation degree and the pain domain of Scoliosis Research Society-22 in the stabilization group than those in the control group ( p < 0.05). No significant differences were observed for other measurements between the groups; however, trends toward greater improvement were observed in the stabilization group. Core stabilization training in addition to traditional exercises was more effective than traditional exercises alone in the correction of vertebral rotation and reduction of pain in adolescent idiopathic scoliosis. Clinical relevance Stabilization exercises are more effective in reducing rotation deformity and pain than traditional exercises in the conservative rehabilitation of adolescent idiopathic scoliosis. These improvements suggest that stabilization training should be added to rehabilitation programs in adolescent idiopathic scoliosis.

  17. Randomized crossover trial studying the effect of music on examination anxiety.

    Science.gov (United States)

    Lai, Hui-Ling; Chen, Pin-Wen; Chen, Chia-Jung; Chang, Hui-Kuan; Peng, Tai-Chu; Chang, Fwu-Mei

    2008-11-01

    The purpose of this study was to assess the effect of lento music on examination anxiety among nursing students. A randomized crossover classroom-based trial was conducted. Thirty-eight students with a mean age of 19.4 years (SD = .54) were randomly assigned to either a music/silence or a silence/music group sequence. The students in the music group were given a 40-min group-based music intervention in a classroom, whereas the students in the silence group received the regular test without music. Using paired t-tests, there were no significant different in pretest scores for state anxiety, examination anxiety, finger temperature and pulse rate between the two conditions. Nonetheless, the findings indicated that music intervention did effectively decrease examination anxiety and state anxiety as well as reducing pulse rate and increasing higher finger temperature (p = 0.05 to 0.001). In addition, significant differences were detected between the pretest and posttest measures for silence (p = 0.001). The results suggest that lento music is effective at anxiety reduction. This study provides evidence for nursing faculty and clinical educators to foster nursing students' mastering over the anxiety of examination by using lento music.

  18. Effect of guided relaxation and imagery on falls self-efficacy: a randomized controlled trial.

    Science.gov (United States)

    Kim, Bang Hyun; Newton, Roberta A; Sachs, Michael L; Glutting, Joseph J; Glanz, Karen

    2012-06-01

    To examine the effects of guided relaxation and imagery (GRI) on improvement in falls self-efficacy in older adults who report having a fear of falling. Randomized, controlled trial with allocation to GRI or guided relaxation with music of choice. General community. Ninety-one men and women aged 60 to 92. Participants were randomized to listen to a GRI audio compact disk (intervention group) or a guided relaxation audio compact disk and music of choice (control group) twice a week for 6 weeks for 10 minutes per session. Primary outcome measure was the Short Falls Efficacy Scale-International (FES-I). Secondary outcome measures were the Leisure Time Exercise Questionnaire (LTEQ) and the Timed Up and Go (TUG) mobility test. GRI participants reported greater improvements on the Short FES-I (P = .002) and LTEQ (P = .001) scores and shorter time on the TUG (P = .002) than the guided relaxation and music-of-choice group. GRI was more effective at increasing falls self-efficacy and self-reported leisure time exercise and reducing times on a simple mobility test than was guided relaxation with music of choice. GRI is an effective, simple, low-cost tool for older adults to improve falls self-efficacy and leisure time exercise behaviors. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  19. Effectiveness of a Multidimensional Randomized Control Intervention to Reduce Quartz Exposure Among Construction Workers.

    Science.gov (United States)

    van Deurssen, Erik; Meijster, Tim; Oude Hengel, Karen M; Boessen, Ruud; Spaan, Suzanne; Tielemans, Erik; Heederik, Dick; Pronk, Anjoeka

    2015-10-01

    There is little evidence with respect to the effectiveness of intervention programs that focus on the reduction of occupational quartz exposure in the construction industry. This article evaluates the effectiveness of a multidimensional intervention which was aimed at reducing occupational quartz exposure among construction workers by increasing the use of technical control measures. Eight companies participating in the cluster randomized controlled trial were randomly allocated to the intervention (four companies) or control condition (four companies). The multidimensional intervention included engineering, organizational, and behavioural elements at both organizational and individual level. Full-shift personal quartz exposure measurements and detailed observations were conducted before and after the intervention among bricklayers, carpenters, concrete drillers, demolishers, and tuck pointers (n = 282). About 59% of these workers measured at baseline were reassessed during follow-up. Bayesian hierarchical models were used to evaluate the intervention effect on exposure levels. Concrete drillers in the intervention group used technical control measures, particularly water suppression, for a significantly greater proportion of the time spent on abrasive tasks during follow-up compared to baseline (93 versus 62%; P quartz exposure (73 versus 40% in the intervention and control group respectively; P quartz exposure among high exposed construction workers. © The Author 2015. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

  20. Few effects of far transfer of working memory training in ADHD: a randomized controlled trial.

    Science.gov (United States)

    Egeland, Jens; Aarlien, Anne Kristine; Saunes, Brit-Kari

    2013-01-01

    Studies have shown that children with ADHD profit from working memory training, although few studies have investigated transfer effects comprehensively. The current Randomized Controlled Trial analyzes transfer to other neuropsychological (NP) domains, academic performance and everyday functioning at home and school. Sixty-seven children with ADHD were randomized into a control group or a training group. The training group underwent Cogmed's RoboMemo program. All participants were assessed pre-training, immediately after and eight months later with a battery of NP tests, measures of mathematical and reading skills, as well as rating scales filled out by parents and teachers. There was a significant training effect in psychomotor speed, but not to any other NP measures. Reading and mathematics were improved. There were no training induced changes in symptom rating scales either at home or at school. The increased reading scores remained significant eight months later. The study is the most comprehensive study of transfer effects to date, and with mixed results compared to previous research. More research is needed regarding how to improve the training program and the conditions and thresholds for successful training. Controlled-Trials.com ISRCTN19133620.

  1. Effects of micro- and subtle-expression reading skill training in medical students: A randomized trial.

    Science.gov (United States)

    Yu, Eun Ho; Choi, Eun Jung; Lee, Sang Yeoup; Im, Sun Ju; Yune, So Jung; Baek, Sun Yong

    2016-10-01

    to investigate the effectiveness of the Micro Expression Training Tool (METT) and the Subtle Expression Training Tool (SETT) to help improve the non-verbal communication skills of medical students. In a randomized controlled trial, all participants were randomly allocated to either a training (n=41) or control group (n=41) and were pre-tested before education with METT and SETT at baseline. Then, training students took second tests after a 1-h class about interpreting micro and subtle expressions and control students took the second tests without the class. METT pre-test scores were positively related with female gender, agreeableness, whereas SETT pre-test scores were negatively related with age and positively related with female gender. Mean METT score increases of 29.3% and mean SETT score increases of 36.2% were observed after training, whereas the control group achieved only a mean METT score increase of 11.0% at second testing. Increases in both test scores in the training group were significantly higher than in the control group. METT and SETT are effective, simple tools for improving the micro- and subtle-expression reading skills of medical students. METT and SETT can be effective for improving the non-verbal communication skills of medical students. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Modeling longitudinal data with nonparametric multiplicative random effects jointly with survival data.

    Science.gov (United States)

    Ding, Jimin; Wang, Jane-Ling

    2008-06-01

    In clinical studies, longitudinal biomarkers are often used to monitor disease progression and failure time. Joint modeling of longitudinal and survival data has certain advantages and has emerged as an effective way to mutually enhance information. Typically, a parametric longitudinal model is assumed to facilitate the likelihood approach. However, the choice of a proper parametric model turns out to be more elusive than models for standard longitudinal studies in which no survival endpoint occurs. In this article, we propose a nonparametric multiplicative random effects model for the longitudinal process, which has many applications and leads to a flexible yet parsimonious nonparametric random effects model. A proportional hazards model is then used to link the biomarkers and event time. We use B-splines to represent the nonparametric longitudinal process, and select the number of knots and degrees based on a version of the Akaike information criterion (AIC). Unknown model parameters are estimated through maximizing the observed joint likelihood, which is iteratively maximized by the Monte Carlo Expectation Maximization (MCEM) algorithm. Due to the simplicity of the model structure, the proposed approach has good numerical stability and compares well with the competing parametric longitudinal approaches. The new approach is illustrated with primary biliary cirrhosis (PBC) data, aiming to capture nonlinear patterns of serum bilirubin time courses and their relationship with survival time of PBC patients.

  3. Effectiveness of papain gel in venous ulcer treatment: randomized clinical trial1

    Science.gov (United States)

    Rodrigues, Ana Luiza Soares; de Oliveira, Beatriz Guitton Renaud Baptista; Futuro, Débora Omena; Secoli, Silvia Regina

    2015-01-01

    OBJECTIVE: to assess the effectiveness of 2% papain gel compared to 2% carboxymethyl cellulose in the treatment of chronic venous ulcer patients. METHOD: randomized controlled clinical trial with 12-week follow-up. The sample consisted of 18 volunteers and 28 venous ulcers. In the trial group, 2% papain gel was used and, in the control group, 2% carboxymethyl cellulose gel. RESULTS: the trial group showed a significant reduction in the lesion area, especially between the fifth and twelfth week of treatment, with two healed ulcers and a considerable increase in the amount of epithelial tissue in the wound bed. CONCLUSION: 2% papain gel demonstrated greater effectiveness in the reduction of the lesion area, but was similar to 2% carboxymethyl cellulose gel regarding the reduction in the amount of exudate and devitalized tissue. Multicenter research is suggested to evidence the effectiveness of 2% papain gel in the healing of venous ulcers. UTN number: U1111-1157-2998 PMID:26155004

  4. Effectiveness of papain gel in venous ulcer treatment: randomized clinical trial.

    Science.gov (United States)

    Rodrigues, Ana Luiza Soares; de Oliveira, Beatriz Guitton Renaud Baptista; Futuro, Débora Omena; Secoli, Silvia Regina

    2015-01-01

    to assess the effectiveness of 2% papain gel compared to 2% carboxymethyl cellulose in the treatment of chronic venous ulcer patients. randomized controlled clinical trial with 12-week follow-up. The sample consisted of 18 volunteers and 28 venous ulcers. In the trial group, 2% papain gel was used and, in the control group, 2% carboxymethyl cellulose gel. the trial group showed a significant reduction in the lesion area, especially between the fifth and twelfth week of treatment, with two healed ulcers and a considerable increase in the amount of epithelial tissue in the wound bed. 2% papain gel demonstrated greater effectiveness in the reduction of the lesion area, but was similar to 2% carboxymethyl cellulose gel regarding the reduction in the amount of exudate and devitalized tissue. Multicenter research is suggested to evidence the effectiveness of 2% papain gel in the healing of venous ulcers. UTN number: U1111-1157-2998.

  5. A prospective randomized study of the effectiveness of aromatherapy for relief of postoperative nausea and vomiting.

    Science.gov (United States)

    Hodge, Nancy S; McCarthy, Mary S; Pierce, Roslyn M

    2014-02-01

    Postoperative nausea and vomiting (PONV) is a major concern for patients having surgery under general anesthesia as it causes subjective distress along with increased complications and delays in discharge from the hospital. Aromatherapy represents a complementary and alternative therapy for the management of PONV. The objective of this study was to compare the effectiveness of aromatherapy (QueaseEase, Soothing Scents, Inc, Enterprise, AL) versus an unscented inhalant in relieving PONV. One hundred twenty-one patients with postoperative nausea were randomized into a treatment group receiving an aromatic inhaler and a control group receiving a placebo inhaler to evaluate the effectiveness of aromatherapy. Initial and follow-up nausea assessment scores in both treatment and placebo groups decreased significantly (P aromatherapy was significantly higher in the treatment group (P Aromatherapy was favorably received by most patients and represents an effective treatment option for postoperative nausea. Published by Elsevier Inc.

  6. Application of a model to investigate the effective thermal conductivity of randomly packed fusion pebble beds

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xiaoliang; Zheng, Jie; Chen, Hongli, E-mail: hlchen1@ustc.edu.cn

    2016-05-15

    In our precious study, a prediction model, which calculates the effective thermal conductivity k{sub eff} of mono-sized pebble beds, has been developed and validated. Based on this model, here the effects of these influencing factors such as pebble size, thermal radiation, contact area, filling gas, gas flow, gas pressure, etc. on the k{sub eff} of randomly packed fusion pebble beds are studied and analyzed. The pebble beds investigated include Li{sub 4}SiO{sub 4}, Li{sub 2}ZrO{sub 3}, Li{sub 2}TiO{sub 3}, Li{sub 2}O, Be and BeO pebble beds. In the current study, many important and meaningful conclusions are derived and some of them are similar to the existing research results. Particularly, some critters that under which conditions the effect of some influencing factors can be neglected or should be considered are also presented.

  7. Randomized Controlled Trial on the Effects of CCTV Training on Quality of Life, Depression, and Adaptation to Vision Loss

    NARCIS (Netherlands)

    Burggraaff, M.C.; van Nispen, R.M.A.; Knol, D.L.; Ringens, P.J.; van Rens, G.H.M.B.

    2012-01-01

    PURPOSE. In addition to performance-based measures, visionrelated quality of life (QOL) and other subjective measures of psychosocial functioning are considered important outcomes of training in the visually impaired. In a multicenter, masked, randomized controlled trial, subjective effects of

  8. Effect of a tailored physical activity intervention delivered in general practice settings: results of a randomized controlled trial

    NARCIS (Netherlands)

    van Sluijs, E.M.F.; van Poppel-Bruinvels, M.N.M.; Twisk, J.W.R.; Chin A Paw, M.J.M.; Calfas, K.J.; van Mechelen, W.

    2005-01-01

    Objectives. We evaluated the effectiveness of a minimal intervention physical activity strategy (physician-based assessment and counseling for exercise [PACE]) applied in general practice settings in the Netherlands. Methods. Randomization took place at the general practice level. Participants were

  9. Results of a multicenter randomized controlled trial of the clinical effectiveness of schema therapy for personality disorders

    NARCIS (Netherlands)

    Bamelis, L.L.M.; Evers, S.M.A.A.; Spinhoven, P.; Arntz, A.

    2014-01-01

    Objective: The authors compared the effectiveness of 50 sessions of schema therapy with clarification-oriented psychotherapy and with treatment as usual among patients with cluster C, paranoid, histrionic, or narcissistic personality disorder. Method: A multicenter randomized controlled trial, with

  10. Effectiveness of second generation antipsychotics: A systematic review of randomized trials

    Directory of Open Access Journals (Sweden)

    Jørgensen Hugo A

    2008-04-01

    Full Text Available Abstract Background Systematic reviews based on efficacy trials are inconclusive about which second generation antipsychotic drug (SGA should be preferred in normal clinical practice, and studies with longer duration and more pragmatic designs are called for. Effectiveness studies, also known as naturalistic, pragmatic, practical or real life studies, adhere to these principles as they aim to mimic daily clinical practice and have longer follow-up. Objective To review the head-to-head effectiveness of SGAs in the domains of global outcomes, symptoms of disease, and tolerability. Methods Searches were made in Embase, PubMED, and the Cochrane central register of controlled trials for effectiveness studies published from 1980 to 2008, week 1. Different combinations of the keywords antipsychotic*, neuroleptic* AND open, pragmatic, practical, naturalistic, real life, effectiveness, side effect*, unwanted effect*, tolera* AND compar* AND random* were used. Results Sixteen different reports of randomized head-to-head comparisons of SGA effectiveness were located. There were differences regarding sample sizes, inclusion criteria and follow-up periods, as well as sources of financial sponsorship. In acute-phase and first-episode patients no differences between the SGAs were disclosed regarding alleviating symptoms of disease. Olanzapine was associated with more weight gain and adverse effects on serum lipids. In the chronic phase patients olanzapine groups had longer time to discontinuation of treatment and better treatment adherence compared to other SGAs. The majority of studies found no differences between the SGAs in alleviating symptoms of psychosis in chronically ill patients. Olanzapine was associated with more metabolic adverse effects compared to the others SGAs. There were surprisingly few between-drug differences regarding side effects. First generation antipsychotics were associated with lower total mental health care costs in 2 of 3 studies

  11. The Effects of Positive or Neutral Communication during Acupuncture for Relaxing Effects: A Sham-Controlled Randomized Trial

    Science.gov (United States)

    Rosén, Annelie; Lekander, Mats; Jensen, Karin; Sachs, Lisbeth; Petrovic, Predrag; Ingvar, Martin; Enblom, Anna

    2016-01-01

    Introduction. The link between patient-clinician communication and its effect on clinical outcomes is an important clinical issue that is yet to be elucidated. Objective. Investigating if communication type (positive or neutral) about the expected treatment outcome affected (i) participants' expectations and (ii) short-term relaxation effects in response to genuine or sham acupuncture and investigating if expectations were related to outcome. Methods. Healthy volunteers (n = 243, mean age of 42) were randomized to one treatment with genuine or sham acupuncture. Within groups, participants were randomized to positive or neutral communication, regarding expected treatment effects. Visual Analogue Scales (0–100 millimeters) were used to measure treatment expectations and relaxation, directly before and after treatment. Results. Participants in the positive communication group reported higher treatment expectancy, compared to the neutral communication group (md 12 versus 6 mm, p = 0.002). There was no difference in relaxation effects between acupuncture groups or between communication groups. Participants with high baseline expectancy perceived greater improvement in relaxation, compared to participants with low baseline levels (md 27 versus 15 mm, p = 0.022). Conclusion. Our data highlights the importance of expectations for treatment outcome and demonstrates that expectations can be effectively manipulated using a standardized protocol that in future research may be implemented in clinical trials. PMID:26981138

  12. The Effects of Positive or Neutral Communication during Acupuncture for Relaxing Effects: A Sham-Controlled Randomized Trial

    Directory of Open Access Journals (Sweden)

    Annelie Rosén

    2016-01-01

    Full Text Available Introduction. The link between patient-clinician communication and its effect on clinical outcomes is an important clinical issue that is yet to be elucidated. Objective. Investigating if communication type (positive or neutral about the expected treatment outcome affected (i participants’ expectations and (ii short-term relaxation effects in response to genuine or sham acupuncture and investigating if expectations were related to outcome. Methods. Healthy volunteers (n=243, mean age of 42 were randomized to one treatment with genuine or sham acupuncture. Within groups, participants were randomized to positive or neutral communication, regarding expected treatment effects. Visual Analogue Scales (0–100 millimeters were used to measure treatment expectations and relaxation, directly before and after treatment. Results. Participants in the positive communication group reported higher treatment expectancy, compared to the neutral communication group (md 12 versus 6 mm, p=0.002. There was no difference in relaxation effects between acupuncture groups or between communication groups. Participants with high baseline expectancy perceived greater improvement in relaxation, compared to participants with low baseline levels (md 27 versus 15 mm, p=0.022. Conclusion. Our data highlights the importance of expectations for treatment outcome and demonstrates that expectations can be effectively manipulated using a standardized protocol that in future research may be implemented in clinical trials.

  13. Effectiveness of an online group course for depression in adolescents and young adults: a randomized trial.

    Science.gov (United States)

    van der Zanden, Rianne; Kramer, Jeannet; Gerrits, Rob; Cuijpers, Pim

    2012-06-07

    Depression is a serious mental health problem, whose first onset is usually in adolescence. Online treatment may offer a solution for the current undertreatment of depression in youth. For adults with depressive symptoms, the effectiveness of Internet-based cognitive behavioral therapy has been demonstrated. This study is one of the first randomized controlled trials to investigate the effectiveness online depression treatment for young people with depressive complaints and the first to focus on an online group course. To evaluate and discuss the effectiveness of a guided Web-based group course called Grip op Je Dip (Master Your Mood [MYM]), designed for young people aged 16 to 25 years with depressive symptoms, in comparison with a wait-listed control group. We randomly assigned 244 young people with depressive symptoms to the online MYM course or to a waiting-list control condition. The primary outcome measure was treatment outcome after 3 months on the Center for Epidemiologic Studies Depression Scale. Secondary outcomes were anxiety (measured by the Hospital Anxiety and Depression Scale) and mastery (Mastery Scale). We studied the maintenance of effects in the MYM group 6 months after baseline. Missing data were imputed. The MYM group (n = 121) showed significantly greater improvement in depressive symptoms at 3 months than the control group (n = 123) (t(187 )= 6.62, P limitation is the infeasibility of comparing the 6-month outcomes of the MYM and control groups, as the controls had access to MYM after 3 months. The online group course MYM was effective in reducing depressive symptoms and anxiety and in increasing mastery in young people. These effects persisted in the MYM group at 6 months.

  14. Reconstructing local population dynamics in noisy metapopulations--the role of random catastrophes and Allee effects.

    Directory of Open Access Journals (Sweden)

    Edmund M Hart

    Full Text Available Reconstructing the dynamics of populations is complicated by the different types of stochasticity experienced by populations, in particular if some forms of stochasticity introduce bias in parameter estimation in addition to error. Identification of systematic biases is critical when determining whether the intrinsic dynamics of populations are stable or unstable and whether or not populations exhibit an Allee effect, i.e., a minimum size below which deterministic extinction should follow. Using a simulation model that allows for Allee effects and a range of intrinsic dynamics, we investigated how three types of stochasticity--demographic, environmental, and random catastrophes--affect our ability to reconstruct the intrinsic dynamics of populations. Demographic stochasticity aside, which is only problematic in small populations, we find that environmental stochasticity--positive and negative environmental fluctuations--caused increased error in parameter estimation, but bias was rarely problematic, except at the highest levels of noise. Random catastrophes, events causing large-scale mortality and likely to be more common than usually recognized, caused immediate bias in parameter estimates, in particular when Allee effects were large. In the latter case, population stability was predicted when endogenous dynamics were actually unstable and the minimum viable population size was overestimated in populations with small or non-existent Allee effects. Catastrophes also generally increased extinction risk, in particular when endogenous Allee effects were large. We propose a method for identifying data points likely resulting from catastrophic events when such events have not been recorded. Using social spider colonies (Anelosimus spp. as models for populations, we show that after known or suspected catastrophes are accounted for, reconstructed growth parameters are consistent with intrinsic dynamical instability and substantial Allee effects. Our

  15. Reconstructing Local Population Dynamics in Noisy Metapopulations—The Role of Random Catastrophes and Allee Effects

    Science.gov (United States)

    Hart, Edmund M.; Avilés, Leticia

    2014-01-01

    Reconstructing the dynamics of populations is complicated by the different types of stochasticity experienced by populations, in particular if some forms of stochasticity introduce bias in parameter estimation in addition to error. Identification of systematic biases is critical when determining whether the intrinsic dynamics of populations are stable or unstable and whether or not populations exhibit an Allee effect, i.e., a minimum size below which deterministic extinction should follow. Using a simulation model that allows for Allee effects and a range of intrinsic dynamics, we investigated how three types of stochasticity—demographic, environmental, and random catastrophes— affect our ability to reconstruct the intrinsic dynamics of populations. Demographic stochasticity aside, which is only problematic in small populations, we find that environmental stochasticity—positive and negative environmental fluctuations—caused increased error in parameter estimation, but bias was rarely problematic, except at the highest levels of noise. Random catastrophes, events causing large-scale mortality and likely to be more common than usually recognized, caused immediate bias in parameter estimates, in particular when Allee effects were large. In the latter case, population stability was predicted when endogenous dynamics were actually unstable and the minimum viable population size was overestimated in populations with small or non-existent Allee effects. Catastrophes also generally increased extinction risk, in particular when endogenous Allee effects were large. We propose a method for identifying data points likely resulting from catastrophic events when such events have not been recorded. Using social spider colonies (Anelosimus spp.) as models for populations, we show that after known or suspected catastrophes are accounted for, reconstructed growth parameters are consistent with intrinsic dynamical instability and substantial Allee effects. Our results are

  16. Reconstructing local population dynamics in noisy metapopulations--the role of random catastrophes and Allee effects.

    Science.gov (United States)

    Hart, Edmund M; Avilés, Leticia

    2014-01-01

    Reconstructing the dynamics of populations is complicated by the different types of stochasticity experienced by populations, in particular if some forms of stochasticity introduce bias in parameter estimation in addition to error. Identification of systematic biases is critical when determining whether the intrinsic dynamics of populations are stable or unstable and whether or not populations exhibit an Allee effect, i.e., a minimum size below which deterministic extinction should follow. Using a simulation model that allows for Allee effects and a range of intrinsic dynamics, we investigated how three types of stochasticity--demographic, environmental, and random catastrophes--affect our ability to reconstruct the intrinsic dynamics of populations. Demographic stochasticity aside, which is only problematic in small populations, we find that environmental stochasticity--positive and negative environmental fluctuations--caused increased error in parameter estimation, but bias was rarely problematic, except at the highest levels of noise. Random catastrophes, events causing large-scale mortality and likely to be more common than usually recognized, caused immediate bias in parameter estimates, in particular when Allee effects were large. In the latter case, population stability was predicted when endogenous dynamics were actually unstable and the minimum viable population size was overestimated in populations with small or non-existent Allee effects. Catastrophes also generally increased extinction risk, in particular when endogenous Allee effects were large. We propose a method for identifying data points likely resulting from catastrophic events when such events have not been recorded. Using social spider colonies (Anelosimus spp.) as models for populations, we show that after known or suspected catastrophes are accounted for, reconstructed growth parameters are consistent with intrinsic dynamical instability and substantial Allee effects. Our results are

  17. Effect of multisensory stimulation on analgesia in term neonates: a randomized controlled trial.

    Science.gov (United States)

    Bellieni, Carlo Valerio; Bagnoli, Franco; Perrone, Serafina; Nenci, Anna; Cordelli, Duccio Maria; Fusi, Mara; Ceccarelli, Simona; Buonocore, Giuseppe

    2002-04-01

    Many attempts have been made to obtain safe and effective analgesia in newborns. Oral glucose-water has been found to have analgesic properties in neonates. We investigated whether other sensory stimulation added to oral glucose provided more effective analgesia than oral glucose alone. In a randomized prospective double-blind trial, we studied 120 term newborns during heel prick. The babies were divided randomly into six groups of 20, and each group was treated with a different procedure during heel prick: A) control; B) 1 mL 33% oral glucose given 2 min before the heel prick; C) sucking; D) 1 mL 33% oral glucose plus sucking; E) multisensory stimulation including 1 mL 33% oral glucose (sensorial saturation); F) multisensory stimulation without oral glucose. Sensorial saturation consisted in massage, voice, eye contact, and perfume smelling during heel prick. Each heel prick was filmed and assigned a point score according to the Douleur Aiguë du Nouveau-né (DAN) neonatal acute pain scale. Camera recording began 30 s before the heel prick, so it was impossible for the scorers to distinguish procedure A (control) from B (glucose given 2 min before), C (sucking water) from D (sucking glucose), and E (multisensory stimulation and glucose) from F (multisensory stimulation and water) from the video. Procedure E (multisensory stimulation and glucose) was found to be the most effective procedure, and the analgesia was even more effective than that produced by procedure D (sucking glucose). We conclude that sensorial saturation is an effective analgesic technique that potentiates the analgesic effect of oral sugar. It can be used for minor painful procedures on newborns.

  18. Causal Effects of Single-Sex Schools on College Entrance Exams and College Attendance: Random Assignment in Seoul High Schools

    OpenAIRE

    Park, Hyunjoon; Behrman, Jere R.; Choi, Jaesung

    2013-01-01

    Despite the voluminous literature on the potentials of single-sex schools, there is no consensus on the effects of single-sex schools because of student selection of school types. We exploit a unique feature of schooling in Seoul—the random assignment of students into single-sex versus coeducational high schools—to assess causal effects of single-sex schools on college entrance exam scores and college attendance. Our validation of the random assignment shows comparable socioeconomic backgroun...

  19. Cost-effectiveness of nutritional intervention in elderly subjects after hip fracture. A randomized controlled trial.

    Science.gov (United States)

    Wyers, C E; Reijven, P L M; Evers, S M A A; Willems, P C; Heyligers, I C; Verburg, A D; van Helden, S; Dagnelie, P C

    2013-01-01

    Hip fracture patients can benefit from nutritional supplementation during their recovery. Up to now, cost-effectiveness evaluation of nutritional intervention in these patients has not been performed. Costs of nutritional intervention are relatively low as compared with medical costs. Cost-effectiveness evaluation shows that nutritional intervention is likely to be cost-effective. Previous research on the effect of nutritional intervention on clinical outcome in hip fracture patients yielded contradictory results. Cost-effectiveness of nutritional intervention in these patients remains unknown. The aim of this study was to evaluate cost-effectiveness of nutritional intervention in elderly subjects after hip fracture from a societal perspective. Open-label, multi-centre randomized controlled trial investigating cost-effectiveness of intensive nutritional intervention comprising regular dietetic counseling and oral nutritional supplementation for 3 months postoperatively. Patients allocated to the control group received care as usual. Costs, weight and quality of life were measured at baseline and at 3 and 6 months postoperatively. Incremental cost-effectiveness ratios (ICERs) were calculated for weight at 3 months and quality adjusted life years (QALYs) at 6 months postoperatively. Of 152 patients enrolled, 73 were randomized to the intervention group and 79 to the control group. Mean costs of the nutritional intervention was 613 Euro. Total costs and subcategories of costs were not significantly different between both groups. Based on bootstrapping of ICERs, the nutritional intervention was likely to be cost-effective for weight as outcome over the 3-month intervention period, regardless of nutritional status at baseline. With QALYs as outcome, the probability for the nutritional intervention being cost-effective was relatively low, except in subjects aged below 75 years. Intensive nutritional intervention in elderly hip fracture patients is likely to be cost-effective

  20. Effectiveness of PELOID therapy in carpal tunnel syndrome: A randomized controlled single blind study

    Science.gov (United States)

    Metin Ökmen, Burcu; Kasapoğlu Aksoy, Meliha; Güneş, Aygül; Eröksüz, Riza; Altan, Lale

    2017-08-01

    Carpal tunnel syndrome(CTS) is the most common neuromuscular cause of upper extremity disability. We aimed to investigate the effectiveness of peloid therapy in patients with CTS. This randomized, controlled, single-blind study enrolled 70 patients between the ages of 30 to 65 who had a diagnosis of either mild, mild-to-moderate, or moderate CTS. The patients were randomized into two groups using random number table. In the first group, (Group 1)( n = 35), patients were given splint (every night for 6 weeks) + peloid treatment(five consecutive days a week for 2 weeks) and in the second group, (Group 2)( n = 28), patients received splint treatment(every night for 6 weeks) alone. The patients were assessed by using visual analog scale(VAS) for pain, electroneuromyography(ENMG), the Boston Carpal Tunnel Syndrome Questionnaire(BCTSQ), hand grip strength(HGS), finger grip strength(FGS), and Short Form-12(SF-12). The data were obtained before treatment(W0), immediately after treatment(W2), and one month after treatment(W6). Both in Group 1 and 2, there was a statistically significant improvement in all the evaluation parameters at W2 and W6 when compared to W0( p study demonstrated that in patients with CTS; peloid + splint treatment was more effective than splint treatment alone in pain, functionality and life quality both at after treatment(W2) and one month after treatment (W6). We may suggest peloid as a supplementary therapeutic agent in CTS.

  1. Effectiveness of Supplementary Cognitive-Behavioral Therapy for Pharmacotherapy-Resistant Depression: A Randomized Controlled Trial.

    Science.gov (United States)

    Nakagawa, Atsuo; Mitsuda, Dai; Sado, Mitsuhiro; Abe, Takayuki; Fujisawa, Daisuke; Kikuchi, Toshiaki; Iwashita, Satoru; Mimura, Masaru; Ono, Yutaka

    Antidepressant medication is efficacious in the treatment of depression, but not all patients improve with antidepressant medication alone. Despite this treatment gap, limited evidence regarding the effectiveness of supplementing psychotherapy for pharmacotherapy-resistant depression is available. Therefore, we investigated the effectiveness of supplementing usual medication management (treatment as usual [TAU]) with cognitive-behavioral therapy (CBT) in patients with pharmacotherapy-resistant depression seeking psychiatric specialty care. A 16-week assessor-masked randomized controlled trial with a 12-month follow-up was conducted in 1 university hospital and 1 psychiatric hospital from September 2008 to December 2014. Outpatients aged 20-65 years with pharmacotherapy-resistant depression (taking antidepressant medications for ≥ 8 weeks, 17-item GRID-Hamilton Depression Rating Scale [GRID-HDRS₁₇] score ≥ 16, Maudsley Staging Method for treatment-resistant depression score ≥ 3, and DSM-IV criteria for major depressive disorder) were randomly assigned (1:1) to CBT combined with TAU or to TAU alone. The primary outcome was the alleviation of depressive symptoms, as measured by change in the total GRID-HDRS₁₇ score from baseline to 16 weeks; primary analysis was done on an intention-to-treat basis. A total of 80 patients were randomized; 78 (97.5%) were assessed for the primary outcome, and 73 (91.3%) were followed up for 12 months. Supplementary CBT significantly alleviated depressive symptoms at 16 weeks, as shown by greater least squares mean changes in GRID-HDRS₁₇ scores in the intervention group than in the control group (-12.7 vs -7.4; difference = -5.4; 95% CI, -8.1 to -2.6; P depression treated in psychiatric specialty care settings may benefit from supplementing usual medication management with CBT. UMIN Clinical Trials Registry identifier: UMIN000001218​​.

  2. Fitting parametric random effects models in very large data sets with application to VHA national data.

    Science.gov (United States)

    Gebregziabher, Mulugeta; Egede, Leonard; Gilbert, Gregory E; Hunt, Kelly; Nietert, Paul J; Mauldin, Patrick

    2012-10-24

    With the current focus on personalized medicine, patient/subject level inference is often of key interest in translational research. As a result, random effects models (REM) are becoming popular for patient level inference. However, for very large data sets that are characterized by large sample size, it can be difficult to fit REM using commonly available statistical software such as SAS since they require inordinate amounts of computer time and memory allocations beyond what are available preventing model convergence. For example, in a retrospective cohort study of over 800,000 Veterans with type 2 diabetes with longitudinal data over 5 years, fitting REM via generalized linear mixed modeling using currently available standard procedures in SAS (e.g. PROC GLIMMIX) was very difficult and same problems exist in Stata's gllamm or R's lme packages. Thus, this study proposes and assesses the performance of a meta regression approach and makes comparison with methods based on sampling of the full data. We use both simulated and real data from a national cohort of Veterans with type 2 diabetes (n=890,394) which was created by linking multiple patient and administrative files resulting in a cohort with longitudinal data collected over 5 years. The outcome of interest was mean annual HbA1c measured over a 5 years period. Using this outcome, we compared parameter estimates from the proposed random effects meta regression (REMR) with estimates based on simple random sampling and VISN (Veterans Integrated Service Networks) based stratified sampling of the full data. Our results indicate that REMR provides parameter estimates that are less likely to be biased with tighter confidence intervals when the VISN level estimates are homogenous. When the interest is to fit REM in repeated measures data with very large sample size, REMR can be used as a good alternative. It leads to reasonable inference for both Gaussian and non-Gaussian responses if parameter estimates are

  3. Randomized Evaluation of the Effectiveness of a Structured Educational Program for Patients With Essential Hypertension.

    Science.gov (United States)

    Perl, Sabine; Niederl, Ella; Kos, Cornelia; Mrak, Peter; Ederer, Herbert; Rakovac, Ivo; Beck, Peter; Kraler, Elisabeth; Stoff, Ingrid; Klima, Gert; Pieske, Burkert M; Pieber, Thomas R; Zweiker, Robert

    2016-07-01

    Adherence to medication and lifestyle interventions are essential keys for the management of hypertension. In this respect, a structured educational program for hypertensive patients has got remarkable merits (herz.leben). In order to determine the isolated effect of participation in the educational program, neglecting the possible impact of more intense care, this prospective multicenter randomized controlled study was designed (NCT00453037). A total of 256 patients in 13 centers were enrolled and randomly assigned to 2 groups (G). G-I (n = 137) underwent the educational program immediately (T-0), G-II (n = 119) after 6 months (T-6). Follow-up visits were done after 6 (T-6) and 12 (T-12) months. Primary endpoint was a difference in office blood pressure (BP) at T-6, when only G-I had undergone the educational program. Patients' baseline characteristics were comparable. At T-6, systolic office and home BP were significantly lower in G-I compared to G-II: office BP systolic 139 (134-150) mm Hg vs. 150 (135-165) mm Hg (P educational program differences in BP disappeared. The results of this multicenter randomized controlled study provide significant evidence for benefit by participation in a structured educational program. Positive effects seem to be mediated by better adherence and life style changes due to higher levels of information and patient empowerment. Therefore, educational strategies should be considered as standard of care for hypertensive patients. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. The effect of exercise on sleep and fatigue in rheumatoid arthritis: a randomized controlled study.

    Science.gov (United States)

    Durcan, Laura; Wilson, Fiona; Cunnane, Gaye

    2014-10-01

    Sleep disturbance and chronic fatigue are common in rheumatoid arthritis (RA) and contribute to disability, symptomatology, and healthcare use. It has long been recognized in other populations that exercise can improve sleep and diminish fatigue. The effect of exercise on sleep quality and fatigue in RA has not been evaluated. Ours is a randomized controlled study in RA to determine the effect of an exercise program on sleep quality and fatigue. These were measured using the Pittsburgh Sleep Quality Index and the Fatigue Severity Scale. Patients were randomized to either a 12-week, home-based exercise intervention or usual care. The exercise program consisted of specific exercises to target individual deficiencies identified using the Health Assessment Questionnaire (HAQ) with cardiovascular work as per the guidelines. The intervention group was evaluated on a 3-week basis. Full evaluation was carried out at baseline and at 12 weeks. Forty patients were randomized to the intervention with 38 controls. In the exercise intervention group, there was a statistically significant improvement in HAQ (p = 0.00), pain (p = 0.05), stiffness (p = 0.05), sleep quality (p = 0.04), and fatigue (p = 0.04). In our control group, there was a statistically significant improvement demonstrated in their overall perceptions of the benefits of exercise, but none of the other variables. Our study demonstrates that an exercise program resulted in significant improvement in sleep quality and fatigue. This is particularly interesting given the importance of fatigue as an outcome measure in RA and gives us yet another reason to prescribe exercise in this population.

  5. The effects of levamisole on experimental endometriosis: a randomized controlled trial in a rat model.

    Science.gov (United States)

    Azimirad, Afshin; Alborzi, Saeed; Kumar, Perikala Vijayananda; Zarei, Afsoon; Azimirad, Mina

    2013-12-01

    To assess the effects of levamisole on experimental endometriosis in rats through the histopathology of the implants, the blood leukocyte and lymphocyte counts and the concentrations of interleukin-6, vascular endothelial growth factor-A and tumor necrosis factor-alpha in the peritoneal environment at the three healthy, endometriotic and post-treatment milestones. Twenty-two 8-week-old Sprague-Dawley rats with normal estrus cycles were recruited in a prospective, parallel-group, placebo-controlled, double-blind, stratified-randomized animal trial with the equal allocation ratio of 1:1 challenging the efficacy of levamisole. Endometriosis was induced. After 6 weeks, laparotomy was performed to randomly excise one implant for histopathology assessment. Based on the results, they were stratified randomized and allocated (by software) to two groups of nine: levamisole (5 mg/rat/day) or placebo. After 6 weeks, necropsy was done. Two days before each laparotomy, blood samples and during the procedure, peritoneal wash were collected for ELISA. Seven rats showed success in treatment in the levamisole group, while three did in the other group. The histopathology results descriptively revealed a drop in the levamisole group, which was not meaningful statistically (0.66 ± 1.32 vs. 2.00 ± 1.50, p = 0.065). The comparisons of the post-treatment leukocytes and lymphocytes in the groups showed significant differences (11088.88 ± 5869.50 vs. 4677.77 ± 3476.98, p = 0.008, and 8588.88 ± 5721.32 vs. 3511.11 ± 2835.24, p = 0.014, respectively). The results of the cytokines were mostly, but not completely, in favor of the efficacy of levamisole. This study indicates a possible successful role for levamisole in the treatment of experimental endometriosis. Further studies to assess the effects of high dose levamisole on endometriosis are recommended.

  6. Effect of vitamin D supplementation on antibiotic use: a randomized controlled trial.

    Science.gov (United States)

    Tran, Bich; Armstrong, Bruce K; Ebeling, Peter R; English, Dallas R; Kimlin, Michael G; van der Pols, Jolieke C; Venn, Alison; Gebski, Val; Whiteman, David C; Webb, Penelope M; Neale, Rachel E

    2014-01-01

    Observational data suggested that supplementation with vitamin D could reduce risk of infection, but trial data are inconsistent. We aimed to examine the effect of oral vitamin D supplementation on antibiotic use. We conducted a post hoc analysis of data from pilot D-Health, which is a randomized trial carried out in a general community setting between October 2010 and February 2012. A total of 644 Australian residents aged 60-84 y were randomly assigned to receive monthly doses of a placebo (n = 214) or 30,000 (n = 215) or 60,000 (n = 215) IU oral cholecalciferol for ≤12 mo. Antibiotics prescribed during the intervention period were ascertained by linkage with pharmacy records through the national health insurance scheme (Medicare Australia). People who were randomly assigned 60,000 IU cholecalciferol had nonsignificant 28% lower risk of having antibiotics prescribed at least once than did people in the placebo group (RR: 0.72; 95% CI: 0.48, 1.07). In analyses stratified by age, in subjects aged ≥70 y, there was a significant reduction in antibiotic use in the high-dose vitamin D compared with placebo groups (RR: 0.53; 95% CI: 0.32, 0.90), whereas there was no effect in participants aged <70 y (RR: 1.07; 95% CI: 0.58, 1.97) (P-interaction = 0.1). Although this study was a post hoc analysis and statistically nonsignificant, this trial lends some support to the hypothesis that supplementation with 60,000 IU vitamin D/mo is associated with lower risk of infection, particularly in older adults. The trial was registered at the Australian New Zealand Clinical Trials Registry (anzctr.org.au) as ACTRN12609001063202.

  7. Biases in Estimating Treatment Effects Due to Attrition in Randomized Controlled Trials and Cluster Randomized Controlled Trials: A Simulation Study

    Science.gov (United States)

    Dong, Nianbo; Lipsey, Mark W.

    2011-01-01

    Attrition occurs when study participants who were assigned to the treatment and control conditions do not provide outcome data and thus do not contribute to the estimation of the treatment effects. It is very common in experimental studies in education as illustrated, for instance, in a meta-analysis studying "the effects of attrition on baseline…

  8. Effect of antioxidant vitamin supplementation on cardiovascular outcomes: a meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Yizhou Ye

    Full Text Available BACKGROUND: Antioxidant vitamin (vitamin E, beta-carotene, and vitamin C are widely used for preventing major cardiovascular outcomes. However, the effect of antioxidant vitamin on cardiovascular events remains unclear. METHODOLOGY AND PRINCIPAL FINDINGS: We searched PubMed, EmBase, the Cochrane Central Register of Controlled Trials, and the proceedings of major conferences for relevant literature. Eligible studies were randomized controlled trials that reported on the effects of antioxidant vitamin on cardiovascular outcomes as compared to placebo. Outcomes analyzed were major cardiovascular events, myocardial infarction, stroke, cardiac death, total death, and any possible adverse events. We used the I(2 statistic to measure heterogeneity between trials and calculated risk estimates for cardiovascular outcomes with random-effect meta-analysis. Independent extraction was performed by two reviewers and consensus was reached. Of 293 identified studies, we included 15 trials reporting data on 188209 participants. These studies reported 12749 major cardiovascular events, 6699 myocardial infarction, 3749 strokes, 14122 total death, and 5980 cardiac deaths. Overall, antioxidant vitamin supplementation as compared to placebo had no effect on major cardiovascular events (RR, 1.00; 95%CI, 0.96-1.03, myocardial infarction (RR, 0.98; 95%CI, 0.92-1.04, stroke (RR, 0.99; 95%CI, 0.93-1.05, total death (RR, 1.03; 95%CI, 0.98-1.07, cardiac death (RR, 1.02; 95%CI, 0.97-1.07, revascularization (RR, 1.00; 95%CI, 0.95-1.05, total CHD (RR, 0.96; 95%CI, 0.87-1.05, angina (RR, 0.98; 95%CI, 0.90-1.07, and congestive heart failure (RR, 1.07; 95%CI, 0.96 to 1.19. CONCLUSION/SIGNIFICANCE: Antioxidant vitamin supplementation has no effect on the incidence of major cardiovascular events, myocardial infarction, stroke, total death, and cardiac death.

  9. Oral domperidone has no additional effect on chronic functional constipation in children: a randomized clinical trial.

    Science.gov (United States)

    Dehghani, Seyed Mohsen; Askarian, Mehrdad; Kaffashan, Heidar Ali

    2014-03-01

    Chronic constipation represents a common problem in children. The treatment of functional constipation is challenging. Some studies have investigated the effect of prokinetic agents as potential therapies for motility disorders of the lower gastrointestinal tract with paradoxical results. The present study aimed to investigate the effect of oral domperidone in the treatment of chronic functional constipation in children. A total of 105 children with chronic functional constipation (according to Rome III criteria) who were referred to the Pediatric Gastroenterology Clinic were recruited in this double-blind randomized clinical trial. The study subjects were randomly divided into two groups, the first of which received polyethylene glycol (PEG) solution 0.6 g/kg/day two times a day for 6 months and domperidone syrup 0.15 mL/kg three times a day for 3 months (case group) while the second one received PEG with the same dose for 6 months and placebo for 3 months with the same dose (control group). The two groups were compared regarding their symptoms and Rome III criteria through 1, 3, and 6 months following therapy. Primary outcome was response to treatment, and a response was defined as decrease in signs and symptoms that did not fulfill Rome III criteria. Secondary outcome measures were side effects during the course of treatment. A significant difference was observed both before and after PEG and domperidone treatment and before and after PEG and placebo treatment regarding Rome III criteria. There was no significant difference in response to treatment between the two study groups during 1 (p = 1), 3 (p = 0.799), and 6 (p = 0.403) month follow up periods. Also, the two groups were not significantly different regarding the Rome III criteria during the mentioned follow up periods. There were no side effects during the course of treatment. There was no additional effect of domperidone as adjunct to PEG in the treatment of children with constipation.

  10. Moderators of intervention effects on parenting practices in a randomized controlled trial in early childhood.

    Science.gov (United States)

    Theise, Rachelle; Huang, Keng-Yen; Kamboukos, Dimitra; Doctoroff, Greta L; Dawson-McClure, Spring; Palamar, Joseph J; Brotman, Laurie Miller

    2014-01-01

    The current study examined whether parent psychological resources (parenting stress, depression, and social support from friends and family) moderated the effects of early family preventive intervention on parenting among high-risk families. Ninety-two preschool-age children (M age = 3.94 years) at familial risk for conduct problems participated in a randomized controlled trial of a family intervention to prevent conduct problems. The majority of families were African American or Latino and experienced multiple stressors associated with poverty and familial antisocial behavior. Families were randomized to a 22-session group-based intervention or to a no-intervention, assessment-only control condition. Parents reported on their psychological resources (parenting stress, depression and social support from friends and family) at baseline. Parenting (responsive, harsh, stimulation for learning) was assessed through self-report and observational measures four times over 24 months. Previously-reported intervention effects on responsive parenting and stimulation for learning were moderated by depression and social support from friends, respectively, such that benefits were concentrated among those at greatest risk (i.e., depressed, limited support from friends). The intervention effect on harsh parenting was not moderated by any of the parent psychological resources examined, such that parents with high and low resources benefited comparably. Consideration of moderators of preventive intervention effects on parenting provides important information about intervention impact among families experiencing multiple barriers to engagement and effective parenting. Findings suggest that parents with diminished psychological resources are just as likely to benefit. Family-focused, group-based intervention is promising for strengthening parenting among the highest risk families.

  11. Metabolic signatures of adiposity in young adults: Mendelian randomization analysis and effects of weight change.

    Science.gov (United States)

    Würtz, Peter; Wang, Qin; Kangas, Antti J; Richmond, Rebecca C; Skarp, Joni; Tiainen, Mika; Tynkkynen, Tuulia; Soininen, Pasi; Havulinna, Aki S; Kaakinen, Marika; Viikari, Jorma S; Savolainen, Markku J; Kähönen, Mika; Lehtimäki, Terho; Männistö, Satu; Blankenberg, Stefan; Zeller, Tanja; Laitinen, Jaana; Pouta, Anneli; Mäntyselkä, Pekka; Vanhala, Mauno; Elliott, Paul; Pietiläinen, Kirsi H; Ripatti, Samuli; Salomaa, Veikko; Raitakari, Olli T; Järvelin, Marjo-Riitta; Smith, George Davey; Ala-Korpela, Mika

    2014-12-01

    Increased adiposity is linked with higher risk for cardiometabolic diseases. We aimed to determine to what extent elevated body mass index (BMI) within the normal weight range has causal effects on the detailed systemic metabolite profile in early adulthood. We used Mendelian randomization to estimate causal effects of BMI on 82 metabolic measures in 12,664 adolescents and young adults from four population-based cohorts in Finland (mean age 26 y, range 16-39 y; 51% women; mean ± standard deviation BMI 24 ± 4 kg/m(2)). Circulating metabolites were quantified by high-throughput nuclear magnetic resonance metabolomics and biochemical assays. In cross-sectional analyses, elevated BMI was adversely associated with cardiometabolic risk markers throughout the systemic metabolite profile, including lipoprotein subclasses, fatty acid composition, amino acids, inflammatory markers, and various hormones (pBMI were generally stronger for men than for women (median 136%, interquartile range 125%-183%). A gene score for predisposition to elevated BMI, composed of 32 established genetic correlates, was used as the instrument to assess causality. Causal effects of elevated BMI closely matched observational estimates (correspondence 87% ± 3%; R(2)= 0.89), suggesting causative influences of adiposity on the levels of numerous metabolites (pBMI during 6 y of follow-up were examined for 1,488 individuals. Change in BMI was accompanied by widespread metabolite changes, which had an association pattern similar to that of the cross-sectional observations, yet with greater metabolic effects (correspondence 160% ± 2%; R(2) = 0.92). Mendelian randomization indicates causal adverse effects of increased adiposity with multiple cardiometabolic risk markers across the metabolite profile in adolescents and young adults within the non-obese weight range. Consistent with the causal influences of adiposity, weight changes were paralleled by extensive metabolic changes, suggesting a broadly

  12. The Effect of Music Therapy in Patients with Huntington's Disease: A Randomized Controlled Trial.

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    van Bruggen-Rufi, Monique C H; Vink, Annemieke C; Wolterbeek, Ron; Achterberg, Wilco P; Roos, Raymund A C

    2017-01-01

    Music therapy may have beneficial effects on improving communication and expressive skills in patients with Huntington's disease (HD). Most studies are, however, small observational studies and methodologically limited. Therefore we conducted a multi-center randomized controlled trial. To determine the efficacy of music therapy in comparison with recreational therapy in improving quality of life of patients with advanced Huntington's disease by means of improving communication. Sixty-three HD-patients with a Total Functional Capacity (TFC) score of ≤7, admitted to four long-term care facilities in The Netherlands, were randomized to receive either group music therapy or group recreational therapy in 16 weekly sessions. They were assessed at baseline, after 8, 16 and 28 weeks using the Behaviour Observation Scale for Huntington (BOSH) and the Problem Behaviour Assessment-short version (PBA-s). A linear mixed model with repeated measures was used to compare the scores between the two groups. Group music therapy offered once weekly for 16 weeks to patients with Huntington's disease had no additional beneficial effect on communication or behavior compared to group recreational therapy. This was the first study to assess the effect of group music therapy on HD patients in the advanced stages of the disease. The beneficial effects of music therapy, recorded in many, mainly qualitative case reports and studies, could not be confirmed with the design (i.e. group therapy vs individual therapy) and outcome measures that have been used in the present study. A comprehensive process-evaluation alongside the present effect evaluation is therefore performed.

  13. Effects of Vitamin D Supplementation on Bone Turnover Markers: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Verena Schwetz

    2017-04-01

    Full Text Available Bone turnover markers (BTMs are used to evaluate bone health together with bone mineral density and fracture assessment. Vitamin D supplementation is widely used to prevent and treat musculoskeletal diseases but existing data on vitamin D effects on markers of bone resorption and formation are inconsistent. We therefore examined the effects of vitamin D supplementation on bone-specific alkaline phosphatase (bALP, osteocalcin (OC, C-terminal telopeptide (CTX, and procollagen type 1 N-terminal propeptide (P1NP. This is a post-hoc analysis of the Styrian Vitamin D Hypertension Trial, a single-center, double-blind, randomized, placebo-controlled trial (RCT performed at the Medical University of Graz, Austria (2011–2014. Two hundred individuals with arterial hypertension and 25-hydroxyvitamin D (25[OH]D levels <75 nmol/L were randomized to 2800 IU of vitamin D daily or placebo for eight weeks. One hundred ninety-seven participants (60.2 ± 11.1 years; 47% women were included in this analysis. Vitamin D had no significant effect on bALP (mean treatment effect (MTE 0.013, 95% CI −0.029 to 0.056 µg/L; p = 0.533, CTX (MTE 0.024, 95% CI −0.163 to 0.210 ng/mL, p = 0.802, OC (MTE 0.020, 95% CI −0.062 to 0.103 ng/mL, p = 0.626, or P1NP (MTE −0.021, 95% CI −0.099 to 0.057 ng/mL, p = 0.597. Analyzing patients with 25(OHD levels <50 nmol/L separately (n = 74 left results largely unchanged. In hypertensive patients with low 25(OHD levels, we observed no significant effect of vitamin D supplementation for eight weeks on BTMs.

  14. Generalized essential energy space random walks to more effectively accelerate solute sampling in aqueous environment.

    Science.gov (United States)

    Lv, Chao; Zheng, Lianqing; Yang, Wei

    2012-01-28

    Molecular dynamics sampling can be enhanced via the promoting of potential energy fluctuations, for instance, based on a Hamiltonian modified with the addition of a potential-energy-dependent biasing term. To overcome the diffusion sampling issue, which reveals the fact that enlargement of event-irrelevant energy fluctuations may abolish sampling efficiency, the essential energy space random walk (EESRW) approach was proposed earlier. To more effectively accelerate the sampling of solute conformations in aqueous environment, in the current work, we generalized the EESRW method to a two-dimension-EESRW (2D-EESRW) strategy. Specifically, the essential internal energy component of a focused region and the essential interaction energy component between the focused region and the environmental region are employed to define the two-dimensional essential energy space. This proposal is motivated by the general observation that in different conformational events, the two essential energy components have distinctive interplays. Model studies on the alanine dipeptide and the aspartate-arginine peptide demonstrate sampling improvement over the original one-dimension-EESRW strategy; with the same biasing level, the present generalization allows more effective acceleration of the sampling of conformational transitions in aqueous solution. The 2D-EESRW generalization is readily extended to higher dimension schemes and employed in more advanced enhanced-sampling schemes, such as the recent orthogonal space random walk method. © 2012 American Institute of Physics

  15. Effect of Mozart music on heel prick pain in preterm infants: a pilot randomized controlled trial

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    Cristina Cavaiuolo

    2015-02-01

    Full Text Available Objective: The aim of this pilot study was to determine the effect of music by Mozart on heel prick procedural pain in premature infants.Background: Painful procedures are routinely performed in the setting of neonatal intensive care unit (NICU. Pain may exert short- and long-term deleterious effects on premature babies. Many non-pharmacological interventions have been proven efficacious for blunting neonatal pain.Study design: Randomized, controlled trial.Methods: The study was carried out in the NICU of the “G. Rummo” Hospital in Benevento, Italy. The sample consisted of 42 preterm infants, with no hearing loss or significant cerebral lesions on cranial ultrasound. They were randomized to receive heel lance during a music condition or a no-music control condition. We set strict criteria for selecting and delivering the music. Baseline and postprocedural heart rate and transcutaneous oxygen saturation were manually recorded. The Premature Infant Pain Profile (PIPP score was used to measure the behavioral response to prick. An unpaired t-test was performed for the intergroup comparisons.Results: There were significant differences between groups on heart rate increase, oxygen saturation reduction and PIPP score following the procedure.Conclusions: Listening to Mozart music during heel prick is a simple and inexpensive tool for pain alleviating in preterm stable neonates.

  16. Effect of ozonated oil and chlorhexidine gel on plaque induced gingivitis: A randomized control clinical trial

    Science.gov (United States)

    Indurkar, Maya Sanjeev; Verma, Renu

    2016-01-01

    Background: Several chemotherapeutic agents have been developed to prevent gingivitis and its progression into periodontitis. In this present study, the efficacy of ozonated oil and chlorhexidine gel was assessed and compared on plaque induced gingivitis. Aim: To evaluate the effect of ozonated oil on plaque induced gingivitis and to compare its efficacy with chlorhexidine gel. Materials and Methods: A total of 20 subjects, aged from 18 to 65 years, with plaque-induced gingivitis were selected from the outpatient Department of Periodontology, Government Dental College and Hospital, Aurangabad, for this study. They were divided randomly into the test or ozonated oil group (Group I) and the control or chlorhexidine gel group (Group II) with 10 subjects in each group. Subjects were randomly assigned to massage their gingiva thrice a day for 3 weeks with ozonated oil (test), and chlorhexidine gel (control). Plaque index and gingival index scores were recorded for the 20 subjects at baseline and after 3 weeks. Results: Ozonated oil (Group I) and chlorhexidine gel (Group II) groups showed statistically significant differences with respect to plaque index and gingival index, from the baseline to 3 weeks (P ozonated oil and chlorhexidine gel, both can be used as an effective agent in maintaining and improving gingival health. PMID:27041835

  17. Effect of lullaby and classical music on physiologic stability of hospitalized preterm infants: a randomized trial.

    Science.gov (United States)

    Amini, E; Rafiei, P; Zarei, K; Gohari, M; Hamidi, M

    2013-01-01

    Music is considered a subset of developmental supportive care. It may act as a suitable auditory stimulant in preterm infants. Also, it may reduce stress responses in autonomic, motor and state systems. To assess and compare the influence of lullaby and classical music on physiologic parameters. This is a randomized clinical trial with cross-over design. A total of 25 stable preterm infants with birth weight of 1000-2500 grams were studied for six consecutive days. Each infant was exposed to three phases: lullaby music, classical music, and no music (control) for two days each. The sequence of these phases was assigned randomly to each subject. Babies were continuously monitored for heart rate, respiratory rate, and oxygen saturation and changes between phases were analyzed. Lullaby reduced heart rate (p music reduced heart rate (p = 0.018). The effects of classical music disappeared once the music stopped. Oxygen saturation did not change during intervention. Music can affect vital signs of preterm infants; this effect can possibly be related to the reduction of stress during hospitalization. The implications of these findings on clinical and developmental outcomes need further study.

  18. Effects of piracetam on pediatric breath holding spells: a randomized double blind controlled trial.

    Science.gov (United States)

    Abbaskhanian, Ali; Ehteshami, Sara; Sajjadi, Sadegh; Rezai, Mohammad Sadegh

    2012-01-01

    Breath holding spells (BHS) are common paroxysmal non-epileptic events in the pediatric population which are very stressfull despite their harmless nature. There has been no specific treatment found for the spells yet. The aim of this study was to evaluate the efficacy of piracetam (2-oxo-l-pyrrolidine) on these children. In this randomized double blind clinical trial study, 150 children with severe BHS referred to our pediatric outpatient service were enrolled from August 2011 to July 2012. The patients were randomized into two equal groups. One received 40mg/kg/day piracetam and the other group received placebo, twice daily. Patients were followed monthly for three months. The number of attacks/month before and after treatment were documented. Of the enrolled patients, 86 were boys. The mean age of the patients was 17 months (range, 6 to 24 months). In the piracetam group, 1 month after treatment an 81% response to treatment was found. In the placebo group, none of the patients had complete remission and 7% of the cases had partial remission. Overall, control of breath-holding spells was observed in 91% of the patients in the group taking piracetam as compared with 16% in the group taking placebo at the end of the study. There was no significant difference detected between the groups regarding the prevalence of drug side effects. A significant difference was detected between piracetam and placebo in prevention and controlling BHS. Piracetam (40mg/kg/day) had a good effect on our patients.

  19. Effect of aromatherapy on dental patient anxiety: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    M Venkataramana

    2016-01-01

    Full Text Available Introduction: Dental anxiety is a common and potentially distressing problem, both for the patients and for dental practitioners. It is considered to be the main barrier and affects the working lives of dental professional potentially compromising their performance. Aim: To know the effect of aromatherapy in the reduction of dental anxiety and to compare the anxiety levels of dental patients with the control group. Materials and Methods: A randomized controlled trial design was used. Of 40 dental clinics in Khammam town, 10 dental clinics were selected by simple random sampling method. A total of 100 patients attending the dental clinic for the first time were included in the study. Ambient odor of lavender was maintained with a candle warmer. A questionnaire comprising demographic information, smoking status, Modified dental anxiety scale (Humphries et al. in 1995, was given to the patients when they were waiting in the waiting room. Student's t-test and ANOVA test were used for data analysis. The level of significance was set at 0.05. Results: Considerable decrease in anxiety scores in 3 age groups was observed. A statistically significant (P = 0.002 decrease with age in mean anxiety score. A significant difference in anxiety scores of lavender group, a significant decrease of anxiety scores with an increase of age. Conclusion: Lavender decreased the current anxiety scores of patients effectively.

  20. Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial.

    Science.gov (United States)

    Cerezo-Téllez, Ester; Torres-Lacomba, María; Fuentes-Gallardo, Isabel; Perez-Muñoz, Milagros; Mayoral-Del-Moral, Orlando; Lluch-Girbés, Enrique; Prieto-Valiente, Luis; Falla, Deborah

    2016-09-01

    Chronic neck pain attributed to a myofascial pain syndrome is characterized by the presence of muscle contractures referred to as myofascial trigger points. In this randomized, parallel-group, blinded, controlled clinical trial, we examined the effectiveness of deep dry needling (DDN) of myofascial trigger points in people with chronic nonspecific neck pain. The study was conducted at a public Primary Health Care Centre in Madrid, Spain, from January 2010 to December 2014. A total of 130 participants with nonspecific neck pain presenting with active myofascial trigger points in their cervical muscles were included. These participants were randomly allocated to receive: DDN plus stretching (n = 65) or stretching only (control group [n = 65]). Four sessions of treatment were applied over 2 weeks with a 6-month follow-up after treatment. Pain intensity, mechanical hyperalgesia, neck active range of motion, neck muscle strength, and perceived neck disability were measured at baseline, after 2 sessions of intervention, after the intervention period, and 15, 30, 90, and 180 days after the intervention. Significant and clinically relevant differences were found in favour of dry needling in all the outcomes (all P stretching is more effective than passive stretching alone in people with nonspecific neck pain. The results support the use of DDN in the management of myofascial pain syndrome in people with chronic nonspecific neck pain.

  1. Immunomodulatory effects of kimchi in chinese healthy college students: a randomized controlled trial.

    Science.gov (United States)

    Lee, Hansongyi; Kim, Do Yeon; Lee, Mi Ae; Jang, Ja-Young; Choue, Ryowon

    2014-07-01

    This study examined the potential immunomodulatory effects of Kimchi, a traditional fermented Korean vegetable, in healthy Chinese college students. The four-week clinical-trial (randomized, open-label, prospective, controlled) was followed by a one week wash-out period. Healthy Chinese college students (over 20 years of age with a body mass index of 18.5-23.0 kg/m(2)) volunteered for this study. Forty-three students were randomly classified into two groups, Kimchi (n = 21, supplemented with 100 g of Kimchi per day) or non-Kimchi (n = 22, supplemented with 100 g of radish per day, control) groups. During the four-week intervention period, students were asked to maintain their usual diet and activity, and instructed not to take any medications, functional food products, or dietary supplements. Anthropometrics, nutritional intake, and blood immune parameters (lymphocyte subsets, cytokines, and immunoglobulins) were measured before and after the four weeks of intervention. Thirty-nine students (19 in the Kimchi group, 20 in the non-Kimchi group) finished the study. After the intervention, no significant changes were observed in lymphocyte subsets (T-cell, B-cell, NK cell), pro-inflammatory cytokines (IL-6, TNF-α), anti-inflammatory cytokines (IL-4 and IL-10), and immunoglobulins (Ig A, G, and M) between groups in either the Kimchi or non-Kimchi. These results suggest that the short-term consumption of Kimchi has no immunomodulatory effects in healthy Chinese college students.

  2. Effects of Yoga on Heart Rate Variability and Depressive Symptoms in Women: A Randomized Controlled Trial.

    Science.gov (United States)

    Chu, I-Hua; Wu, Wen-Lan; Lin, I-Mei; Chang, Yu-Kai; Lin, Yuh-Jen; Yang, Pin-Chen

    2017-04-01

    The purpose of the study was to investigate the effects of a 12-week yoga program on heart rate variability (HRV) and depressive symptoms in depressed women. This was a randomized controlled trial. Twenty-six sedentary women scoring ≥14 on the Beck Depression Inventory-II were randomized to either the yoga or the control group. The yoga group completed a 12-week yoga program, which took place twice a week for 60 min per session and consisted of breathing exercises, yoga pose practice, and supine meditation/relaxation. The control group was instructed not to engage in any yoga practice and to maintain their usual level of physical activity during the course of the study. Participants' HRV, depressive symptoms, and perceived stress were assessed at baseline and post-test. The yoga group had a significant increase in high-frequency HRV and decreases in low-frequency HRV and low frequency/high frequency ratio after the intervention. The yoga group also reported significantly reduced depressive symptoms and perceived stress. No change was found in the control group. A 12-week yoga program was effective in increasing parasympathetic tone and reducing depressive symptoms and perceived stress in women with elevated depressive symptoms. Regular yoga practice may be recommended for women to cope with their depressive symptoms and stress and to improve their HRV.

  3. Effects of Yoga on Heart Rate Variability and Mood in Women: A Randomized Controlled Trial.

    Science.gov (United States)

    Chu, I-Hua; Lin, Yuh-Jen; Wu, Wen-Lan; Chang, Yu-Kai; Lin, I-Mei

    2015-12-01

    To examine the effects of an 8-week yoga program on heart rate variability and mood in generally healthy women. Randomized controlled trial. Fifty-two healthy women were randomly assigned to a yoga group or a control group. Participants in the yoga group completed an 8-week yoga program, which comprised a 60-minute session twice a week. Each session consisted of breathing exercises, yoga pose practice, and supine meditation/relaxation. The control group was instructed not to engage in any yoga practice and to maintain their usual level of physical activity during the study. Participants' heart rate variability, perceived stress, depressive symptoms, and state and trait anxiety were assessed at baseline (week 0) and after the intervention (week 9). No measures of heart rate variability changed significantly in either the yoga or control group after intervention. State anxiety was reduced significantly in the yoga group but not in the control group. No significant changes were noted in perceived stress, depression, or trait anxiety in either group. An 8-week yoga program was not sufficient to improve heart rate variability. However, such a program appears to be effective in reducing state anxiety in generally healthy women. Future research should involve longer periods of yoga training, include heart rate variability measures both at rest and during yoga practice, and enroll women with higher levels of stress and trait anxiety.

  4. Crash Frequency Analysis Using Hurdle Models with Random Effects Considering Short-Term Panel Data.

    Science.gov (United States)

    Chen, Feng; Ma, Xiaoxiang; Chen, Suren; Yang, Lin

    2016-10-26

    Random effect panel data hurdle models are established to research the daily crash frequency on a mountainous section of highway I-70 in Colorado. Road Weather Information System (RWIS) real-time traffic and weather and road surface conditions are merged into the models incorporating road characteristics. The random effect hurdle negative binomial (REHNB) model is developed to study the daily crash frequency along with three other competing models. The proposed model considers the serial correlation of observations, the unbalanced panel-data structure, and dominating zeroes. Based on several statistical tests, the REHNB model is identified as the most appropriate one among four candidate models for a typical mountainous highway. The results show that: (1) the presence of over-dispersion in the short-term crash frequency data is due to both excess zeros and unobserved heterogeneity in the crash data; and (2) the REHNB model is suitable for this type of data. Moreover, time-varying variables including weather conditions, road surface conditions and traffic conditions are found to play importation roles in crash frequency. Besides the methodological advancements, the proposed technology bears great potential for engineering applications to develop short-term crash frequency models by utilizing detailed data from field monitoring data such as RWIS, which is becoming more accessible around the world.

  5. Evaluation of the effects of a diabetes educational program: a randomized clinical trial.

    Science.gov (United States)

    Torres, Heloísa de Carvalho; Pace, Ana Emília; Chaves, Fernanda Figueredo; Velasquez-Melendez, Gustavo; Reis, Ilka Afonso

    2018-02-05

    Evaluate the effectiveness of a diabetes mellitus educational program in primary health care. This cluster randomized trial was conducted in a sample of 470 people with type 2 diabetes mellitus from eight health units, randomly assigned to two groups: intervention (n = 231) and control (n = 239). The intervention group participated in the educational program composed of three strategies: group education, home visit, and telephone intervention. Simultaneously, the control group was monitored individually. Group monitoring took place over nine months in the year 2012. Clinical evaluations were performed at the initial time (T0), three (T3), six (T6) and nine (T9) months after the beginning of the intervention. After nine months of follow-up, 341 users remained in the study, 171 in the control group and 170 in the intervention group. The average age of users was 60.6 years. In both groups, statistically significant differences were observed in mean HbA1c levels over the follow-up time (p educational program model developed was effective to improve the glycemic control of the intervention group participants.

  6. Anxiety sensitivity risk reduction in smokers: A randomized control trial examining effects on panic.

    Science.gov (United States)

    Schmidt, Norman B; Raines, Amanda M; Allan, Nicholas P; Zvolensky, Michael J

    2016-02-01

    Empirical evidence has identified several risk factors for panic psychopathology, including smoking and anxiety sensitivity (AS; the fear of anxiety-related sensations). Smokers with elevated AS are therefore a particularly vulnerable population for panic. Yet, there is little knowledge about how to reduce risk of panic among high AS smokers. The present study prospectively evaluated panic outcomes within the context of a controlled randomized risk reduction program for smokers. Participants (N = 526) included current smokers who all received a state-of-the-art smoking cessation intervention with approximately half randomized to the AS reduction intervention termed Panic-smoking Program (PSP). The primary hypotheses focus on examining the effects of a PSP on panic symptoms in the context of this vulnerable population. Consistent with prediction, there was a significant effect of treatment condition on AS, such that individuals in the PSP condition, compared to those in the control condition, demonstrated greater decreases in AS throughout treatment and the follow-up period. In addition, PSP treatment resulted in lower rates of panic-related symptomatology. Moreover, mediation analyses indicated that reductions in AS resulted in lower panic symptoms. The present study provides the first empirical evidence that brief, targeted psychoeducational interventions can mitigate panic risk among smokers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Effect of cryotherapy after elbow arthrolysis: a prospective, single-blinded, randomized controlled study.

    Science.gov (United States)

    Yu, Shi-yang; Chen, Shuai; Yan, He-de; Fan, Cun-yi

    2015-01-01

    To investigate the effect of cryotherapy after elbow arthrolysis on elbow pain, blood loss, analgesic consumption, range of motion, and long-term elbow function. Prospective, single-blinded, randomized controlled study. University hospital. Patients (N=59; 27 women, 32 men) who received elbow arthrolysis. Patients were randomly assigned into a cryotherapy group (n=31, cryotherapy plus standard care) or a control group (n=28, standard care). Elbow pain at rest and in motion were measured using a visual analog scale (VAS) on postoperative day (POD) 1 to POD 7 and at 2 weeks and 3 months after surgery. Blood loss and analgesic consumption were recorded postoperatively. Elbow range of motion (ROM) was measured before surgery and on POD 1, POD 7, and 3 months after surgery. The Mayo Elbow Performance Score (MEPS) was evaluated preoperatively and 3 months postoperatively. VAS scores were significantly lower in the cryotherapy group during the first 7 PODs, both at rest and in motion (Pcryotherapy group than the control group for pain relief (P.05). Cryotherapy is effective in relieving pain and reducing analgesic consumption for patients received elbow arthrolysis. The application of cryotherapy will not affect blood loss, ROM, or elbow function. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. RANDOMIZED TRIAL OF CESAREAN VERSUS VAGINAL DELIVERY FOR EFFECTS ON THE PELVIC FLOOR IN SQUIRREL MONKEYS

    Science.gov (United States)

    LINDO, Fiona M.; CARR, Emily S.; REYES, Michelle; GENDRON, Jilene M.; (R), RT; RUIZ, Julio C.; PARKS, Virginia L.; KUEHL, Thomas J.; LARSEN, Wilma I.

    2016-01-01

    Objectives Vaginal delivery is a risk factor in pelvic floor disorders. We previously described changes in the pelvic floor associated with pregnancy and parturition in the squirrel monkey, a species with a human-like pattern of spontaneous age and parity associated pelvic organ prolapse. The potential to prevent or diminish these changes with scheduled cesarean section has not been evaluated. In a randomized, controlled trial, we compare female squirrel monkeys undergoing spontaneous vaginal delivery with those undergoing scheduled primary cesarean section for pelvic floor muscle volumes, muscle contrast changes, and dynamic effects on bladder neck position. Study Design Levator ani, obturator internus, and coccygeus muscle volumes and contrast uptake were assessed by magnetic resonance imaging in 20 nulliparous females examined prior to pregnancy, a few days after delivery, and 3 months post-partum. The position of bladder neck relative to boney reference line also was assessed with abdominal pressure using dynamic magnetic resonance imaging. Results Baseline measurements of 10 females randomly assigned to scheduled primary cesarean sections were not different from those of 10 females assigned to spontaneous vaginal delivery. Levator ani and obturator internus muscle volumes did not differ between groups, while volumes were reduced (p pelvic support of the bladder was not protected by this intervention suggesting that effects of pregnancy and delivery are not uniformly prevented by this procedure. PMID:26366665

  9. Effect of olive oil massage on weight gain in preterm infants: A randomized controlled clinical trial.

    Science.gov (United States)

    Jabraeile, Mahnaz; Rasooly, Alehe Seyyed; Farshi, Mahni Rahkar; Malakouti, Jamileh

    2016-01-01

    Despite the fact that effect of massage with or without oil on the baby's weight gain is not clear, but recent studies have shown that massage with essential oils make lipid absorption through the skin. The aim of this study was to evaluate the effect of olive oil massage on weight gain in preterm infants. This study was a single-blind, randomized controlled clinical trial. In this study, infants who met inclusion criteria for the study were divided into two groups by using random numbers table. Newborns in intervention group were under massage for 10 days and 3 times for 15 min daily; the mother of these newborns had been trained already using olive oil. Moreover, the infants of the control group were under massaging without oil same as the above-mentioned method. Researchers weighed babies daily during 10 days and recorded it at the checklist. Data from the study were reviewed and analyzed by descriptive statistics and repeated measure test using the statistical software SPSS/13. This study showed that the neonatal weight gain in the infants with the oil massage was 21 g daily in average, whereas the increase in infant massage without oil was 7 g. This difference was statistically significant (P olive oil, it is recommended that nurses use oil in infant massage in the neonatal units.

  10. Effectiveness of three different oral hygiene techniques on Viridans streptococci: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    N Naveen

    2016-01-01

    Full Text Available Introduction: Tongue cleaning is an important aspect of oral hygiene maintenance along with other mechanical and chemical aids. These methods have an influence on microorganism count in saliva. Aim: To assess the effectiveness of three different oral hygiene techniques on Viridans streptococci. Materials and Methods: This was a randomized controlled trial with 45 study subjects aged between 14 and 16 years and were randomly allocated into three groups: Group A - plastic tongue scraper, Group B - chlorhexidine mouthwash along with plastic tongue scraper, and Group C - chlorhexidine mouthwash. Unstimulated salivary samples were collected on the 1st, 7th, and 15th day before routine oral hygiene practices. Saliva samples were collected and incubated for 48 h on itis Salivarius(MS agar. Streptococcus mitis, Streptococcus mutans, and Streptococcus salivarius were counted. Data were analyzed using descriptive and inferential statistics. Results: The mean count of S. mitis, S. mutans, and S. salivarius for Group A, B, and C was found to be significant (P < 0.001 when compared between 1st, 7th, and 15th day. Between-groups comparisons revealed a significant difference between Groups A and C, B and C (P < 0.001. Conclusion: There was a significant reduction in bacterial count in all the participants indicating that all the three methods are useful in improving oral hygiene. Combination technique was found to be most effective.

  11. The effect of placebo tailoring on smoking cessation: a randomized controlled trial.

    Science.gov (United States)

    Webb Hooper, Monica; Rodríguez de Ybarra, Denise; Baker, Elizabeth A

    2013-10-01

    Previous research has found that smoking cessation messages can be designed to appear as tailored (placebo tailored) and result in superior outcomes compared to standard messages. In the current study, we aimed (a) to test the efficacy of placebo tailoring for smoking cessation and (b) to examine the influence of cognitive processing style. In a 2-arm randomized controlled trial, 424 smokers (M = 19.66 cigarettes per day) from the community (57% female, 30% Caucasian, 40% African American, 29% Hispanic; mean age = 42 years) were randomly assigned to receive 4 placebo-tailored booklets or 4 standard booklets over 3 months. Participants completed a measure of systematic versus heuristic cognitive processing style at baseline. The primary outcome was 7-day point prevalence abstinence (ppa). Twenty-eight-day continuous abstinence, content evaluations, and readiness to quit were secondary outcomes. We hypothesized that placebo tailoring would be superior to standard materials and that the effect would be moderated by cognitive processing style (systematic and heuristic). As expected, placebo tailoring led to greater 7-day ppa at 3 months and greater 28-day continuous abstinence at 6 months. Cognitive processing style moderated the effect on 7-day ppa, such that the placebo-tailored booklets produced greater cessation among participants with heuristic information processing tendencies. Findings support a causal role of placebo tailoring for short-term smoking cessation, particularly for individuals who process information using heuristic strategies. Implications for tailored interventions are discussed.

  12. Effect of laser acupuncture on obesity: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Tseng, Chi-Chuan; Tseng, Alan; Chang, Chia-Hao

    2015-05-15

    Obesity-related diseases have a profound economic impact on health care systems. Laser acupuncture has been shown to have beneficial effects on obesity. However, to our knowledge, those trials were either non-randomized, non-blinded or included low-calorie diet control. We have, therefore, designed a patient-assessor-blinded, randomized, sham-controlled crossover trial to investigate the significance of laser acupuncture on obesity. 104 subjects above 20 years of age with a body mass index (BMI) of over 25 kg/m(2) will be divided into 2 groups: experimental and control. Each subject will receive the treatment relevant to their group 3 times a week for 8 weeks. After 8 weeks of treatment the subject will enter a 2-week washout period, after which the subjects will switch groups. Measurements will include BMI, body fat percentage, waist-to-hip ratio (WHR), waist circumference, hip circumference, skinfold thickness, thigh circumference, body fat, blood pressure, heart rate, hunger and the 36-item Short-Form Health Survey (SF-36). The results of this study will provide the basis for future large-scale multicenter trials investigating the effects of laser acupuncture on obesity. ClinicalTrials.gov Identifier: NCT02167308 ; registration date: 14 June 2014.

  13. Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support.

    Science.gov (United States)

    Saadatmand, Vahid; Rejeh, Nahid; Heravi-Karimooi, Majideh; Tadrisi, Sayed Davood; Vaismoradi, Mojtaba; Jordan, Sue

    2015-08-01

    Nonpharmacologic pain management in patients receiving mechanical ventilation support in critical care units is under investigated. Natural sounds may help reduce the potentially harmful effects of anxiety and pain in hospitalized patients. The aim of this study was to examine the effect of pleasant, natural sounds on self-reported pain in patients receiving mechanical ventilation support, using a pragmatic parallel-arm, randomized controlled trial. The study was conducted in a general adult intensive care unit of a high-turnover teaching hospital, in Tehran, Iran. Between October 2011 and June 2012, we recruited 60 patients receiving mechanical ventilation support to the intervention (n = 30) and control arms (n = 30) of a pragmatic parallel-group, randomized controlled trial. Participants in both arms wore headphones for 90 minutes. Those in the intervention arm heard pleasant, natural sounds, whereas those in the control arm heard nothing. Outcome measures included the self-reported visual analog scale for pain at baseline; 30, 60, and 90 minutes into the intervention; and 30 minutes post-intervention. All patients approached agreed to participate. The trial arms were similar at baseline. Pain scores in the intervention arm fell and were significantly lower than in the control arm at each time point (p mechanical ventilation support. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  14. Clinical Effects of Dry Needling Among Asymptomatic Individuals With Hamstring Tightness: A Randomized Controlled Trial.

    Science.gov (United States)

    Geist, Kathleen; Bradley, Claire; Hofman, Alan; Koester, Rob; Roche, Fenella; Shields, Annalise; Frierson, Elizabeth; Rossi, Ainsley; Johanson, Marie

    2016-11-11

    Randomized controlled trial. The aim of this study was to determine the effects of dry needling on hamstring extensibility and functional performance tests among asymptomatic individuals with hamstring muscle tightness. Dry needling has been shown to increase range of motion in the upper quarter and may have similar effects in the lower quarter. Twenty-seven subjects with hamstring extensibility deficits were randomly assigned to side of treatment (dominant or non-dominant) and group (blunt needling or dry needling). The first session included measurement of hamstring extensibility and performance on four unilateral hop tests, instruction in home hamstring stretching exercises and needling distal to the ischial tuberosity and mid-bellies of the medial and lateral hamstrings. A second session, 3-5 days following the first session included outcome measures and a second needling intervention, and a third session, 4-6 weeks following the first session included outcome measures only. A 2x3x2 ANOVA was used to statistically analyze the data. Hamstring extensibility showed a significant side x time interaction (pdry needling results in increased extensibility beyond that of stretching alone in asymptomatic individuals. Our study findings suggest that dry needling may improve certain dimensions of functional performance, although no clear conclusion can be made. Intervention, level 2b.

  15. The Effect of 1,8-Cineole Inhalation on Preoperative Anxiety: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Ka Young Kim

    2014-01-01

    Full Text Available The aim of this study was to investigate the effect of inhalation of eucalyptus oil and its constituents on anxiety in patients before selective nerve root block (SNRB. This study was a randomized controlled trial carried out in 62 patients before SNRB. The patients were randomized to inhale limonene, 1,8-cineole, or eucalyptus oil, each at concentrations of 1% vol/vol in almond oil or almond oil (control. Anxiety-visual analog scale (A-VAS, state-trait anxiety inventory (STAI, profile of mood states (POMS, pain-visual analog scale (P-VAS, blood pressure, and pulse rate were measured before and after inhalation prior to SNRB. Measures of anxiety, including A-VAS (P<0.001, STAI (P=0.005, and POMS (P<0.001, were significantly lower in 1,8-cineole than in the control group and significantly greater in 1,8-cineole than in the eucalyptus group in A-VAS. P-VAS was significantly lower after than before inhalation of limonene, 1,8-cineole, and eucalyptus, despite having no significant difference in the four groups compared with control group. 1,8-Cineole, a major constituent of eucalyptus, was effective in decreasing anxiety before SNRB. The present findings suggest that inhalation of 1,8-cineole may be used to relieve anxiety before, during, and after various operations, in addition to SNRB.

  16. Effect of Bile Acid Sequestrants on the Risk of Cardiovascular Events: A Mendelian Randomization Analysis.

    Science.gov (United States)

    Ross, Stephanie; D'Mello, Matthew; Anand, Sonia S; Eikelboom, John; Stewart, Alexandre F R; Samani, Nilesh J; Roberts, Robert; Paré, Guillaume

    2015-08-01

    Statins lower low-density lipoprotein cholesterol (LDL-C) and risk of coronary artery disease (CAD), but they may be ineffective or not tolerated. Bile acid sequestrants (BAS) reduce LDL-C, yet their clinical efficacy on CAD remains controversial. We conducted a systematic review and meta-analysis of randomized controlled trials to assess the effect of cholestyramine and colesevelam. We then used Mendelian randomization to estimate the effect of BAS on reducing the risk of CAD. First, we quantified the effect of rs4299376 (ABCG5/ABCG8), which affects the intestinal cholesterol absorption pathway targeted by BAS and then we used these estimates to predict the effect of BAS on CAD. Nineteen randomized controlled trials with a total of 7021 study participants were included. Cholestyramine 24 g/d was associated with a reduction in LDL-C of 23.5 mg/dL (95% confidence interval [CI] -26.8,-20.2; N=3806) and a trend toward reduced risk of CAD (odds ratio 0.81, 95% CI 0.70-1.02; P=0.07; N=3806), whereas colesevelam 3.75 g/d was associated with a reduction in LDL-C of 22.7 mg/dL (95% CI -28.3, -17.2; N=759). Based on the findings that rs4299376 was associated with a 2.75 mg/dL decrease in LDL-C and a 5% decrease in risk of CAD outcomes, we estimated that cholestyramine was associated with an odds ratio for CAD of 0.63 (95% CI 0.52-0.77; P=6.3×10(-6)) and colesevelam with an odds ratio of 0.64 (95% CI 0.52-0.79, P=4.3×10(-5)), which were not statistically different from BAS clinical trials (P>0.05). The cholesterol lowering effect of BAS may translate into a clinically relevant reduction in CAD. © 2015 American Heart Association, Inc.

  17. Effect of Probiotics on Blood Lipid Concentrations: A Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Cho, Young Ae; Kim, Jeongseon

    2015-10-01

    Previous clinical studies have reported mixed results regarding the effect of probiotics on lipid metabolism. Therefore, we conducted a meta-analysis of randomized controlled trials to quantify the direction and magnitude of the potential effect of probiotics on blood lipid concentrations.Eligible studies were randomized, placebo-controlled trials whose interventions were probiotic products containing live bacteria. The studies reported net changes in lipid profiles (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides) and their associated standard deviations (or the data to calculate them). The probiotic products did not contain prebiotics or other active ingredients, and the full article was accessible in English.The pooled mean net change in lipid profiles and 95% confidence intervals (95% CIs) were calculated. Q statistics and I were calculated to examine heterogeneity. Potential sources of heterogeneity were investigated via subgroup and sensitivity analyses, and publication biases were estimated.A total of 30 randomized controlled trials with 1624 participants (828 in intervention groups and 796 in placebo groups) were included in this analysis. Subjects treated with probiotics demonstrated reduced total cholesterol and LDL cholesterol compared to control subjects by 7.8 mg/dL (95% CI: -10.4, -5.2) and 7.3 mg/dL (95% CI: -10.1, -4.4), respectively. There was no significant effect of probiotics on HDL cholesterol or triglycerides. The effect of probiotics on total cholesterol and LDL cholesterol depended on a variety of factors. The significant effects were greater for higher baseline total cholesterol levels, longer treatment durations, and certain probiotic strains. In addition, these associations seem stronger in studies supported by probiotics companies.The studies included in this meta-analysis showed significant heterogeneity as indicated by the Q statistics and I. In addition, industry sponsorship may affect study findings

  18. Effects of interpretive nutrition labels on consumer food purchases: the Starlight randomized controlled trial.

    Science.gov (United States)

    Ni Mhurchu, Cliona; Volkova, Ekaterina; Jiang, Yannan; Eyles, Helen; Michie, Jo; Neal, Bruce; Blakely, Tony; Swinburn, Boyd; Rayner, Mike

    2017-03-01

    Background: Nutrition labeling is a prominent policy to promote healthy eating.Objective: We aimed to evaluate the effects of 2 interpretive nutrition labels compared with a noninterpretive label on consumer food purchases.Design: In this parallel-group randomized controlled trial, we enrolled household shoppers across New Zealand who owned smartphones and were aged ≥18 y. Eligible participants were randomly assigned (1:1:1) to receive either traffic light labels (TLLs), Health Star Rating labels (HSRs), or a control [nutrition information panel (NIP)]. Smartphone technology allowed participants to scan barcodes of packaged foods and to receive allocated labels on their smartphone screens. The primary outcome was the mean healthiness of all packaged food purchases over the 4-wk intervention period, which was measured by using the Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (NPSC).Results: Between October 2014 and November 2015, 1357 eligible shoppers were randomly assigned to TLL (n = 459), HSR (n = 443), or NIP (n = 455) labels. Overall difference in the mean transformed NPSC score for the TLL group compared with the NIP group was -0.20 (95% CI: -0.94, 0.54; P = 0.60). The corresponding difference for HSR compared with NIP was -0.60 (95% CI: -1.35, 0.15; P = 0.12). In an exploratory per-protocol analysis of participants who used the labeling intervention more often than average (n = 423, 31%), those who were assigned to TLL and HSR had significantly better NPSC scores [TLL compared with NIP: -1.33 (95% CI: -2.63, -0.04; P = 0.04); HSR compared with NIP: -1.70 (95% CI: -2.97, -0.43; P = 0.01)]. Shoppers who were randomly assigned to HSR and TLL also found the labels significantly more useful and easy to understand than the NIP (all P values nutrition labels had no significant effect on food purchases. However, shoppers who used interpretive labels found them to be significantly more useful and easy to understand, and compared with

  19. Effectiveness of Earplugs in Preventing Recreational Noise-Induced Hearing Loss: A Randomized Clinical Trial.

    Science.gov (United States)

    Ramakers, Geerte G J; Kraaijenga, Véronique J C; Cattani, Guido; van Zanten, Gijsbert A; Grolman, Wilko

    2016-06-01

    The incidence of hearing loss has risen in past years. Attendance at music festivals and concerts may contribute to this increasing problem. To assess the effectiveness of earplugs in preventing temporary hearing loss immediately following music exposure. A randomized, single-blind clinical trial was conducted on September 5, 2015, at an outdoor music festival in Amsterdam, the Netherlands. Normal-hearing adult volunteers were recruited via social media. An exclusion criterion was the participants' intention to wear earplugs. Of the 86 volunteers assessed, 51 were included in the study. All analyses were performed on an intention-to-treat basis. Participants were randomly assigned to a group using earplugs or an unprotected group during a 4½-hour festival visit. The primary study outcome was a temporary threshold shift (TTS) on the audiogram, primarily for frequencies at 3 and 4 kHz. Secondary study outcomes included distortion product otoacoustic emission (DPOAE) measurements and claims of tinnitus using a questionnaire and tinnitus matching experiments. Of 51 participants included, 25 were randomized to the earplug group and 26 to the unprotected group. Nine in each group (36% and 35%, respectively) were men, and the mean (SD) ages were 27.3 (5.6) years in the earplug group and 27.0 (6.2) years in the unprotected group. Baseline demographics were similar in both groups. The time-averaged, equivalent A-weighted sound pressure level experienced was 100 dBA during the festival. A TTS over frequencies at 3 and 4 kHz after exposure was seen in 4 of 50 ears (8%) in the earplug group compared with 22 of 52 ears (42%) in the unprotected group (P earplug group. The number needed to treat with earplugs for preventing 1 TTS was 2.9. The DPOAE amplitudes decreased significantly more over the frequencies 2 to 8 kHz in the unprotected group: the mean (SD) decrease in magnitude was 0.6 (2.8) dB in the earplug group vs 2.2 (1.9) dB in the unprotected group (P = .04

  20. Effect of ginger (Zingiber officinale) on heavy menstrual bleeding: a placebo-controlled, randomized clinical trial.

    Science.gov (United States)

    Kashefi, Farzaneh; Khajehei, Marjan; Alavinia, Mohammad; Golmakani, Ebrahim; Asili, Javad

    2015-01-01

    A wide range of herbal plants have been reported to treat various gynecological problems of women. This study was set out to investigate the effect of ginger (Zingiber officinale) on heavy menstrual bleeding (HMB) in high school girls. Ninety-two young women who experienced HMB and met the inclusion criteria were recruited in this study. Participants were evaluated for six consecutive menstrual cycles. During 3 assessment cycles, their HMB was confirmed by Pictorial Blood Assessment Chart. They were then randomly allocated to two study groups to receive either ginger or placebo capsules. The participants filled in the same chart during three intervention cycles. The level of menstrual blood loss dramatically declined during the three intervention cycles in ginger-receiving group. The decrease of blood loss in ginger-receiving group was significantly more remarkable than that of participants receiving placebo (pginger may be considered as an effective therapeutic option for HMB. Copyright © 2014 John Wiley & Sons, Ltd.

  1. Comparison of the effectiveness of two different interventions to reduce preoperative anxiety: A randomized controlled study.

    Science.gov (United States)

    Ertuğ, Nurcan; Ulusoylu, Özge; Bal, Ayça; Özgür, Hazal

    2017-06-01

    This study was conducted to determine and compare the effectiveness of nature sounds and relaxation exercises for reducing preoperative anxiety. A repeated measures randomized controlled trial design was used. We divided 159 preoperative patients into three groups: nature sounds (n = 53), relaxation exercises (n = 53), and control groups (n = 53). We evaluated anxiety using the visual analog scale and state anxiety inventory scores immediately before, immediately after, and 30 min after interventions in nature sounds and relaxation exercises groups, and silent rest in the control. We found no differences between the measurement values in the intervention groups, but we did observe a difference between the intervention and control groups. The two interventions were similarly effective in reducing preoperative anxiety. These simple and low-cost interventions can be used to reduce preoperative anxiety in surgical clinics. © 2017 John Wiley & Sons Australia, Ltd.

  2. The per-protocol effect of immediate vs. deferred ART initiation in the START randomized trial

    DEFF Research Database (Denmark)

    Lodi, Sara; Sharma, Shweta; Lundgren, Jens D

    2016-01-01

    OBJECTIVE: The START trial found a lower risk of a composite clinical outcome in HIV-positive individuals assigned to immediate initiation of antiretroviral therapy (ART) compared with those assigned to deferred initiation. However, 30% of those assigned to deferred initiation started ART earlier...... than the protocol specified. To supplement the published intention-to-treat effect estimates, here we estimate the per-protocol effect of immediate versus deferred ART initiation in START. DESIGN: The START trial randomized 4685 HIV-positive participants with CD4 counts > 500 /mm to start ART...... in the immediate and deferred initiation groups had all the trial participants adhered to the protocol. RESULTS: We estimated that the 5-year risk of the composite outcome would have been 3.2% under immediate ART initiation and 7.0% under deferred initiation. The difference of 3.8% (95% confidence interval 1...

  3. [The effect of Christmas joy on the mood among medical doctors - a randomized, blinded intervention study].

    Science.gov (United States)

    Ilkjær, Christine; Møller, Marianne B; Lauridsen, Mette H; Ilkjær, Susanne; Hjortdal, Vibeke E

    2016-12-12

    Each December Santa's elves spread Christmas joy (JN). Laughter and humour may influence health and stress level. No other study has investigated the effect of JN on the good spirit (DGH) among healthcare professionals. We performed a single-centre blinded intervention study with crossover at three hospital departments. JN intervention of three days was randomized. Median ± standard deviation was given. The level of significance was p Christmas atmosphere tended to increase DGH at the morning conferences. JN tended to have an additive effect. JN exposure may be beneficial. The study did not receive any funding. The trial was not registered and was kept secret for the participants in accordance with the tradition of Santa's elves.

  4. Methods for synthesizing findings on moderation effects across multiple randomized trials.

    Science.gov (United States)

    Brown, C Hendricks; Sloboda, Zili; Faggiano, Fabrizio; Teasdale, Brent; Keller, Ferdinand; Burkhart, Gregor; Vigna-Taglianti, Federica; Howe, George; Masyn, Katherine; Wang, Wei; Muthén, Bengt; Stephens, Peggy; Grey, Scott; Perrino, Tatiana

    2013-04-01

    This paper presents new methods for synthesizing results from subgroup and moderation analyses across different randomized trials. We demonstrate that such a synthesis generally results in additional power to detect significant moderation findings above what one would find in a single trial. Three general methods for conducting synthesis analyses are discussed, with two methods, integrative data analysis and parallel analyses, sharing a large advantage over traditional methods available in meta-analysis. We present a broad class of analytic models to examine moderation effects across trials that can be used to assess their overall effect and explain sources of heterogeneity, and present ways to disentangle differences across trials due to individual differences, contextual level differences, intervention, and trial design.

  5. Effectiveness of exercise at workplace in physical fitness: uncontrolled randomized study.

    Science.gov (United States)

    Grande, Antônio José; Silva, Valter; Parra, Sérgio Alencar

    2014-01-01

    To investigate the effectiveness of workplace exercise for employee health by means of health-related physical activity components. A randomized uncontrolled study with 20 workers was carried out during three months to evaluate a workplace exercise program. The selected outcomes were flexibility, body mass, fat percentage, lean mass, blood pressure, and heart rate. For statistical analysis, the paired t test and the intent-to-treat analysis were used. There was a significant increase in weight, fat percentage, blood pressure, and heart rate. However the clinical significance was 10% in the size of the effect. The changes verified in the outcomes analyzed were not significant; the variables are within normality ranges proposed by academic organizations.

  6. 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.

  7. Hemodynamic effects of digoxin in acute myocardial infarction in man: a randomized controlled trial.

    Science.gov (United States)

    Marchionni, N; Pini, R; Vannucci, A; Conti, A; De Alfieri, W; Calamandrei, M; Di Bari, M; Ferrucci, L; Moschi, G; Lombardi, A

    1985-01-01

    Hemodynamic effects of digoxin in acute myocardial infarction (AMI) have been acknowledged to depend on the basal cardiocirculatory state. In the present study, the effects of digoxin in patients with AMI were evaluated in four hemodynamic subsets, based on the relationship between mean pulmonary capillary wedge pressure (PCWP, in mm Hg) and left ventricular stroke work index (LVSWI, in g-m/m2): subset 1: normal (less than or equal to 15 mm Hg) PCWP and normal (greater than or equal to 35 g-m/m2) LVSWI; subset 2: elevated (greater than 15 mm Hg) PCWP and normal LVSWI; subset 3: reduced (less than 35 g-m/m2) LVSWI and normal PCWP; and subset 4: elevated PCWP and LVSWI moderately reduced to a range between 16 and 34 g-m/m2. Forty patients were admitted to the study and were randomly assigned to one of two groups in each subset: control group (19 patients) and treated group (21 patients). Five patients were randomized into each of the subsets 2, 3, and 4 in both the control and treated groups, while in subset 1 there were four control and six digoxin-treated patients. Control patients were administered a placebo saline solution and digoxin-treated patients received 0.50 mg of the drug intravenously in 20 minutes. The effects of the placebo and of the drug were evaluated at 30, 60, and 90 minutes from the end of the infusion. Hemodynamic data did not vary in the control group, and digoxin did not exert any relevant effect in subsets 1 and 2. After drug infusion, cardiac index (Cl, in L/min/m2) significantly increased in subset 3 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Effects of tongue cleaning on plaque and salivary mutans streptococci levels: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kochiyil Chacko Jacob

    2015-01-01

    Full Text Available Introduction: Tongue cleaning has been shown to be effective in preventing plaque formation and reducing oral mutans streptococci (MS when used in combination with other oral hygiene procedures. However, correlation between MS counts and plaque levels remains to be demonstrated. Aim: To evaluate the effect of tongue scraping and tongue brushing on salivary MS and plaque levels. Materials and Methods: A triple-blind three arm randomized controlled parallel-group trial was carried out among 54, 12–15-year-old boys in a residential school in Bengaluru city. The study participants were randomly allocated into Group A (toothbrushing and tongue scraping; n = 19, Group B (toothbrushing and tongue brushing; n = 18 and Group C (only toothbrushing; n = 17. The clinical procedure included a collection of saliva and recording of plaque index at baseline, 10th and 21st day. Salivary MS counts were determined using mitis salivarius bacitracin Agar media. ANOVA, Wilcoxon's signed-rank sum test, Mann–Whitney U-test and Spearman's correlation test were performed on log-transformed CFU/mL of MS. Results: The tongue scraping and tongue brushing groups showed statistically significant reductions in salivary MS counts after 10 days (4.76 ± 0.54 (4.79 ± 0.44 and 21 days (4.50 ± 0.44 (4.41 ± 0.57 respectively when performed along with toothbrushing. However, differences between the interventions were not statistically significant. Furthermore, there was no statistically significant reduction in plaque levels after 10 and 21 days. Conclusions: Tongue scraping and tongue brushing were equally effective in reducing salivary MS counts when used in combination with toothbrushing, however, their effect on reducing plaque levels was not significant. Hence, tongue cleaning is recommended as an adjunct to toothbrushing.

  9. Effects of pentoxifylline on renal function and blood pressure in cardiac transplant recipients: a randomized trial.

    Science.gov (United States)

    Frantz, R P; Edwards, B S; Olson, L J; Schwab, M K; Adams, T F; Textor, S C; Daly, R C; McGregor, C G; Rodeheffer, R J

    1997-06-15

    The current success of cardiac transplantation is in part attributable to the development of effective immunosuppressive agents such as cyclosporine. However, concern remains regarding the potential for cyclosporine-induced nephrotoxicity. Animal studies and early reports of renal protective effects of pentoxifylline in bone marrow transplant recipients prompted a randomized trial in cardiac transplant recipients. Twenty-nine patients were randomized to receive pentoxifylline 400 mg p.o. t.i.d. or matching placebo for 1 year after cardiac transplantation. Renal function was assessed preoperatively and at 1, 6, and 12 months postoperatively. Glomerular filtration rate and renal plasma flow were measured with iothalamate and para-aminohippurate, respectively. Serum creatinine was also measured. Ambulatory blood pressure monitoring after withdrawal of antihypertensives for 3 days was performed 12 months postoperatively. Twenty-seven patients completed the study. Glomerular filtration rate rose between 1 and 6 months after transplantation, presumably due to the reduction in goal cyclosporine level in that period, and then fell modestly between 6 and 12 months, presumably due to ongoing nephrotoxic effects of cyclosporine. No difference in glomerular filtration rate or creatinine was seen between pentoxifylline and placebo groups at any interval. Renal plasma flow increased modestly between baseline and 6 months in the pentoxifylline group, but not in the placebo group, and then fell between 6 and 12 months. Serum creatinine increased between baseline and 6 months in both groups, apparently due to increased body weight. Results of 18-hr ambulatory blood pressure monitoring obtained 1 year after transplantation was not different between groups. Renal function declines only modestly in the first year after cardiac transplantation. Pentoxifylline did not attenuate this process and had no effect on blood pressure. The modest decline in renal function may be related to

  10. Effectiveness of additional trunk exercises on gait performance: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Van Criekinge, Tamaya; Saeys, Wim; Hallemans, Ann; Vereeck, Luc; De Hertogh, Willem; Van de Walle, Patricia; Vaes, Nathalie; Lafosse, Christophe; Truijen, Steven

    2017-06-02

    Evidence is lacking concerning the effect of additional trunk rehabilitation on gait performance. Investigating gait performance by both clinical and biomechanical outcome measures might lead to new scientific insights into the importance of the trunk during gait rehabilitation in people suffering from stroke. This protocol was written according to the SPIRIT 2013 Statement. An assessor-blinded randomized controlled trial will be conducted in patients with impaired trunk control after stroke. A total of 60 patients will be randomly allocated to the control or the experimental group by means of sealed opaque envelopes. They will receive either 16 h of additional trunk exercises (experimental group) or cognitive exercises (controls) for 1 h a day, 4 days a week for 4 weeks. Patients will also receive 2 h of standard care consisting of physiotherapy and occupational therapy. Gait performance will be assessed clinically by the Tinetti Test and biomechanically by means of a full body gait analysis. In addition, the effect of the exercise protocol on the trunk itself and trunk activities of daily living will be assessed by the Trunk Impairment Scale and the Barthel Index. Despite the evidence demonstrating the importance of trunk control after stroke, studies about the effects of trunk rehabilitation on gait performance are inconsistent. In the current study, a more sophisticated treatment protocol will be used to enlarge therapeutic improvements, the relationship between clinical and biomechanical measures of gait performance can be investigated, and the sustainability of the effects of trunk exercises over time will be examined. Since clinical improvements are of greater importance to patients and physiotherapists, clinical assessment scales will be used as primary outcome measures. ClinicalTrials.gov, ID: NCT02708888 . Registered on 2 March 2016.

  11. Effects of acupuncture on patients with fibromyalgia: study protocol of a multicentre randomized controlled trial.

    Science.gov (United States)

    Vas, Jorge; Modesto, Manuela; Aguilar, Inmaculada; Santos-Rey, Koldo; Benítez-Parejo, Nicolás; Rivas-Ruiz, Francisco

    2011-02-28

    Fibromyalgia is a multidimensional disorder for which treatment as yet remains unsatisfactory. Studies of an acupuncture-based approach, despite its broad acceptance among patients and healthcare staff, have not produced sufficient evidence of its effectiveness in treating this syndrome. The present study aims to evaluate the effectiveness of individualized acupuncture for patients with fibromyalgia, with respect to reducing their pain and level of incapacity, and improving their quality of life. Randomized controlled multicentre study, with 156 outpatients, aged over 17 years, diagnosed with fibromyalgia according to American College of Rheumatology criteria, either alone or associated with severe depression, according to the criteria of the Diagnostic and Statistical Manual for Mental Disorders. The participants will be randomly assigned to receive either "True acupuncture" or "Sham acupuncture". They will be evaluated using a specific measurement system, constituted of the Fibromyalgia Impact Questionnaire and the Hamilton rating scale for depression. Also taken into consideration will be the clinical and subjective pain intensity, the patient's family structure and relationships, psychological aspects, quality of life, the duration of previous temporary disability, the consumption of antidepressant, analgesic and anti-inflammatory medication, and the potential effect of factors considered to be predictors of a poor prognosis. All these aspects will be examined by questionnaires and other suitably-validated instruments. The results obtained will be analysed at 10 weeks, and 6 and 12 months from the start of treatment. This trial will utilize high quality trial methodologies in accordance with CONSORT guidelines. It may provide evidence for the effectiveness of acupuncture as a treatment for fibromyalgia either alone or associated with severe depression. ISRCTN trial number ISRCTN60217348 (19 October 2010).

  12. Effects of acupuncture on patients with fibromyalgia: study protocol of a multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Santos-Rey Koldo

    2011-02-01

    Full Text Available Abstract Background Fibromyalgia is a multidimensional disorder for which treatment as yet remains unsatisfactory. Studies of an acupuncture-based approach, despite its broad acceptance among patients and healthcare staff, have not produced sufficient evidence of its effectiveness in treating this syndrome. The present study aims to evaluate the effectiveness of individualized acupuncture for patients with fibromyalgia, with respect to reducing their pain and level of incapacity, and improving their quality of life. Methods/design Randomized controlled multicentre study, with 156 outpatients, aged over 17 years, diagnosed with fibromyalgia according to American College of Rheumatology criteria, either alone or associated with severe depression, according to the criteria of the Diagnostic and Statistical Manual for Mental Disorders. The participants will be randomly assigned to receive either "True acupuncture" or "Sham acupuncture". They will be evaluated using a specific measurement system, constituted of the Fibromyalgia Impact Questionnaire and the Hamilton rating scale for depression. Also taken into consideration will be the clinical and subjective pain intensity, the patient's family structure and relationships, psychological aspects, quality of life, the duration of previous temporary disability, the consumption of antidepressant, analgesic and anti-inflammatory medication, and the potential effect of factors considered to be predictors of a poor prognosis. All these aspects will be examined by questionnaires and other suitably-validated instruments. The results obtained will be analysed at 10 weeks, and 6 and 12 months from the start of treatment. Discussion This trial will utilize high quality trial methodologies in accordance with CONSORT guidelines. It may provide evidence for the effectiveness of acupuncture as a treatment for fibromyalgia either alone or associated with severe depression. Trial registration ISRCTN trial number

  13. The effect of financial incentives on chlamydia testing rates: Evidence from a randomized experiment☆

    Science.gov (United States)

    Dolan, Paul; Rudisill, Caroline

    2014-01-01

    Financial incentives have been used in a variety of settings to motivate behaviors that might not otherwise be undertaken. They have been highlighted as particularly useful in settings that require a single behavior, such as appointment attendance or vaccination. They also have differential effects based on socioeconomic status in some applications (e.g. smoking). To further investigate these claims, we tested the effect of providing different types of non-cash financial incentives on the return rates of chlamydia specimen samples amongst 16–24 year-olds in England. In 2011 and 2012, we ran a two-stage randomized experiment involving 2988 young people (1489 in Round 1 and 1499 in Round 2) who requested a chlamydia screening kit from Freetest.me, an online and text screening service run by Preventx Limited. Participants were randomized to control, or one of five types of financial incentives in Round 1 or one of four financial incentives in Round 2. We tested the effect of five types of incentives on specimen sample return; reward vouchers of differing values, charity donation, participation in a lottery, choices between a lottery and a voucher and including vouchers of differing values in the test kit prior to specimen return. Financial incentives of any type, did not make a significant difference in the likelihood of specimen return. The more deprived individuals were, as calculated using Index of Multiple Deprivation (IMD), the less likely they were to return a sample. The extent to which incentive structures influenced sample return was not moderated by IMD score. Non-cash financial incentives for chlamydia testing do not seem to affect the specimen return rate in a chlamydia screening program where test kits are requested online, mailed to requestors and returned by mail. They also do not appear more or less effective in influencing test return depending on deprivation level. PMID:24373390

  14. The effect of financial incentives on chlamydia testing rates: evidence from a randomized experiment.

    Science.gov (United States)

    Dolan, Paul; Rudisill, Caroline

    2014-03-01

    Financial incentives have been used in a variety of settings to motivate behaviors that might not otherwise be undertaken. They have been highlighted as particularly useful in settings that require a single behavior, such as appointment attendance or vaccination. They also have differential effects based on socioeconomic status in some applications (e.g. smoking). To further investigate these claims, we tested the effect of providing different types of non-cash financial incentives on the return rates of chlamydia specimen samples amongst 16-24 year-olds in England. In 2011 and 2012, we ran a two-stage randomized experiment involving 2988 young people (1489 in Round 1 and 1499 in Round 2) who requested a chlamydia screening kit from Freetest.me, an online and text screening service run by Preventx Limited. Participants were randomized to control, or one of five types of financial incentives in Round 1 or one of four financial incentives in Round 2. We tested the effect of five types of incentives on specimen sample return; reward vouchers of differing values, charity donation, participation in a lottery, choices between a lottery and a voucher and including vouchers of differing values in the test kit prior to specimen return. Financial incentives of any type, did not make a significant difference in the likelihood of specimen return. The more deprived individuals were, as calculated using Index of Multiple Deprivation (IMD), the less likely they were to return a sample. The extent to which incentive structures influenced sample return was not moderated by IMD score. Non-cash financial incentives for chlamydia testing do not seem to affect the specimen return rate in a chlamydia screening program where test kits are requested online, mailed to requestors and returned by mail. They also do not appear more or less effective in influencing test return depending on deprivation level. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Effect of Turkish classical music on blood pressure: a randomized controlled trial in hypertensive elderly patients.

    Science.gov (United States)

    Bekiroğlu, Tansel; Ovayolu, Nimet; Ergün, Yusuf; Ekerbiçer, Hasan Çetin

    2013-06-01

    Existing studies suggest that music therapy can have favorable effects on hypertension and anxiety. We therefore set out to investigate the effect of Turkish classical music. To investigate whether Turkish classical music has positive effects on blood pressures and anxiety levels in elderly patients. This was a randomized controlled trial performed on 60 hypertensive patients living in a local elderly home in Adana, Turkey. Following the completion of a socio-demographic form for each patient, Hamilton anxiety scale was applied. Thereafter, the subjects were randomly divided into two equal-size groups and were allowed to either listen to Turkish classical music (music therapy group) or have a resting period (control group) for 25 min. The primary and secondary outcome measures were blood pressure and Hamilton anxiety scale scores, respectively. The mean reduction in systolic blood pressure was 13.00 mmHg in the music therapy group and 6.50 mmHg in the control group. The baseline adjusted between treatment group difference was not statistically significant (95% CI 6.80-9.36). The median reductions in diastolic blood pressures were 10 mmHg both in the music therapy and control groups. The between treatment group difference was not statistically significant (Mann-Whitney U test, P = 0.839). The mean reduction in HAMA-A was 1.63 in the music therapy group and 0.77 in the control group. The baseline adjusted between treatment group difference was not statistically significant (95% CI 0.82-1.92). The study demonstrated that both Turkish classical music and resting alone have positive effects on blood pressure in patients with hypertension. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Effectiveness of trigger point dry needling for plantar heel pain: a randomized controlled trial.

    Science.gov (United States)

    Cotchett, Matthew P; Munteanu, Shannon E; Landorf, Karl B

    2014-08-01

    Plantar heel pain can be managed with dry needling of myofascial trigger points; however, there is only poor-quality evidence supporting its use. The purpose of this study was to evaluate the effectiveness of dry needling for plantar heel pain. The study was a parallel-group, participant-blinded, randomized controlled trial. The study was conducted in a university health sciences clinic. Study participants were 84 patients with plantar heel pain of at least 1 month's duration. Participants were randomly assigned to receive real or sham trigger point dry needling. The intervention consisted of 1 treatment per week for 6 weeks. Participants were followed for 12 weeks. Primary outcome measures included first-step pain, as measured with a visual analog scale (VAS), and foot pain, as measured with the pain subscale of the Foot Health Status Questionnaire (FHSQ). The primary end point for predicting the effectiveness of dry needling for plantar heel pain was 6 weeks. At the primary end point, significant effects favored real dry needling over sham dry needling for pain (adjusted mean difference: VAS first-step pain=-14.4 mm, 95% confidence interval [95% CI]=-23.5 to -5.2; FHSQ foot pain=10.0 points, 95% CI=1.0 to 19.1), although the between-group difference was lower than the minimal important difference. The number needed to treat at 6 weeks was 4 (95% CI=2 to 12). The frequency of minor transitory adverse events was significantly greater in the real dry needling group (70 real dry needling appointments [32%] compared with only 1 sham dry needling appointment [Dry needling provided statistically significant reductions in plantar heel pain, but the magnitude of this effect should be considered against the frequency of minor transitory adverse events. © 2014 American Physical Therapy Association.

  17. 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

  18. A novel design for randomized immuno-oncology clinical trials with potentially delayed treatment effects

    Directory of Open Access Journals (Sweden)

    Pei He

    2015-10-01

    Full Text Available The semi-parametric proportional hazards model is widely adopted in randomized clinical trials with time-to-event outcomes, and the log-rank test is frequently used to detect a potential treatment effect. Immuno-oncology therapies pose unique challenges to the design of a trial as the treatment effect may be delayed, which violates the proportional hazards assumption, and the log-rank test has been shown to markedly lose power under the non-proportional hazards setting. A novel design and analysis approach for immuno-oncology trials is proposed through a piecewise treatment effect function, which is capable of detecting a potentially delayed treatment effect. The number of events required for the trial will be determined to ensure sufficient power for both the overall log-rank test without a delayed effect and the test beyond the delayed period when such a delay exists. The existence of a treatment delay is determined by a likelihood ratio test with resampling. Numerical results show that the proposed design adequately controls the Type I error rate, has a minimal loss in power under the proportional hazards setting and is markedly more powerful than the log-rank test with a delayed treatment effect.

  19. Effects of a Dual Sensory Loss Protocol on Hearing Aid Outcomes: A Randomized Controlled Trial.

    Science.gov (United States)

    Vreeken, Hilde L; van Rens, Ger H M B; Kramer, Sophia E; Knol, Dirk L; van Nispen, Ruth M A

    2015-01-01

    Dual sensory loss (DSL; concurrent vision and hearing loss) negatively affects quality of life. As speechreading is hampered, use of hearing aids (HAs) is important for older adults with DSL. However, due to vision loss, use of small and complex HAs is assumed to be difficult. An integrative DSL protocol that addresses rehabilitative care for older adults with DSL, including proper HA use, was implemented in low vision rehabilitation centers. The present study aims to evaluate the effectiveness of the DSL protocol among HA owners on HA outcomes (i.e., HA use, benefit, satisfaction with HAs, and hearing with HAs). In a randomized controlled trial, the DSL protocol was compared to a waiting list control group among clients (aged ≥50 years) of low vision rehabilitation centers with DSL. The International Outcome Inventory for Hearing Aids (IOI-HA) and the HA Fitting Questionnaire (HAFQ) were administered at baseline and 3 months follow-up. Participants (n = 128) were randomly allocated to either the intervention (n = 63) or control group (n = 65). Intention-to-treat analyses showed a near significant effect on IOI-HA Residual problems (effect size, 0.35; p = 0.063). Per-protocol analyses showed similar (nonsignificant) results on the main outcomes, and a ceiling effect was found on the HAFQ. Significant effects were found in subgroups of patients: among patients with low HAFQ scores (HAFQ-Use: effect size = 0.56, p = 0.046; HAFQ-Hearing with HAs: effect size = 0.64, p = 0.019), male participants (effect size = 0.80; p = 0.003), and those with moderate hearing loss (effect size = 0.72; p = 0.028), significantly better IOI-HA scores were found in the intervention group at 3 months follow-up. Although the per-protocol and subgroup analyses need to be interpreted with caution, DSL patients who experience HA difficulties could benefit from the DSL protocol by making better use of their HAs. The increasing prevalence and impact of DSL on a person's independence and social

  20. Effects of prayer on the vital signs of patients with chronic kidney disease: randomized controlled trial.

    Science.gov (United States)

    Brasileiro, Thaila Oliveira Zatiti; Prado, Andressa Anunciação de Oliveira; Assis, Bianca Bacelar de; Nogueira, Denismar Alves; Lima, Rogério Silva; Chaves, Erika de Cassia Lopes

    2017-07-20

    To assess the effect of prayer on blood pressure, heart rate and respiratory rate in patients with chronic kidney disease and learn their perception of the intervention. A randomized controlledtrial, double blind with a sample of volunteers, randomized into an intervention group (n=42) and a control group (n=37). Questionnaires addressing socio-demographic, clinical and spiritual characteristics and the Duke University Religious Index were applied. Blood pressure, heart rate and respiratory rate were measured. The prayer was conducted at three different moments on alternating weeks. The qualitative data were organized and analyzed through Thematic Analysis. The sample consisted of 95 randomized volunteers. In the intra-group analysis, a statistically significant reduction (Pvalores de pressão arterial, frequência cardíaca e respiratória em todas as análises das pessoas que receberam a prece. Aanálise qualitativa resultou nos temasA Prece em um "Lugar de Sofrimento" e Avaliação Positiva e nos subtemas Alívio do Sofrimento, Esperança de Superação, Enfrentamento do Tratamento Hemodialítico. A prece reduziu os valores da pressão arterial, frequência cardíaca e respiratória de pacientes com insuficiência renal crônica e a avaliação dos voluntários em relação à intervenção foi positiva. Registro Brasileiro de Ensaios Clínicos: RBR-2zv39y.

  1. Effect of Trospium Chloride on Cognitive Function in Women Aged 50 and Older: A Randomized Trial.

    Science.gov (United States)

    Geller, Elizabeth J; Dumond, Julie B; Bowling, J Michael; Khandelwal, Christine M; Wu, Jennifer M; Busby-Whitehead, Jan; Kaufer, Daniel I

    This study aimed to investigate the effect of trospium chloride on cognitive function in postmenopausal women treated for overactive bladder (OAB). Randomized double-blind placebo-controlled trial conducted from April 2013 to April 2015. Women aged 50 years or older seeking treatment for OAB were randomized to either trospium chloride XR 60 mg daily or placebo. Baseline cognitive function was assessed via Hopkins Verbal Learning Test-Revised (HVLT-R), Mini Mental Status Exam, Mini Mental Status X, Digit Span, Trails A, Trails B, and Epworth Sleepiness Scale. Cognitive function was reassessed at week 1 and week 4. A priori power analysis determined that 21 subjects were needed per group. Although 59 women were enrolled and randomized (28 trospium and 31 placebo), 45 completed assessment (21 trospium and 24 placebo). Mean age was 68 years, 78% were white, and 44% had previously taken OAB medication. For the primary outcome, there was no difference in HVLT-R total score between trospium and placebo groups at week 4 (P = 0.29). There were also no differences based on the other cognitive tests. There was a correlation between age and the following week-4 tests: HVLT-R total score (r = -0.3, P = 0.02), HVLT-R total recall subscale (r = -0.4, P = 0.007), Trails A (r = 0.4, P = 0.002), and Trails B (r = 0.4, P = 0.004). A linear regression model found that HVLT-R total score decreased by 0.372 points for each increased year of age. In women aged 50 years and older, there were no changes in cognitive function between those taking trospium and placebo. Cognitive function was correlated with age.

  2. Effects of hormone therapy on brain structure: A randomized controlled trial.

    Science.gov (United States)

    Kantarci, Kejal; Tosakulwong, Nirubol; Lesnick, Timothy G; Zuk, Samantha M; Gunter, Jeffrey L; Gleason, Carey E; Wharton, Whitney; Dowling, N Maritza; Vemuri, Prashanthi; Senjem, Matthew L; Shuster, Lynne T; Bailey, Kent R; Rocca, Walter A; Jack, Clifford R; Asthana, Sanjay; Miller, Virginia M

    2016-08-30

    To investigate the effects of hormone therapy on brain structure in a randomized, double-blinded, placebo-controlled trial in recently postmenopausal women. Participants (aged 42-56 years, within 5-36 months past menopause) in the Kronos Early Estrogen Prevention Study were randomized to (1) 0.45 mg/d oral conjugated equine estrogens (CEE), (2) 50 μg/d transdermal 17β-estradiol, or (3) placebo pills and patch for 48 months. Oral progesterone (200 mg/d) was given to active treatment groups for 12 days each month. MRI and cognitive testing were performed in a subset of participants at baseline, and at 18, 36, and 48 months of randomization (n = 95). Changes in whole brain, ventricular, and white matter hyperintensity volumes, and in global cognitive function, were measured. Higher rates of ventricular expansion were observed in both the CEE and the 17β-estradiol groups compared to placebo; however, the difference was significant only in the CEE group (p = 0.01). Rates of ventricular expansion correlated with rates of decrease in brain volume (r = -0.58; p ≤ 0.001) and with rates of increase in white matter hyperintensity volume (r = 0.27; p = 0.01) after adjusting for age. The changes were not different between the CEE and 17β-estradiol groups for any of the MRI measures. The change in global cognitive function was not different across the groups. Ventricular volumes increased to a greater extent in recently menopausal women who received CEE compared to placebo but without changes in cognitive performance. Because the sample size was small and the follow-up limited to 4 years, the findings should be interpreted with caution and need confirmation. This study provides Class I evidence that brain ventricular volume increased to a greater extent in recently menopausal women who received oral CEE compared to placebo. © 2016 American Academy of Neurology.

  3. Effectiveness of adjuvant occupational therapy in employees with depression: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hees Hiske L

    2010-09-01

    Full Text Available Abstract Background Major depressive disorder is among the medical conditions with the highest negative impact on work outcome. However, little is known regarding evidence-based interventions targeting the improvement of work outcomes in depressed employees. In this paper, the design of a randomized controlled trial is presented in order to evaluate the effectiveness of adjuvant occupational therapy in employees with depression. This occupational intervention is based on an earlier intervention, which was designed and proven effective by our research group, and is the only intervention to date that specifically targets work outcome in depressed employees. Methods/Design In a two-arm randomized controlled trial, a total of 117 participants are randomized to either 'care as usual' or ' care as usual' with the addition of occupational therapy. Patients included in the study are employees who are absent from work due to depression for at least 25% of their contract hours, and who have a possibility of returning to their own or a new job. The occupational intervention consists of six individual sessions, eight group sessions and a work-place visit over a 16-week period. By increasing exposure to the working environment, and by stimulating communication between employer and employee, the occupational intervention aims to enhance self-efficacy and the acquisition of more adaptive coping strategies. Assessments take place at baseline, and at 6, 12, and 18-month follow-ups. Primary outcome measure is work participation (hours of absenteeism and time until work resumption. Secondary outcome measures are work functioning, symptomatology, health-related quality of life, and neurocognitive functioning. In addition, cost-effectiveness is evaluated from a societal perspective. Finally, mechanisms of change (intermediate outcomes and potential patient-treatment matching variables are investigated. Discussion This study hopes to provide valuable knowledge

  4. Effectiveness of a Web-Based Intervention in Reducing Depression and Sickness Absence: Randomized Controlled Trial.

    Science.gov (United States)

    Beiwinkel, Till; Eißing, Tabea; Telle, Nils-Torge; Siegmund-Schultze, Elisabeth; Rössler, Wulf

    2017-06-15

    Depression is highly prevalent in the working population and is associated with significant loss of workdays; however, access to evidence-based treatment is limited. This study evaluated the effectiveness of a Web-based intervention in reducing mild to moderate depression and sickness absence. In an open-label randomized controlled trial, participants were recruited from a large-scale statutory health insurance and were assigned to two groups. The intervention group had access to a 12 week Web-based program consisting of structured interactive sessions and therapist support upon request. The wait-list control group had access to unguided Web-based psycho-education. Depressive symptoms were self-assessed at baseline, post-treatment, and follow-up (12 weeks after treatment) using the Patient Health Questionnaire (PHQ-9) and Beck Depression Inventory (BDI-II) as primary outcome measures. Data on sickness absence was retrieved from health insurance records. Intention-to-treat (ITT) analysis and per-protocol (PP) analysis were performed. Of the 180 participants who were randomized, 88 completed the post-assessment (retention rate: 48.8%, 88/180). ITT analysis showed a significant between-group difference in depressive symptoms during post-treatment in favor of the intervention group, corresponding to a moderate effect size (PHQ-9: d=0.55, 95% CI 0.25-0.85, Psignificant effect on one primary outcome (PHQ-9: d=0.61, 95% CI 0.15-1.07, P=.04, and BDI-II: d=0.25 95% CI -0.18 to 0.65, P=.37). Analysis of clinical significance using reliable change index revealed that significantly more participants who used the Web-based intervention (63%, 63/100) responded to the treatment versus the control group (33%, 27/80; P<.001). The number needed to treat (NNT) was 4.08. Within both groups, there was a reduction in work absence frequency (IG: -67.23%, P<.001, CG: -82.61%, P<.001), but no statistical difference in sickness absence between groups was found (P=.07). The Web

  5. Effects of adding concentration therapy to Kegel exercise to improve continence after radical prostatectomy, randomized control

    National Research Council Canada - National Science Library

    Kongtragul, Jaruwan; Tukhanon, Wanvara; Tudpudsa, Piyanuch; Suedee, Kanita; Tienchai, Supaporn; Leewansangtong, Sunai; Nualgyong, Chaiyong

    2014-01-01

    .... One hundred thirty five patients were randomized into the intervention group that concentration therapy was added to Kegel exercise, and control group that was Kegel exercise only, using the stratified randomization...

  6. Existence and Ulam stabilities for Hadamard fractional integral equations with random effects

    Directory of Open Access Journals (Sweden)

    Said Abbas

    2016-01-01

    Full Text Available This article concerns the existence and Ulam stabilities for a class of random integral equations via Hadamard's fractional integral. Our main tools is a random fixed point theorem with stochastic domain.

  7. Effects of PMTO in Foster Families with Children with Behavior Problems: A Randomized Controlled Trial.

    Science.gov (United States)

    Maaskant, Anne M; van Rooij, Floor B; Overbeek, Geertjan J; Oort, Frans J; Arntz, Maureen; Hermanns, Jo M A

    2017-01-01

    The present randomized controlled trial examined the effectiveness of Parent Management Training Oregon for foster parents with foster children (aged 4-12) with severe externalizing behavior problems in long-term foster care arrangements. Foster children's behavior problems are challenging for foster parents and increase the risk of placement breakdown. There is little evidence for the effectiveness of established interventions to improve child and parent functioning in foster families. The goal of Parent Management Training Oregon, a relatively long and intensive (6-9 months, with weekly sessions) parent management training, is to reduce children's problem behavior through improvement of parenting practices. We specifically investigated whether Parent Management Training Oregon is effective to reduce foster parenting stress. A significant effect of Parent Management Training Oregon, compared to Care as Usual was expected on reduced parenting stress improved parenting practices, and on reduced child behavior problems. Multi-informant (foster mothers, foster fathers, and teachers) data were used from 86 foster families (46 Parent Management Training Oregon, 40 Care as Usual) using a pre-posttest design. Multilevel analyses based on the intention to treat principle (retention rate 73 %) showed that Parent Management Training Oregon, compared to Care as Usual, reduced general levels of parenting stress as well as child related stress and parent-related stress (small to medium effect sizes). The clinical significance of this effect was, however, limited. Compared to a decrease in the Care as Usual group, Parent Management Training Oregon helped foster mothers to maintain parental warmth (small effect size). There were no other effects of Parent Management Training Oregon on self-reported parenting behaviors. Child behavior problems were reduced in both conditions, indicating no additive effects of Parent Management Training Oregon to Care as Usual on child

  8. How to interpret meta-analysis models: fixed effect and random effects meta-analyses.

    Science.gov (United States)

    Nikolakopoulou, Adriani; Mavridis, Dimitris; Salanti, Georgia

    2014-05-01

    This section of the journal is aimed at providing the essential information readers should know about the topics that are addressed in the 'Statistics in practice' paper published in the same issue of the journal. This stand-alone section has to be seen as an articulated summary of the main notions clinicians have to know about some basic concepts in statistics, which may be useful for their evidence-based practice. After going through these notes, readers are encouraged to read the 'Statistics in practice' articles. Of course, we welcome any feedback from you (via email or Twitter) about this! The EBMH Editors Relative treatment effects studied in trials are typically measured using an effect size. The observed effect sizes are synthesised to obtain a summary treatment effect via meta-analysis.

  9. Effect of Aloe vera mouthwash on periodontal health: triple blind randomized control trial.

    Science.gov (United States)

    Karim, Bushra; Bhaskar, Dara John; Agali, Chandan; Gupta, Devanand; Gupta, Rajendra Kumar; Jain, Ankita; Kanwar, Alpana

    2014-03-01

    With the increasing incidence of periodontal diseases and development of antibiotic resistance, the global need for alternative treatment modalities, safe, effective, and economical products is the need of time. Aloe vera is a medicinal plant which has the greater medicinal value and enormous properties for curing and preventing oral diseases disease. The aim of the study was to access the effect of Aloe vera mouthwash on the dental plaque and gingivitis and comparing it with the bench mark control chlorhexidine and placebo. 345 healthy subjects were randomly allocated in 3 groups to the test group (n=115) - mouthwash containing Aloe vera, Control group (n=115) -chlorhexidene group, Distilled water - Placebo (n=115) . Plaque Index (PI) and Gingival Index (GI) were assessed at days 0, 15 and 30. Subjects were asked to rinse their mouth with the stated mouthwash, twice a day, during a 30-day period. Our result showed that Aloe vera mouthrinse is equally effective in reducing periodontal indices as Chlorhexidine. The results demonstrated a significant reduction of gingival bleeding and plaque indices in both groups over a period of 15 and 30 days as compared to placebo group. There was a significant reduction on plaque and gingivitis in Aloe vera and chlorhexidine groups and no statistically significant difference was observed among them (p>0.05). Aloe vera mouthwash showed no side effects as seen with chlorhexidine. The results of the present study indicate that Aloe vera may prove to be an effective mouthwash owing to its ability in reducing periodontal indices.

  10. Prevention of Anxiety and Depression in Swedish School Children: a Cluster-Randomized Effectiveness Study.

    Science.gov (United States)

    Ahlen, Johan; Hursti, Timo; Tanner, Lindsey; Tokay, Zelal; Ghaderi, Ata

    2017-07-20

    Our study aimed at evaluating FRIENDS for Life, an intervention to prevent anxiety and depression in Swedish school children. A total of 695 children between the ages of 8 and 11 were recruited from 17 schools in Stockholm, Sweden, and cluster-randomized to either the intervention or control group. Teachers in the intervention group received a full day of training and administered FRIENDS for Life in their classrooms. We assessed the children's anxiety and depressive symptoms, general mental health, and academic performance at pre- and post-intervention as well as at the 12-month follow-up. A multi-informant approach was used with data collected from children, parents, and teachers. Assessment was done with the Spence Children's Anxiety Scale, Children's Depression Inventory, and the Strengths and Difficulties Questionnaire. Children's baseline symptoms, gender, and age as well as their teacher's use of supervision were examined as moderators of effect. Our study found no short- or long-term effects of the intervention for any outcome with regard to the entire sample. We found an enhanced effect of the intervention regarding children with elevated depressive symptoms at baseline. We found a decrease in anxiety symptoms among children whose teachers attended a larger number of supervision sessions, compared to children whose teachers attended fewer supervised sessions or the control group. Mediation analyses showed that this effect was driven by change in the last phase of the intervention, suggesting that supervision might play an important role in enhancing teachers' ability to administer the intervention effectively.

  11. The Effect of Exercise Training on Obstructive Sleep Apnea and Sleep Quality: A Randomized Controlled Trial

    Science.gov (United States)

    Kline, Christopher E.; Crowley, E. Patrick; Ewing, Gary B.; Burch, James B.; Blair, Steven N.; Durstine, J. Larry; Davis, J. Mark; Youngstedt, Shawn D.

    2011-01-01

    Study Objectives: To evaluate the efficacy of a 12-week exercise training program for reducing obstructive sleep apnea (OSA) severity and improving sleep quality, and to explore possible mechanisms by which exercise may reduce OSA severity. Design: Randomized controlled trial. Setting: Clinical exercise physiology center, sleep laboratory. Participants: Forty-three sedentary and overweight/obese adults aged 18-55 years with at least moderate-severity untreated OSA (screening apnea-hypopnea index [AHI] ≥ 15). Interventions: Participants randomized to exercise training (n = 27) met 4 times/week for 12 weeks and performed 150 min/week of moderate-intensity aerobic activity, followed by resistance training twice/week. Participants randomized to a stretching control (n = 16) met twice weekly for 12 weeks to perform low-intensity exercises designed to increase whole-body flexibility. Measurements and Results: OSA severity was assessed with one night of laboratory polysomnography (PSG) before and following the 12-week intervention. Measures of sleep quality included PSG, actigraphy (7-10 days), and the Pittsburgh Sleep Quality Index. Compared with stretching, exercise resulted in a significant AHI reduction (exercise: 32.2 ± 5.6 to 24.6 ± 4.4, stretching: 24.4 ± 5.6 to 28.9 ± 6.4; P sleep (P = 0.03). Reductions in AHI and ODI were achieved without a significant decrease in body weight. Improvements in actigraphic sleep and subjective sleep quality were also noted following exercise compared with stretching. Conclusions: Exercise training had moderate treatment efficacy for the reduction of AHI in sedentary overweight/obese adults, which suggests that exercise may be beneficial for the management of OSA beyond simply facilitating weight loss. Trial Registration: Clinicaltrials.gov identification number NCT00956423. Citation: Kline CE; Crowley EP; Ewing GB; Burch JB; Blair SN; Durstine JL; Davis JM; Youngstedt SD. The effect of exercise training on obstructive sleep

  12. Effective degrees of freedom of a random walk on a fractal.

    Science.gov (United States)

    Balankin, Alexander S

    2015-12-01

    We argue that a non-Markovian random walk on a fractal can be treated as a Markovian process in a fractional dimensional space with a suitable metric. This allows us to define the fractional dimensional space allied to the fractal as the ν-dimensional space F(ν) equipped with the metric induced by the fractal topology. The relation between the number of effective spatial degrees of freedom of walkers on the fractal (ν) and fractal dimensionalities is deduced. The intrinsic time of random walk in F(ν) is inferred. The Laplacian operator in F(ν) is constructed. This allows us to map physical problems on fractals into the corresponding problems in F(ν). In this way, essential features of physics on fractals are revealed. Particularly, subdiffusion on path-connected fractals is elucidated. The Coulomb potential of a point charge on a fractal embedded in the Euclidean space is derived. Intriguing attributes of some types of fractals are highlighted.

  13. Effects of Ginger on Serum Lipids and Lipoproteins in Peritoneal Dialysis Patients: A Randomized Controlled Trial.

    Science.gov (United States)

    Tabibi, Hadi; Imani, Hossein; Atabak, Shahnaz; Najafi, Iraj; Hedayati, Mehdi; Rahmani, Leila

    2016-01-01

    ♦ In peritoneal dialysis (PD) patients, one of the major risk factors for cardiovascular disease is lipid abnormalities. This study was designed to investigate the effects of ginger supplementation on serum lipids and lipoproteins in PD patients. ♦ In this randomized, double-blind, placebo-controlled trial, 36 PD patients were randomly assigned to either the ginger or the placebo group. The patients in the ginger group received 1,000 mg ginger daily for 10 weeks, while the placebo group received corresponding placebos. At baseline and at the end of week 10, 7 mL of blood were obtained from each patient after a 12- to 14-hour fast, and serum concentrations of triglyceride, total cholesterol, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and lipoprotein (a) [Lp (a)] were measured. ♦ Serum triglyceride concentration decreased significantly up to 15% in the ginger group at the end of week 10 compared with baseline (p < 0.01), and the reduction was significant in comparison with the placebo group (p < 0.05). There were no significant differences between the 2 groups in mean changes of serum total cholesterol, LDL-C, HDL-C, and Lp (a). ♦ This study indicates that daily administration of 1,000 mg ginger reduces serum triglyceride concentration, which is a risk factor for cardiovascular disease, in PD patients. Copyright © 2016 International Society for Peritoneal Dialysis.

  14. Randomized clinical controlled trial on the effectiveness of conventional and orthodontic manual toothbrushes

    Directory of Open Access Journals (Sweden)

    Lisiane Krieger Gomes

    2012-08-01

    Full Text Available The objective of this study was to compare the effectiveness of two manual toothbrushes (conventional and orthodontic. The following clinical parameters were used: VPI (visible plaque index and GBI (gingival bleeding index. Patients, 64 total (30 males and 34 females, in the permanent dentition, with a mean age of 17.8 years, were randomly selected from a practice specializing in orthodontics. Each participant received audio-visual instructions on oral hygiene as well as a kit of materials containing two manual toothbrushes (orthodontic and conventional. Each toothbrush was randomly allocated to one side of the mouth (split-mouth design and used for a period of approximately 4 weeks. The VPI and GBI were measured by a single calibrated examiner before (T0 and after (T1 the implementation of interventions. The Mann-Whitney test was used to compare the VPI values between the groups, and the Student t-test for independent samples was used to compare GBI values. The level of significance was set at 5%. No statistically significant difference was observed between the groups at T0 for both VPI and GBI, and at T1 for the GBI. The manual orthodontic toothbrush produced a statistically lower VPI (P < 0.05 at T1, but this did not seem to be of clinical importance.

  15. Prophylactic effect of artemether on human schistosomiasis mansoni among Egyptian children: A randomized controlled trial.

    Science.gov (United States)

    Elmorshedy, Hala; Tanner, Marcel; Bergquist, Robert N; Sharaf, Soraya; Barakat, Rashida

    2016-06-01

    A double-blind, randomized controlled trial was conducted in an endemic focus for Schistosoma mansoni in Kafr El-Sheikh Governorate, Northern Nile Delta, Egypt, to evaluate the prophylactic effect of artemether (ART) given in conjunction with praziquantel (PZQ). The study encompassed 913 primary school children randomly assigned to two treatment groups PZQ/ART and PZQ/ART-placebo. At baseline, both groups received 40 mg/kg body weight of PZQ twice four weeks apart, after which one group received 6 mg/kg body weight of ART every 3 weeks in 5 cycles during the transmission season and the other group received ART-placebo. At the end of the study, prevalence of infection among the PZQ/ART was approximately half that of the PZQ/ART-placebo group, i.e. 6.7% versus 11.6%, and incidence of new infections for the PZQ/ART was 2.7% versus 6.5% for the PZQ/ART-placebo. In conclusion, PZQ/ART combined therapy might be considered as an adjunct measure against human schistosomiasis, by specifically reducing transmission and therefore contribute to disease elimination. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  16. Effect of respiratory rehabilitation before open cardiac surgery on respiratory function: a randomized clinical trial.

    Science.gov (United States)

    Shakouri, Seyed Kazem; Salekzamani, Yaghoub; Taghizadieh, Ali; Sabbagh-Jadid, Hamed; Soleymani, Jamal; Sahebi, Leyla; Sahebi, Roya

    2015-01-01

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

  17. Effect of random vacancies on the electronic properties of graphene and T graphene: a theoretical approach

    Science.gov (United States)

    Sadhukhan, B.; Nayak, A.; Mookerjee, A.

    2017-12-01

    In this communication we present together four distinct techniques for the study of electronic structure of solids: the tight-binding linear muffin-tin orbitals, the real space and augmented space recursions and the modified exchange-correlation. Using this we investigate the effect of random vacancies on the electronic properties of the carbon hexagonal allotrope, graphene, and the non-hexagonal allotrope, planar T graphene. We have inserted random vacancies at different concentrations, to simulate disorder in pristine graphene and planar T graphene sheets. The resulting disorder, both on-site (diagonal disorder) as well as in the hopping integrals (off-diagonal disorder), introduces sharp peaks in the vicinity of the Dirac point built up from localized states for both hexagonal and non-hexagonal structures. These peaks become resonances with increasing vacancy concentration. We find that in presence of vacancies, graphene-like linear dispersion appears in planar T graphene and the cross points form a loop in the first Brillouin zone similar to buckled T graphene that originates from π and π* bands without regular hexagonal symmetry. We also calculate the single-particle relaxation time, τ (ěc {q}) of ěc {q} labeled quantum electronic states which originates from scattering due to presence of vacancies, causing quantum level broadening.

  18. Effects of randomness on the critical temperature in quasi-1D and quasi-2D superconductors

    Energy Technology Data Exchange (ETDEWEB)

    Nakhmedov, Enver [Institut fuer Theoretische Physik, Universitaet Wuerzburg, Am Hubland, D-97074 Wuerzburg (Germany); Institute of Physics, Azerbaijan National Academy of Sciences, H. Cavid str. 33, AZ1143 Baku (Azerbaijan); Alekperov, Oktay [Institute of Physics, Azerbaijan National Academy of Sciences, H. Cavid str. 33, AZ1143 Baku (Azerbaijan); Oppermann, Reinhold [Institut fuer Theoretische Physik, Universitaet Wuerzburg, Am Hubland, D-97074 Wuerzburg (Germany)

    2013-07-01

    Effects of non-magnetic disorder on the critical temperature T{sub c} and on diamagnetism of quasi-1D and quasi-2D superconductors (SCs) are reported. The organic SCs are modeled as superconducting wires or layers connecting each others through the Josephson coupling. The Josephson energy is considered to be random parameter with Gaussian distribution. The phase of the order parameter is averaged over thermodynamic fluctuations as well as over disorder by employing the replica method. We show that the randomness destroys phase coherence between wires in quasi-1D SCs and that T{sub c} vanishes discontinuously at a critical disorder-strength. Nevertheless the disorder of arbitrary high strength in quasi-2D organic SCs can not destroy completely the superconducting phase. The interplay between disorder and quantum phase fluctuations is shown to result in quantum critical behavior at T=0 in quasi-1D SCs, which manifests itself as a superconducting-normal metal phase transition of first-order at a critical disorder strength. The parallel and transverse components of the penetration-depth are evaluated. They diverge at different critical temperatures, which correspond to pair-breaking and phase-coherence breaking respectively. Our theory agrees well with the experimental measurements.

  19. The effect of buffered lidocaine in local anesthesia: a prospective, randomized, double-blind study.

    Science.gov (United States)

    Lee, Hyuk Jin; Cho, Young Jae; Gong, Hyun Sik; Rhee, Seung Hwan; Park, Hyun Soo; Baek, Goo Hyun

    2013-05-01

    Open carpal tunnel decompression under local anesthesia is routinely done by many surgeons. However, patients complain of pain during the injection of local anesthesia. This prospective, double-blind, randomized study was to compare the pain visual analog scale (VAS) scores of local anesthesia using lidocaine with and without sodium bicarbonate in patients with bilateral carpal tunnel syndrome. Twenty-five patients underwent bilateral simultaneous carpal tunnel decompression. All had topical anesthetic cream applied on the palm and wrist before the lidocaine block. In a randomized manner, half of the hands were blocked with nonbuffered lidocaine and half were blocked with buffered lidocaine. Pain was evaluated on a VAS score. The mean pain VAS score in the hand with buffered lidocaine was 4.6 ± 1.5 and 6.5 ± 1.5 for the hand with nonbuffered lidocaine. After adjustment for individual threshold of the pain, the mean pain VAS score changed into 4.6 ± 1.3 with buffered lidocaine and 6.6 ± 1.7 without buffered lidocaine. In open carpal tunnel surgery, the use of buffered lidocaine for local anesthesia reduces the anesthetic pain effectively. Therapeutic I. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  20. EFFECTIVENESS OF MOTOR TASK INTERFERENCE DURING GAIT IN SUBJECTS WITH PARKINSON'S DISEASE: A RANDOMIZED CONTROLLED TRAIL

    Directory of Open Access Journals (Sweden)

    Jaya ShankerTedla

    2017-04-01

    Full Text Available Background: In this study, was to evaluated the effectiveness of motor task and cognitive task interference while walking to improve gait parameters of subjects with Parkinson’s disease. Methods: In this Randomized Controlled trial, 30 subjects with Parkinson’s disease of age group between 50and 70 years randomly divided into two groups. The first group had motor task interference, and the second group had calculation task interference while walking along with conventional physical therapy. Gait parameters recorded as outcome measures. Both the groups received 1-hour training for three weeks for one month. Results: As per the paired t-test values, there was significant (p<0.001 improvement in the gait parameters for both the group's pre and post training. Motor task interference showed better improvements than calculation-task interference group among subjects with Parkinson’s disease in all the gait parameters measured with a p-value less than 0.001. Conclusion: To improve the gait parameters for mild to moderately disabled patients with Parkinson’s disease, the dual task training by using motor task while gait training along with conventional Physical Therapy will be more useful than using cognitive task.

  1. Analgesic Effect of Dexamethasone after Arthroscopic Knee Surgery: A Randomized Controlled Trial.

    Science.gov (United States)

    Moyano, Jairo; García, Maria; Caicedo, Maria

    2016-01-01

    Background. Dexamethasone is sometimes used as a coanalgesic because of its anti-inflammatory properties. Objective. To evaluate opioid use, postoperative pain intensity, and side effects after a single dose of dexamethasone in patients undergoing arthroscopic knee surgery. Methods. In this randomized controlled study patients were randomized to receive either 10 mg of intravenous dexamethasone (DM group) or 0.9% normal saline (NS group) during the intraoperative period. Primary outcomes were pain intensity and total morphine and codeine use after surgery. Results. Seventy-eight patients were included in the study. The DM group showed statistically significant higher pain intensity at the fourth postoperative hour (DM: 3.96/10, standard deviation [SD] 0.54; NS: 2.46/10, SD 0.45; p = 0.036). No statistically significant difference in total opioid use (morphine plus codeine) was identified with 15.9 (SD 1.97) codeine tablets used in DM group and 20 (SD 2.14) in NS group (p = 0.25). Discussion. Pain intensity tended to decrease in both groups suggesting morphine as the main source of analgesia. Conclusions. Intravenous dexamethasone during the intraoperative period has no clinical impact on postoperative pain intensity during the first 48 h after arthroscopic knee surgery. This trial is registered with R000020892.

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

    Science.gov (United States)

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

    2012-07-01

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

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

    Directory of Open Access Journals (Sweden)

    A R Pradeep

    2012-01-01

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

  4. The effects of acupressure on labor pains during child birth: randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Reginaldo Roque Mafetoni

    Full Text Available ABSTRACT Objective: to analyze the effects of acupressure on the sanyinjiao point for pregnant women in labor at public maternity wards. Method: single-blind controlled clinical trial, randomly done employing a pragmatic profile. We selected 156 pregnant women in their ≥ 37 week/s, who had cervical dilations of ≥ 4 cm and with two or more contractions in 10 minutes. The pregnant women were randomly divided into three groups at a university hospital in the suburbs of Sao Paulo, Brazil, in order to receive either acupressure treatment, a placebo or participate as part of a control group. The acupressure was applied on the sanyinjiao point during the contractions for 20 minutes. Then the intensity of the pain was evaluated using the Visual Analogue Scale (VAS. Results: The averages for the pain measured using the VAS were not different for the three groups that were a part of the study (p-value=0.0929, however they were less in the acupressure groups immediately after receiving the treatment (p-value=<0.0001. This was also the case where the treatment lasted for 1 hour (p-value=0.0001. This was the case in comparison with placebo and control groups. Conclusion: the use of acupressure on the sanyinjiao point is a useful way to alleviate pain in a non-invasive manner. It can improve the quality of care given to pregnant women in labor. Register: RBR-9mhs8r.

  5. The Effectiveness of Exergames in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial.

    Science.gov (United States)

    Karahan, Ali Yavuz; Tok, Fatih; Yildirim, Pelin; Ordahan, Banu; Turkoglu, Gozde; Sahin, Nilay

    2016-01-01

    Exergames are a well-known type of game based on a virtual avatar's body movements. This hightech approach promotes an active lifestyle. The aim of this randomized controlled trial was to evaluate the effects of exergames on pain, disease activity, functional capacity and quality of life in patients with ankylosing spondylitis (AS). The study involved 60 patients, who were randomized into either the exergame group (EG) or the control group (CG). The EG patients engaged in exergaming, and CG patients did not engage in any exercises. The exergaming sessions were performed five times a week for eight weeks (40 sessions in total). The patients were assessed before and after the eight-week program on a visual analog scale (VAS), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. A statistically significant improvement was observed in VAS, BASFI, BASDAI and ASQoL scores in the EG group after completion of the exercise program (p < 0.05). This study is a first step in investigating the possibilities of using an exergame platform to help patients with spondyloarthropathies to adopt a more physically active lifestyle. The results of this study suggest that exergames increase physical activity and decrease the pain scores in AS patients and also could, therefore, be feasible and safe.

  6. Effects of Kinesio taping in patients with quadriceps inhibition: A randomized, single-blinded study.

    Science.gov (United States)

    Kim, Kyung-Min; Davis, Brandon; Hertel, Jay; Hart, Joseph

    2017-03-01

    To determine effects of Kinesio taping (KT) on quadriceps activation and maximal voluntary isometric contraction (MVIC) in patients with quadriceps inhibition. Randomized, single-blinded. Laboratory. Sixteen participants (9 males, 7 females) with quadriceps inhibition, as determined by 90% or lower in central activation ratio (CAR), participated. Hoffmann reflex (H-reflex) of the vastus medialis and quadriceps CAR and MVIC were measured before taping, and participants were randomly allocated to either KT (KT application with tension) or sham (non-elastic tape application without tension) group. H-reflexes were assessed immediately and 20 min after tape was applied over the rectus femoris. All outcomes were measured again after tape was removed when participants returned the laboratory 24-48 h after taping. Two-way repeated ANOVA found no group-by-time interaction for: H-reflex (F 3,42  = 1.94, P = 0.14), CAR (F 1,14  = 0.03, P = 0.86), or MVIC (F 1,14  = 0.007, P = 0.93). None of the outcome measures differed between groups or over time (P > 0.05). KT applied to the rectus femoris did not change H-reflex of the vastus medialis and quadriceps CAR and MVIC in patients with quadriceps inhibition. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. The effect of additional ankle and midfoot mobilizations on plantar fasciitis: a randomized controlled trial.

    Science.gov (United States)

    Shashua, Anat; Flechter, Shlomo; Avidan, Liat; Ofir, Dani; Melayev, Alex; Kalichman, Leonid

    2015-04-01

    A single-blind randomized controlled trial. To evaluate the efficacy of ankle and midfoot mobilization on pain and function of patients with plantar fasciitis (PF). Plantar fasciitis is a degenerative process of the plantar fascia, with a lifetime prevalence of approximately 10%. Limited ankle dorsiflexion is a common finding and apparently acts as a contributing factor to the development of PF. Fifty patients with PF, aged 23 to 73 years, were randomly assigned to either the intervention or control group. Both groups received 8 treatments, twice a week, consisting of stretching exercises and ultrasound. In addition, the intervention group received mobilization of the ankle and midfoot joints. Dorsiflexion range of motion was measured at the beginning and at the end of treatment. The results were evaluated by 3 outcomes: the numeric pain-rating scale, Lower Extremity Functional Scale, and algometry. No significant difference was found between groups in any of the outcomes. Both groups showed a significant difference in the numeric pain-rating scale and Lower Extremity Functional Scale. Both groups significantly improved in dorsiflexion range of motion, with no difference between groups. The addition of ankle and foot joint mobilization aimed at improving dorsiflexion range of motion is not more effective than stretching and ultrasound alone in treating PF. The association between limited ankle dorsiflexion and PF is most probably due to soft tissue limitations, not the joints. Trial registered at ClinicalTrials.gov (registration number NCT01439932). Therapy, level 1b.

  8. The effect of olive oil on prevention of striae gravidarum: a randomized controlled clinical trial.

    Science.gov (United States)

    Soltanipoor, F; Delaram, M; Taavoni, S; Haghani, H

    2012-10-01

    Striae gravidarum (SG) is one of the cutaneous physiological changes during pregnancy with a high prevalence. This study aimed to evaluate the effect of olive oil in prevention of SG. Randomized controlled clinical trial. Health care centers and three Hospitals affiliated to Tehran University of Medical Sciences. 100 nulliparous pregnant women. Fifty women were randomly allocated to each study group. The treatment group received 1 cc topical olive oil twice a day to apply on the abdominal skin in a gentle manner without massaging it until the delivery. Control group did not receive any cream or oil during the study. Development of SG and its severity was recorded at the end of the study. Although the frequency of severe SG was lower in the users of olive oil compared to the other group, no statistically significant difference was found between the two experimental groups and the control group in the incidence and the severity of SG. Olive oil reduces the incidence of severe SG and increases the incidence of mild SG, but it does not significantly reduce the incidence and the severity of SG and it could not be recommended for SG prevention. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Effect of NICU Department Orientation Program on Mother’s Anxiety: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Leila Valizadeh

    2016-09-01

    Full Text Available Introduction: Neonatal intensive care unit induces the high level of anxiety for mothers. The aim of this study was to evaluate the effectiveness of NICU orientation program on the anxiety of mothers who had preterm newborns hospitalized in NICU. Methods: This study was a randomized clinical trial (three parallel groups. Participants included 99 mothers with preterm newborns hospitalized in NICU of Al- Zahra hospital, affiliated to Tabriz University of Medical Sciences in 2015. Mothers were randomly assigned to one of three groups (film, booklet, and control. Mothers completed the State- Trait Anxiety Inventory before entering to the NICU, and then mothers in the experiment groups became familiar with the NICU environment through watching a film or reading booklet. After the first NICU visit, all mothers completed the STAI and Cattell's Anxiety Questionnaires. Data were analyzed using SPSS ver. 13 software. Results: There was no significant difference between three groups regarding state- trait anxiety before the intervention. After the first NICU visit, a significant reduction in maternal state anxiety was seen in the both experiment groups. There was no statistical significant difference regarding trait anxiety. Data obtained from Cattell's anxiety questionnaire after intervention, showed significant difference in state anxiety between groups. Conclusion: Employing film and booklet orientation strategy after preterm delivery can reduce the mother’s anxiety and beneficent for the mother, baby, family and health care system.

  10. Effects of music therapy on intravitreal injections: a randomized clinical trial.

    Science.gov (United States)

    Chen, Xuejing; Seth, Rajeev K; Rao, Veena S; Huang, John J; Adelman, Ron A

    2012-08-01

    To investigate the effects of music therapy on anxiety, perceived pain, and satisfaction in patients undergoing intravitreal injections in the outpatient setting. This is a randomized clinical trial. Seventy-three patients were recruited from the retina clinic at 1 institution and randomized into a music therapy (n=37) or control (n=36) group. Prior to injection, patients completed the state portion of the Spielberger State Trait Anxiety Inventory (STAI-S). The music therapy group listened to classical music through computer speakers while waiting for and during the injection. The control group underwent the injection in the same setting without music. Afterward, all patients completed another STAI-S and a satisfaction and pain questionnaire. The main outcome measures were objective anxiety derived from STAI-S scores and subjective pain and anxiety from the post procedure questionnaire. The music therapy group had a greater decrease in anxiety than the control group (P=0.0480). Overall, 73% of all patients requested music for future injections (P=0.0001). The music therapy group (84%) requested music in future injections more frequently than the control group (61%) (P=0.0377). Both groups reported similar levels of pain (P=0.5879). Classical music before and during intravitreal injections decreases anxiety in patients without decreasing pain. Most patients desire to have music during future injections. Music therapy is a low-cost, easy, safe intervention that reduces anxiety during intravitreal injections in the outpatient setting.

  11. Clinical effectiveness of aquatic exercise to treat chronic low back pain: a randomized controlled trial.

    Science.gov (United States)

    Dundar, Umit; Solak, Ozlem; Yigit, Ilknur; Evcik, Deniz; Kavuncu, Vural

    2009-06-15

    This study was a prospective, randomized, controlled study. To compare the effectiveness of aquatic exercise interventions with land-based exercises in the treatment of chronic low back pain (CLBP). Land-based exercise and physiotherapy are the main treatment tools used for CLBP. Clinical experience indicates that aquatic exercise may have advantages for patients with musculoskeletal disorders. A total of 65 patients with CLBP were included in this study. Patients were randomly assigned to receive aquatic exercise or land-based exercise treatment protocol. Aquatic exercise program consisted of 20 sessions, 5 x per week for 4 weeks in a swimming pool at 33 degrees C. Land-based exercise (home-based exercise) program were demonstrated by a physiotherapist on one occasion and then they were given written advice The patients were assessed for spinal mobility, pain, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (week 4 and week 12). In both groups, statistically significant improvements were detected in all outcome measures (except modified Schober test) compared with baseline. However, improvement in modified Oswestry Low Back Pain Disability questionnaire and physical function and role limitations due to physical functioning subpart of Short-Form 36 Health Survey were better in aquatic exercise group (P exercises produced better improvement in disability and quality of life of the patients with CLBP than land-based exercise.

  12. Effects of kettlebell training on postural coordination and jump performance: a randomized controlled trial.

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    Jay, Kenneth; Jakobsen, Markus D; Sundstrup, Emil; Skotte, Jørgen H; Jørgensen, Marie B; Andersen, Christoffer H; Pedersen, Mogens T; Andersen, Lars L

    2013-05-01

    The aim of this study was to investigate the effectiveness of a worksite intervention using kettlebell training to improve postural reactions to perturbation and jump performance. This single-blind randomized controlled trial involved 40 adults (n = 40) from occupations with a high prevalence of musculoskeletal pain and discomfort (mean age 44 years, body mass index 23 kg·m, 85% women). A blinded examiner took measures at baseline and follow-up. Participants were randomly assigned to a training group-doing kettlebell swings 3 times a week for 8 weeks-or to a control group. The outcome measures were postural reactions to sudden perturbation and maximal countermovement jump height. Compared with the control group, the training group had a significant decreased stopping time after perturbation (-109 ms, 95% confidence interval [-196 to -21]). Jump height increased significantly in the training group (1.5 cm, 95% confidence interval [0.5 to 2.5]), but this was nonsignificantly different from control. Kettlebell training improves postural reactions to sudden perturbation. Future studies should investigate whether kettlebell training can reduce the risk of low back injury in occupations with manual material handling or patient handling where sudden perturbations often occur.

  13. Effectiveness of START psychological intervention in reducing abuse by dementia family carers: randomized controlled trial.

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    Cooper, Claudia; Barber, Julie; Griffin, Mark; Rapaport, Penny; Livingston, Gill

    2016-06-01

    Family carers of people with dementia frequently report acting abusively toward them and carer psychological morbidity predicts this. We investigated whether START (STrAtegies for RelaTives), a psychological intervention which reduces depression and anxiety in family carers also reduces abusive behavior in carers of people living in their own homes. We also explored the longitudinal course of carer abusive behavior over two year. We included self-identified family carers who gave support at least weekly to people with dementia referred in the previous year to three UK mental health services and a neurological dementia service. We randomly assigned these carers to START, an eight-session, manual-based coping intervention, or treatment as usual (TAU). Carer abusive behavior (Modified Conflict Tactic Scale (MCTS) score ≥2 representing significant abuse) was assessed at baseline, 4, 8, 12, and 24 months. We recruited 260 carers, 173 to START and 87 to TAU. There was no evidence that abusive behavior levels differed between randomization groups or changed over time. A quarter of carers still reported significant abuse after two years, but those not acting abusively at baseline did not become abusive. There was no evidence that START, which reduced carer anxiety and depression, reduced carer abusive behavior. For ethical reasons, we frequently intervened to manage concerning abuse reported in both groups, which may have disguised an intervention effect. Future dementia research should include elder abuse as an outcome, and consider carefully how to manage detected abuse.

  14. Analgesic Effect of Dexamethasone after Arthroscopic Knee Surgery: A Randomized Controlled Trial

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    Jairo Moyano

    2016-01-01

    Full Text Available Background. Dexamethasone is sometimes used as a coanalgesic because of its anti-inflammatory properties. Objective. To evaluate opioid use, postoperative pain intensity, and side effects after a single dose of dexamethasone in patients undergoing arthroscopic knee surgery. Methods. In this randomized controlled study patients were randomized to receive either 10 mg of intravenous dexamethasone (DM group or 0.9% normal saline (NS group during the intraoperative period. Primary outcomes were pain intensity and total morphine and codeine use after surgery. Results. Seventy-eight patients were included in the study. The DM group showed statistically significant higher pain intensity at the fourth postoperative hour (DM: 3.96/10, standard deviation [SD] 0.54; NS: 2.46/10, SD 0.45; p=0.036. No statistically significant difference in total opioid use (morphine plus codeine was identified with 15.9 (SD 1.97 codeine tablets used in DM group and 20 (SD 2.14 in NS group (p=0.25. Discussion. Pain intensity tended to decrease in both groups suggesting morphine as the main source of analgesia. Conclusions. Intravenous dexamethasone during the intraoperative period has no clinical impact on postoperative pain intensity during the first 48 h after arthroscopic knee surgery. This trial is registered with R000020892.

  15. Effects of Exercise on Cognitive Function in Older People with Dementia: A Randomized Controlled Trial.

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    Toots, Annika; Littbrand, Håkan; Boström, Gustaf; Hörnsten, Carl; Holmberg, Henrik; Lundin-Olsson, Lillemor; Lindelöf, Nina; Nordström, Peter; Gustafson, Yngve; Rosendahl, Erik

    2017-01-01

    Although physical exercise has been suggested to influence cognitive function, previous exercise studies show inconsistent results in people with dementia. To investigate effects of exercise on cognitive function in people with dementia. The Umeå Dementia and Exercise (UMDEX) study, a cluster-randomized controlled trial, was set in 16 nursing homes in Umeå, Sweden. One hundred-and-forty-one women and 45 men with dementia; mean age of 85 y and mean Mini-Mental State Examination (MMSE) score of 15, were randomized to a High-Intensity Functional Exercise program or a seated attention control activity. Blinded assessors measured global cognitive function using the MMSE and the Alzheimer's disease Assessment Scale - Cognitive subscale (ADAS-Cog), and executive function using Verbal fluency (VF) at baseline and 4 months (directly after intervention completion), and MMSE and VF at 7 months. Linear mixed models showed no between-group effects in mean difference from baseline (95% confidence intervals, CI) at 4 months in MMSE (-0.27; 95% CI -1.4 to 0.87, p = 0.644), ADAS-Cog (-1.04, 95% CI -4 to 1.92, p = 0.491), or VF (-0.53, 95% CI -1.42 to 0.35, p = 0.241) or at 7 months in MMSE (-1.15, 95% CI -2.32 to 0.03, p = 0.056) or VF (-0.18, 95% CI -1.09 to 0.74, p = 0.707). A 4-month, high-intensity functional exercise program had no superior effects on global cognition or executive function in people with dementia living in nursing homes when compared with an attention control activity.

  16. Randomized multi-centre study on the effect of training on tooth shade matching.

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    Olms, C; Klinke, Th; Pirek, P; Hannak, W B

    2013-12-01

    The aim of this study was to find out whether Toothguide Trainer, TT, and Toothguide Training Box, TTB, show any training effects, independent of the shade guide chosen. Students from four dental schools (N=78) were included in this study. The participants were randomized into a study, 42 students (age range: 19-27 years; 69% female, 31% male) and a control group of 36 students (age range: 19-30 years; 57% female, 43% male). The study group started with a double blind introduction test, followed by the TT and TTB training, finishing with the final test. The control group only passed the introduction and - after a break - the final test. Eight randomly chosen samples, seven of the Vita classical and one of the 3D-Master colour scale, were marked by barcodes. Colour matching was arranged by the Vita classical scale. The results of the pre- and final tests of both groups were combined. For every sample, the value ΔE was determined. The summation of all eight samples from the introduction and final tests offered a summarized ΔE value. The differences between introduction and final tests revealed the individual learning success. 47.6% of the study group showed statistically significant better results than the control group, 33% (p=0.031). TT and TTB show a positive effect of training on tooth shade matching independent of the colour scale used. Visual shade taking is the most frequent clinical method for shade determination. To increase better results in visual colour matching, TT and TTB training is used. This is the first study examining the training effect of TT and TTB using Vita classical scale. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Effect of Vibration on Pain Response to Heel Lance: A Pilot Randomized Control Trial.

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    McGinnis, Kate; Murray, Eileen; Cherven, Brooke; McCracken, Courtney; Travers, Curtis

    2016-12-01

    Applied mechanical vibration in pediatric and adult populations has been shown to be an effective analgesic for acute and chronic pain, including needle pain. Studies among the neonatal population are lacking. According to the Gate Control Theory, it is expected that applied mechanical vibration will have a summative effect with standard nonpharmacologic pain control strategies, reducing behavioral and physiologic pain responses to heel lancing. To determine the safety and efficacy of mechanical vibration for relief of heel lance pain among neonates. In this parallel design randomized controlled trial, eligible enrolled term or term-corrected neonates (n = 56) in a level IV neonatal intensive care unit were randomized to receive either sucrose and swaddling or sucrose, swaddling, and vibration for heel lance analgesia. Vibration was applied using a handheld battery-powered vibrator (Norco MiniVibrator, Hz = 92) to the lateral aspect of the lower leg along the sural dermatome throughout the heel lance procedure. Neonatal Pain, Agitation, and Sedation Scale (N-PASS) scores, heart rate, and oxygen saturations were collected at defined intervals surrounding heel lancing. Infants in the vibration group (n = 30) had significantly lower N-PASS scores and more stable heart rates during heel stick (P = .006, P = .037) and 2 minutes after heel lance (P = .002, P = .016) than those in the nonvibration group. There were no adverse behavioral or physiologic responses to applied vibration in the sample. Applied mechanical vibration is a safe and effective method for managing heel lance pain. This pilot study suggests that mechanical vibration warrants further exploration as a nonpharmacologic pain management tool among the neonatal population.

  18. The adverse effect of selective cyclooxygenase-2 inhibitor on random skin flap survival in rats.

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    Haiyong Ren

    Full Text Available BACKGROUND: Cyclooxygenase-2(COX-2 inhibitors provide desired analgesic effects after injury or surgery, but evidences suggested they also attenuate wound healing. The study is to investigate the effect of COX-2 inhibitor on random skin flap survival. METHODS: The McFarlane flap model was established in 40 rats and evaluated within two groups, each group gave the same volume of Parecoxib and saline injection for 7 days. The necrotic area of the flap was measured, the specimens of the flap were stained with haematoxylin-eosin(HE for histologic analysis. Immunohistochemical staining was performed to analyse the level of VEGF and COX-2 . RESULTS: 7 days after operation, the flap necrotic area ratio in study group (66.65 ± 2.81% was significantly enlarged than that of the control group(48.81 ± 2.33%(P <0.01. Histological analysis demonstrated angiogenesis with mean vessel density per mm(2 being lower in study group (15.4 ± 4.4 than in control group (27.2 ± 4.1 (P <0.05. To evaluate the expression of COX-2 and VEGF protein in the intermediate area II in the two groups by immunohistochemistry test .The expression of COX-2 in study group was (1022.45 ± 153.1, and in control group was (2638.05 ± 132.2 (P <0.01. The expression of VEGF in the study and control groups were (2779.45 ± 472.0 vs (4938.05 ± 123.6(P <0.01.In the COX-2 inhibitor group, the expressions of COX-2 and VEGF protein were remarkably down-regulated as compared with the control group. CONCLUSION: Selective COX-2 inhibitor had adverse effect on random skin flap survival. Suppression of neovascularization induced by low level of VEGF was supposed to be the biological mechanism.

  19. Early intervention in panic: randomized controlled trial and cost-effectiveness analysis

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    van Balkom Anton

    2008-11-01

    Full Text Available Abstract Background Panic disorder (PD is a common, severe and persistent mental disorder, associated with a high degree of distress and occupational and social disability. A substantial proportion of the population experiences subthreshold and mild PD and is at risk of developing a chronic PD. A promising intervention, aimed at preventing panic disorder onset and reducing panic symptoms, is the 'Don't Panic' course. It consists of eight sessions of two hours each. The purpose of this study is to evaluate the effectiveness of this early intervention – based on cognitive behavioural principles – on the reduction of panic disorder symptomatology. We predict that the experimental condition show superior clinical and economic outcomes relative to a waitlisted control group. Methods/design A pragmatic, pre-post, two-group, multi-site, randomized controlled trial of the intervention will be conducted with a naturalistic follow-up at six months in the intervention group. The participants are recruited from the general population and are randomized to the intervention or a waitlist control group. The intervention is offered by community mental health centres. Included are people over 18 years of age with subthreshold or mild panic disorder, defined as having symptoms of PD falling below the cut-off of 13 on the Panic Disorder Severity Scale-Self Report (PDSS-SR. Primary outcomes are panic disorder and panic symptoms. Secondary outcomes are symptoms of agoraphobia, anxiety, cognitive aspects of panic disorder, depressive symptoms, mastery, health-related quality of life, and cost-effectiveness. We will examine the following variables as potential mediators: cognitive aspects of panic disorder, symptoms of agoraphobia, anxiety and mastery. Potential moderating variables are: socio-demographic characteristics, panic disorder, agoraphobia, treatment credibility and mastery. Discussion This study was designed to evaluate the (cost effectiveness of an

  20. Effects of physical therapy on quality of life in osteoporosis patients - a randomized clinical trial

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    Schröder Guido

    2012-08-01

    Full Text Available Abstract Summary The aim of this prospective randomized single-center study was to investigate whether sling exercise therapy is superior to conventional exercises in osteoporosis patients. Background Patients with osteoporosis frequently experience fractures of the vertebral body, which may cause chronic back pain and other symptoms. These, in turn, may lead to immobilization, muscular atrophy, and restrictions in activities of daily living. The situation can be improved with specific medication and physiotherapy. We explored the effects of a variety of physical treatments on activities of daily living in patients with osteoporosis. Method Fifty patients were randomly allocated to two treatment groups. Group A received traditional physiotherapy (PT while group B underwent sling exercise therapy (ST. Both treatments were given twice a week for three months. The results of the treatment were registered on the quality of life questionnaire (Qualeffo-41 devised by the International Osteoporosis Foundation. After a further three months with no specific exercise treatment, we again tested all patients in order to draw conclusions about the long-term effects of both types of exercise. Results Forty-four patients (88% completed the study. Patients were assigned to small groups (a maximum of 5 patients in each group and thus received individual attention and motivation. Quality of life was improved in both groups; a significantly greater improvement was registered in patients who performed sling exercises (Global score Qualeffo: p = 0.002. Conclusion The test results confirm the known positive effects of physical therapy on the quality of life of osteoporosis patients, as well as the fact that sling exercises are a sound alternative treatment for this condition.

  1. Effect of Probiotics on Serum Bilirubin Level in Term Neonates with Jaundice; A Randomized Clinical Trial

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    Yadollah Zahed Pasha

    2017-10-01

    Full Text Available Background In recent years, tendency to use drugs has been increasing in the treatment of neonatal jaundice. Several drugs have been used since then, but the effect of probiotics on serum bilirubin level (SBL is not so clear. This study was conducted to evaluate the effect of probiotics on SBL and the duration of phototherapy in term neonates with hyperbilirubinemia. Materials and Methods: In this randomized clinical trial, we studied 150 term neonate with jaundice hospitalized for phototherapy in Amirkola Children’s Hospital, Babol- Iran, during October 5, 2016 till May 19, 2017. Eligible neonates were randomly divided into two; intervention (n=75, and control (n=75 groups. Both groups received standard conventional phototherapy, but the intervention group received 10 drop/day of probiotics (Pedilact Zisttakhmir. Co. Iran, until hospital discharge. The outcome variables were SBL and the duration of phototherapy. The data was analyzed by SPSS 22.0 and   the P 0.05.After 24, 48 and 72hours it decreased to 13.73±1.72, 10.92±1.87 and 10.25±1.32 in the intervention and 13.66±1.91, 11.01±1.69 and10.09 ±1.38 in the control groups, respectively but comparison of the amount of SBL reduction  between the two groups was not significant (P>0.05. The duration of phototherapy in the intervention group and the control group was 3.61±1.17 days and 3.72±1.18 days respectively (P>0.05. Conclusion Oral probiotics in neonates with jaundice has no significant effect on SBL and the duration of phototherapy. Further studies are needed to with longer time follow-up.

  2. Effects of acupuncture treatment on depression insomnia: a study protocol of a multicenter randomized controlled trial

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    Chen Yuan-Fang

    2013-01-01

    Full Text Available Abstract Background More than 70% of patients with depression who see their doctors experience insomnia. Insomnia treatment is a very important link for depression treatment. Furthermore, antidepression treatment is also important for depression insomnia. In acupuncture, LU-7 (Lie Que and KID-6 (Zhao Hai, which are two of the eight confluence points in meridian theory, are used as main points. An embedded needle technique is used, alternately, at two groups of points to consolidate the treatment effect. These two groups of points are BL-15 (Xin Shu with BL-23 (Shen Shu and BL-19 (Dan Shu with N-HN-54 (An Mian. The effectiveness of these optimized acupuncture formulas is well proven in the practice by our senior acupuncturists in Guangdong Provincial Hospital of TCM. This study has been designed to examine whether this set of optimized clinical formulas is able to increase the clinical efficacy of depression insomnia treatment. Methods/design In this randomized controlled multicenter trial, all the eligible participants are diagnosed with depression insomnia. All participants are randomly assigned to one of two groups in a ratio of 1:1 and receive either conventional acupuncture treatment or optimized acupuncture treatment. Patients are evaluated using the Pittsburgh Sleep Quality Index(PSQIand the Hamilton rating scale(HAMD for depression. The use of antidepression and hypnotics drugs is also considered. Results are obtained at the start of treatment, 1 and 2 months after treatment has begun, and at the end of treatment. The entire duration of the study will be approximately 36 months. Discussion A high quality of trial methodologies is utilized in the study, and the results may provide better evidence for the effectiveness of acupuncture as a treatment for depression insomnia. The optimized acupuncture formula has potential benefits in increasing the efficacy of treating depression insomnia. Trial registration The trial was registered in

  3. Effects of joint mobilization on chronic ankle instability: a randomized controlled trial.

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    Cruz-Díaz, David; Lomas Vega, Rafael; Osuna-Pérez, Maria Catalina; Hita-Contreras, Fidel; Martínez-Amat, Antonio

    2015-01-01

    To evaluate the effects of joint mobilization, in which movement is applied to the ankle's dorsiflexion range of motion, on dynamic postural control and on the self-reported instability of patients with chronic ankle instability (CAI). A double-blind, placebo-controlled, randomized trial with repeated measures and a follow-up period. Ninety patients with a history of recurrent ankle sprain, self-reported instability, and a limited dorsiflexion range of motion, were randomly assigned to either the intervention group (Joint Mobilizations, 3 weeks, two sessions per week) the placebo group (Sham Mobilizations, same duration as joint mobilization) or the control group, with a 6 months follow-up. Dorsiflexion Range of Motion (DFROM), Star Excursion Balance Test (SEBT) and CAI Tool (CAIT) were outcome measures. A separate 3 × 4 mixed model analysis of variance was performed to examine the effect of treatment conditions and time, and intention-to-treat (ITT) analysis was applied to evaluate the effect of the independent variable. The application of joint mobilization resulted in better scores of DFROM, CAIT, and SEBTs in the intervention group when compared with the placebo or the control groups (p mobilization techniques applied to subjects suffering from CAI were able to improve ankle DFROM, postural control, and self-reported instability. These results suggest that joint mobilization could be applied to patients with recurrent ankle sprain to help restore their functional stability. Implications for Rehabilitation Functional instability is a very common sequela in patients with CAI, resulting in reduced quality of living due to the limitations it imposes on daily life activities. The mobilization with movement technique presented by Mulligan, and based on the joint mobilization accompanied by active movement, appears as a valuable tool to be employed by physical therapists to restore ankle function after a recurrent ankle sprain history. ROM restriction

  4. How effective is bibliotherapy for very old adults with subthreshold depression? A randomized controlled trial.

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    Joling, Karlijn J; van Hout, Hein P J; van't Veer-Tazelaar, Petronella J; van der Horst, Henriette E; Cuijpers, Pim; van de Ven, Peter M; van Marwijk, Harm W J

    2011-03-01

    Depressive symptoms are common among elderly primary care patients, and because they encounter considerable barriers in seeking help and they often resist referral to specialized mental health facilities, it is important to look for easily accessible interventions within the primary care setting. Bibliotherapy, which has been found to be effective among younger populations, might be an attractive option. In this study, the authors investigated the effectiveness of bibliotherapy for depressive symptomatology in very old adults. Randomized controlled trial. After a 3-month period of "watchful waiting," the participants were randomly assigned to a bibliotherapy group or a usual care group. Thirty-three general practices in the north-western region of the Netherlands. One hundred seventy community-dwelling adults, aged 75 and older, with subthreshold depression. The bibliotherapy intervention consisted of an information leaflet and a self-help manual "Coping with Depression" adapted for the elderly. Outcome measures after 3 months were a) change in depressive symptoms according to the Center for Epidemiologic Studies Depression Scale (CES-D) and b) the proportion of participants who scored a significant improvement on the CES-D. One hundred forty-six (85.9%) of the 170 participants completed the baseline and follow-up measurements. The authors did not find any clinically relevant and statistically significant differences between the intervention group and the control group in the severity of the depressive symptoms. Bibliotherapy as a stand-alone intervention for the elderly (aged 75 years and older) did not reduce depressive symptoms more than usual care. This might indicate that bibliotherapy can only be effective for patients who are motivated and acknowledge their depression.

  5. Effect of a Prebiotic Formulation on Frailty Syndrome: A Randomized, Double-Blind Clinical Trial

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    Cristina Buigues

    2016-06-01

    Full Text Available Aging can result in major changes in the composition and metabolic activities of bacterial populations in the gastrointestinal system and result in impaired function of the immune system. We assessed the efficacy of prebiotic Darmocare Pre® (Bonusan Besloten Vennootschap (BV, Numansdorp, The Netherlands to evaluate whether the regular intake of this product can improve frailty criteria, functional status and response of the immune system in elderly people affected by the frailty syndrome. The study was a placebo-controlled, randomized, double blind design in sixty older participants aged 65 and over. The prebiotic product was composed of a mixture of inulin plus fructooligosaccharides and was compared with placebo (maltodextrin. Participants were randomized to a parallel group intervention of 13 weeks’ duration with a daily intake of Darmocare Pre® or placebo. Either prebiotic or placebo were administered after breakfast (between 9–10 a.m. dissolved in a glass of water carefully stirred just before drinking. The primary outcome was to study the effect on frailty syndrome. The secondary outcomes were effect on functional and cognitive beh