Sample records for add-on fgd systems

  1. Sustainable Uses of FGD Gypsum in Agricultural Systems: Introduction.

    PubMed

    Watts, Dexter B; Dick, Warren A

    2014-01-01

    Interest in using gypsum as a management tool to improve crop yields and soil and water quality has recently increased. Abundant supply and availability of flue gas desulfurization (FGD) gypsum, a by-product of scrubbing sulfur from combustion gases at coal-fired power plants, in major agricultural producing regions within the last two decades has attributed to this interest. Currently, published data on the long-term sustainability of FGD gypsum use in agricultural systems is limited. This has led to organization of the American Society of Agronomy's Community "By-product Gypsum Uses in Agriculture" and a special collection of nine technical research articles on various issues related to FGD gypsum uses in agricultural systems. A brief review of FGD gypsum, rationale for the special collection, overviews of articles, knowledge gaps, and future research directions are presented in this introductory paper. The nine articles are focused in three general areas: (i) mercury and other trace element impacts, (ii) water quality impacts, and (iii) agronomic responses and soil physical changes. While this is not an exhaustive review of the topic, results indicate that FGD gypsum use in sustainable agricultural production systems is promising. The environmental impacts of FGD gypsum are mostly positive, with only a few negative results observed, even when applied at rates representing cumulative 80-year applications. Thus, FGD gypsum, if properly managed, seems to represent an important potential input into agricultural systems. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  2. The effects of flue gas desulfurization (FGD) system additives on solid by-products. Final report

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

    Huyck, K.A.; Tatum, G.S.; DeKraker, D.P.

    This study was designed to examine characteristics of by-products from flue gas desulfurization (FGD) systems that use performance-enhancing additives. The by-products were evaluated for handling, disposal, properties, and utilization potential. This study was designed to identify potential operation-limiting consequences (fatal flaws) caused by using FGD system additives. It was not intended to be an all-encompassing study of the possible process, environmental, and utilization circumstances at each plant. Seven utilities conducting additive testing agreed to provide samples for this study both before and during their testing. Solid samples were collected from FGD systems using the following additives: di-basic acid (DBA), whichmore » is a mixture of succinic, glutaric, and adipic acids; formate; sulfur; ethylene diamine tetraacetic acid (EDTA); and chloride. Changes in handling properties that may alter process operations were observed at sites where DBS was used. Changes in leaching behavior, permeability and unconfined compressive strength (properties that affect by-product disposal properties) showed no clear trend for additive or system type. The intent of this study is to provide an overall assessment of potential system-limiting effects of FGD additive use. There were no overriding problems relating to disposal with the use of additives. However, properties of solids produced with and without additives should be tested at each site prior to use of an FGD system additive. This is necessary because of the variability in state disposal and permitting requirements and the influence of specific operating conditions on by-product properties.« less

  3. Selenium Speciation and Management in Wet FGD Systems

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

    Searcy, K; Richardson, M; Blythe, G

    2012-02-29

    This report discusses results from bench- and pilot-scale simulation tests conducted to determine the factors that impact selenium speciation and phase partitioning in wet FGD systems. The selenium chemistry in wet FGD systems is highly complex and not completely understood, thus extrapolation and scale-up of these results may be uncertain. Control of operating parameters and application of scrubber additives have successfully demonstrated the avoidance or decrease of selenite oxidation at the bench and pilot scale. Ongoing efforts to improve sample handling methods for selenium speciation measurements are also discussed. Bench-scale scrubber tests explored the impacts of oxidation air rate, tracemore » metals, scrubber additives, and natural limestone on selenium speciation in synthetic and field-generated full-scale FGD liquors. The presence and concentration of redox-active chemical species as well as the oxidation air rate contribute to the oxidation-reduction potential (ORP) conditions in FGD scrubbers. Selenite oxidation to the undesirable selenate form increases with increasing ORP conditions, and decreases with decreasing ORP conditions. Solid-phase manganese [Mn(IV)] appeared to be the significant metal impacting the oxidation of selenite to selenate. Scrubber additives were tested for their ability to inhibit selenite oxidation. Although dibasic acid and other scrubber additives showed promise in early clear liquor (sodium based and without calcium solids) bench-scale tests, these additives did not show strong inhibition of selenite oxidation in tests with higher manganese concentrations and with slurries from full-scale wet FGD systems. In bench-tests with field liquors, addition of ferric chloride at a 250:1 iron-to-selenium mass ratio sorbed all incoming selenite to the solid phase, although addition of ferric salts had no impact on native selenate that already existed in the field slurry liquor sample. As ORP increases, selenite may oxidize to

  4. Key issues for low-cost FGD installations

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

    DePriest, W.; Mazurek, J.M.

    1995-12-01

    This paper will discuss various methods for installing low-cost FGD systems. The paper will include a discussion of various types of FGD systems available, both wet and dry, and will compare the relative cost of each type. Important design issues, such as use of spare equipment, materials of construction, etc. will be presented. An overview of various low-cost construction techniques (i.e., modularization) will be included. This paper will draw heavily from Sargent & Lundy`s database of past and current FGD projects together with information we gathered for several Electric Power Research Institute (EPRI) studies on the subject.

  5. STATUS OF COMMERCIAL UTILITY FGD (FLUE GAS DESULFURIZATION) TECHNOLOGY

    EPA Science Inventory

    The paper summarizes the status of FGD technology as of March 1983 and highlights recent trends in process selection, design, and performance of FGD systems. The information collected in the program is stored in the Flue Gas Desulfurization Information System (FGDIS), a collectio...

  6. Application study of Bio-FGD based on environmental safety during the coal combustion

    NASA Astrophysics Data System (ADS)

    Zhang, Pin

    2018-05-01

    Coal combustion produces a large amount of acidic gas, which is the main cause of acid rain and other natural disasters. Flue Gas Desulfurization (FGD) is a necessary requirement for clean coal combustion. Compared with the traditional chemical desulfurization technology, biological desulfurization has the advantages of low operating cost, without secondary pollution, low carbon emission and the additional economic benefits. The process and structure of BioDeSOx which as one of Bio-FGD technology is introduced. The major factors that influent BioDeSOx Bio- FGD system is the pH, oxidation reduction potential (-300 MV to -400MV), electrical conductivity, the adding amount of nutrient and temperature (30°C-40°C). Taking the Bio- FGD project of Yixing xielian thermal power plant as an example, the BioDeSOx technology was applied in this project. The environmental and economic benefits of the project were greater than the traditional desulfurization technology. With the continuous improvement of environmental safety standards, Bio- FGD technology will have broad application prospects.

  7. Field Testing of a Wet FGD Additive for Enhanced Mercury Control

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

    Gary Blythe; MariJon Owens

    2007-12-31

    This document is the final report for DOE-NETL Cooperative Agreement DE-FC26-04NT42309, 'Field Testing of a Wet FGD Additive'. The objective of the project has been to demonstrate the use of two flue gas desulfurization (FGD) additives, Evonik Degussa Corporation's TMT-15 and Nalco Company's Nalco 8034, to prevent the re-emission of elemental mercury (Hg{sup 0}) in flue gas exiting wet FGD systems on coal-fired boilers. Furthermore, the project was intended to demonstrate whether such additives can be used to precipitate most of the mercury (Hg) removed in the wet FGD system as a fine salt that can be separated from themore » FGD liquor and bulk solid byproducts for separate disposal. The project involved pilot- and full-scale tests of the additives in wet FGD absorbers. The tests were intended to determine required additive dosages to prevent Hg{sup 0} re-emissions and to separate mercury from the normal FGD byproducts for three coal types: Texas lignite/Powder River Basin (PRB) coal blend, high-sulfur Eastern bituminous coal, and low-sulfur Eastern bituminous coal. The project team consists of URS Group, Inc., EPRI, Luminant Power (was TXU Generation Company LP), Southern Company, IPL (an AES company), Evonik Degussa Corporation and the Nalco Company. Luminant Power provided the Texas lignite/PRB co-fired test site for pilot FGD tests and project cost sharing. Southern Company provided the low-sulfur Eastern bituminous coal host site for wet scrubbing tests, the pilot- and full-scale jet bubbling reactor (JBR) FGD systems tested, and project cost sharing. IPL provided the high-sulfur Eastern bituminous coal full-scale FGD test site and cost sharing. Evonik Degussa Corporation provided the TMT-15 additive, and the Nalco Company provided the Nalco 8034 additive. Both companies also supplied technical support to the test program as in-kind cost sharing. The project was conducted in six tasks. Of the six tasks, Task 1 involved project planning and Task 6 involved

  8. Impact of FGD gypsum on soil fertility and plant nutrient uptake

    USDA-ARS?s Scientific Manuscript database

    Use of FGD gypsum is thought to improve soil productivity and increase plant production. Thus, a study was conducted to evaluate the effects of FGD gypsum on yield, plant nutrient uptake and soil productivity. The study was conducted on an established bermudagrass pasture. Poultry litter was applied...

  9. Guidelines for the use of fiberglass reinforced plastic in utility FGD systems. [Flue gas desulfurization (FGD); contains glossary

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

    Rapoza, R.J.; Vollmer, H.R.; Haberly, K.L.

    1992-11-01

    Fiberglass reinforced plastic (FRP) materials offer excellent corrosion-resistant properties and long-term cost advantages compared to exotic alloys or organic lining systems. This guideline document provides potential buyers of FRP FGD (flue gas desulfurization) equipment with enough knowledge of FRP materials and methods to make informed decisions when procuring FRP equipment or services. It is divided into the following chapters: application criteria, procurement strategies, FRP basics, guidelines for designing FRP equipment, quality management. A glossary and manufacturers information/recommendations are included.

  10. Field Testing of a Wet FGD Additive for Enhanced Mercury Control - Pilot-Scale Test Results

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

    Gary M. Blythe

    2006-03-01

    This Topical Report summarizes progress on Cooperative Agreement DE-FC26-04NT42309, ''Field Testing of a Wet FGD Additive.'' The objective of the project is to demonstrate the use of a flue gas desulfurization (FGD) additive, Degussa Corporation's TMT-15, to prevent the reemissions of elemental mercury (Hg{sup 0}) in flue gas exiting wet FGD systems on coal-fired boilers. Furthermore, the project intends to demonstrate that the additive can be used to precipitate most of the mercury (Hg) removed in the wet FGD system as a fine TMT salt that can be separated from the FGD liquor and bulk solid byproducts for separate disposal.more » The project will conduct pilot and full-scale tests of the TMT-15 additive in wet FGD absorbers. The tests are intended to determine required additive dosage requirements to prevent Hg{sup 0} reemissions and to separate mercury from the normal FGD byproducts for three coal types: Texas lignite/Power River Basin (PRB) coal blend, high-sulfur Eastern bituminous coal, and low-sulfur Eastern bituminous coal. The project team consists of URS Group, Inc., EPRI, TXU Generation Company LP, Southern Company, and Degussa Corporation. TXU Generation has provided the Texas lignite/PRB co-fired test site for pilot FGD tests, Monticello Steam Electric Station Unit 3. Southern Company is providing the low-sulfur Eastern bituminous coal host site for wet scrubbing tests, as well as the pilot and full-scale jet bubbling reactor (JBR) FGD systems to be tested. A third utility, to be named later, will provide the high-sulfur Eastern bituminous coal full-scale FGD test site. Degussa Corporation is providing the TMT-15 additive and technical support to the test program. The project is being conducted in six tasks. Of the six project tasks, Task 1 involves project planning and Task 6 involves management and reporting. The other four tasks involve field testing on FGD systems, either at pilot or full scale. The four tasks include: Task 2 - Pilot Additive

  11. FGD liner experiments with wetlands

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

    Mitsch, W.J.; Ahn, C.; Wolfe, W.E.

    1999-07-01

    The construction of artificial wetlands for wastewater treatment often requires impermeable liners not only to protect groundwater resources but also to ensure that there is adequate water in the wetland to support appropriate aquatic life, particularly wetland vegetation. Liners or relatively impervious site soils are very important to the success of constructed treatment wetlands in areas where ground water levels are typically close to the ground surface. This study, carried out at the Olentangy River Wetland Research Park, investigated the use of FGD material from sulfur scrubbers as a possible liner material for constructed wetlands. While several studies have investigatedmore » the use of FGD material to line ponds, no studies have investigated the use of this material as a liner for constructed wetlands. They used experimental mesocosms to see the effect of FGD liner materials in constructed wetlands on water quality and on wetland plant growth. This paper presents the results of nutrient analyses and physicochemical investigation of leachate and surface outflow water samples collected from the mesocosms. Plant growth and biomass of wetland vegetation are also included in this paper. First two year results are reported by Ahn et al. (1998, 1999). The overall goal of this study is the identification of advantages and disadvantages of using FGD by-product as an artificial liner in constructed wetlands.« less

  12. The future of FGD gypsum

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

    Miller, E.C.

    2005-09-30

    According to ACAA's 'Coal combustion production and user survey' covering 2003, FGD gypsum utilization in the USA has risen to 70% but with 12 m tons being produced annually there is great opportunity to expand its use in producing wallboard (its primary use) and also in cement and concrete products and agriculture. In 2003 less than 1 mt of FGD gypsum was sold into these latter markets. Although nearly all the 12 newest wallboard plants announced since 1995 have been designed to use this material, only 27% of total gypsum wallboard production in the USA utilizes FGD gypsum. 1 ref.,more » 2 figs., 2 photos.« less

  13. Analysis of Flue Gas Desulfurization (FGD) Processes for Potential Use on Army Coal-Fired Boilers

    DTIC Science & Technology

    1980-09-01

    TECHNICAL REPORT N-93 September 1980 ANALYSIS OF FLUE GAS DESULFURIZATION (FGD) PROCESSES FOR POTENTIAL USE ON ARMY COAL-FIRED BOILERS TECHNICAL LIBRARY...REFERENCE: Technical Report N-93, Analysis of Flue Gas Desulfurization (FGD) Ppooesses for Potential Use on Army Coal-Fired Boilers Please take a few...REPORT DOCUMENTATION PAGE 1. REPORT NUMBER CERL-TR-N-93 2. GOVT ACCESSION NO «. TITLE (end Subtitle) ANALYSIS OF FLUE GAS DESULFURIZATION (FGD

  14. Sustainable uses of FGD gypsum in agricultural systems

    USDA-ARS?s Scientific Manuscript database

    Interest in using gypsum as a management tool to improve crop yields and soil/water quality has recently increased. Abundant supply and availability of flue gas desulfurization (FGD) gypsum, a by-product of scrubbing sulfur (S) from combustion gases at coal-fired power plants, in major agricultural...

  15. Use of FGD gypsum on a bermudagrass pasture in the Appalachian Plateau Region

    USDA-ARS?s Scientific Manuscript database

    Addition of industrial by-products from coal fired power plants (FGD gypsum and FGD gypsum + fly ash) are thought to increase plant production. Thus, a study was conducted to evaluate the effects of industrial by-products as a soil amendment on bermudagrass (Cynodon dactylon L.) yield. The study was...

  16. FGD Additives to Segregate and Sequester Mercury in Solid Byproducts - Final Report

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

    Searcy, K; Bltyhe, G M; Steen, W A

    2012-02-28

    Many mercury control strategies for U.S. coal-fired power generating plants involve co-benefit capture of oxidized mercury from flue gases treated by wet flue gas desulfurization (FGD) systems. For these processes to be effective at overall mercury control, the captured mercury must not be re-emitted to the atmosphere or into surface or ground water. The project sought to identify scrubber additives and FGD operating conditions under which mercury re-emissions would decrease and mercury would remain in the liquor and be blown down from the system in the chloride purge stream. After exiting the FGD system, mercury would react with precipitating agentsmore » to form stable solid byproducts and would be removed in a dewatering step. The FGD gypsum solids, free of most of the mercury, could then be disposed or processed for reuse as wallboard or in other beneficial reuse. The project comprised extensive bench-scale FGD scrubber tests in Phases I and II. During Phase II, the approaches developed at the bench scale were tested at the pilot scale. Laboratory wastewater treatment tests measured the performance of precipitating agents in removing mercury from the chloride purge stream. Finally, the economic viability of the approaches tested was evaluated.« less

  17. Field Testing of a Wet FGD Additive for Enhanced Mercury Control - Task 3 Full-scale Test Results

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

    Gary Blythe

    2007-05-01

    This Topical Report summarizes progress on Cooperative Agreement DE-FC26-04NT42309, 'Field Testing of a Wet FGD Additive'. The objective of the project is to demonstrate the use of a flue gas desulfurization (FGD) additive, Degussa Corporation's TMT-15, to prevent the reemission of elemental mercury (Hg{sup 0}) in flue gas exiting wet FGD systems on coal-fired boilers. Furthermore, the project intends to demonstrate whether the additive can be used to precipitate most of the mercury (Hg) removed in the wet FGD system as a fine TMT salt that can be separated from the FGD liquor and bulk solid byproducts for separate disposal.more » The project is conducting pilot- and full-scale tests of the TMT-15 additive in wet FGD absorbers. The tests are intended to determine required additive dosages to prevent Hg{sup 0} reemissions and to separate mercury from the normal FGD byproducts for three coal types: Texas lignite/Power River Basin (PRB) coal blend, high-sulfur Eastern bituminous coal, and low-sulfur Eastern bituminous coal. The project team consists of URS Group, Inc., EPRI, TXU Generation Company LP, Southern Company, and Degussa Corporation. TXU Generation has provided the Texas lignite/PRB cofired test site for pilot FGD tests, Monticello Steam Electric Station Unit 3. Southern Company is providing the low-sulfur Eastern bituminous coal host site for wet scrubbing tests, as well as the pilot- and full-scale jet bubbling reactor (JBR) FGD systems to be tested. IPL, an AES company, provided the high-sulfur Eastern bituminous coal full-scale FGD test site and cost sharing. Degussa Corporation is providing the TMT-15 additive and technical support to the test program as cost sharing. The project is being conducted in six tasks. Of the six project tasks, Task 1 involves project planning and Task 6 involves management and reporting. The other four tasks involve field testing on FGD systems, either at pilot or full scale. The four tasks include: Task 2 - Pilot Additive

  18. Field Testing of a Wet FGD Additive for Enhanced Mercury Control - Task 5 Full-Scale Test Results

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

    Gary Blythe; MariJon Owens

    2007-12-01

    This Topical Report summarizes progress on Cooperative Agreement DE-FC26-04NT42309, 'Field Testing of a Wet FGD Additive'. The objective of the project is to demonstrate the use of two flue gas desulfurization (FGD) additives, Evonik Degussa Corporation's TMT-15 and Nalco Company's Nalco 8034, to prevent the re-emission of elemental mercury (Hg{sup 0}) in flue gas exiting wet FGD systems on coal-fired boilers. Furthermore, the project intends to demonstrate whether the additive can be used to precipitate most of the mercury (Hg) removed in the wet FGD system as a fine salt that can be separated from the FGD liquor and bulkmore » solid byproducts for separate disposal. The project is conducting pilot- and full-scale tests of the additives in wet FGD absorbers. The tests are intended to determine required additive dosages to prevent Hg{sup 0} re-emissions and to separate mercury from the normal FGD byproducts for three coal types: Texas lignite/Powder River Basin (PRB) coal blend, high-sulfur Eastern bituminous coal, and low-sulfur Eastern bituminous coal. The project team consists of URS Group, Inc., EPRI, Luminant Power (was TXU Generation Company LP), Southern Company, IPL (an AES company), Evonik Degussa Corporation and the Nalco Company. Luminant Power has provided the Texas lignite/PRB co-fired test site for pilot FGD tests and cost sharing. Southern Company has provided the low-sulfur Eastern bituminous coal host site for wet scrubbing tests, as well as the pilot- and full-scale jet bubbling reactor (JBR) FGD systems tested. IPL provided the high-sulfur Eastern bituminous coal full-scale FGD test site and cost sharing. Evonik Degussa Corporation is providing the TMT-15 additive, and the Nalco Company is providing the Nalco 8034 additive. Both companies are also supplying technical support to the test program as in-kind cost sharing. The project is being conducted in six tasks. Of the six project tasks, Task 1 involves project planning and Task 6 involves

  19. Effects of FGD-gypsum, used-wallboard and calcium sulfate on corn and soybean root growth

    USDA-ARS?s Scientific Manuscript database

    Flue gas desulfurization (FGD)-gypsum production has increased 44 percent from 2007 to 2008. The major use of FGD-gypsum today is in the wallboard industry. Reduction in the construction, however, reduces the demand for wallboard. Agriculture could become the second largest user of FGD-gypsum. F...

  20. Differential partitioning and speciation of Hg in wet FGD facilities of two Spanish PCC power plants.

    PubMed

    Ochoa-González, R; Córdoba, P; Díaz-Somoano, M; Font, O; López-Antón, M A; Leiva, C; Martínez-Tarazona, M R; Querol, X; Pereira, C Fernández; Tomás, A; Gómez, P; Mesado, P

    2011-10-01

    This paper evaluates the speciation and partitioning of mercury in two Spanish pulverised coal combustion power plants (PP1 and PP2), equipped with wet limestone-based flue gas desulphurisation facilities (FGD) operating with forced oxidation and re-circulation of FGD water streams. These plants are fed with coal (PP1) and coal/pet-coke blends (PP2) with different mercury contents. The behaviour, partitioning and speciation of Hg were found to be similar during the combustion processes but different in the FGD systems of the two power plants. A high proportion (86-88%) of Hg escaped the electrostatic precipitator in gaseous form, Hg2+ being the predominant mercury species (68-86%) to enter the FGD. At this point, a relatively high total Hg retention (72% and 65%) was achieved in the PP1 and PP2 (2007) FGD facilities respectively. However, during the second sampling campaign for PP2 (2008), the mercury removal achieved by the FGD was much lower (26%). Lab-scale tests point to liquid/gas ratio as the main parameter affecting oxidised mercury capture in the scrubber. The partitioning of the gaseous mercury reaching the FGD system in the wastes and by-products differed. In the low mercury input power plant (PP1) most of the mercury (67%) was associated with the FGD gypsum. Moreover in PP2 a significant proportion of the gaseous mercury reaching the FGD system remained in the aqueous phase (45%) in the 2007 sampling campaign while most of it escaped in 2008 (74%). This may be attributed to the scrubber operating conditions and the different composition and chemistry of the scrubber solution probably due to the use of an additive. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. 'Bugs' used to treat FGD wastewater

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

    Blankinship, S.

    2009-09-15

    Tough regulation of heavy metals may justify a bioreactor approach in addition to chemical treatment of FGD wastewater. Two of Duke Energy' coal-fired plants, Belews Creek and Allen (in North Carolina) have installed new biological reactor systems to increase selenium removal to levels not achievable by existing scrubber waste water systems. The ABMet system removes nitrate and selenium in a single step. Progress Energy has installed the system at Roxboro and Mayo Stations, also in North Carolina. 1 fig., 2 photos.

  2. Evaluation of FGD-gypsum to improve forage production and reduce phosphorus lossed from Piedmont soils

    USDA-ARS?s Scientific Manuscript database

    Flue gas desulfurization gypsum (FGD-gypsum), a byproduct from coal fired electricity generators, has the potential for beneficial use in agricultural systems as a soil amendment. Similar to mined gypsum it can improve soil chemical and physical properties and increase crop productivity. FGD-gypsum ...

  3. Thioredoxin Reductase 2 (TXNRD2) mutation associated with familial glucocorticoid deficiency (FGD).

    PubMed

    Prasad, Rathi; Chan, Li F; Hughes, Claire R; Kaski, Juan P; Kowalczyk, Julia C; Savage, Martin O; Peters, Catherine J; Nathwani, Nisha; Clark, Adrian J L; Storr, Helen L; Metherell, Louise A

    2014-08-01

    Classic ACTH resistance, due to disruption of ACTH signaling, accounts for the majority of cases of familial glucocorticoid deficiency (FGD). Recently FGD cases caused by mutations in the mitochondrial antioxidant, nicotinamide nucleotide transhydrogenase, have highlighted the importance of redox regulation in steroidogenesis. We hypothesized that other components of mitochondrial antioxidant systems would be good candidates in the etiology of FGD. Whole-exome sequencing was performed on three related patients, and segregation of putative causal variants confirmed by Sanger sequencing of all family members. A TXNRD2-knockdown H295R cell line was created to investigate redox homeostasis. The study was conducted on patients from three pediatric centers in the United Kingdom. Seven individuals from a consanguineous Kashmiri kindred, six of whom presented with FGD between 0.1 and 10.8 years, participated in the study. There were no interventions. Identification and functional interrogation of a novel homozygous mutation segregating with the disease trait were measured. A stop gain mutation, p.Y447X in TXNRD2, encoding the mitochondrial selenoprotein thioredoxin reductase 2 (TXNRD2) was identified and segregated with disease in this extended kindred. RT-PCR and Western blotting revealed complete absence of TXNRD2 in patients homozygous for the mutation. TXNRD2 deficiency leads to impaired redox homeostasis in a human adrenocortical cell line. In contrast to the Txnrd2-knockout mouse model, in which embryonic lethality as a consequence of hematopoietic and cardiac defects is described, absence of TXNRD2 in humans leads to glucocorticoid deficiency. This is the first report of a homozygous mutation in any component of the thioredoxin antioxidant system leading to inherited disease in humans.

  4. Effect of trace metals and sulfite oxidation of adipic acid degradation in FGD systems. Final report Dec 81-May 82

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

    Jarvis, J.B.; Terry, J.C.; Schubert, S.A.

    The report gives results of the measurement of the adipic acid degradation rate in a bench-scale flue gas desulfurization (FGD) system, designed to simulate many of the important aspects of full-scale FGD systems. Results show that the adipic acid degradation rate depends on the sulfite oxidation rate, the adipic acid concentration, the presence of manganese in solution, and temperature. The degradation rate is also affected by pH, but only when manganese is present. Adipic acid degradation products identified in the liquid phase include valeric, butyric, propionic, succinic, and glutaric acids. When manganese was present, the predominant degradation products were succinicmore » and glutaric acids. Analysis of solids from the bench scale tests shows large concentrations of coprecipitated adipic acid in low oxidation sulfite solids. By contrast, low quantities of coprecipitated adipic acid were found in high oxidation gypsum solids.« less

  5. Desulfurization characteristics of rapidly hydrated sorbents with various adhesive carrier particles for a semidry CFB-FGD system.

    PubMed

    You, Changfu; Li, Yuan

    2013-03-19

    Semidry flue gas desulfurization (FGD) experiments were conducted using rapidly hydrated sorbents with four different adhesive carrier particles: circulation ash from a circulating fluidized bed boiler (CFBB circulation ash), fly ash from the first electrical field of the electrostatic precipitator of a circulating fluidized bed boiler (CFBB ESP ash), fly ash from a chain boiler (chain boiler ash), and river sand smaller than 1 mm. The influences of various adhesive carrier particles and operating conditions on the desulfurization characteristics of the sorbents were investigated, including sprayed water, reaction temperature, and the ratio of calcium to sulfur (Ca/S). The experimental results indicated that the rapidly hydrated sorbents had better desulfurization characteristics by using adhesive carrier particles which possessed better pore, adhesion, and fluidization characteristics. The desulfurization efficiency of the system increased as the reaction temperature decreased, it improved from 35% to 90% as the mass flow rate of the sprayed water increased from 0 to 10 kg/h, and it increased from 65.6% to 82.7% as Ca/S increased from 1.0 to 2.0. Based on these findings, a new semidry circulating fluidized bed (CFB)-FGD system using rapidly hydrated sorbent was developed. Using the rapidly hydrated sorbent, this system uses a cyclone separator instead of an ESP or a bag filter to recycle the sorbent particles, thereby decreasing the system flow resistance, saving investment and operating costs of the solids collection equipment.

  6. Properties of mortars made by uncalcined FGD gypsum-fly ash-ground granulated blast furnace slag composite binder

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

    Zhong Shiyun, E-mail: tjzhongshiyun@163.com; Ni Kun; Li Jinmei

    2012-07-15

    Highlights: Black-Right-Pointing-Pointer The mortar with uncalcined FGD gypsum has suitable workability. Black-Right-Pointing-Pointer The strength of mortar with uncalcined FGD gypsum is higher than that of mortar without uncalcined FGD gypsum. Black-Right-Pointing-Pointer The dry shrinkage of mortar with uncalcined FGD gypsum is lower than that of mortar without uncalcined FGD gypsum. Black-Right-Pointing-Pointer The leaching of sulfate ion of mortar is studied. - Abstract: A series of novel mortars were developed from composite binder of uncalcined FGD gypsum, fly ash (FA) and ground granulated blast furnace slag (GGBFS) for the good utilization of flue gas desulphurization (FGD) gypsum. At a fixed ratiomore » (20%) of GGBFS to the composite binder, keeping consistency of the mortar between 9.5 and 10.0 cm, the properties of the composite mortar were studied. The results show that higher water/binder (W/B) is required to keep the consistency when increasing the percentage of FGD gypsum. No obvious influences of the W/B and content of FGD gypsum on the bleeding of paste were observed which keeps lower than 2% under all experimental conditions tried. The highest compressive and flexural strengths (ratio is 20% FGD gypsum, 20% GGBFS and 60% FA) are 22.6 and 4.3 MPa at 28 days, respectively. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) results indicate that massive ettringite crystals and C-S-H gels exist in the hydration products. At 90 days the mortars with FGD gypsum is dramatically smaller drying shrinkage (563-938 micro strain) than that without FGD gypsum (about 2250 micro strain). The release of the SO{sub 4}{sup 2-} from the mortar was analyzed, indicating that the dissolution of sulfate increases with FGD gypsum. The concentration of SO{sub 4}{sup 2-} releasing from the mortar with 10% FGD gypsum is almost equal to that obtained from the mortar without FGD gypsum. The release of SO{sub 4}{sup 2-} from the mortar with 20% FGD gypsum is

  7. Health and environmental impacts of increased generation of coal ash and FGD sludges. Report to the Committee on Health and Ecological Effects of Increased Coal Utilization.

    PubMed Central

    Santhanam, C J; Lunt, R R; Johnson, S L; Cooper, C B; Thayer, P S; Jones, J W

    1979-01-01

    This paper focuses on the incremental impacts of coal ash and flue gas desulfurization (FGD) wastes associated with increased coal usage by utilities and industry under the National Energy Plan (NEP). In the paper, 1985 and 2000 are the assessment points using the baseline data taken from the Annual Environmental Analysis Report (AEAR, September 1977). In each EPA region, the potential mix of disposal options has been broadly estimated and impacts assessed therefrom. In addition, future use of advanced combustion techniques has been taken into account. The quantities of coal ash and FGD wastes depend on ash and sulfur content of the coal, emission regulations, the types of ash collection and FGD systems, and operating conditions of the systems and boiler. The disposal of these wastes is (or will be) subject to Federal and State regulations. The one key legal framework concerning environmental impact on land is the Resource Conservation and Recovery Act (RCRA). RCRA and related Federal and State laws provide a sufficient statutory basis for preventing significant adverse health and environmental impacts from coal ash and FGD waste disposal. However, much of the development and implementation of specific regulations lie ahead. FGD wastes and coal ash and FGD wastes are currently disposed of exclusively on land. The most common land disposal methods are inpoundments (ponds) and landfills, although some mine disposal is also practiced. The potential environmental impacts of this disposal are dependent on the characteristics of the disposal site, characteristics of the coal ash and FGD wastes, control method and the degree of control employed. In general, the major potential impacts are ground and surface water contamination and the "degradation" of large quantities of land. However, assuming land is available for disposal of these wastes, control technology exists for environmentally sound disposal. Because of existing increases in coal use, the possibility of

  8. Use of FGD gypsum to reduce p loss from agricultural fields

    USDA-ARS?s Scientific Manuscript database

    Controlling P loss from agricultural fields has become a major issue in recent years, especially in areas where manure is used as nutrient sources. It is believed that FGD gypsum can be used as a management practice to reduce soluble P loss. Thus, the objective of this study was to determine FGD gy...

  9. Animal waste and FGD gypsum effects on bermudagrass and soil leachate nutrient contents

    USDA-ARS?s Scientific Manuscript database

    In previous experiments on newly relcaimed coal mine soils in northeastern Mississippi, applying poultry litter at 22.4 Mg ha-1 yr-1 enhanced bermudagrass (Cynodon dactylon L.) biomass and selected soil quality parameters. Additionally, co-application of 11.2 Mg ha-1 FGD gypsum and litter reduced so...

  10. Ca removal and Mg recovery from flue gas desulfurization (FGD) wastewater by selective precipitation.

    PubMed

    Xia, Min; Ye, Chunsong; Pi, Kewu; Liu, Defu; Gerson, Andrea R

    2017-11-01

    Selective removal of Ca and recovery of Mg by precipitation from flue gas desulfurization (FGD) wastewater has been investigated. Thermodynamic analysis of four possible additives, Na 2 CO 3 , Na 2 C 2 O 4 , NaF and Na 2 SO 4 , indicated that both carbonate and oxalate could potentially provide effective separation of Ca via precipitation from Mg in FGD wastewater. However, it was found experimentally that the carbonate system was not as effective as oxalate in this regard. The oxalate system performed considerably better, with Ca removal efficiency of 96% being obtained, with little Mg inclusion at pH 6.0 when the dosage was ×1.4 the stoichiometric requirement. On this basis, the subsequent recovery process for Mg was carried out using NaOH with two-step precipitation. The product was confirmed to be Mg(OH) 2 (using X-ray diffraction and thermo gravimetric analysis) with elemental analysis suggesting a purity of 99.3 wt.%.

  11. 40 CFR 63.3546 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  12. 40 CFR 63.3546 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  13. 40 CFR 63.4966 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  14. 40 CFR 63.4966 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  15. Impact of FGD gypsum soil amendment applications on soil and environmental quality

    USDA-ARS?s Scientific Manuscript database

    This paper will discuss the utilization of FGD gypsum in agriculture for improving soil quality and other environmental benefits. Gypsum (CaSO4 .2H2O) has been used as an agricultural soil amendment for over 250 years. It is a soluble source of calcium and sulfur- for crops and has been shown to i...

  16. 40 CFR 63.4966 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  17. 40 CFR 63.4167 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  18. 40 CFR 63.4767 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  19. 40 CFR 63.4767 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  20. 40 CFR 63.4167 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  2. 40 CFR 63.3169 - What are the requirements for a capture system or add-on control device which is not taken into...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  3. 40 CFR 63.3556 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.3556 Section 63... system and add-on control device operating limits during the performance test? During the performance... of key parameters of the valve operating system (e.g., solenoid valve operation, air pressure...

  4. 40 CFR 63.3556 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.3556 Section 63... system and add-on control device operating limits during the performance test? During the performance... of key parameters of the valve operating system (e.g., solenoid valve operation, air pressure...

  5. 40 CFR 63.4966 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.4966 Section 63... system and add-on control device operating limits during the performance test? During the performance... outlet gas temperature is the maximum operating limit for your condenser. (e) Emission capture system...

  6. 40 CFR 63.4966 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.4966 Section 63... system and add-on control device operating limits during the performance test? During the performance... outlet gas temperature is the maximum operating limit for your condenser. (e) Emission capture system...

  7. FGD gypsum application: Impacts on soil P from city parks in the Tampa area

    USDA-ARS?s Scientific Manuscript database

    Controlling excessive P loss from agricultural fields has become a major issue in recent years. However, managed city parks may also contribute to P loss. Thus, a study was conducted at three different city parks located in the Tampa Area to evaluate the use of FGD gypsum as an amendment to reduce w...

  8. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Limits if Using Add-On Control Devices and Capture System If you are required to comply with operating... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Operating Limits if Using Add-On Control Devices and Capture System 1 Table 1 to Subpart JJJJ of Part 63 Protection of Environment...

  9. 40 CFR Table 1 to Subpart Ssss of... - Operating Limits if Using Add-on Control Devices and Capture System

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Using Add-on Control Devices and Capture System If you are required to comply with operating limits by... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Operating Limits if Using Add-on Control Devices and Capture System 1 Table 1 to Subpart SSSS of Part 63 Protection of Environment...

  10. 40 CFR Table 1 to Subpart Ssss of... - Operating Limits if Using Add-on Control Devices and Capture System

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  11. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  12. 40 CFR 63.3556 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  13. 40 CFR 63.3556 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  14. Add-on unidirectional elastic metamaterial plate cloak

    PubMed Central

    Lee, Min Kyung; Kim, Yoon Young

    2016-01-01

    Metamaterial cloaks control the propagation of waves to make an object invisible or insensible. To manipulate elastic waves in space, a metamaterial cloak is typically embedded in a base system that includes or surrounds a target object. The embedding is undesirable because it structurally weakens or permanently alters the base system. In this study, we propose a new add-on metamaterial elastic cloak that can be placed over and mechanically coupled with a base structure without embedding. We designed an add-on type annular metamaterial plate cloak through conformal mapping, fabricated it and performed cloaking experiments in a thin-plate with a hole. Experiments were performed in a thin plate by using the lowest symmetric Lamb wave centered at 100 kHz. As a means to check the cloaking performance of the add-on elastic plate cloak, possibly as a temporary stress reliever or a so-called “stress bandage”, the degree of stress concentration mitigation and the recovery from the perturbed wave field due to a hole were investigated. PMID:26860896

  15. Add-on unidirectional elastic metamaterial plate cloak

    NASA Astrophysics Data System (ADS)

    Lee, Min Kyung; Kim, Yoon Young

    2016-02-01

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

  16. 40 CFR Table 2 to Subpart Oooo of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... to Subpart OOOO of Part 63—Operating Limits if Using Add-On Control Devices and Capture System If you... 40 Protection of Environment 13 2014-07-01 2014-07-01 false Operating Limits if Using Add-On Control Devices and Capture System 2 Table 2 to Subpart OOOO of Part 63 Protection of Environment...

  17. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...—Operating Limits if Using Add-On Control Devices and Capture System If you are required to comply with... 40 Protection of Environment 13 2014-07-01 2014-07-01 false Operating Limits if Using Add-On Control Devices and Capture System 1 Table 1 to Subpart JJJJ of Part 63 Protection of Environment...

  18. 40 CFR Table 1 to Subpart Ssss of... - Operating Limits if Using Add-on Control Devices and Capture System

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...—Operating Limits if Using Add-on Control Devices and Capture System If you are required to comply with... 40 Protection of Environment 13 2014-07-01 2014-07-01 false Operating Limits if Using Add-on Control Devices and Capture System 1 Table 1 to Subpart SSSS of Part 63 Protection of Environment...

  19. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...—Operating Limits if Using Add-On Control Devices and Capture System If you are required to comply with... 40 Protection of Environment 13 2012-07-01 2012-07-01 false Operating Limits if Using Add-On Control Devices and Capture System 1 Table 1 to Subpart JJJJ of Part 63 Protection of Environment...

  20. 40 CFR Table 2 to Subpart Oooo of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... to Subpart OOOO of Part 63—Operating Limits if Using Add-On Control Devices and Capture System If you... 40 Protection of Environment 13 2013-07-01 2012-07-01 true Operating Limits if Using Add-On Control Devices and Capture System 2 Table 2 to Subpart OOOO of Part 63 Protection of Environment...

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

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...—Operating Limits if Using Add-on Control Devices and Capture System If you are required to comply with... 40 Protection of Environment 13 2013-07-01 2012-07-01 true Operating Limits if Using Add-on Control Devices and Capture System 1 Table 1 to Subpart SSSS of Part 63 Protection of Environment...

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

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... to Subpart OOOO of Part 63—Operating Limits if Using Add-On Control Devices and Capture System If you... 40 Protection of Environment 13 2012-07-01 2012-07-01 false Operating Limits if Using Add-On Control Devices and Capture System 2 Table 2 to Subpart OOOO of Part 63 Protection of Environment...

  3. 40 CFR Table 2 to Subpart Oooo of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  4. 40 CFR Table 1 to Subpart Ssss of... - Operating Limits if Using Add-on Control Devices and Capture System

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...—Operating Limits if Using Add-on Control Devices and Capture System If you are required to comply with... 40 Protection of Environment 13 2012-07-01 2012-07-01 false Operating Limits if Using Add-on Control Devices and Capture System 1 Table 1 to Subpart SSSS of Part 63 Protection of Environment...

  5. 40 CFR Table 2 to Subpart Oooo of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... OOOO of Part 63—Operating Limits if Using Add-On Control Devices and Capture System If you are required... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Operating Limits if Using Add-On Control Devices and Capture System 2 Table 2 to Subpart OOOO of Part 63 Protection of Environment...

  6. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...—Operating Limits if Using Add-On Control Devices and Capture System If you are required to comply with... 40 Protection of Environment 13 2013-07-01 2012-07-01 true Operating Limits if Using Add-On Control Devices and Capture System 1 Table 1 to Subpart JJJJ of Part 63 Protection of Environment...

  7. Conversion of waste FGD gypsum into hydroxyapatite for removal of Pb²⁺ and Cd²⁺ from wastewater.

    PubMed

    Yan, Yubo; Dong, Xiaoli; Sun, Xiaolei; Sun, Xiuyun; Li, Jiansheng; Shen, Jinyou; Han, Weiqing; Liu, Xiaodong; Wang, Lianjun

    2014-09-01

    Flue gas desulfurization (FGD) gypsum, a familiar waste generated from coal-fired power plants, was successfully transformed to hydroxyapatite (FGD-HAP) by hydrothermal method. The obtained FGD-HAP was characterized by XRD, FTIR, TEM and BET methods and investigated as adsorbent for removal of Pb(2+) and Cd(2+) from wastewater. Batch experiments were performed by varying the pH values, contact time and initial metal concentration. The result of pH impact showed that the adsorption of two ions was pH dependent process, and the pH 5.0-6.0 was found to be the optimum condition. The achieved experimental data were analyzed with various kinetic and isotherm models. The kinetic studies displayed that the pseudo-second order kinetic model could describe adsorption processes well with high correlation coefficient, and the Langmuir isotherm model provided the best fit to the equilibrium experimental data. The maximum adsorption capacities calculated from Langmuir equation were 277.8 and 43.10mg/g for Pb(2+) and Cd(2+), respectively, which can compete with other adsorbents. The thermodynamic parameters revealed the adsorption processes were endothermic and spontaneous in nature. In binary adsorption, the amount of Cd(2+) adsorbed on FGD-HAP decreased by 46.0% with increasing concentration of Pb(2+), which was higher than that of Pb(2+)(21.7%), demonstrating the stronger affinity between FGD-HAP and Pb(2+). The highest amount of Pb(2+) and Cd(2+) desorbed from saturated FGD-HAP by EDTA solution confirmed the FGD-HAP was a promising alternative adsorbent in treatment of toxic Pb(2+) and Cd(2+) wastewater. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. 40 CFR 63.4767 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... system and add-on control device operating limits during the performance test? 63.4767 Section 63.4767... system and add-on control device operating limits during the performance test? During the performance... operating limits required by § 63.4692 according to this section, unless you have received approval for...

  9. 40 CFR 63.3967 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  10. 40 CFR 63.3967 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  11. 40 CFR 63.3967 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  12. 40 CFR 63.4167 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.4167 Section 63... capture system and add-on control device operating limits during the performance test? During the... the operating limits required by § 63.4092 according to this section unless you have received approval...

  13. 40 CFR 63.4567 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.4567 Section 63... emission capture system and add-on control device operating limits during the performance test? During the... the operating limits required by § 63.4492 according to this section, unless you have received...

  14. 40 CFR 63.4167 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.4167 Section 63... capture system and add-on control device operating limits during the performance test? During the... the operating limits required by § 63.4092 according to this section unless you have received approval...

  15. 40 CFR 63.4767 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.4767 Section 63... capture system and add-on control device operating limits during the performance test? During the... the operating limits required by § 63.4692 according to this section, unless you have received...

  16. 40 CFR 63.4767 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.4767 Section 63... capture system and add-on control device operating limits during the performance test? During the... the operating limits required by § 63.4692 according to this section, unless you have received...

  17. 40 CFR 63.4567 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.4567 Section 63... emission capture system and add-on control device operating limits during the performance test? During the... the operating limits required by § 63.4492 according to this section, unless you have received...

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

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... system and add-on control device operating limits during the performance test? 63.4567 Section 63.4567... capture system and add-on control device operating limits during the performance test? During the... the operating limits required by § 63.4492 according to this section, unless you have received...

  19. 42 CFR § 510.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

    Code of Federal Regulations, 2010 CFR

    2017-10-01

    ... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems. The CJR model... 42 Public Health 5 2017-10-01 2017-10-01 false Treatment of incentive programs or add-on payments...

  20. 42 CFR § 510.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

    Code of Federal Regulations, 2010 CFR

    2016-10-01

    ... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems. The CJR model... 42 Public Health 5 2016-10-01 2016-10-01 false Treatment of incentive programs or add-on payments...

  1. 40 CFR 63.9324 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  2. 40 CFR 63.9324 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  3. 40 CFR 63.9324 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  4. 40 CFR 63.9324 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  5. 40 CFR 63.3967 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.3967 Section 63... establish the emission capture system and add-on control device operating limits during the performance test... must establish the operating limits required by § 63.3892 according to this section, unless you have...

  6. 40 CFR 63.9324 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  7. 40 CFR 63.3967 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.3967 Section 63... establish the emission capture system and add-on control device operating limits during the performance test... must establish the operating limits required by § 63.3892 according to this section, unless you have...

  8. THE ADVANTAGE OF ILLINOIS COAL FOR FGD REMOVAL OF MERCURY

    EPA Science Inventory

    The paper gives results of an investigation conducted to characterize and modify mercury (Hg) speciation in Illinois coal combustion flue gas so that a Hg control strategy can be implemented in conventional flue gas desulfurization (FGD) units. Hg, in trace concentration in coal,...

  9. The potential leaching and mobilization of trace elements from FGD-gypsum of a coal-fired power plant under water re-circulation conditions.

    PubMed

    Córdoba, Patricia; Castro, Iria; Maroto-Valer, Mercedes; Querol, Xavier

    2015-06-01

    Experimental and geochemical modelling studies were carried out to identify mineral and solid phases containing major, minor, and trace elements and the mechanism of the retention of these elements in Flue Gas Desulphurisation (FGD)-gypsum samples from a coal-fired power plant under filtered water recirculation to the scrubber and forced oxidation conditions. The role of the pH and related environmental factors on the mobility of Li, Ni, Zn, As, Se, Mo, and U from FGD-gypsums for a comprehensive assessment of element leaching behaviour were also carried out. Results show that the extraction rate of the studied elements generally increases with decreasing the pH value of the FGD-gypsum leachates. The increase of the mobility of elements such as U, Se, and As in the FGD-gypsum entails the modification of their aqueous speciation in the leachates; UO2SO4, H2Se, and HAsO2 are the aqueous complexes with the highest activities under acidic conditions. The speciation of Zn, Li, and Ni is not affected in spite of pH changes; these elements occur as free cations and associated to SO4(2) in the FGD-gypsum leachates. The mobility of Cu and Mo decreases by decreasing the pH of the FGD-gypsum leachates, which might be associated to the precipitation of CuSe2 and MoSe2, respectively. Time-of-Flight mass spectrometry of the solid phase combined with geochemical modelling of the aqueous phase has proved useful in understanding the mobility and geochemical behaviour of elements and their partitioning into FGD-gypsum samples. Copyright © 2015. Published by Elsevier B.V.

  10. Utilization of FGD gypsum in agriculture for environmental benefits

    USDA-ARS?s Scientific Manuscript database

    This paper will discuss the utilization of FGD gypsum in agriculture for environmental benefits. Gypsum (CaSO4 .2H2O) has been used as an agricultural soil amendment for over 250 years. It is a soluble source of calcium and sulfur for crops and has been shown to improve soil physical and chemical pr...

  11. The Aarskog-Scott Syndrome Protein Fgd1 Regulates Podosome Formation and Extracellular Matrix Remodeling in Transforming Growth Factor β-Stimulated Aortic Endothelial Cells ▿

    PubMed Central

    Daubon, Thomas; Buccione, Roberto; Génot, Elisabeth

    2011-01-01

    Podosomes are dynamic actin-rich adhesion plasma membrane microdomains endowed with extracellular matrix-degrading activities. In aortic endothelial cells, podosomes are induced by transforming growth factor β (TGF-β), but how this occurs is largely unknown. It is thought that, in endothelial cells, podosomes play a role in vessel remodeling and/or in breaching anatomical barriers. We demonstrate here that, in bovine aortic endothelial cells, that the Cdc42-specific guanine exchange factor (GEF) Fgd1 is expressed and regulated by TGF-β to induce Cdc42-dependent podosome assembly. Within 15 min of TGF-β stimulation, Fgd1, but none of the other tested Cdc42 GEFs, undergoes tyrosine phosphorylation, associates with Cdc42, and translocates to the subcortical cytoskeleton via a cortactin-dependent mechanism. Small interfering RNA-mediated Fgd1 knockdown inhibits TGF-β-induced Cdc42 activation. Fgd1 depletion also reduces podosome formation and associated matrix degradation and these defects are rescued by reexpression of Fgd1. Although overexpression of Fgd1 does not promote podosome formation per se, it enhances TGF-β-induced matrix degradation. Our results identify Fgd1 as a TGF-β-regulated GEF and, as such, the first GEF to be involved in the process of cytokine-induced podosome formation. Our findings reveal the involvement of Fgd1 in endothelial cell biology and open up new avenues to study its role in vascular pathophysiology. PMID:21911474

  12. FGD gypsum filters remove soluble phosphorus from agricultural drainage waters

    USDA-ARS?s Scientific Manuscript database

    Decades of chicken litter applications has led to phosphorus (P) levels up to ten times the agronomic optimum in soils of the Delmarva Peninsula. This legacy P is a major source of P entering drainage ditches that eventually empty into the Chesapeake Bay. A Flue Gas Desulfurization (FGD) gypsum ditc...

  13. Sensory feedback add-on for upper-limb prostheses.

    PubMed

    Fallahian, Nader; Saeedi, Hassan; Mokhtarinia, Hamidreza; Tabatabai Ghomshe, Farhad

    2017-06-01

    Sensory feedback systems have been of great interest in upper-limb prosthetics. Despite tremendous research, there are no commercial modality-matched feedback systems. This article aims to introduce the first detachable and feedback add-on option that can be attached to in-use prostheses. A sensory feedback system was tested on a below-elbow myoelectric prosthesis. The aim was to have the amputee grasp fragile objects without crushing while other accidental feedback sources were blocked. A total of 8 successful trials (out of 10) showed that sensory feedback system decreased the amputee's visual dependency by improving awareness of his prosthesis. Sensory feedback system can be used either as post-fabrication (prosthetic add-on option) or para-fabrication (incorporated into prosthetic design). The use of these direct feedback systems can be explored with a current prosthesis before ordering new high-tech prosthesis. Clinical relevance This technical note introduces the first attach/detach-able sensory feedback system that can simply be added to in-use (myo)electric prosthesis, with no obligation to change prosthesis design or components.

  14. Firefox add-ons for medical reference.

    PubMed

    Hoy, Matthew B

    2010-07-01

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

  15. Leaching of FGD Byproducts Using a CSTX

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

    Kairies, C.L.; Schroeder, K.T.; Cardone, C.R.

    2005-09-01

    Leaching studies of coal utilization byproducts (CUB) are often performed to determine the compatibility of the material in a particular end-use or disposal environment. Typically, these studies are conducted using either a batch or a fixed-bed column technique. Fixed-bed columns offer the advantage of a continuous flow of effluent that provides elution profiles with changing elution volume and pH. Unfortunately, clogs can form in fixed-bed leaching columns, either because of cementitious properties of the material itself, such as is seen for fluidized bed combustion (FBC) fly ash, or because of precipitate formation, such as can occur when a high-calcium ashmore » is subjected to sulfate-containing leachates. Also, very fine-grained materials, such as gypsum, do not provide sufficient permeability for study in a fixed-bed column. A continuous, stirred-tank extractor (CSTX) is being used as an alternative technique that can provide the elution profile of column leaching but without the low permeability problems. The CSTX has been successfully employed in the leaching of flue gas desulfurization products that would not be sufficiently permeable under traditional column leaching conditions. The results indicate that the leaching behavior depends on a number of factors, including (but not limited to) solubility and neutralization capacity of the mineral phases present, sorption properties of these phases, behavior of the solubilized material in the tank, and the type of species in solution. In addition, leaching to near-exhaustion of a wallboard produced from FGD gypsum has allowed the isolation of a highly adsorptive phase. This phase appears to be present in at least some FGD gypsums and accounts for the immobilization of trace metals such as arsenic, cobalt, lead, and mercury.« less

  16. 40 CFR 63.3174 - What are the requirements for a capture system or add-on control device which is not taken into...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  17. Coal Combustion Residual Beneficial Use Evaluation: Fly Ash Concrete and FGD Gypsum Wallboard

    EPA Pesticide Factsheets

    This page contains documents related to the evaluation of coal combustion residual beneficial use of fly ash concrete and FGD gypsum wallboard including the evaluation itself and the accompanying appendices

  18. Evaluation of potential for mercury volatilization from natural and FGD gypsum products using flux-chamber tests.

    PubMed

    Shock, Scott S; Noggle, Jessica J; Bloom, Nicholas; Yost, Lisa J

    2009-04-01

    Synthetic gypsum produced by flue-gas desulfurization (FGD) in coal-fired power plants (FGD gypsum) is put to productive use in manufacturing wallboard. FGD gypsum wallboard is widely used, accounting for nearly 30% of wallboard sold in the United States. Mercury is captured in flue gas and thus is one of the trace metals present in FGD gypsum; raising questions about the potential for mercury exposure from wallboard. Mercury is also one of the trace metals present in "natural" mined gypsum used to make wall board. Data available in the literature were not adequate to assess whether mercury in wallboard from either FGD or natural gypsum could volatilize into indoor air. In this study, mercury volatilization was evaluated using small-scale (5 L) glass and Teflon flux chambers, with samples collected using both iodated carbon and gold-coated sand traps. Mercury flux measurements made using iodated carbon traps (n=6) were below the detection limit of 11.5 ng/m2-day for all natural and synthetic gypsum wallboard samples. Mercury flux measurements made using gold-coated sand traps (n=6) were 0.92 +/- 0.11 ng/m2-day for natural gypsum wallboard and 5.9 +/- 2.4 ng/m2-day for synthetic gypsum wallboard. Room air mercury concentrations between 0.028 and 0.28 ng/m3 and between 0.13 and 2.2 ng/m3 were estimated based on the flux-rate data for natural and synthetic gypsum wallboard samples, respectively, and were calculated assuming a 3 m x 4 m x 5 m room, and 10th and 90th percentile air exchange rates of 0.18/hour and 1.26/hour. The resulting concentration estimates are well below the U.S. Environmental Protection Agency (EPA) reference concentration for indoor air elemental mercury of 300 ng/m3 and the Agency for Toxic Substances and Disease Registry minimal risk level (MRL) of 200 ng/m3. Further, these estimates are below background mercury concentrations in indoor air and within or below the range of typical background mercury concentrations in outdoor air.

  19. DEFINITIVE SOX CONTROL PROCESS EVALUATIONS: LIMESTONE, DOUBLE ALKALI, AND CITRATE FGD PROCESSES

    EPA Science Inventory

    The report gives results of a detailed comparative technical and economic evaluation of limestone slurry, generic double alkali, and citrate flue gas desulfurization (FGD) processes, assuming proven technology and using representative power plant, process design, and economic pre...

  20. Hydrologic transport of fecal bacteria attenuated by flu gas desulfurized (FGD) gypsum

    USDA-ARS?s Scientific Manuscript database

    Background Flue gas desulfurized (FGD) gypsum is a byproduct of coal-fired power plants. As a soil amendment for crop production it has the potential of improving soil water infiltration, soil conservation, and decreasing nutrient losses from broiler litter applications. Because broiler litter is a ...

  1. Soil test and bermudagrass forage yield responses to animal waste and FGD gypsum ammendments

    USDA-ARS?s Scientific Manuscript database

    Knowledge of soil and plant responses to animal or industrial byproducts is needed for effective use of these potential amendments on reclaimed mine soil. This study compared seven treatments of 11.2 Mg ha-1 flue gas desulfurized (FGD) gypsum (control), 896 kg ha-1 NPK fertilizer (13-13-13), 22.4 M...

  2. The Cdc42 guanine nucleotide exchange factor FGD6 coordinates cell polarity and endosomal membrane recycling in osteoclasts.

    PubMed

    Steenblock, Charlotte; Heckel, Tobias; Czupalla, Cornelia; Espírito Santo, Ana Isabel; Niehage, Christian; Sztacho, Martin; Hoflack, Bernard

    2014-06-27

    The initial step of bone digestion is the adhesion of osteoclasts onto bone surfaces and the assembly of podosomal belts that segregate the bone-facing ruffled membrane from other membrane domains. During bone digestion, membrane components of the ruffled border also need to be recycled after macropinocytosis of digested bone materials. How osteoclast polarity and membrane recycling are coordinated remains unknown. Here, we show that the Cdc42-guanine nucleotide exchange factor FGD6 coordinates these events through its Src-dependent interaction with different actin-based protein networks. At the plasma membrane, FGD6 couples cell adhesion and actin dynamics by regulating podosome formation through the assembly of complexes comprising the Cdc42-interactor IQGAP1, the Rho GTPase-activating protein ARHGAP10, and the integrin interactors Talin-1/2 or Filamin A. On endosomes and transcytotic vesicles, FGD6 regulates retromer-dependent membrane recycling through its interaction with the actin nucleation-promoting factor WASH. These results provide a mechanism by which a single Cdc42-exchange factor controlling different actin-based processes coordinates cell adhesion, cell polarity, and membrane recycling during bone degradation. © 2014 by The American Society for Biochemistry and Molecular Biology, Inc.

  3. Evaluating the fate of mercury and other metals across the life-cycle stages from the use of FGD gypsum for wallboard production

    EPA Science Inventory

    In 2007, 12.3 million tons of flue gas desulfurization (FGD) gypsum was produced due to air emission controls at coal-fired power plants. With increasing use of wet scrubbers in response to more stringent air pollution control requirements, FGD gypsum production is expected to in...

  4. 2017 National Household Travel Survey - California Add-On |

    Science.gov Websites

    Transportation Secure Data Center | NREL 7 National Household Travel Survey - California Add-On 2017 National Household Travel Survey - California Add-On The California add-on survey supplements the 2017 National Household Travel Survey (NHTS) with additional household samples and detailed travel

  5. DEMONSTRATION OF WELLMAN-LORD/ALLIED CHEMICAL FGD TECHNOLOGY: DEMONSTRATION TEST SECOND YEAR RESULTS

    EPA Science Inventory

    The report gives results of an evaluation of the performance (over a 2-year period) of a full-scale flue gas desulfurization (FGD) unit to demonstrate the Wellman-Lord/Allied Chemical process. The process is regenerable, employing sodium sulfite wet scrubbing, thermal regeneratio...

  6. Framework of risk assessment in relation to FGD-gypsum use as agricultural amendment

    USDA-ARS?s Scientific Manuscript database

    Due to the concerns by EPA of air pollution from coal fired power plants, the industry are building and retrofitting existing facilities to remove more impurities from the environment. Industry has introduced removal of fly ash contaminates before SO2 removal, allowing generation of FGD-gypsum with...

  7. Space station systems technology study (add-on task). Volume 2: Trade study and technology selection

    NASA Technical Reports Server (NTRS)

    1985-01-01

    The current Space Station Systems Technology Study add on task was an outgrowth of the Advanced Platform Systems Technology Study (APSTS) that was completed in April 1983 and the subsequent Space Station System Technology Study completed in April 1984. The first APSTS proceeded from the identification of 106 technology topics to the selection of five for detailed trade studies. During the advanced platform study, the technical issues and options were evaluated through detailed trade processes, individual consideration was given to costs and benefits for the technologies identified for advancement, and advancement plans were developed. An approach similar to that was used in the subsequent study, with emphasis on system definition in four specific technology areas to facilitate a more in depth analysis of technology issues.

  8. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  9. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Operating Limits for Capture Systems... 63—Operating Limits for Capture Systems and Add-On Control Devices If you are required to comply with operating limits by § 63.3093, you must comply with the applicable operating limits in the following table...

  10. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true Operating Limits for Capture Systems... Subpart IIII of Part 63—Operating Limits for Capture Systems and Add-On Control Devices If you are required to comply with operating limits by § 63.3093, you must comply with the applicable operating limits...

  11. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false Operating Limits for Capture Systems... Subpart IIII of Part 63—Operating Limits for Capture Systems and Add-On Control Devices If you are required to comply with operating limits by § 63.3093, you must comply with the applicable operating limits...

  12. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false Operating Limits for Capture Systems... Subpart IIII of Part 63—Operating Limits for Capture Systems and Add-On Control Devices If you are required to comply with operating limits by § 63.3093, you must comply with the applicable operating limits...

  13. 40 CFR 63.3546 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... system and add-on control device operating limits during the performance test? 63.3546 Section 63.3546... of key parameters of the valve operating system (e.g., solenoid valve operation, air pressure... minimum operating limit for that specific capture device or system of multiple capture devices. The...

  14. 40 CFR 63.3546 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.3546 Section 63... of key parameters of the valve operating system (e.g., solenoid valve operation, air pressure... minimum operating limit for that specific capture device or system of multiple capture devices. The...

  15. 40 CFR 63.3546 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... capture system and add-on control device operating limits during the performance test? 63.3546 Section 63... of key parameters of the valve operating system (e.g., solenoid valve operation, air pressure... minimum operating limit for that specific capture device or system of multiple capture devices. The...

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

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  17. Optical add/drop filter for wavelength division multiplexed systems

    DOEpatents

    Deri, Robert J.; Strand, Oliver T.; Garrett, Henry E.

    2002-01-01

    An optical add/drop filter for wavelength division multiplexed systems and construction methods are disclosed. The add/drop filter includes a first ferrule having a first pre-formed opening for receiving a first optical fiber; an interference filter oriented to pass a first set of wavelengths along the first optical fiber and reflect a second set of wavelengths; and, a second ferrule having a second pre-formed opening for receiving the second optical fiber, and the reflected second set of wavelengths. A method for constructing the optical add/drop filter consists of the steps of forming a first set of openings in a first ferrule; inserting a first set of optical fibers into the first set of openings; forming a first set of guide pin openings in the first ferrule; dividing the first ferrule into a first ferrule portion and a second ferrule portion; forming an interference filter on the first ferrule portion; inserting guide pins through the first set of guide pin openings in the first ferrule portion and second ferrule portion to passively align the first set of optical fibers; removing material such that light reflected from the interference filter from the first set of optical fibers is accessible; forming a second set of openings in a second ferrule; inserting a second set of optical fibers into the second set of openings; and positioning the second ferrule with respect to the first ferrule such that the second set of optical fibers receive the light reflected from the interference filter.

  18. Microbial communities associated with wet flue gas desulfurization systems

    PubMed Central

    Brown, Bryan P.; Brown, Shannon R.; Senko, John M.

    2012-01-01

    Flue gas desulfurization (FGD) systems are employed to remove SOx gasses that are produced by the combustion of coal for electric power generation, and consequently limit acid rain associated with these activities. Wet FGDs represent a physicochemically extreme environment due to the high operating temperatures and total dissolved solids (TDS) of fluids in the interior of the FGD units. Despite the potential importance of microbial activities in the performance and operation of FGD systems, the microbial communities associated with them have not been evaluated. Microbial communities associated with distinct process points of FGD systems at several coal-fired electricity generation facilities were evaluated using culture-dependent and -independent approaches. Due to the high solute concentrations and temperatures in the FGD absorber units, culturable halothermophilic/tolerant bacteria were more abundant in samples collected from within the absorber units than in samples collected from the makeup waters that are used to replenish fluids inside the absorber units. Evaluation of bacterial 16S rRNA genes recovered from scale deposits on the walls of absorber units revealed that the microbial communities associated with these deposits are primarily composed of thermophilic bacterial lineages. These findings suggest that unique microbial communities develop in FGD systems in response to physicochemical characteristics of the different process points within the systems. The activities of the thermophilic microbial communities that develop within scale deposits could play a role in the corrosion of steel structures in FGD systems. PMID:23226147

  19. Flue gas desulfurization chemistry studies: limestone grindability. Volume 1. FGD reagent mapping. Final report

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

    Richmann, D.L.; Rossi, J.P.; Rashin, E.B.

    1984-07-01

    The major objective of this project is to provide electric utilities with information concerning the availability of flue gas desulfurization (FGD) system reagents. Data presented in this report were obtained primarily from a comprehensive review of available literature. These were augmented by information gathered through interviews with knowledgeable individuals from industry, government, and academic institutions. Limestone data are presented on regional and state maps displaying, respectively, annual limestone production and number of active quarries by county; and areas most likely to contain potentially commercial deposits of high-Ca (greater than or equal to 90% CaCO/sub 3/) limestone. Lime data are presentedmore » on regional maps indicating ranges of annual production and number of active lime plants by county. Identification of commercial versus captive operations and estimates of lime availability on the open market are summarized in tables accompanying each map.« less

  20. Impact of add-on laboratory testing at an academic medical center: a five year retrospective study.

    PubMed

    Nelson, Louis S; Davis, Scott R; Humble, Robert M; Kulhavy, Jeff; Aman, Dean R; Krasowski, Matthew D

    2015-01-01

    Clinical laboratories frequently receive orders to perform additional tests on existing specimens ('add-ons'). Previous studies have examined add-on ordering patterns over short periods of time. The objective of this study was to analyze add-on ordering patterns over an extended time period. We also analyzed the impact of a robotic specimen archival/retrieval system on add-on testing procedure and manual effort. In this retrospective study at an academic medical center, electronic health records from were searched to obtain all add-on orders that were placed in the time period of May 2, 2009 to December 31, 2014. During the time period of retrospective study, 880,359 add-on tests were ordered on 96,244 different patients. Add-on testing comprised 3.3 % of total test volumes. There were 443,411 unique ordering instances, leading to an average of 1.99 add-on tests per instance. Some patients had multiple episodes of add-on test orders at different points in time, leading to an average of 9.15 add-on tests per patient. The majority of add-on orders were for chemistry tests (78.8 % of total add-ons) with the next most frequent being hematology and coagulation tests (11.2 % of total add-ons). Inpatient orders accounted for 66.8 % of total add-on orders, while the emergency department and outpatient clinics had 14.8 % and 18.4 % of total add-on orders, respectively. The majority of add-ons were placed within 8 hours (87.3 %) and nearly all by 24 hours (96.8 %). Nearly 100 % of add-on orders within the emergency department were placed within 8 hours. The introduction of a robotic specimen archival/retrieval unit saved an average of 2.75 minutes of laboratory staff manual time per unique add-on order. This translates to 24.1 hours/day less manual effort in dealing with add-on orders. Our study reflects the previous literature in showing that add-on orders significantly impact the workload of the clinical laboratory. The majority of add-on orders are clinical chemistry

  1. Use of Flue Gas Desulfurization (FGD) Gypsum as a Heavy Metal Stabilizer in Contaminated Soils

    EPA Science Inventory

    Flue Gas Desulfurization (FGD) gypsum is a synthetic by-product generated from the flue gas desulfurization process in coal power plants. It has several beneficial applications such as an ingredient in cement production, wallboard production and in agricultural practice as a soil...

  2. Impact of fgd1 and ddn Diversity in Mycobacterium tuberculosis Complex on In Vitro Susceptibility to PA-824 ▿ ‡

    PubMed Central

    Feuerriegel, Silke; Köser, Claudio U.; Baù, Davide; Rüsch-Gerdes, Sabine; Summers, David K.; Archer, John A. C.; Marti-Renom, Marc A.; Niemann, Stefan

    2011-01-01

    PA-824 is a promising drug candidate for the treatment of tuberculosis (TB). It is in phase II clinical trials as part of the first newly designed regimen containing multiple novel antituberculosis drugs (PA-824 in combination with moxifloxacin and pyrazinamide). However, given that the genes involved in resistance against PA-824 are not fully conserved in the Mycobacterium tuberculosis complex (MTBC), this regimen might not be equally effective against different MTBC genotypes. To investigate this question, we sequenced two PA-824 resistance genes (fgd1 [Rv0407] and ddn [Rv3547]) in 65 MTBC strains representing major phylogenetic lineages. The MICs of representative strains were determined using the modified proportion method in the Bactec MGIT 960 system. Our analysis revealed single-nucleotide polymorphisms in both genes that were specific either for several genotypes or for individual strains, yet none of these mutations significantly affected the PA-824 MICs (≤0.25 μg/ml). These results were supported by in silico modeling of the mutations identified in Fgd1. In contrast, “Mycobacterium canettii” strains displayed a higher MIC of 8 μg/ml. In conclusion, we found a large genetic diversity in PA-824 resistance genes that did not lead to elevated PA-824 MICs. In contrast, M. canettii strains had MICs that were above the plasma concentrations of PA-824 documented so far in clinical trials. As M. canettii is also intrinsically resistant against pyrazinamide, new regimens containing PA-824 and pyrazinamide might not be effective in treating M. canettii infections. This finding has implications for the design of multiple ongoing clinical trials. PMID:21930879

  3. Stereovision Imaging in Smart Mobile Phone Using Add on Prisms

    NASA Astrophysics Data System (ADS)

    Bar-Magen Numhauser, Jonathan; Zalevsky, Zeev

    2014-03-01

    In this work we present the use of a prism-based add on component installed on top of a smart phone to achieve stereovision capabilities using iPhone mobile operating system. Through these components and the combination of the appropriate application programming interface and mathematical algorithms the obtained results will permit the analysis of possible enhancements for new uses to such system, in a variety of areas including medicine and communications.

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

    PubMed

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

    2017-10-31

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

  5. SURVEY OF FLUE GAS DESULFURIZATION SYSTEMS: ST. CLAIR STATION, DETROIT EDISON CO

    EPA Science Inventory

    The report gives results of a survey of the flue gas desulfurization (FGD) system retrofitted on Unit 6 of Detroit Edison Co.'s St. Clair Station. The experimental FGD system, which operated through a 2-month (October 1976-January 1977) demonstration program, utilized a limestone...

  6. Survey of flue gas desulfurization systems: Hawthorn Station, Kansas City Power and Light Co. Final report

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

    Isaacs, G.A.; Zada, F.K.

    1975-09-01

    Results are given of a survey of the flue gas desulfurization (FGD) systems at Kansas City Power and Light Co.'s Hawthorn Power Station. The FGD systems on Hawthorn boilers 3 and 4 were designed to operate by injection of dry limestone in the boiler's furnace, followed by tail gas scrubbing. Because of tube plugging in boiler 4 the mode of operation of the FGD system on that boiler was modified: ground limestone is now introduced into the flue gas near the gas inlet to the scrubber tower. (GRA)

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

    NASA Astrophysics Data System (ADS)

    Guo, Kaikai; Zheng, Guoan

    2017-03-01

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

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

    PubMed

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

    2017-10-03

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

  9. Evolutionary diversification of protein–protein interactions by interface add-ons

    PubMed Central

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

    2017-01-01

    Cells contain a multitude of protein complexes whose subunits interact with high specificity. However, the number of different protein folds and interface geometries found in nature is limited. This raises the question of how protein–protein interaction specificity is achieved on the structural level and how the formation of nonphysiological complexes is avoided. Here, we describe structural elements called interface add-ons that fulfill this function and elucidate their role for the diversification of protein–protein interactions during evolution. We identified interface add-ons in 10% of a representative set of bacterial, heteromeric protein complexes. The importance of interface add-ons for protein–protein interaction specificity is demonstrated by an exemplary experimental characterization of over 30 cognate and hybrid glutamine amidotransferase complexes in combination with comprehensive genetic profiling and protein design. Moreover, growth experiments showed that the lack of interface add-ons can lead to physiologically harmful cross-talk between essential biosynthetic pathways. In sum, our complementary in silico, in vitro, and in vivo analysis argues that interface add-ons are a practical and widespread evolutionary strategy to prevent the formation of nonphysiological complexes by specializing protein–protein interactions. PMID:28923934

  10. 42 CFR § 512.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

    Code of Federal Regulations, 2010 CFR

    2017-10-01

    ... INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Pricing and Payment § 512.320 Treatment of incentive... under such models are independent of, and do not affect, any incentive programs or add-on payments under... 42 Public Health 5 2017-10-01 2017-10-01 false Treatment of incentive programs or add-on payments...

  11. SURVEY OF FLUE GAS DESULFURIZATION SYSTEMS: WILL COUNTY STATION, COMMONWEALTH EDISON CO

    EPA Science Inventory

    The report gives results of a second survey of the flue gas desulfurization (FGD) system on Unit 1 of Commonwealth Edison Co.'s Will County Station. The FGD system, started up in February 1972, uses a limestone slurry in two parallel scrubbing trains. Each train includes a ventur...

  12. Non-synonymous FGD3 Variant as Positional Candidate for Disproportional Tall Stature Accounting for a Carcass Weight QTL (CW-3) and Skeletal Dysplasia in Japanese Black Cattle

    PubMed Central

    Takasuga, Akiko; Sato, Kunio; Nakamura, Ryouichi; Saito, Yosuke; Sasaki, Shinji; Tsuji, Takehito; Suzuki, Akio; Kobayashi, Hiroshi; Matsuhashi, Tamako; Setoguchi, Koji; Okabe, Hiroshi; Ootsubo, Toshitake; Tabuchi, Ichiro; Fujita, Tatsuo; Watanabe, Naoto; Hirano, Takashi; Nishimura, Shota; Watanabe, Toshio; Hayakawa, Makio; Sugimoto, Yoshikazu; Kojima, Takatoshi

    2015-01-01

    Recessive skeletal dysplasia, characterized by joint- and/or hip bone-enlargement, was mapped within the critical region for a major quantitative trait locus (QTL) influencing carcass weight; previously named CW-3 in Japanese Black cattle. The risk allele was on the same chromosome as the Q allele that increases carcass weight. Phenotypic characterization revealed that the risk allele causes disproportional tall stature and bone size that increases carcass weight in heterozygous individuals but causes disproportionately narrow chest width in homozygotes. A non-synonymous variant of FGD3 was identified as a positional candidate quantitative trait nucleotide (QTN) and the corresponding mutant protein showed reduced activity as a guanine nucleotide exchange factor for Cdc42. FGD3 is expressed in the growth plate cartilage of femurs from bovine and mouse. Thus, loss of FDG3 activity may lead to subsequent loss of Cdc42 function. This would be consistent with the columnar disorganization of proliferating chondrocytes in chondrocyte-specific inactivated Cdc42 mutant mice. This is the first report showing association of FGD3 with skeletal dysplasia. PMID:26306008

  13. Aarskog-Scott syndrome: clinical update and report of nine novel mutations of the FGD1 gene.

    PubMed

    Orrico, A; Galli, L; Faivre, L; Clayton-Smith, J; Azzarello-Burri, S M; Hertz, J M; Jacquemont, S; Taurisano, R; Arroyo Carrera, I; Tarantino, E; Devriendt, K; Melis, D; Thelle, T; Meinhardt, U; Sorrentino, V

    2010-02-01

    Mutations in the FGD1 gene have been shown to cause Aarskog-Scott syndrome (AAS), or facio-digito-genital dysplasia (OMIM#305400), an X-linked disorder characterized by distinctive genital and skeletal developmental abnormalities with a broad spectrum of clinical phenotypes. To date, 20 distinct mutations have been reported, but little phenotypic data are available on patients with molecularly confirmed AAS. In the present study, we report on our experience of screening for mutations in the FGD1 gene in a cohort of 60 European patients with a clinically suspected diagnosis of AAS. We identified nine novel mutations in 11 patients (detection rate of 18.33%), including three missense mutations (p.R402Q; p.S558W; p.K748E), four truncating mutations (p.Y530X; p.R656X; c.806delC; c.1620delC), one in-frame deletion (c.2020_2022delGAG) and the first reported splice site mutation (c.1935+3A>C). A recurrent mutation (p.R656X) was detected in three independent families. We did not find any evidence for phenotype-genotype correlations between type and position of mutations and clinical features. In addition to the well-established phenotypic features of AAS, other clinical features are also reported and discussed. Copyright 2010 Wiley-Liss, Inc.

  14. Stiripentol add-on therapy for focal refractory epilepsy.

    PubMed

    Brigo, Francesco; Igwe, Stanley C; Bragazzi, Nicola Luigi

    2018-05-10

    This is an updated version of the Cochrane review last published in 2015 (Issue 10). For nearly 30% of people with epilepsy, seizures are not controlled by current treatments. Stiripentol is a new antiepileptic drug (AED) that was developed in France and was approved by the European Medicines Agency (EMA) in 2007 for the treatment of Dravet syndrome as an adjunctive therapy with valproate and clobazam, with promising effects. To evaluate the efficacy and tolerability of stiripentol as add-on treatment for people with focal refractory epilepsy who are taking AEDs. For the latest update, we searched the following databases on 21 August 2017: Cochrane Epilepsy Specialized Register, CENTRAL , MEDLINE, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP). We contacted Biocodex (the manufacturer of stiripentol) and epilepsy experts to identify published, unpublished and ongoing trials. Randomised, controlled, add-on trials of stiripentol in people with focal refractory epilepsy. Review authors independently selected trials for inclusion and extracted data. Outcomes investigated included 50% or greater reduction in seizure frequency, seizure freedom, adverse effects, treatment withdrawal and changes in quality of life. On the basis of our selection criteria, we included no new studies in the present review. Only one study was included from the earlier review (32 children with focal epilepsy). This study adopted a 'responder enriched' design and found no clear evidence of a reduction in seizure frequency (≥ 50% seizure reduction) (risk ratio (RR) 1.51, 95% confidence interval (CI) 0.81 to 2.82, low-quality evidence) nor evidence of seizure freedom (RR 1.18, 95% CI 0.31 to 4.43, low-quality evidence) when add-on stiripentol was compared with placebo. Stiripentol led to a greater risk of adverse effects considered as a whole (RR 2.65, 95% CI 1.08 to 6.47, low-quality evidence). When specific adverse events were considered, confidence

  15. User's manual for Axisymmetric Diffuser Duct (ADD) code. Volume 1: General ADD code description

    NASA Technical Reports Server (NTRS)

    Anderson, O. L.; Hankins, G. B., Jr.; Edwards, D. E.

    1982-01-01

    This User's Manual contains a complete description of the computer codes known as the AXISYMMETRIC DIFFUSER DUCT code or ADD code. It includes a list of references which describe the formulation of the ADD code and comparisons of calculation with experimental flows. The input/output and general use of the code is described in the first volume. The second volume contains a detailed description of the code including the global structure of the code, list of FORTRAN variables, and descriptions of the subroutines. The third volume contains a detailed description of the CODUCT code which generates coordinate systems for arbitrary axisymmetric ducts.

  16. Safety and tolerability of dapagliflozin, saxagliptin and metformin in combination: Post-hoc analysis of concomitant add-on versus sequential add-on to metformin and of triple versus dual therapy with metformin.

    PubMed

    Del Prato, Stefano; Rosenstock, Julio; Garcia-Sanchez, Ricardo; Iqbal, Nayyar; Hansen, Lars; Johnsson, Eva; Chen, Hungta; Mathieu, Chantal

    2018-06-01

    The safety of triple oral therapy with dapagliflozin plus saxagliptin plus metformin versus dual therapy with dapagliflozin or saxagliptin plus metformin was compared in a post-hoc analysis of 3 randomized trials of sequential or concomitant add-on of dapagliflozin and saxagliptin to metformin. In the concomitant add-on trial, patients with type 2 diabetes on stable metformin received dapagliflozin 10 mg/d plus saxagliptin 5 mg/d. In sequential add-on trials, patients on metformin plus either saxagliptin 5 mg/d or dapagliflozin 10 mg/d received dapagliflozin 10 mg/d or saxagliptin 5 mg/d, respectively, as add-on therapy. After 24 weeks, incidences of adverse events and serious adverse events were similar between triple and dual therapy and between concomitant and sequential add-on regimens. Urinary tract infections were more common with sequential than with concomitant add-on therapy; genital infections were reported only with sequential add-on of dapagliflozin to saxagliptin plus metformin. Hypoglycaemia incidence was <2.0% across all analysis groups. In conclusion, the safety and tolerability of triple therapy with dapagliflozin, saxagliptin and metformin, as either concomitant or sequential add-on, were similar to dual therapy with either agent added to metformin. © 2018 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  17. ENVIRONMENTAL TECHNOLOGY VERIFICATION: ADD-ON NOX CONTROLS

    EPA Science Inventory

    The paper discusses the environmental technology verification (ETV) of add-on nitrogen oxide (NOx) controls. Research Triangle Institute (RTI) is EPA's cooperating partner for the Air Pollution Control Technology (APCT) Program, one of a dozen ETV pilot programs. Verification of ...

  18. Losigamone add-on therapy for partial epilepsy.

    PubMed

    Xiao, Yousheng; Luo, Man; Wang, Jin; Luo, Hongye

    2012-06-13

    Epilepsy is a common neurologic disorder, affecting approximately 50 million people worldwide; nearly a third of these people are not well controlled by a single antiepileptic drug and usually require treatment with a combination of two or more antiepileptic drugs. In recent years, many newer antiepileptic drugs have been investigated as add-on therapy for partial epilepsy; losigamone is one of these drugs and is the focus of this systematic review. To investigate the efficacy and safety of losigamone when used as an add-on therapy for partial epilepsy. We searched the Cochrane Epilepsy Group Specialized Register (1 May 2012), the Cochrane Central Register of Controlled Trials (CENTRAL Issue 4 of 12, The Cochrane Library, 2012) and MEDLINE (1 May 2012). We searched trials registers and contacted the manufacturer of losigamone and authors of included studies for additional information. There were no language restrictions. Randomized controlled add-on trials comparing losigamone with placebo for partial epilepsy. Two review authors independently assessed trial quality and extracted data. The primary outcomes were 50% or greater reduction in seizure frequency and seizure freedom; the secondary outcomes were treatment withdrawal and adverse events. Results are presented as risk ratios (RR) with 95% confidence intervals (CIs) or 99% CIs (for the individual listed adverse events to make an allowance for multiple testing). Two trials involving a total of 467 patients were eligible for inclusion. Both trials assessed losigamone 1200 or 1500 mg/d as an add-on therapy for partial epilepsy. One trial was assessed as being of good methodologic quality while the other was of uncertain quality. For the efficacy outcomes, results did show patients taking losigamone were significantly more likely to achieve a 50% or greater reduction in seizure frequency (RR 1.75; 95% CI 1.14 to 2.72), but associated with a significant increase of treatment withdrawal when compared with those

  19. THE EFFECT OF MERCURY CONTROLS ON WALLBOARD MANUFACTURE

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

    Sandra Meischen

    2004-07-01

    Pending EPA regulations may mandate 70 to 90% mercury removal efficiency from utility flue gas. A mercury control option is the trapping of oxidized mercury in wet flue gas desulfurization systems (FGD). The potential doubling of mercury in the FGD material and its effect on mercury volatility at temperatures common to wallboard manufacture is a concern that could limit the growing byproduct use of FGD material. Prediction of mercury fate is limited by lack of information on the mercury form in the FGD material. The parts per billion mercury concentrations prevent the identification of mercury compounds by common analytical methods.more » A sensitive analytical method, cold vapor atomic fluorescence, coupled with leaching and thermodecomposition methods were evaluated for their potential to identify mercury compounds in FGD material. The results of the study suggest that the mercury form is dominated by the calcium sulfate matrix and is probably associated with the sulfate form in the FGD material. Additionally, to determine the effect of high mercury concentration FGD material on wallboard manufacture, a laboratory FGD unit was built to trap the oxidized mercury generated in a simulated flue gas. Although the laboratory prepared FGD material did not contain the mercury concentrations anticipated, further thermal tests determined that mercury begins to evolve from FGD material at 380 to 390 F, consequently dropping the drying temperature should mitigate mercury evolution if necessary. Mercury evolution is also diminished as the weight of the wallboard sample increased. Consequently, mercury evolution may not be a significant problem in wallboard manufacture.« less

  20. Lamotrigine add-on for drug-resistant partial epilepsy.

    PubMed

    Ramaratnam, S; Marson, A G; Baker, G A

    2001-01-01

    Epilepsy is a common neurological disorder, affecting almost 0.5 to 1% of the population. Nearly 30% of patients with epilepsy are refractory to currently available drugs. Lamotrigine is one of the newer antiepileptic drugs and is the topic of this review. To examine the effects of lamotrigine on seizures, side effects, cognition and quality of life, when used as an add-on treatment for patients with drug-resistant partial epilepsy. We searched the Cochrane Epilepsy Group trials register, the Cochrane Controlled Trials Register (Cochrane Library Issue 2, 2001), MEDLINE (January 1966 to April 2001) and reference lists of articles. We also contacted the manufacturers of lamotrigine (Glaxo-Wellcome). Randomized placebo controlled trials, of patients with drug-resistant partial epilepsy of any age, in which an adequate method of concealment of randomization was used. The studies may be double, single or unblinded. For crossover studies, the first treatment period was treated as a parallel trial. Two reviewers independently assessed the trials for inclusion and extracted data. Primary analyses were by intention to treat. Outcomes included 50% or greater reduction in seizure frequency, treatment withdrawal (any reason), side effects, effects on cognition, and quality of life. We found three parallel add-on studies and eight cross-over studies, which included 1243 patients (199 children and 1044 adults). The overall Peto's Odds Ratio (OR) and 95% confidence intervals (CIs) across all studies for 50% or greater reduction in seizure frequency was 2.71 (1.87, 3.91) indicating that lamotrigine is significantly more effective than placebo in reducing seizure frequency. The overall OR (95%CI) for treatment withdrawal (for any reason) is 1.12 (0.78, 1.61). The 99% CIs for ataxia, dizziness, nausea, and diplopia do not include unity, indicating that they are significantly associated with lamotrigine. The limited data available precludes any conclusions about effects on cognition

  1. Lamotrigine add-on for drug-resistant partial epilepsy.

    PubMed

    Ramaratnam, S; Marson, A G; Baker, G A

    2000-01-01

    Epilepsy is a common neurological disorder, affecting almost 0.5 to 1% of the population. Nearly 30% of patients with epilepsy are refractory to currently available drugs. Lamotrigine is one of the newer antiepileptic drugs and is the topic of this review. To examine the effects of lamotrigine on seizures, side effects, cognition and quality of life, when used as an add-on treatment for patients with drug-resistant partial epilepsy. We searched the Cochrane Epilepsy Group trials register, the Cochrane Controlled Trials Register (Cochrane Library Issue 1, 2000), MEDLINE (January 1966 to December 1999) and reference lists of articles. We also contacted the manufacturers of lamotrigine (Glaxo-Wellcome). Randomized placebo controlled trials, of patients with drug-resistant partial epilepsy of any age, in which an adequate method of concealment of randomization was used. The studies may be double, single or unblinded. For crossover studies, the first treatment period was treated as a parallel trial. Two reviewers independently assessed the trials for inclusion and extracted data. Primary analyses were by intention to treat. Outcomes included 50% or greater reduction in seizure frequency, treatment withdrawal (any reason), side effects, effects on cognition, and quality of life. We found three parallel add-on studies and eight cross-over studies, which included 1243 patients (199 children and 1044 adults). The overall Peto's Odds Ratio (OR) and 95% confidence intervals (CIs) across all studies for 50% or greater reduction in seizure frequency was 2.71 (1.87, 3.91) indicating that lamotrigine is significantly more effective than placebo in reducing seizure frequency. The overall OR (95%CI) for treatment withdrawal (for any reason) is 1.12 (0.78, 1. 61). The 99% CIs for ataxia, dizziness, nausea, and diplopia do not include unity, indicating that they are significantly associated with lamotrigine. The limited data available preclude any conclusions about effects on

  2. Losigamone add-on therapy for partial epilepsy.

    PubMed

    Xiao, Yousheng; Luo, Man; Wang, Jin; Luo, Hongye

    2015-12-10

    Epilepsy is a common neurologic disorder, affecting approximately 50 million people worldwide; nearly a third of these people are not well controlled by a single antiepileptic drug (AED) and usually require treatment with a combination of two or more AEDs. In recent years, many newer AEDs have been investigated as add-on therapy for partial epilepsy; losigamone is one of these drugs and is the focus of this systematic review. This is an update of a Cochrane review first published in 2012 (Cochrane Database of Systematic Reviews 2012, Issue 6). To investigate the efficacy and safety of losigamone when used as an add-on therapy for partial epilepsy. We searched the Cochrane Epilepsy Group Specialized Register (16 February 2015), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 16 February 2015) and MEDLINE (Ovid, 1946 to 16 February 2015). We searched trials registers and contacted the manufacturer of losigamone and authors of included studies for additional information. We did not impose any language restrictions. Randomized controlled, add-on trials comparing losigamone with placebo for partial epilepsy. Two review authors independently assessed trial quality and extracted data. The primary outcomes were 50% or greater reduction in seizure frequency and seizure freedom; the secondary outcomes were treatment withdrawal and adverse events. Results are presented as risk ratios (RRs) with 95% confidence intervals (CIs) or 99% CIs (for the individual listed adverse events to make an allowance for multiple testing). Two trials involving a total of 467 patients, aged over 18 years, were eligible for inclusion. Both trials assessed losigamone 1200 mg/day or 1500 mg/day as an add-on therapy for partial epilepsy. One trial was assessed as being of good methodological quality while the other was of uncertain quality. For the efficacy outcomes, results did show patients taking losigamone were significantly more likely to achieve a 50% or

  3. Lacosamide add-on therapy for partial epilepsy.

    PubMed

    Weston, Jennifer; Shukralla, Arif; McKay, Andrew J; Marson, Anthony G

    2015-06-16

    Around half of people with epilepsy will not achieve seizure freedom on their first antiepileptic drug; many will require add-on treatment with another drug. Sometimes multiple treatment combinations are tried to achieve maximum seizure control, although around a third of people do not achieve complete seizure control. Lacosamide is an antiepileptic drug that has been licensed as an add-on treatment for partial epilepsy. To evaluate the efficacy and tolerability of lacosamide when used as an add-on treatment for patients with drug-resistant partial epilepsy. We searched the Cochrane Epilepsy Group's Specialized Register (21 May 2015), the Cochrane Central Register of Controlled Trials (CENTRAL , The Cochrane Library Issue 4, April 2015), MEDLINE (Ovid, 1946 to 21 May 2015), Scopus (1823 to 13 November 2014), ClinicalTrials.gov (21 May 2015) and the WHO International Clinical Trials Registry Platform (ICTRP, 21 May 2015). We imposed no language restrictions. We contacted UCB (sponsors of lacosamide) and experts in the field. Randomised controlled trials of add-on lacosamide in people with drug-resistant partial epilepsy. Two review authors independently assessed trials for inclusion and extracted the relevant data. We assessed the following outcomes: (1) 50% or greater reduction in seizure frequency; (2) seizure freedom; (3) treatment withdrawal for any reason; and (4) adverse events. Primary analyses were intention-to-treat. Summary risk ratios were estimated for each outcome. We included three trials in our review (1311 participants), which were classified as having low risk of bias. All trials were placebo-controlled and assessed doses ranging from 200 mg to 600 mg per day. Trial duration ranged from 24 to 26 weeks. All trials used adequate methods of randomisation and were double-blind. Overall the quality of the evidence was rated as moderate to high. The overall risk ratio for a 50% or greater reduction in seizure frequency for all doses of lacosamide compared

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

    PubMed

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

    2014-09-16

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

  5. Losigamone add-on therapy for focal epilepsy.

    PubMed

    Xiao, Yousheng; Luo, Man; Wang, Jin; Luo, Hongye

    2018-01-22

    Epilepsy is a common neurologic disorder, affecting approximately 50 million people worldwide; nearly a third of these people have epilepsy that is not well controlled by a single antiepileptic drug (AED) and they usually require treatment with a combination of two or more AEDs. In recent years, many newer AEDs have been investigated as add-on therapy for focal epilepsy; losigamone is one of these drugs and is the focus of this systematic review. This is an update of a Cochrane review first published in 2012 (Cochrane Database of Systematic Reviews 2012, Issue 6) and updated in 2015. To investigate the efficacy and safety of losigamone when used as an add-on therapy for focal epilepsy. For the latest update on 9 February 2017, we searched the Cochrane Epilepsy Specialized Register, CENTRAL and MEDLINE . We searched trials registers and contacted the manufacturer of losigamone and authors of included studies for additional information. We did not impose any language restrictions. Randomized controlled, add-on trials comparing losigamone with placebo for focal epilepsy. Two review authors independently assessed trial quality and extracted data. The primary outcomes were 50% or greater reduction in seizure frequency and seizure freedom; the secondary outcomes were treatment withdrawal and adverse events. Results are presented as risk ratios (RRs) with 95% confidence intervals (CIs) or 99% CIs (for the individual listed adverse events to make an allowance for multiple testing). Two trials involving a total of 467 participants, aged over 18 years, were eligible for inclusion. Both trials assessed losigamone 1200 mg/day or 1500 mg/day as an add-on therapy for focal epilepsy. We assessed one trial as being of good methodological quality while the other was of uncertain quality. For the efficacy outcomes, results did show that participants taking losigamone were significantly more likely to achieve a 50% or greater reduction in seizure frequency (RR 1.76, 95% CI 1.14 to 2

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

    NASA Technical Reports Server (NTRS)

    McCloud, Peter

    2013-01-01

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

  7. ADD and Physicians.

    ERIC Educational Resources Information Center

    Hewick, Walter; And Others

    In the United States today Attention Deficit Disorder (ADD) is recognized by professionals as a distinct disorder, a neurobiological disability marked by inattentiveness, impulsivity, and hyperactivity. About 2-10% of school-age children suffer from ADD, making it an issue of rising concern to families and school leaders. It is necessary that…

  8. Efficacy and safety of add on low-dose mirtazapine in depression.

    PubMed

    Matreja, Prithpal S; Badyal, Dinesh K; Deswal, Randhir S; Sharma, Arvind

    2012-03-01

    Although antidepressant medications are effective, they have a delayed onset of effect. Mirtazapine, an atypical antidepressant is an important option for add-on therapy in major depression. There is insufficient data on mirtazapine in Indian population; hence this study was designed to study the add-on effect of low-dose mirtazapine with selective serotonin reuptake inhibitors (SSRIs) in major depressive disorder (MDD) in Indian population. In an open, randomized study, 60 patients were divided into two groups. In Group A (n=30) patients received conventional SSRIs for 6 weeks. In Group B (n=30) patients received conventional SSRIs with low-dose mirtazapine for 6 weeks. Patients were evaluated at baseline and then at 1, 2, 3, 4, 5, and 6 weeks. There was significant improvement in Hamilton Depression Rating Scale (HDRS), Montgomery and Asberg depression rating scale (MADRS) scores (P<0.05) in both groups. Mirtazapine in low dose as add on therapy showed improvement in scores, had earlier onset of action, and more number of responders and remitters as compared to conventional treatment (P<0.05). No serious adverse event was reported in either of the groups. Low-dose mirtazapine as add-on therapy has shown better efficacy, earlier onset of action and more number of responders and remitters as compared to conventional treatment in MDD in Indian patients.

  9. Effect and Potential Mechanism of Electroacupuncture Add-On Treatment in Patients with Parkinson's Disease

    PubMed Central

    Wang, Fang; Sun, Li; Zhang, Xiao-zhe; Jia, Jun; Liu, Zhuo; Huang, Xi-yan; Yu, Shu-yang; Zuo, Li-jun; Cao, Chen-jie; Wang, Xiao-min; Zhang, Wei

    2015-01-01

    Objectives. To explore effectiveness and mechanisms of electroacupuncture (EA) add-on treatment in Parkinson's disease (PD) patients. Methods. Fifty PD patients were randomly assigned to drug plus EA (D + EA) group and drug alone (D) group. Subjects in D + EA group received stimulation in points of bilateral fengfu, fengchi, hegu, and central dazhui. Participants were evaluated by scales for motor and nonmotor symptoms. Levels of neuroinflammatory factors and neurotransmitters in serum were detected. Results. EA add-on treatment remarkably reduced scores of Unified Parkinson's Disease Rating Scale (UPDRS) III and its subitems of tremor, rigidity, and bradykinesia and conspicuously decreased UPDRS III scores in patients with bradykinesia-rigidity and mixed types and mild severity. Depression and sleep disturbances were eased, which were reflected by decreased scores of Hamilton Depression Rating Scale, Pittsburgh Sleep Quality Index, and elevated noradrenaline level. Effects of EA add-on treatment on motor symptoms and sleep disturbances were superior to drug alone treatment, markedly improving life quality of PD patients. EA add-on treatment decreased nitric oxide level in serum. Conclusions. EA add-on treatment is effective on most motor symptoms and some nonmotor symptoms and is particularly efficacious in PD patients at early stage. Antineuroinflammation may be a mechanism of EA add-on treatment. PMID:26351515

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

    PubMed Central

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

    2014-01-01

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

  11. One-year efficacy and safety of saxagliptin add-on in patients receiving dapagliflozin and metformin.

    PubMed

    Matthaei, S; Aggarwal, N; Garcia-Hernandez, P; Iqbal, N; Chen, H; Johnsson, E; Chin, A; Hansen, L

    2016-11-01

    Greater reductions in glycated haemoglobin (HbA1c) with saxagliptin, a dipeptidyl peptidase-4 inhibitor, versus placebo add-on in patients with type 2 diabetes who had inadequate glycaemic control with dapagliflozin 10 mg/d plus metformin were demonstrated after 24 weeks of treatment. Results over 52 weeks of treatment were assessed in this analysis. Patients (mean baseline HbA1c 7.9%) receiving open-label dapagliflozin 10 mg/d plus metformin were randomized to double-blind saxagliptin 5 mg/d or placebo add-on. The adjusted mean change from baseline to week 52 in HbA1c was greater with saxagliptin than with placebo add-on -0.38% vs 0.05%; difference -0.42% (95% confidence interval -0.64, -0.20)]. More patients achieved the HbA1c target of <7% with saxagliptin than with placebo add-on (29% vs 13%), and fewer patients were rescued or discontinued the study for lack of glycaemic control with saxagliptin than with placebo add-on (19% vs 28%). Reductions from baseline in body weight (≤1.5 kg) occurred in both groups. Similar proportions of patients reported ≥1 adverse event with saxagliptin (58.2%) and placebo add-on (58.0%); no new safety signals were detected. Hypoglycaemia was infrequent in both treatment groups (≤2.5%), with no major episodes. The rate of urinary tract infections was similar in the saxagliptin and placebo add-on groups (7.8% vs 7.4%). The incidence of genital infections was 3.3% with saxagliptin versus 6.2% with placebo add-on. Triple therapy with saxagliptin add-on to dapagliflozin plus metformin for 52 weeks resulted in sustained improvements in glycaemic control without an increase in body weight or increased risk of hypoglycaemia. © 2016 John Wiley & Sons Ltd.

  12. Power Plant Bromide Discharges and Downstream Drinking Water Systems in Pennsylvania.

    PubMed

    Good, Kelly D; VanBriesen, Jeanne M

    2017-10-17

    Coal-fired power plants equipped with wet flue gas desulfurization (FGD) systems have been implicated in increasing bromide levels and subsequent increases in disinfection byproducts at downstream drinking water plants. Bromide was not included as a regulated constituent in the recent steam electric effluent limitations guidelines and standards (ELGs) since the U.S. EPA analysis suggested few drinking water facilities would be affected by bromide discharges from power plants. The present analysis uses a watershed approach to identify Pennsylvania drinking water intakes downstream of wet FGD discharges and to assess the potential for bromide discharge effects. Twenty-two (22) public drinking water systems serving 2.5 million people were identified as being downstream of at least one wet FGD discharge. During mean August conditions (generally low-flow, minimal dilution) in receiving rivers, the median predicted bromide concentrations contributed by wet FGD at Pennsylvania intake locations ranged from 5.2 to 62 μg/L for the Base scenario (including only natural bromide in coal) and from 16 to 190 μg/L for the Bromide Addition scenario (natural plus added bromide for mercury control); ranges depend on bromide loads and receiving stream dilution capacity.

  13. Survey of flue gas desulfurization systems: Duck Creek Station, Central Illinois Light Co. Final report, Jul-Dec 1978

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

    Laseke, B.A. Jr.

    The report presents the results of a survey of operational flue gas desulfurization (FGD) systems on coal-fired utility boilers in the United States. The FGD system installed on Unit 1 at the Duck Creek Station of Central Illinois Light Company is described in terms of design and performance. The system consists of four parallel, wet-limestone, rod-deck scrubber modules designed for 25% capacity each, providing a total sulfur dioxide removal efficiency of 85%. The bottom ash, fly ash, and scrubbing wastes are disposed of in a sludge pond lined with a natural impermeable material. The first module of this four modulemore » FGD system was placed in service on July 1, 1976, and operated intermittently throughout the remainder of the year and for approximately one month in early 1977. On July 23, 1978, the three remaining modules were completed and all four modules were placed in the gas path for treatment of high sulfur flue gas.« less

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

    PubMed

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

    2017-10-01

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

  15. Sensitivity analysis of add-on price estimate for select silicon wafering technologies

    NASA Technical Reports Server (NTRS)

    Mokashi, A. R.

    1982-01-01

    The cost of producing wafers from silicon ingots is a major component of the add-on price of silicon sheet. Economic analyses of the add-on price estimates and their sensitivity internal-diameter (ID) sawing, multiblade slurry (MBS) sawing and fixed-abrasive slicing technique (FAST) are presented. Interim price estimation guidelines (IPEG) are used for estimating a process add-on price. Sensitivity analysis of price is performed with respect to cost parameters such as equipment, space, direct labor, materials (blade life) and utilities, and the production parameters such as slicing rate, slices per centimeter and process yield, using a computer program specifically developed to do sensitivity analysis with IPEG. The results aid in identifying the important cost parameters and assist in deciding the direction of technology development efforts.

  16. Channel add-drop filter based on dual photonic crystal cavities in push-pull mode.

    PubMed

    Poulton, Christopher V; Zeng, Xiaoge; Wade, Mark T; Popović, Miloš A

    2015-09-15

    We demonstrate an add-drop filter based on a dual photonic crystal nanobeam cavity system that emulates the operation of a traveling wave resonator, and, thus, provides separation of the through and drop port transmission from the input port. The device is on a 3×3  mm chip fabricated in an advanced microelectronics silicon-on-insulator complementary metal-oxide semiconductor (SOI CMOS) process (IBM 45 nm SOI) without any foundry process modifications. The filter shows 1 dB of insertion loss in the drop port with a 3 dB bandwidth of 64 GHz, and 16 dB extinction in the through port. To the best of our knowledge, this is the first implementation of a port-separating, add-drop filter based on standing wave cavities coupled to conventional waveguides, and demonstrates a performance that suggests potential for photonic crystal devices within optical immersion lithography-based advanced CMOS electronics-photonics integration.

  17. Nintedanib with Add-on Pirfenidone in Idiopathic Pulmonary Fibrosis. Results of the INJOURNEY Trial.

    PubMed

    Vancheri, Carlo; Kreuter, Michael; Richeldi, Luca; Ryerson, Christopher J; Valeyre, Dominique; Grutters, Jan C; Wiebe, Sabrina; Stansen, Wibke; Quaresma, Manuel; Stowasser, Susanne; Wuyts, Wim A

    2018-02-01

    Nintedanib and pirfenidone slow the progression of idiopathic pulmonary fibrosis (IPF), but the disease continues to progress. More data are needed on the safety and efficacy of combination therapy with nintedanib and add-on pirfenidone. To investigate safety, tolerability, and pharmacokinetic and exploratory efficacy endpoints in patients treated with nintedanib and add-on pirfenidone versus nintedanib alone. Patients with IPF and FVC greater than or equal to 50% predicted at screening who completed a 4- to 5-week run-in with nintedanib 150 mg twice daily without dose reduction or treatment interruption were randomized to receive nintedanib 150 mg twice daily with add-on pirfenidone (titrated to 801 mg three times daily) or nintedanib 150 mg twice daily alone in an open-label manner for 12 weeks. The primary endpoint was the percentage of patients with on-treatment gastrointestinal adverse events from baseline to Week 12. Analyses were descriptive and exploratory. On-treatment gastrointestinal adverse events were reported in 37 of 53 patients (69.8%) treated with nintedanib with add-on pirfenidone and 27 of 51 patients (52.9%) treated with nintedanib alone. Predose plasma trough concentrations of nintedanib were similar when it was administered alone or with add-on pirfenidone. Mean (SE) changes from baseline in FVC at Week 12 were -13.3 (17.4) ml and -40.9 (31.4) ml in patients treated with nintedanib with add-on pirfenidone (n = 48) and nintedanib alone (n = 44), respectively. Nintedanib with add-on pirfenidone had a manageable safety and tolerability profile in patients with IPF, in line with the adverse event profiles of each drug. These data support further research into combination regimens in the treatment of IPF. Clinical trial registered with www.clinicaltrials.gov (NCT02579603).

  18. 24 CFR 990.190 - Other formula expenses (add-ons).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... operating subsidy is determined to be zero based on the formula is still eligible to receive operating... formula expenses (add-ons). In addition to calculating operating subsidy based on the PEL and UEL, a PHA's... receive an amount for PILOT in accordance with section 6(d) of the 1937 Act, based on its cooperation...

  19. 24 CFR 990.190 - Other formula expenses (add-ons).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... operating subsidy is determined to be zero based on the formula is still eligible to receive operating... formula expenses (add-ons). In addition to calculating operating subsidy based on the PEL and UEL, a PHA's... receive an amount for PILOT in accordance with section 6(d) of the 1937 Act, based on its cooperation...

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

    PubMed

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

    2016-11-15

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

  1. Impact of Modafinil Add-on with Atypical Anti-psychotics on Excessive Daytime Drowsiness

    PubMed Central

    Prasuna, P Lakshmi; Sudhakar, TP

    2015-01-01

    Background: Atypical antipsychotic drugs are known to cause many side effects which include daytime drowsiness. So many add on drugs are tried to reduce the same. Materials and Methods: 72 patients who were on atypical antipsychotic drugs were randomly assigned to either Modafinil or placebo and were followed for a period of 12 weeks. Daytime drowsiness, was taken at baseline, week 3, and at week 12 by using VAS, EDD scales. Results: The results were analyzed and showed that the Modafinil add on therapy significantly reduced the daytime Drowsiness. Conclusions: Modafinil could be a potential candidate in selected group of patients to decrease some of the unwanted adverse events like daytime drowsiness produced by atypical antipsychotics. PMID:26702168

  2. Rotigotine transdermal system as add-on to oral dopamine agonist in advanced Parkinson's disease: an open-label study.

    PubMed

    Kim, Jong-Min; Chung, Sun Ju; Kim, Jae Woo; Jeon, Beom Seok; Singh, Pritibha; Thierfelder, Stephan; Ikeda, Junji; Bauer, Lars

    2015-02-28

    Achieving optimal symptom control with minimal side effects is a major goal in clinical practice. Dual-agent dopamine receptor agonist (DA) therapy in Parkinson's disease (PD) may represent a promising approach to treatment, as the combination of different pharmacokinetic/pharmacological profiles may result in a lesser need for high dosages and, accordingly, may be well tolerated. The objective of the current study was to investigate safety and efficacy of rotigotine transdermal system as add-on to oral DA in patients with advanced PD inadequately controlled with levodopa and low-dose oral DA. PD0015 was an open-label, multinational study in patients with advanced-PD and sleep disturbance or early-morning motor impairment. Patients were titrated to optimal dose rotigotine (≤8 mg/24 h) over 1-4 weeks and maintained for 4-7 weeks (8-week treatment). Dosage of levodopa and oral DA (pramipexole ≤1.5 mg/day, ropinirole ≤6.0 mg/day) was stable. Primary variable was Clinical Global Impressions (CGI) item 4: side effects, assessing safety. Other variables included adverse events (AEs), Patient Global Impressions of Change (PGIC), Unified Parkinson's Disease Rating Scale (UPDRS) II and III, Parkinson's Disease Sleep Scale (PDSS-2), Pittsburgh Sleep Quality Index (PSQI), and "off" time. Of 90 patients who received rotigotine, 79 (88%) completed the study; 5 (6%) withdrew due to AEs. Most (83/89; 93%) had a CGI-4 score <3 indicating that rotigotine add-on therapy did not interfere with functioning; 6 (7%) experienced drug-related AEs that interfered with functioning (score ≥3). AEs occurring in ≥5% were application site pruritus (13%), dizziness (10%), orthostatic hypotension (10%), nausea (8%), dyskinesia (8%), and nasopharyngitis (6%). Numerical improvements in motor function (UPDRS III), activities of daily living (UPDRS II), sleep disturbances (PDSS-2, PSQI), and reduction in "off" time were observed. The majority (71/88; 81%) improved on PGIC. Addition of

  3. Significant treatment effect of add-on ketamine anesthesia in electroconvulsive therapy in depressive patients: A meta-analysis.

    PubMed

    Li, Dian-Jeng; Wang, Fu-Chiang; Chu, Che-Sheng; Chen, Tien-Yu; Tang, Chia-Hung; Yang, Wei-Cheng; Chow, Philip Chik-Keung; Wu, Ching-Kuan; Tseng, Ping-Tao; Lin, Pao-Yen

    2017-01-01

    Add-on ketamine anesthesia in electroconvulsive therapy (ECT) has been studied in depressive patients in several clinical trials with inconclusive findings. Two most recent meta-analyses reported insignificant findings with regards to the treatment effect of add-on ketamine anesthesia in ECT in depressive patients. The aim of this study is to update the current evidence and investigate the role of add-on ketamine anesthesia in ECT in depressive patients via a systematic review and meta-analysis. We performed a thorough literature search of the PubMed and ScienceDirect databases, and extracted all relevant clinical variables to compare the antidepressive outcomes between add-on ketamine anesthesia and other anesthetics in ECT. Total 16 articles with 346 patients receiving add-on ketamine anesthesia in ECT and 329 controls were recruited. We found that the antidepressive treatment effect of add-on ketamine anesthesia in ECT in depressive patients was significantly higher than that of other anesthetics (p<0.001). This significance persisted in both short-term (1-2 weeks) and moderate-term (3-4 weeks) treatment courses (all p<0.05). However, the side effect profiles and recovery time profiles were significantly worse in add-on ketamine anesthesia group than in control group. Our meta-analysis highlights the significantly higher antidepressive treatment effect of add-on ketamine in depressive patients receiving ECT compared to other anesthetics. However, clinicians need to take undesirable side effects into consideration when using add-on ketamine anesthesia in ECT in depressive patients. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

  4. Real-world data on eslicarbazepine acetate as add-on to antiepileptic monotherapy.

    PubMed

    Holtkamp, M; McMurray, R; Bagul, M; Sousa, R; Kockelmann, E

    2016-07-01

    To assess retention, tolerability, and safety, efficacy and effects on quality of life (QoL) of eslicarbazepine acetate (ESL) add-on treatment over 6 months in a real-world adult population with partial-onset seizures. This non-interventional, multicenter, prospective study was performed in eight European countries. Adult patients (n = 247) for whom the physician had decided to initiate ESL as add-on to an existing antiepileptic drug (AED) monotherapy were invited to participate. The study comprised three visits: baseline, and after 3 and 6 months. Data on ESL retention, efficacy, tolerability, safety, and QoL were collected. After 6 months, the retention rate of ESL was 82.2%, and 81.8% of patients reported a reduction of seizure frequency of at least 50%; 39.2% of patients reported seizure freedom at this time. The mean QOLIE-10 score improved from 2.9 (SD ± 0.8) at baseline to 2.1 (SD ± 0.8) after 6 months. 109 adverse events (AEs) were reported in 57 patients (26.0%); the majority were rated as related to ESL by the investigator and led to a discontinuation of ESL in 25 patients (11.4%). Eight patients (3.7%) suffered at least one serious AE. The most frequently reported AEs were dizziness, headache, convulsion, and fatigue. This study shows that ESL was well tolerated and efficacious as add-on therapy to one baseline AED. The use of ESL in patients less refractory than those included in previous clinical trials led to higher responder and seizure freedom rates. No new safety issues were observed. © 2016 Esai Europe Ltd. Acta Neurologica Scandinavica published by John Wiley & Sons Ltd.

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

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

  6. Alternative Fuels Data Center: Seattle Rideshare Fleet Adds EVs, Enjoys

    Science.gov Websites

    Fuels Data Center: Seattle Rideshare Fleet Adds EVs, Enjoys Success on Facebook Tweet about Alternative Fuels Data Center: Seattle Rideshare Fleet Adds EVs, Enjoys Success on Twitter Bookmark Alternative Fuels Data Center: Seattle Rideshare Fleet Adds EVs, Enjoys Success on Google Bookmark Alternative Fuels

  7. Effects of saxagliptin add-on therapy to insulin on blood glycemic fluctuations in patients with type 2 diabetes

    PubMed Central

    Li, Feng-fei; Jiang, Lan-lan; Yan, Reng-na; Zhu, Hong-hong; Zhou, Pei-hua; Zhang, Dan-feng; Su, Xiao-fei; Wu, Jin-dan; Ye, Lei; Ma, Jian-hua

    2016-01-01

    Abstract Background: To investigate whether saxagliptin add-on therapy to continuous subcutaneous insulin infusion (CSII) further improve blood glycemic control than CSII therapy in patients with newly diagnosed type 2 diabetes (T2D). Methods: This was a single-center, randomized, control, open-labeled trial. Newly diagnosed T2D patients were recruited between February 2014 and December 2015. Subjects were divided into saxagliptin add-on therapy to CSII group (n = 31) and CSII therapy group (n = 38). The treatment was maintained for 4 weeks. Oral glucose tolerance test was performed at baseline. Serum samples were obtained before and 30 and 120 minutes after oral administration for glucose, insulin, and C-peptide determination. Continuous glucose monitoring (CGM) was performed before and endpoint. Results: A total of 69 subjects were admitted. After 4-week therapy, CGM data showed that patients with saxagliptin add-on therapy exhibited further improvement of mean amplitude glycemic excursion (MAGE), the incremental area under curve of plasma glucose >7.8 and 10 mmol/L compared with that of control group. In addition, the hourly mean blood glucose concentrations, especially between 0000 and 0600 in patient with saxagliptin add-on therapy, were significantly lower compared with that of the control patients. Furthermore, patients in saxagliptin add-on group needed lower insulin dose to maintain euglycemic control. In addition, severe hypoglycemic episode was not observed from any group. Conclusion: Saxagliptin add-on therapy to insulin had the ability of further improve blood glycemic controlling, with lower insulin dose required by patients with T2D to maintain euglycemic controlling. PMID:27787387

  8. Aerodynamic drag reduction tests on a full-scale tractor-trailer combination with several add-on devices

    NASA Technical Reports Server (NTRS)

    Montoya, L. C.; Steers, L. L.

    1974-01-01

    Aerodynamic drag tests were performed on a conventional cab-over-engine tractor with a 45-foot trailer and five commercially available or potentially available add-on devices using the coast-down method. The tests ranged in velocity from approximately 30 miles per hour to 65 miles per hour and included some flow visualization. A smooth, level runway at Edwards Air Force Base was used for the tests, and deceleration measurements were taken with both accelerometers and stopwatches. An evaluation of the drag reduction results obtained with each of the five add-on devices is presented.

  9. The dissolution kinetics of industrial brine sludge wastes from a chlor-alkali industry as a sorbent for wet flue gas desulfurization (FGD).

    PubMed

    Masilela, E; Lerotholi, L; Seodigeng, T; Rutto, H

    2018-02-01

    The disposal of industrial brine sludge waste (IBSW) in chlor-alkali plants can be avoided by utilization of IBSW as a sorbent in wet flue gas desulfurization (FGD). The shrinking core model was used to determine the dissolution kinetics of IBSW, which is a vital step in wet FGD. The effects of solid-to-liquid ratio (m/v), temperature, pH, particle size, and stirring speed on the conversion and dissolution rate constant are determined. The conversion and dissolution rate constant decreases as the pH, particle size, and solid-to-liquid ratio are increased and increases as the temperature, concentration of acid, and stirring speed are increased. The sorbents before and after dissolution were characterized using x-ray fluorescence (XRF), x-ray diffraction (XRD), and scanning electron microscopy (SEM). An activation energy of 7.195 kJ/mol was obtained and the product layer diffusion model was found to be the rate-controlling step. The use of industrial brine sludge waste as an alternative sorbent in wet flue gas desulfurization can reduce the amounts of industrial wastes disposed of in landfills. This study has proved that the sorbent can contain up to 91% calcium carbonate and trace amounts of sulfate, magnesium, and so on. This can be used as new sorbent to reduce the amount of sulfur dioxide in the atmosphere and the by-product gypsum can be used in construction, as a plaster ingredient, as a fertilizer, and for soil conditioning. Therefore, the sorbent has both economic and environmental benefits.

  10. Effect of a Direct Instruction Flashcard System for Increasing the Performance of Basic Division Facts for a Middle School Student with ADD/OHI

    ERIC Educational Resources Information Center

    Bjordahl, Michaelyn; Talboy, Rebeccah; Neyman, Jennifer; McLaughlin, T. F.; Hoenike, Richelle

    2014-01-01

    The purpose of this study was to evaluate the effects of a Direct Instruction (DI) flashcard system on the mastery, accuracy and fluency of basic division math facts (numbers 0-12) for a seventh grade boy, diagnosed with Attention Deficit Disorder (ADD). The effects of the DI flashcard system were examined in a multiple baseline design across…

  11. Selenium Partitioning and Removal Across a Wet FGD Scrubber at a Coal-Fired Power Plant.

    PubMed

    Senior, Constance L; Tyree, Corey A; Meeks, Noah D; Acharya, Chethan; McCain, Joseph D; Cushing, Kenneth M

    2015-12-15

    Selenium has unique fate and transport through a coal-fired power plant because of high vapor pressures of oxide (SeO2) in flue gas. This study was done at full-scale on a 900 MW coal-fired power plant with electrostatic precipitator (ESP) and wet flue gas desulfurization (FGD) scrubber. The first objective was to quantify the partitioning of selenium between gas and condensed phases at the scrubber inlet and outlet. The second objective was to determine the effect of scrubber operation conditions (pH, mass transfer, SO2 removal) on Se removal in both particulate and vapor phases. During part of the testing, hydrated lime (calcium hydroxide) was injected upstream of the scrubber. Gas-phase selenium and particulate-bound selenium were measured as a function of particle size at the inlet and outlet of the scrubber. The total (both phases) removal of Se across the scrubber averaged 61%, and was enhanced when hydrated lime sorbent was injected. There was evidence of gas-to-particle conversion of selenium across the scrubber, based on the dependence of selenium concentration on particle diameter downstream of the scrubber and on thermodynamic calculations.

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

    PubMed

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

    2017-10-25

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

  13. Novel tunable dynamic tweezers using dark-bright soliton collision control in an optical add/drop filter.

    PubMed

    Teeka, Chat; Jalil, Muhammad Arif; Yupapin, Preecha P; Ali, Jalil

    2010-12-01

    We propose a novel system of the dynamic optical tweezers generated by a dark soliton in the fiber optic loop. A dark soliton known as an optical tweezer is amplified and tuned within the microring resonator system. The required tunable tweezers with different widths and powers can be controlled. The analysis of dark-bright soliton conversion using a dark soliton pulse propagating within a microring resonator system is analyzed. The dynamic behaviors of soliton conversion in add/drop filter is also analyzed. The control dark soliton is input into the system via the add port of the add/drop filter. The dynamic behavior of the dark-bright soliton conversion is observed. The required stable signal is obtained via a drop and throughput ports of the add/drop filter with some suitable parameters. In application, the trapped light/atom and transportation can be realized by using the proposed system.

  14. Experimental re-evaluation of flunarizine as add-on antiepileptic therapy.

    PubMed

    Thakur, Anamika; Sahai, A K; Thakur, J S

    2011-04-01

    Experimental studies have found several calcium channel blockers with anticonvulsant property. Flunarizine is one of the most potent calcium channel blockers, which has shown anticonvulsant effect against pentylenetetrazole (PTZ) and maximal electroshock (MES)-induced seizures. However, further experimental and clinical trials have shown varied results. We conducted a PTZ model experimental study to re-evaluate the potential of flunarizine for add-on therapy in the management of refractory epilepsy. Experiments were conducted in PTZ model involving Swiss strain mice. Doses producing seizures in 50% and 99% mice, i.e. CD(50) and CD(99) values of PTZ were obtained from the dose-response study. Animals received graded, single dose of sodium valproate (100-300 mg/kg), lamotrigine (3-12 mg/kg) and flunarizine (5-20 mg/kg), and then each group of mice was injected with CD(99) dose of PTZ (65mg/kg i.p.). Another group of mice received single ED(50) dose (dose producing seizure protection in 50% mice) of sodium valproate and flunarizine separately in left and right side of abdomen. Results were analysed by Kruskal-Wallis ANOVA on Ranks test. As compared to control, sodium valproate at 250 mg/kg and 300 mg/kg produced statistical significant seizure protection. At none of the pre-treatment dose levels of lamotrigine, the seizure score with PTZ differed significantly from that observed in the vehicle-treated group. Pre-treatment with flunarizine demonstrated dose-dependent decrease in the seizure score to PTZ administration. As compared to control group, flunarizine at 20 mg/kg produced statistical significant seizure protection. As combined use of sodium valproate and flunarizine has shown significant seizure protection in PTZ model, flunarizine has a potential for add-on therapy in refractory cases of partial seizures. It is therefore, we conclude that further experimental studies and multicenter clinical trials involving large sample size are needed to establish

  15. Chance of reimbursement for ADD-ON therapies in Poland and in the world - review of the reimbursement recommendations

    PubMed

    Borowiack, Ewa; Marzec, Magdalena; Nowotarska, Anna; Jarosz, Joanna; Orkisz, Agata; Prząda-Machno, Patrycja

    2018-01-01

    Oncology drugs combined with standard therapies (so-called add-on therapies, e.g. bevacizumab, palbociclib) often receive negative recommendations regarding the legitimacy of public financing, issued by government agencies responsible for their assessment, i.e. health technology assessment agencies. The aim of the study was to estimate the scale of the problem related to the reimbursement of add-on therapies used in the treatment of breast and genitourinary cancers in Poland and in the world. A multimodal approach was used to select add-on therapies. The reimbursement routes were analysed in 8 reference countries (Poland, Canada, England, Wales, France, Scotland, Australia, New Zealand). Based on a systematic search, data for breast and urogenital cancers were included. A total of 68 reimbursement documents for add-on therapies were identified. The analysis showed that in Poland, 20% of innovative schemes including add-on therapies should be reimbursed, while in the world the percentage of positive recommendations reaches 56%. It was observed that globally (including data for Poland) the chance for a favorable reimbursement recommendation for add-on therapies is 53%, with 29% being positive recommendations with limitations. In Poland, the majority of negative recommendations concern genitourinary cancers in comparison to breast cancer (83% vs 75%). Poland is at the head of the countries in terms of the number of negative reimbursement recommendations. Bearing in mind the world’s need of modifying the criteria for the evaluation of oncological therapies in the context of the possibility of their reimbursement, one should expect a change in the approach to the assessment of the legitimacy of financing innovative add-on therapies in Poland.

  16. Efficacy and Safety of Saxagliptin as Add-On Therapy in Type 2 Diabetes

    PubMed Central

    Neumiller, Joshua J.

    2014-01-01

    In Brief Combination therapy for type 2 diabetes using agents with complementary mechanisms of action may improve glycemic control to a greater extent than monotherapy and allow the use of lower doses of antihyperglycemic medications. Dipeptidyl peptidase-4 inhibitors, including saxagliptin, are recommended as add-on therapy to metformin and as part of two- or three-drug combinations in patients not meeting individualized glycemic goals with metformin alone or as part of a dual-therapy regimen. This article reviews the efficacy and safety of saxagliptin as an add-on therapy to metformin, glyburide, a thiazolidinedione, or insulin (with or without metformin) and as a component of triple therapy with metformin and a sulfonylurea. PMID:25646943

  17. Alternative Fuels Data Center: Ozinga Adds 14 Natural Gas Concrete Mixers

    Science.gov Websites

    to Its Fleet Ozinga Adds 14 Natural Gas Concrete Mixers to Its Fleet to someone by E-mail Share Alternative Fuels Data Center: Ozinga Adds 14 Natural Gas Concrete Mixers to Its Fleet on Facebook Tweet about Alternative Fuels Data Center: Ozinga Adds 14 Natural Gas Concrete Mixers to Its Fleet on Twitter Bookmark

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

    PubMed

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

    2016-06-03

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  20. The effect of bifocal add on accommodative lag in myopic children with high accommodative lag.

    PubMed

    Berntsen, David A; Mutti, Donald O; Zadnik, Karla

    2010-12-01

    To determine the effect of a bifocal add and manifest correction on accommodative lag in myopic children with high accommodative lag, who have been reported to have the greatest reduction in myopia progression with progressive addition lenses (PALs). Monocular accommodative lag to a 4-D Badal stimulus was measured on two occasions 6 months apart in 83 children (mean ± SD age, 9.9 ± 1.3 years) with high lag randomized to wearing single-vision lenses (SVLs) or PALs. Accommodative lag was measured with the following corrections: habitual, manifest, manifest with +2.00-D add, and habitual with +2.00-D add (6-month visit only). At baseline, accommodative lag was higher (1.72 ± 0.37 D; mean ± SD) when measured with manifest correction than with habitual correction (1.51 ± 0.50; P < 0.05). This higher lag with manifest correction correlated with a larger amount of habitual undercorrection at baseline (r = -0.29, P = 0.009). A +2.00-D add over the manifest correction reduced lag by 0.45 ± 0.34 D at baseline and 0.33 ± 0.38 D at the 6-month visit. Lag results at 6 months were not different between PAL and SVL wearers (P = 0.92). A +2.00-D bifocal add did not eliminate accommodative lag and reduced lag by less than 25% of the bifocal power, indicating that children mainly responded to a bifocal by decreasing accommodation. If myopic progression is substantial, measuring lag with full correction can overestimate the hyperopic retinal blur that a child most recently experienced. (ClinicalTrials.gov number, NCT00335049.).

  1. The Effect of Bifocal Add on Accommodative Lag in Myopic Children with High Accommodative Lag

    PubMed Central

    Mutti, Donald O.; Zadnik, Karla

    2010-01-01

    Purpose. To determine the effect of a bifocal add and manifest correction on accommodative lag in myopic children with high accommodative lag, who have been reported to have the greatest reduction in myopia progression with progressive addition lenses (PALs). Methods. Monocular accommodative lag to a 4-D Badal stimulus was measured on two occasions 6 months apart in 83 children (mean ± SD age, 9.9 ± 1.3 years) with high lag randomized to wearing single-vision lenses (SVLs) or PALs. Accommodative lag was measured with the following corrections: habitual, manifest, manifest with +2.00-D add, and habitual with +2.00-D add (6-month visit only). Results. At baseline, accommodative lag was higher (1.72 ± 0.37 D; mean ± SD) when measured with manifest correction than with habitual correction (1.51 ± 0.50; P < 0.05). This higher lag with manifest correction correlated with a larger amount of habitual undercorrection at baseline (r = −0.29, P = 0.009). A +2.00-D add over the manifest correction reduced lag by 0.45 ± 0.34 D at baseline and 0.33 ± 0.38 D at the 6-month visit. Lag results at 6 months were not different between PAL and SVL wearers (P = 0.92). Conclusions. A +2.00-D bifocal add did not eliminate accommodative lag and reduced lag by less than 25% of the bifocal power, indicating that children mainly responded to a bifocal by decreasing accommodation. If myopic progression is substantial, measuring lag with full correction can overestimate the hyperopic retinal blur that a child most recently experienced. (ClinicalTrials.gov number, NCT00335049.) PMID:20688729

  2. Antileukotriene Agents Versus Long-Acting Beta-Agonists in Older Adults with Persistent Asthma: A Comparison of Add-On Therapies.

    PubMed

    Altawalbeh, Shoroq M; Thorpe, Carolyn T; Zgibor, Janice C; Kane-Gill, Sandra; Kang, Yihuang; Thorpe, Joshua M

    2016-08-01

    To compare the effectiveness and cardiovascular safety of long-acting beta-agonists (LABAs) with those of leukotriene receptor antagonists (LTRAs) as add-on treatments in older adults with asthma already taking inhaled corticosteroids (ICSs). Retrospective cohort study. Medicare fee-for-service (FFS) claims (2009-10) for a 10% random sample of beneficiaries continuously enrolled in Parts A, B, and D in 2009. Medicare beneficiaries aged 66 and older continuously enrolled in FFS Medicare with Part D coverage with a diagnosis of asthma before 2009 treated exclusively with ICSs plus LABAs or ICSs plus LTRAs (N = 14,702). The augmented inverse propensity-weighted estimator was used to compare the effect of LABA add-on therapy with that of LTRA add-on therapy on asthma exacerbations requiring inpatient, emergency, or outpatient care and on cardiovascular (CV) events, adjusting for demographic characteristics, comorbidities, and county-level healthcare-access variables. The primary analysis showed that LTRA add-on treatment was associated with greater odds of asthma-related hospitalizations or emergency department visits (odds ratio (OR) = 1.4, P < .001), as well as outpatient exacerbations requiring oral corticosteroids or antibiotics (OR = 1.41, P < .001) than LABA treatment. LTRA add-on therapy was also less effective in controlling acute symptoms, as indicated by greater use of short-acting beta agonists (rate ratio = 1.58, P < .001). LTRA add-on treatment was associated with lower odds of experiencing a CV event than LABA treatment (OR = 0.86, P = .006). This study provides new evidence specific to older adults to help healthcare providers weigh the risks and benefits of these add-on treatments. Further subgroup analysis is needed to personalize asthma treatments in this high-risk population. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  3. Early add-on lacosamide in a real-life setting: results of the REALLY study.

    PubMed

    Villanueva, Vicente; Garcés, Mercedes; López-Gomáriz, Elena; Serratosa, José María; González-Giráldez, Beatriz; Parra, Jaime; Rodríguez-Uranga, Juan; Toledo, Manuel; López González, Francisco Javier; Bermejo, Pedro; Giner, Pau; Castillo, Ascensión; Molins, Albert; Campos, Dulce; Mauri, José Ángel; Muñoz, Rosario; Bonet, Macarena; Serrano-Castro, Pedro; del Villar, Ana; Saiz-Díaz, Rosa Ana

    2015-02-01

    Many patients with epilepsy are treated with antiepileptic drug (AED) polytherapy. Several factors influence the choice of early add-on therapy, and deciding on the most appropriate drug can be difficult. This study aimed to assess the efficacy and tolerability of lacosamide as early add-on therapy in patients with partial-onset seizures. REALLY (REtrospective study of lAcosamide as earLy add-on aLong one Year) was a multicenter, retrospective, 1-year, real-life study. Patients included were aged older than 16 years, had partial-onset seizures, and were treated with lacosamide as add-on therapy after one or two prior AEDs. Data were collected retrospectively from clinical records. The primary study objective was to assess the efficacy of lacosamide over 12 months (seizure-free and responder rates), and the secondary objective was to assess the tolerability of lacosamide at 3, 6, and 12 months [adverse events (AEs) and discontinuation]. One hundred and ninety-nine patients were enrolled in the study; 89 patients (44.7 %) had tried one AED and 110 patients (55.3 %) had tried two AEDs before lacosamide. At 12 months, the proportion of patients who were seizure free was 44.9 %, and 76 % of patients were responders. The seizure-free rate at 12 months for patients who had previously received one or two AEDs was 58 and 34.3 %, and the responder rate at 12 months was 83.0 and 70.4 %, respectively. The AE rate was 21.5 % at 3 months, 27.1 % at 6 months, and 31.2 % at 12 months, with 7.0 % of patients discontinuing treatment because of an AE. The most common AE reported was dizziness (11.6 %). Cryptogenic epilepsy, a higher number of prior AEDs, and the use of a sodium channel blocker at onset were associated with a worse outcome. The number of concomitant AEDs decreased over 1 year (Z = 5.89; p < 0.001). Twenty-two patients were converted to lacosamide monotherapy with at least one evaluation ≥6 months from the beginning of monotherapy conversion

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

    ERIC Educational Resources Information Center

    Riner, Phillip S.; Tanase, Madalina

    2014-01-01

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

  5. Adjunctive antiepileptic drugs in adult epilepsy: how the first add-on could be the last.

    PubMed

    Cretin, Benjamin; Hirsch, Edouard

    2010-05-01

    In adult epilepsies, incomplete seizure control under monotherapy affects approximately 20-25% of patients with idiopathic generalized epilepsies (IGE) and approximately 20-40% of patients with epilepsies with focal seizures (FE). The choice of an adjunctive therapy is therefore a common event. Efficacy studies of add-on anti-epileptic drugs for adult epilepsies--approved since the early 1990s until 2008--were reviewed. An exception was made for valproate. Efficacy studies give important clues for add-on drug choice but--beyond this--we encourage physicians to consider other parameters, especially co-morbidity(ies) and special situation(s). According to clinical and pharmacological data, an original, practical approach is proposed, by which decisions are based on three main criteria, which aim to optimize patients' seizure control and quality of life. The need for drugs that act not only on 'ictogenesis' but also on 'epileptogenesis' is also discussed briefly. Given the increasing disposal of anti-epileptic drugs, the choice of an add-on therapy appears to be partly based on subjective criteria (physician opinions and preferences). In fact, the selection criteria can be clarified as: treatment decisions rely not only on seizure type, efficacy and tolerability profiles but also on patient-related factors.

  6. The impact of wet flue gas desulfurization scrubbing on mercury emissions from coal-fired power stations.

    PubMed

    Niksa, Stephen; Fujiwara, Naoki

    2005-07-01

    This article introduces a predictive capability for Hg retention in any Ca-based wet flue gas desulfurization (FGD) scrubber, given mercury (Hg) speciation at the FGD inlet, the flue gas composition, and the sulphur dioxide (SO2) capture efficiency. A preliminary statistical analysis of data from 17 full-scale wet FGDs connects flue gas compositions, the extents of Hg oxidation at FGD inlets, and Hg retention efficiencies. These connections clearly signal that solution chemistry within the FGD determines Hg retention. A more thorough analysis based on thermochemical equilibrium yields highly accurate predictions for total Hg retention with no parameter adjustments. For the most reliable data, the predictions were within measurement uncertainties for both limestone and Mg/lime systems operating in both forced and natural oxidation mode. With the U.S. Environmental Protection Agency's (EPA) Information Collection Request (ICR) database, the quantitative performance was almost as good for the most modern FGDs, which probably conform to the very high SO2 absorption efficiencies assumed in the calculations. The large discrepancies for older FGDs are tentatively attributed to the unspecified SO2 capture efficiencies and operating temperatures and to the possible elimination of HCl in prescrubbers. The equilibrium calculations suggest that Hg retention is most sensitive to inlet HCl and O2 levels and the FGD temperature; weakly dependent on SO2 capture efficiency; and insensitive to HgCl2, NO, CA:S ratio, slurry dilution level in limestone FGDs, and MgSO3 levels in Mg/lime systems. Consequently, systems with prescrubbers to eliminate HCl probably retain less Hg than fully integrated FGDs. The analysis also predicts re-emission of Hg(O) but only for inlet O2 levels that are much lower than those in full-scale FGDs.

  7. [Toric add-on intraocular lenses for correction of high astigmatism after pseudophakic keratoplasty].

    PubMed

    Hassenstein, A; Niemeck, F; Giannakakis, K; Klemm, M

    2017-06-01

    Perforating keratoplasty shows good morphological results with a clear cornea; however, a limiting factor is often the resulting astigmatism, which cannot be corrected with either glasses or contact lenses (CL) in up to 20% of the patients. We retrospectively investigated 15 patients after pseudophakic perforating keratoplasty, who received implantation of toric add-on intraocular lenses (IOL) to correct astigmatism. The mean preoperative astigmatism of 6.5 diopter (dpt) could be reduced to a mean postoperative value of 1.0 dpt. The mean visual acuity could be improved from a preoperative value of sc <0.05 (cc 0.6) to a postoperative value of sc 0.4 (cc 0.63). There were no complications except for one case of a lens extension tear. Based on our good experiences we now provide toric add-on IOL to all patients with pseudophakic perforating keratoplasty when this cannot be corrected or only insufficiently corrected by conservative methods.

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  10. 40 CFR 63.3167 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... device operating limits during the performance test? 63.3167 Section 63.3167 Protection of Environment... Limitations § 63.3167 How do I establish the add-on control device operating limits during the performance.... (a) Thermal oxidizers. If your add-on control device is a thermal oxidizer, establish the operating...

  11. A common reference-based indirect comparison meta-analysis of eslicarbazepine versus lacosamide as add on treatments for focal epilepsy.

    PubMed

    Brigo, Francesco; Trinka, Eugen; Bragazzi, Nicola Luigi; Nardone, Raffaele; Milan, Alberto; Grillo, Elisabetta

    2016-11-01

    Eslicarbazepine acetate (ESL) and lacosamide (LCM) have recently emerged as add-on treatments in patients with focal epilepsy experiencing seizures despite adequate monotherapy. Both drugs enhance slow inactivation of voltage-gated sodium channels. To date no randomized controlled trial (RCT) has directly compared ESL with LCM as add-on treatments for focal epilepsy. Our aim was to indirectly compare the efficacy of ESL and LCM used as add-on treatments in patients with focal epilepsy using common reference-based indirect comparison meta-analysis. We systematically searched RCTs in which ESL or LCM has been used as add-on treatment in patients with focal epilepsy and compared with placebo. Following outcomes were considered: ≥50% reduction in seizure frequency; seizure freedom; treatment withdrawal for any reason; ≥25% increase in seizure frequency. Random-effects Mantel-Haenszel meta-analyses were performed to obtain odds ratios (ORs) for the efficacy of ESL or LCM versus placebo. Adjusted indirect comparisons were then made between ESL and LCM using the obtained results, and comparing the minimum and the highest effective recommended daily dose of each drug. Eight studies were included. Indirect comparisons adjusted for dose-effect showed no difference between ESL and LCM for responder rate, seizure freedom, and withdrawal rates. We could not assess increase in seizure frequency due to lack of data. Indirect comparisons failed to find a significant difference in efficacy between add-on ESL and LCM in patients with focal epilepsy. Direct head-to-head clinical trials comparing ESL with LCM as add-on antiepileptic treatment are required to confirm these results. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Influence of Flue Gas Desulfurization Gypsum Amendments on Heavy Metal Distribution in Reclaimed Sodic Soils.

    PubMed

    Chen, Qun; Wang, Shujuan; Li, Yan; Zhang, Ning; Zhao, Bo; Zhuo, Yuqun; Chen, Changhe

    2015-06-01

    Although flue gas desulfurization (FGD) gypsum has become an effective soil amendment for sodic soil reclamation, it carries extra heavy metal contamination into the soil environment. The fate of heavy metals introduced by FGD gypsum in sodic or saline-alkali soils is still unclear. This work aims to investigate the effects of FGD gypsum addition on the heavy metal distributions in a sodic soil. Original soil samples were collected from typical sodic land in north China. Soil column leaching tests were conducted to investigate the influence of FGD gypsum addition on the soil properties, especially on distribution profiles of the heavy metals (Pb, Cd, Cr, As, and Hg) in the soil layers. Results showed that pH, electrical conductivity, and exchangeable sodium percentage in amended soils were significantly reduced from 10.2 to 8.46, 1.8 to 0.2 dS/m, and 18.14% to 1.28%, respectively. As and Hg concentrations in the soils were found to be positively correlated with FGD gypsum added. The amount of Hg in the leachate was positively correlated with FGD gypsum application ratio, whereas a negative correlation was observed between the Pb concentration in the leachate and the FGD gypsum ratio. Results revealed that heavy metal concentrations in soils complied well with Environmental Quality Standard for Soils in China (GB15618-1995). This work helps to understand the fate of FGD gypsum-introduced heavy metals in sodic soils and provides a baseline for further environmental risk assessment associated with applying FGD gypsum for sodic soil remediation.

  13. Influence of Flue Gas Desulfurization Gypsum Amendments on Heavy Metal Distribution in Reclaimed Sodic Soils

    PubMed Central

    Chen, Qun; Wang, Shujuan; Li, Yan; Zhang, Ning; Zhao, Bo; Zhuo, Yuqun; Chen, Changhe

    2015-01-01

    Abstract Although flue gas desulfurization (FGD) gypsum has become an effective soil amendment for sodic soil reclamation, it carries extra heavy metal contamination into the soil environment. The fate of heavy metals introduced by FGD gypsum in sodic or saline–alkali soils is still unclear. This work aims to investigate the effects of FGD gypsum addition on the heavy metal distributions in a sodic soil. Original soil samples were collected from typical sodic land in north China. Soil column leaching tests were conducted to investigate the influence of FGD gypsum addition on the soil properties, especially on distribution profiles of the heavy metals (Pb, Cd, Cr, As, and Hg) in the soil layers. Results showed that pH, electrical conductivity, and exchangeable sodium percentage in amended soils were significantly reduced from 10.2 to 8.46, 1.8 to 0.2 dS/m, and 18.14% to 1.28%, respectively. As and Hg concentrations in the soils were found to be positively correlated with FGD gypsum added. The amount of Hg in the leachate was positively correlated with FGD gypsum application ratio, whereas a negative correlation was observed between the Pb concentration in the leachate and the FGD gypsum ratio. Results revealed that heavy metal concentrations in soils complied well with Environmental Quality Standard for Soils in China (GB15618-1995). This work helps to understand the fate of FGD gypsum-introduced heavy metals in sodic soils and provides a baseline for further environmental risk assessment associated with applying FGD gypsum for sodic soil remediation. PMID:26064038

  14. 77 FR 3712 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Regional Haze

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... equal incremental change in visibility perceived by the human eye. Most people can detect a change in... desulfurization (FGD), semi-dry FGD, and over-fire air (OFA) with a sorbent injection system (SIS). Ohio and MPRO... on up to 7 days a year. Ohio selected semi-dry FGD as the BART SO 2 control, which is expected to...

  15. Effects of saxagliptin add-on therapy to insulin on blood glycemic fluctuations in patients with type 2 diabetes: A randomized, control, open-labeled trial.

    PubMed

    Li, Feng-Fei; Jiang, Lan-Lan; Yan, Reng-Na; Zhu, Hong-Hong; Zhou, Pei-Hua; Zhang, Dan-Feng; Su, Xiao-Fei; Wu, Jin-Dan; Ye, Lei; Ma, Jian-Hua

    2016-10-01

    To investigate whether saxagliptin add-on therapy to continuous subcutaneous insulin infusion (CSII) further improve blood glycemic control than CSII therapy in patients with newly diagnosed type 2 diabetes (T2D). This was a single-center, randomized, control, open-labeled trial. Newly diagnosed T2D patients were recruited between February 2014 and December 2015. Subjects were divided into saxagliptin add-on therapy to CSII group (n = 31) and CSII therapy group (n = 38). The treatment was maintained for 4 weeks. Oral glucose tolerance test was performed at baseline. Serum samples were obtained before and 30 and 120 minutes after oral administration for glucose, insulin, and C-peptide determination. Continuous glucose monitoring (CGM) was performed before and endpoint. A total of 69 subjects were admitted. After 4-week therapy, CGM data showed that patients with saxagliptin add-on therapy exhibited further improvement of mean amplitude glycemic excursion (MAGE), the incremental area under curve of plasma glucose >7.8 and 10 mmol/L compared with that of control group. In addition, the hourly mean blood glucose concentrations, especially between 0000 and 0600 in patient with saxagliptin add-on therapy, were significantly lower compared with that of the control patients. Furthermore, patients in saxagliptin add-on group needed lower insulin dose to maintain euglycemic control. In addition, severe hypoglycemic episode was not observed from any group. Saxagliptin add-on therapy to insulin had the ability of further improve blood glycemic controlling, with lower insulin dose required by patients with T2D to maintain euglycemic controlling.

  16. Efficacy and safety of lacosamide as first add-on or later adjunctive treatment for uncontrolled partial-onset seizures: A multicentre open-label trial.

    PubMed

    Zadeh, Wendy Waldman; Escartin, Antonio; Byrnes, William; Tennigkeit, Frank; Borghs, Simon; Li, Ting; Dedeken, Peter; De Backer, Marc

    2015-09-01

    To evaluate the efficacy and safety of lacosamide administered as either first add-on or later add-on antiepileptic drug (AED) therapy for patients with uncontrolled partial-onset seizures (POS). In this open-label, multicentre trial, patients with POS initiated oral lacosamide (titrated to 400 mg/day) either as add-on to first AED monotherapy, or as later add-on to 1-3 concomitant AEDs after ≥ 2 previous AEDs. The primary efficacy variable was the proportion of patients achieving seizure freedom for the first 12 weeks of the 24-week Maintenance Phase. 456 patients received ≥ 1 dose of lacosamide (96 as first add-on, 360 as later add-on). In the first add-on cohort, 27/72 (37.5%) patients completed 12 weeks treatment and remained seizure-free; 18/68 (26.5%) remained seizure-free after 24 weeks. 64/91 (70.3%) patients achieved ≥ 50% reduction in seizure frequency during maintenance treatment. This was accompanied by a mean 7.1 ± 16.00 point improvement from Baseline in the Quality of Life Inventory in Epilepsy (QOLIE-31-P) total score for 24-week completers, with improvement reported in all subscales. Most common treatment-emergent adverse events (TEAEs) were dizziness (31.3%) and headache (13.5%). In the later add-on cohort, 39/261 (14.9%) and 29/249 (11.6%) patients remained seizure-free after completing 12 and 24 weeks' treatment, respectively. 178/353 (50.4%) patients achieved ≥ 50% reduction in seizure frequency during maintenance treatment. Mean change in QOLIE-31-P total score was 4.8 ± 14.74 points among 24-week completers. Common TEAEs were dizziness (33.6%), somnolence (15.0%) and headache (11.4%). Lacosamide initiated as first add-on treatment was efficacious and well tolerated in patients with uncontrolled POS. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Memantine add-on to antipsychotic treatment for residual negative and cognitive symptoms of schizophrenia: a meta-analysis.

    PubMed

    Kishi, Taro; Matsuda, Yuki; Iwata, Nakao

    2017-07-01

    We examined whether memantine add-on to antipsychotic treatment is beneficial in schizophrenia treatment. This systematic review and meta-analysis aimed to achieve stronger evidence on the efficacy and safety of memantine add-on for treating schizophrenia. We analyzed double-blind, randomized, placebo-controlled trials of memantine add-on treatment in schizophrenia patients receiving antipsychotics. The primary outcomes were amelioration of negative symptoms and all-cause discontinuation. Dichotomous outcomes are presented as risk ratios (RRs), and continuous outcomes are presented as mean differences (MDs) or standardized mean differences (SMDs). Eight studies (n = 448) were included. Although memantine add-on treatment was superior to placebo for ameliorating negative symptoms (SMD = -0.96, p = 0.006, I 2  = 88%; N = 7, n = 367) in the Positive and Negative Syndrome Scale general subscale (MD = -1.62, p = 0.002, I 2  = 0%; N = 4, n = 151) and Mini-Mental Status Examination score (MD = -3.07, p < 0.0001, I 2  = 21%; N = 3, n = 83), there were no statistically significant differences in the amelioration of overall (SMD = -0.75, p = 0.06, I 2  = 86%; N = 5, n = 271), positive (SMD = -0.46, p = 0.07, I 2  = 80%; N = 7, n = 367), and depressive symptoms (SMD = -0.127, p = 0.326, I 2  = 0%; N = 4, n = 201); all-cause discontinuation (RR = 1.34, p = 0.31, I 2  = 0%; N = 8, n = 448); and individual adverse events (fatigue, dizziness, headache, nausea, constipation) between the groups. For negative symptoms, the significant heterogeneity disappeared when risperidone studies alone were considered (I 2  = 0%). However, memantine add-on treatment remained superior to placebo (SMD = -1.29, p = 0.00001). Meta-regression analysis showed that patient age was associated with memantine-associated amelioration of negative symptoms (slope = 0.171, p = 0.0206). Memantine add-on treatment may be

  18. Application Potential of Energy Systems at Navy Sites. Volume I. Methodology and Results.

    DTIC Science & Technology

    1980-01-01

    see Table 5-4). Flue gas desulfurization (FGD), electrostatic precipitators (ESP), and staged combustion (SC) were selected to control SOX...energy sources are required to meet proposed Federal Stationary Source Standards. Flue gas desulfurization (FGD), electrostatic precipitators (ESP...pollution control equipment follows: * FGD -- Flue gas from the furnace is passed counter-currently through a limestone (CaCO3) slurry which reacts with

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

    NASA Astrophysics Data System (ADS)

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

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

  20. Influence Of Coal Combustion Flue Gas Desulfurization Waste On Element Uptake By Maize (Zea Mays L.)

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

    ANNA, KNOX

    2005-01-10

    A greenhouse study was conducted to determine the effect of coal combustion flue gas desulfurization (FGD) waste from a coal combustion electric power facility on element uptake by maize (Zea mays L.). Unweathered FGD was applied to an Orangeburg Series (Typic Paleudult) soil with an initial soil pH salt of 4.90. The FGD was added at 0, 1, 2, 4, 6, 8, and 10 per cent by weight. The test plant, maize, was harvested after 6 weeks of growth. Within 56 days of the FGD application, all rates of FGD significantly increased pH in the soil and the soil leachatemore » above 6.0. The elemental concentration of the maize tissues indicated a characteristic elevation of B, Se, Mo, and As. However, no visual symptoms of toxicity of B or other elements in plants were observed. Increasing level of FGD caused a steady decline in dry weight, with the highest treatment producing plants which had approximately half the biomass of the control plants. Due to elevated concentrations of B and other elements and due to adverse yield effects measured on plants, unweathered FGD would not be a suitable amendment for 6-week old maize on this soil.« less

  1. Neural Biomarkers for Dyslexia, ADHD, and ADD in the Auditory Cortex of Children.

    PubMed

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

    2016-01-01

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

  2. Neural Biomarkers for Dyslexia, ADHD, and ADD in the Auditory Cortex of Children

    PubMed Central

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

    2016-01-01

    Dyslexia, attention deficit hyperactivity disorder (ADHD), and attention deficit disorder (ADD) show distinct clinical profiles that may include auditory and language-related impairments. Currently, an objective brain-based diagnosis of these developmental disorders is still unavailable. We investigated the neuro-auditory systems of dyslexic, ADHD, ADD, and age-matched control children (N = 147) using neuroimaging, magnetencephalography and psychoacoustics. All disorder subgroups exhibited an oversized left planum temporale and an abnormal interhemispheric asynchrony (10–40 ms) of the primary auditory evoked P1-response. Considering right auditory cortex morphology, bilateral P1 source waveform shapes, and auditory performance, the three disorder subgroups could be reliably differentiated with outstanding accuracies of 89–98%. We therefore for the first time provide differential biomarkers for a brain-based diagnosis of dyslexia, ADHD, and ADD. The method allowed not only allowed for clear discrimination between two subtypes of attentional disorders (ADHD and ADD), a topic controversially discussed for decades in the scientific community, but also revealed the potential for objectively identifying comorbid cases. Noteworthy, in children playing a musical instrument, after three and a half years of training the observed interhemispheric asynchronies were reduced by about 2/3, thus suggesting a strong beneficial influence of music experience on brain development. These findings might have far-reaching implications for both research and practice and enable a profound understanding of the brain-related etiology, diagnosis, and musically based therapy of common auditory-related developmental disorders and learning disabilities. PMID:27471442

  3. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  4. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I determine the outlet THC.../outlet Concentration Option § 63.3555 How do I determine the outlet THC emissions and add-on control... section to determine either the outlet THC emissions or add-on control device emission destruction or...

  5. Hybrid optical fiber add-drop filter based on wavelength dependent light coupling between micro/nano fiber ring and side-polished fiber

    PubMed Central

    Yu, Jianhui; Jin, Shaoshen; Wei, Qingsong; Zang, Zhigang; Lu, Huihui; He, Xiaoli; Luo, Yunhan; Tang, Jieyuan; Zhang, Jun; Chen, Zhe

    2015-01-01

    In this paper, we report our experimental study on directly coupling a micro/nano fiber (MNOF) ring with a side-polished fiber(SPF). As a result of the study, the behavior of an add-drop filter was observed. The demonstrated add-drop filter explored the wavelength dependence of light coupling between a MNOF ring and a SPF. The characteristics of the filter and its performance dependence on the MNOF ring diameter were investigated experimentally. The investigation resulted in an empirically obtained ring diameter that showed relatively good filter performance. Since light coupling between a (MNOF) and a conventional single mode fiber has remained a challenge in the photonic integration community, the present study may provide an alternative way to couple light between a MNOF device and a conventional single mode fiber based device or system. The hybridization approach that uses a SPF as a platform to integrate a MNOF device may enable the realization of other all-fiber optical hybrid devices. PMID:25578467

  6. Hybrid optical fiber add-drop filter based on wavelength dependent light coupling between micro/nano fiber ring and side-polished fiber

    NASA Astrophysics Data System (ADS)

    Yu, Jianhui; Jin, Shaoshen; Wei, Qingsong; Zang, Zhigang; Lu, Huihui; He, Xiaoli; Luo, Yunhan; Tang, Jieyuan; Zhang, Jun; Chen, Zhe

    2015-01-01

    In this paper, we report our experimental study on directly coupling a micro/nano fiber (MNOF) ring with a side-polished fiber(SPF). As a result of the study, the behavior of an add-drop filter was observed. The demonstrated add-drop filter explored the wavelength dependence of light coupling between a MNOF ring and a SPF. The characteristics of the filter and its performance dependence on the MNOF ring diameter were investigated experimentally. The investigation resulted in an empirically obtained ring diameter that showed relatively good filter performance. Since light coupling between a (MNOF) and a conventional single mode fiber has remained a challenge in the photonic integration community, the present study may provide an alternative way to couple light between a MNOF device and a conventional single mode fiber based device or system. The hybridization approach that uses a SPF as a platform to integrate a MNOF device may enable the realization of other all-fiber optical hybrid devices.

  7. Hybrid optical fiber add-drop filter based on wavelength dependent light coupling between micro/nano fiber ring and side-polished fiber.

    PubMed

    Yu, Jianhui; Jin, Shaoshen; Wei, Qingsong; Zang, Zhigang; Lu, Huihui; He, Xiaoli; Luo, Yunhan; Tang, Jieyuan; Zhang, Jun; Chen, Zhe

    2015-01-12

    In this paper, we report our experimental study on directly coupling a micro/nano fiber (MNOF) ring with a side-polished fiber(SPF). As a result of the study, the behavior of an add-drop filter was observed. The demonstrated add-drop filter explored the wavelength dependence of light coupling between a MNOF ring and a SPF. The characteristics of the filter and its performance dependence on the MNOF ring diameter were investigated experimentally. The investigation resulted in an empirically obtained ring diameter that showed relatively good filter performance. Since light coupling between a (MNOF) and a conventional single mode fiber has remained a challenge in the photonic integration community, the present study may provide an alternative way to couple light between a MNOF device and a conventional single mode fiber based device or system. The hybridization approach that uses a SPF as a platform to integrate a MNOF device may enable the realization of other all-fiber optical hybrid devices.

  8. A low-complexity add-on score for protein remote homology search with COMER.

    PubMed

    Margelevicius, Mindaugas

    2018-06-15

    Protein sequence alignment forms the basis for comparative modeling, the most reliable approach to protein structure prediction, among many other applications. Alignment between sequence families, or profile-profile alignment, represents one of the most, if not the most, sensitive means for homology detection but still necessitates improvement. We aim at improving the quality of profile-profile alignments and the sensitivity induced by them by refining profile-profile substitution scores. We have developed a new score that represents an additional component of profile-profile substitution scores. A comprehensive evaluation shows that the new add-on score statistically significantly improves both the sensitivity and the alignment quality of the COMER method. We discuss why the score leads to the improvement and its almost optimal computational complexity that makes it easily implementable in any profile-profile alignment method. An implementation of the add-on score in the open-source COMER software and data are available at https://sourceforge.net/projects/comer. The COMER software is also available on Github at https://github.com/minmarg/comer and as a Docker image (minmar/comer). Supplementary data are available at Bioinformatics online.

  9. Fate of Mercury in Synthetic Gypsum Used for Wallboard Production

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

    Jessica Sanderson; Gary M. Blythe; Mandi Richardson

    2006-12-01

    This report presents and discusses results from Task 6 of the study 'Fate of Mercury in Synthetic Gypsum Used for Wallboard Production,' performed at a full-scale commercial wallboard plant. Synthetic gypsum produced by wet flue gas desulfurization (FGD) systems on coal-fired power plants is commonly used in the manufacture of wallboard. This practice has long benefited the environment by recycling the FGD gypsum byproduct, which is becoming available in increasing quantities, decreasing the need to landfill this material, and increasing the sustainable design of the wallboard product. However, new concerns have arisen as recent mercury control strategies involve the capturemore » of mercury in FGD systems. The objective of this study is to determine whether any mercury is released into the atmosphere when the synthetic gypsum material is used as a feedstock for wallboard production. The project is being co-funded by the U.S. DOE National Energy Technology Laboratory (Cooperative Agreement DE-FC26-04NT42080), USG Corporation, and EPRI. USG Corporation is the prime contractor, and URS Group is a subcontractor. The project scope now includes six discrete tasks, each conducted at various USG wallboard plants using synthetic gypsum from different FGD systems. The project was originally composed of five tasks, which were to include (1) a baseline test, then variations representing differing power plant: (2) emissions control configurations, (3) treatment of fine gypsum particles, (4) coal types, and (5) FGD reagent types. However, Task 5, which was to include testing with an alternate FGD reagent, could not be conducted as planned. Instead, Task 5 was conducted at conditions similar to Task 3, although with gypsum from an alternate FGD system. Subsequent to conducting Task 5 under these revised conditions, an opportunity arose to test gypsum produced at the same FGD system, but with an additive (Degussa Corporation's TMT-15) being used in the FGD system. TMT-15 was

  10. Effects of add-on treatment with sitagliptin on narrowing the range of glucose fluctuations in Japanese type 2 diabetes patients receiving insulin therapy.

    PubMed

    Mori, Yutaka; Taniguchi, Yukiko; Miyazaki, Shigeru; Yokoyama, Junichi; Utsunomiya, Kazunori

    2013-03-01

    In an earlier continuous glucose monitoring (CGM)-based study, we reported that sitagliptin not only reduced 24-h mean glucose levels but also suppressed postprandial glucose increases, thus reducing the range of glycemic fluctuations in type 2 diabetes patients. In this study, we investigated whether sitagliptin might provide similar benefits in type 2 diabetes patients receiving insulin therapy by using CGM. The study included a total of 13 type 2 diabetes patients in whom stable glycemic control had been achieved after admission for glycemic control. Insulin regimens used included long-acting insulin preparations once daily in four patients and biphasic insulin preparations twice daily in nine, with the daily insulin dose being 19.0±12.7 U. During the CGM-based study, the patients were given insulin therapy alone on Days 1 and 2 and were given sitagliptin 50 mg/day as add-on treatment on Days 3-6, with their daily insulin doses maintained. The add-on treatment with sitagliptin led to significant decreases in 24-h mean glucose levels and SDs of 288 glucose levels measured by CGM for 24 h, as well as in the indices for magnitude of glucose variability and proportion of time in hyperglycemia, compared with insulin therapy alone (P<0.01), whereas there was no significant change seen in regard to the proportion of time in hypoglycemia with or without add-on treatment with sitagliptin. This CGM-based study clearly demonstrated that insulin therapy alone, whether with long-acting or biphasic insulin preparations, does not provide adequate glycemic control in type 2 diabetes patients. In contrast, add-on sitagliptin was shown to narrow the range of 24-h glucose fluctuations in these patients, suggesting that add-on treatment with sitagliptin is effective for postprandial glucose control in type 2 diabetes patients receiving insulin therapy.

  11. Landslide remediation on Ohio State Route 83 using clean coal combustion by-products

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

    Payette, R.; Chen, Xi You; Wolfe, W.

    1995-12-31

    The disposal of flue gas desulfurization (FGD) by-products has become a major concern as issues of emission cleansing and landfill costs continue to rise. Laboratory tests conducted at the Ohio State University have shown that dry FGD by-products possess certain engineering properties that have proven desirable in a number of construction uses. As a follow on to the laboratory program, a field investigation into engineering uses of dry FGD wastes was initiated. In the present work, an FGD by-product was used to reconstruct the failed portion of a highway embankment. The construction process and the stability of the repaired embankmentmore » are examined.« less

  12. FGD gypsum issues

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

    Buecker, B.

    2007-11-15

    The article first explains how gypsum by-product is produced in flue gas desulfurization systems in coal-fired power plants. It goes on to talk about the main markets for gypsum - wallboard manufacture (Plaster of Paris), cement production and soil stabilization. In the USA in 2006 41.6 million tons of gypsum was used by manufacturers of wallboard and plaster products, 3.0 mt for cement production and 1.1 mt for agricultural purposes. A method of determining the by-product gypsum content by thermogravimetric analysis is outlined. 4 refs., 1 fig.

  13. COMPUTERIZED FGD BYPRODUCT PRODUCTION AND MARKETING SYSTEM: USERS MANUAL

    EPA Science Inventory

    The users manual describes a computerized system--consisting of a number of integrated programs, models, and data bases--that has been developed to compare the costs of power plant strategies designed to meet clean air regulations. It describes the data bases, programs, and proce...

  14. DISPOSAL OF BY-PRODUCTS FROM NONREGENERABLE FLUE GAS DESULFURIZATION SYSTEMS

    EPA Science Inventory

    The report gives results of a 4-year study to determine environmentally sound methods for disposing of wastes from nonregenerable flue gas desulfurization (FGD) systems. Data presented incorporates results obtained during the fourth year with material from report EPA-600/7-77-052...

  15. Discovering Focus: Helping Students with ADD (Attention Deficit Disorder)

    ERIC Educational Resources Information Center

    Valkenburg, Jim

    2012-01-01

    Attention Deficit Disorder (ADD) is a neurological disorder which effects learning and that has a confusing set of diagnostic symptoms and an even more confusing set of remedies ranging from medication to meditation to nothing at all. Current neurological research suggests, however, that there are strategies that the individual with ADD can use to…

  16. Randomized, Double-Blind Trial of Triple Therapy With Saxagliptin Add-on to Dapagliflozin Plus Metformin in Patients With Type 2 Diabetes.

    PubMed

    Matthaei, Stephan; Catrinoiu, Doina; Celiński, Aleksander; Ekholm, Ella; Cook, William; Hirshberg, Boaz; Chen, Hungta; Iqbal, Nayyar; Hansen, Lars

    2015-11-01

    The objective of this study was to assess the efficacy and safety of triple therapy with saxagliptin add-on versus placebo add-on to dapagliflozin plus metformin in adults with type 2 diabetes. Patients on stable metformin (≥1,500 mg/day) for ≥8 weeks with glycated hemoglobin (HbA1c) 8.0-11.5% (64-102 mmol/mol) at screening received open-label dapagliflozin (10 mg/day) plus metformin immediate release (IR) for 16 weeks. Patients with inadequate glycemic control (HbA1c 7-10.5% [53-91 mmol/mol]) were then randomized to receive placebo (n = 153) or saxagliptin 5 mg/day (n = 162) in addition to background dapagliflozin plus metformin IR. The primary efficacy end point was change in HbA1c from baseline to week 24. There was a significantly greater reduction in HbA1c at 24 weeks with saxagliptin add-on (-0.51% [-5.6 mmol/mol]) versus placebo (-0.16% [-1.7 mmol/mol]) add-on to dapagliflozin plus metformin (difference, -0.35% [95% CI -0.52% to -0.18%] and -3.8 [-5.7 to -2.0 mmol/mol], respectively; P < 0.0001). Reductions in fasting plasma glucose and 2-h postprandial glucose were similar between treatment arms. A larger proportion of patients achieved HbA1c <7% (53 mmol/mol) with saxagliptin add-on (35.3%) versus placebo add-on (23.1%) to dapagliflozin plus metformin. Adverse events were similar between treatment groups. Episodes of hypoglycemia were infrequent in both treatment arms, and there were no episodes of major hypoglycemia. Triple therapy with the addition of saxagliptin to dapagliflozin plus metformin was well tolerated and produced significant improvements in HbA1c in patients with type 2 diabetes inadequately controlled with dapagliflozin plus metformin. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  17. Alternative Deployment Duration - Reserve Component (ADD-RC)

    DTIC Science & Technology

    2003-02-01

    Other Personnel Equipment & S 8,375.00 1.50 12,562.50 2.00 16,750.00 Medical Support/Health Services 158.50...VAARNG) CPT Zana , 29th Infantry Division (VAARNG) ADD-RC A-1 CAA-R-01-67 (THIS PAGE INTENTIONALLY... Medical , Signal) as well as on availability of qualified instructors - Current training requirements being fulfilled through an additional cycle of

  18. Concepts of Resilience for Coastal Systems

    DTIC Science & Technology

    2015-11-06

    respond to, and adapt to changing conditions and to withstand and recover rapidly from disruptions with minimal damage.” Urban Land Institute, “After...AR5/images/uploads/WGIIAR5-Glossary_FGD.pdf “The capacity of a social- ecological system to cope with a hazardous event or disturbance, responding or...dunes, wetlands Ecological Resilience The capacity of a system to absorb disturbance and reorganize while undergoing change Ecological Resilience

  19. Experimental Investigation of the Influence of a Reverse Delta Type Add-on Device on the Flap-tip Vortex of a Wing

    NASA Astrophysics Data System (ADS)

    Altaf, A.; Thong, T. B.; Omar, A. A.; Asrar, W.

    2017-03-01

    Particle Image Velocimetry was used in a low speed wind tunnel to investigate the effect of interactions of vortices produced by an outboard flap-tip of a half wing (NACA 23012 in landing configuration) and a slender reverse delta type add-on device, placed in the proximity of the outboard flap-tip, on the upper surface of the half wing. This work investigates the characteristics of the vortex interactions generated downstream in planes perpendicular to the free stream direction at a chord-based Reynolds number of Rec=2.74×105 . It was found that the add-on device significantly reduces the tangential velocity magnitude and enlarges the vortex core of the resultant vortex by up to 36.1% and 36.8%, respectively.

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

    NASA Astrophysics Data System (ADS)

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

    2008-04-01

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

  1. Baclofen add-on to citalopram in treatment of posttraumatic stress disorder.

    PubMed

    Manteghi, Ali Akhoundpour; Hebrani, Paria; Mortezania, Mohammad; Haghighi, Mehri Baghban; Javanbakht, Arash

    2014-04-01

    Posttraumatic stress disorder (PTSD) is a chronic disabling illness, resulting from exposure to extreme traumatic event. Although different pharmacologic agents are suggested for treatment of PTSD, none have been completely effective in eliminating symptoms. The purpose of this study was to assess the use of baclofen as an add-on to citalopram in treatment of PTSD. In this double-blind clinical trial, 40 Iranian combat veterans with PTSD were randomly assigned to 2 groups. The first group received a combination treatment of 20 to 60 mg/d citalopram and 40 mg/d baclofen, and the second group received 20 to 60 mg/d citalopram plus placebo. Symptom severity was assessed by Clinician-Administered PTSD Scale at the beginning of the study and after 2, 4, 6, and 8 weeks. Global Assessment of Functioning and Hamilton Rating Scale for Anxiety and Depression were also used at the same periods. Data were analyzed with independent t test and paired t test using SPSS software version 13 (IBM, Armonk, NY). Twenty-three male patients (baclofen group, 13 patients; placebo group, 10 patients) completed the study. Dropout from the treatment was not caused by adverse effects of the new medications in any of the subjects. Baclofen group showed significantly larger improvement in Clinician-Administered PTSD Scale total (P = 0.040), hyperarousal (P = 0.020), and avoidance (0.020) scores, Global Assessment of Functioning score (0.001), depression (P = 0.000), and anxiety (P = 0.000) after 8 weeks of treatment. No intergroup difference was found in improvement of reexperience symptoms (P = 0.740). Baclofen showed to be an effective add-on to selective serotonin reuptake inhibitors in treatment of PTSD for better symptom recovery and functional improvement.

  2. Distribution and progression of add power among people in need of near correction.

    PubMed

    Han, Xiaotong; Lee, Pei Ying; Liu, Chi; He, Mingguang

    2018-04-16

    This study helps to better understand the need and trend in presbyopic add power in the aging society. Distribution and progression of presbyopic add power in East Asian population is largely unknown. Prospective cohort study. About 303 participants from a population-based study of residents aged 35 years and older in Guangzhou, China. Visual acuity (VA) test and non-cycloplegic automated refraction were performed at baseline in 2008 and the 6-year follow-up per standardized protocol. Participants with presenting near VA ≤ 20/40 underwent distance subjective refraction and add power measurement by increasing plus lens at a standard distance of 40 cm at each visit. Add power at baseline and follow-ups. Mean (standard deviation) age of the study participants was 57.6 (11.1) years and 50.2% were female. The mean add power at baseline was 1.43, 1.73, 2.03 and 2.20 diopters (D) for individuals in the age groups of 35-44, 45-54, 55-64 and 65+ years, respectively. Participants with older age and lower educational level had significantly higher add power requirements (P < 0.001). The overall 6-year increase in add power was 0.15D (95% CI: 0.06 to 0.25), and was smaller in myopic subjects (P = 0.03). Baseline age and add power, but not changes in biometric factors, were associated with longitudinal change in add power (P < 0.001). Distribution and progression of add power in Chinese was different from that previously suggested by Caucasian studies. More studies are needed to establish up-to-date age-related add power prescription norms for population of different ethnicities. © 2018 Royal Australian and New Zealand College of Ophthalmologists.

  3. Space station systems technology study (add-on task). Volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    1985-01-01

    System concepts were characterized in order to define cost versus benefits for autonomous functional control and for controls and displays for OMV, OTV, and spacecraft servicing and operation. The attitude control topic focused on characterizing the Space Station attitude control problem through simulation of control system responses to structural disturbances. The first two topics, mentioned above, focused on specific technology items that require advancement in order to support an early 1990s initial launch of a Space Station, while the attitude control study was an exploration of the capability of conventional controller techniques.

  4. Early add-on treatment vs alternative monotherapy in patients with partial epilepsy.

    PubMed

    Semah, Franck; Thomas, Pierre; Coulbaut, Safia; Derambure, Philippe

    2014-06-01

    The aim of this study was to evaluate the impact of two different therapeutic strategies in patients with partial seizures who were intractable to the first prescribed antiepileptic drug (AED); alternative monotherapy vs early add-on treatment. We conducted an open, cluster-randomised, prospective, controlled trial in patients with persistent partial seizures, despite treatment with one AED, who were never administered any other AEDs. Neurologists were randomised to two strategies: in group A, an alternative monotherapy with a second AED was employed; in group B, add-on treatment with a second AED was employed. The primary outcome was the percentage of seizure-free patients during a two-month period after six months of treatment. The secondary outcomes were: (i) the percentage of patients achieving a 50% reduction in the number of seizures at six months; (ii) the quality of life based on the Quality Of Life In Epilepsy scale; and (iii) tolerability. A total of 143 neurologists were included and randomised, and 264 patients were evaluated. At six months, the primary outcome was 51% in group A and 45% in group B (p=0.34). The percentage of patients achieving a 50% reduction in the number of seizures at six months was 76% in group A and 84% in group B (p=0.53). The quality of life and the tolerability did not significantly differ between the two groups. Alternative monotherapy or early treatment initiation with another AED drug resulted in similar efficacy, and the side effects associated with monotherapy and combined therapies were similar, which suggests that individual susceptibility is more important than the number and burden of AEDs used.

  5. Social Capital: Does It Add to the Health Inequalities Debate?

    ERIC Educational Resources Information Center

    Chappell, Neena L.; Funk, Laura M.

    2010-01-01

    This paper empirically examines the relationship between advantage, social capital and health status to assess (a) whether social capital adds explanatory power to what we already know about the relationship between advantage and health and (b) whether social capital adds anything beyond its component parts, namely social participation and trust.…

  6. Rivastigmine as an effective add-on to standard treatment of veterans with chronic posttraumatic stress disorder: a case series.

    PubMed

    Fayyazi Bordbar, Mohammad Reza; Talaei, Ali

    2013-10-01

    After 23 years of the end of the Iran-Iraq war, the country is left with many patients with chronic posttraumatic stress disorder (PTSD) who need close psychiatric services and are in need for recurrent hospitalization. So far, there are no reports of the rivastigmine use in PTSD patients. We report dramatic reduction of symptoms in 3 veterans with chronic PTSD, after rivastigmine augmentation. This report describes the efficacy of rivastigmine as an add-on to standard treatment of 3 Iranian male veterans with chronic PTSD (aged 52, 46, and 45 years) with severe active symptoms in all 3 dimensions of the disorder. Although they had gone through many approved drug treatments (selective serotonin reuptake inhibitors, tricyclic antidepressants, mood stabilizers, antipsychotics, benzodiazepines, β-blockers, and so on), from the beginning of the disorder, their recovery remained poor (PTSD Checklist-Military Version [PCL-M] scores were 67, 71, and 73 before rivastigmine add-on). Rivastigmine was added to the ongoing therapeutic regimens of the patients for 6 months.Evaluating their condition with PCL-M after 1 and 6 months of treatment showed a significant improvement in patients with PTSD (PCL-M scores were 37, 40, and 47 and dropped to 30, 27, and 31, respectively). Hyperarousal symptoms of PTSD in patients are noted to be the most improved. The rivastigmine add-on experience did not report any adverse effects. The present study showed that rivastigmine is an effective and safe add-on to treatment of patients with chronic PTSD. This effect could be due to improved cognitive status or cholinergic-adrenergic balance adjustment in patients.

  7. The impact of add-on catalytic devices on pollutant emissions from unvented kerosene heaters

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

    Apte, M.G.; Traynor, G.W.; Froehlich, D.A.

    1989-09-01

    Many studies have documented pollutant emission rates from kerosene heaters. Carbon monoxide (CO), carbon dioxide (CO{sub 2}), nitric oxide (NO), nitrogen dioxide (NO{sub 2}), formaldehyde (HCHO), suspended particles, and semivolatile and nonvolatile organic compounds, including some nitrated and non-nitrated polycyclic aromatic hydrocarbons, can be emitted by kerosene heaters. Recently, several add-on catalytic devices designed to reduce some pollutant emissions have become commercially available. The tests described here were designed to measure the impact of these devices on pollutant emissions from unvented kerosene heaters. Emissions of CO, NO, NO{sub 2}, HCHO, and total suspended particles were investigated in this study. Inmore » addition, analyses of particulate sulfur and chromium were conducted for some tests.« less

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

    NASA Astrophysics Data System (ADS)

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

    2009-10-01

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

  9. Effects of postmeal exercise on postprandial glucose excursions in people with type 2 diabetes treated with add-on hypoglycemic agents.

    PubMed

    Erickson, Melissa L; Little, Jonathan P; Gay, Jennifer L; McCully, Kevin K; Jenkins, Nathan T

    2017-04-01

    Type 2 diabetes treatment primarily focuses on reducing hyperglycemia, including postprandial glucose excursions. Hypoglycemic agents are used clinically to lower fasting and postprandial glucose. Metformin is the first-line therapy; however, if metformin is inadequate then 'add-on' hypoglycemic agents are implemented. Postmeal exercise has been shown to lower postprandial glucose. The aim of this study was to assess if postmeal exercise provides additional glucose-lowering benefit, beyond medication alone, in those on add-on hypoglycemic agents. Postprandial glucose excursions in eight participants with type 2 diabetes (Age: 60±10.7, HbA 1C : 7.9±2.3) being treated with add-on hypoglycemic agents were assessed during both drug-treated sedentary and drug-treated postmeal exercise conditions. Continuous glucose monitoring was used to assess peak and area under the glucose curve (AUC) during exercise, as well as peak within a 2-h time window, 2-h total and 2-h incremental AUC after a standardized breakfast meal. Postmeal exercise consisted of 3×10-min intervals of treadmill walking at 50% maximal oxygen uptake. Glucose peak (drug only: 13.8±3.7, drug/exercise: 9.9±2.7mmol/L; p=0.02) and AUC (drug only: 500±136, drug/exercise: 357±89mmol/L×40min; p=0.03) were reduced during postmeal exercise. Breakfast 2-h incremental AUC was also reduced (drug only: 585±291, drug/exercise: 330±294; p=0.047). Post-breakfast exercise lowered glucose during the exercise bout, although this effect was not sustained on later meals. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Novel all-optical logic gate using an add/drop filter and intensity switch.

    PubMed

    Threepak, T; Mitatha, S; Yupapin, P P

    2011-12-01

    A novel design of all-optical logic device is proposed. An all-optical logic device system composes of an optical intensity switch and add/drop filter. The intensity switch is formed to switch signal by using the relationship between refraction angle and signal intensity. In operation, two input signals are coupled into one with some coupling loss and attenuation, in which the combination of add/drop with intensity switch produces the optical logic gate. The advantage is that the proposed device can operate the high speed logic function. Moreover, it uses low power consumption. Furthermore, by using the extremely small component, this design can be put into a single chip. Finally, we have successfully produced the all-optical logic gate that can generate the accurate AND and NOT operation results.

  11. The Source for ADD/ADHD: Attention Deficit Disorder and Attention Deficit/Hyperactivity Disorder.

    ERIC Educational Resources Information Center

    Richard, Gail J.; Russell, Joy L.

    This book is intended for professionals who are responsible for designing and implementing educational programs for children with attention deficit disorders and attention deficit/hyperactivity disorder (ADD/ADHD). Chapters address: (1) myths and realities about ADD/ADHD; (2) definitions, disorders associated with ADD/ADHD, and federal educational…

  12. Preliminary, open-label, pilot study of add-on oral Δ9-tetrahydrocannabinol in chronic post-traumatic stress disorder.

    PubMed

    Roitman, Pablo; Mechoulam, Raphael; Cooper-Kazaz, Rena; Shalev, Arieh

    2014-08-01

    Many patients with post-traumatic stress disorder (PTSD) achieve but partial remission with current treatments. Patients with unremitted PTSD show high rates of substance abuse. Marijuana is often used as compassion add-on therapy for treatment-resistant PTSD. This open-label study evaluates the tolerance and safety of orally absorbable Δ(9)-tetrahydrocannabinol (THC) for chronic PTSD. Ten outpatients with chronic PTSD, on stable medication, received 5 mg of Δ(9)-THC twice a day as add-on treatment. There were mild adverse effects in three patients, none of which led to treatment discontinuation. The intervention caused a statistically significant improvement in global symptom severity, sleep quality, frequency of nightmares, and PTSD hyperarousal symptoms. Orally absorbable Δ(9)-THC was safe and well tolerated by patients with chronic PTSD.

  13. Empagliflozin as add-on to metformin in people with Type 2 diabetes.

    PubMed

    Merker, L; Häring, H-U; Christiansen, A V; Roux, F; Salsali, A; Kim, G; Meinicke, T; Woerle, H J; Broedl, U C

    2015-12-01

    To investigate the long-term efficacy and safety of empagliflozin as add-on to metformin in people with Type 2 diabetes. Of 637 participants treated with empagliflozin 10 mg, empagliflozin 25 mg, or placebo once daily for 24 weeks, 463 (72.7%) were treated in a double-blind extension trial for ≥ 52 weeks. Prespecified exploratory endpoints included changes from baseline in HbA1c , weight and blood pressure at week 76. Compared with placebo, adjusted mean changes from baseline in HbA1c (overall baseline mean ± sd 63 ± 9 mmol/mol [7.9 ± 0.9%]) were -7 mmol/mol [(-0.6%) 95% CI -8, -5 mmol/mol (-0.8, -0.5%); P < 0.001] and -8 mmol/mol [(-0.7%) 95% CI -10, -6 mmol/mol (-0.9, -0.6%); P < 0.001], for empagliflozin 10 mg and 25 mg, respectively. Compared with placebo, adjusted mean changes from baseline in weight were -1.9 kg (95% CI -2.5, -1.3; P < 0.001) and -2.2 kg (95% CI -2.8, -1.6; P < 0.001) for empagliflozin 10 mg and 25 mg, respectively. Empagliflozin led to sustained reductions in systolic blood pressure vs. placebo. Adverse events were reported in 77.7, 80.2 and 72.0% of participants on placebo, empagliflozin 10 mg and empagliflozin 25 mg, respectively. Confirmed hypoglycaemic adverse events (glucose ≤ 3.9 mmol/l and/or event requiring assistance) were reported in 3.4, 4.1 and 4.2% of participants in these groups, respectively. In people with Type 2 diabetes, empagliflozin 10 mg and 25 mg given as add-on to metformin for 76 weeks were well tolerated and led to sustained reductions in HbA1c , weight and systolic blood pressure. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

  14. Environmental Compliance Assessment System (ECAS). Kentucky Supplement (Revised)

    DTIC Science & Technology

    1994-02-01

    vehicles or vehicle bodies. "* FGD - Flue Gas Desulfurization . "* Field-Erected - assembled from components at a final site of operation. "* Flare - a...34* Spare Flue Gas Desulfurization System Module - a separate system of sulfur dioxide emission con- trol equipment capable of treating an amount of flue ...Carryover - particulate matter which is passed from the primary chamber of an incinerator into the flue gas stream. " Particulate Matter Emissions

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

    PubMed

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

    2009-10-01

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

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

    PubMed

    Meineke, I

    2000-10-01

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

  17. Safinamide: an add-on treatment for managing Parkinson's disease.

    PubMed

    Müller, Thomas

    2018-01-01

    Heterogeneous expression of neurotransmitter deficits results from onset and progression of Parkinson's disease. Intervals, characterized by reappearance of motor and associated certain nonmotor symptoms, determine the end of good tolerability and efficacy of oral levodopa therapy. These "OFF" states result from levodopa pharmacokinetics and disease progression-related deterioration of the central buffering capacity for fluctuations of dopamine levels. This review discusses safinamide as an add-on therapeutic agent in orally levodopa-treated patients with "OFF" phenomena. Safinamide provided beneficial effects on "OFF" symptoms in pivotal trials with doses of 50 or 100 mg once daily. Safinamide reversibly inhibits mono-amine oxidase B and declines abnormal glutamate release by modulation of potassium- and sodium ion channels. An ideal candidate for combination with safinamide is opicapone. This inhibitor of peripheral catechol-O-methyltransferase supports continuous brain delivery of levodopa and, thus, the continuous dopaminergic stimulation concept. Both compounds with their once-daily application and good tolerability may complement each other by reduction of necessary oral levodopa intakes and "OFF" times. Thus, a promising, future option will be combination of safinamide and opicapone in one formulation. It will reduce adherence issues and may complement levodopa treatment. It will probably cause less nausea and edema than a dopamine agonist/levodopa regimen.

  18. Cilostazol as an add-on therapy for patients with Alzheimer's disease in Taiwan: a case control study.

    PubMed

    Tai, Shu-Yu; Chen, Chun-Hung; Chien, Chen-Yu; Yang, Yuan-Han

    2017-02-23

    Combination therapy using acetylcholinesterase inhibitors (AChEIs) and cilostazol is of unknown efficacy for patients with Alzheimer's disease (AD). We explored the therapeutic responses by using a case-control study, which was conducted in Taiwan. We enrolled 30 participants with stable AD who were receiving cilostazol (50 mg) twice per day as an add-on therapy combined with AChEIs, and 30 participants as controls who were not receiving cilostazol as an add-on therapy. The therapeutic responses were measured using neuropsychological assessments and analyzed in relation to cilostazol use, apolipoprotein E genotype, and demographic characteristics. Mini-mental state examination (MMSE) and clinical dementia rating sum of boxes (CDR-SB) were administered at the outset of the study and 12 months later. Multiple logistic regression analysis was used to estimate the association between the therapeutic response and cilostazol use. For the therapeutic indicator of cognition, Cilostazol use (adjusted odds ratio (aOR) = 0.17, 95% confidence interval (CI) = 0.03-0.80), initial CDR-SB score (aOR = 2.06, 95% CI = 1.31-3.72), and initial MMSE score (aOR = 1.41, 95% CI = 1.11-1.90), but not age, sex, education, or ApoE ε4 status, were significantly associated with poor therapeutic outcomes. For the therapeutic indicator of global status, no significant association was observed between the covariates and poor therapeutic outcomes. Cilostazol may reduce the decline of cognitive function in stable AD patients when applied as an add-on therapy.

  19. Using Wet-FGD systems for mercury removal.

    PubMed

    Díaz-Somoano, Mercedes; Unterberger, Sven; Hein, Klaus R G

    2005-09-01

    A plan to control mercury emissions to the atmosphere and to establish mercury emission limits has recently been elaborated by the European Commission, making it necessary to devise an efficient and cost effective mercury removal technology. Towards this end wet flue gas desulfurization units appear as a promising option for multi-pollutant control. However, more investigation on mercury removal and a greater mercury removal efficiency are required to achieve this objective. In the present work scrubber chemistry and the application of various solid additives to enhance mercury removal in wet scrubbers is evaluated. The results obtained show a significant correlation between mercury removal efficiency and the pH of the scrubber slurry and SO2 concentration. A weaker correlation was observed between oxygen or slurry concentration and removal efficiency. Finally several solid oxides were found to be effective additives for enhancing mercury capture in wet scrubbers.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  1. Crystal Structures of An F420-Dependent Glucose-6-Phosphate Dehydrogenase Fgd1 Involved in the Activation of the Anti-Tb Drug Candidate Pa-824 Reveal the Basis of Coenzyme And Substrate Binding

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

    Bashiri, G.; Squire, C.J.; Moreland, N.J.

    2009-05-11

    The modified flavin coenzyme F{sub 420} is found in a restricted number of microorganisms. It is widely distributed in mycobacteria, however, where it is important in energy metabolism, and in Mycobacterium tuberculosis (Mtb) is implicated in redox processes related to non-replicating persistence. In Mtb, the F{sub 420}-dependent glucose-6-phosphate dehydrogenase FGD1 provides reduced F{sub 420} for the in vivo activation of the nitroimidazopyran prodrug PA-824, currently being developed for anti-tuberculosis therapy against both replicating and persistent bacteria. The structure of M. tuberculosis FGD1 has been determined by x-ray crystallography both in its apo state and in complex with F{sub 420} andmore » citrate at resolutions of 1.90 and 1.95{angstrom}, respectively. The structure reveals a highly specific F{sub 420} binding mode, which is shared with several other F{sub 420}-dependent enzymes. Citrate occupies the substrate binding pocket adjacent to F{sub 420} and is shown to be a competitive inhibitor (IC{sub 50} 43 {micro}m). Modeling of the binding of the glucose 6-phosphate (G6P) substrate identifies a positively charged phosphate binding pocket and shows that G6P, like citrate, packs against the isoalloxazine moiety of F{sub 420} and helps promote a butterfly bend conformation that facilitates F{sub 420} reduction and catalysis.« less

  2. 76 FR 49508 - ``Add Us In'' Initiative

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

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

  3. Prevalence of Aggression and Defiance in Children with ADD/ADHD Tendencies

    ERIC Educational Resources Information Center

    Hill, Janella

    2011-01-01

    Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) appear to have become more prevalent in the past few years. Many children who display ADD/ADHD tendencies also display behaviors which cause problems in a classroom setting. Considering the fact that these behaviors could be displayed by the student population as…

  4. 76 FR 47240 - ``Add Us In'' Initiative

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-04

    ... DEPARTMENT OF LABOR Office of Disability Employment Policy ``Add Us In'' Initiative AGENCY: Office of Disability Employment Policy, Department of Labor. Announcement Type: New Notice of Availability... Disability Employment Policy (ODEP) announces the availability of approximately $1.65 million to be awarded...

  5. Global analysis of double-strand break processing reveals in vivo properties of the helicase-nuclease complex AddAB

    PubMed Central

    Badrinarayanan, Anjana; Cisse, Ibrahim I.

    2017-01-01

    In bacteria, double-strand break (DSB) repair via homologous recombination is thought to be initiated through the bi-directional degradation and resection of DNA ends by a helicase-nuclease complex such as AddAB. The activity of AddAB has been well-studied in vitro, with translocation speeds between 400–2000 bp/s on linear DNA suggesting that a large section of DNA around a break site is processed for repair. However, the translocation rate and activity of AddAB in vivo is not known, and how AddAB is regulated to prevent excessive DNA degradation around a break site is unclear. To examine the functions and mechanistic regulation of AddAB inside bacterial cells, we developed a next-generation sequencing-based approach to assay DNA processing after a site-specific DSB was introduced on the chromosome of Caulobacter crescentus. Using this assay we determined the in vivo rates of DSB processing by AddAB and found that putative chi sites attenuate processing in a RecA-dependent manner. This RecA-mediated regulation of AddAB prevents the excessive loss of DNA around a break site, limiting the effects of DSB processing on transcription. In sum, our results, taken together with prior studies, support a mechanism for regulating AddAB that couples two key events of DSB repair–the attenuation of DNA-end processing and the initiation of homology search by RecA–thereby helping to ensure that genomic integrity is maintained during DSB repair. PMID:28489851

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

    PubMed

    Odawara, Masato; Sagara, Rieko

    2015-01-01

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

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

    PubMed

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

    2017-02-01

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

  8. Add-On Memantine Treatment for Bipolar II Disorder Comorbid with Alcohol Dependence: A 12-Week Follow-Up Study.

    PubMed

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

    2018-06-01

    Bipolar disorder (BD), especially BD-II, is frequently comorbid with alcohol dependence. Because BD-II and alcohol dependence are neurodegenerative disorders, agents with anti-inflammatory and neurotrophic effects might provide effective therapy. We investigated whether add-on memantine to regular valproic acid treatment ameliorated clinical symptoms, reduced alcohol use, and cytokine levels, and increased plasma brain-derived neurotrophic factor (BDNF) in BD-II patients with comorbid alcohol dependence. In a single-arm 12-week clinical trial, BD-II patients with comorbid alcohol dependence (n = 45) undergoing regular valproic acid treatments were given add-on memantine (5 mg/d). Symptom severity, alcohol use, cytokine (plasma tumor necrosis factor-α and C-reactive protein [CRP], transforming growth factor-β1 [TGF-β1], interleukin-8 [IL-8], IL-10), and plasma BDNF levels were regularly assessed. Mean within-group decreases in Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) scores, alcohol use, CRP, BDNF, and IL-8 levels were significantly different from baseline after 12 weeks of treatment. We found no significant correlation between alcohol use levels and changes in HDRS or YMRS scores. The correlation between reduced alcohol use and reduced TGF-β1 level was significant (B = 0.003, p = 0.019). BD-II comorbid with alcohol dependence might benefit from add-on memantine treatment, which significantly reduced clinical severity, alcohol use, and plasma cytokine levels, and increased BDNF levels. Copyright © 2018 by the Research Society on Alcoholism.

  9. Add-on clinical effects of selective antagonist of 5HT6 receptors AVN-211 (CD-008-0173) in patients with schizophrenia stabilized on antipsychotic treatment: pilot study.

    PubMed

    Morozova, Margarita A; Lepilkina, Taisiya A; Rupchev, Georgy E; Beniashvily, Allan G; Burminskiy, Denis S; Potanin, Sergey S; Bondarenko, Evgeny V; Kazey, Vasily I; Lavrovsky, Yan; Ivachtchenko, Alexandre V

    2014-08-01

    The serotoninergic system as a target for add-on treatment seems to be a promising approach in patients with schizophrenia. To clarify if selective 5HT-6 antagonist AVN-211 (CD-008-0173) adds clinical and cognitive effects to stable antipsychotic treatment. A randomized, double-blind, placebo-controlled, add-on, 4r-week trial in 47 schizophrenia patients (21 patients receiving study drug and 26 receiving placebo) who were stabilized on antipsychotic medication was performed. Seventeen patients from the study drug group and 25 patients from the placebo group completed the trial. Treatment effects were measured using clinical rating scales and attention tests. With no differences at baseline, there was a significant difference between the groups in Positive and Negative Syndrome Scale (PANSS) positive subscale score (p = 0.058) in favor of patients in the treatment group at the endpoint. The PANSS positive subscore (p = 0.0068) and Clinical Global Impression-Severity (CGI-S) (p = 0.048) score significantly changed only in the treatment group. Only in the placebo group were significant changes in Calgary Depression Rating Scale (CDRS) total score registered. The indices of attention tests at endpoint did not show differences between the groups, with the exception of the scope of change in the results of the subtest VIII of the Wechsler Adult Intelligence Scale (WAIS), which showed difference between the groups (p = 0.02) and was significantly larger in the treatment group. Only inside the study drug group, significant changes in selectivity and continuous attention were observed regarding total correct responses (p = 0.0038) and reaction time (p = 0.058) in the Continuous Attention Task (CAT) test. Selective 5HT6 antagonist AVN-211 (CD-008-0173) added antipsychotic and some procognitive (attention) effects to antipsychotic medication.

  10. Disturbances of automatic gait control mechanisms in higher level gait disorder.

    PubMed

    Danoudis, Mary; Ganesvaran, Ganga; Iansek, Robert

    2016-07-01

    The underlying mechanisms responsible for the gait changes in frontal gait disorder (FGD), a form of higher level gait disorders, are poorly understood. We investigated the relationship between stride length and cadence (SLCrel) in people with FGD (n=15) in comparison to healthy older adults (n=21) to improve our understanding of the changes to gait in FGD. Gait data was captured using an electronic walkway system as participants walked at five self-selected speed conditions: preferred, very slow, slow, fast and very fast. Linear regression was used to determine the strength of the relationship (R(2)), slope and intercept. In the FGD group 9 participants had a strong SLCrel (linear group) (R(2)>0.8) and 6 a weak relationship (R(2)<0.8) (nonlinear group). The linear FGD group did not differ to healthy control for slope (p>0.05) but did have a lower intercept (p<0.001). The linear FGD group modulated gait speed by adjusting stride length and cadence similar to controls whereas the nonlinear FGD participants adjusted stride length but not cadence similar to controls. The non-linear FGD group had greater disturbance to their gait, poorer postural control and greater fear of falling compared to the linear FGD group. Investigation of the SLCrel resulted in new insights into the underlying mechanisms responsible for the gait changes found in FGD. The findings suggest stride length regulation was disrupted in milder FGD but as the disorder worsened, cadence control also became disordered resulting in a break down in the relationship between stride length and cadence. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Fate of Mercury in Synthetic Gypsum Used for Wallboard Production

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

    Jessica Marshall Sanderson

    2006-06-01

    This report presents and discusses results from Task 5 of the study ''Fate of Mercury in Synthetic Gypsum Used for Wallboard Production,'' performed at a full-scale commercial wallboard plant. Synthetic gypsum produced by wet flue gas desulfurization (FGD) systems on coal-fired power plants is commonly used in the manufacture of wallboard. The FGD process is used to control the sulfur dioxide emissions which would result in acid rain if not controlled. This practice has long benefited the environment by recycling the FGD gypsum byproduct, which is becoming available in increasing quantities, decreasing the need to landfill this material, and increasingmore » the sustainable design of the wallboard product. However, new concerns have arisen as recent mercury control strategies developed for power plants involve the capture of mercury in FGD systems. The objective of this study is to determine whether any mercury is released into the atmosphere when the synthetic gypsum material is used as a feedstock for wallboard production. The project is being co-funded by the U.S. DOE National Energy Technology Laboratory (Cooperative Agreement DE-FC26-04NT42080), USG Corporation, and EPRI. USG Corporation is the prime contractor, and URS Group is a subcontractor. The project scope includes five discrete tasks, each conducted at various USG wallboard plants using synthetic gypsum from different FGD systems. The five tasks were to include (1) a baseline test, then variations representing differing power plant (2) emissions control configurations, (3) treatment of fine gypsum particles, (4) coal types, and (5) FGD reagent types. However, Task 5, which was to evaluate gypsum produced from an alternate FGD reagent, could not be conducted as planned. Instead, Task 5 was conducted at conditions similar to a previous task, Task 3, although with gypsum from an alternate FGD system. In this project, process stacks in the wallboard plant have been sampled using the Ontario Hydro method

  12. IDENTIFICATION AND RESPONSES TO POTENTIAL EFFECTS OF SCR AND WET SCRUBBERS ON SUBMICRON PARTICULATE EMISSIONS AND PLUME CHARACTERISTICS

    EPA Science Inventory

    Applications of selective catalytic reduction (SCR) systems and wet flue gas desulfurization (FGD) scrubbers on coal-fired boilers have led to substantial reductions in emissions of nitrogen oxides (NOX) and sulfur dioxide (SO2). However, observations of pilot- and full-scale tes...

  13. Comparison of the clinical outcomes between antiviral-naïve patients treated with entecavir and lamivudine-resistant patients receiving adefovir add-on lamivudine combination treatment

    PubMed Central

    Kim, Hong Joo; Park, Soo Kyung; Yang, Hyo Joon; Jung, Yoon Suk; Park, Jung Ho; Park, Dong Il; Cho, Yong Kyun; Sohn, Chong Il; Jeon, Woo Kyu; Kim, Byung Ik; Choi, Kyu Yong

    2016-01-01

    Background/Aims To analyze the effects of preexisting lamivudine (LAM) resistance and applying antiviral treatment (adefovir [ADV] add-on LAM combination treatment) on long-term treatment outcomes, and comparing the clinical outcomes of antiviral-naïve chronic hepatitis B patients receiving entecavir (ETV) monotherapy. Methods This study enrolled 73 antiviral-naïve patients who received 0.5-mg ETV as an initial therapy and 54 patients who received ADV add-on LAM combination treatment as a rescue therapy from July 2006 to July 2010. Results During 24-month treatments, the decreases in serum log10HBV-DNA values (copies/mL) were significantly greater in the antiviral-naïve patients treated with ETV than the patients receiving ADV add-on LAM combination treatment. The biochemical response rates for alanine aminotransferase normalization at 6 months (ETV) and 12 months (ADV add-on LAM) were 90.4% (66/73) and 77.8% (42/54), respectively (P=0.048). A Kaplan-Meier analysis indicated that the rates of serologic response, viral breakthrough, and emergence of genotypic resistance did not differ significantly between the two patient groups. There were also no significant intergroup differences in the rates of disease progression (PD) and new development of hepatocellular carcinoma (HCC). Conclusion The long-term clinical outcomes of antiviral-naïve patients treated with ETV and LAM-resistant patients receiving ADV add-on LAM combination treatment were comparable in terms of the emergence of HCC and disease progression. PMID:27729626

  14. Adjuncts in the IVF laboratory: where is the evidence for 'add-on' interventions?

    PubMed

    Harper, Joyce; Jackson, Emily; Sermon, Karen; Aitken, Robert John; Harbottle, Stephen; Mocanu, Edgar; Hardarson, Thorir; Mathur, Raj; Viville, Stephane; Vail, Andy; Lundin, Kersti

    2017-03-01

    Globally, IVF patients are routinely offered and charged for a selection of adjunct treatments and tests or 'add-ons' that they are told may improve their chance of a live birth, despite there being no clinical evidence supporting the efficacy of the add-on. Any new IVF technology claiming to improve live birth rates (LBR) should, in most cases, first be tested in an appropriate animal model, then in clinical trials, to ensure safety, and finally in a randomized controlled trial (RCT) to provide high-quality evidence that the procedure is safe and effective. Only then should the technique be considered as 'routine' and only when applied to the similar patient population as those studied in the RCT. Even then, further pediatric and long-term follow-up studies will need to be undertaken to examine the long-term safety of the procedure. Alarmingly, there are currently numerous examples where adjunct treatments are used in the absence of evidence-based medicine and often at an additional fee. In some cases, when RCTs have shown the technique to be ineffective, it is eventually withdrawn from the clinic. In this paper, we discuss some of the adjunct treatments currently being offered globally in IVF laboratories, including embryo glue and adherence compounds, sperm DNA fragmentation, time-lapse imaging, preimplantation genetic screening, mitochondria DNA load measurement and assisted hatching. We examine the evidence for their safety and efficacy in increasing LBRs. We conclude that robust studies are needed to confirm the safety and efficacy of any adjunct treatment or test before they are offered routinely to IVF patients. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Regulatory role of glycogen synthase kinase 3 for transcriptional activity of ADD1/SREBP1c.

    PubMed

    Kim, Kang Ho; Song, Min Jeong; Yoo, Eung Jae; Choe, Sung Sik; Park, Sang Dai; Kim, Jae Bum

    2004-12-10

    Adipocyte determination- and differentiation-dependent factor 1 (ADD1) plays important roles in lipid metabolism and insulin-dependent gene expression. Because insulin stimulates carbohydrate and lipid synthesis, it would be important to decipher how the transcriptional activity of ADD1/SREBP1c is regulated in the insulin signaling pathway. In this study, we demonstrated that glycogen synthase kinase (GSK)-3 negatively regulates the transcriptional activity of ADD1/SREBP1c. GSK3 inhibitors enhanced a transcriptional activity of ADD1/SREBP1c and expression of ADD1/SREBP1c target genes including fatty acid synthase (FAS), acetyl-CoA carboxylase 1 (ACC1), and steroyl-CoA desaturase 1 (SCD1) in adipocytes and hepatocytes. In contrast, overexpression of GSK3beta down-regulated the transcriptional activity of ADD1/SREBP1c. GSK3 inhibitor-mediated ADD1/SREBP1c target gene activation did not require de novo protein synthesis, implying that GSK3 might affect transcriptional activity of ADD1/SREBP1c at the level of post-translational modification. Additionally, we demonstrated that GSK3 efficiently phosphorylated ADD1/SREBP1c in vitro and in vivo. Therefore, these data suggest that GSK3 inactivation is crucial to confer stimulated transcriptional activity of ADD1/SREBP1c for insulin-dependent gene expression, which would coordinate lipid and glucose metabolism.

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

    PubMed

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

    2010-02-24

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

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

    PubMed Central

    2010-01-01

    Background In the current era of scientific research, efficient communication of information is paramount. As such, the nature of scholarly and scientific communication is changing; cyberinfrastructure is now absolutely necessary and new media are allowing information and knowledge to be more interactive and immediate. One approach to making knowledge more accessible is the addition of machine-readable semantic data to scholarly articles. Results The Word add-in presented here will assist authors in this effort by automatically recognizing and highlighting words or phrases that are likely information-rich, allowing authors to associate semantic data with those words or phrases, and to embed that data in the document as XML. The add-in and source code are publicly available at http://www.codeplex.com/UCSDBioLit. Conclusions The Word add-in for ontology term recognition makes it possible for an author to add semantic data to a document as it is being written and it encodes these data using XML tags that are effectively a standard in life sciences literature. Allowing authors to mark-up their own work will help increase the amount and quality of machine-readable literature metadata. PMID:20181245

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

    PubMed

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

    2017-09-04

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  20. Steering air bubbles with an add-on vacuum layer for biopolymer membrane biofabrication in PDMS microfluidics.

    PubMed

    Pham, Phu; Vo, Thanh; Luo, Xiaolong

    2017-01-17

    Membrane functionality is crucial in microfluidics for realizing operations such as filtration, separation, concentration, signaling among cells and gradient generation. Currently, common methods often sandwich commercially available membranes in multi-layer devices, or use photopolymerization or temperature-induced gelation to fabricate membrane structures in one-layer devices. Biofabrication offers an alternative to forming membrane structures with biomimetic materials and mechanisms in mild conditions. We have recently developed a biofabrication strategy to form parallel biopolymer membranes in gas-permeable polydimethylsiloxane (PDMS) microfluidic devices, which used positive pressure to dissipate air bubbles through PDMS to initiate membrane formation but required careful pressure balancing between two flows. Here, we report a technical innovation by simply placing as needed an add-on PDMS vacuum layer on PDMS microfluidic devices to dissipate air bubbles and guide the biofabrication of biopolymer membranes. Vacuuming through PDMS was simply achieved by either withdrawing a syringe or releasing a squeezed nasal aspirator. Upon vacuuming, air bubbles dissipated within minutes, membranes were effortlessly formed, and the add-on vacuum layer can be removed. Subsequent membrane growth could be robustly controlled with the flows and pH of solutions. This new process is user-friendly and has achieved a 100% success rate in more than 200 trials in membrane biofabrication.

  1. Add-on levetiracetam in children and adolescents with refractory epilepsy: results of an open-label multi-centre study.

    PubMed

    Callenbach, Petra M C; Arts, Willem Frans M; ten Houten, Robert; Augustijn, Paul; Gunning, W Boudewijn; Peeters, Els A J; Weber, Alma M; Stroink, Hans; Geerts, Yvette; Geerts, Ada T; Brouwer, Oebele F

    2008-07-01

    To study the efficacy and tolerability of add-on levetiracetam in children and adolescents with refractory epilepsy. In this prospective multi-centre, open-label, add-on study, 33 children aged 4-16 years (median 8.5 years) with epilepsy refractory to at least two antiepileptic drugs were treated with levetiracetam in addition to their present treatment regimen with a follow-up of 26 weeks. The starting dose of 10 mg/kg/day was increased with 2-week steps of 10 mg/kg/day, if necessary, up to a maximum dose of 60 mg/kg/day. Retention rate was 69.7% after 26 weeks on a median levetiracetam dosage of 22 mg/kg/day. Four children dropped-out because levetiracetam was ineffective, four because seizure frequency increased and/or seizures became more severe, and two because they developed aggressive behaviour. Compared to their baseline seizure frequency, 13 children (39.4%) had a >50% seizure reduction 12 weeks after initiation of levetiracetam, and 17 children (51.5%) at 26 weeks. At 26 weeks, nine children (27.3%) had been seizure-free for at least the last 4 weeks, terminal remission ranged from 0 to 187 days (mean 46 days). Levetiracetam was effective in both partial and primary generalized seizures, but had most effect in partial seizures. Most reported side effects were hyperactivity (48.5%), somnolence (36.4%), irritability (33.3%) and aggressive behaviour (27.3%). Severity of most side effects was mild. Five children had a serious adverse event, which all concerned hospital admissions that were not related to levetiracetam use. Levetiracetam proved to be an effective and well-tolerated add-on treatment in this group of children with refractory epilepsy.

  2. Meeting Learning Challenges: Working with the Child Who Has ADD

    ERIC Educational Resources Information Center

    Greenspan, Stanley I.

    2006-01-01

    The terms ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder) are applied to several symptoms, including: difficulty in paying attention, distractibility, having a hard time following through on things, and sometimes over-activity and impulsivity. There are many different reasons why children have these symptoms.…

  3. 40 CFR 63.3966 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... device emission destruction or removal efficiency? 63.3966 Section 63.3966 Protection of Environment... or removal efficiency? You must use the procedures and test methods in this section to determine the add-on control device emission destruction or removal efficiency as part of the performance test...

  4. 40 CFR 63.3966 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... device emission destruction or removal efficiency? 63.3966 Section 63.3966 Protection of Environment... or removal efficiency? You must use the procedures and test methods in this section to determine the add-on control device emission destruction or removal efficiency as part of the performance test...

  5. Saxagliptin versus glipizide as add-on therapy to metformin: assessment of hypoglycemia.

    PubMed

    Mintz, Matthew L; Minervini, Gianmaria

    2014-05-01

    To compare characteristics of hypoglycemic episodes in patients with type 2 diabetes receiving saxagliptin or glipizide add-on therapy to metformin. This was a post hoc analysis of an international, randomized, parallel-group, double-blind, active-controlled, phase 3 trial. The 52-week trial and 52-week extension were conducted from December 2007 to August 2010. Patients aged ≥18 years with glycated hemoglobin (HbA1c) >6.5% to 10.0% receiving stable metformin doses (≥1500 mg/d) were randomized 1:1 to add-on therapy with saxagliptin 5 mg/d or glipizide 5 to 20 mg/d (titrated to optimal effect or highest tolerable dose during the initial 18 weeks). Hypoglycemic episodes were recorded in patient diaries. Confirmed hypoglycemic events were defined as fingerstick glucose ≤50 mg/dL (≤2.8 mmol/L) with associated symptoms. Of 858 patients randomized, 428 received saxagliptin + metformin, and 430 received glipizide + metformin. Saxagliptin was noninferior to glipizide in lowering HbA1c. Hypoglycemia with saxagliptin + metformin and glipizide + metformin was reported by 15 (24 events) and 165 (896 events) patients, respectively, through week 104. The mean (SD) number of hypoglycemic events per patient reporting hypoglycemia was lower with saxagliptin + metformin versus glipizide + metformin through weeks 52 (1.5 [SD 0.88] vs 4.8 [SD 4.9], respectively) and 104 (1.6 [SD 0.99] vs 5.4 [SD 5.8]). Most patients receiving glipizide + metformin with hypoglycemia had multiple events (124/165 patients [75%]). Confirmed hypoglycemia, major events, and severe events occurred only with glipizide + metformin. Time to first hypoglycemic event was shorter with glipizide versus saxagliptin. Limitations of this analysis include its post hoc nature, a high rate of study discontinuation, and exclusion of patients with serious comorbidities and complications. Saxagliptin + metformin was associated with fewer patients reporting hypoglycemia

  6. Higher efficacy of pegylated interferon-α2b add-on therapy in hepatitis B envelope antigen-positive chronic hepatitis B patients on tenofovir monotherapy.

    PubMed

    Jindal, Ankur; Vyas, Ashish Kumar; Kumar, Devesh; Kumar, Guresh; Sharma, Manoj Kumar; Sarin, Shiv Kumar

    2018-05-01

    Monotherapy with pegylated interferon-α (Peg-IFNα) or the nucleos(t)ide analogs (NA) currently approved for treating chronic hepatitis B (CHB) has limited efficacy. Studies on the combination of Peg-IFNα/NA have shown conflicting results. We investigated whether sequentially adding on Peg-IFNα to tenofovir enhances serological response rates. Treatment-naïve, hepatitis B envelope antigen (HBeAg)-positive CHB patients with moderately elevated alanine aminotransferase (ALT; 48-200 IU/mL) were started on tenofovir (300 mg/day) and enrolled at week 12 in a 1:1 ratio to either receive Peg-IFNα2b add-on (1.5 μg/kg/week) from week 12 to 36 (n = 53) or continue tenofovir monotherapy (n = 53). Both treatment arms received tenofovir consolidation therapy until week 72. The primary end-point was HBeAg loss at week 72. At week 72, the rate of HBeAg loss was higher in the Peg-IFNα2b add-on group (35.8%) compared to the tenofovir monotherapy group (17%) (P = 0.028; odds ratio, 2.73, 95% confidence interval, 1.09-6.79), and considerably higher in patients with a baseline hepatitis B virus (HBV)-DNA level >6 log IU/mL (32.6% vs 11.4%; P = 0.021). Rates of HBV-DNA loss (77.4% vs 71.7%; P = 0.51), ALT normalization (62.3% vs 52.8%; P = 0.32), and sustained virologic response (20.8% vs 11.3%; P = 0.18) at week 72 were comparable between the two groups. Significantly more patients in the add-on group had >3 log HBV-DNA reduction at week 36 (92.5% vs 66%; P = 0.001). Four patients treated with Peg-IFNα2b add-on achieved hepatitis B surface antigen (HBsAg) loss compared with one patient receiving tenofovir monotherapy. Decline of HBV-DNA of >2 log at week 4 led to higher HBeAg loss at week 72, independent of treatment arm. No patient had treatment-related adverse effects requiring treatment discontinuation. Twenty-four weeks of Peg-IFNα2b as an add-on sequential regimen to tenofovir is safe and resulted in greater loss of HBeAg and HBs

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

    EPA Science Inventory

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

  8. Add-on perampanel and aggressive behaviour in severe drug-resistant focal epilepsies.

    PubMed

    Juhl, S; Rubboli, G

    This study aimed to investigate the incidence of aggressiveness in patients with severe drug-refractory focal epilepsy (DRE) who started perampanel (PER) as add-on treatment, and to identify possible predisposing factors. Data on 49 consecutive patients with severe DRE who initiated PER were retrospectively collected. Twelve of the 49 patients experienced aggressiveness as adverse event related to PER treatment, one third of them on low (2-4 mg/day) PER dosages. PER was discontinued in 10/12 patients because of aggressive behaviors. Aggressiveness could appear after several months or even more than one year of PER treatment. One third of patients with PER-related aggressiveness had intellectual disabilities and 5/12 patients took levetiracetam as a concomitant antiepileptic drug. Our study suggests that the occurrence of aggressive behaviors in patients with severe DRE is not uncommon during PER treatment and that it may occur after months or even years of treatment with a stable dosage, requiring PER discontinuation in the great majority of patients.

  9. Control system adds to precipitator efficiency

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

    Gurrole, G.

    1978-02-01

    An electrostatic precipitator in use at Lion Oil Co., Martinez, Calif., in a fluid catalytic cracking and CO boiler application, was upgraded by mechanical sectionalization of the gas passage and a new electronic control system. The electrostatic precipitator is installed upstream of the CO boiler to handle gas flow up to 4.77 ft/sec, and pressure to 4.5 psi. The independent gas chambers in the electrostatic precipitator were divided by installing gas-tight partition walls to form a total of four electrostatic fields. The precipitator was also equipped with adjustable inlet gas flow-control baffles for even gas distribution. Rows of grounded collectingmore » electrodes are parallel with the flow of gas. The emitting electrode system, powered by separate high-energy transformers for each collecting field, uses silicon-controlled rectifiers and analog electronic networks for rapid response to changing gas and dust conditions. Regulatory requirements call for efficient collection of catalyst fines with no more than 40 lb/hr escaping through the boiler stack. Currently, stack losses average about 38 lb/hr. The installation of two additional control systems with transformers and rectifiers should reduce stack losses to 34 lb/hr.« less

  10. Lacosamide in refractory mixed pediatric epilepsy: a prospective add-on study.

    PubMed

    Rastogi, Reena Gogia; Ng, Yu-Tze

    2012-04-01

    Lacosamide is a new antiepileptic drug that is currently approved by the US Food and Drug Administration (FDA) for adults 17 years or older for partial-onset seizures. The authors reviewed 21 pediatric patients (<17 years) with various seizure types who were started on oral lacosamide as part of a prospective add-on study as adjunctive therapy for refractory epilepsy. Five patients were excluded due to less than 3 months of meaningful follow-up. Maintenance dosages used ranged from 2.4 to 19.4 mg/kg/d. Eight of 16 (50%) patients had greater than 50% reduction in seizure frequency with adjunctive lacosamide therapy. Eight (50%) patients had generalized epilepsy including 4 with Lennox-Gastaut syndrome. Lacosamide was effective therapy for most seizure types but was particularly effective for partial-onset seizures. Lacosamide was effective in treating 5 of 8 (62.5%) localization-related epilepsies but only 2 of 8 (25%) generalized epilepsies, both Lennox-Gastaut syndrome patients with greater than 90% seizure reduction. None of these very refractory patients remained seizure free.

  11. Sociodemographic and diagnostic characteristics of prescribing a second-line lipid-lowering medication: ezetimibe used as initial medication, switch from statins, or add-on medication.

    PubMed

    Wallach-Kildemoes, Helle; Hansen, Ebba Holme

    2015-10-01

    Ezetimibe is used as a second-line lipid-lowering medication (LLM) if statin therapy is not tolerated or cholesterol targets are not reached by statins alone. We aimed to investigate the impact of sociodemographic factors on ezetimibe initiation as (a) incident LLM therapy, (b) add-on therapy, and (c) switch from statins. All individuals aged 30+ who had filled at least one prescription for either statins (N = 581.074) or ezetimibe (N = 7.932) in 2011 were followed in the nationwide Danish registries to explore LLM prescribing patterns from 1 January 2011 to end 2012. Using logistic regression analyses, the odds ratio (OR) with 95% confidence intervals (CIs) was calculated for (a) incident ezetimibe use among LLM initiators (N = 77,472), (b) ezetimibe switching by discontinuing statin users (N = 37,509), and (c) ezetimibe as add-on by non-discontinuing statin users (N = 442,672). Women had higher odds for initiating ezetimibe than men (switch OR = 1.55; 95% CI = 1.32-1.82). While prior use of newer high-potency statins was the strongest predictor (add-on (5.56; 4.95-6.24), income was the strongest socioeconomic predictor for incident LLM use (1.33; 1.14-1.56) and switching (1.64; 1.27-2.13). Both income and education were predictors for add-on therapy, with the educational effect mediated by prior use of high-potency statins. Odds for ezetimibe prescribing were highest in myocardial infarction patients. While higher income is a predictor for switching to ezetimibe, both higher education and income are weak predictors for using ezetimibe as add-on therapy. Women and individuals with myocardial infarction are more likely to be prescribed ezetimibe than others, despite lack of evidence of ezetimibe lowering the risk of cardiovascular events.

  12. 40 CFR 63.9323 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... device emission destruction or removal efficiency? 63.9323 Section 63.9323 Protection of Environment... determine the add-on control device emission destruction or removal efficiency? You must use the procedures... removal efficiency as part of the performance test required by § 63.9310. You must conduct three test runs...

  13. 40 CFR 63.9323 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... device emission destruction or removal efficiency? 63.9323 Section 63.9323 Protection of Environment... determine the add-on control device emission destruction or removal efficiency? You must use the procedures... removal efficiency as part of the performance test required by § 63.9310. You must conduct three test runs...

  14. 40 CFR 63.4166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... device emission destruction or removal efficiency? 63.4166 Section 63.4166 Protection of Environment....4166 How do I determine the add-on control device emission destruction or removal efficiency? (a) For... device organic emissions destruction or removal efficiency, using Equation 2 of this section. ER23JY02...

  15. 40 CFR 63.4566 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... device emission destruction or removal efficiency? 63.4566 Section 63.4566 Protection of Environment... efficiency? You must use the procedures and test methods in this section to determine the add-on control device emission destruction or removal efficiency as part of the performance test required by § 63.4560...

  16. 40 CFR 63.4965 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... device emission destruction or removal efficiency? 63.4965 Section 63.4965 Protection of Environment....4965 How do I determine the add-on control device emission destruction or removal efficiency? You must... destruction or removal efficiency as part of the performance test required by § 63.4960. You must conduct...

  17. 40 CFR 63.4566 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... device emission destruction or removal efficiency? 63.4566 Section 63.4566 Protection of Environment... efficiency? You must use the procedures and test methods in this section to determine the add-on control device emission destruction or removal efficiency as part of the performance test required by § 63.4560...

  18. Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations

    PubMed Central

    Borgohain, Rupam; Szasz, J; Stanzione, P; Meshram, C; Bhatt, M; Chirilineau, D; Stocchi, F; Lucini, V; Giuliani, R; Forrest, E; Rice, P; Anand, R

    2014-01-01

    Levodopa is effective for the motor symptoms of Parkinson's disease (PD), but is associated with motor fluctuations and dyskinesia. Many patients require add-on therapy to improve motor fluctuations without exacerbating dyskinesia. The objective of this Phase III, multicenter, double-blind, placebo-controlled, parallel-group study was to evaluate the efficacy and safety of safinamide, an α-aminoamide with dopaminergic and nondopaminergic mechanisms, as add-on to l-dopa in the treatment of patients with PD and motor fluctuations. Patients were randomized to oral safinamide 100 mg/day (n = 224), 50 mg/day (n = 223), or placebo (n = 222) for 24 weeks. The primary endpoint was total on time with no or nontroublesome dyskinesia (assessed using the Hauser patient diaries). Secondary endpoints included off time, Unified Parkinson's Disease Rating Scale (UPDRS) Part III (motor) scores, and Clinical Global Impression-Change (CGI-C). At week 24, mean ± SD increases in total on time with no or nontroublesome dyskinesia were 1.36 ± 2.625 hours for safinamide 100 mg/day, 1.37 ± 2.745 hours for safinamide 50 mg/day, and 0.97 ± 2.375 hours for placebo. Least squares means differences in both safinamide groups were significantly higher versus placebo. Improvements in off time, UPDRS Part III, and CGI-C were significantly greater in both safinamide groups versus placebo. There were no significant between-group differences for incidences of treatment-emergent adverse events (TEAEs) or TEAEs leading to discontinuation. The addition of safinamide 50 mg/day or 100 mg/day to l-dopa in patients with PD and motor fluctuations significantly increased total on time with no or nontroublesome dyskinesia, decreased off time, and improved parkinsonism, indicating that safinamide improves motor symptoms and parkinsonism without worsening dyskinesia. PMID:24323641

  19. The use of a supplemental sulcus fixated IOL (HumanOptics Add-On IOL) to correct pseudophakic refractive errors.

    PubMed

    Basarir, Berna; Kaya, Vedat; Altan, Cigdem; Karakus, Sezen; Pinarci, Eylem Y; Demirok, Ahmet

    2012-01-01

    To evaluate the safety and efficacy of piggybacking with the HumanOptics Add-On intraocular lens (IOL) to correct pseudophakic refractive errors. Ten eyes of 10 patients with pseudophakic refractive errors were included in this study. All patients were targeted for a range of refraction -0.50 to +0.50 D. Uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively), endothelial cell count (ECC), anterior chamber depth (ACD), the distance between intraocular lenses, and contrast sensitivity measurements under mesopic, scotopic, and scotopic with glare conditions were evaluated preoperatively and postoperatively. The mean age of the patients was 54±27 years (range 4-78). Mean follow-up time was 10.5±1.36 months (range 6-15 months). Mean diopters of implanted Add-On IOLs were -1.4±6.9 (range -12 to +9 D). Mean preoperative and postoperative UDVA was 0.133±0.12 and 0.73±0.27, respectively (p=0.0001); mean preoperative and postoperative CDVA were 0.77±0.26 and 0.79±0.27, respectively (p=0.066). Mean preoperative and postoperative ACD were 3.87±0.91 mm vs 3.58±1.05 mm, respectively (p=0.343); mean inter-IOL distance was 0.53±0.08 mm. Mean preoperative and postoperative ECC were 2455±302 and 2426±294, respectively (p=0.55). All patients were within the targeted refractive range of -0.50 D to +0.50 D. No complications were observed during the operations or postoperative follow-up period. Piggybacking with the Add-On IOL is a safe, efficient, and reliable technique to correct pseudophakic refractive errors.

  20. Safinamide: an add-on treatment for managing Parkinson’s disease

    PubMed Central

    Müller, Thomas

    2018-01-01

    Heterogeneous expression of neurotransmitter deficits results from onset and progression of Parkinson’s disease. Intervals, characterized by reappearance of motor and associated certain nonmotor symptoms, determine the end of good tolerability and efficacy of oral levodopa therapy. These “OFF” states result from levodopa pharmacokinetics and disease progression-related deterioration of the central buffering capacity for fluctuations of dopamine levels. This review discusses safinamide as an add-on therapeutic agent in orally levodopa-treated patients with “OFF” phenomena. Safinamide provided beneficial effects on “OFF” symptoms in pivotal trials with doses of 50 or 100 mg once daily. Safinamide reversibly inhibits mono-amine oxidase B and declines abnormal glutamate release by modulation of potassium- and sodium ion channels. An ideal candidate for combination with safinamide is opicapone. This inhibitor of peripheral catechol-O-methyltransferase supports continuous brain delivery of levodopa and, thus, the continuous dopaminergic stimulation concept. Both compounds with their once-daily application and good tolerability may complement each other by reduction of necessary oral levodopa intakes and “OFF” times. Thus, a promising, future option will be combination of safinamide and opicapone in one formulation. It will reduce adherence issues and may complement levodopa treatment. It will probably cause less nausea and edema than a dopamine agonist/levodopa regimen. PMID:29670409

  1. Characteristics of Learning Disabled, Emotionally Disturbed, ADHD/ADD, and Nonexceptional Children: A Behavioral Assessment Measurement Approach.

    ERIC Educational Resources Information Center

    Palomares, Ronald S.; And Others

    This paper presents data comparing normal, learning-disabled (LD), emotionally disturbed (ED), and attention deficit/hyperactivity disorder (ADHD) or attention deficit disorder (ADD) children, from a total of 1,303 children used to standardize the Texas Features of Emotional Disturbance (Tx-FED), an assessment system involving parent and teacher…

  2. Sensitivity analysis of the add-on price estimate for the silicon web growth process

    NASA Technical Reports Server (NTRS)

    Mokashi, A. R.

    1981-01-01

    The web growth process, a silicon-sheet technology option, developed for the flat plate solar array (FSA) project, was examined. Base case data for the technical and cost parameters for the technical and commercial readiness phase of the FSA project are projected. The process add on price, using the base case data for cost parameters such as equipment, space, direct labor, materials and utilities, and the production parameters such as growth rate and run length, using a computer program developed specifically to do the sensitivity analysis with improved price estimation are analyzed. Silicon price, sheet thickness and cell efficiency are also discussed.

  3. 40 CFR 63.3166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... device emission destruction or removal efficiency? 63.3166 Section 63.3166 Protection of Environment... Limitations § 63.3166 How do I determine the add-on control device emission destruction or removal efficiency... emission destruction or removal efficiency as part of the performance test required by § 63.3160. You must...

  4. 40 CFR 63.3166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... device emission destruction or removal efficiency? 63.3166 Section 63.3166 Protection of Environment... Limitations § 63.3166 How do I determine the add-on control device emission destruction or removal efficiency... emission destruction or removal efficiency as part of the performance test required by § 63.3160. You must...

  5. 40 CFR 63.4766 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... device emission destruction or removal efficiency? 63.4766 Section 63.4766 Protection of Environment... Option § 63.4766 How do I determine the add-on control device emission destruction or removal efficiency... emission destruction or removal efficiency as part of the performance test required by § 63.4760. You must...

  6. A large indel mutation of the bovine ADD1/SREBP1c gene and its effects on growth traits in some native cattle breeds from China.

    PubMed

    Huang, Yong-Zhen; Zhang, En-Ping; Wang, Jing; Huai, Yong-Tao; Ma, Liang; Chen, Fu-Ying; Lan, Xian-Yong; Lei, Chu-Zhao; Fang, Xing-Tang; Wang, Ju-Qiang; Chen, Hong

    2011-03-01

    Adipocyte determination and differentiation-dependent factor 1/sterol regulatory element-binding protein-1c (ADD1/SREBP1c) is a major determinant of tissue differential lipogenic capacity in mammalian and avian species. The objectives of the present study were to focus on insertion-deletion polymorphism (indel) in the bovine ADD1/SREBP1c gene, and analyzing its effect on growth traits in a sample of 1035 cattle belonging to four Chinese cattle breeds. PCR-SSCP, DNA sequencing and agarose electrophoresis methods were used. The 778 bp PCR products of ADD1/SREBP1c gene exhibited three genotypes and two alleles were revealed: W and D. Frequencies of the W allele varied from 0.8651 to 1.000. The associations of the 84 bp indel mutation of ADD1/SREBP1c gene with growth traits of 265 Nanyang cows were analyzed. The animals with genotype WD had significantly higher birth weight, body weight, average daily gain than those with genotype WW at birth, 6-, 12-, 18-, and 24-month old (P < 0.05 or P < 0.01). These results suggest that the indel mutation of bovine ADD1/SREBP1c gene may influence the growth traits in cattle.

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

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2015-12-09

    In non-dialysis chronic kidney disease (CKD) patients with dyslipidemia, statin therapy is recommended to prevent cardiovascular complications. Dyslipidemia has been also shown to be an independent risk factor for the progression of CKD. However, it is still unclear whether statin therapy exerts an inhibitory effect on renal deterioration in CKD patients with dyslipidemia. The purpose of the present study was to examine possible therapeutic effects of statin add-on therapy on renal function as well as parameters of lipid and glucose metabolism, arterial stiffness and oxidative stress, in comparison to diet therapy, in CKD patients with dyslipidemia. This study was a randomized, open-label, and parallel-group trial consisted of a 12-months treatment period in non-dialysis CKD patients with alubuminuria and dyslipidemia. Twenty eight patients were randomly assigned either to receive diet counseling alone (diet therapy group) or diet counseling plus pitavastatin (diet-plus-statin therapy group), to achieve the LDL-cholesterol (LDL-C) target of <100 mg/dl. The statin treatment by pitavastatin was well tolerated in all of the patients without any significant adverse events and the average dose of pitavastatin was 1.0 ± 0.0 mg daily after treatment. After the 12-months treatment period, LDL-C was significantly lower in the diet-plus-statin therapy group compared with the diet therapy group (diet vs diet-plus-statin: LDL-C, 126 ± 5 vs 83 ± 4 mg/dL, P < 0.001). On the other hand, the diet-plus-statin therapy did not significantly reduce albuminuria or delay the decline in eGFR compared with the diet therapy, and there was no relationship between the change in LDL-C and the change in eGFR or albuminuria. However, diet therapy as well as diet-plus-statin therapy exerted similar lowering effects on the pentosidine levels (diet therapy group, baseline vs 12 months: 40 ± 4 vs 24 ± 3 ng/mL, P = 0.001; diet-plus-statin therapy, 46 ± 7 vs 34

  9. Digging Postholes Adds Depth and Authenticity to a Shallow Curriculum

    ERIC Educational Resources Information Center

    Virtue, David C.; Buchanan, Anne; Vogler, Kenneth E.

    2012-01-01

    In the current era of high-stakes testing and accountability, many social studies teachers struggle to find creative ways to add depth and authenticity to a broad, shallow curriculum. Teachers can use the time after tests are administered for students to reflect back on the social studies curriculum and select topics they want to study more deeply…

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

    PubMed

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

    2017-01-01

    The use of dipeptidyl peptidase (DPP)-4 inhibitors in patients with type 2 diabetes treated with insulin may be beneficial. However, the long-term efficacy and safety of vildagliptin add-on therapy in these patients remains unclear. A total of 73 patients with type 2 diabetes treated with insulin were randomly assigned to receive either add-on therapy of vildagliptin (n=37) or conventional therapy without DPP-4 inhibitors (n=36) for glucose control. Hemoglobin A1c (HbA1c) levels, dose and number of insulin injections, number of hypoglycemia episodes, and liver and renal function were monitored for 2years. The baseline characteristics of subjects, including age, dose of insulin injections, or HbA1c levels, did not differ between the two groups. In the vildagliptin group, HbA1c levels significantly decreased and the significance of HbA1c reduction was maintained for 24months (from 8.0±1.2% to 7.4±1.0%, p<0.05, at the end of observational period). In addition, the dose and number of insulin injections significantly reduced (-5.6units, p<0.01, and -0.9 times, p<0.001). However, these parameters were unchanged in the control group. The number of patients who experienced three or more episodes of hypoglycemia per year was significantly lower in the vildagliptin group (n=4) than in the control group (n=11) (odds ratio, 0.28; 95% confidence interval, 0.08-0.97; p<0.05). Vildagliptin as an add-on to insulin treatment for 24months was well tolerated and led to sustained reductions in HbA1c, the dose and number of insulin injections, and the risk of hypoglycemia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. The Integration of the Neurosciences, Child Public Health, and Education Practice: Hemisphere-Specific Remediation Strategies as a Discipline Partnered Rehabilitation Tool in ADD/ADHD.

    PubMed

    Leisman, Gerry; Mualem, Raed; Machado, Calixto

    2013-01-01

    ADD/ADHD is the most common and most studied neurodevelopmental problem. Recent statistics from the U.S. Center for Disease Control state that 11% or approximately one out of every nine children in the US and one in five high school boys are diagnosed with ADD/ADHD. This number is thought to be increasing at around 15-20% per year. The US National Institute of Mental Health's Multi-modal Treatment Study has shown that medication has no long-term benefit for those with ADHD. To effectively address ADD/ADHD from within the framework of child public health, an interdisciplinary strategy is necessary that is based on a neuroeducational model that can be readily implemented on a large-scale within the educational system. This study is based on previous findings that ADD/ADHD children possess underactivity between sub-cortical and cortical regions. An imbalance of activity or arousal in one area can result in functional disconnections similar to that seen in split-brain patients. Since ADD/ADHD children exhibit deficient performance on tests developed to measure perceptual laterality, evidence of weak laterality or failure to develop laterality has been found across various modalities (auditory, visual, tactile). This has reportedly resulted in abnormal cerebral organization and ineffective cortical specialization necessary for the development of language and non-language function. This pilot study examines groups of ADD/ADHD and control elementary school children all of whom were administered all of the subtests of the Wechsler Individual Achievement Tests, the Brown Parent Questionnaire, and given objective performance measures on tests of motor and sensory coordinative abilities. Results measured after a 12-week remediation program aimed at increasing the activity of the hypothesized underactive right hemisphere function, yielded significant improvement of greater than 2 years in grade level in all domains except in mathematical reasoning. The treated group also

  12. Add-On Antihypertensive Medications to Angiotensin-Aldosterone System Blockers in Diabetes: A Comparative Effectiveness Study.

    PubMed

    Schroeder, Emily B; Chonchol, Michel; Shetterly, Susan M; Powers, J David; Adams, John L; Schmittdiel, Julie A; Nichols, Gregory A; O'Connor, Patrick J; Steiner, John F

    2018-05-07

    In individuals with diabetes, the comparative effectiveness of add-on antihypertensive medications added to an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker on the risk of significant kidney events is unknown. We used an observational, multicenter cohort of 21,897 individuals with diabetes to compare individuals who added β -blockers, dihydropyridine calcium channel blockers, loop diuretics, or thiazide diuretics to angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. We examined the hazard of significant kidney events, cardiovascular events, and death using Cox proportional hazard models with propensity score weighting. The composite significant kidney event end point was defined as the first occurrence of a ≥30% decline in eGFR to an eGFR<60 ml/min per 1.73 m 2 , initiation of dialysis, or kidney transplant. The composite cardiovascular event end point was defined as the first occurrence of hospitalization for acute myocardial infarction, acute coronary syndrome, stroke, or congestive heart failure; coronary artery bypass grafting; or percutaneous coronary intervention, and it was only examined in those free of cardiovascular disease at baseline. Over a maximum of 5 years, there were 4707 significant kidney events, 1498 deaths, and 818 cardiovascular events. Compared with thiazide diuretics, hazard ratios for significant kidney events for β -blockers, calcium channel blockers, and loop diuretics were 0.81 (95% confidence interval, 0.74 to 0.89), 0.67 (95% confidence interval, 0.58 to 0.78), and 1.19 (95% confidence interval, 1.00 to 1.41), respectively. Compared with thiazide diuretics, hazard ratios of mortality for β -blockers, calcium channel blockers, and loop diuretics were 1.19 (95% confidence interval, 0.97 to 1.44), 0.73 (95% confidence interval, 0.52 to 1.03), and 1.67 (95% confidence interval, 1.31 to 2.13), respectively. Compared with thiazide diuretics, hazard ratios of cardiovascular events

  13. Top 5 Ways to Help Students with ADD/ADHD

    ERIC Educational Resources Information Center

    Johnson, Kathy

    2011-01-01

    This article suggests five ways to help students with ADD/ADHD. These are: (1) Integrate the primitive reflexes; (2) Diet; (3) Visual attention; (4) Help for auditory attention; and (5) Cognitive training.

  14. Lopez-Alegria adds patch to bulkhead in Node 1 / Unity module

    NASA Image and Video Library

    2007-04-17

    ISS014-E-19541 (17 April 2007) --- Astronaut Michael E. Lopez-Alegria, Expedition 14 commander and NASA space station science officer, adds the Expedition 14 patch to the Unity node's growing collection of insignias representing crews who have lived and worked on the International Space Station.

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

    PubMed

    Adams, Peter J; Livingstone, Charles

    2015-01-01

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

  16. 40 CFR 63.4965 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... an alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide, and carbon..., Instruments and Apparatus]” (incorporated by reference, see § 63.14). (4) Use Method 4 of appendix A to 40 CFR... total gaseous organic mass emissions as carbon at the inlet and outlet of the add-on control device...

  17. 40 CFR 63.3545 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... an alternative to Method 3B the manual method for measuring the oxygen, carbon dioxide, and carbon..., Instruments and Apparatus]” (incorporated by reference, see § 63.14). (4) Use Method 4 of appendix A to 40 CFR... total gaseous organic mass emissions as carbon at the inlet and outlet of the add-on control device...

  18. Adsorption and desorption of sulfur dioxide on novel adsorbents for flue gas desulfurization. Final report, September 1, 1993--August 31, 1994

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

    Lin, Y.S.

    Dry regenerative sorption processes have recently attracted increasing attention in flue gas desulfurization (FGD) because of their several advantages over the conventional wet-scrubbing processes. Dry sorbents are usually made by coating a transition or alkaline earth metal precursor on the surface of a porous support. Major disadvantages of these sorbents prepared by the conventional methods include relatively poor attrition resistance and low SO{sub 2} sorption capacity. The physical and especially chemical attrition (associated with the sulphation-oxidation-reduction cycles in the process) deteriorates the performance of the sorbents. The low SO{sub 2} sorption capacity is primarily due to the small surface areamore » of the support. Materials with a high surface area are not used as the supports for FGD sorbents because these materials usually are not thermally stable at high temperatures. In the past year, the research supported by Ohio Coal Development Office was focused on synthesis and properties of sol-gel derived alumina and zeolite sorbents with improved properties for FGD. The sol-gel derived alumina has large surface area, mesopore size and excellent mechanical strength. Some alumina-free zeolites not only posses the basic properties required as a sorbent for FGD (hydrophobicity, thermal and chemical stability, mechanical strength) but also have extremely large surface area and selective surface chemistry. The major objectives of this research program were to synthesize the sol-gel derived sorbents and to explore the use of the zeolites either directly as adsorbents or as sorbent support for FGD. The research was aimed at developing novel FGD sorbents possessing better sorption equilibrium and kinetic properties and improved physical and chemical attrition resistance.« less

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

    PubMed

    Al Saif, Amer; Alsenany, Samira

    2015-01-01

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

  20. 24 CFR 983.206 - HAP contract amendments (to add or substitute contract units).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  1. Sturckow adds STS-128 crew patch to wall in Node 1 Unity

    NASA Image and Video Library

    2009-09-07

    S128-E-007940 (7 Sept. 2009) --- NASA astronaut Rick Sturckow, STS-128 commander, adds his crew’s patch to the growing collection, in the Unity node, of insignias representing crews who have worked on the International Space Station.

  2. Sturckow adds STS-128 crew patch to wall in Node 1 Unity

    NASA Image and Video Library

    2009-09-07

    S128-E-007939 (7 Sept. 2009) --- NASA astronaut Rick Sturckow, STS-128 commander, adds his crew’s patch to the growing collection, in the Unity node, of insignias representing crews who have worked on the International Space Station.

  3. The dubious assessment of gay, lesbian, and bisexual adolescents of add health.

    PubMed

    Savin-Williams, Ritch C; Joyner, Kara

    2014-04-01

    In this essay, we argue that researchers who base their investigations of nonheterosexuality derived from reports of romantic attractions of adolescent participants from Wave 1 of Add Health must account for their disappearance in future waves of data collection. The high prevalence of Wave 1 youth with either both-sex or same-sex romantic attractions was initially striking and unexpected. Subsequent data from Add Health indicated that this prevalence sharply declined over time such that over 70 % of these Wave 1 adolescents identified as exclusively heterosexual as Wave 4 young adults. Three explanations are proposed to account for the high prevalence rate and the temporal inconsistency: (1) gay adolescents going into the closet during their young adult years; (2) confusion regarding the use and meaning of romantic attraction as a proxy for sexual orientation; and (3) the existence of mischievous adolescents who played a "jokester" role by reporting same-sex attraction when none was present. Relying on Add Health data, we dismissed the first explanation as highly unlikely and found support for the other two. Importantly, these "dubious" gay, lesbian, and bisexual adolescents may have led researchers to erroneously conclude from the data that sexual-minority youth are more problematic than heterosexual youth in terms of physical, mental, and social health.

  4. Long-term efficacy and safety of safinamide as add-on therapy in early Parkinson's disease.

    PubMed

    Schapira, A H V; Stocchi, F; Borgohain, R; Onofrj, M; Bhatt, M; Lorenzana, P; Lucini, V; Giuliani, R; Anand, R

    2013-02-01

    Safinamide is an α-aminoamide with both dopaminergic and non-dopaminergic mechanisms of action in Phase III clinical development as a once-daily add-on to dopamine agonist (DA) therapy for early Parkinson's disease (PD). Study 017 was a 12-month, randomized, double-blind, placebo-controlled pre-planned extension study to the previously reported Study 015. Patients received safinamide 100 or 200 mg/day or placebo added to a single DA in early PD. The primary efficacy endpoint was the time from baseline (Study 015 randomization) to 'intervention', defined as increase in DA dose; addition of another DA, levodopa or other PD treatment; or discontinuation due to lack of efficacy. Safinamide groups were pooled for the primary efficacy endpoint analysis; post hoc analyses were performed on each separate dose group. Of the 269 patients randomized in Study 015, 227 (84%) enrolled in Study 017 and 187/227 (82%) patients completed the extension study. Median time to intervention was 559 and 466 days in the pooled safinamide and placebo groups, respectively (log-rank test; P = 0.3342). In post hoc analyses, patients receiving safinamide 100 mg/day experienced a significantly lower rate of intervention compared with placebo (25% vs. 51%, respectively) and a delay in median time to intervention of 9 days (P < 0.05; 240- to 540-day analysis). The pooled data from the safinamide groups failed to reach statistical significance for the primary endpoint of median time from baseline to additional drug intervention. Post hoc analyses indicate that safinamide 100 mg/day may be effective as add-on treatment to DA in PD. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

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

    ERIC Educational Resources Information Center

    Davis, Mark S.; Brunell, Amy B.

    2012-01-01

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

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

    PubMed

    Prakash, Surya; Bajaj, Abhay

    2017-01-01

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

  7. NASA Adds Leap Second to Master Clock

    NASA Image and Video Library

    2017-12-08

    On Dec. 31, 2016, official clocks around the world will add a leap second just before midnight Coordinated Universal Time — which corresponds to 6:59:59 p.m. EST. NASA missions will also have to make the switch, including the Solar Dynamics Observatory, or SDO, which watches the sun 24/7. Clocks do this to keep in sync with Earth's rotation, which gradually slows down over time. When the dinosaurs roamed Earth, for example, our globe took only 23 hours to make a complete rotation. In space, millisecond accuracy is crucial to understanding how satellites orbit. "SDO moves about 1.9 miles every second," said Dean Pesnell, the project scientist for SDO at NASA's Goddard Space Flight Center in Greenbelt, Maryland. "So does every other object in orbit near SDO. We all have to use the same time to make sure our collision avoidance programs are accurate. So we all add a leap second to the end of 2016, delaying 2017 by one second." The leap second is also key to making sure that SDO is in sync with the Coordinated Universal Time, or UTC, used to label each of its images. SDO has a clock that counts the number of seconds since the beginning of the mission. To convert that count to UTC requires knowing just how many leap seconds have been added to Earth-bound clocks since the mission started. When the spacecraft wants to provide a time in UTC, it calls a software module that takes into consideration both the mission's second count and the number of leap seconds — and then returns a time in UTC.

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

    PubMed

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

    2014-01-08

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

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

    PubMed Central

    2014-01-01

    Background Within a feasibility study the use of antibiotics in pigs and cattle was determined in 24 veterinary practices in Lower Saxony and on 66 farms in North Rhine-Westphalia in Germany. Focus was laid on the comparison of the Used Daily Doses (UDD) (dose per animal and day prescribed by the veterinarians) with the Defined Animal Daily Doses (ADD) (dose per animal and day calculated by means of recommended dosages and estimated live weights). Results For piglets and calves most of the UDD (50% and 46% of nUDD, respectively) were above the ADD (i.e. UDD/ADD-ratio above 1.25). Regarding sows, fattening pigs, dairy and beef cattle, most of the UDDs (49% to 65% of nUDD) were lower than the respective ADD (i.e. UDD/ADD-ratio below 0.8). In pigs, the UDDs of beta-lactams, fluoroquinolones and cephalosporins, and in cattle, those of macrolides and beta-lactams were often below the ADDs. Tetracyclines were frequently used above the recommended dose. Enteric diseases were more often treated below the recommended dose than respiratory diseases, possibly due to overestimation of the live weight (diarrhea in young animals, respiratory diseases in elder animals) and consequently overestimation of the recommended dose. Conclusion Comparisons between UDD and ADD can be used to observe differences between antimicrobials and trends in the usage of antibiotics. But individual treatment comparisons of UDD and ADD must be interpreted carefully, because they may be due to lower live weights than estimated. Correlating such data with data on the occurrence of resistant bacteria in future may help to improve resistance prevention and control. PMID:24401194

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

    NASA Astrophysics Data System (ADS)

    Löwe, Peter

    2015-04-01

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

  11. Enhancing Teaching using MATLAB Add-Ins for Excel

    ERIC Educational Resources Information Center

    Hamilton, Paul V.

    2004-01-01

    In this paper I will illustrate how to extend the capabilities of Microsoft Excel spreadsheets with add-ins created by MATLAB. Excel provides a broad array of fundamental tools but often comes up short when more sophisticated scenarios are involved. To overcome this short-coming of Excel while retaining its ease of use, I will describe how…

  12. Add+VantageMR® Assessments: A Case Study of Teacher and Student Gains

    ERIC Educational Resources Information Center

    Briand, Cathy

    2013-01-01

    This case study analyzes the effect of the Add+VantageMRRTM (AVMR) program on a teacher's pedagogy and on her students' progress in mathematics. AVMR, a professional development program in early mathematics, trains teachers to assess their students' progress and apply those insights to their teaching pedagogy. The AVMR assessment uses a…

  13. Evaluation of pitting corrosion resistance of high-alloyed stainless steels welds for FGD plants in Korea

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

    Baek, K.K.; Sung, H.J.; Im, C.S.

    1998-12-31

    For successful application of high-alloyed stainless steels for Flue Gas Desulfurization (FGD) plants, pitting corrosion resistance of arc welds of N-added 6%Mo austenitic stainless steels (UNS N 08367) and super duplex stainless steels (UNS S 32550) made with various filler metals were evaluated using the Green Death solution. For Gas Tungsten Arc (GTA) and Gas Metal Arc (GMA) welds of N 08367, Critical Pitting Temperature (CPT) of base metal was 65--70 C, whereas weld made by ERNiCrMo-3 filler metal yielded CPT of 50 C. Welds made by ERNiCrMo-10 or ERNiCrMo-4 filler metals showed CPT of 60--65 C and 65--70C, respectively.more » For GTA and GMA welds of S 32550, CPT of welds made by ERNiCrMo-3 was 45--50 C, indicating that the filler metal can provide pitting corrosion resistance matching the S 32550 alloy. Thus, a proper pitting corrosion resistance of weldments of high-alloy stainless steels can be achieved by selecting filler metals having at least +10 higher Pitting Resistance Equivalent Number (PRE{sub N}) value than the base metal regardless of the type of arc welding process. The over-alloyed filler metals would compensate preferential segregation of Cr, MO along the dendrite boundary, which made the dendrite core more susceptible to pitting. Nitrogen addition to the GTA welds of N 08367 made with ERNiCrMo-3 failed to improve pitting corrosion resistance, which was attributed to the precipitation of nitrogen in the weld metal in the form of Nb-nitride.« less

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

    ERIC Educational Resources Information Center

    Melago, Kathleen A.

    2014-01-01

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

  15. Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations.

    PubMed

    Borgohain, Rupam; Szasz, J; Stanzione, P; Meshram, C; Bhatt, M; Chirilineau, D; Stocchi, F; Lucini, V; Giuliani, R; Forrest, E; Rice, P; Anand, R

    2014-02-01

    Levodopa is effective for the motor symptoms of Parkinson's disease (PD), but is associated with motor fluctuations and dyskinesia. Many patients require add-on therapy to improve motor fluctuations without exacerbating dyskinesia. The objective of this Phase III, multicenter, double-blind, placebo-controlled, parallel-group study was to evaluate the efficacy and safety of safinamide, an α-aminoamide with dopaminergic and nondopaminergic mechanisms, as add-on to l-dopa in the treatment of patients with PD and motor fluctuations. Patients were randomized to oral safinamide 100 mg/day (n = 224), 50 mg/day (n = 223), or placebo (n = 222) for 24 weeks. The primary endpoint was total on time with no or nontroublesome dyskinesia (assessed using the Hauser patient diaries). Secondary endpoints included off time, Unified Parkinson's Disease Rating Scale (UPDRS) Part III (motor) scores, and Clinical Global Impression-Change (CGI-C). At week 24, mean ± SD increases in total on time with no or nontroublesome dyskinesia were 1.36 ± 2.625 hours for safinamide 100 mg/day, 1.37 ± 2.745 hours for safinamide 50 mg/day, and 0.97 ± 2.375 hours for placebo. Least squares means differences in both safinamide groups were significantly higher versus placebo. Improvements in off time, UPDRS Part III, and CGI-C were significantly greater in both safinamide groups versus placebo. There were no significant between-group differences for incidences of treatment-emergent adverse events (TEAEs) or TEAEs leading to discontinuation. The addition of safinamide 50 mg/day or 100 mg/day to l-dopa in patients with PD and motor fluctuations significantly increased total on time with no or nontroublesome dyskinesia, decreased off time, and improved parkinsonism, indicating that safinamide improves motor symptoms and parkinsonism without worsening dyskinesia. © 2013 The Authors. Movement Disorders published by Wiley on behalf of the International Parkinson and Movement

  16. Photothermally tunable silicon-microring-based optical add-drop filter through integrated light absorber.

    PubMed

    Chen, Xi; Shi, Yuechun; Lou, Fei; Chen, Yiting; Yan, Min; Wosinski, Lech; Qiu, Min

    2014-10-20

    An optically pumped thermo-optic (TO) silicon ring add-drop filter with fast thermal response is experimentally demonstrated. We propose that metal-insulator-metal (MIM) light absorber can be integrated into silicon TO devices, acting as a localized heat source which can be activated remotely by a pump beam. The MIM absorber design introduces less thermal capacity to the device, compared to conventional electrically-driven approaches. Experimentally, the absorber-integrated add-drop filter shows an optical response time of 13.7 μs following the 10%-90% rule (equivalent to a exponential time constant of 5 μs) and a wavelength shift over pump power of 60 pm/mW. The photothermally tunable add-drop filter may provide new perspectives for all-optical routing and switching in integrated Si photonic circuits.

  17. Effects of gypsum on trace metals in soils and earthworms

    USDA-ARS?s Scientific Manuscript database

    Mined gypsum has been beneficially used for many years as an agricultural amendment. Currently a large amount of flue gas desulfurization (FGD) gypsum is produced by removal of SO2 from flue gas streams when fuels with high S content are burned. The FGD gypsum, similar to mined gypsum, can enhance c...

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

    PubMed

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

    2013-12-01

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

  19. 47 CFR 73.9006 - Add-in covered demodulator products.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Section 73.9006 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES... passed to an output (e.g., where a demodulator add-in card in a personal computer passes such content to an associated software application installed in the same computer), it shall pass such content: (1...

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

    PubMed

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

    2015-10-01

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

  1. Investigation of a mercury speciation technique for flue gas desulfurization materials.

    PubMed

    Lee, Joo-Youp; Cho, Kyungmin; Cheng, Lei; Keener, Tim C; Jegadeesan, Gautham; Al-Abed, Souhail R

    2009-08-01

    Most of the synthetic gypsum generated from wet flue gas desulfurization (FGD) scrubbers is currently being used for wallboard production. Because oxidized mercury is readily captured by the wet FGD scrubber, and coal-fired power plants equipped with wet scrubbers desire to benefit from the partial mercury control that these systems provide, some mercury is likely to be bound in with the FGD gypsum and wallboard. In this study, the feasibility of identifying mercury species in the FGD gypsum and wallboard samples was investigated using a large sample size thermal desorption method. Potential candidates of pure mercury standards including mercuric chloride (HgCl2), mercurous chloride (Hg2Cl2), mercury oxide (HgO), mercury sulfide (HgS), and mercuric sulfate (HgSO4) were analyzed to compare their results with those obtained from FGD gypsum and dry wallboard samples. Although any of the thermal evolutionary curves obtained from these pure mercury standards did not exactly match with those of the FGD gypsum and wallboard samples, it was identified that Hg2Cl2 and HgCl2 could be candidates. An additional chlorine analysis from the gypsum and wallboard samples indicated that the chlorine concentrations were approximately 2 orders of magnitude higher than the mercury concentrations, suggesting possible chlorine association with mercury.

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

    PubMed

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

    2008-01-01

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

  3. SO2 SCRUBBING TECHNOLOGIES: A REVIEW

    EPA Science Inventory

    The paper gives results of a review of commercially available flue gas desulfurization (FGD) technologies that have an established record of performance. Data on worldwide FGD applications reflect that wet FGD technologies have been used at most of the installations. Among the ...

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

    PubMed

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

    2015-07-01

    The aim of present study is to compare the efficacy and safety of adding vildagliptin with sulfonylurea dose-increasing as an active comparator in patients who had inadequately controlled type 2 diabetes mellitus (T2DM) using metformin plus sulfonylurea in real clinical practice. Patients using metformin plus sulfonylurea were assigned to either vildagliptin add-on (50 mg twice a day, n=172) or sulfonylurea dose-increasing by 50% (n=172) treatment groups. The primary endpoint was a change in HbA(1c) after 24 weeks. The secondary endpoints were patients achieving HbA(1c)≤7.0% (53 mmol/mol) and changes in the fasting plasma glucose (FPG), 2-h postprandial glucose (2pp), lipid profiles, and urine albumin-to-creatinine ratio. Body weight and hypoglycemia were also investigated. The mean HbA(1c) at baseline was 8.6% (70 mmol/mol) in both groups. At week 24, the adjusted mean HbA(1c) levels decreased by -1.19% (-13.09 mmol/mol) with vildagliptin add-on and -0.46% (-5.06 mmol/mol) with sulfonylurea (P<0.001). Significantly more vildagliptin add-on patients achieved HbA(1c)≤7.0% (53 mmol/mol) than did sulfonylurea patients (40.1% vs. 7.9%; P<0.001). Greater reductions in FPG and 2pp were observed with vildagliptin add-on than with sulfonylurea (P<0.001). The vildagliptin add-on group exhibited no clinically relevant weight gain and had a lower incidence of hypoglycemia compared with the sulfonylurea group. Vildagliptin add-on therapy might be a suitable option for patients with T2DM that is controlled inadequately by metformin and sulfonylurea, based on its greater glucose control and better safety profile (ClinicalTrial.gov: NCT01099137). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I determine the outlet THC... Control Efficiency/outlet Concentration Option § 63.3555 How do I determine the outlet THC emissions and... methods in this section to determine either the outlet THC emissions or add-on control device emission...

  6. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false How do I determine the outlet THC... Control Efficiency/outlet Concentration Option § 63.3555 How do I determine the outlet THC emissions and... methods in this section to determine either the outlet THC emissions or add-on control device emission...

  7. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false How do I determine the outlet THC... Control Efficiency/outlet Concentration Option § 63.3555 How do I determine the outlet THC emissions and... methods in this section to determine either the outlet THC emissions or add-on control device emission...

  8. Influence of the effective lens position, as predicted by axial length and keratometry, on the near add power of multifocal intraocular lenses.

    PubMed

    Savini, Giacomo; Hoffer, Kenneth J; Lombardo, Marco; Serrao, Sebastiano; Schiano-Lomoriello, Domenico; Ducoli, Pietro

    2016-01-01

    To calculate the near focal distance of different multifocal intraocular lenses (IOLs) as a function of the 2 parameters that are measured before cataract surgery; that is, axial length (AL) and refractive corneal power (keratometry [K]). GB Bietti Foundation IRCCS, Rome, Italy. Noninterventional theoretical study. The IOL power for emmetropia was first calculated in an eye model with the AL ranging from 20 to 30 mm and K from 38 to 48 diopters (D). Then, the predicted myopic refraction for any given IOL add power (from +1.5 to +4.0 D) was calculated, and from this value the near focal distance was obtained. Calculations were also performed for the average eye (K = 43.81 D; AL = 23.65 mm). The near focal distance increased with increasing values of K and AL for each near power add. The near focal distance ranged between 53 cm and 72 cm (21 inches and 28 inches) for a multifocal IOL with +2.50 D, between 44 cm and 60 cm (17 inches and 24 inches) for a multifocal IOL with +3.00 D add, and between 33 cm and 44 cm (13 inches and 18 inches) for a multifocal IOL with +4.00 D add. In the average eye, the near focal distance ranges between 36 cm (near add power = 4.00 D) and 99 cm (near add power = 1.5 D). Longer eyes with steeper corneas showed the longest near focal distance and could experience more difficulties in focusing near objects after surgery. The opposite was true for short hyperopic eyes. Dr. Hoffer receives licensing fees for the commercial use of the registered trademark Hoffer from all biometry manufacturers using the Hoffer Q formula to ensure that it is programmed correctly and book royalties from Slack, Inc., for the textbook IOL Power. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Nonvisualization of the ovaries on pelvic ultrasound: does MRI add anything?

    PubMed

    Lisanti, Christopher J; Wood, Jonathan R; Schwope, Ryan B

    2014-02-01

    The purpose of our study is to assess the utility of pelvic magnetic resonance imaging (MRI) in the event that either one or both ovaries are not visualized by pelvic ultrasound. This HIPAA-compliant retrospective study was approved by our local institutional review board and informed consent waived. 1926 pelvic MRI examinations between March 2007 and December 2011 were reviewed and included if a combined transabdominal and endovaginal pelvic ultrasound had been performed in the preceding 6 months with at least one ovary nonvisualized. Ovaries not visualized on pelvic ultrasound were assumed to be normal and compared with the pelvic MRI findings. MRI findings were categorized as concordant or discordant. Discordant findings were divided into malignant, non-malignant physiologic or non-malignant non-physiologic. The modified Wald, the "rule of thirds", and the binomial distribution probability tests were performed. 255 pelvic ultrasounds met inclusion criteria with 364 ovaries not visualized. 0 malignancies were detected on MRI. 6.9% (25/364) of nonvisualized ovaries had non-malignant discordant findings on MRI: 5.2% (19/364) physiologic, 1.6% (6/364) non-physiologic. Physiologic findings included: 16 functional cysts and 3 hemorrhagic cysts. Non-physiologic findings included: 3 cysts in post-menopausal women, 1 hydrosalpinx, and 2 broad ligament fibroids. The theoretical risk of detecting an ovarian carcinoma on pelvic MRI when an ovary is not visualized on ultrasound ranges from 0 to 1.3%. If an ovary is not visualized on pelvic ultrasound, it can be assumed to be without carcinoma and MRI rarely adds additional information.

  10. 12 CFR 502.60 - When will OTS adjust, add, waive, or eliminate a fee?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  11. A randomized, double-blind, controlled trial of add-on therapy in moderate-to-severe Parkinson's disease.

    PubMed

    Zhao, Shifu; Cheng, Rongchuan; Zheng, Jian; Li, Qianning; Wang, Jingzhou; Fan, Wenhui; Zhang, Lili; Zhang, Yanling; Li, Hongzeng; Liu, Shuxiao

    2015-10-01

    The primary objective was to evaluate the efficacy and safety of droxidopa as add-on therapy in improving stiffness, tremors and other motor functions and activities of daily living for moderate-to-severe Parkinson's disease (PD). PD patients, above Hoehn-Yahr III (including Hoehn-Yahr III), were randomly assigned to drug therapy (droxidopa 600 mg/day for 8 weeks) or placebo. Efficacy indicators were the Unified Parkinson's Disease Rating Scale (UPDRS) part I, II, III subscale, Clinical Global Impression (CGI) rating score, and individual symptom scores (e.g. stiffness, tremors), to evaluate motor function and activities of daily life. There are 109 patients in the droxidopa group, and 110 in the placebo group, at baseline, there were no differences between the two groups for age, body weight, disease severity and previous drugs therapy. At days 14 and 57 of droxidopa add on treatment, UPDRS-II scores reflecting activities of daily life and UPDRS-III scores reflecting motor functions were significantly different compared to the pre-treatment baseline scores (P < 0.01), UPDRS- II and UPDRS-III scores at day 14 and day 57 were also significantly different (P < 0.01) between the two groups. Individual motor symptoms such as stiffness, resting tremor, and alternate hand motion were also significantly improved with droxidopa on days 14 and 57 of treatment (P < 0.01 vs placebo), showing that droxidopa is effective in improving rigidity, tremor and alternate motion of hand. Droxidopa was effective as symptomatic adjunct therapy, improved significantly motor function and activities of daily living, benefited patients with signs of tremor and Stiffness. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2015-01-01

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

  13. Lopez-Alegria adds patch to collection in Node 1 / Unity module

    NASA Image and Video Library

    2007-04-17

    ISS014-E-19545 (17 April 2007) --- Astronauts Michael E. Lopez-Alegria (right), Expedition 14 commander and NASA space station science officer; Sunita L. Williams, flight engineer; and cosmonaut Mikhail Tyurin (left), flight engineer representing Russia's Federal Space Agency, add the Expedition 14 patch to the Unity node's growing collection of insignias representing crews who have lived and worked on the International Space Station.

  14. Do petroleum-based protective coatings add fuel value to slash

    Treesearch

    James L. Murphy; Charles W. Philpot

    1965-01-01

    Asphalts and wax emulsions have been recommended as protective coatings to help obtain clean, safe burns in slash disposal work. Fuel value determinations in the laboratory indicate that such coatings add little to the fuel value of slash.

  15. Rapid response to methylphenidate as an add-on therapy to mirtazapine in the treatment of major depressive disorder in terminally ill cancer patients: a four-week, randomized, double-blinded, placebo-controlled study.

    PubMed

    Ng, Chong Guan; Boks, Marco P M; Roes, Kit C B; Zainal, Nor Zuraida; Sulaiman, Ahmad Hatim; Tan, Seng Beng; de Wit, Niek J

    2014-04-01

    This is a 4 week, randomized, double-blind, placebo-controlled study to examine the effects of methylphenidate as add-on therapy to mirtazapine compared to placebo for treatment of depression in terminally ill cancer patients. It involved 88 terminally ill cancer patients from University of Malaya Medical Centre, Kuala Lumpur, Malaysia. They were randomized and treated with either methylphenidate or placebo as add on to mirtazapine. The change in Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to day 3 was analyzed by linear regression. Changes of MADRS and Clinical Global Impression-Severity Scale (CGI-S) over 28 days were analyzed using mixed model repeated measures (MMRM). Secondary analysis of MADRS response rates, defined as 50% or more reduction from baseline score. A significantly larger reduction of Montgomery-Åsberg Depression Rating Scale (MADRS) score in the methylphenidate group was observed from day 3 (B=4.14; 95% CI=1.83-6.45). Response rate (defined as 50% or more reduction from baseline MADRS score) in the methylphenidate treated group was superior from day 14. Improvement in Clinical Global Impression-Severity Scale (CGI-S) was greater in the methylphenidate treated group from day 3 until day 28. The drop-out rates were 52.3% in the methylphenidate group and 59.1% in the placebo group (relative risk=0.86, 95%CI=0.54-1.37) due to cancer progression. Nervous system adverse events were more common in methylphenidate treated subjects (20.5% vs 9.1%, p=0.13). In conclusions, methylphenidate as add on therapy to mirtazapine demonstrated an earlier antidepressant response in terminally ill cancer patients, although at an increased risk of the nervous system side effects. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

  16. Vinogradov adds a patch to the Node 1/Unity collection during Expedition 13

    NASA Image and Video Library

    2006-09-04

    ISS013-E-75813 (4 Sept. 2006) --- Cosmonaut Pavel V. Vinogradov, Expedition 13 commander representing Russia's Federal Space Agency, adds the Expedition 13 patch to the Unity node's growing collection of insignias representing crews who have lived and worked on the International Space Station.

  17. Impact of maternal and paternal preconception health on birth outcomes using prospective couples’ data in Add Health

    PubMed Central

    Moss, Jennifer L.; Harris, Kathleen Mullan

    2014-01-01

    Purpose Retrospective studies of preconception health have demonstrated that parents’ health conditions and behaviors can impact a newborn’s birth outcomes and, subsequently, future health status. This study sought to examine the impact of preconception health, measured prospectively, among both mothers and fathers, on two important birth outcomes: birthweight and gestational age. Methods Data came from Add Health (the National Longitudinal Study of Adolescent Health), which included interviews with original participants and a subsample of their partners in 2001–02. In 2008, the original respondents again completed an interview for Add Health. For 372 eligible infants born to these couples, birth outcomes (measured in 2008) were regressed on preconception health conditions and behaviors among non-pregnant heterosexual partners (measured in 2001–02). Results Mean birthweight was 3399 grams, and mean gestational age was 39 weeks. Birthweight was higher for infants born to mothers with diabetes or high blood pressure, and for mothers who drank alcohol at least once per month, and lower for infants born to fathers with diabetes (p < .05). Infant gestational age was marginally lower for infants born to mothers with higher levels of depression (p < .10), and lower for infants born to fathers with diabetes and with higher levels of fast food consumption (p < .05). Conclusions Both maternal and paternal preconception health conditions and behaviors influenced infant birth outcomes. Interventions to promote preconception health should focus on prevention of diabetes and high blood pressure, as well as minimizing consumption of alcohol and fast food. PMID:25367598

  18. Safety and efficacy of doxazosin as an "add-on" antihypertensive therapy in mild to moderate heart failure patients.

    PubMed

    Spoladore, Roberto; Roccaforte, Rosa; Fragasso, Gabriele; Gardini, Chiara; Palloshi, Altin; Cuko, Amarild; Arioli, Francesco; Salerno, Anna; Margonato, Alberto

    2009-08-01

    Doxazosin treatment has been discouraged in hypertensive patients in order to prevent heart failure (HF) development. However, this drug is still prescribed as an "add-on" medication to achieve a better blood pressure (BP) control. The aim of this study was to evaluate the safety and efficacy of doxazosin as an "add-on" medication in HF patients with uncontrolled hypertension. We reviewed our HF clinic files to collect patient variables recorded at baseline and during follow-up visits in patients receiving, or not, doxazosin. We compared HF-related hospitalization rates and all-cause and cardiovascular mortality rates between patients on doxazosin and those not on doxazosin. We constructed cumulative risk curves for time to first event (HF-related hospitalization and/or death) for both groups of patients. Fifty-two HF patients had been prescribed doxazosin. At baseline, several relevant variables were unevenly distributed between patients receiving doxazosin and those not receiving doxazosin (N=122), such as left ventricular ejection fraction (LVEF) and NYHA class. HF-related hospitalization and death rates were similar between patients on doxazosin and those not on doxazosin at the end of the follow-up. Even after adjustment for all potentially confounding variables, doxazosin was not associated with HF-related hospitalization and/or death. Doxazosin significantly reduced BP, but did not affect NYHA class. Doxazosin, "on top" of other antihypertensive treatments was safe and effective, and did not appear to be associated with HF-related hospitalization and mortality rates in our patients with mild/moderate HF.

  19. No evidence for an effect on brain atrophy rate of atorvastatin add-on to interferon β1b therapy in relapsing-remitting multiple sclerosis (the ARIANNA study).

    PubMed

    Lanzillo, Roberta; Quarantelli, Mario; Pozzilli, Carlo; Trojano, Maria; Amato, Maria Pia; Marrosu, Maria G; Francia, Ada; Florio, Ciro; Orefice, Giuseppe; Tedeschi, Gioacchino; Bellantonio, Paolo; Annunziata, Pasquale; Grimaldi, Luigi M; Comerci, Marco; Brunetti, Arturo; Bonavita, Vincenzo; Alfano, Bruno; Marini, Stefano; Brescia Morra, Vincenzo

    2016-08-01

    A previous phase 2 trial has suggested that statins might delay brain atrophy in secondary progressive multiple sclerosis. The objective of this study was to evaluate the effect of atorvastatin add-on therapy on cerebral atrophy in relapsing-remitting multiple sclerosis. This randomised, placebo-controlled study compared atorvastatin 40 mg or placebo add-on therapy to interferon β1b for 24 months. Brain magnetic resonance imaging, multiple sclerosis functional composite score, Rao neuropsychological battery and expanded disability status scale were evaluated over 24 months. A total of 154 patients were randomly assigned, 75 in the atorvastatin and 79 in the placebo arms, with a comparable drop-out rate (overall 23.4%). Brain atrophy over 2 years was not different in the two arms (-0.38% and -0.32% for the atorvastatin and placebo groups, respectively). Relapse rate, expanded disability status scale, multiple sclerosis functional composite score or cognitive changes were not different in the two arms. Patients withdrawing from the study had a higher number of relapses in the previous 2 years (P=0.04) and a greater probability of relapsing within 12 months. Our results suggest that the combination of atorvastatin and interferon β1b is not justified in early relapsing-remitting multiple sclerosis and adds to the body of evidence indicating an absence of significant radiological and clinical benefit of statins in relapsing-remitting multiple sclerosis. © The Author(s), 2015.

  20. Medicalization, ambivalence and social control: mothers' descriptions of educators and ADD/ADHD.

    PubMed

    Malacrida, Claudia

    2004-01-01

    Conrad notes that non-medical personnel often accomplish the routine, everyday work of medicalization. This is particularly so in the case of Attention Deficit (Hyperactivity) Disorder, where teachers, special educators and school psychologists identify, assess and administer medication to 'problematic' children. Drawing on data from interviews with Canadian and British mothers of ADD/ADHD children, this article explores mothers' perceptions of educators' roles in medicalizing children who are different, comparing medicalization in two divergent sites. In Canada, where ADD/ADHD is a highly medicalized phenomenon, and teachers have few alternative forms of social control available to them in classrooms, it appears that educators are prepared to identify problem children and press for medical treatment with remarkable vigor. In Britain, where medicalization remains incomplete, and where teachers and special educators have more stringent alternative forms of social control available to them, educators were often described as gatekeepers who will refuse the label or to administer medication.

  1. Transport and Transformation of Selenium and Other Constituents of Flue-Gas Desulfurization Wastewater in Water-Saturated Soil Materials.

    PubMed

    Galkaduwa, Madhubhashini B; Hettiarachchi, Ganga M; Kluitenberg, Gerard J; Hutchinson, Stacy L; Davis, Lawrence; Erickson, Larry E

    2017-03-01

    Constructed wetland treatment systems are used to remove selenium (Se) from flue-gas desulfurization (FGD) wastewater (WW). However, direct confirmation of the mechanism responsible for FGD WW Se retention in soil is lacking. A laboratory-based soil column study was performed to develop an evidence-based mechanism of Se retention and to study the behavior and the retention capacity of FGD WW constituents in water-saturated soil. A deoxygenated 1:1 mixture of FGD WW and raw water was delivered to the columns bottom-up at a flux of 1.68 cm d for 100 d. Some of the columns were flushed with the raw water at the same rate for an additional 100 d. Column effluent was analyzed for constituents of concern. Results showed a complete retention of FGD WW Se in the soil materials. Boron and fluorine were partially retained; however, sulfur, sodium, and chlorine retention was poor, agreeing with field observations. The FGD WW Se was retained in soil near the inlet end of the columns, indicating its limited mobility under reduced conditions. Sequential extraction procedure revealed that retained Se was mainly sequestered as stable/residual forms. Bulk- and micro-X-ray absorption near-edge structure spectroscopy confirmed that Se was mainly retained as reduced/stable species [Se(IV), organic Se, and Se(0)]. This study provides direct evidence for FGD WW Se retention in water-saturated soil via the transformation of oxidized Se into reduced/stable forms. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  2. Spironolactone Add-on for Preventing or Slowing the Progression of Diabetic Nephropathy: A Meta-analysis.

    PubMed

    Hou, Jing; Xiong, Weiquan; Cao, Ling; Wen, Xiangqiong; Li, Ailing

    2015-09-01

    The aim of this meta-analysis was to evaluate the benefits and potential adverse effects of adding spironolactone to standard antidiabetic/renoprotective/antihypertensive (AD/RP/AHT) treatment in patients with diabetic nephropathy (DN). PubMed/MEDLINE and Web of Knowledge were searched for relevant randomized, controlled studies (RCTs) or quasi-RCTs of the effects of adding spironolactone to standard AD/RP/AHT treatment in patients with DN. Results were summarized with a random-effects model or a fixed-effects model. According to the outcomes measured (benefits and risks of adding spironolactone to standard AD/RP/AHT treatment), compared with controls, the addition of spironolactone significantly decreased end-of-treatment (EOT) 24-hour urinary albumin/protein excretion and significantly increased percentage reduction from baseline in urinary albumin/creatinine ratio (UACR), although it did not significantly affect EOT UACR. The addition of spironolactone further led to a significantly greater reduction from baseline in glomerular filtration rate (GFR)/estimated (e) GFR, although it did not significantly affect EOT GFR/eGFR. Further, the addition of spironolactone significantly reduced EOT in-office, 24-hour, and daytime systolic and diastolic blood pressure (SBP and DBP, respectively) and led to significantly greater reductions from baseline in in-office SBP and DBP, although it did not significantly affect nighttime SBP or DBP. Finally, the addition of spironolactone significantly increased mean serum/plasma potassium levels and the risk for hyperkalemia. Spironolactone could be added to preexisting AD/RP/AHT therapy in patients with DN to prevent or slow DN progression by reducing proteinuria. The addition of spironolactone would likely provide even more beneficial effect in patients with DN and hypertension due to the BP reduction associated with spironolactone use. However, the beneficial effects of spironolactone add-on should be weighed against its potential

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

    PubMed

    Epstein, Richard H; Dexter, Franklin

    2015-07-01

    The American Society of Anesthesiologists has embraced the concept of the Perioperative Surgical Home as a means through which anesthesiologists can add value to the health systems in which they practice. One key listed element of the Perioperative Surgical Home is to support "scheduling initiatives to reduce cancellations and increase efficiency." In this study, we explored the potential benefits of the Perioperative Surgical Home with respect to inpatient cancellations and add-on case scheduling. We evaluated 6 hypotheses related to the timing of inpatient cancellations and preoperative anesthesia evaluations. Inpatient cancellations were studied during 26 consecutive 4-week intervals between July 2012 and June 2014 at a tertiary care academic hospital. All timestamps related to scheduling, rescheduling, and cancellation activities were retrieved from the operating room (OR) case scheduling system. Timestamps when patients were seen by anesthesia residents were obtained from the preoperative evaluation system database. Batch mean methods were used to calculate means and SE. For cases cancelled, we determined whether, for "most" (>50%) cancellations, a subsequent procedure (of any type) was performed on the patient within 7 days of the cancellation. Comparisons with most and other fractions were assessed using the 1 group, 1-sided Student t test. We evaluated whether a few procedures were highly represented among the cancelled cases via the Herfindahl (Simpson's) index, comparing it with <0.15. The rate of scheduling activity was assessed by computing the number of OR scheduling office decisions in each 1-hour bin between 6:00 AM and 3:59 PM. These values were compared with ≥1 decision per hour at the study hospital. Data from 24,735 scheduled inpatient cases were assessed. Cases cancelled after 7 AM on the day before or at any time on the scheduled day of surgery accounted for 22.6% ± 0.5% (SE) of the scheduled minutes all scheduled cases, and 26.8% ± 0.4% of

  4. triADD: The Risk for Alcohol Abuse, Depression, and Diabetes Multimorbidity in the American Indian and Alaska Native Population

    ERIC Educational Resources Information Center

    Tann, Sheila S.; Yabiku, Scott T.; Okamoto, Scott K.; Yanow, Jessica

    2007-01-01

    This study examined the risk for alcoholism, diabetes, and depression (triADD) in American Indian/Alaska Native (AI/AN) populations in the U.S. Using the Behavioral Risk Factor Surveillance System, a series of descriptive statistics and regression models were used to examine the interrelationships among these disorders in AI/AN populations.…

  5. Investigation of a mercury speciation technique for flue gas desulfurization materials

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

    Lee, J.Y.; Cho K.; Cheng L.

    2009-08-15

    Most of the synthetic gypsum generated from wet flue gas desulfurization (FGD) scrubbers is currently being used for wallboard production. Because oxidized mercury is readily captured by the wet FGD scrubber, and coal-fired power plants equipped with wet scrubbers desire to benefit from the partial mercury control that these systems provide, some mercury is likely to be bound in with the FGD gypsum and wallboard. In this study, the feasibility of identifying mercury species in the FGD gypsum and wallboard samples was investigated using a large sample size thermal desorption method and samples from power plants in Pennsylvania. Potential candidatesmore » of pure mercury standards including mercuric chloride, mercurous chloride, mercury oxide, mercury sulfide, and mercuric sulfate were analyzed to compare their results with those obtained from FGD gypsum and dry wallboard samples. Although any of the thermal evolutionary curves obtained from these pure mercury standards did not exactly match with those of the FGD gypsum and wallboard samples, it was identified that Hg{sub 2}Cl{sub 2} and HgCl{sub 2} could be candidates. An additional chlorine analysis from the gypsum and wallboard samples indicated that the chlorine concentrations were approximately 2 orders of magnitude higher than the mercury concentrations, suggesting possible chlorine association with mercury. 21 refs., 5 figs., 3 tabs.« less

  6. Coupling analysis of high Q resonators in add-drop configuration through cavity ringdown spectroscopy

    NASA Astrophysics Data System (ADS)

    Frigenti, G.; Arjmand, M.; Barucci, A.; Baldini, F.; Berneschi, S.; Farnesi, D.; Gianfreda, M.; Pelli, S.; Soria, S.; Aray, A.; Dumeige, Y.; Féron, P.; Nunzi Conti, G.

    2018-06-01

    An original method able to fully characterize high-Q resonators in an add-drop configuration has been implemented. The method is based on the study of two cavity ringdown (CRD) signals, which are produced at the transmission and drop ports by wavelength sweeping a resonance in a time interval comparable with the photon cavity lifetime. All the resonator parameters can be assessed with a single set of simultaneous measurements. We first developed a model describing the two CRD output signals and a fitting program able to deduce the key parameters from the measured profiles. We successfully validated the model with an experiment based on a fiber ring resonator of known characteristics. Finally, we characterized a high-Q, home-made, MgF2 whispering gallery mode disk resonator in the add-drop configuration, assessing its intrinsic and coupling parameters.

  7. Effect of ezetimibe add-on therapy over 52 weeks extension analysis of prospective randomized trial (RESEARCH study) in type 2 diabetes subjects.

    PubMed

    Sakamoto, Kentaro; Kawamura, Mitsunobu; Watanabe, Takayuki; Ashidate, Keiko; Kohro, Takahide; Tanaka, Akira; Mori, Yasumichi; Tagami, Motoki; Hirano, Tsutomu; Yamazaki, Tsutomu; Shiba, Teruo

    2017-06-24

    Lowering cholesterol levels decreases the risk of atherosclerotic diseases. Effective ways to stably reduce LDL-C level are warranted in type 2 diabetic patients, a high-risk population for CVD, with various anti-diabetic therapeutic background. The RESEARCH study focuses on LDL-C reduction in this population along with modifications of the lipid profiles. We evaluated long-term ezetimibe add-on therapy in T2DM patients with hypercholesterolemia. In a randomized, multicenter, open-label, prospective study, a total of 109 T2DM patients not attaining LDL-C target value despite first-line dose statin (10 mg of atorvastatin or 1 mg of pitavastatin) therapy in Japan were recruited. We investigated the difference in cholesterol lowering effect between ezetimibe (10 mg) add-on statin (EAT) group and double-dose statin (DST) group. Changes of parameters related to atherosclerotic event risks were assessed. The reduction of LDL-C was larger in the EAT group (28.3%) than in the DST group (9.2%) at 52 weeks as well as the primary endpoint of 12 weeks. EAT achieved significant lower levels of TC and apo B, respectively. Both treatments attained significant reduction in sd-LDL-C or hsCRP on this long-term basis. Notably, sd-LDL-C in EAT reduced as low as 36.1 ± 14.9 mg/dl to reach near the threshold (35.0 mg/dl) for atherosclerosis with significantly higher achievement rate (55.6%) than DST treatment. Simultaneously, hsCRP reduction by EAT attained as low value as 0.52 ± 0.43 mg/l. In the present 52-week long-term period, ezetimibe add-on therapy showed a robust advantage in lowering LDL-C and in attaining target LDL-C values compared with the doubling of statin dose. Moreover, it's meaningful that sd-LDL, powerfully atherogenic lipoprotein, exhibited prominent decrease consistently prominently by ezetimibe add-on therapy. DM patients with hypercholesterolemia are at high risk for CAD, and adding ezetimibe onto usual-dose statin treatment in Japan has been

  8. Power Parenting for Children with ADD/ADHD: A Practical Parent's Guide for Managing Difficult Behaviors.

    ERIC Educational Resources Information Center

    Flick, Grad L.

    The first step in dealing with an attention deficit disorder (ADD/ADHD) child's difficult behavior is to understand its origins. This book presents behavior management techniques to help parents care for their ADD child while ensuring that the child continues to develop positive, healthy self-esteem. The guide shows how to: (1) ensure an accurate…

  9. Add-on lacosamide: a retrospective study on the relationship between serum concentration, dosage, and adverse events.

    PubMed

    Hillenbrand, Barbara; Wisniewski, Ilona; Jürges, Uta; Steinhoff, Bernhard J

    2011-11-01

    We performed a retrospective study in patients with poorly controlled epilepsy treated with add-on lacosamide (LCM) to investigate the relationship of LCM-related adverse events with LCM serum concentration and weight-dependent dosage. We collected serum concentrations, weight-related dosages, and occurrences of the seven most frequent adverse events according to the randomized double-blind, placebo-controlled trials. Seventy of 131 patients could be sufficiently evaluated. LCM serum concentrations and weight-related dosages in patients with and without typical adverse events did not differ significantly. Closer analysis of the data suggested that dizziness as the leading adverse event occurred significantly more often if LCM was combined with classic sodium channel blockers. There was a significant correlation between LCM serum concentrations and co-medication, so there is still evidence for dependent variables that might have a relevant impact in individual cases. However, our data do not allow definition of a safety range for LCM. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. 76 FR 4399 - Joint Industry Plan; Order Approving Amendment To Add the BATS Y-Exchange, Inc. as Participant to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ...; Order Approving Amendment To Add the BATS Y- Exchange, Inc. as Participant to National Market System... September 9, 2010, the BATS Y-Exchange, Inc. (``BYX'' or ``Exchange'') submitted to the Securities and... their monthly reports available to the public under Rule 11Ac1-5 under the Act (n/ k/a Rule 605 of...

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

    PubMed

    Holzinger, B; Klösch, G; Saletu, B

    2015-06-01

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

  12. Effectiveness of vildagliptin versus other oral antidiabetes drugs as add-on to sulphonylurea monotherapy: Post hoc analysis from the EDGE study.

    PubMed

    Prasanna Kumar, K M; Phadke, U; Brath, H; Gawai, A; Paldánius, P M; Mathieu, C

    2016-12-01

    In this post hoc analysis of the EDGE study, we assessed the effectiveness and safety of vildagliptin versus other oral antidiabetes drugs (OADs) as add-on to first-line sulphonylurea (SU) therapy in patients who did not receive metformin in a real-life setting. The primary endpoint was odds of achieving an HbA1c reduction of >0.3% without tolerability issues. Secondary endpoint was odds of achieving HbA1c <7.0% without hypoglycaemia or weight gain. Changes in HbA1c, body weight; and safety were also assessed. 2936 patients received vildagliptin and 820 received comparator OADs (any α-GI, TZD, glinide) as add-on to first-line SU therapy. Overall, the mean age, disease duration, HbA1c, and BMI at baseline were 57.1 years, 6.3 years, 8.5%, and 27.7kg/m 2 , respectively. The odds ratios for achieving primary and secondary endpoints were 1.6 (95% CI: 1.36, 1.86; p<0.0001) and 1.8 (1.45, 2.21; p<0.0001), respectively, in favour of vildagliptin. The between-treatment differences (vildagliptin vs. comparator OAD) for the mean change in HbA1c and body weight were -0.2±0.04% (p<0.0001) and -0.8±0.16kg (p<0.0001), respectively. Overall, the incidence of adverse events was low (vildagliptin, 7% vs. comparator, 8.2%) in both groups. Similar results were observed in a subset of patients enrolled from India and patients who received TZDs as a comparator OAD. Under real-life settings, vildagliptin as add-on to SU monotherapy showed better glycaemic response without tolerability issues compared with other OADs. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2017-06-01

    Clinical outcome may differ owing to the distinct pharmacological characteristics of insulin sensitizers and insulin. This study was performed to compare the metabolic and renal function changes with add-on pioglitazone treatment versus basal insulin in patients with type 2 diabetes mellitus (DM) in whom sulfonylurea and metformin regimens failed. Patients who were consecutively managed in the diabetes comprehensive program with add-on pioglitazone or detemir/glargine treatment for at least 2 years following sulfonylurea and metformin treatment failure were included. A total of 1002 patients were enrolled (pioglitazone: 559, detemir: 264, glargine: 179). After propensity score matching, there were 105 patients with matchable baseline characteristics in each group. After a mean of 3.5 years of follow-up, the pioglitazone group showed a greater HbA1c reduction than the detemir group and the glargine group. Despite patients in all three groups exhibiting significant body weight gain, those in the pioglitazone group and the glargine group showed greater body weight increases than the patients in the detemir group (2.1, 1.6 and 0.8 kg, respectively, p < 0.05). Interestingly, Cox regression analysis indicated that patients under detemir or glargine treatment had a higher probability of CKD progression as compared with the pioglitazone group, with hazard ratios of 2.63 (95% CI 1.79-3.88) and 3.13 (95% CI 2.01-4.87), respectively. Our study first showed that treatment with both pioglitazone and basal insulin improved glycemic control, while only pioglitazone treatment was observed to be advantageous in terms of preserving renal function when used as an add-on therapy for patients with type 2 DM in whom sulfonylurea and metformin regimens failed.

  14. Production development and utilization of Zimmer Station wet FGD by-products. Final report. Volume 5, A laboratory greenhouse study conducted in fulfillment of Phase 2, Objective 2 titled. Use of FGD by-product gypsum enriched with magnesium hydroxide as a soil amendment

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

    Yibirin, H.; Stehouwer, R. C.; Bigham, J. M.

    The Clean Air Act, as revised in 1992, has spurred the development of flue gas desulfurization (FGD) technologies that have resulted in large volumes of wet scrubber sludges. In general, these sludges must be dewatered, chemically treated, and disposed of in landfills. Disposal is an expensive and environmentally questionable process for which suitable alternatives must be found. Wet scrubbing with magnesium (Mg)-enhanced lime has emerged as an efficient, cost effective technology for SO 2 removal. When combined with an appropriate oxidation system, the wet scrubber sludge can be used to produce gypsum (CaSO 4-2H 2O) and magnesium hydroxide [Mg(OH) 2]more » of sufficient purity for beneficial re-use. Product value generally increases with purity of the by-product(s). The pilot plant at the CINERGY Zimmer Station near Cincinnati produces gypsum by products that can be formulated to contain varying amounts of Mg(OH) 2. Such materials may have agricultural value as soil conditioners, liming agents and sources of plant nutrients (Ca, Mg, S). This report describes a greenhouse study designed to evaluate by-product gypsum and Mg gypsum from the Zimmer Station pilot plant as amendments for improving the quality of agricultural soils and mine spoils that are currently unproductive because of phytotoxic conditions related to acidity and high levels of toxic dissolved aluminum (Al). In particular, the technical literature contains evidence to suggest that gypsum may be more effective than agricultural limestone in modifying soil chemical conditions below the immediate zone of application. Representative samples of by-product gypsum and Mg(OH) 2 from the Zimmer Station were initially characterized. The gypsum was of high chemical purity and consisted of well crystalline, lath-shaped particles of low specific surface area. By contrast, the by-product Mg(OH) 2 was a high surface area material (50 m 2 g -1) that contained 20% CaSO 4 with variable hydration state. Artificial

  15. Humor adds the creative touch to CQI teams.

    PubMed

    Balzer, J W

    1994-07-01

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

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

    PubMed

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

    2014-12-01

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

  17. Efficacy and Safety of Dapagliflozin or Dapagliflozin Plus Saxagliptin Versus Glimepiride as Add-on to Metformin in Patients With Type 2 Diabetes.

    PubMed

    Müller-Wieland, Dirk; Kellerer, Monika; Cypryk, Katarzyna; Skripova, Dasa; Rohwedder, Katja; Johnsson, Eva; Garcia-Sanchez, Ricardo; Kurlyandskaya, Raisa; David Sjöström, C; Jacob, Stephan; Seufert, Jochen; Dronamraju, Nalina; Csomós, Katalin

    2018-06-27

    To compare efficacy and safety of dapagliflozin ± saxagliptin with glimepiride as add-on to metformin in patients with type 2 diabetes. This 52-week, multicenter, double-blind, active-controlled study (NCT02471404) randomized (1:1:1) patients (n=939; HbA 1C 7.5-10.5%) on metformin monotherapy (≥1500 mg/day) to add-on dapagliflozin 10 mg, dapagliflozin 10 mg plus saxagliptin 5 mg, or glimepiride 1-6 mg (titrated). The primary efficacy end point was change in HbA 1C from baseline to week 52. Baseline mean age, diabetes duration and HbA 1C were 58.4 years, 7.0 years and 8.3%, respectively. Adjusted mean HbA 1C change from baseline was -1.20% with dapagliflozin plus saxagliptin and -0.82% with dapagliflozin, vs. -0.99% with glimepiride (mean dose at week 52: 4.6 mg). Changes in body weight (-3.2 kg and -3.5 k vs +1.8 kg) and systolic blood pressure (SBP; -6.4 mmHg and -5.6 mmHg vs -1.6 mmHg) were significantly greater with dapagliflozin plus saxagliptin and dapagliflozin vs glimepiride; FPG decreased significantly with dapagliflozin plus saxagliptin vs glimepiride (-2.1 mmol/L vs -1.5 mmol/L) and was similar for dapagliflozin (-1.6 mmol/L) vs glimepiride. Confirmed hypoglycemia incidence was lower with dapagliflozin regimens than with glimepiride (0 and 1 vs 13 patients) and fewer patients required rescue. Genital infections were more frequent with dapagliflozin; other AE profiles were similar. Dapagliflozin, saxagliptin and metformin improved glycemic control compared with glimepiride plus metformin; add-on of dapagliflozin alone showed similar efficacy to glimepiride. Both dapagliflozin regimens decreased body weight and SBP, with lower hypoglycemia incidence compared with glimepiride. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  18. [Multimodal therapy of functional gastrointestinal disorders].

    PubMed

    Egloff, N; Beer, C; Gschossmann, J M; Sendensky, A; von Känel, R

    2010-04-14

    A multimodal approach is state-of-the art for effective treatment of functional gastrointestinal disorders (FGD) like irritable bowel syndrome and functional dyspepsia. Based on the now established view that the pathogenesis of FGD is multicausal, evidence-based therapeutic options comprise education about the nature of the disorder, dietary modifications, relaxation techniques, behavioral changes, and pharmacological treatments. These therapies are variously combined depending on the severity of the FGD and the individual needs of the patient. Our overview portrays the options for the therapy of FGD and proposes that these are best provided by an interdisciplinary team of primary care physicians, gastroenterologists, and psychosomatic medicine specialists.

  19. System on a Chip (SoC) Overview

    NASA Technical Reports Server (NTRS)

    LaBel, Kenneth A.

    2010-01-01

    System-on-a-chip or system on chip (SoC or SOC) refers to integrating all components of a computer or other electronic system into a single integrated circuit (chip). It may contain digital, analog, mixed-signal, and often radio-frequency functions all on a single chip substrate. Complexity drives it all: Radiation tolerance and testability are challenges for fault isolation, propagation, and validation. Bigger single silicon die than flown before and technology is scaling below 90nm (new qual methods). Packages have changed and are bigger and more difficult to inspect, test, and understand. Add in embedded passives. Material interfaces are more complex (underfills, processing). New rules for board layouts. Mechanical and thermal designs, etc.

  20. N-acetyl cysteine add-on treatment for bipolar II disorder: a subgroup analysis of a randomized placebo-controlled trial.

    PubMed

    Magalhães, P V; Dean, O M; Bush, A I; Copolov, D L; Malhi, G S; Kohlmann, K; Jeavons, S; Schapkaitz, I; Anderson-Hunt, M; Berk, M

    2011-03-01

    The evidence base for the pharmacological treatment of bipolar II disorder is limited. In bipolar disorder, there is evidence for glutathione depletion and increased oxidative stress, as well as dysregulation of glutamate; N-acetyl cysteine (NAC) has effects on both of these systems. Add-on NAC has been shown to have a significant benefit on depressive symptoms in a randomized placebo-controlled trial. In this report, we explore the effects of this compound in a subset of patients with bipolar II disorder from that trial. Individuals were randomized to NAC or placebo in addition to treatment as usual, in a double-blind fashion. Mood and functional outcomes were assessed up to 24 weeks of treatment. Fourteen individuals were available for this report, seven in each group. Six people achieved full remission of both depressive and manic symptoms in the NAC group; this was true for only two people in the placebo group (χ(2)=4.67, p=0.031). Subgroup analyses in a small subsample of patients. Not all participants had elevated depression scores at baseline. Notwithstanding all the limitations that subgroup analysis of trials carry, this data could serve as a hypothesis-generating stimulus for further clinical trials of pharmacologic treatment for bipolar II depression. Copyright © 2010 Elsevier B.V. All rights reserved.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  2. Once-Daily Liraglutide Versus Lixisenatide as Add-on to Metformin in Type 2 Diabetes: A 26-Week Randomized Controlled Clinical Trial.

    PubMed

    Nauck, Michael; Rizzo, Manfredi; Johnson, Andrew; Bosch-Traberg, Heidrun; Madsen, Jesper; Cariou, Bertrand

    2016-09-01

    To compare the efficacy and safety of liraglutide versus lixisenatide as add-on to metformin in patients with type 2 diabetes not achieving adequate glycemic control on metformin alone. In this 26-week, randomized, parallel-group, open-label trial, 404 patients were randomized 1:1 to liraglutide 1.8 mg or lixisenatide 20 µg as add-on to metformin. Liraglutide was administered once daily at any time of the day. Lixisenatide was administered once daily within 1 h prior to the morning or evening meal. At week 26, liraglutide reduced HbA1c (primary end point) more than lixisenatide (estimated treatment difference -0.62% [95% CI -0.8; -0.4]; P < 0.0001), with more patients reaching HbA1c <7% (53 mmol/mol) and ≤6.5% (48 mmol/mol) versus lixisenatide (74.2% and 54.6% for liraglutide vs. 45.5% and 26.2% for lixisenatide; P < 0.0001 for both). Liraglutide reduced fasting plasma glucose more than lixisenatide (estimated treatment difference -1.15 mmol/L [95% CI -1.5; -0.8]; P < 0.0001). Liraglutide provided greater reduction in mean 9-point self-measured plasma glucose (P < 0.0001). However, postprandial glucose increments were smaller with lixisenatide for the meal directly after injection compared with liraglutide (P < 0.05), with no differences between treatments across all meals. Both drugs promoted similar body weight decrease (-4.3 kg for liraglutide, -3.7 kg for lixisenatide; P = 0.23). The most common adverse events in both groups were gastrointestinal disorders. Greater increases in pulse, lipase, and amylase were observed with liraglutide. Hypoglycemic episodes were rare and similar between the two treatments. At the dose levels studied, liraglutide was more effective than lixisenatide as add-on to metformin in improving glycemic control. Body weight reductions were similar. Both treatments were well tolerated, with low risk of hypoglycemia and similar gastrointestinal adverse event profiles. © 2016 by the American Diabetes Association.

  3. Safety and effectiveness of tacrolimus add-on therapy for rheumatoid arthritis patients without an adequate response to biological disease-modifying anti-rheumatic drugs (DMARDs): Post-marketing surveillance in Japan.

    PubMed

    Takeuchi, Tsutomu; Ishida, Kota; Shiraki, Katsuhisa; Yoshiyasu, Takashi

    2018-01-01

    Post-marketing surveillance (PMS) was conducted to assess the safety and effectiveness of tacrolimus (TAC) add-on therapy for patients with rheumatoid arthritis (RA) and an inadequate response to biological disease-modifying anti-rheumatic drugs (DMARDs). Patients with RA from 180 medical sites across Japan were registered centrally with an electronic investigation system. The observational period was 24 weeks from the first day of TAC administration concomitantly with biological DMARDs. Safety and effectiveness populations included 624 and 566 patients, respectively. Patients were predominantly female (81.1%), with a mean age of 61.9 years. Overall, 125 adverse drug reactions (ADRs) occurred in 94 patients (15.1%), and 15 serious ADRs occurred in 11 patients (1.8%). These incidences were lower compared with previously reported incidences after TAC treatment in PMS, and all of the observed ADRs were already known. A statistically significant improvement was observed in the primary effectiveness variable of Simplified Disease Activity Index after TAC treatment; 62.7% of patients achieved remission or low disease activity at week 24. TAC is well tolerated and effective when used as an add-on to biological DMARDs in Japanese patients with RA who do not achieve an adequate response to biological DMARDs in a real-world clinical setting.

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

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

    Iwase, Shigeki; Xiang, Bin; Ghosh, Sharmistha

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

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

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

    S Iwase; B Xiang; S Ghosh

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

  6. Comparative behavioral and neurochemical analysis of phenytoin and valproate treatment on epilepsy induced learning and memory deficit: Search for add on therapy.

    PubMed

    Mishra, Awanish; Goel, Rajesh Kumar

    2015-08-01

    Our previous work demonstrated, chronic epilepsy affects learning and memory of rodents along with peculiar neurochemical changes in discrete brain parts. Most commonly used antiepileptic drugs (phenytoin and sodium valproate) also worsen learning and memory in the patients with epilepsy. Therefore this study was designed to carry out comparison of behavioral and neurochemical changes with phenytoin and sodium valproate treatment in pentylenetetrazole-kindling induced learning and memory deficit to devise add on therapy for this menace. For the experimental epilepsy, animals were kindled using PTZ (35 mg/kg; i.p., at 48 ± 2 h intervals) and successful kindled animals were involved in the study. These kindled animals were treated with saline, phenytoin (30 mg/kg/day, i.p.) and sodium valproate (300 mg/kg/day, i.p.) for 20 days. These animals were challenged with PTZ challenging dose (35 mg/kg) on day 5, 10, 15 and 20 to evaluate the effect on seizure severity score on different days. Effect on learning and memory was evaluated using elevated plus maze and passive shock avoidance paradigm. On day 20, after behavioral evaluations, animals were sacrificed to analyze glutamate, GABA, norepinephrine, dopamine, serotonin, total nitrite level and acetylcholinesterase level in cortex and hippocampus. Behavioral evaluations suggested that phenytoin and sodium valproate treatment significantly reduced seizure severity in the kindled animals, while sodium valproate treatment controls seizures with least memory deficit in comparison to phenytoin. Neurochemical findings revealed that elevated cortical acetylcholinesterase level could be one of the responsible factors leading to memory deficit in phenytoin treated animals. However sodium valproate treatment reduced cortical acetylcholinesterase level and had least debilitating consequences on memory deficit. Therefore, attenuation of elevated AChE activity can be one of add-on approach for management of memory deficit

  7. Evaluation of ADD392124 for the Delayed Treatment of Nerve Agent-Induced Status Epilepticus Seizures

    DTIC Science & Technology

    2011-09-01

    Induced Status Epilepticus Seizures John H. McDonough Kerry E. Van Shura Megan E. Lyman Claire G. Eisner Amelia Mazza Robert K. Kan Tsung...TITLE AND SUBTITLE 5a. CONTRACT NUMBER Evaluation of ADD392124 for the delayed treatment of nerve agent-induced status epilepticus seizures 5b... status epilepticus seizures. We evaluated the ability of ADD392124 to control seizures induced by the nerve agent soman. Rats were exposed to a

  8. Project DyAdd: Implicit Learning in Adult Dyslexia and ADHD

    ERIC Educational Resources Information Center

    Laasonen, Marja; Väre, Jenni; Oksanen-Hennah, Henna; Leppämäki, Sami; Tani, Pekka; Harno, Hanna; Hokkanen, Laura; Pothos, Emmanuel; Cleeremans, Axel

    2014-01-01

    In this study of the project DyAdd, implicit learning was investigated through two paradigms in adults (18-55 years) with dyslexia (n?=?36) or with attention deficit/hyperactivity disorder (ADHD, n?=?22) and in controls (n?=?35). In the serial reaction time (SRT) task, there were no group differences in learning. However, those with ADHD exhibited…

  9. Field Collection Methods for an EPA Pilot Study Evaluating Personal, Housing, and Community Factors Influencing Children’s Potential Exposures to Indoor Contaminants at Various Lifestages (EPA Pilot Study Add-On to the GreenHousing Study)

    EPA Science Inventory

    This compilation of field collection standard operating procedures (SOPs) was assembled for the U.S. Environmental Protection Agency’s (EPA) Pilot Study add-on to the Green Housing Study (GHS). A detailed description of this add-on study can be found in the peer reviewed research...

  10. A novel photonic crystal ring resonator configuration for add/drop filtering

    NASA Astrophysics Data System (ADS)

    Zhang, Juan; Liu, Hao; Ding, Yipeng; Wang, Yang

    2018-07-01

    A novel compact photonic crystal ring resonator (PCRR) configuration is proposed to realize high-efficiency waveguided add-drop filtering. Its wavelength selection and dropping-direction exchange functions are demonstrated numerically. The working mechanism of this nested dual-loop resonant cavity structure is analyzed in detail.

  11. Dipeptidyl peptidase-4 inhibitors or sodium glucose co-transporter-2 inhibitors as an add-on to insulin therapy: A comparative review

    PubMed Central

    Singh, Awadhesh Kumar; Singh, Ritu

    2016-01-01

    The gradual decline in β-cell function is inevitable in type 2 diabetes mellitus and therefore, substantial proportions of patients require insulin subsequently, in order to achieve optimal glucose control. While weight gain, hypoglycemia, and fluid retention especially during dose intensification is a known limitation to insulin therapy, these adverse effects also reduce patient satisfaction and treatment adherence. It is also possible that the benefits of intensive control achieved by insulin therapy, perhaps get nullified by the weight gain and hypoglycemia. In addition, improvement in plasma glucose or glycated hemoglobin (HbA1c) itself is associated with weight gain. Notably, studies have already suggested that reduction in body weight by ~3–5%, may allow a significantly better glycemic control. Thus, a class of drugs, which can reduce HbA1c effectively, yet are weight neutral or preferably reduce body weight, could be the most sought out strategy as an add-on therapy to insulin. While sulfonylureas (SUs) are associated with weight gain and hypoglycemia, pioglitazone increases body weight and fluid retention. Moreover, SUs are not recommended once premix or prandial insulin is commenced. The addition of newer agents, such as glucagon-like peptide-1 receptor agonist to insulin certainly appears to be an effective tool in reducing both HbA1c and body weight as is evident across the studies; however, this approach incurs an additional injection as well as cost. Dipeptidyl peptidase-4 inhibitors (DPP-4I) and sodium-glucose co-transporter-2 inhibitors (SGLT-2I) are other exciting options, as an add-on to insulin therapy primarily because these are oral drugs and do not possess any intrinsic potential of hypoglycemia. Furthermore, these are either weight neutral or induce significant weight loss. This review article aims to comparatively analyze the safety and efficacy of DPP-4I and SGLT-2I, as an add-on therapy to insulin. PMID:26904466

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

    PubMed

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

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

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

    PubMed

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

    2017-12-01

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

  14. The Impact of Highly and Minimally Guided Discovery Instruction on Promoting the Learning of Reasoning Strategies for Basic Add-1 and Doubles Combinations

    ERIC Educational Resources Information Center

    Baroody, Arthur J.; Purpura, David J.; Eiland, Michael D.; Reid, Erin E.

    2015-01-01

    A 9-month training experiment was conducted to evaluate the efficacy of highly and minimally guided discovery interventions targeting the add-1 rule (the sum of a number and one is the next number on the mental number list) and doubles relations (e.g., an everyday example of the double 5 + 5 is five fingers on the left hand and five fingers on the…

  15. A cost-effective add-on-value card-assisted firewall over Taiwan's NHI VPN framework.

    PubMed

    Huang, Jyh-Win; Hou, Ting-Wei

    2007-06-01

    Besides the overall budget for building the infrastructure of a healthcare-service-based virtual private network (VPN) in Taiwan, two issues were considered critical for its acceptance by the country's 17,000 plus medical institutions. One was who was to pay for the network (ADSL or modem) connection fee; the other was who was to pay for the firewall/anti-virus software. This paper addresses the second issue by proposing an efficient freeware firewall, named card-assisted firewall (CAF), for NHI VPN edge-hosts, which is also an add-on-value application of the National Healthcare IC card that every insurant and medical professional has. The innovative concept is that any NHI VPN site (edge-host) can establish diversified secure-authenticated connections with other sites only by an authentication mechanism, which requires a NHI Java card state machine and the Access Control List of the host. It is different from two-factor authentication cards in four ways: (1) a PIN code is not a must; (2) it requires authentication with the remote IC card Data Centre; (3) the NHI cards are already available, no modification is needed, and there is no further cost for the deployment of the cards; (4) although the cards are in the reader, the communication cannot start unless the cards are in the corresponding states; i.e. the states allow communication. An implementation, on a Microsoft Windows XP platform, demonstrated the system's feasibility over an emulation of the NHI VPN framework. It maintained a high line speed, the driver took up 39 KB of disk space, installation was simple, not requiring any extra hardware or software, and the average packet processing time of the CAF driver measured was 0.3084 ms. The average overhead in comparing the Access Control List predefined routing in card, in an FTP testing experiment, was 5.7 micros (receiving) and 8 micros (sending).

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

    PubMed

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

    2017-10-01

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

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

    PubMed Central

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

    2017-01-01

    Abstract Essential hypertension (EH) is a complex disease in which physiological, environmental, and genetic factors are involved in its genesis. The genetic variant of the alpha-adducin gene (ADD1) has been described as a risk factor for EH, but with controversial results. The objective of this study was to evaluate the association of ADD1 (Gly460Trp) gene polymorphism with the EH risk in a population from Madeira Island. A case-control study with 1614 individuals of Caucasian origin was performed, including 817 individuals with EH and 797 controls. Cases and controls were matched for sex and age, by frequency-matching method. All participants collected blood for biochemical and genotypic analysis for the Gly460Trp polymorphism. We further investigated which variables were independently associated to EH, and, consequently, analyzed their interactions. In our study, we found a significant association between the ADD1 gene polymorphism and EH (odds ratio 2.484, P = .01). This association remained statistically significant after the multivariate analysis (odds ratio 2.548, P = .02). The ADD1 Gly460Trp gene polymorphism is significantly and independently associated with EH risk in our population. The knowledge of genetic polymorphisms associated with EH is of paramount importance because it leads to a better understanding of the etiology and pathophysiology of this pathology. PMID:29049185

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Thanopoulos, John

    2010-01-01

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

  20. Application of shift-and-add algorithms for imaging objects within biological media

    NASA Astrophysics Data System (ADS)

    Aizert, Avishai; Moshe, Tomer; Abookasis, David

    2017-01-01

    The Shift-and-Add (SAA) technique is a simple mathematical operation developed to reconstruct, at high spatial resolution, atmospherically degraded solar images obtained from stellar speckle interferometry systems. This method shifts and assembles individual degraded short-exposure images into a single average image with significantly improved contrast and detail. Since the inhomogeneous refractive indices of biological tissue causes light scattering similar to that induced by optical turbulence in the atmospheric layers, we assume that SAA methods can be successfully implemented to reconstruct the image of an object within a scattering biological medium. To test this hypothesis, five SAA algorithms were evaluated for reconstructing images acquired from multiple viewpoints. After successfully retrieving the hidden object's shape, quantitative image quality metrics were derived, enabling comparison of imaging error across a spectrum of layer thicknesses, demonstrating the relative efficacy of each SAA algorithm for biological imaging.

  1. The development of a web-based assessment system to identify students’ misconception automatically on linear kinematics with a four-tier instrument test

    NASA Astrophysics Data System (ADS)

    Pujayanto, Pujayanto; Budiharti, Rini; Adhitama, Egy; Nuraini, Niken Rizky Amalia; Vernanda Putri, Hanung

    2018-07-01

    This research proposes the development of a web-based assessment system to identify students’ misconception. The system, named WAS (web-based assessment system), can identify students’ misconception profile on linear kinematics automatically after the student has finished the test. The test instrument was developed and validated. Items were constructed and arranged from the result of a focus group discussion (FGD), related to previous research. Fifty eight students (female  =  37, male  =  21) were used as samples. They were from different classes with 18 students from the gifted class and another 40 students from the normal class. WAS was designed specifically to support the teacher as an efficient replacement for a paper-based test system. In addition, WAS offers flexible timing functionally, stand-alone subject module, robustness and scalability. The entire WAS program and interface was developed with open source-based technologies such as the XAMP server, MySQL database, Javascript and PHP. It provides results immediately and provides diagrammatic questions as well as scientific symbols. It is feasible to apply this system to many students at once. Thus, it could be integrated in many schools as part of physics courses.

  2. The Incidence and gastrointestinal infectious risk of functional gastrointestinal disorders in a healthy US adult population.

    PubMed

    Porter, Chad K; Gormley, Robert; Tribble, David R; Cash, Brooks D; Riddle, Mark S

    2011-01-01

    Functional gastrointestinal disorders (FGDs) are recognized sequelae of infectious gastroenteritis (IGE). Within the active duty military population, a group with known high IGE rates, the population-based incidence, risk factors, and attributable burden of care referable to FGD after IGE are poorly defined. Using electronic medical encounter data (1999-2007) on active duty US military, a matched, case-control study describing the epidemiology and risk determinants of FGD (irritable bowel syndrome (IBS), functional constipation (FC), functional diarrhea (FD), dyspepsia (D)) was conducted. Incidence rates and duration of FGD-related medical care were estimated, and conditional logistic regression was utilized to evaluate FGD risk after IGE. A total of 31,866 cases of FGD identified were distributed as follows: FC 55% (n=17,538), D 21.2% (n=6,750), FD 2.1% (n=674), IBS 28.5% (n=9,091). Previous IGE episodes were distributed as follows: specific bacterial pathogen (n=65, 1.2%), bacterial, with no pathogen specified (n=2155, 38.9%), protozoal (n=38, 0.7%), viral (n=3431, 61.9%). A significant association between IGE and all FGD (odds ratio (OR) 2.64; P<0.001) was seen, with highest risk for FD (OR 6.28, P<0.001) and IBS (OR 3.72, P<0.001), and moderate risk for FC (2.15, P<0.001) and D (OR 2.39, P<0.001). Risk generally increased with temporal proximity to, and bacterial etiology of, exposure. Duration of FGD-related care was prolonged with 22.7% having FGD-associated medical encounters 5 years after diagnosis. FGD are common in this population at high risk for IGE. When considering effective countermeasures and mitigation strategies, attention directed toward prevention as well as the acute and chronic sequelae of these infections is needed.

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  4. 76 FR 37114 - Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... determination concerning a petition to add a class of employees from the Linde Ceramics Plant in Tonawanda, New...

  5. 77 FR 76490 - Determination Concerning a Petition to Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition to Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice of a determination concerning a petition to add a class of...

  6. 76 FR 37114 - Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... determination concerning a petition to add a class of employees from the Dow Chemical Company in Madison...

  7. 77 FR 9251 - Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice of a determination concerning a petition to add a class of...

  8. 78 FR 98 - Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice of a determination concerning a petition to add a class of...

  9. 76 FR 37115 - Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... determination concerning a petition to add a class of employees from the Bliss & Laughlin Steel Company located...

  10. 76 FR 37115 - Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... determination concerning a petition to add a class of employees from the Wah Chang facility in Albany, Oregon...

  11. 78 FR 64501 - Determination Concerning a Petition to Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition to Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice of a determination concerning a petition to add a class of...

  12. 77 FR 58383 - Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice of a determination concerning a petition to add a class of...

  13. 78 FR 64502 - Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice of a determination concerning a petition to add a class of...

  14. 76 FR 37115 - Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Determination Concerning a Petition To Add a Class of Employees to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... determination concerning a petition to add a class of employees from the Chapman Valve Manufacturing Company (i...

  15. Drug-resistant MS spasticity treatment with Sativex(®) add-on and driving ability.

    PubMed

    Freidel, M; Tiel-Wilck, K; Schreiber, H; Prechtl, A; Essner, U; Lang, M

    2015-01-01

    The aim of the present observational study was to determine the effects of a delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) oromucosal spray (Sativex(®) spray), brand name Sativex(®), indicated for drug-resistant MS spasticity, on the driving ability of treated MS patients. The study was conducted over a period of 4-6 weeks. Thirty-three MS patients with moderate to severe treatment-resistant spasticity and planned to begin add-on treatment with Sativex(®) were enrolled at three specialized MS centres in Germany. A set of five driving test procedures from a validated computerized test battery was used to evaluate the driving ability of eligible patients. Tests were performed by patients at baseline and repeated after 4-6 weeks of treatment with Sativex(®) oromucosal spray. According to German normative data, the test thresholds achieved by the general population served as a reference to allow for a fitness/unfitness to drive classification. Patients showed comparable driving test results at baseline and at final visits. Only two patients changed classification shifting from 'unfit' to drive to 'fit' and vice versa. The mean severity of spasticity, as self-reported by the patients, improved with statistical significance. Sativex(®) was generally well tolerated. Treatment of MS patients with Sativex(®) does not negatively impact on driving ability and may improve moderate to severe treatment-resistant MS spasticity. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Quality of life and health care consultation in 13 to 18 year olds with abdominal pain predominant functional gastrointestinal diseases.

    PubMed

    Devanarayana, Niranga Manjuri; Rajindrajith, Shaman; Benninga, Marc A

    2014-08-21

    Abdominal pain predominant functional gastrointestinal diseases (AP-FGD) are commonly seen in the paediatric age group. It has significant impact on daily activities of affected children. Main objective of this study was to assess the health related quality of life (HRQoL) in children with AP-FGD. This was a cross sectional survey conducted in children aged 13-18 years, in four randomly selected schools in Western province of Sri Lanka. Data was collected using a previously validated, self-administered questionnaire. It had questions on symptoms, HRQoL and health care consultation. AP-FGD were diagnosed using Rome III criteria. A total of 1850 questionnaires were included in the analysis [males 1000 (54.1%), mean age 14.4 years and SD 1.3 years]. Of them, 305 (16.5%) had AP-FGD [irritable bowel syndrome = 91(4.9%), functional dyspepsia = 11 (0.6%), abdominal migraine = 37 (1.9%) and functional abdominal pain = 180 (9.7%)]. Lower HRQoL scores for physical (83.6 vs. 91.4 in controls), social (85.0 vs. 92.7), emotional (73.6 vs. 82.7) and school (75.0 vs. 82.5) functioning domains, and lower overall scores (79.6 vs. 88.0) were seen in children with AP-FGD (p < 0.001). A weak but significant negative correlation was observed between HRQoL score and severity of abdominal pain (r = -0.24, p < 0.0001). Eighty five children (27.9%) had sought healthcare for AP-FGD. Factors determining healthcare seeking were presence of abdominal bloating and vomiting (p < 0.05). Children with AP-FGD have lower quality of life in all 4 domains. Those with severe symptoms have lower HRQoL. Approximately 28% of children with AP-FGD seek healthcare for their symptoms.

  17. 76 FR 62788 - Privacy Act of 1974; System of Records; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-11

    ...; System of Records; Correction AGENCY: Department of the Army, Department of Defense (DoD). ACTION: Notice to add a system of records; correction. SUMMARY: On October 5, 2011 (76 FR 61680-61682), DoD published a notice announcing its intent to add a new Privacy Act System of Records. The Contesting Records...

  18. Randomized, Double-Blind, Phase 3 Trial of Triple Therapy With Dapagliflozin Add-on to Saxagliptin Plus Metformin in Type 2 Diabetes.

    PubMed

    Mathieu, Chantal; Ranetti, Aurelian Emil; Li, Danshi; Ekholm, Ella; Cook, William; Hirshberg, Boaz; Chen, Hungta; Hansen, Lars; Iqbal, Nayyar

    2015-11-01

    To compare the efficacy and safety of treatment with dapagliflozin versus that with placebo add-on to saxagliptin plus metformin in patients whose type 2 diabetes is inadequately controlled with saxagliptin plus metformin treatment. Patients receiving treatment with stable metformin (stratum A) (screening HbA1c level 8.0-11.5% [64-102 mmol/mol]) or stable metformin and a dipeptidyl peptidase-4 (DPP-4) inhibitor (stratum B) (HbA1c 7.5-10.5% [58-91 mmol/mol]) for ≥8 weeks received open-label saxagliptin 5 mg/day and metformin for 16 weeks (stratum A) or 8 weeks (stratum B) (saxagliptin replaced any DPP-4 inhibitor). Patients with inadequate glycemic control (HbA1c 7-10.5% [53-91 mmol/mol]) were randomized to receive placebo or dapagliflozin 10 mg/day plus saxagliptin and metformin. The primary end point was the change in HbA1c from baseline to week 24. Secondary end points included fasting plasma glucose (FPG) level, 2-h postprandial glucose (PPG) level, body weight, and proportion of patients achieving an HbA1c level of <7% (53 mmol/mol). Treatment with dapagliflozin add-on to saxagliptin plus metformin resulted in a greater mean HbA1c reduction than placebo (-0.82 vs. -0.10% [-9 vs. -1.1 mmol/mol], P < 0.0001). Significantly greater reductions in FPG level, 2-h PPG level, and body weight were observed, and more patients achieved an HbA1c level of <7% (53 mmol/mol) with treatment with dapagliflozin versus placebo. Adverse events were similar across treatment groups, with a low overall risk of hypoglycemia (∼1%). Genital infections developed in more patients with dapagliflozin treatment (5%) than with placebo (0.6%). Triple therapy with dapagliflozin add-on to saxagliptin plus metformin improves glycemic control and is well tolerated in patients whose type 2 diabetes is inadequately controlled with saxagliptin plus metformin therapy. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is

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

    PubMed

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

    2015-10-30

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

  20. Dry flue gas desulfurization by-product application effects on plant uptake and soil storage changes in a managed grassland.

    PubMed

    Burgess-Conforti, Jason R; Brye, Kristofor R; Miller, David M; Pollock, Erik D; Wood, Lisa S

    2018-02-01

    Environmental regulations mandate that sulfur dioxide (SO 2 ) be removed from the flue gases of coal-fired power plants, which results in the generation of flue gas desulfurization (FGD) by-products. These FGD by-products may be a viable soil amendment, but the large amounts of trace elements contained in FGD by-products are potentially concerning. The objective of this study was to evaluate the effects of land application of a high-Ca dry FGD (DFGD) by-product on trace elements in aboveground biomass and soil. A high-Ca DFGD by-product was applied once at a rate of 9 Mg ha -1 on May 18, 2015 to small plots with mixed-grass vegetation. Soil and biomass were sampled prior to application and several times thereafter. Aboveground dry matter and tissue As, Co, Cr, Hg, Se, U, and V concentrations increased (P < 0.05) following application, but did not differ (P > 0.05) from pre-application levels or the unamended control within 3 to 6 months of application. Soil pH in the amended treatment 6 months after application was greater (P < 0.05) than in the unamended control. Soil Ca, S, and Na contents also increased (P < 0.05), following by-product application compared to the unamended control. High-Ca DFGD by-products appear to be useful as a soil amendment, but cause at least a temporary increase in tissue concentrations of trace elements, which may be problematic for animal grazing situations.

  1. A Review of the Performance of AFFF Systems Serving Helicopter Decks on U.S. Navy Surface Combatants

    DTIC Science & Technology

    2001-04-23

    The AFFF systems serving the helo decks on surface combatants are designed for rapid control and extinguishment of JP-5 pool fires. Based on the...add 15-30 seconds to the above times. This estimate also assumes that the AFFF systems are adequately maintained and operationally ready and that

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

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

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

  3. Add-on therapy with anagliptin in Japanese patients with type-2 diabetes mellitus treated with metformin and miglitol can maintain higher concentrations of biologically active GLP-1/total GIP and a lower concentration of leptin.

    PubMed

    Osonoi, Takeshi; Saito, Miyoko; Hariya, Natsuyo; Goto, Moritaka; Mochizuki, Kazuki

    2016-12-01

    Metformin, α-glucosidase inhibitors (α-GIs), and dipeptidyl peptidase 4 inhibitors (DPP-4Is) reduce hyperglycemia without excessive insulin secretion, and enhance postprandial plasma concentration of glucagon-like peptide-1 (GLP-1) in type-2 diabetes mellitus (T2DM) patients. We assessed add-on therapeutic effects of DPP-4I anagliptin in Japanese T2DM patients treated with metformin, an α-GI miglitol, or both drugs on postprandial responses of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), and on plasma concentration of the appetite-suppressing hormone leptin. Forty-two Japanese T2DM patients with inadequately controlled disease (HbA1c: 6.5%-8.0%) treated with metformin (n=14), miglitol (n=14) or a combination of the two drugs (n=14) received additional treatment with anagliptin (100mg, p.o., b.i.d.) for 52 weeks. We assessed glycemic control, postprandial responses of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), and on plasma concentration of leptin in those patients. Add-on therapy with anagliptin for 52 weeks improved glycemic control and increased the area under the curve of biologically active GLP-1 concentration without altering obesity indicators. Total GIP concentration at 52 weeks was reduced by add-on therapy in groups treated with miglitol compared with those treated with metformin. Add-on therapy reduced leptin concentrations. Add-on therapy with anagliptin in Japanese T2DM patients treated with metformin and miglitol for 52 weeks improved glycemic control and enhanced postprandial concentrations of active GLP-1/total GIP, and reduce the leptin concentration. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Quality of life, mood and seizure control in patients with brain tumor related epilepsy treated with lacosamide as add-on therapy: A prospective explorative study with a historical control group.

    PubMed

    Maschio, Marta; Zarabla, Alessia; Maialetti, Andrea; Fabi, Alessandra; Vidiri, Antonello; Villani, Veronica; Giannarelli, Diana

    2017-08-01

    Brain tumor-related epilepsy (BTRE) is often drug resistant and patients can be forced to take polytherapy that can adversely affect their quality of life (QoL). Lacosamide (LCM) is a new antiepileptic drug (AED) used as adjunctive therapy in patients with partial seizures with or without secondary generalization, with a favorable pharmacokinetic profile that seems to be effective and well tolerated. Therefore it represents a possible therapeutic choice for patients with BTRE. We propose a prospective study with a historical control group to evaluate the effect of LCM as add-on therapy on seizure control and quality of life in patients with BTRE. This study has been designed to test the superiority of Lacosamide over Levetiracetam as an add-on. We compared a prospective cohort of 25 patients treated with Lacosamide with a historical control group (n=19) treated with Levetiracetam as an add-on. We recruited 25 adult patients (M 18, F 7; mean age 41.9) affected by BTRE with uncontrolled partial-onset seizures treated with AED polytherapy. We added LCM as an add-on. Patients were evaluated at baseline, after 3months and at 6months. This population has been compared with a historical control group of 19 BTRE adult patients (M 13, F 6; median age 48.0, range: 28-70) with uncontrolled partial-onset seizures treated with LEV as add-on. The patients underwent QoL, mood and adverse events tests (Adverse Event Profile-AEP) and evaluation of seizure frequency. Twelve patients had high grade gliomas, and thirteen had low grade gliomas. During follow-up, thirteen patients underwent chemotherapy, three radiotherapy and five patients had disease progression. Nine patients had simple partial seizures, eight had complex partial seizures, and eight had secondary generalized seizures. Fifteen patients were in monotherapy and ten in polytherapy with AEDs. LCM was added up to reach the maximum dosage of 400mg/die (mean final dose 300mg/die). Four patients dropped out due to poor

  5. Linagliptin as add-on to empagliflozin and metformin in patients with type 2 diabetes: Two 24-week randomized, double-blind, double-dummy, parallel-group trials.

    PubMed

    Tinahones, Francisco J; Gallwitz, Baptist; Nordaby, Matias; Götz, Sophia; Maldonado-Lutomirsky, Mario; Woerle, Hans J; Broedl, Uli C

    2017-02-01

    To evaluate the efficacy and safety of linagliptin vs placebo as add-on to empagliflozin and metformin in patients with type 2 diabetes. Patients with inadequate glycaemic control despite stable-dose metformin received open-label empagliflozin 10 mg (study 1) or 25 mg (study 2) as add-on therapy for 16 weeks. Subsequently, those with HbA1c ≥7.0 and ≤10.5% (>53 and ≤91 mmol/mol) (N = 482) were randomized to 24 weeks' double-blind, double-dummy treatment with linagliptin 5 mg or placebo in study 1, or to linagliptin 5 mg or placebo in study 2; all patients continued treatment with metformin and empagliflozin 10 mg (study 1) or metformin and empagliflozin 25 mg (study 2). The primary endpoint was change from baseline (defined as the last value before first intake of randomized, double-blind treatment) in HbA1c at week 24. At week 24, HbA1c (mean baseline 7.82-8.04 [62-64 mmol/mol]) was significantly reduced with linagliptin vs placebo; adjusted mean (SE) differences in change from baseline in HbA1c with linagliptin vs placebo were -.32% (.10) (-3.59 [1.08] mmol/mol) ( P = .001) for patients on empagliflozin 10 mg and metformin, and -0.47% (0.10) (-5.15 [1.04] mmol/mol) ( P < 0.001) for patients on empagliflozin 25 mg and metformin. Adverse events were reported in more patients receiving placebo than in those receiving linagliptin: 55.5% vs 48.4% in study 1 and 58.9% vs 52.7% in study 2. Linagliptin as add-on to empagliflozin and metformin for 24 weeks improved glycaemic control vs placebo, and was well tolerated. © 2016 John Wiley & Sons Ltd.

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

    PubMed

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

    2017-12-01

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

  7. Cognitive bias modification as an add-on treatment in clinical depression: Results from a placebo-controlled, single-blinded randomized control trial.

    PubMed

    Vrijsen, Janna N; Fischer, Verena S; Müller, Bernhard W; Scherbaum, Norbert; Becker, Eni S; Rinck, Mike; Tendolkar, Indira

    2018-06-06

    Only 60% of depressed patients respond sufficiently to treatment, so there is a dire need for novel approaches to improve treatment effects. Cognitive Bias Modification (CBM) may be an effective and easily implemented computerized add-on to treatment-as-usual. Therefore, we investigated the effects of a positivity-attention training and a positivity-approach training compared to control trainings. In a blinded randomized-controlled design, 139 depressed inpatients received either the CBM Attention Dot-Probe Training (DPT) or the CBM Approach-Avoidance Training (AAT), next to treatment as usual. N = 121 finished all four training sessions. Both trainings had an active and a control condition. In both active conditions, patients were trained to preferentially process generally positive pictures over neutral pictures. Depressive symptom severity was assessed before and after CBM, and positivity bias was measured at the start and end of each session. Clinician-rated depressive symptom severity decreased more in patients who received the active condition of the DPT or the AAT compared to patients in the control conditions. Significant change in positivity bias was found for the DPT (not the AAT), but did not mediate the effect of the training on depressive symptoms. The results suggest that both types of CBM (i.e., DPT and AAT) may provide a fitting add-on treatment option for clinical depression. The working mechanisms and optimal dose of CBM trainings, plus their possible combination, should be examined in more detail. Copyright © 2018. Published by Elsevier B.V.

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

    PubMed

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

    2007-07-17

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

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

    PubMed Central

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

    2017-01-01

    Abstract Background: Drug intensification is often required for patients with type 2 diabetes mellitus on stable metformin therapy. Among the potential candidates for a combination therapy, sodium-glucose transporter-2 (SGLT2) inhibitors have shown promising outcomes. This meta-analysis was performed to compare the efficacy and safety of SGLT2 inhibitors with non-SGLT2 combinations as add-on treatment to metformin. Methods: Literature search was carried out in multiple electronic databases for the acquisition of relevant randomized controlled trials (RCTs) by following a priori eligibility criteria. After the assessment of quality of the included RCTs, meta-analyses of mean differences or odds ratios (OR) were performed to achieve overall effect sizes of the changes from baseline in selected efficacy and safety endpoints reported in the individual studies. Between-studies heterogeneity was estimated with between-studies statistical heterogeneity (I2) index. Results: Six RCTs fulfilled the eligibility criteria. SGLT2 inhibitors as add-on to metformin treatment reduced % HbA1c significantly more than non-SGLT2 combinations after 52 weeks (P = .002) as well as after 104 weeks (P < .00001). Among other endpoints, SGLT2 inhibitors also reduced fasting plasma glucose levels, body weight, systolic, and diastolic blood pressures after 52 weeks and 104 weeks significantly (P < .00001) more than non-SGLT2 combinations. Incidence of hypoglycemia was significantly lower (P = .02) but incidence of suspected or confirmed genital tract infections was significantly higher (P < .00001) in SGLT2 inhibitors treated in comparison with non-SGLT2 combinations. Conclusion: As add-on to metformin treatment, SGLT2 inhibitors are found significantly more efficacious than non-SGLT2 inhibitor combinations in the management of type 2 diabetes mellitus, although, SGLT2 inhibitor therapy is associated with significantly higher incidence of suspected or confirmed genital tract

  10. Capturing CO2 from Coal-Fired Power Plants: Challenges for a Comprehensive Strategy

    DTIC Science & Technology

    2008-08-15

    efficient flue gas desulfurization (FGD) or selective catalytic reduction (SCR) devices (or none), requiring either upgrading of existing FGD and SCR...saturated flue Figure 6. CO2 Price Projections CRS-16 42 Donald Shattuck, et al., A History of Flue Gas Desulfurization (FGD) — The Early Years, UE Technical...available in both the eastern and western parts of the United States, or by the use of emerging flue gas desulfurization (FGD) devices.46 At the time

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

    ERIC Educational Resources Information Center

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

    2003-01-01

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

  12. 36 CFR 1011.5 - What interest, penalty charges and administrative costs will the Presidio Trust add to a debt?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... charges and administrative costs will the Presidio Trust add to a debt? 1011.5 Section 1011.5 Parks, Forests, and Public Property PRESIDIO TRUST DEBT COLLECTION Procedures To Collect Presidio Trust Debts § 1011.5 What interest, penalty charges and administrative costs will the Presidio Trust add to a debt...

  13. SOXAL{trademark} pilot plant demonstration at Niagara Mohawk`s Dunkirk Station

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

    Strangway, P.K.

    The Clean Air Act Amendments of 1990 made it necessary to accelerate the development of scrubber systems for use by some utilities burning sulfur-containing fuels, primarily coal. While many types of Flue Gas Desulfurization (FGD) systems operate based on lime and limestone scrubbing, these systems have drawbacks when considered for incorporation into long-term emissions control plans. Although the costs associated with disposal of large amounts of scrubber sludge may be manageable today, the trend is toward increased disposal costs. Many new SO{sub 2} control technologies are being pursued in the hope of developing an economical regenerable FGD system did recoversmore » the SO{sub 2} as a saleable commercial product, thus minimizing the formation of disposal waste. Some new technologies include the use of exotic chemical absorbents which are alien to the utility industry and utilities` waste treatment facilities. These systems present utilities with new environmental issues. The SOXAL{trademark} process has been developed so as to eliminate such issues.« less

  14. Establishment of Health Utility Indices for Post-Infectious Functional Gastrointestinal Disorders in Active Duty US Military.

    PubMed

    Porter, Chad K; Thura, Nadia; Schlett, Carey D; Sanders, John W; Tribble, David R; Monteville, Marshall R; Riddle, Mark S

    2015-01-01

    Knowledge of disease burden attributable to functional gastrointestinal disorders (FGD) in travelers is lacking, despite the high incidence of travelers' diarrhea (TD) associated with increased FGD risk. One tool for assessing the impact of disease on health-related quality of life is the health utility index (HUI), which values health states based on preferential health outcomes. Health utilities can be used as preference weights in the estimation of quality-adjusted life-years (QALYs). Six months following travel to Egypt or Turkey, 120 US military personnel completed a survey on TD during deployment, health-related quality of life (SF-36), and the onset of functional bowel disorders (Rome II). Elements from the SF-36 were used to develop SF-6D values, which were combined with health state valuations to enable calculation of HUI scores for each subject. Mean index scores were compared across functional outcomes, specific symptoms, and demographic profiles. The presence of FGD significantly reduced index scores, with irritable bowel syndrome (IBS) and dyspepsia showing the greatest impact (-0.17 and -0.19, respectively) compared with those with no FGD (p < 0.05). Importantly, however, several individuals met multiple FGD outcome definitions. Additionally, a number of symptoms associated with abnormal bowel habits and abdominal pain were associated with reduced index scores regardless of outcome. FGD are associated with significant morbidity as assessed by HUIs. Given the strong link between TD and FGD as well as the large number of travelers from the developed to the developing world, additional study is needed to further understand this association and efforts aimed at primary disease prevention are warranted. Published 2015. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

  15. Specifically Designed Constructed Wetlands: A Novel Treatment Approach for Scrubber Wastewater

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

    John H. Rodgers Jr; James W. Castle; Chris Arrington: Derek Eggert

    2005-09-01

    A pilot-scale wetland treatment system was specifically designed and constructed at Clemson University to evaluate removal of mercury, selenium, and other constituents from flue gas desulfurization (FGD) wastewater. Specific objectives of this research were: (1) to measure performance of a pilot-scale constructed wetland treatment system in terms of decreases in targeted constituents (Hg, Se and As) in the FGD wastewater from inflow to outflow; (2) to determine how the observed performance is achieved (both reactions and rates); and (3) to measure performance in terms of decreased bioavailability of these elements (i.e. toxicity of sediments in constructed wetlands and toxicity ofmore » outflow waters from the treatment system). Performance of the pilot-scale constructed wetland treatment systems was assessed using two criteria: anticipated NPDES permit levels and toxicity evaluations using two sentinel toxicity-testing organisms (Ceriodaphnia dubia and Pimephales promelas). These systems performed efficiently with varied inflow simulations of FGD wastewaters removing As, Hg, and Se concentrations below NPDES permit levels and reducing the toxicity of simulated FGD wastewater after treatment with the constructed wetland treatment systems. Sequential extraction procedures indicated that these elements (As, Hg, and Se) were bound to residual phases within sediments of these systems, which should limit their bioavailability to aquatic biota. Sediments collected from constructed wetland treatment systems were tested to observe toxicity to Hyalella azteca or Chironomus tetans. Complete survival (100%) was observed for H. azteca in all cells of the constructed wetland treatment system and C. tentans had an average of 91% survival over the three treatment cells containing sediments. Survival and growth of H. azteca and C. tentans did not differ significantly between sediments from the constructed wetland treatment system and controls. Since the sediments of the

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

    PubMed

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

    2017-05-23

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

  17. Towards physical implementation of an optical add-drop multiplexer (OADM) based upon properties of 12-fold photonic quasicrystals

    NASA Astrophysics Data System (ADS)

    Gauthier, Robert C.; Mnaymneh, Khaled

    2005-09-01

    The key feature that gives photonic crystals (PhCs) their ability to form photonic band gaps (PBGs) analogous to electronic band gaps of semiconductors is their translation symmetries. In recent years, however, it has been found that structures that possess only rotational symmetries can also have PBGs. In addition, these structures, known as Photonic Quasicrystals (PhQs), have other interesting qualities that set them apart of their translational cousins. One interesting feature is how defect states can be created in PhQs. If the rotational symmetry is disturbed, defect states analogous to defects states that are created in PhCs can be obtained. Simulation results of these defect states and other propagation properties of planar 12-fold photonic quasicrystal patterns, and its physical implementations in Silicon-On-Insulator (SOI) are presented. The main mechanisms required to make any optical multiplexing system is propagation; stop bands and add/drop ports. With the rotationally symmetry of the PhQ causing the stop bands, line defects facilitating propagation and now these specially design defect states acting as add/drop ports, a physical implementation of an OADM can be presented. Theoretical, practical and manufacturing benefits of PhQs are discussed. Simulated transmission plots are shown for various fill factors, dielectric contrast and propagation direction. It is shown that low index waveguides can be produced using the quasi-crystal photonic crystal pattern. Fabrication steps and results are shown.

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

    PubMed

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

    2017-02-01

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

  19. Changes in biomarkers of bone turnover in an aripiprazole add-on or switching study.

    PubMed

    Lodhi, Rohit J; Masand, Salaj; Malik, Amna; Shivakumar, Kuppuswami; McAllister, Victoria D M; O'Keane, Veronica; Young, Leah C; Heald, Adrian H; Sherwood, Roy A; Aitchison, Katherine J

    2016-02-01

    The association between mental illness and osteoporosis and fractures is particularly pronounced in psychotic disorders. Antipsychotic use has previously been described to affect bone density. A 52-week follow-up of patients switched to aripiprazole or with aripiprazole added on, conducting a specific analysis of markers of bone turnover: urinary NTX (a biomarker of bone resorption) and serum BSAP (a biomarker of bone formation). Baseline and serial measurements of bone markers NTX, BSAP and of hormones prolactin, oestrogen and testosterone were done at weeks 0 and 1, 2, 6, 12, 26 and 52, respectively. NTX concentration reduced over time but this did not reach significance in the whole group (log-NTX: β=-0.0012, p=0.142). For BSAP the addition of or replacement with aripiprazole produced a significant reduction (log-BSAP: β=-0.00039, p=0.002). Analysis with prolactin similarly showed a significant reduction (log-prolactin: β=-0.0024, p<0.001); other hormones did not change significantly. Sensitivity analysis to compare the switchers to aripiprazole versus the "add-on" showed that the former group had a significant reduction in NTX. We found that switching to aripiprazole was associated with changes in molecular biomarkers of bone resorption, indicating a more favourable profile for bone health. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Pregabalin as mono- or add-on therapy for patients with refractory chronic neuropathic pain: a post-marketing prescription-event monitoring study.

    PubMed

    Lampl, Christian; Schweiger, Christine; Haider, Bernhard; Lechner, Anita

    2010-08-01

    This observational study examined the outcome of two different therapeutic strategies in the treatment of chronic neuropathic pain by including pregabalin (PGB) as mono- or add-on therapy in one of two treatment options. Patients with a pain score of > or =4, refractory to usual care for neuropathic pain for at least 6 months, were allocated consecutively to one of two treatment strategies according to the decision of the physician: complete switch to a flexible-dosage, monotherapeutic or add-on therapy with pregabalin (PGB group), or change established doses and combinations of pre-existing mono- or combination therapy without pregabalin (non-PGB group). After 4 weeks (primary endpoint) a significant improvement in pain reduction was documented in both intention-to treat (ITT) analysis (PGB group, n = 85: mean pain score reduction of 3.53, SD 2.03, p < 0.001; non-PGB group, n = 102; mean pain score reduction of 2.83, SD 2.23, p < 0.001) and per-protocol (PP) analysis (PGB group, n = 79: mean pain score reduction 3.53 vs. 2.83, p < 0.05; non-PGB group, n = 81; 3.5 vs. 2.9, p < 0.05) compared to baseline. Comparison of the results observed in the two groups shows that patients in the PGB group achieved significantly greater pain reduction. These results demonstrate that PGB administered twice daily is superior to treatment regimes without PGB in reducing pain and pain-related interference in quality of life.

  1. Use Of limestone resources in flue-gas desulfurization power plants in the Ohio River Valley

    USGS Publications Warehouse

    Foose, M.P.; Barsotti, A.F.

    1999-01-01

    In 1994, more than 41 of the approximately 160 coal-fired, electrical- power plants within the six-state Ohio River Valley region used flue-gas desulfurization (FGD) units to desulfurize their emissions, an approximately 100% increase over the number of plants using FGD units in 1989. This increase represents a trend that may continue with greater efforts to meet Federal Clean Air Act standards. Abundant limestone resources exist in the Ohio River Valley and are accessed by approximately 975 quarries. However, only 35 of these are believed to have supplied limestone for FGD electrical generating facilities. The locations of these limestone suppliers do not show a simple spatial correlation with FGD facilities, and the closest quarries are not being used in most cases. Thus, reduction in transportation costs may be possible in some cases. Most waste generated by FGD electrical-generating plants is not recycled. However, many FGD sites are relatively close to gypsum wallboard producers that may be able to process some of their waste.

  2. Development of a Cl-impregnated activated carbon for entrained-flow capture of elemental mercury.

    PubMed

    Ghorishi, S Behrooz; Keeney, Robert M; Serre, Shannon D; Gullett, Brian K; Jozewicz, Wojciech S

    2002-10-15

    Efforts to discern the role of an activated carbon's surface functional groups on the adsorption of elemental mercury (Hg0) and mercuric chloride demonstrated that chlorine (Cl) impregnation of a virgin activated carbon using dilute solutions of hydrogen chloride leads to increases (by a factor of 2-3) in fixed-bed capture of these mercury species. A commercially available activated carbon (DARCO FGD, NORITAmericas Inc. [FGD])was Cl-impregnated (Cl-FGD) [5 lb (2.3 kg) per batch] and tested for entrained-flow, short-time-scale capture of Hg0. In an entrained flow reactor, the Cl-FGD was introduced in Hg0-laden flue gases (86 ppb of Hg0) of varied compositions with gas/solid contact times of about 3-4 s, resulting in significant Hg0 removal (80-90%), compared to virgin FGD (10-15%). These levels of Hg0 removal were observed across a wide range of very low carbon-to-mercury weight ratios (1000-5000). Variation of the natural gas combustion flue gas composition, by doping with nitrogen oxides and sulfur dioxide, and the flow reactor temperature (100-200 degrees C) had minimal effects on Hg0 removal bythe Cl-FGD in these carbon-to-mercury weight ratios. These results demonstrate significant enhancement of activated carbon reactivity with minimal treatment and are applicable to combustion facilities equipped with downstream particulate matter removal such as an electrostatic precipitator.

  3. Usefulness of Isosorbide Dinitrate and Hydralazine as Add-on Therapy in Patients Discharged for Advanced Decompensated Heart Failure

    PubMed Central

    Mullens, Wilfried; Abrahams, Zuheir; Francis, Gary S.; Sokos, George; Starling, Randall C.; Young, James B.; Taylor, David O.; Tang, W.H. Wilson

    2010-01-01

    Data supporting the use of oral isosorbide dinitrate and/or hydralazine (I/H) as add-on therapy to standard neurohormonal antagonists in advanced decompensated heart failure (ADHF) are limited, especially in the non–African-American population. Our objective was to determine if addition of I/H to standard neurohormonal blockade in patients discharged from the hospital with ADHF is associated with improved hemodynamic profiles and improved clinical outcomes. We reviewed consecutive patients with ADHF admitted from 2003 to 2006 with a cardiac index <2.2 L/min/m2 admitted for intensive medical therapy. Patients discharged with angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers (control group) were compared with those receiving angiotensin-converting enzyme inhibitors/angiotensin receptor blockers plus I/H (I/H group). The control (n = 97) and I/H (n = 142) groups had similar demographic characteristics, baseline blood pressure, and renal function. Patients in the I/H group had a significantly higher estimated systemic vascular resistance (1,660 vs 1,452 dynes/cm5, p <0.001) and a lower cardiac index (1.7 vs 1.9 L/min/m2, p <0.001) on admission. The I/H group achieved a similar decrease in intracardiac filling pressures and discharge blood pressures as controls, but had greater improvement in cardiac index and systemic vascular resistance. Use of I/H was associated with a lower rate of all-cause mortality (34% vs 41%, odds ratio 0.65, 95% confidence interval 0.43 to 0.99, p = 0.04) and all-cause mortality/heart failure rehospitalization (70% vs 85%, odds ratio 0.72, 95% confidence interval 0.54 to 0.97, p = 0.03), irrespective of race. In conclusion, the addition of I/H to neurohormonal blockade is associated with a more favorable hemodynamic profile and long-term clinical outcomes in patients discharged with low-output ADHF regardless of race. PMID:19361599

  4. Abdominal pain-predominant functional gastrointestinal diseases in children and adolescents: prevalence, symptomatology, and association with emotional stress.

    PubMed

    Devanarayana, Niranga Manjuri; Mettananda, Sachith; Liyanarachchi, Chathurangi; Nanayakkara, Navoda; Mendis, Niranjala; Perera, Nimnadi; Rajindrajith, Shaman

    2011-12-01

    Functional gastrointestinal disorders (FGD) are common among children, but little is known regarding their prevalence in developing countries. We assessed the prevalence of abdominal pain-predominant FGD, in addition to the predisposing factors and symptomatology, in Sri Lankan children. A cross-sectional survey was conducted among a randomly selected group of 10- to 16-year-olds in 8 randomly selected schools in 4 provinces in Sri Lanka. A validated, self-administered questionnaire was completed by children independently in an examination setting. FGD were diagnosed using Rome III criteria. A total of 2180 questionnaires were distributed and 2163 (99.2%) were included in the analysis (1189 [55%] boys, mean age 13.4 years, standard deviation 1.8 years). Of them, 270 (12.5%) had at least 1 abdominal pain-predominant FGD. Irritable bowel syndrome (IBS) was seen in 107 (4.9%), functional dyspepsia in 54 (2.5%), functional abdominal pain in 96 (4.4%), and abdominal migraine (AM) in 21 (1.0%) (2 had AM and functional dyspepsia, 6 had AM and IBS). Extraintestinal symptoms were more common among affected children (P < 0.05). Abdominal pain-predominant FGD were higher in girls and those exposed to stressful events (P < 0.05). Prevalence negatively correlated with age (r = -0.05, P = 0.02). Abdominal pain-predominant FGD affects 12.5% of children ages 10 to 16 years and constitutes a significant health problem in Sri Lanka. IBS is the most common FGD subtype present. Abdominal pain-predominant FGD are higher in girls and those exposed to emotional stress. Prevalence of FGD decreased with age. Extraintestinal symptoms are more frequent in affected children.

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

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2017-09-01

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

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

    PubMed

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

    2016-05-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  9. Efficacy and Safety of Vildagliptin as an Add-On Therapy in Inadequately Controlled Type 2 Diabetes Patients Treated With Basal Insulin.

    PubMed

    Saito, Daisuke; Kanazawa, Akio; Shigihara, Nayumi; Sato, Fumihiko; Uchida, Toyoyoshi; Sato, Junko; Goto, Hiromasa; Miyatsuka, Takeshi; Ikeda, Fuki; Ogihara, Takeshi; Ohmura, Chie; Watada, Hirotaka

    2017-03-01

    The aim of this study was to investigate the efficacy and safety of vildagliptin as an add-on therapy for patients with type 2 diabetes mellitus inadequately controlled with basal insulin. Twenty-four patients treated with basal insulin and oral anti-diabetes drugs were randomly allocated into two groups: the control group (did not receive any add-on drugs) and vildagliptin group (received vildagliptin 100 mg/day for 6 months). The primary outcome was changes in hemoglobin A1c (HbA1c) from baseline to end of study. Treatment with vildagliptin significantly reduced HbA1c from 8.1±0.7% at baseline to 7.1±0.7% (P < 0.01), while there was no significant change of HbA1c in the control group. Vildagliptin group showed significant reduction of HbA1c compared with control group (-1.0±0.3% vs. 0.2±0.8%, P < 0.01). In addition, vildagliptin group showed a significant increase in 1,5-anhydroglucitol compared with the control group (4.5 ± 3.4 vs. 0.5 ± 4.1 μg/mL, P < 0.05). Mild hypoglycemia was reported in one patient of the vildagliptin group and two patients of the control group. Vildagliptin improved glycemic control without increasing hypoglycemia in Japanese type 2 diabetes inadequately controlled with basal insulin treatment and other oral anti-diabetes drugs. This study was registered with UMIN (University Hospital Medical Information Network ID#000010849).

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

    PubMed

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

    2018-01-01

    Vildagliptin is a dipeptidyl peptidase-4 inhibitor commonly used as a dual oral agent with metformin, thiazolidinediones, or sulfonylurea for the treatment of type 2 diabetes mellitus (T2DM). The efficacy of dual therapy with vildagliptin and metformin has been established in randomized controlled trials, but there is little evidence from observational studies. The aims of the present study were to evaluate the effectiveness of vildagliptin as an add-on therapy to metformin in reducing HbA1c and its affects on body weight and blood lipids in a real-life setting. Included in the present retrospective cohort were T2DM patients (n = 345) who were uncontrolled on metformin monotherapy and intensified treatment with vildagliptin. The efficacy of at least 90 days of dual therapy with vildagliptin and metformin in reducing HbA1c levels, as well as changes in blood lipids and body weight, were evaluated. After 180 days (range 90-365 days) from the index date with a mean daily dose of 92 mg vildagliptin, HbA1c was significantly (P < 0.001) reduced by an average of 0.9% (95% confidence interval -1.0%, -0.7%). The absolute reduction in HbA1c was positively associated with baseline HbA1c levels. In addition to HbA1c, a modest but significant (P < 0.05) decrement was also calculated in the patients' body weight and blood lipids. The present analysis of real-world data corroborates the results of previous randomized controlled trials indicating that add-on therapy with vildagliptin in uncontrolled patients on metformin monotherapy is associated with a significant improvement in the control of HbA1c. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  11. Psychometric properties and norms of the German ABC-Community and PAS-ADD Checklist.

    PubMed

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

    2011-01-01

    The aim of the present study was to standardize and generate psychometric evidence of the German language versions of two well-established English language mental health instruments: the Aberrant Behavior Checklist-Community (ABC-C) and the Psychiatric Assessment Schedule for Adults with Developmental Disabilities (PAS-ADD) Checklist. New methods in this field were introduced: a simulation method for testing the factor structure and an exploration of long-term stability over two years. The checklists were both administered to a representative sample of 270 individuals with intellectual disability (ID) and, two years later in a second data collection, to 128 participants of the original sample. Principal component analysis and parallel analysis were performed. Reliability measures, long-term stability, subscale intercorrelations, as well as standardized norms were generated. Prevalence of mental health problems was examined. Psychometric properties were mostly excellent, with long-term stability showing moderate to strong effects. The original factor structure of the ABC-C was replicated. PAS-ADD Checklist produced a similar, but still different structure compared with findings from the English language area. The overall prevalence rate of mental health problems in the sample was about 20%. Considering the good results on the measured psychometric properties, the two checklists are recommended for the early detection of mental health problems in persons with ID. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Cost-effectiveness analysis of exenatide twice daily (BID) vs insulin glargine once daily (QD) as add-on therapy in Chinese patients with Type 2 diabetes mellitus inadequately controlled by oral therapies.

    PubMed

    Deng, Jing; Gu, Shuyan; Shao, Hui; Dong, Hengjin; Zou, Dajin; Shi, Lizheng

    2015-01-01

    To estimate cost-effectiveness of exenatide twice daily (BID) vs insulin glargine once daily (QD) as add-on therapy in Chinese type 2 diabetes patients not well controlled by oral anti-diabetic (OAD) agents. The Cardiff model was populated with data synthesized from three head-to-head randomized clinical trials of up to 30 weeks in China comparing exenatide BID vs insulin glargine as add-on therapies to oral therapies in the Chinese population. The Cardiff model generated outputs including macrovascular and microvascular complications, diabetes-specific mortality, costs, and quality-adjusted life years (QALYs). Cost and QALYs were estimated with a time horizon of 40 years at a discount rate of 3% from a societal perspective. Compared with insulin glargine plus OAD treatments, patients on exenatide BID plus OAD gained 1.88 QALYs, at an incremental cost saving of Chinese Renminbi (RMB) 114,593 (i.e., cost saving of RMB 61078/QALY). The cost-effectiveness results were robust to various sensitivity analyses including probabilistic sensitivity analysis. The variables with the most impact on incremental cost-effectiveness ratio included HbA1c level at baseline, health utilities decrement, and BMI at baseline. Compared with insulin glargine QD, exenatide BID as add-on therapy to OAD is a cost-effective treatment in Chinese patients inadequately controlled by OAD treatments.

  13. 76 FR 65763 - Self-Regulatory Organizations; ICE Clear Credit LLC; Order Approving Proposed Rule Change To Add...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-24

    ... Organizations; ICE Clear Credit LLC; Order Approving Proposed Rule Change To Add Rules Related to the Clearing of Emerging Markets Sovereigns October 18, 2011. I. Introduction On August 30, 2011, ICE Clear Credit... Contracts by ICE Trust), 26D- 315 (Terms of the Cleared SES Contract), 26D-316 (Relevant Physical Settlement...

  14. Add-on LABA in a separate inhaler as asthma step-up therapy versus increased dose of ICS or ICS/LABA combination inhaler.

    PubMed

    Price, David B; Colice, Gene; Israel, Elliot; Roche, Nicolas; Postma, Dirkje S; Guilbert, Theresa W; van Aalderen, Willem M C; Grigg, Jonathan; Hillyer, Elizabeth V; Thomas, Victoria; Martin, Richard J

    2016-04-01

    Asthma management guidelines recommend adding a long-acting β 2 -agonist (LABA) or increasing the dose of inhaled corticosteroid (ICS) as step-up therapy for patients with uncontrolled asthma on ICS monotherapy. However, it is uncertain which option works best, which ICS particle size is most effective, and whether LABA should be administered by separate or combination inhalers. This historical, matched cohort study compared asthma-related outcomes for patients (aged 12-80 years) prescribed step-up therapy as a ≥50% extrafine ICS dose increase or add-on LABA, via either a separate inhaler or a fine-particle ICS/LABA fixed-dose combination (FDC) inhaler. Risk-domain asthma control was the primary end-point in comparisons of cohorts matched for asthma severity and control during the baseline year. After 1:2 cohort matching, the increased extrafine ICS versus separate ICS+LABA cohorts included 3232 and 6464 patients, respectively, and the fine-particle ICS/LABA FDC versus separate ICS+LABA cohorts included 7529 and 15 058 patients, respectively (overall mean age 42 years; 61-62% females). Over one outcome year, adjusted OR (95% CI) for achieving asthma control were 1.25 (1.13-1.38) for increased ICS versus separate ICS+LABA and 1.06 (1.05-1.09) for ICS/LABA FDC versus separate ICS+LABA. For patients with asthma, increased dose of extrafine-particle ICS, or add-on LABA via ICS/LABA combination inhaler, is associated with significantly better outcomes than ICS+LABA via separate inhalers.

  15. Fate of Mercury in Synthetic Gypsum Used for Wallboard Production

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

    Jessica Sanderson

    2007-12-31

    This report presents and discusses results from the project 'Fate of Mercury in Synthetic Gypsum Used for Wallboard Production', performed at five different full-scale commercial wallboard plants. Synthetic gypsum produced by wet flue gas desulfurization (FGD) systems on coal-fired power plants is commonly used in the manufacture of wallboard. This practice has long benefited the environment by recycling the FGD gypsum byproduct, which is becoming available in increasing quantities, decreasing the need to landfill this material, and increasing the sustainable design of the wallboard product. However, new concerns have arisen as recent mercury control strategies involve the capture of mercurymore » in FGD systems. The objective of this study has been to determine whether any mercury is released into the atmosphere at wallboard manufacturing plants when the synthetic gypsum material is used as a feedstock for wallboard production. The project has been co-funded by the U.S. DOE National Energy Technology Laboratory (Cooperative Agreement DE-FC26-04NT42080), USG Corporation, and EPRI. USG Corporation is the prime contractor, and URS Group is a subcontractor. The project scope included seven discrete tasks, each including a test conducted at various USG wallboard plants using synthetic gypsum from different wet FGD systems. The project was originally composed of five tasks, which were to include (1) a base-case test, then variations representing differing power plant: (2) emissions control configurations, (3) treatment of fine gypsum particles, (4) coal types, and (5) FGD reagent types. However, Task 5,could not be conducted as planned and instead was conducted at conditions similar to Task 3. Subsequently an opportunity arose to test gypsum produced from the Task 5 FGD system, but with an additive expected to impact the stability of mercury, so Task 6 was added to the project. Finally, Task 7 was added to evaluate synthetic gypsum produced at a power plant from an

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

    PubMed

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

    2011-01-01

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

  17. The SKATE study: an open-label community-based study of levetiracetam as add-on therapy for adults with uncontrolled partial epilepsy.

    PubMed

    Steinhoff, Bernhard J; Somerville, Ernest R; Van Paesschen, Wim; Ryvlin, Philippe; Schelstraete, Isabelle

    2007-08-01

    The Safety of Keppra as Adjunctive Therapy in Epilepsy (SKATE) study aimed to evaluate the safety and efficacy of levetiracetam (Keppra, LEV) as add-on therapy for refractory partial seizures in clinical practice. This Phase IV, 16-week, open-label study recruited patients > or =16-year old with treatment-resistant partial seizures. LEV (1000 mg/day) was added to a stable concomitant antiepileptic drug regimen. LEV dosage was adjusted based on seizure control and tolerability to a maximum of 3000 mg/day. 1541 patients (intent-to-treat population) were recruited including 1346 (87.3%) who completed the study and 77.0% who declared further continuing on LEV after the trial. Overall, 50.5% of patients reported at least one adverse event that was considered related to LEV treatment. The most frequently reported drug-related adverse events were mild-to-moderate somnolence, fatigue, dizziness and headache. Serious adverse events considered related to LEV occurred in 1.0% of patients. 7.5% of patients reported adverse events as the most important reason for study drug discontinuation. The median reduction from baseline in the frequency of all seizures was 50.2%; 15.8% of patients were seizure free; 50.1% had seizure frequency reduction of > or =50%. At the end of the study, 60.4% of patients were considered by the investigator to show marked or moderate improvement. There was a significant improvement in health-related quality of life as assessed with the QOLIE-10-P (total score increasing from 55.6 to 61.6; p<0.001). This community-based study suggests that LEV is well tolerated and effective as add-on therapy for refractory partial seizures in adults. These data provide supportive evidence for the safety and efficacy of LEV demonstrated in the pivotal Phase III placebo-controlled studies.

  18. 78 FR 12409 - Self-Regulatory Organizations; ICE Clear Credit LLC; Order Approving Proposed Rule Change To Add...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ... Organizations; ICE Clear Credit LLC; Order Approving Proposed Rule Change To Add Rules Related to the Clearing of iTraxx Europe Index CDS February 15, 2013. I. Introduction On December 6, 2012, ICE Clear Credit... (Acceptance of iTraxx Europe Untranched Contracts by ICE Clear Credit), 26F-315 (Terms of the Cleared iTraxx...

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

    PubMed

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

    2017-01-01

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

  20. Efficacy and safety of triple therapy with dapagliflozin add-on to saxagliptin plus metformin over 52 weeks in patients with type 2 diabetes.

    PubMed

    Mathieu, C; Herrera Marmolejo, M; González González, J G; Hansen, L; Chen, H; Johnsson, E; Garcia-Sanchez, R; Iqbal, N

    2016-11-01

    We previously reported that dapagliflozin versus placebo as add-on to saxagliptin plus metformin resulted in greater reductions in glycated haemoglobin (A1C), fasting plasma glucose (FPG) and body weight (BW) after 24 weeks of treatment in patients with type 2 diabetes (T2D). Here we report results after 52 weeks of treatment. Patients stabilized on open-label metformin and saxagliptin 5 mg/day for 8-16 weeks were randomized to placebo or dapagliflozin 10 mg/day plus open-label saxagliptin plus metformin for 52 weeks. Changes from baseline to week 52 were greater with dapagliflozin versus placebo in A1C (-0.74% vs. 0.07%), FPG (-27 vs. 10 mg/dL) and BW (-2.1 vs. -0.4 kg). More patients achieved A1C <7% with dapagliflozin (29.4%) versus placebo (12.6%). Adverse events were similar with dapagliflozin (66%) and placebo (71%), and hypoglycaemia was rare (≤2%). Genital infections occurred more often with dapagliflozin (6%) than with placebo (1%); frequency of urinary tract infections was similar between the two groups (9% vs. 10%). Triple therapy with dapagliflozin add-on to saxagliptin plus metformin is a durable, effective and well-tolerated intervention for the treatment of T2D. © 2016 John Wiley & Sons Ltd.

  1. 75 FR 43497 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ...; System of Records AGENCY: National Geospatial-Intelligence Agency (NGA), DoD. ACTION: Notice to add a system of records. SUMMARY: The National Geospatial-Intelligence Agency (NGA) proposes to add a system of...-3808. SUPPLEMENTARY INFORMATION: The National Geospatial-Intelligence Agency notices for systems of...

  2. Systemic Problems: A perspective on stem cell aging and rejuvenation.

    PubMed

    Conboy, Irina M; Conboy, Michael J; Rebo, Justin

    2015-10-01

    This review provides balanced analysis of the advances in systemic regulation of young and old tissue stem cells and suggests strategies for accelerating development of therapies to broadly combat age-related tissue degenerative pathologies. Many highlighted recent reports on systemic tissue rejuvenation combine parabiosis with a "silver bullet" putatively responsible for the positive effects. Attempts to unify these papers reflect the excitement about this experimental approach and add value in reproducing previous work. At the same time, defined molecular approaches, which are "beyond parabiosis" for the rejuvenation of multiple old organs represent progress toward attenuating or even reversing human tissue aging.

  3. Scientific Data Analysis Toolkit: A Versatile Add-in to Microsoft Excel for Windows

    ERIC Educational Resources Information Center

    Halpern, Arthur M.; Frye, Stephen L.; Marzzacco, Charles J.

    2018-01-01

    Scientific Data Analysis Toolkit (SDAT) is a rigorous, versatile, and user-friendly data analysis add-in application for Microsoft Excel for Windows (PC). SDAT uses the familiar Excel environment to carry out most of the analytical tasks used in data analysis. It has been designed for student use in manipulating and analyzing data encountered in…

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

    PubMed

    Rao, Naren; Menon, Sangeetha

    2016-06-01

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

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

    PubMed Central

    Feher, Olga; Fimiarz, Daniel; Conley, Dalton

    2017-01-01

    ABSTRACT Distributed social learning may occur at many temporal and spatial scales, but it rarely adds up to a stable culture. Cultures vary in stability and diversity (polymorphism), ranging from chaotic or drifting cultures, through cumulative polymorphic cultures, to stable monolithic cultures with high conformity levels. What features can sustain polymorphism, preventing cultures from collapsing into either chaotic or highly conforming states? We investigate this question by integrating studies across two quite separate disciplines: the emergence of song cultures in birds, and the spread of public opinion and social conventions in humans. In songbirds, the learning process has been studied in great detail, while in human studies the structure of social networks has been experimentally manipulated on large scales. In both cases, the manner in which communication signals are compressed and filtered – either during learning or while traveling through the social network – can affect culture polymorphism and stability. We suggest a simple mechanism of a shifting balance between converging and diverging social forces to explain these effects. Understanding social forces that shape cultural evolution might be useful for designing agile communication systems, which are stable and polymorphic enough to promote gradual changes in institutional behavior. PMID:28057835

  6. Environmental chamber measurements of mercury flux from coal utilization by-products

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

    Pekney, Natalie J.; Martello, Donald; Schroeder, Karl

    2009-05-01

    An environmental chamber was constructed to measure the mercury flux from coal utilization by-product (CUB) samples. Samples of fly ash, FGD gypsum, and wallboard made from FGD gypsum were tested under both dark and illuminated conditions with or without the addition of water to the sample. Mercury releases varied widely, with 7- day experiment averages ranging from -6.8 to 73 ng/m(2) h for the fly ash samples and -5.2 to 335 ng/m(2) h for the FGD/wallboard samples. Initial mercury content, fly ash type, and light exposure had no observable consistent effects on the mercury flux. For the fly ash samples,more » the effect of a mercury control technology was to decrease the emission. For three of the four pairs of FGD gypsum and wallboard samples, the wallboard sample released less (or absorbed more) mercury than the gypsum.« less

  7. Environmental chamber measurements of mercury flux from coal utilization by-products

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

    Pekney, N.J.; Martello, D.V.; Schroeder, K.T.

    2009-05-01

    An environmental chamber was constructed to measure the mercury flux from coal utilization by-product (CUB) samples. Samples of fly ash, FGD gypsum, and wallboard made from FGD gypsum were tested under both dark and illuminated conditions with or without the addition of water to the sample. Mercury releases varied widely, with 7-day experiment averages ranging from -6.8 to 73 ng/m2 h for the fly ash samples and -5.2 to 335 ng/m2 h for the FGD/wallboard samples. Initial mercury content, fly ash type, and light exposure had no observable consistent effects on the mercury flux. For the fly ash samples, themore » effect of a mercury control technology was to decrease the emission. For three of the four pairs of FGD gypsum and wallboard samples, the wallboard sample released less (or absorbed more) mercury than the gypsum.« less

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2010-09-01

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

  10. 75 FR 33792 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... instructions for submitting comments. Mail: Federal Docket Management System Office, 1160 Defense Pentagon...; System of Records AGENCY: Defense Intelligence Agency, DoD. ACTION: Notice to add a system of records. SUMMARY: The Defense Intelligence proposes to add a system of records notice to its inventory of record...

  11. Aprepitant as an add-on therapy in children receiving highly emetogenic chemotherapy: a randomized, double-blind, placebo-controlled trial.

    PubMed

    Bakhshi, Sameer; Batra, Atul; Biswas, Bivas; Dhawan, Deepa; Paul, Reeja; Sreenivas, Vishnubhatla

    2015-11-01

    Aprepitant, a neurokinin-1 receptor antagonist, in combination with 5 HT-3 antagonist and dexamethasone is recommended in adults receiving moderately and highly emetogenic chemotherapy to reduce chemotherapy-induced vomiting (CIV). Data for use of aprepitant in children is limited and hence aprepitant is not recommended by Pediatric Oncology Group of Ontario guidelines for prevention of CIV in children <12 years. A randomized, double-blind, placebo-controlled trial was conducted at a single center in chemotherapy naïve children (5-18 years) receiving highly emetogenic chemotherapy. All patients received intravenous ondansetron (0.15 mg/kg) and dexamethasone (0.15 mg/kg) prior to chemotherapy followed by oral ondansetron and dexamethasone. Patients randomly assigned to aprepitant arm received oral aprepitant (15-40 kg = days 1-3, 80 mg; 41-65 kg = day 1, 125 mg and days 2-3, 80 mg) 1 h before chemotherapy. Control group received placebo as add-on therapy. Primary outcome measure was the incidence of acute moderate to severe vomiting, which was defined as more than two vomiting episodes within 24 h after the administration of the first chemotherapy dose until 24 h after the last chemotherapy dose in the block. Complete response (CR) was defined as absence of vomiting and retching during the specified phase. Of the 96 randomized patients, three were excluded from analysis; 93 patients were analyzed (50 in aprepitant arm and 43 in placebo arm). Acute moderate and severe vomiting was reported in 72 % patients receiving placebo and 38 % patients receiving aprepitant (p = 0.001). Complete response rates during acute phase were significantly higher in aprepitant arm (48 vs. 12 %, p < 0.001). No major adverse effects were reported by patients/guardians. This double-blind, randomized, placebo-controlled trial shows that aprepitant significantly decreases the incidence of CIV during acute phase when used as an add-on drug with ondansetron and dexamethasone in children

  12. 3-D System-on-System (SoS) Biomedical-Imaging Architecture for Health-Care Applications.

    PubMed

    Sang-Jin Lee; Kavehei, O; Yoon-Ki Hong; Tae Won Cho; Younggap You; Kyoungrok Cho; Eshraghian, K

    2010-12-01

    This paper presents the implementation of a 3-D architecture for a biomedical-imaging system based on a multilayered system-on-system structure. The architecture consists of a complementary metal-oxide semiconductor image sensor layer, memory, 3-D discrete wavelet transform (3D-DWT), 3-D Advanced Encryption Standard (3D-AES), and an RF transmitter as an add-on layer. Multilayer silicon (Si) stacking permits fabrication and optimization of individual layers by different processing technology to achieve optimal performance. Utilization of through silicon via scheme can address required low-power operation as well as high-speed performance. Potential benefits of 3-D vertical integration include an improved form factor as well as a reduction in the total wiring length, multifunctionality, power efficiency, and flexible heterogeneous integration. The proposed imaging architecture was simulated by using Cadence Spectre and Synopsys HSPICE while implementation was carried out by Cadence Virtuoso and Mentor Graphic Calibre.

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

    PubMed

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

    2014-05-01

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

  14. Evaluation of mercury speciation and removal through air pollution control devices of a 190 MW boiler.

    PubMed

    Wu, Chengli; Cao, Yan; Dong, Zhongbing; Cheng, Chinmin; Li, Hanxu; Pan, Weiping

    2010-01-01

    Air pollution control devices (APCDs) are installed at coal-fired power plants for air pollutant regulation. Selective catalytic reduction (SCR) and wet flue gas desulfurization (FGD) systems have the co-benefits of air pollutant and mercury removal. Configuration and operational conditions of APCDs and mercury speciation affect mercury removal efficiently at coal-fired utilities. The Ontario Hydro Method (OHM) recommended by the U.S. Environmental Protection Agency (EPA) was used to determine mercury speciation simultaneously at five sampling locations through SCR-ESP-FGD at a 190 MW unit. Chlorine in coal had been suggested as a factor affecting the mercury speciation in flue gas; and low-chlorine coal was purported to produce less oxidized mercury (Hg2+) and more elemental mercury (Hg0) at the SCR inlet compared to higher chlorine coal. SCR could oxidize elemental mercury into oxidized mercury when SCR was in service, and oxidation efficiency reached 71.0%. Therefore, oxidized mercury removal efficiency was enhanced through a wet FGD system. In the non-ozone season, about 89.5%-96.8% of oxidized mercury was controlled, but only 54.9%-68.8% of the total mercury was captured through wet FGD. Oxidized mercury removal efficiency was 95.9%-98.0%, and there was a big difference in the total mercury removal efficiencies from 78.0% to 90.2% in the ozone season. Mercury mass balance was evaluated to validate reliability of OHM testing data, and the ratio of mercury input in the coal to mercury output at the stack was from 0.84 to 1.08.

  15. Broiler Litter × Industrial By-Products Reduce Nutrients and Microbial Losses in Surface Runoff When Applied to Forages.

    PubMed

    Adeli, Ardeshir; Read, John J; Brooks, John P; Miles, Dana; Feng, Gary; Jenkins, Johnie N

    2017-03-01

    The inability to incorporate broiler litter (BL) into permanent hayfields and pastures leads to nutrient accumulation near the soil surface and increases the potential transport of nutrients in runoff. This study was conducted on Marietta silt loam soil to determine the effect of flue gas desulfurization (FGD) gypsum and lignite on P, N, C, and microbial concentrations in runoff. Treatments were (i) control (unfertilized) and (ii) BL at 13.4 Mg ha alone or (iii) treated with either FGD gypsum or lignite applied at 20% (w/w) (2.68 Mg ha). Rainfall simulators were used to produce a 5.6 cm h storm event sufficient in duration to cause 15 min of continuous runoff. Repeated rains were applied at 3-d intervals to determine how long FGD gypsum and lignite are effective in reducing loss of litter-derived N, P, and C from soil. Application of BL increased N, P, and C concentrations in runoff as compared to the control. Addition of FGD gypsum reduced ( < 0.05) water-soluble P and dissolved organic C concentrations in runoff by 39 and 16%, respectively, as compared to BL alone. Lignite reduced runoff total N and NH-N concentrations by 38 and 70%, respectively, as compared to BL alone. Addition of FGD gypsum or lignite failed to significantly reduce microbial loads in runoff, although both treatments reduced microbial concentration by >20%. Thus, BL treated with FGD and lignite can be considered as cost-effective management practices in the mitigation of P, N, and C and possibly microbial concentration in runoff. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  16. Desulfurization: Critical step towards enhanced selenium removal from industrial effluents.

    PubMed

    Staicu, Lucian C; Morin-Crini, Nadia; Crini, Grégorio

    2017-04-01

    Selenium (Se) removal from synthetic solutions and from real Flue Gas Desulfurization (FGD) wastewater generated by a coal-fired power plant was studied for the first time using a commercial iron oxide impregnated strong base anion exchange resin, Purolite ® FerrIX A33E. In synthetic solutions, the resin showed high affinity for selenate and selenite, while sulfate exhibited a strong competition for both oxyanions. The FGD wastewater investigated is a complex system that contains Se (∼1200 μg L -1 ), SO 4 2- (∼1.1 g L -1 ), Cl - (∼9.5 g L -1 ), and Ca 2+ (∼5 g L -1 ), alongside a broad spectrum of toxic trace metals including Cd, Cr, Hg, Ni, and Zn. The resin performed poorly against Se in the raw FGD wastewater and showed moderate to good removal of several trace elements such as Cd, Cr, Hg, and Zn. In FGD effluent, sulfate was identified as a powerful competing anion for Se, having high affinity for the exchange active sites of the resin. The desulfurization of the FGD effluent using BaCl 2 led to the increase in Se removal from 3% (non-desulfurized effluent) to 80% (desulfurized effluent) by combined precipitation and ion exchange treatment. However, complete desulfurization using equimolar BaCl 2 could not be achieved due to the presence of bicarbonate that acts as a sulfate competitor for barium. In addition to selenium and sulfate removal, several toxic metals were efficiently removed (Cd: 91%; Cr: 100%; Zn: 99%) by the combined (desulfurization and ion exchange) treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. 75 FR 4788 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-29

    ... practices for storing, retrieving, accessing, retaining, and disposing of records in the system: Storage...; System of Records AGENCY: Office of the Secretary, DoD. ACTION: Notice to add a system of records. SUMMARY: The Office of the Secretary of Defense is proposing to add a system of records notice to its...

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

    PubMed Central

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

    2013-01-01

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

  19. How PET/MR Can Add Value For Children With Cancer.

    PubMed

    Daldrup-Link, Heike

    2017-03-01

    To review how PET/MR technology could add value for pediatric cancer patients. Since many primary tumors in children are evaluated with MRI and metastases are detected with PET/CT, integrated PET/MR can be a time-efficient and convenient solution for pediatric cancer staging. 18 F-FDG PET/MR can assess primary tumors and the whole body in one imaging session, avoid repetitive anesthesia and reduce radiation exposure compared to 18 F-FDG PET/CT. This article lists 10 action points, which might improve the clinical value of PET/MR for children with cancer. However, even if PET/MR proves valuable, it cannot enter mainstream applications if it is not accessible to the majority of pediatric cancer patients. Therefore, innovations are needed to make PET/MR scanners affordable and increase patient throughput. PET/MR offers opportunities for more efficient, accurate and safe diagnoses of pediatric cancer patients. The impact on patient management and outcomes has to be substantiated by large-scale prospective clinical trials.

  20. 77 FR 2052 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-13

    ...; System of Records AGENCY: U.S. Strategic Command, DoD. ACTION: Notice to Add a System of Records. SUMMARY: The U.S. Strategic Command proposes to add a system of records to its inventory of record systems...: The U.S. Strategic Command systems of records notices subject to the Privacy Act of 1974 (5 U.S.C...

  1. 75 FR 33791 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ...; System of Records AGENCY: Defense Intelligence Agency, DoD. ACTION: Notice to add a system of records. SUMMARY: The Defense Intelligence Agency proposes to add a system of records to its inventory of record...: The Defense Intelligence Agency systems of records notices subject to the Privacy Act of 1974, (5 U.S...

  2. The chemical and oxidation characteristics of semi-dry flue gas desulfurization ash from a steel factory.

    PubMed

    Liu, Ren-ping; Guo, Bin; Ren, Ailing; Bian, Jing-feng

    2010-10-01

    Some samples of semi-dry flue gas desulfurization (FGD) ash were taken from sinter gas of a steel factory. Scanning electron microscope (SEM) and X-ray diffraction (XRD) analyses were employed to identify the samples in order to investigate their physical and chemical characteristics. The results show that semi-dry FGD ash from a steel factory is stable under atmospheric conditions. It has irregular shape, a smooth surface and loose construction. The size of FGD ash particles is around 0.5-25 µm, the average size is about 5 µm and the median diameter is 4.18 µm. Semi-dry FGD ash from a steel factory consists of CaSO₃, CaSO₄, CaCO₃, some amorphous vitreous material and unburned carbon. An experimental method was found to study the oxidation characteristics of ash. A prediction model of the oxidation efficiency was obtained based on response surface methodology. The results show that not only the temperature, but also gas:solid ratio, play an important role in influencing the oxidation efficiency. The interactions of the gas:solid ratio with temperature play an essential role. An improved response surface model was obtained which can be helpful to describe the degree of oxidation efficiency of semi-dry FGD ash.

  3. U.S. Chamber Adds Business Viewpoint on Schools' Quality

    ERIC Educational Resources Information Center

    Archer, Jeff

    2007-01-01

    With a new and highly critical report card offering a business perspective on the effectiveness of state education systems, the U.S. Chamber of Commerce is pushing what it sees as a prescription for more innovative, efficient, and better-performing schools. For the chamber, the grades and policy platform further a concerted new effort to shape…

  4. Manifold regularized discriminative nonnegative matrix factorization with fast gradient descent.

    PubMed

    Guan, Naiyang; Tao, Dacheng; Luo, Zhigang; Yuan, Bo

    2011-07-01

    Nonnegative matrix factorization (NMF) has become a popular data-representation method and has been widely used in image processing and pattern-recognition problems. This is because the learned bases can be interpreted as a natural parts-based representation of data and this interpretation is consistent with the psychological intuition of combining parts to form a whole. For practical classification tasks, however, NMF ignores both the local geometry of data and the discriminative information of different classes. In addition, existing research results show that the learned basis is unnecessarily parts-based because there is neither explicit nor implicit constraint to ensure the representation parts-based. In this paper, we introduce the manifold regularization and the margin maximization to NMF and obtain the manifold regularized discriminative NMF (MD-NMF) to overcome the aforementioned problems. The multiplicative update rule (MUR) can be applied to optimizing MD-NMF, but it converges slowly. In this paper, we propose a fast gradient descent (FGD) to optimize MD-NMF. FGD contains a Newton method that searches the optimal step length, and thus, FGD converges much faster than MUR. In addition, FGD includes MUR as a special case and can be applied to optimizing NMF and its variants. For a problem with 165 samples in R(1600), FGD converges in 28 s, while MUR requires 282 s. We also apply FGD in a variant of MD-NMF and experimental results confirm its efficiency. Experimental results on several face image datasets suggest the effectiveness of MD-NMF.

  5. Open-label add-on treatment trial of minocycline in fragile X syndrome.

    PubMed

    Paribello, Carlo; Tao, Leeping; Folino, Anthony; Berry-Kravis, Elizabeth; Tranfaglia, Michael; Ethell, Iryna M; Ethell, Douglas W

    2010-10-11

    Fragile X syndrome (FXS) is a disorder characterized by a variety of disabilities, including cognitive deficits, attention-deficit/hyperactivity disorder, autism, and other socio-emotional problems. It is hypothesized that the absence of the fragile X mental retardation protein (FMRP) leads to higher levels of matrix metallo-proteinase-9 activity (MMP-9) in the brain. Minocycline inhibits MMP-9 activity, and alleviates behavioural and synapse abnormalities in fmr1 knockout mice, an established model for FXS. This open-label add-on pilot trial was conducted to evaluate safety and efficacy of minocycline in treating behavioural abnormalities that occur in humans with FXS. Twenty individuals with FXS, ages 13-32, were randomly assigned to receive 100 mg or 200 mg of minocycline daily. Behavioural evaluations were made prior to treatment (baseline) and again 8 weeks after daily minocycline treatment. The primary outcome measure was the Aberrant Behaviour Checklist-Community Edition (ABC-C) Irritability Subscale, and the secondary outcome measures were the other ABC-C subscales, clinical global improvement scale (CGI), and the visual analog scale for behaviour (VAS). Side effects were assessed using an adverse events checklist, a complete blood count (CBC), hepatic and renal function tests, and antinuclear antibody screen (ANA), done at baseline and at 8 weeks. The ABC-C Irritability Subscale scores showed significant improvement (p < 0.001), as did the VAS (p = 0.003) and the CGI (p < 0.001). The only significant treatment-related side effects were minor diarrhea (n = 3) and seroconversion to a positive ANA (n = 2). Results from this study demonstrate that minocycline provides significant functional benefits to FXS patients and that it is well-tolerated. These findings are consistent with the fmr1 knockout mouse model results, suggesting that minocycline modifies underlying neural defects that account for behavioural abnormalities. A placebo-controlled trial of

  6. 5 CFR 591.227 - What adjustment factors does OPM add to the price indexes?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false What adjustment factors does OPM add to the price indexes? 591.227 Section 591.227 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living Allowances §...

  7. 75 FR 61450 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ..., Corporate Communications, Defense Finance and Accounting Service, DFAS-HKC/IN, 8899 E. 56th Avenue...; System of Records AGENCY: Defense Finance and Accounting Service; DoD. ACTION: Notice to add a system of records. SUMMARY: The Defense Finance and Accounting Service (DFAS) is proposing to add a system of...

  8. 76 FR 24000 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-29

    ...; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to add a system of records. SUMMARY: The Defense Logistics Agency proposes to add a system of records notice to its existing inventory... Act Officer, Headquarters, Defense Logistics Agency, Attn: DGA, 8725 John J. Kingman Road, Stop 16443...

  9. 77 FR 57077 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-17

    ...; System of Records AGENCY: Defense Intelligence Agency, DoD. ACTION: Notice to Add a System of Records. SUMMARY: The Defense Intelligence Agency is proposing the add a system to its existing inventory of... information. FOR FURTHER INFORMATION CONTACT: Ms. Theresa Lowery at Defense Intelligence Agency, DAN 1-C, 600...

  10. Health Policy, Health Systems Research and Analysis Capacity Assessment of the School of Public Health, University of Ghana.

    PubMed

    Agyepong, I A; Anniah, K; Aikins, M; Akweongo, P; Esena, R; Mirzoev, T

    2015-09-01

    Health Policy and Systems Research and Analysis (HPSR&A) is an applied science that deals with complexity as it tries to provide lessons, tools and methods to understand and improve health systems and health policy. It is defined by the kinds of questions asked rather than a particular methodology. Our objective was to assess capacity and capacity strengthening needs for HPSR&A conduct and teaching in the University of Ghana School of Public Health (UG-SPH). We conceptualized dynamically inter-related levels of capacity as contextual, institutional and individual. The study had a cross sectional, mixed methods design. Data collection involved desk review, ,an in-depth interview, focus group discussions (FGD) and an interviewer administered questionnaire with closed and open ended items. Netmap was used as a tool in the FGD. At all levels, HPSR&A capacity exists in Ghana but is somewhat fragile. The fragility reflects in part contextual challenges related to national income and priorities as well as the fact that globally HPSR&A remains an emerging field. At the contextual level, Institutions involved in some way or other in HPSR&A were part of larger organizations with broader mandates. Only a handful of SPH staff indicated that they specifically do teaching and /or research related to HPSR&A. There is a need to raise awareness of the field of HPSR&A and its potential contributions to health sector development; build upon already existing contextual, institutional and individual capacity; and also attract and develop the next generation of researchers and teachers.

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

    PubMed

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

    2017-08-01

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

  12. No common understanding of profession terms utilized in health services research : An add-on qualitative study in the context of the QUALICOPC project in Austria.

    PubMed

    Hoffmann, Kathryn; Wojczewski, Silvia; Aarendonk, Diederik; Maier, Manfred; Dorner, Thomas Ernst; de Maeseneer, Jan

    2017-01-01

    Health services research, especially in primary care, is challenging because the systems differ widely between countries. This study aimed to explore the different understanding of the terminology used, particularly, regarding the professions nursing and medical secretaries. The study was an add-on study to the Quality and Costs in Primary Care (QUALICOPC) project in Austria and designed as qualitative research. The qualitative phase was conducted by using semi-structured telephone interviews with general practitioners (GP). and17 GPs participated in the study. No uniform meaning of the terms commonly utilized for the abovementioned health professions could be found among Austrian GPs. For example, under the profession term practice assistants, nurses as well as literal medical secretaries with and without special education and related work competencies and responsibilities were subsumed. Our study results show that no uniform meaning of the terms commonly utilized for above described health profession could be found even within one country by GPs. These findings are highly relevant, especially, when trying to compare results with similar data from other countries or negotiating about workforce issues. Our findings implicate several action points for health services research and health policy. We propose the development of a harmonized terminology in Europe for the health profession based on standards of undergraduate and postgraduate education, competencies and continuous education commitments. This would not only benefit comparative health system research but also patient safety across Europe.

  13. Novel Image Quality Control Systems(Add-On). Innovative Computational Methods for Inverse Problems in Optical and SAR Imaging

    DTIC Science & Technology

    2007-02-28

    Iterative Ultrasonic Signal and Image Deconvolution for Estimation of the Complex Medium Response, International Journal of Imaging Systems and...1767-1782, 2006. 31. Z. Mu, R. Plemmons, and P. Santago. Iterative Ultrasonic Signal and Image Deconvolution for Estimation of the Complex...rigorous mathematical and computational research on inverse problems in optical imaging of direct interest to the Army and also the intelligence agencies

  14. Does waist circumference uncorrelated with BMI add valuable information?

    PubMed

    Ngueta, Gerard; Laouan-Sidi, Elhadji A; Lucas, Michel

    2014-09-01

    Estimation of relative contribution of Body Mass Index (BMI) and waist circumference (WC) on health outcomes requires a regression model that includes both obesity metrics. But, multicollinearity could yield biased estimates. To address the multicollinearity issue between BMI and WC, we used the residual model approach. The standard WC (Y-axis) was regressed on the BMI (X-axis) to obtain residual WC. Data from two adult population surveys (Nunavik Inuit and James Bay Cree) were analysed to evaluate relative effect of BMI and WC on four cardiometabolic risk factors: insulin, triglycerides, systolic blood pressure and high-density lipoprotein levels. In multivariate models, standard WC and BMI were significantly associated with cardiometabolic outcomes. Residual WC was not linked with any outcomes. The BMI effect was weakened by including standard WC in the model, but its effect remained unchanged if residual WC was considered. The strong correlation between standard WC and BMI does not allow assessment of their relative contributions to health in the same model without a risk of making erroneous estimations. By contrast with BMI, fat distribution (residual WC) does not add valuable information to a model that already contains overall adiposity (BMI) in Inuit and Cree. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. A High-Availability, Distributed Hardware Control System Using Java

    NASA Technical Reports Server (NTRS)

    Niessner, Albert F.

    2011-01-01

    Two independent coronagraph experiments that require 24/7 availability with different optical layouts and different motion control requirements are commanded and controlled with the same Java software system executing on many geographically scattered computer systems interconnected via TCP/IP. High availability of a distributed system requires that the computers have a robust communication messaging system making the mix of TCP/IP (a robust transport), and XML (a robust message) a natural choice. XML also adds the configuration flexibility. Java then adds object-oriented paradigms, exception handling, heavily tested libraries, and many third party tools for implementation robustness. The result is a software system that provides users 24/7 access to two diverse experiments with XML files defining the differences

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

    PubMed

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

    2017-01-01

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

  17. Moclobemide as add-on therapy to agomelatine in a patient with treatment-resistant major depressive disorder: a psychopharmacological case.

    PubMed

    Stuhec, Matej; Oravecz, Robert

    2016-04-01

    Treatment-resistant depression is a major depressive disorder that does not respond to adequate treatment of at least two antidepressants and is one of the major clinical challenges for clinicians and clinical pharmacists. One treatment option is to switch the patient to a different medication. Another option is to add a medication to the patient's current pharmacotherapy. This article presents an improvement of symptoms induced by a combination of moclobemide (MOC) and agomelatine (AG) treatment in a 48-year-old Caucasian woman with treatment-resistant major depressive disorder (MDD). The patient had been treated with numerous antidepressants in the last 2 years that had not been effective or had caused serious adverse effects. When MOC 300 mg daily was added to AG 25 mg daily, the patient recovered progressively without any adverse effects. Her functional status also appeared stable. No other drugs known to interact with AG were administered. The MOC dose was subsequently increased to 600 mg daily and was taken with AG 25 mg daily and zolpidem 5 mg daily. The positive effects of AG or MOC on MDD have been widely reported, but there have not been reports of a combined treatment with MOG and AG improving symptoms of treatment-resistant MDD. The exact mechanism of this effect on the central nervous system is unknown. The additive activity could have been caused by a broader spectrum activity of AG and MOC. In this report, we identified a case with positive evidence of this antidepressant combination relieving the symptoms of treatment-resistant MDD, which is otherwise difficult to manage. This case report may serve to help clinicians and clinical pharmacists as a new treatment option for treatment-resistant MDD, although further research is needed to confirm this practice.

  18. Efficacy and tolerability of vildagliptin as add-on therapy to metformin in Chinese patients with type 2 diabetes mellitus.

    PubMed

    Pan, C; Xing, X; Han, P; Zheng, S; Ma, J; Liu, J; Lv, X; Lu, J; Bader, G

    2012-08-01

    To investigate the efficacy and tolerability of vildagliptin as add-on therapy to metformin in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled with metformin. This was a 24-week, randomized, double-blind, placebo-controlled study. Patients with T2DM (N = 438) with haemoglobin A1c (HbA1c) of 7.0-10.0% and fasting plasma glucose (FPG) <15 mmol/l (<270 mg/dl) were randomized (1 : 1 : 1) to vildagliptin 50 mg bid, vildagliptin 50 mg qd or placebo in addition to metformin. The treatment groups were well balanced at baseline [mean HbA1c, 8.0%, FPG, 8.8 mmol/l (158 mg/dl); body mass index, 25.5 kg/m(2) ]. The adjusted mean change (AMΔ) in HbA1c at endpoint was -1.05 ± 0.08%, -0.92 ± 0.08% and -0.54 ± 0.08% in patients receiving vildagliptin 50 mg bid, 50 mg qd and placebo, respectively. The between-treatment difference (vildagliptin 50 mg bid-placebo) was -0.51 ± 0.11%, p < 0.001. A greater proportion of vildagliptin-treated patients met at least one responder criterion (82.1 and 70.7%) compared to placebo-treated patients (60.4%). The AMΔ at endpoint for FPG with vildagliptin 50 mg bid, -0.95 mmol/l (-17.1 mg/dl); 50 mg qd, -0.84 mmol/l (-15.1 mg/dl) was significantly different compared with the placebo -0.26 mmol/l (-4.68 mg/dl) (p ≤ 0.001). Adverse events (AEs) were reported as 34.2, 36.5 and 37.5% for patients receiving vildagliptin 50 mg bid, 50 mg qd or placebo, respectively. Two patients in the vildagliptin 50 mg qd and one in the placebo group reported serious AEs, which were not considered to be related to the study drug; one incidence of hypoglycaemic event was reported in the vildagliptin 50 mg bid group. Vildagliptin as add-on therapy to metformin improved glycaemic control and was well tolerated in Chinese patients who were inadequately controlled by metformin only. © 2012 Blackwell Publishing Ltd.

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

    PubMed Central

    Carletto, Sara; Oliva, Francesco; Barnato, Micaela; Antonelli, Teresa; Cardia, Antonina; Mazzaferro, Paolo; Raho, Carolina; Ostacoli, Luca; Fernandez, Isabel; Pagani, Marco

    2018-01-01

    Background: Substance use disorders (SUD) are patterns of substance use leading to severe impairment on social, working and economic levels. In vivo and clinical findings have enhanced the role of the brain's stress-related system in maintaining SUD behaviors. Several studies have also revealed a high prevalence of post-traumatic symptoms among SUD patients, suggesting that a trauma-informed treatment approach could lead to better treatment outcomes. However, only few studies have evaluated the use of eye movement desensitization and reprocessing (EMDR) in SUD without consistent results. The aim of the present pilot study was to assess the efficacy of a combined trauma-focused (TF) and addiction-focused (AF) EMDR intervention in treating post-traumatic and stress-related symptoms of patients with SUD. Methods: Forty patients with different SUD were enrolled in the study. Twenty patients underwent treatment as usual (TAU), the other 20 patients were treated with TAU plus 24 weekly sessions of EMDR. All patients were assessed before and after intervention for several psychological dimensions using specific tools (i.e., BDI-II, DES, IES-R, STAI, and SCL-90-GSI). A repeated measure MANOVA was performed to evaluate both between groups (TAU + EMDR vs. TAU) and within group (pre- vs. post-intervention) effects and interactions. A secondary outcome was the dichotomous variable yielded by the urine drug testing immunoassay (yes/no). Results: The RM-MANOVA revealed both a significant pre–post main effect (p < 0.001), and a significant group-by-time main effect (p < 0.001). Significant improvements on IES-R, DES, and SCL-90-GSI scales were shown in both groups according to time effects (p < 0.05). However, significant greater effects were found for TAU + EMDR group than TAU group. No differences were found between TAU and TAU + EMDR groups in terms of urine drug immunoassay results before and after the interventions. Conclusions: The TAU + EMDR group showed a significant

  20. Saxagliptin vs. glipizide as add-on therapy in patients with type 2 diabetes mellitus inadequately controlled on metformin alone: long-term (52-week) extension of a 52-week randomised controlled trial.

    PubMed

    Göke, Burkhard; Gallwitz, Baptist; Eriksson, Johan G; Hellqvist, Åsa; Gause-Nilsson, Ingrid

    2013-04-01

    To compare the long-term safety, tolerability and efficacy of saxagliptin vs. glipizide as add-on therapy to metformin. Adults with glycated haemoglobin (HbA1c) > 6.5-10% (on stable metformin ≥ 1500 mg/day) were randomised to saxagliptin 5 mg/day (n = 428) or glipizide titrated from 5 to 20 mg/day (mean dose 15 mg/day; n = 430) for 52 weeks with a 52-week extension (NCT00575588). Assessment of the long-term safety, tolerability and efficacy of add-on saxagliptin vs. glipizide after 104 weeks was a tertiary objective of the initial 52-week study. Saxagliptin was well tolerated during the 104-week period; 67.1% of patients receiving saxagliptin vs. 72.6% receiving glipizide had ≥ 1 adverse event (AE), and few patients (4.9% vs. 5.6%) discontinued owing to AEs. Fewer patients treated with saxagliptin experienced hypoglycaemia (3.5% vs. 38.4% with glipizide; difference, -34.9%, 95% CI, -39.8 to -30.0) or confirmed hypoglycaemia (0 vs. 9.1% with glipizide). Weight loss was observed with saxagliptin (-1.5 kg) vs. weight gain with glipizide (+1.3 kg; between-group difference, -2.8 kg, 95% CI, -3.32 kg to -2.20 kg). Change from baseline in HbA1c was -0.41 ± 0.04% with saxagliptin and -0.35 ± 0.04% with glipizide (between-group difference, -0.05%, 95% CI, -0.17 to 0.06%). A post hoc analysis showed that the proportion of patients with baseline HbA1c ≥ 7% who achieved HbA1c < 7% (observed data) at week 104 was 23.1% for saxagliptin + metformin and 22.7% for glipizide + metformin. A lower risk of hypoglycaemia and reduced body weight were observed with saxagliptin vs. glipizide. No other clinically significant differences were observed between groups in safety profile. No significant between-group differences were observed for reductions in glycaemic parameters. After week 24, a smaller weekly rise in HbA1c was observed with saxagliptin vs. glipizide as add-on therapy to metformin.

  1. Home Automation System Based on Intelligent Transducer Enablers.

    PubMed

    Suárez-Albela, Manuel; Fraga-Lamas, Paula; Fernández-Caramés, Tiago M; Dapena, Adriana; González-López, Miguel

    2016-09-28

    This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers), which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet.

  2. Home Automation System Based on Intelligent Transducer Enablers

    PubMed Central

    Suárez-Albela, Manuel; Fraga-Lamas, Paula; Fernández-Caramés, Tiago M.; Dapena, Adriana; González-López, Miguel

    2016-01-01

    This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers), which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet. PMID:27690031

  3. Impact of FGD gypsum application on trace elements

    USDA-ARS?s Scientific Manuscript database

    There are concerns regarding the fate of nutrients from surface application of animal waste. One approach to reduce losses of P is to treat manure with the industrial byproducts flue gas desulfurization gypsum (FGDG). However, concerns regarding heavy metal contributions to the environment have ar...

  4. Research on the Education System of Business English Courses Based on the Case of GDUFS

    ERIC Educational Resources Information Center

    Zhengguo, Zhu; Lili, Lin; Wenzhong, Zhu

    2016-01-01

    In order to develop a more scientific education system of Business English courses, this paper studies the case of Guangdong University of Foreign Studies (GDUFS, one of Chinese top-three foreign language universities) by questionnaires. The result shows that: 1) Most of the students hope that the school could add more business courses in the…

  5. 77 FR 21975 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-12

    ...; System of Records AGENCY: Defense Intelligence Agency, DoD. ACTION: Notice to add a system of records. SUMMARY: The Defense Intelligence Agency is proposing to add a system to its existing inventory of records... Intelligence Agency, DAN 1-C, 600 MacDill Blvd., Washington, DC 20340- 0001 or by phone at (202) 231-1193...

  6. Oxidation of S(IV) in Seawater by Pulsed High Voltage Discharge Plasma with TiO2/Ti Electrode as Catalyst

    NASA Astrophysics Data System (ADS)

    Gong, Jianying; Zhang, Xingwang; Wang, Xiaoping; Lei, Lecheng

    2013-12-01

    Oxidation of S(IV) to S(VI) in the effluent of a flue gas desulfurization(FGD) system is very critical for industrial applications of seawater FGD. This paper reports a pulsed corona discharge oxidation process combined with a TiO2 photocatalyst to convert S(IV) to S(VI) in artificial seawater. Experimental results show that the oxidation of S(IV) in artificial seawater is enhanced in the pulsed discharge plasma process through the application of TiO2 coating electrodes. The oxidation rate of S(IV) using Ti metal as a ground electrode is about 2.0×10-4 mol · L-1 · min-1, the oxidation rate using TiO2/Ti electrode prepared by annealing at 500°C in air is 4.5×10-4 mol · L-1 · min-1, an increase with a factor 2.25. The annealing temperature for preparing TiO2/Ti electrode has a strong effect on the oxidation of S(IV) in artificial seawater. The results of in-situ emission spectroscopic analysis show that chemically active species (i.e. hydroxyl radicals and oxygen radicals) are produced in the pulsed discharge plasma process. Compared with the traditional air oxidation process and the sole plasma-induced oxidation process, the combined application of TiO2 photocatalysts and a pulsed high-voltage electrical discharge process is useful in enhancing the energy and conversion efficiency of S(IV) for the seawater FGD system.

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

    PubMed

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

    2013-04-01

    Some 5-HT3 antagonists such as ondansetron have shown beneficial effects on negative symptoms of patients with schizophrenia. We aimed to evaluate the efficacy of granisetron (another 5-HT3 antagonist) add-on therapy in the treatment of negative symptoms of patients with stable schizophrenia. In a randomized, double-blind, and placebo-controlled study, forty stable patients with schizophrenia (DSM-IV-TR), were randomized to either granisetron (1 mg twice daily) or placebo (twice daily) in addition to risperidone up to 6 mg/day for eight weeks. The patients were assessed using positive and negative syndrome scale (PANSS) and extrapyramidal symptom rating scale (ESRS) at baseline, week 4 and 8. Hamilton depression rating scale (HDRS) was used to assess depression at baseline and week 8. Thirty-eight patients completed the trial. Granisetron group showed a significantly greater improvement on negative subscale than the placebo group at endpoint [t(38) = 6.046, mean difference (±95% CI) = 3.2(1.8-3.7), P < 0.001]. The same effect was observed for total score [t(38) = 4.168, mean difference (95% CI) = 3.2(1.6-4.7), P < 0.001]. However the placebo and granisetron groups did not differ in their reduction of positive and general psychopathology symptoms scores. HDRS scores and its changes did not differ between the two groups. The ESRS score at week 4 was significantly lower in the granisetron than the placebo group while the two groups showed similar ESRS score at week 8. Frequency of other side effects was similar between the two groups. In summary, granisetron add-on can safely and effectively reduce the primary negative symptoms of patients with schizophrenia. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Mercury in coal and the impact of coal quality on mercury emissions from combustion systems

    USGS Publications Warehouse

    Kolker, A.; Senior, C.L.; Quick, J.C.

    2006-01-01

    The proportion of Hg in coal feedstock that is emitted by stack gases of utility power stations is a complex function of coal chemistry and properties, combustion conditions, and the positioning and type of air pollution control devices employed. Mercury in bituminous coal is found primarily within Fe-sulfides, whereas lower rank coal tends to have a greater proportion of organic-bound Hg. Preparation of bituminous coal to reduce S generally reduces input Hg relative to in-ground concentrations, but the amount of this reduction varies according to the fraction of Hg in sulfides and the efficiency of sulfide removal. The mode of occurrence of Hg in coal does not directly affect the speciation of Hg in the combustion flue gas. However, other constituents in the coal, notably Cl and S, and the combustion characteristics of the coal, influence the species of Hg that are formed in the flue gas and enter air pollution control devices. The formation of gaseous oxidized Hg or particulate-bound Hg occurs post-combustion; these forms of Hg can be in part captured in the air pollution control devices that exist on coal-fired boilers, without modification. For a given coal type, the capture efficiency of Hg by pollution control systems varies according to type of device and the conditions of its deployment. For bituminous coal, on average, more than 60% of Hg in flue gas is captured by fabric filter (FF) and flue-gas desulfurization (FGD) systems. Key variables affecting performance for Hg control include Cl and S content of the coal, the positioning (hot side vs. cold side) of the system, and the amount of unburned C in coal ash. Knowledge of coal quality parameters and their effect on the performance of air pollution control devices allows optimization of Hg capture co-benefit. ?? 2006 Elsevier Ltd. All rights reserved.

  9. Gypsum effects on crop yield and chemistry of soil, crop tissue, and vadose zone water: A meta-analysis.

    USDA-ARS?s Scientific Manuscript database

    Gypsum has various potential benefits as a soil amendment, but data are lacking on gypsum effects on crop yields and on environmental impacts across diverse field sites. Gypsum studies were conducted in six states using a common design with three rates each of mined and flue gas desulfurization (FGD...

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

    PubMed Central

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

    2014-01-01

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

  11. Saxagliptin add-on therapy to insulin with or without metformin for type 2 diabetes mellitus: 52-week safety and efficacy.

    PubMed

    Barnett, Anthony H; Charbonnel, Bernard; Li, Jia; Donovan, Mark; Fleming, Douglas; Iqbal, Nayyar

    2013-10-01

    Achievement of glycemic control is an important objective in the management of type 2 diabetes mellitus (T2DM). The objective of this study was to evaluate the safety and efficacy of the dipeptidyl peptidase-4 inhibitor saxagliptin versus placebo as add-on therapy in patients with T2DM inadequately controlled with insulin alone or insulin plus metformin. This was a long-term (28-week) extension of a short-term (24-week), randomized, double-blind, parallel-group trial of saxagliptin 5 mg once daily versus placebo as add-on therapy to open-label insulin or insulin plus metformin therapy totaling 52 weeks of treatment. In contrast with the goal of maintaining a stable insulin dosage during the short-term phase, during the extension phase the insulin dosage was flexible and adjusted as deemed appropriate by the investigator. The study was conducted in a clinical practice setting, including family practice and hospital sites. Patients with T2DM aged 18-78 years with glycated hemoglobin (HbA1c) 7.5-11 % on a stable insulin regimen (30-150 U/day with or without metformin) for ≥8 weeks at screening were included in the study. Patients were stratified by metformin use and randomly assigned 2:1 to oral saxagliptin 5 mg (n = 304) or placebo (n = 151) once daily. All patients who completed the initial 24 weeks of treatment were eligible to participate in the 28-week extension, regardless of whether they had required rescue treatment. The main outcome measure was change in HbA1c from baseline to week 52. In general, the outcomes achieved at week 24 were sustained to week 52. Adjusted mean change from baseline HbA1c at week 52 was greater with saxagliptin (-0.75 %) versus placebo (-0.38 %); the adjusted between-group difference was -0.37 % (95 % CI -0.55 to -0.19); between-group differences were similar in patients treated with metformin (-0.37 % [95 % CI -0.59 to -0.15]) and without metformin (-0.37 % [95 % CI -0.69 to -0.04]). At week 52, a greater proportion of patients

  12. Mercury emission trend influenced by stringent air pollutants regulation for coal-fired power plants in Korea

    NASA Astrophysics Data System (ADS)

    Pudasainee, Deepak; Kim, Jeong-Hun; Seo, Yong-Chil

    2009-12-01

    Regulatory control of mercury emission from anthropogenic sources has become a global concern in the recent past. Coal-fired power plants are one of the largest sources of anthropogenic mercury emission into the atmosphere. This paper summarizes the current reducing trend of mercury emission as co-beneficial effect by more stringent regulation changes to control primary air pollutants with introducing test results from the commercial coal-fired facilities and suggesting a guideline for future regulatory development in Korea. On average, mercury emission concentrations ranged 16.3-2.7 μg Sm -3, 2.4-1.1 μg Sm -3, 3.1-0.7 μg Sm -3 from anthracite coal-fired power plants equipped with electrostatic precipitator (ESP), bituminous coal-fired power plants with ESP + flue gas desulphurization (FGD) and bituminous coal-fired power plants with selective catalytic reactor (SCR) + cold side (CS) - ESP + wet FGD, respectively. Among the existing air pollution control devices, the best configuration for mercury removal in coal-fired power plants was SCR + CS - ESP + wet FGD, which were installed due to the stringent regulation changes to control primary air pollutants emission such as SO 2, NOx and dust. It was estimated that uncontrolled and controlled mercury emission from coal-fired power plants as 10.3 ton yr -1 and 3.2 ton yr -1 respectively. After the installation of ESP, FGD and SCR system, following the enforcement of the stringent regulation, 7.1 ton yr -1 of mercury emission has been reduced (nearly 69%) from coal-fired power plants as a co-benefit control. Based on the overall study, a sample guideline including emission limits were suggested which will be applied to develop a countermeasure for controlling mercury emission from coal-fired power plants.

  13. 77 FR 56628 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-13

    ... to the National Security Agency/Central Security Service, Freedom of Information Act/Privacy Act...; System of Records AGENCY: National Security Agency/Central Security Service, DoD. ACTION: Notice to add a system of records. SUMMARY: The National Security Agency/Central Security Service proposes to add a new...

  14. [Irritable bowel syndrome and cardiac right-to-left shunt through a patent foramen ovale].

    PubMed

    Alarcón-Fernández, Onofre; Alvarez-Fernández, Jesús-Andrés; Baudet, Juan-Salvador; Pérez-Quintero, Raquel; Sánchez-Del Río, Antonio; Borja-Gutiérrez, Elisa; Borque-Barrera, Pilar

    2008-05-31

    Both irritable bowel syndrome (IBS) and patent foramen ovale (PFO) have a similar prevalence in the general population, affect more commonly women and are related to comorbidities such as migraine. In IBS there are alterations in the metabolism of certain substances like serotonin. In the presence of PFO with a right- to left-shunt (RLS), a percentage of venous blood bypasses the lung filter and may increase these substances in blood. A phone interview was done to determine the presence of IBS in patients previously attended for detection of RLS with transcranial Doppler ultrasound. The presence and grade of RLS was analyzed and compared with subjects without gastrointestinal symptoms (NoGI). Rome II criteria were used to diagnose IBS or other functional gastrointestinal disorder (FGD) and Venice 1999 consensus were used for the diagnosis of RLS. Thirthy-three (18.3%) of 180 interviewed patients had IBS and 62 (34.4%) other FGD. RLS was found in 41% of NoGI patients, 64% of patients with IBS and 68% of patients with other FGD (odds ratio [OR] = 2.56; p < 0.05 for SII, and OR = 3.06; p < 0.01 for other FGD). RLS with a massive pattern was registered in en 27% of NoGI patients, 39% of patients with IBS and 45% of patients with other FGD (OR = 1.73; p = 1 for IBS, and OR = 2.21; p < 0.05 for other FGD). We found a higher prevalence of cardiac RLS through a PFO in patients with IBS and other FGD. A possible etiopathogenic relationship must be considered in future studies.

  15. Exercise or basic body awareness therapy as add-on treatment for major depression: a controlled study.

    PubMed

    Danielsson, Louise; Papoulias, Ilias; Petersson, Eva-Lisa; Carlsson, Jane; Waern, Margda

    2014-10-01

    While physical exercise as adjunctive treatment for major depression has received considerable attention in recent years, the evidence is conflicting. This study evaluates the effects of two different add-on treatments: exercise and basic body awareness therapy. Randomized controlled trial with two intervention groups and one control, including 62 adults on antidepressant medication, who fulfilled criteria for current major depression as determined by the Mini International Neuropsychiatric Interview. Interventions (10 weeks) were aerobic exercise or basic body awareness therapy (BBAT), compared to a single consultation with advice on physical activity. Primary outcome was depression severity, rated by a blinded assessor using the Montgomery Asberg Rating Scale (MADRS). Secondary outcomes were global function, cardiovascular fitness, self-rated depression, anxiety and body awareness. Improvements in MADRS score (mean change=-10.3, 95% CI (-13.5 to -7.1), p=0.038) and cardiovascular fitness (mean change=2.4ml oxygen/kg/min, 95% CI (1.5 to 3.3), p=0.017) were observed in the exercise group. Per-protocol analysis confirmed the effects of exercise, and indicated that BBAT has an effect on self-rated depression. The small sample size and the challenge of missing data. Participants׳ positive expectations regarding the exercise intervention need to be considered. Exercise in a physical therapy setting seems to have effect on depression severity and fitness, in major depression. Our findings suggest that physical therapy can be a viable clinical strategy to inspire and guide persons with major depression to exercise. More research is needed to clarify the effects of basic body awareness therapy. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. 75 FR 24932 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-06

    ... of Records AGENCY: U.S. Marine Corps, Department of the Navy, DoD. ACTION: Notice to add a system of records. SUMMARY: The U.S. Marine Corps proposes to add a system of records to its inventory of record.... Marine Corps system of records notices subject to the Privacy Act of 1974, (5 U.S.C. 552a), as amended...

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

    PubMed

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

    2002-11-01

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

  18. Retrospective comparison of voglibose or acarbose as an add-on therapy to sulfonylureas in Western Indian patients with uncontrolled overweight/obese type 2 diabetes.

    PubMed

    Talaviya, Praful A; Saboo, Banshi D; Dodiya, Hardik G; Rao, Shaival K; Joshi, Shashank R; Modh, Vipul B; Ghadiya, Sneha V

    2016-01-01

    The study was aimed to investigate the effect of voglibose or acarbose as an add-on treatment in overweight/obese type 2 diabetes (T2DM) patients who are uncontrolled with metformin and sulfonylureas (SUs) in Western part of India. A retrospective study included 77 participants (BMI≥25kg/m(2); HbA1c level>8% and<9.5%) with overweight/obese T2DM. These participants were treated with either voglibose or acarbose. Glycemic parameters (fasting blood glucose and glycated hemoglobin [HbA1c]), bodyweight, BMI and lipid parameters were evaluated at baseline, 3-month, 6-month and 9-month of treatment. Adverse events were also captured at respective time points. Voglibose showed significant reduction in HbA1c and bodyweight with short duration of treatment (6 months; P<0.05 and 9 months; P<0.01) whereas acarbose showed significant reduction with longer duration of treatment (9 months; P<0.05) when compared with baseline. Moreover, both treatment groups were reported with reduction in BMI. Further, significant improvement in lipid parameters except LDL and HDL were observed in both treatment groups when compared with baseline. None of participant was discontinued due to side effects of the treatment. In addition, the frequency of hypoglycemia was decreased in both treatment groups. Voglibose or acarbose as an add-on treatment with metformin and sulfonylureas in uncontrolled obese/overweight T2DM provides desired glycemic control, reduces bodyweight and improves lipid parameters with good tolerability profile. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  19. 'Add women & stir'--the biomedical approach to cardiac research!

    PubMed

    O'Donnell, Sharon; Condell, Sarah; Begley, Cecily M

    2004-07-01

    In conditions shared by women and men, the biomedical model of disease assumes that illness-symptoms and outcomes are biologically and socially 'neutral'. Consequently, up until a decade ago, white middle-aged men were the model subjects in most funded cardiac trials, with the assumption that whatever the findings, the results would also hold true for women. This 'add women and stir' approach has resulted in imbalances in cardiac care and an image of coronary artery disease, which portrays a middle-aged male as its victim. Moreover, cardiac health care has been designed with the male anatomy and male experience of illness in mind, and health promotional measures have been targeted towards men. Women have received these health promotional messages to protect the hearts of men, and have been less likely to modify their own lifestyles in a cardio-protective manner. However, the biological and social differences that exist between women and men, must surely invalidate such biased biomedical assertions, and signify a need to delve beyond the realm of biomedical reductionism for greater insights and understanding. This review examines how scientific reductionism has failed to explore the impact of coronary artery disease on the lives of women and how the gendered image of this disease has privileged the normative frame.

  20. The effects of antecedent dry days on the nitrogen removal in layered soil infiltration systems for storm run-off control.

    PubMed

    Cho, Kang-Woo; Yoon, Min-Hyuk; Song, Kyung-Guen; Ahn, Kyu-Hong

    2011-01-01

    The effects of antecedent dry days (ADD) on nitrogen removal efficiency were investigated in soil infiltration systems, with three distinguishable layers: mulch layer (ML), coarse soil layer (CSL) and fine soil layer (FSL). Two sets of lab-scale columns with loamy CSL (C1) and sandy CSL (C2) were dosed with synthetic run-off, carrying chemical oxygen demand of 100 mg L(-1) and total nitrogen of 13 mg L(-1). The intermittent dosing cycle was stepwise adjusted for 5, 10 and 20 days. The influent ammonium and organic nitrogen were adsorbed to the entire depth in C1, while dominantly to the FSL in C2. In both columns, the effluent ammonium concentration increased while the organic nitrogen concentration decreased, as ADD increased from 5 to 20 days. The effluent of C1 always showed nitrate concentration exceeding influent, caused by nitrification, by increasing amounts as ADD increased. However, the wash-out of nitrate in C1 was not distinct in terms of mass since the effluent flow rate was only 25% of the influent. In contrast, efficient reduction (>95%) of nitrate loading was observed in C2 under ADD of 5 and 10 days, because of insignificant nitrification in the CSL and denitrification in the FSL. However, for the ADD of 20 days, a significant nitrate wash-out appeared in C2 as well, possibly because of the re-aeration by the decreasing water content in the FSL. Consequently, the total nitrogen load escaping with the effluent was always smaller in C2, supporting the effectiveness of sandy CSL over loamy FSL for nitrogen removal under various ADDs.