Sample records for ad patients methods

  1. Nurse Value-Added and Patient Outcomes in Acute Care

    PubMed Central

    Yakusheva, Olga; Lindrooth, Richard; Weiss, Marianne

    2014-01-01

    Objective The aims of the study were to (1) estimate the relative nurse effectiveness, or individual nurse value-added (NVA), to patients’ clinical condition change during hospitalization; (2) examine nurse characteristics contributing to NVA; and (3) estimate the contribution of value-added nursing care to patient outcomes. Data Sources/Study Setting Electronic data on 1,203 staff nurses matched with 7,318 adult medical–surgical patients discharged between July 1, 2011 and December 31, 2011 from an urban Magnet-designated, 854-bed teaching hospital. Study Design Retrospective observational longitudinal analysis using a covariate-adjustment value-added model with nurse fixed effects. Data Collection/Extraction Methods Data were extracted from the study hospital's electronic patient records and human resources databases. Principal Findings Nurse effects were jointly significant and explained 7.9 percent of variance in patient clinical condition change during hospitalization. NVA was positively associated with having a baccalaureate degree or higher (0.55, p = .04) and expertise level (0.66, p = .03). NVA contributed to patient outcomes of shorter length of stay and lower costs. Conclusions Nurses differ in their value-added to patient outcomes. The ability to measure individual nurse relative value-added opens the possibility for development of performance metrics, performance-based rankings, and merit-based salary schemes to improve patient outcomes and reduce costs. PMID:25256089

  2. A Robust Deep Model for Improved Classification of AD/MCI Patients

    PubMed Central

    Li, Feng; Tran, Loc; Thung, Kim-Han; Ji, Shuiwang; Shen, Dinggang; Li, Jiang

    2015-01-01

    Accurate classification of Alzheimer’s Disease (AD) and its prodromal stage, Mild Cognitive Impairment (MCI), plays a critical role in possibly preventing progression of memory impairment and improving quality of life for AD patients. Among many research tasks, it is of particular interest to identify noninvasive imaging biomarkers for AD diagnosis. In this paper, we present a robust deep learning system to identify different progression stages of AD patients based on MRI and PET scans. We utilized the dropout technique to improve classical deep learning by preventing its weight co-adaptation, which is a typical cause of over-fitting in deep learning. In addition, we incorporated stability selection, an adaptive learning factor, and a multi-task learning strategy into the deep learning framework. We applied the proposed method to the ADNI data set and conducted experiments for AD and MCI conversion diagnosis. Experimental results showed that the dropout technique is very effective in AD diagnosis, improving the classification accuracies by 5.9% on average as compared to the classical deep learning methods. PMID:25955998

  3. Patient-centered care as value-added service by compounding pharmacists.

    PubMed

    McPherson, Timothy B; Fontane, Patrick E; Day, Jonathan R

    2013-01-01

    The term "value-added" is widely used to describe business and professional services that complement a product or service or that differentiate it from competing products and services. The objective of this study was to determine compounding pharmacists' self-perceptions of the value-added services they provide. A web-based survey method was used. Respondents' perceptions of their most important value-added service frequently fell into one of two categories: (1) enhanced pharmacist contribution to developing and implementing patient therapeutic plans and (2) providing customized medications of high pharmaceutical quality. The results were consistent with a hybrid community clinical practice model for compounding pharmacists wherein personalization of the professional relationship is the value-added characteristic.

  4. Ad hoc vs. Non-ad hoc Percutaneous Coronary Intervention Strategies in Patients With Stable Coronary Artery Disease.

    PubMed

    Toyota, Toshiaki; Morimoto, Takeshi; Shiomi, Hiroki; Ando, Kenji; Ono, Koh; Shizuta, Satoshi; Kato, Takao; Saito, Naritatsu; Furukawa, Yutaka; Nakagawa, Yoshihisa; Horie, Minoru; Kimura, Takeshi

    2017-03-24

    Few studies have evaluated the prevalence and clinical outcomes of ad hoc percutaneous coronary intervention (PCI), performing diagnostic coronary angiography and PCI in the same session, in stable coronary artery disease (CAD) patients.Methods and Results:From the CREDO-Kyoto PCI/CABG registry cohort-2, 6,943 patients were analyzed as having stable CAD and undergoing first PCI. Ad hoc PCI and non-ad hoc PCI were performed in 1,722 (24.8%) and 5,221 (75.1%) patients, respectively. The cumulative 5-year incidence and adjusted risk for all-cause death were not significantly different between the 2 groups (15% vs. 15%, P=0.53; hazard ratio: 1.15, 95% confidence interval: 0.98-1.35, P=0.08). Ad hoc PCI relative to non-ad hoc PCI was associated with neutral risk for myocardial infarction, any coronary revascularization, and bleeding, but was associated with a trend towards lower risk for stroke (hazard ratio: 0.78, 95% confidence interval: 0.60-1.02, P=0.06). Ad hoc PCI in stable CAD patients was associated with at least comparable 5-year clinical outcomes as with non-ad hoc PCI. Considering patients' preference and the cost-saving, the ad hoc PCI strategy might be a safe and attractive option for patients with stable CAD, although the prevalence of ad hoc PCI was low in the current study population.

  5. Individual Patient Diagnosis of AD and FTD via High-Dimensional Pattern Classification of MRI

    PubMed Central

    Davatzikos, C.; Resnick, S. M.; Wu, X.; Parmpi, P.; Clark, C. M.

    2008-01-01

    The purpose of this study is to determine the diagnostic accuracy of MRI-based high-dimensional pattern classification in differentiating between patients with Alzheimer’s Disease (AD), Frontotemporal Dementia (FTD), and healthy controls, on an individual patient basis. MRI scans of 37 patients with AD and 37 age-matched cognitively normal elderly individuals, as well as 12 patients with FTD and 12 age-matched cognitively normal elderly individuals, were analyzed using voxel-based analysis and high-dimensional pattern classification. Diagnostic sensitivity and specificity of spatial patterns of regional brain atrophy found to be characteristic of AD and FTD were determined via cross-validation and via split-sample methods. Complex spatial patterns of relatively reduced brain volumes were identified, including temporal, orbitofrontal, parietal and cingulate regions, which were predominantly characteristic of either AD or FTD. These patterns provided 100% diagnostic accuracy, when used to separate AD or FTD from healthy controls. The ability to correctly distinguish AD from FTD averaged 84.3%. All estimates of diagnostic accuracy were determined via cross-validation. In conclusion, AD- and FTD-specific patterns of brain atrophy can be detected with high accuracy using high-dimensional pattern classification of MRI scans obtained in a typical clinical setting. PMID:18474436

  6. Color perception differentiates Alzheimer's Disease (AD) from Vascular Dementia (VaD) patients.

    PubMed

    Arnaoutoglou, N A; Arnaoutoglou, M; Nemtsas, P; Costa, V; Baloyannis, S J; Ebmeier, K P

    2017-08-01

    Alzheimer's Disease (AD) and Vascular Dementia (VaD) are the most common causes of dementia in older people. Both diseases appear to have similar clinical symptoms, such as deficits in attention and executive function, but specific cognitive domains are affected. Current cohort studies have shown a close relationship between αβ deposits and age-related macular degeneration (Johnson et al., 2002; Ratnayaka et al., 2015). Additionally, a close link between the thinning of the retinal nerve fiber (RNFL) and AD patients has been described, while it has been proposed that AD patients suffer from a non-specific type of color blindness (Pache et al., 2003). Our study included 103 individuals divided into three groups: A healthy control group (n = 35), AD (n = 32) according to DSM-IV-TR, NINCDS-ADRDA criteria, and VaD (n = 36) based on ΝΙΝDS-AIREN, as well as Magnetic Resonance Imaging (MRI) results. The severity of patient's cognitive impairment, was measured with the Mini-Mental State Examination (MMSE) and was classified according to the Reisberg global deterioration scale (GDS). Visual perception was examined using the Ishihara plates: "Ishihara Color Vision Test - 38 Plate." The three groups were not statistically different for demographic data (age, gender, and education). The Ishihara color blindness test has a sensitivity of 80.6% and a specificity of 87.5% to discriminate AD and VaD patients when an optimal (32.5) cut-off value of performance is used. Ishihara Color Vision Test - 38 Plate is a promising potential method as an easy and not time-consuming screening test for the differential diagnosis of dementia between AD and VaD.

  7. Partition functions with spin in AdS2 via quasinormal mode methods

    DOE PAGES

    Keeler, Cynthia; Lisbão, Pedro; Ng, Gim Seng

    2016-10-12

    We extend the results of [1], computing one loop partition functions for massive fields with spin half in AdS 2 using the quasinormal mode method proposed by Denef, Hartnoll, and Sachdev [2]. We find the finite representations of SO(2,1) for spin zero and spin half, consisting of a highest weight state |hi and descendants with non-unitary values of h. These finite representations capture the poles and zeroes of the one loop determinants. Together with the asymptotic behavior of the partition functions (which can be easily computed using a large mass heat kernel expansion), these are sufficient to determine the fullmore » answer for the one loop determinants. We also discuss extensions to higher dimensional AdS 2n and higher spins.« less

  8. Advanced Doubling Adding Method for Radiative Transfer in Planetary Atmospheres

    NASA Astrophysics Data System (ADS)

    Liu, Quanhua; Weng, Fuzhong

    2006-12-01

    The doubling adding method (DA) is one of the most accurate tools for detailed multiple-scattering calculations. The principle of the method goes back to the nineteenth century in a problem dealing with reflection and transmission by glass plates. Since then the doubling adding method has been widely used as a reference tool for other radiative transfer models. The method has never been used in operational applications owing to tremendous demand on computational resources from the model. This study derives an analytical expression replacing the most complicated thermal source terms in the doubling adding method. The new development is called the advanced doubling adding (ADA) method. Thanks also to the efficiency of matrix and vector manipulations in FORTRAN 90/95, the advanced doubling adding method is about 60 times faster than the doubling adding method. The radiance (i.e., forward) computation code of ADA is easily translated into tangent linear and adjoint codes for radiance gradient calculations. The simplicity in forward and Jacobian computation codes is very useful for operational applications and for the consistency between the forward and adjoint calculations in satellite data assimilation.

  9. Immunostimulatory AdCD40L gene therapy combined with low-dose cyclophosphamide in metastatic melanoma patients

    PubMed Central

    Loskog, Angelica; Maleka, Aglaia; Mangsbo, Sara; Svensson, Emma; Lundberg, Christina; Nilsson, Anders; Krause, Johan; Agnarsdóttir, Margrét; Sundin, Anders; Ahlström, Håkan; Tötterman, Thomas H; Ullenhag, Gustav

    2016-01-01

    Background: Current approaches for treating metastatic malignant melanoma (MM) are not effective enough and are associated with serious adverse events. Due to its immunogenicity, melanoma is an attractive target for immunostimulating therapy. In this phase I/IIa study, local AdCD40L immunostimulatory gene therapy was evaluated in patients with MM. Methods: AdCD40L is an adenovirus carrying the gene for CD40 ligand. Patients that failed standard treatments were enrolled. Six patients received four weekly intratumoral AdCD40L injections. Next, nine patients received low-dose cyclophosphamide conditioning before the first and fourth AdCD40L injection. The blood samples were collected at multiple time points for chemistry, haematology and immunology evaluations. Radiology was performed at enrolment and repeated twice after the treatment. Results: AdCD40L was safe with mild transient reactions. No objective responses were recorded by MRI, however, local and distant responses were seen on FDG-PET. The overall survival at 6 months was significantly better when cyclophosphamide was added to AdCD40L. The patients with the best survival developed the highest levels of activated T cells and experienced a pronounced decrease of intratumoral IL8. Conclusions: AdCD40L therapy for MM was well tolerated. Local and distant responses along with better survival in the low-dose cyclophosphamide group are encouraging. PMID:27031851

  10. PS1-20: Understanding Patient Barriers and Preferences to Completing Advance Directives (AD) in the Primary Care Setting

    PubMed Central

    Jones, J.B.; Tomcavage, Janet; Fisher, Dorothy; Van Loan, Ryan; Lerch, Virginia; Graf, Thomas

    2014-01-01

    Background/Aims Advance Care Planning (ACP) is a complex process that allows individuals to contemplate and document end of life decisions using tools such as an Advance Directive (AD). The proportion of patients who have an AD on file remains low both nationally and at Geisinger. To date, little research has focused on healthy populations’ attitudes towards ACP and AD completion. We describe the design and implementation of a web-based application to collect patients’ preferences for and barriers to AD completion in a large, non-diseased primary care population. Methods We developed a simple web application and questionnaire (denoted “eACP”) designed to educate patients about completing an AD. The eACP application was automatically presented on a touchscreen computer to all patients aged 50–64 who were seen in one of 5 Geisinger Clinic locations for a routine appointment. The questionnaire introduced ACP as a part of good healthcare and asked patients if they were interested in learning more. Patients who chose not to learn more indicated why they declined. Patients who elected to learn more selected topics of AD completion for which they would like more information and indicated how they wished to review the information. Results A total of 2169 patients completed the questionnaire using the eACP application in 5 practice sites between 07/31/13 and 10/30/13. Nearly 40% (852/2169) of patients were interested in learning more while 49.8% (1080/2169) were not. The primary reasons for declining to learn more included lack of time, a preference for leaving the choice to others, or prior AD completion. Among the patients who elected to learn more, the most common topics of interest were related to the process of completing an AD (e.g., what goes into an AD and how/when to complete it). Patients had a strong preference for printed materials (70%) versus using a website (30%) or talking to a healthcare professional (<10%). Conclusions Our findings suggest that

  11. Elevated serum levels of soluble CD30 in patients with atopic dermatitis (AD).

    PubMed

    Bengtsson, A; Holm, L; Bäck, O; Fransson, J; Scheynius, A

    1997-09-01

    The immunopathology of AD is still unclear, but evidence for an immune response polarized towards Th2 activity has been provided. The CD30 molecule belongs to the tumour necrosis factor (TNF) receptor family and is expressed on activated T cells with a sustained expression in Th2 cells. This molecule also exists in a soluble form (sCD30). Elevated serum levels of sCD30 have been found in patients with Hodgkin's disease, chronic hepatitis B infection and HIV infection. Studies were undertaken to compare the serum levels of sCD30 in patients with AD (n=49) and healthy non-atopic controls (n=94). The presence of sCD30 was analysed with ELISA. A significantly higher concentration of sCD30 was noted in AD patients, median sCD30 level 29 U/ml (range 1-708 U/ml), compared with healthy non-atopic controls (P<0.001), where the median level was 11 U/ml with a range of 1-1042 U/ml. No correlation was found between sCD30 levels and total serum IgE, or between the AD patients' SCORAD values and concentration of sCD30. sCD30 levels were also analysed in 20 AD patients, which during ketoconazole treatment had improved their clinical scores and reduced their serum IgE and eosinophil cationic protein levels. However, no significant decrease in sCD30 levels was noted after treatment. The results show that patients with AD have elevated levels of sCD30, but without correlation to total serum IgE or disease activity.

  12. The Reliability, Impact, and Cost-Effectiveness of Value-Added Teacher Assessment Methods

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2012-01-01

    This article reviews evidence regarding the intertemporal reliability of teacher rankings based on value-added methods. Value-added methods exhibit low reliability, yet are broadly supported by prominent educational researchers and are increasingly being used to evaluate and fire teachers. The article then presents a cost-effectiveness analysis…

  13. Value-added care: a paradigm shift in patient care delivery.

    PubMed

    Upenieks, Valda V; Akhavan, Jaleh; Kotlerman, Jenny

    2008-01-01

    Spiraling costs in health care have placed hospitals in a constant state of transition. As a result, nursing practice is now influenced by numerous factors and has remained in a continuous state of flux. Multiple changes within the last 2 decades in nurse/patient ratio and blend of front-line nurses are examples of this transition. To reframe the nursing practice into an economic equation that captures the cost, quality, and service, a paradigm shift in thinking is needed in order to assess work redesign. Nursing productivity must be evaluated in terms of value-added care, a vision that goes beyond direct care activities and includes team collaboration, physician rounding, increased RN-to-aide communication, and patient centeredness; all of which are crucial to the nurse's role and the patient's well-being. The science of appropriating staffing depends on assessment and implementation of systematic changes best illustrated through a "systems theory" framework. A throughput transformation is required to create process changes with input elements (number of front-line nurses) in order to increase time spent in value-added care and to decrease waste activities with an improvement in efficiency, quality, and service. The purpose of this pilot study was two-fold: (a) to gain an understanding of how much time RNs spent in value-added care, and (b) whether increasing the combined level of RNs and unlicensed assistive personnel increased the amount of time spent in value-added care compared to time spent in necessary tasks and waste.

  14. Meta-Analysis of a Continuous Outcome Combining Individual Patient Data and Aggregate Data: A Method Based on Simulated Individual Patient Data

    ERIC Educational Resources Information Center

    Yamaguchi, Yusuke; Sakamoto, Wataru; Goto, Masashi; Staessen, Jan A.; Wang, Jiguang; Gueyffier, Francois; Riley, Richard D.

    2014-01-01

    When some trials provide individual patient data (IPD) and the others provide only aggregate data (AD), meta-analysis methods for combining IPD and AD are required. We propose a method that reconstructs the missing IPD for AD trials by a Bayesian sampling procedure and then applies an IPD meta-analysis model to the mixture of simulated IPD and…

  15. Reflections on the added value of using mixed methods in the SCAPE study.

    PubMed

    Murphy, Kathy; Casey, Dympna; Devane, Declan; Meskell, Pauline; Higgins, Agnes; Elliot, Naomi; Lalor, Joan; Begley, Cecily

    2014-03-01

    To reflect on the added value that a mixed method design gave in a large national evaluation study of specialist and advanced practice (SCAPE), and to propose a reporting guide that could help make explicit the added value of mixed methods in other studies. Recently, researchers have focused on how to carry out mixed methods research (MMR) rigorously. The value-added claims for MMR include the capacity to exploit the strengths and compensate for weakness inherent in single designs, generate comprehensive description of phenomena, produce more convincing results for funders or policy-makers and build methodological expertise. Data illustrating value added claims were drawn from the SCAPE study. Studies about the purpose of mixed methods were identified from a search of literature. The authors explain why and how they undertook components of the study, and propose a guideline to facilitate such studies. If MMR is to become the third methodological paradigm, then articulation of what extra benefit MMR adds to a study is essential. The authors conclude that MMR has added value and found the guideline useful as a way of making value claims explicit. The clear articulation of the procedural aspects of mixed-methods research, and identification of a guideline to facilitate such research, will enable researchers to learn more effectively from each other.

  16. Secure ADS-B authentication system and method

    NASA Technical Reports Server (NTRS)

    Viggiano, Marc J (Inventor); Valovage, Edward M (Inventor); Samuelson, Kenneth B (Inventor); Hall, Dana L (Inventor)

    2010-01-01

    A secure system for authenticating the identity of ADS-B systems, including: an authenticator, including a unique id generator and a transmitter transmitting the unique id to one or more ADS-B transmitters; one or more ADS-B transmitters, including a receiver receiving the unique id, one or more secure processing stages merging the unique id with the ADS-B transmitter's identification, data and secret key and generating a secure code identification and a transmitter transmitting a response containing the secure code and ADSB transmitter's data to the authenticator; the authenticator including means for independently determining each ADS-B transmitter's secret key, a receiver receiving each ADS-B transmitter's response, one or more secure processing stages merging the unique id, ADS-B transmitter's identification and data and generating a secure code, and comparison processing comparing the authenticator-generated secure code and the ADS-B transmitter-generated secure code and providing an authentication signal based on the comparison result.

  17. A small effect of adding antiviral agents in treating patients with severe Bell palsy.

    PubMed

    van der Veen, Erwin L; Rovers, Maroeska M; de Ru, J Alexander; van der Heijden, Geert J

    2012-03-01

    In this evidence-based case report, the authors studied the following clinical question: What is the effect of adding antiviral agents to corticosteroids in the treatment of patients with severe or complete Bell palsy? The search yielded 250 original research articles. The 6 randomized trials of these that could be used all reported low-quality data for answering the clinical question; apart from apparent flaws, they did not primarily include patients with severe or complete Bell palsy. Complete functional facial nerve recovery was seen in 75% of the patients receiving prednisolone only and in 83% with additional antiviral treatment. The pooled risk difference of 7% (95% confidence interval, -1% to 15%) results in a number needed to treat of 14 (ie, slightly favors adding an antiviral agent). The authors conclude that although a strong recommendation for adding antiviral agents to corticosteroids to further improve the recovery of patients with severe Bell palsy is precluded by the lack of robust evidence, it should be discussed with the patient.

  18. Use and cost of outpatient visits of AD patients: CERAD XXII.

    PubMed

    Fillenbaum, G; Heyman, A; Peterson, B L; Pieper, C F; Weiman, A L

    2001-06-26

    To determine the probability, frequency, and cost of outpatient visits of patients with AD in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) as a function of stage of dementia and institutional status. Clinical information on 388 patients with AD enrolled in CERAD who had no serious comorbidities at baseline and for whom the stage of disease and institutional status were known, were linked to Health Care Financing Administration Physician/Supplier and Outpatient Standard Analytic (institutional outpatient) files for 1991 through 1995. None was registered in a health maintenance organization. Repeated measures regression models were used to examine the relationship of stage of disease to probability, frequency, and cost of outpatient visits for institutionalized and noninstitutionalized patients, with demographic characteristics and calendar time controlled. The annual proportion of patients with AD and a Medicare-reimbursed outpatient visit ranged from 81% to 95% and was not related to stage of dementia or institutional status. Among those with at least one outpatient visit, however, those living at home had fewer visits than did those in institutions, but their number of visits increased as dementia worsened. Those in institutions had a larger number of outpatient visits, but these did not vary significantly by stage of dementia. Neither location of residence nor stage affected the cost of outpatient visits. Among those with an outpatient visit, the frequency of visits and their relationship to stage of disease depends on institutional status.

  19. Local irradiation does not enhance the effect of immunostimulatory AdCD40L gene therapy combined with low dose cyclophosphamide in melanoma patients

    PubMed Central

    Irenaeus, Sandra; Schiza, Aglaia; Mangsbo, Sara M.; Wenthe, Jessica; Eriksson, Emma; Krause, Johan; Sundin, Anders; Ahlström, Håkan; Tötterman, Thomas H.; Loskog, Angelica; Ullenhag, Gustav J.

    2017-01-01

    Background AdCD40L is an immunostimulatory gene therapy under evaluation for advanced melanoma, including ocular melanoma. Herein, we present the final data of a Phase I/IIa trial using AdCD40L alone or in combination with low dose cyclophosphamide +/- radiation therapy. Methods AdCD40L is a replication-deficient adenovirus carrying the gene for CD40 ligand (CD40L). Twenty-four patients with advanced melanoma were enrolled and treated with AdCD40L monotherapy, or combined with cyclophosphamide +/- single fraction radiotherapy. The patients were monitored for 10 weeks using immunological and radiological evaluations and thereafter for survival. Results AdCD40L treatment was safe and well tolerated both alone and in combination with cyclophosphamide as well as local radiotherapy. Four out of twenty-four patients had >1 year survival. Addition of cyclophosphamide was beneficial but adding radiotherapy did not further extend survival. High initial plasma levels of IL12 and MIP3b correlated to overall survival, whereas IL8 responses post-treatment correlated negatively with survival. Interestingly, antibody reactions to the virus correlated negatively with post IL6 and pre IL1b levels in blood. Conclusions AdCD40L was safely administered to patients and effect was improved by cyclophosphamide but not by radiotherapy. Immune activation profile at baseline may predict responders better than shortly after treatment. PMID:29108250

  20. [Donepezil in patients with Alzheimer's disease--a critical appraisal of the AD2000 study].

    PubMed

    Kaiser, Thomas; Florack, Christiane; Franz, Heinrich; Sawicki, Peter T

    2005-03-15

    The AD2000 study was a randomized placebo-controlled trial, the effects of donepezil, a cholinesterase inhibitor, in patients with Alzheimer's disease. It was the first long-term RCT not sponsored by the pharmaceutical industry. The study did not show any significant effect on patient-relevant outcomes. However, donepezil had a significant effect on cognitive scores. More patients taking donepezil stopped treatment due to adverse events, even when taking only 5 mg once daily. There are major concerns regarding the conduction of the AD2000 study as well as the presentation of the results. Much less patients than previously planned have been recruited, resulting in a low statistical power to detect a significant difference between both treatments. In addition, no true intention-to-treat analysis based on the first randomization is presented. The validity of the AD2000 trial has to be questioned. However, there is still insufficient evidence to support the claim that cholinesterase inhibitors have beneficial effects on patient-relevant outcomes in patients with Alzheimer's disease. The change of cognitive performance as measured by different scales does not necessarily correspond to substantial changes in patient-relevant outcomes. In conclusion, the widespread use of cholinesterase inhibitors in patients with Alzheimer's disease is not supported by current evidence. Long-term-randomized controlled trials focusing on patient-relevant outcomes instead of cognitive scores are urgently needed.

  1. Aerodynamic optimization of wind turbine rotor using CFD/AD method

    NASA Astrophysics Data System (ADS)

    Cao, Jiufa; Zhu, Weijun; Wang, Tongguang; Ke, Shitang

    2018-05-01

    The current work describes a novel technique for wind turbine rotor optimization. The aerodynamic design and optimization of wind turbine rotor can be achieved with different methods, such as the semi-empirical engineering methods and more accurate computational fluid dynamic (CFD) method. The CFD method often provides more detailed aerodynamics features during the design process. However, high computational cost limits the application, especially for rotor optimization purpose. In this paper, a CFD-based actuator disc (AD) model is used to represent turbulent flow over a wind turbine rotor. The rotor is modeled as a permeable disc of equivalent area where the forces from the blades are distributed on the circular disc. The AD model is coupled with a Reynolds Averaged Navier-Stokes (RANS) solver such that the thrust and power are simulated. The design variables are the shape parameters comprising the chord, the twist and the relative thickness of the wind turbine rotor blade. The comparative aerodynamic performance is analyzed between the original and optimized reference wind turbine rotor. The results showed that the optimization framework can be effectively and accurately utilized in enhancing the aerodynamic performance of the wind turbine rotor.

  2. Reduced cGMP levels in CSF of AD patients correlate with severity of dementia and current depression.

    PubMed

    Hesse, Raphael; Lausser, Ludwig; Gummert, Pauline; Schmid, Florian; Wahler, Anke; Schnack, Cathrin; Kroker, Katja S; Otto, Markus; Tumani, Hayrettin; Kestler, Hans A; Rosenbrock, Holger; von Arnim, Christine A F

    2017-03-09

    Alzheimer's disease (AD) is a neurodegenerative disorder, primarily affecting memory. That disorder is thought to be a consequence of neuronal network disturbances and synapse loss. Decline in cognitive function is associated with a high burden of neuropsychiatric symptoms (NPSs) such as depression. The cyclic nucleotides cyclic adenosine-3',5'-monophosphate (cAMP) and cyclic guanosine-3',5'-monophosphate (cGMP) are essential second messengers that play a crucial role in memory processing as well as synaptic plasticity and are potential therapeutic targets. Biomarkers that are able to monitor potential treatment effects and that reflect the underlying pathology are of crucial interest. In this study, we measured cGMP and cAMP in cerebrospinal fluid (CSF) in a cohort of 133 subjects including 68 AD patients and 65 control subjects. To address the association with disease progression we correlated cognitive status with cyclic nucleotide levels. Because a high burden of NPSs is associated with decrease in cognitive function, we performed an exhaustive evaluation of AD-relevant marker combinations in a depressive subgroup. We show that cGMP, but not cAMP, levels in the CSF of AD patients are significantly reduced compared with the control group. Reduced cGMP levels in AD patients correlate with memory impairment based on Mini-Mental State Examination score (r = 0.17, p = 0.048) and tau as a marker of neurodegeneration (r = -0.28, p = 0.001). Moreover, we were able to show that AD patients suffering from current depression show reduced cGMP levels (p = 0.07) and exhibit a higher degree of cognitive impairment than non-depressed AD patients. These results provide further evidence for an involvement of cGMP in AD pathogenesis and accompanying co-morbidities, and may contribute to elucidating synaptic plasticity alterations during disease progression.

  3. Methods for Accounting for Co-Teaching in Value-Added Models. Working Paper

    ERIC Educational Resources Information Center

    Hock, Heinrich; Isenberg, Eric

    2012-01-01

    Isolating the effect of a given teacher on student achievement (value-added modeling) is complicated when the student is taught the same subject by more than one teacher. We consider three methods, which we call the Partial Credit Method, Teacher Team Method, and Full Roster Method, for estimating teacher effects in the presence of co-teaching.…

  4. Cost effectiveness of budesonide/formoterol added to tiotropium bromide versus placebo added to tiotropium bromide in patients with chronic obstructive pulmonary disease: Australian, Canadian and Swedish healthcare perspectives.

    PubMed

    Mittmann, Nicole; Hernandez, Paul; Mellström, Carl; Brannman, Lance; Welte, Tobias

    2011-05-01

    Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease associated with increasing morbidity and mortality and an economic burden that stretches beyond the patient to healthcare systems. Avoiding exacerbations and subsequent hospitalizations is an important clinical aim and can avoid significant costs associated with the disease. International guidelines recommend the addition of an inhaled corticosteroid (ICS) to a long-acting β₂-adrenoceptor agonist (LABA) for patients with severe to very severe COPD and a history of exacerbations. To evaluate retrospectively over a 3-month period, the cost effectiveness of budesonide/formoterol added to tiotropium bromide (tiotropium) compared with placebo added to tiotropium in COPD patients eligible for ICS/LABA combination therapy, based on the CLIMB study (NCT00496470). A cost-effectiveness analysis of data from the 12-week, randomized, double-blind CLIMB study of COPD patients (n = 659; eligible for ICS/LABA; aged ≥ 40 years) comparing budesonide/formoterol (Symbicort® Turbuhaler® 320/9 μg twice daily) added to tiotropium (18 μg daily) or placebo added to tiotropium was conducted. A severe exacerbation was defined as a requirement for systemic glucocorticosteroids and/or ED visit and/or hospitalization. The effectiveness variable used for this analysis was the number of severe exacerbations avoided. Direct costs (medications, hospitalizations, ED and GP visits) were calculated by applying year 2009 unit costs from Australia ($A), Canada ($Can) and Sweden (Swedish krona [SEK]) to the study's pooled resource use. One-way sensitivity analyses for each country's mean incremental cost-effectiveness ratio and sensitivity to overall exacerbations were conducted. Bootstrapping was performed to estimate the variation around resource use, exacerbations and each country's mean incremental cost-effectiveness ratio. The mean number of severe exacerbations per patient 3-month period was 0

  5. Added diagnostic value of magnetoencephalography (MEG) in patients suspected for epilepsy, where previous, extensive EEG workup was unrevealing.

    PubMed

    Duez, Lene; Beniczky, Sándor; Tankisi, Hatice; Hansen, Peter Orm; Sidenius, Per; Sabers, Anne; Fuglsang-Frederiksen, Anders

    2016-10-01

    To elucidate the possible additional diagnostic yield of MEG in the workup of patients with suspected epilepsy, where repeated EEGs, including sleep-recordings failed to identify abnormalities. Fifty-two consecutive patients with clinical suspicion of epilepsy and at least three normal EEGs, including sleep-EEG, were prospectively analyzed. The reference standard was inferred from the diagnosis obtained from the medical charts, after at least one-year follow-up. MEG (306-channel, whole-head) and simultaneous EEG (MEG-EEG) was recorded for one hour. The added sensitivity of MEG was calculated from the cases where abnormalities were seen in MEG but not EEG. Twenty-two patients had the diagnosis epilepsy according to the reference standard. MEG-EEG detected abnormalities, and supported the diagnosis in nine of the 22 patients with the diagnosis epilepsy at one-year follow-up. Sensitivity of MEG-EEG was 41%. The added sensitivity of MEG was 18%. MEG-EEG was normal in 28 of the 30 patients categorized as 'not epilepsy' at one year follow-up, yielding a specificity of 93%. MEG provides additional diagnostic information in patients suspected for epilepsy, where repeated EEG recordings fail to demonstrate abnormality. MEG should be included in the diagnostic workup of patients where the conventional, widely available methods are unrevealing. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Innovative neurophysiological methods in itch research: long-latency evoked potentials after electrical and thermal stimulation in patients with atopic dermatitis.

    PubMed

    Yudina, Marina M; Toropina, Galina G; Lvov, Andrey; Gieler, Uwe

    2011-10-01

    The aim of this study was to examine the findings of innovative neurophysiological methods of itch research. Short-latency and pain-related somatosensory-evoked potentials after electrical stimulation, as well as long-latency evoked potentials after thermal stimulation were studied in 38 patients with atopic dermatitis (AD) and 26 healthy volunteers. Quantitative Sensory Testing of thermal perception was performed in 22 patients with AD from the main AD group and in 15 healthy volunteers. Brain hyperactivity to electrical stimuli, delayed thermal-evoked potentials and elevated thermal thresholds were revealed in patients with AD compared with healthy controls. The data indicate small nerve fibre dysfunction in patients with AD, which may contribute to the pathogenesis of AD and chronic itch. The study demonstrates objective approaches to assess the function of small nerve fibres in patients with chronic itch.

  7. Tweaking one-loop determinants in AdS3

    NASA Astrophysics Data System (ADS)

    Castro, Alejandra; Keeler, Cynthia; Szepietowski, Phillip

    2017-10-01

    We revisit the subject of one-loop determinants in AdS3 gravity via the quasi-normal mode method. Our goal is to evaluate a one-loop determinant with chiral boundary conditions for the metric field; chirality is achieved by imposing Dirichlet boundary conditions on certain components while others satisfy Neumann. Along the way, we give a generalization of the quasinormal mode method for stationary (non-static) thermal backgrounds, and propose a treatment for Neumann boundary conditions in this framework. We evaluate the graviton one-loop determinant on the Euclidean BTZ background with parity-violating boundary conditions (CSS), and find excellent agreement with the dual warped CFT. We also discuss a more general falloff in AdS3 that is related to two dimensional quantum gravity in lightcone gauge. The behavior of the ghost fields under both sets of boundary conditions is novel and we discuss potential interpretations.

  8. Validity of using ad hoc methods to analyze secondary traits in case-control association studies.

    PubMed

    Yung, Godwin; Lin, Xihong

    2016-12-01

    Case-control association studies often collect from their subjects information on secondary phenotypes. Reusing the data and studying the association between genes and secondary phenotypes provide an attractive and cost-effective approach that can lead to discovery of new genetic associations. A number of approaches have been proposed, including simple and computationally efficient ad hoc methods that ignore ascertainment or stratify on case-control status. Justification for these approaches relies on the assumption of no covariates and the correct specification of the primary disease model as a logistic model. Both might not be true in practice, for example, in the presence of population stratification or the primary disease model following a probit model. In this paper, we investigate the validity of ad hoc methods in the presence of covariates and possible disease model misspecification. We show that in taking an ad hoc approach, it may be desirable to include covariates that affect the primary disease in the secondary phenotype model, even though these covariates are not necessarily associated with the secondary phenotype. We also show that when the disease is rare, ad hoc methods can lead to severely biased estimation and inference if the true disease model follows a probit model instead of a logistic model. Our results are justified theoretically and via simulations. Applied to real data analysis of genetic associations with cigarette smoking, ad hoc methods collectively identified as highly significant (P<10-5) single nucleotide polymorphisms from over 10 genes, genes that were identified in previous studies of smoking cessation. © 2016 WILEY PERIODICALS, INC.

  9. Theory and methods for measuring the effective multiplication constant in ADS

    NASA Astrophysics Data System (ADS)

    Rugama Saez, Yolanda

    2001-10-01

    In the thesis an absolute measurements technique for the subcriticality determination is presented. The ADS is a hybrid system where a subcritical system is fed by a proton accelerator. There are different proposals to define an ADS, one is to use plutonium and minor actinides from power plants waste as fuel to be transmuted into non radioactive isotopes (transmuter/burner, ATW). Another proposal is to use a Th232-U233 cycle (Energy Amplifier), being that thorium is an interesting and abundant fertile isotope. The development of accelerator driven systems (ADS) requires the development of methods to monitor and control the subcriticality of this kind of system without interfering with its normal operation mode. With this finality, we have applied noise analysis techniques that allow us to characterise the system when it is operating. The method presented in this thesis is based on the stochastic neutron and photon transport theory that can be implemented by presently available neutron/photon transport codes. In this work, first we analyse the stochastic transport theory which has been applied to define a parameter to determine the subcritical reactivity monitoring measurements. Finally we give the main limitations and recommendations for these subcritical monitoring methodology. As a result of the theoretical methodology, done in the first part of this thesis, a monitoring measurement technique has been developed and verified using two coupled Monte Carlo programs. The first one, LAHET, simulates the spallation collisions and the high energy transport and the other, MCNP-DSP, is used to estimate the counting statistics from a neutron/photon ray counter in a fissile system, as well as the transport for neutron with energies less than 20 MeV. From the coupling of both codes we developed the LAHET/MCNP-DSP code which, has the capability to simulate the total process in the ADS from the proton interaction to the signal detector processing. In these simulations, we

  10. Direct-to-consumer print ads for drugs: do they undermine the physician-patient relationship?

    PubMed

    Cline, Rebecca J Welch; Young, Henry J

    2005-12-01

    Critics of direct-to-consumer print advertising for drugs (DTCA) contend it alters physician-patient communication by promoting greater patient participation and control. We assessed the nature of messages in print DTCA to identify potential guidelines they may provide to consumers for communicating with physicians. We analyzed all unique advertisements (ie, excluded ads repeated across issues or magazines) in 18 popular magazines (684 issues) from January 1998 to December 1999 (n=225). We identified every statement that referred to physicians, and within that set, statements that focused on physician-patient communication. Each communication-related statement was coded as a message to consumers about communication in terms of cues suggesting who should initiate communication, who should be in relational control, and appropriate interaction topic(s). More than three-quarters (83.8%) of the advertisements' statements referring to physicians focused on physician-patient communication (M=2.6 per ad; SD=1.8). Most (76.1%) of these messages explicitly or implicitly promoted consumers initiating communication, but cast the physician in relational control (54.5%). The most frequently suggested interaction topics were clinical judgments of the product's appropriateness (41.8%) and information about the product (32.1%). Typical direct-to-consumer print ads contain multiple messages about communicating with physicians. The patterned nature of these messages appears to promote social norms for consumers' communication behavior by repeatedly implying the appropriateness of consumers initiating interaction, physicians maintaining relational control, and avoiding negative consequences of advertised drugs as conversational topics.

  11. Long-term follow-up of the AdVance®/AdVanceXP® sling. What are the surgeons' impressions? What are the patients'?

    PubMed

    Romero Hoyuela, A; Reina Alcaina, L; Izquierdo Morejon, E; Rosino Sanchez, A; Carrillo George, C; Rivero Guerra, A; Barcelo Bayonas, I; Pardo Martinez, A; Muñoz Guillermo, V; Pietricica, B; Fernandez Aparicio, T; Hita Villaplana, G; Miñana Lopez, B

    2018-04-01

    To analyse the safety, efficacy and quality of life of patients with male stress urinary incontinence after radical prostatectomy treated with the AdVance ® and AdvanceXP ® slings. The study included 92 patients with stress urinary incontinence after radical prostatectomy treated with the AdVance ® and AdVanceXP ® sling between May 2008 and December 2015. A perineal repositioning test was performed in all cases with sphincter coaptation of≥1.5cm. Mild stress urinary incontinence was defined as the use of 1-2 absorbers/24h; moderate was defined as 3-5 absorbers/24h; and severe was defined as more than 5 absorbers/24h. Healing was defined as the total absence of using pads; improvement was defined as a reduction>50% in the number of pads; and failure was defined as a reduction<50, no improvement or worsened incontinence. Check-ups were conducted at 3, 12 and 36 months after the surgery. We employed the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) for the quality of life index. The complications are listed according to the Clavien-Dindo classification. The degree of preoperative incontinence was mild in 23.9%, moderate in 67.4% and severe in 8.7% of the patients. The mean use of preoperative pads was 3.1 (range 1-6, 95% CI). The mean preoperative ICIQ-SF score was 16.5 (15-20). Sphincter coaptation≥1.5cm using the perineal repositioning test was present in 87 patients (94.6%). The mean follow-up from insertion of the sling was 42.1 months. Some 89.1% of the patients were healed at 3 months, 70.7% were healed at 12 months, and 70.4% were healed at 36 months. The ICIQ-SF score at 3, 12 and 36 months showed significant improvement (P<.001) compared with the preoperative score. The Advance ® and AdvanceXP ® system are effective over time in terms of urinary continence and patient satisfaction. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Reflectance of a vegetation canopy using the Adding method

    NASA Technical Reports Server (NTRS)

    Cooper, K.; Smith, J. A.; Pitts, D.

    1982-01-01

    A modified vegetation reflectance model based on the Adding method is presented as a means to measure the interaction of shortwave radiation within a vegetation canopy. The canopy is conceptualized with reflecting and transmitting leaf facets, with the leaf orientations described by a leaf slope distribution, thereby yielding scattering matrices for canopy layers. The model predictions, when compared with ground-truth measurements, show good agreement except at visible wavelengths, where overestimations are observed. Conditions under which the model satisfies the reciprocity theorem are defined. Extension of the model by including azimuth is indicated.

  13. Multi Blending Technology (MBT): mineral processing method for increasing added value of marginal reserve

    NASA Astrophysics Data System (ADS)

    Agustinus, E. T. S.

    2018-02-01

    Indonesia's position on the path of ring of fire makes it rich in mineral resources. Nevertheless, in the past, the exploitation of Indonesian mineral resources was uncontrolled resulting in environmental degradation and marginal reserves. Exploitation of excessive mineral resources is very detrimental to the state. Reflecting on the occasion, the management and utilization of Indonesia's mineral resources need to be good in mining practice. The problem is how to utilize the mineral reserve resources effectively and efficiently. Utilization of marginal reserves requires new technologies and processing methods because the old processing methods are inadequate. This paper gives a result of Multi Blending Technology (MBT) Method. The underlying concept is not to do the extraction or refinement but processing through the formulation of raw materials by adding an additive and produce a new material called functional materials. Application of this method becomes important to be summarized into a scientific paper in a book form, so that the information can spread across multiple print media and become focused on and optimized. This book is expected to be used as a reference for stakeholder providing added value to environmentally marginal reserves in Indonesia. The conclusions are that Multi Blending Technology (MBT) Method can be used as a strategy to increase added values effectively and efficiently to marginal reserve minerals and that Multi Blending Technology (MBT) method has been applied to forsterite, Atapulgite Synthesis, Zeoceramic, GEM, MPMO, SMAC and Geomaterial.

  14. Gauge boson exchange in AdS d+1

    NASA Astrophysics Data System (ADS)

    D'Hoker, Eric; Freedman, Daniel Z.

    1999-04-01

    We study the amplitude for exchange of massless gauge bosons between pairs of massive scalar fields in anti-de Sitter space. In the AdS/CFT correspondence this amplitude describes the contribution of conserved flavor symmetry currents to 4-point functions of scalar operators in the boundary conformal theory. A concise, covariant, Y2K compatible derivation of the gauge boson propagator in AdS d + 1 is given. Techniques are developed to calculate the two bulk integrals over AdS space leading to explicit expressions or convenient, simple integral representations for the amplitude. The amplitude contains leading power and sub-leading logarithmic singularities in the gauge boson channel and leading logarithms in the crossed channel. The new methods of this paper are expected to have other applications in the study of the Maldacena conjecture.

  15. Psychometric properties of the Spanish QoL-AD with institutionalized dementia patients and their family caregivers in Spain.

    PubMed

    León-Salas, B; Logsdon, R G; Olazarán, J; Martínez-Martín, P; The Msu-Adru

    2011-08-01

    To evaluate the psychometric attributes of the Spanish version of the Quality of Life-Alzheimer's Disease Scale (QoL-AD) in institutionalized patients and family caregivers in Spain. 101 patients (88.1% women; mean age, 83.2  ±  6.3) with Alzheimer's disease (AD) (n = 82) and mixed dementia (n = 19) and their closest family caregivers. Patient-related variables included severity of dementia, cognitive status, perceived general health, quality of life, behavior, apathy, depression, and functional status. QoL-AD acceptability, reliability, and construct validity were analyzed. The mean Mini-Mental State Examination (MMSE) score was 7.2  ±  6.1 and Global Deterioration Scale was: stage four (4%); five (21.2%); six (34.3%); and seven (40.4%). Both, QoL-AD patient version (QoL-ADp) (n = 40; MMSE = 12.0  ±  4.5) and QoL-AD caregiver version (QoL-ADc) (n = 101) lacked significant floor and ceiling effects and the Cronbach α index was 0.90 and 0.86, respectively. The corrected item-total correlation was 0.11-0.68 (QoL-ADc) and 0.28-0.84 (QoL-ADp). Stability was satisfactory for QoL-ADp (intraclass correlation coefficient [ICC]=0.83) but low for QoL-ADc (ICC = 0.51); the standard error of measurement was 2.72 and 4.69. Construct validity was moderate/high for QoL-ADc (QUALID=-0.43; EQ-5D = 0.65), but lower for QoL-ADp. No significant correlations were observed between QoL-ADp and patient variables or QoL-ADc. A low to high association (r = 0.18-0.55) was obtained between QoL-ADc and patient-related measures of neuropsychiatric, function, and cognitive status. Differences in their psychometric attributes, and discrepancy between them, were found for QoL-ADp and QoL-ADc. In patients with AD and advanced dementia, the QoL perceived by the patient could be based on a construct that is different from the traditional QoL construct.

  16. Caregivers' male gender is associated with poor nutrient intake in AD families (NuAD-trial).

    PubMed

    Puranen, T M; Pietila, S E; Pitkala, K H; Kautiainen, H; Raivio, M; Eloniemi-Sulkava, U; Jyvakorpi, S K; Suominen, M

    2014-07-01

    Alzheimer patients (AD) are known to be at risk for malnutrition and their older spouses may also have nutritional problems. The aim of our study was to clarify the association of caregivers' sex on the nutrient intake of AD couples. Our study uses the baseline data of a randomized nutritional trial exploring the effectiveness of nutrition intervention among home-dwelling AD patients. The central AD register in Finland was used to recruit AD patients living with a spousal caregiver, 99 couples participated in our study. Nutritional status was assessed using the Mini-Nutritional Assessment (MNA). Nutrient intakes for both AD patients and their spouses were calculated from 3-day food diaries. The mean age of caregivers and AD spouses was 75.2 (SD 7.0) and 77.4 years (SD 5.6), respectively. According to the MNA, 40% of male and 52% of female AD spouses were at risk for malnutrition. Among male caregivers, the mean energy and protein intakes were 1605 kcal (SD 458) and 0.93 g/body kg (SD 0.30), whereas the respective figures for their female AD spouses were 1313 kcal (SD 340) and 0.86 g/body kg (SD 0.32), respectively. Among female caregivers, the mean energy and protein intakes were 1536 kcal (SD 402) and 1.00 g/body kg (SD 0.30), whereas the respective figures for their male AD spouses were 1897 kcal (SD 416) and 1.04 g/body kg (SD 0.30). The interaction between male caregiver sex and lower energy (p<0.001) and lower protein intake (p=0.0048) (adjusted for age and MMSE) was significant. Similar differences between caregiver sexes were observed with the intake of various nutrients. A gender difference exists in the ability to cope with caregiver responsibilities related to nutrition. A need exists for tailored nutritional guidance among older individuals and especially among male caregivers.

  17. Method for conversion of carbohydrate polymers to value-added chemical products

    DOEpatents

    Zhang, Zongchao C [Norwood, NJ; Brown, Heather M [Kennewick, WA; Su, Yu [Richland, WA

    2012-02-07

    Methods are described for conversion of carbohydrate polymers in ionic liquids, including cellulose, that yield value-added chemicals including, e.g., glucose and 5-hydroxylmethylfurfural (HMF) at temperatures below 120.degree. C. Catalyst compositions that include various mixed metal halides are described that are selective for specified products with yields, e.g., of up to about 56% in a single step process.

  18. Influence of Method of Adding Water to Combustible Mixture on Diesel Engine Performance

    NASA Astrophysics Data System (ADS)

    Devyanin, S. N.; Bigaev, A. V.; Markov, V. A.

    2018-03-01

    The supply of water to the cylinders of the diesel engine is one way to reduce the maximum temperature in the combustion zone of the fuel. A reduction of the maximum combustion temperature allows reducing the formation of nitrogen oxides and improving the environmental characteristics of the engine, which remains one of the urgent tasks at the present stage of their development. The methods of supplying water to the engine together with air at the inlet and with the fuel into the cylinder are well known. This article considers the influence of the way the water is supplied to the engine cylinders on its environmental characteristics. It presents the results of experimental studies on the internal combustion engine and analysis of the method of adding water on the engine performance from exhaust gas toxicity, operating efficiency and its thermal state. There are marked different effects on the motor performance of the method of adding water.

  19. Thermodynamic and classical instability of AdS black holes in fourth-order gravity

    NASA Astrophysics Data System (ADS)

    Myung, Yun Soo; Moon, Taeyoon

    2014-04-01

    We study thermodynamic and classical instability of AdS black holes in fourth-order gravity. These include the BTZ black hole in new massive gravity, Schwarzschild-AdS black hole, and higher-dimensional AdS black holes in fourth-order gravity. All thermo-dynamic quantities which are computed using the Abbot-Deser-Tekin method are used to study thermodynamic instability of AdS black holes. On the other hand, we investigate the s-mode Gregory-Laflamme instability of the massive graviton propagating around the AdS black holes. We establish the connection between the thermodynamic instability and the GL instability of AdS black holes in fourth-order gravity. This shows that the Gubser-Mitra conjecture holds for AdS black holes found from fourth-order gravity.

  20. Study on the optimal moisture adding rate of brown rice during germination by using segmented moisture conditioning method.

    PubMed

    Cao, Yinping; Jia, Fuguo; Han, Yanlong; Liu, Yang; Zhang, Qiang

    2015-10-01

    The aim of this study was to find out the optimal moisture adding rate of brown rice during the process of germination. The process of water addition in brown rice could be divided into three stages according to different water absorption speeds in soaking process. Water was added with three different speeds in three stages to get the optimal water adding rate in the whole process of germination. Thus, the technology of segmented moisture conditioning which is a method of adding water gradually was put forward. Germinated brown rice was produced by using segmented moisture conditioning method to reduce the loss of water-soluble nutrients and was beneficial to the accumulation of gamma aminobutyric acid. The effects of once moisture adding amount in three stages on the gamma aminobutyric acid content in germinated brown rice and germination rate of brown rice were investigated by using response surface methodology. The optimum process parameters were obtained as follows: once moisture adding amount of stage I with 1.06 %/h, once moisture adding amount of stage II with 1.42 %/h and once moisture adding amount of stage III with 1.31 %/h. The germination rate under the optimum parameters was 91.33 %, which was 7.45 % higher than that of germinated brown rice produced by soaking method (84.97 %). The content of gamma aminobutyric acid in germinated brown rice under the optimum parameters was 29.03 mg/100 g, which was more than two times higher than that of germinated brown rice produced by soaking method (12.81 mg/100 g). The technology of segmented moisture conditioning has potential applications for studying many other cereals.

  1. Loops in AdS from conformal field theory

    DOE PAGES

    Aharony, Ofer; Alday, Luis F.; Bissi, Agnese; ...

    2017-07-10

    We propose and demonstrate a new use for conformal field theory (CFT) crossing equations in the context of AdS/CFT: the computation of loop amplitudes in AdS, dual to non-planar correlators in holographic CFTs. Loops in AdS are largely unexplored, mostly due to technical difficulties in direct calculations. We revisit this problem, and the dual 1=N expansion of CFTs, in two independent ways. The first is to show how to explicitly solve the crossing equations to the first subleading order in 1=N 2, given a leading order solution. This is done as a systematic expansion in inverse powers of the spin, to all orders. These expansions can be resummed, leading to the CFT data for nite values of the spin. Our second approach involves Mellin space. We show how the polar part of the four-point, loop-level Mellin amplitudes can be fully reconstructed from the leading-order data. The anomalous dimensions computed with both methods agree. In the case ofmore » $$\\phi$$ 4 theory in AdS, our crossing solution reproduces a previous computation of the one-loop bubble diagram. We can go further, deriving the four-point scalar triangle diagram in AdS, which had never been computed. In the process, we show how to analytically derive anomalous dimensions from Mellin amplitudes with an in nite series of poles, and discuss applications to more complicated cases such as the N = 4 super-Yang-Mills theory.« less

  2. Loops in AdS from conformal field theory

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Aharony, Ofer; Alday, Luis F.; Bissi, Agnese

    We propose and demonstrate a new use for conformal field theory (CFT) crossing equations in the context of AdS/CFT: the computation of loop amplitudes in AdS, dual to non-planar correlators in holographic CFTs. Loops in AdS are largely unexplored, mostly due to technical difficulties in direct calculations. We revisit this problem, and the dual 1=N expansion of CFTs, in two independent ways. The first is to show how to explicitly solve the crossing equations to the first subleading order in 1=N 2, given a leading order solution. This is done as a systematic expansion in inverse powers of the spin, to all orders. These expansions can be resummed, leading to the CFT data for nite values of the spin. Our second approach involves Mellin space. We show how the polar part of the four-point, loop-level Mellin amplitudes can be fully reconstructed from the leading-order data. The anomalous dimensions computed with both methods agree. In the case ofmore » $$\\phi$$ 4 theory in AdS, our crossing solution reproduces a previous computation of the one-loop bubble diagram. We can go further, deriving the four-point scalar triangle diagram in AdS, which had never been computed. In the process, we show how to analytically derive anomalous dimensions from Mellin amplitudes with an in nite series of poles, and discuss applications to more complicated cases such as the N = 4 super-Yang-Mills theory.« less

  3. Loops in AdS from conformal field theory

    NASA Astrophysics Data System (ADS)

    Aharony, Ofer; Alday, Luis F.; Bissi, Agnese; Perlmutter, Eric

    2017-07-01

    We propose and demonstrate a new use for conformal field theory (CFT) crossing equations in the context of AdS/CFT: the computation of loop amplitudes in AdS, dual to non-planar correlators in holographic CFTs. Loops in AdS are largely unexplored, mostly due to technical difficulties in direct calculations. We revisit this problem, and the dual 1 /N expansion of CFTs, in two independent ways. The first is to show how to explicitly solve the crossing equations to the first subleading order in 1 /N 2, given a leading order solution. This is done as a systematic expansion in inverse powers of the spin, to all orders. These expansions can be resummed, leading to the CFT data for finite values of the spin. Our second approach involves Mellin space. We show how the polar part of the four-point, loop-level Mellin amplitudes can be fully reconstructed from the leading-order data. The anomalous dimensions computed with both methods agree. In the case of ϕ 4 theory in AdS, our crossing solution reproduces a previous computation of the one-loop bubble diagram. We can go further, deriving the four-point scalar triangle diagram in AdS, which had never been computed. In the process, we show how to analytically derive anomalous dimensions from Mellin amplitudes with an infinite series of poles, and discuss applications to more complicated cases such as the N = 4 super-Yang-Mills theory.

  4. Persistence of atopic dermatitis (AD): A systematic review and meta-analysis

    PubMed Central

    Kim, Jooho P.; Chao, Lucy X.; Simpson, Eric L.; Silverberg, Jonathan I.

    2016-01-01

    Background Previous studies found conflicting results about whether childhood atopic dermatitis (AD) persists into adulthood. Objective We sought to determine persistence rates and clinical factors associated with prolonged AD. Methods A systematic review was performed in MEDLINE, EMBASE, Scopus, GREAT, LILACS, Web of Science, Academic Search Complete, and Cochrane Library. Meta-analysis was performed using Kaplan-Meier plots and random-effects proportional hazards regression. Results In total, 45 studies including 110,651 subjects spanning 434,992 patient-years from 15 countries were included. In pooled analysis, 80% of childhood AD did not persist by 8 years and less than 5% persisted by 20 years after diagnosis (mean ± SE: 6.1 ± 0.02 years). Children with AD that persisted already for more than 10 years (8.3 ± 0.08 years) had longer persistence than those with 3 (3.2 ± 0.02 years) or 5 (6.8 ± 0.06 years) years of persistence. Children who developed AD by age 2 years had less persistent disease (P < .0001). Persistence was greater in studies using patient-/caregiver-assessed versus physician-assessed outcomes, female versus male patients (P ≤ .0006), but not in those with sensitivity to allergens (P = .90). Three studies found prolonged persistence with more severe AD. Limitations Some studies did not capture recurrences later in life. Conclusions Most childhood AD remitted by adulthood. However, children with already persistent disease, later onset, and/or more severe disease have increased persistence. PMID:27544489

  5. Effect of methylphenidate on attention in apathetic AD patients in a randomized, placebo-controlled trial.

    PubMed

    Lanctôt, Krista L; Chau, Sarah A; Herrmann, Nathan; Drye, Lea T; Rosenberg, Paul B; Scherer, Roberta W; Black, Sandra E; Vaidya, Vijay; Bachman, David L; Mintzer, Jacobo E

    2014-02-01

    Little is known about the effect of methylphenidate (MPH) on attention in Alzheimer's disease (AD). MPH has shown to improve apathy in AD, and both apathy and attention have been related to dopaminergic function. The goal was to investigate MPH effects on attention in AD and assess the relationship between attention and apathy responses. MPH (10 mg PO twice daily) or placebo was administered for six weeks in a randomized, double-blind trial in mild-to-moderate AD outpatients with apathy (Neuropsychiatric Inventory (NPI) Apathy ≥ 4). Attention was measured with the Wechsler Adult Intelligence Scale--Digit Span (DS) subtest (DS forward, selective attention) and apathy with the Apathy Evaluation Scale (AES). A mixed effects linear regression estimated the difference in change from baseline between treatment groups, defined as δ (MPH (DS week 6-DS baseline)) - (placebo (DS week 6-DS baseline)). In 60 patients (37 females, age = 76 ± 8, Mini-Mental State Examination (MMSE) = 20 ± 5, NPI Apathy = 7 ± 2), the change in DS forward (δ = 0.87 (95% CI: 0.06-1.68), p = 0.03) and DS total (δ = 1.01 (95% CI: 0.09-1.93), p = 0.03) favored MPH over placebo. Of 57 completers, 17 patients had improved apathy (≥3.3 points on the AES from baseline to end point) and 40 did not. There were no significant associations between AES and NPI Apathy with DS change scores in the MPH, placebo, AES responder, or non-responder groups. DS scores did not predict apathy response to MPH treatment. These results suggest MPH can improve attention and apathy in AD; however, the effects appear independent in this population.

  6. Distinct chronology of neuronal cell cycle re-entry and tau pathology in the 3xTg-AD mouse model and Alzheimer's disease patients.

    PubMed

    Hradek, Alex C; Lee, Hyun-Pil; Siedlak, Sandra L; Torres, Sandy L; Jung, Wooyoung; Han, Ashley H; Lee, Hyoung-gon

    2015-01-01

    Cell cycle re-entry in Alzheimer's disease (AD) has emerged as an important pathological mechanism in the progression of the disease. This appearance of cell cycle related proteins has been linked to tau pathology in AD, but the causal and temporal relationship between the two is not completely clear. In this study, we found that hyperphosphorylated retinoblastoma protein (ppRb), a key regulator for G1/S transition, is correlated with a late marker for hyperphosphorylation of tau but not with other early markers for tau alteration in the 3xTg-AD mouse model. However, in AD brains, ppRb can colocalize with both early and later markers for tau alterations, and can often be found singly in many degenerating neurons, indicating the distinct development of pathology between the 3xTg-AD mouse model and human AD patients. The conclusions of this study are two-fold. First, our findings clearly demonstrate the pathological link between the aberrant cell cycle re-entry and tau pathology. Second, the chronological pattern of cell cycle re-entry with tau pathology in the 3xTg-AD mouse is different compared to AD patients suggesting the distinct pathogenic mechanism between the animal AD model and human AD patients.

  7. Classification of Neuropsychiatric Symptoms Requiring Antipsychotic Treatment in Patients with Alzheimer's Disease: Analysis of the CATIE-AD Study.

    PubMed

    Nagata, Tomoyuki; Shinagawa, Shunichiro; Nakajima, Shinichiro; Plitman, Eric; Mihashi, Yukiko; Hayashi, Shogo; Mimura, Masaru; Nakayama, Kazuhiko

    2016-01-01

    The Neuropsychiatric Inventory (NPI) comprises 12 items, which were conventionally determined by psychopathological symptoms of patients with dementia. The clinical rating scales with structured questionnaires have been useful to evaluate neuropsychiatric symptoms (NPSs) of patients with dementia over the past twenty year. The aim of this study was to classify the conventional NPSs in patients with Alzheimer's disease (AD) requiring antipsychotic treatment for their NPSs into distinct clusters to simplify assessment of these numerous symptoms. Twelve items scores (product of severity and frequency of each symptom) in the NPI taken from the baseline visit were classified into subgroups by principle component analysis using data from 421 outpatients with AD enrolled in the Clinical Antipsychotic Trials of Intervention Effectiveness-Alzheimer's Disease (CATIE-AD) Phase 1. Chi square tests were conducted to examine the co-occurrence of the subgroups. We found four distinct clusters: aggressiveness (agitation and irritabilities), apathy and eating problems (apathy and appetite/eating disturbance), psychosis (delusions and hallucinations), and emotion and disinhibition (depression, euphoria, and disinhibition). Anxiety, aberrant motor behavior, and sleep disturbance were not included by these clusters. Apathy and eating problems, and emotion and disinhibition co-occurred (p = 0.002), whereas aggressiveness and psychosis occurred independent of the other clusters. Four distinct category clusters were identified from NPSs in patients with AD requiring antipsychotic treatment. Future studies should investigate psychosocial backgrounds or risk factors of each distinct cluster, in addition to their longitudinal course over treatment intervention.

  8. Intrinsic atopic dermatitis (AD) shows similar Th2 and higher Th17 immune activation compared to extrinsic AD

    PubMed Central

    Suárez-Fariñas, M; Dhingra, N; Gittler, J; Shemer, A; Cardinale, I; de Guzman Strong, C; Krueger, JG; Guttman-Yassky, E

    2013-01-01

    Background Atopic dermatitis (AD) is classified as extrinsic (ADe) and intrinsic (ADi), representing approximately 80% and 20% of patients, respectively. While sharing a similar clinical phenotype, only ADe is characterized by high serum IgE. Since most AD patients exhibit high IgE, an “allergic”/IgE-mediated disease pathogenesis was hypothesized. However, current models associate AD with T-cell activation, particularly Th2/Th22 polarization, and epidermal barrier defects. Objective To define if both variants share a common pathogenesis. Methods We stratified 51 severe AD patients as ADe (42) and ADi (9) (with similar mean disease activity/SCORAD), and analyzed the molecular and cellular skin pathology of lesional and non-lesional ADi and ADe using gene-expression (RT-PCR) and immunohistochemistry. Results A significant correlation between IgE levels and SCORAD (r=0.76, p<10−5) was found only in ADe. Marked infiltrates of T-cells and dendritic cells and corresponding epidermal alterations (K16, Mki67, S100A7/A8/A9) defined lesional skin of both variants. However, higher activation of all inflammatory axes (including Th2) was detected in ADi, particularly Th17 and Th22-cytokines. Positive correlations between Th17-related molecules and SCORAD were only found in ADi, while only ADe showed positive correlations between SCORAD and Th2-cytokines (IL-4, IL-5), and negative correlations with differentiation products (loricrin, periplakin). Conclusions Although differences in Th17 and Th22 activation exist between ADi and ADe, we identified common disease-defining features of T-cell activation, production of polarized cytokines, and keratinocyte responses to immune products. Our data indicate that a Th2 bias is not the sole cause of high IgE in ADe, with important implications for similar therapeutic interventions. Clinical Implications Both extrinsic and intrinsic AD variants might be treated with T-cell targeted therapeutics or agents that modify keratinocyte

  9. Witten diagrams revisited: the AdS geometry of conformal blocks

    DOE PAGES

    Hijano, Eliot; Kraus, Per; Perlmutter, Eric; ...

    2016-01-25

    Here, we develop a new method for decomposing blocks. The steps involved are elementary, requiring no explicit integration, and operate directly in position space. Central to this construction is an appealingly simple answer to the question: what object in AdS computes a conformal block? The answer is a "geodesic Witten diagram", which is essentially an ordinary exchange Witten diagram, except that the cubic vertices are not integrated over all of AdS, but only over bulk geodesics connecting the boundary operators. In particular, we also consider the case of four-point functions of scalar operators, and show how to easily reproduce existingmore » results for the relevant conformal blocks in arbitrary dimension.« less

  10. An evidence-based patient-centered method makes the biopsychosocial model scientific.

    PubMed

    Smith, Robert C; Fortin, Auguste H; Dwamena, Francesca; Frankel, Richard M

    2013-06-01

    To review the scientific status of the biopsychosocial (BPS) model and to propose a way to improve it. Engel's BPS model added patients' psychological and social health concerns to the highly successful biomedical model. He proposed that the BPS model could make medicine more scientific, but its use in education, clinical care, and, especially, research remains minimal. Many aver correctly that the present model cannot be defined in a consistent way for the individual patient, making it untestable and non-scientific. This stems from not obtaining relevant BPS data systematically, where one interviewer obtains the same information another would. Recent research by two of the authors has produced similar patient-centered interviewing methods that are repeatable and elicit just the relevant patient information needed to define the model at each visit. We propose that the field adopt these evidence-based methods as the standard for identifying the BPS model. Identifying a scientific BPS model in each patient with an agreed-upon, evidence-based patient-centered interviewing method can produce a quantum leap ahead in both research and teaching. A scientific BPS model can give us more confidence in being humanistic. In research, we can conduct more rigorous studies to inform better practices. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Beneficial Effects of Adding Ketamine to Intravenous Patient-Controlled Analgesia with Fentanyl after the Nuss Procedure in Pediatric Patients

    PubMed Central

    Cha, Moon Ho; Eom, Ji Hye; Lee, Yoon Sook; Kim, Woon Young; Park, Young Cheol; Min, Sam Hong

    2012-01-01

    Purpose The aim of this prospective, double-blind, randomized study was to investigate the analgesic effects of low-dose ketamine on intravenous patient-controlled analgesia (IV-PCA) with fentanyl for pain control in pediatric patients following the Nuss procedure for pectus excavatum. Materials and Methods Sixty pediatric patients undergoing the Nuss procedure were randomly assigned to receive fentanyl (Group F, n=30) or fentanyl plus ketamine (Group FK, n=30). Ten minutes before the end of surgery, following the loading dose of each solution, 0.5 µg/kg/hr of fentanyl or 0.5 µg/kg/hr of fentanyl plus 0.15 mg/kg/hr of ketamine was infused via an IV-PCA pump (basal rate, 1 mL/hr; bolus, 0.5 mL; lock out interval, 30 min). Fentanyl consumption, pain score, ketorolac use, nausea/vomiting, ondansetron use, pruritus, respiratory depression, hallucination, dreaming, and parent satisfaction with pain control were measured throughout the 48 hours following surgery. Results The pain scores, ketorolac use, and fentanyl consumption of Group FK were significantly lower than in Group F (p<0.05). The incidence of nausea/vomiting and ondansetron use in Group FK was significantly lower than in Group F (p<0.05). There were no reports of respiratory depression, hallucination or dreaming. Parent satisfaction with pain control was similar between the two groups. Conclusion We concluded that low-dose ketamine added to IV-PCA with fentanyl after the Nuss procedure in pediatric patients can reduce pain scores, consumption of fentanyl, and incidence of nausea/vomiting without increasing side effects. PMID:22318834

  12. Interdisciplinary research on patient-provider communication: a cross-method comparison.

    PubMed

    Chou, Wen-Ying Sylvia; Han, Paul; Pilsner, Alison; Coa, Kisha; Greenberg, Larrie; Blatt, Benjamin

    2011-01-01

    Patient-provider communication, a key aspect of healthcare delivery, has been assessed through multiple methods for purposes of research, education, and quality control. Common techniques include satisfaction ratings and quantitatively- and qualitatively-oriented direct observations. Identifying the strengths and weaknesses of different approaches is critically important in determining the appropriate assessment method for a specific research or practical goal. Analyzing ten videotaped simulated encounters between medical students and Standardized Patients (SPs), this study compared three existing assessment methods through the same data set. Methods included: (1) dichotomized SP ratings on students' communication skills; (2) Roter Interaction Analysis System (RIAS) analysis; and (3) inductive discourse analysis informed by sociolinguistic theories. The large dichotomous contrast between good and poor ratings in (1) was not evidenced in any of the other methods. Following a discussion of strengths and weaknesses of each approach, we pilot-tested a combined assessment done by coders blinded to results of (1)-(3). This type of integrative approach has the potential of adding a quantifiable dimension to qualitative, discourse-based observations. Subjecting the same data set to separate analytic methods provides an excellent opportunity for methodological comparisons with the goal of informing future assessment of clinical encounters.

  13. Digital Quantum Simulation of Minimal AdS /CFT

    NASA Astrophysics Data System (ADS)

    García-Álvarez, L.; Egusquiza, I. L.; Lamata, L.; del Campo, A.; Sonner, J.; Solano, E.

    2017-07-01

    We propose the digital quantum simulation of a minimal AdS /CFT model in controllable quantum platforms. We consider the Sachdev-Ye-Kitaev model describing interacting Majorana fermions with randomly distributed all-to-all couplings, encoding nonlocal fermionic operators onto qubits to efficiently implement their dynamics via digital techniques. Moreover, we also give a method for probing nonequilibrium dynamics and the scrambling of information. Finally, our approach serves as a protocol for reproducing a simplified low-dimensional model of quantum gravity in advanced quantum platforms as trapped ions and superconducting circuits.

  14. Effect of Adding McKenzie Syndrome, Centralization, Directional Preference, and Psychosocial Classification Variables to a Risk-Adjusted Model Predicting Functional Status Outcomes for Patients With Lumbar Impairments.

    PubMed

    Werneke, Mark W; Edmond, Susan; Deutscher, Daniel; Ward, Jason; Grigsby, David; Young, Michelle; McGill, Troy; McClenahan, Brian; Weinberg, Jon; Davidow, Amy L

    2016-09-01

    Study Design Retrospective cohort. Background Patient-classification subgroupings may be important prognostic factors explaining outcomes. Objectives To determine effects of adding classification variables (McKenzie syndrome and pain patterns, including centralization and directional preference; Symptom Checklist Back Pain Prediction Model [SCL BPPM]; and the Fear-Avoidance Beliefs Questionnaire subscales of work and physical activity) to a baseline risk-adjusted model predicting functional status (FS) outcomes. Methods Consecutive patients completed a battery of questionnaires that gathered information on 11 risk-adjustment variables. Physical therapists trained in Mechanical Diagnosis and Therapy methods classified each patient by McKenzie syndromes and pain pattern. Functional status was assessed at discharge by patient-reported outcomes. Only patients with complete data were included. Risk of selection bias was assessed. Prediction of discharge FS was assessed using linear stepwise regression models, allowing 13 variables to enter the model. Significant variables were retained in subsequent models. Model power (R(2)) and beta coefficients for model variables were estimated. Results Two thousand sixty-six patients with lumbar impairments were evaluated. Of those, 994 (48%), 10 (<1%), and 601 (29%) were excluded due to incomplete psychosocial data, McKenzie classification data, and missing FS at discharge, respectively. The final sample for analyses was 723 (35%). Overall R(2) for the baseline prediction FS model was 0.40. Adding classification variables to the baseline model did not result in significant increases in R(2). McKenzie syndrome or pain pattern explained 2.8% and 3.0% of the variance, respectively. When pain pattern and SCL BPPM were added simultaneously, overall model R(2) increased to 0.44. Although none of these increases in R(2) were significant, some classification variables were stronger predictors compared with some other variables included in

  15. Methods for conversion of carbohydrates in ionic liquids to value-added chemicals

    DOEpatents

    Zhao, Haibo [The Woodlands, TX; Holladay, Johnathan E [Kennewick, WA; Zhang, Zongchao C [Norwood, NJ

    2011-05-10

    Methods are described for converting carbohydrates including, e.g., monosaccharides, disaccharides, and polysaccharides in ionic liquids to value-added chemicals including furans, useful as chemical intermediates and/or feedstocks. Fructose is converted to 5-hydroxylmethylfurfural (HMF) in the presence of metal halide and acid catalysts. Glucose is effectively converted to HMF in the presence of chromium chloride catalysts. Yields of up to about 70% are achieved with low levels of impurities such as levulinic acid.

  16. Beyond AdS Space-times, New Holographic Correspondences and Applications

    NASA Astrophysics Data System (ADS)

    Ghodrati, Mahdis

    The AdS/CFT correspondence conjectures a mathematical equivalence between string theories and gauge theories. In a particular limit it allows a description of strongly coupled conformal field theory via weakly coupled gravity. This feature has been used to gain insight into many condensed matter (CM) systems. However, to apply the duality in more physical scenarios, one needs to go beyond the usual AdS/CFT framework and extend the duality to non-AdS situations. To describe Lifshitz and hyperscaling violating (HSV) phenomena in CM one uses gauge fields on the gravity side which naturally realize the breaking of Lorentz invariance. These gravity constructions often contain naked singularities. In this thesis, we construct a resolution of the infra-red (IR) singularity of the HSV background. The idea is to add squared curvature terms to the Einstein-Maxwell dilaton action to build a flow from AdS4 in the ultra violate (UV) to an intermediating HSV region and then to an AdS2 x R 2 region in the IR. This general solution is free from the naked singularities and would be more appropriate for applications of HSV in physical systems. We also study the Schwinger effect by using the AdS/CFT duality. We present the phase diagrams of the Schwinger effect and also the "butterfly shaped-phase diagrams" of the entanglement entropy for four different confining supergravity backgrounds. Comparing different features of all of these diagrams could point out to a potential relation between the Schwinger effect and the entanglement entropy which could lead to a method of measuring entanglement entropy in the laboratory. Finally, we study the "new massive gravity" theory and the different black hole solutions it admits. We first present three different methods of calculating the conserved charges. Then, by calculating the on-shell Gibbs free energy we construct the Hawking-Page phase diagrams for different solutions in two thermodynamical ensembles. As the massive gravity models are

  17. HOMA-AD in Assessing Insulin Resistance in Lean Noncirrhotic HCV Outpatients.

    PubMed

    Michalczuk, Matheus Truccolo; Kappel, Camila Rippol; Birkhan, Oscar; Bragança, Ana Carolina; Alvares-da-Silva, Mário Reis

    2012-01-01

    Introduction. There is an association between HCV and insulin resistance (IR), which is currently assessed by HOMA-IR. There is evidence that HOMA-adiponectin (HOMA-AD) is more accurate, but its role in HCV patients is unknown. The purpose of this study was to evaluate IR in an HCV sample and controls, in order to compare the accuracy of HOMA-IR and HOMA-AD. Methods. Ninety-four HCV outpatients aged <60 years who met the criteria of nondiabetic, nonobese, noncirrhotic, and nonalcohol abusers were included and compared to 29 controls. Fasting glucose, insulin, adiponectin, and lipid profiles were determined. IR was estimated by HOMA-IR and HOMA-AD. Results. The groups were similar regarding sex and BMI, but the HCV patients were older. The median insulin level was higher in the HCV group (8.6 mU/mL (6.5-13.7) versus 6.5 (4.3-10.7), P = 0.004), as was median HOMA-IR (1.94 (1.51 to 3.48) versus 1.40 (1.02 to 2.36), P = 0.002) and the prevalence of IR (38.3% versus 10.3% (P = 0.009)). No differences were found in adiponectin levels (P = 0.294) and HOMA-AD (P = 0.393). Conclusion. IR is highly prevalent even in low-risk HCV outpatients. Adiponectin is not influenced by the presence of HCV. HOMA-AD does not seem to be useful in assessing IR in HCV patients.

  18. COGNITIVELY NORMAL INDIVIDUALS WITH AD PARENTS MAY BE AT RISK FOR DEVELOPING AGING-RELATED CORTICAL THINNING PATTERNS CHARACTERISTIC OF AD

    PubMed Central

    Reiter, Katherine; Alpert, Kathryn I.; Cobia, Derin J.; Kwasny, Mary J.; Morris, John C.; Csernansky, John C.; Wang, Lei

    2012-01-01

    Children of Alzheimer's Disease (AD) patients are at heightened risk of developing AD due to genetic influences, including the apolipoprotein E4 (ApoE4) allele. In this study, we assessed the earliest cortical changes associated with AD in 71 cognitively healthy, adult children of AD patients (AD offspring) as compared with 69 with no family history of AD (non-AD offspring). Cortical thickness measures were obtained using FreeSurfer from 1.5T magnetic resonance (MR) scans. ApoE genotyping was obtained. Primary analyses examined family history and ApoeE4 effects on cortical thickness. Secondary analyses examined age effects within groups. All comparisons were adjusted using False Discovery Rate at a significance threshold of p < 0.05. There were no statistically significant differences between family history and ApoE4 groups. Within AD offspring, increasing age was related to reduced cortical thickness (atrophy) over large areas of the precuneus, superior frontal and superior temporal gyri, starting at around age 60. Further, these patterns existed within female and maternal AD offspring, but were absent in male and paternal AD offspring. Within non-AD offspring, negative correlations existed over small regions of the superior temporal, insula and lingual cortices. These results suggest that as AD offspring age, cortical atrophy is more prominent, particularly if the parent with AD is mother or if the AD offspring is female. PMID:22503937

  19. Classification of MR brain images by combination of multi-CNNs for AD diagnosis

    NASA Astrophysics Data System (ADS)

    Cheng, Danni; Liu, Manhua; Fu, Jianliang; Wang, Yaping

    2017-07-01

    Alzheimer's disease (AD) is an irreversible neurodegenerative disorder with progressive impairment of memory and cognitive functions. Its early diagnosis is crucial for development of future treatment. Magnetic resonance images (MRI) play important role to help understand the brain anatomical changes related to AD. Conventional methods extract the hand-crafted features such as gray matter volumes and cortical thickness and train a classifier to distinguish AD from other groups. Different from these methods, this paper proposes to construct multiple deep 3D convolutional neural networks (3D-CNNs) to learn the various features from local brain images which are combined to make the final classification for AD diagnosis. First, a number of local image patches are extracted from the whole brain image and a 3D-CNN is built upon each local patch to transform the local image into more compact high-level features. Then, the upper convolution and fully connected layers are fine-tuned to combine the multiple 3D-CNNs for image classification. The proposed method can automatically learn the generic features from imaging data for classification. Our method is evaluated using T1-weighted structural MR brain images on 428 subjects including 199 AD patients and 229 normal controls (NC) from Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Experimental results show that the proposed method achieves an accuracy of 87.15% and an AUC (area under the ROC curve) of 92.26% for AD classification, demonstrating the promising classification performances.

  20. "What about People Our Age?" Applying Qualitative and Quantitative Methods to Uncover How Political Ads Alienate College Students

    ERIC Educational Resources Information Center

    Parmelee, John H.; Perkins, Stephynie C.; Sayre, Judith J.

    2007-01-01

    This study uses a sequential transformative mixed methods research design to explain how political advertising fails to engage college students. Qualitative focus groups examined how college students interpret the value of political advertising to them, and a quantitative manifest content analysis concerning ad framing of more than 100 ads from…

  1. Thermodynamics of charged Lovelock: AdS black holes

    NASA Astrophysics Data System (ADS)

    Prasobh, C. B.; Suresh, Jishnu; Kuriakose, V. C.

    2016-04-01

    We investigate the thermodynamic behavior of maximally symmetric charged, asymptotically AdS black hole solutions of Lovelock gravity. We explore the thermodynamic stability of such solutions by the ordinary method of calculating the specific heat of the black holes and investigating its divergences which signal second-order phase transitions between black hole states. We then utilize the methods of thermodynamic geometry of black hole spacetimes in order to explain the origin of these points of divergence. We calculate the curvature scalar corresponding to a Legendre-invariant thermodynamic metric of these spacetimes and find that the divergences in the black hole specific heat correspond to singularities in the thermodynamic phase space. We also calculate the area spectrum for large black holes in the model by applying the Bohr-Sommerfeld quantization to the adiabatic invariant calculated for the spacetime.

  2. What's the point? Hole-ography in Poincaré AdS

    NASA Astrophysics Data System (ADS)

    Espíndola, Ricardo; Güijosa, Alberto; Landetta, Alberto; Pedraza, Juan F.

    2018-01-01

    In the context of the AdS/CFT correspondence, we study bulk reconstruction of the Poincaré wedge of AdS_3 via hole-ography, i.e., in terms of differential entropy of the dual CFT_2. Previous work had considered the reconstruction of closed or open spacelike curves in global AdS, and of infinitely extended spacelike curves in Poincaré AdS that are subject to a periodicity condition at infinity. Working first at constant time, we find that a closed curve in Poincaré is described in the CFT by a family of intervals that covers the spatial axis at least twice. We also show how to reconstruct open curves, points and distances, and obtain a CFT action whose extremization leads to bulk points. We then generalize all of these results to the case of curves that vary in time, and discover that generic curves have segments that cannot be reconstructed using the standard hole-ographic construction. This happens because, for the nonreconstructible segments, the tangent geodesics fail to be fully contained within the Poincaré wedge. We show that a previously discovered variant of the hole-ographic method allows us to overcome this challenge, by reorienting the geodesics touching the bulk curve to ensure that they all remain within the wedge. Our conclusion is that all spacelike curves in Poincaré AdS can be completely reconstructed with CFT data, and each curve has in fact an infinite number of representations within the CFT.

  3. Capturing patients' needs in casemix: a systematic literature review on the value of adding functioning information in reimbursement systems.

    PubMed

    Hopfe, Maren; Stucki, Gerold; Marshall, Ric; Twomey, Conal D; Üstün, T Bedirhan; Prodinger, Birgit

    2016-02-03

    Contemporary casemix systems for health services need to ensure that payment rates adequately account for actual resource consumption based on patients' needs for services. It has been argued that functioning information, as one important determinant of health service provision and resource use, should be taken into account when developing casemix systems. However, there has to date been little systematic collation of the evidence on the extent to which the addition of functioning information into existing casemix systems adds value to those systems with regard to the predictive power and resource variation explained by the groupings of these systems. Thus, the objective of this research was to examine the value of adding functioning information into casemix systems with respect to the prediction of resource use as measured by costs and length of stay. A systematic literature review was performed. Peer-reviewed studies, published before May 2014 were retrieved from CINAHL, EconLit, Embase, JSTOR, PubMed and Sociological Abstracts using keywords related to functioning ('Functioning', 'Functional status', 'Function*, 'ICF', 'International Classification of Functioning, Disability and Health', 'Activities of Daily Living' or 'ADL') and casemix systems ('Casemix', 'case mix', 'Diagnosis Related Groups', 'Function Related Groups', 'Resource Utilization Groups' or 'AN-SNAP'). In addition, a hand search of reference lists of included articles was conducted. Information about study aims, design, country, setting, methods, outcome variables, study results, and information regarding the authors' discussion of results, study limitations and implications was extracted. Ten included studies provided evidence demonstrating that adding functioning information into casemix systems improves predictive ability and fosters homogeneity in casemix groups with regard to costs and length of stay. Collection and integration of functioning information varied across studies. Results suggest

  4. Financial and health literacy predict incident AD dementia and AD pathology

    PubMed Central

    Yu, Lei; Wilson, Robert S.; Schneider, Julie A.; Bennett, David A.; Boyle, Patricia A.

    2017-01-01

    Background Domain specific literacy is a multidimensional construct that requires multiple resources including cognitive and non-cognitive factors. Objective We test the hypothesis that domain specific literacy is associated with AD dementia and AD pathology after controlling for cognition. Methods Participants were community based older persons who completed a baseline literacy assessment, underwent annual clinical evaluations for up to 8 years and agreed to organ donation after death. Financial and health literacy was measured using 32 questions and cognition was measured using 19 tests. Annual diagnosis of AD dementia followed standard criteria. AD pathology was examined post-mortem by quantifying plaques and tangles. Cox models examined the association of literacy with incident AD dementia. Performance of model prediction for incident AD dementia was assessed using indices for integrated discrimination improvement and continuous net reclassification improvement. Linear regression models examined the independent association of literacy with AD pathology in autopsied participants. Results All 805 participants were free of dementia at baseline and 102 (12.7%) developed AD dementia during the follow-up. Lower literacy was associated with higher risk for incident AD dementia (p<0.001), and the association persisted after controlling for cognition (Hazard Ratio=1.50, p=0.004). The model including the literacy measure had better predictive performance than the one with demographics and cognition only. Lower literacy also was associated with higher burden of AD pathology after controlling for cognition (β=0.07, p=0.035). Conclusion Literacy predicts incident AD dementia and AD pathology in community-dwelling older persons, and the association is independent of traditional measures of cognition. PMID:28157101

  5. Constructing the AdS dual of a Fermi liquid: AdS black holes with Dirac hair

    NASA Astrophysics Data System (ADS)

    Čubrović, Mihailo; Zaanen, Jan; Schalm, Koenraad

    2011-10-01

    We provide evidence that the holographic dual to a strongly coupled charged Fermi liquid has a non-zero fermion density in the bulk. We show that the pole-strength of the stable quasiparticle characterizing the Fermi surface is encoded in the AdS probability density of a single normalizable fermion wavefunction in AdS. Recalling Migdal's theorem which relates the pole strength to the Fermi-Dirac characteristic discontinuity in the number density at ω F , we conclude that the AdS dual of a Fermi liquid is described by occupied on-shell fermionic modes in AdS. Encoding the occupied levels in the total spatially averaged probability density of the fermion field directly, we show that an AdS Reissner-Nordström black holein a theory with charged fermions has a critical temperature, at which the system undergoes a first-order transition to a black hole with a non-vanishing profile for the bulk fermion field. Thermodynamics and spectral analysis support that the solution with non-zero AdS fermion-profile is the preferred ground state at low temperatures.

  6. Cognitively normal individuals with AD parents may be at risk for developing aging-related cortical thinning patterns characteristic of AD.

    PubMed

    Reiter, Katherine; Alpert, Kathryn I; Cobia, Derin J; Kwasny, Mary J; Morris, John C; Csernansky, John C; Wang, Lei

    2012-07-02

    Children of Alzheimer's disease (AD) patients are at heightened risk of developing AD due to genetic influences, including the apolipoprotein E4 (ApoE4) allele. In this study, we assessed the earliest cortical changes associated with AD in 71 cognitively healthy, adult children of AD patients (AD offspring) as compared with 69 with no family history of AD (non-AD offspring). Cortical thickness measures were obtained using FreeSurfer from 1.5T magnetic resonance (MR) scans. ApoE genotyping was obtained. Primary analyses examined family history and ApoeE4 effects on cortical thickness. Secondary analyses examined age effects within groups. All comparisons were adjusted using False Discovery Rate at a significance threshold of p<0.05. There were no statistically significant differences between family history and ApoE4 groups. Within AD offspring, increasing age was related to reduced cortical thickness (atrophy) over large areas of the precuneus, superior frontal and superior temporal gyri, starting at around age 60. Further, these patterns existed within female and maternal AD offspring, but were absent in male and paternal AD offspring. Within non-AD offspring, negative correlations existed over small regions of the superior temporal, insula and lingual cortices. These results suggest that as AD offspring age, cortical atrophy is more prominent, particularly if the parent with AD is mother or if the AD offspring is female. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Segmented strings in AdS 3

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Callebaut, Nele; Gubser, Steven S.; Samberg, Andreas

    We study segmented strings in flat space and in AdS 3. In flat space, these well known classical motions describe strings which at any instant of time are piecewise linear. In AdS 3, the worldsheet is composed of faces each of which is a region bounded by null geodesics in an AdS 2 subspace of AdS 3. The time evolution can be described by specifying the null geodesic motion of kinks in the string at which two segments are joined. The outcome of collisions of kinks on the worldsheet can be worked out essentially using considerations of causality. We studymore » several examples of closed segmented strings in AdS 3 and find an unexpected quasi-periodic behavior. Here, we also work out a WKB analysis of quantum states of yo-yo strings in AdS 5 and find a logarithmic term reminiscent of the logarithmic twist of string states on the leading Regge trajectory.« less

  8. Segmented strings in AdS 3

    DOE PAGES

    Callebaut, Nele; Gubser, Steven S.; Samberg, Andreas; ...

    2015-11-17

    We study segmented strings in flat space and in AdS 3. In flat space, these well known classical motions describe strings which at any instant of time are piecewise linear. In AdS 3, the worldsheet is composed of faces each of which is a region bounded by null geodesics in an AdS 2 subspace of AdS 3. The time evolution can be described by specifying the null geodesic motion of kinks in the string at which two segments are joined. The outcome of collisions of kinks on the worldsheet can be worked out essentially using considerations of causality. We studymore » several examples of closed segmented strings in AdS 3 and find an unexpected quasi-periodic behavior. Here, we also work out a WKB analysis of quantum states of yo-yo strings in AdS 5 and find a logarithmic term reminiscent of the logarithmic twist of string states on the leading Regge trajectory.« less

  9. Adding value to laboratory medicine: a professional responsibility.

    PubMed

    Beastall, Graham H

    2013-01-01

    Laboratory medicine is a medical specialty at the centre of healthcare. When used optimally laboratory medicine generates knowledge that can facilitate patient safety, improve patient outcomes, shorten patient journeys and lead to more cost-effective healthcare. Optimal use of laboratory medicine relies on dynamic and authoritative leadership outside as well as inside the laboratory. The first responsibility of the head of a clinical laboratory is to ensure the provision of a high quality service across a wide range of parameters culminating in laboratory accreditation against an international standard, such as ISO 15189. From that essential baseline the leadership of laboratory medicine at local, national and international level needs to 'add value' to ensure the optimal delivery, use, development and evaluation of the services provided for individuals and for groups of patients. A convenient tool to illustrate added value is use of the mnemonic 'SCIENCE'. This tool allows added value to be considered in seven domains: standardisation and harmonisation; clinical effectiveness; innovation; evidence-based practice; novel applications; cost-effectiveness; and education of others. The assessment of added value in laboratory medicine may be considered against a framework that comprises three dimensions: operational efficiency; patient management; and patient behaviours. The profession and the patient will benefit from sharing examples of adding value to laboratory medicine.

  10. Functional determinants of radial operators in AdS2

    DOE PAGES

    Aguilera-Damia, Jeremías; Faraggi, Alberto; Zayas, Leopoldo Pando; ...

    2018-06-01

    We study the zeta-function regularization of functional determinants of Laplace and Dirac-type operators in two-dimensional Euclidean AdS2 space. More specifically, we consider the ratio of determinants between an operator in the presence of background fields with circular symmetry and the free operator in which the background fields are absent. By Fourier-transforming the angular dependence, one obtains an infinite number of one-dimensional radial operators, the determinants of which are easy to compute. The summation over modes is then treated with care so as to guarantee that the result coincides with the two-dimensional zeta-function formalism. The method relies on some well-known techniquesmore » to compute functional determinants using contour integrals and the construction of the Jost function from scattering theory. Our work generalizes some known results in flat space. The extension to conformal AdS2 geometries is also considered. We provide two examples, one bosonic and one fermionic, borrowed from the spectrum of fluctuations of the holographic 1/4-BPS latitude Wilson loop.« less

  11. Functional determinants of radial operators in AdS 2

    NASA Astrophysics Data System (ADS)

    Aguilera-Damia, Jeremías; Faraggi, Alberto; Zayas, Leopoldo Pando; Rathee, Vimal; Silva, Guillermo A.

    2018-06-01

    We study the zeta-function regularization of functional determinants of Laplace and Dirac-type operators in two-dimensional Euclidean AdS 2 space. More specifically, we consider the ratio of determinants between an operator in the presence of background fields with circular symmetry and the free operator in which the background fields are absent. By Fourier-transforming the angular dependence, one obtains an infinite number of one-dimensional radial operators, the determinants of which are easy to compute. The summation over modes is then treated with care so as to guarantee that the result coincides with the two-dimensional zeta-function formalism. The method relies on some well-known techniques to compute functional determinants using contour integrals and the construction of the Jost function from scattering theory. Our work generalizes some known results in flat space. The extension to conformal AdS 2 geometries is also considered. We provide two examples, one bosonic and one fermionic, borrowed from the spectrum of fluctuations of the holographic 1/4 -BPS latitude Wilson loop.

  12. [Item function analysis on the Quality of Life-Alzheimer's Disease(QOL-AD)Chinese version, based on the Item Response Theory(IRT)].

    PubMed

    Wan, Li-ping; He, Run-lian; Ai, Yong-mei; Zhang, Hui-min; Xing, Min; Yang, Lin; Song, Yan-long; Yu, Hong-mei

    2013-07-01

    To introduce the Item Function Analysis(IFA) of Quality of Life- Alzheimer's disease(QOL-AD)Chinese version and to explore the feasibility of its application on Chinese patients with AD. Two hundred AD patients were interviewed and assessed by QOL-AD, through the stratified cluster sampling method. Multilog 7.03. was used for Item Function Analysis. Difference scale(a), difficulty scale(b)and Item Characteristic Curve(ICC) of each item of QOL-AD were provided. Different scales of the item 1, 7 were below 0.6, while all the others were above 0.6. As for ICC. The first and last lines for the other items were monotonic in which the two in between were in inverted V-shape, with very steep slopes, except for the item 1 and 7. Results form the IFA showed that QOL-AD was applicable to be used in the Chinese patients with AD.

  13. Early identification of MCI converting to AD: a FDG PET study.

    PubMed

    Pagani, Marco; Nobili, Flavio; Morbelli, Silvia; Arnaldi, Dario; Giuliani, Alessandro; Öberg, Johanna; Girtler, Nicola; Brugnolo, Andrea; Picco, Agnese; Bauckneht, Matteo; Piva, Roberta; Chincarini, Andrea; Sambuceti, Gianmario; Jonsson, Cathrine; De Carli, Fabrizio

    2017-11-01

    Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer's disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not. FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy. The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89% (AUC 0.91), correctly detecting 93% of the nc-MCI patients. In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89%. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD.

  14. Bendamustine added to allogeneic conditioning improves long-term outcomes in patients with CLL.

    PubMed

    Khouri, I F; Sui, D; Jabbour, E J; Samuels, B I; Turturro, F; Alatrash, G; Anderlini, P; Ahmed, S; Oran, B; Ciurea, S O; Marin, D; Olson, A; Patel, K K; Popat, U R; Ledesma, C; Kadia, T M; Ferrajoli, A; Burger, J A; Jorgensen, J L; Medeiros, L J; Bassett, R L; Gulbis, A M

    2017-01-01

    Bendamustine has shown a favorable safety profile when included in chemotherapy regimens for several types of lymphoma, including CLL. This study investigated the long-term effect of adding bendamustine to a conditioning regimen on survival, rate of engraftment, immune recovery and GvHD after allogeneic stem cell transplantation (alloSCT) in CLL patients. These outcomes were compared with the fludarabine, cyclophosphamide and rituximab (FCR) conditioning regimen. We reviewed the data for 89 CLL patients treated on three trials at our institution. Twenty-six (29%) patients received bendamustine, fludarabine and rituximab (BFR) and 63 (71%) received FCR. Patient characteristics were similar in both groups. Ten (38%) BFR-treated patients vs only two (3%) FCR-treated patients did not experience severe neutropenia (P=<0.001). The 3-year overall survival estimates for the BFR and FCR groups were 82 and 51% (P=0.03), and the 3-year PFS estimates were 63% and 27% (P=0.001), respectively. The 2-year treatment-related mortality was 8 and 23% and the incidence of grade 3 or 4 GvHD was 4% and 10%, respectively. This study is the first to report that addition of bendamustine to alloSCT conditioning for CLL patients is associated with improved survival and lower mortality, myelosuppression, and GvHD.

  15. Entanglement entropy of AdS5 × S5 with massive flavors

    NASA Astrophysics Data System (ADS)

    Hu, Sen; Wu, Guozhen

    2018-01-01

    We consider backreacted AdS5 × S5 coupled with Nf massive flavors introduced by D7 branes. The backreacted geometry is in the Veneziano limit with fixed Nf/Nc. By dividing one of the directions into a line segment with length l, we get two subspaces. Then we calculate the entanglement entropy between them. With the method of [I. R. Klebanov, D. Kutasov and A. Murugan, Nucl. Phys. B 796, 274 (2008)], we are able to find the cut-off independent part of the entanglement entropy and finally find that this geometry shows no confinement/deconfinement phase transition at zero temperature from the holographic entanglement entropy point of view similar to the case in pure AdS5 × S5.

  16. The AdS3 propagator and the fate of locality

    NASA Astrophysics Data System (ADS)

    Chen, Hongbin; Fitzpatrick, A. Liam; Kaplan, Jared; Li, Daliang

    2018-04-01

    We recently used Virasoro symmetry considerations to propose an exact formula for a bulk proto-field ϕ in AdS3. In this paper we study the propagator < ϕϕ>. We show that many techniques from the study of conformal blocks can be generalized to compute it, including the semiclassical monodromy method and both forms of the Zamolodchikov recursion relations. When the results from recursion are expanded at large central charge, they match gravitational perturbation theory for a free scalar field coupled to gravity in our chosen gauge. We find that although the propagator is finite and well-defined at long distances, its perturbative expansion in {G}_N=3/2c exhibits UV/IR mixing effects. If we nevertheless interpret < ϕϕ> as a probe of bulk locality, then when {G}_{N{m}_{φ }}≪ 1 locality breaks down at the new short-distance scale {σ}_{\\ast}˜ √[4]{G_N{R}_{AdS}^3} . For ϕ with very large bulk mass, or at small central charge, bulk locality fails at the AdS length scale. In all cases, locality `breakdown' manifests as singularities or branch cuts at spacelike separation arising from non-perturbative quantum gravitational effects.

  17. Warped AdS3 black holes

    NASA Astrophysics Data System (ADS)

    Song, Wei; Anninos, Dionysios; Li, Wei; Padi, Megha; Strominger, Andrew

    2009-03-01

    Three dimensional topologically massive gravity (TMG) with a negative cosmological constant -ell-2 and positive Newton constant G admits an AdS3 vacuum solution for any value of the graviton mass μ. These are all known to be perturbatively unstable except at the recently explored chiral point μell = 1. However we show herein that for every value of μell ≠ 3 there are two other (potentially stable) vacuum solutions given by SL(2,Bbb R) × U(1)-invariant warped AdS3 geometries, with a timelike or spacelike U(1) isometry. Critical behavior occurs at μell = 3, where the warping transitions from a stretching to a squashing, and there are a pair of warped solutions with a null U(1) isometry. For μell > 3, there are known warped black hole solutions which are asymptotic to warped AdS3. We show that these black holes are discrete quotients of warped AdS3 just as BTZ black holes are discrete quotients of ordinary AdS3. Moreover new solutions of this type, relevant to any theory with warped AdS3 solutions, are exhibited. Finally we note that the black hole thermodynamics is consistent with the hypothesis that, for μell > 3, the warped AdS3 ground state of TMG is holographically dual to a 2D boundary CFT with central charges c_R-formula and c_L-formula.

  18. Warped AdS3 black holes

    NASA Astrophysics Data System (ADS)

    Anninos, Dionysios; Li, Wei; Padi, Megha; Song, Wei; Strominger, Andrew

    2009-03-01

    Three dimensional topologically massive gravity (TMG) with a negative cosmological constant -l-2 and positive Newton constant G admits an AdS3 vacuum solution for any value of the graviton mass μ. These are all known to be perturbatively unstable except at the recently explored chiral point μl = 1. However we show herein that for every value of μl ≠ 3 there are two other (potentially stable) vacuum solutions given by SL(2,Bbb R) × U(1)-invariant warped AdS3 geometries, with a timelike or spacelike U(1) isometry. Critical behavior occurs at μl = 3, where the warping transitions from a stretching to a squashing, and there are a pair of warped solutions with a null U(1) isometry. For μl > 3, there are known warped black hole solutions which are asymptotic to warped AdS3. We show that these black holes are discrete quotients of warped AdS3 just as BTZ black holes are discrete quotients of ordinary AdS3. Moreover new solutions of this type, relevant to any theory with warped AdS3 solutions, are exhibited. Finally we note that the black hole thermodynamics is consistent with the hypothesis that, for μl > 3, the warped AdS3 ground state of TMG is holographically dual to a 2D boundary CFT with central charges c_R-formula and c_L-formula.

  19. Effect of guar gum added to the diet of patients with duodenal ulcer.

    PubMed

    Harju, E J; Larmi, T K

    1985-01-01

    In a randomized, double-blind, controlled clinical study, the effects of 5 g of guar gum, a dietary fiber composed of galactose and mannose, or placebo added to the diet of 20 patients with duodenal ulcer for 1 wk each were examined. Ten patients derived evident benefit and five some help from guar gum, on comparing symptoms during administration of guar gum with those experienced earlier or during the placebo week, whereas four patients found that neither guar gum nor placebo had any effect (p less than 0.001). The beneficial effect was associated with increased feelings of repletion after meals. Patients with fewest symptoms benefited only slightly, or not at all, from guar gum. In one patient, guar gum abolished pain felt earlier and on placebo, but also caused severe gastric retention after meals. This patient had pyloric stenosis. In patients who were intolerant to berries, fruits, sugar, sweet rolls, and pizza these foodstuffs were better tolerated during guar gum administration. The diarrhea which occurs in some patients ingesting guar gum was avoided by giving low initial doses. In three patients unpalatability of guar gum was a minor complaint. It is concluded that guar gum is helpful to many patients with uncomplicated duodenal ulcer, but that it is harmful to those having increased gastric emptying, eg, pyloric stenosis patients, and that guar gum may exert its effects by increasing gastric emptying time.

  20. 27 CFR 19.456 - Adding denaturants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... methods of mixing denaturants and spirits if he deems such denaturation will not hinder effective... Denaturation § 19.456 Adding denaturants. Denaturants and spirits shall be mixed in packages, tanks, or bulk... proprietor shall submit a flow diagram of the intended process or method of adding denaturants. (Sec. 201...

  1. Dupilumab therapy provides clinically meaningful improvement in patient-reported outcomes (PROs): A phase IIb, randomized, placebo-controlled, clinical trial in adult patients with moderate to severe atopic dermatitis (AD).

    PubMed

    Simpson, Eric L; Gadkari, Abhijit; Worm, Margitta; Soong, Weily; Blauvelt, Andrew; Eckert, Laurent; Wu, Richard; Ardeleanu, Marius; Graham, Neil M H; Pirozzi, Gianluca; Sutherland, E Rand; Mastey, Vera

    2016-09-01

    Moderate to severe atopic dermatitis (AD) is associated with substantial patient burden despite current therapies. We sought to evaluate dupilumab treatment on patient-reported outcomes in adults with moderate to severe AD. Adults (N = 380) with moderate to severe AD inadequately controlled by topical medications were randomized to 16 weeks of double-blind, subcutaneous treatment with dupilumab 100 mg every 4 weeks, 200 mg every 2 weeks, 300 mg every 2 weeks, 300 mg once weekly, or placebo. Patient-reported outcomes included pruritus numeric rating scale; patient-reported sleep item on Scoring AD scale; Patient-Oriented Eczema Measure; Hospital Anxiety and Depression Scale; Dermatology Life Quality Index; and 5-dimension 3-level EuroQol. Dupilumab reduced peak itch at 16 weeks relative to placebo by 1.1 to 3.2 points on numeric rating scale (P < .0001 all doses, except 100 mg every 4 weeks P < .05); improved sleep and health-related quality of life on Dermatology Life Quality Index and 5-dimension 3-level EuroQol (P < .05 all doses, except 100 mg every 4 weeks); and reduced anxiety and depression symptoms (P < .05 all doses). Dupilumab's effects appeared early and achieved clinically relevant improvements without significant safety concerns. There are potential cultural differences affecting patient-reported outcome responses. Outcomes were secondary or exploratory end points. Dupilumab produced early and sustained patient-reported and clinically relevant improvements in sleep, mental health, and health-related quality of life; the two 300-mg dose regimens resulted in greatest benefits. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Bayesian Methods for Scalable Multivariate Value-Added Assessment

    ERIC Educational Resources Information Center

    Lockwood, J. R.; McCaffrey, Daniel F.; Mariano, Louis T.; Setodji, Claude

    2007-01-01

    There is increased interest in value-added models relying on longitudinal student-level test score data to isolate teachers' contributions to student achievement. The complex linkage of students to teachers as students progress through grades poses both substantive and computational challenges. This article introduces a multivariate Bayesian…

  3. Adding Debriefing to Objective Structured Clinical Examinations to Enhance Disability Cultural Sensitivity in Pharmacy Students

    ERIC Educational Resources Information Center

    Smith, Mark Joseph

    2016-01-01

    Debriefing was added to the design of an objective structured clinical examination (OSCE) after second-year pharmacy students performed poorly at considering patient disability in planning for patient care. This mixed-methods study examines secondary data to explore whether and how the addition of a debriefing to an OSCE impacted pharmacy…

  4. Does adding ketamine to morphine patient-controlled analgesia safely improve post-thoracotomy pain?

    PubMed

    Mathews, Timothy J; Churchhouse, Antonia M D; Housden, Tessa; Dunning, Joel

    2012-02-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'is the addition of ketamine to morphine patient-controlled analgesia (PCA) following thoracic surgery superior to morphine alone'. Altogether 201 papers were found using the reported search, of which nine represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. This consisted of one systematic review of PCA morphine with ketamine (PCA-MK) trials, one meta-analysis of PCA-MK trials, four randomized controlled trials of PCA-MK, one meta-analysis of trials using a variety of peri-operative ketamine regimes and two cohort studies of PCA-MK. Main outcomes measured included pain score rated on visual analogue scale, morphine consumption and incidence of psychotomimetic side effects/hallucination. Two papers reported the measurements of respiratory function. This evidence shows that adding ketamine to morphine PCA is safe, with a reported incidence of hallucination requiring intervention of 2.9%, and a meta-analysis finding an incidence of all central nervous system side effects of 18% compared with 15% with morphine alone, P = 0.31, RR 1.27 with 95% CI (0.8-2.01). All randomized controlled trials of its use following thoracic surgery found no hallucination or psychological side effect. All five studies in thoracic surgery (n = 243) found reduced morphine requirements with PCA-MK. Pain scores were significantly lower in PCA-MK patients in thoracic surgery papers, with one paper additionally reporting increased patient satisfaction. However, no significant improvement was found in a meta-analysis of five papers studying PCA-MK in a variety of surgical settings. Both papers reporting respiratory outcomes found improved oxygen saturations and PaCO(2) levels in PCA-MK patients following thoracic surgery

  5. Early-onset Alzheimer's disease: nonamnestic subtypes and type 2 AD.

    PubMed

    Mendez, Mario F

    2012-11-01

    Patients with Alzheimer's disease (AD), the most prevalent neurodegenerative dementia, are usually elderly; however, ∼4-5% develop early-onset AD (EOAD) with onset before age 65. Most EOAD is sporadic, but about 5% of patients with EOAD have an autosomal dominant mutation such as Presenilin 1, Presenilin 2, or alterations in the Amyloid Precursor Protein gene. Although most Alzheimer's research has concentrated on older, late-onset AD (LOAD), there is much recent interest and research in EOAD. These recent studies indicate that EOAD is a heterogeneous disorder with significant differences from LOAD. From 22-64% of EOAD patients have a predominant nonamnestic syndrome presenting with deficits in language, visuospatial abilities, praxis, or other non-memory cognition. These nonamnestic patients may differ in several ways from the usual memory or amnestic patients. Patients with nonamnestic EOAD compared to typical amnestic AD have a more aggressive course, lack the apolipoprotein Eɛ4 (APOE ɛ4) susceptibility gene for AD, and have a focus and early involvement of non-hippocampal areas of brain, particularly parietal neocortex. These differences in the EOAD subtypes indicate differences in the underlying amyloid cascade, the prevailing pathophysiological theory for the development of AD. Together the results of recent studies suggest that nonamnestic subtypes of EOAD constitute a Type 2 AD distinct from the usual, typical disorder. In sum, the study of EOAD can reveal much about the clinical heterogeneity, predisposing factors, and neurobiology of this disease. Copyright © 2012 IMSS. Published by Elsevier Inc. All rights reserved.

  6. Topological terms, AdS2 n gravity, and renormalized entanglement entropy of holographic CFTs

    NASA Astrophysics Data System (ADS)

    Anastasiou, Giorgos; Araya, Ignacio J.; Olea, Rodrigo

    2018-05-01

    We extend our topological renormalization scheme for entanglement entropy to holographic CFTs of arbitrary odd dimensions in the context of the AdS /CFT correspondence. The procedure consists in adding the Chern form as a boundary term to the area functional of the Ryu-Takayanagi minimal surface. The renormalized entanglement entropy thus obtained can be rewritten in terms of the Euler characteristic and the AdS curvature of the minimal surface. This prescription considers the use of the replica trick to express the renormalized entanglement entropy in terms of the renormalized gravitational action evaluated on the conically singular replica manifold extended to the bulk. This renormalized action is obtained in turn by adding the Chern form as the counterterm at the boundary of the 2 n -dimensional asymptotically AdS bulk manifold. We explicitly show that, up to next-to-leading order in the holographic radial coordinate, the addition of this boundary term cancels the divergent part of the entanglement entropy. We discuss possible applications of the method for studying CFT parameters like central charges.

  7. Loop corrections for Kaluza-Klein AdS amplitudes

    NASA Astrophysics Data System (ADS)

    Aprile, F.; Drummond, J. M.; Heslop, P.; Paul, H.

    2018-05-01

    Recently we conjectured the four-point amplitude of graviton multiplets in AdS5 × S5 at one loop by exploiting the operator product expansion of N = 4 super Yang-Mills theory. Here we give the first extension of those results to include Kaluza-Klein modes, obtaining the amplitude for two graviton multiplets and two states of the first KK mode. Our method again relies on resolving the large N degeneracy among a family of long double-trace operators, for which we obtain explicit formulas for the leading anomalous dimensions. Having constructed the one-loop amplitude we are able to obtain a formula for the one-loop corrections to the anomalous dimensions of all twist five double-trace operators.

  8. Aspects of warped AdS3/CFT2 correspondence

    NASA Astrophysics Data System (ADS)

    Chen, Bin; Zhang, Jia-Ju; Zhang, Jian-Dong; Zhong, De-Liang

    2013-04-01

    In this paper we apply the thermodynamics method to investigate the holographic pictures for the BTZ black hole, the spacelike and the null warped black holes in three-dimensional topologically massive gravity (TMG) and new massive gravity (NMG). Even though there are higher derivative terms in these theories, the thermodynamics method is still effective. It gives consistent results with the ones obtained by using asymptotical symmetry group (ASG) analysis. In doing the ASG analysis we develop a brute-force realization of the Barnich-Brandt-Compere formalism with Mathematica code, which also allows us to calculate the masses and the angular momenta of the black holes. In particular, we propose the warped AdS3/CFT2 correspondence in the new massive gravity, which states that quantum gravity in the warped spacetime could holographically dual to a two-dimensional CFT with {c_R}={c_L}=24 /{Gm{β^2√{{2( {21-4{β^2}} )}}}}.

  9. Quantitative EEG and LORETA: valuable tools in discerning FTD from AD?

    PubMed

    Caso, Francesca; Cursi, Marco; Magnani, Giuseppe; Fanelli, Giovanna; Falautano, Monica; Comi, Giancarlo; Leocani, Letizia; Minicucci, Fabio

    2012-10-01

    Drawing a clinical distinction between frontotemporal dementia (FTD) and Alzheimer's disease (AD) is tricky, particularly at the early stages of disease. This study evaluates the possibility in differentiating 39 FTD, 39 AD, and 39 controls (CTR) by means of power spectral analysis and standardized low resolution brain electromagnetic tomography (sLORETA) within delta, theta, alpha 1 and 2, beta 1, 2, and 3 frequency bands. Both analyses revealed in AD patients, relative to CTR, higher expression of diffuse delta/theta and lower central/posterior fast frequency (from alpha1 to beta2) bands. FTD patients showed diffuse increased theta power compared with CTR and lower delta relative to AD patients. Compared with FTD, AD patients showed diffuse higher theta power at spectral analysis and, at sLORETA, decreased alpha2 and beta1 values in central/temporal regions. Spectral analysis and sLORETA provided complementary information that might help characterizing different patterns of electroencephalogram (EEG) oscillatory activity in AD and FTD. Nevertheless, this differentiation was possible only at the group level because single patients could not be discerned with sufficient accuracy. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Early detection of AD using cortical thickness measurements

    NASA Astrophysics Data System (ADS)

    Spjuth, M.; Gravesen, F.; Eskildsen, S. F.; Østergaard, L. R.

    2007-03-01

    Alzheimer's disease (AD) is a neurodegenerative disorder that causes cortical atrophy and impaired cognitive functions. The diagnosis is difficult to make and is often made over a longer period of time using a combination of neuropsychological tests, and structural and functional imaging. Due to the impact of early intervention the challenge of distinguishing early AD from normal ageing has received increasing attention. This study uses cortical thickness measurements to characterize the atrophy in nine mild AD patients (mean MMSE-score 23.3 (std: 2.6)) compared to five healthy middle-aged subjects. A fully automated method based on deformable models is used for delineation of the inner and outer boundaries of the cerebral cortex from Magnetic Resonance Images. This allows observer independent high-resolution quantification of the cortical thickness. The cortex analysis facilitates detection of alterations throughout the entire cortical mantle. To perform inter-subject thickness comparison in which the spatial information is retained, a feature-based registration algorithm is developed which uses local cortical curvature, normal vector, and a distance measure. A comparison of the two study groups reveals that the lateral side of the hemispheres shows diffuse thinner areas in the mild AD group but especially the medial side shows a pronounced thinner area which can be explained by early limbic changes in AD. For classification principal component analysis is applied to reduce the high number of thickness measurements (>200,000) into fewer features. All mild AD and healthy middle-aged subjects are classified correctly (sensitivity and specificity 100%).

  11. Efficacy and safety of adding alirocumab to rosuvastatin versus adding ezetimibe or doubling the rosuvastatin dose in high cardiovascular-risk patients: The ODYSSEY OPTIONS II randomized trial.

    PubMed

    Farnier, Michel; Jones, Peter; Severance, Randall; Averna, Maurizio; Steinhagen-Thiessen, Elisabeth; Colhoun, Helen M; Du, Yunling; Hanotin, Corinne; Donahue, Stephen

    2016-01-01

    To compare lipid-lowering efficacy of adding alirocumab to rosuvastatin versus other treatment strategies (NCT01730053). Patients receiving baseline rosuvastatin regimens (10 or 20 mg) were randomized to: add-on alirocumab 75 mg every-2-weeks (Q2W) (1-mL subcutaneous injection via pre-filled pen); add-on ezetimibe 10 mg/day; or double-dose rosuvastatin. Patients had cardiovascular disease (CVD) and low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dL (1.8 mmol/L) or CVD risk factors and LDL-C ≥100 mg/dL (2.6 mmol/L). In the alirocumab group, dose was blindly increased at Week 12 to 150 mg Q2W (also 1-mL volume) in patients not achieving their LDL-C target. Primary endpoint was percent change in calculated LDL-C from baseline to 24 weeks (intent-to-treat). 305 patients were randomized. In the baseline rosuvastatin 10 mg group, significantly greater LDL-C reductions were observed with add-on alirocumab (-50.6%) versus ezetimibe (-14.4%; p < 0.0001) and double-dose rosuvastatin (-16.3%; p < 0.0001). In the baseline rosuvastatin 20 mg group, LDL-C reduction with add-on alirocumab was -36.3% compared with -11.0% with ezetimibe and -15.9% with double-dose rosuvastatin (p = 0.0136 and 0.0453, respectively; pre-specified threshold for significance p < 0.0125). Overall, ∼80% alirocumab patients were maintained on 75 mg Q2W. Of alirocumab-treated patients, 84.9% and 66.7% in the baseline rosuvastatin 10 and 20 mg groups, respectively, achieved risk-based LDL-C targets. Treatment-emergent adverse events occurred in 56.3% of alirocumab patients versus 53.5% ezetimibe and 67.3% double-dose rosuvastatin (pooled data). The addition of alirocumab to rosuvastatin provided incremental LDL-C lowering versus adding ezetimibe or doubling the rosuvastatin dose. Copyright © 2015 Regeneron Pharmaceuticals, Inc. Published by Elsevier Ireland Ltd.. All rights reserved.

  12. Mystery cloud of AD 536

    NASA Technical Reports Server (NTRS)

    Stothers, R. B.

    1984-01-01

    The possible cause of the densest and most persistent dry fog on record, which was observed in Europe and the Middle East during AD 536 and 537, is discussed. The fog's long duration toward the south and the high sulfuric acid signal detected in Greenland in ice cores dated around AD 540 support the theory that the fog was due to the explosion of the Rabaul volcano, the occurrence of which has been dated at about AD 540 by the radiocarbon method.

  13. What makes an ad a cigarette ad? Commercial tobacco imagery in the lesbian, gay, and bisexual press

    PubMed Central

    Smith, E.; Offen, N.; Malone, R.

    2005-01-01

    Objectives: To determine the extent of commercial tobacco imagery in the lesbian, gay, and bisexual (LGB) press. Methods: Content analysis of all advertising containing tobacco related text or imagery in 20 LGB community periodicals, published between January 1990 and December 2000. Results: 3428 ads were found: 689 tobacco product ads, 1607 ads for cessation products or services, 99 ads with a political message about tobacco, and 1033 non-tobacco ads that showed tobacco (NAST). Although cessation ads were numerically dominant, tobacco product ads and NAST occupied more space and were more likely to use images. NAST almost never had an anti-tobacco message. Formal sponsorship between tobacco and other companies was very rare. Lesbian periodicals had proportionally more NAST and fewer cessation ads. Conclusions: Cigarette ads were outnumbered by NAST. Although these ads do not usually show brands, and are unlikely to be the result of formal sponsorship agreements, they may be "selling" smoking. Tobacco control advocates should persuade editors to refuse tobacco product ads and those with gratuitous tobacco imagery. PMID:16286500

  14. Phenotypic regional fMRI activation patterns during memory encoding in MCI and AD

    PubMed Central

    Browndyke, Jeffrey N.; Giovanello, Kelly; Petrella, Jeffrey; Hayden, Kathleen; Chiba-Falek, Ornit; Tucker, Karen A.; Burke, James R.; Welsh-Bohmer, Kathleen A.

    2014-01-01

    Background Reliable blood-oxygen-level-dependent (BOLD) fMRI phenotypic biomarkers of Alzheimer's disease (AD) or mild cognitive impairment (MCI) are likely to emerge only from a systematic, quantitative, and aggregate examination of the functional neuroimaging research literature. Methods A series of random-effects, activation likelihood estimation (ALE) meta-analyses were conducted on studies of episodic memory encoding operations in AD and MCI samples relative to normal controls. ALE analyses were based upon a thorough literature search for all task-based functional neuroimaging studies in AD and MCI published up to January 2010. Analyses covered 16 fMRI studies, which yielded 144 distinct foci for ALE meta-analysis. Results ALE results indicated several regional task-based BOLD consistencies in MCI and AD patients relative to normal controls across the aggregate BOLD functional neuroimaging research literature. Patients with AD and those at significant risk (MCI) showed statistically significant consistent activation differences during episodic memory encoding in the medial temporal lobe (MTL), specifically parahippocampal gyrus, as well superior frontal gyrus, precuneus, and cuneus, relative to normal controls. Conclusions ALE consistencies broadly support the presence of frontal compensatory activity, MTL activity alteration, and posterior midline “default mode” hyperactivation during episodic memory encoding attempts in the diseased or prospective pre-disease condition. Taken together these robust commonalities may form the foundation for a task-based fMRI phenotype of memory encoding in AD. PMID:22841497

  15. Development of a method to manufacture uncured, no-nitrate/nitrite-added whole muscle jerky.

    PubMed

    Sindelar, Jeffrey J; Terns, Matthew J; Meyn, Elizabeth; Boles, Jane A

    2010-10-01

    "Natural curing" is accomplished by use of vegetable juice/powder high in naturally occurring nitrates combined with a nitrate reducing starter culture to result in indirectly "cured" products. Since the starter culture used is not water soluble, making "naturally cured" whole muscle jerky with current manufacturing techniques has been found ineffective. The objective was to investigate processes for whole muscle beef jerky that might provide cured meat characteristics similar to those of a nitrite-added control. Treatments where jerky was placed in a barrier bag during incubation were found to be the least similar to the nitrite-added control. Jerky placed in a 40.6 degrees C smokehouse during incubation resulted in significantly more (P<0.05) converted cured pigment than the barrier bag treatments but less (P<0.05) than the control. The processing methods investigated to manufacture "naturally cured" whole muscle jerky in this study were ineffective in resulting in products similar to those cured with sodium nitrite. Published by Elsevier Ltd.

  16. Evaluation of the added value of imaging the pelvis in patients with hepatocellular cancer.

    PubMed

    Szklaruk, Janio; Kaya, Diana; Wei, Wei

    2018-02-01

    The study aims to evaluate added value of the pelvic portion of the computed tomography (CT) and magnetic resonance imaging (MRI) examination in patients with a primary diagnosis of hepatocellular cancer (HCC). The study reviewed the medical records of 478 patients with 881 examinations of the abdomen and pelvis who underwent treatment at our institution between March 2015 and March 2016. These patients were reviewed for presence of pathology in the pelvis, which were classified into two categories as new or old (already known on prior imaging). Of 478 patients, 230 underwent MRI examination of the abdomen and pelvis, and the other 248 underwent CT scans of these regions. There were no findings on the CT or MRI of the pelvis in 80.5% of patients (n = 385), including 81.5% of those who had CT and 79.6% of those who had MRI. Ninety-three patients had findings in the pelvis, the most common of which were bone metastases (31 patients), ascites (27 patients), implants (seven patients), and bladder wall thickening (five patients). In only 7.9% of patients, the findings were related to metastatic disease. In 5.4% of all imaging studies revealed a new finding in the pelvis. Imaging of the pelvis (CT or MRI) does not seem to provide additional information in the majority of cases with HCC. The results suggest that the follow-up evaluation of patients with HCC may not include a pelvis exam. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  17. AdVance male sling

    PubMed Central

    Chung, Amanda S. J.; Suarez, Oscar A.

    2017-01-01

    The AdVance sling (American Medical Systems, Minnetonka, MN, United States of America) is a synthetic transobturator sling, which is a safe and effective minimally invasive treatment for mild to moderate stress urinary incontinence (SUI) in male patients. This article provides a step-by-step description of our technique for placement of the AdVance male sling, including details and nuances gained from surgical experience, advice for avoidance of complications and discussion on management of complications and sling failures. Patient selection is very important, including exclusion and preoperative treatment of urethral stenosis and bladder dysfunction. Previous pelvic radiation is a poor prognostic factor. In brief, the steps of sling placement are: (I) mobilization of the corpus spongiosum (CS); (II) marking and mobilization of the central tendon; (III) passage of the helical trocar needles exiting at the apex of the angle between the CS and inferior pubic ramus; (IV) fixation of the broad part of the sling body to the CS at the previous mark; (V) cystoscopy during sling tensioning; (VI) placement of a Foley urethral catheter; (VII) Subcutaneous tunnelling of the sling arms back toward the midline; (VIII) wound closure. The most common early postoperative complication is urinary retention but long-term retention is extremely rare. Management of sling failures include placement of an artificial urinary sphincter, repeat AdVance sling, urethral bulking agent or ProACT device. PMID:28904900

  18. Autism Disorder (AD): An Updated Review for Paediatric Dentists.

    PubMed

    J, Udhya; M M, Varadharaja; J, Parthiban; Srinivasan, Ila

    2014-02-01

    Over the past two decades, there has been an explosion of interest in Autism Disorder (AD). Knowledge and awareness on the condition has grown exponentially at all levels among the general public, parents, health professionals, the research community and more recently, at parliamentary level. The world has begun to recognize the scope of this problem and act internationally and locally to improve the lives of the growing number of individuals and families affected by this devastating disorder. This article reviews the dental literature since 1969 and it summarizes characteristics of patients with AD, oral health status and dental management of patients with AD.

  19. Do Value-Added Methods Level the Playing Field for Teachers? What We Know Series: Value-Added Methods and Applications. Knowledge Brief 2

    ERIC Educational Resources Information Center

    McCaffrey, Daniel F.

    2012-01-01

    Value-added models have caught the interest of policymakers because, unlike using student tests scores for other means of accountability, they purport to "level the playing field." That is, they supposedly reflect only a teacher's effectiveness, not whether she teaches high- or low-income students, for instance, or students in accelerated or…

  20. The added mass forces in insect flapping wings.

    PubMed

    Liu, Longgui; Sun, Mao

    2018-01-21

    The added mass forces of three-dimensional (3D) flapping wings of some representative insects, and the accuracy of the often used simple two-dimensional (2D) method, are studied. The added mass force of a flapping wing is calculated by both 3D and 2D methods, and the total aerodynamic force of the wing is calculated by the CFD method. Our findings are as following. The added mass force has a significant contribution to the total aerodynamic force of the flapping wings during and near the stroke reversals, and the shorter the stroke amplitude is, the larger the added mass force becomes. Thus the added mass force could not be neglected when using the simple models to estimate the aerodynamics force, especially for insects with relatively small stroke amplitudes. The accuracy of the often used simple 2D method is reasonably good: when the aspect ratio of the wing is greater than about 3.3, error in the added mass force calculation due to the 2D assumption is less than 9%; even when the aspect ratio is 2.8 (approximately the smallest for an insect), the error is no more than 13%. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. The value of adding mirror therapy for upper limb motor recovery of subacute stroke patients: a randomized controlled trial.

    PubMed

    Invernizzi, M; Negrini, S; Carda, S; Lanzotti, L; Cisari, C; Baricich, A

    2013-06-01

    Upper limb paresis remains a relevant challenge in stroke rehabilitation. To evaluate if adding mirror therapy (MT) to conventional therapy (CT) can improve motor recovery of the upper limb in subacute stroke patients. Prospective, single-center, single-blind, randomised, controlled trial. Subacute stroke patients referred to a Physical and Rehabilitation Medicine Unit between October 2009 and August 2011. Twenty-six subacute stroke patients (time from stroke <4 weeks) with upper limb paresis (Motricity Index ≤ 77). Patients were randomly allocated to the MT (N.=13) or to the CT group (N.=13). Both followed a comprehensive rehabilitative treatment. In addition, MT Group had 30 minutes of MT while the CT group had 30 minutes of sham therapy. Action Research Arm Test (ARAT) was the primary outcome measures. Motricity Index (MI) and the Functional Independence Measure (FIM) were the secondary outcome measures. After one month of treatment patients of both groups showed statistically significant improvements in all the variables measured (P<0.05). Moreover patients of the MT group had greater improvements in the ARAT, MI and FIM values compared to CT group (P<0.01, Glass's Δ Effect Size: 1.18). No relevant adverse event was recorded during the study. MT is a promising and easy method to improve motor recovery of the upper limb in subacute stroke patients. While MT use has been advocated for acute patients with no or negligible motor function, it can be usefully extended to patients who show partial motor recovery. The easiness of implementation, the low cost and the acceptability makes this therapy an useful tool in stroke rehabilitation.

  2. Characteristics of patients with autistic disorder (AD) presenting for dental treatment: a survey and chart review.

    PubMed

    Klein, U; Nowak, A J

    1999-01-01

    A group of 43 patients with AD (mean age, 13.5; SD, 5.9 yrs) was identified from the University Hospital School Pediatric Dentistry Clinic. We reviewed the patients' charts to obtain demographic data, dental findings, and the management techniques used for treatment. The patients were divided into groups according to Frankl's categories of behavior, ranging from definitely negative to positive. Descriptive data are provided for each group. Commonly used communications and pharmacological management techniques, as well as physical restraints, enabled us to treat all the patients in the traditional dental setting, when simple procedures were planned. Treatment under general anesthesia in the operating room was necessary in 37% of all patients when comprehensive care was required or difficult procedures were carried out. A questionnaire was also sent out to the caregivers to gather data on patients' nutrition and eating/chewing habits. In the sample surveyed, two-thirds of the individuals reportedly exhibited a normal eating pattern, while 14% pouched food. Soft, sweet, or sticky foods were preferred by 41% of the patients.

  3. Histopathological features of a patient with Charcot-Marie-Tooth disease type 2U/AD-CMTax-MARS.

    PubMed

    Hirano, Makito; Oka, Nobuyuki; Hashiguchi, Akihiro; Ueno, Shuichi; Sakamoto, Hikaru; Takashima, Hiroshi; Higuchi, Yujiro; Kusunoki, Susumu; Nakamura, Yusaku

    2016-12-01

    Charcot-Marie-Tooth (CMT) disease is a complex of peripheral nervous system disorders. CMT type 2U (CMT2U) is an autosomal dominant (AD) disease caused by mutations in the MARS gene encoding methionyl-tRNA synthetase; this disease has thus been newly called AD-CMTax-MARS. A few families with mutations in the MARS gene have been reported, without detailed histopathological findings. We describe a 70-year-old woman who had bilateral dysesthesia of the soles since the age of 66 years. Sural nerve biopsy showed a decrease in the density of large myelinated nerve fibers. Increased clusters of regenerating myelinated nerve fibers were noted. Electron microscopic analyses revealed degeneration of unmyelinated nerves. There was no vasculitis or inflammatory cell infiltration. Genetic analysis identified a heterozygous p.P800T mutation, a reported mutation in the MARS gene. We report the detailed histopathological findings in a patient with CMT2U/AD-CMTax-MARS. The findings are similar to those found in CMT2D caused by mutations in the GARS gene, encoding glycyl-tRNA synthetase. © 2016 Peripheral Nerve Society.

  4. Closed strings and moduli in AdS3/CFT2

    NASA Astrophysics Data System (ADS)

    Sax, Olof Ohlsson; Stefański, Bogdan

    2018-05-01

    String theory on AdS3 × S3 × T4 has 20 moduli. We investigate how the perturbative closed string spectrum changes as we move around this moduli space in both the RR and NSNS flux backgrounds. We find that, at weak string coupling, only four of the moduli affect the energies. In the RR background the only effect of these moduli is to change the radius of curvature of the background. On the other hand, in the NSNS background, the moduli introduce worldsheet interactions which enable the use of integrability methods to solve the spectral problem. Our results show that the worldsheet theory is integrable across the 20 dimensional moduli space.

  5. The clinical, histochemical, and molecular spectrum of PEO1 (Twinkle)-linked adPEO

    PubMed Central

    Fratter, C.; Gorman, G.S.; Stewart, J.D.; Buddles, M.; Smith, C.; Evans, J.; Seller, A.; Poulton, J.; Roberts, M.; Hanna, M.G.; Rahman, S.; Omer, S.E.; Klopstock, T.; Schoser, B.; Kornblum, C.; Czermin, B.; Lecky, B.; Blakely, E.L.; Craig, K.; Chinnery, P.F.; Turnbull, D.M.; Horvath, R.; Taylor, R.W.

    2010-01-01

    Background: Mutations in the Twinkle (PEO1) gene are a recognized cause of autosomal dominant progressive external ophthalmoplegia (adPEO), resulting in the accumulation of multiple mitochondrial DNA (mtDNA) deletions and cytochrome c oxidase (COX)-deficient fibers in skeletal muscle secondary to a disorder of mtDNA maintenance. Patients typically present with isolated extraocular muscle involvement, with little apparent evidence of the clinical heterogeneity documented in other mtDNA maintenance disorders, in particular POLG-related disease. Methods: We reviewed the clinical, histochemical, and molecular genetics analysis of 33 unreported patients from 26 families together with all previous cases described in the literature to define the clinical phenotype associated with PEO1 mutations. Results: Ptosis and ophthalmoparesis were almost universal clinical features among this cohort, with 52% (17/33) reporting fatigue and 33% (11/33) having mild proximal myopathy. Features consistent with CNS involvement were rarely described; however, in 24% (8/33) of the patients, cardiac abnormalities were reported. Mitochondrial histochemical changes observed in muscle showed remarkable variability, as did the secondary mtDNA deletions, which in some patients were only detected by PCR-based assays and not Southern blotting. Moreover, we report 7 novel PEO1 variants. Conclusions: Our data suggest a shared clinical phenotype with variable mild multiorgan involvement, and that the contribution of PEO1 mutations as a cause of adPEO may well be underestimated. Direct sequencing of the PEO1 gene should be considered in adPEO patients prior to muscle biopsy. GLOSSARY adPEO = autosomal dominant progressive external ophthalmoplegia; COX = cytochrome c oxidase; IOSCA = infantile-onset spinocerebellar ataxia; mtDNA = mitochondrial DNA; PEO = progressive external ophthalmoplegia; SANDO = sensory ataxic neuropathy, dysarthria, and ophthalmoparesis; SDH = succinate dehydrogenase. PMID

  6. SAO/NASA ADS at SAO: ADS Browse Service

    Science.gov Websites

    Sign on [SAO/NASA ADS] ADS Browse Service ADS Home | HELP | Sitemap ADS Services Search Browse myADS Mirrors Feedback FAQ What's new Site Map Help Other NASA Centers CXC HEASARC IRSA MAST NED NSSDC -Smithsonian Center for Astrophysics [ Smithsonian logo ] The NASA Astrophysics Data System provides different

  7. A method to quantify the "cone of economy".

    PubMed

    Haddas, Ram; Lieberman, Isador H

    2018-05-01

    A non-randomized, prospective, concurrent control cohort study. The purpose of this study is to develop and evaluate a method to quantify the dimensions of the cone of economy (COE) and the energy expenditure associated with maintaining a balanced posture within the COE, scoliosis patients and compare them to matched non-scoliotic controls in a group of adult degenerative. Balance is defined as the ability of the human body to maintain its center of mass (COM) within the base of support with minimal postural sway. The cone of economy refers to the stable region of upright standing posture. The underlying assumption is that deviating outside one's individual cone challenges the balance mechanisms. Adult degenerative scoliosis (ADS) patients exhibit a variety of postural changes within their COE, involving the spine, pelvis and lower extremities, in their effort to compensate for the altered posture. Ten ADS patients and ten non-scoliotic volunteers performed a series of functional balance tests. The dimensions of the COE and the energy expenditure related to maintaining balance within the COE were measured using a human motion video capture system and dynamic surface electromyography. ADS patients presented more COM sway in the sagittal (ADS: 1.59 cm vs. H: 0.61 cm; p = 0.049) and coronal (ADS: 2.84 cm vs. H: 1.72 cm; p = 0.046) directions in comparison to the non-scoliotic control. ADS patients presented with more COM (ADS: 33.30 cm vs. H: 19.13 cm; p = 0.039) and head (ADS: 31.06 cm vs. H: 19.13 cm; p = 0.013) displacements in comparison to the non-scoliotic controls. Scoliosis patients expended more muscle activity to maintain static standing, as manifest by increased muscle activity in their erector spinae (ADS: 37.16 mV vs. H: 20.31 mV; p = 0.050), and gluteus maximus (ADS: 33.12 mV vs. H: 12.09 mV; p = 0.001) muscles. We were able to develop and evaluate a method that quantifies the COE boundaries, COM displacement, and amount of sway within the COE

  8. Adding A Measure Of Patient Self-Management Capability To Risk Assessment Can Improve Prediction Of High Costs.

    PubMed

    Hibbard, Judith H; Greene, Jessica; Sacks, Rebecca; Overton, Valerie; Parrotta, Carmen D

    2016-03-01

    We explored whether supplementing a clinical risk score with a behavioral measure could improve targeting of the patients most in need of supports that reduce their risk of costly service utilization. Using data from a large health system that determines patient self-management capability using the Patient Activation Measure, we examined utilization of hospital and emergency department care by the 15 percent of patients with the highest clinical risk scores. After controlling for risk scores and placing patients within segments based on their level of activation in 2011, we found that the lower the activation level, the higher the utilization and cost of hospital services in each of the following three years. These findings demonstrate that adding a measure of patient self-management capability to a risk assessment can improve prediction of high care costs and inform actions to better meet patient needs. Project HOPE—The People-to-People Health Foundation, Inc.

  9. Autism Disorder (AD): An Updated Review for Paediatric Dentists

    PubMed Central

    J., Udhya; M.M, Varadharaja; J., Parthiban; Srinivasan, Ila

    2014-01-01

    Over the past two decades, there has been an explosion of interest in Autism Disorder (AD). Knowledge and awareness on the condition has grown exponentially at all levels among the general public, parents, health professionals, the research community and more recently, at parliamentary level. The world has begun to recognize the scope of this problem and act internationally and locally to improve the lives of the growing number of individuals and families affected by this devastating disorder. This article reviews the dental literature since 1969 and it summarizes characteristics of patients with AD, oral health status and dental management of patients with AD. PMID:24701555

  10. The Efficacy and Safety of Saxagliptin When Added to Metformin Therapy in Patients With Inadequately Controlled Type 2 Diabetes With Metformin Alone

    PubMed Central

    DeFronzo, Ralph A.; Hissa, Miguel N.; Garber, Alan J.; Luiz Gross, Jorge; Yuyan Duan, Raina; Ravichandran, Shoba; Chen, Roland S.

    2009-01-01

    OBJECTIVE This 24-week trial assessed the efficacy and safety of saxagliptin as add-on therapy in patients with type 2 diabetes with inadequate glycemic control with metformin alone. RESEARCH DESIGN AND METHODS This was a randomized, double-blind, placebo-controlled study of saxagliptin (2.5, 5, or 10 mg once daily) or placebo plus a stable dose of metformin (1,500–2,500 mg) in 743 patients (A1C ≥7.0 and ≤10.0%). Efficacy analyses were performed using an ANCOVA model using last observation carried forward methodology on primary (A1C) and secondary (fasting plasma glucose [FPG] and postprandial glucose [PPG] area under the curve [AUC]) end points. RESULTS Saxagliptin (2.5, 5, and 10 mg) plus metformin demonstrated statistically significant adjusted mean decreases from baseline to week 24 versus placebo in A1C (−0.59, −0.69, and −0.58 vs. +0.13%; all P < 0.0001), FPG (−14.31, −22.03, and −20.50 vs. +1.24 mg/dl; all P < 0.0001), and PPG AUC (−8,891, −9,586, and −8,137 vs. −3,291 mg · min/dl; all P < 0.0001). More than twice as many patients achieved A1C <7.0% with 2.5, 5, and 10 mg saxagliptin versus placebo (37, 44, and 44 vs. 17%; all P < 0.0001). β-Cell function and postprandial C-peptide, insulin, and glucagon AUCs improved in all saxagliptin treatment groups at week 24. Incidence of hypoglycemic adverse events and weight reductions were similar to those with placebo. CONCLUSIONS Saxagliptin once daily added to metformin therapy was generally well tolerated and led to statistically significant improvements in glycemic indexes versus placebo added to metformin in patients with type 2 diabetes inadequately controlled with metformin alone. PMID:19478198

  11. Tensionless string spectra on AdS3

    NASA Astrophysics Data System (ADS)

    Gaberdiel, Matthias R.; Gopakumar, Rajesh

    2018-05-01

    The spectrum of superstrings on AdS3 × S3 × M 4 with pure NS-NS flux is analysed for the background where the radius of the AdS space takes the minimal value ( k = 1). Both for M 4 = S3 × S1 and M 4 = T 4 we show that there is a special set of physical states, coming from the bottom of the spectrally flowed continuous representations, which agree in precise detail with the single particle spectrum of a free symmetric product orbifold. For the case of AdS3 × S3 × T 4 this relies on making sense of the world-sheet theory at k = 1, for which we make a concrete proposal. We also comment on the implications of this striking result.

  12. Distribution of Malassezia species on the skin of patients with atopic dermatitis, psoriasis, and healthy volunteers assessed by conventional and molecular identification methods.

    PubMed

    Jagielski, Tomasz; Rup, Elżbieta; Ziółkowska, Aleksandra; Roeske, Katarzyna; Macura, Anna B; Bielecki, Jacek

    2014-03-07

    The Malassezia yeasts which belong to the physiological microflora of human skin have also been implicated in several dermatological disorders, including pityriasis versicolor (PV), atopic dermatitis (AD), and psoriasis (PS). The Malassezia genus has repeatedly been revised and it now accommodates 14 species, all but one being lipid-dependent species. The traditional, phenotype-based identification schemes of Malassezia species are fraught with interpretative ambiguities and inconsistencies, and are thus increasingly being supplemented or replaced by DNA typing methods. The aim of this study was to explore the species composition of Malassezia microflora on the skin of healthy volunteers and patients with AD and PS. Species characterization was performed by conventional, culture-based methods and subsequently molecular techniques: PCR-RFLP and sequencing of the internal transcribed spacer (ITS) 1/2 regions and the D1/D2 domains of the 26S rRNA gene. The Chi-square test and Fisher's exact test were used for statistical analysis. Malassezia sympodialis was the predominant species, having been cultured from 29 (82.9%) skin samples collected from 17 out of 18 subjects under the study. Whereas AD patients yielded exclusively M. sympodialis isolates, M. furfur isolates were observed only in PS patients. The isolation of M. sympodialis was statistically more frequent among AD patients and healthy volunteers than among PS patients (P < 0.03). Whether this mirrors any predilection of particular Malassezia species for certain clinical conditions needs to be further evaluated. The overall concordance between phenotypic and molecular methods was quite high (65%), with the discordant results being rather due to the presence of multiple species in a single culture (co-colonization) than true misidentification. All Malassezia isolates were susceptible to cyclopiroxolamine and azole drugs, with M. furfur isolates being somewhat more drug tolerant than other Malassezia species

  13. Relearning of Activities of Daily Living: A Comparison of the Effectiveness of Three Learning Methods in Patients with Dementia of the Alzheimer Type.

    PubMed

    Bourgeois, J; Laye, M; Lemaire, J; Leone, E; Deudon, A; Darmon, N; Giaume, C; Lafont, V; Brinck-Jensen, S; Dechamps, A; König, A; Robert, P

    2016-01-01

    This study examined the effectiveness of three different learning methods: trial and error learning (TE), errorless learning (EL) and learning by modeling with spaced retrieval (MR) on the relearning process of IADL in mild-to-moderately severe Alzheimer's Dementia (AD) patients (n=52), using a 6-weeks randomized controlled trial design. The participants had to relearn three IADLs. Repeated-measure analyses during pre-intervention, post-intervention and 1-month delayed sessions were performed. All three learning methods were found to have similar efficiency. However, the intervention produced greater improvements in the actual performance of the IADL tasks than on their explicit knowledge. This study confirms that the relearning of IADL is possible with AD patients through individualized interventions, and that the improvements can be maintained even after the intervention.

  14. Autoimmune Manifestations in the 3xTg-AD Model of Alzheimer's Disease

    PubMed Central

    Marchese, Monica; Cowan, David; Head, Elizabeth; Ma, Donglai; Karimi, Khalil; Ashthorpe, Vanessa; Kapadia, Minesh; Zhao, Hui; Davis, Paulina; Sakic, Boris

    2015-01-01

    Background Immune system activation is frequently reported in patients with Alzheimer's disease (AD). However, it remains unknown whether this is a cause, a consequence, or an epiphenomenon of brain degeneration. Objective The present study examines whether immunological abnormalities occur in a well-established murine AD model and if so, how they relate temporally to behavioral deficits and neuropathology. Methods A broad battery of tests was employed to assess behavioral performance and autoimmune/inflammatory markers in 3xTg-AD (AD) mice and wild type controls from 1.5 to 12 months of age. Results Aged AD mice displayed severe manifestations of systemic autoimmune/inflammatory disease, as evidenced by splenomegaly, hepatomegaly, elevated serum levels of anti-nuclear/anti-dsDNA antibodies, low hematocrit, and increased number of double-negative T splenocytes. However, anxiety-related behavior and altered spleen function were evident as early as 2 months of age, thus preceding typical AD-like brain pathology. Moreover, AD mice showed altered olfaction and impaired “cognitive” flexibility in the first 6 months of life, suggesting mild cognitive impairment-like manifestations before general learning/memory impairments emerged at an older age. Interestingly, all of these features were present in 3xTg-AD mice prior to significant amyloid-β or tau pathology. Conclusion The results indicate that behavioral deficits in AD mice develop in parallel with systemic autoimmune/inflammatory disease. These changes antedate AD-like neuropathology, thus supporting a causal link between autoimmunity and aberrant behavior. Consequently, 3xTg-AD mice may be a useful model in elucidating the role of immune system in the etiology of AD. PMID:24150111

  15. Distribution of Malassezia species on the skin of patients with atopic dermatitis, psoriasis, and healthy volunteers assessed by conventional and molecular identification methods

    PubMed Central

    2014-01-01

    Background The Malassezia yeasts which belong to the physiological microflora of human skin have also been implicated in several dermatological disorders, including pityriasis versicolor (PV), atopic dermatitis (AD), and psoriasis (PS). The Malassezia genus has repeatedly been revised and it now accommodates 14 species, all but one being lipid-dependent species. The traditional, phenotype-based identification schemes of Malassezia species are fraught with interpretative ambiguities and inconsistencies, and are thus increasingly being supplemented or replaced by DNA typing methods. The aim of this study was to explore the species composition of Malassezia microflora on the skin of healthy volunteers and patients with AD and PS. Methods Species characterization was performed by conventional, culture-based methods and subsequently molecular techniques: PCR-RFLP and sequencing of the internal transcribed spacer (ITS) 1/2 regions and the D1/D2 domains of the 26S rRNA gene. The Chi-square test and Fisher’s exact test were used for statistical analysis. Results Malassezia sympodialis was the predominant species, having been cultured from 29 (82.9%) skin samples collected from 17 out of 18 subjects under the study. Whereas AD patients yielded exclusively M. sympodialis isolates, M. furfur isolates were observed only in PS patients. The isolation of M. sympodialis was statistically more frequent among AD patients and healthy volunteers than among PS patients (P < 0.03). Whether this mirrors any predilection of particular Malassezia species for certain clinical conditions needs to be further evaluated. The overall concordance between phenotypic and molecular methods was quite high (65%), with the discordant results being rather due to the presence of multiple species in a single culture (co-colonization) than true misidentification. All Malassezia isolates were susceptible to cyclopiroxolamine and azole drugs, with M. furfur isolates being somewhat more drug tolerant

  16. AdS7/CFT6 with orientifolds

    NASA Astrophysics Data System (ADS)

    Apruzzi, Fabio; Fazzi, Marco

    2018-01-01

    AdS7 solutions of massive type IIA have been classified, and are dual to a large class of six-dimensional (1, 0) SCFT's whose tensor branch deformations are described by linear quivers of SU groups. Quivers and AdS vacua depend solely on the group theory data of the NS5-D6-D8 brane configurations engineering the field theories. This has allowed for a direct holographic match of their a conformal anomaly. In this paper we extend the match to cases where O6 and O8-planes are present, thereby introducing SO and USp groups in the quivers. In all of them we show that the a anomaly computed in supergravity agrees with the holographic limit of the exact field theory result, which we extract from the anomaly polynomial. As a byproduct we construct special AdS7 vacua dual to nonperturbative F-theory configurations. Finally, we propose a holographic a-theorem for six-dimensional Higgs branch RG flows.

  17. Quantifying the added value of BNP in suspected heart failure in general practice: an individual patient data meta-analysis.

    PubMed

    Kelder, Johannes C; Cowie, Martin R; McDonagh, Theresa A; Hardman, Suzanna M C; Grobbee, Diederick E; Cost, Bernard; Hoes, Arno W

    2011-06-01

    Diagnosing early stages of heart failure with mild symptoms is difficult. B-type natriuretic peptide (BNP) has promising biochemical test characteristics, but its diagnostic yield on top of readily available diagnostic knowledge has not been sufficiently quantified in early stages of heart failure. To quantify the added diagnostic value of BNP for the diagnosis of heart failure in a population relevant to GPs and validate the findings in an independent primary care patient population. Individual patient data meta-analysis followed by external validation. The additional diagnostic yield of BNP above standard clinical information was compared with ECG and chest x-ray results. Derivation was performed on two existing datasets from Hillingdon (n=127) and Rotterdam (n=149) while the UK Natriuretic Peptide Study (n=306) served as validation dataset. Included were patients with suspected heart failure referred to a rapid-access diagnostic outpatient clinic. Case definition was according to the ESC guideline. Logistic regression was used to assess discrimination (with the c-statistic) and calibration. Of the 276 patients in the derivation set, 30.8% had heart failure. The clinical model (encompassing age, gender, known coronary artery disease, diabetes, orthopnoea, elevated jugular venous pressure, crackles, pitting oedema and S3 gallop) had a c-statistic of 0.79. Adding, respectively, chest x-ray results, ECG results or BNP to the clinical model increased the c-statistic to 0.84, 0.85 and 0.92. Neither ECG nor chest x-ray added significantly to the 'clinical plus BNP' model. All models had adequate calibration. The 'clinical plus BNP' diagnostic model performed well in an independent cohort with comparable inclusion criteria (c-statistic=0.91 and adequate calibration). Using separate cut-off values for 'ruling in' (typically implying referral for echocardiography) and for 'ruling out' heart failure--creating a grey zone--resulted in insufficient proportions of patients

  18. Antiemetic effects of midazolam added to fentanyl-ropivacaine patient-controlled epidural analgesia after subtotal gastrectomy: A prospective, randomized, double-blind, controlled trial

    PubMed Central

    Kim, Sioh; Seo, Jeongwon; Jeon, Younghoon

    2010-01-01

    Background: Nausea and vomiting are frequent adverse effects of patient-controlled epidural analgesia (PCEA) with opioids. Objective: This study was designed to assess the antiemetic effect of midazolam added to fentanyl—ropivacaine PCEA. Methods: In a prospective, randomized, double-blind, controlled trial, smoking patients with gastric cancer undergoing elective subtotal gastrectomy were evenly allocated to 1 of 2 treatment groups to manage postoperative pain: 0.2% ropivacaine mixed with fentanyl 4 μg/mL and midazolam 0.2 mg/mL (test group) or 0.2% ropivacaine mixed with fentanyl 4 μg/mL (control group). The PCEA infusion was set to deliver 4 μL/h of the study solution, with a bolus of 2 mL per demand and a 15-minute lockout time. The incidence of postoperative nausea and vomiting (PONV), pain intensity, sedation score, usage of rescue analgesia and rescue antiemetic, respiratory depression, urinary retention, and pruritus were recorded at 2, 6, 12, 24, 48, and 72 hours after surgery. Total infused volume of PCEA at 72 hours after surgery was measured. Results: A total of 60 patients were approached and randomized to treatment. No patients were excluded by exclusion criteria and all enrolled patients completed this study. Incidence of nausea (7% vs 33%; P = 0.02) in the test group was significantly lower than in the control group. The overall frequency of PONV in the test group was significantly less than that of the control group (7% vs 40%; P = 0.006). In addition, the mean (SD) infused volume of PCEA in the test group was significantly lower than that in the control group (392.3 [68.9] vs 351.2 [49.8] mL; P = 0.01). However, there were no significant differences in pain intensity, usage of rescue antiemetics and rescue analgesics, and mild pruritus between groups. No patient reported moderate or severe sedation, respiratory depression, or hypoxemia. In addition, there were no severe adverse events. Conclusions: Midazolam added to fentanyl-ropivacaine PCEA

  19. Added value of involving patients in the first step of multidisciplinary guideline development: a qualitative interview study among infertile patients.

    PubMed

    den Breejen, Elvira M E; Hermens, Rosella P M G; Galama, Wienke H; Willemsen, Wim N P; Kremer, Jan A M; Nelen, Willianne L D M

    2016-06-01

    Patient involvement in scoping the guideline is emphasized, but published initiatives actively involving patients are generally limited to the writing and reviewing phase. To assess patients' added value to the scoping phase of a multidisciplinary guideline on infertility. Qualitative interview study. We conducted interviews among 12 infertile couples and 17 professionals. We listed and compared the couples' and professionals' key clinical issues (=care aspects that need improvement) to be addressed in the guideline according to four domains: current guidelines, professionals, patients and organization of care. Main key clinical issues suggested by more than three quarters of the infertile couples and/or at least two professionals were identified and compared. Overall, we identified 32 key clinical issues among infertile couples and 23 among professionals. Of the defined main key clinical issues, infertile couples mentioned eight issues that were not mentioned by the professionals. These main key clinical issues mainly concerned patient-centred (e.g. poor information provision and poor alignment of care) aspects of care on the professional and organizational domain. Both groups mentioned two main key clinical issues collectively that were interpreted differently: the lack of emotional support and respect for patients' values. Including patients from the first phase of the guideline development process leads to valuable additional main key clinical issues for the next step of a multidisciplinary guideline development process and broadens the scope of the guideline, particularly regarding patient-centredness and organizational issues from a patients' perspective. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  20. Two Virasoro symmetries in stringy warped AdS 3

    DOE PAGES

    Compere, Geoffrey; Guica, Monica; Rodriguez, Maria J.

    2014-12-02

    We study three-dimensional consistent truncations of type IIB supergravity which admit warped AdS 3 solutions. These theories contain subsectors that have no bulk dynamics. We show that the symplectic form for these theories, when restricted to the non-dynamical subsectors, equals the symplectic form for pure Einstein gravity in AdS 3. Consequently, for each consistent choice of boundary conditions in AdS 3, we can define a consistent phase space in warped AdS 3 with identical conserved charges. This way, we easily obtain a Virasoro × Virasoro asymptotic symmetry algebra in warped AdS 3; two different types of Virasoro × Kač-Moody symmetriesmore » are also consistent alternatives. Next, we study the phase space of these theories when propagating modes are included. We show that, as long as one can define a conserved symplectic form without introducing instabilities, the Virasoro × Virasoro asymptotic symmetries can be extended to the entire (linearised) phase space. In conclusion, this implies that, at least at semi-classical level, consistent theories of gravity in warped AdS 3 are described by a two-dimensional conformal field theory, as long as stability is not an issue.« less

  1. Two Virasoro symmetries in stringy warped AdS 3

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Compere, Geoffrey; Guica, Monica; Rodriguez, Maria J.

    We study three-dimensional consistent truncations of type IIB supergravity which admit warped AdS 3 solutions. These theories contain subsectors that have no bulk dynamics. We show that the symplectic form for these theories, when restricted to the non-dynamical subsectors, equals the symplectic form for pure Einstein gravity in AdS 3. Consequently, for each consistent choice of boundary conditions in AdS 3, we can define a consistent phase space in warped AdS 3 with identical conserved charges. This way, we easily obtain a Virasoro × Virasoro asymptotic symmetry algebra in warped AdS 3; two different types of Virasoro × Kač-Moody symmetriesmore » are also consistent alternatives. Next, we study the phase space of these theories when propagating modes are included. We show that, as long as one can define a conserved symplectic form without introducing instabilities, the Virasoro × Virasoro asymptotic symmetries can be extended to the entire (linearised) phase space. In conclusion, this implies that, at least at semi-classical level, consistent theories of gravity in warped AdS 3 are described by a two-dimensional conformal field theory, as long as stability is not an issue.« less

  2. Phases of global AdS black holes

    NASA Astrophysics Data System (ADS)

    Basu, Pallab; Krishnan, Chethan; Subramanian, P. N. Bala

    2016-06-01

    We study the phases of gravity coupled to a charged scalar and gauge field in an asymptotically Anti-de Sitter spacetime ( AdS 4) in the grand canonical ensemble. For the conformally coupled scalar, an intricate phase diagram is charted out between the four relevant solutions: global AdS, boson star, Reissner-Nordstrom black hole and the hairy black hole. The nature of the phase diagram undergoes qualitative changes as the charge of the scalar is changed, which we discuss. We also discuss the new features that arise in the extremal limit.

  3. Data Delivery Method Based on Neighbor Nodes' Information in a Mobile Ad Hoc Network

    PubMed Central

    Hayashi, Takuma; Taenaka, Yuzo; Okuda, Takeshi; Yamaguchi, Suguru

    2014-01-01

    This paper proposes a data delivery method based on neighbor nodes' information to achieve reliable communication in a mobile ad hoc network (MANET). In a MANET, it is difficult to deliver data reliably due to instabilities in network topology and wireless network condition which result from node movement. To overcome such unstable communication, opportunistic routing and network coding schemes have lately attracted considerable attention. Although an existing method that employs such schemes, MAC-independent opportunistic routing and encoding (MORE), Chachulski et al. (2007), improves the efficiency of data delivery in an unstable wireless mesh network, it does not address node movement. To efficiently deliver data in a MANET, the method proposed in this paper thus first employs the same opportunistic routing and network coding used in MORE and also uses the location information and transmission probabilities of neighbor nodes to adapt to changeable network topology and wireless network condition. The simulation experiments showed that the proposed method can achieve efficient data delivery with low network load when the movement speed is relatively slow. PMID:24672371

  4. Data delivery method based on neighbor nodes' information in a mobile ad hoc network.

    PubMed

    Kashihara, Shigeru; Hayashi, Takuma; Taenaka, Yuzo; Okuda, Takeshi; Yamaguchi, Suguru

    2014-01-01

    This paper proposes a data delivery method based on neighbor nodes' information to achieve reliable communication in a mobile ad hoc network (MANET). In a MANET, it is difficult to deliver data reliably due to instabilities in network topology and wireless network condition which result from node movement. To overcome such unstable communication, opportunistic routing and network coding schemes have lately attracted considerable attention. Although an existing method that employs such schemes, MAC-independent opportunistic routing and encoding (MORE), Chachulski et al. (2007), improves the efficiency of data delivery in an unstable wireless mesh network, it does not address node movement. To efficiently deliver data in a MANET, the method proposed in this paper thus first employs the same opportunistic routing and network coding used in MORE and also uses the location information and transmission probabilities of neighbor nodes to adapt to changeable network topology and wireless network condition. The simulation experiments showed that the proposed method can achieve efficient data delivery with low network load when the movement speed is relatively slow.

  5. New massive gravity and AdS(4) counterterms.

    PubMed

    Jatkar, Dileep P; Sinha, Aninda

    2011-04-29

    We show that the recently proposed Dirac-Born-Infeld extension of new massive gravity emerges naturally as a counterterm in four-dimensional anti-de Sitter space (AdS(4)). The resulting on-shell Euclidean action is independent of the cutoff at zero temperature. We also find that the same choice of counterterm gives the usual area law for the AdS(4) Schwarzschild black hole entropy in a cutoff-independent manner. The parameter values of the resulting counterterm action correspond to a c=0 theory in the context of the duality between AdS(3) gravity and two-dimensional conformal field theory. We rewrite this theory in terms of the gauge field that is used to recast 3D gravity as a Chern-Simons theory.

  6. Effective teaching strategies and methods of delivery for patient education: a systematic review and practice guideline recommendations.

    PubMed

    Friedman, Audrey Jusko; Cosby, Roxanne; Boyko, Susan; Hatton-Bauer, Jane; Turnbull, Gale

    2011-03-01

    The objective of this study was to determine effective teaching strategies and methods of delivery for patient education (PE). A systematic review was conducted and reviews with or without meta-analyses, which examined teaching strategies and methods of delivery for PE, were included. Teaching strategies identified are traditional lectures, discussions, simulated games, computer technology, written material, audiovisual sources, verbal recall, demonstration, and role playing. Methods of delivery focused on how to deliver the teaching strategies. Teaching strategies that increased knowledge, decreased anxiety, and increased satisfaction included computer technology, audio and videotapes, written materials, and demonstrations. Various teaching strategies used in combination were similarly successful. Moreover, structured-, culturally appropriate- and patient-specific teachings were found to be better than ad hoc teaching or generalized teaching. Findings provide guidance for establishing provincial standards for the delivery of PE. Recommendations concerning the efficacy of the teaching strategies and delivery methods are provided.

  7. Cost-effectiveness of extended-release niacin/laropiprant added to a stable simvastatin dose in secondary prevention patients not at cholesterol goal in Germany.

    PubMed

    Michailov, Galin V; Davies, Glenn M; Krobot, Karl J

    2012-06-01

    Coronary heart disease (CHD) remains the leading cause of death in Germany despite statin use to reduce low-density lipoprotein cholesterol (LDL-C) levels; improving lipids beyond LDL-C may further reduce cardiovascular risk. A fixed-dose combination of extended-release niacin (ERN) with laropiprant (LRPT) provides comprehensive lipid management. We adapted a decision-analytic model to evaluate the economic value (incremental cost-effectiveness ratio [ICER] in terms of costs per life-years gained [LYG]) of ERN/LRPT 2 g over a lifetime in secondary prevention patients in a German setting. Two scenarios were modelled: (1) ERN/LRPT 2 g added to simvastatin 40 mg in patients not at LDL-C goal with simvastatin 40 mg; (2) adding ERN/LRPT 2 g compared with titration to simvastatin 40 mg in patients not at LDL-C goal with simvastatin 20 mg. In both scenarios, adding ERN/LRPT was cost-effective relative to simvastatin monotherapy at a commonly accepted threshold of €30,000 per LYG; ICERs for ERN/LRPT were €13,331 per LYG in scenario 1 and €17,684 per LYG in scenario 2. Subgroup analyses showed that ERN/LRPT was cost-effective in patients with or without diabetes, patients aged ≤ 65 or >65 years and patients with low baseline high-density lipoprotein cholesterol levels; ICERs ranged from €10,342 to €15,579 in scenario 1, and from €14,081 to €20,462 in scenario 2. In conclusion, comprehensive lipid management with ERN/LRPT 2 g is cost-effective in secondary prevention patients in Germany who have not achieved LDL-C goal with simvastatin monotherapy.

  8. Floquet scalar dynamics in global AdS

    NASA Astrophysics Data System (ADS)

    Biasi, Anxo; Carracedo, Pablo; Mas, Javier; Musso, Daniele; Serantes, Alexandre

    2018-04-01

    We study periodically driven scalar fields and the resulting geometries with global AdS asymptotics. These solutions describe the strongly coupled dynamics of dual finite-size quantum systems under a periodic driving which we interpret as Floquet condensates. They span a continuous two-parameter space that extends the linearized solutions on AdS. We map the regions of stability in the solution space. In a significant portion of the unstable subspace, two very different endpoints are reached depending upon the sign of the perturbation. Collapse into a black hole occurs for one sign. For the opposite sign instead one attains a regular solution with periodic modulation. We also construct quenches where the driving frequency and amplitude are continuously varied. Quasistatic quenches can interpolate between pure AdS and sourced solutions with time periodic vev. By suitably choosing the quasistatic path one can obtain boson stars dual to Floquet condensates at zero driving field. We characterize the adiabaticity of the quenching processes. Besides, we speculate on the possible connections of this framework with time crystals.

  9. A Comparison of Problem Behavior Profiles in Turkish Children with AD/HD and Non-AD/HD Children

    ERIC Educational Resources Information Center

    Ozdemir, Selda

    2010-01-01

    Introduction: There is an increasing number of studies describing the symptoms of ADHD among school-age children in western cultures. Yet, studies on children with ADHD living in non-western cultures are limited. Thus, the purpose of this study was to compare problem behavior profiles of Turkish children with AD/HD and non-AD/HD children. Method:…

  10. Antismoking Ads at the Point of Sale: The Influence of Ad Type and Context on Ad Reactions.

    PubMed

    Kim, Annice; Nonnemaker, James; Guillory, Jamie; Shafer, Paul; Parvanta, Sarah; Holloway, John; Farrelly, Matthew

    2017-06-01

    Efforts are underway to educate consumers about the dangers of smoking at the point of sale (POS). Research is limited about the efficacy of POS antismoking ads to guide campaign development. This study experimentally tests whether the type of antismoking ad and the context in which ads are viewed influence people's reactions to the ads. A national convenience sample of 7,812 adult current smokers and recent quitters was randomized to 1 of 39 conditions. Participants viewed one of the four types of antismoking ads (negative health consequences-graphic, negative social consequences-intended emotive, benefits of quitting-informational, benefits of quitting-graphic) in one of the three contexts (alone, next to a cigarette ad, POS tobacco display). We assessed participants' reactions to the ads, including perceived effectiveness, negative emotion, affective dissonance, and motivational reaction. Graphic ads elicited more negative emotion and affective dissonance than benefits of quitting ads. Graphic ads elicited higher perceived effectiveness and more affective dissonance than intended emotive ads. Antismoking ads fared best when viewed alone, and graphic ads were least influenced by the context in which they were viewed. These results suggest that in developing POS campaigns, it is important to consider the competitive pro-tobacco context in which antismoking ads will be viewed.

  11. Adenomatous-Dominant Benign Prostatic Hyperplasia (AdBPH) as a Predictor for Clinical Success Following Prostate Artery Embolization: An Age-Matched Case–Control Study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Little, M. W., E-mail: m.little@doctors.org.uk; Boardman, P.; Macdonald, A. C.

    PurposeTo investigate the clinical impact of performing prostate artery embolization (PAE) on patients with adenomatous-dominant benign prostatic hyperplasia (AdBPH).Materials and MethodsTwelve patients from the ongoing proSTatic aRtery EmbolizAtion for the treatMent of benign prostatic hyperplasia (STREAM) trial were identified as having AdBPH; defined as two or more adenomas within the central gland of ≥1 cm diameter on multi-parametric MRI (MP-MRI). These patients were age-matched with patients from the STREAM cohort, without AdBPH. Patients were followed up with repeat MP-MRI at 3 months and 1 year. International prostate symptom score (IPSS), international index for erectile function (IIEF), and quality of life assessment from themore » IPSS and EQ-5D-5S questionnaires were recorded pre-PAE and at 6 weeks, 3 months, and 1 year.ResultsThe mean age of patients was 68 (61–76). All patients had PAE as a day-case procedure. The technical success in the cohort was 23/24 (96%). There was a significant reduction in prostate volume following embolization with a median reduction of 34% (30–55) in the AdBPH group, compared to a mean volume reduction of 22% (9–44) in the non-AdBPH group (p = 0.04). There was a significant reduction in IPSS in the AdBPH group following PAE when compared with the control group [AdBPH median IPSS 8 (3–15) vs. non-AdBPH median IPSS 13 (8–18), p = 0.01]. IPSS QOL scores significantly improved in the AdBPH group (p = 0.007). There was no deterioration in sexual function in either group post-PAE.ConclusionsThis is the first time that AdBPH has been identified as being a predictor of clinical success following PAE.« less

  12. How Can Value-Added Measures Be Used for Teacher Improvement? What We Know Series: Value-Added Methods and Applications. Knowledge Brief 13

    ERIC Educational Resources Information Center

    Loeb, Susanna

    2013-01-01

    The question for this brief is whether education leaders can use value-added measures as tools for improving schooling and, if so, how to do this. Districts, states, and schools can, at least in theory, generate gains in educational outcomes for students using value-added measures in three ways: creating information on effective programs, making…

  13. Does Value-Added Work Better in Elementary than in Secondary Grades? What We Know Series: Value-Added Methods Applications. Knowledge Brief 7

    ERIC Educational Resources Information Center

    Harris, Douglas N.; Anderson, Andrew

    2013-01-01

    There is a growing body of research on the validity and reliability of value-added measures, but most of this research has focused on elementary grades. Driven by several federal initiatives such as Race to the Top, Teacher Incentive Fund, and ESEA waivers, however, many states have incorporated value-added measures into the evaluations not only…

  14. Effect of Adding Oral Calcium Dobesilate to Laser Photocoagulation on the Macular Thickness in Patients with Diabetic Macular Edema: A Randomized Clinical Trial

    PubMed Central

    Feghhi, Mostafa; Farrahi, Fereydoun; Abbaspour, Mohammadreza; Takhtaeian, Akbar

    2014-01-01

    Purpose: To evaluate the effect of oral calcium dobesilate (Doxium) on macular thickness in clinically significant macular edema (CSME). Methods: Overall, 71 eyes of 40 patients with non-proliferative diabetic retinopathy and clinically significant macular edema were included. All patients were received laser treatment for macular edema. Coherence optical tomography was used to determine the retinal thickness. Patients were randomized into two groups: group A received three Doxium capsule daily and group B received three placebo capsule daily for six months. Results: The mean macular thickness before and after treatment in the group A was 340 and 257 micrometers respectively (24.5% reduced), and in the group B was 336 micrometers and 263 micrometers respectively (21.5% reduced). Macular thickness significantly decreased after treatment in both groups and the reduction in group A is higher but the difference of reduction between the two groups was not statistically significant (P>0.05). Conclusion: In respect to the effect of adding oral Doxium to Laser Photocoagulation on the macular thickness in patients with diabetic macular edema, this study showed no statistically significant difference between Doxium and placebo. PMID:25436194

  15. Computer-aided diagnostic method for classification of Alzheimer's disease with atrophic image features on MR images

    NASA Astrophysics Data System (ADS)

    Arimura, Hidetaka; Yoshiura, Takashi; Kumazawa, Seiji; Tanaka, Kazuhiro; Koga, Hiroshi; Mihara, Futoshi; Honda, Hiroshi; Sakai, Shuji; Toyofuku, Fukai; Higashida, Yoshiharu

    2008-03-01

    Our goal for this study was to attempt to develop a computer-aided diagnostic (CAD) method for classification of Alzheimer's disease (AD) with atrophic image features derived from specific anatomical regions in three-dimensional (3-D) T1-weighted magnetic resonance (MR) images. Specific regions related to the cerebral atrophy of AD were white matter and gray matter regions, and CSF regions in this study. Cerebral cortical gray matter regions were determined by extracting a brain and white matter regions based on a level set based method, whose speed function depended on gradient vectors in an original image and pixel values in grown regions. The CSF regions in cerebral sulci and lateral ventricles were extracted by wrapping the brain tightly with a zero level set determined from a level set function. Volumes of the specific regions and the cortical thickness were determined as atrophic image features. Average cortical thickness was calculated in 32 subregions, which were obtained by dividing each brain region. Finally, AD patients were classified by using a support vector machine, which was trained by the image features of AD and non-AD cases. We applied our CAD method to MR images of whole brains obtained from 29 clinically diagnosed AD cases and 25 non-AD cases. As a result, the area under a receiver operating characteristic (ROC) curve obtained by our computerized method was 0.901 based on a leave-one-out test in identification of AD cases among 54 cases including 8 AD patients at early stages. The accuracy for discrimination between 29 AD patients and 25 non-AD subjects was 0.840, which was determined at the point where the sensitivity was the same as the specificity on the ROC curve. This result showed that our CAD method based on atrophic image features may be promising for detecting AD patients by using 3-D MR images.

  16. Verification of rapid method for estimation of added food colorant type in boiled sausages based on measurement of cross section color

    NASA Astrophysics Data System (ADS)

    Jovanović, J.; Petronijević, R. B.; Lukić, M.; Karan, D.; Parunović, N.; Branković-Lazić, I.

    2017-09-01

    During the previous development of a chemometric method for estimating the amount of added colorant in meat products, it was noticed that the natural colorant most commonly added to boiled sausages, E 120, has different CIE-LAB behavior compared to artificial colors that are used for the same purpose. This has opened the possibility of transforming the developed method into a method for identifying the addition of natural or synthetic colorants in boiled sausages based on the measurement of the color of the cross-section. After recalibration of the CIE-LAB method using linear discriminant analysis, verification was performed on 76 boiled sausages, of either frankfurters or Parisian sausage types. The accuracy and reliability of the classification was confirmed by comparison with the standard HPLC method. Results showed that the LDA + CIE-LAB method can be applied with high accuracy, 93.42 %, to estimate food color type in boiled sausages. Natural orange colors can give false positive results. Pigments from spice mixtures had no significant effect on CIE-LAB results.

  17. ADMultiImg: a novel missing modality transfer learning based CAD system for diagnosis of MCI due to AD using incomplete multi-modality imaging data

    NASA Astrophysics Data System (ADS)

    Liu, Xiaonan; Chen, Kewei; Wu, Teresa; Weidman, David; Lure, Fleming; Li, Jing

    2018-02-01

    Alzheimer's Disease (AD) is the most common cause of dementia and currently has no cure. Treatments targeting early stages of AD such as Mild Cognitive Impairment (MCI) may be most effective to deaccelerate AD, thus attracting increasing attention. However, MCI has substantial heterogeneity in that it can be caused by various underlying conditions, not only AD. To detect MCI due to AD, NIA-AA published updated consensus criteria in 2011, in which the use of multi-modality images was highlighted as one of the most promising methods. It is of great interest to develop a CAD system based on automatic, quantitative analysis of multi-modality images and machine learning algorithms to help physicians more adequately diagnose MCI due to AD. The challenge, however, is that multi-modality images are not universally available for many patients due to cost, access, safety, and lack of consent. We developed a novel Missing Modality Transfer Learning (MMTL) algorithm capable of utilizing whatever imaging modalities are available for an MCI patient to diagnose the patient's likelihood of MCI due to AD. Furthermore, we integrated MMTL with radiomics steps including image processing, feature extraction, and feature screening, and a post-processing for uncertainty quantification (UQ), and developed a CAD system called "ADMultiImg" to assist clinical diagnosis of MCI due to AD using multi-modality images together with patient demographic and genetic information. Tested on ADNI date, our system can generate a diagnosis with high accuracy even for patients with only partially available image modalities (AUC=0.94), and therefore may have broad clinical utility.

  18. Worldsheet scattering in AdS3/CFT2

    NASA Astrophysics Data System (ADS)

    Sundin, Per; Wulff, Linus

    2013-07-01

    We confront the recently proposed exact S-matrices for AdS 3/ CFT 2 with direct worldsheet calculations. Utilizing the BMN and Near Flat Space (NFS) expansions for strings on AdS 3 × S 3 × S 3 × S 1 and AdS 3 × S 3 × T 4 we compute both tree-level and one-loop scattering amplitudes. Up to some minor issues we find nice agreement in the tree-level sector. At the one-loop level however we find that certain non-zero tree-level processes, which are not visible in the exact solution, contribute, via the optical theorem, and give an apparent mismatch for certain amplitudes. Furthermore we find that a proposed one-loop modification of the dressing phase correctly reproduces the worldsheet calculation while the standard Hernandez-Lopez phase does not. We also compute several massless to massless processes.

  19. Treatment of Acute Hepatic Encephalopathy: Comparing the Effects of Adding Rifaximin to Lactulose on Patient Outcomes.

    PubMed

    Courson, Alesa; Jones, G Morgan; Twilla, Jennifer D

    2016-06-01

    Rifaximin is approved for the reduction of hepatic encephalopathy (HE) recurrence in patients with chronic liver disease (CLD); however, few studies have evaluated the benefit of adding rifaximin to lactulose for treatment of acute HE. The aim of this study was to determine the impact of combination therapy with lactulose and rifaximin on hospital length of stay (LOS) and readmission rates. A retrospective study of patients admitted to an adult hospital within the Methodist LeBonheur Healthcare (MLH) System in Memphis, Tennessee, between 2007 and 2012 was conducted. Patients were identified via International Classification of Diseases, Ninth Revision (ICD-9) coding for liver cirrhosis. Of the 173 patients included, 87 (50%) received lactulose monotherapy and 62 (36%) combination therapy, while 24 (14%) underwent therapy escalation. Median LOS was 6 days in monotherapy group and 8 days in combination group (P = .9). At 180 days, patients receiving combination therapy had fewer readmissions for HE than those receiving monotherapy (2.4% vs 16.2%, P = .02). Addition of rifaximin to lactulose for treatment of acute HE did not reduce hospital LOS; however, it did result in lower readmission rates for HE at 180 days. © The Author(s) 2015.

  20. A Comparison of Methods for Capturing Patient Preferences for Delivery of Mental Health Services to Low-Income Hispanics Engaged in Primary Care.

    PubMed

    Herman, Patricia M; Ingram, Maia; Cunningham, Charles E; Rimas, Heather; Murrieta, Lucy; Schachter, Kenneth; de Zapien, Jill Guernsey; Carvajal, Scott C

    2016-08-01

    Consideration of patient preferences regarding delivery of mental health services within primary care may greatly improve access and quality of care for the many who could benefit from those services. This project evaluated the feasibility and usefulness of adding a consumer-products design method to qualitative methods implemented within a community-based participatory research (CBPR) framework. Discrete-choice conjoint experiment (DCE) added to systematic focus group data collection and analysis. Focus group data were collected from 64 patients of a Federally-Qualified Health Center (FQHC) serving a predominantly low-income Hispanic population. A total of 604 patients in the waiting rooms of the FQHC responded to the DCE. The DCE contained 15 choice tasks that each asked respondents to choose between three mental health services options described by the levels of two (of eight) attributes based on themes that emerged from focus group data. The addition of the DCE was found to be feasible and useful in providing distinct information on relative patient preferences compared with the focus group analyses alone. According to market simulations, the package of mental health services guided by the results of the DCE was preferred by patients. Unique patterns of patient preferences were uncovered by the DCE and these findings were useful in identifying pragmatic solutions to better address the mental health service needs of this population. However, for this resource-intensive method to be adopted more broadly, the scale of the primary care setting and/or scope of the issue addressed have to be relatively large.

  1. A scoping review of indirect comparison methods and applications using individual patient data.

    PubMed

    Veroniki, Areti Angeliki; Straus, Sharon E; Soobiah, Charlene; Elliott, Meghan J; Tricco, Andrea C

    2016-04-27

    Several indirect comparison methods, including network meta-analyses (NMAs), using individual patient data (IPD) have been developed to synthesize evidence from a network of trials. Although IPD indirect comparisons are published with increasing frequency in health care literature, there is no guidance on selecting the appropriate methodology and on reporting the methods and results. In this paper we examine the methods and reporting of indirect comparison methods using IPD. We searched MEDLINE, Embase, the Cochrane Library, and CINAHL from inception until October 2014. We included published and unpublished studies reporting a method, application, or review of indirect comparisons using IPD and at least three interventions. We identified 37 papers, including a total of 33 empirical networks. Of these, only 9 (27 %) IPD-NMAs reported the existence of a study protocol, whereas 3 (9 %) studies mentioned that protocols existed without providing a reference. The 33 empirical networks included 24 (73 %) IPD-NMAs and 9 (27 %) matching adjusted indirect comparisons (MAICs). Of the 21 (64 %) networks with at least one closed loop, 19 (90 %) were IPD-NMAs, 13 (68 %) of which evaluated the prerequisite consistency assumption, and only 5 (38 %) of the 13 IPD-NMAs used statistical approaches. The median number of trials included per network was 10 (IQR 4-19) (IPD-NMA: 15 [IQR 8-20]; MAIC: 2 [IQR 3-5]), and the median number of IPD trials included in a network was 3 (IQR 1-9) (IPD-NMA: 6 [IQR 2-11]; MAIC: 2 [IQR 1-2]). Half of the networks (17; 52 %) applied Bayesian hierarchical models (14 one-stage, 1 two-stage, 1 used IPD as an informative prior, 1 unclear-stage), including either IPD alone or with aggregated data (AD). Models for dichotomous and continuous outcomes were available (IPD alone or combined with AD), as were models for time-to-event data (IPD combined with AD). One in three indirect comparison methods modeling IPD adjusted results from different trials

  2. Sintering and microstructure of silicon carbide ceramic with Y3Al5O12 added by sol-gel method*

    PubMed Central

    Guo, Xing-zhong; Yang, Hui

    2005-01-01

    Silicon carbide (SiC) ceramic with YAG (Y3Al5O12) additive added by sol-gel method was liquid-phase sintered at different sintering temperatures, and the sintering mechanism and microstructural characteristics of resulting silicon carbide ceramics were analyzed by X-ray diffraction (XRD), scanning electron microscopy (SEM) and elemental distribution of surface (EDS). YAG (yttrium aluminum garnet) phase formed before the sintering and its uniform distribution in the SiC/YAG composite powder decreased the sintering temperature and improved the densification of SiC ceramic. The suitable sintering temperature was 1860 °C with the specimen sintered at this temperature having superior sintering and mechanical properties, smaller crystal size and fewer microstructure defects. Three characteristics of improved toughness of SiC ceramic with YAG added by sol-gel method were microstructural densification, main-crack deflection and crystal ‘bridging’. PMID:15682507

  3. Mitochondrial haplogroups associated with Japanese centenarians, Alzheimer's patients, Parkinson's patients, type 2 diabetic patients and healthy non-obese young males.

    PubMed

    Takasaki, Shigeru

    2009-07-01

    The relationships between five classes of Japanese people (i.e., 96 centenarians, 96 Alzheimer's disease (AD) patients, 96 Parkinson's disease (PD) patients, 96 type 2 diabetic (T2D) patients, and 96 healthy non-obese young males) and their mitochondrial single nucleotide polymorphism (mtSNP) frequencies at individual mtDNA positions of the entire mitochondrial genome were examined using the radial basis function (RBF) network and the modified method. New findings of mitochondrial haplogroups were obtained for individual classes. The five classes of people were associated with the following haplogroups: Japanese centenarians-M7b2, D4b2a, and B5b; Japanese AD patients-G2a, B4c1, and N9b1; Japanese PD patients-M7b2, B4e, and B5b; Japanese T2D patients-B5b, M8a1, G, D4, and F1; and Japanese healthy non-obese young males- D4g and D4b1b. From the points of common haplogroups among the five classes, the centenarians have the common haplogroups M7b2 and B5b with the PD patients and common haplogroup B5b with the T2D patients. In addition, the 112 Japanese semi-supercentenarians (over 105 years old) recently reported were also examined by the method proposed. The results obtained were the haplogroups D4a, B4c1a, M7b2, F1, M1, and B5b. These results are different from the previously reported haplogroup classifications. As the proposed analysis method can predict a person's mtSNP constitution and the probabilities of becoming a centenarian, AD patient, PD patient, or T2D patient, it may be useful in initial diagnosis of various diseases.

  4. Novel method for the determination of added annatto colour in extruded corn snack products.

    PubMed

    de Oliveira Rios, A; Mercadante, A Z

    2004-02-01

    There is considerable interest in determining the added levels of the natural dye annatto in foods like snack products, particularly because they are mostly consumed by young people. The objective was to use response surface methodology to develop a new method to analyse annatto in extruded snacks. A pretreatment of the samples was necessary, digesting the ground sample with alpha-amylase at room temperature. The pigment was extracted by shaking with ethyl acetate at room temperature, eight extractions being necessary for completion extract the pigment. Lipids were removed by alkaline saponification. Under these conditions, 100% of the bixin was converted into norbixin, which was then quantified by high-performance liquid chromatography. The method had a mean recovery of 97% and a coefficient of variation for duplicate analysis of 1%. Using this method, of the 13 commercial samples analysed, a parmesan cheese-flavoured snack product showed the highest level of dye expressed as norbixin (15.5 mg kg(-1)), whilst other brands of onion-flavoured snack products had the lowest levels (0.7 and 0.4 mg kg(-1), respectively).

  5. Spinning AdS loop diagrams: two point functions

    NASA Astrophysics Data System (ADS)

    Giombi, Simone; Sleight, Charlotte; Taronna, Massimo

    2018-06-01

    We develop a systematic approach to evaluating AdS loop amplitudes with spinning legs based on the spectral (or "split") representation of bulk-to-bulk propagators, which re-expresses loop diagrams in terms of spectral integrals and higher-point tree diagrams. In this work we focus on 2pt one-loop Witten diagrams involving totally symmetric fields of arbitrary mass and integer spin. As an application of this framework, we study the contribution to the anomalous dimension of higher-spin currents generated by bubble diagrams in higher-spin gauge theories on AdS.

  6. Holography in Lovelock Chern-Simons AdS gravity

    NASA Astrophysics Data System (ADS)

    Cvetković, Branislav; Miskovic, Olivera; Simić, Dejan

    2017-08-01

    We analyze holographic field theory dual to Lovelock Chern-Simons anti-de Sitter (AdS) gravity in higher dimensions using first order formalism. We first find asymptotic symmetries in the AdS sector showing that they consist of local translations, local Lorentz rotations, dilatations and non-Abelian gauge transformations. Then, we compute 1-point functions of energy-momentum and spin currents in a dual conformal field theory and write Ward identities. We find that the holographic theory possesses Weyl anomaly and also breaks non-Abelian gauge symmetry at the quantum level.

  7. Value of CT added to ultrasonography for the diagnosis of lymph node metastasis in patients with thyroid cancer.

    PubMed

    Lee, Younghen; Kim, Ji-Hoon; Baek, Jung Hwan; Jung, So Lyung; Park, Sun-Won; Kim, Jinna; Yun, Tae Jin; Ha, Eun Ju; Lee, Kyu Eun; Kwon, Soon Young; Yang, Kyung-Sook; Na, Dong Gyu

    2018-05-13

    The benefit of CT for the diagnosis of lymph node metastasis in patients with thyroid cancer is still unclear. Three hundred fifty-one patients with thyroid cancers from 7 hospitals were prospectively enrolled in order to compare diagnostic performance between a combination of ultrasound and CT (ultrasound/CT) and ultrasound alone for prediction of lymph node metastasis and to calculate patient-based benefits of CT added to ultrasound. Of 801 pathologically proven neck levels, ultrasound/CT showed higher sensitivities in both central and lateral compartments and improved accuracy in the lateral compartment compared to ultrasound alone. In the retropharyngeal/superior mediastinal compartment, although CT could detect lymph node metastasis an ultrasound could not. Patient-based benefit was demonstrated in 13.1% of patients (46/351), and was higher in patients with cancers >1 cm than cancers ≤1 cm. In patients with thyroid cancer, CT improved surgical planning by enhancing the sensitivity for lymph node metastasis and by detecting lymph node metastasis that was overlooked with ultrasound alone. © 2018 Wiley Periodicals, Inc.

  8. Hierarchical Interactions Model for Predicting Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD) Conversion

    PubMed Central

    Li, Han; Liu, Yashu; Gong, Pinghua; Zhang, Changshui; Ye, Jieping

    2014-01-01

    Identifying patients with Mild Cognitive Impairment (MCI) who are likely to convert to dementia has recently attracted increasing attention in Alzheimer's disease (AD) research. An accurate prediction of conversion from MCI to AD can aid clinicians to initiate treatments at early stage and monitor their effectiveness. However, existing prediction systems based on the original biosignatures are not satisfactory. In this paper, we propose to fit the prediction models using pairwise biosignature interactions, thus capturing higher-order relationship among biosignatures. Specifically, we employ hierarchical constraints and sparsity regularization to prune the high-dimensional input features. Based on the significant biosignatures and underlying interactions identified, we build classifiers to predict the conversion probability based on the selected features. We further analyze the underlying interaction effects of different biosignatures based on the so-called stable expectation scores. We have used 293 MCI subjects from Alzheimer's Disease Neuroimaging Initiative (ADNI) database that have MRI measurements at the baseline to evaluate the effectiveness of the proposed method. Our proposed method achieves better classification performance than state-of-the-art methods. Moreover, we discover several significant interactions predictive of MCI-to-AD conversion. These results shed light on improving the prediction performance using interaction features. PMID:24416143

  9. Adding methylphenidate to prism-adaptation improves outcome in neglect patients. A randomized clinical trial.

    PubMed

    Luauté, Jacques; Villeneuve, Laurent; Roux, Adeline; Nash, Stuart; Bar, Jean-Yves; Chabanat, Eric; Cotton, François; Ciancia, Sophie; Sancho, Pierre-Olivier; Hovantruc, Patrick; Quelard, François; Sarraf, Thierry; Cojan, Yann; Hadj-Bouziane, Fadila; Farné, Alessandro; Janoly-Dumenil, Audrey; Boisson, Dominique; Jacquin-Courtois, Sophie; Rode, Gilles; Rossetti, Yves

    2018-04-04

    Spatial neglect is one of the main predictors of poor functional recovery after stroke. Many therapeutic interventions have been developed to alleviate this condition, but to date the evidence of their effectiveness is still scarce. The purpose of this study was to test whether combining prism adaptation (PA) and methylphenidate (MP) could enhance the recovery of neglect patients at a functional level. RITAPRISM is a multicentre, randomized, double-blind, placebo-controlled study comparing PA plus placebo (control) versus PA plus MP. 24 patients were prospectively enrolled (10 in the placebo group and 14 in the MP group). The main result is a long-term functional improvement (on the functional independence measure (FIM) and on Bergego's scale) induced by MP combined with PA. No serious adverse event occurred. The long-term benefit on activities of daily living (ADL) obtained in this randomized controlled trial set this intervention apart from previous attempts and supports with a high level of evidence the value of combining PA and MP in order to improve the autonomy of neglect patients. Further studies will be needed to clarify the mechanism of this improvement. Although not specifically assessed at this stage, a part of the improvement in ADL might be related to the collateral effect of MP on mood, executive functions or fatigue, and/or the combined effect of PA and MP on motor intentional bias of neglect patients. This study provides Class I evidence that adding MP to PA improves the functional outcome of neglect patients. EUCTR2008-000325-20-FR. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Differential Impact of Whole-Brain Radiotherapy Added to Radiosurgery for Brain Metastases

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kong, Doo-Sik; Lee, Jung-Il, E-mail: jilee@skku.ed; Im, Yong-Seok

    2010-10-01

    Purpose: The authors investigated whether the addition of whole-brain radiotherapy (WBRT) to stereotactic radiosurgery (SRS) provided any therapeutic benefit according to recursive partitioning analysis (RPA) class. Methods and Materials: Two hundred forty-five patients with 1 to 10 metastases who underwent SRS between January 2002 and December 2007 were included in the study. Of those, 168 patients were treated with SRS alone and 77 patients received SRS followed by WBRT. Actuarial curves were estimated using the Kaplan-Meier method regarding overall survival (OS), distant brain control (DC), and local brain control (LC) stratified by RPA class. Analyses for known prognostic variables weremore » performed using the Cox proportional hazards model. Results: Univariate and multivariate analysis revealed that control of the primary tumor, small number of brain metastases, Karnofsky performance scale (KPS) > 70, and initial treatment modalities were significant predictors for survival. For RPA class 1, SRS plus WBRT was associated with a longer survival time compared with SRS alone (854 days vs. 426 days, p = 0.042). The SRS plus WBRT group also showed better LC rate than did the SRS-alone group (p = 0.021), although they did not show a better DC rate (p = 0.079). By contrast, for RPA class 2 or 3, no significant difference in OS, LC, or DC was found between the two groups. Conclusions: These results suggest that RPA classification should determine whether or not WBRT is added to SRS. WBRT may be recommended to be added to SRS for patients in whom long-term survival is expected on the basis of RPA classification.« less

  11. Next-Generation A/D Sampler ADS3000+ for VLBI2010

    NASA Technical Reports Server (NTRS)

    Takefuji, Kazuhiro; Takeuchi, Hiroshi; Tsutsumi, Masanori; Koyama, Yasuhiro

    2010-01-01

    A high-speed A/D sampler, called ADS3000+, has been developed in 2008, which can sample one analog signal up to 4 Gbps to versatile Linux PC. After A/D conversion, the ADS3000+ can perform digital signal processing such as real-time DBBC (Digital Base Band Conversion) and FIR filtering such as simple CW RFI filtering using the installed FPGAs. A 4 Gsps fringe test with the ADS3000+ has been successfully performed. The ADS3000+ will not exclusively be used for VLBI but will also be employed in other applications.

  12. White Matter Hyperintensities and Changes in White Matter Integrity in Patients with Alzheimer’s Disease

    PubMed Central

    Wang, Liya; Goldstein, Felicia C.; Levey, Allan I.; Lah, James J.; Meltzer, Carolyn C.; Holder, Chad A.; Mao, Hui

    2012-01-01

    Purpose White matter hyperintensities (WMHs) are a risk factor for Alzheimer’s disease (AD). This study investigated the relationship between WMHs and white matter changes in AD using diffusion tensor imaging (DTI) and the sensitivity of each DTI index in distinguishing AD with WMHs. Subjects and Methods Forty-four subjects with WMHs were included. Subjects were classified into three groups based on the Scheltens rating scale: 15 AD patients with mild WMHs, 12 AD patients with severe WMHs, and 17 controls with mild WMHs. Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (DR) and axial diffusivity (DA) were analyzed using the region of interest and Tract-Based Spatial Statistics methods. Sensitivity and specificity of DTI indices in distinguishing AD groups from the controls were evaluated. Results AD patients with mild WMHs exhibited differences from control subjects in most DTI indices in the medial temporal and frontal areas; however, differences in DTI indices from AD patients with mild WMHs and AD patients with severe WMHs were found in the parietal and occipital areas. FA and DR were more sensitive measurements than MD and DA in differentiating AD patients from controls, while MD was a more sensitive measurement in distinguishing AD patients with severe WMHs from those with mild WMHs. Conclusions WMHs may contribute to the white matter changes in AD brains, specifically in temporal and frontal areas. Changes in parietal and occipital lobes may be related to the severity of WMHs. DR may serve as an imaging marker of myelin deficits associated with AD. PMID:21152911

  13. Walking stabilizes cognitive functioning in Alzheimer's disease (AD) across one year

    PubMed Central

    Winchester, J.; Dick, M.B.; Gillen, D.; Reed, B.; Miller, B.; Tinklenberg, J.; Mungas, D.; Chui, H.; Galasko, D.; Hewett, L.; Cotman, C.W.

    2013-01-01

    AD is a public health epidemic, which seriously impacts cognition, mood and daily activities; however, one type of activity, exercise, has been shown to alter these states. Accordingly, we sought to investigate the relationship between exercise and mood, in early-stage AD patients (N = 104) from California, over a 1-year period. Patients completed the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Blessed-Roth Dementia Rating Scale (BRDRS), while their caregivers completed the Yale Physical Activity Survey (YALE), Profile of Mood States (POMS), the Neuropsychiatric Inventory (NPI) and Functional Abilities Questionnaire (FAQ). Approximately half of the participants were female, from a variety of ethnic groups (Caucasian = 69.8%; Latino/Hispanic Americans = 20.1%). Our results demonstrated that the patients spent little time engaged in physical activity in general, their overall activity levels decreased over time, and this was paired with a change in global cognition (e.g., MMSE total score) and affect/mood (e.g., POMS score). Patients were parsed into Active and Sedentary groups based on their Yale profiles, with Active participants engaged in walking activities, weekly, over 1 year. Here, Sedentary patients had a significant decline in MMSE scores, while the Active patients had an attenuation in global cognitive decline. Importantly, among the Active AD patients, those individuals who engaged in walking for more than 2 h/week had a significant improvement in MMSE scores. Structured clinical trials which seek to increase the amount of time AD patients were engaged in walking activities and evaluate the nature and scope of beneficial effects in the brain are warranted. PMID:22959822

  14. Walking stabilizes cognitive functioning in Alzheimer's disease (AD) across one year.

    PubMed

    Winchester, J; Dick, M B; Gillen, D; Reed, B; Miller, B; Tinklenberg, J; Mungas, D; Chui, H; Galasko, D; Hewett, L; Cotman, C W

    2013-01-01

    AD is a public health epidemic, which seriously impacts cognition, mood and daily activities; however, one type of activity, exercise, has been shown to alter these states. Accordingly, we sought to investigate the relationship between exercise and mood, in early-stage AD patients (N=104) from California, over a 1-year period. Patients completed the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Blessed-Roth Dementia Rating Scale (BRDRS), while their caregivers completed the Yale Physical Activity Survey (YALE), Profile of Mood States (POMS), the Neuropsychiatric Inventory (NPI) and Functional Abilities Questionnaire (FAQ). Approximately half of the participants were female, from a variety of ethnic groups (Caucasian=69.8%; Latino/Hispanic Americans=20.1%). Our results demonstrated that the patients spent little time engaged in physical activity in general, their overall activity levels decreased over time, and this was paired with a change in global cognition (e.g., MMSE total score) and affect/mood (e.g., POMS score). Patients were parsed into Active and Sedentary groups based on their Yale profiles, with Active participants engaged in walking activities, weekly, over 1 year. Here, Sedentary patients had a significant decline in MMSE scores, while the Active patients had an attenuation in global cognitive decline. Importantly, among the Active AD patients, those individuals who engaged in walking for more than 2 h/week had a significant improvement in MMSE scores. Structured clinical trials which seek to increase the amount of time AD patients were engaged in walking activities and evaluate the nature and scope of beneficial effects in the brain are warranted. Copyright © 2012. Published by Elsevier Ireland Ltd.

  15. Contractions of AdS brane algebra and superGalileon Lagrangians

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kamimura, Kiyoshi; Onda, Seiji

    2013-06-15

    We examine AdS Galileon Lagrangians using the method of nonlinear realization. By contractions (1) flat curvature limit, (2) non-relativistic brane algebra limit, and (3) (1) + (2) limits we obtain DBI, Newton-Hoock, and Galilean Galileons, respectively. We make clear how these Lagrangians appear as invariant 4-forms and/or pseudo-invariant Wess-Zumino (WZ) terms using Maurer-Cartan (MC) equations on the coset G/SO(3, 1). We show the equations of motion are written in terms of the MC forms only and explain why the inverse Higgs condition is obtained as the equation of motion for all cases. The supersymmetric extension is also examined using amore » supercoset SU(2, 2 Double-Vertical-Line 1)/(SO(3, 1) Multiplication-Sign U(1)) and five WZ forms are constructed. They are reduced to the corresponding five Galileon WZ forms in the bosonic limit and are candidates for supersymmetric Galileon action.« less

  16. Does adding a dietician to the liaison team after discharge of geriatric patients improve nutritional outcome: a randomised controlled trial.

    PubMed

    Beck, A; Andersen, U T; Leedo, E; Jensen, L L; Martins, K; Quvang, M; Rask, K Ø; Vedelspang, A; Rønholt, F

    2015-11-01

    The objective was to test whether adding a dietician to a discharge Liaison-Team after discharge of geriatric patients improves nutritional status, muscle strength and patient relevant outcomes. Twelve-week randomized controlled trial. Geriatric patients (70 + years and at nutritional risk) at discharge. Participants were randomly allocated to receive discharge Liaison-Team vs. discharge Liaison-Team in cooperation with a dietician. The dietician performed a total of three home visits with the aim of developing and implementing an individual nutritional care plan. The first visit took place at the day of discharge together with the discharge Liaison-Team while the remaining visits took place approximately three and eight weeks after discharge and were performed by a dietician alone. Nutritional status (weight, and dietary intake), muscle strength (hand grip strength, chair-stand), functional status (mobility, and activities of daily living), quality of life, use of social services, re-/hospitalization and mortality. Seventy-one patients were included (34 in the intervention group), and 63 (89%) completed the second data collection after 12 weeks (31 in the intervention group). Odds ratios for hospitalization and mortality 6 months after discharge were 0.367 (0.129; 1.042) and 0.323 (0.060; 1.724). Nutritional status improved and some positive tendencies in favour of the intervention group were observed for patient relevant outcomes, i.e. activities of daily living, and quality of life. Almost 100% of the intervention group received three home visits by a dietician. Adding a dietician to the discharge Liaison-Team after discharge of geriatric patients can improve nutritional status and may reduce the number of times hospitalized within 6 months. A larger study is necessary to see a significant effect on other patient relevant outcomes. © The Author(s) 2014.

  17. A practical guide for implementing and maintaining value-added clinical systems learning roles for medical students using a diffusion of innovations framework.

    PubMed

    Gonzalo, Jed D; Graaf, Deanna; Ahluwalia, Amarpreet; Wolpaw, Dan R; Thompson, Britta M

    2018-03-21

    After emphasizing biomedical and clinical sciences for over a century, US medical schools are expanding experiential roles that allow students to learn about health care delivery while also adding value to patient care. After developing a program where all 1st-year medical students are integrated into interprofessional care teams to contribute to patient care, authors use a diffusion of innovations framework to explore and identify barriers, facilitators, and best practices for implementing value-added clinical systems learning roles. In 2016, authors conducted 32 clinical-site observations, 29 1:1 interviews with mentors, and four student focus-group interviews. Data were transcribed verbatim, and a thematic analysis was used to identify themes. Authors discussed drafts of the categorization scheme, and agreed upon results and quotations. Of 36 sites implementing the program, 17 (47%) remained, 8 (22%) significantly modified, and 11 (31%) withdrew from the program. Identified strategies for implementing value-added roles included: student education, patient characteristics, patient selection methods, activities performed, and resources. Six themes influencing program implementation and maintenance included: (1) educational benefit, (2) value added to patient care from student work, (3) mentor time and site capacity, (4) student engagement, (5) working relationship between school, site, and students, and, (6) students' continuity at the site. Health systems science is an emerging focus for medical schools, and educators are challenged to design practice-based roles that enhance education and add value to patient care. Health professions' schools implementing value-added roles will need to invest resources and strategize about best-practice strategies to guide efforts.

  18. A Chemical-Biological-Radio-Nuclear (CBRN) Filter can be Added to the Air-Outflow Port of a Ventilator to Protect a Home Ventilated Patient From Inhalation of Toxic Industrial Compounds.

    PubMed

    Be'eri, Eliezer; Owen, Simon; Beeri, Maurit; Millis, Scott R; Eisenkraft, Arik

    2018-02-21

    Chemical-biological-radio-nuclear (CBRN) gas masks are the standard means for protecting the general population from inhalation of toxic industrial compounds (TICs), for example after industrial accidents or terrorist attacks. However, such gas masks would not protect patients on home mechanical ventilation, as ventilator airflow would bypass the CBRN filter. We therefore evaluated in vivo the safety of adding a standard-issue CBRN filter to the air-outflow port of a home ventilator, as a method for providing TIC protection to such patients. Eight adult patients were included in the study. All had been on stable, chronic ventilation via a tracheostomy for at least 3 months before the study. Each patient was ventilated for a period of 1 hour with a standard-issue CBRN filter canister attached to the air-outflow port of their ventilator. Physiological and airflow measurements were made before, during, and after using the filter, and the patients reported their subjective sensation of ventilation continuously during the trial. For all patients, and throughout the entire study, no deterioration in any of the measured physiological parameters and no changes in measured airflow parameters were detected. All patients felt no subjective difference in the sensation of ventilation with the CBRN filter canister in situ, as compared with ventilation without it. This was true even for those patients who were breathing spontaneously and thus activating the ventilator's trigger/sensitivity function. No technical malfunctions of the ventilators occurred after addition of the CBRN filter canister to the air-outflow ports of the ventilators. A CBRN filter canister can be added to the air-outflow port of chronically ventilated patients, without causing an objective or subjective deterioration in the quality of the patients' mechanical ventilation. (Disaster Med Public Health Preparedness. 2018;page 1 of 5).

  19. Vacuum degeneracy and Conformal Mass in Lovelock AdS gravity

    NASA Astrophysics Data System (ADS)

    Arenas-Henriquez, Gabriel; Miskovic, Olivera; Olea, Rodrigo

    2017-11-01

    It is shown that the notion of Conformal Mass can be defined within a given anti-de Sitter (AdS) branch of a Lovelock gravity theory as long as the corresponding vacuum is not degenerate. Indeed, conserved charges obtained by the addition of Kounterterms to the bulk action turn out to be proportional to the electric part of the Weyl tensor, when the fall-off of a generic solution in that AdS branch is considered. The factor of proportionality is the degeneracy condition for the vacua in the particular Lovelock AdS theory under study. This last feature explains the obstruction to define Conformal Mass in the degenerate case.

  20. Neural Correlates of Anosognosia in Alzheimer's Disease and Mild Cognitive Impairment: A Multi-Method Assessment

    PubMed Central

    Tondelli, Manuela; Barbarulo, Anna M.; Vinceti, Giulia; Vincenzi, Chiara; Chiari, Annalisa; Nichelli, Paolo F.; Zamboni, Giovanna

    2018-01-01

    Patients with Alzheimer's Disease (AD) and Mild Cognitive Impairment (MCI) may present anosognosia for their cognitive deficits. Three different methods have been usually used to measure anosognosia in patients with AD and MCI, but no studies have established if they share similar neuroanatomical correlates. The purpose of this study was to investigate if anosognosia scores obtained with the three most commonly used methods to assess anosognosia relate to focal atrophy in AD and MCI patients, in order to improve understanding of the neural basis of anosognosia in dementia. Anosognosia was evaluated in 27 patients (15 MCI and 12 AD) through clinical rating (Clinical Insight Rating Scale, CIRS), patient-informant discrepancy (Anosognosia Questionnaire Dementia, AQ-D), and performance discrepancy on different cognitive domains (self-appraisal discrepancies, SADs). Voxel-based morphometry correlational analyses were performed on magnetic resonance imaging (MRI) data with each anosognosia score. Increasing anosognosia on any anosognosia measurement (CIRS, AQ-D, SADs) was associated with increasing gray matter atrophy in the medial temporal lobe including the right hippocampus. Our results support a unitary mechanism of anosognosia in AD and MCI, in which medial temporal lobes play a key role, irrespectively of the assessment method used. This is in accordance with models suggesting that anosognosia in AD is primarily caused by a decline in mnemonic processes. PMID:29867398

  1. A new method to assess the added value of high-resolution regional climate simulations: application to the EURO-CORDEX dataset

    NASA Astrophysics Data System (ADS)

    Soares, P. M. M.; Cardoso, R. M.

    2017-12-01

    Regional climate models (RCM) are used with increasing resolutions pursuing to represent in an improved way regional to local scale atmospheric phenomena. The EURO-CORDEX simulations at 0.11° and simulations exploiting finer grid spacing approaching the convective-permitting regimes are representative examples. The climate runs are computationally very demanding and do not always show improvements. These depend on the region, variable and object of study. The gains or losses associated with the use of higher resolution in relation to the forcing model (global climate model or reanalysis), or to different resolution RCM simulations, is known as added value. Its characterization is a long-standing issue, and many different added-value measures have been proposed. In the current paper, a new method is proposed to assess the added value of finer resolution simulations, in comparison to its forcing data or coarser resolution counterparts. This approach builds on a probability density function (PDF) matching score, giving a normalised measure of the difference between diverse resolution PDFs, mediated by the observational ones. The distribution added value (DAV) is an objective added value measure that can be applied to any variable, region or temporal scale, from hindcast or historical (non-synchronous) simulations. The DAVs metric and an application to the EURO-CORDEX simulations, for daily temperatures and precipitation, are here presented. The EURO-CORDEX simulations at both resolutions (0.44o,0.11o) display a clear added value in relation to ERA-Interim, with values around 30% in summer and 20% in the intermediate seasons, for precipitation. When both RCM resolutions are directly compared the added value is limited. The regions with the larger precipitation DAVs are areas where convection is relevant, e.g. Alps and Iberia. When looking at the extreme precipitation PDF tail, the higher resolution improvement is generally greater than the low resolution for seasons

  2. Value added medicines: what value repurposed medicines might bring to society?

    PubMed

    Toumi, Mondher; Rémuzat, Cécile

    2017-01-01

    Background & objectives : Despite the wide interest surrounding drug repurposing, no common terminology has been yet agreed for these products and their full potential value is not always recognised and rewarded, creating a disincentive for further development. The objectives of the present study were to assess from a wide perspective which value drug repurposing might bring to society, but also to identify key obstacles for adoption of these medicines and to discuss policy recommendations. Methods : A preliminary comprehensive search was conducted to assess how the concept of drug repurposing was described in the literature. Following completion of the literature review, a primary research was conducted to get perspective of various stakeholders across EU member states on drug repurposing ( healthcare professionals, regulatory authorities and Health Technology Assessment (HTA) bodies/payers, patients, and representatives of the pharmaceutical industry developing medicines in this field). Ad hoc literature review was performed to illustrate, when appropriate, statements of the various stakeholders. Results : Various nomenclatures have been used to describe the concept of drug repurposing in the literature, with more or less broad definitions either based on outcomes, processes, or being a mix of both. In this context, Medicines for Europe (http://www.medicinesforeurope.com/value-added-medicines/) established one single terminology for these medicines, known as value added medicines, defined as 'medicines based on known molecules that address healthcare needs and deliver relevant improvements for patients, healthcare professionals and/or payers'. Stakeholder interviews highlighted three main potential benefits for value added medicines: (1) to address a number of medicine-related healthcare inefficiencies related to irrational use of medicines, non-availability of appropriate treatment options, shortage of mature products, geographical inequity in medicine access

  3. Value added medicines: what value repurposed medicines might bring to society?

    PubMed Central

    Toumi, Mondher; Rémuzat, Cécile

    2017-01-01

    ABSTRACT Background & objectives: Despite the wide interest surrounding drug repurposing, no common terminology has been yet agreed for these products and their full potential value is not always recognised and rewarded, creating a disincentive for further development. The objectives of the present study were to assess from a wide perspective which value drug repurposing might bring to society, but also to identify key obstacles for adoption of these medicines and to discuss policy recommendations. Methods: A preliminary comprehensive search was conducted to assess how the concept of drug repurposing was described in the literature. Following completion of the literature review, a primary research was conducted to get perspective of various stakeholders across EU member states on drug repurposing (healthcare professionals, regulatory authorities and Health Technology Assessment (HTA) bodies/payers, patients, and representatives of the pharmaceutical industry developing medicines in this field). Ad hoc literature review was performed to illustrate, when appropriate, statements of the various stakeholders. Results: Various nomenclatures have been used to describe the concept of drug repurposing in the literature, with more or less broad definitions either based on outcomes, processes, or being a mix of both. In this context, Medicines for Europe (http://www.medicinesforeurope.com/value-added-medicines/) established one single terminology for these medicines, known as value added medicines, defined as ‘medicines based on known molecules that address healthcare needs and deliver relevant improvements for patients, healthcare professionals and/or payers’. Stakeholder interviews highlighted three main potential benefits for value added medicines: (1) to address a number of medicine-related healthcare inefficiencies related to irrational use of medicines, non-availability of appropriate treatment options, shortage of mature products, geographical inequity in medicine

  4. Holographic reconstruction of AdS exchanges from crossing symmetry

    DOE PAGES

    Alday, Luis F.; Bissi, Agnese; Perlmutter, Eric

    2017-08-31

    Motivated by AdS/CFT, we address the following outstanding question in large N conformal field theory: given the appearance of a single-trace operator in the O x O OPE of a scalar primary O, what is its total contribution to the vacuum four-point function (OOOO) as dictated by crossing symmetry? We solve this problem in 4d conformal field theories at leading order in 1/N. Viewed holographically, this provides a field theory reconstruction of crossing-symmetric, four-point exchange amplitudes in AdS 5. Our solution takes the form of a resummation of the large spin solution to the crossing equations, supplemented by corrections atmore » finite spin, required by crossing. The method can be applied to the exchange of operators of arbitrary twist τ and spin s, although it vastly simplifies for even-integer twist, where we give explicit results. The output is the set of OPE data for the exchange of all double-trace operators [OO] n,ℓ. We find that the double-trace anomalous dimensions γ n,ℓ are negative, monotonic and convex functions of ℓ, for all n and all ℓ > s. This constitutes a holographic signature of bulk causality and classical dynamics of even-spin fields. We also find that the “derivative relation” between double-trace anomalous dimensions and OPE coefficients does not hold in general, and derive the explicit form of the deviation in several cases. Finally, we study large n limits of γ n,ℓ, relevant for the Regge and bulk-point regimes.« less

  5. Taste detection and recognition thresholds in Japanese patients with Alzheimer-type dementia.

    PubMed

    Ogawa, Takao; Irikawa, Naoya; Yanagisawa, Daijiro; Shiino, Akihiko; Tooyama, Ikuo; Shimizu, Takeshi

    2017-04-01

    Alzheimer-type dementia (AD) is pathologically characterized by massive neuronal loss in the brain, and the taste cortex is thought to be affected. However, there are only a few reports regarding the gustatory function of AD patients, and the conclusions of this research are inconsistent. This prospective study enrolled 22 consecutive patients with mild to moderately severe Alzheimer-type dementia (AD) with mean age of 84.0 years, and 49 elderly volunteers without dementia with mean age of 71.0 years as control subjects. The control subjects were divided into two groups according to age: a younger group (N=28, mean age: 68.5) and an older group (N=21, mean age: 83.0). The gustatory function was investigated using the filter paper disc method (FPD) and electrogustometry (EGM). The gustatory function as measured by the FPD was significantly impaired in patients with AD as compared with age-matched control subjects; no such difference was found between the younger and the older control groups. On the other hand, as for the EGM thresholds, there were no differences between the AD patient group and the age-matched controls. The FPD method demonstrated decreased gustatory function in AD patients beyond that of aging. On the other hand, EGM thresholds did not differ between the AD patient group and the age-matched controls. These results suggest that failure of taste processing in the brain, but not taste transmission in the peripheral taste system, occurs in patients with AD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. The Use of Advance Directives Among Patients With Implantable Cardioverter Defibrillators

    PubMed Central

    Tajouri, Tanya H.; Ottenberg, Abigale L.; Hayes, David L.; Mueller, Paul S.

    2013-01-01

    Background We aimed to determine the prevalence of advance directives (ADs) among patients with implantable cardioverter defibrillators (ICDs) and of ADs that addressed ICD management at the end of life. Methods The medical records of all patients who underwent ICD implantation during 2007 at a single institution were reviewed retrospectively to determine the number of patients with an AD and the number of ADs mentioning the ICD specifically (ie, ICD management at end of life). Results During 2007, 420 patients (males, 71%) underwent ICD implantation at our institution (mean age [range] at implantation, 63 [1–90] years). Primary prevention was the most common indication for device therapy (254 patients [61%]). Overall, 127 patients (30%) had an AD, with 83 ADs (65%) completed more than 12 months before ICD implantation and 10 (8%) completed after it. Several life-sustaining treatments were mentioned in the ADs: tube feeding, 46 (37%); cardiopulmonary resuscitation, 25 (20%); mechanical ventilation, 22 (17%); and hemodialysis, 9 (7%). Pain control was mentioned in 58 ADs (46%) and comfort measures in 38 (30%). However, only 2 ADs (2%) mentioned the ICD or its deactivation at end of life. Conclusions About one-third of patients with ICDs had an AD, but only a couple ADs mentioned the ICD. These results suggest that clinicians should not only encourage patients with ICDs to complete an AD, but also encourage them to address ICD management specifically. Not addressing ICD management in an AD may result in ethical dilemmas during end-of- life care. PMID:22432897

  7. Diffusion and chaos from near AdS 2 horizons

    DOE PAGES

    Blake, Mike; Donos, Aristomenis

    2017-02-03

    We calculate the thermal diffusivity D =more » $$\\kappa/c_\\rho$$ and butterfy velocity $$\\upsilon_\\beta$$ in holographic models that flow to $$AdS_2$$ x $R^d$ fixed points in the infra-red. We show that both these quantities are governed by the same irrelevant deformation of $$AdS_2$$ and hence establish a simple relationship between them. When this deformation corresponds to a universal dilaton mode of dimension $$\\Delta$$ = 2 then this relationship is always given by D = $$\\upsilon_B^2$$/(2$$\\pi$$T).« less

  8. AdS6 solutions of type II supergravity

    NASA Astrophysics Data System (ADS)

    Apruzzi, Fabio; Fazzi, Marco; Passias, Achilleas; Rosa, Dario; Tomasiello, Alessandro

    2014-11-01

    Very few AdS6 × M 4 supersymmetric solutions are known: one in massive IIA, and two IIB solutions dual to it. The IIA solution is known to be unique; in this paper, we use the pure spinor approach to give a classification for IIB supergravity. We reduce the problem to two PDEs on a two-dimensional space Σ. M 4 is then a fibration of S 2 over Σ; the metric and fluxes are completely determined in terms of the solution to the PDEs. The results seem likely to accommodate near-horizon limits of ( p, q)-fivebrane webs studied in the literature as a source of CFT5's. We also show that there are no AdS6 solutions in eleven-dimensional supergravity.

  9. Intelligent self-organization methods for wireless ad hoc sensor networks based on limited resources

    NASA Astrophysics Data System (ADS)

    Hortos, William S.

    2006-05-01

    A wireless ad hoc sensor network (WSN) is a configuration for area surveillance that affords rapid, flexible deployment in arbitrary threat environments. There is no infrastructure support and sensor nodes communicate with each other only when they are in transmission range. To a greater degree than the terminals found in mobile ad hoc networks (MANETs) for communications, sensor nodes are resource-constrained, with limited computational processing, bandwidth, memory, and power, and are typically unattended once in operation. Consequently, the level of information exchange among nodes, to support any complex adaptive algorithms to establish network connectivity and optimize throughput, not only deplete those limited resources and creates high overhead in narrowband communications, but also increase network vulnerability to eavesdropping by malicious nodes. Cooperation among nodes, critical to the mission of sensor networks, can thus be disrupted by the inappropriate choice of the method for self-organization. Recent published contributions to the self-configuration of ad hoc sensor networks, e.g., self-organizing mapping and swarm intelligence techniques, have been based on the adaptive control of the cross-layer interactions found in MANET protocols to achieve one or more performance objectives: connectivity, intrusion resistance, power control, throughput, and delay. However, few studies have examined the performance of these algorithms when implemented with the limited resources of WSNs. In this paper, self-organization algorithms for the initiation, operation and maintenance of a network topology from a collection of wireless sensor nodes are proposed that improve the performance metrics significant to WSNs. The intelligent algorithm approach emphasizes low computational complexity, energy efficiency and robust adaptation to change, allowing distributed implementation with the actual limited resources of the cooperative nodes of the network. Extensions of the

  10. Geometry and supersymmetry of heterotic warped flux AdS backgrounds

    NASA Astrophysics Data System (ADS)

    Beck, S.; Gutowski, J.; Papadopoulos, G.

    2015-07-01

    We classify the geometries of the most general warped, flux AdS backgrounds of heterotic supergravity up to two loop order in sigma model perturbation theory. We show under some mild assumptions that there are no AdS n backgrounds with n ≠ 3. Moreover the warp factor of AdS3 backgrounds is constant, the geometry is a product AdS 3 × M 7 and such solutions preserve, 2, 4, 6 and 8 supersymmetries. The geometry of M 7 has been specified in all cases. For 2 supersymmetries, it has been found that M 7 admits a suitably restricted G 2 structure. For 4 supersymmetries, M 7 has an SU(3) structure and can be described locally as a circle fibration over a 6-dimensional KT manifold. For 6 and 8 supersymmetries, M 7 has an SU(2) structure and can be described locally as a S 3 fibration over a 4-dimensional manifold which either has an anti-self dual Weyl tensor or a hyper-Kähler structure, respectively. We also demonstrate a new Lichnerowicz type theorem in the presence of α' corrections.

  11. Disrupted Structural Brain Network in AD and aMCI: A Finding of Long Fiber Degeneration.

    PubMed

    Fang, Rong; Yan, Xiao-Xiao; Wu, Zhi-Yuan; Sun, Yu; Yin, Qi-Hua; Wang, Ying; Tang, Hui-Dong; Sun, Jun-Feng; Miao, Fei; Chen, Sheng-Di

    2015-01-01

    Although recent evidence has emerged that Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) patients show both regional brain abnormalities and topological degeneration in brain networks, our understanding of the effects of white matter fiber aberrations on brain network topology in AD and aMCI is still rudimentary. In this study, we investigated the regional volumetric aberrations and the global topological abnormalities in AD and aMCI patients. The results showed a widely distributed atrophy in both gray and white matters in the AD and aMCI groups. In particular, AD patients had weaker connectivity with long fiber length than aMCI and normal control (NC) groups, as assessed by fractional anisotropy (FA). Furthermore, the brain networks of all three groups exhibited prominent economical small-world properties. Interestingly, the topological characteristics estimated from binary brain networks showed no significant group effect, indicating a tendency of preserving an optimal topological architecture in AD and aMCI during degeneration. However, significantly longer characteristic path length was observed in the FA weighted brain networks of AD and aMCI patients, suggesting dysfunctional global integration. Moreover, the abnormality of the characteristic path length was negatively correlated with the clinical ratings of cognitive impairment. Thus, the results therefore suggested that the topological alterations in weighted brain networks of AD are induced by the loss of connectivity with long fiber lengths. Our findings provide new insights into the alterations of the brain network in AD and may indicate the predictive value of the network metrics as biomarkers of disease development.

  12. Satisfaction of patients receiving value added-services compared to traditional counter service for prescription refills in Malaysia

    PubMed Central

    2018-01-01

    Background: Patients’ satisfaction is the key parameter to measure the quality of healthcare services. Value added-services (VAS) were introduced to improve the quality of medication deliveries and to reduce the waiting time at outpatient pharmacy. Objective: This study aimed to compare the satisfaction levels of patients receiving VAS and traditional counter service (TCS) for prescription refills in Port Dickson Hospital. Methods: A single-center, cross-sectional study was conducted in the outpatient pharmacy department of Port Dickson Hospital from 1 March to 30 June 2017. Systematic sampling method was utilized to recruit subjects into the study, except mail pharmacy in which universal sampling method was used. Data collection was done via telephone interviews for both groups. Results: There was 104 and 105 in TCS and VAS group respectively. The response rate was 99.5%. Overall, a significant higher total mean satisfaction score in VAS group was observed as compared to TCS group (43.39 versus 40.49, p=0.002). The same finding was observed after confounding factors were controlled (VAS=44.66, 95% CI 43.07:46.24 versus TCS=39.88, 95% CI 38.29:41.46; p<0.001). VAS respondents reported more satisfaction than TCS respondents for both general and technical aspects. Among the VAS offered, mail pharmacy service respondents showed highest total mean satisfaction score, but no significant different was seen between groups (p=0.064). Conclusion: VAS respondents were generally more satisfied than TCS respondents for prescription refills. A longitudinal study is necessary to examine the impact of other dimensions and other types of VAS on patients’ satisfaction levels. PMID:29619135

  13. [Value-Added--Adding Economic Value in the Food Industry].

    ERIC Educational Resources Information Center

    Welch, Mary A., Ed.

    1989-01-01

    This booklet focuses on the economic concept of "value added" to goods and services. A student activity worksheet illustrates how the steps involved in processing food are examples of the concept of value added. The booklet further links food processing to the idea of value added to the Gross National Product (GNP). Discussion questions,…

  14. Impaired Attention in the 3xTgAD Model of Alzheimer’s Disease Assessed Using a Translational Touchscreen Method for Mice: Rescue by Donepezil (Aricept)

    PubMed Central

    Romberg, Carola; Mattson, Mark P.; Mughal, Mohamed R.; Bussey, Timothy J.; Saksida, Lisa M.

    2011-01-01

    Several mouse models of Alzheimer’s Disease (AD) with abundant β-amyloid and/or aberrantly phosphorylated tau develop memory impairments. However, multiple non-mnemonic cognitive domains such as attention and executive control are also compromised early in AD individuals. Currently, it is unclear whether mutations in the β-amyloid precursor protein (APP) and tau are sufficient to cause similar, AD-like attention deficits in mouse models of the disease. To address this question, we tested 3xTgAD mice (which express APPswe, PS1M146V and tauP301L mutations) and wild type control mice on a newly-developed touchscreen-based 5-choice serial reaction time test of attention and response control. The 3xTgAD mice attended less accurately to short, spatially unpredictable stimuli when the attentional demand of the task was high, and also showed a general tendency to make more perseverative responses than wild type mice. The attentional impairment of 3xTgAD mice was comparable to that of AD patients in two aspects; first, although 3xTgAD mice initially responded as accurately as wild type mice, they subsequently failed to sustain their attention over the duration of the task; second, the ability to sustain attention was enhanced by the cholinesterase inhibitor donepezil (Aricept). These findings demonstrate that familial AD mutations not only affect memory, but also cause significant impairments in attention, a cognitive domain supported by the prefrontal cortex and its afferents. Because attention deficits are likely to affect memory encoding and other cognitive abilities, our findings have important consequences for the assessment of disease mechanisms and therapeutics in animal models of AD. PMID:21368062

  15. snpAD: An ancient DNA genotype caller.

    PubMed

    Prüfer, Kay

    2018-06-21

    The study of ancient genomes can elucidate the evolutionary past. However, analyses are complicated by base-modifications in ancient DNA molecules that result in errors in DNA sequences. These errors are particularly common near the ends of sequences and pose a challenge for genotype calling. I describe an iterative method that estimates genotype frequencies and errors along sequences to allow for accurate genotype calling from ancient sequences. The implementation of this method, called snpAD, performs well on high-coverage ancient data, as shown by simulations and by subsampling the data of a high-coverage Neandertal genome. Although estimates for low-coverage genomes are less accurate, I am able to derive approximate estimates of heterozygosity from several low-coverage Neandertals. These estimates show that low heterozygosity, compared to modern humans, was common among Neandertals. The C ++ code of snpAD is freely available at http://bioinf.eva.mpg.de/snpAD/. Supplementary data are available at Bioinformatics online.

  16. Familiarity-based memory as an early cognitive marker of preclinical and prodromal AD

    PubMed Central

    Wolk, David A.; Mancuso, Lauren; Kliot, Daria; Arnold, Steven E.; Dickerson, Bradford C.

    2013-01-01

    There is great interest in the development of cognitive markers that differentiate “normal” age-associated cognitive change from that of Alzheimer's disease (AD) in its prodromal (i.e., mild cognitive impairment; MCI) or even preclinical stages. Dual process models posit that recognition memory is supported by the dissociable processes of recollection and familiarity. Familiarity-based memory has generally been considered to be spared during normal aging, but it remains controversial whether this type of memory is impaired in early AD. Here, we describe findings of estimates of recollection and familiarity in young adults (YA), cognitively normal older adults (CN), and patients with amnestic-MCI (a-MCI). These measures in the CN and a-MCI patients were then related to a structural imaging biomarker of AD that has previously been demonstrated to be sensitive to preclinical and prodromal AD, the Cortical Signature of AD (ADsig). Consistent with much work in the literature, recollection, but not familiarity, was impaired in CN versus YA. Replicating our prior findings, a-MCI patients displayed impairment in both familiarity and recollection. Finally, the familiarity measure was correlated with the ADsig biomarker across the CN and a-MCI group, as well as within the CN adults alone. No other standard psychometric measure was as highly associated with the ADsig, suggesting that familiarity may be a sensitive biomarker of AD-specific brain changes in preclinical and prodromal AD and that it may offer a qualitatively distinct measure of early AD memory impairment relative to normal age-associated change. PMID:23474075

  17. Analysis of Added Value of Subscores with Respect to Classification

    ERIC Educational Resources Information Center

    Sinharay, Sandip

    2014-01-01

    Brennan noted that users of test scores often want (indeed, demand) that subscores be reported, along with total test scores, for diagnostic purposes. Haberman suggested a method based on classical test theory (CTT) to determine if subscores have added value over the total score. One way to interpret the method is that a subscore has added value…

  18. Consumer preferences and willingness to pay for value-added chicken product attributes.

    PubMed

    Martínez Michel, Lorelei; Anders, Sven; Wismer, Wendy V

    2011-10-01

    A growing demand for convenient and ready-to-eat products has increased poultry processors' interest in developing consumer-oriented value-added chicken products. In this study, a conjoint analysis survey of 276 chicken consumers in Edmonton was conducted during the summer of 2009 to assess the importance of the chicken part, production method, processing method, storage method, the presence of added flavor, and cooking method on consumer preferences for different value-added chicken product attributes. Estimates of consumer willingness to pay (WTP) premium prices for different combinations of value-added chicken attributes were also determined. Participants'"ideal" chicken product was a refrigerated product made with free-range chicken breast, produced with no additives or preservatives and no added flavor, which could be oven heated or pan heated. Half of all participants on average were willing to pay 30% more for a value-added chicken product over the price of a conventional product. Overall, young consumers, individuals who shop at Farmers' Markets and those who prefer free-range or organic products were more likely to pay a premium for value-added chicken products. As expected, consumers' WTP was affected negatively by product price. Combined knowledge of consumer product attribute preferences and consumer WTP for value-added chicken products can help the poultry industry design innovative value-added chicken products. Practical Application:  An optimum combination of product attributes desired by consumers for the development of a new value-added chicken product, as well as the WTP for this product, have been identified in this study. This information is relevant to the poultry industry to enhance consumer satisfaction of future value-added chicken products and provide the tools for future profit growth. © 2011 Institute of Food Technologists®

  19. Using U.S. Medicare records to evaluate the indirect health effects on spouses: a case study in Alzheimer's disease patients.

    PubMed

    Gilden, Daniel M; Kubisiak, Joanna M; Kahle-Wrobleski, Kristin; Ball, Daniel E; Bowman, Lee

    2014-07-07

    The burden experienced by spouses of patients with Alzheimer's disease (AD) may have negative consequences for their physical health. We describe here a method for analyzing United States Medicare records to determine the changes in health service use and costs experienced by spouses after their marital partner receives an AD diagnosis. We initially identified all beneficiaries in the 2001-2005 Medicare 5% sample who had multiple claims listing the ICD-9 diagnostic code for AD, 331.0. The 5% sample includes spouses who share a Medicare account with their marital partners because they lack a sufficient work history for full eligibility on their own. A matched cohort study assessed incremental health costs in the spouses of AD patients versus a control group of spouses of non-AD patients. Longitudinal and cross-sectional analyses tracked the impact of a patient's AD diagnosis on his or her spouse's healthcare costs. Our method located 54,593 AD patients of whom 11.5% had spouses identifiable via a shared Medicare account. AD diagnosis in one member of a couple was associated with significantly higher monthly Medicare payments for the other member's healthcare. The spouses' elevated costs commenced 2 to 3 months before their partners' AD diagnosis and persisted over the follow-up period. After 31 months, the cumulative additional Medicare reimbursements totaled a mean $4,600 in the spouses of AD patients. This excess was significant even after accounting for differences in baseline health status between the cohorts. The study methodology provides a framework for comprehensively evaluating medical costs of both chronically ill patients and their spouses. This method also provides monthly data, which makes possible a longitudinal evaluation of the cost effects of specific health events. The observed correlations provide a coherent demonstration of the interdependence between AD patients' and spouses' health. Future research should examine caregiving burden and other

  20. Collapse and Nonlinear Instability of AdS Space with Angular Momentum

    NASA Astrophysics Data System (ADS)

    Choptuik, Matthew W.; Dias, Óscar J. C.; Santos, Jorge E.; Way, Benson

    2017-11-01

    We present a numerical study of rotational dynamics in AdS5 with equal angular momenta in the presence of a complex doublet scalar field. We determine that the endpoint of gravitational collapse is a Myers-Perry black hole for high energies and a hairy black hole for low energies. We investigate the time scale for collapse at low energies E , keeping the angular momenta J ∝E in anti-de Sitter (AdS) length units. We find that the inclusion of angular momenta delays the collapse time, but retains a t ˜1 /E scaling. We perturb and evolve rotating boson stars, and find that boson stars near AdS space appear stable, but those sufficiently far from AdS space are unstable. We find that the dynamics of the boson star instability depend on the perturbation, resulting either in collapse to a Myers-Perry black hole, or development towards a stable oscillating solution.

  1. On information loss in AdS 3/CFT 2

    DOE PAGES

    Fitzpatrick, A. Liam; Kaplan, Jared; Li, Daliang; ...

    2016-05-18

    We discuss information loss from black hole physics in AdS 3, focusing on two sharp signatures infecting CFT 2 correlators at large central charge c: ‘forbidden singularities’ arising from Euclidean-time periodicity due to the effective Hawking temperature, and late-time exponential decay in the Lorentzian region. We study an infinite class of examples where forbidden singularities can be resolved by non-perturbative effects at finite c, and we show that the resolution has certain universal features that also apply in the general case. Analytically continuing to the Lorentzian regime, we find that the non-perturbative effects that resolve forbidden singularities qualitatively change themore » behavior of correlators at times t ~S BH, the black hole entropy. This may resolve the exponential decay of correlators at late times in black hole backgrounds. By Borel resumming the 1/c expansion of exact examples, we explicitly identify ‘information-restoring’ effects from heavy states that should correspond to classical solutions in AdS 3. Lastly, our results suggest a line of inquiry towards a more precise formulation of the gravitational path integral in AdS 3.« less

  2. Semiclassical Virasoro blocks from AdS 3 gravity

    DOE PAGES

    Hijano, Eliot; Kraus, Per; Perlmutter, Eric; ...

    2015-12-14

    We present a unified framework for the holographic computation of Virasoro conformal blocks at large central charge. In particular, we provide bulk constructions that correctly reproduce all semiclassical Virasoro blocks that are known explicitly from conformal field theory computations. The results revolve around the use of geodesic Witten diagrams, recently introduced in [1], evaluated in locally AdS 3 geometries generated by backreaction of heavy operators. We also provide an alternative computation of the heavy-light semiclassical block — in which two external operators become parametrically heavy — as a certain scattering process involving higher spin gauge fields in AdS 3; thismore » approach highlights the chiral nature of Virasoro blocks. Finally, these techniques may be systematically extended to compute corrections to these blocks and to interpolate amongst the different semiclassical regimes.« less

  3. EXACT S-MATRICES FOR AdS3/CFT2

    NASA Astrophysics Data System (ADS)

    Ahn, Changrim; Bombardelli, Diego

    2013-12-01

    We propose exact S-matrices for the AdS3/CFT2 duality between type IIB strings on AdS3×S3×M4 with M4 = S3×S1 or T4 and the corresponding two-dimensional conformal field theories. We fix the two-particle S-matrices on the basis of the symmetries su(1|1) and su(1|1)×su(1|1). A crucial justification comes from the derivation of the all-loop Bethe ansatz matching exactly the recent conjecture proposed by Babichenko et al. [J. High Energy Phys.1003, 058 (2010), arXiv:0912.1723 [hep-th

  4. Minimal surfaces in AdS space and integrable systems

    NASA Astrophysics Data System (ADS)

    Burrington, Benjamin A.; Gao, Peng

    2010-04-01

    We consider the Pohlmeyer reduction for spacelike minimal area worldsheets in AdS5. The Lax pair for the reduced theory is found, and written entirely in terms of the A3 = D3 root system, generalizing the B2 affine Toda system which appears for the AdS4 string. For the B2 affine Toda system, we show that the area of the worlsheet is obtainable from the moduli space Kähler potential of a related Hitchin system. We also explore the Saveliev-Leznov construction for solutions of the B2 affine Toda system, and recover the rotationally symmetric solution associated to Painleve transcendent.

  5. Preventing Fusion Mass Shift Avoids Postoperative Distal Curve Adding-on in Adolescent Idiopathic Scoliosis.

    PubMed

    Shigematsu, Hideki; Cheung, Jason Pui Yin; Bruzzone, Mauro; Matsumori, Hiroaki; Mak, Kin-Cheung; Samartzis, Dino; Luk, Keith Dip Kei

    2017-05-01

    Surgery for adolescent idiopathic scoliosis (AIS) is only complete after achieving fusion to maintain the correction obtained intraoperatively. The instrumented or fused segments can be referred to as the "fusion mass". In patients with AIS, the ideal fusion mass strategy has been established based on fulcrum-bending radiographs for main thoracic curves. Ideally, the fusion mass should achieve parallel endplates of the upper and lower instrumented vertebra and correct any "shift" for truncal balance. Distal adding-on is an important element to consider in AIS surgery. This phenomenon represents a progressive increase in the number of vertebrae included distally in the primary curvature and it should be avoided as it is associated with unsatisfactory cosmesis and an increased risk of revision surgery. However, it remains unknown whether any fusion mass shift, or shift in the fusion mass or instrumented segments, affects global spinal balance and distal adding-on after curve correction surgery in patients with AIS. (1) To investigate the relationship among postoperative fusion mass shift, global balance, and distal adding-on phenomenon in patients with AIS; and (2) to identify a cutoff value of fusion mass shift that will lead to distal adding-on. This was a retrospective study of patients with AIS from a single institution. Between 2006 and 2011 we performed 69 selective thoracic fusions for patients with main thoracic AIS. All patients were evaluated preoperatively and at 2 years postoperatively. The Cobb angle between the cranial and caudal endplates of the fusion mass and the coronal shift between them, which was defined as "fusion mass shift", were measured. Patients with a fusion mass Cobb angle greater than 20° were excluded to specifically determine the effect of fusion mass shift on distal adding-on phenomenon. Fusion mass shift was empirically set as 20 mm for analysis. Therefore, of the 69 patients who underwent selective thoracic fusion, only 52 with a

  6. IGF-I gene variability is associated with an increased risk for AD.

    PubMed

    Vargas, Teo; Martinez-Garcia, Ana; Antequera, Desiree; Vilella, Elisabet; Clarimon, Jordi; Mateo, Ignacio; Sanchez-Juan, Pascual; Rodriguez-Rodriguez, Eloy; Frank, Ana; Rosich-Estrago, Marcel; Lleo, Alberto; Molina-Porcel, Laura; Blesa, Rafael; Gomez-Isla, Teresa; Combarros, Onofre; Bermejo-Pareja, Felix; Valdivieso, Fernando; Bullido, Maria Jesus; Carro, Eva

    2011-03-01

    Insulin-like growth factor I (IGF-I), a neuroprotective factor with a wide spectrum of actions in the adult brain, is involved in the pathogenesis of Alzheimer's disease (AD). Circulating levels of IGF-I change in AD patients and are implicated in the clearance of brain amyloid beta (Aβ) complexes. To investigate this hypothesis, we screened the IGF-I gene for various well known single nucleotide polymorphisms (SNPs) covering % of the gene variability in a population of 2352 individuals. Genetic analysis indicated different distribution of genotypes of 1 single nucleotide polymorphism, and 1 extended haplotype in the AD population compared with healthy control subjects. In particular, the frequency of rs972936 GG genotype was significantly greater in AD patients than in control subjects (63% vs. 55%). The rs972936 GG genotype was associated with an increased risk for disease, independently of apolipoprotein E genotype, and with enhanced circulating levels of IGF-I. These findings suggest that polymorphisms within the IGF-I gene could infer greater risk for AD through their effect on IGF-I levels, and confirm the physiological role IGF-I in the pathogenesis of AD. Copyright © 2011 IBRO. Published by Elsevier Inc. All rights reserved.

  7. How redesigning AD clinical trials might increase study partners’ willingness to participate

    PubMed Central

    Karlawish, Jason; Cary, Mark S.; Rubright, Jonathan; TenHave, Tom

    2008-01-01

    Background: Timely recruiting and retaining participants into Alzheimer disease (AD) clinical trials is a challenge. We used conjoint analysis to identify how alterations in attributes of clinical trial design improve willingness to participate: risk, home visits, car service, or increased chance of receiving intervention. Method: A total of 108 study partners of patients with very mild to severe stage AD rated willingness to allow their relative to participate in eight clinical trials that varied combinations of the four attributes. Results: The highest utility was for home visits (0.89) which essentially compensated for the disutility of high risk (−0.85). The combination of home visits and car service was redundant, with almost no increase in utility over home visits alone. Seventeen percent were willing to participate in a trial with no amenities; the addition of home visits increased predicted willingness to participate to 27%; low risk, home visits, and higher chance of active treatment increased predicted willingness to 60%. The value of reducing the hassles of travel correlated well with measures of AD severity (activities of daily living r = 0.41, p < 0.001; basic activities of daily living r = 0.38, p < 0.001; Neuropsychiatric Inventory severity p = 0.24, p = 0.01; Neuropsychiatric Inventory distress r = 0.23, p < 0.02). No association was found between degree of study partner burden and willingness to tolerate risk of an intervention. Conclusion: Clinical trials that reduce travel inconvenience may offset the disincentive of study features such as the risk of intervention and may also increase willingness to participate. Redesigning trials may also help recruit patients with more severe Alzheimer disease. Shorter recruitment periods and increased retention rates may offset costs of these changes. GLOSSARY AD = Alzheimer disease; BLUP = best linear unbiased prediction; RAQ = Research Attitude Questionnaire. PMID:19047560

  8. The Effect of Comparatively-Framed versus Similarity-Framed E-Cigarette and Snus Print Ads on Young Adults’ Ad and Product Perceptions

    PubMed Central

    Banerjee, Smita C.; Greene, Kathryn; Li, Yuelin; Ostroff, Jamie S.

    2016-01-01

    Objectives This study examined the effects of comparative-framing [C-F; ads highlighting differences between the advertised product and conventional cigarettes and/or smokeless tobacco products] versus similarity-framing (S-F; ads highlighting congruence with conventional cigarettes and/or smokeless tobacco products) in e-cigarette and snus ads on young adult smokers’ and non-smokers’ ad- and product-related perceptions. Methods One thousand fifty one (1,051) young adults (18–24 years; 76% women; 50% smokers) from existing consumer panels were recruited in a within-subjects quasi-experiment. Each participant viewed 4 online advertisements, varied by tobacco product type (e-cigarette or snus) and ad framing (C-F or S-F). The dependent measures for this study were ad-related (ad perceptions, ad credibility) and product-related perceptions (absolute and comparative risk perceptions, product appeal, and product use intentions). Results Former and current smokers rated C-F ads as more persuasive than S-F ads, as evidenced by favorable ad perceptions and high product use intentions. Former and current smokers also rated e-cigarette ads with more favorable ad perceptions, low absolute and comparative risk perceptions, high product appeal, and high product use intentions as compared to snus ads. However, the effect sizes of the significant differences are less than.2, indicating small magnitude of difference between the study variables. Conclusions Unless FDA regulates e-cig and snus advertising, there is a potential of decreasing risk perceptions and increasing use of e-cigs among young adults. Further research on implicit/explicit comparative claims in e-cigarettes and snus advertisements that encourage risk misperceptions is recommended. PMID:28042597

  9. String in AdS black hole: A thermo field dynamic approach

    NASA Astrophysics Data System (ADS)

    Cantcheff, M. Botta; Gadelha, Alexandre L.; Marchioro, Dáfni F. Z.; Nedel, Daniel Luiz

    2012-10-01

    Based on Maldacena’s description of an eternal anti-de Sitter (AdS) black hole, we reassess the thermo field dynamics (TFD) formalism in the context of the AdS/CFT correspondence. The model studied here involves the maximally extended AdS-Schwarschild solution and two (noninteracting) copies of the conformal field theory (CFT) associated to the global AdS spacetime, along with an extension of the string by imposing natural gluing conditions in the horizon. We show that the gluing conditions in the horizon define a string boundary state which is identified with the TFD thermal vacuum, globally defined in the Kruskal extension of the AdS black hole. We emphasize the connection of this picture with unitary SU(1,1) TFD formulation, and we show that information about the bulk and the conformal boundary is present in the SU(1,1) parameters. Using the unitary SU(1,1) TFD formulation, a canonical prescription for calculating the world sheet real time thermal Green’s function is made, and the entropy associated with the entanglement of the two CFT’s is calculated.

  10. Continuous-spin mixed-symmetry fields in AdS(5)

    NASA Astrophysics Data System (ADS)

    Metsaev, R. R.

    2018-05-01

    Free mixed-symmetry continuous-spin fields propagating in AdS(5) space and flat R(4,1) space are studied. In the framework of a light-cone gauge formulation of relativistic dynamics, we build simple actions for such fields. The realization of relativistic symmetries on the space of light-cone gauge mixed-symmetry continuous-spin fields is also found. Interrelations between constant parameters entering the light-cone gauge actions and eigenvalues of the Casimir operators of space-time symmetry algebras are obtained. Using these interrelations and requiring that the field dynamics in AdS(5) be irreducible and classically unitary, we derive restrictions on the constant parameters and eigenvalues of the second-order Casimir operator of the algebra.

  11. Cost-effectiveness analysis of adding low dose ribavirin to peginterferon alfa-2a for treatment of chronic hepatitis C infected thalassemia major patients in iran.

    PubMed

    Mehrazmay, Alireza; Alavian, Seyed Moayed; Moradi-Lakeh, Maziar; Mokhtari Payam, Mahdi; Hashemi-Meshkini, Amir; Behnava, Bita; Miri, Seyyed Mohammad; Karimi Elizee, Pegah; Tabatabaee, Seyed Vahid; Keshvari, Maryam; Bagheri Lankarani, Kamran

    2013-01-01

    The prevalence of hepatitis C in Iran is 1% and 18% in general population and thalassemia patients respectively. The cost effectiveness analysis of adding Ribavirin to Peginterferon alfa-2a (PEG IFN alfa-2a) as a combination treatment strategy of chronic hepatitis C in thalassemia patients in comparison with monotherapy could help clinicians and policy makers to provide the best treatment for the patients. In this study we aimed to assess whether adding Ribavirin to PEG IFN alfa-2a is a cost effective strategy in different genotypes and different subgroups of 280 patients with chronic hepatitis C infection from the perspective of society in Iranian setting. A cost effectiveness analysis including all costs and outcomes of treatments for chronic hepatitis C infected thalassemia major patients was conducted. We constructed a decision tree of treatment course in which a hypothetical cohort of 100 patients received "PEG IFN alfa-2a" or "Peg IFN alfa-2a plus Ribavirin." The cost analysis was based on cost data for 2008 and we used 9300 Iranian Rials (IR Rial) as exchange rate declared by the Iranian Central Bank on that time to calculating costs by US Dollar (USD). To evaluate whether a strategy is cost effective, one time and three times of GDP per capita were used as threshold based on recommendation of the World Health Organization. The Incremental Cost Effectiveness Ratio (ICER) for combination therapy in genotype-1 and genotypes non-1 subgroups was 2,673 and 19,211 US dollars (USD) per one Sustain Virological Response (SVR), respectively. In low viral load and high viral load subgroups, the ICER was 5,233 and 14,976 USD per SVR, respectively. The calculated ICER for combination therapy in subgroup of patients with previously resistant to monotherapy was 13,006 USD per SVR. Combination therapy in previously resistant patients to combination therapy was a dominant strategy. Adding low dose of Ribavirin to PEG IFN alfa-2a for treatment of chronic hepatitis C patients

  12. Ad hoc instrumentation methods in ecological studies produce highly biased temperature measurements

    USGS Publications Warehouse

    Terando, Adam J.; Youngsteadt, Elsa; Meineke, Emily K.; Prado, Sara G.

    2017-01-01

    In light of global climate change, ecological studies increasingly address effects of temperature on organisms and ecosystems. To measure air temperature at biologically relevant scales in the field, ecologists often use small, portable temperature sensors. Sensors must be shielded from solar radiation to provide accurate temperature measurements, but our review of 18 years of ecological literature indicates that shielding practices vary across studies (when reported at all), and that ecologists often invent and construct ad hoc radiation shields without testing their efficacy. We performed two field experiments to examine the accuracy of temperature observations from three commonly used portable data loggers (HOBO Pro, HOBO Pendant, and iButton hygrochron) housed in manufactured Gill shields or ad hoc, custom‐fabricated shields constructed from everyday materials such as plastic cups. We installed this sensor array (five replicates of 11 sensor‐shield combinations) at weather stations located in open and forested sites. HOBO Pro sensors with Gill shields were the most accurate devices, with a mean absolute error of 0.2°C relative to weather stations at each site. Error in ad hoc shield treatments ranged from 0.8 to 3.0°C, with the largest errors at the open site. We then deployed one replicate of each sensor‐shield combination at five sites that varied in the amount of urban impervious surface cover, which presents a further shielding challenge. Bias in sensors paired with ad hoc shields increased by up to 0.7°C for every 10% increase in impervious surface. Our results indicate that, due to variable shielding practices, the ecological literature likely includes highly biased temperature data that cannot be compared directly across studies. If left unaddressed, these errors will hinder efforts to predict biological responses to climate change. We call for greater standardization in how temperature data are recorded in the field, handled in analyses, and

  13. Saxagliptin added to a submaximal dose of sulphonylurea improves glycaemic control compared with uptitration of sulphonylurea in patients with type 2 diabetes: a randomised controlled trial

    PubMed Central

    Chacra, A R; Tan, G H; Apanovitch, A; Ravichandran, S; List, J; Chen, R

    2009-01-01

    Aims: Assess the efficacy and safety of saxagliptin added to a submaximal sulphonylurea dose vs. uptitration of sulphonylurea monotherapy in patients with type 2 diabetes and inadequate glycaemic control with sulphonylurea monotherapy. Methods and patients: A total of 768 patients (18–77 years; HbA1c screening ≥ 7.5 to ≤ 10.0%) were randomised and treated with saxagliptin 2.5 or 5 mg in combination with glyburide 7.5 mg vs. glyburide 10 mg for 24 weeks. Blinded uptitration glyburide was allowed in the glyburide-only arm to a maximum total daily dose of 15 mg. Efficacy analyses were performed using ANCOVA and last-observation-carried-forward methodology. Results: At week 24, 92% of glyburide-only patients were uptitrated to a total glyburide dose of 15 mg/day. Saxagliptin 2.5 and 5 mg provided statistically significant adjusted mean decreases from baseline to week 24 vs. uptitrated glyburide, respectively, in HbA1c (−0.54%, −0.64% vs. +0.08%; both p < 0.0001) and fasting plasma glucose (−7, −10 vs. +1 mg/dl; p = 0.0218 and p = 0.002). The proportion of patients achieving an HbA1c < 7% was greater for saxagliptin 2.5 and 5 mg vs. uptitrated glyburide (22.4% and 22.8% vs. 9.1%; both p < 0.0001). Postprandial glucose area under the curve was reduced for saxagliptin 2.5 and 5 mg vs. uptitrated glyburide (−4296 and −5000 vs. +1196 mg·min/dl; both p < 0.0001). Adverse event occurrence was similar across all groups. Reported hypoglycaemic events were not statistically significantly different for saxagliptin 2.5 (13.3%) and 5 mg (14.6%) vs. uptitrated glyburide (10.1%). Conclusion: Saxagliptin added to submaximal glyburide therapy led to statistically significant improvements vs. uptitration of glyburide alone across key glycaemic parameters and was generally well tolerated. PMID:19614786

  14. ADS genes for reducing saturated fatty acid levels in seed oils

    DOEpatents

    Heilmann, Ingo H; Shanklin, John

    2014-03-18

    The present invention relates to enzymes involved in lipid metabolism. In particular, the present invention provides coding sequences for Arabidopsis Desaturases (ADS), the encoded ADS polypeptides, and methods for using the sequences and encoded polypeptides, where such methods include decreasing and increasing saturated fatty acid content in plant seed oils.

  15. ADS genes for reducing saturated fatty acid levels in seed oils

    DOEpatents

    Heilmann, Ingo H.; Shanklin, John

    2010-02-02

    The present invention relates to enzymes involved in lipid metabolism. In particular, the present invention provides coding sequences for Arabidopsis Desaturases (ADS), the encoded ADS polypeptides, and methods for using the sequences and encoded polypeptides, where such methods include decreasing and increasing saturated fatty acid content in plant seed oils.

  16. Evaluating Special Educator Effectiveness: Addressing Issues Inherent to Value-Added Modeling

    ERIC Educational Resources Information Center

    Steinbrecher, Trisha D.; Selig, James P.; Cosbey, Joanna; Thorstensen, Beata I.

    2014-01-01

    States are increasingly using value-added approaches to evaluate teacher effectiveness. There is much debate regarding whether these methods should be employed and, if employed, what role such methods should play in comprehensive teacher evaluation systems. In this article, we consider the use of value-added modeling (VAM) to evaluate special…

  17. Role of electrical stimulation added to conventional therapy in patients with idiopathic facial (Bell) palsy.

    PubMed

    Tuncay, Figen; Borman, Pinar; Taşer, Burcu; Ünlü, İlhan; Samim, Erdal

    2015-03-01

    The aim of this study was to determine the efficacy of electrical stimulation when added to conventional physical therapy with regard to clinical and neurophysiologic changes in patients with Bell palsy. This was a randomized controlled trial. Sixty patients diagnosed with Bell palsy (39 right sided, 21 left sided) were included in the study. Patients were randomly divided into two therapy groups. Group 1 received physical therapy applying hot pack, facial expression exercises, and massage to the facial muscles, whereas group 2 received electrical stimulation treatment in addition to the physical therapy, 5 days per week for a period of 3 wks. Patients were evaluated clinically and electrophysiologically before treatment (at the fourth week of the palsy) and again 3 mos later. Outcome measures included the House-Brackmann scale and Facial Disability Index scores, as well as facial nerve latencies and amplitudes of compound muscle action potentials derived from the frontalis and orbicularis oris muscles. Twenty-nine men (48.3%) and 31 women (51.7%) with Bell palsy were included in the study. In group 1, 16 (57.1%) patients had no axonal degeneration and 12 (42.9%) had axonal degeneration, compared with 17 (53.1%) and 15 (46.9%) patients in group 2, respectively. The baseline House-Brackmann and Facial Disability Index scores were similar between the groups. At 3 mos after onset, the Facial Disability Index scores were improved similarly in both groups. The classification of patients according to House-Brackmann scale revealed greater improvement in group 2 than in group 1. The mean motor nerve latencies and compound muscle action potential amplitudes of both facial muscles were statistically shorter in group 2, whereas only the mean motor latency of the frontalis muscle decreased in group 1. The addition of 3 wks of daily electrical stimulation shortly after facial palsy onset (4 wks), improved functional facial movements and electrophysiologic outcome measures at

  18. F-theory and AdS3/CFT2 (2, 0)

    NASA Astrophysics Data System (ADS)

    Couzens, Christopher; Martelli, Dario; Schäfer-Nameki, Sakura

    2018-06-01

    We continue to develop the program initiated in [1] of studying supersymmetric AdS3 backgrounds of F-theory and their holographic dual 2d superconformal field theories, which are dimensional reductions of theories with varying coupling. Imposing 2d N=(0,2) supersymmetry,wederivethegeneralconditionsonthegeometryforTypeIIB AdS3 solutions with varying axio-dilaton and five-form flux. Locally the compact part of spacetime takes the form of a circle fibration over an eight-fold Y_8^{τ } , which is elliptically fibered over a base \\tilde{M}_6 . We construct two classes of solutions given in terms of a product ansatz \\tilde{M}_6}=Σ × {M}_4 , where Σ is a complex curve and \\tilde{M}_4 is locally a Kähler surface. In the first class \\tilde{M}_4 is globally a Kähler surface and we take the elliptic fibration to vary non-trivially over either of these two factors, where in both cases the metrics on the total space of the elliptic fibrations are not Ricci-flat. In the second class the metric on the total space of the elliptic fibration over either curve or surface are Ricci-flat. This results in solutions of the type AdS3 × K3 × ℳ 5 τ , dual to 2d (0, 2) SCFTs, and AdS3 × S 3/Γ × CY 3, dual to 2d (0, 4) SCFTs, respectively. In all cases we compute the charges for the dual field theories with varying coupling and find agreement with the holographic results. We also show that solutions with enhanced 2d N=(2,2) supersymmetry must have constant axio-dilaton. Allowing the internal geometry to be non-compact leads to the most general class of Type IIB AdS5 solutions with varying axio-dilaton, i.e. F-theoretic solutions, that are dual to 4d N=1 SCFTs.

  19. [Change in soil enzymes activities after adding biochar or straw by fluorescent microplate method].

    PubMed

    Zhang, Yu-Lan; Chen, Li-Jun; Duan, Zheng-Hu; Wu, Zhi-Jie; Sun, Cai-Xia; Wang, Jun-Yu

    2014-02-01

    The present work was aimed to study soil a-glucosidase and beta-glucosidase activities of and red soils based on fluorescence detection method combined with 96 microplates with TECAN Infinite 200 Multi-Mode Microplate Reader. We added biochar or straw (2.5 g air dry sample/50g air dry soil sample) into and red soils and the test was carried under fixed temperature and humidity condition (25 degrees C, 20% soil moisture content). The results showed that straw addition enhances soil alpha-glucosidase and beta-glucosidase activities, beta-glucosidase activity stimulated by rice straw treatment was higher than that of corn straw treatment, and activity still maintains strong after 40 days, accounting for increasing soil carbon transformation with straw inputting. Straw inputting increased soil nutrients contents and may promote microbial activity, which also lead to the increase oin enzyme Straw inputting increased soil nutrients contents and may promote microbial activity, which also lead to the increase oin enzyme activities. Different effects of straw kinds may be related to material source that needs further research. However, biochar inputting has little effect on soil alpha-glucosidase and beta-glucosidase activity. Biochar contains less available nutrients than straw and have degradation-resistant characteristics. Compared with the conventional spectrophotometric method, fluorescence microplate method is more sensitive to soil enzyme activities in suspension liquid, which can be used in a large number of samples. In brief, fluorescence microplate method is fast, accurate, and simple to determine soil enzymes activities.

  20. Mitochondrial Bioenergetics Is Altered in Fibroblasts from Patients with Sporadic Alzheimer's Disease.

    PubMed

    Pérez, María J; Ponce, Daniela P; Osorio-Fuentealba, Cesar; Behrens, Maria I; Quintanilla, Rodrigo A

    2017-01-01

    The identification of an early biomarker to diagnose Alzheimer's disease (AD) remains a challenge. Neuropathological studies in animal and AD patients have shown that mitochondrial dysfunction is a hallmark of the development of the disease. Current studies suggest the use of peripheral tissues, like skin fibroblasts as a possibility to detect the early pathological alterations present in the AD brain. In this context, we studied mitochondrial function properties (bioenergetics and morphology) in cultured fibroblasts obtained from AD, aged-match and young healthy patients. We observed that AD fibroblasts presented a significant reduction in mitochondrial length with important changes in the expression of proteins that control mitochondrial fusion. Moreover, AD fibroblasts showed a distinct alteration in proteolytic processing of OPA1, a master regulator of mitochondrial fusion, compared to control fibroblasts. Complementary to these changes AD fibroblasts showed a dysfunctional mitochondrial bioenergetics profile that differentiates these cells from aged-matched and young patient fibroblasts. Our findings suggest that the human skin fibroblasts obtained from AD patients could replicate mitochondrial impairment observed in the AD brain. These promising observations suggest that the analysis of mitochondrial bioenergetics could represent a promising strategy to develop new diagnostic methods in peripheral tissues of AD patients.

  1. Mitochondrial Bioenergetics Is Altered in Fibroblasts from Patients with Sporadic Alzheimer's Disease

    PubMed Central

    Pérez, María J.; Ponce, Daniela P.; Osorio-Fuentealba, Cesar; Behrens, Maria I.; Quintanilla, Rodrigo A.

    2017-01-01

    The identification of an early biomarker to diagnose Alzheimer's disease (AD) remains a challenge. Neuropathological studies in animal and AD patients have shown that mitochondrial dysfunction is a hallmark of the development of the disease. Current studies suggest the use of peripheral tissues, like skin fibroblasts as a possibility to detect the early pathological alterations present in the AD brain. In this context, we studied mitochondrial function properties (bioenergetics and morphology) in cultured fibroblasts obtained from AD, aged-match and young healthy patients. We observed that AD fibroblasts presented a significant reduction in mitochondrial length with important changes in the expression of proteins that control mitochondrial fusion. Moreover, AD fibroblasts showed a distinct alteration in proteolytic processing of OPA1, a master regulator of mitochondrial fusion, compared to control fibroblasts. Complementary to these changes AD fibroblasts showed a dysfunctional mitochondrial bioenergetics profile that differentiates these cells from aged-matched and young patient fibroblasts. Our findings suggest that the human skin fibroblasts obtained from AD patients could replicate mitochondrial impairment observed in the AD brain. These promising observations suggest that the analysis of mitochondrial bioenergetics could represent a promising strategy to develop new diagnostic methods in peripheral tissues of AD patients. PMID:29056898

  2. Stability of warped AdS3 vacua of topologically massive gravity

    NASA Astrophysics Data System (ADS)

    Anninos, Dionysios; Esole, Mboyo; Guica, Monica

    2009-10-01

    AdS3 vacua of topologically massive gravity (TMG) have been shown to be perturbatively unstable for all values of the coupling constant except the chiral point μl = 1. We study the possibility that the warped vacua of TMG, which exist for all values of μ, are stable under linearized perturbations. In this paper, we show that spacelike warped AdS3 vacua with Compère-Detournay boundary conditions are indeed stable in the range μl>3. This is precisely the range in which black hole solutions arise as discrete identifications of the warped AdS3 vacuum. The situation somewhat resembles chiral gravity: although negative energy modes do exist, they are all excluded by the boundary conditions, and the perturbative spectrum solely consists of boundary (pure large gauge) gravitons.

  3. AdS/QCD and Applications of Light-Front Holography

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brodsky, Stanley J.; /SLAC /Southern Denmark U., CP3-Origins; Cao, Fu-Guang

    2012-02-16

    Light-Front Holography leads to a rigorous connection between hadronic amplitudes in a higher dimensional anti-de Sitter (AdS) space and frame-independent light-front wavefunctions of hadrons in 3 + 1 physical space-time, thus providing a compelling physical interpretation of the AdS/CFT correspondence principle and AdS/QCD, a useful framework which describes the correspondence between theories in a modified AdS5 background and confining field theories in physical space-time. To a first semiclassical approximation, where quantum loops and quark masses are not included, this approach leads to a single-variable light-front Schroedinger equation which determines the eigenspectrum and the light-front wavefunctions of hadrons for general spinmore » and orbital angular momentum. The coordinate z in AdS space is uniquely identified with a Lorentz-invariant coordinate {zeta} which measures the separation of the constituents within a hadron at equal light-front time. The internal structure of hadrons is explicitly introduced and the angular momentum of the constituents plays a key role. We give an overview of the light-front holographic approach to strongly coupled QCD. In particular, we study the photon-to-meson transition form factors (TFFs) F{sub M{gamma}}(Q{sup 2}) for {gamma}{gamma}* {yields} M using light-front holographic methods. The results for the TFFs for the {eta} and {eta}' mesons are also presented. Some novel features of QCD are discussed, including the consequences of confinement for quark and gluon condensates. A method for computing the hadronization of quark and gluon jets at the amplitude level is outlined.« less

  4. 17 CFR 240.17Ad-4 - Applicability of §§ 240.17Ad-2, 240.17Ad-3 and 240.17Ad-6(a) (1) through (7) and (11).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Applicability of §§ 240.17Ad-2, 240.17Ad-3 and 240.17Ad-6(a) (1) through (7) and (11). 240.17Ad-4 Section 240.17Ad-4 Commodity... Commission or the Office of the Comptroller of the Currency, prepare and maintain in its possession a...

  5. 17 CFR 240.17Ad-4 - Applicability of §§ 240.17Ad-2, 240.17Ad-3 and 240.17Ad-6(a) (1) through (7) and (11).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Applicability of §§ 240.17Ad-2, 240.17Ad-3 and 240.17Ad-6(a) (1) through (7) and (11). 240.17Ad-4 Section 240.17Ad-4 Commodity... Commission or the Office of the Comptroller of the Currency, prepare and maintain in its possession a...

  6. A method to achieve control of dietary macronutrient composition in ad libitum diets consumed by free-living subjects.

    PubMed

    Skov, A R; Toubro, S; Raben, A; Astrup, A

    1997-10-01

    To validate a shop system in controlling macronutrient composition during ad libitum dietary intervention. Six months randomized intervention trial. A shop at the department from which all foods were collected free of charge and registered by a purpose-designed computer system. Sixty-five free-living obese subjects (25 kg/m2 < BMI < 34 kg/m2) recruited through advertisement and from a waiting list at the Department. Total drop-out rate was 8%. Ad libitum low-fat diets (30 energy-% (E%) fat): (1) High-protein (25 E% protein, HP) or (2) Low-protein, (12 E% protein, LP) or habitual diet (controls, C). Compliance was assessed by 24 h urinary nitrogen excretion (24 h UN). After one month of dietary intervention 24 h UN increased significantly in the HP group and decreased significantly in the LP group (Group difference 95% CI):6.8 g (5.0-8.7 g), P < 0.0001). This group difference remained throughout the trial. There was good agreement between protein intake as estimated by the shop computer and as estimated from 24 h UN in both first (r = 0.86) and second half of the intervention (r = 0.80). The high dietary compliance demonstrates the potential of this method to control macronutrient composition in ad libitum dietary intervention studies in free-living subjects.

  7. Prediction of Fitness to Drive in Patients with Alzheimer's Dementia

    PubMed Central

    Piersma, Dafne; Fuermaier, Anselm B. M.; de Waard, Dick; Davidse, Ragnhild J.; de Groot, Jolieke; Doumen, Michelle J. A.; Bredewoud, Ruud A.; Claesen, René; Lemstra, Afina W.; Vermeeren, Annemiek; Ponds, Rudolf; Verhey, Frans; Brouwer, Wiebo H.; Tucha, Oliver

    2016-01-01

    The number of patients with Alzheimer’s disease (AD) is increasing and so is the number of patients driving a car. To enable patients to retain their mobility while at the same time not endangering public safety, each patient should be assessed for fitness to drive. The aim of this study is to develop a method to assess fitness to drive in a clinical setting, using three types of assessments, i.e. clinical interviews, neuropsychological assessment and driving simulator rides. The goals are (1) to determine for each type of assessment which combination of measures is most predictive for on-road driving performance, (2) to compare the predictive value of clinical interviews, neuropsychological assessment and driving simulator evaluation and (3) to determine which combination of these assessments provides the best prediction of fitness to drive. Eighty-one patients with AD and 45 healthy individuals participated. All participated in a clinical interview, and were administered a neuropsychological test battery and a driving simulator ride (predictors). The criterion fitness to drive was determined in an on-road driving assessment by experts of the CBR Dutch driving test organisation according to their official protocol. The validity of the predictors to determine fitness to drive was explored by means of logistic regression analyses, discriminant function analyses, as well as receiver operating curve analyses. We found that all three types of assessments are predictive of on-road driving performance. Neuropsychological assessment had the highest classification accuracy followed by driving simulator rides and clinical interviews. However, combining all three types of assessments yielded the best prediction for fitness to drive in patients with AD with an overall accuracy of 92.7%, which makes this method highly valid for assessing fitness to drive in AD. This method may be used to advise patients with AD and their family members about fitness to drive. PMID:26910535

  8. Examination of an Electronic Patient Record Display Method to Protect Patient Information Privacy.

    PubMed

    Niimi, Yukari; Ota, Katsumasa

    2017-02-01

    Electronic patient records facilitate the provision of safe, high-quality medical care. However, because personnel can view almost all stored information, this study designed a display method using a mosaic blur (pixelation) to temporarily conceal information patients do not want shared. This study developed an electronic patient records display method for patient information that balanced the patient's desire for personal information protection against the need for information sharing among medical personnel. First, medical personnel were interviewed about the degree of information required for both individual duties and team-based care. Subsequently, they tested a mock display method that partially concealed information using a mosaic blur, and they were interviewed about the effectiveness of the display method that ensures patient privacy. Participants better understood patients' demand for confidentiality, suggesting increased awareness of patients' privacy protection. However, participants also indicated that temporary concealment of certain information was problematic. Other issues included the inconvenience of removing the mosaic blur to obtain required information and risk of insufficient information for medical care. Despite several issues with using a display method that temporarily conceals information according to patient privacy needs, medical personnel could accept this display method if information essential to medical safety remains accessible.

  9. Inadequate awareness among chronic kidney disease patients regarding food and drinks containing artificially added phosphate.

    PubMed

    Shutto, Yoshiko; Shimada, Michiko; Kitajima, Maiko; Yamabe, Hideaki; Saitoh, Yoko; Saitoh, Hisao; Razzaque, Mohammed S

    2013-01-01

    Hyperphosphatemia is an important determinant of morbidity and mortality in patients with chronic kidney disease (CKD). Patients with CKD are advised to consume a low phosphate diet and are often prescribed phosphate-lowering drug therapy. However, commercially processed food and drinks often contain phosphate compounds, but the phosphate level is not usually provided in the ingredient list, which makes it difficult for CKD patients to choose a correct diet. We conducted a survey of the awareness of food/beverages containing artificially added phosphate among CKD patients undergoing hemodialysis. The subjects were 153 patients (77 males and 76 females; average age 56±11 years) who were randomly selected from the Dialysis Center of Hirosaki City, Japan. The subjects were provided with a list of questions. The survey results showed that 93% of the subjects were aware of the presence of high sugar content in soda, whereas only 25% were aware of the presence of phosphate (phosphoric acid) in such drinks. Despite 78% of the subjects being aware of the detrimental effects of consumption of a high phosphate diet, 43% drank at least 1 to 5 cans of soda per week and about 17% consumed "fast food" once each week. We also assessed the immediate effects of high-phosphate containing carbonated soda consumption by determining urinary calcium, phosphate, protein and sugar contents in overnight fasted healthy volunteers (n = 55; average age 20.7±0.3 years old, 20 males and 35 females). Significantly higher urinary calcium (adjusted using urinary creatinine) excretion was found 2 h after consuming 350 ml of carbonated soda compared to the fasting baseline level (0.15±0.01 vs. 0.09±0.01, p = 0.001). Our survey results suggest that CKD patients undergoing hemodialysis are not adequately aware of the hidden source of phosphate in their diet, and emphasize the need for educational initiatives to raise awareness of this issue among CKD patients.

  10. Inadequate Awareness among Chronic Kidney Disease Patients Regarding Food and Drinks Containing Artificially Added Phosphate

    PubMed Central

    Shutto, Yoshiko; Shimada, Michiko; Kitajima, Maiko; Yamabe, Hideaki; Saitoh, Yoko; Saitoh, Hisao; Razzaque, Mohammed S.

    2013-01-01

    Hyperphosphatemia is an important determinant of morbidity and mortality in patients with chronic kidney disease (CKD). Patients with CKD are advised to consume a low phosphate diet and are often prescribed phosphate-lowering drug therapy. However, commercially processed food and drinks often contain phosphate compounds, but the phosphate level is not usually provided in the ingredient list, which makes it difficult for CKD patients to choose a correct diet. We conducted a survey of the awareness of food/beverages containing artificially added phosphate among CKD patients undergoing hemodialysis. The subjects were 153 patients (77 males and 76 females; average age 56±11 years) who were randomly selected from the Dialysis Center of Hirosaki City, Japan. The subjects were provided with a list of questions. The survey results showed that 93% of the subjects were aware of the presence of high sugar content in soda, whereas only 25% were aware of the presence of phosphate (phosphoric acid) in such drinks. Despite 78% of the subjects being aware of the detrimental effects of consumption of a high phosphate diet, 43% drank at least 1 to 5 cans of soda per week and about 17% consumed “fast food” once each week. We also assessed the immediate effects of high-phosphate containing carbonated soda consumption by determining urinary calcium, phosphate, protein and sugar contents in overnight fasted healthy volunteers (n = 55; average age 20.7±0.3 years old, 20 males and 35 females). Significantly higher urinary calcium (adjusted using urinary creatinine) excretion was found 2 h after consuming 350 ml of carbonated soda compared to the fasting baseline level (0.15±0.01 vs. 0.09±0.01, p = 0.001). Our survey results suggest that CKD patients undergoing hemodialysis are not adequately aware of the hidden source of phosphate in their diet, and emphasize the need for educational initiatives to raise awareness of this issue among CKD patients. PMID:24236030

  11. Clinical Symptom Responses to Atypical Antipsychotic Medications in Alzheimer’s Disease: Phase 1 Outcomes from the CATIE-AD Effectiveness Trial

    PubMed Central

    Sultzer, David L.; Davis, Sonia M.; Tariot, Pierre N.; Dagerman, Karen S.; Lebowitz, Barry D.; Lyketsos, Constantine G.; Rosenheck, Robert A.; Hsiao, John K.; Lieberman, Jeffrey A.; Schneider, Lon S.

    2009-01-01

    Objective To measure the effects of atypical antipsychotic medication on psychiatric and behavioral symptoms in patients with Alzheimer’s disease (AD) and psychosis or agitated behavior. Method The CATIE-AD effectiveness study included 421 outpatients with AD and psychosis or agitated/aggressive behavior. Patients were assigned randomly to masked flexible-dose treatment with olanzapine, quetiapine, risperidone, or placebo for up to 36 weeks. Patients could be re-randomized to a different medication treatment at the clinician’s discretion, which ended the Phase 1 period. Psychiatric and behavioral symptoms, functional abilities, cognition, care needs, and quality of life were measured at regular intervals. Results At the last observation in Phase 1 compared to placebo, there was greater improvement in patients treated with olanzapine or risperidone on the Neuropsychiatric Inventory total score, with risperidone on the Clinical Global Impression of Change, with olanzapine or risperidone on the Brief Psychiatric Rating Scale (BPRS) Hostile Suspiciousness factor, and with risperidone on the BPRS Psychosis factor. There was worsening with olanzapine on the BPRS Withdrawn Depression factor. Among patients continuing Phase 1 treatment at 12 weeks, there were no significant antipsychotic – placebo group differences on measures of cognition, functional skills, care needs, or quality of life, except for worsening of functional skills in the olanzapine treatment group compared to placebo. Conclusion In this descriptive analysis of clinical outcomes in AD outpatients in usual care settings, some clinical symptoms improved with atypical antipsychotic treatment. Antipsychotic medications may be more effective for particular symptoms, such as anger, aggression, and paranoid ideas. Functional abilities, care needs, or quality of life do not appear to improve with antipsychotic treatment. PMID:18519523

  12. Infrared realization of dS2 in AdS2

    NASA Astrophysics Data System (ADS)

    Anninos, Dionysios; Hofman, Diego M.

    2018-04-01

    We describe a two-dimensional geometry that smoothly interpolates between an asymptotically AdS2 geometry and the static patch of dS2. We find this ‘centaur’ geometry to be a solution of dilaton gravity with a specific class of potentials for the dilaton. We interpret the centaur geometry as a thermal state in the putative quantum mechanics dual to the AdS2 evolved with the global Hamiltonian. We compute the thermodynamic properties and observe that the centaur state has finite entropy and positive specific heat. The static patch is the infrared part of the centaur geometry. We discuss boundary observables sensitive to the static patch region.

  13. QCD Condensates and Holographic Wilson Loops for Asymptotically AdS Spaces

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Quevedo, R. Carcasses; Goity, Jose L.; Trinchero, Roberto C.

    2014-02-01

    The minimization of the Nambu-Goto (NG) action for a surface whose contour defines a circular Wilson loop of radius a placed at a finite value of the coordinate orthogonal to the border is considered. This is done for asymptotically AdS spaces. The condensates of dimension n = 2, 4, 6, 8, and 10 are calculated in terms of the coefficients in the expansion in powers of the radius a of the on-shell subtracted NG action for small a->0. The subtraction employed is such that it presents no conflict with conformal invariance in the AdS case and need not introduce anmore » additional infrared scale for the case of confining geometries. It is shown that the UV value of the gluon condensates is universal in the sense that it only depends on the first coefficients of the difference with the AdS case.« less

  14. Computer-aided classification of patients with dementia of Alzheimer's type based on cerebral blood flow determined with arterial spin labeling technique

    NASA Astrophysics Data System (ADS)

    Yamashita, Yasuo; Arimura, Hidetaka; Yoshiura, Takashi; Tokunaga, Chiaki; Magome, Taiki; Monji, Akira; Noguchi, Tomoyuki; Toyofuku, Fukai; Oki, Masafumi; Nakamura, Yasuhiko; Honda, Hiroshi

    2010-03-01

    Arterial spin labeling (ASL) is one of promising non-invasive magnetic resonance (MR) imaging techniques for diagnosis of Alzheimer's disease (AD) by measuring cerebral blood flow (CBF). The aim of this study was to develop a computer-aided classification system for AD patients based on CBFs measured by the ASL technique. The average CBFs in cortical regions were determined as functional image features based on the CBF map image, which was non-linearly transformed to a Talairach brain atlas by using a free-form deformation. An artificial neural network (ANN) was trained with the CBF functional features in 10 cortical regions, and was employed for distinguishing patients with AD from control subjects. For evaluation of the method, we applied the proposed method to 20 cases including ten AD patients and ten control subjects, who were scanned a 3.0-Tesla MR unit. As a result, the area under the receiver operating characteristic curve obtained by the proposed method was 0.893 based on a leave-one-out-by-case test in identification of AD cases among 20 cases. The proposed method would be feasible for classification of patients with AD.

  15. Static Einstein-Maxwell Black Holes with No Spatial Isometries in AdS Space.

    PubMed

    Herdeiro, Carlos A R; Radu, Eugen

    2016-11-25

    We explicitly construct static black hole solutions to the fully nonlinear, D=4, Einstein-Maxwell-anti-de Sitter (AdS) equations that have no continuous spatial symmetries. These black holes have a smooth, topologically spherical horizon (section), but without isometries, and approach, asymptotically, global AdS spacetime. They are interpreted as bound states of a horizon with the Einstein-Maxwell-AdS solitons recently discovered, for appropriate boundary data. In sharp contrast to the uniqueness results for a Minkowski electrovacuum, the existence of these black holes shows that single, equilibrium, black hole solutions in an AdS electrovacuum admit an arbitrary multipole structure.

  16. Value-Added Results for Public Virtual Schools in California

    ERIC Educational Resources Information Center

    Ford, Richard; Rice, Kerry

    2015-01-01

    The objective of this paper is to present value-added calculation methods that were applied to determine whether online schools performed at the same or different levels relative to standardized testing. This study includes information on how we approached our value added model development and the results for 32 online public high schools in…

  17. Added Sugars and Cardiovascular Disease Risk in Children

    PubMed Central

    Vos, Miriam B.; Kaar, Jill L.; Welsh, Jean A.; Van Horn, Linda V.; Feig, Daniel I.; Anderson, Cheryl A.M.; Patel, Mahesh J.; Munos, Jessica Cruz; Krebs, Nancy F.; Xanthakos, Stavra A.; Johnson, Rachel K.

    2017-01-01

    BACKGROUND Poor lifestyle behaviors are leading causes of preventable diseases globally. Added sugars contribute to a diet that is energy dense but nutrient poor and increase risk of developing obesity, cardiovascular disease, hypertension, obesity-related cancers, and dental caries. METHODS AND RESULTS For this American Heart Association scientific statement, the writing group reviewed and graded the current scientific evidence for studies examining the cardiovascular health effects of added sugars on children. The available literature was subdivided into 5 broad subareas: effects on blood pressure, lipids, insulin resistance and diabetes mellitus, nonalcoholic fatty liver disease, and obesity. CONCLUSIONS Associations between added sugars and increased cardiovascular disease risk factors among US children are present at levels far below current consumption levels. Strong evidence supports the association of added sugars with increased cardiovascular disease risk in children through increased energy intake, increased adiposity, and dyslipidemia. The committee found that it is reasonable to recommend that children consume ≤25 g (100 cal or ≈6 teaspoons) of added sugars per day and to avoid added sugars for children <2 years of age. Although added sugars most likely can be safely consumed in low amounts as part of a healthy diet, few children achieve such levels, making this an important public health target. PMID:27550974

  18. The CERAD Neuropsychological Battery in Patients with Frontotemporal Lobar Degeneration

    PubMed Central

    Haanpää, Ramona M.; Suhonen, Noora-Maria; Hartikainen, Päivi; Koivisto, Anne M.; Moilanen, Virpi; Herukka, Sanna-Kaisa; Hänninen, Tuomo; Remes, Anne M.

    2015-01-01

    Background/Aims The diagnosis of frontotemporal lobar degeneration (FTLD) is based on neuropsychological examination in addition to clinical symptoms and brain imaging. There is no simple, validated, cognitive tool available in screening for FTLD. The Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery (CERAD-NB) was originally devised to identify the early cognitive changes related to Alzheimer's disease (AD). Our aim was to investigate the utility of the CERAD-NB in FTLD. Methods Patients with FTLD (n = 95) and AD (n = 90) were assessed with the CERAD-NB, Trail Making Test parts A and B and single-letter Phonemic Fluency. Results FTLD patients were more severely impaired in the Verbal Fluency subtest in the CERAD-NB and Trail Making Test part A compared to AD patients. In addition, AD patients were more impaired in memory subtests compared to FTLD patients. Conclusion The CERAD-NB may be a useful tool in screening for FTLD. Impaired performance in Verbal Fluency with moderately well-preserved Delayed Recall and Memory Tests may help in identifying patients with probable FTLD and discriminating FTLD from AD. Adding the Trail Making Test to the battery might enhance its value as a screening instrument for FTLD. PMID:25999981

  19. AdS 2 holographic dictionary

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cvetic, Mirjam; Papadimitriou, Ioannis

    Here, we construct the holographic dictionary for both running and constant dilaton solutions of the two dimensional Einstein-Maxwell-Dilaton theory that is obtained by a circle reduction from Einstein-Hilbert gravity with negative cosmological constant in three dimensions. This specific model ensures that the dual theory has a well defined ultraviolet completion in terms of a two dimensional conformal field theory, but our results apply qualitatively to a wider class of two dimensional dilaton gravity theories. For each type of solutions we perform holographic renormalization, compute the exact renormalized one-point functions in the presence of arbitrary sources, and derive the asymptotic symmetriesmore » and the corresponding conserved charges. In both cases we find that the scalar operator dual to the dilaton plays a crucial role in the description of the dynamics. Its source gives rise to a matter conformal anomaly for the running dilaton solutions, while its expectation value is the only non trivial observable for constant dilaton solutions. The role of this operator has been largely overlooked in the literature. We further show that the only non trivial conserved charges for running dilaton solutions are the mass and the electric charge, while for constant dilaton solutions only the electric charge is non zero. However, by uplifting the solutions to three dimensions we show that constant dilaton solutions can support non trivial extended symmetry algebras, including the one found by Compère, Song and Strominger, in agreement with the results of Castro and Song. Finally, we demonstrate that any solution of this specific dilaton gravity model can be uplifted to a family of asymptotically AdS 2 × S 2 or conformally AdS 2 × S 2 solutions of the STU model in four dimensions, including non extremal black holes. As a result, the four dimensional solutions obtained by uplifting the running dilaton solutions coincide with the so called ‘subtracted geometries

  20. AdS 2 holographic dictionary

    DOE PAGES

    Cvetic, Mirjam; Papadimitriou, Ioannis

    2016-12-02

    Here, we construct the holographic dictionary for both running and constant dilaton solutions of the two dimensional Einstein-Maxwell-Dilaton theory that is obtained by a circle reduction from Einstein-Hilbert gravity with negative cosmological constant in three dimensions. This specific model ensures that the dual theory has a well defined ultraviolet completion in terms of a two dimensional conformal field theory, but our results apply qualitatively to a wider class of two dimensional dilaton gravity theories. For each type of solutions we perform holographic renormalization, compute the exact renormalized one-point functions in the presence of arbitrary sources, and derive the asymptotic symmetriesmore » and the corresponding conserved charges. In both cases we find that the scalar operator dual to the dilaton plays a crucial role in the description of the dynamics. Its source gives rise to a matter conformal anomaly for the running dilaton solutions, while its expectation value is the only non trivial observable for constant dilaton solutions. The role of this operator has been largely overlooked in the literature. We further show that the only non trivial conserved charges for running dilaton solutions are the mass and the electric charge, while for constant dilaton solutions only the electric charge is non zero. However, by uplifting the solutions to three dimensions we show that constant dilaton solutions can support non trivial extended symmetry algebras, including the one found by Compère, Song and Strominger, in agreement with the results of Castro and Song. Finally, we demonstrate that any solution of this specific dilaton gravity model can be uplifted to a family of asymptotically AdS 2 × S 2 or conformally AdS 2 × S 2 solutions of the STU model in four dimensions, including non extremal black holes. As a result, the four dimensional solutions obtained by uplifting the running dilaton solutions coincide with the so called ‘subtracted geometries

  1. Display methods of electronic patient record screens: patient privacy concerns.

    PubMed

    Niimi, Yukari; Ota, Katsumasa

    2013-01-01

    To provide adequate care, medical professionals have to collect not only medical information but also information that may be related to private aspects of the patient's life. With patients' increasing awareness of information privacy, healthcare providers have to pay attention to the patients' right of privacy. This study aimed to clarify the requirements of the display method of electronic patient record (EPR) screens in consideration of both patients' information privacy concerns and health professionals' information needs. For this purpose, semi-structured group interviews were conducted of 78 medical professionals. They pointed out that partial concealment of information to meet patients' requests for privacy could result in challenges in (1) safety in healthcare, (2) information sharing, (3) collaboration, (4) hospital management, and (5) communication. They believed that EPRs should (1) meet the requirements of the therapeutic process, (2) have restricted access, (3) provide convenient access to necessary information, and (4) facilitate interprofessional collaboration. This study provides direction for the development of display methods that balance the sharing of vital information and protection of patient privacy.

  2. Oral reading fluency analysis in patients with Alzheimer disease and asymptomatic control subjects.

    PubMed

    Martínez-Sánchez, F; Meilán, J J G; García-Sevilla, J; Carro, J; Arana, J M

    2013-01-01

    Many studies highlight that an impaired ability to communicate is one of the key clinical features of Alzheimer disease (AD). To study temporal organisation of speech in an oral reading task in patients with AD and in matched healthy controls using a semi-automatic method, and evaluate that method's ability to discriminate between the 2 groups. A test with an oral reading task was administered to 70 subjects, comprising 35 AD patients and 35 controls. Before speech samples were recorded, participants completed a battery of neuropsychological tests. There were no differences between groups with regard to age, sex, or educational level. All of the study variables showed impairment in the AD group. According to the results, AD patients' oral reading was marked by reduced speech and articulation rates, low effectiveness of phonation time, and increases in the number and proportion of pauses. Signal processing algorithms applied to reading fluency recordings were shown to be capable of differentiating between AD patients and controls with an accuracy of 80% (specificity 74.2%, sensitivity 77.1%) based on speech rate. Analysis of oral reading fluency may be useful as a tool for the objective study and quantification of speech deficits in AD. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  3. Impact of Adding a Pictorial Display to Enhance Recall of Cancer Patient Histories: A Randomized Trial.

    PubMed

    Wolch, Gary; Ghosh, Sunita; Boyington, Curtiss; Watanabe, Sharon M; Fainsinger, Robin; Burton-Macleod, Sarah; Thai, Vincent; Thai, JoAnn; Fassbender, Konrad

    2017-01-01

    Current health care delivery models have increased the need for safe and concise patient handover. Handover interventions in the literature have focused on the use of structured tools but have not evaluated their ability to facilitate retention of patient information. In this study, mock pictorial displays were generated in an attempt to create a snapshot of each patient's medical and social circumstances. These pictorial displays contained the patient's photograph and other disease- and treatment-related images. The objective of this randomized trial was to assess the ability of these snapshots to enhance delayed information recall by care providers. Participating physicians were given four advanced cancer patient histories to review, two at a time over two weeks. Pictorial image displays, referred to as the Electronic Whiteboard (EWB) were added, in a randomized manner to half of the textual histories. The impact of the EWB on information recall was tested in immediate and delayed time frames. Overall, patient information recall declined significantly over time, with or without the EWB. Still, this trial demonstrates significantly higher test scores after 24 hours with the addition of pictures to textual patient information, compared with textual information alone (P = 0.0002). A more modest improvement was seen with the addition of the EWB for questionnaires administered immediately after history review (P = 0.008). Most participants agreed that the EWB was a useful enhancement and that seeing a patient's photograph improved their ability to retain information. Most studies examining the institution of handover protocols in the health care setting have failed to harness the power of pictures and other representative images. This study demonstrates the ability of pictorial displays to improve both immediate and delayed recall of patient histories without increasing review time. These types of displays may be amenable to generation by software programs and

  4. Half-BPS Wilson loop and AdS 2/CFT 1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Giombi, Simone; Roiban, Radu; Tseytlin, Arkady A.

    Here, we study correlation functions of local operator insertions on the 1/2-BPS Wilson line in N=4 super Yang–Mills theory. These correlation functions are constrained by the 1d superconformal symmetry pre-served by the 1/2-BPS Wilson line and define a defect CFT 1 living on the line. At strong coupling, a set of elementary operator insertions with protected scaling dimensions correspond to fluctuations of the dual fundamental string in AdS 5×S 5 ending on the line at the boundary and can be thought of as light fields propagating on the AdS 2 worldsheet. We use AdS/CFT techniques to compute the tree-level AdSmore » 2 Witten diagrams describing the strong coupling limit of the four-point functions of the dual operator insertions. Using the OPE, we also extract the leading strong coupling corrections to the anomalous dimensions of the “two-particle” operators built out of elementary excitations. In the case of the circular Wilson loop, we match our results for the 4-point functions of a special type of scalar insertions to the prediction of localization to 2d Yang–Mills theory.« less

  5. Half-BPS Wilson loop and AdS 2/CFT 1

    DOE PAGES

    Giombi, Simone; Roiban, Radu; Tseytlin, Arkady A.

    2017-09-01

    Here, we study correlation functions of local operator insertions on the 1/2-BPS Wilson line in N=4 super Yang–Mills theory. These correlation functions are constrained by the 1d superconformal symmetry pre-served by the 1/2-BPS Wilson line and define a defect CFT 1 living on the line. At strong coupling, a set of elementary operator insertions with protected scaling dimensions correspond to fluctuations of the dual fundamental string in AdS 5×S 5 ending on the line at the boundary and can be thought of as light fields propagating on the AdS 2 worldsheet. We use AdS/CFT techniques to compute the tree-level AdSmore » 2 Witten diagrams describing the strong coupling limit of the four-point functions of the dual operator insertions. Using the OPE, we also extract the leading strong coupling corrections to the anomalous dimensions of the “two-particle” operators built out of elementary excitations. In the case of the circular Wilson loop, we match our results for the 4-point functions of a special type of scalar insertions to the prediction of localization to 2d Yang–Mills theory.« less

  6. Addressing the Heterogeneity of Subject Indexing in the ADS Databases

    NASA Astrophysics Data System (ADS)

    Dubin, David S.

    A drawback of the current document representation scheme in the ADS abstract service is its heterogeneous subject indexing. Several related but inconsistent indexing languages are represented in ADS. A method of reconciling some indexing inconsistencies is described. Using lexical similarity alone, one out of six ADS descriptors can be automatically mapped to some other descriptor. Analysis of postings data can direct administrators to those mergings it is most important to check for errors.

  7. Value Added?

    ERIC Educational Resources Information Center

    UCLA IDEA, 2012

    2012-01-01

    Value added measures (VAM) uses changes in student test scores to determine how much "value" an individual teacher has "added" to student growth during the school year. Some policymakers, school districts, and educational advocates have applauded VAM as a straightforward measure of teacher effectiveness: the better a teacher,…

  8. Design of a Recommendation System for Adding Support in the Treatment of Chronic Patients.

    PubMed

    Torkar, Simon; Benedik, Peter; Rajkovič, Uroš; Šušteršič, Olga; Rajkovič, Vladislav

    2016-01-01

    Rapid growth of chronic disease cases around the world is adding pressure on healthcare providers to ensure a structured patent follow-up during chronic disease management process. In response to the increasing demand for better chronic disease management and improved health care efficiency, nursing roles have been specialized or enhanced in the primary health care setting. Nurses become key players in chronic disease management process. Study describes a system to help nurses manage the care process of patient with chronic disease. It supports focusing nurse's attention on those resources/solutions that are likely to be most relevant to their particular situation/problem in nursing domain. System is based on multi-relational property graph representing a flexible modeling construct. Graph allows modeling a nursing ontology and the indices that partition domain into an efficient, searchable space where the solution to a problem is seen as abstractly defined traversals through its vertices and edges.

  9. Evaporation of large black holes in AdS: coupling to the evaporon

    NASA Astrophysics Data System (ADS)

    Rocha, Jorge V.

    2008-08-01

    Large black holes in an asymptotically AdS spacetime have a dual description in terms of approximately thermal states in the boundary CFT. The reflecting boundary conditions of AdS prevent such black holes from evaporating completely. On the other hand, the formulation of the information paradox becomes more stringent when a black hole is allowed to evaporate. In order to address the information loss problem from the AdS/CFT perspective we then need the boundary to become partially absorptive. We present a simple model that produces the necessary changes on the boundary by coupling a bulk scalar field to the evaporon, an external field propagating in one extra spatial dimension. The interaction is localized at the boundary of AdS and leads to partial transmission into the additional space. The transmission coefficient is computed in the planar limit and perturbatively in the coupling constant. Evaporation of the large black hole corresponds to cooling down the CFT by transferring energy to an external sector.

  10. Assessment of Bowel Wall Enhancement for the Diagnosis of Intestinal Ischemia in Patients with Small Bowel Obstruction: Value of Adding Unenhanced CT to Contrast-enhanced CT.

    PubMed

    Chuong, Anh Minh; Corno, Lucie; Beaussier, Hélène; Boulay-Coletta, Isabelle; Millet, Ingrid; Hodel, Jérôme; Taourel, Patrice; Chatellier, Gilles; Zins, Marc

    2016-07-01

    Purpose To determine whether adding unenhanced computed tomography (CT) to contrast material-enhanced CT improves the diagnostic performance of decreased bowel wall enhancement as a sign of ischemia complicating mechanical small bowel obstruction (SBO). Materials and Methods This retrospective study was approved by the institutional review board, which waived the requirement for informed consent. Two gastrointestinal radiologists independently performed retrospective assessments of 164 unenhanced and contrast-enhanced CT studies from 158 consecutive patients (mean age, 71.2 years) with mechanical SBO. The reference standard was the intraoperative and/or histologic diagnosis (in 80 cases) or results from clinical follow-up in patients who did not undergo surgery (84 cases). Decreased bowel wall enhancement was evaluated with contrast-enhanced images then and both unenhanced and contrast-enhanced images 1 month later. Diagnostic performance of decreased bowel wall enhancement and confidence in the diagnosis were compared between the two readings by using McNemar and Wilcoxon signed rank tests. Interobserver agreement was assessed by using κ statistics and compared with bootstrapping. Results Ischemia was diagnosed in 41 of 164 (25%) episodes of SBO. For both observers, adding unenhanced images improved decreased bowel wall enhancement sensitivity (observer 1: 46.3% [19 of 41] vs 65.8% [27 of 41], P = .02; observer 2: 56.1% [23 of 41] vs 63.4% [26 of 41], P = .45), Youden index (from 0.41 to 0.58 for observer 1 and from 0.42 to 0.61 for observer 2), and confidence score (P < .001 for both). Specificity significantly increased for observer 2 (84.5% [104 of 123] vs 94.3% [116 of 123], P = .002), and interobserver agreement significantly increased, from moderate (κ = 0.48) to excellent (κ = 0.89; P < .0001). Conclusion Adding unenhanced CT to contrast-enhanced CT improved the sensitivity, diagnostic confidence, and interobserver agreement of the diagnosis of ischemia

  11. Hairy black holes and the endpoint of AdS4 charged superradiance

    NASA Astrophysics Data System (ADS)

    Dias, Óscar J. C.; Masachs, Ramon

    2017-02-01

    We construct hairy black hole solutions that merge with the anti-de Sitter (AdS4) Reissner-Nordström black hole at the onset of superradiance. These hairy black holes have, for a given mass and charge, higher entropy than the corresponding AdS4-Reissner-Nordström black hole. Therefore, they are natural candidates for the endpoint of the charged superradiant instability. On the other hand, hairy black holes never dominate the canonical and grand-canonical ensembles. The zero-horizon radius of the hairy black holes is a soliton (i.e. a boson star under a gauge transformation). We construct our solutions perturbatively, for small mass and charge, so that the properties of hairy black holes can be used to testify and compare with the endpoint of initial value simulations. We further discuss the near-horizon scalar condensation instability which is also present in global AdS4-Reissner-Nordström black holes. We highlight the different nature of the near-horizon and superradiant instabilities and that hairy black holes ultimately exist because of the non-linear instability of AdS.

  12. A memory and organizational aid improves AD research consent capacity: Results of a randomized, controlled trial

    PubMed Central

    Rubright, Jonathan; Sankar, Pamela; Casarett, David J; Gur, Ruben; Xie, Sharon X; Karlawish, Jason

    2010-01-01

    Objectives AD patients' early and progressive cognitive impairments hinder their capacity to provide informed consent. Unfortunately, the limited research on techniques to improve capacity has shown mixed results. Therefore, we tested whether a memory and organizational aid improves AD patient performance on measures of capacity and competency to give informed consent. Design, Setting, and Participants AD patients randomly assigned to standard consent, or standard plus a memory and organizational aid. Intervention Memory and organizational aid summarized at a 6th grade reading level the content of information mandated under the Common Rule's informed consent disclosure requirements. Measurements Three psychiatrists without access to patient data independently reviewed MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) interview transcripts to judge whether the patient was capable of providing informed consent. The agreement of at least two of three experts defined a participant as capable of providing informed consent. Secondary outcomes are MacCAT-CR measures of understanding, appreciation and reasoning, and comparison to cognitively normal older adult norms. Results AD intervention and control groups were similar in terms of age, education, and cognitive status. The intervention group was more likely to be judged competent than control group and had higher scores on MacCAT-CR measure of understanding. The intervention had no effect on measures of appreciation or reasoning. Conclusions A consent process that addresses an AD patients' deficits in memory and attention can improve capacity to give informed consent for early phase AD research. The results also validate the MacCAT-CR as an instrument to measure capacity, especially the understanding subscale. PMID:20808101

  13. Does the Market Value Value-Added? Evidence from Housing Prices after a Public Release of School and Teacher Value-Added. Working Paper #47

    ERIC Educational Resources Information Center

    Imberman, Scott; Lovenheim, Michael F.

    2015-01-01

    Value-added data have become an increasingly common evaluation tool for schools and teachers. Many school districts have begun to adopt these methods and have released results publicly. In this paper, we use the unique public release of value-added data in Los Angeles to identify how this measure of school quality is capitalized into housing…

  14. Intake of added sugar in Malaysia: a review.

    PubMed

    Amarra, Maria Sofia V; Khor, Geok Lin; Chan, Pauline

    2016-01-01

    The term 'added sugars' refers to sugars and syrup added to foods during processing or preparation, and sugars and syrups added at the table. Calls to limit the daily intakes of added sugars and its sources arose from evidence analysed by WHO, the American Heart Association and other organizations. The present review examined the best available evidence regarding levels of added sugar consumption among different age and sex groups in Malaysia and sources of added sugars. Information was extracted from food balance sheets, household expenditure surveys, nutrition surveys and published studies. Varying results emerged, as nationwide information on intake of sugar and foods with added sugar were obtained at different times and used different assessment methods. Data from the 2003 Malaysian Adult Nutrition Survey (MANS) using food frequency questionnaires suggested that on average, Malaysian adults consumed 30 grams of sweetened condensed milk (equivalent to 16 grams sugar) and 21 grams of table sugar per day, which together are below the WHO recommendation of 50 grams sugar for every 2000 kcal/day to reduce risk of chronic disease. Published studies suggested that, for both adults and the elderly, frequently consumed sweetened foods were beverages (tea or coffee) with sweetened condensed milk and added sugar. More accurate data should be obtained by conducting population-wide studies using biomarkers of sugar intake (e.g. 24-hour urinary sucrose and fructose excretion or serum abundance of the stable isotope 13C) to determine intake levels, and multiple 24 hour recalls to identify major food sources of added sugar.

  15. Smooth causal patches for AdS black holes

    NASA Astrophysics Data System (ADS)

    Raju, Suvrat

    2017-06-01

    We review the paradox of low energy excitations of a black hole in anti-de Sitter space (AdS). An appropriately chosen unitary operator in the boundary theory can create a locally strong excitation near the black hole horizon, whose global energy is small as a result of the gravitational redshift. The paradox is that this seems to violate a general rule of statistical mechanics, which states that an operator with energy parametrically smaller than k T cannot create a significant excitation in a thermal system. When we carefully examine the position dependence of the boundary unitary operator that produces the excitation and the bulk observable necessary to detect the anomalously large effect, we find that they do not both fit in a single causal patch. This follows from a remarkable property of position-space AdS correlators that we establish explicitly and resolves the paradox in a generic state of the system, since no combination of observers can both create the excitation and observe its effect. As a special case of our analysis, we show how this resolves the "Born rule" paradox of Marolf and Polchinski [J. High Energy Phys. 01 (2016) 008, 10.1007/JHEP01(2016)008] and we verify our solution using an independent calculation. We then consider boundary states that are finely tuned to display a spontaneous excitation outside the causal patch of the infalling observer, and we propose a version of causal patch complementarity in AdS/CFT that resolves the paradox for such states as well.

  16. Mixed-method research protocol: defining and operationalizing patient-related complexity of nursing care in acute care hospitals.

    PubMed

    Huber, Evelyn; Kleinknecht-Dolf, Michael; Müller, Marianne; Kugler, Christiane; Spirig, Rebecca

    2017-06-01

    To define the concept of patient-related complexity of nursing care in acute care hospitals and to operationalize it in a questionnaire. The concept of patient-related complexity of nursing care in acute care hospitals has not been conclusively defined in the literature. The operationalization in a corresponding questionnaire is necessary, given the increased significance of the topic, due to shortened lengths of stay and increased patient morbidity. Hybrid model of concept development and embedded mixed-methods design. The theoretical phase of the hybrid model involved a literature review and the development of a working definition. In the fieldwork phase of 2015 and 2016, an embedded mixed-methods design was applied with complexity assessments of all patients at five Swiss hospitals using our newly operationalized questionnaire 'Complexity of Nursing Care' over 1 month. These data will be analysed with structural equation modelling. Twelve qualitative case studies will be embedded. They will be analysed using a structured process of constructing case studies and content analysis. In the final analytic phase, the quantitative and qualitative data will be merged and added to the results of the theoretical phase for a common interpretation. Cantonal Ethics Committee Zurich judged the research programme as unproblematic in December 2014 and May 2015. Following the phases of the hybrid model and using an embedded mixed-methods design can reach an in-depth understanding of patient-related complexity of nursing care in acute care hospitals, a final version of the questionnaire and an acknowledged definition of the concept. © 2016 John Wiley & Sons Ltd.

  17. Using U.S. Medicare records to evaluate the indirect health effects on spouses: a case study in Alzheimer’s disease patients

    PubMed Central

    2014-01-01

    Background The burden experienced by spouses of patients with Alzheimer’s disease (AD) may have negative consequences for their physical health. We describe here a method for analyzing United States Medicare records to determine the changes in health service use and costs experienced by spouses after their marital partner receives an AD diagnosis. Methods We initially identified all beneficiaries in the 2001–2005 Medicare 5% sample who had multiple claims listing the ICD-9 diagnostic code for AD, 331.0. The 5% sample includes spouses who share a Medicare account with their marital partners because they lack a sufficient work history for full eligibility on their own. A matched cohort study assessed incremental health costs in the spouses of AD patients versus a control group of spouses of non-AD patients. Longitudinal and cross-sectional analyses tracked the impact of a patient’s AD diagnosis on his or her spouse’s healthcare costs. Results Our method located 54,593 AD patients of whom 11.5% had spouses identifiable via a shared Medicare account. AD diagnosis in one member of a couple was associated with significantly higher monthly Medicare payments for the other member’s healthcare. The spouses’ elevated costs commenced 2 to 3 months before their partners’ AD diagnosis and persisted over the follow-up period. After 31 months, the cumulative additional Medicare reimbursements totaled a mean $4,600 in the spouses of AD patients. This excess was significant even after accounting for differences in baseline health status between the cohorts. Conclusion The study methodology provides a framework for comprehensively evaluating medical costs of both chronically ill patients and their spouses. This method also provides monthly data, which makes possible a longitudinal evaluation of the cost effects of specific health events. The observed correlations provide a coherent demonstration of the interdependence between AD patients’ and spouses’ health

  18. Position space analysis of the AdS (in)stability problem

    NASA Astrophysics Data System (ADS)

    Dimitrakopoulos, Fotios V.; Freivogel, Ben; Lippert, Matthew; Yang, I.-Sheng

    2015-08-01

    We investigate whether arbitrarily small perturbations in global AdS space are generically unstable and collapse into black holes on the time scale set by gravitational interactions. We argue that current evidence, combined with our analysis, strongly suggests that a set of nonzero measure in the space of initial conditions does not collapse on this time scale. We perform an analysis in position space to study this puzzle, and our formalism allows us to directly study the vanishing-amplitude limit. We show that gravitational self-interaction leads to tidal deformations which are equally likely to focus or defocus energy, and we sketch the phase diagram accordingly. We also clarify the connection between gravitational evolution in global AdS and holographic thermalization.

  19. Quantum spectral curve for the η-deformed AdS5 × S5 superstring

    NASA Astrophysics Data System (ADS)

    Klabbers, Rob; van Tongeren, Stijn J.

    2017-12-01

    The spectral problem for the AdS5 ×S5 superstring and its dual planar maximally supersymmetric Yang-Mills theory can be efficiently solved through a set of functional equations known as the quantum spectral curve. We discuss how the same concepts apply to the η-deformed AdS5 ×S5 superstring, an integrable deformation of the AdS5 ×S5 superstring with quantum group symmetry. This model can be viewed as a trigonometric version of the AdS5 ×S5 superstring, like the relation between the XXZ and XXX spin chains, or the sausage and the S2 sigma models for instance. We derive the quantum spectral curve for the η-deformed string by reformulating the corresponding ground-state thermodynamic Bethe ansatz equations as an analytic Y system, and map this to an analytic T system which upon suitable gauge fixing leads to a Pμ system - the quantum spectral curve. We then discuss constraints on the asymptotics of this system to single out particular excited states. At the spectral level the η-deformed string and its quantum spectral curve interpolate between the AdS5 ×S5 superstring and a superstring on "mirror" AdS5 ×S5, reflecting a more general relationship between the spectral and thermodynamic data of the η-deformed string. In particular, the spectral problem of the mirror AdS5 ×S5 string, and the thermodynamics of the undeformed AdS5 ×S5 string, are described by a second rational limit of our trigonometric quantum spectral curve, distinct from the regular undeformed limit.

  20. Suicidal thoughts/acts and clinical correlates in patients with depressive disorders in Asians: results from the REAP-AD study.

    PubMed

    Park, Seon-Cheol; Lee, Min-Soo; Hahn, Sang Woo; Si, Tian-Mei; Kanba, Shigenobu; Chong, Mian-Yoon; Yoon, Chee Kok; Udomratn, Pichet; Tripathi, Adarsh; Sartorius, Norman; Shinfuku, Naotaka; Maramis, Margarita M; Park, Yong Chon

    2016-12-01

    Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) study, we aimed to present the rates and clinical correlates of suicidal thoughts/acts in patients recruited from a total of 40 centres in 10 Asian countries/areas: China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Singapore, Taiwan, and Thailand. Data from 1122 patients with depressive disorders in the REAP-AD study were used. The ICD-10 was employed to diagnose depressive episodes and recurrent depressive disorder. The presence or absence of suicidal thoughts/acts and profile of other depressive symptoms was established using the National Institute for Health and Clinical Excellence guidelines for depression. Country/area differences in rates of suicidal thoughts/acts were evaluated with the χ2 test. In addition, depressive symptom profiles, other clinical characteristics, and patterns of psychotropic drug prescription in depressed patients with and without suicidal thoughts/acts were compared using analysis of covariance for continuous variables and logistic regression analysis for discrete variables to adjust the effects of covariates. The rates of suicidal thoughts/acts in 10 countries/areas varied from 12.8% in Japan to 36.3% in China. Patients with suicidal thoughts/acts presented more persistent sadness (adjusted odds ratio [aOR]=2.64, p<0.001), loss of interest (aOR=2.33, p<0.001), fatigue (aOR=1.58, p<0.001), insomnia (aOR=1.74, p<0.001), poor concentration (aOR=1.88, p<0.001), low self-confidence (aOR=1.78, p<0.001), poor appetite (aOR=2.27, p<0.001), guilt/self-blame (aOR=3.03, p<0.001), and use of mood stabilisers (aOR=1.79, p<0.001) than those without suicidal thoughts/acts. Suicidal thoughts/acts can indicate greater severity of depression, and are associated with a poorer response to antidepressants and increased burden of illness. Hence, suicidal thoughts/acts can provide a clinical index reflecting the clinical status of depressive

  1. Innovative research of AD HOC network mobility model

    NASA Astrophysics Data System (ADS)

    Chen, Xin

    2017-08-01

    It is difficult for researchers of AD HOC network to conduct actual deployment during experimental stage as the network topology is changeable and location of nodes is unfixed. Thus simulation still remains the main research method of the network. Mobility model is an important component of AD HOC network simulation. It is used to describe the movement pattern of nodes in AD HOC network (including location and velocity, etc.) and decides the movement trail of nodes, playing as the abstraction of the movement modes of nodes. Therefore, mobility model which simulates node movement is an important foundation for simulation research. In AD HOC network research, mobility model shall reflect the movement law of nodes as truly as possible. In this paper, node generally refers to the wireless equipment people carry. The main research contents include how nodes avoid obstacles during movement process and the impacts of obstacles on the mutual relation among nodes, based on which a Node Self Avoiding Obstacle, i.e. NASO model is established in AD HOC network.

  2. Comparison of low-abundance biomarker levels in capillary-collected nonstimulated tears and washout tears of aqueous-deficient and normal patients.

    PubMed

    Guyette, Nicole; Williams, Larezia; Tran, My-Tho; Than, Tammy; Bradley, John; Kehinde, Lucy; Edwards, Clara; Beasley, Mark; Fullard, Roderick

    2013-05-01

    Low tear volume limits the use of nonstimulated (NS) microcapillary tear collection in aqueous-deficient (AD) patients. Adding a small amount of "washout" fluid to the eye prior to tear collection is a potentially viable alternative method for abundant proteins, but is relatively untested for low-abundance biomarkers. This study determined the feasibility of the washout (WO) method as an NS alternative for low-abundance biomarkers. NS and WO biomarker profiles were compared between AD patients and non-AD controls to determine if the two methods identify the same intergroup differences. Matching NS and WO tears were collected from 48 patients by micropipette, the WO sample after instillation of 10 μL saline. Tear cytokine levels were measured by 27-Plex Bio-Rad assay. Bland-Altman analyses for each biomarker determined the agreement between tear sample types. Patients were grouped as AD or non-AD based on Schirmer score to determine if NS profile between-group differences were preserved in WO tears. Bland-Altman plots showed good biomarker level agreement between NS and WO tears for most cytokines. Five biomarkers, among those most often cited as differing in AD dry eye, differed significantly between non-AD and AD groups in both tear types. Additional biomarker differences were seen in NS tears only. The WO tear collection method is a viable alternative to NS tears for many low-abundance biomarkers and is able to replicate major NS tear differences between dry eye groups. More subtle intergroup differences are lost in WO samples because of reduced statistical power.

  3. Value-Added and Other Methods for Measuring School Performance: An Analysis of Performance Measurement Strategies in Teacher Incentive Fund Proposals. Research Brief

    ERIC Educational Resources Information Center

    National Center on Performance Incentives, 2008

    2008-01-01

    In "Value-Added and Other Methods for Measuring School Performance: An Analysis of Performance Measurement Strategies in Teacher Incentive Fund Proposals"--a paper presented at the February 2008 National Center on Performance Incentives research to policy conference--Robert Meyer and Michael Christian examine select performance-pay plans…

  4. Quantitative Balance and Gait Measurement in Patients with Frontotemporal Dementia and Alzheimer Diseases: A Pilot Study

    PubMed Central

    Velayutham, Selva Ganapathy; Chandra, Sadanandavalli Retnaswami; Bharath, Srikala; Shankar, Ravi Girikamatha

    2017-01-01

    Introduction: Alzhiemers disease and Frontotemporal dementia are common neurodegenerative dementias with a wide prevalence. Falls are a common cause of morbidity in these patients. Identifying subclinical involvement of these parameters might serve as a tool in differential analysis of these distinct parameters involved in these conditions and also help in planning preventive strategies to prevent falls. Patients and Methods: Eight patients in age and gender matched patients in each group were compared with normal controls. Standardizes methods of gait and balance aseesment were done in all persons. Results: Results revealed subclinical involvement of gait and balancesin all groups specially during divided attention. The parameters were significantly more affected in patients. Patients with AD and FTD had involement of over all ambulation index balance more affected in AD patients FTD patients showed step cycle, stride length abnormalities. Discussion: There is balance and gait involvement in normal ageing as well as patients with AD and FTD. The pattern of involvement in AD correlates with WHERE pathway involvement and FTD with frontal subcortical circuits involvement. Conclusion: Identification the differential patterns of involvement in subclinical stage might help to differentiate normal ageing and the different types of cortical dementias. This could serve as an additional biomarker and also assist in initiating appropriate training methods to prevent future falls. PMID:28515555

  5. New markers of dietary added sugar intake.

    PubMed

    Davy, Brenda; Jahren, Hope

    2016-07-01

    Added sugar consumption is associated with adverse health outcomes, including weight gain and cardio-metabolic disease, yet the reliance on self-reported methods to determine added sugar intake continues to be a significant research limitation. The purpose of this review is to summarize recent advances in the development of two potential predictive biomarkers of added sugar intake: δC and urinary sugar excretion. The results of numerous cross-sectional investigations have indicated modest associations of the δC sugar biomarker measured in a variety of sample types (e.g., fingerstick blood, serum, red blood cells, and hair) with self-reported added sugar and sugar-sweetened beverage intake, and δC values have been reported to change over time with changes in reported sugar-sweetened beverage intake. Results from large-scale trials have suggested modest associations of urinary sugar excretion with reported sugar intake, and a dose-response relation has been demonstrated between urinary sugar excretion and actual sugar intake. Valid markers of sugar intake are urgently needed to more definitively determine the health consequences of added sugar intake. Adequately powered controlled feeding studies are needed to validate and compare these two biomarkers of sugar intake, and to determine what individual characteristics and conditions impact biomarker results.

  6. Quantitation of heteroplasmy of mtDNA sequence variants identified in a population of AD patients and controls by array-based resequencing.

    PubMed

    Coon, Keith D; Valla, Jon; Szelinger, Szabolics; Schneider, Lonnie E; Niedzielko, Tracy L; Brown, Kevin M; Pearson, John V; Halperin, Rebecca; Dunckley, Travis; Papassotiropoulos, Andreas; Caselli, Richard J; Reiman, Eric M; Stephan, Dietrich A

    2006-08-01

    The role of mitochondrial dysfunction in the pathogenesis of Alzheimer's disease (AD) has been well documented. Though evidence for the role of mitochondria in AD seems incontrovertible, the impact of mitochondrial DNA (mtDNA) mutations in AD etiology remains controversial. Though mutations in mitochondrially encoded genes have repeatedly been implicated in the pathogenesis of AD, many of these studies have been plagued by lack of replication as well as potential contamination of nuclear-encoded mitochondrial pseudogenes. To assess the role of mtDNA mutations in the pathogenesis of AD, while avoiding the pitfalls of nuclear-encoded mitochondrial pseudogenes encountered in previous investigations and showcasing the benefits of a novel resequencing technology, we sequenced the entire coding region (15,452 bp) of mtDNA from 19 extremely well-characterized AD patients and 18 age-matched, unaffected controls utilizing a new, reliable, high-throughput array-based resequencing technique, the Human MitoChip. High-throughput, array-based DNA resequencing of the entire mtDNA coding region from platelets of 37 subjects revealed the presence of 208 loci displaying a total of 917 sequence variants. There were no statistically significant differences in overall mutational burden between cases and controls, however, 265 independent sites of statistically significant change between cases and controls were identified. Changed sites were found in genes associated with complexes I (30.2%), III (3.0%), IV (33.2%), and V (9.1%) as well as tRNA (10.6%) and rRNA (14.0%). Despite their statistical significance, the subtle nature of the observed changes makes it difficult to determine whether they represent true functional variants involved in AD etiology or merely naturally occurring dissimilarity. Regardless, this study demonstrates the tremendous value of this novel mtDNA resequencing platform, which avoids the pitfalls of erroneously amplifying nuclear-encoded mtDNA pseudogenes, and

  7. Impaired activity of CCA-adding enzyme TRNT1 impacts OXPHOS complexes and cellular respiration in SIFD patient-derived fibroblasts.

    PubMed

    Liwak-Muir, Urszula; Mamady, Hapsatou; Naas, Turaya; Wylie, Quinlan; McBride, Skye; Lines, Matthew; Michaud, Jean; Baird, Stephen D; Chakraborty, Pranesh K; Holcik, Martin

    2016-06-18

    SIFD (Sideroblastic anemia with B-cell immunodeficiency, periodic fevers, and developmental delay) is a novel form of congenital sideroblastic anemia associated with B-cell immunodeficiency, periodic fevers, and developmental delay caused by mutations in the CCA-adding enzyme TRNT1, but the precise molecular pathophysiology is not known. We show that the disease causing mutations in patient-derived fibroblasts do not affect subcellular localization of TRNT1 and show no gross morphological differences when compared to control cells. Analysis of cellular respiration and oxidative phosphorylation (OXPHOS) complexes demonstrates that both basal and maximal respiration rates are decreased in patient cells, which may be attributed to an observed decrease in the abundance of select proteins of the OXPHOS complexes. Our data provides further insight into cellular pathophysiology of SIFD.

  8. A Secure and Privacy-Preserving Targeted Ad-System

    NASA Astrophysics Data System (ADS)

    Androulaki, Elli; Bellovin, Steven M.

    Thanks to its low product-promotion cost and its efficiency, targeted online advertising has become very popular. Unfortunately, being profile-based, online advertising methods violate consumers' privacy, which has engendered resistance to the ads. However, protecting privacy through anonymity seems to encourage click-fraud. In this paper, we define consumer's privacy and present a privacy-preserving, targeted ad system (PPOAd) which is resistant towards click fraud. Our scheme is structured to provide financial incentives to all entities involved.

  9. Excess Costs Associated with Possible Misdiagnosis of Alzheimer’s Disease Among Patients with Vascular Dementia in a UK CPRD Population

    PubMed Central

    Happich, Michael; Kirson, Noam Y.; Desai, Urvi; King, Sarah; Birnbaum, Howard G.; Reed, Catherine; Belger, Mark; Lenox-Smith, Alan; Price, David

    2016-01-01

    Background: Prior diagnosis of Alzheimer’s disease (AD) among patients later diagnosed with vascular dementia (VaD) has been associated with excess costs, suggesting potential benefits of earlier rule-out of AD diagnosis. Objective: To investigate whether prior diagnosis with AD among patients with VaD is associated with excess costs in the UK. Methods: Patients with a final VaD diagnosis, continuous data visibility for≥6 months prior to index date, and linkage to Hospital Episode Statistics data were retrospectively selected from de-identified Clinical Practice Research Datalink data. Patients with AD diagnosis before a final VaD diagnosis were matched to similar patients with no prior AD diagnosis using propensity score methods. Annual excess healthcare costs were calculated for 5 years post-index, stratified by time to final diagnosis. Results: Of 9,311 patients with VaD, 508 (6%) had prior AD diagnosis with a median time to VaD diagnosis exceeding 2 years from index date. Over the entire follow-up period, patients with prior AD diagnosis had accumulated healthcare costs that were approximately GBP2,000 higher than those for matched counterparts (mostly due to higher hospitalization costs). Cost differentials peaked particularly in the period including the final VaD diagnosis, with excess costs quickly declining thereafter. Conclusion: Potential misdiagnosis of AD among UK patients with VaD resulted in substantial excess costs. The decline in excess costs following a final VaD diagnosis suggests potential benefits from earlier rule-out of AD. PMID:27163798

  10. Vacuum currents in braneworlds on AdS bulk with compact dimensions

    NASA Astrophysics Data System (ADS)

    Bellucci, S.; Saharian, A. A.; Vardanyan, V.

    2015-11-01

    The two-point function and the vacuum expectation value (VEV) of the current density are investigated for a massive charged scalar field with arbitrary curvature coupling in the geometry of a brane on the background of AdS spacetime with partial toroidal compactification. The presence of a gauge field flux, enclosed by compact dimensions, is assumed. On the brane the field obeys Robin boundary condition and along compact dimensions periodicity conditions with general phases are imposed. There is a range in the space of the values for the coefficient in the boundary condition where the Poincaré vacuum is unstable. This range depends on the location of the brane and is different for the regions between the brane and AdS boundary and between the brane and the horizon. In models with compact dimensions the stability condition is less restrictive than that for the AdS bulk with trivial topology. The vacuum charge density and the components of the current along non-compact dimensions vanish. The VEV of the current density along compact dimensions is a periodic function of the gauge field flux with the period equal to the flux quantum. It is decomposed into the boundary-free and brane-induced contributions. The asymptotic behavior of the latter is investigated near the brane, near the AdS boundary and near the horizon. It is shown that, in contrast to the VEVs of the field squared an denergy-momentum tensor, the current density is finite on the brane and vanishes for the special case of Dirichlet boundary condition. Both the boundary-free and brane-induced contributions vanish on the AdS boundary. The brane-induced contribution vanishes on the horizon and for points near the horizon the current is dominated by the boundary-free part. In the near-horizon limit, the latter is connected to the corresponding quantity for a massless field in the Minkowski bulk by a simple conformal relation. Depending on the value of the Robin coefficient, the presence of the brane can either

  11. Transformations of asymptotically AdS hyperbolic initial data and associated geometric inequalities

    NASA Astrophysics Data System (ADS)

    Cha, Ye Sle; Khuri, Marcus

    2018-01-01

    We construct transformations which take asymptotically AdS hyperbolic initial data into asymptotically flat initial data, and which preserve relevant physical quantities. This is used to derive geometric inequalities in the asymptotically AdS hyperbolic setting from counterparts in the asymptotically flat realm, whenever a geometrically motivated system of elliptic equations admits a solution. The inequalities treated here relate mass, angular momentum, charge, and horizon area. Furthermore, new mass-angular momentum inequalities in this setting are conjectured and discussed.

  12. Added Diagnostic Value of Cerebrospinal Fluid Biomarkers for Differential Dementia Diagnosis in an Autopsy-Confirmed Cohort.

    PubMed

    Niemantsverdriet, Ellis; Feyen, Bart F E; Le Bastard, Nathalie; Martin, Jean-Jacques; Goeman, Johan; De Deyn, Peter Paul; Bjerke, Maria; Engelborghs, Sebastiaan

    2018-01-01

    Differential dementia diagnosis remains a challenge due to overlap of clinical profiles, which often results in diagnostic doubt. Determine the added diagnostic value of cerebrospinal fluid (CSF) biomarkers for differential dementia diagnosis as compared to autopsy-confirmed diagnosis. Seventy-one dementia patients with autopsy-confirmed diagnoses were included in this study. All neuropathological diagnoses were established according to standard neuropathological criteria and consisted of Alzheimer's disease (AD) or other dementias (NONAD). CSF levels of Aβ1 - 42, T-tau, and P-tau181 were determined and interpreted based on the IWG-2 and NIA-AA criteria, separately. A panel of three neurologists experienced with dementia made clinical consensus dementia diagnoses. Clinical and CSF biomarker diagnoses were compared to the autopsy-confirmed diagnoses. Forty-two patients (59%) had autopsy-confirmed AD, whereas 29 patients (41%) had autopsy-confirmed NONAD. Of the 24 patients with an ambiguous clinical dementia diagnosis, a correct diagnosis would have been established in 67% of the cases applying CSF biomarkers in the context of the IWG-2 or the NIA-AA criteria respectively. AD CSF biomarkers have an added diagnostic value in differential dementia diagnosis and can help establishing a correct dementia diagnosis in case of ambiguous clinical dementia diagnoses.

  13. Open string fluctuations in AdS space with and without torsion

    NASA Astrophysics Data System (ADS)

    Larsen, A. L.; Lomholt, M. A.

    2003-09-01

    The equations of motion and boundary conditions for the fluctuations around a classical open string, in a curved space-time with torsion, are considered in compact and world-sheet covariant form. The rigidly rotating open strings in anti de Sitter space with and without torsion are investigated in detail. By carefully analyzing the tangential fluctuations at the boundary, we show explicitly that the physical fluctuations (which at the boundary are combinations of normal and tangential fluctuations) are finite, even though the world-sheet is singular there. The divergent 2-curvature thus seems less dangerous than expected in these cases. The general formalism can be straightforwardly used also to study the (bosonic part of the) fluctuations around the closed strings, recently considered in connection with the AdS/conformal field theory duality, on AdS5×S5 and AdS3×S3×T4.

  14. AdS5×S(5) mirror model as a string sigma model.

    PubMed

    Arutyunov, Gleb; van Tongeren, Stijn J

    2014-12-31

    Doing a double Wick rotation in the world sheet theory of the light cone AdS5×S(5) superstring results in an inequivalent, so-called mirror theory that plays a central role in the field of integrability in the AdS-CFT correspondence. We show that this mirror theory can be interpreted as the light cone theory of a free string on a different background. This background is related to dS5×H(5) by a double T-duality, and has hidden supersymmetry. The geometry can also be extracted from an integrable deformation of the AdS5×S(5) sigma model, and we prove the observed mirror duality of these deformed models at the bosonic level as a byproduct. While we focus on AdS5×S(5), our results apply more generally.

  15. Fermionic currents in AdS spacetime with compact dimensions

    NASA Astrophysics Data System (ADS)

    Bellucci, S.; Saharian, A. A.; Vardanyan, V.

    2017-09-01

    We derive a closed expression for the vacuum expectation value (VEV) of the fermionic current density in a (D +1 )-dimensional locally AdS spacetime with an arbitrary number of toroidally compactified Poincaré spatial dimensions and in the presence of a constant gauge field. The latter can be formally interpreted in terms of a magnetic flux treading the compact dimensions. In the compact subspace, the field operator obeys quasiperiodicity conditions with arbitrary phases. The VEV of the charge density is zero and the current density has nonzero components along the compact dimensions only. They are periodic functions of the magnetic flux with the period equal to the flux quantum and tend to zero on the AdS boundary. Near the horizon, the effect of the background gravitational field is small and the leading term in the corresponding asymptotic expansion coincides with the VEV for a massless field in the locally Minkowski bulk. Unlike the Minkowskian case, in the system consisting of an equal number of fermionic and scalar degrees of freedom, with same masses, charges and phases in the periodicity conditions, the total current density does not vanish. In these systems, the leading divergences in the scalar and fermionic contributions on the horizon are canceled and, as a consequence of that, the charge flux, integrated over the coordinate perpendicular to the AdS boundary, becomes finite. We show that in odd spacetime dimensions the fermionic fields realizing two inequivalent representations of the Clifford algebra and having equal phases in the periodicity conditions give the same contribution to the VEV of the current density. Combining the contributions from these fields, the current density in odd-dimensional C -,P - and T -symmetric models are obtained. As an application, we consider the ground state current density in curved carbon nanotubes described in terms of a (2 +1 )-dimensional effective Dirac model.

  16. Symmetry operators of Killing spinors and superalgebras in AdS5

    NASA Astrophysics Data System (ADS)

    Ertem, Ümit

    2016-04-01

    We construct the first-order symmetry operators of Killing spinor equation in terms of odd Killing-Yano forms. By modifying the Schouten-Nijenhuis bracket of Killing-Yano forms, we show that the symmetry operators of Killing spinors close into an algebra in AdS5 spacetime. Since the symmetry operator algebra of Killing spinors corresponds to a Jacobi identity in extended Killing superalgebras, we investigate the possible extensions of Killing superalgebras to include higher-degree Killing-Yano forms. We found that there is a superalgebra extension but no Lie superalgebra extension of the Killing superalgebra constructed out of Killing spinors and odd Killing-Yano forms in AdS5 background.

  17. Survival of Alzheimer's disease patients in Korea.

    PubMed

    Go, Seok Min; Lee, Kang Soo; Seo, Sang Won; Chin, Juhee; Kang, Sue J; Moon, So Young; Na, Duk L; Cheong, Hae-Kwan

    2013-01-01

    The natural history of Alzheimer's disease (AD) has rarely been studied in the Korean population. Our study on survival analyses in Korean AD patients potentially provides a basis for cross-cultural comparisons. We studied 724 consecutive patients from a memory disorder clinic in a tertiary hospital in Seoul, who were diagnosed as having AD between April 1995 and December 2005. Deaths were identified by the Statistics Korea database. The Kaplan-Meier method was used for survival analysis, and a Cox proportional hazard model was used to assess factors related to patient survival. The overall median survival from the onset of first symptoms and from the time of diagnosis was 12.6 years (95% confidence interval 11.7-13.4) and 9.3 years (95% confidence interval 8.7-9.9), respectively. The age of onset, male gender, history of diabetes mellitus, lower Mini-Mental State Examination score, and higher Clinical Dementia Rating score were negatively associated with survival. There was a reversal of risk of AD between early-onset and later-onset AD, 9.1 years after onset. The results of our study show a different pattern of survival compared to those studies carried out with western AD populations. Mortality risk of early-onset AD varied depending on the duration of follow-up. Copyright © 2013 S. Karger AG, Basel.

  18. Categorical spatial memory in patients with mild cognitive impairment and Alzheimer dementia: positional versus object-location recall.

    PubMed

    Kessels, Roy P C; Rijken, Stefan; Joosten-Weyn Banningh, Liesbeth W A; Van Schuylenborgh-VAN Es, Nelleke; Olde Rikkert, Marcel G M

    2010-01-01

    Memory for object locations, as part of spatial memory function, has rarely been studied in patients with Alzheimer dementia (AD), while studies in patients with Mild Cognitive Impairment (MCI) patients are lacking altogether. The present study examined categorical spatial memory function using the Location Learning Test (LLT) in MCI patients (n = 30), AD patients (n = 30), and healthy controls (n = 40). Two scoring methods were compared, aimed at disentangling positional recall (location irrespective of object identity) and object-location binding. The results showed that AD patients performed worse than the MCI patients on the LLT, both on recall of positional information and on recall of the locations of different objects. In addition, both measures could validly discriminate between AD and MCI patients. These findings are in agreement with the notion that visual cued-recall tests may have better diagnostic value than traditional (verbal) free-recall tests in the assessment of patients with suspected MCI or AD.

  19. Reconstructive and rehabilitating methods in patients with dysphagia and nutritional disturbances

    PubMed Central

    Motsch, Christiane

    2005-01-01

    As diverse as the causes of oropharyngeal dysphagia can be, as broad is the range of potential therapeutical approaches. In the past two decades, methods of plastic-reconstructive surgery, in particular microsurgically revascularised tissue transfer and minimally invasive, endoscopic techniques of every hue have substantially added to the portfolio of reconstructive surgery available for rehabilitating deglutition. Numerically, reconstructing the pharyngolaryngeal tract following resection of squamous-cell carcinomas in the oral cavity, the pharynx and the larynx has been gaining ground, as has functional deglutitive therapy performed to treat posttherapeutical sequelae. Dysphagia and malnutrition are closely interrelated. Every third patient hospitalised in Germany suffers from malnutrition; ENT tumour patients are not excluded. For patients presenting with advancing malnutrition, the mortality, the morbidity and the individual complication rate have all been observed to increase; also a longer duration of stay in hospital has been noted and a lesser individual toleration of treatment, diminished immunocompetence, impaired general physical and psychical condition and, thus, a less favourable prognosis on the whole. Therefore, in oncological patients, the dietotherapy will have to assume a key role in supportive treatment. It is just for patients, who are expected to go through a long process of deglutitive rehabilitation, that enteral nutrition through percutaneous endoscopically controlled gastrostomy (PEG) performed at an early stage can provide useful and efficient support to the therapeutic efforts. Nutrition and oncology are mutually influencing fields where, sooner or later, a change in paradigms will have to take place, i.e. gradually switching from therapy to prevention. While cancer causes malnutrition, feasible changes in feeding and nutrition-associated habits, including habitual drinking and smoking, might lower the incidence of cancer worldwide by 30

  20. Euclidean Wilson loops and minimal area surfaces in lorentzian AdS 3

    DOE PAGES

    Irrgang, Andrew; Kruczenski, Martin

    2015-12-14

    The AdS/CFT correspondence relates Wilson loops in N=4 SYM theory to minimal area surfaces in AdS 5 × S 5 space. If the Wilson loop is Euclidean and confined to a plane (t, x) then the dual surface is Euclidean and lives in Lorentzian AdS 3 c AdS 5. In this paper we study such minimal area surfaces generalizing previous results obtained in the Euclidean case. Since the surfaces we consider have the topology of a disk, the holonomy of the flat current vanishes which is equivalent to the condition that a certain boundary Schrödinger equation has all its solutionsmore » anti-periodic. If the potential for that Schrödinger equation is found then reconstructing the surface and finding the area become simpler. In particular we write a formula for the Area in terms of the Schwarzian derivative of the contour. Finally an infinite parameter family of analytical solutions using Riemann Theta functions is described. In this case, both the area and the shape of the surface are given analytically and used to check the previous results.« less

  1. Minimal unitary representation of 5d superconformal algebra F(4) and AdS 6/CFT 5 higher spin (super)-algebras

    DOE PAGES

    Fernando, Sudarshan; Günaydin, Murat

    2014-11-28

    We study the minimal unitary representation (minrep) of SO(5, 2), obtained by quantization of its geometric quasiconformal action, its deformations and supersymmetric extensions. The minrep of SO(5, 2) describes a massless conformal scalar field in five dimensions and admits a unique “deformation” which describes a massless conformal spinor. Scalar and spinor minreps of SO(5, 2) are the 5d analogs of Dirac’s singletons of SO(3, 2). We then construct the minimal unitary representation of the unique 5d supercon-formal algebra F(4) with the even subalgebra SO(5, 2) ×SU(2). The minrep of F(4) describes a massless conformal supermultiplet consisting of two scalar andmore » one spinor fields. We then extend our results to the construction of higher spin AdS 6/CFT 5 (super)-algebras. The Joseph ideal of the minrep of SO(5, 2) vanishes identically as operators and hence its enveloping algebra yields the AdS 6/CFT 5 bosonic higher spin algebra directly. The enveloping algebra of the spinor minrep defines a “deformed” higher spin algebra for which a deformed Joseph ideal vanishes identically as operators. These results are then extended to the construction of the unique higher spin AdS 6/CFT 5 superalgebra as the enveloping algebra of the minimal unitary realization of F(4) obtained by the quasiconformal methods.« less

  2. Holographic Rényi entropy in AdS3/LCFT2 correspondence

    NASA Astrophysics Data System (ADS)

    Chen, Bin; Song, Feng-yan; Zhang, Jia-ju

    2014-03-01

    The recent study in AdS3/CFT2 correspondence shows that the tree level contribution and 1-loop correction of holographic Rényi entanglement entropy (HRE) exactly match the direct CFT computation in the large central charge limit. This allows the Rényi entanglement entropy to be a new window to study the AdS/CFT correspondence. In this paper we generalize the study of Rényi entanglement entropy in pure AdS3 gravity to the massive gravity theories at the critical points. For the cosmological topological massive gravity (CTMG), the dual conformal field theory (CFT) could be a chiral conformal field theory or a logarithmic conformal field theory (LCFT), depending on the asymptotic boundary conditions imposed. In both cases, by studying the short interval expansion of the Rényi entanglement entropy of two disjoint intervals with small cross ratio x, we find that the classical and 1-loop HRE are in exact match with the CFT results, up to order x 6. To this order, the difference between the massless graviton and logarithmic mode can be seen clearly. Moreover, for the cosmological new massive gravity (CNMG) at critical point, which could be dual to a logarithmic CFT as well, we find the similar agreement in the CNMG/LCFT correspondence. Furthermore we read the 2-loop correction of graviton and logarithmic mode to HRE from CFT computation. It has distinct feature from the one in pure AdS3 gravity.

  3. Skin Prick Test in Patients with Chronic Allergic Skin Disorders

    PubMed Central

    Bains, Pooja; Dogra, Alka

    2015-01-01

    Background: Chronic allergic skin disorders are the inflammatory and proliferative conditions in which both genetic and environmental factors play important roles. Chronic idiopathic urticaria (CIU) and atopic dermatitis (AD) are among the most common chronic allergic skin disorders. These can be provoked by various food and aeroallergens. Skin prick tests (SPTs) represent the cheapest and most effective method to diagnose type I hypersensitivity. Positive skin tests with a history suggestive of clinical sensitivity strongly incriminate the allergen as a contributor to the disease process. Aims and Objectives: To determine the incidence of positive SPT in patients with chronic allergic skin disorders and to identify the various allergens implicated in positive SPT. Methods: Fifty patients of chronic allergic disorders were recruited in this study. They were evaluated by SPT with both food and aeroallergens. Results: In our study, SPT positivity in patients of CIU was 63.41% and in AD was 77.78%. Out of the 41 patients of CIU, the most common allergen groups showing SPT positivity were dust and pollen, each comprising 26.83% patients. SPT reaction was positive with food items (21.6%), insects (17.07%), fungus (12.20%), and Dermatophagoides farinae, that is, house dust mite (HDM) (7.32%). The allergen which showed maximum positivity was grain dust wheat (19.51%). Among nine patients of AD, maximum SPT positivity was seen with Dermatophagoides farinae, pollen Amaranthus spinosus, grain dust wheat, and cotton mill dust; each comprising 22.22% of patients. Conclusion: Our study showed that a significant number of patients of CIU and AD showed sensitivity to dust, pollen, insects, Dermatophagoides farinae, and fungi on SPT. Thus, it is an important tool in the diagnosis of CIU and AD. PMID:25814704

  4. Will Courts Shape Value-Added Methods for Teacher Evaluation? ACT Working Paper Series. WP-2014-2

    ERIC Educational Resources Information Center

    Croft, Michelle; Buddin, Richard

    2014-01-01

    As more states begin to adopt teacher evaluation systems based on value-added measures, legal challenges have been filed both seeking to limit the use of value-added measures ("Cook v. Stewart") and others seeking to require more robust evaluation systems ("Vergara v. California"). This study reviews existing teacher evaluation…

  5. Immunotherapy of Alzheimer's disease (AD): from murine models to anti-amyloid beta (Abeta) human monoclonal antibodies.

    PubMed

    Geylis, Valeria; Steinitz, Michael

    2006-01-01

    The deposition of amyloid beta (Abeta) protein is a key pathological feature in Alzheimer's disease (AD). In murine models of AD, both active and passive immunization against Abeta induce a marked reduction in amyloid brain burden and an improvement in cognitive functions. Preliminary results of a prematurely terminated clinical trial where AD patients were actively vaccinated with aggregated Abeta bear resemblance to those documented in murine models. Passive immunization of AD patients with anti-Abeta antibodies, in particular human antibodies, is a strategy that provides a more cautious management and control of any undesired side effects. Sera of all healthy adults contain anti-Abeta IgG autoimmune antibodies. Hence antigen-committed human B-cells are easily immortalized by Epstein-Barr virus (EBV) into anti-Abeta secreting cell lines. Two anti-Abeta human monoclonal antibodies which we recently prepared bind to the N-terminus of Abeta peptide and were shown to stain amyloid plaques in non-fixed brain sections from an AD patient. It is anticipated that specifically selected anti-Abeta human monoclonal antibodies could reduce and inhibit deposits of amyloid in brain while avoiding the cognitive decline that characterizes AD. In the future, this type of antibody may prove to be a promising immune therapy for the disease.

  6. Boundary stress tensor and asymptotically AdS3 non-Einstein spaces at the chiral point

    NASA Astrophysics Data System (ADS)

    Giribet, Gaston; Goya, Andrés; Leston, Mauricio

    2011-09-01

    Chiral gravity admits asymptotically AdS3 solutions that are not locally equivalent to AdS3; meaning that solutions do exist which, while obeying the strong boundary conditions usually imposed in general relativity, happen not to be Einstein spaces. In topologically massive gravity (TMG), the existence of non-Einstein solutions is particularly connected to the question about the role played by complex saddle points in the Euclidean path integral. Consequently, studying (the existence of) nonlocally AdS3 solutions to chiral gravity is relevant to understanding the quantum theory. Here, we discuss a special family of nonlocally AdS3 solutions to chiral gravity. In particular, we show that such solutions persist when one deforms the theory by adding the higher-curvature terms of the so-called new massive gravity. Moreover, the addition of higher-curvature terms to the gravity action introduces new nonlocally AdS3 solutions that have no analogues in TMG. Both stationary and time-dependent, axially symmetric solutions that asymptote AdS3 space without being locally equivalent to it appear. Defining the boundary stress tensor for the full theory, we show that these non-Einstein geometries have associated vanishing conserved charges.

  7. Hypoglycaemia when adding sulphonylurea to metformin: a systematic review and network meta‐analysis

    PubMed Central

    Christensen, Mikkel

    2016-01-01

    Aims The risk of hypoglycaemia may differ among sulphonylureas (SUs), but evidence from head‐to‐head comparisons is sparse. Performing a network meta‐analysis to use indirect evidence from randomized controlled trials (RCTs), we compared the relative risk of hypoglycaemia with newer generation SUs when added to metformin. Methods A systematic review identified RCTs lasting 12–52 weeks and evaluating SUs added to inadequate metformin monotherapy (≥1000 mg/day) in type 2 diabetes. Adding RCTs investigating the active comparators from the identified SU trials, we established a coherent network. Hypoglycaemia of any severity was the primary end point. Results Thirteen trials of SUs and 14 of oral non‐SU antihyperglycaemic agents (16 260 patients) were included. All reported hypoglycaemia only as adverse events. Producing comparable reductions in HbA1C of −0.66 to −0.84% (−7 to −9 mmol/mol), the risk of hypoglycaemia was lowest with gliclazide compared to glipizide (OR 0.22, CrI: 0.05 to 0.96), glimepiride (OR 0.40, CrI: 0.13 to 1.27), and glibenclamide (OR 0.21, CrI: 0.03 to 1.48). A major limitation is varying definitions of hypoglycaemia across studies. Conclusions When added to metformin, gliclazide was associated with the lowest risk of hypoglycaemia between the newer generation SUs. Clinicians should consider the risk of hypoglycaemia agent‐specific when selecting an SU agent. PMID:27426428

  8. A universal counting of black hole microstates in AdS4

    NASA Astrophysics Data System (ADS)

    Azzurli, Francesco; Bobev, Nikolay; Crichigno, P. Marcos; Min, Vincent S.; Zaffaroni, Alberto

    2018-02-01

    Many three-dimensional N=2 SCFTs admit a universal partial topological twist when placed on hyperbolic Riemann surfaces. We exploit this fact to derive a universal formula which relates the planar limit of the topologically twisted index of these SCFTs and their three-sphere partition function. We then utilize this to account for the entropy of a large class of supersymmetric asymptotically AdS4 magnetically charged black holes in M-theory and massive type IIA string theory. In this context we also discuss novel AdS2 solutions of eleven-dimensional supergravity which describe the near horizon region of large new families of supersymmetric black holes arising from M2-branes wrapping Riemann surfaces.

  9. Image Ads and Issue Ads in U.S. Presidential Advertising: Using Videostyle To Explore Stylistic Differences in Televised Political Ads From 1952 to 2000.

    ERIC Educational Resources Information Center

    Johnston, Anne; Kaid, Lynda Lee

    2002-01-01

    Explores the differences in techniques, strategies, narratives, and symbols used in 1,213 television issue ads and image ads from 13 U.S. presidential campaigns. Concludes that although the majority of both types of ads were positive, negative appeals dominated a higher percentage of issue ads as compared with image ads. (SG)

  10. Latent feature representation with stacked auto-encoder for AD/MCI diagnosis

    PubMed Central

    Lee, Seong-Whan

    2014-01-01

    Recently, there have been great interests for computer-aided diagnosis of Alzheimer’s disease (AD) and its prodromal stage, mild cognitive impairment (MCI). Unlike the previous methods that considered simple low-level features such as gray matter tissue volumes from MRI, and mean signal intensities from PET, in this paper, we propose a deep learning-based latent feature representation with a stacked auto-encoder (SAE). We believe that there exist latent non-linear complicated patterns inherent in the low-level features such as relations among features. Combining the latent information with the original features helps build a robust model in AD/MCI classification, with high diagnostic accuracy. Furthermore, thanks to the unsupervised characteristic of the pre-training in deep learning, we can benefit from the target-unrelated samples to initialize parameters of SAE, thus finding optimal parameters in fine-tuning with the target-related samples, and further enhancing the classification performances across four binary classification problems: AD vs. healthy normal control (HC), MCI vs. HC, AD vs. MCI, and MCI converter (MCI-C) vs. MCI non-converter (MCI-NC). In our experiments on ADNI dataset, we validated the effectiveness of the proposed method, showing the accuracies of 98.8, 90.7, 83.7, and 83.3 % for AD/HC, MCI/HC, AD/MCI, and MCI-C/MCI-NC classification, respectively. We believe that deep learning can shed new light on the neuroimaging data analysis, and our work presented the applicability of this method to brain disease diagnosis. PMID:24363140

  11. Nonlinearity-aware based dimensionality reduction and over-sampling for AD/MCI classification from MRI measures.

    PubMed

    Cao, Peng; Liu, Xiaoli; Yang, Jinzhu; Zhao, Dazhe; Huang, Min; Zhang, Jian; Zaiane, Osmar

    2017-12-01

    Alzheimer's disease (AD) has been not only a substantial financial burden to the health care system but also an emotional burden to patients and their families. Making accurate diagnosis of AD based on brain magnetic resonance imaging (MRI) is becoming more and more critical and emphasized at the earliest stages. However, the high dimensionality and imbalanced data issues are two major challenges in the study of computer aided AD diagnosis. The greatest limitations of existing dimensionality reduction and over-sampling methods are that they assume a linear relationship between the MRI features (predictor) and the disease status (response). To better capture the complicated but more flexible relationship, we propose a multi-kernel based dimensionality reduction and over-sampling approaches. We combined Marginal Fisher Analysis with ℓ 2,1 -norm based multi-kernel learning (MKMFA) to achieve the sparsity of region-of-interest (ROI), which leads to simultaneously selecting a subset of the relevant brain regions and learning a dimensionality transformation. Meanwhile, a multi-kernel over-sampling (MKOS) was developed to generate synthetic instances in the optimal kernel space induced by MKMFA, so as to compensate for the class imbalanced distribution. We comprehensively evaluate the proposed models for the diagnostic classification (binary class and multi-class classification) including all subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. The experimental results not only demonstrate the proposed method has superior performance over multiple comparable methods, but also identifies relevant imaging biomarkers that are consistent with prior medical knowledge. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Extremal Correlators in the Ads/cft Correspondence

    NASA Astrophysics Data System (ADS)

    D'Hoker, Eric; Freedman, Daniel Z.; Mathur, Samir D.; Matusis, Alec; Rastelli, Leonardo

    The non-renormalization of the 3-point functions AdS/CFT correspondence. A two-fold puzzle appears in the extremal case, e.g. k1 = k2 + k3. First, the supergravity calculation involves analytic continuation in the ki variables to define the product of a vanishing bulk coupling and an infinite integral over AdS. Second, extremal correlators are uniquely sensitive to mixing of the single-trace operators trXk with protected multi-trace operators in the same representation of SU(4). We show that the calculation of extremal correlators from supergravity is subject to the same subtley of regularization known for 2-point functions, and we present a careful method which justifies the analytic continuation and shows that supergravity fields couple to single traces without admixture. We also study extremal n-point functions of chiral primary operators, and argue that type IIB supergravity requires that their space-time form is a product of n - 1 two-point functions (as in the free-field approximation) multiplied by a non-renormalized coefficient. This non-renormalization property of extremal n-point functions is a new prediction of the AdS/CFT correspondence. As a by-product of this work we obtain the cubic couplings tϕϕ and sϕϕ of fields in the dilaton and 5-sphere graviton towers of type IIB supergravity on AdS5 × S5.

  13. Estimating Free and Added Sugar Intakes in New Zealand.

    PubMed

    Kibblewhite, Rachael; Nettleton, Alice; McLean, Rachael; Haszard, Jillian; Fleming, Elizabeth; Kruimer, Devonia; Te Morenga, Lisa

    2017-11-27

    The reduction of free or added sugar intake (sugars added to food and drinks as a sweetener) is almost universally recommended to reduce the risk of obesity-related diseases and dental caries. The World Health Organisation recommends intakes of free sugars of less than 10% of energy intake. However, estimating and monitoring intakes at the population level is challenging because free sugars cannot be analytically distinguished from naturally occurring sugars and most national food composition databases do not include data on free or added sugars. We developed free and added sugar estimates for the New Zealand (NZ) food composition database (FOODfiles 2010) by adapting a method developed for Australia. We reanalyzed the 24 h recall dietary data collected for 4721 adults aged 15 years and over participating in the nationally representative 2008/09 New Zealand Adult Nutrition Survey to estimate free and added sugar intakes. The median estimated intake of free and added sugars was 57 and 49 g/day respectively and 42% of adults consumed less than 10% of their energy intake from free sugars. This approach provides more direct estimates of the free and added sugar contents of New Zealand foods than previously available and will enable monitoring of adherence to free sugar intake guidelines in future.

  14. Estimating Free and Added Sugar Intakes in New Zealand

    PubMed Central

    Kibblewhite, Rachael; Nettleton, Alice; McLean, Rachael; Haszard, Jillian; Fleming, Elizabeth; Kruimer, Devonia

    2017-01-01

    The reduction of free or added sugar intake (sugars added to food and drinks as a sweetener) is almost universally recommended to reduce the risk of obesity-related diseases and dental caries. The World Health Organisation recommends intakes of free sugars of less than 10% of energy intake. However, estimating and monitoring intakes at the population level is challenging because free sugars cannot be analytically distinguished from naturally occurring sugars and most national food composition databases do not include data on free or added sugars. We developed free and added sugar estimates for the New Zealand (NZ) food composition database (FOODfiles 2010) by adapting a method developed for Australia. We reanalyzed the 24 h recall dietary data collected for 4721 adults aged 15 years and over participating in the nationally representative 2008/09 New Zealand Adult Nutrition Survey to estimate free and added sugar intakes. The median estimated intake of free and added sugars was 57 and 49 g/day respectively and 42% of adults consumed less than 10% of their energy intake from free sugars. This approach provides more direct estimates of the free and added sugar contents of New Zealand foods than previously available and will enable monitoring of adherence to free sugar intake guidelines in future. PMID:29186927

  15. Massive quiver matrix models for massive charged particles in AdS

    DOE PAGES

    Asplund, Curtis T.; Denef, Frederik; Dzienkowski, Eric

    2016-01-11

    Here, we present a new class of N = 4 supersymmetric quiver matrix models and argue that it describes the stringy low-energy dynamics of internally wrapped D-branes in four-dimensional anti-de Sitter (AdS) flux compactifications. The Lagrangians of these models differ from previously studied quiver matrix models by the presence of mass terms, associated with the AdS gravitational potential, as well as additional terms dictated by supersymmetry. These give rise to dynamical phenomena typically associated with the presence of fluxes, such as fuzzy membranes, internal cyclotron motion and the appearance of confining strings. We also show how these models can bemore » obtained by dimensional reduction of four-dimensional supersymmetric quiver gauge theories on a three-sphere.« less

  16. The eleven observations of comets between 687 AD and 1114 AD recorded in the Anglo Saxon Chronicle

    NASA Technical Reports Server (NTRS)

    Mardon, E. G.; Williams, J.; Mardon, A. A.

    1992-01-01

    This research paper is an examination of the eleven cometary references (679AD, 729AD, 892AD, 950AD, 975AD, 995AD, 1066AD, 1097AD, 1106AD, 1110AD and 1114AD) found in the various manuscripts of The Anglo Saxon Chronicle between 678 AD and 1114 AD. The manuscripts contain more than 35 celestial observations. This is an examination of astronomical phenomena and other climatic or natural events, that are described in The Anglo Saxon Chronicle, which is also referred to as The Old English Annals.

  17. The eleven observations of comets between 687 AD and 1114 AD recorded in the Anglo Saxon Chronicle

    NASA Astrophysics Data System (ADS)

    Mardon, E. G.; Mardon, A. A.; Williams, J.

    1992-12-01

    This research paper is an examination of the eleven cometary references (679AD, 729AD, 892AD, 950AD, 975AD, 995AD, 1066AD, 1097AD, 1106AD, 1110AD and 1114AD) found in the various manuscripts of The Anglo Saxon Chronicle between 678 AD and 1114 AD. The manuscripts contain more than 35 celestial observations. This is an examination of astronomical phenomena and other climatic or natural events, that are described in The Anglo Saxon Chronicle, which is also referred to as The Old English Annals.

  18. Patient and caregiver characteristics related to completion of advance directives in terminally ill patients.

    PubMed

    Ho, Grace W K; Skaggs, Lauren; Yenokyan, Gayane; Kellogg, Anela; Johnson, Julie A; Lee, Mei Ching; Heinze, Katherine; Hughes, Mark T; Sulmasy, Daniel P; Kub, Joan; Terry, Peter B; Astrow, Alan B; Zheng, Jing; Lehmann, Lisa Soleymani; Nolan, Marie T

    2017-02-01

    There is a growing body of literature describing the characteristics of patients who plan for the end of life, but little research has examined how caregivers influence patients' advance care planning (ACP). The purpose of this study was to examine how patient and caregiver characteristics are associated with advance directive (AD) completion among patients diagnosed with a terminal illness. We defined AD completion as having completed a living will and/or identified a healthcare power of attorney. A convenience sample of 206 caregiver-patient dyads was included in the study. All patients were diagnosed with an advanced life-limiting illness. Trained research nurses administered surveys to collect information on patient and caregiver demographics (i.e., age, sex, race, education, marital status, and individual annual income) and patients' diagnoses and completion of AD. Multivariate logistic regression was employed to model predictors for patients' AD completion. Over half of our patient sample (59%) completed an AD. Patients who were older, diagnosed with amyotrophic lateral sclerosis, and with a caregiver who was Caucasian or declined to report an income level were more likely to have an AD in place. Our results suggest that both patient and caregiver characteristics may influence patients' decisions to complete an AD at the end of life. When possible, caregivers should be included in advance care planning for patients who are terminally ill.

  19. Treating Depression and Adherence (CBT-AD) in Patients with HIV in Care: A Three-arm Randomized Controlled Trial

    PubMed Central

    Safren, Steven A.; Bedoya, C. Andres; O’Cleirigh, Conall; Biello, Katie B.; Pinkston, Megan M.; Stein, Michael D.; Traeger, Lara; Kojic, Erna; Robbins, Gregory K.; Lerner, Jonathan A.; Herman, Debra S.; Mimiaga, Matthew J.; Mayer, Kenneth H.

    2016-01-01

    Summary Background Depression, highly prevalent in HIV, is consistently associated with worse ART adherence. Integrating CBT for depression with adherence counseling using the “Life-Steps” approach (CBT-AD) has an emerging evidence base. The aim of the current study was to test the efficacy of CBT-AD. Methods We conducted a three-arm RCT (N=240 HIV-positive adults with depression), comparing CBT-AD to Life-Steps integrated with information and supportive psychotherapy (ISP-AD) (both 12 sessions), and to ETAU (1 session Life-Steps). Participants were recruited from three sites in New England area, two being hospital settings, and one being a community health center. Randomization was done via a 2:2:1 ratio, using random allocation software by the data manager, in pairs, stratified by three variables: site, whether or not the participant was prescribed antidepressant medications, and history of injection drug use. The primary outcome was adherence assessed via electronic pill caps (MEMs) with correction for “pocketed” doses. Secondary outcomes included depression, plasma HIV RNA and CD4. Follow-ups occurred at 4, 8 and 12 months. We used intent-to treat analyses with ANCOVA for independent-assessor pre-post assessments of depression and mixed effects modeling for longitudinal assessments. Clinical Trial Registration: NCT00951028, https://clinicaltrials.gov/ct2/show/NCT00951028), closed to new participants. Findings The period of recruitment was February 26, 2009 to June 21, 2012, with the 12-month follow-up period extending until April 29, 2013. There were no study-related adverse events. CBT-AD (n=94 randomized, 83 retained) had greater improvements in adherence (Est.=1·00, CI=0·34, 1·66, p=0·003) and depression (CES-D Est.=−0·41, CI=−0·66, −0·16, p=0·001; MADRS Est.=−4·69, CI=−8·09, −1·28, p=0·007; CGI Est.=−0·66, CI=−1·11,-0·21, p=0·005) than ETAU (49 randomized, 46 retained) at post-treatment (4-month). Over follow-ups, CBT-AD

  20. Proper temperature of the Schwarzschild AdS black hole revisited

    NASA Astrophysics Data System (ADS)

    Eune, Myungseok; Kim, Wontae

    2017-10-01

    The Unruh temperature calculated by using the global embedding of the Schwarzschild AdS spacetime into the Minkowski spacetime was identified with the local proper temperature; however, it became imaginary in a certain region outside the event horizon. So, the temperature was assumed to be zero of non-thermal radiation for that region. In this work, we revisit this issue in an exactly soluble two-dimensional Schwarzschild AdS black hole and present an alternative resolution to this problem in terms of the Tolman's procedure. However, the process appears to be non-trivial in the sense that the original procedure assuming the traceless energy-momentum tensor should be extended in such a way that it should cover the non-vanishing case of the energy-momentum tensor in the presence of the trace anomaly. Consequently, we show that the proper temperature turns out to be real everywhere outside the event horizon without any imaginary value, in particular, it vanishes at both the horizon and the asymptotic infinity.

  1. Ad Hoc Supervision of General Practice Registrars as a "Community of Practice": Analysis, Interpretation and Re-Presentation

    ERIC Educational Resources Information Center

    Clement, T.; Brown, J.; Morrison, J.; Nestel, D.

    2016-01-01

    General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also…

  2. A noninterventional study evaluating the effectiveness and safety of lacosamide added to monotherapy in patients with epilepsy with partial-onset seizures in daily clinical practice: The VITOBA study.

    PubMed

    Runge, Uwe; Arnold, Stephan; Brandt, Christian; Reinhardt, Fritjof; Kühn, Frank; Isensee, Kathleen; Ramirez, Francisco; Dedeken, Peter; Lauterbach, Thomas; Noack-Rink, Matthias; Mayer, Thomas

    2015-12-01

    Evidence for the efficacy and safety of adjunctive lacosamide in the treatment of partial-onset seizures (POS) was gained during placebo-controlled clinical trials in patients with treatment-resistant seizures who were taking one to three concomitant antiepileptic drugs (AEDs). The VITOBA study (NCT01098162) evaluated the effectiveness and tolerability of adjunctive lacosamide added to one baseline AED in real-world clinical practice. We conducted a 6-month observational study at 112 sites across Germany. Adult patients (≥ 16 years) with POS received lacosamide adjunctive to only one baseline AED. Seizure frequency reduction at the end of the observation period was compared with a 3-month retrospective baseline period. Five hundred seventy-one patients received lacosamide at least once (Safety Set [SS]); 520 provided evaluable seizure records (Full Analysis Set [FAS]); and 499 took in-label dosages of lacosamide (up to 400 mg) and were evaluated for effectiveness (modified FAS). Median baseline seizure frequency was 2.0 per 28 days: 47.1% of patients (235/499, mFAS) took a concomitant sodium channel-blocking (SCB) AED; 38.1% (190/499) had only one lifetime AED; and 18.4% (92/499) were aged ≥ 65 years (mFAS). At the final visit, 72.5% (358/494) of patients showed a ≥ 50% reduction in seizure frequency from baseline, 63.8% (315/494) showed a ≥ 75% reduction, and 45.5% (225/494) were seizure-free. Seizure freedom rates were higher in patients aged ≥ 65 years (56.7%) compared with patients aged <65 years (43.1%), in patients with ≤ 5 years epilepsy duration (52.5%) versus >5 years duration (41.0%), and when added to first monotherapy (60.5%) rather than as a later therapy option. Treatment-emergent adverse events (TEAEs) were reported by 48.5% (277/571) of patients (SS), with a profile similar to that observed in pivotal trials; 466 of patients (81.6%, SS) continued lacosamide therapy after the trial. These results suggest that lacosamide use, added to one

  3. Using Google AdWords for International Multilingual Recruitment to Health Research Websites

    PubMed Central

    Gross, Margaret S; Liu, Nancy H; Contreras, Omar; Muñoz, Ricardo F

    2014-01-01

    Background Google AdWords, the placement of sponsored links in Google search results, is a potent method of recruitment to Internet-based health studies and interventions. However, the performance of Google AdWords varies considerably depending on the language and the location of the target audience. Objective Our goal was to describe differences in AdWords performance when recruiting participants to the same study conducted in four languages and to determine whether AdWords campaigns can be optimized in order to increase recruitment while decreasing costs. Methods Google AdWords were used to recruit participants to the Mood Screener, a multilingual online depression screening tool available in English, Russian, Spanish, and Chinese. Two distinct recruitment periods are described: (1) “Unmanaged”, a 6-month period in which ads were allowed to run using only the AdWords tool itself, with no human intervention, and (2) “Managed”, a separate 7-week period during which we systematically sought to optimize our recruitment campaigns. Results During 6 months of unmanaged recruitment, our ads were shown over 1.3 million times, resulting in over 60,000 site visits. The average click-through rate (ratio of ads clicked to ads displayed) varied from 1.86% for Chinese ads to 8.48% for Russian ads, as did the average cost-per-click (from US $0.20 for Chinese ads to US $0.50 for English ads). Although Chinese speakers’ click-through rate was lowest, their rate of consenting to participate was the highest, at 3.62%, with English speakers exhibiting the lowest consent rate (0.97%). The conversion cost (cost to recruit a consenting participant) varied from US $10.80 for Russian speakers to US $51.88 for English speakers. During the 7 weeks of “managed” recruitment, we attempted to improve AdWords’ performance in regards to the consent rate and cost by systematically deleting underperforming ads and adjusting keywords. We were able to increase the number of people who

  4. Non-ad-hoc decision rule for the Dempster-Shafer method of evidential reasoning

    NASA Astrophysics Data System (ADS)

    Cheaito, Ali; Lecours, Michael; Bosse, Eloi

    1998-03-01

    This paper is concerned with the fusion of identity information through the use of statistical analysis rooted in Dempster-Shafer theory of evidence to provide automatic identification aboard a platform. An identity information process for a baseline Multi-Source Data Fusion (MSDF) system is defined. The MSDF system is applied to information sources which include a number of radars, IFF systems, an ESM system, and a remote track source. We use a comprehensive Platform Data Base (PDB) containing all the possible identity values that the potential target may take, and we use the fuzzy logic strategies which enable the fusion of subjective attribute information from sensor and the PDB to make the derivation of target identity more quickly, more precisely, and with statistically quantifiable measures of confidence. The conventional Dempster-Shafer lacks a formal basis upon which decision can be made in the face of ambiguity. We define a non-ad hoc decision rule based on the expected utility interval for pruning the `unessential' propositions which would otherwise overload the real-time data fusion systems. An example has been selected to demonstrate the implementation of our modified Dempster-Shafer method of evidential reasoning.

  5. Integrability of the Ad{{S}_{5}}\\times {{S}^{5}} superstring and its deformations

    NASA Astrophysics Data System (ADS)

    van Tongeren, Stijn J.

    2014-10-01

    This article reviews the application of integrability to the spectral problem of strings on Ad{{S}5}× {{S}5} and its deformations. We begin with a pedagogical introduction to integrable field theories culminating in the description of their finite-volume spectra through the thermodynamic Bethe ansatz (TBA). Next, we apply these ideas to the Ad{{S}5}× {{S}5} string and in later sections discuss how to account for particular integrable deformations. Through the AdS/CFT correspondence this gives an exact description of anomalous scaling dimensions of single trace operators in planar N=4 supersymmetry Yang-Mills theory, its ‘orbifolds’, and β and γ-deformed supersymmetric Yang-Mills theory. We also touch upon some subtleties arising in these deformed theories. Furthermore, we consider complex excited states (bound states) in the su(2) sector and give their TBA description. Finally we discuss the TBA for a quantum deformation of the Ad{{S}5}× {{S}5} superstring S-matrix, with close relations to among others Pohlmeyer reduced string theory, and briefly indicate more recent developments in this area.

  6. AD HOC Networks for the Autonomous Car

    NASA Astrophysics Data System (ADS)

    Ron, Davidescu; Negrus, Eugen

    2017-10-01

    The future of the vehicle is made of cars, roads and infrastructures connected in a two way automated communication in a holistic system. It is a mandatory to use Encryption to maintain Confidentiality, Integrity and Availability in an ad hoc vehicle network. Vehicle to Vehicle communication, requires multichannel interaction between mobile, moving and changing parties to insure the full benefit from data sharing and real time decision making, a network of such users referred as mobile ad hoc network (MANET), however as ad hoc networks were not implemented in such a scale, it is not clear what is the best method and protocol to apply. Furthermore the visibility of secure preferred asymmetric encrypted ad hoc networks in a real time environment of dense moving autonomous vehicles has to be demonstrated, In order to evaluate the performance of Ad Hoc networks in changing conditions a simulation of multiple protocols was performed on large number of mobile nodes. The following common routing protocols were tested, DSDV is a proactive protocol, every mobile station maintains a routing table with all available destinations, DSR is a reactive routing protocol which allows nodes in the MANET to dynamically discover a source route across multiple network hops, AODV is a reactive routing protocol Instead of being proactive. It minimizes the number of broadcasts by creating routes based on demand, SAODV is a secure version of AODV, requires heavyweight asymmetric cryptographic, ARIANDE is a routing protocol that relies on highly efficient symmetric cryptography the concept is primarily based on DSR. A methodical evolution was performed in a various density of transportation, based on known communication bench mark parameters including, Throughput Vs. time, Routing Load per packets and bytes. Out of the none encrypted protocols, It is clear that in terms of performance of throughput and routing load DSR protocol has a clear advantage the high node number mode. The encrypted

  7. Study of activity based costing implementation for palm oil production using value-added and non-value-added activity consideration in PT XYZ palm oil mill

    NASA Astrophysics Data System (ADS)

    Sembiring, M. T.; Wahyuni, D.; Sinaga, T. S.; Silaban, A.

    2018-02-01

    Cost allocation at manufacturing industry particularly in Palm Oil Mill still widely practiced based on estimation. It leads to cost distortion. Besides, processing time determined by company is not in accordance with actual processing time in work station. Hence, the purpose of this study is to eliminates non-value-added activities therefore processing time could be shortened and production cost could be reduced. Activity Based Costing Method is used in this research to calculate production cost with Value Added and Non-Value-Added Activities consideration. The result of this study is processing time decreasing for 35.75% at Weighting Bridge Station, 29.77% at Sorting Station, 5.05% at Loading Ramp Station, and 0.79% at Sterilizer Station. Cost of Manufactured for Crude Palm Oil are IDR 5.236,81/kg calculated by Traditional Method, IDR 4.583,37/kg calculated by Activity Based Costing Method before implementation of Activity Improvement and IDR 4.581,71/kg after implementation of Activity Improvement Meanwhile Cost of Manufactured for Palm Kernel are IDR 2.159,50/kg calculated by Traditional Method, IDR 4.584,63/kg calculated by Activity Based Costing Method before implementation of Activity Improvement and IDR 4.582,97/kg after implementation of Activity Improvement.

  8. Evaluation of the long-term cost-effectiveness of IDegLira versus liraglutide added to basal insulin for patients with type 2 diabetes failing to achieve glycemic control on basal insulin in the USA.

    PubMed

    Hunt, B; Mocarski, M; Valentine, W J; Langer, J

    2017-07-01

    IDegLira, a fixed ratio combination of insulin degludec and glucagon-like peptide-1 receptor agonist liraglutide, utilizes the complementary mechanisms of action of these two agents to improve glycemic control with low risk of hypoglycemia and avoidance of weight gain. The aim of the present analysis was to assess the long-term cost-effectiveness of IDegLira vs liraglutide added to basal insulin, for patients with type 2 diabetes not achieving glycemic control on basal insulin in the US setting. Projections of lifetime costs and clinical outcomes were made using the IMS CORE Diabetes Model. Treatment effect data for patients receiving IDegLira and liraglutide added to basal insulin were modeled based on the outcomes of a published indirect comparison, as no head-to-head clinical trial data is currently available. Costs were accounted in 2015 US dollars ($) from a healthcare payer perspective. IDegLira was associated with small improvements in quality-adjusted life expectancy compared with liraglutide added to basal insulin (8.94 vs 8.91 discounted quality-adjusted life years [QALYs]). The key driver of improved clinical outcomes was the greater reduction in glycated hemoglobin associated with IDegLira. IDegLira was associated with mean costs savings of $17,687 over patient lifetimes vs liraglutide added to basal insulin, resulting from lower treatment costs and cost savings as a result of complications avoided. The present long-term modeling analysis found that IDegLira was dominant vs liraglutide added to basal insulin for patients with type 2 diabetes failing to achieve glycemic control on basal insulin in the US, improving clinical outcomes and reducing direct costs.

  9. Capturing the Patient’s Experience: Using Qualitative Methods to Develop a Measure of Patient-Reported Symptom Burden: An Example from Ovarian Cancer

    PubMed Central

    Williams, Loretta A.; Agarwal, Sonika; Bodurka, Diane C.; Saleeba, Angele K.; Sun, Charlotte C.; Cleeland, Charles S.

    2013-01-01

    Context Experts in patient-reported outcome (PRO) measurement emphasize the importance of including patient input in the development of PRO measures. Although best methods for acquiring this input are not yet identified, patient input early in instrument development ensures that instrument content captures information most important and relevant to patients in understandable terms. Objectives The M. D. Anderson Symptom Inventory (MDASI) is a reliable, valid PRO instrument for assessing cancer symptom burden. We report a qualitative (open-ended, in-depth) interviewing method that can be used to incorporate patient input into PRO symptom measure development, with our experience in constructing a MDASI module for ovarian cancer (MDASI-OC) as a model. Methods Fourteen patients with ovarian cancer (OC) described symptoms experienced at the time of the study, at diagnosis, and during prior treatments. Researchers and clinicians used content analysis of interview transcripts to identify symptoms in patient language. Symptoms were ranked on the basis of the number of patients mentioning them and by clinician assessment of relevance. Results Forty-two symptoms were mentioned. Eight OC-specific items will be added to the 13 core symptom items and six interference items of the MDASI in a test version of the MDASI-OC based on the number of patients mentioning them and clinician assessment of importance. The test version is undergoing psychometric evaluation. Conclusion The qualitative interviewing process, used to develop the test MDASI-OC, systematically captures common symptoms important to patients with ovarian cancer. This methodology incorporates the patient experience recommended by experts in PRO instrument development. PMID:23615044

  10. "Value Added" Gauge of Teaching Probed

    ERIC Educational Resources Information Center

    Viadero, Debra

    2009-01-01

    A new study by a public and labor economist suggests that "value added" methods for determining the effectiveness of classroom teachers are built on some shaky assumptions and may be misleading. The study, due to be published in February in the "Quarterly Journal of Economics," is the first of a handful of papers now in the…

  11. On supersymmetric AdS6 solutions in 10 and 11 dimensions

    NASA Astrophysics Data System (ADS)

    Gutowski, J.; Papadopoulos, G.

    2017-12-01

    We prove a non-existence theorem for smooth, supersymmetric, warped AdS 6 solutions with connected, compact without boundary internal space in D = 11 and (massive) IIA supergravities. In IIB supergravity we show that if such AdS 6 solutions exist, then the NSNS and RR 3-form fluxes must be linearly independent and certain spinor bilinears must be appropriately restricted. Moreover we demonstrate that the internal space admits an so(3) action which leaves all the fields invariant and for smooth solutions the principal orbits must have co-dimension two. We also describe the topology and geometry of internal spaces that admit such a so(3) action and show that there are no solutions for which the internal space has topology F × S 2, where F is an oriented surface.

  12. Education and occupation as proxies for reserve in aMCI converters and AD: FDG-PET evidence.

    PubMed

    Garibotto, V; Borroni, B; Kalbe, E; Herholz, K; Salmon, E; Holtoff, V; Sorbi, S; Cappa, S F; Padovani, A; Fazio, F; Perani, D

    2008-10-21

    Previous reports have shown that higher education is associated with more severe brain pathology in patients with Alzheimer disease (AD), suggesting that these individuals have a functional reserve provided by education, which masks the clinical expression of a higher degree of neurodegeneration. It is unknown if a similar reserve mechanism exists in patients with amnestic mild cognitive impairment (aMCI). The aim of this study was to assess the impact of education and occupation on brain glucose metabolism (rCMRglc) measured with FDG-PET in aMCI and in a very large sample of subjects with probable AD (pAD). A total of 242 patients with pAD, 72 with aMCI, and 144 healthy controls participated in the study. At follow-up, 21 subjects with aMCI progressed to AD. A regression analysis was conducted (SPM2), with education and occupation as independent variables, and rCMRglc as dependent variable, adjusting for demographic data, global cognitive status, and neuropsychological scores. The analysis showed a significant association between higher education/occupation and lower rCMRglc in posterior temporoparietal cortex and precuneus in pAD and aMCI converters, and no correlation in aMCI nonconverters and healthy controls. This means that, when submitted to FDG-PET for diagnostic evaluation, pAD and aMCI converters with higher education/occupation had, for comparable cognitive impairment, a more severe rCMRglc reduction than the ones with lower education/occupation. This study suggests that education and occupation may be proxies for brain functional reserve, reducing the severity and delaying the clinical expression of Alzheimer disease (AD) pathology. The results in aMCI converters suggest that functional reserve is already at play in the predementia phase of AD.

  13. Abnormal functional connectivity of the posterior cingulate cortex is associated with depressive symptoms in patients with Alzheimer’s disease

    PubMed Central

    Zhang, Jiangtao; Guo, Zhongwei; Liu, Xiaozheng; Jia, Xize; Li, Jiapeng; Li, Yaoyao; Lv, Danmei; Chen, Wei

    2017-01-01

    Background Depressive symptoms are significant and very common psychiatric complications in patients with Alzheimer’s disease (AD), which can aggravate the decline in social function. However, changes in the functional connectivity (FC) of the brain in AD patients with depressive symptoms (D-AD) remain unclear. Objective To investigate whether any differences exist in the FC of the posterior cingulate cortex (PCC) between D-AD patients and non-depressed AD patients (nD-AD). Materials and methods We recruited 15 D-AD patients and 17 age-, sex-, educational level-, and Mini-Mental State Examination (MMSE)-matched nD-AD patients to undergo tests using the Neuropsychiatric Inventory, Hamilton Depression Rating Scale, and 3.0T resting-state functional magnetic resonance imaging. Bilateral PCC were selected as the regions of interest and between-group differences in the PCC FC network were assessed using Student’s t-test. Results Compared with the nD-AD group, D-AD patients showed increased PCC FC in the right amygdala, right parahippocampus, right superior temporal pole, right middle temporal lobe, right middle temporal pole, and right hippocampus (AlphaSim correction; P<0.05). In the nD-AD group, MMSE scores were positively correlated with PCC FC in the right superior temporal pole and right hippocampus (false discovery rate corrected; P<0.05). Conclusion Differences were detected in PCC FC between nD-AD and D-AD patients, which may be related to depressive symptoms. Our study provides a significant enhancement to our understanding of the functional mechanisms underlying D-AD. PMID:29066900

  14. Quantitative Balance and Gait Measurement in Patients with Frontotemporal Dementia and Alzheimer Diseases: A Pilot Study.

    PubMed

    Velayutham, Selva Ganapathy; Chandra, Sadanandavalli Retnaswami; Bharath, Srikala; Shankar, Ravi Girikamatha

    2017-01-01

    Alzhiemers disease and Frontotemporal dementia are common neurodegenerative dementias with a wide prevalence. Falls are a common cause of morbidity in these patients. Identifying subclinical involvement of these parameters might serve as a tool in differential analysis of these distinct parameters involved in these conditions and also help in planning preventive strategies to prevent falls. Eight patients in age and gender matched patients in each group were compared with normal controls. Standardizes methods of gait and balance aseesment were done in all persons. Results revealed subclinical involvement of gait and balancesin all groups specially during divided attention. The parameters were significantly more affected in patients. Patients with AD and FTD had involement of over all ambulation index balance more affected in AD patients FTD patients showed step cycle, stride length abnormalities. There is balance and gait involvement in normal ageing as well as patients with AD and FTD. The pattern of involvement in AD correlates with WHERE pathway involvement and FTD with frontal subcortical circuits involvement. Identification the differential patterns of involvement in subclinical stage might help to differentiate normal ageing and the different types of cortical dementias. This could serve as an additional biomarker and also assist in initiating appropriate training methods to prevent future falls.

  15. Ad Hoc Information Extraction for Clinical Data Warehouses.

    PubMed

    Dietrich, Georg; Krebs, Jonathan; Fette, Georg; Ertl, Maximilian; Kaspar, Mathias; Störk, Stefan; Puppe, Frank

    2018-05-01

    Clinical Data Warehouses (CDW) reuse Electronic health records (EHR) to make their data retrievable for research purposes or patient recruitment for clinical trials. However, much information are hidden in unstructured data like discharge letters. They can be preprocessed and converted to structured data via information extraction (IE), which is unfortunately a laborious task and therefore usually not available for most of the text data in CDW. The goal of our work is to provide an ad hoc IE service that allows users to query text data ad hoc in a manner similar to querying structured data in a CDW. While search engines just return text snippets, our systems also returns frequencies (e.g. how many patients exist with "heart failure" including textual synonyms or how many patients have an LVEF < 45) based on the content of discharge letters or textual reports for special investigations like heart echo. Three subtasks are addressed: (1) To recognize and to exclude negations and their scopes, (2) to extract concepts, i.e. Boolean values and (3) to extract numerical values. We implemented an extended version of the NegEx-algorithm for German texts that detects negations and determines their scope. Furthermore, our document oriented CDW PaDaWaN was extended with query functions, e.g. context sensitive queries and regex queries, and an extraction mode for computing the frequencies for Boolean and numerical values. Evaluations in chest X-ray reports and in discharge letters showed high F1-scores for the three subtasks: Detection of negated concepts in chest X-ray reports with an F1-score of 0.99 and in discharge letters with 0.97; of Boolean values in chest X-ray reports about 0.99, and of numerical values in chest X-ray reports and discharge letters also around 0.99 with the exception of the concept age. The advantages of an ad hoc IE over a standard IE are the low development effort (just entering the concept with its variants), the promptness of the results and the

  16. Multi-Skyrmions on AdS2 × S2, rational maps and popcorn transitions

    NASA Astrophysics Data System (ADS)

    Canfora, Fabrizio; Tallarita, Gianni

    2017-08-01

    By combining two different techniques to construct multi-soliton solutions of the (3 + 1)-dimensional Skyrme model, the generalized hedgehog and the rational map ansatz, we find multi-Skyrmion configurations in AdS2 ×S2. We construct Skyrmionic multi-layered configurations such that the total Baryon charge is the product of the number of kinks along the radial AdS2 direction and the degree of the rational map. We show that, for fixed total Baryon charge, as one increases the charge density on ∂ (AdS2 ×S2) , it becomes increasingly convenient energetically to have configurations with more peaks in the radial AdS2 direction but a lower degree of the rational map. This has a direct relation with the so-called holographic popcorn transitions in which, when the charge density is high, multi-layered configurations with low charge on each layer are favored over configurations with few layers but with higher charge on each layer. The case in which the geometry is M2 ×S2 can also be analyzed.

  17. Retrieving atmospheric turbulence information from regular commercial aircraft using Mode-S and ADS-B

    NASA Astrophysics Data System (ADS)

    Kopeć, Jacek M.; Kwiatkowski, Kamil; de Haan, Siebren; Malinowski, Szymon P.

    2016-05-01

    Navigational information broadcast by commercial aircraft in the form of Mode-S EHS (Mode-S Enhanced Surveillance) and ADS-B (Automatic Dependent Surveillance-Broadcast) messages can be considered a new source of upper tropospheric and lower stratospheric turbulence estimates. A set of three processing methods is proposed and analysed using a quality record of turbulence encounters made by a research aircraft.The proposed methods are based on processing the vertical acceleration or the background wind into the eddy dissipation rate. Turbulence intensity can be estimated using the standard content of the Mode-S EHS/ADS-B.The results are based on a Mode-S EHS/ADS-B data set generated synthetically based on the transmissions from the research aircraft. This data set was validated using the overlapping record of the Mode-S EHS/ADS-B received from the same research aircraft. The turbulence intensity, meaning the eddy dissipation rate, obtained from the proposed methods based on the Mode-S EHS/ADS-B is compared with the value obtained using on-board accelerometer. The results of the comparison indicate the potential of the methods. The advantages and limitation of the presented approaches are discussed.

  18. Relatives' attitudes towards informing patients about the diagnosis of Alzheimer's disease

    PubMed Central

    Pucci, E; Belardinelli, N; Borsetti, G; Giuliani, G

    2003-01-01

    Objectives: To evaluate relatives' attitudes towards informing patients with Alzheimer's disease (AD) about their diagnosis. Setting: A university hospital in Italy. Methods: The closest relatives of each of 71 subjects diagnosed for the first time as having AD were interviewed, using a semistructured questionnaire. Spontaneous requests by relatives not to communicate issues concerning the diagnosis were also recorded. Results: Forty three (60.6%) relatives spontaneously requested that patients not be fully informed. After being interviewed, nobody thought that the patient should be given all the information. Justifications were related to the fear of the onset or worsening of depressive symptoms in the patient. Conclusions: In Italy relatives' opposition to informing AD patients appears to be common. Knowledge of the relatives' attitudes may be useful for clinicians but disclosure of diagnosis should be based on the clinical evaluation of the patient and on a prudent evaluation of the relationship between the patient and her/his relative caregiver. PMID:12569197

  19. Closed Timelike Curves in (2+1)-AdS Gravity

    NASA Astrophysics Data System (ADS)

    Valtancoli, P.

    We build the (2+1)-AdS gravity generalization of the Gott time machine using a first-order formalism for solving the scattering of point sources. The two-body dynamics is solved by two invariant masses, whose difference is simply related to the total angular momentum of the system. We show how to build a time machine when at least one of the two invariant masses is no more real but acquires an imaginary part.

  20. Stochastic quantization of conformally coupled scalar in AdS

    NASA Astrophysics Data System (ADS)

    Jatkar, Dileep P.; Oh, Jae-Hyuk

    2013-10-01

    We explore the relation between stochastic quantization and holographic Wilsonian renormalization group flow further by studying conformally coupled scalar in AdS d+1. We establish one to one mapping between the radial flow of its double trace deformation and stochastic 2-point correlation function. This map is shown to be identical, up to a suitable field re-definition of the bulk scalar, to the original proposal in arXiv:1209.2242.

  1. Exploring the bulk in AdS /CFT : A covariant approach

    NASA Astrophysics Data System (ADS)

    Engelhardt, Netta

    2017-03-01

    I propose a general, covariant way of defining when one region is "deeper in the bulk" than another. This definition is formulated outside of an event horizon (or in the absence thereof) in generic geometries; it may be applied to both points and surfaces, and it may be used to compare the depth of bulk points or surfaces relative to a particular boundary subregion or relative to the entire boundary. Using the recently proposed "light-cone cut" formalism, the comparative depth between two bulk points can be determined from the singularity structure of Lorentzian correlators in the dual field theory. I prove that, by this definition, causal wedges of progressively larger regions probe monotonically deeper in the bulk. The definition furthermore matches expectations in pure AdS and in static AdS black holes with isotropic spatial slices, where a well-defined holographic coordinate exists. In terms of holographic renormalization group flow, this new definition of bulk depth makes contact with coarse graining over both large distances and long time scales.

  2. Puffed cereals with added chamomile - quantitative analysis of polyphenols and optimization of their extraction method.

    PubMed

    Blicharski, Tomasz; Oniszczuk, Anna; Olech, Marta; Oniszczuk, Tomasz; Wójtowicz, Agnieszka; Krawczyk, Wojciech; Nowak, Renata

    2017-05-11

    [b]Abstract Introduction[/b]. Functional food plays an important role in the prevention, management and treatment of chronic diseases. One of the most interesting techniques of functional food production is extrusion-cooking. Functional foods may include such items as puffed cereals, breads and beverages that are fortified with vitamins, some nutraceuticals and herbs. Due to its pharmacological activity, chamomile flowers are the most popular components added to functional food. Quantitative analysis of polyphenolic antioxidants, as well as comparison of various methods for the extraction of phenolic compounds from corn puffed cereals, puffed cereals with an addition of chamomile (3, 5, 10 and 20%) and from [i]Chamomillae anthodium. [/i] [b]Materials and Methods[/b]. Two modern extraction methods - ultrasound assisted extraction (UAE) at 40 °C and 60 °C, as well as accelerated solvent extraction (ASE) at 100 °C and 120 °C were used for the isolation of polyphenols from functional food. Analysis of flavonoids and phenolic acids was carried out using reversed-phase high-performance liquid chromatography and electrospray ionization mass spectrometry (LC-ESI-MS/MS). [b]Results and Conclusions[/b]. For most of the analyzed compounds, the highest yields were obtained by ultrasound assisted extraction. The highest temperature during the ultrasonification process (60 °C) increased the efficiency of extraction, without degradation of polyphenols. UAE easily arrives at extraction equilibrium and therefore permits shorter periods of time, reducing the energy input. Furthermore, UAE meets the requirements of 'Green Chemistry'.

  3. [Patients with ICD-10 disorders F3 and F4 in psychiatric and psychosomatic in-patient units - who is treated where? : Allocation features from the PfAD study].

    PubMed

    Bichescu-Burian, D; Cerisier, C; Czekaj, A; Grempler, J; Hund, S; Jaeger, S; Schmid, P; Weithmann, G; Steinert, T

    2017-01-01

    In Germany, in-patient treatment of patients with depressive, neurotic, anxiety, and somatoform disorders (ICD-10 F3, F4) is carried out in different settings in psychiatry and psychosomatics. Which patient characteristics determine referral to one or the other specialty is a crucial question in mental health policy and is a matter of ongoing controversy. However, comparative data on patient populations are widely lacking. In the study of Treatment Pathways of Patients with Anxiety and Depression (PfAD study), a total of 320 patients with ICD-10 F3/F4 clinical diagnoses were consecutively recruited from four treatment settings (psychiatric depression ward, psychiatric crisis intervention ward, psychiatric day hospitals, or psychosomatic hospital units; 80 participants per setting) and investigated. In all treatment settings, patients with considerable severity of illness and chronicity were treated. Female gender, higher education, and higher income predicted referral to psychosomatic units; male gender, transfer from another hospital or emergency hospitalization, co-morbidity with a personality disorder, higher general psychiatric co-morbidity, and danger to self at admission predicted referral to psychiatric unit. Patients in psychosomatic units had neither more psychosomatic disorders nor more somatic problems. There is considerable overlap between the clientele of psychiatric and psychosomatic units. Referral and allocation appears to be determined by aspects of severity and social status.

  4. Methods for the determination of European Union-permitted added natural colours in foods: a review.

    PubMed

    Scotter, M J

    2011-05-01

    Coupled to increasing consumer demand, food manufacturers have moved towards increased usage of approved natural colours. There is a legal requirement for governments to monitor the consumption of all food additives in the European Union to ensure the acceptable daily intakes (ADIs) are not exceeded, especially by young children. Validated analytical methods are needed to fulfil this requirement. The aim of this paper is to review the available literature on methods of extraction for approved natural colours in food and drink. Available analytical methods for the determination of European Union-permitted natural food colour additives in foods and beverages have been assessed for their fitness for purpose in terms of their key extraction and analysis procedures, selectivity and sensitivity, especially with regard to maximum permitted levels, and their applicability for use in surveillance and in an enforcement role. The advantages and disadvantages of available analytical methods for each of nine designated chemical classes (groups) of natural colours in different food and beverage matrices are given. Other important factors such as technical requirements, cost, transferability and applicability are given due consideration. Gaps in the knowledge and levels of validation are identified and recommendations made on further research to develop suitable methods. The nine designated natural colour classes covered are: 1. Curcumin (E100), 2. Riboflavins (E101i-ii), 3. Cochineal (E120), 4. Chlorophylls--including chlorophyllins and copper analogues (E140-141), 5. Caramel Classes I-IV (E150a-d), 6. Carotenoids (E160a-f, E161b, E161g), 7. Beetroot red (E162), 8. Anthocyanins (E163), and 9. Other colours--Vegetable carbon (E153), Calcium carbonate (E170), Titanium dioxide (E171) and Iron oxides and hydroxides (E172).

  5. Gibbilimbols A-D, cytotoxic and antibacterial alkenylphenols from Piper gibbilimbum.

    PubMed

    Orjala, J; Mian, P; Rali, T; Sticher, O

    1998-07-01

    Fractionation of the petroleum ether extract from the leaves of Piper gibbilimbum collected in Papua New Guinea afforded four new alkenylphenols, gibbilimbols A-D (1-4). The structures of the isolates were elucidated by spectroscopic methods, mainly 1D- and 2D-NMR spectroscopy. Gibbilimbols A-D were found to be toxic to brine shrimp with an LC50 of approximately 5 microg/mL. Gibbilimbols A-D were further found to be cytotoxic toward KB nasopharyngal carcinoma cells (ED50 7.8-2.1 microg/mL). All isolates also showed antibacterial activity toward Staphylococcus epidermidis and Bacillus cereus.

  6. Genetics of Aggression in Alzheimer’s Disease (AD)

    PubMed Central

    Lukiw, Walter J.; Rogaev, Evgeny I.

    2017-01-01

    Alzheimer’s disease (AD) is a terminal, age-related neurological syndrome exhibiting progressive cognitive and memory decline, however AD patients in addition exhibit ancillary neuropsychiatric symptoms (NPSs) and these include aggression. In this communication we provide recent evidence for the mis-regulation of a small family of genes expressed in the human hippocampus that appear to be significantly involved in expression patterns common to both AD and aggression. DNA array- and mRNA transcriptome-based gene expression analysis and candidate gene association and/or genome-wide association studies (CGAS, GWAS) of aggressive attributes in humans have revealed a surprisingly small subset of six brain genes that are also strongly associated with altered gene expression patterns in AD. These genes encoded on five different chromosomes (chr) include the androgen receptor (AR; chrXq12), brain-derived neurotrophic factor (BDNF; chr11p14.1), catechol-O-methyl transferase (COMT; chr22q11.21), neuronal specific nitric oxide synthase (NOS1; chr12q24.22), dopamine beta-hydroxylase (DBH chr9q34.2) and tryptophan hydroxylase (TPH1, chr11p15.1 and TPH2, chr12q21.1). Interestingly, (i) the expression of three of these six genes (COMT, DBH, NOS1) are highly variable; (ii) three of these six genes (COMT, DBH, TPH1) are involved in DA or serotonin metabolism, biosynthesis and/or neurotransmission; and (iii) five of these six genes (AR, BDNF, COMT, DBH, NOS1) have been implicated in the development, onset and/or propagation of schizophrenia. The magnitude of the expression of genes implicated in aggressive behavior appears to be more pronounced in the later stages of AD when compared to MCI. These recent genetic data further indicate that the extent of cognitive impairment may have some bearing on the degree of aggression which accompanies the AD phenotype. PMID:28443016

  7. Small black holes in global AdS spacetime

    NASA Astrophysics Data System (ADS)

    Jokela, Niko; Pönni, Arttu; Vuorinen, Aleksi

    2016-04-01

    We study the properties of two-point functions and quasinormal modes in a strongly coupled field theory holographically dual to a small black hole in global anti-de Sitter spacetime. Our results are seen to smoothly interpolate between known limits corresponding to large black holes and thermal AdS space, demonstrating that the Son-Starinets prescription works even when there is no black hole in the spacetime. Omitting issues related to the internal space, the results can be given a field theory interpretation in terms of the microcanonical ensemble, which provides access to energy densities forbidden in the canonical description.

  8. Constant curvature black holes in Einstein AdS gravity: Euclidean action and thermodynamics

    NASA Astrophysics Data System (ADS)

    Guilleminot, Pablo; Olea, Rodrigo; Petrov, Alexander N.

    2018-03-01

    We compute the Euclidean action for constant curvature black holes (CCBHs), as an attempt to associate thermodynamic quantities to these solutions of Einstein anti-de Sitter (AdS) gravity. CCBHs are gravitational configurations obtained by identifications along isometries of a D -dimensional globally AdS space, such that the Riemann tensor remains constant. Here, these solutions are interpreted as extended objects, which contain a (D -2 )-dimensional de-Sitter brane as a subspace. Nevertheless, the computation of the free energy for these solutions shows that they do not obey standard thermodynamic relations.

  9. Does the use of thiopental provide added cerebral protection during deep hypothermic circulatory arrest?

    PubMed Central

    Al-Hashimi, Sara; Zaman, Mahvash; Waterworth, Paul; Bilal, Haris

    2013-01-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Does the use of thiopental provide added cerebral protection during deep hypothermic circulatory arrest (DHCA)? Altogether, more than 62 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Four of the seven papers used thiopental alongside other neuroprotective methods and agents. The methods included the use of ice packs to the head and core systemic hypothermia. Agents used alongside thiopental included nicardipine and mannitol. Thiopental was found to have the ability to lower oxygen consumption, where oxygen consumption was measured using the phosphocreatinine and adenosine triphosphate ratio. The neuroprotective effect of thiopental was evaluated by assessing the electrical activity of the brain during circulatory arrest, by which it was shown to be advantageous. However, other trials suggested that adding thiopental during circulatory arrest did not provide any extra protection to the brain. The timing of thiopental administration is of importance in order to gain positive outcomes, as it's ability to lower the cerebral energy state may result in unfavourable results if added before hypothermic circulatory arrest, where this may lead to an ischaemic event. We conclude that the use of thiopental during deep hypothermic circulatory arrest is beneficial, but if administered too early, it may replete the cerebral energy state before arrest and prove to be detrimental. PMID:23644730

  10. Does the use of thiopental provide added cerebral protection during deep hypothermic circulatory arrest?

    PubMed

    Al-Hashimi, Sara; Zaman, Mahvash; Waterworth, Paul; Bilal, Haris

    2013-08-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Does the use of thiopental provide added cerebral protection during deep hypothermic circulatory arrest (DHCA)? Altogether, more than 62 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Four of the seven papers used thiopental alongside other neuroprotective methods and agents. The methods included the use of ice packs to the head and core systemic hypothermia. Agents used alongside thiopental included nicardipine and mannitol. Thiopental was found to have the ability to lower oxygen consumption, where oxygen consumption was measured using the phosphocreatinine and adenosine triphosphate ratio. The neuroprotective effect of thiopental was evaluated by assessing the electrical activity of the brain during circulatory arrest, by which it was shown to be advantageous. However, other trials suggested that adding thiopental during circulatory arrest did not provide any extra protection to the brain. The timing of thiopental administration is of importance in order to gain positive outcomes, as it's ability to lower the cerebral energy state may result in unfavourable results if added before hypothermic circulatory arrest, where this may lead to an ischaemic event. We conclude that the use of thiopental during deep hypothermic circulatory arrest is beneficial, but if administered too early, it may replete the cerebral energy state before arrest and prove to be detrimental.

  11. Identifying strategy for ad hoc percutaneous coronary intervention in patients with anticipated unfavorable radial access: the Little Women study.

    PubMed

    Sgueglia, Gregory A; Todaro, Daniel; De Santis, Antonella; Conte, Micaela; Gioffrè, Gaetano; Di Giorgio, Angela; D'Errico, Fabrizio; Piccioni, Fabiana; Summaria, Francesco; Gaspardone, Achille

    2017-10-16

    Transradial percutaneous coronary intervention (PCI) offers important advantages over transfemoral PCI, including better outcomes. However, when there is indication to ad hoc PCI, a 6 French workflow is a common default strategy, hence potentially influencing vascular access selection in patients with anticipated small size radial artery. A multidimensional evaluation was performed to compare two ad hoc interventional strategies in women <160cm: a full 6 French workflow (namely 6 French introducer sheath, diagnostic catheters and guiding catheter) with a modified workflow consisting in the use of 5 French diagnostic catheters preceded by the placement of a 6 French sheath introducer and followed by a 6 French guiding catheter use for PCI. Overall 120 women (68±11years) were enrolled in the study. Coronary angiography has been performed using 5 French or 6 French diagnostic catheters in 57 (47.5%) and 63 (52.5%) cases, respectively. Radial spasm and switch to another access occurred more frequently among women who underwent coronary angiography with 6 French rather than 5 French diagnostic catheters (43% vs. 25%, p=0.03 and 2% vs. 11%, p=0.04, respectively). Total time to guidewire lesion crossing was also significantly higher when PCI has been preceded by 6 French rather than 5 French coronary angiography (23±11min vs 16±7min, p=0.013). In patients with anticipated unfavorable radial access, a workflow consisting in 6 French introducer sheath placement, 5 French coronary angiography, and 6 French coronary intervention is on multiple parameters the most straightforward and effective strategy. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. A randomized, double-blind, placebo-controlled study to evaluate the efficacy in AD of liquid soap containing 12% ammonium lactate + 20% urea.

    PubMed

    Amichai, B; Grunwald, M H

    2009-12-01

    Atopic dermatitis (AD) is a common chronic skin disease, which mainly affects children. Xerosis is one of the most troublesome signs of the disease. The aim of this study was to evaluate the efficacy of liquid soap containing 12% ammonium lactate + 20% urea in patients with AD. In a randomized, double-blind study, 36 patients (both male and female patients; age range 3-40 years) with mild to moderate AD were enrolled. Patients were divided randomly into two groups, in a ratio of 2:1 (active:placebo). The prescribed soap was used on a daily basis during a shower for 3 weeks. All patients continued all other systemic or topical medication but avoided any other soap or emollients. After 3 weeks of treatment, efficacy was assessed both by clinician and patient. There were significant improvements in scaling (P < 0.0001), skin dryness (P < 0.0001) and redness (P = 0.03) as rated by the investigator, and subjective patient assessment of itch also improved (P < 0.001) in the study group compared with the control group. The liquid soap was found to be effective in patients with AD, as use of this soap in patients with stable mild to moderate AD improved the parameters studied.

  13. Sex steroid levels and AD-like pathology in 3xTgAD mice

    PubMed Central

    Ma, Chunqi; Taves, Matthew D.; Soma, Kiran K.; Mufson, Elliott J.

    2014-01-01

    Decreases in testosterone (T) and 17β-oestradiol (E2) are associated with an increased risk for Alzheimer's disease (AD), which has been attributed to an increase in beta amyloid (Aβ) and tau pathologic lesions. While recent studies have used transgenic animal models to test the effects of sex steroid manipulations on AD-like pathology, virtually none have systematically characterised the associations between AD lesions and sex steroid levels in the blood or brain in any mutant model. The present study evaluated age-related changes in T and E2 concentrations, as well as androgen receptor (AR) and oestrogen receptor (ER) α and β expression, in brain regions displaying AD pathology in intact male and female 3xTgAD and non-transgenic (ntg) mice. We report for the first time that circulating and brain T levels significantly increase in male 3xTgAD mice with age, but without changes in AR-immunoreactive (ir) cell number in either the hippocampal CA1 or medial amygdala. The age-related increase in hippocampal T levels correlated positively with increases in the conformational tau isoform, Alz50. These data suggest that the over-expression of human tau may up regulate the hypothalamic-pituitary-gonadal axis in these mice. Although circulating and brain E2 levels remained stable with age in both male and female 3xTgAD and ntg mice, ER-ir cell number in the hippocampus and medial amygdala decreased with age in female transgenic mice. Further, E2 levels were significantly higher in the hippocampus than in serum, suggesting local production of E2. Although triple transgenic mice mimic AD-like pathology, they do not fully replicate changes in human sex steroid levels, and may not be the best model for studying the effects of sex steroids on AD lesions. PMID:22889357

  14. Ambulatory orthopaedic surgery patients' emotions when using different patient education methods.

    PubMed

    Heikkinen, Katja; Salanterä, Sanna; Leppänen, Tiina; Vahlberg, Tero; Leino-Kilpi, Helena

    2012-07-01

    A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods.

  15. Sembragiline in Moderate Alzheimer’s Disease: Results of a Randomized, Double-Blind, Placebo-Controlled Phase II Trial (MAyflOwer RoAD)

    PubMed Central

    Nave, Stephane; Doody, Rachelle S.; Boada, Mercè; Grimmer, Timo; Savola, Juha-Matti; Delmar, Paul; Pauly-Evers, Meike; Nikolcheva, Tania; Czech, Christian; Borroni, Edilio; Ricci, Benedicte; Dukart, Juergen; Mannino, Marie; Carey, Tracie; Moran, Emma; Gilaberte, Inma; Muelhardt, Nicoletta Milani; Gerlach, Irene; Santarelli, Luca; Ostrowitzki, Susanne; Fontoura, Paulo

    2017-01-01

    Background: Sembragiline is a potent, selective, long-acting, and reversible MAO-B inhibitor developed as a potential treatment for Alzheimer’s disease (AD). Objective: To evaluate the safety, tolerability, and efficacy of sembragiline in patients with moderate AD. Methods: In this Phase II study (NCT01677754), 542 patients with moderate dementia (MMSE 13–20) on background acetylcholinesterase inhibitors with/without memantine were randomized (1:1:1) to sembragiline 1 mg, 5 mg, or placebo once daily orally for 52 weeks. Results: No differences between treated groups and placebo in adverse events or in study completion. The primary endpoint, change from baseline in ADAS-Cog11, was not met. At Week 52, the difference between sembragiline and placebo in ADAS-Cog11 change from baseline was – 0.15 (p = 0.865) and 0.90 (p = 0.312) for 1 and 5 mg groups, respectively. Relative to placebo at Week 52 (but not at prior assessment times), the 1 mg and 5 mg sembragiline groups showed differences in ADCS-ADL of 2.64 (p = 0.051) and 1.89 (p = 0.160), respectively. A treatment effect in neuropsychiatric symptoms (as assessed by the difference between sembragiline and placebo on BEHAVE-AD-FW) was also seen at Week 52 only: – 2.80 (p = 0.014; 1 mg) and – 2.64 (p = 0.019; 5 mg), respectively. A post hoc subgroup analysis revealed greater treatment effects on behavior and functioning in patients with more severe baseline behavioral symptoms (above the median). Conclusions: This study showed that sembragiline was well-tolerated in patients with moderate AD. The study missed its primary and secondary endpoints. Post hoc analyses suggested potential effect on neuropsychiatric symptoms and functioning in more behaviorally impaired study population at baseline. PMID:28550255

  16. AdS black disk model for small-x DIS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cornalba, Lorenzo; Costa, Miguel S.; Penedones, Joao

    2011-05-23

    Using the approximate conformal invariance of QCD at high energies we consider a simple AdS black disk model to describe saturation in DIS. Deep inside saturation the structure functions have the same power law scaling, F{sub T}{approx}F{sub L}{approx}{sup -}{omega}, where {omega} is related to the expansion rate of the black disk with energy. Furthermore, the ratio F{sub L}/F{sub T} is given by the universal value (1+{omega}/3+{omega}), independently of the target.

  17. Using qualitative methods to understand factors contributing to patient satisfaction among dermatology patients: a systematic review.

    PubMed

    Gibbons, Caitlin; Singh, Sanminder; Gibbons, Brittany; Clark, Caitlin; Torres, Josefina; Cheng, Michelle Y; Wang, Elizabeth A; Armstrong, April W

    2018-05-01

    In this systematic review, we aimed to synthesize data that identify factors contributing to patient satisfaction in dermatology care using qualitative methods. We performed a comprehensive search of the literature using the PubMed database for articles published between January 1, 2000 and February 9, 2015. The initial search yielded 186 articles, of which 13 were included after applying inclusion and exclusion criteria. The systematic review of 13 articles included a total of 330 patients. Using in-field observations and semistructured interviews, studies found that qualitative methods and analysis increased the provider's sensitivity to patient needs and enhanced patient care. Analyses using qualitative methods found increased patient satisfaction in their healthcare provider is associated with (1) confidence in the provider's diagnosis, (2) perception of patient-centered, individualized recommendations and (3) quality of patient education and provider explanation during a visit. Patient satisfaction is measured using either quantitative or qualitative methods. Quantitative methods result in standardized data that often does not capture the nuances of patient experience. In contrast, qualitative methodology is integral to gathering patient perspectives on patient care and satisfaction and should be included in future research models.

  18. The Tetrahedral Zamolodchikov Algebra and the {AdS_5× S^5} S-matrix

    NASA Astrophysics Data System (ADS)

    Mitev, Vladimir; Staudacher, Matthias; Tsuboi, Zengo

    2017-08-01

    The S-matrix of the {AdS_5× S^5} string theory is a tensor product of two centrally extended su{(2|2)\\ltimes R^2 S-matrices, each of which is related to the R-matrix of the Hubbard model. The R-matrix of the Hubbard model was first found by Shastry, who ingeniously exploited the fact that, for zero coupling, the Hubbard model can be decomposed into two XX models. In this article, we review and clarify this construction from the AdS/CFT perspective and investigate the implications this has for the {AdS_5× S^5} S-matrix.

  19. Towards Linking Anonymous Authorship in Casual Sexual Encounter Ads

    PubMed Central

    Fries, Jason A.; Segre, Alberto M.; Polgreen, Philip M.

    2013-01-01

    our existing near-duplicate detection system, and in the future identify features for more robust authorship attribution techniques. Methods From 7-1-2009 until 7-1-2011, RSS feeds were collected daily for 8 personal ad categories from 414 sites across the United States, for a total of 67 million ads. To create an anonymous, author-linked corpus, we used a regular expression to identify obfuscated phone numbers in ad text. We measure the ability of near-duplicate detection to link clusters in two ways: 1) detecting all ads in a cluster; and 2) correctly detecting a subset of ads within a single cluster. Ads incorrectly assigned to more than 1 cluster are considered false positives. All results are reported in terms of precision, recall, and F-scores (common information retrieval metrics) across cluster size, expressed as number of ads. Results 652,014 ads contained phone numbers, producing a total of 46,079 authorship-linked ad clusters. For detecting all ads within a cluster, precision ranged from 0.05 to 0.0 and recall from 0.02 to 0.0 for all cluster sizes. For detecting partial clusters, see Figure 1. Conclusions We find that near-duplicate detection alone is insufficient to detect all ads within a cluster. However, we do find that the process can, with high precision and low recall, detect a subset of ads associated with a single author. This follows the intuition that an author’s total set of ads is itself comprised of multiple self-similar subsets. While a near-duplicate detection approach can correctly identify subsets of ads linked to a single author, this process alone cannot attribute multiple clusters to a single author. Future work will explore leveraging additional linguistic features to improve author attribution. (Top) Evaluations for partial cluster detection using the near-duplicate identification approach to linking anonymous authorship in Craigslist ads and (bottom) the distribution of ad cluster sizes.

  20. A New Interpretation of Augmented Subscores and Their Added Value in Terms of Parallel Forms

    ERIC Educational Resources Information Center

    Sinharay, Sandip

    2018-01-01

    The value-added method of Haberman is arguably one of the most popular methods to evaluate the quality of subscores. The method is based on the classical test theory and deems a subscore to be of added value if the subscore predicts the corresponding true subscore better than does the total score. Sinharay provided an interpretation of the added…

  1. Methods for chemical recovery of non-carrier-added radioactive tin from irradiated intermetallic Ti-Sb targets

    DOEpatents

    Lapshina, Elena V [Troitsk, RU; Zhuikov, Boris L [Troitsk, RU; Srivastava, Suresh C [Setauket, NY; Ermolaev, Stanislav V [Obninsk, RU; Togaeva, Natalia R [Obninsk, RU

    2012-01-17

    The invention provides a method of chemical recovery of no-carrier-added radioactive tin (NCA radiotin) from intermetallide TiSb irradiated with accelerated charged particles. An irradiated sample of TiSb can be dissolved in acidic solutions. Antimony can be removed from the solution by extraction with dibutyl ether. Titanium in the form of peroxide can be separated from tin using chromatography on strong anion-exchange resin. In another embodiment NCA radiotin can be separated from iodide solution containing titanium by extraction with benzene, toluene or chloroform. NCA radiotin can be finally purified from the remaining antimony and other impurities using chromatography on silica gel. NCA tin-117m can be obtained from this process. NCA tin-117m can be used for labeling organic compounds and biological objects to be applied in medicine for imaging and therapy of various diseases.

  2. Validity of Particle-Counting Method Using Laser-Light Scattering for Detecting Platelet Aggregation in Diabetic Patients

    NASA Astrophysics Data System (ADS)

    Nakadate, Hiromichi; Sekizuka, Eiichi; Minamitani, Haruyuki

    We aimed to study the validity of a new analytical approach that reflected the phase from platelet activation to the formation of small platelet aggregates. We hoped that this new approach would enable us to use the particle-counting method with laser-light scattering to measure platelet aggregation in healthy controls and in diabetic patients without complications. We measured agonist-induced platelet aggregation for 10 min. Agonist was added to the platelet-rich plasma 1 min after measurement started. We compared the total scattered light intensity from small aggregates over a 10-min period (established analytical approach) and that over a 2-min period from 1 to 3 min after measurement started (new analytical approach). Consequently platelet aggregation in diabetics with HbA1c ≥ 6.5% was significantly greater than in healthy controls by both analytical approaches. However, platelet aggregation in diabetics with HbA1c < 6.5%, i.e. patients in the early stages of diabetes, was significantly greater than in healthy controls only by the new analytical approach, not by the established analytical approach. These results suggest that platelet aggregation as detected by the particle-counting method using laser-light scattering could be applied in clinical examinations by our new analytical approach.

  3. Thermodynamics and phase transition of charged AdS black holes with a global monopole

    NASA Astrophysics Data System (ADS)

    Deng, Gao-Ming; Fan, Jinbo; Li, Xinfei; Huang, Yong-Chang

    2018-01-01

    Thermodynamical properties of charged AdS black holes with a global monopole still remain obscure. In this paper, we investigate the thermodynamics and phase transition of the black holes in the extended phase space. It is shown that thermodynamical quantities of the black holes exhibit an interesting dependence on the internal global monopole, and they perfectly satisfy both the first law of thermodynamics and Smarr relation. Furthermore, analysis of the local and the global thermodynamical stability manifests that the charged AdS black hole undergoes an elegant phase transition at critical point. Of special interest, critical behaviors of the black holes resemble a Van der Waals liquid-gas system. Our results not only reveal the effect of a global monopole on thermodynamics of AdS black holes, but also further support that Van der Waals-like behavior of the black holes is a universal phenomenon.

  4. Accuracy of geographically targeted internet advertisements on Google AdWords for recruitment in a randomized trial.

    PubMed

    Jones, Ray B; Goldsmith, Lesley; Williams, Christopher J; Kamel Boulos, Maged N

    2012-06-20

    Google AdWords are increasingly used to recruit people into research studies and clinical services. They offer the potential to recruit from targeted control areas in cluster randomized controlled trials (RCTs), but little is known about the feasibility of accurately targeting ads by location and comparing with control areas. To examine the accuracy and contamination of control areas by a location-targeted online intervention using Google AdWords in a pilot cluster RCT. Based on previous use of online cognitive behavioral therapy for depression and population size, we purposively selected 16 of the 121 British postcode areas and randomized them to three intervention and one (do-nothing) control arms. Two intervention arms included use of location-targeted AdWords, and we compared these with the do-nothing control arm. We did not raise the visibility of our research website to normal Web searches. Users who clicked on the ad were directed to our project website, which collected the computer Internet protocol (IP) address, date, and time. Visitors were asked for their postcode area and to complete the Patient Health Questionnaire (depression). They were then offered links to several online depression resources. Google Analytics largely uses IP methods to estimate location, but AdWords uses additional information. We compared locations assessed by (1) Analytics, and (2) as self-identified by users. Ads were shown 300,523 times with 4207 click-throughs. There were few site visits except through AdWord click-throughs. Both methods of location assessment agreed there was little contamination of control areas. According to Analytics, 69.75% (2617/3752) of participants were in intervention areas, only 0% (8/3752) in control areas, but 30.04% (1127/3752) in other areas. However, according to user-stated postcodes, only 20.7% (463/2237) were in intervention areas, 1% (22/2236) in control areas, but 78.31% (1751/2236) in other areas. Both location assessments suggested most

  5. Food sources of sodium, saturated fat and added sugar in the Spanish hypertensive and diabetic population.

    PubMed

    Guallar-Castillón, Pilar; Muñoz-Pareja, Maritza; Aguilera, Ma Teresa; León-Muñoz, Luz María; Rodríguez-Artalejo, Fernando

    2013-07-01

    Previous research has shown that the diet of hypertensive and diabetic patients has a low accordance with the main nutritional recommendations, mostly due to the high intake of sodium, saturated fat and added sugars. This is the first study to identify the main food sources of these nutrients in these patients. Cross-sectional study conducted in 2008-2010 in a representative sample of the Spanish adult population, including 2323 patients with hypertension and 635 with diabetes. The habitual diet was assessed using a validated diet history. The intake of sodium, saturated fat and added sugars was estimated with Spanish food composition tables. The hypertensive and diabetic population showed, respectively, an intake of 2.9 and 3.1 g/day of sodium, 26 and 26 g/day of saturated fat, and 33 and 24 g/day of added sugar. In hypertensive and diabetic patients, respectively, most sodium intake came from bread (35%, 34%), raw-cured sausages (15%, 15%), cooked sausages (6%, 7%), and soup (5%, 6%). The main sources of saturated fat were cured cheese (13%, 13%), bakery products (12%, 11%), red meat (10%, 11%), raw-cured sausages (8%, 9%) and whole milk (4%, 4%). The food groups that most contributed to added sugar intake were sugar directly added to coffee and other beverages (27%, 19%), bakery products (15%, 19%), sugary soft drinks (10%, 13%), and whole yogurt (9%, 12%). The main food sources of nutrients were similar in all sex and age groups. In patients with hypertension and diabetes, the intake of sodium, saturated fat and added sugar can be substantially reduced by prioritizing low-salt varieties of bread, reducing the consumption of bakery products and sausages, replacing cured cheese and other whole dairy products by low-fat products, using non-sugary sweeteners, and substituting sugar-free soft drinks, or plain water, for sugary sodas. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Seed-competent HMW tau species accumulates in the cerebrospinal fluid of Alzheimer's disease mouse model and human patients

    PubMed Central

    Takeda, Shuko; Commins, Caitlin; DeVos, Sarah L.; Nobuhara, Chloe K.; Wegmann, Susanne; Roe, Allyson D.; Costantino, Isabel; Fan, Zhanyun; Nicholls, Samantha B.; Sherman, Alexis E.; Trisini Lipsanopoulos, Ana T.; Scherzer, Clemens R.; Carlson, George A.; Pitstick, Rose; Peskind, Elaine R.; Raskind, Murray A.; Li, Ge; Montine, Thomas J.; Frosch, Matthew P.; Hyman, Bradley T.

    2016-01-01

    Objective Cerebrospinal fluid (CSF) tau is an excellent surrogate marker for assessing neuropathological changes that occur in Alzheimer's disease (AD) patients. However, whether the elevated tau in AD CSF is just a marker of neurodegeneration or in fact a part of the disease process is uncertain. Moreover, it is unknown how CSF tau relates to the recently described soluble high-molecular-weight (HMW) species that is found in postmortem AD brain and can be taken up by neurons and seed aggregates. Methods We have examined seeding and uptake properties of brain extracellular tau from various sources including: interstitial fluid (ISF) and CSF from an AD transgenic mouse model, and postmortem ventricular and antemortem lumbar CSF from AD patients. Results We found that brain ISF and CSF tau from the AD mouse model can be taken up by cells and induce intracellular aggregates. Ventricular CSF from AD patients contained a rare HMW tau species that exerted a higher seeding activity. Notably, the HMW tau species was also detected in lumbar CSF from AD patients and its levels were significantly elevated compared with control subjects. HMW tau derived from CSF of AD patients was seed-competent in vitro. Interpretation These findings suggest that CSF from an AD brain contains potentially bioactive HMW tau species giving new insights into the role of CSF tau and biomarker development for AD. PMID:27351289

  7. Supergravity backgrounds for deformations of AdS n × S n supercoset string models

    DOE PAGES

    Lunin, O.; Roiban, R.; Tseytlin, A. A.

    2014-12-11

    We considermore » type IIB supergravity backgrounds corresponding to the deformed AdS n × S n × T 10 - 2 n supercoset string models of the type constructed in arXiv:1309.5850[2] which depend on one deformation parameter κ. In AdS 2 × S 2 case we find that the deformed metric can be extended to a full supergravity solution with non-trivial dilaton, RR scalar and RR 5-form strength. The solution depends on a free parameter a that should be chosen as a particular function of κ to correspond to the deformed supercoset model. In AdS 3 × S 3 case the full solution supported by the dilaton, RR scalar and RR 3-form strength exists only in the two special cases, a = 0 and a = 1 . We conjecture that there may be a more general one-parameter solution supported by several RR fields that for particular a = a ( κ ) corresponds to the supercoset model. In the most complicated deformed AdS 5 × S 5 case we were able to find only the expressions for the dilaton and the RR scalar. The full solution is likely to be supported by a combination of the 5-form and 3-form field strengths. We comment on the singularity structure of the resulting metric and exact dilaton field.« less

  8. Supergravity backgrounds for deformations of AdS n × S n supercoset string models

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lunin, O.; Roiban, R.; Tseytlin, A. A.

    We considermore » type IIB supergravity backgrounds corresponding to the deformed AdS n × S n × T 10 - 2 n supercoset string models of the type constructed in arXiv:1309.5850[2] which depend on one deformation parameter κ. In AdS 2 × S 2 case we find that the deformed metric can be extended to a full supergravity solution with non-trivial dilaton, RR scalar and RR 5-form strength. The solution depends on a free parameter a that should be chosen as a particular function of κ to correspond to the deformed supercoset model. In AdS 3 × S 3 case the full solution supported by the dilaton, RR scalar and RR 3-form strength exists only in the two special cases, a = 0 and a = 1 . We conjecture that there may be a more general one-parameter solution supported by several RR fields that for particular a = a ( κ ) corresponds to the supercoset model. In the most complicated deformed AdS 5 × S 5 case we were able to find only the expressions for the dilaton and the RR scalar. The full solution is likely to be supported by a combination of the 5-form and 3-form field strengths. We comment on the singularity structure of the resulting metric and exact dilaton field.« less

  9. Construction and comparative evaluation of different activity detection methods in brain FDG-PET.

    PubMed

    Buchholz, Hans-Georg; Wenzel, Fabian; Gartenschläger, Martin; Thiele, Frank; Young, Stewart; Reuss, Stefan; Schreckenberger, Mathias

    2015-08-18

    We constructed and evaluated reference brain FDG-PET databases for usage by three software programs (Computer-aided diagnosis for dementia (CAD4D), Statistical Parametric Mapping (SPM) and NEUROSTAT), which allow a user-independent detection of dementia-related hypometabolism in patients' brain FDG-PET. Thirty-seven healthy volunteers were scanned in order to construct brain FDG reference databases, which reflect the normal, age-dependent glucose consumption in human brain, using either software. Databases were compared to each other to assess the impact of different stereotactic normalization algorithms used by either software package. In addition, performance of the new reference databases in the detection of altered glucose consumption in the brains of patients was evaluated by calculating statistical maps of regional hypometabolism in FDG-PET of 20 patients with confirmed Alzheimer's dementia (AD) and of 10 non-AD patients. Extent (hypometabolic volume referred to as cluster size) and magnitude (peak z-score) of detected hypometabolism was statistically analyzed. Differences between the reference databases built by CAD4D, SPM or NEUROSTAT were observed. Due to the different normalization methods, altered spatial FDG patterns were found. When analyzing patient data with the reference databases created using CAD4D, SPM or NEUROSTAT, similar characteristic clusters of hypometabolism in the same brain regions were found in the AD group with either software. However, larger z-scores were observed with CAD4D and NEUROSTAT than those reported by SPM. Better concordance with CAD4D and NEUROSTAT was achieved using the spatially normalized images of SPM and an independent z-score calculation. The three software packages identified the peak z-scores in the same brain region in 11 of 20 AD cases, and there was concordance between CAD4D and SPM in 16 AD subjects. The clinical evaluation of brain FDG-PET of 20 AD patients with either CAD4D-, SPM- or NEUROSTAT

  10. The generalization of charged AdS black hole specific volume and number density

    NASA Astrophysics Data System (ADS)

    Wang, Zi-Liang; He, Miao; Fang, Chao; Sun, Dao-Quan; Deng, Jian-Bo

    2017-04-01

    In this paper, by proposing a generalized specific volume, we restudy the P- V criticality of charged AdS black holes in the extended phase space. The results show that most of the previous conclusions can be generalized without change, but the ratio {\\tilde{ρ }}_c should be 3 {\\tilde{α }}/16 in general case. Further research on the thermodynamical phase transition of black hole leads us to a natural interpretation of our assumption, and more black hole properties can be generalized. Finally, we study the number density for charged AdS black hole in higher dimensions, the results show the necessity of our assumption.

  11. An evaluation of patients' experienced usability of a diabetes mHealth system using a multi-method approach.

    PubMed

    Georgsson, Mattias; Staggers, Nancy

    2016-02-01

    mHealth systems are becoming more common to aid patients in their diabetes self-management, but recent studies indicate a need for thorough evaluation of patients' experienced usability. Current evaluations lack a multi-method design for data collection and structured methods for data analyses. The purpose of this study was to provide a feasibility test of a multi-method approach for both data collection and data analyses for patients' experienced usability of a mHealth system for diabetes type 2 self-management. A random sample of 10 users was selected from a larger clinical trial. Data collection methods included user testing with eight representative tasks and Think Aloud protocol, a semi-structured interview and a questionnaire on patients' experiences using the system. The Framework Analysis (FA) method and Usability Problem Taxonomy (UPT) were used to structure, code and analyze the results. A usability severity rating was assigned after classification. The combined methods resulted in a total of 117 problems condensed into 19 usability issues with an average severity rating of 2.47 or serious. The usability test detected 50% of the initial usability problems, followed by the post-interview at 29%. The usability test found 18 of 19 consolidated usability problems while the questionnaire uncovered one unique issue. Patients experienced most usability problems (8) in the Glucose Readings View when performing complex tasks such as adding, deleting, and exporting glucose measurements. The severity ratings were the highest for the Glucose Diary View, Glucose Readings View, and Blood Pressure View with an average severity rating of 3 (serious). Most of the issues were classified under the artifact component of the UPT and primary categories of Visualness (7) and Manipulation (6). In the UPT task component, most issues were in the primary category Task-mapping (12). Multiple data collection methods yielded a more comprehensive set of usability issues. Usability

  12. [Malassezia species in patients with seborrheic dermatitis and atopic dermatitis].

    PubMed

    Tajima, Mami

    2005-01-01

    Malassezia species, organisms normally colonizing the skin surface, are thought to play a role as either the cause or an exacerbating factor in a number of skin conditions, including pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis (SD) and atopic dermatitis (AD). Using a non-cultural PCR method, we analyzed Malassezia spp. extracted from the skin surface of SD and AD patients. The species most commonly detected in both patient groups were M. globosa and M. restricta, and the number of Malassezia spp. In these patients was higher than in healthy subjects. After a topical application of 2% ketoconazole cream, changes in the population of Malassezia spp. in 20 intractable cases of AD were recorded. The addition of the 2% ketoconazole cream to the standard topical treatments was found to have reduced the Malassezia spp. population by 90%, and showed a clinical efficacy rate of 70%. Furthermore, a combination of azole agents and tacrolimus produced a synergistic anti-fungal effect against Malassezia spp. in vitro. A clinical trial using this drug combination conducted on the face and neck of patients with intractable AD showed a 66.6% efficacy rate in both the reduction of the flora and in clinical improvement. From these results it was evident that Malassezia is one of the factors exacerbating AD, and that removal of the organism results in an improvement in the clinical condition of the patient.

  13. Assessment of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Atopic Dermatitis Patients

    PubMed Central

    Jiang, Ying; Ma, Wencong

    2017-01-01

    Background To develop new strategies for identifying atopic dermatitis patients, a better understanding of the signs for chronic inflammatory status is needed. This study was designed to investigate whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are related to the severity of atopic dermatitis (AD) assessed by the Scoring Atopic Dermatitis (SCORAD) index. Material/Methods A retrospective study involving 80 AD patients and 45 healthy control subjects was performed. NLR, PLR, and the number of peripheral blood eosinophils were compared between AD patients and healthy controls, and correlations between these indexes and clinical characteristics were analyzed. Results NLR, PLR, and eosinophils in AD patients were all significantly higher than in healthy individuals. Among AD patients, NLR (p<0.001) and PLR (p<0.001), as contrasted with eosinophils (p=0.146), were correlated positively with SCORAD index. Additionally, an NLR level of 1.75 was determined as the predictive cut-off value of severe AD (SCORAD ≥51) (sensitivity 94.7%, specificity 58.6%, the area under the receiver-operating characteristic curve (AUROC) 0.778, p=0.001). For eosinophils, the sensitivity and specificity were 78.9% and 62.1%, respectively, and the AUROC was only 0.685 (p=0.032) in predicting high SCORAD. Conclusions NLR and PLR reflect inflammatory response and disease severity in AD patients. PMID:28306706

  14. Stability of Teacher Value-Added Rankings across Measurement Model and Scaling Conditions

    ERIC Educational Resources Information Center

    Hawley, Leslie R.; Bovaird, James A.; Wu, ChaoRong

    2017-01-01

    Value-added assessment methods have been criticized by researchers and policy makers for a number of reasons. One issue includes the sensitivity of model results across different outcome measures. This study examined the utility of incorporating multivariate latent variable approaches within a traditional value-added framework. We evaluated the…

  15. The role of Ad-36 as a risk factor in males with gynecomastia.

    PubMed

    Kocazeybek, Bekir; Saribas, Suat; Ergin, Sevgi

    2015-12-01

    Gynecomastia is highly prevalent worldwide and Adenovirus-36 (Ad-36), recently implicated in increased adipose tissue deposition due to its affinity for adipose tissue, is a potential etiological agent in the development of obesity and therefore we hypothesized that Ad-36 may also play a role in the development of gynecomastia by possibly accompanying increased regional adiposity. To support our hypothesis, we conducted a study that included 33 adult males with gynecomastia (PG) and 15 adult males as the patient control group (HCG). Leptin and adiponectin levels were monitored using ELISA. A significant difference in Ad-36 antibody positivity was found between the groups (p<0.05). Average leptin levels were found to be higher, but average adiponectin levels were found to be lower in Ad-36 Ab(+) patient group. No Ad-36 DNA was detected in any tissue samples. In conclusion, we hypothesize that low-grade chronic inflammation, which was caused by Ad-36 infection, possibly caused an increase in circulating leptin. This in turn may have caused an increase in local or circulating estrogens and/or the estrogen/androgen ratio by stimulating the aromatase enzyme activity in adipose stromal cells and breast tissues. We suggest that gynecomastia may develop following an increase in aromatase enzyme activity, by which more oestrogen is produced and the estrogen-androgen balance disrupted. Also, regional adipose tissue enlargements may cause the excessive production of estrogens leading to gynecomastia. Adipose tissue has been recognized as a major endocrine organ in recent years. Another plausible explanation is excessive aromatization of androgens to estrogens by peripheral adipose tissue may promote gynecomastia in males. Moreover, our results suggest that there might be a relationship between Ad-36 and gynecomastia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Qualitative Methods in Patient-Centered Outcomes Research.

    PubMed

    Vandermause, Roxanne; Barg, Frances K; Esmail, Laura; Edmundson, Lauren; Girard, Samantha; Perfetti, A Ross

    2017-02-01

    The Patient-Centered Outcomes Research Institute (PCORI), created to fund research guided by patients, caregivers, and the broader health care community, offers a new research venue. Many (41 of 50) first funded projects involved qualitative research methods. This study was completed to examine the current state of the science of qualitative methodologies used in PCORI-funded research. Principal investigators participated in phenomenological interviews to learn (a) how do researchers using qualitative methods experience seeking funding for, implementing and disseminating their work; and (b) how may qualitative methods advance the quality and relevance of evidence for patients? Results showed the experience of doing qualitative research in the current research climate as "Being a bona fide qualitative researcher: Staying true to research aims while negotiating challenges," with overlapping patterns: (a) researching the elemental, (b) expecting surprise, and (c) pushing boundaries. The nature of qualitative work today was explicitly described and is rendered in this article.

  17. Evaluation of Metabolic and Synaptic Dysfunction Hypotheses of Alzheimer’s Disease (AD): A Meta-Analysis of CSF Markers

    PubMed Central

    Manyevitch, Roni; Protas, Matthew; Scarpiello, Sean; Deliso, Marisa; Bass, Brittany; Nanajian, Anthony; Chang, Matthew; Thompson, Stefani M.; Khoury, Neil; Gonnella, Rachel; Trotz, Margit; Moore, D. Blaine; Harms, Emily; Perry, George; Clunes, Lucy; Ortiz, Angélica; Friedrich, Jan O.; Murray, Ian V.J.

    2018-01-01

    Background: Alzheimer’s disease (AD) is currently incurable and a majority of investigational drugs have failed clinical trials. One explanation for this failure may be the invalidity of hypotheses focus-ing on amyloid to explain AD pathogenesis. Recently, hypotheses which are centered on synaptic and met-abolic dysfunction are increasingly implicated in AD. Objective: Evaluate AD hypotheses by comparing neurotransmitter and metabolite marker concentrations in normal versus AD CSF. Methods: Meta-analysis allows for statistical comparison of pooled, existing cerebrospinal fluid (CSF) marker data extracted from multiple publications, to obtain a more reliable estimate of concentrations. This method also provides a unique opportunity to rapidly validate AD hypotheses using the resulting CSF con-centration data. Hubmed, Pubmed and Google Scholar were comprehensively searched for published Eng-lish articles, without date restrictions, for the keywords “AD”, “CSF”, and “human” plus markers selected for synaptic and metabolic pathways. Synaptic markers were acetylcholine, gamma-aminobutyric acid (GABA), glutamine, and glycine. Metabolic markers were glutathione, glucose, lactate, pyruvate, and 8 other amino acids. Only studies that measured markers in AD and controls (Ctl), provided means, standard er-rors/deviation, and subject numbers were included. Data were extracted by six authors and reviewed by two others for accuracy. Data were pooled using ratio of means (RoM of AD/Ctl) and random effects meta-analysis using Cochrane Collaboration’s Review Manager software. Results: Of the 435 identified publications, after exclusion and removal of duplicates, 35 articles were in-cluded comprising a total of 605 AD patients and 585 controls. The following markers of synaptic and met-abolic pathways were significantly changed in AD/controls: acetylcholine (RoM 0.36, 95% CI 0.24-0.53, p<0.00001), GABA (0.74, 0.58-0.94, p<0.01), pyruvate (0.48, 0.24-0.94, p=0

  18. Bone Marrow Stem Cells Added to a Hydroxyapatite Scaffold Result in Better Outcomes after Surgical Treatment of Intertrochanteric Hip Fractures

    PubMed Central

    Gutierres, Manuel; Lopes, M. Ascenção; Santos, J. Domingos; Cabral, A. T.; Pinto, R.

    2014-01-01

    Introduction. Intertrochanteric hip fractures occur in the proximal femur. They are very common in the elderly and are responsible for high rates of morbidity and mortality. The authors hypothesized that adding an autologous bone marrow stem cells concentrate (ABMC) to a hydroxyapatite scaffold and placing it in the fracture site would improve the outcome after surgical fixation of intertrochanteric hip fractures. Material and Methods. 30 patients were randomly selected and divided into 2 groups of 15 patients, to receive either the scaffold enriched with the ABMC (Group A) during the surgical procedure, or fracture fixation alone (Group B). Results. There was a statistically significant difference in favor of group A at days 30, 60, and 90 for Harris Hip Scores (HHS), at days 30 and 60 for VAS pain scales, for bedridden period and time taken to start partial and total weight bearing (P < 0.05). Discussion. These results show a significant benefit of adding a bone marrow enriched scaffold to surgical fixation in intertrochanteric hip fractures, which can significantly reduce the associated morbidity and mortality rates. Conclusion. Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures. PMID:24955356

  19. Adding Users to the Website Design Process

    ERIC Educational Resources Information Center

    Tomeo, Megan L.

    2012-01-01

    Alden Library began redesigning its website over a year ago. Throughout the redesign process the students, faculty, and staff that make up the user base were added to the conversation by utilizing several usability test methods. This article focuses on the usability testing conducted at Alden Library and delves into future usability testing, which…

  20. Influence of Preoperative Peripheral Parenteral Nutrition with Micronutrients after Colorectal Cancer Patients

    PubMed Central

    Tang, Hsiu-Chih; Hu, Shu-Hui; Yang, Hui-Lan

    2015-01-01

    Background. The inflammatory reactions are stronger after surgery of malnourished preoperative patients. Many studies have shown vitamin and trace element deficiencies appear to affect the functioning of immune cells. Enteral nutrition is often inadequate for malnourished patients. Therefore, total parenteral nutrition (TPN) is considered an effective method for providing preoperative nutritional support. TPN needs a central vein catheter, and there are more risks associated with TPN. However, peripheral parenteral nutrition (PPN) often does not provide enough energy or nutrients. Purpose. This study investigated the inflammatory response and prognosis for patients receiving a modified form of PPN with added fat emulsion infusion, multiple vitamins (MTV), and trace elements (TE) to assess the feasibility of preoperative nutritional support. Methods. A cross-sectional design was used to compare the influence of PPN with or without adding MTV and TE on malnourished abdominal surgery patients. Results. Both preoperative groups received equal calories and protein, but due to the lack of micronutrients, patients in preoperative Group B exhibited higher inflammation, lower serum albumin levels, and higher anastomotic leak rates and also required prolonged hospital stays. Conclusion. Malnourished patients who receive micronutrient supplementation preoperatively have lower postoperative inflammatory responses and better prognoses. PPN with added fat emulsion, MTV, and TE provides valid and effective preoperative nutritional support. PMID:26000296

  1. Influence of preoperative peripheral parenteral nutrition with micronutrients after colorectal cancer patients.

    PubMed

    Liu, Ming-Yi; Tang, Hsiu-Chih; Hu, Shu-Hui; Yang, Hui-Lan; Chang, Sue-Joan

    2015-01-01

    The inflammatory reactions are stronger after surgery of malnourished preoperative patients. Many studies have shown vitamin and trace element deficiencies appear to affect the functioning of immune cells. Enteral nutrition is often inadequate for malnourished patients. Therefore, total parenteral nutrition (TPN) is considered an effective method for providing preoperative nutritional support. TPN needs a central vein catheter, and there are more risks associated with TPN. However, peripheral parenteral nutrition (PPN) often does not provide enough energy or nutrients. This study investigated the inflammatory response and prognosis for patients receiving a modified form of PPN with added fat emulsion infusion, multiple vitamins (MTV), and trace elements (TE) to assess the feasibility of preoperative nutritional support. Methods. A cross-sectional design was used to compare the influence of PPN with or without adding MTV and TE on malnourished abdominal surgery patients. Both preoperative groups received equal calories and protein, but due to the lack of micronutrients, patients in preoperative Group B exhibited higher inflammation, lower serum albumin levels, and higher anastomotic leak rates and also required prolonged hospital stays. Malnourished patients who receive micronutrient supplementation preoperatively have lower postoperative inflammatory responses and better prognoses. PPN with added fat emulsion, MTV, and TE provides valid and effective preoperative nutritional support.

  2. Does adding low doses of oral naltrexone to morphine alter the subsequent opioid requirements and side effects in trauma patients?

    PubMed

    Farahmand, Shervin; Ahmadi, Omid; Dehpour, Ahmadreza; Khashayar, Patricia

    2012-01-01

    The present study aims to assess the influence of ultra-low doses of opioid antagonists on the analgesic properties of opioids and their side effects. In the present randomized, double-blind controlled trial, the influence of the combination of ultra-low-dose naltrexone and morphine on the total opioid requirement and the frequency of the subsequent side effects was compared with that of morphine alone (added with placebo) in patients with trauma in the upper or lower extremities. Although the morphine and naltrexone group required 0.04 mg more opioids during the study period, there was no significant difference between the opioid requirements of the 2 groups. Nausea was less frequently reported in patients receiving morphine and naltrexone. The combination of ultra-low-dose naltrexone and morphine in extremity trauma does not affect the opioid requirements; it, however, lowers the risk of nausea. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. A Content Analysis of Unique Selling Propositions of Tobacco Print Ads

    PubMed Central

    Shen, Megan Johnson; Banerjee, Smita C.; Greene, Kathryn; Carpenter, Amanda; Ostroff, Jamie S.

    2017-01-01

    Objectives The present study described the unique selling propositions (USPs) (propositions used to convince customers to use a particular brand/product by focusing on the unique benefit) of print tobacco ads. Methods A qualitative content analysis was conducted of print tobacco ads (N = 171) selected from August 2012-August 2013 for cigarettes, moist snuff, e-cigarettes, cigars, and snus to determine the content and themes of USPs for tobacco ads. Results Cigarette ad USP themes focused on portraying the product as attractive; moist snuff ads focused on portraying product as masculine; cigar ads focused on selling a “high end product;” and new and emerging tobacco products (e-cigarette, snus) focused on directly comparing these products to cigarettes. Conclusions Whereas traditional tobacco product ads used USPs focused on themes of enjoyment and pleasure (eg, attractive for cigarettes, “high end product” for cigars), new and emerging tobacco product ads offered the unique benefit (USP) of their product being a better and “safer” alternative to traditional tobacco products. Snuff’s USPs focused nearly exclusively on the masculinity of their products. Results of this study provide targets for potential tobacco regulatory actions that could be implemented to reduce demand for tobacco products by reducing their perceived unique benefits. PMID:28452697

  4. Cost-effectiveness of dapagliflozin (Forxiga®) added to metformin compared with sulfonylurea added to metformin in type 2 diabetes in the Nordic countries.

    PubMed

    Sabale, Ugne; Ekman, Mattias; Granström, Ola; Bergenheim, Klas; McEwan, Phil

    2015-02-01

    The aim of this study was to assess the long-term cost-effectiveness of dapagliflozin (Forxiga(®)) added to metformin, compared with sulfonylurea (SU) added to metformin, in Nordic Type 2 diabetes mellitus (T2DM) patients inadequately controlled on metformin. Data from a 52-week clinical trial comparing dapagliflozin and SU in combination with metformin was used in a Cardiff simulation model to estimate long term diabetes-related complications in a cohort of T2DM patients. Costs and QALYs were calculated from a healthcare provider perspective and estimated over a patient's lifetime. Compared with metformin+SU, the cost per QALY gained with dapagliflozin+metformin was €7944 in Denmark, €5424 in Finland, €4769 in Norway, and €6093 in Sweden. Metformin+dapagliflozin was associated with QALY gains ranging from 0.236 in Norway to 0.278 in Sweden and incremental cost ranging from €1125 in Norway to €1962 in Denmark. Results were robust across both one-way and probabilistic sensitivity analyses. Results were driven by weight changes associated with each treatment. Results indicate that metformin+dapagliflozin is associated with gains in QALY compared with metformin+SU in Nordic T2DM patients inadequately controlled on metformin. Dapagliflozin treatment is a cost-effective treatment alternative for Type 2 diabetes in all four Nordic countries. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  5. TU-EF-204-08: Dose Efficiency of Added Beam-Shaping Filter with Varied Attenuation Levels in Lung-Cancer Screening CT

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ma, C; Yu, L; Vrieze, T

    Purpose: Added filtration such as tin filter has the potential to improve dose efficiency of x-ray beam in lung-cancer screening CT. However, dose efficiency with added beam filtration is highly dependent on patient attenuation level. In this phantom study, we evaluated the image quality at different tube voltages with and without added tin filter when attenuation level varies. Methods: A 30 x 20 cm anthropomorphic thorax phantom with three added extension rings were used to simulate small (S), medium (M), large (L), and extra-large (XL) adult patients. These phantoms were scanned on a 192-slice CT scanner (Force, Siemens) at 100more » and 120kV without tin filtration, and 100 and 150 kV with tin filtration (100Sn and 150Sn), at multiple dose levels at each kV. Images were reconstructed using iterative reconstruction (ADMIRE, Siemens). Radiation dose was measured with a 0.6 cc ion chamber in the middle and peripheral areas of the phantom. Image quality was assessed using mean image noise at uniform areas in the central region and lung. Radiation dose that is required for each kV to match the noise in a routine lung-cancer CT screening technique (120kV, 25 quality reference mAs) was calculated. Results: At each of the four phantom sizes, 100Sn had the lowest noise in both soft tissue and lung. Compared with 120 kV, 100Sn saved 39%–60% dose for the same noise, depending on phantom size. For the XL phantom (50 by 40 cm), 150Sn provided images with the least beam-hardening artifact in peripheral region. Conclusion: For thoracic CT, added tin filtration can provide considerable dose reduction compared with 120 kV. 100Sn provides better dose efficiencies for all phantom sizes, while 150Sn provides better image quality in peripheral region for extra-large patients. Drs.Joel G. Fletcher and Cynthia H. McCollough receive research support from Siemens Healthcare.« less

  6. Effect of added weight on landing kinematics in jumping horses.

    PubMed

    Clayton, H M

    1997-05-01

    Six event horses jumped a 1.10 m high table fence 4 times under each of 2 conditions; the rider weight condition involved carrying the weight of the rider and saddle (61 kg), whereas the added weight condition included an additional 18 kg weight cloth. Sagittal view, 60 Hz video recordings were analysed using standard methods. Comparisons between the rider weight and added weight conditions using paired t tests (P<0.05) showed a number of significant differences. In the added weight condition the leading forelimb landed closer to the fence, and there were increases in the maximal extension of the fetlock and carpal joints in this limb during the landing phase. In the first departure stride, the stance durations of both hindlimbs increased, and the advanced placement between them was reduced for the added weight condition. The head was significantly further ahead of the vertical in the added weight condition at the instants of ground contact of the TrH, LdH and TrF in the first departure stride.

  7. Effect of patient selection method on provider group performance estimates.

    PubMed

    Thorpe, Carolyn T; Flood, Grace E; Kraft, Sally A; Everett, Christine M; Smith, Maureen A

    2011-08-01

    Performance measurement at the provider group level is increasingly advocated, but different methods for selecting patients when calculating provider group performance have received little evaluation. We compared 2 currently used methods according to characteristics of the patients selected and impact on performance estimates. We analyzed Medicare claims data for fee-for-service beneficiaries with diabetes ever seen at an academic multispeciality physician group in 2003 to 2004. We examined sample size, sociodemographics, clinical characteristics, and receipt of recommended diabetes monitoring in 2004 for the groups of patients selected using 2 methods implemented in large-scale performance initiatives: the Plurality Provider Algorithm and the Diabetes Care Home method. We examined differences among discordantly assigned patients to determine evidence for differential selection regarding these measures. Fewer patients were selected under the Diabetes Care Home method (n=3558) than the Plurality Provider Algorithm (n=4859). Compared with the Plurality Provider Algorithm, the Diabetes Care Home method preferentially selected patients who were female, not entitled because of disability, older, more likely to have hypertension, and less likely to have kidney disease and peripheral vascular disease, and had lower levels of predicted utilization. Diabetes performance was higher under Diabetes Care Home method, with 67% versus 58% receiving >1 A1c tests, 70% versus 65% receiving ≥1 low-density lipoprotein (LDL) test, and 38% versus 37% receiving an eye examination. The method used to select patients when calculating provider group performance may affect patient case mix and estimated performance levels, and warrants careful consideration when comparing performance estimates.

  8. Adding moxifloxacin is associated with a shorter time to culture conversion in pulmonary tuberculosis.

    PubMed

    Wang, J-Y; Wang, J-T; Tsai, T-H; Hsu, C-L; Yu, C-J; Hsueh, P-R; Lee, L-N; Yang, P-C

    2010-01-01

    To investigate whether adding moxifloxacin (MXF) to the standard anti-tuberculosis regimen can shorten the time to sputum culture conversion in pulmonary tuberculosis (PTB). Adults with culture-positive PTB were divided into two treatment groups by their choice: standard regimen alone (HERZ group) and standard regimen plus daily 400 mg MXF in the first 2 months (MXF group). Sputum samples were collected thrice weekly in the first 8 weeks. The propensity score was calculated to estimate the conditional probability of entering the MXF group. Factors influencing time to culture conversion were investigated using Cox proportional hazards regression analysis stratified by propensity score. Sixty-two patients were enrolled in the MXF group and 88 in the HERZ group; respectively 51 and 72 completed the study. The regimen was modified before culture conversion in respectively 6 (12%) and 12 (16%; P = 0.47) patients, due to adverse effects. The time to culture conversion was shorter in the MXF group (HR 2.1, 95%CI 1.4-3.2). The culture conversion rate after 6 weeks of treatment was respectively 82% and 61% (P = 0.011, <0.05/4, calculated using the modified Bonferroni method). Adding MXF to the standard anti-tuberculosis regimen in the first 2 months was associated with a shorter time to culture conversion, a higher 6-week culture conversion rate and reduced transmission of tuberculosis.

  9. Can Value Added Add Value to Teacher Evaluation?

    ERIC Educational Resources Information Center

    Darling-Hammond, Linda

    2015-01-01

    The five thoughtful papers included in this issue of "Educational Researcher" ("ER") raise new questions about the use of value-added methods (VAMs) to estimate teachers' contributions to students' learning as part of personnel evaluation. The papers address both technical and implementation concerns, considering potential…

  10. Complexity of the AdS soliton

    NASA Astrophysics Data System (ADS)

    Reynolds, Alan P.; Ross, Simon F.

    2018-05-01

    We consider the holographic complexity conjectures in the context of the AdS soliton, which is the holographic dual of the ground state of a field theory on a torus with antiperiodic boundary conditions for fermions on one cycle. The complexity is a non-trivial function of the size of the circle with antiperiodic boundary conditions, which sets an IR scale in the dual geometry. We find qualitative differences between the calculations of complexity from spatial volume and action (CV and CA). In the CV calculation, the complexity for antiperiodic boundary conditions is smaller than for periodic, and decreases monotonically with increasing IR scale. In the CA calculation, the complexity for antiperiodic boundary conditions is larger than for periodic, and initially increases with increasing IR scale, eventually decreasing to zero as the IR scale becomes of order the UV cutoff. We compare these results to a simple calculation for free fermions on a lattice, where we find the complexity for antiperiodic boundary conditions is larger than for periodic.

  11. Independent effects of adding weight and inertia on balance during quiet standing

    PubMed Central

    2012-01-01

    Background Human balance during quiet standing is influenced by adding mass to the body with a backpack, with symmetrically-applied loads to the trunk, or with obesity. Adding mass to the body increases both the weight and inertia of the body, which theoretically could provide counteracting effects on body dynamics and balance. Understanding the independent effects of adding weight and inertia on balance may provide additional insight into human balance that could lead to novel advancements in balance training and rehabilitation. Therefore, the purpose of this study was to investigate the independent effects of adding weight and inertia on balance during quiet standing. Methods Sixteen normal-weight young adult participants stood as still as possible on a custom-built backboard apparatus under four experimental conditions: baseline, added inertia only, added weight only, and added inertia and weight. Results Adding inertia by itself had no measurable effect on center of pressure movement or backboard movement. Adding weight by itself increased center of pressure movement (indicated greater effort by the postural control system to stand as still as possible) and backboard movement (indicating a poorer ability of the body to stand as still as possible). Adding inertia and weight at the same time increased center of pressure movement but did not increase backboard movement compared to the baseline condition. Conclusions Adding inertia and adding weight had different effects on balance. Adding inertia by itself had no effect on balance. Adding weight by itself had a negative effect on balance. When adding inertia and weight at the same time, the added inertia appeared to lessen (but did not eliminate) the negative effect of adding weight on balance. These results improve our fundamental understanding of how added mass influences human balance. PMID:22507125

  12. No-carrier-added [1.sup.11 c]putrescine

    DOEpatents

    McPherson, Daniel W.; Fowler, Joanna S.; Wolf, Alfred P.

    1989-01-01

    The invention relates to a new radiolabeled imaging agent, no-carrier-added [1-.sup.11 C]putrescine, and to the use of this very pure material as a radiotracer with positron emission tomography for imaging brain tumors. The invention further relates to the synthesis of no-carrier-added [1-.sup.11 C]putrescine based on the Michael addition of potassium .sup.11 C-labeled cyanide to acrylonitrile followed by reduction of the .sup.11 C-labeled dinitrile. The new method is rapid and efficient and provides radiotracer with a specific activity greater than 1.4 curies per millimol and in a purity greater than 95%.

  13. Correlation between hippocampal volumes and medial temporal lobe atrophy in patients with Alzheimer's disease

    PubMed Central

    Dhikav, Vikas; Duraiswamy, Sharmila; Anand, Kuljeet Singh

    2017-01-01

    Introduction: Hippocampus undergoes atrophy in patients with Alzheimer's disease (AD). Calculation of hippocampal volumes can be done by a variety of methods using T1-weighted images of magnetic resonance imaging (MRI) of the brain. Medial temporal lobes atrophy (MTL) can be rated visually using T1-weighted MRI brain images. The present study was done to see if any correlation existed between hippocampal volumes and visual rating scores of the MTL using Scheltens Visual Rating Method. Materials and Methods: We screened 84 subjects presented to the Department of Neurology of a Tertiary Care Hospital and enrolled forty subjects meeting the National Institute of Neurological and Communicative Disorders and Stroke, AD related Disease Association criteria. Selected patients underwent MRI brain and T1-weighted images in a plane perpendicular to long axis of hippocampus were obtained. Hippocampal volumes were calculated manually using a standard protocol. The calculated hippocampal volumes were correlated with Scheltens Visual Rating Method for Rating MTL. A total of 32 cognitively normal age-matched subjects were selected to see the same correlation in the healthy subjects as well. Sensitivity and specificity of both methods was calculated and compared. Results: There was an insignificant correlation between the hippocampal volumes and MTL rating scores in cognitively normal elderly (n = 32; Pearson Correlation coefficient = 0.16, P > 0.05). In the AD Group, there was a moderately strong correlation between measured hippocampal volumes and MTL Rating (Pearson's correlation coefficient = −0.54; P < 0.05. There was a moderately strong correlation between hippocampal volume and Mini-Mental Status Examination in the AD group. Manual delineation was superior compared to the visual method (P < 0.05). Conclusions: Good correlation was present between manual hippocampal volume measurements and MTL scores. Sensitivity and specificity of manual measurement of hippocampus was

  14. Adding Expansile Duraplasty to Posterior Fossa Decompression May Restore Cervical Range of Motion in Grade 3 Chiari Malformation Type 1 Patients.

    PubMed

    Yilmaz, Adem; Urgun, Kamran; Aoun, Salah G; Colak, Ibrahim; Yilmaz, Ilhan; Altas, Kadir; Musluman, Murat

    2017-02-01

    Few studies have assessed the effect of Chiari malformation type 1 (CM-1) surgical decompression on cervical lordosis and range of motion (ROM). We aimed to assess the effect of expansile duraplasty on postoperative cervical mobility and spinal stability. This was a single-center retrospective review of prospectively collected data. Patients were included if they underwent surgical treatment for symptomatic CM-1 between the years 1999 and 2009. Cervical ROM and lordosis were assessed before and after surgery in all patients. Collected data also included clinical improvement, as well as surgical complications after the procedure. Patients were divided into 2 groups. The first group underwent a posterior fossa bony decompression alone, while the second group additionally received an expansile duraplasty. Patients were further subdivided into 3 subgroups on the basis of the severity of tonsillar herniation. A total of 76 patients fit our selection criteria. Fifty-five patients belonged to the duraplasty group. Twenty-one patients underwent bony decompression alone. The 2 groups were statistically demographically and clinically similar. There was no difference in clinical outcome or in ROM and cervical lordosis between the groups except for patients with severe tonsillar herniation (CM-I grade 3). These patients had a statistically significant improvement in their postoperative cervical motility without compromising their spinal stability. Adding an expansile duraplasty to craniovertebral decompression in CM-1 patients with severe tonsillar herniation may restore cervical ROM while preserving stability and alignment. This may relieve postoperative pain and improve clinical prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Usefulness of Sweat Management for Patients with Adult Atopic Dermatitis, regardless of Sweat Allergy: A Pilot Study.

    PubMed

    Kaneko, Sakae; Murota, Hiroyuki; Murata, Susumu; Katayama, Ichiro; Morita, Eishin

    2017-01-01

    Background . Sweat is an aggravating factor in atopic dermatitis (AD), regardless of age. Sweat allergy may be involved in AD aggravated by sweating. Objective. We investigated whether sweat exacerbates adult AD symptoms and examined the extent of sweat allergy's involvement. Method. We asked 34 AD patients (17 men, 17 women; mean age: 27.8 years) to record the extent to which sweat aggravated their symptoms on a 10-point numerical scale. Participant responses were compared with histamine release tests (HRT). Furthermore, 24 of the patients received instructions on methods of sweat management, and their outcomes were evaluated on a 10-point scale. Results. Sweat HRT results were class ≥ 2 in 13 patients, but HRT results were not correlated with the patients' self-assessments of symptom aggravation by sweat. One month after receiving sweat management instructions, a low mean score of 4.6 was obtained regarding whether active sweating was good, but a high mean score of 7.0 was obtained in response to whether the sweat management instructions had been helpful. Conclusion . Our investigation showed that patients' negative impressions of sweat might derive from crude personal experiences that are typically linked to sweating. Sweat management for patients with adult atopic dermatitis was extremely useful regardless of sweat allergy.

  16. The benefit of adding ezetimibe to statin therapy in patients with prior coronary artery bypass graft surgery and acute coronary syndrome in the IMPROVE-IT trial.

    PubMed

    Eisen, Alon; Cannon, Christopher P; Blazing, Michael A; Bohula, Erin A; Park, Jeong-Gun; Murphy, Sabina A; White, Jennifer A; Giugliano, Robert P; Braunwald, Eugene

    2016-12-21

    To examine the efficacy and safety of ezetimibe added to statin in patients with prior coronary artery bypass graft surgery (CABG) following hospitalization for an acute coronary syndrome (ACS). In the IMPROVE-IT trial, post-ACS patients with mean low density lipoprotein cholesterol (LDL-C) of 93.8 mg/dL at presentation were randomized to simvastatin/ezetimibe or simvastatin/placebo. The primary endpoint was cardiovascular death, major coronary event or stroke, and the median follow-up was 6 years. Efficacy and safety endpoints were examined by prior CABG status. Among 18 134 patients, 1684 (9.3%) had a prior CABG (median age 69 years, 82% male). During the trial, the median time-weighted LDL-C level was 55.0 mg/dL with simvastatin/ezetimibe vs. 69.9 mg/dL with simvastatin/placebo in patients with prior CABG (P < 0.001), and it was 53.6 mg/dL vs. 69.5 mg/dL, respectively, in patients without prior CABG (P < 0.001). The rate of the primary endpoint was higher in patients with vs. without prior CABG [56% vs. 32%, adj. hazard ratio 1.45, 95% confidence interval (CI) 1.33-1.58]. Patients with prior CABG receiving simvastatin/ezetimibe had an 8.8% (95% CI 3.1-14.6%) lower absolute risk over simvastatin/placebo in the primary endpoint, whereas patients without prior CABG had a 1.3% (95% CI 0-2.6%) lower absolute risk (P-interaction = 0.02). There were no between-group significant differences in safety endpoints. The clinical benefit of adding ezetimibe to statin appears to be enhanced in patients with prior CABG, supporting the use of intensive lipid lowering therapy in these high-risk patients following ACS. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For Permissions, please email: journals.permissions@oup.com.

  17. Elevated cerebrospinal fluid pressure in patients with Alzheimer's disease

    PubMed Central

    Silverberg, Gerald; Mayo, Martha; Saul, Thomas; Fellmann, Jere; McGuire, Dawn

    2006-01-01

    Background Abnormalities in cerebrospinal fluid (CSF) production and turnover, seen in normal pressure hydrocephalus (NPH) and in Alzheimer's disease (AD), may be an important cause of amyloid retention in the brain and may relate the two diseases. There is a high incidence of AD pathology in patients being shunted for NPH, the AD-NPH syndrome. We now report elevated CSF pressure (CSFP), consistent with very early hydrocephalus, in a subset of AD patients enrolled in a clinical trial of chronic low-flow CSF drainage. Our objective was to determine the frequency of elevated CSFP in subjects meeting National Institutes of Neurological and Communicative Diseases and Stroke – Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for AD, excluding those with signs of concomitant NPH. Methods AD subjects by NINCDS-ADRDA criteria (n = 222), were screened by history, neurological examination, and radiographic imaging to exclude those with clinical or radiographic signs of NPH. As part of this exclusion process, opening CSFP was measured supine under general anesthesia during device implantation surgery at a controlled pCO2 of 40 Torr (40 mmHg). Results Of the 222 AD subjects 181 had pressure measurements recorded. Seven subjects (3.9%) enrolled in the study had CSFP of 220 mmH20 or greater, mean 249 ± 20 mmH20 which was significantly higher than 103 ± 47 mmH2O for the AD-only group. AD-NPH patients were significantly younger and significantly less demented on the Mattis Dementia Rating Scale (MDRS). Conclusion Of the AD subjects who were carefully screened to exclude those with clinical NPH, 4% had elevated CSFP. These subjects were presumed to have the AD-NPH syndrome and were withdrawn from the remainder of the study. PMID:16737542

  18. Getting Value out of Value-Added: Report of a Workshop

    ERIC Educational Resources Information Center

    Braun, Henry, Ed.; Chudowsky, Naomi, Ed.; Koenig, Judith, Ed.

    2010-01-01

    Value-added methods refer to efforts to estimate the relative contributions of specific teachers, schools, or programs to student test performance. In recent years, these methods have attracted considerable attention because of their potential applicability for educational accountability, teacher pay-for-performance systems, school and teacher…

  19. Direct simulation Monte Carlo method for gas flows in micro-channels with bends with added curvature

    NASA Astrophysics Data System (ADS)

    Tisovský, Tomáš; Vít, Tomáš

    Gas flows in micro-channels are simulated using an open source Direct Simulation Monte Carlo (DSMC) code dsmcFOAM for general application to rarefied gas flow written within the framework of the open source C++ toolbox called OpenFOAM. Aim of this paper is to investigate the flow in micro-channel with bend with added curvature. Results are compared with flows in channel without added curvature and equivalent straight channel. Effects of micro-channel bend was already thoroughly investigated by White et al. Geometry proposed by White is also used here for refference.

  20. TECNOB Study: Ad Interim Results of a Randomized Controlled Trial of a Multidisciplinary Telecare Intervention for Obese Patients with Type-2 Diabetes.

    PubMed

    Castelnuovo, Gianluca; Manzoni, Gian Mauro; Cuzziol, Paola; Cesa, Gian Luca; Corti, Stefania; Tuzzi, Cristina; Villa, Valentina; Liuzzi, Antonio; Petroni, Maria Letizia; Molinari, Enrico

    2011-03-04

    Obesity increases the risk of many health complications such as hypertension, coronary heart disease and type 2 diabetes, needs long-lasting treatment for effective results and involves high public and private care-costs. Therefore, it is imperative that enduring and low-cost clinical programs for obesity and related co-morbidities are developed and evaluated. Information and communication technologies (ICT) can help clinicians to deliver treatment in a cost-effective and time-saving manner to a large number of obese individuals with co-morbidities. To examine ad interim effectiveness of a 12-month multidisciplinary telecare intervention for weight loss provided to obese patients with type 2 diabetes. A single-center randomized controlled trial (TECNOB study) started in December 2008. At present, 72 obese patients with type 2 diabetes have been recruited and randomly allocated to the TECNOB program (n=37) or to a control condition (n=39). However, only 34 participants have completed at least the 3-month follow-up and have been included in this ad interim analysis. 21 out of them have reached also the 6-month follow-up and 13 have achieved the end of the program. Study is still on-going. All participants attended 1-month inpatient intensive program that involved individualized medical care, diet therapy, physical training and brief psychological counseling. At discharge, participants allocated to the TECNOB program were instructed to use a weight-loss web-site, a web-based videoconference tool, a dietary software installed into their cellular phones and an electronic armband measuring daily steps and energy expenditure. Weight and disordered eating-related behaviors and cognitions (EDI-2) at entry to hospital, at discharge from hospital, at 3,6 and 12 months. Ad interim analysis of data from 34 participants showed no statistically significant difference between groups in weight change at any time-point. However, within-group analysis revealed significant reductions

  1. Risk of Damage to the Somatic Innervation of the Penis during the AdVanceProcedure: An Anatomical Study.

    PubMed

    Hogewoning, Cornelis R C; Elzevier, Henk W; Pelger, Rob C M; Bekker, Milou D; DeRuiter, Marco C

    2015-08-01

    One of the methods to treat post radical prostatectomy stress urinary incontinence is the AdVance (American Medical Systems, Minnetonka, MN, USA) male sling procedure. During this procedure, the somatic innervation of the penis may be at risk for injury. Six AdVance procedures were performed in six donated bodies at the Anatomy and Embryology Department of the Leiden University Medical Centre. The pelves were dissected and the shortest distance between the sling and the dorsal nerve of the penis (DNP) was documented. The aim of this study was to describe the anatomical relation between the AdVance male sling and penile nerves based on the dissection of six adult male pelves. The AdVance male sling procedure was conducted in six donated male bodies. After placement, the pelves were dissected and the shortest distance between sling and the DNP was documented. The main outcome measure was the distance between the AdVance male sling and the DNP. The mean distance of the sling to the DNP was 4.1 mm and was found situated directly next to the nerve (distance 0 mm) in 4 out of 12 (33%) hemipelves. The distance of the sling to the obturator neurovascular bundle was 30 mm or more in all six bodies. Damage to the DNP caused by the AdVance male sling procedure appears to be an extremely rare complication, which has not been described in current literature. The proximity of the AdVance to the DNP could, however, pose a risk that should be taken into consideration by physicians and patients when opting for surgery. © 2015 International Society for Sexual Medicine.

  2. The Immunology of AD and its Reversibility with Broad Spectrum and Targeted Therapies

    PubMed Central

    Brunner, Patrick M.; Guttman-Yassky, Emma; Leung, Donald Y. M.

    2017-01-01

    Atopic dermatitis (AD), the most common chronic inflammatory skin disease, is driven by both terminal keratinocyte differentiation defects and strong type 2 immune responses. In contrast to chronic plaque-type psoriasis, AD is now understood to be a much more heterogeneous disease, with additional activation of Th22, Th17/IL-23 and Th1 cytokine pathways, depending on the subtype of the disease. In this review, we discuss our current understanding of the AD immune map in both early-onset as well as chronic disease. Clinical studies using broad and targeted therapeutics have helped to elucidate the contribution of various immune axes to the disease phenotype. Importantly, immune activation extends well beyond lesional AD, as non-lesional skin and the blood component harbor AD-specific inflammatory changes. For this reason, future therapeutics will need to focus on a systemic treatment approach, especially in patients suffering from moderate-to-severe disease. PMID:28390479

  3. Adiabatic pumping solutions in global AdS

    NASA Astrophysics Data System (ADS)

    Carracedo, Pablo; Mas, Javier; Musso, Daniele; Serantes, Alexandre

    2017-05-01

    We construct a family of very simple stationary solutions to gravity coupled to a massless scalar field in global AdS. They involve a constantly rising source for the scalar field at the boundary and thereby we name them pumping solutions. We construct them numerically in D = 4. They are regular and, generically, have negative mass. We perform a study of linear and nonlinear stability and find both stable and unstable branches. In the latter case, solutions belonging to different sub-branches can either decay to black holes or to limiting cycles. This observation motivates the search for non-stationary exactly timeperiodic solutions which we actually construct. We clarify the role of pumping solutions in the context of quasistatic adiabatic quenches. In D = 3 the pumping solutions can be related to other previously known solutions, like magnetic or translationally-breaking backgrounds. From this we derive an analytic expression.

  4. Addison's disease: a survey on 633 patients in Padova.

    PubMed

    Betterle, Corrado; Scarpa, Riccardo; Garelli, Silvia; Morlin, Luca; Lazzarotto, Francesca; Presotto, Fabio; Coco, Graziella; Masiero, Stefano; Parolo, Anna; Albergoni, Maria Paola; Favero, Roberta; Barollo, Susi; Salvà, Monica; Basso, Daniela; Chen, Shu; Rees Smith, Bernard; Furmaniak, Jadwiga; Mantero, Franco

    2013-12-01

    Addison's disease (AD) is a rare endocrine condition. We aimed to evaluate clinical, immunologic, adrenal imaging, and genetic features in 633 Italian patients with AD followed up since 1967. Adrenal cortex autoantibodies, presence of other autoimmune and nonautoimmune diseases, nonadrenal autoantibodies, adrenal imaging, and genetic profile for HLA-DRB1 and AIRE were analyzed. A total of 492 (77.7%) patients were found to be affected by autoimmune AD (A-AD), 57 (9%) tuberculous AD, 29 (4.6%) genetic-associated AD, 10 (1.6%) adrenal cancer, six (0.94%) post-surgical AD, four (0.6%) vascular disorder-related AD, three (0.5%) post-infectious AD, and 32 (5.1%) were defined as idiopathic. Adrenal cortex antibodies were detected in the vast majority (88100%) of patients with recent onset A-AD, but in none of those with nonautoimmune AD. Adrenal imaging revealed normal/atrophic glands in all A-AD patients: 88% of patients with A-AD had other clinical or subclinical autoimmune diseases or were positive for nonadrenal autoantibodies. Based on the coexistence of other autoimmune disorders, 65.6% of patients with A-AD were found to have type 2 autoimmune polyendocrine syndrome (APS2), 14.4% have APS1, and 8.5% have APS4. Class II HLA alleles DRB1*03 and DRB1*04 were increased, and DRB1*01, DRB1*07, DRB1*013 were reduced in APS2 patients when compared with controls. Of the patients with APS1, 96% were revealed to have AIRE gene mutations. A-AD is the most prevalent form of adrenal insufficiency in Italy, and ∼90% of the patients are adrenal autoantibody-positive at the onset. Assessment of patients with A-AD for the presence of other autoimmune diseases should be helpful in monitoring and diagnosing APS types 1, 2, or 4 and improving patients' care.

  5. Relationship between Eating Disturbance and Dementia Severity in Patients with Alzheimer’s Disease

    PubMed Central

    Kai, Kyoko; Hashimoto, Mamoru; Amano, Koichiro; Tanaka, Hibiki; Fukuhara, Ryuji; Ikeda, Manabu

    2015-01-01

    Background Eating is one of the most important daily activities in managing patients with dementia. Although various eating disturbance occur as dementia progresses, to our knowledge, most of the studies focused on a part of eating disturbance such as swallowing and appetite. There have been few comprehensive studies including eating habits and food preference in patients with Alzheimer’s disease (AD). The aims of this study were to investigate almost all eating disturbance and to examine the relationship of eating disturbance to dementia stage in AD. Methods A total of 220 patients with AD and 30 normal elderly (NE) subjects were recruited. Eating disturbance was assessed by a comprehensive questionnaire that had been previously validated. Potential relationships between the characteristics of eating disturbance and dementia stage as classified by the Clinical Dementia Rating (CDR) were assessed. Results Overall, 81.4% of patients with AD showed some eating and swallowing disturbance, whereas only 26.7% of the NE subjects had such a disturbance. Even in an early stage, patients with AD had many types of eating disturbance; “Appetite change” was shown in nearly half of the mild AD patients (49.5%). In the moderate stage, the scores of “change of eating habits and food preference” were highest, and in the severe stage “swallowing disturbance” became critical. Conclusion In AD, the relationship of dementia stage to eating disturbance differs according to the type of eating disturbance. The relationships between various eating disturbance and the severity of dementia should be considered. PMID:26266531

  6. Genome-wide copy number variation (CNV) in patients with autoimmune Addison's disease

    PubMed Central

    2011-01-01

    Background Addison's disease (AD) is caused by an autoimmune destruction of the adrenal cortex. The pathogenesis is multi-factorial, involving genetic components and hitherto unknown environmental factors. The aim of the present study was to investigate if gene dosage in the form of copy number variation (CNV) could add to the repertoire of genetic susceptibility to autoimmune AD. Methods A genome-wide study using the Affymetrix GeneChip® Genome-Wide Human SNP Array 6.0 was conducted in 26 patients with AD. CNVs in selected genes were further investigated in a larger material of patients with autoimmune AD (n = 352) and healthy controls (n = 353) by duplex Taqman real-time polymerase chain reaction assays. Results We found that low copy number of UGT2B28 was significantly more frequent in AD patients compared to controls; conversely high copy number of ADAM3A was associated with AD. Conclusions We have identified two novel CNV associations to ADAM3A and UGT2B28 in AD. The mechanism by which this susceptibility is conferred is at present unclear, but may involve steroid inactivation (UGT2B28) and T cell maturation (ADAM3A). Characterization of these proteins may unravel novel information on the pathogenesis of autoimmunity. PMID:21851588

  7. An 'adding' algorithm for the Markov chain formalism for radiation transfer

    NASA Technical Reports Server (NTRS)

    Esposito, L. W.

    1979-01-01

    An adding algorithm is presented, that extends the Markov chain method and considers a preceding calculation as a single state of a new Markov chain. This method takes advantage of the description of the radiation transport as a stochastic process. Successive application of this procedure makes calculation possible for any optical depth without increasing the size of the linear system used. It is determined that the time required for the algorithm is comparable to that for a doubling calculation for homogeneous atmospheres. For an inhomogeneous atmosphere the new method is considerably faster than the standard adding routine. It is concluded that the algorithm is efficient, accurate, and suitable for smaller computers in calculating the diffuse intensity scattered by an inhomogeneous planetary atmosphere.

  8. Rapid, simultaneous and interference-free determination of three rhodamine dyes illegally added into chilli samples using excitation-emission matrix fluorescence coupled with second-order calibration method.

    PubMed

    Chang, Yue-Yue; Wu, Hai-Long; Fang, Huan; Wang, Tong; Liu, Zhi; Ouyang, Yang-Zi; Ding, Yu-Jie; Yu, Ru-Qin

    2018-06-15

    In this study, a smart and green analytical method based on the second-order calibration algorithm coupled with excitation-emission matrix (EEM) fluorescence was developed for the determination of rhodamine dyes illegally added into chilli samples. The proposed method not only has the advantage of high sensitivity over the traditional fluorescence method but also fully displays the "second-order advantage". Pure signals of analytes were successfully extracted from severely interferential EEMs profiles via using alternating trilinear decomposition (ATLD) algorithm even in the presence of common fluorescence problems such as scattering, peak overlaps and unknown interferences. It is worth noting that the unknown interferents can denote different kinds of backgrounds, not only refer to a constant background. In addition, the method using interpolation method could avoid the information loss of analytes of interest. The use of "mathematical separation" instead of complicated "chemical or physical separation" strategy can be more effective and environmentally friendly. A series of statistical parameters including figures of merit and RSDs of intra- (≤1.9%) and inter-day (≤6.6%) were calculated to validate the accuracy of the proposed method. Furthermore, the authoritative method of HPLC-FLD was adopted to verify the qualitative and quantitative results of the proposed method. Compared with the two methods, it also showed that the ATLD-EEMs method has the advantages of accuracy, rapidness, simplicity and green, which is expected to be developed as an attractive alternative method for simultaneous and interference-free determination of rhodamine dyes illegally added into complex matrices. Copyright © 2018. Published by Elsevier B.V.

  9. On the on-shell: the action of AdS4 black holes

    NASA Astrophysics Data System (ADS)

    Halmagyi, Nick; Lal, Shailesh

    2018-03-01

    We compute the on-shell action of static, BPS black holes in AdS4 from N=2 gauged supergravity coupled to vector multiplets and show that for a certain class it is equal to minus the entropy of the black hole. Holographic renormalization is used to demonstrate that with Neumann boundary conditions on the scalar fields, the divergent and finite contributions from the asymptotic boundary vanish. The entropy arises from the extrinsic curvature on Σ g × S 1 evaluated at the horizon, where Σ g may have any genus g ≥ 0. This provides a clarification of the equivalence between the partition function of the twisted ABJM theory on Σ g × S 1 and the entropy of the dual black hole solutions. It also demonstrates that the complete entropy resides on the AdS2 × Σ g horizon geometry, implying the absence of hair for these gravity solutions.

  10. Exploring the spectrum of planar AdS4 /CFT3 at finite coupling

    NASA Astrophysics Data System (ADS)

    Bombardelli, Diego; Cavaglià, Andrea; Conti, Riccardo; Tateo, Roberto

    2018-04-01

    The Quantum Spectral Curve (QSC) equations for planar N=6 super-conformal Chern-Simons (SCS) are solved numerically at finite values of the coupling constant for states in the sl(2\\Big|1) sector. New weak coupling results for conformal dimensions of operators outside the sl(2) -like sector are obtained by adapting a recently proposed algorithm for the QSC perturbative solution. Besides being interesting in their own right, these perturbative results are necessary initial inputs for the numerical algorithm to converge on the correct solution. The non-perturbative numerical outcomes nicely interpolate between the weak coupling and the known semiclassical expansions, and novel strong coupling exact results are deduced from the numerics. Finally, the existence of contour crossing singularities in the TBA equations for the operator 20 is ruled out by our analysis. The results of this paper are an important test of the QSC formalism for this model, open the way to new quantitative studies and provide further evidence in favour of the conjectured weak/strong coupling duality between N=6 SCS and type IIA superstring theory on AdS4 × CP 3. Attached to the arXiv submission, a Mathematica implementation of the numerical method and ancillary files containing the numerical results are provided.

  11. Winograd Method Versus Winograd Method With Electrocoagulation in the Treatment of Ingrown Toenails.

    PubMed

    Acar, Erdinc

    An important component of the Winograd surgical method for an ingrown toenail is total excision of the associated germinal matrix. However, this might not always be accomplished with the procedure. We hypothesized that the surgical results might be improved by adding electrocoagulation of the germinal matrix to the Winograd method. The objective of the present study was to compare the recurrence, satisfaction, and complication rates of the Winograd method with those of the Winograd method with electrocoagulation. We retrospectively evaluated the records of 102 patients with single Heifetz stage 2 or 3 ingrown toenails who had undergone surgery from January 2013 to October 2014 using 1 of these 2 methods. Of the 102 patients, 50 (49%) underwent the Winograd method and 52 (51%) underwent the Winograd method with electrocoagulation. The mean follow-up period of our patients was 12 (range 6 to 22) months. An ingrown toenail recurred in 3 patients (6%) in the Winograd group and in no patient in the Winograd with electrocoagulation group (p = .04). Among the patients in the Winograd group, 46 (92.0%) were satisfied or very satisfied. Among the patients in the Winograd plus electrocoagulation group, 49 (94.2%) were satisfied or very satisfied (p = .04). No complications developed in either group. In conclusion, the Winograd method for ingrown toenails results in high satisfaction rates, low recurrence rates, and low complication rates. The addition of electrocoagulation of the germinal matrix to the Winograd method could result in even lower recurrence rates, while maintaining high patient satisfaction and without increasing the risk of complications. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Costs and added value of haemodialysis and peritoneal dialysis outsourcing agreements.

    PubMed

    Lamas Barreiro, J M; Alonso Suárez, M; Saavedra Alonso, J A; Gándara Martínez, A

    2011-01-01

    Despite the discrepancy in results from Spanish studies on the costs of dialysis, it is assumed that peritoneal dialysis (PD) is more efficient than haemodialysis (HD). To analyse the costs and added value of HD and PD outsourcing agreements in Galicia, the medical transport for HD and the relationship between the cost of the agreement and the cost of consumables used in continuous ambulatory peritoneal dialysis (CAPD) with bicarbonate. The cost of the outsourcing agreements and the staff was obtained from official publications. The cost of PD and medical transport were calculated using health service data for one month and extrapolating it to one year. The cost of CAPD consumables was provided by the suppliers. The added value was calculated from the investments generated for each agreement treating 40 patients. Expressed as patient/year, the mean costs for treatment were €21595 and €25664 in HD and PD, respectively. Medical transport varied between €3323 and €6338, while those of the CAPD agreement and consumables were €19268 and €12057, respectively. The added value was greater with the HD agreement, especially considering the jobs created. One cannot generalise that the cost of PD, which is significantly influenced by prescriptions, is lower than that of HD. It would be appropriate to review the additional cost to consumables in the CAPD agreement. The added value generated by dialysis agreements should be considered in future studies and in health planning. More controlled studies are needed to better understand this issue.

  13. Mortality among patients due to adverse drug reactions that lead to hospitalization: a meta-analysis.

    PubMed

    Patel, Tejas K; Patel, Parvati B

    2018-06-01

    The aim of this study was to estimate the prevalence of mortality among patients due to adverse drug reactions that lead to hospitalisation (fatal ADR Ad ), to explore the heterogeneity in its estimation through subgroup analysis of study characteristics, and to identify system-organ classes involved and causative drugs for fatal ADR Ad . We identified prospective ADR Ad -related studies via screening of the PubMed and Google Scholar databases with appropriate key terms. We estimated the prevalence of fatal ADR Ad using a double arcsine method and explored heterogeneity using the following study characteristics: age groups, wards, study region, ADR definitions, ADR identification methods, study duration and sample size. We examined patterns of fatal ADR Ad and causative drugs. Among 312 full-text articles assessed, 49 studies satisfied the selection criteria and were included in the analysis. The mean prevalence of fatal ADR Ad was 0.20% (95% CI: 0.13-0.27%; I 2  = 93%). The age groups and study wards were the important heterogeneity modifiers. The mean fatal ADR Ad prevalence varied from 0.01% in paediatric patients to 0.44% in the elderly. Subgroup analysis showed a higher prevalence of fatal ADR Ad in intensive care units, emergency departments, multispecialty wards and whole hospitals. Computer-based monitoring systems in combination with other methods detected higher mortality. Intracranial haemorrhage, renal failure and gastrointestinal bleeding accounted for more than 50% of fatal ADR Ad cases. Warfarin, aspirin, renin-angiotensin system (RAS) inhibitors and digoxin accounted for 60% of fatal ADR Ad . ADR Ad is an important cause of mortality. Strategies targeting the safer use of warfarin, aspirin, RAS inhibitors and digoxin could reduce the large number of fatal ADR Ad cases.

  14. Donepezil treatment and Alzheimer disease: can the results of randomized clinical trials be applied to Alzheimer disease patients in clinical practice?

    PubMed

    Tinklenberg, Jared R; Kraemer, Helena C; Yaffe, Kristine; Ross, Leslie; Sheikh, Javaid; Ashford, John W; Yesavage, Jerome A; Taylor, Joy L

    2007-11-01

    To determine if results from randomized clinical trials of donepezil in Alzheimer disease (AD) patients can be applied to AD patients in clinical practice by comparing the findings from a Nordic one-year randomized AD donepezil trial with data from a one-year prospective, observational study of AD patients. AD patients from a consortium of California sites were systematically followed for at least one year. Their treatment regimens, including prescription of donepezil, were determined by their individual physician according to his or her usual criteria. The 148 California patients treated with donepezil had a one-year decline of 1.3 (3.5 SD) points on the Mini-Mental State Exam compared to a decline of 3.3 (4.4 SD) in the 158 AD patients who received no anti-Alzheimer drugs. The Mini-Mental State Exam decline in Nordic sample was approximately 0.25 points for the 91 patients receiving donepezil and approximately 2.2 for the 98 placebo patients. The overall effect sizes were estimated at about 0.49 in both studies. The California data were further analyzed using propensity methods; after taking into account differences that could bias prescribing decisions, benefits associated with taking donepezil remained. A comparison of a randomized clinical trial of donepezil in AD patients and this observational study indicates that if appropriate methodological and statistical precautions are undertaken, then results from randomized clinical trials can be predictive with AD patients in clinical practice. This California study supports the modest effectiveness of donepezil in AD patients having clinical characteristics similar to those of the Nordic study.

  15. Assessing the added value of health technologies: reconciling different perspectives.

    PubMed

    Drummond, Michael; Tarricone, Rosanna; Torbica, Aleksandra

    2013-01-01

    Providing universal access to innovative, high-cost technologies leads to tensions in today's health care systems. The tension becomes particularly evident in the context of scarce resources, where the risk of taking contentious coverage decisions increases rapidly. To ensure economic sustainability, the payers of health care think that the benefits from the use of the new technologies need to be commensurate with the costs. Therefore, many jurisdictions have programs of health technology assessment, which often results in restrictions of access to care, either through complete refusal to reimburse the technology or its restriction of use to only a subset of the eligible patient population. However, manufacturers feel that they should be adequately rewarded for their innovations and require sufficient funds to invest in further research. Finally, patients perceive these technologies to have added benefits, and so they are concerned when they are denied access. If sustainable access to health care is to be maintained in the future, approaches are needed to reconcile these different perspectives. This article explores the approaches, in both methods and policy, to help bring about this reconciliation. These include rethinking the notion of social value (on the part of payers), aligning manufacturers' research more closely with societal objectives, and increasing patient participation in health technology assessment. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  16. Identifying patients with Alzheimer's disease using resting-state fMRI and graph theory.

    PubMed

    Khazaee, Ali; Ebrahimzadeh, Ata; Babajani-Feremi, Abbas

    2015-11-01

    Study of brain network on the basis of resting-state functional magnetic resonance imaging (fMRI) has provided promising results to investigate changes in connectivity among different brain regions because of diseases. Graph theory can efficiently characterize different aspects of the brain network by calculating measures of integration and segregation. In this study, we combine graph theoretical approaches with advanced machine learning methods to study functional brain network alteration in patients with Alzheimer's disease (AD). Support vector machine (SVM) was used to explore the ability of graph measures in diagnosis of AD. We applied our method on the resting-state fMRI data of twenty patients with AD and twenty age and gender matched healthy subjects. The data were preprocessed and each subject's graph was constructed by parcellation of the whole brain into 90 distinct regions using the automated anatomical labeling (AAL) atlas. The graph measures were then calculated and used as the discriminating features. Extracted network-based features were fed to different feature selection algorithms to choose most significant features. In addition to the machine learning approach, statistical analysis was performed on connectivity matrices to find altered connectivity patterns in patients with AD. Using the selected features, we were able to accurately classify patients with AD from healthy subjects with accuracy of 100%. Results of this study show that pattern recognition and graph of brain network, on the basis of the resting state fMRI data, can efficiently assist in the diagnosis of AD. Classification based on the resting-state fMRI can be used as a non-invasive and automatic tool to diagnosis of Alzheimer's disease. Copyright © 2015 International Federation of Clinical Neurophysiology. All rights reserved.

  17. The effects of exenatide twice daily compared to insulin lispro added to basal insulin in Latin American patients with type 2 diabetes: A retrospective analysis of the 4B trial.

    PubMed

    de Lapertosa, Silvia Beatriz Gorban; Frechtel, Gustavo; Hardy, Elise; Sauque-Reyna, Leobardo

    2016-12-01

    Socioeconomic changes in Latin American countries have led to an increased prevalence of type 2 diabetes (T2D). We examined the effects of exenatide twice daily (BID) or insulin lispro, each added to insulin glargine, in Latin American patients with T2D. This was a subgroup analysis of patients from Argentina and Mexico in the 4B study (N=114). Patients with glycated hemoglobin (HbA1c) of 7.0-10.0% (53-86mmol/mol) after 12weeks of intensive basal insulin optimization were randomized to exenatide BID or thrice-daily insulin lispro added to insulin glargine and metformin. After 30weeks, addition of exenatide BID or insulin lispro resulted in significant (P<0.0001) reductions in HbA1c (exenatide BID: -0.9% [-10mmol/mol]; insulin lispro: -1.2% [-13mmol/mol]). Weight was stable in the exenatide BID group (-0.1kg) and increased significantly (+3.4kg; P<0.0001) with insulin lispro. Major and minor hypoglycemia occurred less frequently (40 vs. 253 events) with exenatide BID compared with insulin lispro. Gastrointestinal adverse events of nausea, diarrhea, and vomiting occurred more frequently with exenatide BID than with insulin lispro. Both exenatide BID and prandial insulin lispro, each added to basal insulin glargine, were effective at reducing HbA1c in Latin American patients. Treatment with exenatide BID resulted in stable weight but more gastrointestinal adverse events. Treatment with insulin lispro resulted in weight gain and an increased risk of hypoglycemia. These findings support the addition of exenatide BID to insulin glargine as an option for Latin American patients unable to achieve glycemic control on basal insulin alone. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  18. Added Value of Assessing Adnexal Masses with Advanced MRI Techniques

    PubMed Central

    Thomassin-Naggara, I.; Balvay, D.; Rockall, A.; Carette, M. F.; Ballester, M.; Darai, E.; Bazot, M.

    2015-01-01

    This review will present the added value of perfusion and diffusion MR sequences to characterize adnexal masses. These two functional MR techniques are readily available in routine clinical practice. We will describe the acquisition parameters and a method of analysis to optimize their added value compared with conventional images. We will then propose a model of interpretation that combines the anatomical and morphological information from conventional MRI sequences with the functional information provided by perfusion and diffusion weighted sequences. PMID:26413542

  19. Differences in severity at admission for heart failure between rural and urban patients: the value of adding laboratory results to administrative data.

    PubMed

    Smith, Mark W; Owens, Pamela L; Andrews, Roxanne M; Steiner, Claudia A; Coffey, Rosanna M; Skinner, Halcyon G; Miyamura, Jill; Popescu, Ioana

    2016-04-18

    Rural/urban variations in admissions for heart failure may be influenced by severity at hospital presentation and local practice patterns. Laboratory data reflect clinical severity and guide hospital admission decisions and treatment for heart failure, a costly chronic illness and a leading cause of hospitalization among the elderly. Our main objective was to examine the role of laboratory test results in measuring disease severity at the time of admission for inpatients who reside in rural and urban areas. We retrospectively analyzed discharge data on 13,998 hospital discharges for heart failure from three states, Hawai'i, Minnesota, and Virginia. Hospital discharge records from 2008 to 2012 were derived from the State Inpatient Databases of the Healthcare Cost and Utilization Project, and were merged with results of laboratory tests performed on the admission day or up to two days before admission. Regression models evaluated the relationship between clinical severity at admission and patient urban/rural residence. Models were estimated with and without use of laboratory data. Patients residing in rural areas were more likely to have missing laboratory data on admission and less likely to have abnormal or severely abnormal tests. Rural patients were also less likely to be admitted with high levels of severity as measured by the All Patient Refined Diagnosis Related Groups (APR-DRG) severity subclass, derivable from discharge data. Adding laboratory data to discharge data improved model fit. Also, in models without laboratory data, the association between urban compared to rural residence and APR-DRG severity subclass was significant for major and extreme levels of severity (OR 1.22, 95% CI 1.03-1.43 and 1.55, 95% CI 1.26-1.92, respectively). After adding laboratory data, this association became non-significant for major severity and was attenuated for extreme severity (OR 1.12, 95% CI 0.94-1.32 and 1.43, 95% CI 1.15-1.78, respectively). Heart failure patients

  20. The added value of measuring thumb and finger strength when comparing strength measurements in hypoplastic thumb patients.

    PubMed

    Molenaar, H M Ties; Selles, Ruud W; de Kraker, Marjolein; Stam, Henk J; Hovius, Steven E R

    2013-10-01

    When interventions to the hand are aimed at improving function of specific fingers or the thumb, the RIHM (Rotterdam Intrinsic Hand Myometer) is a validated tool and offers more detailed information to assess strength of the involved joints besides grip and pinch measurements. In this study, strength was measured in 65 thumbs in 40 patients diagnosed with thumb hypoplasia. These 65 thumbs were classified according to Blauth. Longitudinal radial deficiencies were also classified. The strength measurements comprised of grip, tip, tripod and key pinch. Furthermore palmar abduction and opposition of the thumb as well as abduction of the index and little finger were measured with the RIHM. For all longitudinal radial deficiency patients, grip and pinch strength as well as palmar abduction and thumb opposition were significantly lower than reference values (P<0.001). However, strength in the index finger abduction and the little finger abduction was maintained or decreased to a lesser extent according to the degree of longitudinal radial deficiency. All strength values decreased with increasing Blauth-type. Blauth-type II hands (n=15) with flexor digitorum superficialis 4 opposition transfer including stabilization of the metacarpophalangeal joint showed a trend toward a higher opposition strength without reaching statistical significance (P=0.094),however compared to non-operated Blauth-type II hands (n=6) they showed a lower grip strength (P=0.019). The RIHM is comparable in accuracy to other strength dynamometers. Using the RIHM, we were able to illustrate strength patterns on finger-specific level, showing added value when evaluating outcome in patients with hand related problems. © 2013.

  1. Application of advanced machine learning methods on resting-state fMRI network for identification of mild cognitive impairment and Alzheimer's disease.

    PubMed

    Khazaee, Ali; Ebrahimzadeh, Ata; Babajani-Feremi, Abbas

    2016-09-01

    The study of brain networks by resting-state functional magnetic resonance imaging (rs-fMRI) is a promising method for identifying patients with dementia from healthy controls (HC). Using graph theory, different aspects of the brain network can be efficiently characterized by calculating measures of integration and segregation. In this study, we combined a graph theoretical approach with advanced machine learning methods to study the brain network in 89 patients with mild cognitive impairment (MCI), 34 patients with Alzheimer's disease (AD), and 45 age-matched HC. The rs-fMRI connectivity matrix was constructed using a brain parcellation based on a 264 putative functional areas. Using the optimal features extracted from the graph measures, we were able to accurately classify three groups (i.e., HC, MCI, and AD) with accuracy of 88.4 %. We also investigated performance of our proposed method for a binary classification of a group (e.g., MCI) from two other groups (e.g., HC and AD). The classification accuracies for identifying HC from AD and MCI, AD from HC and MCI, and MCI from HC and AD, were 87.3, 97.5, and 72.0 %, respectively. In addition, results based on the parcellation of 264 regions were compared to that of the automated anatomical labeling atlas (AAL), consisted of 90 regions. The accuracy of classification of three groups using AAL was degraded to 83.2 %. Our results show that combining the graph measures with the machine learning approach, on the basis of the rs-fMRI connectivity analysis, may assist in diagnosis of AD and MCI.

  2. A note on the entropy of rotating BPS AdS7 × S4 black holes

    NASA Astrophysics Data System (ADS)

    Hosseini, Seyed Morteza; Hristov, Kiril; Zaffaroni, Alberto

    2018-05-01

    In this note we show that the entropy of BPS, rotating, electrically charged AdS7 × S 4 black holes can be obtained by an extremization principle involving a particular combination of anomaly coefficients of the six-dimensional N=(2,0) theory. This result extends our previous finding for BPS, rotating AdS5 × S 5 black holes.

  3. Effect Size Analyses of Souvenaid in Patients with Alzheimer’s Disease

    PubMed Central

    Cummings, Jeffrey; Scheltens, Philip; McKeith, Ian; Blesa, Rafael; Harrison, John E.; Bertolucci, Paulo H.F.; Rockwood, Kenneth; Wilkinson, David; Wijker, Wouter; Bennett, David A.; Shah, Raj C.

    2016-01-01

    Background: Souvenaid® (uridine monophosphate, docosahexaenoic acid, eicosapentaenoic acid, choline, phospholipids, folic acid, vitamins B12, B6, C, and E, and selenium), was developed to support the formation and function of neuronal membranes. Objective: To determine effect sizes observed in clinical trials of Souvenaid and to calculate the number needed to treat to show benefit or harm. Methods: Data from all three reported randomized controlled trials of Souvenaid in Alzheimer’s disease (AD) dementia (Souvenir I, Souvenir II, and S-Connect) and an open-label extension study were included in analyses of effect size for cognitive, functional, and behavioral outcomes. Effect size was determined by calculating Cohen’s d statistic (or Cramér’s V method for nominal data), number needed to treat and number needed to harm. Statistical calculations were performed for the intent-to-treat populations. Results: In patients with mild AD, effect sizes were 0.21 (95% confidence intervals: –0.06, 0.49) for the primary outcome in Souvenir II (neuropsychological test battery memory z-score) and 0.20 (0.10, 0.34) for the co-primary outcome of Souvenir I (Wechsler memory scale delayed recall). No effect was shown on cognition in patients with mild-to-moderate AD (S-Connect). The number needed to treat (6 and 21 for Souvenir I and II, respectively) and high number needed to harm values indicate a favorable harm:benefit ratio for Souvenaid versus control in patients with mild AD. Conclusions: The favorable safety profile and impact on outcome measures converge to corroborate the putative mode of action and demonstrate that Souvenaid can achieve clinically detectable effects in patients with early AD. PMID:27767993

  4. Protective Effect of Ad-VEGF-Bone Mesenchymal Stem Cells on Cerebral Infarction.

    PubMed

    Chen, Bo; Zhang, Feng; Li, Qiao-Yu; Gong, Aihua; Lan, Qing

    2016-01-01

    To understand the mechanism of intracerebroventricular transplantation of vascular endothelial growth factor (VEGF) genemodified bone mesenchymal stem cells (BMSCs) in rats after cerebral infarction. The middle cerebral artery occlusion ischemia/reperfusion (MCAO I/R) model was established in rats using the Zea-Longa suture method. A recombinant adenovirus (Ad-VEGF) was engineered to express VEGF. The rats were divided into 3 groups. Control BMSC infected with control adenovirus (BMSC-Ad), BMSC infected by Ad-VEGF (BMSC-Ad-VEGF), and phosphate buffered saline (PBS) suspension were injected into the intracerebroventricular system of the rats in groups 1, 2 and 3 respectively, 24 hours after middle cerebral artery occlusion (MCAO). The neurological function of rats was evaluated with the modified Neurological Severity Scores (mNSS). The infarct volume of brain in rats was determined using 2,3,5-triphenyltetrazolium chloride (TTC) stain at 14 days. GFAP and pGSK3β expression of ischemic penumbra was determined using immunohistochemical method. GFAP, pAKT, AKT, and pGSK3β expressions were determined with Western blot. Functional improvement was accelerated in animals receiving BMSC-Ad, while improvement at all times between 7 days and 28 days post MCAO was significantly greater in animals transplanted with BMSC-Ad-VEGF than for other treated animals. The number of GFAP-labeled cells was prevented by post-ischemic BMSC-Ad-VEGF treatment; pMCAO activate the PI3K/AKT/GSK3β pathway to reduce reactive gliosis. Our findings demonstrate that PI3K/AKT/GSK3β pathway could reduce reactive gliosis, ameliorate neurological deficit, diminish the percentage of cerebral infarction volume in rats, and facilitate angiogenesis.

  5. Visual rating method and tensor-based morphometry in the diagnosis of mild cognitive impairment and Alzheimer's disease: a comparative magnetic resonance imaging study.

    PubMed

    Tuokkola, Terhi; Koikkalainen, Juha; Parkkola, Riitta; Karrasch, Mira; Lötjönen, Jyrki; Rinne, Juha O

    2016-03-01

    Atrophy of the medial temporal lobe (MTL) is the main structural magnetic resonance imaging (MRI) finding in the brain of patients with Alzheimer's disease (AD). However, evaluating the degree of atrophy is still demanding. The visual rating method (VRM) was compared with multi-template tensor-based morphometry (TBM), in terms of its efficacy in diagnosing of mild cognitive impairment (MCI) and AD. Forty-seven patients with MCI, 80 patients with AD and 84 controls were studied. TBM seems to be more sensitive than VRM at the early stage of dementia in the areas of MTL and ventricles. The methods were equally good in distinguishing controls and the MCI group from the AD group. At the frontal areas TBM was better than VRM in all comparisons. A user-friendly VRM is still useful for the clinical evaluation of MCI patients, but multi-template TBM is more sensitive for diagnosing the early stages of dementia. However, TBM is currently too demanding to use for daily clinical work. © The Foundation Acta Radiologica 2015.

  6. Extensive numerical study of a D-brane, anti-D-brane system in AdS 5 /CFT 4

    NASA Astrophysics Data System (ADS)

    Hegedűs, Árpád

    2015-04-01

    In this paper the hybrid-NLIE approach of [38] is extended to the ground state of a D-brane anti-D-brane system in AdS/CFT. The hybrid-NLIE equations presented in the paper are finite component alternatives of the previously proposed TBA equations and they admit an appropriate framework for the numerical investigation of the ground state of the problem. Straightforward numerical iterative methods fail to converge, thus new numerical methods are worked out to solve the equations. Our numerical data confirm the previous TBA data. In view of the numerical results the mysterious L = 1 case is also commented in the paper.

  7. Finding of increased caudate nucleus in patients with Alzheimer's disease.

    PubMed

    Persson, K; Bohbot, V D; Bogdanovic, N; Selbaek, G; Braekhus, A; Engedal, K

    2018-02-01

    A recently published study using an automated MRI volumetry method (NeuroQuant®) unexpectedly demonstrated larger caudate nucleus volume in patients with Alzheimer's disease dementia (AD) compared to patients with subjective and mild cognitive impairment (SCI and MCI). The aim of this study was to explore this finding. The caudate nucleus and the hippocampus volumes were measured (both expressed as ratios of intracranial volume) in a total of 257 patients with SCI and MCI according to the Winblad criteria and AD according to ICD-10 criteria. Demographic data, cognitive measures, and APOE-ɛ4 status were collected. Compared with non-dementia patients (SCI and MCI), AD patients were older, more of them were female, and they had a larger caudate nucleus volume and smaller hippocampus volume (P<.001). In multiple linear regression analysis, age and female sex were associated with larger caudate nucleus volume, but neither diagnosis nor memory function was. Age, gender, and memory function were associated with hippocampus volume, and age and memory function were associated with caudate nucleus/hippocampus ratio. A larger caudate nucleus volume in AD patients was partly explained by older age and being female. These results are further discussed in the context of (1) the caudate nucleus possibly serving as a mechanism for temporary compensation; (2) methodological properties of automated volumetry of this brain region; and (3) neuropathological alterations. Further studies are needed to fully understand the role of the caudate nucleus in AD. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Correlation between hippocampal volumes and medial temporal lobe atrophy in patients with Alzheimer's disease.

    PubMed

    Dhikav, Vikas; Duraiswamy, Sharmila; Anand, Kuljeet Singh

    2017-01-01

    Hippocampus undergoes atrophy in patients with Alzheimer's disease (AD). Calculation of hippocampal volumes can be done by a variety of methods using T1-weighted images of magnetic resonance imaging (MRI) of the brain. Medial temporal lobes atrophy (MTL) can be rated visually using T1-weighted MRI brain images. The present study was done to see if any correlation existed between hippocampal volumes and visual rating scores of the MTL using Scheltens Visual Rating Method. We screened 84 subjects presented to the Department of Neurology of a Tertiary Care Hospital and enrolled forty subjects meeting the National Institute of Neurological and Communicative Disorders and Stroke, AD related Disease Association criteria. Selected patients underwent MRI brain and T1-weighted images in a plane perpendicular to long axis of hippocampus were obtained. Hippocampal volumes were calculated manually using a standard protocol. The calculated hippocampal volumes were correlated with Scheltens Visual Rating Method for Rating MTL. A total of 32 cognitively normal age-matched subjects were selected to see the same correlation in the healthy subjects as well. Sensitivity and specificity of both methods was calculated and compared. There was an insignificant correlation between the hippocampal volumes and MTL rating scores in cognitively normal elderly ( n = 32; Pearson Correlation coefficient = 0.16, P > 0.05). In the AD Group, there was a moderately strong correlation between measured hippocampal volumes and MTL Rating (Pearson's correlation coefficient = -0.54; P < 0.05. There was a moderately strong correlation between hippocampal volume and Mini-Mental Status Examination in the AD group. Manual delineation was superior compared to the visual method ( P < 0.05). Good correlation was present between manual hippocampal volume measurements and MTL scores. Sensitivity and specificity of manual measurement of hippocampus was higher compared to visual rating scores for MTL in patients

  9. Verbal Communication among Alzheimer’s Disease Patients, their Caregivers, and Primary Care Physicians during Primary Care Office Visits

    PubMed Central

    Schmidt, Karen L.; Lingler, Jennifer H.; Schulz, Richard

    2009-01-01

    Objective Primary care visits of patients with Alzheimer’s disease (AD) often involve communication among patients, family caregivers, and primary care physicians (PCPs). The objective of this study was to understand the nature of each individual’s verbal participation in these triadic interactions. Methods To define the verbal communication dynamics of AD care triads, we compared verbal participation (percent of total visit speech) by each participant in patient/caregiver/PCP triads. Twenty three triads were audio taped during a routine primary care visit. Rates of verbal participation were described and effects of patient cognitive status (MMSE score, verbal fluency) on verbal participation were assessed. Results PCP verbal participation was highest at 53% of total visit speech, followed by caregivers (31%) and patients (16%). Patient cognitive measures were related to patient and caregiver verbal participation, but not to PCP participation. Caregiver satisfaction with interpersonal treatment by PCP was positively related to caregiver’s own verbal participation. Conclusion Caregivers of AD patients and PCPs maintain active, coordinated verbal participation in primary care visits while patients participate less. Practice Implications Encouraging verbal participation by AD patients and their caregivers may increase the AD patient’s active role and caregiver satisfaction with primary care visits. PMID:19395224

  10. Risk of incident clinical diagnosis of AD-type dementia attributable to pathology-confirmed vascular disease

    PubMed Central

    Dodge, Hiroko H.; Zhu, Jian; Woltjer, Randy; Nelson, Peter T.; Bennett, David A.; Cairns, Nigel J.; Fardo, David W.; Kaye, Jeffrey A.; Lyons, Deniz-Erten; Mattek, Nora; Schneider, Julie A; Silbert, Lisa C.; Xiong, Chengjie; Yu, Lei; Schmitt, Frederick A.; Kryscio, Richard J.; Abner, Erin L.

    2016-01-01

    Introduction Presence of cerebrovascular pathology may increase the risk of clinical diagnosis of AD. Methods We examined excess risk of incident clinical diagnosis of AD (probable and possible AD) posed by the presence of lacunes and large infarcts beyond AD pathology using data from the Statistical Modelling of Aging and Risk of Transition (SMART) study, a consortium of longitudinal cohort studies with over 2000 autopsies. We created six mutually exclusive pathology patterns combining three levels of AD pathology (low, moderate or high AD pathology) and two levels of vascular pathology (without lacunes and large infarcts or with lacunes and/or large infarcts). Results The coexistence of lacunes and large infarcts results in higher likelihood of clinical diagnosis of AD only when AD pathology burden is low. Discussion Our results reinforce the diagnostic importance of AD pathology in clinical AD. Further harmonization of assessment approaches for vascular pathologies is required. PMID:28017827

  11. Value Added in English Schools

    ERIC Educational Resources Information Center

    Ray, Andrew; McCormack, Tanya; Evans, Helen

    2009-01-01

    Value-added indicators are now a central part of school accountability in England, and value-added information is routinely used in school improvement at both the national and the local levels. This article describes the value-added models that are being used in the academic year 2007-8 by schools, parents, school inspectors, and other…

  12. Study of micro piezoelectric vibration generator with added mass and capacitance suitable for broadband vibration

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    He, Qing, E-mail: hqng@163.com; Mao, Xinhua, E-mail: 30400414@qq.com; Chu, Dongliang, E-mail: 569256386@qq.com

    This study proposes an optimized frequency adjustment method that uses a micro-cantilever beam-based piezoelectric vibration generator based on a combination of added mass and capacitance. The most important concept of the proposed method is that the frequency adjustment process is divided into two steps: the first is a rough adjustment step that changes the size of the mass added at the end of cantilever to adjust the frequency in a large-scale and discontinuous manner; the second step is a continuous but short-range frequency adjustment via the adjustable added capacitance. Experimental results show that when the initial natural frequency of amore » micro piezoelectric vibration generator is 69.8 Hz, then this natural frequency can be adjusted to any value in the range from 54.2 Hz to 42.1 Hz using the combination of the added mass and the capacitance. This method simply and effectively matches a piezoelectric vibration generator’s natural frequency to the vibration source frequency.« less

  13. Careers in Online: Want Ads in the Online Industry.

    ERIC Educational Resources Information Center

    Dolan, Donna R.; Hoffman, Laura J.

    1984-01-01

    Describes sources of job listings in online industry including "New York Times,""Boston Globe,""Washington Post,""Los Angeles Times,""Wall Street Journal,""National Business Employment Weekly," and hints on methods for reading and responding to ads and placing them. Sample advertisements…

  14. Hagedorn Temperature of AdS5/CFT4 via Integrability

    NASA Astrophysics Data System (ADS)

    Harmark, Troels; Wilhelm, Matthias

    2018-02-01

    We establish a framework for calculating the Hagedorn temperature of AdS5/CFT4 via integrability. Concretely, we derive the thermodynamic Bethe ansatz equations that yield the Hagedorn temperature of planar N =4 super Yang-Mills theory at any value of the 't Hooft coupling. We solve these equations perturbatively at weak coupling via the associated Y system, confirming the known results at tree level and one-loop order as well as deriving the previously unknown two-loop Hagedorn temperature. Finally, we comment on solving the equations at finite coupling.

  15. Modifying Repetitive Verbalizations of Community-Dwelling Patients with AD.

    ERIC Educational Resources Information Center

    Bourgeois, Michelle S.; And Others

    1997-01-01

    Reports on behavior management training given to seven caregivers of a home-dwelling spouse with Alzheimer's disease. Results reveal that trained caregivers were successful at decreasing patient repetitions using written cues. Patients of control subjects showed no systematic changes in behavioral disturbances. Intervention effects lasted for 16…

  16. Hydrotherapy added to endurance training versus endurance training alone in elderly patients with chronic heart failure: a randomized pilot study.

    PubMed

    Caminiti, Giuseppe; Volterrani, Maurizio; Marazzi, Giuseppe; Cerrito, Anna; Massaro, Rosalba; Sposato, Barbara; Arisi, Arianna; Rosano, Giuseppe

    2011-04-14

    To assess if Hydrotherapy (HT) added to endurance training (ET) is more effective than ET alone in order to improve exercise tolerance of elderly male patients with chronic heart failure (CHF). Twenty-one male CHF patients, age 68+/-7 (mean+/-DS) years; ejection fraction 32+/-9. NYHA II-III were enrolled. Eleven pts were randomized to combined training (CT) group performing HT+ET and 10 patients to ET group (ET only). At baseline and after 24 weeks all patients underwent: 6-minute walking test (6MWT), assessment of quadriceps maximal voluntary contraction (MVC) and peak torque (PT), blood pressure and heart rate (HR), echocardiography and non-invasive hemodynamic evaluation. HT was performed 3 times/week in upright position at up to the xyphoid process at a temperature of 31°C. ET was performed 3 times/week. Exercise was well tolerated. No patients had adverse events. Distance at 6MWT improved in both groups (CT group: 150+/-32 m; ET group:105+/-28 m) with significant intergroup differences (p 0.001). On land diastolic BP and HR significantly decreased in the CT group while remained unchanged in the ET group (-11 mmHg+/-2, p 0.04; e - 12 bpm, p 0.03; respectively) CO and SV had a relative despite no significant increase in CT group TPR on land significantly decreased in CT group (-23+/-3 mmHg/l/m; p 0.01) while remained unchanged in ET group. Patients of CT group had no significant higher increase of both MVC and PT than ET group. CT training, significantly improves exercise tolerance and hemodynamic profile of patients with CHF. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  17. Classification of Alzheimer's disease patients with hippocampal shape wrapper-based feature selection and support vector machine

    NASA Astrophysics Data System (ADS)

    Young, Jonathan; Ridgway, Gerard; Leung, Kelvin; Ourselin, Sebastien

    2012-02-01

    It is well known that hippocampal atrophy is a marker of the onset of Alzheimer's disease (AD) and as a result hippocampal volumetry has been used in a number of studies to provide early diagnosis of AD and predict conversion of mild cognitive impairment patients to AD. However, rates of atrophy are not uniform across the hippocampus making shape analysis a potentially more accurate biomarker. This study studies the hippocampi from 226 healthy controls, 148 AD patients and 330 MCI patients obtained from T1 weighted structural MRI images from the ADNI database. The hippocampi are anatomically segmented using the MAPS multi-atlas segmentation method, and the resulting binary images are then processed with SPHARM software to decompose their shapes as a weighted sum of spherical harmonic basis functions. The resulting parameterizations are then used as feature vectors in Support Vector Machine (SVM) classification. A wrapper based feature selection method was used as this considers the utility of features in discriminating classes in combination, fully exploiting the multivariate nature of the data and optimizing the selected set of features for the type of classifier that is used. The leave-one-out cross validated accuracy obtained on training data is 88.6% for classifying AD vs controls and 74% for classifying MCI-converters vs MCI-stable with very compact feature sets, showing that this is a highly promising method. There is currently a considerable fall in accuracy on unseen data indicating that the feature selection is sensitive to the data used, however feature ensemble methods may overcome this.

  18. Effective Ad-Hoc Committees.

    ERIC Educational Resources Information Center

    Young, David G.

    1983-01-01

    Ad-hoc committees may be symbolic, informational, or action committees. A literature survey indicates such committees' structural components include a suprasystem and three subsystems involving linkages, production, and implementation. Other variables include size, personal factors, and timing. All the factors carry implications about ad-hoc…

  19. Introducing ADS Labs

    NASA Astrophysics Data System (ADS)

    Accomazzi, Alberto; Henneken, E.; Grant, C. S.; Kurtz, M. J.; Di Milia, G.; Luker, J.; Thompson, D. M.; Bohlen, E.; Murray, S. S.

    2011-05-01

    ADS Labs is a platform that ADS is introducing in order to test and receive feedback from the community on new technologies and prototype services. Currently, ADS Labs features a new interface for abstract searches, faceted filtering of results, visualization of co-authorship networks, article-level recommendations, and a full-text search service. The streamlined abstract search interface provides a simple, one-box search with options for ranking results based on a paper relevancy, freshness, number of citations, and downloads. In addition, it provides advanced rankings based on collaborative filtering techniques. The faceted filtering interface allows users to narrow search results based on a particular property or set of properties ("facets"), allowing users to manage large lists and explore the relationship between them. For any set or sub-set of records, the co-authorship network can be visualized in an interactive way, offering a view of the distribution of contributors and their inter-relationships. This provides an immediate way to detect groups and collaborations involved in a particular research field. For a majority of papers in Astronomy, our new interface will provide a list of related articles of potential interest. The recommendations are based on a number of factors, including text similarity, citations, and co-readership information. The new full-text search interface allows users to find all instances of particular words or phrases in the body of the articles in our full-text archive. This includes all of the scanned literature in ADS as well as a select portion of the current astronomical literature, including ApJ, ApJS, AJ, MNRAS, PASP, A&A, and soon additional content from Springer journals. Fulltext search results include a list of the matching papers as well as a list of "snippets" of text highlighting the context in which the search terms were found. ADS Labs is available at http://adslabs.org

  20. How Do Value-Added Indicators Compare to Other Measures of Teacher Effectiveness? What We Know Series: Value-Added Methods and Applications. Knowledge Brief 5

    ERIC Educational Resources Information Center

    Harris, Douglas N.

    2012-01-01

    In the recent drive to revamp teacher evaluation and accountability, measures of a teacher's value added have played the starring role. But the star of the show is not always the best actor, nor can the star succeed without a strong supporting cast. In assessing teacher performance, observations of classroom practice, portfolios of teachers' work,…

  1. Exact microstate counting for dyonic black holes in AdS4

    NASA Astrophysics Data System (ADS)

    Benini, Francesco; Hristov, Kiril; Zaffaroni, Alberto

    2017-08-01

    We present a counting of microstates of a class of dyonic BPS black holes in AdS4 which precisely reproduces their Bekenstein-Hawking entropy. The counting is performed in the dual boundary description, that provides a non-perturbative definition of quantum gravity, in terms of a twisted and mass-deformed ABJM theory. We evaluate its twisted index and propose an extremization principle to extract the entropy, which reproduces the attractor mechanism in gauged supergravity.

  2. Education, leisure activities and cognitive and functional ability of Alzheimer's disease patients: A follow-up study

    PubMed Central

    Sobral, Margarida; Paúl, Constança

    2013-01-01

    Education and participation in leisure activities appear to be highly relevant variables in Alzheimer's disease (AD) and usually form the basis of the Cognitive Reserve construct. OBJECTIVE [A] To determine the association between education, cognitive and functional ability of AD patients; [B] To determine the association between participation in leisure activities and cognitive and functional ability of AD patients; [C] To evaluate the association of education and participation in leisure activities in the course of AD. METHODS Functional and neuropsychological abilities of 120 outpatients with probable AD were evaluated at baseline, at 36 and 54 months. Data collected at baseline included socio-demographics, clinical variables, education and frequency of participation in leisure activities throughout life. All participants and/or caregivers answered the questionnaire, "Participation in leisure activities throughout life" while patients completed the MMSE, the Clinical Dementia Rating scale, neuropsychological tests from the Lisbon Screening for Dementia Assessment, Barthel Index and Lawton and Brody's Index. RESULTS AD patients with higher levels of education achieved better results on cognitive tests. The participants with higher participation in leisure activities exhibited better results on cognitive and functional tests than those with lower participation. The disease progression was linear and progressed similarly regardless of the level of education of participants. However, the results suggest a slower disease progression in patients with a higher level of participation in leisure activities throughout their lives. CONCLUSION AD patients with high education and high participation in leisure activities may benefit from a slower cognitive and functional decline after diagnosis of AD. PMID:29213838

  3. The complexity of identifying Ryu-Takayanagi surfaces in AdS 3/CFT 2

    DOE PAGES

    Bao, Ning; Chatwin-Davies, A.

    2016-11-07

    Here, we present a constructive algorithm for the determination of Ryu-Takayanagi surfaces in AdS 3/CFT 2 which exploits previously noted connections between holographic entanglement entropy and max-flow/min-cut. We then characterize its complexity as a polynomial time algorithm.

  4. Zooming in on AdS3/CFT2 near a BPS bound

    NASA Astrophysics Data System (ADS)

    Hartong, Jelle; Lei, Yang; Obers, Niels; Oling, Gerben

    2018-05-01

    Any ( d + 1)-dimensional CFT with a U(1) flavor symmetry, a BPS bound and an exactly marginal coupling admits a decoupling limit in which one zooms in on the spectrum close to the bound. This limit is an Inönü-Wigner contraction of so(2 , d+1)⊕ u(1) that leads to a relativistic algebra with a scaling generator but no conformal generators. In 2D CFTs, Lorentz boosts are abelian and by adding a second u(1) we find a contraction of two copies of sl(2, ℝ) ⊕ u(1) to two copies of P 2 c , the 2-dimensional centrally extended Poincaré algebra. We show that the bulk is described by a novel non-Lorentzian geometry that we refer to as pseudo-Newton-Cartan geometry. Both the Chern-Simons action on sl(2, ℝ) ⊕ u(1) and the entire phase space of asymptotically AdS3 spacetimes are well-behaved in the corresponding limit if we fix the radial component for the u(1) connection. With this choice, the resulting Newton-Cartan foliation structure is now associated not with time, but with the emerging holographic direction. Since the leaves of this foliation do not mix, the emergence of the holographic direction is much simpler than in AdS3 holography. Furthermore, we show that the asymptotic symmetry algebra of the limit theory consists of a left- and a right-moving warped Virasoro algebra.

  5. Fine Grained Chaos in AdS2 Gravity

    NASA Astrophysics Data System (ADS)

    Haehl, Felix M.; Rozali, Moshe

    2018-03-01

    Quantum chaos can be characterized by an exponential growth of the thermal out-of-time-order four-point function up to a scrambling time u^*. We discuss generalizations of this statement for certain higher-point correlation functions. For concreteness, we study the Schwarzian theory of a one-dimensional time reparametrization mode, which describes two-dimensional anti-de Sitter space (AdS2 ) gravity and the low-energy dynamics of the Sachdev-Ye-Kitaev model. We identify a particular set of 2 k -point functions, characterized as being both "maximally braided" and "k -out of time order," which exhibit exponential growth until progressively longer time scales u^*(k)˜(k -1 )u^*. We suggest an interpretation as scrambling of increasingly fine grained measures of quantum information, which correspondingly take progressively longer time to reach their thermal values.

  6. Fine Grained Chaos in AdS_{2} Gravity.

    PubMed

    Haehl, Felix M; Rozali, Moshe

    2018-03-23

    Quantum chaos can be characterized by an exponential growth of the thermal out-of-time-order four-point function up to a scrambling time u[over ^]_{*}. We discuss generalizations of this statement for certain higher-point correlation functions. For concreteness, we study the Schwarzian theory of a one-dimensional time reparametrization mode, which describes two-dimensional anti-de Sitter space (AdS_{2}) gravity and the low-energy dynamics of the Sachdev-Ye-Kitaev model. We identify a particular set of 2k-point functions, characterized as being both "maximally braided" and "k-out of time order," which exhibit exponential growth until progressively longer time scales u[over ^]_{*}^{(k)}∼(k-1)u[over ^]_{*}. We suggest an interpretation as scrambling of increasingly fine grained measures of quantum information, which correspondingly take progressively longer time to reach their thermal values.

  7. [The effect of Ai Chi method in fibromyalgic patients].

    PubMed

    Santana, Jacqueline Soares de; Almeida, Ana Paula Gonçalves de; Brandão, Patrícia Martins Carvalho

    2010-06-01

    The objective of this article is to show the effect of the Ai Chi method, as an alternative form of hydrotherapeutic approach in fibromyalgia syndrome patients. Ten patients were studied, four were part of the experiment group and five of the control group, with one desistance. The patients were evaluated through the Fibromyalgia Impact Questionnaire (QIF) and Scale of Intensity and Index of pain in Sensible Points. Two evaluations were performed, before and after the treatment. The patients were submitted to ten sessions of the Ai Chi method during 40 minutes. The scale of intensity of pain in sensible points presented an improvement in the intensity of pain after the intervention, while quality of life remained without alteration. Regarding the quality of life, it was observed that the groups had similar results, because of the fact that patients had not presented improvement at depressive state. It was also verified a difference in the index of the sensible points between the groups; the explanation for this difference might be because of the benefits of the immersion in warm water and the effect of the Ai Chi method. There was no significant difference between the groups, which can be attributed to its limitations. In this way, new studies referring to the application of the Ai Chi method in patients carrying fibromyalgia syndrome become relevant.

  8. Thermodynamic Volume in AdS/CFT

    NASA Astrophysics Data System (ADS)

    Kim, Kyung Kiu; Ahn, Byoungjoon

    2018-01-01

    In this note, we study on extended thermodynamics of AdS black holes by varying cosmological constant. We found and discussed pressure and volume of both bulk and boundary physics through AdS/CFT correspondence. In particular, we derive the relation between thermodynamic volume and a chemical potential for M2 brane dual to four dimensional AdS space. In addition, we show that thermodynamic volume of hyperbolic black hole is related to `entanglement pressure' coming from a generalized first law of entanglement entropy.

  9. Rapid reduction of central line infections in hospitalized pediatric oncology patients through simple quality improvement methods.

    PubMed

    Choi, Sung W; Chang, Lawrence; Hanauer, David A; Shaffer-Hartman, Jacqueline; Teitelbaum, Daniel; Lewis, Ian; Blackwood, Alex; Akcasu, Nur; Steel, Janell; Christensen, Joy; Niedner, Matthew F

    2013-02-01

    Pediatric hematology-oncology (PHO) patients are at significant risk for developing central line-associated bloodstream infections (CLA-BSIs) due to their prolonged dependence on such catheters. Effective strategies to eliminate these preventable infections are urgently needed. In this study, we investigated the implementation of bundled central line maintenance practices and their effect on hospital-acquired CLA-BSIs. CLA-BSI rates were analyzed within a single-institution's PHO unit between January 2005 and June 2011. In May 2008, a multidisciplinary quality improvement team developed techniques to improve the PHO unit's safety culture and implemented the use of catheter maintenance practices tailored to PHO patients. Data analysis was performed using time-series methods to evaluate the pre- and post-intervention effect of the practice changes. The pre-intervention CLA-BSI incidence was 2.92 per 1,000-patient days (PD) and coagulase-negative Staphylococcus was the most prevalent pathogen (29%). In the post-intervention period, the CLA-BSI rate decreased substantially (45%) to 1.61 per 1,000-PD (P < 0.004). Early on, blood and marrow transplant (BMT) patients had a threefold higher CLA-BSI rate compared to non-BMT patients (P < 0.033). With additional infection control countermeasures added to the bundled practices, BMT patients experienced a larger CLA-BSI rate reduction such that BMT and non-BMT CLA-BSI rates were not significantly different post-intervention. By adopting and effectively implementing uniform maintenance catheter care practices, learning multidisciplinary teamwork, and promoting a culture of patient safety, the CLA-BSI incidence in our study population was significantly reduced and maintained. Copyright © 2012 Wiley Periodicals, Inc.

  10. Distribution of Malassezia Species in Patients with Different Dermatological Disorders and Healthy Individuals.

    PubMed

    Prohić, Asja; Jovović Sadiković, Tamara; Kuskunović-Vlahovljak, Suada; Baljić, Rusmir

    2016-12-01

    There are differences with respect to the commonly isolated Malassezia species, not only between healthy individuals and the patients with various skin diseases, but also between different countries. We investigated the species composition of Malassezia microflora on the skin of patients with Malassezia-associated diseases and of healthy subjects (HS). Two hundred and fifty skin scrapings from patients with pityriasis versicolor (PV), seborrheic dermatitis (SD), atopic dermatitis (AD), psoriasis (PS), and healthy subjects (HS), fifty each, were inoculated into Sabouraud dextrose agar and into modified Dixon agar and identified using conventional culture-based methods. In PV and PS lesions, the most common species was M. globosa (62% and 52%, respectively), while M. restricta was predominant in SD lesions (28%). M. sympodialis was the most common species recovered from AD (52%) and healthy trunk skin (30%). Fewer cultures were positive for Malassezia growth in patients with AD than in patients with other skin conditions, and even in controls. Our data are in agreement with other studies and suggest that the pathogenic species of PV is M. globosa. The evidence that any given species is clinically important in the pathogenicity of SD, AD and PS is still lacking.

  11. A new yeast, Malassezia yamatoensis, isolated from a patient with seborrheic dermatitis, and its distribution in patients and healthy subjects.

    PubMed

    Sugita, Takashi; Tajima, Mami; Takashima, Masako; Amaya, Misato; Saito, Masuyoshi; Tsuboi, Ryoji; Nishikawa, Akemi

    2004-01-01

    Over the last few years, new Malassezia species have been found regularly in Japanese subjects. We isolated another new Malassezia species from a Japanese patient with seborrheic dermatitis (SD), and named it M. yamatoensis. In its physiological characteristics and the utilization of Tween by M. yamatoensis is similar to that of M. furfur and M. dermatis. It is distinguished by its growth temperature. To examine the distribution of the microorganism in the skin of patients with SD and atopic dermatitis (AD), and healthy subjects, we applied transparent dressings to the skin, and detected M. yamatoensis DNA using a non-culture-based method that consisted of nested PCR with specific primers. M. yamatoensis DNA was detected from 3 of 31 SD patients (9.7%), 5 of 36 AD patients (13.9%), and 1 of 22 healthy subjects (4.6%). Therefore, M. yamatoensis is a rare member of the cutaneous microflora.

  12. Minocycline added to subcutaneous interferon β-1a in multiple sclerosis: randomized RECYCLINE study.

    PubMed

    Sørensen, P S; Sellebjerg, F; Lycke, J; Färkkilä, M; Créange, A; Lund, C G; Schluep, M; Frederiksen, J L; Stenager, E; Pfleger, C; Garde, E; Kinnunen, E; Marhardt, K

    2016-05-01

    Combining different therapies may improve disease control in patients with relapsing-remitting multiple sclerosis (RRMS). This study assessed the efficacy and safety of minocycline added to subcutaneous (sc) interferon (IFN) β-1a therapy. This was a double-blind, randomized, placebo-controlled multicentre study. Within 3 months (±1 month) of starting sc IFN β-1a 44 μg three times weekly, patients with RRMS were randomized to minocycline 100 mg twice daily or placebo, added to sc IFN β-1a, for 96 weeks. The primary efficacy endpoint was the time to first qualifying relapse. Secondary efficacy endpoints were the annualized relapse rate for qualifying relapses, the number of new/enlarging T2-weighted lesions and change in brain volume [magnetic resonance imaging (MRI) was performed only in a few selected centres]. In addition, a number of tertiary efficacy endpoints were assessed. One hundred and forty-nine patients received minocycline and 155 received placebo; MRI data were available for 23 and 27 patients, respectively. The time to first qualifying relapse did not differ significantly for minocycline versus placebo (hazard ratio 0.85; 95% confidence interval 0.53, 1.35; log-rank = 0.50; P = 0.48). There were no statistically significant differences between the two groups on other efficacy endpoints, although some numerical trends in favour of minocycline were observed. No unexpected adverse events were reported, but more patients discontinued because of adverse events with minocycline versus placebo. Minocycline showed no statistically significant beneficial effect when added to sc IFN β-1a therapy. © 2016 EAN.

  13. Benefit and harm of adding ketamine to an opioid in a patient-controlled analgesia device for the control of postoperative pain: systematic review and meta-analyses of randomized controlled trials with trial sequential analyses.

    PubMed

    Assouline, Benjamin; Tramèr, Martin R; Kreienbühl, Lukas; Elia, Nadia

    2016-12-01

    Ketamine is often added to opioids in patient-controlled analgesia devices. We tested whether in surgical patients, ketamine added to an opioid patient-controlled analgesia decreased pain intensity by ≥25%, cumulative opioid consumption by ≥30%, the risk of postoperative nausea and vomiting by ≥30%, the risk of respiratory adverse effects by ≥50%, and increased the risk of hallucination not more than 2-fold. In addition, we searched for evidence of dose-responsiveness. Nineteen randomized trials (1349 adults, 104 children) testing different ketamine regimens added to various opioids were identified through searches in databases and bibliographies (to 04.2016). In 9 trials (595 patients), pain intensity at rest at 24 hours was decreased by 32% with ketamine (weighted mean difference -1.1 cm on the 0-10 cm visual analog scale [98% CI, -1.8 to -0.39], P < 0.001). In 7 trials (495 patients), cumulative 24 hours morphine consumption was decreased by 28% with ketamine (weighted mean difference -12.9 mg [-22.4 to -3.35], P = 0.002). In 7 trials (435 patients), the incidence of postoperative nausea and vomiting was decreased by 44% with ketamine (risk ratio 0.56 [0.40 to 0.78], P < 0.001). There was no evidence of a difference in the incidence of respiratory adverse events (9 trials, 871 patients; risk ratio 0.31 [0.06 to 1.51], P = 0.08) or hallucination (7 trials, 690 patients; odds ratio 1.16 [0.47 to 2.79], P = 0.70). Trial sequential analyses confirmed the significant benefit of ketamine on pain intensity, cumulative morphine consumption, and postoperative nausea and vomiting and its inability to double the risk of hallucination. The available data did not allow us to make a conclusion on respiratory adverse events or to establish dose-responsiveness.

  14. Some semiclassical structure constants for AdS 4 × CP 3

    NASA Astrophysics Data System (ADS)

    Ahn, Changrim; Bozhilov, Plamen

    2018-02-01

    We compute structure constants in three-point functions of three string states in AdS 4× CP 3 in the framework of the semiclassical approach. We consider HHL correlation functions where two of the states are "heavy" string states of finite-size giant magnons carrying one or two angular momenta and the other one corresponds to such "light" states as dilaton operators with non-zero momentum, primary scalar operators, and singlet scalar operators with higher string levels.

  15. Adding Once-Daily Lixisenatide for Type 2 Diabetes Inadequately Controlled With Newly Initiated and Continuously Titrated Basal Insulin Glargine

    PubMed Central

    Riddle, Matthew C.; Forst, Thomas; Aronson, Ronnie; Sauque-Reyna, Leobardo; Souhami, Elisabeth; Silvestre, Louise; Ping, Lin; Rosenstock, Julio

    2013-01-01

    OBJECTIVE When oral therapy for type 2 diabetes is ineffective, adding basal insulin improves glycemic control. However, when glycated hemoglobin (HbA1c) remains elevated because of postprandial hyperglycemia, the next therapeutic step is controversial. We examined the efficacy and safety of lixisenatide in patients with HbA1c still elevated after initiation of insulin glargine. RESEARCH DESIGN AND METHODS This double-blind, parallel-group trial enrolled patients with HbA1c 7–10% despite oral therapy. Insulin glargine was added and systematically titrated during a 12-week run-in, after which candidates with fasting glucose ≤7.8 mmol/L and HbA1c 7–9% were randomized to lixisenatide 20 µg or placebo for 24 weeks while insulin titration continued. The primary end point was HbA1c change after randomization. RESULTS The randomized population (n = 446) had mean diabetes duration of 9.2 years, BMI 31.8 kg/m2, and daily glargine dosage of 44 units. HbA1c had decreased during run-in from 8.6 to 7.6%; adding lixisenatide further reduced HbA1c by 0.71 vs. 0.40% with placebo (least squares mean difference, –0.32%; 95% CI, –0.46 to –0.17; P < 0.0001). More participants attained HbA1c <7% with lixisenatide (56 vs. 39%; P < 0.0001). Lixisenatide reduced plasma glucose 2 h after a standardized breakfast (difference vs. placebo –3.2 mmol/L; P < 0.0001) and had a favorable effect on body weight (difference vs. placebo –0.89 kg; P = 0.0012). Nausea, vomiting, and symptomatic hypoglycemia <3.3 mmol/L were more common with lixisenatide. CONCLUSIONS Adding lixisenatide to insulin glargine improved overall and postprandial hyperglycemia and deserves consideration as an alternative to prandial insulin for patients not reaching HbA1c goals with recently initiated basal insulin. PMID:23564915

  16. Sparse Bayesian Learning for Identifying Imaging Biomarkers in AD Prediction

    PubMed Central

    Shen, Li; Qi, Yuan; Kim, Sungeun; Nho, Kwangsik; Wan, Jing; Risacher, Shannon L.; Saykin, Andrew J.

    2010-01-01

    We apply sparse Bayesian learning methods, automatic relevance determination (ARD) and predictive ARD (PARD), to Alzheimer’s disease (AD) classification to make accurate prediction and identify critical imaging markers relevant to AD at the same time. ARD is one of the most successful Bayesian feature selection methods. PARD is a powerful Bayesian feature selection method, and provides sparse models that is easy to interpret. PARD selects the model with the best estimate of the predictive performance instead of choosing the one with the largest marginal model likelihood. Comparative study with support vector machine (SVM) shows that ARD/PARD in general outperform SVM in terms of prediction accuracy. Additional comparison with surface-based general linear model (GLM) analysis shows that regions with strongest signals are identified by both GLM and ARD/PARD. While GLM P-map returns significant regions all over the cortex, ARD/PARD provide a small number of relevant and meaningful imaging markers with predictive power, including both cortical and subcortical measures. PMID:20879451

  17. Chemical and neuropathological analyses of an Alzheimer’s disease patient treated with solanezumab

    PubMed Central

    Roher, Alex E; Maarouf, Chera L; Kokjohn, Tyler A; Belden, Christine; Serrano, Geidy; Sabbagh, Marwan S; Beach, Thomas G

    2016-01-01

    Introduction: Based on the amyloid cascade hypothesis of Alzheimer’s disease (AD) pathogenesis, a series of clinical trials involving immunotherapies have been undertaken including infusion with the IgG1 monoclonal anti-Aβ antibody solanezumab directed against the middle of the soluble Aβ peptide. In this report, we give an account of the clinical history, psychometric testing, gross and microscopic neuropathology as well as immunochemical quantitation of soluble and insoluble Aβ peptides and other proteins of interest related to AD pathophysiology in a patient treated with solanezumab. Materials and Methods: The solanezumab-treated AD case (SOLA-AD) was compared to non-demented control (NDC, n = 5) and non-immunized AD (NI-AD, n = 5) subjects. Brain sections were stained with H&E, Thioflavine-S, Campbell-Switzer and Gallyas methods. ELISA and Western blots were used for quantification of proteins of interest. Results: The SOLA-AD subject’s neuropathology and biochemistry differed sharply from the NDC and NI-AD groups. The SOLA-AD case had copious numbers of amyloid laden blood vessels in all areas of the cerebral cortex, from leptomeningeal perforating arteries to arteriolar deposits which attained the cerebral amyloid angiopathy (CAA) maximum score of 12. In contrast, the maximum CAA for the NI-AD cases averaged a total of 3.6, while the NDC cases only reached 0.75. The SOLA-AD subject had 4.4-fold more soluble Aβ40 and 5.6-fold more insoluble Aβ40 in the frontal lobe compared to NI-AD cases. In the temporal lobe of the SOLA-AD case, the soluble Aβ40 was 80-fold increased, and the insoluble Aβ40 was 13-fold more abundant compared to the non-immunized AD cases. Both soluble and insoluble Aβ42 levels were not dramatically different between the SOLA-AD and NI-AD cohort. Discussion: Solanezumab immunotherapy provided no apparent relief in the clinical evolution of dementia in this particular AD patient, since there was a continuous cognitive deterioration

  18. Adding video recording increases the diagnostic yield of routine electroencephalograms in children with frequent paroxysmal events.

    PubMed

    Watemberg, Nathan; Tziperman, Barak; Dabby, Ron; Hasan, Mariana; Zehavi, Liora; Lerman-Sagie, Tally

    2005-05-01

    To report on the usefulness of adding video recording to routine EEG studies of infants and children with frequent paroxysmal events. We analyzed the efficacy of this diagnostic means during a 4-year period. The decision whether to add video recording was made by the pediatric EEG interpreter at the time of the study. Studies were planned to last between 20 and 30 min, and, if needed, were extended by the EEG interpreter. For most studies, video recording was added from the beginning of EEG recording. In a minority of cases, the addition of video was implemented during the first part of the EEG test, as clinical events became obvious. In these cases, a new study (file) was begun. The success rate was analyzed according to the indications for the EEG study: paroxysmal eye movements, tremor, suspected seizures, myoclonus, staring episodes, suspected stereotypias and tics, absence epilepsy follow-up, cyanotic episodes, and suspected psychogenic nonepileptic events. Video recording was added to 137 of 666 routine studies. Mean patient age was 4.8 years. The nature of the event was determined in 61 (45%) of the EEG studies. Twenty-eight percent were hospitalized patients. The average study duration was 26 min. This diagnostic means was particularly useful for paroxysmal eye movements, staring spells, myoclonic jerks, stereotypias, and psychogenic nonepileptic events. About 46% of 116 patients for whom cognitive data were available were mentally retarded. EEG with added video recording was successfully performed in all 116 cases and provided useful information in 29 (55%) of these 53 patients. Adding video recording to routine EEG was helpful in 45% of cases referred for frequent paroxysmal events. This technique proved useful for hospitalized children as well as for outpatients. Moreover, it was successfully applied in cognitively impaired patients. Infants and children with paroxysmal eye movements, staring spells, myoclonic jerks, stereotypias, and pseudoseizures

  19. Exploring Visual Selective Attention towards Novel Stimuli in Alzheimer's Disease Patients.

    PubMed

    Chau, Sarah A; Herrmann, Nathan; Eizenman, Moshe; Chung, Jonathan; Lanctôt, Krista L

    2015-01-01

    Alzheimer's disease (AD) is associated with selective attention impairments, which could contribute to cognitive and functional deficits. Selective attention can be explored through examination of novelty preference. In this study, we quantified novelty preference in AD patients by measuring visual scanning behaviour using an eye tracking paradigm. Mild-to-moderate AD patients and elderly controls viewed slides containing novel and repeated images simultaneously. The outcome measure was time spent on specific images, with novelty preference defined by greater relative fixation time (RFT) on novel versus repeated images. Cognitive status (Standardized Mini-Mental State Examination, SMMSE) and attention (Digit Span, DS) were also measured. AD patients (age 79.2 ± 6.7 years, SMMSE 22.2 ± 4.0, n = 41) and controls (age 76.2 ± 6.4 years, SMMSE 28.1 ± 2.0, n = 24) were similar in age, education and sex. Compared with controls, AD patients had lower RFT on novel than on repeated images (F1,63 = 11.18, p = 0.001). Further, reduced RFT was associated with lower scores on SMMSE (r63 = 0.288, p = 0.020) and DS (r63 = 0.269, p = 0.030). Within individuals, novelty preference was detected in 92.3% of patients and in 100% of controls. These findings suggest that novelty preference, measured by visual scanning behaviour, can differentiate cognitively healthy and impaired people and may offer a nonverbal, less cognitively demanding method of assessing selective attention.

  20. Myths & Facts about Value-Added Analysis

    ERIC Educational Resources Information Center

    TNTP, 2011

    2011-01-01

    This paper presents myths as well as facts about value-added analysis. These myths include: (1) "Value-added isn't fair to teachers who work in high-need schools, where students tend to lag far behind academically"; (2) "Value-added scores are too volatile from year-to-year to be trusted"; (3) "There's no research behind value-added"; (4) "Using…

  1. Integrability in AdS/CFT correspondence: quasi-classical analysis

    NASA Astrophysics Data System (ADS)

    Gromov, Nikolay

    2009-06-01

    In this review, we consider a quasi-classical method applicable to integrable field theories which is based on a classical integrable structure—the algebraic curve. We apply it to the Green-Schwarz superstring on the AdS5 × S5 space. We show that the proposed method reproduces perfectly the earlier results obtained by expanding the string action for some simple classical solutions. The construction is explicitly covariant and is not based on a particular parameterization of the fields and as a result is free from ambiguities. On the other hand, the finite size corrections in some particularly important scaling limit are studied in this paper for a system of Bethe equations. For the general superalgebra \\su(N|K) , the result for the 1/L corrections is obtained. We find an integral equation which describes these corrections in a closed form. As an application, we consider the conjectured Beisert-Staudacher (BS) equations with the Hernandez-Lopez dressing factor where the finite size corrections should reproduce quasi-classical results around a general classical solution. Indeed, we show that our integral equation can be interpreted as a sum of all physical fluctuations and thus prove the complete one-loop consistency of the BS equations. We demonstrate that any local conserved charge (including the AdS energy) computed from the BS equations is indeed given at one loop by the sum of the charges of fluctuations with an exponential precision for large S5 angular momentum of the string. As an independent result, the BS equations in an \\su(2) sub-sector were derived from Zamolodchikovs's S-matrix. The paper is based on the author's PhD thesis.

  2. Validation of an LC-MS/MS Method for Urinary Lactulose and Mannitol Quantification: Results in Patients with Irritable Bowel Syndrome.

    PubMed

    Gervasoni, Jacopo; Schiattarella, Arcangelo; Giorgio, Valentina; Primiano, Aniello; Russo, Consuelo; Tesori, Valentina; Scaldaferri, Franco; Urbani, Andrea; Zuppi, Cecilia; Persichilli, Silvia

    2016-01-01

    Aim . Lactulose/mannitol ratio is used to assess intestinal barrier function. Aim of this work was to develop a robust and rapid method for the analysis of lactulose and mannitol in urine by liquid chromatography coupled to tandem mass spectrometry. Lactulose/mannitol ratio has been measured in pediatric patients suffering from irritable bowel syndrome. Methods . Calibration curves and raffinose, used as internal standard, were prepared in water : acetonitrile 20 : 80. Fifty μ L of urine sample was added to 450  μ L of internal standard solution. The chromatographic separation was performed using a Luna NH 2 column operating at a flow rate of 200  μ L/min and eluted with a linear gradient from 20% to 80% water in acetonitrile. Total run time is 9 minutes. The mass spectrometry operates in electrospray negative mode. Method was fully validated according to European Medicine Agency guidelines. Results and Conclusions . Linearity ranged from 10 to 1000 mg/L for mannitol and 2.5 to 1000 mg/L for lactulose. Imprecision in intra- and interassay was lower than 15% for both analytes. Accuracy was higher than 85%. Lactulose/mannitol ratio in pediatric patients is significantly higher than that measured in controls. The presented method, rapid and sensitive, is suitable in a clinical laboratory.

  3. Particle collisions near a three-dimensional warped AdS black hole

    NASA Astrophysics Data System (ADS)

    Bécar, Ramón; González, P. A.; Vásquez, Yerko

    2018-04-01

    In this paper we consider the warped AdS3 black hole solution of topologically massive gravity with a negative cosmological constant, and we study the possibility that it acts as a particle accelerator by analyzing the energy in the center of mass (CM) frame of two colliding particles in the vicinity of its horizon, which is known as the Bañnados, Silk and West (BSW) process. Mainly, we show that the critical angular momentum (L_c) of the particle decreases when the warping parameter(ν ) increases. Also, we show that despite the particle with L_c being able to exist for certain values of the conserved energy outside the horizon, it will never reach the event horizon; therefore, the black hole cannot act as a particle accelerator with arbitrarily high CM energy on the event horizon. However, such a particle could also exist inside the outer horizon, with the BSW process being possible on the inner horizon. On the other hand, for the extremal warped AdS3 black hole, the particle with L_c and energy E could exist outside the event horizon and, the CM energy blows up on the event horizon if its conserved energy fulfills the condition E2>(ν 2+3)l2/3(ν ^{2-1)}, with the BSW process being possible.

  4. Introducing ADS 2.0

    NASA Astrophysics Data System (ADS)

    Accomazzi, Alberto; Kurtz, M. J.; Henneken, E. A.; Grant, C. S.; Thompson, D.; Luker, J.; Chyla, R.; Murray, S. S.

    2014-01-01

    In the spring of 1993, the Smithsonian/NASA Astrophysics Data System (ADS) first launched its bibliographic search system. It was known then as the ADS Abstract Service, a component of the larger Astrophysics Data System effort which had developed an interoperable data system now seen as a precursor of the Virtual Observatory. As a result of the massive technological and sociological changes in the field of scholarly communication, the ADS is now completing the most ambitious technological upgrade in its twenty-year history. Code-named ADS 2.0, the new system features: an IT platform built on web and digital library standards; a new, extensible, industrial strength search engine; a public API with various access control capabilities; a set of applications supporting search, export, visualization, analysis; a collaborative, open source development model; and enhanced indexing of content which includes the full-text of astronomy and physics publications. The changes in the ADS platform affect all aspects of the system and its operations, including: the process through which data and metadata are harvested, curated and indexed; the interface and paradigm used for searching the database; and the follow-up analysis capabilities available to the users. This poster describes the choices behind the technical overhaul of the system, the technology stack used, and the opportunities which the upgrade is providing us with, namely gains in productivity and enhancements in our system capabilities.

  5. ADS Bumblebee comes of age

    NASA Astrophysics Data System (ADS)

    Accomazzi, Alberto; Kurtz, Michael J.; Henneken, Edwin; Grant, Carolyn S.; Thompson, Donna M.; Chyla, Roman; McDonald, Steven; Shaulis, Taylor J.; Blanco-Cuaresma, Sergi; Shapurian, Golnaz; Hostetler, Timothy W.; Templeton, Matthew R.; Lockhart, Kelly E.

    2018-01-01

    The ADS Team has been working on a new system architecture and user interface named “ADS Bumblebee” since 2015. The new system presents many advantages over the traditional ADS interface and search engine (“ADS Classic”). A new, state of the art search engine features a number of new capabilities such as full-text search, advanced citation queries, filtering of results and scalable analytics for any search results. Its services are built on a cloud computing platform which can be easily scaled to match user demand. The Bumblebee user interface is a rich javascript application which leverages the features of the search engine and integrates a number of additional visualizations such as co-author and co-citation networks which provide a hierarchical view of research groups and research topics, respectively. Displays of paper analytics provide views of the basic article metrics (citations, reads, and age). All visualizations are interactive and provide ways to further refine search results. This new search system, which has been in beta for the past three years, has now matured to the point that it provides feature and content parity with ADS Classic, and has become the recommended way to access ADS content and services. Following a successful transition to Bumblebee, the use of ADS Classic will be discouraged starting in 2018 and phased out in 2019. You can access our new interface at https://ui.adsabs.harvard.edu

  6. Cardiovascular Risk Factors in Patients with Addison's Disease: A Comparative Study of South African and Swedish Patients

    PubMed Central

    Ross, Ian Louis; Bergthorsdottir, Ragnhildur; Levitt, Naomi; Dave, Joel Alex; Schatz, Desmond; Marais, David; Johannsson, Gudmundur

    2014-01-01

    Background Patients with Addison's disease (AD) in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD). Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa. Methods In a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden) matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP) and adiponectin were studied. Results All patients were Caucasian and the majority were women N = 36 (65.5%). Mean (standard deviation; SD) ages of the Swedish and South African patients were 52.9 (13.0) and 52.6 (14.4) years and BMI 25.3 (3.2) and 25.8 (4.1) kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1) versus 24.3 (8.0) mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR) triglycerides (TG) [1.59 (1.1–2.46) versus 0.96 (0.74–1.6) mmol/l; p<0.001], total cholesterol (TC) [6.02(1.50) versus 5.13 (0.87) mmol/l; p<0.001], LDL-C [4.43 (1.44) versus 2.75 (0.80) mmol/l; p<0.001] and median hs-CRP [2.15 (0.93–5.45) versus 0.99 (0.57–2.10) mg/L; p<0.003] and lower HDL-C [0.80 (0.40) versus 1.86 (0.46) mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus. Conclusions South African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors. PMID:24603607

  7. Predicting the effectiveness of virtual reality relaxation on pain and anxiety when added to PCA morphine in patients having burns dressings changes.

    PubMed

    Konstantatos, A H; Angliss, M; Costello, V; Cleland, H; Stafrace, S

    2009-06-01

    Pain arising in burns sufferers is often severe and protracted. The prospect of a dressing change can heighten existing pain by impacting both physically and psychologically. In this trial we examined whether pre-procedural virtual reality guided relaxation added to patient controlled analgesia with morphine reduced pain severity during awake dressings changes in burns patients. We conducted a prospective randomized clinical trial in all patients with burns necessitating admission to a tertiary burns referral centre. Eligible patients requiring awake dressings changes were randomly allocated to single use virtual reality relaxation plus intravenous morphine patient controlled analgesia (PCA) infusion or to intravenous morphine patient controlled analgesia infusion alone. Patients rated their worst pain intensity during the dressing change using a visual analogue scale. The primary outcome measure was presence of 30% or greater difference in pain intensity ratings between the groups in estimation of worst pain during the dressing change. Of 88 eligible and consenting patients having awake dressings changes, 43 were assigned to virtual reality relaxation plus intravenous morphine PCA infusion and 43 to morphine PCA infusion alone. The group receiving virtual reality relaxation plus morphine PCA infusion reported significantly higher pain intensities during the dressing change (mean=7.3) compared with patients receiving morphine PCA alone (mean=5.3) (p=0.003) (95% CI 0.6-2.8). The addition of virtual reality guided relaxation to morphine PCA infusion in burns patients resulted in a significant increase in pain experienced during awake dressings changes. In the absence of a validated predictor for responsiveness to virtual reality relaxation such a therapy cannot be recommended for general use in burns patients having awake dressings changes.

  8. Music Therapy Using Singing Training Improves Psychomotor Speed in Patients with Alzheimer's Disease: A Neuropsychological and fMRI Study

    PubMed Central

    Satoh, Masayuki; Yuba, Toru; Tabei, Ken-ichi; Okubo, Yukari; Kida, Hirotaka; Sakuma, Hajime; Tomimoto, Hidekazu

    2015-01-01

    Background/Aims To investigate the effect of singing training on the cognitive function in Alzheimer's disease (AD) patients. Methods Ten AD patients (mean age 78.1 years) participated in music therapy using singing training once a week for 6 months (music therapy group). Each session was performed with professional musicians using karaoke and a unique voice training method (the YUBA Method). Before and after the intervention period, each patient was assessed by neuropsychological batteries, and functional magnetic resonance imaging (fMRI) was performed while the patients sang familiar songs with a karaoke device. As the control group, another 10 AD patients were recruited (mean age 77.0 years), and neuropsychological assessments were performed twice with an interval of 6 months. Results In the music therapy group, the time for completion of the Japanese Raven's Colored Progressive Matrices was significantly reduced (p = 0.026), and the results obtained from interviewing the patients' caregivers revealed a significant decrease in the Neuropsychiatric Inventory score (p = 0.042) and a prolongation of the patients' sleep time (p = 0.039). The fMRI study revealed increased activity in the right angular gyrus and the left lingual gyrus in the before-minus-after subtraction analysis of the music therapy intervention. Conclusion Music therapy intervention using singing training may be useful for dementia patients by improving the neural efficacy of cognitive processing. PMID:26483829

  9. SAO/NASA ADS at SAO: User Feedback

    Science.gov Websites

    Sign on [SAO/NASA ADS] User Feedback ADS Home | HELP | Sitemap ADS Services Search Browse myADS Mirrors Feedback FAQ What's new Site Map Help Other NASA Centers CXC HEASARC IRSA MAST NED NSSDC PDS [NASA] NASA ads at cfa.harvard.edu

  10. A general CPL-AdS methodology for fixing dynamic parameters in dual environments.

    PubMed

    Huang, De-Shuang; Jiang, Wen

    2012-10-01

    The algorithm of Continuous Point Location with Adaptive d-ary Search (CPL-AdS) strategy exhibits its efficiency in solving stochastic point location (SPL) problems. However, there is one bottleneck for this CPL-AdS strategy which is that, when the dimension of the feature, or the number of divided subintervals for each iteration, d is large, the decision table for elimination process is almost unavailable. On the other hand, the larger dimension of the features d can generally make this CPL-AdS strategy avoid oscillation and converge faster. This paper presents a generalized universal decision formula to solve this bottleneck problem. As a matter of fact, this decision formula has a wider usage beyond handling out this SPL problems, such as dealing with deterministic point location problems and searching data in Single Instruction Stream-Multiple Data Stream based on Concurrent Read and Exclusive Write parallel computer model. Meanwhile, we generalized the CPL-AdS strategy with an extending formula, which is capable of tracking an unknown dynamic parameter λ in both informative and deceptive environments. Furthermore, we employed different learning automata in the generalized CPL-AdS method to find out if faster learning algorithm will lead to better realization of the generalized CPL-AdS method. All of these aforementioned contributions are vitally important whether in theory or in practical applications. Finally, extensive experiments show that our proposed approaches are efficient and feasible.

  11. Efficacy and safety of teneligliptin added to canagliflozin monotherapy in Japanese patients with type 2 diabetes mellitus: A multicentre, randomized, double‐blind, placebo‐controlled, parallel‐group comparative study

    PubMed Central

    Kadowaki, Takashi; Inagaki, Nobuya; Kondo, Kazuoki; Nishimura, Kenichi; Kaneko, Genki; Maruyama, Nobuko; Nakanishi, Nobuhiro; Gouda, Maki; Iijima, Hiroaki

    2017-01-01

    Dipeptidyl peptidase‐4 (DPP‐4) inhibitors and sodium glucose co‐transporter 2 (SGLT2) inhibitors are frequently used in combination for the treatment of type 2 diabetes mellitus (T2DM). We examined the efficacy and safety of teneligliptin (a DPP‐4 inhibitor) added to canagliflozin (an SGLT2 inhibitor) monotherapy in Japanese patients with poorly controlled T2DM as part of the development of a fixed‐dose combination of teneligliptin and canagliflozin. Japanese patients treated with canagliflozin (100 mg) for ≥12 weeks were randomized to receive add‐on teneligliptin (20 mg; C + T group) or placebo (C + P group) for 24 weeks. The primary endpoint was change in glycated haemoglobin (HbA1c) from baseline to Week 24. The between‐group differences in reductions from baseline to Week 24 were significantly greater in the C + T group for HbA1c (−0.94%; P < .001). The incidence of adverse events was similar in both groups (55.8% and 49.4% in the C + T and C + P groups, respectively). No episodes of hypoglycaemia were reported. Teneligliptin added to ongoing canagliflozin monotherapy improved glycaemic control and was well tolerated in Japanese patients with inadequately controlled T2DM. PMID:28786530

  12. Description of Streptococcus pneumoniae Infections in Burn Patients

    DTIC Science & Technology

    2010-01-01

    Description of Streptococcus pneumoniae infections in burn patients§ Jessie S. Glasser a, Michael L. Landruma,b,c, Kevin K. Chung a,d, Duane R...Staphylococcus aureus. Although Streptococcus pneumoniae infections are common in the community and can cause nosocomial infections , the incidence and...risk factors for pneu- mococcal infections in burn patients is unclear. Methods: We performed an electronic retrospective chart review to collect rates

  13. Using Google AdWords for international multilingual recruitment to health research websites.

    PubMed

    Gross, Margaret S; Liu, Nancy H; Contreras, Omar; Muñoz, Ricardo F; Leykin, Yan

    2014-01-20

    Google AdWords, the placement of sponsored links in Google search results, is a potent method of recruitment to Internet-based health studies and interventions. However, the performance of Google AdWords varies considerably depending on the language and the location of the target audience. Our goal was to describe differences in AdWords performance when recruiting participants to the same study conducted in four languages and to determine whether AdWords campaigns can be optimized in order to increase recruitment while decreasing costs. Google AdWords were used to recruit participants to the Mood Screener, a multilingual online depression screening tool available in English, Russian, Spanish, and Chinese. Two distinct recruitment periods are described: (1) "Unmanaged", a 6-month period in which ads were allowed to run using only the AdWords tool itself, with no human intervention, and (2) "Managed", a separate 7-week period during which we systematically sought to optimize our recruitment campaigns. During 6 months of unmanaged recruitment, our ads were shown over 1.3 million times, resulting in over 60,000 site visits. The average click-through rate (ratio of ads clicked to ads displayed) varied from 1.86% for Chinese ads to 8.48% for Russian ads, as did the average cost-per-click (from US $0.20 for Chinese ads to US $0.50 for English ads). Although Chinese speakers' click-through rate was lowest, their rate of consenting to participate was the highest, at 3.62%, with English speakers exhibiting the lowest consent rate (0.97%). The conversion cost (cost to recruit a consenting participant) varied from US $10.80 for Russian speakers to US $51.88 for English speakers. During the 7 weeks of "managed" recruitment, we attempted to improve AdWords' performance in regards to the consent rate and cost by systematically deleting underperforming ads and adjusting keywords. We were able to increase the number of people who consent after coming to the site by 91.8% while also

  14. Isometry group orbit quantization of spinning strings in AdS3 × S3

    NASA Astrophysics Data System (ADS)

    Heinze, Martin; Jorjadze, George; Megrelidze, Luka

    2015-03-01

    Describing the bosonic AdS3 × S3 particle and string in SU(1,1) × SU(2) group variables, we provide a Hamiltonian treatment of the isometry group orbits of solutions via analysis of the pre-symplectic form. For the particle we obtain a one-parameter family of orbits parameterized by creation-annihilation variables, which leads to the Holstein-Primakoff realization of the isometry group generators. The scheme is then applied to spinning string solutions characterized by one winding number in AdS3 and two winding numbers in S3. We find a two-parameter family of orbits, where quantization again provides the Holstein-Primakoff realization of the symmetry generators with an oscillator-type energy spectrum. Analyzing the minimal energy at strong coupling, we verify the spectrum of short strings at special values of winding numbers.

  15. AdS/QCD and Light Front Holography: A New Approximation to QCD

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brodsky, Stanley J.; de Teramond, Guy

    2010-02-15

    The combination of Anti-de Sitter space (AdS) methods with light-front holography leads to a semi-classical first approximation to the spectrum and wavefunctions of meson and baryon light-quark bound states. Starting from the bound-state Hamiltonian equation of motion in QCD, we derive relativistic light-front wave equations in terms of an invariant impact variable {zeta} which measures the separation of the quark and gluonic constituents within the hadron at equal light-front time. These equations of motion in physical space-time are equivalent to the equations of motion which describe the propagation of spin-J modes in anti-de Sitter (AdS) space. Its eigenvalues give themore » hadronic spectrum, and its eigenmodes represent the probability distribution of the hadronic constituents at a given scale. Applications to the light meson and baryon spectra are presented. The predicted meson spectrum has a string-theory Regge form M{sup 2} = 4{kappa}{sup 2}(n+L+S/2); i.e., the square of the eigenmass is linear in both L and n, where n counts the number of nodes of the wavefunction in the radial variable {zeta}. The space-like pion form factor is also well reproduced. One thus obtains a remarkable connection between the description of hadronic modes in AdS space and the Hamiltonian formulation of QCD in physical space-time quantized on the light-front at fixed light-front time {tau}. The model can be systematically improved by using its complete orthonormal solutions to diagonalize the full QCD light-front Hamiltonian or by applying the Lippmann-Schwinger method in order to systematically include the QCD interaction terms.« less

  16. The Politics and Statistics of Value-Added Modeling for Accountability of Teacher Preparation Programs

    ERIC Educational Resources Information Center

    Lincove, Jane Arnold; Osborne, Cynthia; Dillon, Amanda; Mills, Nicholas

    2014-01-01

    Despite questions about validity and reliability, the use of value-added estimation methods has moved beyond academic research into state accountability systems for teachers, schools, and teacher preparation programs (TPPs). Prior studies of value-added measurement for TPPs test the validity of researcher-designed models and find that measuring…

  17. Sociodemographic and Behavioral Factors Associated with Added Sugars Intake among US Adults

    PubMed Central

    Park, Sohyun; Thompson, Frances E.; McGuire, Lisa C.; Pan, Liping; Galuska, Deborah A.; Blanck, Heidi M.

    2016-01-01

    Background Reducing added sugars intake is one of the Healthy People 2020 objectives. High added sugars intake may be associated with adverse health consequences. Objective This cross-sectional study identified sociodemographic and behavioral characteristics associated with added sugars intake among US adults (18 years and older) using the 2010 National Health Interview Survey data (n=24,967). Methods The outcome variable was added sugars intake from foods and beverages using scoring algorithms to convert dietary screener frequency responses on nine items to estimates of individual dietary intake of added sugars in teaspoons per day. Added sugars intake was categorized into tertiles (lowest, middle, highest) stratified by sex. The explanatory variables were sociodemographic and behavioral characteristics. Multinomial logistic regression was used to estimate the adjusted odds ratios for the highest and middle tertile added sugars intake groups as compared with the lowest tertile group. Results Estimated median added sugars intake was 17.6 tsp/d for men and 11.7 tsp/d for women. For men and women, those who had significantly greater odds for being in the highest tertile of added sugars intake (men: ≥22.0 tsp/d; women: ≥14.6 tsp/d) were younger, less educated, had lower income, were less physically active, were current smokers, and were former or current infrequent/light drinkers, whereas non-Hispanic other/multiracial and those living in the West had significantly lower odds for being in the highest tertile of added sugars intake. Different patterns were found by sex. Non-Hispanic black men had lower odds for being in the highest tertile of added sugars intake, whereas non-Hispanic black women had greater odds for being in the highest tertile. Conclusions One in three men consumed ≥22.0 tsp added sugars and one in three women consumed ≥14.6 tsp added sugars daily. Higher added sugars intake was associated with various sociodemographic and behavioral

  18. AdS5 solutions from M5-branes on Riemann surface and D6-branes sources

    DOE PAGES

    Bah, Ibrahima

    2015-09-24

    Here, we describe the gravity duals of four-dimensional N = 1 superconformal field theories obtained by wrapping M5-branes on a punctured Riemann surface. The internal geometry, normal to the AdS 5 factor, generically preserves two U(1)s, with generators (J +, J –), that are fibered over the Riemann surface. The metric is governed by a single potential that satisfies a version of the Monge-Ampère equation. The spectrum of N = 1 punctures is given by the set of supersymmetric sources of the potential that are localized on the Riemann surface and lead to regular metrics near a puncture. We usemore » this system to study a class of punctures where the geometry near the sources corresponds to M-theory description of D6-branes. These carry a natural (p, q) label associated to the circle dual to the killing vector pJ + + qJ – which shrinks near the source. In the generic case the world volume of the D6-branes is AdS 5 × S 2 and they locally preserve N = 2 supersymmetry. When p = –q, the shrinking circle is dual to a flavor U(1). The metric in this case is non-degenerate only when there are co-dimension one sources obtained by smearing M5-branes that wrap the AdS 5 factor and the circle dual the superconformal R-symmetry. The D6-branes are extended along the AdS 5 and on cups that end on the co-dimension one branes. In the special case when the shrinking circle is dual to the R-symmetry, the D6-branes are extended along the AdS 5 and wrap an auxiliary Riemann surface with an arbitrary genus. When the Riemann surface is compact with constant curvature, the system is governed by a Monge-Ampère equation.« less

  19. Evaluation of Metabolic and Synaptic Dysfunction Hypotheses of Alzheimer's Disease (AD): A Meta-Analysis of CSF Markers.

    PubMed

    Manyevitch, Roni; Protas, Matthew; Scarpiello, Sean; Deliso, Marisa; Bass, Brittany; Nanajian, Anthony; Chang, Matthew; Thompson, Stefani M; Khoury, Neil; Gonnella, Rachel; Trotz, Margit; Moore, D Blaine; Harms, Emily; Perry, George; Clunes, Lucy; Ortiz, Angelica; Friedrich, Jan O; Murray, Ian V J

    2018-01-01

    Alzheimer's disease (AD) is currently incurable and a majority of investigational drugs have failed clinical trials. One explanation for this failure may be the invalidity of hypotheses focusing on amyloid to explain AD pathogenesis. Recently, hypotheses which are centered on synaptic and metabolic dysfunction are increasingly implicated in AD. Evaluate AD hypotheses by comparing neurotransmitter and metabolite marker concentrations in normal versus AD CSF. Meta-analysis allows for statistical comparison of pooled, existing cerebrospinal fluid (CSF) marker data extracted from multiple publications, to obtain a more reliable estimate of concentrations. This method also provides a unique opportunity to rapidly validate AD hypotheses using the resulting CSF concentration data. Hubmed, Pubmed and Google Scholar were comprehensively searched for published English articles, without date restrictions, for the keywords "AD", "CSF", and "human" plus markers selected for synaptic and metabolic pathways. Synaptic markers were acetylcholine, gamma-aminobutyric acid (GABA), glutamine, and glycine. Metabolic markers were glutathione, glucose, lactate, pyruvate, and 8 other amino acids. Only studies that measured markers in AD and controls (Ctl), provided means, standard errors/deviation, and subject numbers were included. Data were extracted by six authors and reviewed by two others for accuracy. Data were pooled using ratio of means (RoM of AD/Ctl) and random effects meta-analysis using Cochrane Collaboration's Review Manager software. Of the 435 identified publications, after exclusion and removal of duplicates, 35 articles were included comprising a total of 605 AD patients and 585 controls. The following markers of synaptic and metabolic pathways were significantly changed in AD/controls: acetylcholine (RoM 0.36, 95% CI 0.24-0.53, p<0.00001), GABA (0.74, 0.58-0.94, p<0.01), pyruvate (0.48, 0.24-0.94, p=0.03), glutathione (1.11, 1.01- 1.21, p=0.03), alanine (1.10, 0

  20. Localized AdS_{5}×S^{5} Black Holes.

    PubMed

    Dias, Óscar J C; Santos, Jorge E; Way, Benson

    2016-10-07

    According to heuristic arguments, global AdS_{5}×S^{5} black holes are expected to undergo a phase transition in the microcanonical ensemble. At high energies, one expects black holes that respect the symmetries of the S^{5}; at low energies, one expects "localized" black holes that appear pointlike on the S^{5}. According to anti-de Sitter/conformal field theory correspondence, N=4 supersymmetric Yang-Mills (SYM) theory on a 3-sphere should therefore exhibit spontaneous R-symmetry breaking at strong coupling. In this Letter, we numerically construct these localized black holes. We extrapolate the location of this phase transition, and compute the expectation value of the broken scalar operator with lowest conformal dimension. Via the correspondence, these results offer quantitative predictions for N=4 SYM theory.

  1. Local amygdala structural differences with 3T MRI in patients with Alzheimer disease

    PubMed Central

    Cavedo, E.; Boccardi, M.; Ganzola, R.; Canu, E.; Beltramello, A.; Caltagirone, C.; Thompson, P.M.

    2011-01-01

    Objective: Histologic studies show that the amygdala is affected by Alzheimer disease (AD) pathology, and its medial aspect is the most involved. We aimed to assess in vivo local structural differences in the amygdala of patients with AD using high-field MRI. Methods: A total of 19 patients with AD (mean age 76, SD 6 years, mean Mini-Mental State Examination score [MMSE] 13, SD 4) and 19 healthy elderly controls (age 74, SD 5, MMSE 29, SD 1) were enrolled. The radial atrophy mapping technique was used to reconstruct the 3-dimensional surface of the amygdala. Maps of surface tissue loss in patients with AD vs controls were computed and statistically tested with permutation tests thresholded at p < 0.05, to correct for multiple comparisons. A digital atlas of the amygdalar nuclei was used to infer which nuclei were involved. Results: Both amygdalar volumes were significantly smaller in patients with AD (right 1,508 mm3, SD 418; left 1,646, SD 419) than controls (right 2,129 mm3, SD 316; left 2,077, SD 376; p < 0.002). In the dorsomedial part, significant local tissue loss (20%–30%) was mapped in the medial and central nuclei. Ventrally, the lateral nucleus (La) and the basolateral ventral medial nucleus (BLVM) were also involved (20%–30% loss). Conclusions: We found in vivo local structural differences in the amygdala of patients with AD. The nuclei involved have known connections to the hippocampus (BLVM, La) and olfactory system (medial nucleus) and with cholinergic pathways (central nucleus). This pattern is consistent with the known pathophysiology of neural systems affected by AD. PMID:21339500

  2. Writing Impairments in Japanese Patients with Mild Cognitive Impairment and with Mild Alzheimer's Disease

    PubMed Central

    Hayashi, Atsuko; Nomura, Hiroshi; Mochizuki, Ruriko; Ohnuma, Ayumu; Kimpara, Teiko; Suzuki, Kyoko; Mori, Etsuro

    2015-01-01

    Background/Aims We investigated writing abilities in patients with the amnestic type of mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD). To examine the earliest changes in writing function, we used writing tests for both words and sentences with different types of Japanese characters (Hiragana, Katakana, and Kanji). Methods A total of 25 aMCI patients, 38 AD patients, and 22 healthy controls performed writing to dictation for Kana and Kanji words, copied Kanji words, and wrote in response to a picture story task. Analysis of variance was used to test the subject group effects on the scores in the above writing tasks. Results For the written Kanji words, the mild AD group performed worse than the aMCI group and the controls, but there was no difference between the aMCI group and the controls. For the picture story writing task, the mild AD and aMCI groups performed worse than the controls, but the difference between the AD and the aMCI groups was not significant. Conclusions The mild AD group showed defects in writing Kanji characters, and the aMCI group showed impairments in narrative writing. Our study suggests that narrative writing, which demands complex integration of multiple cognitive functions, can be used to detect the subtle writing deficits in aMCI patients. PMID:26483830

  3. Transfer of omega-3 fatty acids across the blood-brain barrier after dietary supplementation with a docosahexaenoic acid-rich omega-3 fatty acid preparation in patients with Alzheimer's disease: the OmegAD study.

    PubMed

    Freund Levi, Y; Vedin, I; Cederholm, T; Basun, H; Faxén Irving, G; Eriksdotter, M; Hjorth, E; Schultzberg, M; Vessby, B; Wahlund, L-O; Salem, N; Palmblad, J

    2014-04-01

    Little is known about the transfer of essential fatty acids (FAs) across the human blood-brain barrier (BBB) in adulthood. In this study, we investigated whether oral supplementation with omega-3 (n-3) FAs would change the FA profile of the cerebrospinal fluid (CSF). A total of 33 patients (18 receiving the n-3 FA supplement and 15 receiving placebo) were included in the study. These patients were participants in the double-blind, placebo-controlled randomized OmegAD study in which 204 patients with mild Alzheimer's disease (AD) received 2.3 g n-3 FA [high in docosahexaenoic acid (DHA)] or placebo daily for 6 months. CSF FA levels were related to changes in plasma FA and to CSF biomarkers of AD and inflammation. At 6 months, the n-3 FA supplement group displayed significant increases in CSF (and plasma) eicosapentaenoic acid (EPA), DHA and total n-3 FA levels (P < 0.01), whereas no changes were observed in the placebo group. Changes in CSF and plasma levels of EPA and n-3 docosapentaenoic acid were strongly correlated, in contrast to those of DHA. Changes in DHA levels in CSF were inversely correlated with CSF levels of total and phosphorylated tau, and directly correlated with soluble interleukin-1 receptor type II. Thus, the more DHA increased in CSF, the greater the change in CSF AD/inflammatory biomarkers. Oral supplementation with n-3 FAs conferred changes in the n-3 FA profile in CSF, suggesting transfer of these FAs across the BBB in adults. © 2013 The Association for the Publication of the Journal of Internal Medicine.

  4. Ultrasonic Evaluation of the Pull-Off Adhesion between Added Repair Layer and a Concrete Substrate

    NASA Astrophysics Data System (ADS)

    Czarnecki, Slawomir

    2017-10-01

    This paper concerns the evaluation of the pull-off adhesion between a concrete added repair layer with variable thickness and a concrete substrate, based on parameters assessed using ultrasonic pulse velocity (UPV) method. In construction practice, the experimental determination of pull-off adhesion f b, between added repair layer and a concrete substrate is necessary to assess the quality of repair. This is usually carried out with the use of pull-off method which results in local damage of the added concrete layer in all the testing areas. Bearing this in mind, it is important to describe the method without these disadvantages. The prediction of the pull-off adhesion of the two-layer concrete elements with variable thickness of each layer might be provided by means of UPV method with two-sided access to the investigated element. For this purpose, two-layered cylindrical specimens were obtained by drilling the borehole from a large size specially prepared concrete element. Those two-layer elements were made out of concrete substrate layer and Polymer Cement Concrete (PCC) mortar as an added repair layer. The values of pull-off adhesion f b of the elements were determined before obtaining the samples by using the semi-destructive pull-off method. The ultrasonic wave velocity was determined in samples with variable thickness of each layer and was then compared to theoretical ultrasonic wave velocity predicted for those specimens. The regression curve for the dependence of velocity and pull-off adhesion, determined by the pulloff method, was made. It has been proved that together with an increase of ratio of investigated ultrasonic wave velocity divided by theoretical ultrasonic wave velocity, the pull-off adhesion value f b between added repair layer with variable thickness and a substrate layer also increases.

  5. Puncture point-traction method: A novel method applied for right internal jugular vein catheterization

    PubMed Central

    WU, TIANLIANG; ZANG, HONGCHENG

    2016-01-01

    The ultrasound probe and advancement of the needle during real-time ultrasound-assisted guidance of catheterization of the right internal jugular vein (RIJV) tend to collapse the vein, which reduces the success rate of the procedure. We have developed a novel puncture point-traction method (PPTM) to facilitate RIJV cannulation. The present study examined whether this method facilitated the performance of RIJV catheterization in anesthetized patients. In this study, 120 patients were randomly assigned to a group in which PPTM was performed (PPTM group, n=60) or a group in which it was not performed (non-PPTM group, n=60). One patient was excluded because of internal carotid artery puncture and 119 patients remained for analysis. The cross-sectional area (CSA), anteroposterior diameter (AD) and transverse diameter (TD) of the RIJV at the cricoid cartilage level following the induction of anesthesia and during catheterization were measured, and the number with obvious loss of resistance (NOLR), the number with easy aspiration of blood into syringe (NEABS) during advancement of the needle, and the number of first-pass punctures (NFPP) during catheterization were determined. In the non-PPTM group, the CSA was smaller during catheterization compared with that following the induction of anesthesia (P<0.01). In the PPTM group compared with the non-PPTM group during catheterization, the CSA was larger (P<0.01) and the AD (P<0.01) and TD (P<0.05) were wider; NOLR (P<0.01), NEABS (P<0.01) and NFPP (P<0.01) increased significantly. The findings from this study confirmed that the PPTM facilitated catheterization of the RIJV and improved the success rate of RIJV catheterization in anesthetized patients in the supine position. PMID:27347054

  6. Duality invariance of s ≥ 3/2 fermions in AdS

    DOE PAGES

    Deser, S.; Seminara, D.

    2014-09-30

    The research show that in D = 4 AdS, s ≥ 3/2 partially massless (PM) fermions retain the duality invariances of their flat space massless counterparts. They have tuned ratios m 2/M 2 ≠ 0 that turn them into sums of effectively massless unconstrained helicity ±(s, ···, 3/2) excitations, shorn of the lowest (non-dual) helicity ±1/2-rung and — more generally — of succeeding higher rung as well. Each helicity mode is separately duality invariant, like its flat space counterpart.

  7. New Kaluza-Klein instantons and the decay of AdS vacua

    DOE PAGES

    Ooguri, Hirosi; Spodyneiko, Lev

    2017-07-19

    We construct a generalization of Witten’s Kaluza-Klein instanton, where a higher-dimensional sphere (rather than a circle as in Witten’s instanton) collapses to zero size and the geometry terminates at a bubble of nothing, in a low energy effective theory of M theory. We then use the solution to exhibit the instability of nonsupersymmetric AdS 5 vacua in M theory compactified on positive Kähler-Einstein spaces, providing further evidence for the recent conjecture that any nonsupersymmetric anti–de Sitter vacuum supported by fluxes must be unstable.

  8. Thermodynamic Geometry of Charged AdS Black Hole Surrounded by Quintessence

    NASA Astrophysics Data System (ADS)

    Wei, Shao-Wen; Man, Qing-Tao; Yu, Hao

    2018-02-01

    In this paper, we study the thermodynamic geometry for the charged AdS black hole surrounded by quintessence. Three different kinds of the geometries are constructed, and the corresponding curvatures are obtained. It is found that there are different divergence behaviors of these curvatures, which is general thought to closely link to the phase transition of the black hole. Supported by the National Natural Science Foundation of China under Grant Nos. 11675064, 11205074, and the Fundamental Research Funds for the Central Universities under Grant No. lzujbky-2016-121

  9. Can Value-Added Measures of Teacher Performance Be Trusted?

    ERIC Educational Resources Information Center

    Guarino, Cassandra M.; Reckase, Mark D.; Wooldridge, Jeffrey M.

    2015-01-01

    We investigate whether commonly used value-added estimation strategies produce accurate estimates of teacher effects under a variety of scenarios. We estimate teacher effects in simulated student achievement data sets that mimic plausible types of student grouping and teacher assignment scenarios. We find that no one method accurately captures…

  10. Age-related changes in core body temperature and activity in triple-transgenic Alzheimer's disease (3xTgAD) mice.

    PubMed

    Knight, Elysse M; Brown, Timothy M; Gümüsgöz, Sarah; Smith, Jennifer C M; Waters, Elizabeth J; Allan, Stuart M; Lawrence, Catherine B

    2013-01-01

    Alzheimer's disease (AD) is characterised, not only by cognitive deficits and neuropathological changes, but also by several non-cognitive behavioural symptoms that can lead to a poorer quality of life. Circadian disturbances in core body temperature and physical activity are reported in AD patients, although the cause and consequences of these changes are unknown. We therefore characterised circadian patterns of body temperature and activity in male triple transgenic AD mice (3xTgAD) and non-transgenic (Non-Tg) control mice by remote radiotelemetry. At 4 months of age, daily temperature rhythms were phase advanced and by 6 months of age an increase in mean core body temperature and amplitude of temperature rhythms were observed in 3xTgAD mice. No differences in daily activity rhythms were seen in 4- to 9-month-old 3xTgAD mice, but by 10 months of age an increase in mean daily activity and the amplitude of activity profiles for 3xTgAD mice were detected. At all ages (4-10 months), 3xTgAD mice exhibited greater food intake compared with Non-Tg mice. The changes in temperature did not appear to be solely due to increased food intake and were not cyclooxygenase dependent because the temperature rise was not abolished by chronic ibuprofen treatment. No β-amyloid (Aβ) plaques or neurofibrillary tangles were noted in the hypothalamus of 3xTgAD mice, a key area involved in temperature regulation, although these pathological features were observed in the hippocampus and amygdala of 3xTgAD mice from 10 months of age. These data demonstrate age-dependent changes in core body temperature and activity in 3xTgAD mice that are present before significant AD-related neuropathology and are analogous to those observed in AD patients. The 3xTgAD mouse might therefore be an appropriate model for studying the underlying mechanisms involved in non-cognitive behavioural changes in AD.

  11. Effects of kinesiotaping added to a rehabilitation programme for patients with rotator cuff tendinopathy: protocol for a single-blind, randomised controlled trial addressing symptoms, functional limitations and underlying deficits

    PubMed Central

    de Fontenay, Benoît Pairot; Bouyer, Laurent Julien; Desmeules, François; Roy, Jean-Sébastien

    2017-01-01

    Introduction Rotator cuff tendinopathy (RCTe) is the most frequent cause of shoulder pain, resulting in considerable losses to society and public resources. Muscle imbalance and inadequate sensorimotor control are deficits often associated with RCTe. Kinesiotaping (KT) is widely used by clinicians for rehabilitation of RCTe. While previous studies have examined the immediate effects of KT on shoulder injuries or the effects of KT as an isolated method of treatment, no published study has addressed its mid-term and long-term effects when combined with a rehabilitation programme for patients with RCTe. The primary objective of this randomised controlled trial (RCT) will be to assess the efficacy of therapeutic KT, added to a rehabilitation programme, in reducing pain and disabilities in individuals with RCTe. Secondary objectives will look at the effects of KT on the underlying factors involved in shoulder control, such as muscular activity, acromiohumeral distance (AHD) and range of motion (ROM). Methods and analysis A single-blind RCT will be conducted. Fifty-two participants, randomly allocated to one of two groups (KT or no-KT), will take part in a 6-week rehabilitation programme. The KT group will receive KT added to the rehabilitation programme, whereas the no-KT group will receive only the rehabilitation programme. Measurements will be taken at baseline, week 3, week 6, week 12 and 6 months. Primary outcomes will be symptoms and functional limitations assessed by the Disabilities of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include shoulder ROM, AHD at rest and at 60° of abduction, and muscle activation during arm elevation. The added effects of KT will be assessed through a two-way analysis of variance for repeated measures. Ethics and dissemination Ethics approval was obtained from the Ethics Committee of Quebec Rehabilitation Institute of the Centre Integrated University Health and Social Services. Results will be disseminated

  12. Methods to improve patient recruitment and retention in stroke trials.

    PubMed

    Berge, Eivind; Stapf, Christian; Al-Shahi Salman, Rustam; Ford, Gary A; Sandercock, Peter; van der Worp, H Bart; Petersson, Jesper; Dippel, Diederik Wj; Krieger, Derk W; Lees, Kennedy R

    2016-08-01

    The success of randomized-controlled stroke trials is dependent on the recruitment and retention of a sufficient number of patients, but fewer than half of all trials meet their target number of patients. We performed a search and review of the literature, and conducted a survey and workshop among 56 European stroke trialists, to identify barriers, suggest methods to improve recruitment and retention, and make a priority list of interventions that merit further evaluation. The survey and workshop identified a number of barriers to patient recruitment and retention, from patients' incapacity to consent, to handicaps that prevent patients from participation in trial-specific follow-up. Methods to improve recruitment and retention may include simple interventions with individual participants, funding of research networks, and reimbursement of new treatments by health services only when delivered within clinical trials. The literature review revealed that few methods have been formally evaluated. The top five priorities for evaluation identified in the workshop were as follows: short and illustrated patient information leaflets, nonwritten consent, reimbursement for new interventions only within a study, and monetary incentives to institutions taking part in research (for recruitment); and involvement of patient groups, remote and central follow-up, use of mobile devices, and reminders to patients about their consent to participate (for retention). Many interventions have been used with the aim of improving recruitment and retention of patients in stroke studies, but only a minority has been evaluated. We have identified methods that could be tested, and propose that such evaluations may be nested within on-going clinical trials. © 2016 World Stroke Organization.

  13. Logarithmic corrections to entropy of magnetically charged AdS4 black holes

    NASA Astrophysics Data System (ADS)

    Jeon, Imtak; Lal, Shailesh

    2017-11-01

    Logarithmic terms are quantum corrections to black hole entropy determined completely from classical data, thus providing a strong check for candidate theories of quantum gravity purely from physics in the infrared. We compute these terms in the entropy associated to the horizon of a magnetically charged extremal black hole in AdS4×S7 using the quantum entropy function and discuss the possibility of matching against recently derived microscopic expressions.

  14. Clinical Use of Mood Stabilizers With Antidepressants in Asia: Report From the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) Projects in 2004 and 2013.

    PubMed

    Rajaratnam, Kamini; Xiang, Yu-Tao; Tripathi, Adarsh; Chiu, Helen F K; Si, Tian-Mei; Chee, Kok-Yoon; Avasthi, Ajit; Grover, Sandeep; Chong, Mian-Yoon; Kuga, Hironori; Kanba, Shigenobu; He, Yan-Ling; Lee, Min-Soo; Yang, Shu-Yu; Udomratn, Pichet; Kallivayalil, Roy A; Tanra, Andi J; Maramis, Margarita M; Shen, Winston W; Sartorius, Norman; Kua, Ee-Heok; Tan, Chay-Hoon; Mahendran, Rathi; Shinfuku, Naotaka; Sum, Min Yi; Baldessarini, Ross J; Sim, Kang

    2017-04-01

    As most reports concerning treatment with combinations of mood stabilizer (MS) with antidepressant (AD) drugs are based in the West, we surveyed characteristics of such cotreatment in 42 sites caring for the mentally ill in 10 Asian countries. This cross-sectional, pharmacoepidemiologic study used 2004 and 2013 data from the REAP-AD (Research Study on Asian Psychotropic Prescription Patterns for Antidepressants) to evaluate the rates and doses of MSs given with ADs and associated factors in 4164 psychiatric patients, using standard bivariate methods followed by multivariable logistic regression modeling. Use of MS + AD increased by 104% (5.5% to 11.2%) between 2004 and 2013 and was much more associated with diagnosis of bipolar disorder than major depression or anxiety disorder, as well as with hospitalization > outpatient care, psychiatric > general-medical programs, and young age (all P < 0.001), but not with country, sex, or AD dose. The findings provide a broad picture of contemporary use of MSs with ADs in Asia, support predictions that such treatment increased in recent years, and was associated with diagnosis of bipolar disorder, treatment in inpatient and psychiatric settings, and younger age.

  15. Benefits of use, and tolerance of, medium-chain triglyceride medical food in the management of Japanese patients with Alzheimer's disease: a prospective, open-label pilot study.

    PubMed

    Ohnuma, Tohru; Toda, Aiko; Kimoto, Ayako; Takebayashi, Yuto; Higashiyama, Ryoko; Tagata, Yuko; Ito, Masanobu; Ota, Tsuneyoshi; Shibata, Nobuto; Arai, Heii

    2016-01-01

    This is the first clinical trial of this type in Japan, designed to analyze two important aspects of Alzheimer's disease (AD) management using medium-chain triglycerides. Axona was administered for 3 months (40 g of powder containing 20 g of caprylic triglycerides). We used an indurating, four-step dose-titration method (from 10 to 40 g per day) for 7 days before the trial, and examined the tolerance and adverse effects of this intervention. We also investigated its effect on cognitive function in mild-to-moderate AD patients. This was a clinical intervention in 22 Japanese patients with sporadic AD at a mild-to-moderate stage (ten females, 12 males), mean age (± standard deviation) 63.9 (±8.5) years, Mini-Mental State Examination (MMSE) score, 10-25, seven patients were ApoE4-positive. During Axona administration, we examined changes in cognitive function by obtaining MMSE and AD assessment-scale scores. Intolerance and serum ketone concentrations were also examined. The tolerance of Axona was good, without severe gastrointestinal adverse effects. Axona did not improve cognitive function in our sample of AD patients, even in those patients without the ApoE4 allele. However, some ApoE4-negative patients with baseline MMSE score ≥14 showed improvement in their cognitive functions. The modified dose-titration method, starting with a low dose of Axona, decreased gastrointestinal adverse effects in Japanese patients. Axona might be effective for some relatively mildly affected patients with AD (with cognitive function MMSE score of ≥14 and lacking the ApoE4 allele).

  16. Evaluation and validation of a method for determining platelet catecholamine in patients with obstructive sleep apnea and arterial hypertension.

    PubMed

    Feres, Marcia C; Cintra, Fatima D; Rizzi, Camila F; Mello-Fujita, Luciane; Lino de Souza, Altay A; Tufik, Sergio; Poyares, Dalva

    2014-01-01

    Measurements of plasma and urinary catecholamine are susceptible to confounding factors that influence the results, complicating the interpretation of sympathetic nervous system (SNS) activity in the Obstructive sleep apnea (OSA) and arterial hypertension (HYP) conditions. In this study, we validated a test for platelet catecholamine and compared the catecholamine levels (adrenaline and noradrenaline) in urine, plasma and platelets in patients with OSA and HYP compared with controls. In the validation, 30 healthy, nonsmoking volunteers who were not currently undergoing treatment or medication were selected as the control group. One hundred fifty-four individuals (114 OSA, 40 non-OSA) were consecutively selected from the outpatient clinic of the Sleep Institute and underwent clinical, polysomnographic and laboratory evaluation, including the urinary, plasma and platelet levels of adrenaline (AD) and noradrenaline (NA). Patients were then allocated to groups according to the presence of OSA and/or hypertension. A logistic regression model, controlled for age and BMI, showed that urinary AD and urinary NA were risk factors in the OSA+HYP group and the HYP group; however, the model showed higher levels of platelet NA for OSA without HYP. After 1 year of CPAP (continuous upper airway pressure) treatment, patients (n = 9) presented lower levels of urinary NA (p = 0.04) and platelet NA (p = 0.05). Urinary NA and AD levels were significantly associated with the condition of hypertension with and without OSA, whereas platelet NA with OSA without comorbidity. These findings suggest that platelet catecholamine levels might reflect nocturnal sympathetic activation in OSA patients without hypertension.

  17. Supersymmetric Renyi entropy in CFT 2 and AdS 3

    DOE PAGES

    Giveon, Amit; Kutasov, David

    2016-01-01

    We show that in any two dimensional conformal field theory with (2, 2) super-symmetry one can define a supersymmetric analog of the usual Renyi entropy of a spatial region A. It differs from the Renyi entropy by a universal function (which we compute) of the central charge, Renyi parameter n and the geometric parameters of A. In the limit n → 1 it coincides with the entanglement entropy. Thus, it contains the same information as the Renyi entropy but its computation only involves correlation functions of chiral and anti-chiral operators. We also show that this quantity appears naturally in stringmore » theory on AdS3.« less

  18. Mass-deformed ABJM and black holes in AdS4

    NASA Astrophysics Data System (ADS)

    Bobev, Nikolay; Min, Vincent S.; Pilch, Krzysztof

    2018-03-01

    We find a class of new supersymmetric dyonic black holes in four-dimensional maximal gauged supergravity which are asymptotic to the SU(3) × U(1) invariant AdS4 Warner vacuum. These black holes can be embedded in eleven-dimensional supergravity where they describe the backreaction of M2-branes wrapped on a Riemann surface. The holographic dual description of these supergravity backgrounds is given by a partial topological twist on a Riemann surface of a three-dimensional N=2 SCFT that is obtained by a mass-deformation of the ABJM theory. We compute explicitly the topologically twisted index of this SCFT and show that it accounts for the entropy of the black holes.

  19. Neuropsychiatric Symptoms and Executive Functioning in Patients with Mild Cognitive Impairment: Relationship to Caregiver Burden

    PubMed Central

    Ryan, Kelly A.; Weldon, Anne; Persad, Carol; Heidebrink, Judith L.; Barbas, Nancy; Giordani, Bruno

    2013-01-01

    Background Caregivers of patients with mild cognitive impairment (MCI) need similar levels of support services as Alzheimer’s disease (AD) caregivers, but it is unclear if this translates to increased caregiver burden. Methods 135 participants and their caregivers (40 MCI, 55 AD and 40 normal controls, NC) completed questionnaires, and the patients were administered neuropsychological tests. Results The MCI caregivers reported significantly more overall caregiving burden than the NC, but less than the AD. They showed similar levels of emotional, physical and social burden as the AD caregivers. Among the MCI caregivers, the neuropsychiatric symptoms and executive functioning of the patients were related to a greater burden, and the caregivers with a greater burden reported lower life satisfaction and social support, and a greater need for support services. Conclusion These results indicate that MCI caregivers are at increased risk for caregiver stress, and they require enhanced assistance and/or education in caring for their loved ones. PMID:23128102

  20. Process and apparatus for adding and removing particles from pressurized reactors

    DOEpatents

    Milligan, John D.

    1983-01-01

    A method for adding and removing fine particles from a pressurized reactor is provided, which comprises connecting the reactor to a container, sealing the container from the reactor, filling the container with particles and a liquid material compatible with the reactants, pressurizing the container to substantially the reactor pressure, removing the seal between the reactor and the container, permitting particles to fall into or out of the reactor, and resealing the container from the reactor. An apparatus for adding and removing particles is also disclosed.

  1. Calculation of neutral weak nucleon form factors with the AdS/QCD correspondence

    NASA Astrophysics Data System (ADS)

    Lohmann, Mark

    The AdS/QCD (Anti-de Sitter/Quantum Chromodynamics) is a mathematical formalism applied to a theory based on the original AdS/CFT (Anti-de Sitter/ Conformal Field Theory) correspondence. The aim is to describe properties of the strong force in an essentially non-perturbative way. AdS/QCD theories break the conformal symmetry of the AdS metric (a sacrifice) to arrive at a boundary theory which is QCD-like (a payoff). This correspondence has been used to calculate well-known quantities in nucleon spectra and structure like Regge trajectories, form factors, and many others within an error of less than 20% from experiment. This is impressive considering that ordinary perturbation theory in QCD applied to the strongly interacting domain usually obtains an error of about 30%. In this thesis, the AdS/QCD correspondence method of light-front holography established by Brodsky and de Teramond is used in an attempt to calculate the Dirac and Pauli neutral weak form factors, FZ1 (Q2) and FZ2 (Q 2) respectively, for both the proton and the neutron. With this approach, we were able to determine the neutral weak Dirac form factor for both nucleons and the Pauli form factor for the proton, while the method did not succeed at determining the neutral weak Pauli form factor for the neutron. With these we were also able to extract the proton's strange electric and magnetic form factor, which addresses important questions in nucleon sub-structure that are currently being investigated through experiments at the Thomas Jefferson National Accelerator Facility.

  2. Ontology Development for Patient Education Documents Using a Professional- and Patient-Oriented Delphi Method.

    PubMed

    Heimonen, Juho; Danielsson-Ojala, Riitta; Salakoski, Tapio; Lundgrén-Laine, Heljä; Salanterä, Sanna

    2018-04-12

    Written patient education materials are essential to motivate and help patients to participate in their own care, but the production and management of a large collection of high-quality and easily accessible patient education documents can be challenging. Ontologies can aid in these tasks, but the existing resources are not directly applicable to patient education. An ontology that models patient education documents and their readers was constructed. The Delphi method was used to identify a compact but sufficient set of entities with which the topics of documents may be described. The preferred terms of the entities were also considered to ensure their understandability. In the ontology, readers may be characterized by gender, age group, language, and role (patient or professional), whereas documents may be characterized by audience, topic(s), and content, as well as the time and place of use. The Delphi method yielded 265 unique document topics that are organized into seven hierarchies. Advantages and disadvantages of the ontology design, as well as possibilities for improvements, were identified. The patient education material ontology can enhance many applications, but further development is needed to reach its full potential.

  3. Introduction to the AdS/CFT Correspondence

    NASA Astrophysics Data System (ADS)

    Nąstase, Horaǧiu

    2015-09-01

    Preface; Introduction; Part I. Background: 1. Elements of quantum field theory and gauge theory; 2. Basics of general relativity. Anti-de Sitter space; 3. Basics of supersymmetry; 4. Basics of supergravity; 5. Kaluza-Klein dimensional reduction; 6. Black holes and p-branes; 7. String theory actions and spectra; 8. Elements of conformal field theory; 9. D-branes; Part II. Basics of AdS/CFT for N = 4 SYM vs AdS5 × S5: 10. The AdS/CFT correspondence: motivation, definition and spectra; 11. Witten prescription and 3-point correlator calculations; 12. Holography in Lorentzian signature: Poincaré and global; 13. Solitonic objects in AdS/CFT; 14. Quarks and the Wilson loop; 15. Finite temperature and N = 4 SYM plasmas; 16. Scattering processes and gravitational shockwave limit; 17. The pp-wave correspondence; 18. Spin chains; Part III. AdS/CFT Developments and Gauge-Gravity Dualities: 19. Other conformal cases; 20. The 3 dimensional ABJM model vs. AdS4 × CP3; 21. Gravity duals; 22. Holographic renormalization; 23. RG flow between fixed points; 24. Phenomenological gauge-gravity duality I: AdS/QCD; 25. Phenomenological gauge-gravity duality II: AdS/CMT; 26. Gluon scattering: the Alday-Maldacena prescription; 27. Holographic entanglement entropy: the Ryu-Takayanagi prescription.

  4. Asymptotically locally AdS and flat black holes in Horndeski theory

    NASA Astrophysics Data System (ADS)

    Anabalon, Andres; Cisterna, Adolfo; Oliva, Julio

    2014-04-01

    In this paper we construct asymptotically locally AdS and flat black holes in the presence of a scalar field whose kinetic term is constructed out from a linear combination of the metric and the Einstein tensor. The field equations as well as the energy-momentum tensor are second order in the metric and the field, therefore the theory belongs to the ones defined by Horndeski. We show that in the presence of a cosmological term in the action, it is possible to have a real scalar field in the region outside the event horizon. The solutions are characterized by a single integration constant, the scalar field vanishes at the horizon and it contributes to the effective cosmological constant at infinity. We extend these results to the topological case. The solution is disconnected from the maximally symmetric AdS background, however, within this family there exists a gravitational soliton which is everywhere regular. This soliton is therefore used as a background to define a finite Euclidean action and to obtain the thermodynamics of the black holes. For a certain region in the space of parameters, the thermodynamic analysis reveals a critical temperature at which a Hawking-Page phase transition between the black hole and the soliton occurs. We extend the solution to arbitrary dimensions greater than 4 and show that the presence of a cosmological term in the action allows one to consider the case in which the standard kinetic term for the scalar it is not present. In such a scenario, the solution reduces to an asymptotically flat black hole.

  5. Extravasation of the contrast media during voiding cystourethrography in a long-term spinal cord injury patient.

    PubMed

    Kovindha, A; Sivasomboon, C; Ovatakanont, P

    2005-07-01

    To present complications and pitfalls in voiding cystourethrography (VCUG) and introduce a guideline for performing VCUG in a long-term spinal cord injury (SCI) patient with neurogenic bladder dysfunction (NBD) and contracted bladder. A case report. Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand. We describe a chronic C(5) tetraplegic man with NBD and contracted bladder, who developed autonomic dysreflexia (AD), gross hematuria and extravasation of contrast median during VCUG. A foley catheter was retained after VCUG. AD was resolved and urine cleared after a week of continuous bladder irrigation. VCUG should be performed with caution in a long-term SCI patient with NBD and contracted bladder. Forceful pushing of the contrast media by the hand-injection method caused abrupt distention of the contracted bladder, damaged bladder mucosa and aggrevated AD. We suggest a guideline as follows: report bladder capacity and AD, if present, in an X-ray requisition form; use the gravity-drip method, stop the drip and drain the contrast media if a sudden headache and rising of blood pressure (BP) develop; observe urine colour, and report if bleeding or AD occurs.

  6. Critical behavior and microscopic structure of charged AdS black holes via an alternative phase space

    NASA Astrophysics Data System (ADS)

    Dehyadegari, Amin; Sheykhi, Ahmad; Montakhab, Afshin

    2017-05-01

    It has been argued that charged Anti-de Sitter (AdS) black holes have similar thermodynamic behavior as the Van der Waals fluid system, provided one treats the cosmological constant as a thermodynamic variable (pressure) in an extended phase space. In this paper, we disclose the deep connection between charged AdS black holes and Van der Waals fluid system from an alternative point of view. We consider the mass of an AdS black hole as a function of square of the charge Q2 instead of the standard Q, i.e. M = M (S ,Q2 , P). We first justify such a change of view mathematically and then ask if a phase transition can occur as a function of Q2 for fixed P. Therefore, we write the equation of state as Q2 =Q2 (T , Ψ) where Ψ (conjugate of Q2) is the inverse of the specific volume, Ψ = 1 / v. This allows us to complete the analogy of charged AdS black holes with Van der Waals fluid system and derive the phase transition as well as critical exponents of the system. We identify a thermodynamic instability in this new picture with real analogy to Van der Waals fluid with physically relevant Maxwell construction. We therefore study the critical behavior of isotherms in Q2- Ψ diagram and deduce all the critical exponents of the system and determine that the system exhibits a small-large black hole phase transition at the critical point (Tc , Qc2 ,Ψc). This alternative view is important as one can imagine such a change for a given single black hole i.e. acquiring charge which induces the phase transition. Finally, we disclose the microscopic properties of charged AdS black holes by using thermodynamic geometry. Interestingly, we find that scalar curvature has a gap between small and large black holes, and this gap becomes exceedingly large as one moves away from the critical point along the transition line. Therefore, we are able to attribute the sudden enlargement of the black hole to the strong repulsive nature of the internal constituents at the phase transition.

  7. A consistent and unified picture for critical phenomena of f(R) AdS black holes

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mo, Jie-Xiong; Li, Gu-Qiang; Wu, Yu-Cheng, E-mail: mojiexiong@gmail.com, E-mail: zsgqli@hotmail.com, E-mail: wuyucheng0827@163.com

    A consistent and unified picture for critical phenomena of charged AdS black holes in f ( R ) gravity is drawn in this paper. Firstly, we investigate the phase transition in canonical ensemble. We derive the explicit solutions corresponding to the divergence of C {sub Q} . The two solutions merge into one when the condition Q {sub c} =√(−1/3 R {sub 0}) is satisfied. The curve of specific heat for Q < Q {sub c} has two divergent points and can be divided into three regions. Both the large radius region and the small radius region are thermodynamically stablemore » with positive specific heat while the medium radius region is unstable with negative specific heat. However, when Q > Q {sub c} , the specific heat is always positive, implying the black holes are locally stable and no phase transition will take place. Secondly, both the T − r {sub +} curve and T − S curve f ( R ) AdS black holes are investigated and they exhibit Van der Vaals like behavior as the P − v curve in the former research. Critical physical quantities are obtained and they are consistent with those derived from the specific heat analysis. We carry out numerical check of Maxwell equal area law for the cases Q =0.2 Q {sub c} , 0.4 Q {sub c} , 0.6 Q {sub c} , 0.8 Q {sub c} . The relative errors are amazingly small and can be negligible. So the Maxwell equal area law holds for T − S curve of f ( R ) black holes. Thirdly, we establish geometrothermodynamics for f ( R ) AdS black hole to examine the phase structure. It is shown that the Legendre invariant scalar curvature R would diverge exactly where the specific heat diverges. To summarize, the above three perspectives are consistent with each other, thus providing a unified picture which deepens the understanding of critical phenomena of f ( R ) AdS black holes.« less

  8. Accurate multimodal probabilistic prediction of conversion to Alzheimer's disease in patients with mild cognitive impairment.

    PubMed

    Young, Jonathan; Modat, Marc; Cardoso, Manuel J; Mendelson, Alex; Cash, Dave; Ourselin, Sebastien

    2013-01-01

    Accurately identifying the patients that have mild cognitive impairment (MCI) who will go on to develop Alzheimer's disease (AD) will become essential as new treatments will require identification of AD patients at earlier stages in the disease process. Most previous work in this area has centred around the same automated techniques used to diagnose AD patients from healthy controls, by coupling high dimensional brain image data or other relevant biomarker data to modern machine learning techniques. Such studies can now distinguish between AD patients and controls as accurately as an experienced clinician. Models trained on patients with AD and control subjects can also distinguish between MCI patients that will convert to AD within a given timeframe (MCI-c) and those that remain stable (MCI-s), although differences between these groups are smaller and thus, the corresponding accuracy is lower. The most common type of classifier used in these studies is the support vector machine, which gives categorical class decisions. In this paper, we introduce Gaussian process (GP) classification to the problem. This fully Bayesian method produces naturally probabilistic predictions, which we show correlate well with the actual chances of converting to AD within 3 years in a population of 96 MCI-s and 47 MCI-c subjects. Furthermore, we show that GPs can integrate multimodal data (in this study volumetric MRI, FDG-PET, cerebrospinal fluid, and APOE genotype with the classification process through the use of a mixed kernel). The GP approach aids combination of different data sources by learning parameters automatically from training data via type-II maximum likelihood, which we compare to a more conventional method based on cross validation and an SVM classifier. When the resulting probabilities from the GP are dichotomised to produce a binary classification, the results for predicting MCI conversion based on the combination of all three types of data show a balanced accuracy

  9. Perception of Fechner Illusory Colors in Alzheimer Disease Patients

    PubMed Central

    Kaubrys, Gintaras; Bukina, Vera; Bingelytė, Ieva; Taluntis, Vladas

    2016-01-01

    Background Alzheimer disease (AD) primarily affects cognition. A variety of visual disorders was established in AD. Fechner illusory colors are produced by a rotating disk with a black and white pattern. The purpose of our research was to explore the perception of illusory colors in AD. Material/Methods W recruited 40 AD patients (MMSE ≥14) and 40 normal controls (CG group) matched by age, education, gender in this prospective, cross-sectional, case-control study. An achromatic Benham’s disk attached to a device to control the speed and direction of rotation was used to produce illusory colors. Primary, secondary, and tertiary RGB system colors were used for matching of illusory and physical colors. Results Subjects in the AD group perceived less illusory colors in 5 arcs (p<0.05) of the 8 arcs assessed. The biggest difference was found between AD and CG groups for pure blue (χ2=26.87, p<0.001 clockwise, χ2=22.75, p<0.001 counter-clockwise). Groups did not differ in perception of pure yellow opponent colors (p>0.05). Mixed colors of the blue-yellow axis were perceived less often in AD, but more frequently than pure blue (#0000FF). The sequence of colors on Benham’s disk followed a complex pattern, different from the order of physical spectral colors and opponent processes-based colors. Conclusions AD patients retained reduced perception of illusory colors. The perception of pure blue illusory color is almost absent in AD. The asymmetrical shift to the yellow opponent is observed in AD with red prevailing over green constituent. This may indicate cortical rather than retinal impairment. PMID:27902677

  10. Perception of Fechner Illusory Colors in Alzheimer Disease Patients.

    PubMed

    Kaubrys, Gintaras; Bukina, Vera; Bingelytė, Ieva; Taluntis, Vladas

    2016-11-30

    BACKGROUND Alzheimer disease (AD) primarily affects cognition. A variety of visual disorders was established in AD. Fechner illusory colors are produced by a rotating disk with a black and white pattern. The purpose of our research was to explore the perception of illusory colors in AD. MATERIAL AND METHODS W recruited 40 AD patients (MMSE ≥14) and 40 normal controls (CG group) matched by age, education, gender in this prospective, cross-sectional, case-control study. An achromatic Benham's disk attached to a device to control the speed and direction of rotation was used to produce illusory colors. Primary, secondary, and tertiary RGB system colors were used for matching of illusory and physical colors. RESULTS Subjects in the AD group perceived less illusory colors in 5 arcs (p<0.05) of the 8 arcs assessed. The biggest difference was found between AD and CG groups for pure blue (χ²=26.87, p<0.001 clockwise, χ²=22.75, p<0.001 counter-clockwise). Groups did not differ in perception of pure yellow opponent colors (p>0.05). Mixed colors of the blue-yellow axis were perceived less often in AD, but more frequently than pure blue (#0000FF). The sequence of colors on Benham's disk followed a complex pattern, different from the order of physical spectral colors and opponent processes-based colors. CONCLUSIONS AD patients retained reduced perception of illusory colors. The perception of pure blue illusory color is almost absent in AD. The asymmetrical shift to the yellow opponent is observed in AD with red prevailing over green constituent. This may indicate cortical rather than retinal impairment.

  11. Prevalence of Alzheimer's disease in patients investigated for presumed normal pressure hydrocephalus: a clinical and neuropathological study.

    PubMed

    Savolainen, S; Paljärvi, L; Vapalahti, M

    1999-01-01

    During 1991-1995, 223 patients were investigated in the Department of Neurosurgery, Kuopio University Hospital because of a clinical and CT diagnosis of NPH. All patients underwent intracranial pressure measurements and were formed into 3 biopsy groups. Group A included incidentally biopsied patients (104 patients, 34 biopsies) seen during 1991-1992; Group B was a prospective study group from 1993-1995 (all 51 patients biopsied); and Group C patients excluded from Group B (68 patients, 34 biopsies) by age and concomitant diseases. A cortical biopsy was taken before intracranial pressure recording altogether in 118 of the 223 patients. The biopsy revealed normal brain tissue in 66 patients. Prevalence of Alzheimer's disease (AD) in biopsied patients was 42% in Group A, 31.3% in Group B and 50% in Group C. A shunt was placed according to pressure measurement in 110 patients; of these, 8 had both AD and raised ICP. Two patients with both AD and raised ICP improved after shunt placement during the first follow-up year, 4 patients deteriorated and the condition of 2 was similar to that before shunting. The frequency of haematomas after biopsy was 2.9% in groups A and C; in Group B patients had no postoperative haematomas. There was no difference in the incidence of complications in patients who had or did not have a biopsy. The relatively high prevalence of AD in patients with NPH may explain the unsuccessful recovery of many patients after shunt placement. Cortical biopsy is an effective and safe method for finding the co-existence of AD and thus improving the diagnosis of NPH and may prevent unnecessary shunt surgery.

  12. Q ‑ Φ criticality and microstructure of charged AdS black holes in f(R) gravity

    NASA Astrophysics Data System (ADS)

    Deng, Gao-Ming; Huang, Yong-Chang

    2017-12-01

    The phase transition and critical behaviors of charged AdS black holes in f(R) gravity with a conformally invariant Maxwell (CIM) source and constant curvature are further investigated. As a highlight, this research is carried out by employing new state parameters (T,Q, Φ) and contributes to deeper understanding of the thermodynamics and phase structure of black holes. Our analyses manifest that the charged f(R)-CIM AdS black hole undergoes a first-order small-large black hole phase transition, and the critical behaviors qualitatively behave like a Van der Waals liquid-vapor system. However, differing from the case in Einstein’s gravity, phase structures of the black holes in f(R) theory exhibit an interesting dependence on gravity modification parameters. Moreover, we adopt the thermodynamic geometry to probe the black hole microscopic properties. The results show that, on the one hand, both the Ruppeiner curvature and heat capacity diverge exactly at the critical point, on the other hand, the f(R)-CIM AdS black hole possesses the property as ideal Fermi gases. Of special interest, we discover a microscopic similarity between the black holes and a Van der Waals liquid-vapor system.

  13. Efficacy of adding the Kinesio Taping method to guideline-endorsed conventional physiotherapy in patients with chronic nonspecific low back pain: a randomised controlled trial.

    PubMed

    Added, Marco Aurélio Nemitalla; Costa, Leonardo Oliveira Pena; Fukuda, Thiago Yukio; de Freitas, Diego Galace; Salomão, Evelyn Cassia; Monteiro, Renan Lima; Costa, Lucíola da Cunha Menezes

    2013-10-24

    Chronic nonspecific low back pain is a significant health condition with high prevalence worldwide and it is associated with enormous costs to society. Clinical practice guidelines show that many interventions are available to treat patients with chronic low back pain, but the vast majority of these interventions have a modest effect in reducing pain and disability. An intervention that has been widespread in recent years is the use of elastic bandages called Kinesio Taping. Although Kinesio Taping has been used extensively in clinical practice, current evidence does not support the use of this intervention; however these conclusions are based on a small number of underpowered studies. Therefore, questions remain about the effectiveness of the Kinesio Taping method as an additional treatment to interventions, such as conventional physiotherapy, that have already been recommended by the current clinical practice guidelines in robust and high-quality randomised controlled trials. We aim to determine the effectiveness of the addition of the use of Kinesio Taping in patients with chronic nonspecific low back pain who receive guideline-endorsed conventional physiotherapy. One hundred and forty-eight patients will be randomly allocated to receive either conventional physiotherapy, which consists of a combination of manual therapy techniques, general exercises, and specific stabilisation exercises (Guideline-Endorsed Conventional Physiotherapy Group) or to receive conventional physiotherapy with the addition of Kinesio Taping to the lumbar spine (Conventional Physiotherapy plus Kinesio Taping Group) over a period of 5 weeks (10 sessions of treatment). Clinical outcomes (pain intensity, disability and global perceived effect) will be collected at baseline and at 5 weeks, 3 months, and 6 months after randomisation. We will also collect satisfaction with care and adverse effects after treatment. Data will be collected by a blinded assessor. All statistical analysis will be

  14. New Features in ADS Labs

    NASA Astrophysics Data System (ADS)

    Accomazzi, Alberto; Kurtz, M. J.; Henneken, E. A.; Grant, C. S.; Thompson, D.; Di Milia, G.; Luker, J.; Murray, S. S.

    2013-01-01

    The NASA Astrophysics Data System (ADS) has been working hard on updating its services and interfaces to better support our community's research needs. ADS Labs is a new interface built on the old tried-and-true ADS Abstract Databases, so all of ADS's content is available through it. In this presentation we highlight the new features that have been developed in ADS Labs over the last year: new recommendations, metrics, a citation tool and enhanced fulltext search. ADS Labs has long been providing article-level recommendations based on keyword similarity, co-readership and co-citation analysis of its corpus. We have now introduced personal recommendations, which provide a list of articles to be considered based on a individual user's readership history. A new metrics interface provides a summary of the basic impact indicators for a list of records. These include the total and normalized number of papers, citations, reads, and downloads. Also included are some of the popular indices such as the h, g and i10 index. The citation helper tool allows one to submit a set of records and obtain a list of top 10 papers which cite and/or are cited by papers in the original list (but which are not in it). The process closely resembles the network approach of establishing "friends of friends" via an analysis of the citation network. The full-text search service now covers more than 2.5 million documents, including all the major astronomy journals, as well as physics journals published by Springer, Elsevier, the American Physical Society, the American Geophysical Union, and all of the arXiv eprints. The full-text search interface interface allows users and librarians to dig deep and find words or phrases in the body of the indexed articles. ADS Labs is available at http://adslabs.org

  15. AdS/CFT, Black Holes, And Fuzzballs

    NASA Astrophysics Data System (ADS)

    Zadeh, Ida G.

    In this thesis we investigate two different aspects of the AdS/CFT correspondence. We first investigate the holographic AdS/CMT correspondence. Gravitational backgrounds in d + 2 dimensions have been proposed as holographic duals to Lifshitz-like theories describing critical phenomena in d + 1 dimensions with critical exponent z ≥ 1. We numerically explore a dilaton-Einstein-Maxwell model admitting such backgrounds as solutions. We show how to embed these solutions into AdS space for a range of values of z and d. We next investigate the AdS3/CFT2 correspondence and focus on the microscopic CFT description of the D1--D5 system on T4 x S1. In the context of the fuzzball programme, we investigate deforming the CFT away from the orbifold point and study lifting of the low-lying string states. We start by considering general 2D orbifold CFTs of the form M N/SN, with M a target space manifold and SN the symmetric group. The Lunin-Mathur covering space technique provides a way to compute correlators in these orbifold theories, and we generalize this technique in two ways. First, we consider excitations of twist operators by modes of fields that are not twisted by that operator, and show how to account for these excitations when computing correlation functions in the covering space. Second, we consider non-twist sector operators and show how to include the effects of these insertions in the covering space. Using the generalization of the Lunin-Mathur symmetric orbifold technology and conformal perturbation theory, we initiate a program to compute the anomalous dimensions of low-lying string states in the D1--D5 superconformal field theory. Our method entails finding four-point functions involving a string operator O of interest and the deformation operator, taking coincidence limits to identify which other operators mix with O, subtracting conformal families of these operators, and computing their mixing coefficients. We find evidence of operator mixing at first order in

  16. Ipilimumab in metastatic melanoma patients with pre-existing autoimmune disorders.

    PubMed

    Kähler, Katharina C; Eigentler, Thomas K; Gesierich, Anja; Heinzerling, Lucie; Loquai, Carmen; Meier, Friedegund; Meiss, Frank; Pföhler, Claudia; Schlaak, Max; Terheyden, Patrick; Thoms, Kai M; Ziemer, Mirjana; Zimmer, Lisa; Gutzmer, Ralf

    2018-05-01

    Ipilimumab and programmed death (PD) 1-antibodies are effective treatment options in metastatic melanoma. The safety and efficacy of ipilimumab in patients with pre-existing autoimmune disorders (AD) has only been evaluated in a selected number of patients. We performed a retrospective analysis in 14 German skin cancer centers for patients with metastatic melanoma and pre-existing AD treated with ipilimumab. 41 patients with 44 pre-existing AD were treated with ipilimumab (thyroiditis n = 15, rheumatoid n = 11, dermatologic n = 10, Crohn's disease/ulcerative colitis n = 3, neurological n = 2, sarcoidosis n = 2, pancreatitis n = 1). 3 out of 41 patients had two AD, 11 patients required immunosuppressants at the time of induction of ipilimumab. 12 patients (29.2%) experienced a flare of their pre-existing AD, mainly patients with rheumatoid or dermatologic diseases. Additional immune-related adverse events (irAEs) occurred in 12 patients (29.2%). In 23 patients (56%) neither a change of their AD nor additional irAEs were observed. Objective responses were seen in five patients (one complete remission, four partial remissions, 12.1%). This is the largest series of patients with pre-existing AD and treatment with ipilimumab reported. Flares of pre-existing AD were observed but manageable. Response rates and occurrence of new irAEs were comparable to previous trials. Thus, in this patient subgroup, ipilimumab can be a treatment option after a thorough discussion of pros and cons and taking severity and activity of the preexisting AD into account.

  17. On the Selection of Non-Invasive Methods Based on Speech Analysis Oriented to Automatic Alzheimer Disease Diagnosis

    PubMed Central

    López-de-Ipiña, Karmele; Alonso, Jesus-Bernardino; Travieso, Carlos Manuel; Solé-Casals, Jordi; Egiraun, Harkaitz; Faundez-Zanuy, Marcos; Ezeiza, Aitzol; Barroso, Nora; Ecay-Torres, Miriam; Martinez-Lage, Pablo; de Lizardui, Unai Martinez

    2013-01-01

    The work presented here is part of a larger study to identify novel technologies and biomarkers for early Alzheimer disease (AD) detection and it focuses on evaluating the suitability of a new approach for early AD diagnosis by non-invasive methods. The purpose is to examine in a pilot study the potential of applying intelligent algorithms to speech features obtained from suspected patients in order to contribute to the improvement of diagnosis of AD and its degree of severity. In this sense, Artificial Neural Networks (ANN) have been used for the automatic classification of the two classes (AD and control subjects). Two human issues have been analyzed for feature selection: Spontaneous Speech and Emotional Response. Not only linear features but also non-linear ones, such as Fractal Dimension, have been explored. The approach is non invasive, low cost and without any side effects. Obtained experimental results were very satisfactory and promising for early diagnosis and classification of AD patients. PMID:23698268

  18. [The preparation of recombinant adenovirus Ad-Rad50-GFP and detection of the optimal multiplicity of infection in CNE1 transfected hv Ad-Rad50-GFP].

    PubMed

    Yan, Ruicheng; Huang, Jiancong; Zhu, Ling; Chang, Lihong; Li, Jingjia; Wu, Xifu; Ye, Jin; Zhang, Gehua

    2015-12-01

    The optimal multiplicity of infection (MOI) of the recombinant adenovirus Ad-Rad50-GFP carrying a mutant Rad50 gene expression region on the cell growth of nasopharyngeal carcinoma and the viral amplification efficiency of CNE1 cell infected by this adenovirus were studied. The biological titer of Ad-Rad50-GFP was measured by end point dilution method. The impact of recombinant adenoviral vector transfection on the growth of CNE1 cells was observed by cell growth curve. Transfection efficacy of recombinant adenoviral vector was observed and calculated through fluorescence microscope. The expression f mutant Rad50 in the Ad-Rad50-GFP transfected CNE1 cells with optimal MOI was detected by Western Blot after transfection. The biological titer of Ad-Rad50-GFP was 1.26 x 10¹¹ pfu/ml. CNE1 cell growth was not influenced significantly as they were transfected by recombinant adenoviral vector with MOI less than 50. Transfection efficacy of recombinant adenoviral vector was most salient at 24 hours after transfection, with the high expression of mutant Rad50, and the efficiency still remained about 70% after 72 hours. Recombinant adenoviral vector Ad-Rad50-GFP could transfect CNE1 cells as well as result in the expression of mutant Rad50 in CNE1 cells effectively. MOI = 50 was the optimal multiplicity of infection of CNE1 cells transfected by recombinant adenoviral vector Ad-Rad50-GFP.

  19. Face-name association learning in early Alzheimer's disease: a comparison of learning methods and their underlying mechanisms.

    PubMed

    Bier, Nathalie; Van Der Linden, Martial; Gagnon, Lise; Desrosiers, Johanne; Adam, Stephane; Louveaux, Stephanie; Saint-Mleux, Julie

    2008-06-01

    This study compared the efficacy of five learning methods in the acquisition of face-name associations in early dementia of Alzheimer type (AD). The contribution of error production and implicit memory to the efficacy of each method was also examined. Fifteen participants with early AD and 15 matched controls were exposed to five learning methods: spaced retrieval, vanishing cues, errorless, and two trial-and-error methods, one with explicit and one with implicit memory task instructions. Under each method, participants had to learn a list of five face-name associations, followed by free recall, cued recall and recognition. Delayed recall was also assessed. For AD, results showed that all methods were efficient but there were no significant differences between them. The number of errors produced during the learning phases varied between the five methods but did not influence learning. There were no significant differences between implicit and explicit memory task instructions on test performances. For the control group, there were no differences between the five methods. Finally, no significant correlations were found between the performance of the AD participants in free recall and their cognitive profile, but generally, the best performers had better remaining episodic memory. Also, case study analyses showed that spaced retrieval was the method for which the greatest number of participants (four) obtained results as good as the controls. This study suggests that the five methods are effective for new learning of face-name associations in AD. It appears that early AD patients can learn, even in the context of error production and explicit memory conditions.

  20. What's the Value in Value-Added?

    ERIC Educational Resources Information Center

    Duffrin, Elizabeth

    2011-01-01

    A growing number of school districts are adopting "value-added" measures of teaching quality to award bonuses or even tenure. And two competitive federal grants are spurring them on. Districts using value-added data are encouraged by the results. But researchers who support value-added measures advise caution. The ratings, which use a…

  1. Impact on Medical Cost, Cumulative Survival, and Cost-Effectiveness of Adding Rituximab to First-Line Chemotherapy for Follicular Lymphoma in Elderly Patients: An Observational Cohort Study Based on SEER-Medicare

    PubMed Central

    Griffiths, Robert I.; Gleeson, Michelle L.; Mikhael, Joseph; Danese, Mark D.

    2012-01-01

    Rituximab improves survival in follicular lymphoma (FL), but is considerably more expensive than conventional chemotherapy. We estimated the total direct medical costs, cumulative survival, and cost-effectiveness of adding rituximab to first-line chemotherapy for FL, based on a single source of data representing routine practice in the elderly. Using surveillance, epidemiology, and end results (SEER) registry data plus Medicare claims, we identified 1,117 FL patients who received first-line CHOP (cyclophosphamide (C), doxorubicin, vincristine (V), and prednisone (P)) or CVP +/− rituximab. Multivariate regression was used to estimate adjusted cumulative cost and survival differences between the two groups over four years after beginning treatment. The median age was 73 years (minimum 66 years), 56% had stage III-IV disease, and 67% received rituximab. Adding rituximab to first-line chemotherapy was associated with higher adjusted incremental total cost ($18,695; 95% Confidence Interval (CI) $9,302–$28,643) and longer adjusted cumulative survival (0.18 years; 95% CI 0.10–0.27) over four years of followup. The expected cost-effectiveness was $102,142 (95% CI $34,531–296,337) per life-year gained. In routine clinical practice, adding rituximab to first-line chemotherapy for elderly patients with FL results in higher direct medical costs to Medicare and longer cumulative survival after four years. PMID:22969803

  2. ADS pilot program Plan

    NASA Technical Reports Server (NTRS)

    Clauson, J.; Heuser, J.

    1981-01-01

    The Applications Data Service (ADS) is a system based on an electronic data communications network which will permit scientists to share the data stored in data bases at universities and at government and private installations. It is designed to allow users to readily locate and access high quality, timely data from multiple sources. The ADS Pilot program objectives and the current plans for accomplishing those objectives are described.

  3. An anisotropic diffusion method for denoising dynamic susceptibility contrast-enhanced magnetic resonance images

    NASA Astrophysics Data System (ADS)

    Murase, Kenya; Yamazaki, Youichi; Shinohara, Masaaki; Kawakami, Kazunori; Kikuchi, Keiichi; Miki, Hitoshi; Mochizuki, Teruhito; Ikezoe, Junpei

    2001-10-01

    The purpose of this study was to present an application of a novel denoising technique for improving the accuracy of cerebral blood flow (CBF) images generated from dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSC-MRI). The method presented in this study was based on anisotropic diffusion (AD). The usefulness of this method was firstly investigated using computer simulations. We applied this method to patient data acquired using a 1.5 T MR system. After a bolus injection of Gd-DTPA, we obtained 40-50 dynamic images with a 1.32-2.08 s time resolution in 4-6 slices. The dynamic images were processed using the AD method, and then the CBF images were generated using pixel-by-pixel deconvolution analysis. For comparison, the CBF images were also generated with or without processing the dynamic images using a median or Gaussian filter. In simulation studies, the standard deviation of the CBF values obtained after processing by the AD method was smaller than that of the CBF values obtained without any processing, while the mean value agreed well with the true CBF value. Although the median and Gaussian filters also reduced image noise, the mean CBF values were considerably underestimated compared with the true values. Clinical studies also suggested that the AD method was capable of reducing the image noise while preserving the quantitative accuracy of CBF images. In conclusion, the AD method appears useful for denoising DSC-MRI, which will make the CBF images generated from DSC-MRI more reliable.

  4. Real-world clinical responses in patients with type 2 diabetes mellitus adding exenatide BID (EBID) or mealtime insulin to basal insulin: a retrospective study using electronic medical record data.

    PubMed

    Lang, Kathleen; Nguyen, Hiep; Huang, Huan; Bauer, Elise; Levin, Philip

    2018-06-01

    Exenatide twice daily (EBID) and mealtime insulin are effective add-on therapies to basal insulin for type 2 diabetes patients in clinical trials. This study used electronic medical record (EMR) data to evaluate analogous real-world clinical responses. Adult patients initiating EBID or mealtime insulin as add-on to basal insulin during January 2008-March 2013 were identified in a US EMR database. EBID patients were propensity score matched 1:1 to mealtime insulin patients. Cohorts were followed for 12 months before (baseline) and 6 months after the index. A1C, hypoglycemic events, change in weight, and other clinical measures were evaluated by A1C attainment level (<6.5, < 7, < 7.5, <8, <9%) and baseline A1C. In total, 1249 EBID patients were matched to 1249 mealtime insulin patients. During follow-up, the percentage reaching A1C levels was similar for EBID vs mealtime insulin cohorts for all attainment levels (<7%: 27.8% vs 24.2%; < 9%: 79.7% vs 79.2%; p = NS). The percentage reaching A1C < 7% was similar for both cohorts with different baseline A1C. EBID patients had less hypoglycemia at all attainment levels (3.1% vs 11.1% [<6.5%]; 2.5% vs 4.7% [<9%]; all p < .03) and more weight loss (-9.0 vs -3.2 lb [<6.5%]; -3.4 vs +0.8 lb [<9%]; all p < .01). EBID added to basal insulin was as effective in a real-world setting as mealtime insulin added to basal insulin in reducing A1C, with less weight gain and less hypoglycemia for a wide range of A1C attainment levels and baseline values.

  5. Postoperative ambulation in thoracic surgery patients: standard versus modern ambulation methods.

    PubMed

    Nesbitt, Jonathan C; Deppen, Stephen; Corcoran, Richard; Cogdill, Shari; Huckabay, Sarah; McKnight, Drew; Osborne, Breanne F; Werking, Kristin; Gardner, Megan; Perrigo, Laurel

    2012-01-01

    A single-subject study of two methods of postoperative ambulation of patients recovering from thoracic surgery. During the postoperative setting, patients are often burdened by their condition that reduces their ability to ambulate. This problem is compounded by the addition of devices that make walking more cumbersome. To simplify the process of ambulation during the postoperative period, an intravenous pole/walker (IVPW) was specifically designed to allow all patient devices and attachments to accompany the patient during ambulation, without the need for supplemental caregiver assistance. The IVPW method of ambulation was compared with standard method of ambulation (SMA) in a single-subject clinical trial. Thirty-nine consecutive thoracic surgery patients with at least an IV and chest tube were ambulated using alternatively either the IVPW or the SMA. Immediately following the ambulation periods, the patient and patient's health care worker assessed both methods using satisfaction surveys consisting of several questions about the episodes of ambulation and the number of health care workers needed to assist during ambulation. Patient satisfaction was significantly higher in the ability of the IVPW to provide support and assist in ambulation in comparison with the SMA (p < 0·001). Nurses felt the IVPW both facilitated and provided a safer method for ambulation compared with the SMA (p < 0·001). On average, one less employee was required during ambulation with the IVPW (p < 0·001). The IVPW provided better support and was perceived as a safer method for ambulation compared with the SMA. The IVPW also required one less person to assist with ambulation. Facilitation of ambulation in the postoperative setting can impact nursing care and patient satisfaction. © 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.

  6. Assessing the relationship between ad volume and awareness of a tobacco education media campaign

    PubMed Central

    Modayil, Mary V; Stevens, Colleen

    2010-01-01

    Background The relation between aided ad recall and level of television ad placement in a public health setting is not well established. We examine this association by looking back at 8 years of the California's Tobacco Control Program's (CTCP) media campaign. Methods Starting in July 2001, California's campaign was continuously monitored using five telephone series of surveys and six web-based series of surveys immediately following a media flight. We used population-based statewide surveys to measure aided recall for advertisements that were placed in each of these media flights. Targeted rating points (TRPs) were used to measure ad placement intensity throughout the state. Results Cumulative TRPs exhibited a stronger relation with aided ad recall than flight TRPs or TRP density. This association increased after log-transforming cumulative TRP values. We found that a one-unit increase in log-cumulative TRPs led to a 13.6% increase in aided ad recall using web-based survey data, compared to a 5.3% increase in aided ad recall using telephone survey data. Conclusions In California, the relation between aided ad recall and cumulative TRPs showed a diminishing return after a large volume of ad placements These findings may be useful in planning future ad placement for CTCP's media campaign. PMID:20382649

  7. From free fields to AdS space. II

    NASA Astrophysics Data System (ADS)

    Gopakumar, Rajesh

    2004-07-01

    We continue with the program of paper I [Phys. Rev. D 70, 025009 (2004)] to implement open-closed string duality on free gauge field theory (in the large-N limit). In this paper we consider correlators such as <∏ni=1TrΦJi(xi)>. The Schwinger parametrization of this n-point function exhibits a partial gluing up into a set of basic skeleton graphs. We argue that the moduli space of the planar skeleton graphs is exactly the same as the moduli space of genus zero Riemann surfaces with n holes. In other words, we can explicitly rewrite the n-point (planar) free-field correlator as an integral over the moduli space of a sphere with n holes. A preliminary study of the integrand also indicates compatibility with a string theory on AdS space. The details of our argument are quite insensitive to the specific form of the operators and generalize to diagrams of a higher genus as well. We take this as evidence of the field theory’s ability to reorganize itself into a string theory.

  8. No added diagnostic value of non-phosphorylated tau fraction (p-taurel) in CSF as a biomarker for differential dementia diagnosis.

    PubMed

    Goossens, Joery; Bjerke, Maria; Struyfs, Hanne; Niemantsverdriet, Ellis; Somers, Charisse; Van den Bossche, Tobi; Van Mossevelde, Sara; De Vil, Bart; Sieben, Anne; Martin, Jean-Jacques; Cras, Patrick; Goeman, Johan; De Deyn, Peter Paul; Van Broeckhoven, Christine; van der Zee, Julie; Engelborghs, Sebastiaan

    2017-07-14

    The Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers Aβ 1-42 , t-tau, and p-tau 181 overlap with other diseases. New tau modifications or epitopes, such as the non-phosphorylated tau fraction (p-tau rel ), may improve differential dementia diagnosis. The goal of this study is to investigate if p-tau rel can improve the diagnostic performance of the AD CSF biomarker panel for differential dementia diagnosis. The study population consisted of 45 AD, 45 frontotemporal lobar degeneration (FTLD), 45 dementia with Lewy bodies (DLB), and 21 Creutzfeldt-Jakob disease (CJD) patients, and 20 cognitively healthy controls. A substantial subset of the patients was pathology-confirmed. CSF levels of Aβ 1-42 , t-tau, p-tau 181 , and p-tau rel were determined with commercially available single-analyte enzyme-linked immunosorbent assay (ELISA) kits. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analyses, and area under the curve (AUC) values were compared using DeLong tests. The diagnostic performance of single markers as well as biomarker ratios was determined for each pairwise comparison of different dementia groups and controls. The addition of p-tau rel to the AD biomarker panel decreased its diagnostic performance when discriminating non-AD, FTLD, and DLB from AD. As a single marker, p-tau rel increased the diagnostic performance for CJD. No significant difference was found in AUC values with the addition of p-tau rel when differentiating between AD or non-AD dementias and controls. The addition of p-tau rel to the AD CSF biomarker panel failed to improve differentiation between AD and non-AD dementias.

  9. AD-LIBS: inferring ancestry across hybrid genomes using low-coverage sequence data.

    PubMed

    Schaefer, Nathan K; Shapiro, Beth; Green, Richard E

    2017-04-04

    Inferring the ancestry of each region of admixed individuals' genomes is useful in studies ranging from disease gene mapping to speciation genetics. Current methods require high-coverage genotype data and phased reference panels, and are therefore inappropriate for many data sets. We present a software application, AD-LIBS, that uses a hidden Markov model to infer ancestry across hybrid genomes without requiring variant calling or phasing. This approach is useful for non-model organisms and in cases of low-coverage data, such as ancient DNA. We demonstrate the utility of AD-LIBS with synthetic data. We then use AD-LIBS to infer ancestry in two published data sets: European human genomes with Neanderthal ancestry and brown bear genomes with polar bear ancestry. AD-LIBS correctly infers 87-91% of ancestry in simulations and produces ancestry maps that agree with published results and global ancestry estimates in humans. In brown bears, we find more polar bear ancestry than has been published previously, using both AD-LIBS and an existing software application for local ancestry inference, HAPMIX. We validate AD-LIBS polar bear ancestry maps by recovering a geographic signal within bears that mirrors what is seen in SNP data. Finally, we demonstrate that AD-LIBS is more effective than HAPMIX at inferring ancestry when preexisting phased reference data are unavailable and genomes are sequenced to low coverage. AD-LIBS is an effective tool for ancestry inference that can be used even when few individuals are available for comparison or when genomes are sequenced to low coverage. AD-LIBS is therefore likely to be useful in studies of non-model or ancient organisms that lack large amounts of genomic DNA. AD-LIBS can therefore expand the range of studies in which admixture mapping is a viable tool.

  10. An alternative path to the boundary: The CFT as the Fourier space of AdS

    NASA Astrophysics Data System (ADS)

    Tolfree, Ian M.

    2009-12-01

    In this thesis we shed new light on the conjectured duality between an n + 1 dimensional theory of gravity in anti de Sitter space (AdS) and an n dimensional conformal field theory (CFT) by showing that the CFT can be interpreted as the Fourier space of AdS. We then make use of this to gain insight into the nature of black hole entropy. In the first part of this thesis, we give an introduction to the ideas of and review the basics of the AdS/CFT. In the next section we make use of well known integral geometry techniques to derive the Fourier transformation of a function on AdS and see it is a function with compact support on the boundary. Comparing this to the literature, we find that the Green's functions from the literature are actually the Fourier weights of the transformation and that the boundary values of fields appearing in the correspondence are the Fourier coefficients of the transformation. One is thus left to interpret the CFT as the quantized version of a classical theory in AdS and the dual operator as the Fourier coefficients. Group theoretic considerations are discussed in relation to the transformation and its potential use in constructing QCD like theories. In the last section, we then build upon this to study the BTZ black hole. Named after its authors, Banados, Teitelboim and Zanelli, the BTZ black hole is a three dimensional (two space plus one time dimension) black hole in anti de Sitter space. Following standard procedures for modifying Fourier Transformations to accommodate quotient spaces we arrive at a mapping in a black hole background consistent with known results that yields the exact micro-states of a scalar field in a black hole background. We find that the micro-states are the Fourier coefficients on the boundary, which transform under the principal series representation of SL(2, R). Using the knowledge of how to represent a bulk scalar field in the CFT, and knowing how a black hole interacts with a scalar field, we deduce the

  11. The ‘added value’ GPs bring to commissioning: a qualitative study in primary care

    PubMed Central

    Perkins, Neil; Coleman, Anna; Wright, Michael; Gadsby, Erica; McDermott, Imelda; Petsoulas, Christina; Checkland, Kath

    2014-01-01

    Background The 2012 Health and Social Care Act in England replaced primary care trusts with clinical commissioning groups (CCGs) as the main purchasing organisations. These new organisations are GP-led, and it was claimed that this increased clinical input would significantly improve commissioning practice. Aim To explore some of the key assumptions underpinning CCGs, and to examine the claim that GPs bring ‘added value’ to commissioning. Design and setting In-depth interviews with clinicians and managers across seven CCGs in England between April and September 2013. Method A total of 40 clinicians and managers were interviewed. Interviews focused on the perceived ‘added value’ that GPs bring to commissioning. Results Claims to GP ‘added value’ centred on their intimate knowledge of their patients. It was argued that this detailed and concrete knowledge improves service design and that a close working relationship between GPs and managers strengthens the ability of managers to negotiate. However, responders also expressed concerns about the large workload that they face and about the difficulty in engaging with the wider body of GPs. Conclusion GPs have been involved in commissioning in many ways since fundholding in the 1990s, and claims such as these are not new. The key question is whether these new organisations better support and enable the effective use of this knowledge. Furthermore, emphasis on experiential knowledge brings with it concerns about representativeness and the extent to which other voices are heard. Finally, the implicit privileging of GPs’ personal knowledge ahead of systematic public health intelligence also requires exploration. PMID:25348997

  12. Ketamine added to morphine or hydromorphone patient-controlled analgesia for acute postoperative pain in adults: a systematic review and meta-analysis of randomized trials.

    PubMed

    Wang, Li; Johnston, Bradley; Kaushal, Alka; Cheng, Davy; Zhu, Fang; Martin, Janet

    2016-03-01

    To determine whether ketamine added to morphine or hydromorphone patient-controlled analgesia (PCA) provides clinically relevant reductions in postoperative pain, opioid requirements, and adverse events when compared with morphine or hydromorphone PCA in adults undergoing surgery. We systematically searched six databases up to June 2, 2015 for randomized controlled trials (RCTs) comparing ketamine plus morphine/hydromorphone PCA vs morphine/hydromorphone PCA for postoperative pain in adults. Thirty-six RCTs including 2,502 patients proved eligible, and 22 of these were at low risk of bias. The addition of ketamine to morphine/hydromorphone PCA decreased postoperative pain intensity at six to 72 hr when measured at rest (weighted mean difference [WMD] on a 10-cm visual analogue scale ranged from -0.4 to -1.3 cm) and during mobilization (WMD ranged from -0.4 to -0.5 cm). Adjunctive ketamine also significantly reduced cumulative morphine consumption at 24-72 hr by approximately 5-20 mg. Predefined subgroup analyses and meta-regression did not detect significant differences across subgroups, including a dose-response relationship. There was no significant difference in patient satisfaction scores at 24 and 48 hr. Nevertheless, the addition of ketamine to morphine/hydromorphone PCA significantly reduced postoperative nausea and vomiting (relative risk, 0.71; 95% confidence interval [CI], 0.60 to 0.85; absolute risk reduction, 8.9%; 95% CI, 4.6 to 12.2). Significant effects on other adverse events (e.g., hallucinations, vivid dreams) were not detected, though only a few studies reported on them. Adding ketamine to morphine/hydromorphone PCA provides a small improvement in postoperative analgesia while reducing opioid requirements. Adjunctive ketamine also reduces postoperative nausea and vomiting without a detected increase in other adverse effects; however, adverse events were probably underreported.

  13. Lithium Treatment for Agitation in Alzheimer's disease (Lit-AD): Clinical rationale and study design.

    PubMed

    Devanand, D P; Strickler, Jesse G; Huey, Edward D; Crocco, Elizabeth; Forester, Brent P; Husain, Mustafa M; Vahia, Ipsit V; Andrews, Howard; Wall, Melanie M; Pelton, Gregory H

    2018-05-31

    Symptoms of agitation, aggression, and psychosis frequently occur in patients with Alzheimer's disease (AD). These symptoms are distressing to patients and caregivers, often lead to institutionalization, are associated with increased mortality, and are very difficult to treat. Lithium is an established treatment for bipolar and other psychotic disorders in which agitation can occur. The Lit-AD study is the first randomized, double-blind, placebo-controlled trial to assess the efficacy of lithium treatment for symptoms of agitation or aggression, with or without psychosis, in older adults diagnosed with AD. Patients are randomly assigned to low dose (150-600 mg) lithium or placebo, targeting a blood level of 0.2-0.6 mmol/L, stratified by the presence/absence of psychotic symptoms. The study duration for each patient is 12 weeks. The primary study outcome is change in the agitation/aggression domain score on the Neuropsychiatric Inventory (NPI) over the study period. The secondary outcome is improvement in neuropsychiatric symptoms defined as a 30% decrease in a NPI core score that combines agitation/aggression and psychosis domain scores. The Treatment Emergent Symptom Scale (TESS) is used to assess somatic side effects. Other exploratory analyses examine the associations between improvement on lithium and indices shown to be associated with response to lithium in bipolar disorder: serum brain-derived neurotrophic factor (BDNF) levels, a SNP in intron 1 of the ACCN1 gene, and variation at the 7q11.2 gene locus. If lithium demonstrates efficacy in this Phase II pilot trial, a Phase III study will be developed to establish its clinical utility in these patients. ClinicalTrials.gov Identifier NCT02129348. Copyright © 2018. Published by Elsevier Inc.

  14. Quantum statistical relation for black holes in nonlinear electrodynamics coupled to Einstein-Gauss-Bonnet AdS gravity

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Miskovic, Olivera; Olea, Rodrigo

    2011-03-15

    We consider curvature-squared corrections to Einstein-Hilbert gravity action in the form of a Gauss-Bonnet term in D>4 dimensions. In this theory, we study the thermodynamics of charged static black holes with anti-de Sitter (AdS) asymptotics, and whose electric field is described by nonlinear electrodynamics. These objects have received considerable attention in recent literature on gravity/gauge dualities. It is well-known that, within the framework of anti-de Sitter/conformal field theory (AdS/CFT) correspondence, there exists a nonvanishing Casimir contribution to the internal energy of the system, manifested as the vacuum energy for global AdS spacetime in odd dimensions. Because of this reason, wemore » derive a quantum statistical relation directly from the Euclidean action and not from the integration of the first law of thermodynamics. To this end, we employ a background-independent regularization scheme which consists, in addition to the bulk action, of counterterms that depend on both extrinsic and intrinsic curvatures of the boundary (Kounterterm series). This procedure results in a consistent inclusion of the vacuum energy and chemical potential in the thermodynamic description for Einstein-Gauss-Bonnet AdS gravity regardless of the explicit form of the nonlinear electrodynamics Lagrangian.« less

  15. Age-related changes in core body temperature and activity in triple-transgenic Alzheimer’s disease (3xTgAD) mice

    PubMed Central

    Knight, Elysse M.; Brown, Timothy M.; Gümüsgöz, Sarah; Smith, Jennifer C. M.; Waters, Elizabeth J.; Allan, Stuart M.; Lawrence, Catherine B.

    2013-01-01

    SUMMARY Alzheimer’s disease (AD) is characterised, not only by cognitive deficits and neuropathological changes, but also by several non-cognitive behavioural symptoms that can lead to a poorer quality of life. Circadian disturbances in core body temperature and physical activity are reported in AD patients, although the cause and consequences of these changes are unknown. We therefore characterised circadian patterns of body temperature and activity in male triple transgenic AD mice (3xTgAD) and non-transgenic (Non-Tg) control mice by remote radiotelemetry. At 4 months of age, daily temperature rhythms were phase advanced and by 6 months of age an increase in mean core body temperature and amplitude of temperature rhythms were observed in 3xTgAD mice. No differences in daily activity rhythms were seen in 4- to 9-month-old 3xTgAD mice, but by 10 months of age an increase in mean daily activity and the amplitude of activity profiles for 3xTgAD mice were detected. At all ages (4–10 months), 3xTgAD mice exhibited greater food intake compared with Non-Tg mice. The changes in temperature did not appear to be solely due to increased food intake and were not cyclooxygenase dependent because the temperature rise was not abolished by chronic ibuprofen treatment. No β-amyloid (Aβ) plaques or neurofibrillary tangles were noted in the hypothalamus of 3xTgAD mice, a key area involved in temperature regulation, although these pathological features were observed in the hippocampus and amygdala of 3xTgAD mice from 10 months of age. These data demonstrate age-dependent changes in core body temperature and activity in 3xTgAD mice that are present before significant AD-related neuropathology and are analogous to those observed in AD patients. The 3xTgAD mouse might therefore be an appropriate model for studying the underlying mechanisms involved in non-cognitive behavioural changes in AD. PMID:22864021

  16. The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma.

    PubMed

    Bennie, George; Vorster, Mariza; Buscombe, John; Sathekge, Mike

    2015-01-01

    Single-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and radiation burden of these reported benefits remains somewhat uncertain. This study aimed to evaluate the possible added value of SPECT-CT and intra-operative gamma-probe use over planar imaging alone in the South African setting. 80 patients with breast cancer or malignant melanoma underwent both planar and SPECT-CT imaging for SLN mapping. We assessed and compared the number of nodes detected on each study, false positive and negative findings, changes in surgical approach and or patient management. In all cases where a sentinel node was identified, SPECT-CT was more accurate anatomically. There was a significant change in surgical approach in 30 cases - breast cancer (n = 13; P 0.001) and malignant melanoma (n = 17; P 0.0002). In 4 cases a node not identified on planar imaging was seen on SPECT-CT. In 16 cases additional echelon nodes were identified. False positives were excluded by SPECT-CT in 12 cases. The addition of SPECT-CT and use of intra-operative gamma-probe to planar imaging offers important benefits in patients who present with breast cancer and melanoma. These benefits include increased nodal detection, elimination of false positives and negatives and improved anatomical localization that ultimately aids and expedites surgical management. This has been demonstrated in the context of industrialized country previously and has now also been confirmed in the setting of a emerging-market nation.

  17. Differences in the effects of Asian dust on pulmonary function between adult patients with asthma and those with asthma–chronic obstructive pulmonary disease overlap syndrome

    PubMed Central

    Watanabe, Masanari; Noma, Hisashi; Kurai, Jun; Sano, Hiroyuki; Ueda, Yasuto; Mikami, Masaaki; Yamamoto, Hiroyuki; Tokuyasu, Hirokazu; Kato, Kazuhiro; Konishi, Tatsuya; Tatsukawa, Toshiyuki; Shimizu, Eiji; Kitano, Hiroya

    2016-01-01

    Background Asian dust (AD) exposure exacerbates pulmonary dysfunction in patients with asthma. Asthma–chronic obstructive pulmonary disease overlap syndrome (ACOS), characterized by coexisting symptoms of asthma and chronic obstructive pulmonary disease, is considered a separate disease entity. Previously, we investigated the effects of AD on pulmonary function in adult patients with asthma. Here, we present the findings of our further research on the differences in the effects of AD exposure on pulmonary function between patients with asthma alone and those with ACOS. Methods Between March and May 2012, we conducted a panel study wherein we monitored daily peak expiratory flow (PEF) values in 231 adult patients with asthma. These patients were divided into 190 patients with asthma alone and 41 patients with ACOS in this study. Daily AD particle levels were measured using light detection and ranging systems. Two heavy AD days (April 23 and 24) were determined according to the Japan Meteorological Agency definition. A linear mixed model was used to estimate the association between PEF and AD exposure. Results Increments in the interquartile range of AD particles (0.018 km−1) led to PEF changes of −0.50 L/min (95% confidence interval, −0.98 to −0.02) in patients with asthma alone and −0.11 L/min (−0.11 to 0.85) in patients with ACOS. The PEF changes after exposure to heavy AD were −2.21 L/min (−4.28 to −0.15) in patients with asthma alone and −2.76 L/min (−6.86 to 1.35) in patients with ACOS. In patients with asthma alone, the highest decrease in PEF values was observed on the heavy AD day, with a subsequent gradual increase over time. Conclusion Our results suggest that the effects of AD exposure on pulmonary function differ between patients with asthma alone and ACOS, with the former exhibiting a greater likelihood of decreased pulmonary function after AD exposure. PMID:26869784

  18. Osteoporosis in adult patients with atopic dermatitis: A nationwide population-based study

    PubMed Central

    Lu, Chun-Ching; Su, Yu-Feng; Tsai, Tai-Hsin; Wu, Chieh-Hsin

    2017-01-01

    The aim of this study was to investigate osteoporosis risk in atopic dermatitis (AD) patients. This study included patients in the Taiwan National Health Insurance Research dataset. The population-based study included all patients aged 20–49 years who had been diagnosed with AD during 1996–2010. In total, 35,229 age and gender-matched patients without AD in a 1:1 ratio were randomly selected as the non-AD group. Cox proportional-hazards regression and Kaplan–Meier analyses were used to measure the hazard ratios and the cumulative incidences of osteoporosis, respectively. During the follow-up period, 360(1.02%) AD patients and 127(0.36%) non-AD patients developed osteoporosis. The overall incidence of osteoporosis was4.72-fold greater in the AD patients compared to the non-AD patients (1.82 vs. 0.24 per 1,000 person-years, respectively) after adjusting for potential confounding factors. Osteoporosis risk factors included female gender, age, advanced Charlson Comorbidity Index, depression and use of corticosteroids. The dataset analysis showed that AD was significantly associated with subsequent risk of osteoporosis. PMID:28207767

  19. Consumption of Added Sugars and Cardiometabolic Risk Indicators Among US Adolescents

    PubMed Central

    Welsh, Jean A.; Sharma, Andrea; Argeseanu, Solveig; Vos, Miriam B.

    2014-01-01

    Background Increased carbohydrate and sugar consumption has been associated with dyslipidemia among adults. However, the effect of high consumption of added sugars (caloric sweeteners) on measures of cardiometabolic risk among US adolescents is unknown. Methods and Results This was a cross-sectional study of 2,252 US adolescents (13–18 y) in the National Health and Nutrition Examination Survey (NHANES) 1999–2004. Dietary data from one 24-hour recall were merged with added sugar content data from the USDA MyPyramid Equivalents Databases. Multivariate-adjusted means of cardiometabolic indicators were estimated by added sugar consumption level (<10%, 10– <15%, 15– <20%, 20– <25%, 25– <30%, and ≥30% total energy) and weighted to be representative of US adolescents. Mean consumption of added sugars was 21.4% of daily energy intake. Adjusted mean high-density lipoprotein cholesterol (HDL) levels were lower, 1.38 mmol/L (95% CI: 1.32, 1.43) among the lowest consumers to 1.28 mmol/L (95% confidence interval [CI]: 1.23, 1.33) among the highest (p-trend=0.007). Geometric mean triglyceride levels ranged from 0.79 mmol/L (95% CI: 0.72, 0.86) to 0.89 mmol/L (95% CI: 0.83, 0.96) (p-trend=0.03) with greater consumption of added sugars. Among those overweight/obese (≥85th percentile body-mass-index [BMI]), HOMA-IRs were positively associated with added sugars (p-linear trend<0.001), averaging 78% higher among the highest vs. the lowest consumers (p<0.001). No significant trends were seen with low-density lipoproteins, body-mass-index, or blood pressure. Conclusion In US adolescents, consumption of added sugars is positively associated with measures of cardiometabolic risk. Long-term studies are needed to determine if reduction in added sugars will improve these parameters and, thereby decrease future cardiovascular events. PMID:21220734

  20. Measuring the effectiveness of patient-chosen reminder methods in a private orthodontic practice.

    PubMed

    Wegrzyniak, Lauren M; Hedderly, Deborah; Chaudry, Kishore; Bollu, Prashanti

    2018-05-01

    To evaluate the effectiveness of patient-chosen appointment reminder methods (phone call, e-mail, or SMS text) in reducing no-show rates. This was a retrospective case study that determined the correlation between patient-chosen appointment reminder methods and no-show rates in a private orthodontic practice. This study was conducted in a single office location of a multioffice private orthodontic practice using data gathered in 2015. The subjects were patients who self-selected the appointment reminder method (phone call, e-mail, or SMS text). Patient appointment data were collected over a 6-month period. Patient attendance was analyzed with descriptive statistics to determine any significant differences among patient-chosen reminder methods. There was a total of 1193 appointments with an average no-show rate of 2.43% across the three reminder methods. No statistically significant differences ( P = .569) were observed in the no-show rates between the three methods: phone call (3.49%), e-mail (2.68%), and SMS text (1.90%). The electronic appointment reminder methods (SMS text and e-mail) had lower no-show rates compared with the phone call method, with SMS text having the lowest no-show rate of 1.90%. However, since no significant differences were observed between the three patient-chosen reminder methods, providers may want to allow patients to choose their reminder method to decrease no-shows.